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PubMed2006

Physical activity for bone health in inactive teenage girls: is a supervised, teacher-led program or self-led program best?

PURPOSE: To investigate the effect of a six-month teacher-led osteogenic physical activity program, vs. a self-led activity program, on ultrasound measurements of bone in inactive teenage girls. METHODS: Ninety sedentary girls [mean (SD) age 16.3 (.6) years] were identified from 300 assessed for physical activity across five schools in southeast Ireland. Schools were matched and randomly assigned to a teacher-led physical activity (TLPA) program, a self-led physical activity (SLPA) program, or a control group. Broadband ultrasound attenuation (BUA), speed of sound (SOS), and os calcis stiffness index (OCSI) were measured using a portable ultrasound machine. Anthropometry, aerobic fitness, calcium intake, and physical activity were assessed, and focus groups held one month after program completion. Descriptive statistics, paired t-tests, and analysis of variance were used to analyze the data. RESULTS: Both intervention groups demonstrated significant improvements (p < .05) in BUA, SOS, OCSI and aerobic fitness, i.e., TLPA: +14.9%, +21.9%, + 15.9%, and +8.5%, respectively, and SLPA: +10.6%, +30.3%, + 15.6%, and +5.1%, respectively, with no change in controls. Differences between intervention groups and controls were significant for BUA and OCSI (p < .05). TLPA and SLPA groups engaged in an average of 4.5 and 3.4 hours/week of physical activity, respectively, over the intervention period. The SLPA group continued to exercise after the intervention had ceased, whereas the TLPA group did not. CONCLUSIONS: Previously inactive teenage girls can adhere to an osteogenic activity program whether supervised or directing their own activity. Longer-term, sustainable initiatives with this age group are needed and might focus on developing personal skills for physical activity.

Absorptiometry, Photon↗
PubMed2005

Megestrol acetate in a moderate dose for the treatment of malnutrition-inflammation complex in maintenance dialysis patients.

BACKGROUND: Malnutrition-inflammation complex syndrome and anorexia, common conditions in maintenance dialysis patients, are strongly associated with higher mortality and hospitalization and lower quality of life (QoL) in this population. Megestrol acetate, 800 mg/day, has been shown to increase appetite and food intake and to mitigate inflammation in cachectic AIDS and cancer patients, leading to weight gain, but it is also associated with side effects at this dose. METHODS: We evaluated the efficacy of the oral solution of megestrol acetate in half of its conventional dose in improving the nutritional state and inflammation in 10 hypoalbuminemic dialysis patients (albumin < 3.7 g/dL). Six women and 4 men, ages 60.2 years, took 400 mg of megestrol acetate solution daily for 16 weeks. Anthropometry, dual energy x-ray absorptiometry, 24-hour diet recalls, and biochemical measurements of nutrition and inflammation, including serum C-reactive protein and leptin, were performed. RESULTS: At the end of the 16 weeks of intervention, weight and body mass index increased by 9%, body fat proportion by 31%, and triceps skinfold by 40% (P < .01). Serum albumin increased from 3.0 to 3.3 g/dL and continued to increase significantly to 3.6 g/dL after 3 months postintervention (P = .03). Serum leptin increased from 5.2 to 10.7 ng/mL (P = .09). Daily protein and energy intake increased progressively up to 27% to 42% by the end of the trial (P < or = .01). In 8 patients without acute infection, serum C-reactive protein declined from 1.24 to 0.78 mg/L (P = .06). QoL and appetite were reported to be improved. No major side effects were observed, and all 10 patients completed the 16 weeks of daily intake of megestrol acetate without interruption. CONCLUSIONS: Megestrol acetate oral solution in half of its conventional dose is safe and improves the nutritional state, inflammation, and anorexia in maintenance dialysis patients. Larger-scale placebo-controlled randomized studies are needed to confirm the beneficial effects of 400 mg/day of megestrol acetate in dialysis patients.

Adult↗
PubMed2006

Association of vascular risk factors with increasing glycemia even in normoglycemic subjects in an older Chinese population: the Guangzhou Biobank Cohort Study.

