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Liu X, He M, Li Y. Adult obesity diagnostic tool: A narrative review. Medicine (Baltimore) 2024; 103:e37946. [PMID: 38669386 PMCID: PMC11049696 DOI: 10.1097/md.0000000000037946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Obesity is a complex chronic metabolic disorder characterized by abnormalities in lipid metabolism. Obesity is not only associated with various chronic diseases but also has negative effects on physiological functions such as the cardiovascular, endocrine and immune systems. As a global health problem, the incidence and prevalence of obesity have increased significantly in recent years. Therefore, understanding assessment methods and measurement indicators for obesity is critical for early screening and effective disease control. Current methods for measuring obesity in adult include density calculation, anthropometric measurements, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, computerized imaging, etc. Measurement indicators mainly include weight, hip circumference, waist circumference, neck circumference, skinfold thickness, etc. This paper provides a comprehensive review of the literature to date, summarizes and analyzes various assessment methods and measurement indicators for adult obesity, and provides insights and guidance for the innovation of obesity assessment indicators.
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Affiliation(s)
- Xiaolong Liu
- School of Life & Environmental Sciences, Guilin University of Electronic Technology, Guilin, Guangxi, China
- School of Electronic Engineering and Automation, Guilin University of Electronic Technology, Guilin, Guangxi, China
- Rehabilitation College, Guilin Life and Health Career Technical College, Guilin, Guangxi, China
| | - Mengxiao He
- School of Physical Education and Health, Guilin University, Guilin, Guangxi, China
| | - Yi Li
- School of Physical Education and Health, Guilin University, Guilin, Guangxi, China
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Onishi S, Fukuda A, Matsui M, Ushiro K, Nishikawa T, Asai A, Kim SK, Nishikawa H. Association between the Suita Score and Body Composition in Japanese Adults: A Large Cross-Sectional Study. Nutrients 2023; 15:4816. [PMID: 38004210 PMCID: PMC10674627 DOI: 10.3390/nu15224816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
The purpose of this study was to clarify the relationship between the Suita score (a prediction model for the development of cardiovascular disease) and body composition in Japanese health check-up subjects (6873 men and 8685 women). The Suita score includes 8 items (age, gender, smoking, diabetes, blood pressure, low-density lipoprotein, high-density lipoprotein, and chronic kidney disease). Factors associated with the Suita score within body composition-related parameters (body mass index (BMI), waist circumference (WC), fat mass index, fat-free mass index, fat mass to fat-free mass ratio (F-FF ratio), and water mass index) as assessed by bioelectrical impedance analysis were examined. The mean age of subjects was 54.8 years in men and 52.8 years in women (p < 0.0001). The mean BMI was 23.9 kg/m2 in men and 21.8 kg/m2 in women (p < 0.0001). Diabetes mellitus was found in 1282 subjects (18.7%) among men and 816 subjects (9.4%) among women (p < 0.0001). The mean Suita score was 42.0 in men and 29.6 in women (p < 0.0001). In multivariate analysis, WC (p < 0.0001), F-FF ratio (p < 0.0001), and water mass index (p < 0.0001) were independent factors linked to the Suita score for both genders. In conclusion, body composition can be associated with the Suita score in Japanese adults receiving health check-ups.
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Affiliation(s)
- Saori Onishi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Akira Fukuda
- Health Science Clinic, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Masahiro Matsui
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Kosuke Ushiro
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Tomohiro Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Akira Asai
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
| | - Soo Ki Kim
- Department of Gastroenterology, Kobe Asahi Hospital, Kobe 653-8501, Hyogo, Japan
| | - Hiroki Nishikawa
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan (T.N.)
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Lee JB, Sung BJ, Ko BG, Cho EH, Seo TB. A comparative study on the reliability and validity of body composition results by impedance method measurement device. J Exerc Rehabil 2023; 19:299-308. [PMID: 37928832 PMCID: PMC10622934 DOI: 10.12965/jer.2346404.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
The purpose of this study was to analyze the reliability and validity of the body composition results for each impedance device and use them as primary data for body composition research. Total of 58 participants, including 24 men and 34 women, were recruited. The correlation was analyzed by measuring two repetitive measurements for each device. Dual energy x-ray absorptiometry (DEXA) equipment was used as reference equipment for body composition research. All data were analyzed as IBM SPSS Statistics ver. 25.0, and the validity and reliability were estimated by calculating the timely correlation coefficient. As a result of the study, repeated measurements of the measuring instrument showed high reliability by gender and age, especially in the child age group, with relatively higher reliability than those in their 50s or older. In the validity analysis between DEXA, in the case of the male group, the validity of the fat mass amount was relatively higher than the body fat amount and body fat rate. In the case of the women's group, the validity of the body fat amount and body fat rate was relatively higher than that of the fat mass amount. The company B had the highest validity for body fat rate and body fat amount in both men and women. However, the validity for men's fat mass amount was the lowest. In subsequent studies, it is believed that studies that have expanded the population further and studies targeting special groups such as athletes should be conducted.
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Affiliation(s)
- Jong-Baek Lee
- Center for Sport Science in Gangwon, Chuncheon,
Korea
| | | | | | | | - Tae-Beom Seo
- Department of Kinesiology, College of Natural Science, Jeju National University, Jeju,
Korea
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Cheng E, Kirley J, Cespedes Feliciano EM, Caan BJ. Adiposity and cancer survival: a systematic review and meta-analysis. Cancer Causes Control 2022; 33:1219-1246. [PMID: 35971021 PMCID: PMC10101770 DOI: 10.1007/s10552-022-01613-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 07/07/2022] [Indexed: 10/28/2022]
Abstract
PURPOSE The increasing availability of clinical imaging tests (especially CT and MRI) that directly quantify adipose tissue has led to a rapid increase in studies examining the relationship of visceral, subcutaneous, and overall adiposity to cancer survival. To summarize this emerging body of literature, we conducted a systematic review and meta-analysis of imaging-measured as well as anthropometric proxies for adipose tissue distribution and cancer survival across a wide range of cancer types. METHODS Using keywords related to adiposity, cancer, and survival, we conducted a systematic search of the literature in PubMed and MEDLINE, Embase, and Web of Science Core Collection databases from database inception to 30 June 2021. We used a random-effect method to calculate pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) within each cancer type and tested for heterogeneity using Cochran's Q test and the I2 test. RESULTS We included 203 records for this review, of which 128 records were utilized for quantitative analysis among 10 cancer types: breast, colorectal, gastroesophageal, head and neck, hepatocellular carcinoma, lung, ovarian, pancreatic, prostate, and renal cancer. We found that imaging-measured visceral, subcutaneous, and total adiposity were not significantly associated with increased risk of overall mortality, death from primary cancer, or cancer progression among patients diagnosed with these 10 cancer types; however, we found significant or high heterogeneity for many cancer types. For example, heterogeneity was similarly high when the pooled HRs (95% CI) for overall mortality associated with visceral adiposity were essentially null as in 1.03 (0.55, 1.92; I2 = 58%) for breast, 0.99 (0.81, 1.21; I2 = 71%) for colorectal, versus when they demonstrated a potential increased risk 1.17 (0.85, 1.60; I2 = 78%) for hepatocellular carcinoma and 1.62 (0.90, 2.95; I2 = 84%) for renal cancer. CONCLUSION Greater adiposity at diagnosis (directly measured by imaging) is not associated with worse survival among cancer survivors. However, heterogeneity and other potential limitations were noted across studies, suggesting differences in study design and adiposity measurement approaches, making interpretation of meta-analyses challenging. Future work to standardize imaging measurements and data analyses will strengthen research on the role of adiposity in cancer survival.
