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Evaluation of muscle protein mass in children with solid tumors by muscle thickness measurement with ultrasonography, as compared with anthropometric methods and visceral protein concentrations.

OBJECTIVE: To compare the merits of regional ultrasonography, anthropometry, and measurement of visceral protein concentrations for determining muscle protein mass and nutritional status. DESIGN: Prospective follow-up study. SUBJECTS: Nineteen children (median age 4.7 y, range, 1.4-14.1 y) with malignant solid tumors were examined at diagnosis, monthly during preoperative chemotherapy, and 1-2 months after operation; 19 healthy age- and sex-matched children served as controls. INTERVENTIONS: We measured the thickness of the quadriceps muscle by ultrasonography (muscle index), and body weight, mid-arm circumference, triceps skinfold thickness, and serum concentrations of albumin, prealbumin, and transferrin. RESULTS: At diagnosis, the muscle index was smaller in the patients (mean 5.6 cm2/m2, 95% CI 4.5-6.7 cm2/m2) than in the controls (8.5 cm2/m2, 95% CI 7.7-9.3 cm2/m2) (P = 0.0007), whereas the anthropometric measurements did not differ. The sensitivity, specificity, and predictive value of anthropometry and measurements of visceral proteins were poor in detecting reduced muscle protein reserves when compared with the muscle index as the baseline standard. During the anticancer therapy the mean concentrations of serum albumin and prealbumin increased. CONCLUSIONS: In children with cancer, nutritional status should be assessed with methods more sensitive than anthropometry and visceral protein concentration measurements. We advocate regional ultrasonography for the evaluation of nutrition in these patients.

Adolescent↗

Nutritional status using mini nutritional assessment and subjective global assessment predict mortality in geriatric patients.

OBJECTIVES: To evaluate the clinical assessment of nutritional status and mortality in geriatric patients. DESIGN: Prospective follow-up study. SETTING: Acute geriatric inpatient ward. PARTICIPANTS: Eighty-three consecutive acute geriatric patients (mean age +/- standard deviation = 83 +/- 7; 68% women). MEASUREMENTS: Patients were classified as (1) having protein-energy malnutrition (PEM), (2) having moderate PEM or being at risk for PEM, or (3) being well nourished according to Subjective Global Assessment (SGA) and Mini Nutritional Assessment (MNA). Body mass index ((BMI) kg/m2), arm anthropometry, and handgrip strength were determined. In a subgroup of patients (n = 39), body composition was analyzed using dual energy x-ray absorption and bioelectrical impedance. Three-year mortality data were obtained from the Swedish population records. RESULTS: Twenty percent and 26% of the patients were classified as having PEM based on SGA and MNA, respectively, whereas 43% and 56%, respectively, were classified as having moderate PEM or being at risk for PEM. Objective measures, such as BMI, arm anthropometry, handgrip, and body fat were 20% to 50% lower in the malnourished group than in the well-nourished subjects (P <.05). Moreover, mortality was higher in those classified as being malnourished, ranging from 40% after 1 year to 80% after 3 years, compared with 20% after 1 year (P =.03-0.17) and 50% after 3 years (P <.01) in patients classified as being well nourished. CONCLUSION: Fewer than one-third of newly admitted geriatric patients had a normal nutritional status according to SGA and MNA. BMI, arm anthropometry, body fat mass, and handgrip strength were reduced, and 1-, 2-, and 3-year mortality was higher in patients classified as malnourished. The present data justify the use of SGA and MNA for the assessment of nutritional status in geriatric patients.

Aged↗

Nutritional status and dietary manipulation in predialysis chronic renal failure patients.

