Organ-tissue mass measurement allows modeling of REE and metabolically active tissue mass

Investigators have expressed interest in the associations between resting energy expenditure (REE) and body mass for over a century. Traditionally, descriptive models using regression analysis are applied, linking REE with metabolically active compartments such as body cell mass (BCM) and fat-free body mass (FFM). Recently developed whole body magnetic resonance imaging (MRI) and echocardiography methods now allow estimation of all major organs and tissue volumes in vivo. Because measured values are available for REE, BCM, and FFM content of individual organs and tissues, it should now be possible to develop energy expenditure-body composition estimation models based on MRI-measured organ-tissue volumes. Specifically, the present investigation tested the hypothesis that in vivo estimation of whole body REE, BCM, and FFM is possible using MRI- and echocardiography-derived organ volumes combined with previously reported organ-tissue metabolic rates and chemical composition. Thirteen subjects (5 females, 8 males) had REE, BCM, and FFM measured by indirect calorimetry, whole body 40K counting, and dual-energy X-ray absorptiometry, respectively. Models developed from estimated and measured variables were highly correlated, with no significant differences between those estimated and measured [e.g., calculated vs. measured REE: r = 0.92, P < 0. 001; (mean +/- SD) 6,962 +/- 1,455 and 7,045 +/- 1,450 kJ/day, respectively (P = not significant)]. Strong associations were observed between REE, individual or combined organ weights, BCM, and FFM that provide new insights into earlier observed metabolic phenomona. The present approach, the first to establish an energy expenditure-body composition link with a mechanistic model in vivo, has the potential to greatly expand our knowledge of energy expenditure-body size relationships in humans.

Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography

Magnetic resonance imaging (MRI) and computerized tomography (CT) are promising reference methods for quantifying whole body and regional skeletal muscle mass. Earlier MRI and CT validation studies used data-acquisition techniques and data-analysis procedures now outdated, evaluated anatomic rather than adipose tissue-free skeletal muscle (ATFSM), studied only the relatively large thigh, or found unduly large estimation errors. The aim of the present study was to compare arm and leg ATFSM cross-sectional area estimates (cm2) by using standard MRI and CT acquisition and image-analysis methods with corresponding cadaver estimates. A second objective was to validate MRI and CT measurements of adipose tissue embedded within muscle (interstitial adipose tissue) and surrounding muscle (subcutaneous adipose tissue). ATFSM area (n = 119) by MRI [38.9 +/- 22.3 (SD) cm2], CT (39.7 +/- 22.8 cm2), and cadaver (39.5 +/- 23.0 cm2) were not different (P > 0.001), and both MRI and CT estimates of ATFSM were highly correlated with corresponding cadaver values [MRI: r = 0.99, SE of estimate (SEE) 3.9 cm2, P < 0.001; and CT: r = 0.99, SEE = 3.8 cm2, P < 0.001]. Similarly good results were observed between MRI- and CT-measured vs. cadaver-measured interstitial and subcutaneous adipose tissue. For MRI-ATFSM the intraobserver correlation for duplicate measurements in vivo was 0. 99 [SEE = 8.7 cm2 (2.9%), P < 0.001]. These findings strongly support the use of MRI and CT as reference methods for appendicular skeletal muscle, interstitial and subcutaneous adipose tissue measurement in vivo.

Appendicular skeletal muscle mass: prediction from multiple frequency segmental bioimpedance analysis

OBJECTIVES

Bioimpedance analysis (BIA) methods have potential to predict appendicular skeletal muscle mass (SM), although available 50 kHz prediction models include, in addition to impedance (Z), an independent age term. An age term in models is undesirable as it reflects incomplete understanding of underlying conduction physiology. This study tested the hypothesis, based on fluid distribution models related to aging, that appendicular SM bioimpedance analysis (BIA) prediction models would no longer include an independent age term, after first controlling for stature-adjusted appendicular impedance (height2/Z), at injected frequencies greater than 50 kHz.