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Affiliation(s)
- En Cheng
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Jocelyn Kirley
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | | | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
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Phase Angle and Bio-Impedance Values during the First Year after Delivery in Women with Previous Excessive Gestational Weight Gain: Innovative Data from the Belgian INTER-ACT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147482. [PMID: 34299927 PMCID: PMC8306720 DOI: 10.3390/ijerph18147482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 01/26/2023]
Abstract
Phase angle (PhA) is a body composition parameter that measures changes in the amount and quality of soft tissue. Few studies have explored PhA in pregnancy or postpartum. The aim of this study was to explore the PhA during the first year postpartum in a Belgian cohort using data from the control group of the INTER-ACT study, an intervention trial targeting those with excess gestational weight gain. A secondary aim was to examine associations between PhA and potential explanatory variables. Women aged ≥18 with excessive weight gain in a singleton pregnancy and without a chronic disease were eligible. Data collection included anthropometry as well as demographic and lifestyle questionnaires at 6 weeks, 6 months and 12 months postpartum. Body composition, including PhA, was measured with the Tanita MC780SMA device. Data was analysed using correlation and mixed model analyses. A total of 509 participants (median age 31.2) were included. The median PhA at 6 weeks postpartum was 5.8°. Higher PhA values were seen in multiparous women (p = 0.02) but there was no association with any other lifestyle or demographic factors. PhA values were positively associated with muscle mass and BMI (r = 0.13, p = 0.004 and r = 0.18, p < 0.001) at 6 weeks postpartum. PhA increased slightly in the 12 months postpartum, which was related to a decrease in fat percentage (p = 0.004). Further research in the pregnant/postpartum population is needed to elucidate any links with perinatal or future health outcomes.
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Validation of a new prognostic body composition parameter in cancer patients. Clin Nutr 2021; 40:615-623. [DOI: 10.1016/j.clnu.2020.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 05/27/2020] [Accepted: 06/12/2020] [Indexed: 01/11/2023]
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Lara-Pompa NE, Hill S, Williams J, Macdonald S, Fawbert K, Valente J, Kennedy K, Shaw V, Wells JC, Fewtrell M. Use of standardized body composition measurements and malnutrition screening tools to detect malnutrition risk and predict clinical outcomes in children with chronic conditions. Am J Clin Nutr 2020; 112:1456-1467. [PMID: 32520318 DOI: 10.1093/ajcn/nqaa142] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/15/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Better tools are needed to diagnose and identify children at risk of clinical malnutrition. OBJECTIVES We aimed to compare body composition (BC) and malnutrition screening tools (MSTs) for detecting malnutrition on admission; and examine their ability to predict adverse clinical outcomes [increased length of stay (LOS) and complications] in complex pediatric patients. METHODS This was a prospective study in children 5-18 y old admitted to a tertiary pediatric hospital (n = 152). MSTs [Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids)] were completed on admission. Weight, height, and BC [fat mass (FM) and lean mass (LM) by DXA] were measured (n = 118). Anthropometry/BC and MSTs were compared with each other and with clinical outcomes. RESULTS Subjects were significantly shorter with low LM compared to reference data. Depending on the diagnostic criteria used, 3%-17% were classified as malnourished. Agreement between BC/anthropometric parameters and MSTs was poor. STAMP and STRONGkids identified children with low weight, LM, and height. PYMS, and to a lesser degree STRONGkids, identified children with increased LOS, as did LM compared with weight or height. Patients with complications had lower mean ± SD LM SD scores (-1.38 ± 1.03 compared with -0.74 ± 1.40, P < 0.05). In multivariable models, PYMS high risk and low LM were independent predictors of increased LOS (OR: 3.76; 95% CI: 1.36, 10.35 and OR: 3.69; 95% CI: 1.24, 10.98, respectively). BMI did not predict increased LOS or complications. CONCLUSIONS LM appears better than weight and height for predicting adverse clinical outcomes in this population. BMI was a poor diagnostic parameter. MSTs performed differently in associations to BC/anthropometry and clinical outcomes. PYMS and LM provided complementary information regarding LOS. Studies on specific patient populations may further clarify the use of these tools and measurements.
