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Alemán-Mateo H, López-Teros MT, Pallaro AN, Márquez C, Guzmán EMQ, Ramírez-Zea M, Sánchez MED, Umpiérrez E, Moirano M, Badaloo A, O'Donnell AR, Murphy-Alford AJ, Ferrioli E. Assessment of the performance of the body mass index in diagnosing obesity in community-dwelling older adults in Latin American and Caribbean countries. Arch Gerontol Geriatr 2024; 116:105170. [PMID: 37659347 DOI: 10.1016/j.archger.2023.105170] [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: 06/24/2023] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND The body mass index (BMI) ≥30 kg/m2 is the universally accepted cut-off point for defining obesity; however, its accuracy in classifying obesity in older adults is poorly understood. OBJECTIVES To assess the performance of the BMI cut-off point ≥30 kg/m2 in classifying obesity in older adults, using the fat mass index (FMI) and fat mass percentage (FM%) as reference criteria; and to establish region- and sex-specific BMI-based cut-off points to classify obesity in older adults. METHODS The present study is a secondary analysis derived from a cross-sectional project that included a sample of 1463 older adults from ten Latin American and Caribbean countries. Volunteers underwent total body water measurements using the deuterium dilution technique to determine FMI and FM%. Accuracy of the BMI and derived cutoff points was assessed by the area under the receiver operating characteristic curve (AUC). RESULTS The BMI cut-off point ≥30 kg/m2 had low sensitivity for classifying obesity in these older adults compared to the FMI and FM%. The AUC values for the optimal BMI-derived cut-off points showed an acceptable-to-outstanding discriminatory capacity in diagnosing obesity defined by the FMI. There was also a better balance between sensitivity and specificity than with the values obtained by a BMI ≥30 kg/m2 in older subjects in both regions. CONCLUSION The BMI cut-off point ≥30 kg/m2 had poor sensitivity for accurately diagnosing obesity in older adults from two regions. The region- and sex-specific BMI-derived cut-off points for defining obesity using the FMI are more accurate in classifying obesity in older men and women subjects from both regions.
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Affiliation(s)
- Heliodoro Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo (CIAD), A.C., Carretera Gustavo Enrique Astiazarán Rosas, No. 46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México.
| | - Miriam T López-Teros
- Departamento de Salud, Universidad Iberoamericana, Ciudad de México, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, C.P. 01219, Ciudad de México, Distrito Federal, México
| | - Anabel Nora Pallaro
- Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junin 956, 2 piso 1113 Buenos Aires, Argentina
| | - Carlos Márquez
- Instituto de Nutrición y Tecnología de los Alimentos. El Libano 5724 Casilla 138-11, Santiago, Chile
| | - Eugenia María Quintana Guzmán
- Facultad de Microbiología, Universidad de Costa Rica, Ciudad Universitaria Rodrigo Facio, San Pedro, Montes de Oca San José, Costa Rica
| | - Manuel Ramírez-Zea
- Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - María Elena Díaz Sánchez
- Centro de Nutrición e Higiene de los Alimentos, Instituto Nacional de Higiene, Epidemiología y Microbiología, Ministerio de Salud Pública, Apartado Postal Habana 3, Infanta 1158 e/Clavel y Llinás. La Habana 10300, Cuba
| | - Eleuterio Umpiérrez
- Unidad de Medio Ambiente, Drogas y Doping, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Av. General Aparicio Saravia S/N, By pass Ruta 8 y Ruta 101, Pando, Canelones, Uruguay
| | - Marina Moirano
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni s/n. Montevideo, Uruguay
| | - Asha Badaloo
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston 7, Jamaica
| | - Ada Rodriguez O'Donnell
- Servicio de Bioquímica, Instituto Nacional de Salud del Niño. Av. Brasil 600, Breña 15083, Perú
| | - Alexia J Murphy-Alford
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Eduardo Ferrioli
- Department of Internal Medicine, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