DESIGN

Cross-sectional evaluation of adults who had segmental Z and phase angle (phi) measured with multiple frequency BIA, and arm and leg SM with dual-energy X-ray absorptiometry (DXA). Skeletal muscle prediction models were developed with appendicular SM as dependent variable and height2/Z, gender, age and phi as potential independent variables.

RESULTS

Examination of hypothesis in 49 subjects indicated: both arm and leg SM were highly correlated with height2/segmental Z at frequencies ranging from 1-300 kHz; gender was significant covariate in prediction models only at 1 kHz; age remained a significant covariate after controlling for height2/segmental Z at all frequencies; phi did not add significantly to models; and SM prediction models gave maximum R2 at 50 kHz for arm but R2 continued to rise up to 300 kHz for leg.

CONCLUSION

Although multifrequency BIA did not eliminate SM prediction model age term, our findings suggest injected frequencies up to 300 kHz may have advantages for evaluating leg SM over conventional 50 kHz method.

Fraction of carbon-free body mass as oxygen is a constant body composition ratio in men

Although elements are the foundation of the human body, information concerning the atomic level of body composition is still limited. The aim of this study was to explore potentially constant relationships among elements found in vivo. Based on the known stoichiometries of relevant chemical components, a theoretical model was derived, suggesting the existence of a relatively constant ratio of total body oxygen to carbon-free body mass (TBO/CFM) in men. Eight elements (C, H, N, Ca, P, K, Na and Cl ) were measured in 22 healthy male subjects by using in vivo neutron activation-40K whole-body counting, and TBO was calculated as the difference between body mass and the sum of the eight measured elements. TBO (in kg) was significantly correlated with CFM (in kg): TBO = 0.829 x CFM - 1.8; r = 0.998, P < 0.001, standard error of estimate = 0.4 kg. The ratio of TBO to CFM was relatively constant, mean +/- SD at 0. 800 +/- 0.009 with a CV of 1.1%. Oxygen and carbon are the two most abundant elements in the human body. The discovery of a constant relationship between oxygen and carbon is not only helpful for understanding the atomic level of body composition, but also provides the possibility of estimating the content of specific elements in vivo.

Calcium supplementation suppresses bone turnover during weight reduction in postmenopausal women

Bone mobilization, lowering of bone mineral density (BMD), and osteoporotic fractures are recognized in postmenopausal women with weight loss. Because a high-calcium intake suppresses bone loss in peri- and postmenopausal women, the present randomized, double-blind, placebo-controlled study was designed to test the hypothesis that calcium supplementation prevents net bone mobilization and consequent bone mineral loss during voluntary weight reduction in obese postmenopausal women. Subjects were placed on a moderate energy-restricted diet and either calcium supplementation (1 g/day) or placebo for 6 months. Body weight, bone turnover markers (pyridinium cross-links), osteocalcin, and parathyroid hormone (PTH) were measured at treatment weeks 1-5, 7, 10, 13, 16, 20, and 25. Total body BMD, insulin-like growth factor, 25-hydroxyvitamin D, and sex hormone binding globulin (SHBG) were measured at baseline and week 25. The calcium supplemented (n = 15; age 60.9 +/- 9.4 years, body mass index [BMI] 33.2 +/- 4.6 kg/m2) and placebo (n = 16; age 55.8 +/- 8.3 years, BMI 32.9 +/- 4.5 kg/m2) groups lost similar amounts of weight over the study interval (10.2 +/- 5.3% vs. 10.0 +/- 5.2%) and both groups increased SHBG (p < 0.001). There was a statistical effect of calcium supplementation during weight loss to suppress pyridinium cross-links, osteocalcin, and PTH (p < 0.05, < 0.01, and < 0.05, respectively). Loss of BMD tended to be greater in the placebo group by 1.4% (p < 0.08) after weight loss. One gram per day calcium supplementation normalizes the increased calcium-PTH axis activity and the elevated bone turnover rate observed during moderate voluntary energy restriction in postmenopausal women.