Hyperglycemia increases cardiovascular disease risk, but the association between increasing glycemia and cardiovascular risk factors, angina, and coronary heart disease in normoglycemic subjects is less clear, particularly in Chinese. We report on possible associations in a large group of Mainland Chinese subjects. A total of 10,400 older subjects (> or = 50 years) were recruited, and vascular risk factors were measured, including anthropometry, blood pressure, and fasting plasma biochemical factors including glucose, lipid profile, and C-reactive protein (CRP). Subjects were categorized by glycemic status, and the relationship between glycemia and cardiovascular risk factors was investigated using analysis of variance and multiple linear regression analyses. Tertiles of fasting glucose levels showed a clear positive relationship with cardiovascular risk factors including age, obesity, blood pressure, lipid levels, and CRP (P < .001 for all). The overall prevalence of self-reported vascular disease was low, but significantly associated with increasing glycemia. Multiple regression showed that waist circumference (standardized regression coefficient beta = .10, P < .001), triglycerides (beta = 0.16, P < .001), CRP (beta = 0.06, P < .001), female sex (beta = .03, P = .007), high-density lipoprotein cholesterol (beta = -.02, P = .016), and mean arterial pressure (beta = .06, P < .001) were independently associated with fasting glucose levels. Among the normoglycemic subjects (n = 5190), increasing glycemia was still associated with increasing obesity indices, systolic blood pressure, triglyceride, and CRP levels (all P < .05). Increasing glycemia, even in the reference range, is associated with increasing prevalence of vascular risk factors. Control of these risk factors, particularly obesity, the most important avoidable independent determinant of glycemia in normoglycemic subjects, is critical to reduce the risk of the associated vascular disease.

Age Factors↗
PubMed2004

Energy expenditure, nutrition status, and body composition in children with cystic fibrosis.

OBJECTIVE: Undernutrition is a frequent complication in patients with cystic fibrosis (CF). Elevated energy requirements have been found to be 4% to 33% higher than in controls in some studies. Whether or not this is caused by a primary defect or energy metabolism is still a matter of controversy. To this end, we assessed energy expenditure, nutrition status, and body composition of clinically stable CF outpatients. METHODS: Fifteen clinically stable CF patients, ages 2 to 15 y, were paired with 15 healthy control children. Measurements consisted of anthropometry and body composition. Plasma tocopherol, retinol, and hair zinc content were measured. Resting energy expenditure was determined by indirect calorimetry. Physical activity and dietary intake were recorded by recall methods. RESULTS: Two children were nutritionally at risk according to the weight/height index, eight were normal, three were overweight, and two were obese. Body composition was similar in both groups. Zinc, tocopherol, and retinol levels were low in three, two, and three patients, respectively. Resting energy expenditures were 4.7 MJ/d (1127 +/- 220 kcal/d) in CF children and 4.63 MJ/d (1108 +/- 191 kcal/d) in control children (P = not significant). Physical activity level was sedentary in 86.6% of CF patients; the rest had a light physical activity pattern. Energy intake represented 141% of the estimated daily energy expenditure. CONCLUSIONS: Non-oxygen-dependent CF children, without acute respiratory infection, had resting energy expenditures comparable to those of matched controls. Total energy expenditure was similar to or slightly lower than that in healthy children. Dietary recommendations for CF patients need to be reassessed.

Adolescent↗
PubMed2004

Feeding practices and growth of infants from birth to 12 months in the central region of the Limpopo Province of South Africa.

OBJECTIVE: We evaluated feeding practices and growth patterns of infants in the central region of the Limpopo Province over the first 12 mo of life. METHODS: A follow-up study on a cohort of term infants born to 276 mothers recruited during their third trimester of pregnancy was undertaken. The mothers were recruited by the nursing staff at nine randomly selected clinics. From this sample, 219 women gave birth at the local hospital and the infants were followed from birth to 12 mo. Data collected included infant feeding practices and anthropometry at regular intervals (1, 3, 6, 9 and 12 mo). The anthropometric measurements taken were body weight, length, and head circumference. RESULTS: At birth 8.8% of infants had a low birth weight, 9.6% were stunted, 48.9% were underweight, and 7.3% were wasted. Mothers in this study breastfed their infants for long periods with more than 80% still breastfeeding by the ninth month. However, exclusive breastfeeding during the first 3 mo was uncommon as mothers tended to introduce supplementary feeds at an early age, with 56% of the infants receiving some form of supplement by the end of the first month. The most common supplementary foods were maize meal porridge and mabella (sorghum). Stunting became increasingly apparent in the early months with 30% of infants being stunted (<-2 standard deviations [SD] of the National Center for Health Statistics [NCHS] reference curves) by the first month, and this percentage remained high for the 12-mo period, remaining at below - 1 SD NCHS height-for-age standard. Increased weight gain was seen during the first 3 mo and then declined until mean weight-for-age at 12 mo was below 0 SD NCHS. Twelve percent of infants were overweight (>2 SD NCHS) by the 12th month. Postnatally the infants showed a pattern of gradual stunting. Postnatal factors associated with this pattern were related to maternal socioeconomic status, and these included the mother's level of education, employment status, parity, and access to electricity. CONCLUSION: There was a high frequency of underweight infants at birth but stunting was less common. With respect to feeding practices, the mothers tended to introduce supplementary feeds at an early age.