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González-Arellanes R, Urquidez-Romero R, Rodríguez-Tadeo A, Esparza-Romero J, Méndez-Estrada RO, Ramírez-López E, Robles-Sardin AE, Pacheco-Moreno BI, Alemán-Mateo H. Agreement between laboratory methods and the 4-compartment model in assessing fat mass in obese older Hispanic-American adults. Clin Nutr 2021; 40:3592-3600. [PMID: 33419614 DOI: 10.1016/j.clnu.2020.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/02/2020] [Accepted: 12/16/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES Densitometry (Siri's and Brožek's equations), hydrometry (by the deuterium dilution technique), and dual-energy X-ray absorptiometry (DXA) are three methods for estimating body composition. However, because they are all based on certain assumptions, they may not be applicable to aged and obese subjects due to changes in their body composition. Hence, the validity of these "laboratory methods" could be affected in obese older people. The main aim was to assess the agreement between densitometry, hydrometry, and DXA with the 4-compartment (4C) model to estimate fat mass (FM) in obese older Hispanic-American adults. As secondary goals, we explored whether the bias in densitometry and hydrometry results could be improved by modifying the assumptions regarding fat-free mass (FFM) density and hydration factor (HF) values, respectively. In the case of DXA, we explored the factors that contribute to bias. SUBJECTS/METHODS This is a cross-sectional study based on a sample of 171 obese subjects aged ≥60 years from 3 regions of northern Mexico. Body composition was assessed by the 4C model as the reference method and by all three laboratory methods. Agreement of the latter with the 4C model was probed by Bland and Altman analysis, a paired sample t-test, and simple linear regression analyses. In addition, the mean FFM density estimated in this sample, and HF values (published previously) of 0.737 and 0.753 for obese older Hispanic-American men and women, respectively, were considered as ethnic- and gender-specific values. These values were used to modify the densitometric and hydrometric equations in order to improve their bias. Finally, we tested whether the hydration status and indirect markers of adiposity are contributing factors to the bias of DXA using multiple linear regression analysis. RESULTS Siri's equation overestimated FM by 0.57 kg (p < 0.01), while Brožek's equation, hydrometry, and DXA underestimated it by 1.24 kg, 0.89 kg, and 0.79 kg (p < 0.01), respectively, compared to the 4C model. The bias in the densitometry and hydrometry results was eliminated by substituting the ethnic- and gender-specific values into the equations. Finally, we found that hip circumference contributes to the bias in DXA. CONCLUSION The densitometry, hydrometry, and DXA methods are not interchangeable with the 4C model for assessing fat mass in obese, older Hispanic-American adults. The lack of agreement could indicate that the assumptions of each method do not apply to this population.
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Affiliation(s)
- Rogelio González-Arellanes
- Centro de Investigación en Alimentación y Desarrollo, A.C. Coordinación de Nutrición, Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México
| | - Rene Urquidez-Romero
- Universidad Autónoma de Ciudad Juárez, Instituto de Ciencias Biomédicas, Departamento de Ciencias de la Salud. Ave. Plutarco Elías Calles #1210, Col. Fovissste Chamizal, C.P. 32310, Ciudad Juárez, Chihuahua, México
| | - Alejandra Rodríguez-Tadeo
- Universidad Autónoma de Ciudad Juárez, Instituto de Ciencias Biomédicas, Departamento de Ciencias de la Salud. Ave. Plutarco Elías Calles #1210, Col. Fovissste Chamizal, C.P. 32310, Ciudad Juárez, Chihuahua, México
| | - Julián Esparza-Romero
- Centro de Investigación en Alimentación y Desarrollo, A.C. Coordinación de Nutrición, Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México
| | - Rosa Olivia Méndez-Estrada
- Centro de Investigación en Alimentación y Desarrollo, A.C. Coordinación de Nutrición, Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México
| | - Erik Ramírez-López
- Universidad Autónoma de Nuevo León, Facultad de Salud Pública y Nutrición. Ave. Dr. Eduardo Aguirre Pequeño #905, Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, México
| | - Alma Elizabeth Robles-Sardin
- Centro de Investigación en Alimentación y Desarrollo, A.C. Coordinación de Nutrición, Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México
| | - Bertha Isabel Pacheco-Moreno
- Centro de Investigación en Alimentación y Desarrollo, A.C. Coordinación de Nutrición, Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México
| | - Heliodoro Alemán-Mateo
- Centro de Investigación en Alimentación y Desarrollo, A.C. Coordinación de Nutrición, Carretera Gustavo Enrique Astiazarán Rosas #46, Col. La Victoria, C.P. 83304, Hermosillo, Sonora, México.