Muscle distribution: variations with body weight, gender, and age

Little is known about skeletal muscle distribution in healthy adults. Data were collected on 132 healthy, ambulatory, Caucasian women and men, aged 20-89 yr. Appendicular skeletal muscle mass multiple regression models were developed to assess the relationships between regional skeletal muscle and height, weight, age, ethnicity, and extremity lengths.

RESULTS

(1) with an increase in body weight there is a greater relative increase in upper muscle distribution; (2) women have less upper muscle mass compared to men; (3) with increasing age there is a relative reduction in upper muscle distribution. The present results indicate that skeletal muscle is not a homogenous component, but has at least three independent factors, gender, weight, and age, influencing distribution.

Dual-energy X-ray absorptiometry: fat estimation errors due to variation in soft tissue hydration

Dual-energy X-ray absorptiometry (DXA) is rapidly gaining acceptance as a reference method for analyzing body composition. An important and unresolved concern is whether and to what extent variation in soft tissue hydration causes errors in DXA fat estimates. The present study aim was to develop and validate a DXA physical hydration model and then to apply this model by simulating errors arising from hypothetical overhydration states. The DXA physical hydration model was developed by first linking biological substance elemental content with photon attenuation. The validated physical model was next extended to describe photon attenuation changes anticipated when predefined amounts of two known composition components are mixed, as would occur when overhydration develops. Two overhydration models were developed in the last phase of study, formulated on validated physical models, and error was simulated for fluid surfeit states. Results indicate that systematic errors in DXA percent fat arise with added fluids when fractional masses are varied as a percentage of combined fluid + soft tissue mass. Three independent determinants of error magnitude were established: elemental content of overhydration fluid, fraction of combined fluid + soft tissue as overhydration fluid, and initial soft tissue composition. Small but systematic and predictable errors in DXA soft tissue composition analysis thus can arise with fluid balance changes.

Prader-Willi syndrome: relationship of adiposity to plasma leptin levels

OBJECTIVE

Prader-Willi syndrome (PWS) is an autosomal dominant disorder involving the proximal long arm of chromosome 15, in which obesity is common. However, there is limited information on the underlying physiological mechanisms promoting obesity in this population. We tested whether there was a significant positive association between leptin and total body fat (TBF) in subjects with PWS, and whether this association was stronger among subjects with than without PWS.

RESEARCH METHODS AND PROCEDURES

We studied 21 PWS patients and 64 non-PWS controls on whom we measured serum leptin, total body fat, glucose, insulin, and resting energy expenditure. We tested whether the slope of the regression line between leptin and TBF (in kg), measured by dual energy X-ray absorptiometry, was the same for PWS patients and non-PWS controls.

RESULTS

Regression analyses indicated that the leptin-TBF association was significantly stronger among PWS patients. In contrast, the slope of the leptin-body mass index association did not significantly differ between PWS patients and non-PWS controls. None of the other outcome variables showed associations with leptin.

DISCUSSION

Results suggest that the role of leptin in promoting obesity may be greater among subjects with PWS than among non-PWS controls.

Upper extremity skeletal muscle mass: potential of measurement with single frequency bioimpedance analysis

This study examined the potential of single frequency (50 kHz) BIA for estimation of upper extremity skeletal muscle (SM) mass. Subjects (n = 50) were weight stable adults varying in age (X +/- SD, 51.6 +/- 17 yr) and body mass index (27.2 +/- 5.9 kg/m2). Determinants of arm to arm impedance index (length L; L2/Z) were examined using multiple regression analysis. A good correlation was observed between L2/Z and arm SM estimated by dual-energy X-ray absorptiometry (r = 0.88, p < 0.001). Additional significant model covariates were arm fat mass (p < 0.05), bone mass (p < 0.01), and age (p < 0.001). These findings suggest that upper extremity SM may be rapidly and easily quantified using a simple and inexpensive BIA system combined with appropriate age-adjusted impedance prediction equations.