OBJECTIVE: A properly implemented dietary treatment for patients with chronic renal failure (CRF) can correct several metabolic and endocrine disturbances and delay initiation of dialysis, but concerns exist about the risk of malnutrition and protein depletion. The goal of this study is to evaluate nutritional status and its relation to the dietary treatment in patients with advanced CRF. DESIGN: Cross-sectional survey. SETTING: Predialysis outpatient clinic. PATIENTS: Seventy patients (43 males, 27 females, 50 +/- 12 years) with severe CRF (glomerular filtration rate [GFR] <15 mL/min) being treated with a low-protein (0.6 g/kg/day) diet (LPD) or a very-low-protein (0.3 g/kg/day) diet supplemented with essential amino acids and ketoacids (KAD). Fifty-two healthy subjects with comparable age and sex served as controls. MAIN OUTCOME MEASURES: In all patients and controls, we performed biochemistry, anthropometry, bioelectrical impedance vector analysis (BIVA), and subjective global assessment (SGA), and the patients' outcomes were also assessed. RESULTS: Values of anthropometry and BIVA were similar in patients and controls. SGA scores showed a normal nutritional status (SGA-0) in 50 patients (71.4%) and mild to moderate SGA abnormalities (SGA-1) in 20 patients (28.6%); none had severe malnutrition. The SGA-1 patients differed from the SGA-0 patients by having higher serum urea, lower bicarbonate, and lower renal function (87% of SGA-1 patients had GFR <10 mL/min.). At the same GFR values (6.6 +/- 2.3 versus 6.6 +/- 2.3 mL/min) SGA-1 patients had lower bicarbonate (21.9 +/- 4.3 versus 25.3 +/- 2.7 mM, P <.01) and higher serum urea (115 +/- 29 versus 82 +/- 38 mg/dL, P =.01) and protein intake than SGA-0 patients; SGA-1 score was more prevalent with LPD compared with KAD treatment (45% versus 27%, P <.05). BIVA and anthropometry, serum levels of albumin, prealbumin, insulin-like growth factor-1, hematocrit, and lymphocyte count did not differ between SGA-1 and SGA-0 patients, but the number entering dialysis was higher in the group scoring as SGA-1 compared with SGA-0 (82% versus 47%, P <.05). CONCLUSIONS: With a planned dietary regimen, severe or overt malnutrition does not occur in predialysis CRF without other serious illnesses. However, some mild to moderate SGA abnormalities were detected in association with a more severe renal insufficiency, a lower serum bicarbonate, a higher serum urea and dietary protein levels and were predictive of poor renal outcome. This study emphasizes the role of proper dietary implementation, correction of metabolic acidosis, and clinical monitoring including SGA in the predialysis conservative care of CRF patients.

Amino Acids↗

Prediction of body composition in elderly men over 75 years of age.

A comprehensive number of body composition predictions (involving weight, height, skinfold thicknesses, bioelectrical impedance and near-infrared interactance-NIRI) were evaluated against total body water (TBW from isotope dilution), in 23 randomly selected men over 75 years old, and dual-energy X-ray absorptiometry (DXA), in 15 volunteers from this group. Comparisons were made between anthropometric and impedance methods for estimating limb muscle mass (obtained using DXA). Bias and 95% limits of agreement between measured TBW and DXA estimates were -2.1 kg and 3.1 kg, respectively (for fat, 5.4% and 6.1% body weight). Agreement between TBW predictions and reference measurements was remarkably variable, irrespective of whether TBW was predicted from TBW-specific equations or indirectly from estimates of fat or fat-free mass: for predictions using anthropometry, bias ranged from -4.7 kg to 1.6 kg and 95% limits of agreement from bias +/- 3.8 kg to +/- 5.0 kg; using impedance, bias was -8.8 kg to 3.2 kg and 95% limits of agreement were bias +/- 3.6 kg to +/- 7.8 kg; corresponding values for NIRI were -5.3 kg and +/- 5.4 kg. Although some non-age-specific equations appeared valid, age-specific equations generally predicted TBW better. Limb muscle mass (DXA) was predicted better using the segmental impedance method, from indices of limb muscle area (r = 0.76; SEE = 1.9 kg) and volume (r = 0.86; SEE = 1.6 kg), than by anthropometry alone (r = 0.61 and 0.71; SEE = 2.3 kg and 2.1 kg, respectively). In conclusion, some body composition predictions are unacceptable (at least for TBW) in older men, and care is recommended when selecting from these methods or equations. Also, the segmental impedance method is as good as, if not better than, anthropometry alone in predicting limb muscle mass (DXA) in older men.

Absorptiometry, Photon↗

Fasting levels of serum glucose, cholesterol and triglyceride at age eleven to twelve years in stunted and non-stunted Jamaican children.

