Anthropometric measurements in the elderly of Havana, Cuba: Age and sex differences

Waist-to-Height Ratio: A Sensitive Tool for Assessing the Need for Nutritional Risk Management in Elderly Populations from Brazil

INTRODUCTION

Nutritional status assessment commonly relies on body mass index (BMI), which overlooks lean mass and adipose tissue distribution. However, waist circumference (WC) and waist-to-height ratio (WHtR) provide additional insights into fat accumulation. By combining these indices, it may be possible to identify older adults needing weight management interventions.

OBJECTIVES

To assess the WC and WHtR as strategies for identifying individuals requiring weight management.

METHODS

A cross-sectional study was conducted with 509 elderly individuals in Northeast Brazil. Weight, height, hip circumference, and waist circumference were measured, and combined with indices such as BMI WC, WHR, and WHtR to identify those who require weight management. The DeLong test compared areas under the curves using receiver operating characteristic curves and statistical significance. Sensitivity, specificity, and positive and negative predictive values were calculated to verify usefulness for clinical application. A validation sample of 599 elderly individuals from the country's Southern region was used to confirm the results.

RESULTS

Both WC and WHtR showed adequate diagnostic accuracy with no statistically significant difference in AUCs. WHtR ≥ 0.50 had 92% sensitivity in identifying men and women requiring nutritional management. WC presented lower sensitivity but 93% specificity, useful for excluding elderly individuals from the nutritional risk category. These results were consistent in the validation sample.

CONCLUSION

WHtR is a valuable index for screening nutritional risk management in the elderly population, applicable to men and women. Conversely, WC performs better in excluding individuals who do not need nutritional risk management.

Anthropometry as a readily accessible health assessment of older adults

Anthropometry (derived from the Greek Anthropos: human, and metron: measure) refers to the systematic collection, and measurement of the physical characteristics of the human body, primarily body weight, body size, and shape. Anthropometric values are closely related to genetic factors, environmental characteristics, social, and cultural conditions, lifestyle, functional status, and health. Anthropometric measurements can be used to assess risk of malnutrition, obesity, muscle wasting, increased fat mass, and maldistribution of adipose tissue. Potential modifiable factors include circumferences, skinfolds, and body weight. While are height, and the bone diameters are non-modifiable. Kinanthropometry is the study of size, shape, proportionality, composition, biological maturation, and body function, in order to understand the process of growth, exercise, sports performance, and nutrition. Aging of the population, which is associated with increased risk of chronic disease, and disability, is one of the most important demographic changes facing many countries. Anthropometric indicators are simple, portable, non-invasive, inexpensive, and easily applied measurements that can be readily applied in geriatric populations to guide preventative measures, and medical interventions in older adults.

Interpopulation Similarity of Sex and Age-Related Body Composition Variations Among Older Adults

The aim of the study was to analyze sex and age-related body composition variations among older adults from the Brazilian, Italian, and Mexican population. A cross-sectional analysis was conducted in 1103 community-dwelling older adults (634 women and 469 men), aged 60 to 89 years, living in Brazil (n = 176), Italy (n = 554), and Mexico (n = 373). Anthropometric measurements were taken, BMI was calculated, and impedance measurements were obtained (resistance, R, reactance, Xc). Specific bioelectrical impedance vector analysis (specific BIVA) was applied, with the specific vector defined by impedance, or vector length (Z = (Rsp² + Xcsp)^0.5), and phase angle (PA = arctan Xc/R 180/π). Population, sex, and age differences in anthropometric and bioelectrical variables were evaluated by means of a two way ANOVA. The mean bioelectrical vectors were graphed by confidence ellipses and statistically compared by the Hotelling's T² test. The three population groups showed differences in body mass and composition (p < 0.001): the Brazilian sample was characterized by greater body dimensions, longer vectors (higher relative content of fat mass), and lower phase angles (lower skeletal muscle mass). Men were taller and heavier than women (p < 0.001) but had a similar BMI (p = 0.102). They also had higher phase angle (higher skeletal muscle mass) (p < 0.001) and lower vector length (lower %FM) (p < 0.001). In the three population groups, the oldest individuals showed lower anthropometric and phase angle values with respect to the youngest ones (p < 0.001), whereas the vector length did not change significantly with age (p = 0.665). Despite the differences between sexes and among populations, the trend of age-related variations was similar in the Brazilian, Italian, and Mexican older adults.

