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Total body water measurement in renal insufficiency.

Total body water was measured in 15 children with renal insufficiency (glomerular filtration rate < 25 ml/min per 1.73 m2) using deuterium oxide dilution. Total body water was also measured using bioelectrical impedance and skinfold anthropometry in the same 15 children. There was a linear correlation (r = 0.98, P < 0.01) between total body water measured by deuterium and height2/impedance. The 95% confidence limits for estimates of total body water were -1.5 to 0.9 for impedance and 0.65-3.16 l for skinfold anthropometry when compared with deuterium dilution. Bioelectrical impedance estimation of total body water is better than the current existing non-invasive method of skinfold anthropometry.

Adolescent↗

Early detection of protein depletion in alcoholic cirrhosis: role of body composition analysis.

BACKGROUND: Malnutrition is common in alcoholic cirrhosis. Bedside nutritional assessment techniques may be unreliable in patients with chronic liver disease. The aim of this study was to quantify changes in body composition and compare methods for measuring body composition in alcoholic cirrhosis. METHODS: Thirty-eight men with alcoholic cirrhosis were compared with 16 age-matched healthy men. Body composition was assessed using anthropometry and bioelectrical impedance to determine fat-free mass and body fat, deuterium oxide dilution to measure total body water, in vivo neutron activation analysis to measure total body protein, and dual energy x-ray absorptiometry to measure bone mineral content and total body fat mass. RESULTS: With increasing severity of cirrhosis, total body water increased, whereas total body protein decreased with a significant decrease in serum albumin levels. Total body protein levels, expressed as an index, were a more sensitive indicator of protein depletion than serum albumin levels. When patients were assessed by anthropometry and bioelectrical impedance for fat-free mass, there was no reduction compared with controls. CONCLUSIONS: Anthropometry and bioelectrical impedance do not accurately reflect changes in body composition associated with chronic liver disease. Quantification of body composition changes in alcoholic cirrhosis requires the use of direct methods such as in vivo neutron activation analysis, dual energy x-ray absorptiometry, or deuterium oxide dilution.

Adult↗

Evidence of genetic regulation of fetal longitudinal growth.

BACKGROUND: Genetic as well as environmental factors are important determinants of fetal growth but there have been few studies of the influence of paternal factors on fetal growth. AIM: To study the influence of paternal anthropometry on detailed measurements of offspring at birth. DESIGN: A prospective cohort study involving biochemistry, and anthropometry, of mothers and fathers at 28 weeks gestation, and detailed anthropometry of children within 24 h of birth. SUBJECTS: 567 White Caucasian singleton, non-diabetic, full term pregnancies recruited from central Exeter, UK. RESULTS: Paternal height, but not paternal BMI, was correlated with birth weight (r = 0.19) and with birth length (r = 0.33). This was independent of potential confounders and maternal height. All measurements of fetal skeletal growth including crown-rump, knee-heel and head circumference were associated with paternal height. Maternal height showed similar correlations with birth weight (r = 0.18) and birth length (r = 0.26). Maternal BMI was correlated with birth weight (r = 0.27) and birth length (r = 0.15). In a multifactorial analysis 38% of the variance in fetal height could be explained by gestation, sex, paternal height, maternal height, maternal glucose, maternal BMI, parity and maternal smoking. CONCLUSION: Paternal height has an independent influence on size at birth. This predominantly influences length and skeletal growth of the baby. In contrast to maternal obesity the degree of paternal obesity does not influence birth weight. This work suggests that there is genetic regulation of skeletal growth while the maternal environment predominantly alters the adiposity of the fetus.

Adolescent↗

Nutritional status of children with cystic fibrosis measured by total body potassium as a marker of body cell mass: lack of sensitivity of anthropometric measures.