Lean R value for DXA two-component soft-tissue model: influence of age and tissue or organ type

Dual-energy X-ray absorptiometry (DXA) is an important new body composition method that is based on tissue attenuation of two main photon energies. When the two photon energies pass through tissue, attenuation at the lower energy compared with that at the higher energy can expressed as a ratio (R), which is used for tissue component identification. We tested whether: (1) the R value of lean tissue is related to age, and (2) the R value of lean tissue differs between soft tissue locations. Elemental content of various tissues from the literature was used. Results show that lean R values for 40 keV and 70 keV are independent of age and tissue type.

Total body lipid and triglyceride response to energy deficit: relevance to body composition models

Although the study of human body composition is advancing rapidly, confusion still prevails regarding the molecular-level lipid component. Most molecular-level body composition models are presently based on the overall hypothesis that nontriglyceride lipids constitute an insignificant proportion of total body lipid. A single lipid or "fat" component consisting of triglycerides is thus assumed in most molecular-level body composition models. To test this hypothesis, the present study, carried out in adult rats, was designed to examine two questions: 1) What is the proportion of total lipids as triglycerides? and 2) Is this proportion constant or does it change with negative energy balance and weight loss produced by calorie restriction and increased exercise? Results indicated that with negative energy balance and weight loss there were progressive losses of total body triglyceride and lipid. The proportion of total lipids as triglyceride was 0.83 +/- 0.08 (SD) in control animals, with reductions at 2 and 9 wk of energy restriction [0.82 +/- 0.04 (P = NS vs. control) and 0.70 +/- 0.15 (P = 0.05)] and at 9 wk for energy restriction plus exercise [0.67 +/- 0.09 (P = 0.003)]. Nontriglyceride lipids comprised 2.8% of carcass weight at baseline and decreased to 2.2% by 9 wk of energy restriction and exercise (P = NS). Substantial differences were observed between body composition ratios expressed as percentages of the lipid-free body mass (LFM) and triglyceride-free body mass (TGFM); (e.g., total body water/LFM and TGFM in controls = 72.7 +/- 0.7 and 70.4 +/- 2.2, respectively; P = 0.02). These observations strongly support the existence and importance of nontriglyceride lipids as a body composition component that responds independently from storage triglycerides, with negative energy balance produced by food restriction and exercise.

Epidemiology of sarcopenia among the elderly in New Mexico

Muscle mass decreases with age, leading to "sarcopenia," or low relative muscle mass, in elderly people. Sarcopenia is believed to be associated with metabolic, physiologic, and functional impairments and disability. Methods of estimating the prevalence of sarcopenia and its associated risks in elderly populations are lacking. Data from a population-based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico (the New Mexico Elder Health Survey, 1993-1995) were analyzed to develop a method for estimating the prevalence of sarcopenia. An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a random subsample (n = 199) of participants and was extended to the total sample. Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 (m2) being less than two standard deviations below the mean of a young reference group. Prevalences increased from 13-24% in persons under 70 years of age to >50% in persons over 80 years of age, and were slightly greater in Hispanics than in non-Hispanic whites. Sarcopenia was significantly associated with self-reported physical disability in both men and women, independent of ethnicity, age, morbidity, obesity, income, and health behaviors. This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia.

Six-compartment body composition model: inter-method comparisons of total body fat measurement

OBJECTIVE

To compare 16 currently used total body fat methods to a six-compartment criterion model based on in vivo neutron activation analysis.

DESIGN

Observational, inter-method comparison study.

SUBJECTS

Twenty-three healthy subjects (17 male and 6 female).

MEASUREMENTS

Total body water (TBW) was measured by tritium dilution; body volume by underwater weighing (UWW); total body fat and bone mineral by dual-energy X-ray absorptiometry (DXA), total body potassium (TBK) by whole-body 40K counting; total body carbon, nitrogen, calcium, phosphorus, sodium and chlorine by in vivo neutron activation analysis; skinfolds/circumferences by anthropometry (Anth); and resistance by single-frequency bioimpedance analysis (BIA).