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Ndagire CT, Muyonga JH, Odur B, Nakimbugwe D. Prediction equations for body composition of children and adolescents aged 8-19 years in Uganda using deuterium dilution as the reference technique. Clin Nutr ESPEN 2018; 28:103-109. [PMID: 30390864 DOI: 10.1016/j.clnesp.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 09/11/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Body composition is important as a marker of both current and future health status. Bioelectrical impedance analysis (BIA) is a simple and accurate method for estimating body composition in field, clinical and research settings, if standard protocol procedures are followed. However, BIA requires population-specific equations since applicability of existing equations to diverse populations has been questioned. This study aimed to derive predictive equations for Total Body Water (TBW), Fat Free Mass (FFM) and Fat Mass (FM) determinations with BIA and anthropometric measurements in a population of children and adolescents aged 8-19 years in Uganda. METHODS A cross-sectional study was conducted among 203 children and adolescents aged 8-19 years attending schools in Kampala district (also referred to as Kampala city since the city is conterminous with the district), Uganda through a two-stage cluster sample design. Deuterium dilution method (DDM) was used as the reference measure while BIA and anthropometric measures were used to create the new body composition prediction equations through multivariate regression. RESULTS The new prediction equations explained 88%, 87% and 71% of the variance in TBW, FFM % and of FM respectively with no statistical shrinkage upon cross-validation. The linear regression models proposed in this study were well adjusted with respect to TBW, FFM and FM. Log of TBW obtained by DDM = 0.0129 × Impedance index + 0.0055 × Age + 0.0049 Waist Circumference + 0.1219Ht2 + 2.0388. Log of FFM obtained by DDM = 0.0197 × FFM obtained by BIA - 0.0181 sex code - 0.00055 × Impedance + 3.1761. Log of FM obtained by DDM = 0.0634 × FM obtained by BIA - 0.1881 sex code + 0.0252 × Weight + 0.5273. CONCLUSION The use of these equations for more accurate body composition assessment may facilitate identification of effective intervention strategies to prevent or combat overweight and obesity among children and adolescents. They may also assist in treatment of conditions where more accurate information on body composition measures is required.
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Affiliation(s)
- Catherine T Ndagire
- Department of Food Technology and Nutrition, Makerere University, P.O. Box 7062, Kampala, Uganda.
| | - John H Muyonga
- Department of Food Technology and Nutrition, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Benard Odur
- Department of Statistical Methods and Actuarial Science, School of Statistics, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Dorothy Nakimbugwe
- Department of Food Technology and Nutrition, Makerere University, P.O. Box 7062, Kampala, Uganda
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Shi L, Zheng C, Shen Y, Chen Z, Silveira ES, Zhang L, Wei M, Liu C, de Sena-Tomas C, Targoff K, Min W. Optical imaging of metabolic dynamics in animals. Nat Commun 2018; 9:2995. [PMID: 30082908 PMCID: PMC6079036 DOI: 10.1038/s41467-018-05401-3] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/05/2018] [Indexed: 12/13/2022] Open
Abstract
Direct visualization of metabolic dynamics in living animals with high spatial and temporal resolution is essential to understanding many biological processes. Here we introduce a platform that combines deuterium oxide (D2O) probing with stimulated Raman scattering (DO-SRS) microscopy to image in situ metabolic activities. Enzymatic incorporation of D2O-derived deuterium into macromolecules generates carbon-deuterium (C-D) bonds, which track biosynthesis in tissues and can be imaged by SRS in situ. Within the broad vibrational spectra of C-D bonds, we discover lipid-, protein-, and DNA-specific Raman shifts and develop spectral unmixing methods to obtain C-D signals with macromolecular selectivity. DO-SRS microscopy enables us to probe de novo lipogenesis in animals, image protein biosynthesis without tissue bias, and simultaneously visualize lipid and protein metabolism and reveal their different dynamics. DO-SRS microscopy, being noninvasive, universally applicable, and cost-effective, can be adapted to a broad range of biological systems to study development, tissue homeostasis, aging, and tumor heterogeneity.
