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Grigoletto A, Mauro M, Oppio A, Greco G, Fischetti F, Cataldi S, Toselli S. Effects of Nordic Walking Training on Anthropometric, Body Composition and Functional Parameters in the Middle-Aged Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127433. [PMID: 35742680 PMCID: PMC9224194 DOI: 10.3390/ijerph19127433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022]
Abstract
Nordic walking (NW) is an easy physical exercise that is usually proposed for clinical populations and for the elderly. The aim of the present study was to examine the effects of a period of NW training in a non-clinical middle-aged population on anthropometric, body composition and functional parameters. A pre-test/post-test study design was conducted on 77 participants: 56 women (72.7%, age 55.53 ± 9.73 years) and 21 men (27.3%, age 60.51 ± 8.15 years). The measurements were carried out with physical tests at the baseline and at the follow up. Participants did two weekly NW training sessions of about 60 min each. A questionnaire was administered to evaluate their feelings after the training period. Paired Students' test was carried out to evaluate the pre-post differences, and the analysis of variance was performed to evaluate the questionnaire. Participants had significantly less stress and anxiety after the NW training. Body fat parameters showed a significant decrease, especially for women. Phase angle and strength of lower body presented a significant increase in both sexes after the training period. In conclusion, NW shows many potential benefits also for the nonclinical population and could be an important exercise to remain active and to maintain a good health condition.
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Affiliation(s)
- Alessia Grigoletto
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (A.G.); (S.T.)
| | - Mario Mauro
- Department of Life Quality Studies, University of Bologna, 47921 Rimini, Italy;
| | - Alberto Oppio
- School of Pharmacy, Biotechnology and sport Science, University of Bologna, 40126 Bologna, Italy;
| | - Gianpiero Greco
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy;
- Correspondence: (G.G.); (F.F.)
| | - Francesco Fischetti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy;
- Correspondence: (G.G.); (F.F.)
| | - Stefania Cataldi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Study of Bari, 70124 Bari, Italy;
| | - Stefania Toselli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (A.G.); (S.T.)
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Vanzella LM, Lawand R, Shuaib M, Oh P, Corbett D, Marzolini S. Validity of Bioelectric Impedance in Relation to Dual-Energy X-Ray Absorptiometry for Measuring Baseline and Change in Body Composition After an Exercise Program in Stroke. J Strength Cond Res 2022; 36:3273-3279. [DOI: 10.1519/jsc.0000000000004287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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3
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Kiefer LS, Fabian J, Rospleszcz S, Lorbeer R, Machann J, Kraus MS, Fischer M, Roemer F, Rathmann W, Meisinger C, Heier M, Nikolaou K, Peters A, Storz C, Schlett CL, Bamberg F. Population-based cohort imaging: skeletal muscle mass by magnetic resonance imaging in correlation to bioelectrical-impedance analysis. J Cachexia Sarcopenia Muscle 2022; 13:976-986. [PMID: 35080141 PMCID: PMC8977960 DOI: 10.1002/jcsm.12913] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 11/12/2021] [Accepted: 12/06/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Skeletal muscle mass is subjected to constant changes and is considered a good predictor for outcome in various diseases. Bioelectrical-impedance analysis (BIA) and magnetic resonance imaging (MRI) are approved methodologies for its assessment. However, muscle mass estimations by BIA may be influenced by excess intramuscular lipids and adipose tissue in obesity. The objective of this study was to evaluate the feasibility of quantitative assessment of skeletal muscle mass by MRI as compared with BIA. METHODS Subjects from a population-based cohort underwent BIA (50 kHz, 0.8 mA) and whole-body MRI including chemical-shift encoded MRI (six echo times). Abdominal muscle mass by MRI was quantified as total and fat-free cross-sectional area by a standardized manual segmentation-algorithm and normalized to subjects' body height2 (abdominal muscle mass indices: AMMIMRI ). RESULTS Among 335 included subjects (56.3 ± 9.1 years, 56.1% male), 95 (28.4%) were obese (BMI ≥ 30 kg/m2 ). MRI-based and BIA-based measures of muscle mass were strongly correlated, particularly in non-obese subjects [r < 0.74 in non-obese (P < 0.001) vs. r < 0.56 in obese (P < 0.001)]. Median AMMITotal(MRI) was significantly higher in obese as compared with non-obese subjects (3246.7 ± 606.1 mm2 /m2 vs. 2839.0 ± 535.8 mm2 /m2 , P < 0.001, respectively), whereas the ratio AMMIFat-free /AMMITotal (by MRI) was significantly higher in non-obese individuals (59.3 ± 10.1% vs. 53.5 ± 10.6%, P < 0.001, respectively). No significant difference was found regarding AMMIFat-free(MRI) (P = 0.424). In analyses adjusted for age and sex, impaired glucose tolerance and measures of obesity were significantly and positively associated with AMMITotal(MRI) and significantly and inversely with the ratio AMMIFat-free(MRI) /AMMITotal(MRI) (P < 0.001). CONCLUSIONS MRI-based assessment of muscle mass is feasible in population-based imaging and strongly correlated with BIA. However, the observed weaker correlation in obese subjects may explain the known limitation of BIA in obesity and promote MRI-based assessments. Thus, skeletal muscle mass parameters by MRI may serve as practical imaging biomarkers independent of subjects' body weight.