RESULTS

The average of total body fat mass measurements by the six-compartment neutron activation model was 19.7+/-10.2kg (mean+/-s.d.) and comparable estimates by other methods ranged from 17.4-24.3 kg. Although all 16 methods were highly correlated with the six-compartment criterion model, three groups emerged based on their comparative characteristics (technical error, coefficient of reliability, Bland-Altman analysis) relative to criterion fat estimates, in decreasing order of agreement: 1. multi-compartment model methods of Baumgartner (19.5+/-9.9 kg), Heymsfield (19.6+/-9.9 kg), Selinger (19.7+/-10.2 kg) and Siri-3C (19.6+/-9.9 kg); 2. DXA (20.0+/-10.8 kg), Pace-TBW (18.8+/-10.1 kg), Siri-2C (20.0+/-9.9 kg), and Brozek-UWW (19.4+/-9.2 kg) methods; and 3. Segal-BIA (17.4+/-7.2 kg), Forbes-TBN (21.8+/-10.5 kg), Durnin-Anth (22.1+/-9.5 kg), Forbes-TBK (22.9+/-11.9 kg), and Steinkamp-Anth (24.3+/-9.5 kg) methods.

CONCLUSION

Relative to criterion fat estimates, body composition methods can be organized into three groups based on inter-method comparisons including technical error, coefficient of reliability and Bland-Altman analysis. These initial groupings may prove useful in establishing the clinical and research role of the many available fat estimation methods.

Urinary 3-methylhistidine excretion: association with total body skeletal muscle mass by computerized axial tomography

BACKGROUND

The urinary excretion of endogenous 3-methylhistidine (3-MH) has been proposed as a predictor of skeletal muscle mass (SM). In this study, we report the relationship between 24-hour urinary 3-MH excretion and SM.

METHODS

Total body SM was measured by multiscan computerized axial tomography (CT) in a sample of 10 healthy adult men who followed a meat-free diet for 7 days. 3-MH was measured during the last 3 days of the meat-free diet protocol on consecutive 24-hour urine collections.

RESULTS

The 3-MH excretion was 216.3 +/- 44.7 mumol/d (mean +/- SD) and was found well associated with SM (in kilograms), SM = 0.0887 x 3-MH + 11.8; r = .88, p < .001. Compared with CT, the previous 3-MH-SM prediction equation suggested by Lukaski et al underestimated SM by an average of 8.9 kg in the 10 healthy men. This difference was caused by the Burkinshaw-Cohn neutron activation model, which underestimated SM and was used as the reference in the Lukaski method.

CONCLUSIONS

Twenty-four-hour urinary 3-MH excretion can be applied for estimating SM in healthy adult men on a meat-free diet.

Body mass index as a measure of adiposity among children and adolescents: a validation study

OBJECTIVES

To test the hypothesis that in a healthy pediatric population body mass index (BMI) (kilograms per meter square) is a valid measure of fatness that is independent of age for both sexes.

METHODS

Total body fat (TBF) (in kilograms) and percent of body weight as fat (PBF) were estimated by dual energy x-ray absorptiometry (DXA) in 198 healthy Italian children and adolescents between 5 and 19 years of age. We developed multiple regression analysis models with TBF and percent body fat as dependent variables and BMI, age, and interaction terms as independent variables. Separate analyses were conducted for boys and girls.

RESULTS

BMI was strongly associated with TBF (R2 = 0.85 and 0.89 for boys and girls, respectively) and PBF (R2 =0.63 and 0.69 for boys and girls, respectively). Confidence limits on BMI-fatness association were wide, with individuals of similar BMI showing large differences in TBF and in PBF. Age was a significant covariate in all regression models. Addition of nonlinear terms for BMI did not substantially increase the R2 for TBF and PBF models in boys and girls.

CONCLUSION

Our results support the use of BMI as a fatness measure in groups of children and adolescents, although interpretation should be cautious when comparing BMI across groups that differ in age or when predicting a specific individual's TBF or PBF.