Osteosarcopenic obesity, the coexistence of osteoporosis, sarcopenia and obesity and consequences in the quality of life in older adults ≥65 years-old in Greece

OBJECTIVE

We investigated the coexistence of sarcopenia and obesity in older adults≥65 years diagnosed with osteoporosis and the association with Quality of Life (QoL).

METHODS

A Cross-sectional survey has been performed on a randomized sample of 50 diagnosed osteoporotic elderly people from both sexes (Men=16; Women=34).

MEASUREMENTS

Quantitative ultrasound was conducted to identify osteoporosis and defined with a T score ≤2.5. Validated anthropometric equations were used in order to estimate body fat percentage and skeletal muscle mass so as to detect the reallocation of body fat and lean muscle. 10m gait speed and hand grip strength was measured in order to diagnose sarcopenia according to European Society for Clinical Nutrition and Metabolism (ESPEN) algorithm. The evaluation of QoL was conducted using a QoL questionnaire specific to osteoporosis. The data were analyzed with descriptive statistics and a chi-square test was performed to examine if Osteosarcopenic Obesity (OSO) is sex related and the correlation between OSO and QoL.

RESULTS

From the 50 participants, 40%(n=19) were classified as people with OSO and 60%(n=31) without OSO. From n=19 people that experienced OSO women represent 20% (n=9) and men 18% (n=9); with the latter had a greater decline in muscle mass than women, while women had lower BMD than men according to the z score. OSO is not related with sex (p>.05) and there is no significant association between OSO and QoL (p> .05 for all the domains of QoL questionnaire).

CONCLUSION

Osteoporosis in the elderly often coexists with reduced muscle mass and muscle strength as well as an increase in adiposity and was independently associated with QoL. People that experience OSO presenting lower functionality that increases the risk for falls and bone fractures originated from the decline in bone and muscle mass, and increased adiposity. Increased awareness of OSO may help develop efficient interventions and public health policies for healthier and more active elderly people.

An anti-inflammatory phenotype in visceral adipose tissue of old lean mice, augmented by exercise

Visceral adipose tissue is an immunogenic tissue, which turns detrimental during obesity by activation of proinflammatory macrophages. During aging, chronic inflammation increases proportional to visceral adipose tissue (VAT) mass and associates with escalating morbidity and mortality. Here, we utilize a mouse model to investigate the inflammatory status of visceral adipose tissue in lean aging mice and assess the effects of exercise training interventions. We randomized adult (11 months; n = 21) and old (23 months; n = 27) mice to resistance training (RT) or endurance training (ET), or to a sedentary control group (S). Strikingly, we observed an anti-inflammatory phenotype in the old mice, consisting of higher accumulation of M2 macrophages and IL-10 expression, compared to the adult mice. In concordance, old mice also had less VAT mass and smaller adipocytes compared to adult mice. In both age groups, exercise training enhanced the anti-inflammatory phenotype and increased PGC1-α mRNA expression. Intriguingly, the brown adipose tissue marker UCP1 was modestly higher in old mice, while remained unchanged by the intervention. In conclusion, in the absence of obesity, visceral adipose tissue possesses a pronounced anti-inflammatory phenotype during aging which is further enhanced by exercise.

Normative hand grip strength and prediction models for Iranian office employees

BACKGROUND

Normative data on Hand grip strength has a wide range of application and is of great value.

OBJECTIVE

To establish gender and age-specific reference data concerning hand grip strength of Iranian office workers, to explore possible relationships with demographic and anthropometric factors and to develop appropriate predictive models.