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Affiliation(s)
- Lingyan Shi
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Chaogu Zheng
- Department of Biological Sciences, Columbia University, New York, NY, 10027, USA
| | - Yihui Shen
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Zhixing Chen
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | | | - Luyuan Zhang
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Mian Wei
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Chang Liu
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | | | - Kimara Targoff
- Department of Pediatrics, Columbia University, New York, NY, 10027, USA
| | - Wei Min
- Department of Chemistry, Columbia University, New York, NY, 10027, USA.
- Kavli Institute for Brain Science, Columbia University, New York, NY, 10027, USA.
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Tedrus GMAS, Srebernich SM, Santos TBN. Correlation between clinical and cognitive aspects and nutritional indicators of elderly patients with new-onset epilepsy. Epilepsy Behav 2018; 85:105-109. [PMID: 29935414 DOI: 10.1016/j.yebeh.2018.05.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/22/2018] [Accepted: 05/27/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Nutritional indicators were correlated with cognitive and clinical aspects of 25 elderly patients with new-onset epilepsy (EPWE). The nutritional indicators of the EPWE were compared with those of a similar control group at a significance level of p < 0.05. RESULTS There was lower cognitive performance, greater risk of malnutrition and muscle tissue depletion, and higher waist circumference (WC) in the EPWE. Longer epilepsy duration was correlated with loss of muscle mass (Pearson's correlation: 0.433; p = 0.044). Performance in the verbal fluency test, in the clock-drawing test, and in the immediate memory test was negatively associated with body fat. Better performance in the image recognition test was negatively associated with the indicators of muscle reserve. CONCLUSION There was lower cognitive performance, higher risk of malnutrition, and high abdominal obesity in EPWE. Cognitive performance was related to adiposity. Cognitive impairment and longer disease duration are related to increased nutritional risk.
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VALIDITY OF USING WAIST AND HIP CIRCUMFERENCE MEASUREMENTS TO DETERMINE BODY COMPOSITION OF YOUNG SYRIAN MEN. J Biosoc Sci 2016; 48:647-57. [PMID: 26971838 DOI: 10.1017/s0021932015000413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined the relation between waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR) and triceps skin-fold thickness and percentage body fat in young Syrian men. The aim was to develop equations that can use these anthropometric characteristics to estimate percentage body fat in this group of subjects. A total of 2470 healthy Syrian men aged 18-19 years were enrolled in the study in 2010-2011. The anthropometric characteristics of all subjects were measured. The percentage body fat of 213 of the subjects was determined using the deuterium dilution (DD) technique as a reference method. The validity of using WC, HC, WHpR and WHtR to calculate percentage body fat, in comparison with the reference method (DD technique), was assessed by calculating biases and limits of agreement. The estimates of percentage body fat using 'WC' and 'WC with triceps skin-fold' measurements ranged from 13.00±5.56% to 14.55±8.63%, and were lower than those determined using the reference method (21.32±6.42%). A better prediction equation is proposed for young adults, based on a multiple linear regression model using WC, HC and WHtR.