OBJECTIVE: To investigate measures aimed at defining the nutritional status of cystic fibrosis (CF) populations, this study compared standard anthropometric measurements and total body potassium (TBK) as indicators of malnutrition. METHODS: Height, weight, and TBK measurements of 226 children with CF from Royal Children's Hospital, Brisbane, Australia, were analyzed. Z scores for height for age, weight for age, and weight for height were analyzed by means of the National Centre for Health Statistics reference. TBK was measured by means of whole body counting and compared with predicted TBK for age. Two criteria were evaluated with respect to malnutrition: (1) a z score < -2.0 and (2) a TBK for age <80% of predicted. RESULTS: Males and females with CF had lower mean height-for-age and weight-for-age z scores than the National Centre for Health Statistics reference (P <.01), but mean weight-for-height z score was not significantly different. There were no significant gender differences. According to anthropometry, only 7.5% of this population were underweight and 7.6% were stunted. However, with TBK as an indicator of nutritional status, 29.9% of males and 22.0% of females were malnourished. CONCLUSION: There are large differences in the percentage of patients with CF identified as malnourished depending on whether anthropometry or body composition data are used as the nutritional indicator. At an individual level, weight-based indicators are not sensitive indicators of suboptimal nutritional status in CF, significantly underestimating the extent of malnutrition. Current recommendations in which anthropometry is used as the indicator of malnutrition in CF should be revised.

Body Composition↗

Prediction of fat and fat-free mass in male athletes using dual X-ray absorptiometry as the reference method.

The ability of bioelectrical impedance analysis and anthropometry to predict fat mass and fat-free mass was compared in a sample of 82 male athletes from a wide variety of sports, using dual-energy X-ray absorptiometry (DXA) as the reference method. The percent fat measured by DXA was 10.9+/-4.9% (mean +/- s), and fat mass was predicted with a standard error of the estimate of 1.7 kg for skinfolds and 2.8 kg for bioelectrical impedance analysis (P < 0.001). Fat-free mass was predicted with a standard error of the estimate of 1.7 kg for anthropometry and 2.6 kg for bioelectrical impedance analysis (P < 0.001). Regression of various individual skinfolds and summed skinfolds, to examine the effect of skinfold selection combinations by stepwise regression, produced an optimal fat mass prediction using the thigh and abdominal skinfold sites, and an optimal fat-free mass prediction using the thigh, abdominal and supra-ilium sites. These results suggest that anthropometry offers a better way of assessing body composition in athletes than bioelectrical impedance analysis. Applying the derived equations to a separate sample of 24 athletes predicted fat and fat-free mass with a total error of 2.3 kg (2.9%) and 2.2 kg (2.7%), respectively. Combining the samples introduced more heterogeneity into the sample (n = 106), and the optimal prediction of fat mass used six skinfolds in producing a similar standard error of the estimate (1.7 kg), although this explained a further 4% of the variation in DXA-derived fat. Fat-free mass was predicted best from four skinfolds, although the standard error of the estimate and coefficient of determination were unchanged.

Absorptiometry, Photon↗

Digital three-dimensional photogrammetry: evaluation of anthropometric precision and accuracy using a Genex 3D camera system.

OBJECTIVE: To determine the precision and accuracy of facial anthropometric measurements obtained through digital three-dimensional (3D) photogrammetry. DESIGN: Nineteen standard craniofacial measurements were repeatedly obtained on 20 subjects by two independent observers, using calipers and 3D photos (obtained with a Genex 3D camera system), both with and without facial landmarks labeled. Four different precision estimates were then calculated and compared statistically across techniques. In addition, mean measurements from 3D photos were compared statistically with those from direct anthropometry. RESULTS: In terms of measurement precision, the 3D photos were clearly better than direct anthropometry. In almost all cases, the 3D photo with landmarks labeled had the highest overall precision. In addition, labeling landmarks prior to taking measurements improved precision, regardless of method. Good congruence was observed between means derived from the 3D photos and direct anthropometry. Statistically significant differences were noted for seven measurements; however, the magnitude of these differences was often clinically insignificant (< 2 mm). CONCLUSIONS: Digital 3D photogrammetry with the Genex camera system is sufficiently precise and accurate for the anthropometric needs of most medical and craniofacial research designs.

Adolescent↗

Experimental determination of adult and pediatric neck scale factors.