METHODS

The study population included 418 (220 males and 198 females) Iranian office employees. They were divided into 5-year age-groups. Hand length, palm width, palm length, forearm length, wrist circumference, and forearm circumference were measured by means of a digital Caliper (±0.01 mm) and a tape meter (±0.1 cm). The value of hand grip strength was measured by JAMAR hydraulic dynamometer respecting the American Society of Hand Therapy recommendations.

RESULTS

The average of grip strength for dominant and non-dominant hands (in Kg) respectively was 51.10±9.50 and 46.90±9.89 for male and 28.76±4.47 and 25.89±4.60 for female. Age was curvilinearly related to hand grip strength. All selected hand dimensions were highly correlated with grip strength; palm width, palm length and hand length being the most correlated ones, respectively. Prediction equations of hand grip strength were developed for dominant and non-dominant hands of both genders.

CONCLUSIONS

Suggested norms would provide more accuracy for ergonomic designers as well as health practitioners especially with regards to proposed prediction models with which grip strength could be estimated faster and easier.

Anthropometric Indicators in Hypertriglyceridemia Discrimination: Application as Screening Tools in Older Adults

Background and Purpose: The use of anthropometric indicators as discriminators of hypertriglyceridemia has not been thoroughly investigated. The purpose of this article is to comparatively evaluate anthropometric indicators as discriminators of hypertriglyceridemia in older Brazilian adults. Methods: This cross-sectional study derived from population-based epidemiological research involving 316 community-dwelling older adults (60–105 years old). Results: Except for the conicity index and the body adiposity index in the group of women, all other anthropometric indicators (i.e., body mass index, waist and calf circumferences, triceps skinfold thickness, and waist–stature and waist–hip ratios) were sufficient to identify hypertriglyceridemia in the population. Conclusions: We endorse anthropometric indicators for use in screening for hypertriglyceridemia in older Brazilian adults.

Association of Grip Strength, Upper Arm Circumference, and Waist Circumference with Dementia in Older Adults of the WiSE Study: A Cross-Sectional Analysis

OBJECTIVE

We examined the associations of handgrip strength, upper arm circumference, and waist circumference with dementia among Singapore older adults.

DESIGN

Cross-sectional epidemiological study.

SETTING

Residential homes, day care centres, nursing homes and institutions.

PARTICIPANTS

2,565 men and women aged 60 years and above who participated in the Well-being of the Singapore Elderly (WiSE) study in 2013.

MEASUREMENTS

Socio-demographic correlates, dietary habits, health behaviours, grip strength, upper arm circumference, and waist circumference were collected. Grip strength was measured using a hand dynamometer with the dominant hand. Upper arm circumference was measured using a measuring tape around the thickest part of the upper arm while waist circumference measured in centimetres was measured at the narrowest part of the body between the chest and hips for women, and measured at the level of the umbilicus for men. Dementia was diagnosed using the 10/66 dementia diagnostic criteria.

RESULTS

Mean grip strength was 13.07 kg (SE=0.60) for people with dementia and 21.98 kg (SE=0.26) for people without dementia. After adjusting for all factors, grip strength remained significantly associated with dementia (p <0.0001). Upper arm circumference was associated with dementia (p <0.0001) but this association was only significant in the univariate analysis. Waist circumference was not significantly associated with dementia.

CONCLUSIONS

Lower grip strength was independently associated with dementia in the older adult population in Singapore. Further research needs to be done to ascertain whether this association exists for specific types of dementia and look into the relationship of other anthropometric measurements with dementia in Singapore.

Comparação de medidas antropométricas de idosos residentes em área urbana no sul do Brasil, segundo sexo e faixa etária