Anthropometric equations for studying body fat in pregnant women

Anthropometric data from 200 pregnant women were used to estimate body fat at gestation weeks 14 and 37 and changes in body fat from week 14 to week 37 with four formulas from the literature. The resulting estimates were evaluated against the estimation of fat by a four-compartment model that determined fat from weight, total body water, bone mineral mass, and body density. The estimates of fat by existing anthropometric models were statistically different from those by the four-compartment model in both early and late pregnancy. Most importantly, the change in body fat estimated by the anthropometric models (all > 4 kg) was considerably higher than that estimated by the four-compartment model (3.3 kg). Two new anthropometric equations were developed, both of which used the four-compartment model as the reference method. The equation for predicting change in fat mass from week 14 to 37 of pregnancy was as follows: 0.77 (change in weight, kg)+ 0.07 (change in thigh skinfold thickness, mm)-6.13 (r2 = 0.73). The equation for determining fat (kg) at term was as follows: 0.40 (weight at week 37, kg)+ 0.16 (biceps skinfold thickness at week 37, mm) + 0.15 (thigh skinfold thickness at week 37, mm)-0.09 (wrist circumference at week 37. mm)+ 0.10 (prepregnancy weight.kg)-6.56 (r2 = 0.89). Both equations were derived on a randomly selected half of the total sample and validated on the remaining half. Both equations were found to be valid for use in studying pregnant women with different prepregnancy body mass indexes, different gestational weight gains, different ethnicities, and different socioeconomic status.

Does adipose tissue influence bioelectric impedance in obese men and women?

Bioelectric-impedance analysis overestimates fat-free mass in obese people. No clear hypotheses have been presented or tested that explain this effect. This study tested the hypothesis that adipose tissue affects measurements of resistance by using data for whole body and body segment resistance and by using muscle, adipose tissue, and bone volumes from magnetic resonance imaging for 86 overweight and obese men and women (body mass index > 27 kg/m2; age 38.5 +/- 10.2 yr). In multiple-regression analysis, muscle volumes had strong associations with resistance, confirming that the electric currents are conducted primarily in the lean soft tissues. Subcutaneous adipose tissue had a slight but statistically significant effect in women, primarily for the leg, suggesting that adipose tissue can affect measured resistance when the volume of adipose tissue is greater than muscle volume, as may occur in obese women in particular. This resulted in a slight overestimation of fat-free mass (e.g., +3 kg) when a bioelectric-impedance-analysis equation calibrated for nonobese female subjects was applied.

QTc interval (cardiac repolarization): lengthening after meals

Weight reduction, either by dietary or surgical means, is associated with prolongation of the heart rate corrected QT interval (QTc = QT/R-R0.5) and, on occasion, sudden death. Screening subjects with obesity before weight loss for prolonged QTc intervals is an accepted practice, although at present, there are no guidelines for whether subjects should be fasting before electrocardiogram (EKG) evaluation. The aim of this study was to test the hypothesis that EKG QTc interval duration is independent of meal ingestion. The hypothesis was tested in 11 healthy subjects who ingested a 500-kcal formula meal. A small decrease in absolute QT interval and a steady decline in R-R interval were observed for up to 60 minutes after formula ingestion. The QTc interval increased above baseline at 15 minutes (p < 0.007) after meal, a change that persisted for the 1-hour postmeal observation period. Spectral analysis of EKG R-R intervals (low-/high-frequency amplitude ratio) indicated a change in cardiac autonomic flow after meal ingestion. The QTc interval did not lengthen and R-R low-/high-frequency amplitude ratio remained unchanged in eight subjects evaluated in a similar manner but in whom isovolumic amounts of water replaced the meal. These observations suggest that (1) cardiac repolarization changes with fasting and feeding, (2) the QTc interval is influenced by meal intake, and (3) the autonomic nervous system may play a role in meal-related QTc changes. These findings have implications for the evaluation of patients with obesity before starting and during weight loss treatment.