AIM: To determine whether fasting serum concentrations of glucose, cholesterol and triglyceride at age 11-12 y (a) differed between children stunted in early childhood and those who were never stunted, (b) were related to birthweight or current anthropometry and (c) were related to stunting after controlling for current size. METHODS: Anthropometry, serum glucose and lipid concentrations were measured in 112 children stunted in early childhood and 181 non-stunted children. RESULTS: Children who were stunted in infancy remained shorter, weighed less and were significantly less fat than non-stunted children but had a more central distribution of fat. They were also less likely to have entered puberty. Non-stunted children had higher fasting serum triglyceride concentrations than stunted children (p < 0.05). There were no significant correlations between birthweight and fasting glucose or any measure of serum lipids. The percentage of variance in biochemical measures explained by anthropometry was low: between 2.1 for HDL cholesterol and 14.6 for triglyceride. Nutritional status in early childhood (stunted or non-stunted) made no additional contribution to the variance. CONCLUSIONS: Linear growth retardation in early childhood was not independently related to fasting serum concentrations of glucose, cholesterol and triglyceride at age 11-12 y. However, despite being thinner, stunted children had a more central distribution of fat.

Analysis of Variance↗

Assessment of protein nutrition in surgical patients--the value of anthropometrics.

In order to evaluate the reliability of anthropometry in assessing protein stores we have compared, in 10 normal adults and 82 surgical patients with varying degrees of weight loss, measurements of weight/height, arm circumference, arm muscle circumference, and arm muscle area with direct measurements of body nitrogen using in vivo neutron activation analysis. Anthropometry is reliable for the assessment of protein nutrition in groups of patients (for 100 patients 95% confidence limits are +/- 30 g nitrogen) but the magnitude of variance shown makes it inappropriate for assessing the individual as a single measurement (95% confidence limits are +/- 300 g nitrogen). Repeat measurements were made after 2 weeks on 35 patients and there was no correlation between changes in body nitrogen and changes in the anthropometric measurements. Anthropometry is not reliable in following changes in body nitrogen in individual patients over short periods of time.

Adult↗

Measurement of abdominal and visceral fat with computed tomography and dual-energy x-ray absorptiometry.

These studies were undertaken to compare dual-energy x-ray absorptiometry (DXA) and computed tomography (CT) measurements of abdominal fat and to determine whether anthropometry could be combined with DXA to predict intraabdominal (visceral) fat mass in humans. Twenty-one volunteers underwent abdominal CT scans, DXA, and anthropometry. DXA- and CT-measured total abdominal fat were similar (8448 +/- 5005 and 8066 +/- 5354 mL, respectively; NS) and were highly correlated (r = 0.985, P < 0.001). The combination of anthropometry and DXA was a suboptimal predictor of CT-measured intraabdominal fat (r = 0.61, P < 0.05); however, the combination of a single CT slice (to assess the ratio of intraabdominal to total abdominal adipose tissue) and DXA-measured abdominal fat was an excellent predictor of CT-measured intraabdominal fat (r = 0.98, P < 0.001). We conclude that a single-slice CT scan (or other imaging technique) with or without DXA is required for accurate predictions of intraabdominal fat.

Absorptiometry, Photon↗

Endemic goitre, nutrition, and landholding in Bangladesh.

Endemic goitre in adult females, cretinism, and anthropometry in children were examined in a goitrous area of Bangladesh. An area survey showed total goitre varying from 62.0 to 93.0%, visible goitre from 9.0 to 54.8% between areas. A village study examining thyroid size in 538 adult females and anthropometry in 116 children showed goitre prevalences varying significantly (p less than 0.001) but unpredictably with household landholding size; underweight and wasting varied inversely and significantly (p less than 0.01 and 0.05 respectively) with the same socioeconomic indicator. By household, there was no relationship between anthropometry in children and thyroid enlargement in the mother. Hormone analyses showed depressed serum T4, but no raised TSH. Only one deaf-mute cretin was found in the area. It is speculated that variation in goitre prevalence in this moderately severe endemic primarily reflects qualitative and quantitative changes in diet, as a function of the socioeconomic status of the household.

Adolescent↗

Body composition of children aged 1 to 12 years with biliary atresia or Alagille syndrome.