Anthropometry↗
PubMed2004

Anthropometric measurements in the elderly population of Santiago, Chile.

OBJECTIVE: There are few studies on anthropometry and nutritional status in large and representative samples of elderly populations in Chile and South America. We describe age and sex differences in weight, height, body mass index, knee height, waist circumference, midarm circumference, triceps skinfold thickness, arm muscle area, and calf circumference in Chilean elderly subjects. METHODS: This was a population-based, cross-sectional study. A total of 1220 elderly persons (819 women and 411 men; age range, 60-99 y) were recruited in the city of Santiago (Chile) through a probabilistic sampling procedure carried out from October to December 1999. RESULTS: Men were significantly heavier and taller than women in all age groups, whereas body mass index values were significantly higher in women than in men. All anthropometric variables showed a decrease in average values with aging in men and women. The apparent negative slopes for the decline in average values of body weight with aging was of greater magnitude in women than in men (-0.42 kg/y and -0.54 kg/y in male and female subjects, respectively). However, significant age x sex interaction was detected only for triceps skinfold thickness. In women, quadratic terms for age provided a significantly better fit than did the simple linear model for the association between age and weight, body mass index, waist circumference, triceps skinfold thickness, calf circumference, or midarm circumference. CONCLUSION: These observations indicated that body weight changes associated with aging might be more severe in Chilean women than in men, probably determining a differential pattern of lean and fat mass loss.

Age Distribution↗
PubMedDate not supplied

Prospective study of resting energy expenditure changes in head and neck cancer patients treated with chemoradiotherapy measured by indirect calorimetry.

OBJECTIVE: The prevalence of malnutrition is high in patients with head and neck cancer due to tumor location and coadjuvant treatment. We studied changes in resting energy expenditure (REE) during treatment with chemoradiotherapy and compared the measured REE by indirect calorimetry (IC) with the value estimated by the Harris-Benedict (HB) formula. METHODS: Eighteen patients with head and neck cancer (15 men and 3 women, mean age 57 +/- 10.7 y, age range 30-71 y) entered the study. All patients were treated with radiotherapy (70.8 +/- 1 Gy, range 70-72) and received 37.4 +/- 3.5 fractions (range 32-42) and concurrent chemotherapy with cisplatinum (absolute doses of 400 to 1000 mg). Nutrition assessment included anthropometry (body mass index, triceps skinfold thickness, subscapular skinfold thickness, midarm circumference, and midarm muscle circumference) and tetrapolar bioimpedance (Holtain BC). The IC (kcal/24 h; Deltatrac II MBM-200) was performed after an overnight fast. Measurements were done before treatment, at weeks 2, 4, and 6 of treatment, at the end of treatment, and 2 wk after treatment. RESULTS: Body mass index decreased during treatment from 24.7 +/- 4.4 kg/m(2) (range 16.9-31.4) to 22.3 +/- 4.2 kg/m(2) (range 15.1-29.6). REE (kcal/24 h) changed significantly during treatment (IC P < 0.05, HB formula P < 0.001). REE measured by IC appeared as a U-shaped curve, but REE estimated by the HB formula decreased during treatment. The HB underestimated REE measurements compared with IC. These differences were statistically significant before treatment, at the end of treatment, and 2 wk after treatment (P < 0.05) and showed a limited clinical agreement with the Bland-Altman method. CONCLUSIONS: REE measured by IC significantly changed during chemoradiotherapy. It was higher before treatment, at the end of treatment, and 2 wk after treatment. The HB formula underestimated REE in these patients. IC is a suitable method for measuring REE in this cohort of patients.