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Affiliation(s)
- Lena S Kiefer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Jana Fabian
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Susanne Rospleszcz
- Department of Epidemiology, Ludwig-Maximilians-University München, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.,German Centre for Cardiovascular Research (DZHK e.V.), Munich, Germany
| | - Jürgen Machann
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases (IDM), Helmholtz Center Munich, University of Tuebingen, Tuebingen, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Mareen S Kraus
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Marc Fischer
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany.,Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Frank Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.,Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Wolfgang Rathmann
- German Center for Diabetes Research (DZD), Neuherberg, Germany.,Institute for Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany
| | - Christa Meisinger
- Chair of Epidemiology, Ludwig-Maximilians-University München, UNIKA-T Augsburg, Augsburg, Germany.,Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,KORA Study Centre, University Hospital Augsburg, Augsburg, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Annette Peters
- Department of Epidemiology, Ludwig-Maximilians-University München, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,German Centre for Cardiovascular Research (DZHK e.V.), Munich, Germany.,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Corinna Storz
- Department of Neuroradiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Sinaga M, Sinaga Teshome M, Yemane T, Tegene E, Lindtsrom D, Belachew T. Ethnic Specific body fat percent prediction equation as surrogate marker of obesity in Ethiopian adults. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:17. [PMID: 33836830 PMCID: PMC8033699 DOI: 10.1186/s41043-021-00224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Application of advanced body composition measurement methods is not practical in developing countries context due to cost and unavailability of facilities. This study generated ethnic specific body fat percent prediction equation for Ethiopian adults using appropriate data. METHODS A cross-sectional study was carried ifrom February to April 2015 among 704 randomly selected adult employees of Jimma University. Ethnic specific Ethiopian body fat percent (BF%) prediction equation was developed using a multivariable linear regression model with measured BF% as dependent variable and age, sex, and body mass index as predictor variables. Agreement between fat percent measured using air displacement plethysmography and body fat percent estimated using Caucasian prediction equations was determined using Bland Altman plot. RESULTS Comparison of ADP measured and predicted BF% showed that Caucasian prediction equation underestimated body fat percent among Ethiopian adults by 6.78% (P < 0.0001). This finding is consistent across all age groups and ethnicities in both sexes. Bland Altman plot did not show agreement between ADP and Caucasian prediction equation (mean difference = 6.7825) and some of the points are outside 95% confidence interval. The caucasian prediction equation significantly underestimates body fat percent in Ethiopian adults, which is consistent across all ethnic groups in the sample. The study developed Ethnic specific BF% prediction equations for Ethiopian adults. CONCLUSION The Caucasian prediction equation significantly underestimates body fat percent among Ethiopian adults regardless of ethnicity. Ethiopian ethnic-specific prediction equation can be used as a very simple, cheap, and cost-effective alternative for estimating body fat percent among Ethiopian adults for health care provision in the prevention of obesity and related morbidities and for research purposes.