BACKGROUND: Growth and body composition have not been well described in older children with biliary atresia or Alagille syndrome living with their native liver. To optimize nutritional management of these conditions it is essential to understand the normal growth characteristics. OBJECTIVES: The purpose of this study was to evaluate and compare the growth and body composition of children, particularly school-age children, with biliary atresia and Alagille syndrome. METHODS: A single observer measured height, weight, arm anthropometry and skin fold thickness in subjects aged 1 to 12 years with biliary atresia or Alagille syndrome who had not undergone liver transplantation. RESULTS: Forty-six subjects (10 biliary atresia/36 Alagille syndrome) were assessed. Biliary atresia subjects were below average in height for age with normal weight and elevated body mass index. Mean fat stores were mildly depressed. The z-scores for body mass index and weight for age were inversely correlated with age. Alagille subjects were stunted and had low body weight and reduced fat and muscle stores. Body mass index z-score was inversely correlated with age despite improved cholestasis. CONCLUSIONS: Children with Alagille syndrome had significant growth deficits as measured by weight, height and upper arm anthropometry at all ages studied. In contrast, subjects with biliary atresia had normal weights and heights. However, body mass index and weight for age z-scores were lower in the older biliary atresia subjects. Few studies of anthropometry in biliary atresia or Alagille syndrome have included the school-aged child. This study addresses this gap in knowledge and provides baseline data for nutritional interventions in these patients.

Alagille Syndrome↗

Fetal growth and cardiovascular risk factors in Jamaican schoolchildren.

OBJECTIVE: To determine relation between schoolchildren's blood pressure, glycated haemoglobin level, and cholesterol concentration and their anthropometry, socioeconomic status, and birth measurements. DESIGN: Retrospective cohort study. SETTING: 27 schools closest to University Hospital of the West Indies, Kingston, Jamaica. SUBJECTS: 2337 children aged 6-16 years who were born at university hospital were recruited, and their birth records were recovered: 1610 had suitable records, 659 had records including birth length, and 610 of these were prepubertal. MAIN OUTCOME MEASURES: Blood pressure, glycated haemoglobin level, serum cholesterol concentration, anthropometry at birth, current anthropometry, and socioeconomic status. RESULTS: Multiple regression analysis showed that children's systolic blood pressure was inversely related to their birth weight (P < 0.0001) and directly related to their current weight. Glycated haemoglobin level was higher in children with thicker triceps skinfolds (P < 0.001) and who had been shorter at birth (P = 0.003). Serum cholesterol concentration was inversely related to current height (P = 0.001) and to length at birth (P = 0.09) and was directly related to triceps skinfold thickness and higher socioeconomic status (P < 0.001). CONCLUSIONS: Blood pressure in childhood was inversely related to birth weight and directly to current weight. Glycaemic control and serum cholesterol were related to short length at birth, height deficit in childhood, and childhood obesity.

Adolescent↗

Anthropometric assessment of the adult hospitalized patient.

Anthropometry is a technique in which simple measuring instruments are used to describe human form. By applying the measurement directly or through use of additional calculations, the practitioner can partition the body into fat and fat-free components. Quantifying these two body spaces provides information on the amount and rate of change over time in whole body energy supply and protein mass. These data can then be used in association with other indices of energy and protein metabolism. Whereas anthropometry is simple, practical, and inexpensive, the technique is limited to a qualitative tool by several sources of error. A thorough understanding of the strengths, limitations, and appropriate applications of anthropometry is essential when applying the method in clinical practice.

Anthropometry↗

Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial.

BACKGROUND: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. OBJECTIVE: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum cholesterol in patients at increased cardiovascular risk. METHODS: We conducted a randomized controlled trial among patients with increased cardiovascular risk in Canadian family practices. During 8 months, patients in the intervention group and control groups received usual care. Patients in the intervention group also had access to a Web-based nutrition counselling and social support tool (Heartweb). Site use during the study was monitored. We measured social support, body mass index, waist/hip ratio, blood pressure, and cholesterol levels at baseline and at 4 and 8 months to assess the effectiveness of the intervention. RESULTS: We randomized 146 patients into the Web-based intervention (n=73) or the control group (n=73). Within the Web-based intervention group, Heartweb was used by only 33% (24/73) of patients, with users being significantly younger than nonusers (P=.03). There were no statistically significant differences between the intervention group and the control group in changes in social support, anthropometry, blood pressure, and serum cholesterol levels. CONCLUSIONS: Uptake of the Web-based intervention was low. This study showed no favourable effects of a Web-based nutrition counselling and social support intervention on social support, anthropometry, blood pressure, and serum cholesterol. Improvements in reach and frequency of site use are needed to increase the effectiveness of Web-based interventions.

Anthropometry↗

[Bioelectric impedance in the nutritional evaluation of mentally deficient quadriplegic adults].