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Affiliation(s)
- Nara E Lara-Pompa
- Childhood Nutrition Research Centre, University College London Great Ormond St Institute of Child Health, London, United Kingdom
| | - Susan Hill
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Jane Williams
- Childhood Nutrition Research Centre, University College London Great Ormond St Institute of Child Health, London, United Kingdom
| | - Sarah Macdonald
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Katherine Fawbert
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Jane Valente
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Kathy Kennedy
- Childhood Nutrition Research Centre, University College London Great Ormond St Institute of Child Health, London, United Kingdom
| | - Vanessa Shaw
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, University College London Great Ormond St Institute of Child Health, London, United Kingdom
| | - Mary Fewtrell
- Childhood Nutrition Research Centre, University College London Great Ormond St Institute of Child Health, London, United Kingdom
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Hetherington-Rauth M, Baptista F, Sardinha LB. BIA-assessed cellular hydration and muscle performance in youth, adults, and older adults. Clin Nutr 2019; 39:2624-2630. [PMID: 31837838 DOI: 10.1016/j.clnu.2019.11.040] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/06/2019] [Accepted: 11/20/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Alterations in body hydration can have an impact on muscle performance, with consequences not only at a sporting level, but on overall health and daily functional competence. Given that the estimation of body water from BIA is based on prediction equations involving assumptions on tissue hydration and body geometry, it is unclear if phase angle (PhA), which is not influenced by assumptions, is a better marker of muscle performance than the BIA estimated parameters of body water. Therefore, the aims of this investigation were to analyze the relationships of BIA-estimated body water compartments with muscle performance among youth, adults, and older adults, and to assess the added value of PhA as a marker of muscle performance. METHODS BIA assessments were completed on 263 youth (ages 6-17), 249 adults (ages 18-64), and 75 older adults (ages 65+). Muscle performance was assessed by jumping mechanography (power and force) and handgrip strength. Partial correlations were used to compare the degree of association among the BIA measures with muscle performance for each age group, controlling for sex, age, and body weight. RESULTS TBW, ICW, and PhA were associated with muscle performance at the lower and upper limbs in all age groups (p < 0.05), with the exception of PhA with handgrip strength in adults and older adults and TBW with lower limb total force in the older adults. In youth, the highest associations observed were PhA with lower limb muscle power (r = 0.45, CI:0.35-0.54, p < 0.05) and with handgrip strength (r = 0.42, CI:0.32-0.52, p < 0.05). In adults and older adults, the major associations observed were those of ICW with lower limb muscle power (adults, r = 0.53, CI:0.43-0.61, p < 0.05; older adults, r = 0.52, CI = 0.33-0.67, p < 0.05). ECW had significantly lower associations (p < 0.05) with both lower limb force and power in adults and older adults compared to youth. In the older adults, ECW was negatively associated with lower limb total force (r = -0.24; p < 0.05). CONCLUSIONS BIA derived hydration parameters may be useful markers of muscle performance in all age groups. In particular, the ICW compartment was a better predictor of muscle performance in adults and older adults compared to youth. In youth, PhA had stronger associations with muscle performance than those of ICW. Thus, phase angle appears to be a useful marker of muscle performance, particularly in youth.
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Affiliation(s)
- Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Fátima Baptista
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal.
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González-Víllora S, Sierra-Díaz MJ, Pastor-Vicedo JC, Contreras-Jordán OR. The Way to Increase the Motor and Sport Competence Among Children: The Contextualized Sport Alphabetization Model. Front Physiol 2019; 10:569. [PMID: 31156456 PMCID: PMC6532438 DOI: 10.3389/fphys.2019.00569] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/24/2019] [Indexed: 11/16/2022] Open
Abstract
There is a concern to implement games that will be able to increase the students' motor and sport competence during the sport contents in Physical Education. Some games encompassed in Models-Based Practice (MsBP) are more beneficial for physical and physiological development than others. The main purpose of this study is to compare the degree of physical and physiological performance in several futsal games that have been implemented through two MsBP: the Teaching Games for Understanding (TGfU) and the Contextualized Sport Alphabetization Model (CSAM). The second objective is to analyze the relationship between physical and physiological variables. A quasi-experimental and cross-sectional study with pre- and post-test evaluations had been carried out. The sample was composed of 112 Primary Education students from First to Sixth grade (9.35 ± 1.76 years). Polar Team Pro® technology was implemented to compare and analyze the physical and physiological variables. Data was analyze comparing both models with a two-step cluster model. Afterward, Student's t-test was executed to compare the progression of both models. Besides, two-level multilevel model (MANOVA-ANOVA, followed by MANCOVA- ANCOVA) were also executed by means of applying a 4 versus 4 Small-Sided and Conditioned Game (SSCG). Finally, Pearson correlation between physical and physiological variables was calculated. Results showed that physical and physiological performance was higher in CSAM groups. In this regard, throughout the intervention of both models, results showed significant differences in physical and physiological variables at SSCGs implemented in the CSAM over the games implemented during the TGfU. Additionally, multilevel and MANCOVA post-test analyses shows significant differences in the physical and physiological performance during the post-test 4 vs. 4 SSCG at the CSAM students, in contrast to the TGfU students (p < 0.001). These results demonstrate that both physical (e.g., distance covered) and physiological performance (e.g., Edwards' TRIMP) are significantly higher during CSAM in contrast to TGfU. Moreover, relationship between physical and physiological variables help teachers to adapt sessions to the features of the context.
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Affiliation(s)
- Sixto González-Víllora
- EDAF Group, Didactics of Musical, Plastic and Physical Education Department, Faculty of Education, University of Castilla-La Mancha, Cuenca, Spain
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Innerd P, Harrison R, Coulson M. Using open source accelerometer analysis to assess physical activity and sedentary behaviour in overweight and obese adults. BMC Public Health 2018; 18:543. [PMID: 29685121 PMCID: PMC5914039 DOI: 10.1186/s12889-018-5215-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 02/26/2018] [Indexed: 01/26/2023] Open
Abstract
Background Physical activity and sedentary behaviour are difficult to assess in overweight and obese adults. However, the use of open-source, raw accelerometer data analysis could overcome this. This study compared raw accelerometer and questionnaire-assessed moderate-to-vigorous physical activity (MVPA), walking and sedentary behaviour in normal, overweight and obese adults, and determined the effect of using different methods to categorise overweight and obesity, namely body mass index (BMI), bioelectrical impedance analysis (BIA) and waist-to-hip ratio (WHR). Methods One hundred twenty adults, aged 24–60 years, wore a raw, tri-axial accelerometer (Actigraph GT3X+), for 3 days and completed a physical activity questionnaire (IPAQ-S). We used open-source accelerometer analyses to estimate MVPA, walking and sedentary behaviour from a single raw accelerometer signal. Accelerometer and questionnaire-assessed measures were compared in normal, overweight and obese adults categorised using BMI, BIA and WHR. Results Relationships between accelerometer and questionnaire-assessed MVPA (Rs = 0.30 to 0.48) and walking (Rs = 0.43 to 0.58) were stronger in normal and overweight groups whilst sedentary behaviour were modest (Rs = 0.22 to 0.38) in normal, overweight and obese groups. The use of WHR resulted in stronger agreement between the questionnaire and accelerometer than BMI and BIA. Finally, accelerometer data showed stronger associations with BMI, BIA and WHR (Rs = 0.40 to 0.77) than questionnaire data (Rs = 0.24 to 0.37). Conclusions Open-source, raw accelerometer data analysis can be used to estimate MVPA, walking and sedentary behaviour from a single acceleration signal in normal, overweight and obese adults. Our data supports the use of WHR to categorise overweight and obese adults. This evidence helps researchers obtain more accurate measures of physical activity and sedentary behaviour in overweight and obese populations.