Adult↗
PubMed2005

Diacylglycerol oil ingestion in type 2 diabetic patients with hypertriglyceridemia.

OBJECTIVE: Coronary arteriosclerotic heart disease frequently develops in patients with diabetes. Decreases in [corrected] serum high-density lipoprotein cholesterol (HDL-C) [corrected] concentration and low-density lipoprotein (LDL) particle size, accompanied by hypertriglyceridemia, are associated with the onset of atherosclerosis. We recently reported that hypertriglyceridemia was significantly improved in patients with type 2 diabetes who ingested diacylglycerol (DAG) oil. The effect on variables, including LDL particle size related to lipid metabolism, however, was not examined. The present study investigated the effects on these variables in more detail. METHODS: Patients with type 2 diabetes (n = 24) were assigned to receive DAG oil or triacylglycerol oil, and a 3-mo, single-blind, controlled study was performed. Patients replaced cooking oil in their daily diet with DAG or triacylglycerol oil, and anthropometry and blood sampling were performed at monthly intervals. RESULTS: There were no significant differences in calorie intake or amount of test oil ingested between groups. Waist circumference and serum triacylglycerol concentrations were significantly lower and serum concentrations of high-density lipoprotein cholesterol and apolipoprotein-AI were significantly higher in the DAG oil group than in the triacylglycerol oil group. Plasma plasminogen activator inhibitor-1 concentrations were significantly lower in the DAG oil group. LDL particle size tended to increase in the DAG oil group and was significantly larger in patients who had a small initial LDL particle size (<25.5 nm). There were no significant differences in variables related to glucose metabolism or in serum concentration of free fatty acids or total ketone bodies. CONCLUSIONS: These results indicate that DAG oil may be useful for patients who have type 2 diabetes in the management of obesity and lipid abnormalities.

Adult↗
PubMed2005

Ethnic differences in thermal pain responses: a comparison of South Asian and White British healthy males.

The expression and report of pain is influenced by social environment and culture. Previous studies have suggested ethnically determined differences in report of pain threshold, intensity and affect. The influence of ethnic differences between White British and South Asians has remained unexplored. Twenty age-matched, male volunteers in each group underwent evaluation. Cold and warm perception and cold and heat threshold were assessed using an ascending method of limits. Magnitude estimation of pain unpleasantness and pain intensity were investigated with thermal stimuli of 46, 47, 48 and 49 degrees C. Subjects also completed a pain anxiety questionnaire. Data was analysed using t-test, Mann-Whitney and repeated measures analysis of variance as appropriate. There were no differences in cold and warm perception between the two groups. There was a statistically significant difference between the two groups for heat pain threshold (P=0.006) and heat pain intensity demonstrated a significant effect for ethnicity (F=13.84, P=0.001). Although no group differences emerged for cold pain threshold and heat unpleasantness, South Asians demonstrated lower cold pain threshold and reported more unpleasantness at all temperatures but this was not statistically significant. Our study shows that ethnicity plays an important role in heat pain threshold and pain report, South Asian males demonstrated lower pain thresholds and higher pain report when compared with matched White British males. There were no differences in pain anxiety between the two groups and no correlations were identified between pain and pain anxiety Haemodynamic measures and anthropometry did not explain group differences.

Adult↗
PubMed2005

Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism.

BACKGROUND AND PURPOSE: Anecdotal reports suggest that sleep-disordered breathing (SDB) is common among patients with primary hypothyroidism. This study was undertaken to determine the prevalence of SDB and to evaluate the effect of thyroxine replacement therapy on SDB in patients with primary hypothyroidism. PATIENTS AND METHODS: Fifty consecutive newly diagnosed, untreated symptomatic patients with primary hypothyroidism (age: 34+/-11 years; males: 21 [42%]) were prospectively studied. Physical examination, anthropometry, fasting blood glucose and serum lipids were performed in all patients at baseline. Polysomnography was done at baseline in all patients and was repeated after adequate thyroxine replacement in those who had SDB. RESULTS: SDB defined as apnea-hypopnea index (AHI) > or =5 was present in 15 patients (30%) at baseline and was reversible in 10 of the 12 patients evaluated following thyroxine replacement therapy (P=0.006). Thyroxine replacement therapy was associated with improvement in findings that reflect a compromised upper airway, such as macroglossia (4 [33%] vs. 1 [8%]; P=0.083), myoedema (5 [42%] vs. 1 [8%]; P=0.046) and facial puffiness (10 [83%] vs. 1 [8%]; P=0.003). CONCLUSIONS: Reversible SDB is common among patients with primary hypothyroidism. Changes in upper airway anatomy resulting from hypothyroidism probably contribute to the development of SDB in these patients.