OBJETIVO: Comparar o índice de massa corporal (IMC), dobra cutânea tricipital (DCT), perímetro do braço (PB), circunferência muscular do braço (CMB) e área muscular do braço em idosos (AMB), segundo sexo e faixa etária. MÉTODOS: Estudo transversal realizado com idosos residentes na área urbana de Sarandi-PR, selecionados a partir dos setores censitários e domicílios. Os dados foram coletados no período de outubro de 2010 a março de 2011, com verificação de peso, estatura, PB e DCT e após, calculados IMC, CMB e AMB. Os valores obtidos apresentam-se sob a forma de média, desvio-padrão e percentil, com comparação entre os sexos e as faixas etárias. Na análise foram utilizados os testes Qui-quadrado, t Student, ANOVA e Tukey. Diferenças entre os valores médios foram consideradas significativas quando p<0,05. RESULTADOS: Os valores médios do IMC (28,80 x 27,26), DCT (20,93 x 12,52) e PB (31,92 x 30,90) foram significativamente maiores entre as mulheres, enquanto os homens apresentaram valores médios de CMB (26,97 x 25,35) significativamente maiores. A média da AMB também foi maior entre os homens (48,97 x 45,81), mas não de forma significativa. Os valores médios de todas as variáveis diminuíram com o avançar da idade nos dois sexos, com exceção da DCT nos homens. Observou-se, ainda, que a proporção de idosos com obesidade foi significativamente maior entre as mulheres (35,9% x 24,2%). CONCLUSÃO: Mulheres apresentaram valores médios maiores para a maioria das variáveis antropométricas analisadas. A diminuição nos valores dessas variáveis com o avançar da idade nos dois sexos, inclusive de forma mais acentuada nas mulheres, constitui indicativo da necessidade de monitoramento nutricional e de implementação de estratégias que evitem perdas patológicas na composição corporal de idosos.

Female gender is a social determinant of diabetes in the Caribbean: a systematic review and meta-analysis

Background

Diabetes (DM) is estimated to affect 10–15% of the adult population in the Caribbean. Preventive efforts require population wide measures to address its social determinants. We undertook a systematic review to determine current knowledge about the social distribution of diabetes, its risk factors and major complications in the Caribbean. This paper describes our findings on the distribution by gender.

Methods

We searched Medline, Embase and five databases through the Virtual Health Library, for Caribbean studies published between 2007 and 2013 that described the distribution by gender for: known risk factors for Type 2 DM, prevalence of DM, and DM control or complications. PRISMA guidance on reporting systematic reviews on health equity was followed. Only quantitative studies (n>50) were included; each was assessed for risk of bias. Meta-analyses were performed, where appropriate, on studies with a low or medium risk of bias, using random effects models.

Results

We found 50 articles from 27 studies, yielding 118 relationships between gender and the outcomes. Women were more likely to have DM, obesity, be less physically active but less likely to smoke. In meta-analyses of good quality population-based studies odds ratios for women vs. men for DM, obesity and smoking were: 1.65 (95% CI 1.43, 1.91), 3.10 (2.43, 3.94), and 0.24 (0.17, 0.34). Three studies found men more likely to have better glycaemic control but only one achieved statistical significance.

Conclusion and Implications

Female gender is a determinant of DM prevalence in the Caribbean. In the vast majority of world regions women are at a similar or lower risk of type 2 diabetes than men, even when obesity is higher in women. Caribbean female excess of diabetes may be due to a much greater excess of risk factors in women, especially obesity. These findings have major implications for preventive policies and research.

Anthropometric reference data for elderly Swedes and its disease-related pattern

Background/Objectives:

Anthropometric measurement is a noninvasive and cost-efficient method for nutritional assessment. The study aims to present age- and gender-specific anthropometric reference data for Swedish elderly in relation to common medical conditions, and also formulate prediction equations for such anthropometric measurements.

Subjects/Methods:

A cross-sectional study among random heterogeneous sample of 3360 subjects, aged 60–99 years, from a population study ‘Good Aging in Scania. Means (±s.d.) and percentiles for height, weight, waist-, hip-, arm-, calf circumferences, triceps- (TST) and subscapular skinfold thickness (SST), body mass index (BMI), waist-hip ratio (WHR) and arm muscle circumference (AMC) were presented. The values were estimated based on the prevalence of myocardial infarction (MI), cardiac failure (CHF), stroke, cognitive impairment, dementia and dependence in daily living activities (ADL). Linear regression analysis was used to formulate the prediction equations.