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Affiliation(s)
- Paul Innerd
- School of Nursing and Health Sciences, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK.
| | - Rory Harrison
- School of Nursing and Health Sciences, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK
| | - Morc Coulson
- School of Nursing and Health Sciences, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK
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Martinez CH, Diaz AA, Meldrum CA, McDonald MLN, Murray S, Kinney GL, Hokanson JE, Curtis JL, Bowler RP, Han MK, Washko GR. Handgrip Strength in Chronic Obstructive Pulmonary Disease. Associations with Acute Exacerbations and Body Composition. Ann Am Thorac Soc 2017; 14:1638-1645. [PMID: 29090990 PMCID: PMC5711268 DOI: 10.1513/annalsats.201610-821oc] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/24/2017] [Indexed: 01/26/2023] Open
Abstract
RATIONALE Handgrip strength (HGS) predicts mortality in the elderly, but its determinants and clinical significance in chronic obstructive pulmonary disease (COPD) has not been defined. OBJECTIVES We tested associations of HGS with pectoralis muscle area (PMA), subcutaneous adipose tissue (SAT), imaging characteristics, and lung function in smokers with COPD, and evaluated the cross-sectional and longitudinal associations of HGS with acute respiratory events. METHODS We analyzed demographic, clinical, spirometry, HGS, and imaging data of 272 subjects with COPD, obtaining measures of airway thickness, emphysema, PMA, and SAT from chest computed tomography scans. We tested associations of lung function and imaging characteristics with HGS, using linear models. HGS association to acute respiratory events at enrollment and during follow-up (mean, 2.6 years) was analyzed using adjusted logistic models. RESULTS HGS correlated with PMA, SAT, forced expiratory volume, and airway thickness, but not with body mass index or emphysema severity. In adjusted regression models, HGS was directly (β, 1.5; 95% confidence interval [CI], 0.1-3.0) and inversely (β, -3.3; 95% CI, -5.1 to -0.9) associated with one standard deviation of PMA and SAT, respectively, independent of body mass index and emphysema. In regression models adjusted for age, sex, body mass index, race, pack-years smoked, current smoking, chronic bronchitis, FEV1% predicted, emphysema, and airway metrics, HGS was associated with exacerbation risk; in cross-sectional analyses, there was an increment of 5% in the risk of exacerbations for each 1-kg decrement in HGS (risk ratio, 1.05; 95% CI, 1.01-1.08), and there was a similar risk during follow-up (risk ratio, 1.04; 95% CI, 1.01-1,07). CONCLUSIONS In ever-smokers with COPD, HGS is associated with computed tomography markers of body composition and airway thickness, independent of body mass index and emphysema. Higher HGS is associated with lower exacerbation frequency.
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Affiliation(s)
- Carlos H. Martinez
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Catherine A. Meldrum
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | - Merry-Lynn N. McDonald
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susan Murray
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | | | - John E. Hokanson
- School of Public Health, University of Colorado, Aurora, Colorado
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and
| | - Jeffrey L. Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | - Russell P. Bowler
- Division of Pulmonary Medicine, National Jewish Health, Denver, Colorado
| | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - for the COPDGene Investigators
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan
- Division of Pulmonary and Critical Care Medicine, and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- School of Public Health, University of Michigan, Ann Arbor, Michigan
- School of Public Health, University of Colorado, Aurora, Colorado
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan; and
- Division of Pulmonary Medicine, National Jewish Health, Denver, Colorado
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12
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de Blasio F, Santaniello MG, de Blasio F, Mazzarella G, Bianco A, Lionetti L, Franssen FME, Scalfi L. Raw BIA variables are predictors of muscle strength in patients with chronic obstructive pulmonary disease. Eur J Clin Nutr 2017; 71:1336-1340. [DOI: 10.1038/ejcn.2017.147] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 08/07/2017] [Indexed: 11/09/2022]
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Aristizábal JC, Giraldo A. Comparación de la composición corporal de mujeres jóvenes obtenida por hidrodensitometría y tres técnicas de bioimpedancia. IATREIA 2017. [DOI: 10.17533/udea.iatreia.v30n3a01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14
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Dodds RM, Granic A, Davies K, Kirkwood TBL, Jagger C, Sayer AA. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study. J Cachexia Sarcopenia Muscle 2017; 8:229-237. [PMID: 27897431 PMCID: PMC5377385 DOI: 10.1002/jcsm.12157] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/13/2016] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Recognition that an older person has sarcopenia is important because this condition is linked to a range of adverse outcomes. Sarcopenia becomes increasingly common with age, and yet there are few data concerning its descriptive epidemiology in the very old (aged 85 years and above). Our aims were to describe risk factors for sarcopenia and estimate its prevalence and incidence in a British sample of the very old. METHODS We used data from two waves (2006/07 and 2009/10) of the Newcastle 85+ Study, a cohort born in 1921 and registered with a Newcastle/North Tyneside general practice. We assessed sarcopenia status using the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Grip strength was measured using a Takei digital dynamometer (Takei Scientific Instruments Ltd., Niigata, Japan), gait speed was calculated from the Timed Up and Go test, and lean mass was estimated using a Tanita-305 body fat analyzer. We used logistic regression to examine associations between risk factors for prevalent sarcopenia at baseline and incident sarcopenia at follow-up. RESULTS European Working Group on Sarcopenia in Older People sarcopenia was present in 21% of participants at baseline [149/719 participants, mean age 85.5 (0.4) years]. Many participants had either slow gait speed or weak grip strength (74.3%), and hence measurement of muscle mass was frequently indicated by the EWGSOP definition. Incidence data were available for 302 participants, and the incident rate was 3.7 cases per 100 person years at risk. Low Standardized Mini-Mental State Examination, lower occupational social class, and shorter duration of education were associated with sarcopenia at baseline, while low muscle mass was associated with incident sarcopenia. Low body mass index (BMI) was a risk factor for both in a graded fashion, with each unit decrease associated with increased odds of prevalent [odds ratio (OR) 1.29, 95% confidence interval (CI): 1.21, 1.37] and incident (OR 1.20, 95% CI: 1.08, 1.33) sarcopenia. CONCLUSIONS To our knowledge, this is the first study to describe prevalence and incidence of EWGSOP sarcopenia in the very old. Low BMI was a risk factor for both current and future sarcopenia; indeed, there was some evidence that low BMI may be a reasonable proxy for low lean mass. Overall, the high prevalence of sarcopenia among the very old suggests that this group should be a focus for future research.