Adult↗
PubMedDate not supplied

Nutritional status and body composition evolution in early post-renal transplantation: is there a female advantage?

OBJECTIVE: Chronic renal failure is associated with metabolic derangements, affecting proteins, amino acids, and lipids. Usually these patients follow a restricted diet. Kidney transplant patients enjoy a recovery of renal function, but their therapeutics may entail significant changes in general metabolism. We compare the anthropometric results during the first 3 months after successful transplant for male and female patients versus a healthy group. METHODS: Eighteen patients (11 men and 7 women) were studied. Anthropometry was assessed before and at month 1 and month 3 posttransplant including body weight (Wt), body mass index (BMI), triceps (TSF), biceps (BSF), subscapular (SCSF), and suprailiac skinfolds (SISF), midarm circumference (MAC), midarm muscle circumference (MAMC), corrected arm muscle area (CT.AMA), total body muscle mass (MM), body density (D), fat mass (FM), and fat-free mass (FFM). The healthy group was evaluated three times in the first year. RESULTS: Pretransplant men showed lower Wt, BMI, TSF, BSF, SCSF, SISF, MAC, MAMC, CT.AMA, MM, FM and FFM than controls, while women displayed no differences from controls. By the third month, men showed only a partial recovery and women higher TSF and SCSF than controls. CONCLUSIONS: Uremic men before transplant displayed undernutrition indices. During the first 3 months posttransplant men showed an incomplete recovery of anthropometric parameters. Quite differently, women started close to normal and had significantly increased body weight and fat content posttransplant. We suggest that nutritional requirements post-kidney grafting may be significantly different among male compared to female patients.

Adipose Tissue↗
PubMed2005

Cardiovascular disease risk factors in 6-7-year-old Danish children: the Copenhagen School Child Intervention Study.

OBJECTIVE: To describe population values in cardiovascular disease (CVD) risk factors such as blood lipids, fasting insulin and glucose and blood pressure in this young age group, and calculate associations to fitness and fatness. METHODS: Participants were 369 boys (6.8 +/- 0.4 years) and 327 girls (6.7 +/- 0.4 years) from preschool classes in Copenhagen. Peak VO2, blood pressure (BP), fat content and anthropometry were determined. A fasting blood sample was analysed for insulin, glucose and blood lipids. Physical activity was measured using accelerometry. RESULTS: Mean BMI, BP and blood lipids were not different between sexes. Fat percentage assessed from skinfolds was higher (21.5% vs. 16.5%) in girls than in boys (P < 0.001). Peak VO2 and physical activity were higher in boys than in girls (8% and 9%, respectively). Peak VO2 associated to fatness independent of body weight (r = 0.41; P < 0.001). Among the CVD risk factors, fitness was associated to high-density lipoprotein (HDL) (r = 0.14; P < 0.01) and physical activity (r = 0.12; P < 0.01). Fatness assessed by skinfold was associated to blood pressure (r = 0.19-0.28; P < 0.001), to fasting glucose (r = 0.11, P < 0.05) and insulin (r = 0.17; P < 0.001). CONCLUSIONS: Mean BP in 6-7-year-old Danish children has decreased since 1979 and BMI has increased modestly since 1986/1987. The lipid profile was similar compared with data from 1973 and 1978 in Danish children. Weak relationships were found between CVD risk factors, fitness and fatness.

Age Factors↗
PubMed1999

The influence of head restraint and occupant factors on peak head/neck kinematics in low-speed rear-end collisions.

Prior two-way analyses of variance showed that the peak kinematic response of the head and neck of subjects exposed to low-speed rear-end collisions was related to speed change and gender, however potential reasons for this gender dependence were not determined. Using multiple linear regression, this study further examined these response data to determine the relative influence of specific factors, including subject anthropometry, neck strength, cervical range of motion, seated posture and head restraint position, which may have been responsible for the previously-observed gender dependence. The results of this analysis showed that vehicle speed change and relative head restraint position explained the largest proportion of the observed variation in peak occupant kinematic response. Seated posture measures also explained some of the variation in kinematic response. The current analysis prioritizes which variables to explore more thoroughly in future research and which variables should be carefully controlled in future studies.