Body fat and water changes during pregnancy in women with different body weight and weight gain

OBJECTIVE

To determine the fat deposited during pregnancy in women gaining according to recommendations of the Institute of Medicine and the relationship of weight gain to fat gain in women of different starting weights (classified by their body mass index).

METHODS

A cohort study of healthy, nonsmoking women, 18-36 years of age, identified during prenatal visits at three hospital clinics and one birthing center in New York City. From a pool of 432 eligible volunteers who signed a consent form, body composition measurements were performed on 200 women at weeks 14 (+/-2) and 37+ of pregnancy, and bone mineral mass was measured at 2-4 weeks postpartum. Body fat was estimated with a model that used total body water, weight, and density and bone mineral mass.

RESULTS

In women gaining as recommended by the Institute of Medicine, fat gains during pregnancy for women underweight, normal weight, overweight, or obese before pregnancy were 6.0 +/- 2.6 kg, 3.8 +/- 3.4 kg, 3.5 +/- 4.1 kg, and -0.6 +/- 4.6 kg, respectively. Higher weight gain increased fat gain. Body water gain was not different among the four prepregnancy weight groups.

CONCLUSION

Recommended weight gain should not cause obesity in any weight group. Underweight women will normalize their body composition if they gain as recommended, whereas obese women will have little or no change in body fat. A majority of women do not gain as recommended during pregnancy.

Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects

Given that resting metabolic rate (RMR) is related largely to the amount of fat-free mass (FFM), the hypothesis was that strength training, which stimulates muscle hypertrophy, would help preserve both FFM and RMR during dieting. In a randomized controlled intervention trial, moderately obese subjects (aged 19-48 y) were assigned to one of three groups: diet plus strength training, diet plus aerobic training, or diet only. Sixty-five subjects (25 men and 40 women) completed the study. They received a formula diet with an energy content of 70% of RMR or 5150 +/- 1070 kJ/d (x +/- SD) during the 8-wk intervention. They were seen weekly for individual nutritional counseling. Subjects in the two exercise groups, designed to be isoenergetic, trained three times per week under supervision. Those in the strength-training group performed progressive weight-resistance exercises for the upper and lower body. Those in the aerobic group performed alternate leg and arm cycling. After 8 wk, the mean amount of weight lost, 9.0 kg, did not differ significantly among groups. The strength-training group, however, lost significantly less FFM (P < 0.05) than the aerobic and diet-only groups. The strength-training group also showed significant increases (P < 0.05) in anthropometrically measured flexed arm muscle mass and grip strength. Mean RMR declined significantly, without differing among groups. Peak oxygen consumption increased the most for the aerobic group (P = 0.03). In conclusion, strength training significantly reduced the loss of FFM during dieting but did not prevent the decline in RMR.

New electrode system for rapid whole-body and segmental bioimpedance assessment

Skeletal muscle is a clinically important body composition component which at present is difficult to quantify in vivo. Previous studies suggest that measured appendicular resistance at 50 kHz can be used to predict extremity skeletal muscle mass, although accurate technician placement of multiple gel electrodes is required. In the present study we developed a new bioimpedance analysis (BIA) electrode stand designed for rapid whole-body and segmental resistance and reactance measurements. The new system incorporates stainless steel hand and foot contact electrodes in place of gel electrodes and employs a previously reported lead placement algorithm for deriving extremity resistances without the need for placing conventional proximal limb gel electrodes. This report describes the new electrode system's design and examines the relationships between contact and gel electrode-measured resistance and between appendicular resistance measured with the recently reported lead placement algorithm and conventionally placed segmental electrodes. Results in healthy adults demonstrate high correlations between contact and gel electrodes (e.g., hand-to-hand, N = 12, r = 0.994, P < 0.001) and between segmental resistance measured by the recently reported approach and conventionally-measured segmental resistance (e.g., right arm, N = 13; r = 0.997, P < 0.001). These results strongly support the validity of the new electrode system's resistance measurements and suggests the feasibility of developing a BIA system for rapidly measuring extremity skeletal muscle mass.