The purpose of this study was to determine scale factors for small, mid-size and large adults using a caprine model. In a previous study conducted in our lab, scaling relationships were developed to define cervical spine tolerance values of children using caprine specimens. In that study, tolerances were normalized with respect to an average adult. Because airbag-related injuries are associated with out-of-position children and small adult females, additional experimental data are needed to better estimate human tolerance. In the present study, cervical spine radiographs from the 5th, 50th and 95th percentile human adults were used to determine vertebral body heights for small, mid-size and large anthropometries. Mean human vertebral body heights were computed for each anthropometry and were normalized with respect to mid-size anthropometry. Similar measurements were calculated from caprine cervical spine radiographs and each caprine specimen was grouped into one of the three categories based upon vertebral body size. Seventy-two motion segments (OC-C2, C3-C4, C5-C6 and C7-T1) from 18 adult caprine cadavers were subjected to pure moment and distraction loads. Pure moment testing resulted in bending stiffness, and distraction testing resulted in failure force and linear stiffness. Data were normalized with respect to the mid-size anthropometric category. For the small, mid-size and large adult categories, tensile failure force yielded scaling ratios of 0.74, 1.00 and 1.13, linear stiffness yielded ratios of 0.78, 1.00 and 1.10 and bending stiffness resulted in ratios of 0.89, 1.00 and 1.03. For the one-year-old, three-year-old, six-year-old and 12-year-old, scaling ratios were 0.10, 0.16, 0.30 and 0.62 for the tension force, 0.13, 0.18, 0.38 and 0.66 for the linear stiffness and 0.13, 0.19, 0.42 and 0.76 for the bending stiffness. These scale factors are compared with FMVSS 208.

Journal Article↗

Reliability of physical examination of the upper extremity among keyboard operators.

BACKGROUND: Physical examination is a traditional outcome measure in epidemiological research. Its value as a reliable measure depends, in part, on the prevalence of positive findings. The purpose of this paper is to determine the empirical reliability of physical examination and anthropometry in a field study of upper extremity disorders among keyboard operators. METHODS: Two experienced examiners independently performed common provocative tests and procedures in physical examinations of the neck and upper extremity among 160 keyboard operators. Two additional examiners conducted anthropometric surveys among 137 workers. Inter-examiner reliability was assessed with observed agreement, kappa statistics, and intra-class correlations (ICC). RESULTS: Observed agreement was between 96% and 100% for neck and upper extremity signs, muscle stretch reflexes, and muscle strength, however, with the exception of provocative tests, reliability statistics were unstable. Among the provocative tests, Phalen and Tinel tests had modest agreement after adjusting for chance (kappa range: 0.20-0.43). The carpal compression test had the best reliability (kappa=0.60 and kappa=0.67, left and right side, respectively). The ICCs for anthropometry ranged from 0.36-0.91. CONCLUSIONS: Results from the study showed that statistically, except for the carpal compression test, physical examination contributed minimal reliable information. This was attributed mainly to the low prevalence of positive findings, and generally mild nature of upper extremity disorders in this population. The results are the best estimate of what would be found in a field study with experienced examiners. While it may reduce bias, separating physical examination from medical history may contribute to the poor reliability of findings. With a shift toward reliable measures, resources can be allocated to more effective tools, like questionnaires, in epidemiological research of upper extremity disorders among keyboard operators.

Adult↗

Nutritional status by socioeconomic level in an urban sample from Bilbao (Basque Country).

Anthropometry, records of food intake, and bioelectric impedance were gathered from a sample of 297 adults of both sexes who lived in marginal districts in the town of Bilbao and benefited from a program of social assistance. This survey aimed to determine present nutritional status and to ascertain the relationship between food intake and nutritional conditions. A comparative evaluation of anthropometry and food intake was then carried out using a reference from the Basque Country and a control sample from the same area but from better-off nutritional and socioeconomic conditions. Males from low socioeconomic status (SES) displayed lower heights and weights compared to the local reference and control sample. They showed higher skinfold thickness than males in the local reference but lower thicknesses than those in the control sample. All anthropometric variables, except height, were higher in women of low socioeconomic status compared to the local reference and control sample. Low socioeconomic males had lower estimated percentage of body fat than the control sample, while females showed the opposite pattern. On the other hand, estimates of food intake in males did not reveal great differences among samples from different socioeconomic backgrounds, while low SES females had greater intakes of food than the better-off control sample. Estimated zinc intake showed differences by SES in both sexes.

Adult↗

Empirically derived new equations for calculating body fat percentage based on skinfold thickness and midarm circumference in preschool Indian children.