Acceleration↗
PubMed2000

Descriptive anthropometric reference data for older Americans.

OBJECTIVE: To present selected anthropometric data derived from adults aged 60 years and older examined in the third National Health and Nutrition Examination Survey (NHANES III). DESIGN: NHANES III used a complex, stratified, multistage, probability cluster sample design to obtain a nationally representative sample of the US civilian, noninstitutionalized population. Persons aged 60 years and older, Mexican-Americans, and African-Americans were oversampled to produce more reliable estimates for these groups. Trained technicians measured height, weight, skinfold thickness, and circumferences using standardized procedures. SUBJECTS: A total of 5,700 persons aged 60 years and older, and 1,861 persons aged 50 to 59 years. STATISTICAL ANALYSES PERFORMED: Mean and selected percentiles for body weight, body mass index, triceps skinfold thickness, mid upper arm circumference, and arm muscle circumference were calculated by gender, race/ethnicity, and 3 age categories. Weight (lb) per height (in) tables were generated for men and women by age group. RESULTS: Mean body weight was lowest for persons aged 80 years and older. A decline in body mass index occurred that paralleled the direction and magnitude of the progressive decrease observed in weight. Muscle loss with increasing age, as indicated by arm muscle circumference, appeared to be greater among men than women. APPLICATIONS/CONCLUSIONS: In addition to being relatively simple, quick, and inexpensive, anthropometry is the most reliable and specific indicator of malnutrition in the older adult population. The cross-sectional reference data provided can be used by dietitians to interpret anthropometric measurements of persons aged 60 years and older.

Black or African American↗
PubMed2001

Acculturation of Mexican-American mothers influences child feeding strategies.

OBJECTIVE: The purpose of this study was to examine the influence of maternal acculturation level on child feeding strategies and anthropometry in preschoolers from low-income Mexican-American families. DESIGN/SUBJECTS: Data are from a cross-sectional survey of 238 low-income Mexican-American families with preschool children living in California during 1998. Interviewers collected data from the mothers on child-feeding practices and weighed and measured the children in their homes. STATISTICAL ANALYSES: Spearman's correlation coefficients, analysis of variance, and chi 2 were used to examine the relationship pf maternal acculturation level with feeding strategies and anthropometric measurements. RESULTS: Compared with more acculturated mothers, less acculturated mothers tend to offer alternative foods more often when their children refuse to eat. More acculturated women are less likely to view bribes, threats, and punishments as effective strategies and are more likely to give vitamins than less acculturated mothers. Maternal acculturation is not associated with differences in weight-for-height z-scores, height-for-age, or body mass index of the children. Triceps skinfold thickness are larger in children of more acculturated mothers than in children of less acculturated women. APPLICATIONS/CONCLUSIONS: Dietitians should consider differences in child feeding practices due to acculturation among Mexican-Americans. Successful strategies to encourage consumption of nutritious traditional foods and to transition from child-led snacking to more structured meals should be part of nutrition education programs.

Acculturation↗
PubMed2001

The fat redistribution syndrome in patients infected with HIV: measurements of body shape abnormalities.

OBJECTIVE: To describe the body shape changes in the syndrome of fat redistribution or lipodystrophy seen in patients infected with HIV. DESIGN: An objective description of patients with HIV with fat redistribution syndrome. Body-height, weight, shape, and composition were measured by anthropometrics and biolectrical impedance analysis by a single observer. Clinical data were collected by chart review. SUBJECTS/SETTING: Thirty-nine patients with HIV receiving primary HIV care at a university hospital-affiliated infectious disease clinic who presented with complaints of body shape changes or who were referred by their primary care providers for body shape changes. ANALYSIS: Descriptive statistics were performed. RESULTS: Four of the 39 patients (10%) had not used protease inhibitor therapy. HIV status (by clinical presentation, CD4 and VL) varied widely. Laboratory abnormalities were moderate. Percent body fat differed widely when measured by bioelectrical impedance analysis and anthropometry (23% vs 13%). The mean body mass index was 25.6 kg/m2 for men and 25.8 kg/m2 for women. The mean waist/hip ratio was above normal, at 1.02. The mean mid-arm circumference and triceps skinfolds were below national standards for both men (30.4 cm and 8.1 mm, respectively) and women (26.7 cm and 7.5 mm, respectively). Nine patients (23%) had an increased dorso-cervical pad. Seventeen patients returned for follow-up measurements at 3 months; no significant differences were found between baseline and follow-up measurements. CONCLUSIONS: The waist/hip ratio, mid-arm and mid-thigh circumference, and triceps skinfolds were useful measures to define and follow the fat redistribution syndrome in patients with HIV. These body composition changes were not transitory in this short follow-up period.