Results:

Mean BMI was 27.5±5.8 kg/m² (men) and 27.2±8.1 kg/m² (women). WHR was higher among men (Men: 0.98±0.3, women: 0.87±0.2), except at age 85+ (women: 0.91±0.6). TST was 6.7±0.4 mm higher among women. Men with MI had BMI: 28.6±4.8 kg/m² and SST: 21±9.2 mm, whereas subjects with dementia had lower weight (by 9.5±2.9 kg) compared with the non-demented. ADL-dependent women had BMI= 29.0±3.9 kg/m², TST=19.2±1.3 mm.

Conclusion:

New normative data on gender- and age-specific anthropometrics on the general elderly population are presented. Cardiovascular diseases are associated with subcutaneous and central adiposity opposed to fat loss with dementia. ADL dependence indicates inadequate physical activity. The prediction models could be used as possible indicators monitoring physical activity and adiposity among the general elderly population hence potential health indicators in health promotion.

Association between oxidative stress and nutritional status in the elderly

Ageing is a dynamic and progressive process that is characterized by the occurrence of morphological, biochemical, functional and psychological changes in the organism. The aim of the present article is to provide updated concepts on oxidative stress, covering its importance in aging, as well as nutritional status and supplementation with antioxidants (substances that prevent or attenuate oxidation of oxidizable substrates, such as lipids, proteins, carbohydrates and deoxyribonucleic acid) in the geriatric population. Evidence suggests that there is an inverse relationship between oxidative stress and nutritional status in elderly individuals. Although an increase in oxidative stress in chronic diseases associated with aging has been proven, such as Parkinson's disease and Alzheimer's disease, up to now there has been no consistent clinical evidence proving the efficiency of supplementation with antioxidants against oxidative stress. In this context, supplementation is not recommended. On the other hand, the elderly should be encouraged to eat antioxidant foods, such as fruits and vegetables. Maintaining a normal weight (body mass index between 23 and 28 Kg/m(2)) should also be stimulated.

Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: calf circumference, midarm muscle circumference and walking speed

BACKGROUND/OBJECTIVES

The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors.

SUBJECTS/METHODS

This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS.

RESULTS

A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (<31 cm) and MAMC(<21.1 cm in males, <19.9 cm in females) was 6.7% and 7.3%, respectively. The prevalence of low 4 m WS (≤ 0.8 m/s) was 81.8% (91.3% in females and 72.3% in males, respectively). We compared MAMC, CC and 4 m WS and found that AUC for 4 m WS was the best predictor of sarcopenia.

CONCLUSIONS

An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups.

Perfil antropométrico dos idosos residentes em Campina Grande-PB

O objetivo deste estudo foi descrever o perfil antropométrico dos idosos residentes em Campina Grande - PB. Este estudo é populacional, transversal e domiciliar. Os dados são apresentados sob a forma de média, desvio-padrão e percentil (P5, P10, P25, P50, P75, P90 e P95) do peso, estatura, índice de massa corporal (IMC), perímetro do braço (PB), dobra cutânea tricipital (DCT), circunferência muscular do braço (CMB), perímetro da panturrilha (PP) e perímetro da cintura (PC). Foi realizado o teste t Student para verificar a diferença dos valores médios das variáveis entre os sexos. Foi realizada a análise de variância (ANOVA) para verificar o efeito da idade nas variáveis. Foram avaliados 806 idosos (60 anos ou mais). Os valores médios de todas as variáveis apresentaram diferença estatisticamente significativa entre os sexos. As médias das variáveis peso, estatura, CMB, PP e PC foram significativamente maiores entre os homens, enquanto que as médias de IMC, PB e DCT foram significativamente maiores entre as mulheres. Todas as variáveis apresentaram tendência de declínio entre os grupos etários mais avançados. Os resultados mostram que o padrão antropométrico dos idosos deste estudo segue a tendência de outros estudos, no entanto, os valores diferem. Dessa forma, sugere-se que estes possam ser usados para auxiliar na avaliação antropométrica de idosos.