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Affiliation(s)
- Richard Matthew Dodds
- Academic Geriatric Medicine, Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDHampshireUK
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
| | - Antoneta Granic
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
| | - Karen Davies
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
| | - Thomas B. L. Kirkwood
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for Cell and Molecular BiosciencesNewcastle UniversityNewcastle upon TyneNE1 7RUTyne and WearUK
| | - Carol Jagger
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneTyne and WearUK
| | - Avan Aihie Sayer
- Academic Geriatric Medicine, Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDHampshireUK
- Ageing Geriatrics and Epidemiology, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- NIHR Newcastle Biomedical Research CentreNewcastle University and Newcastle upon Tyne NHS Foundation TrustNewcastle upon TyneNE4 5PLTyne and WearUK
- Institute for AgeingNewcastle UniversityNewcastle upon TyneNE4 5PLTyne and WearUK
- MRC Lifecourse Epidemiology Unit, Faculty of MedicineUniversity of SouthamptonSouthamptonSO16 6YDHampshireUK
- NIHR Collaboration for Leadership in Applied Health Research and Care WessexUniversity of SouthamptonSouthamptonHamphsireUK
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15
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Azzeh FS, Bukhari HM, Header EA, Ghabashi MA, Al-Mashi SS, Noorwali NM. Trends in overweight or obesity and other anthropometric indices in adults aged 18-60 years in western Saudi Arabia. Ann Saudi Med 2017; 37:106-113. [PMID: 28377539 PMCID: PMC6150549 DOI: 10.5144/0256-4947.2017.106] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The prevalence of overweight and obesity has increased considerably in Saudi Arabia in the past two decades. We conducted this study because to examine trends in weight gain with age and related anthropometric measurements in Saudi Arabia such data are limited. OBJECTIVE To determine trends in overweight and obesity and examine anthropometric indices by age group. DESIGN Analytical cross-sectional study. SETTING Universities, malls, and hospitals in the cities of Mecca, Jeddah, and Al-Taif. METHODS Participants were selected by convenience sampling. Body weight, body fat percentage, visceral fat percentage, and skeletal muscle percentage were measured with the Omron body composition monitor device. Waist circumference, height, and body mass index (BMI) were also measured. MAIN OUTCOME MEASURE(S) Changes in BMI, body fat percentage, visceral fat percentage, and skel-etal muscle with age for both genders. RESULTS We selected 2548 Saudis, 1423 males and 1125 females, aged 18 to 60 years. A significant trend (ptrend < .001) for BMI and all anthropometric indices was observed with age for both genders. About 55.1% of the participants were overweight and obese (BMI > 25 kg/m2). Obesity and overweight were more prevalent in men than in women and was observed early in both genders, at the ages of 18-19 in men and 30-39 years for women. In the age range of 40-60 years, muscle mass dropped significantly (P < .05) for both genders. Mean waist circumference and visceral fat were significantly (P < .001) higher in men than in women, but the mean total body fat percentage was higher in females than in males (P < .001). CONCLUSIONS Significant trends were observed for BMI, WC, body fat, visceral fat, and muscle mass for both genders with age. National programs should be maintained to encourage physical activity and weight reduction as well as focusing on obesity-related lifestyle and behaviors at early ages to prevent weight gain and possibly muscle wasting with age. LIMITATIONS There was an unequal distribution in numbers of subjects between study groups. Convenience sampling was used to recruit the participants.
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Affiliation(s)
- Firas Sultan Azzeh
- Prof. Firas Sultan Azzeh, Department of Clinical Nutrition,, Umm Al-Qura University,, Makkah 21955, Saudi Arabia, T: +966-540833661, F: +966-25720000-4227, , ORCID: http://orcid.org/0000-0002-1400-5465
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16
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Staelens AS, Vonck S, Molenberghs G, Malbrain MLNG, Gyselaers W. Maternal body fluid composition in uncomplicated pregnancies and preeclampsia: a bioelectrical impedance analysis. Eur J Obstet Gynecol Reprod Biol 2016; 204:69-73. [PMID: 27525683 DOI: 10.1016/j.ejogrb.2016.07.502] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/15/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Body fluid composition changes during the course of pregnancy and there is evidence to suggest that these changes are different in uncomplicated pregnancies compared to hypertensive pregnancies. The aim of this study was to evaluate the changes in maternal body fluid composition during the course of an uncomplicated pregnancy and to assess differences in uncomplicated pregnancies versus hypertensive pregnancies by using a bio-impedance analysis technique. STUDY DESIGN Body fluid composition of each patient was assessed using a multiple frequency bioelectrical impedance analyser. Measurements were performed in 276 uncomplicated pregnancies, 34 patients with gestational hypertension, 35 with late onset preeclampsia and 11 with early onset preeclampsia. Statistical analysis was performed at nominal level α=0.05. A longitudinal linear mixed model based analysis was performed for longitudinal evolutions, and ANOVA with a post-hoc Bonferroni was used to identify differences between groups. RESULTS Measurements showed that total body water (TBW), intracellular (ICW) and extracellular water (ECW) and ECW/ICW significantly increase during the course of pregnancy. Late onset preeclampsia is associated with a higher TBW and ECW as compared to uncomplicated pregnancies, the ECW/ICW ratio is higher in preeclamptic patients compared to uncomplicated pregnancies and gestational hypertension, and ICW is not different between groups. CONCLUSION Body fluid composition changes differently during the course of uncomplicated pregnancies versus hypertensive pregnancies.