Adipose Tissue↗
PubMed2002

Feeding dysfunction is associated with poor growth and health status in children with cerebral palsy.

OBJECTIVE: To describe parent-reported feeding dysfunction and its association with health and nutritional status in children with cerebral palsy. DESIGN: Anthropometry was measured and z scores calculated. The Child Health Questionnaire was used to assess health status, and a categorical scale (none to severe) was used to classify subjects according to severity of feeding dysfunction. SUBJECTS: 230 children (9.7+/-4.6 years; 59% boys) with moderate to severe cerebral palsy were recruited from 6 centers in the United States and Canada. STATISTICAL ANALYSES: Descriptive statistics, the Kruskal-Wallis and Pearson chi2 tests. RESULTS: Severity of feeding dysfunction was strongly associated with indicators of poor health and nutritional status. The mean weight z scores were -1.7, -2.5, -3.3, and -1.8 among children with none, mild, moderate, or severe (largely tube-fed) feeding dysfunction, respectively (P= .003). Similar results were observed for height z score (P=.008), triceps z score (P=.03), and poor Global Health score (part of the Child Health Questionnaire) (P<.001). Subjects who were tube fed were taller (P=.014) and had greater body fat stores (triceps z score, P=.001) than orally fed subjects with similar motor impairment. For subjects exclusively fed by mouth, a dose-response relationship was observed between feeding dysfunction severity and poor nutritional status. Subjects with only mild feeding dysfunction had reduced triceps z score (-0.9) compared with those with no feeding problems (-0.3). CONCLUSION: For children with moderate to severe cerebral palsy, feeding dysfunction is a common problem associated with poor health and nutritional status. Even children with only mild feeding dysfunction, requiring chopped or mashed foods, may be at risk for poor nutritional status. Parental report of feeding dysfunction with a structured questionnaire may be useful in screening children for nutritional risk.

Adolescent↗
PubMed1999

Anthropometric and physiologic correlates of mitral valve prolapse in a biethnic cohort of young adults: the CARDIA study.

OBJECTIVE: To describe the epidemiology of echocardiographic mitral valve prolapse (MVP) and its anthropometric, physiologic, and psychobehavioral correlates with a cross-sectional analysis at 4 urban clinical centers. PATIENTS: A biethnic, community-based sample of 4136 young (aged 23 to 35 years) adult participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who had echocardiograms during their third examination between 1990 and 1991. MEASUREMENTS: Echocardiographic mitral valve prolapse, Doppler mitral regurgitation, blood pressure, anthropometry, and 4 psychobehavioral scales. RESULTS: Definite echocardiographic MVP prevalence was 0.6% overall and was similar across the 4 ethnicity/sex groups. Most participants (21 of 26, 80%) with definite echocardiographic MVP were unaware of their condition. Relative to persons with normal echocardiograms, those with echocardiographic MVP were taller (174.6 cm vs 171.0 cm, P <.01), leaner (26.7 mm vs 37.4 mm sum of triceps and subscapular skinfolds, P <.01), had lower body mass index (22.0 kg/m(2) vs 26.2 kg/m(2), P <.01), and more often has Doppler mitral regurgitation (34.8% vs 11. 8%, P <.01). Women with echocardiographic MVP had higher ethnicity-adjusted hostility scores (19.9 vs 16.1, P <.05) than women with no MVP. Among 111 (2.7%) of 4136 participants reporting prior physician diagnosis of MVP, only 5 (0.45%) of 111 had definite echocardiographic MVP. CONCLUSIONS: These data document a low prevalence of definite echocardiographic MVP and suggest a constellation of anthropometric, physiologic, and psychobehavioral characteristics in young adults with echocardiographic MVP. Most definite echocardiographic MVP diagnoses were discordant with self-reported MVP status, and false-positive diagnoses of echocardiographic MVP were made more often in women and whites.

Adult↗