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Accuracy of a predictive bioelectrical impedance analysis equation for estimating appendicular skeletal muscle mass in a non-Caucasian sample of older people. Arch Gerontol Geriatr 2015; 61:39-43. [DOI: 10.1016/j.archger.2015.03.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 03/23/2015] [Accepted: 03/25/2015] [Indexed: 12/20/2022]
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Mijnarends DM, Meijers JM, Halfens RJ, ter Borg S, Luiking YC, Verlaan S, Schoberer D, Cruz Jentoft AJ, van Loon LJ, Schols JM. Validity and Reliability of Tools to Measure Muscle Mass, Strength, and Physical Performance in Community-Dwelling Older People: A Systematic Review. J Am Med Dir Assoc 2013; 14:170-8. [PMID: 23276432 DOI: 10.1016/j.jamda.2012.10.009] [Citation(s) in RCA: 309] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 10/18/2012] [Indexed: 10/27/2022]
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Pfrimer K, Moriguti JC, Lima NKC, Marchini JS, Ferriolli E. Bioelectrical impedance with different equations versus deuterium oxide dilution method for the inference of body composition in healthy older persons. J Nutr Health Aging 2012; 16:124-7. [PMID: 22323345 DOI: 10.1007/s12603-011-0137-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no consensus regarding the accuracy of bioimpedance for the determination of body composition in older persons. OBJECTIVE This study aimed to compare the assessment of lean body mass of healthy older volunteers obtained by the deuterium dilution method (reference) with those obtained by two frequently used bioelectrical impedance formulas and one formula specifically developed for a Latin-American population. DESIGN A cross-sectional study. PARTICIPANTS Twenty one volunteers were studied, 12 women, with mean age 72±6.7 years. SETTING Urban community, Ribeirão Preto, Brazil. MEASUREMENT Fat free mass was determined, simultaneously, by the deuterium dilution method and bioelectrical impedance; results were compared. In bioelectrical impedance, body composition was calculated by the formulas of Deuremberg, Lukaski and Bolonchuck and Valencia et al. RESULTS Lean body mass of the studied volunteers, as determined by bioelectrical impedance was 37.8±9.2 kg by the application of the Lukaski e Bolonchuk formula, 37.4±9.3 kg (Deuremberg) and 43.2±8.9 kg (Valencia et. al.). The results were significantly correlated to those obtained by the deuterium dilution method (41.6±9.3 Kg), with r=0.963, 0.932 and 0.971, respectively. Lean body mass obtained by the Valencia formula was the most accurate. CONCLUSION In this study, lean body mass of older persons obtained by the bioelectrical impedance method showed good correlation with the values obtained by the deuterium dilution method. The formula of Valencia et al., developed for a Latin-American population, showed the best accuracy.
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Affiliation(s)
- K Pfrimer
- Division of Nutrition and Metabolism, Universidade de São Paulo, Avenida Bandeirantes, 3900, 14049-900 - Ribeirão Preto - SP, Brasil.
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Lifestyle risk factors and cardiovascular disease in cubans and cuban americans. Cardiol Res Pract 2011; 2012:470705. [PMID: 22203917 PMCID: PMC3235660 DOI: 10.1155/2012/470705] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 10/14/2011] [Indexed: 11/18/2022] Open
Abstract
Cardiovascular disease is the leading cause of mortality in Cuba. Lifestyle risk factors for coronary heart disease (CHD) in Cubans have not been compared to risk factors in Cuban Americans. Articles spanning the last 20 years were reviewed. The data on Cuban Americans are largely based on the Hispanic Health and Nutrition Examination Survey (HHANES), 1982–1984, while more recent data on epidemiological trends in Cuba are available. The prevalence of obesity and type 2 diabetes mellitus remains greater in Cuban Americans than in Cubans. However, dietary preferences, low physical activity, and tobacco use are contributing to the rising rates of obesity, type 2 diabetes mellitus, and CHD in Cuba, putting Cubans at increased cardiovascular risk. Comprehensive national strategies for cardiovascular prevention that address these modifiable lifestyle risk factors are necessary to address the increasing threat to public health in Cuba.