Severely mentally retarded persons with cerebral palsy show a high rate of acute and chronic malnutrition. Without discarging other factors which might be at play, caloric intake deficiency stemming from the difficulties involved in being fed appear to play a crucial role in its etiology. In the assessment of these disorders, anthropometry is limited by the lack of adequate reference values and by the difficulty or impossibility of measuring height using the conventional method. The purpose of this study is to see how changes in body composition brought about by an increase in dietary caloric intake are perceived by both anthropometry and biolectrical impedance analysis. To do so, 13 subjects were selected from a group of 203 severely mentally retarded persons made up of 25% cerebral palsy patients and 13% quadriplegics. The 13 subjects were fed orally without tubes and all had tricipital skinfolds of less than P25. All 13 were given a 25% caloric increase over the regular diets for a period of two months. This increase was provided by means of a polymeric, normoproteic, hypercaloric preparation. Weight and brachial perimeter showed significant increases coinciding with the administration of the supplement. Theses increases were not noticeable two months after discontinuing the supplement. There were no significant changes in tricipital and subescapular skinfolds, muscular circumference of de mid-arm, resistance, reactance, or the total body an extracellular water calculated from the latter two values. From these results we deduce that biolectrical impedance analisys offers no advantages over anthropometry in monitoring the nutritional status of quadriplegics.

Adult↗

A novel objective nutritional score for children on chronic peritoneal dialysis.

OBJECTIVES: To establish a novel nutritional score based on a series of objective parameters capable of detecting protein-calorie malnutrition in children being treated with chronic peritoneal dialysis (CPD), to test the score in a healthy pediatric population, and to apply it to children on CPD to evaluate their nutritional status. STUDY POPULATION: 264 healthy school children (mean age 8.69 +/- 3.26 years, range 3.05-14.98 years) and 29 patients treated with CPD for 1.75 +/- 1.02 years (mean age 10.54 +/- 6.28 years, range 2.8-15.24 years). METHODS: Nutritional status was evaluated by means of three sets of measurements: anthropometric (A1 and A2) and bioimpedance analysis (BIA) measurements. Anthropometry included two sets of measures: set A1 consisted of height (H), weight (W), and body mass index (BMI); set A2 consisted of midarm muscle circumference (MAMC), arm muscle area (AMA), and arm fat area (AFA). The BIA measurements included reactance, phase angle, and distance. All parameters are expressed as standard deviation scores (SDS).Tanner's, Rolland-Cachera's, and Frisancho's data were used as references for H, W, BMI, MAMC, AMA, and AFA; personal data obtained from 551 healthy boys and girls were used for the BIA indices. The nine anthropometry and BIA parameters were given scores of 1 to 5: 5 = > 0 SDS, 4 = < or = 0 and > -1 SDS, 3 = < or = -1 and > -2 SDS, 2 = <-2 and > -3 SDS, and 1 = < or = -3 SDS. Average scores were established for each of A1, A2, and BIA, and then summed to obtain the anthropometry-BIA nutrition (ABN) score. To establish the cutoff value between normal nutritional status and malnutrition, the method was first applied to the 264 healthy children; distribution percentiles were calculated for each area score and the ABN score. The ABN score corresponding to the 3rd percentile was considered the limit of normality and then applied three times to the 29 children on CPD, for a total of 87 nutritional assessments. RESULTS: The score corresponding to the 3rd percentile in the population of healthy children was 10.33. Among the CPD-treated children, 41.4% of the ABN scores were higher than 10.33 (indicating a state of normal nutrition) and 58.6% were lower (indicating various degrees of malnutrition). Severe malnutrition was found in only 1.1% of the cases. The values of all nine A1, A2, and BIA parameters, as well as serum albumin levels, were significantly higher in patients with an ABN score > 10.33 than in those with a score < 10.33. CONCLUSION: The ABN score is a simple and objective method of assessing, in clinical practice, the nutritional status of children on CPD.

Adolescent↗

Computed axial tomographic scanning of the thigh: an alternative method of nutritional assessment in pediatrics.