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Affiliation(s)
- Makeda Sinaga
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Melese Sinaga Teshome
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tilhun Yemane
- Department of Laboratory and Biomedical Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Elsah Tegene
- Department of Internal Medicine, Faculty of Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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5
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Sinaga M, Teshome MS, Lindstrom D, Belachew T. Development and validation of body fat percent prediction equation for screening obesity in adults. Clin Nutr ESPEN 2021; 43:487-494. [PMID: 34024559 DOI: 10.1016/j.clnesp.2021.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/11/2021] [Accepted: 02/20/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND In Ethiopia, use of advanced body composition measurement methods may not be feasible due cost and unavailability of the facilities. This study developed and validated body fat percent prediction equation for adults using locally appropriate data. METHODS The study was conducted from February to April 2015 among 704 randomly selected adult employees of Jimma University. The total sample was spilt and randomly assigned to a training (n = 352) sample used for developing Ethiopian body fat percent (BF%) prediction equation and a testing (validation) sample (n = 352) used for determining the validity of the equation. A multivariable linear regression model was used to develop BF% prediction equation on the training sample using Air displacement Plethysmography (ADP) measured BF% as dependent variable and age, sex and body mass index as predictor variables. For the testing (validation) sample, BF% measured using ADP and the one predicted using the newly developed Ethiopian and Caucasian BF% prediction equations were compared using validity measures, Kappa statistics and agreement between the two measures was determined using Bland Altman plot. RESULTS A multivariable linear regression model run on the testing population showed that age, sex and BMI were significant predictors of ADP measured BF%. Accordingly, the BF% prediction equation of Ethiopian adults was generated as follows: BF% = -8.601 + BMI (1.521) + Age (0.243) + Sex (-10.568), where sex = 1 for males and 0 for females. Comparison of measured and predicted BF% showed that there was no significant (P = 0.932) difference between ADP measured BF% and BF% predicted using Ethiopian equation with a mean (±SD) difference of 0.03 (±5.44). Conversely, there was a significant difference (<0.0001) between ADP measured BF% and the Caucasian Equation estimated BF% with a mean (±SD) of 6.83 (±5.57). In both males and females, the Ethiopian equation demonstrated a very good to excellent sensitivity, specificity, positive predictive value and negative predictive values. Conversely, the Caucasian equation had poor sensitivity and negative predictive values, while it demonstrated an excellent specificity and positive predictive value. Likewise, there was a substantial Kappa agreement for males (K = 0.741) and for females (K = 0.720) between Ethiopian equation and ADP in diagnosing obesity among males based on BF%, while there was a slight Kappa agreement for males (K = 0.156) and a fair Kappa agreement for females (K = 0.365) between Caucasian equation and ADP (P < 0.001). Bland Altman plot showed a good agreement between ADP measured BF% for the Ethiopian Equation and not for the Caucasian equation. It was observed that the Ethiopian equation has a better prediction of BF% when compared to the measured one, but the Caucasian equation consistently underestimated BF% for all samples with different levels BF%. CONCLUSION The new Ethiopian BF% prediction equation performed very well in predicting BF% in the testing population in terms of validity measures, Kappa agreement and Bland Altman plot; while the Caucasian equation significantly underestimated body fat percent among Ethiopian adults. The results imply that the new Ethiopian equation can be used as a cost effective and user friendly screening method for early detection of obesity for the prevention of associated morbidity and mortality in Ethiopian adults.
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Affiliation(s)
- Makeda Sinaga
- Department of Nutrition and Dietetics, Jimma University, Po. Box 378, Jimma, Ethiopia.
| | - Melese Sinaga Teshome
- Department of Nutrition and Dietetics, Jimma University, Po. Box 378, Jimma, Ethiopia.
| | - David Lindstrom
- Population Studies Centre, Brown University, Providence, USA.
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Po. Box 378, Jimma, Ethiopia.
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Orsso CE, Silva MIB, Gonzalez MC, Rubin DA, Heymsfield SB, Prado CM, Haqq AM. Assessment of body composition in pediatric overweight and obesity: A systematic review of the reliability and validity of common techniques. Obes Rev 2020; 21:e13041. [PMID: 32374499 DOI: 10.1111/obr.13041] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/05/2020] [Accepted: 04/16/2020] [Indexed: 01/13/2023]
Abstract
Accurate measurement of body composition is required to improve health outcomes in children and adolescents with overweight or obesity. This systematic review aimed to summarize the reliability and validity of field and laboratory body composition techniques employed in pediatric obesity studies to facilitate technique selection for research and clinical practice implementation. A systematic search in MEDLINE (via PubMed), EMBASE, CINAHL, and SPORTDiscus from inception up to December 2019 was conducted, using a combination of the following concepts: body composition, pediatric overweight/obesity, and reliability/validity. The search strategy resulted in 66 eligible articles reporting reliability (19.7%), agreement between body composition techniques cross sectionally (80.3%), and/or diagnostic test accuracy (10.6%) in children and adolescents with overweight or obesity (mean age range = 7.0-16.5 years). Skinfolds, air-displacement plethysmography (ADP), dual-energy X-ray absorptiometry (DXA), and ultrasound presented as reliable techniques. DXA, ADP, and isotope dilution showed similar and the best agreement with reference standards. Compared with these laboratory techniques, the validity of estimating body composition by anthropometric equations, skinfolds, and BIA was inferior. In conclusion, the assessment of body composition by laboratory techniques cannot be replaced by field techniques due to introduction of measurement errors, which potentially conceal actual changes in body components.