We wanted to develop and apply new equations based on skinfold and midarm measurements for estimating %fat in preschool children suitable for field use. Prediction equations were developed on preschool-aged urban boys (n = 100) and girls (n = 84). Skinfolds at four sites and midarm measurements were regressed on %fat derived from equations based on height and weight and from bioelectrical impedance analysis (BIA; resistance at 50 kHz). These equations were applied: 1) to 12 children in whom the %fat was determined using D2O dilution, and 2) to 50 children in whom their %fat was derived using height-weight and BIA equations. The 95% limits of agreement (mean +/- 2 SD) for %fat derived by anthropometry and by new equations were within 1.7% in boys (r = 0.85; P < 0.001) and girls (r = 0.90; P < 0.001) and by BIA and new equations were within 1.5% in boys (r = 0.82; P < 0.001) and 2% in girls (r = 0.88; P < 0.001). For %fat measured by D2O dilution and new equations, 95% limits of agreement was within 1.3% (r = 0.98; P < 0.001). In 50 children 95% limits of agreement between anthropometry and new equations were within 1.8% in boys (r = 0.88; P < 0.001) and 1.4% in girls (r = 0.92; P < 0.001) and between BIA and new equations were within 1% in boys (r = 0.91; P < 0.001) and 1.5% in girls (r = 0.89; P < 0.001). The new equations for measuring %fat based on midarm circumference and skinfold measurements are rapid and accurate for South Asian children and should be useful for prediction of body composition and nutritional survey in field studies.

Anthropometry↗

Directional asymmetry of body dimensions among white adolescents.

Asymmetry of paired dimensions has been recognized as a methodological problem in anthropometry and more recently as an indicator of environmental stress. This study seeks to determine the extent of directional asymmetry for some of the measurements commonly made in anthropometry. Upper arm circumference, biepicondylar breadth, triceps and subscapular skinfolds, bicondylar breadth of the femur, and calf circumference were measured on right and left sides among 135 white adolescents from suburban Philadelphia. Handedness (right or nonright) was subject-assessed. Body composition was estimated through underwater weighing. Asymmetry was evaluated using a paired t test. Arm measurements are significantly asymmetric in favor of the right side; subscapular skinfolds and leg measurements are not significantly asymmetric. Among the sample of right-handed subjects (n = 116), upper arm circumference and biepicondylar breadth were significantly larger on the right side, and, among the males of this subsample, triceps was as well. The nonright-handed subjects (n = 19) did not show statistically significant asymmetry. Asymmetry was negatively but weakly related to body composition. These results are consistent with an explanation in terms of preferred use of one side of the body and consequent muscle hypertrophy, but an adequate test of this explanation requires hypothesis testing in larger samples of nonright-handed subjects.

Adolescent↗

Do human parents face a quantity-quality tradeoff?: evidence from a Shuar community.

A number of evolutionary theories of human life history assume a quantity-quality tradeoff for offspring production: parents with fewer offspring can have higher biological fitness than those with more. Direct evidence for such a tradeoff, however, is mixed. We tested this assumption in a community of Ecuadorian Shuar hunter-horticulturalists, using child anthropometry as a proxy for fitness. We measured the impact of household consumer/producer (CP) ratio on height, weight, skinfold thicknesses, and arm and calf circumferences of 85 children and young adults. To control for possible "phenotypic" correlates that might mask the effect of CP ratio on anthropometry, we also measured household garden productivity, wealth, and social status. Regression models of the age-standardized variables indicated a significant negative impact of CP ratio on child growth and nutrition. The age-standardized height and weight of children in households with the largest CP ratio (10) were 1.38 and 1.44 standard deviations, respectively, below those of children in households with the smallest CP ratio (2). Surprisingly, garden productivity, wealth, and status had little to no effect on the fitness proxies. There was, however, an interesting and unexpected interaction between status and sex: for females, but not males, higher father status correlated significantly with higher values on the proxies.

Adult↗

Anthropometrics do not influence dual X-ray absorptiometry (DXA) measurement of fat in normal to obese adults: a comparison with in vivo neutron activation analysis (IVNA).