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Affiliation(s)
- Anneleen S Staelens
- Dept. of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium; Dept. of Physiology, Hasselt University, Hasselt, Belgium.
| | - Sharona Vonck
- Dept. of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium; Dept. of Physiology, Hasselt University, Hasselt, Belgium
| | - Geert Molenberghs
- I-BioStat, Hasselt University, Hasselt, Belgium; I-BioStat, University of Leuven, Leuven, Belgium
| | - Manu L N G Malbrain
- Dept. of Intensive Care, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Antwerp, Belgium
| | - Wilfried Gyselaers
- Dept. of Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium; Dept. of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
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17
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Barrea L, Nappi F, Di Somma C, Savanelli MC, Falco A, Balato A, Balato N, Savastano S. Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070743. [PMID: 27455297 PMCID: PMC4962284 DOI: 10.3390/ijerph13070743] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/01/2016] [Accepted: 07/19/2016] [Indexed: 12/16/2022]
Abstract
Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In particular, body weight, nutrition, and diet may exacerbate the clinical manifestations, or even trigger the disease. Understanding the epidemiological relationship between obesity and psoriasis is also important for delineating the risk profile for the obesity-related comorbidities commonly found among psoriatic patients. Moreover, obesity can affect both drug’s pharmacokinetics and pharmacodynamics. Additionally, the overall beneficial effects on the obesity-associated comorbidities, clinical recommendations to reduce weight and to adopt a healthy lifestyle could improve the psoriasis severity, particularly in those patients with moderate to severe disease, thus exerting additional therapeutic effects in the conventional treatment in obese patients with psoriasis. Education regarding modifiable environmental factors is essential in the treatment of this disease and represents one of the primary interventions that can affect the prognosis of patients with psoriasis. The goal is to make psoriatic patients and health care providers aware of beneficial dietary interventions. The aim of this review is to assess the relevance of the environmental factors as modifiable risk factors in psoriasis pathogenesis, with particular regard to the involvement of obesity and nutrition in the management of psoriasis, providing also specific nutrition recommendations.
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Affiliation(s)
| | | | | | | | | | - Anna Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Nicola Balato
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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18
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Earthman CP. Body Composition Tools for Assessment of Adult Malnutrition at the Bedside: A Tutorial on Research Considerations and Clinical Applications. JPEN J Parenter Enteral Nutr 2016; 39:787-822. [PMID: 26287016 DOI: 10.1177/0148607115595227] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Because of the key role played by the body's lean tissue reserves (of which skeletal muscle is a major component) in the response to injury and illness, its maintenance is of central importance to nutrition status. With the recent development of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition diagnostic framework for malnutrition, the loss of muscle mass has been recognized as one of the defining criteria. Objective methods to evaluate muscle loss in individuals with acute and chronic illness are needed. Bioimpedance and ultrasound techniques are currently the best options for the clinical setting; however, additional research is needed to investigate how best to optimize measurements and minimize error and to establish if these techniques (and which specific approaches) can uniquely contribute to the assessment of malnutrition, beyond more subjective evaluation methods. In this tutorial, key concepts and statistical methods used in the validation of bedside methods to assess lean tissue compartments are discussed. Body composition assessment methods that are most widely available for practice and research in the clinical setting are presented, and clinical cases are used to illustrate how the clinician might use bioimpedance and/or ultrasound as a tool to assess nutrition status at the bedside. Future research needs regarding malnutrition assessment are identified.
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Affiliation(s)
- Carrie P Earthman
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St Paul, Minnesota
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19
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Smith S, Madden AM. Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques. J Hum Nutr Diet 2016; 29:714-732. [PMID: 27137882 DOI: 10.1111/jhn.12372] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The accurate and valid assessment of body composition is essential for the diagnostic evaluation of nutritional status, identifying relevant outcome measures, and determining the effectiveness of current and future nutritional interventions. Developments in technology and our understanding of the influences of body composition on risk and outcome will provide practitioners with new opportunities to enhance current practice and to lead future improvements in practice. This is the second of a two-part narrative review that aims to critically evaluate body composition methodology in diverse adult populations, with a primary focus on its use in the assessment and monitoring of under-nutrition. Part one focused on anthropometric variables [Madden and Smith (2016) J Hum Nutr Diet 29: 7-25] and part two focuses on the use of imaging techniques, bioelectrical impedance analysis, markers of muscle strength and functional status, with particular reference to developments relevant to practice.
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Affiliation(s)
- S Smith
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - A M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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20
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Oldroyd B, Robinson M, Lindley E, Rhodes L, Hind K. Resonant cavity perturbation: a promising new method for the assessment of total body water in children. Physiol Meas 2015; 36:2503-17. [PMID: 26535491 DOI: 10.1088/0967-3334/36/12/2503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The accurate measurement of total body water (TBW) in children has important clinical and nutritional applications. Resonant cavity perturbation (RCP) is a new method for estimating TBW. This method measures the dielectric properties of the body which are related to body water. For RCP measurements, each subject lay supine on a bed inside a screened room which acts as a resonant cavity. A network analyser measures the frequencies of two low-order cavity resonances of the room, with electric-field vectors that were respectively vertical and horizontal, the resonant frequency shifts relative to the empty room are then derived. These frequency shifts correlates with TBW. The aims of this present study were to (a) develop TBW(RCP) predictive equations for children using TBWdil as the criterion method, (b) cross-validate the derived equations, (c) determine precision of the TBW(RCP) method, and (d) compare the criterion method TBWdil with three methods of estimating TBW: RCP, MFBIS and anthropometry.Predictive equations, independent of sex, were developed with linear regression in a group of 36 children. The relationship between combined RCP frequency shifts and TBWdilution had an r2 = 0.90 and standard error of the estimate (SEE) =1.42 kg. Multiple regression analysis, that included a term for body mass index, only had a small effect on r2 = 0.93 and SEE = 1.25 kg. In vivo TBW precision for the vertical, horizontal and combined frequency modes ranged from 0.7 to 3.4%. Bland-Altman analysis indicated close agreement between the criterion method TBWdil and the three other methods of TBW estimation. Mean differences were TBW(RCP(2)) = 0.01 ± /- 1.34 kg, TBW(MFBIS) = 0.45 ± /- 1.35 kg, TBWAnthropometry = 0.29 ± /- 1.29 kg.Currently the RCP method does not significantly improve the prediction of TBW compared to MFBIS and anthropometry in this initial study. However the derived equation was independent of sex and body size had only a small effect.
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Affiliation(s)
- Brian Oldroyd
- Carnegie Research Institute, Leeds Beckett University, Headingley Campus, Leeds, LS6 3QS, UK
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21
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Abstract
‘Ageing well’ has been declared a global health priority by the World Health Organisation and the role of sarcopenia and frailty in late-life health is receiving increasing attention. Frailty is the decline in an individual's homeostatic function, strength and physiologic reserves leading to increased vulnerability, while sarcopenia describes the loss of muscle mass and function with age. The conceptual definitions of these conditions have been widely agreed but there is a lack of consensus on how to measure them. We review the different operational definitions described in the literature and the evidence that, whatever definition used, the prevalence and clinical impact of these conditions is high. We also consider the commonality of low physical function to both conditions, a feature which could provide a pragmatic way forward in terms of identifying those at risk. Objective measures of physical function such as usual walking speed are simple and feasible measures, extensively validated against health outcomes. Additionally, clinical applications of sarcopenia and frailty are reviewed with particular consideration to their potential role in the management of older people undergoing surgery. Frailty appears to outperform traditional anaesthetic and surgical risk scores in terms of its association with post-operative complications, length of hospital stay, institutionalisation and mortality. However, even within this sub-specialty area there is wide variation in the approaches used to measure frailty and there is an urgent need for studies to utilise established, validated and reproducible methods to identify sarcopenia and frailty in their study participants, in order to expedite scientific development.