In this study we compared the findings of computed axial tomographic (CT) scanning of the thigh with the findings of arm anthropometry and urinary creatinine determinations to assess nutrition in children with inflammatory bowel disease receiving total parenteral nutrition. All 14 children received our standard solution for total parenteral nutrition as well as prednisone and sulfasalazine (Azulfidine) therapy. All patients were assessed by arm anthropometry, 24-hour urine collections for creatinine clearance, and CT scanning of the thigh during total parenteral nutrition. Arm muscle and fat area were estimated by anthropometry, and those in the thigh were estimated by CT scanning. Our results show the total muscle area from the CT scan can predict muscle mass calculated from the urinary creatinine excretion rates. In addition, there is a close correlation between the thigh muscle area as measured by CT scanning and the muscle area calculated from urinary creatinine excretion rates. In addition, the comparison of thigh muscle area and thigh fat area to the midarm muscle area and midarm fat area, respectively, showed that the thigh is a better predictor of muscle than fat in the midarm. We conclude that the total thigh muscle area is a better predictor of muscle mass as compared to the midarm muscle area. In addition, the CT scan cut at the level of the thigh in children and adolescents with inflammatory bowel disease can provide valuable information about the thigh compartment and analyses of different cross-sectional areas of the thigh.

Adolescent↗

Peripheral and abdominal adiposity in childhood obesity.

The aim of this work was to evaluate peripheral and abdominal adipose tissue (AT) content detected by MRI in normal weight and obese children, to compare MRI data with simple anthropometric indexes and to estimate intrabdominal adipose tissue (IAT) influence on cardiovascular risk factors. The subjects were 23 obese and 21 normal weight children aged 10 to 15 years. The following measurements were carried out: MRI analysis at lumbar level with definition of subcutaneous adipose tissue (SAT) area and IAT area; arm fat area (AFA); thigh fat area (TFA) and waist/hip ratio from anthropometry. SAT (353 +/- 94 cm2) was predominant compared with IAT (49 +/- 21 cm2) in obese as well as in controls (SAT: 79 +/- 61 cm2; IAT: 22 +/- 11 cm2). No differences in SAT/IAT ratio were found for sex and puberty, either in obese subjects or in controls. SAT and IAT were significantly related in controls (r = 0.77, P < 0.0001), but not in obese subjects (r = 0.12, P = 0.59). IAT was related to total and LDL cholesterol and triglycerides levels (r = 0.54, P < 0.02, r = 0.60, P < 0.01, r = 0.46, P < 0.04, respectively) in obese children. AFA and TFA from anthropometry significantly underestimated AT compared with MRI in both groups. Methods agreement analysis showed unacceptable results for anthropometry. It was concluded that childhood obesity has a subcutaneous adipose pattern with no differences between the sexes. IAT already begins to have clinical significance since it has a relationship to some cardiovascular risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

Longitudinal assessment of body composition in continuous ambulatory peritoneal dialysis patients using bioelectric impedance and anthropometric measurements.

We assessed the utility of bioelectric impedance analysis (BIA) and anthropometry for longitudinal evaluation of body composition in continuous ambulatory peritoneal dialysis (CAPD) patients. Eleven subjects were studied at the beginning of CAPD and again at regular intervals during the first 6 months of treatment. The significant weight gain that occurs in our patients is mainly due to a rise in total body water (TBW), as measured by BIA, during the first weeks of CAPD, and later on due to a body fat increase. Anthropometry seems more reliable than BIA in the evaluation of body mass, because the latter is derived from TBW in BIA. Therefore, any change in TBW that occurs in a CAPD patient necessarily causes a similar change in the fat-free mass. In our experience, only the combined use of both anthropometry and BIA allows a proper assessment of body composition in patients on CAPD.

Adult↗

[Comparative analysis of body composition assessment methods in healthy adult men].

BACKGROUND: The degree of agreement between different methods to assess total body composition is not well known. AIM: To determine the level of agreement for total body fat mass measurement by dual-photon absorptiometry (DEXA), bioelectrical impedance (BIA) and anthropometry using the deuterium dilution method as the gold-standard technique, in normal male volunteers. SUBJECTS AND METHODS: Total body fat mass was measured by DEXA, BIA, anthropometry and deuterium dilution in thirty one healthy men, aged 41.9 +/- 8.6 years old. RESULTS: Mean differences in percentage of total body fat compared with deuterium dilution were 0.3% +/- 2.2, 1.3% +/- 3.4 and 1.8 +/- 2.3% for DEXA1 BIA and anthropometry respectively. DEXA had the lower difference with deuterium dilution and the confidence intervals for this difference (+/- DS) showed that, at the individual level, the maximum difference was 4.4%. CONCLUSIONS: All the methods evaluated gave similar average measurements for total body fat mass, but with different individual variability. In this group of healthy male subjects, DEXA was the best method in terms of agreement with the gold-standard.

Absorptiometry, Photon↗