Dual-energy X-ray absorptiometry (DXA) is now a commonly used method for the determination of bone mineral status and body composition in humans. The purposes of this study were to compare fat mass by in vitro neutron activation analysis (FMIVNA) with that by DXA (FMDXA) in an anthropometrically heterogeneous sample of healthy adult men (n = 33) and women (n = 36) (19 < or = BMI < or = 39), and to determine whether differences in fat mass estimates between the two methods (delta FM) were attributable to subject anthropometry as defined by several circumference (waist, iliac crest, thigh) and skinfold thickness (umbilical, suprailiac, abdominal) measurements. No significant differences between FMDXA and FMIVNA were observed in men (p = 0.46) or women (p = 0.09). The two methods were very highly correlated in both sexes (women r2 = 0.97, p < 0.001, men r2 = 0.91, p < 0.001), although the regression line for men was significantly different from the line of identity (p = 0.043). These results suggest modest trends toward underestimation of FMDXA in men when FMIVNA < 18 kg, and overestimation in men when FMIVNA > 18 kg. delta FM (IVNA-DXA) was not significantly related to any combination of skinfold thickness and circumferences in either gender. Age explained 27% of the variance in delta FM for the men (p = 0.008). Furthermore, delta FM was not significantly related to inter-method disparity in total-body bone mineral measurements in men or women (p < 0.05). The present study demonstrates strong correlation in fat measurements between IVNA and DXA in men and women ranging from normal to markedly obese. Correction for subject anthropometry does not significantly improve this relationship.

Absorptiometry, Photon↗

The use of anthropometric and dual-energy X-ray absorptiometry (DXA) measures to estimate total abdominal and abdominal visceral fat in men and women.

OBJECTIVE: A single-slice computed tomography (CT) scan provides a criterion measure of total abdominal fat (TAF) and abdominal visceral fat (AVF), but this procedure is often prohibitive due to radiation exposure, cost, and accessibility. In the present study, the utility of anthropometric measures and estimates of trunk and abdominal fat mass by dual-energy X-ray absorptiometry (DXA) to predict CT measures of TAF and AVF (cross-sectional area, cm2) was assessed. RESEARCH METHODS AND PROCEDURES: CT measures of abdominal fat (at the level of the L4-L5 inter-vertebral space), DXA scans, and anthropometric measures were obtained in 76 Caucasian adults ages 20-80 years. RESULTS: Results demonstrated that abdominal sagittal diameter measured by anthropometry is an excellent predictor of sagittal diameter measured from a CT image (r=0.88 and 0.94; Total Error [TE]=4.1 and 3.1 cm, for men and women, respectively). In both men and women, waist circumference and abdominal sagittal diameter were the anthropometric measures most strongly associated with TAF (r=0.87 to 0.93; Standard Error of Estimate (SEE)=60.7 to 75.4 cm2) and AVF (r=0.84 to 0.93; SEE=0.7 to 30.0 cm2). The least predictive anthropometric measure of TAF or AVF was the commonly used waist-to-hip ratio (WHR). DXA estimates of trunk and abdominal fat mass were strongly associated with TAF (r=.94 to 0.97; SEE=36.9 to 50.9 cm2) and AVF (r=0.86 to 0.90; SEE=4.9 to 27.7 cm2). DISCUSSION: The present results suggest that waist circumference and/or abdominal sagittal diameter are better predictors of TAF and AVF than the more commonly used WHR. DXA trunk fat and abdominal fat appear to be slightly better predictors of TAF but not AVF compared to these anthropometric measures. Thus DXA does not offer a significant advantage over anthropometry for estimation of AVF.

Abdomen↗

The biomechanics of an overarm throwing task: a simulation model examination of optimal timing of muscle activations.

A series of overarm throws, constrained to the parasagittal plane, were simulated using a muscle model actuated two-segment model representing the forearm and hand plus projectile. The parameters defining the modeled muscles and the anthropometry of the two-segment models were specific to the two young male subjects. All simulations commenced from a position of full elbow flexion and full wrist extension. The study was designed to elucidate the optimal inter-muscular coordination strategies for throwing projectiles to achieve maximum range, as well as maximum projectile kinetic energy for a variety of projectile masses. A proximal to distal (PD) sequence of muscle activations was seen in many of the simulated throws but not all. Under certain conditions moment reversal produced a longer throw and greater projectile energy, and deactivation of the muscles resulted in increased projectile energy. Therefore, simple timing of muscle activation does not fully describe the patterns of muscle recruitment which can produce optimal throws. The models of the two subjects required different timings of muscle activations, and for some of the tasks used different coordination patterns. Optimal strategies were found to vary with the mass of the projectile, the anthropometry and the muscle characteristics of the subjects modeled. The tasks examined were relatively simple, but basic rules for coordinating these tasks were not evident.

Anthropometry↗

Postural kinematics of trumpet playing.