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Amin F, Fatima SS, Islam N, Gilani AH. Prevalence of obesity and overweight, its clinical markers and associated factors in a high risk South-Asian population. BMC OBESITY 2015. [PMID: 26217531 PMCID: PMC4510896 DOI: 10.1186/s40608-015-0044-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Obesity is a global epidemic, which is a risk factor for cardiovascular diseases and metabolic abnormalities. It is measured by body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), body fat (BF) distribution and abdominal fat mass, each having its own merits and limitations. Variability in body composition between ethnic groups in South-Asians is significant and may not be truly reflected by BMI alone, which may result in misclassification. This study therefore, aims to determine the frequency of obesity, body fat composition and distribution, in a high risk population of an urban slum of Karachi, Pakistan. This survey included 451 participants selected by systematic sampling who were administered pre-tested questionnaires on socio-demographics, diet and physical activity. Chi-square was used to determine the association between categorical variables and multiple linear regression was used for quantitative variables. A P value of less than 0.05 was considered significant. Results Classified by BMI, 29% study subjects were overweight and 21% obese (58.7% with central obesity). Body fat percent (BF%) classified 81% as overweight. Females were more obese (P 0.03) with higher prevalence of central obesity (P <0.001) and WHR (P 0.003) but with a lower muscle mass (P 0.001). Activity score and muscle mass showed inverse linear association with BF% whereas, WC, weight, BMI and WHR had a positive linear association with BF%. The relationship between BMI and BF% was quadratic with a weaker association at lower BMI. Adjusting for socio-demographic variables, BF%, weight, diastolic blood pressure (DBP), BMI and score on the diet questionnaire had a positive linear association with WC, while WC, WHR and BP had a positive linear association with BF%. BF%, muscle content and WC had a positive linear association with BMI. Conclusion Considering lower cut-offs for South-Asians BMI and WC, this study showed a high prevalence of obesity among a sub-urban population of Karachi, which was even higher when BF% was measured. Considering the rising prevalence of non-communicable diseases, BF%, WC, WHR and BMI measurements are convenient and feasible means of identifying population at risk and hence addressing it through public awareness and early detection. Electronic supplementary material The online version of this article (doi:10.1186/s40608-015-0044-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Faridah Amin
- Natural Product Research Unit, Department of Biological and Biomedical Sciences, The Aga Khan University Medical College, Karachi, 74800 Pakistan
| | - Syeda Sadia Fatima
- Department of Biological and Biomedical Sciences, The Aga Khan University Medical College, Karachi, 74800 Pakistan
| | - Najmul Islam
- Department of Medicine, The Aga Khan University Medical College, Karachi, 74800 Pakistan
| | - Anwar H Gilani
- Natural Product Research Unit, Department of Biological and Biomedical Sciences, The Aga Khan University Medical College, Karachi, 74800 Pakistan ; College of Health Sciences, Mekelle University, PO Box 1871, Mekelle, Ethiopia
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Sabia S, Cogranne P, van Hees VT, Bell JA, Elbaz A, Kivimaki M, Singh-Manoux A. Physical activity and adiposity markers at older ages: accelerometer vs questionnaire data. J Am Med Dir Assoc 2015; 16:438.e7-13. [PMID: 25752539 PMCID: PMC4417049 DOI: 10.1016/j.jamda.2015.01.086] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/19/2015] [Accepted: 01/19/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Physical activity is critically important for successful aging, but its effect on adiposity markers at older ages is unclear as much of the evidence comes from self-reported data on physical activity. We assessed the associations of questionnaire-assessed and accelerometer-assessed physical activity with adiposity markers in older adults. DESIGN/SETTING/PARTICIPANTS This was a cross-sectional study on 3940 participants (age range 60-83 years) of the Whitehall II study who completed a 20-item physical activity questionnaire and wore a wrist-mounted accelerometer for 9 days in 2012 and 2013. MEASUREMENTS Total physical activity was estimated using metabolic equivalent hours/week for the questionnaire and mean acceleration for the accelerometer. Time spent in moderate-and-vigorous physical activity (MVPA) was also assessed by questionnaire and accelerometer. Adiposity assessment included body mass index, waist circumference, and fat mass index. Fat mass index was calculated as fat mass/height² (kg/m²), with fat mass estimated using bioimpedance. RESULTS Greater total physical activity was associated with lower adiposity for all adiposity markers in a dose-response manner. In men, the strength of this association was 2.4 to 2.8 times stronger with the accelerometer than with questionnaire data. In women, it was 1.9 to 2.3 times stronger. For MVPA, questionnaire data in men suggested no further benefit for adiposity markers past 1 hour/week of activity. This was not the case for accelerometer-assessed MVPA where, for example, compared with men undertaking <1 hour/week of accelerometer-assessed MVPA, waist circumference was 3.06 (95% confidence interval 2.06-4.06) cm lower in those performing MVPA 1-2.5 hours/week, 4.69 (3.47-5.91) cm lower in those undertaking 2.5-4 hours/week, and 7.11 (5.93-8.29) cm lower in those performing ≥4 hours/week. CONCLUSIONS The association of physical activity with adiposity markers in older adults was stronger when physical activity was assessed by accelerometer compared with questionnaire, suggesting that physical activity might be more important for adiposity than previously estimated.