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Kim H, Kim CH, Kim DW, Park M, Park HS, Min SS, Han SH, Yee JY, Chung S, Kim C. External cross-validation of bioelectrical impedance analysis for the assessment of body composition in Korean adults. Nutr Res Pract 2011; 5:246-52. [PMID: 21779529 PMCID: PMC3133758 DOI: 10.4162/nrp.2011.5.3.246] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 06/14/2011] [Accepted: 06/14/2011] [Indexed: 11/10/2022] Open
Abstract
Bioelectrical impedance analysis (BIA) models must be validated against a reference method in a representative population sample before they can be accepted as accurate and applicable. The purpose of this study was to compare the eight-electrode BIA method with DEXA as a reference method in the assessment of body composition in Korean adults and to investigate the predictive accuracy and applicability of the eight-electrode BIA model. A total of 174 apparently healthy adults participated. The study was designed as a cross-sectional study. FM, %fat, and FFM were estimated by an eight-electrode BIA model and were measured by DEXA. Correlations between BIA_%fat and DEXA_%fat were 0.956 for men and 0.960 for women with a total error of 2.1%fat in men and 2.3%fat in women. The mean difference between BIA_%fat and DEXA_%fat was small but significant (P < 0.05), which resulted in an overestimation of 1.2 ± 2.2%fat (95% CI: -3.2-6.2%fat) in men and an underestimation of -2.0 ± 2.4%fat (95% CI: -2.3-7.1%fat) in women. In the Bland-Altman analysis, the %fat of 86.3% of men was accurately estimated and the %fat of 66.0% of women was accurately estimated to within 3.5%fat. The BIA had good agreement for prediction of %fat in Korean adults. However, the eight-electrode BIA had small, but systemic, errors of %fat in the predictive accuracy for individual estimation. The total errors led to an overestimation of %fat in lean men and an underestimation of %fat in obese women.
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Affiliation(s)
- Hyeoijin Kim
- Measurement and evaluation in sports science, Soonchunhyang University, Chungman 336-745, Korea
| | - Chul-Hyun Kim
- Department of Physiology and Biophysics, Antiaging Research Center, School of Medicine, Eulji University, 143-5, Yogdu-dong, Chung-gu, Daejeon 301-832, Korea
| | - Dong-Won Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul 133-792, Korea
| | - Mira Park
- Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon 301-832, Korea
| | - Hye Soon Park
- Department of Family Medicine, Asan Medical Center, Seoul 138-736, Korea
| | - Sun-Seek Min
- Department of Physiology and Biophysics, Antiaging Research Center, School of Medicine, Eulji University, 143-5, Yogdu-dong, Chung-gu, Daejeon 301-832, Korea
| | - Seung-Ho Han
- Department of Physiology and Biophysics, Antiaging Research Center, School of Medicine, Eulji University, 143-5, Yogdu-dong, Chung-gu, Daejeon 301-832, Korea
| | - Jae-Yong Yee
- Department of Physiology and Biophysics, Antiaging Research Center, School of Medicine, Eulji University, 143-5, Yogdu-dong, Chung-gu, Daejeon 301-832, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul 143-729, Korea
| | - Chan Kim
- Department of Physiology and Biophysics, Antiaging Research Center, School of Medicine, Eulji University, 143-5, Yogdu-dong, Chung-gu, Daejeon 301-832, Korea
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Aleman-Mateo H, Rush E, Esparza-Romero J, Ferriolli E, Ramirez-Zea M, Bour A, Yuchingtat G, Ndour R, Mokhtar N, Valencia ME, Schoeller DA. Prediction of fat-free mass by bioelectrical impedance analysis in older adults from developing countries: a cross-validation study using the deuterium dilution method. J Nutr Health Aging 2010; 14:418-26. [PMID: 20617282 DOI: 10.1007/s12603-010-0031-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Several limitations of published bioelectrical impedance analysis (BIA) equations have been reported. The aims were to develop in a multiethnic, elderly population a new prediction equation and cross-validate it along with some published BIA equations for estimating fat-free mass using deuterium oxide dilution as the reference method. DESIGN AND SETTING Cross-sectional study of elderly from five developing countries. METHODS Total body water (TBW) measured by deuterium dilution was used to determine fat-free mass (FFM) in 383 subjects. Anthropometric and BIA variables were also measured. Only 377 subjects were included for the analysis, randomly divided into development and cross-validation groups after stratified by gender. Stepwise model selection was used to generate the model and Bland Altman analysis was used to test agreement. RESULTS FFM = 2.95 - 3.89 (Gender) + 0.514 (Ht2/Z) + 0.090 (Waist) + 0.156 (Body weight). The model fit parameters were an R2, total F-Ratio, and the SEE of 0.88, 314.3, and 3.3, respectively. None of the published BIA equations met the criteria for agreement. The new BIA equation underestimated FFM by just 0.3 kg in the cross-validation sample. The mean of the difference between FFM by TBW and the new BIA equation were not significantly different; 95% of the differences were between the limits of agreement of -6.3 to 6.9 kg of FFM. There was no significant association between the mean of the differences and their averages (r= 0.008 and p= 0.2). CONCLUSIONS This new BIA equation offers a valid option compared with some of the current published BIA equations to estimate FFM in elderly subjects from five developing countries.