Anthropometric changes in the Brazilian cohort of older adults: SABE survey (health, well-being, and aging)

The aim of the present study was to analyze the anthropometric changes in a home-based cohort of Brazilian older adults who participated in the SABE Survey, conducted in 2000 and 2006. A total of 1030 men and women were examined by age group: 60-69, 70-79, and ≥80 years. This representative sample consists of the survivors of the 2000 cohort. The following anthropometric variables were assessed: body mass, arm muscle, waist and calf circumferences, triceps skinfold thickness, body mass index, waist-hip ratio, and arm muscle area according to mean values and percentile distribution. Except for body mass and body mass index, a significant difference (P < 0.05) was observed among the assessed anthropometric variables during the follow-up period. The older adults ≥80 years presented the lowest values. The reduction in the mean values of triceps skinfold thickness was greater (30%) than that of waist circumference (9%) and was more pronounced in women (21%) than in men (9%). Arm muscle circumference and area reduced by 8% and 19%, respectively, in men and 1% and 3%, correspondingly, in women. Our findings revealed reductions in the mean values for all anthropometric variables in the follow-up period from 2000 to 2006 among older adults.

Estado nutricional e fatores associados em idosos do Município de Viçosa, Minas Gerais, Brasil

Investigaram-se as prevalências de baixo peso e excesso de peso, bem como os fatores associados em idosos. Trata-se de um estudo transversal, com 621 idosos residentes no Município de Viçosa, Minas Gerais, Brasil, realizado em 2009. As informações foram obtidas por meio de entrevistas domiciliares e se referiam à avaliação do estado nutricional, condições sociodemográficas e de saúde. Do total de pessoas estudadas, 53,3% eram do gênero feminino. A mediana do IMC foi de 26,40kg/m² (mínima 15,20 e máxima 46,82) e foi menor para os homens do que para as mulheres. A prevalência de excesso de peso foi elevada (45%; IC95%: 40%-49%), diminuiu com a idade, associou-se positivamente ao gênero feminino e história de artrite/artrose, e negativamente à faixa etária de 80 anos ou mais e ao tabagismo. A prevalência de baixo peso foi maior no gênero masculino (18,2%), aumentou com o avanço da idade e associou-se positivamente à pior percepção de saúde. O conjunto dos resultados salientam a importância de estratégias em saúde que favoreçam mudanças no estilo de vida e hábitos alimentares saudáveis.

Anthropometric indexes of obesity and hypertension in elderly from Cuba and Barbados

OBJECTIVE

To investigate the association between various anthropometric indexes of obesity with arterial hypertension in elderly from Barbados (Bridgetown) and Cuba (Havana).

DESIGN

Cross-sectional data were extracted from the Survey on Health, Aging and Well being in Latin America and the Caribbean (SABE).

SAMPLE SIZE

In Bridgetown and Havana, respectively, 1508 and 1905 subjects ( ≥ 60 years) were examined, and were selected by a controlled sampling design.

MEASUREMENTS

The occurrence of hypertension was assessed by self-report. Multiple measurements of adiposity were used including body mass index (BMI ≥ 28 kg/m(2)), waist hip ratio (WHR = > 0.95 men; > 0.80 women), waist to height ratio (W/ht. = > 0.50) and waist circumference - WC(L) ( > 88 cm, women; > 102 cm, men) e WC(OK) ( > 90.3 cm, women; > 91.3 cm, men). Binary logistic regression analyses (Odds Ratio) were used to measure strengths of relationships.

RESULTS

In the elderly of Bridgetown, the final design (adjusted for age, education, race, smoking, regular physical activity and diabetes) shows that, in men, WC(OK) and W/Ht were associated with hypertension, and in women, WCL and WCOK were the indexes associated. In the Cuban elderly, the final design shows that, with the exception of WHR, all indicators were associated with hypertension. WCOK and W/ht were the indexes most strongly associated with the outcome.

CONCLUSION

The explanatory power of anthropometric indicators when determining the outcome differed between men and women, as well as between cultural groups living in relative proximity (Barbadians and Cubans).