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Affiliation(s)
- Séverine Sabia
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; University Versailles St-Quentin, Boulogne-Billancourt, France.
| | - Pol Cogranne
- INSERM, U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Vincent T van Hees
- MoveLab-Physical Activity and Exercise Research, Institute of Cellular Medicine, Newcastle University, United Kingdom
| | - Joshua A Bell
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Alexis Elbaz
- INSERM, U1018, Center for Research in Epidemiology and Population Health, Villejuif, France; University Paris 11, Villejuif, France
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; University Versailles St-Quentin, Boulogne-Billancourt, France; INSERM, U1018, Center for Research in Epidemiology and Population Health, Villejuif, France; University Paris 11, Villejuif, France; Centre de Gérontologie, Hôpital Ste Périne, AP-HP, France
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Abstract
Sarcopenia, the loss of muscle mass and function with age, is highly relevant to clinical practice as it has been associated with a wide range of ageing outcomes including disability and shorter survival times. As such it is now a major focus for research and drug discovery. There has been recent progress in the development of consensus definitions for the diagnosis of sarcopenia, taking the form of measurements of muscle mass and strength or physical performance. These definitions form potential inclusion criteria for use in trials, although the optimum choice of outcome measures is less clear. Prevalence estimates using these new definitions vary, although they suggest that sarcopenia is a common (approximately 13% from one study) clinical problem in older people. A range of lifestyle factors have been investigated in regard to the development of this condition, and progressive resistance training is the most well-established intervention so far. There is also marked research interest in the role of diet, although so far the value of supplementation is less clear. Other potential treatments for sarcopenia include the angiotensin-converting enzyme inhibitors, with some evidence that they can improve physical performance in older people. Future research directions include an increased understanding of the molecular and cellular mechanisms of sarcopenia and the use of a life course approach to explore the possibility of earlier intervention and prevention.
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Affiliation(s)
- Richard Dodds
- University of Southampton, UK; University of Southampton, UK
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25
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Keevil VL, Hayat S, Dalzell N, Moore S, Bhaniani A, Luben R, Wareham NJ, Khaw KT. The physical capability of community-based men and women from a British cohort: the European Prospective Investigation into Cancer (EPIC)-Norfolk study. BMC Geriatr 2013; 13:93. [PMID: 24020915 PMCID: PMC3846689 DOI: 10.1186/1471-2318-13-93] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 09/02/2013] [Indexed: 11/20/2022] Open
Abstract
Background The European Working Group for Sarcopenia in Older People (EWGSOP) published a case-finding algorithm for sarcopenia, recommending muscle mass measurement in older adults with low grip strength (women <20 kg; men <30 kg) or slow walking speed (≤0.8 m/s). However, the implications of adopting this algorithm into clinical practice are unclear. Therefore, we aimed to explore the physical capability of men and women from a British population-based cohort study. Methods In the European Prospective Investigation into Cancer-Norfolk study, 8,623 community-based adults (48-92 years old) underwent assessment of grip strength, walking speed, timed chair stands and standing balance. The proportion of older men and women (≥65 years) fulfilling EWGSOP criteria for muscle mass measurement was estimated. Additionally, cross-sectional associations of physical capability with age and sex were explored using linear and logistic regression. Results Approximately 1 in 4 older participants (28.8%) fulfilled criteria for muscle mass measurement with a greater proportion of women than men falling below threshold criteria (33.6% versus 23.6%). Even after adjustment for anthropometry, women were 12.4 kg (95% Confidence Interval [CI] 12.0, 12.7) weaker, took 12.0% (95% CI 10.0, 14.0) longer to perform five chair stands and were 1.82 (95% CI 1.48, 2.23) times more likely to be unable to hold a tandem stand for 10 seconds than men, although usual walking speed was similar. Physical capability was inversely associated with age and per year, walking speed decreased by 0.01 m/s (95% CI 0.01, 0.01) and grip strength decreased by 0.49 kg (men; 95% CI 0.46, 0.51) and 0.25 kg (women; 95% CI 0.23, 0.27). Despite this, there was still variation within age-groups and not all older people had low physical capability. Conclusions Every effort to optimise functional health in later life should be made since poor function is not inevitable. However, if the EWGSOP sarcopenia case-finding algorithm is endorsed, large proportions of older people could qualify for muscle mass measurement which is not commonly available. Considering population ageing, further discussion is needed over the utility of muscle mass measurement in clinical practice.
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Affiliation(s)
- Victoria L Keevil
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wort's Causeway, Cambridge CB1 8RN, UK.
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Krachler B, Völgyi E, Savonen K, Tylavsky FA, Alén M, Cheng S. BMI and an anthropometry-based estimate of fat mass percentage are both valid discriminators of cardiometabolic risk: a comparison with DXA and bioimpedance. J Obes 2013; 2013:862514. [PMID: 24455216 PMCID: PMC3886548 DOI: 10.1155/2013/862514] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/03/2013] [Accepted: 11/14/2013] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To determine whether categories of obesity based on BMI and an anthropometry-based estimate of fat mass percentage (FM% equation) have similar discriminative ability for markers of cardiometabolic risk as measurements of FM% by dual-energy X-ray absorptiometry (DXA) or bioimpedance analysis (BIA). DESIGN AND METHODS A study of 40-79-year-old male (n = 205) and female (n = 388) Finns. Weight, height, blood pressure, triacylglycerols, HDL cholesterol, and fasting blood glucose were measured. Body composition was assessed by DXA and BIA and a FM%-equation. RESULTS For grade 1 hypertension, dyslipidaemia, and impaired fasting glucose >6.1 mmol/L, the categories of obesity as defined by BMI and the FM% equation had 1.9% to 3.7% (P < 0.01) higher discriminative power compared to DXA. For grade 2 hypertension the FM% equation discriminated 1.2% (P = 0.05) lower than DXA and 2.8% (P < 0.01) lower than BIA. Receiver operation characteristics confirmed BIA as best predictor of grade 2 hypertension and the FM% equation as best predictor of grade 1 hypertension. All other differences in area under curve were small (≤0.04) and 95% confidence intervals included 0. CONCLUSIONS Both BMI and FM% equations may predict cardiometabolic risk with similar discriminative ability as FM% measured by DXA or BIA.
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Affiliation(s)
- Benno Krachler
- Department of Health Sciences, University of Jyväskylä, P.O. BOX 35 (L), 40014 Jyväskylä, Finland
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, 901 85 Umeå, Sweden
| | - Eszter Völgyi
- Department of Health Sciences, University of Jyväskylä, P.O. BOX 35 (L), 40014 Jyväskylä, Finland
- Department of Preventive Medicine, University of TN Health Science Center, Memphis, Tennessee 38163, USA
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, 70211 Kuopio, Finland
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of TN Health Science Center, Memphis, Tennessee 38163, USA
| | - Markku Alén
- Department of Medical Rehabilitation, Oulu University Hospital and Institute of Health Sciences, University of Oulu, 90029 Oulu, Finland
| | - Sulin Cheng
- Department of Health Sciences, University of Jyväskylä, P.O. BOX 35 (L), 40014 Jyväskylä, Finland
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- *Sulin Cheng:
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