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Affiliation(s)
- H Aleman-Mateo
- Departamento de Nutricion y Metabolismo. Coordinacion de Nutricion. Centro de Investigacion en Alimentacion y Desarrollo, A.C. Carretera a La Victoria km. 0.6 Hermosillo, Sonora. Apdo. Postal 1735. C.P. 83000.
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Vilaça KHC, Ferriolli E, Lima NKC, Paula FJA, Moriguti JC. Effect of fluid and food intake on the body composition evaluation of elderly persons. J Nutr Health Aging 2009; 13:183-6. [PMID: 19262949 DOI: 10.1007/s12603-009-0055-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Several studies have shown that liquid and food intake interfere with the evaluation of body composition in adults. However, since there are no reports about this interference in the elderly population, the need to fast for this evaluation may be dispensable. OBJECTIVES The objective of the present study was to assess the influence of liquid and solid food on the measurement of body composition by bioelectrical impedance analysis (BIA) and by dual energy X-ray absorptiometry (DXA). DESIGN Forty-one male volunteers aged 62 to 87 years participated in the study. The subjects were submitted to evaluation of body composition by DXA and BIA under fasting conditions and 1 hour after the ingestion of breakfast (500 ml of orange juice and one 50 g bread roll with butter). RESULTS There was no significant difference in the variables fat-free mass (FFM) or fat mass (FM) between the fasting condition and the evaluation performed 1 hour after the meal as measured by BIA or DXA. There was also no significant difference when the same variables were compared between methods. CONCLUSION In the present study, the ingestion of 500 ml orange juice and of one bread roll with butter by elderly subjects did not affect the results of the parameters of body composition determined by BIA or DXA. Thus, these exams could be performed without the rigor of fasting, often poorly tolerated by the elderly.