This paper examines the effects of anthropometry on body posture of trumpeters playing in standing position. Sixteen virtuosi trumpeters were photographed while hitting three notes (low C, high F and high F sustained) during performance of musical tasks. Initial standing posture and anthropometric data were recorded. Six body segment angles were computed and a vectorial sum was obtained to describe whole body posture in neutral and playing conditions. Horn angle and dental overbite were also computed. Earlier results showed that the musical task has no effect on playing posture. One-way ANOVA showed notable differences between the neutral posture and the note-related playing postures. A multiple regression model showed that in addition to the note effect, anthropometric variables, mainly neck length, explain the changes in playing posture. Horn angle is determined by the dental overbite. The importance of the anthropometric variables in playing the more demanding notes indicate that anthropometry may act to constrain trumpeters' performance.

Adult↗

Multivariable optimization of cycling biomechanics.

Relying on a biomechanical model of the lower limb which treats the leg-bicycle system as a five-bar linkage constrained to plane motion, a cost function derived from the joint moments developed during cycling is computed. At constant average power of 200 W, the effect of five variables on the cost function is studied. The five variables are pedalling rate, crank arm length, seat tube angle, seat height, and longitudinal foot position on the pedal. A sensitivity analysis of each of the five variables shows that pedalling rate is the most sensitive, followed by the crank arm length, seat tube angle, seat height, and longitudinal foot position on the pedal (the least sensitive). Based on Powell's method, a multivariable optimization search is made for the combination of variable values which minimize the cost function. For a rider of average anthropometry (height 1.78 m, weight 72.5 kg), a pedalling rate of 115 rev min-1, crank arm length of 0.140 m, seat tube angle of 76 degrees, seat height plus crank arm length equal to 97% of trochanteric leg length, and longitudinal foot position on the pedal equal to 54% of foot length correspond to the cost function global minimum. The effect of anthropometric parameter variations is also examined and these variations influence the results significantly. The optimal crank arm length, seat height, and longitudinal foot position on the pedal increase as the size of rider increases whereas the optimal cadence and seat tube angle decrease as the rider's size increases. The dependence of optimization results on anthropometric parameters emphasizes the importance of tailoring bicycle equipment to the anthropometry of the individual.

Anthropometry↗

The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively--a randomised clinical trial.

AIM: Recent evidence suggests that the provision of energy-containing fluids is safe and may impact positively on markers of recovery. The aims of this study were to assess the tolerance of preoperative carbohydrate fluid administration and to determine its effect on postoperative metabolic and clinical responses. METHODS: Patients admitted to the Royal Infirmary of Edinburgh for major, elective abdominal surgery were recruited to this double-blind, randomised study and received either a placebo drink or carbohydrate (12.6g/100ml) drink (CHOD). Patients consumed 800 ml of their drink on the evening before surgery and 400 ml on the day of surgery 2-3 h before the induction of anaesthesia. Nutritional status was determined using body mass index (BMI) and upper arm anthropometry; all measurements were taken preoperatively, postoperatively and at discharge. Blood glucose and insulin concentrations were also measured preoperatively and on the first post operative day. Length of hospital stay (LOS) and postoperative complications were recorded. RESULTS: Seventy-two patients were recruited and 65 (34 male:31 female) completed this study. Thirty-four patients were randomised to receive the placebo drink (control group) and 31 patients to receive the carbohydrate drink (CHOD group). Groups were well-matched in terms of gender and age. There were no differences between the two groups at baseline for BMI (control: -25.1+/-1.7 kg/m2; CHOD -25.2+/-1.2 kg/m2), upper arm anthropometry or surgical procedure. At discharge loss of muscle mass (arm muscle circumference) was significantly greater in the control group when compared with the CHOD group (control: -1.1+/-0.15 cm; CHOD: -0.5+/-0.16 cm; P<0.05). Baseline insulin (control: 20.7+/-4.9 mU/l; CHOD: 24.6+/-6.2 mU/l) and glucose (control: 6.0+/-1.4 mmol/l; CHOD 5.7+/-1.4 mmol/l) were comparable in the two groups and did not differ postoperatively. No complications were recorded as a result of preoperative fluid consumption. Postoperative morbidity occurred in six patients from each group. Median LOS in the control group was 10 days (IQR=6), and 8 days (IQR=4) in the CHOD group. CONCLUSION: Preoperative consumption of carbohydrate-containing fluids is safe. Provision of a carbohydrate energy source prior to surgery may attenuate depletion of muscle mass after surgery. Further studies are required to determine if this preservation of muscle mass is reflected in improved function and reduced rehabilitation time.

Abdomen↗