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Affiliation(s)
- K H C Vilaça
- Division of General Internal Medicine and Geriatric Medicine, Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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Macias N, Alemán-Mateo H, Esparza-Romero J, Valencia ME. Body fat measurement by bioelectrical impedance and air displacement plethysmography: a cross-validation study to design bioelectrical impedance equations in Mexican adults. Nutr J 2007; 6:18. [PMID: 17697388 PMCID: PMC2020472 DOI: 10.1186/1475-2891-6-18] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Accepted: 08/15/2007] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The study of body composition in specific populations by techniques such as bio-impedance analysis (BIA) requires validation based on standard reference methods. The aim of this study was to develop and cross-validate a predictive equation for bioelectrical impedance using air displacement plethysmography (ADP) as standard method to measure body composition in Mexican adult men and women. METHODS This study included 155 male and female subjects from northern Mexico, 20-50 years of age, from low, middle, and upper income levels. Body composition was measured by ADP. Body weight (BW, kg) and height (Ht, cm) were obtained by standard anthropometric techniques. Resistance, R (ohms) and reactance, Xc (ohms) were also measured. A random-split method was used to obtain two samples: one was used to derive the equation by the "all possible regressions" procedure and was cross-validated in the other sample to test predicted versus measured values of fat-free mass (FFM). RESULTS AND DISCUSSION The final model was: FFM (kg) = 0.7374 * (Ht2 /R) + 0.1763 * (BW) - 0.1773 * (Age) + 0.1198 * (Xc) - 2.4658. R2 was 0.97; the square root of the mean square error (SRMSE) was 1.99 kg, and the pure error (PE) was 2.96. There was no difference between FFM predicted by the new equation (48.57 +/- 10.9 kg) and that measured by ADP (48.43 +/- 11.3 kg). The new equation did not differ from the line of identity, had a high R2 and a low SRMSE, and showed no significant bias (0.87 +/- 2.84 kg). CONCLUSION The new bioelectrical impedance equation based on the two-compartment model (2C) was accurate, precise, and free of bias. This equation can be used to assess body composition and nutritional status in populations similar in anthropometric and physical characteristics to this sample.
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Affiliation(s)
- Nayeli Macias
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Universidad 655, Santa Maria Ahuacatitlan, CP 62508, Cuernavaca, México
| | - Heliodoro Alemán-Mateo
- División de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a la Victoria km, 0.6 Hermosillo, Sonora, Apartado Postal 1735, CP 8300, México
| | - Julián Esparza-Romero
- División de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a la Victoria km, 0.6 Hermosillo, Sonora, Apartado Postal 1735, CP 8300, México
| | - Mauro E Valencia
- División de Nutrición, Centro de Investigación en Alimentación y Desarrollo, A.C. Carretera a la Victoria km, 0.6 Hermosillo, Sonora, Apartado Postal 1735, CP 8300, México
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Alemán-Mateo H, Salazar G, Hernández-Triana M, Valencia ME. Total energy expenditure, resting metabolic rate and physical activity level in free-living rural elderly men and women from Cuba, Chile and México. Eur J Clin Nutr 2006; 60:1258-65. [PMID: 16721397 DOI: 10.1038/sj.ejcn.1602446] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this study was to assess total energy expenditure (TEE), resting metabolic rate (RMR) and physical activity level (PAL), and to estimate energy requirements (ERs) in free-living elderly subjects from Cuba, Chile and Mexico. DESIGN Cross-sectional study designed to estimate ERs. SETTING Rural regions of Cuba, Chile and Mexico. SUBJECTS Forty subjects >60 years old were selected to participate in this study. INTERVENTIONS A dose of doubly labeled water (DLW) was administered and urine samples were collected in the following 12-14 days. From the isotopic analysis, TEE was derived. RMR was measured by indirect calorimetry. RESULTS TEE in Chilean (8.8+/-1.6 MJ/day) and Cuban (8.3+/-1.3 MJ/day) elderly was not different, and was higher for the Mexican group (9.5+/-1.5 MJ/day) (P < 0.0001). RMR was not different between countries. PAL and activity energy expenditure (AEE) were only different between Chile and Mexico (P < 0.002). For the three regions, overall PALs were 1.70+/-0.16 for male and 1.62+/-0.13 for female subjects (P < 0.02), and AEE was 3.05+/-0.66 and 2.27+/-0.66 MJ/day for male and female subjects, respectively (P < 0.001). Predictive equations (MJ/day) were RMR = 1.6447 + 0.05714 x weight (kg) + 0.449 sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.479) and TEE = 3.414 + 0.0795 x weight (kg) + 1.227 x sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.668). CONCLUSIONS There were differences in TEE and PAL owing to sex and region. The average PAL in men was higher than the PAL reported either with factorial approach or with the DLW method in elderly. Predictive ER equations based on RMR and TEE gave very similar results to calculations from the 2004 FAO/WHO/UNU report.
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Affiliation(s)
- H Alemán-Mateo
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, AC (CIAD, AC), Hermosillo, Sonora, México.
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