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Affiliation(s)
- Camila E Orsso
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Maria Ines B Silva
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.,Department of Applied Nutrition, Nutrition School, Federal University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.,Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
| | - Daniela A Rubin
- Department of Kinesiology, California State University, Fullerton, California, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Andrea M Haqq
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.,Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Courville AB, Yang SB, Andrus S, Hayat N, Kuemmerle A, Leahy E, Briker S, Zambell K, Chung S, Sumner AE. Body adiposity measured by bioelectrical impedance is an alternative to dual-energy x-ray absorptiometry in black Africans: The Africans in America Study. Nutrition 2020; 74:110733. [PMID: 32179385 DOI: 10.1016/j.nut.2020.110733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/02/2020] [Accepted: 01/09/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The prevalence of cardiometabolic disease has risen in Africa and parallels the obesity epidemic. To assess cardiometabolic risk, body composition measurements by dual-energy X-ray absorptiometry (DXA) are ideal. In communities with limited resources, alternative measures may be useful but have not been compared extensively in black Africans. Therefore, the aim of this study was to identify alternative methods of body composition assessment, such as body adiposity index (BAI) and bioelectrical impedance analysis (BIA), for use in African-born blacks. METHODS This was a cross-sectional study with African-born blacks. BAI and five BIA predictive equations (using variations of height, weight, age, sex, and impedance) were compared with DXA to estimate percent fat. Participants were 266 African-born blacks (39 ± 10 y, body mass index 28 ± 4 kg/m2, and 68% men) living in metropolitan Washington DC. Equivalence (90% confidence interval, -3 to 3), concordance, and Bland-Altman analyses (bias <2%, R2 closest to zero) compared BAI or BIA predictive equations to DXA as the criterion method. RESULTS DXA percent fat was 27.2% ± 5.5% and 40.3% ± 6.9% in men and women, respectively. BAI underestimated percent fat in men (bias: 1.88 ± 4.71, R2 = 0.25, P < 0.001) and women (bias: 6.47 ± 4.94, R2 = 0.08, P = 0.01). Of the five BIA predictive equations, the equation reported by Sun et al. had the best agreement with DXA percent fat for men (bias: -0.91 ± 3.67, R2 = 0.02, P = 0.05) and women (bias: -0.92 ± 4.02, R2 = 0.003, P = 0.58). Percent fat from the Sun et al. equation best agreed with DXA percent fat. CONCLUSION BIA with the Sun et al. predictive equation was the best alternative to DXA for body fat assessment in African-born blacks.
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Affiliation(s)
- Amber B Courville
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA.
| | - Shanna B Yang
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA
| | - Sarah Andrus
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA
| | - Nosheen Hayat
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA
| | - Anneliese Kuemmerle
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA
| | - Elizabeth Leahy
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA
| | - Sara Briker
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Kirsten Zambell
- National Institutes of Health, Clinical Center, Nutrition Department, Bethesda, Maryland, USA
| | - Stephanie Chung
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Anne E Sumner
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA; National Institutes of Health, National Institute of Minority Health, Bethesda, Maryland, USA
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van Zyl A, White Z, Ferreira J, Wenhold FAM. Developing an Impedance Based Equation for Fat-Free Mass of Black Preadolescent South African Children. Nutrients 2019; 11:nu11092021. [PMID: 31466343 PMCID: PMC6769520 DOI: 10.3390/nu11092021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/10/2019] [Accepted: 08/27/2019] [Indexed: 12/01/2022] Open
Abstract
Bioelectrical impedance analysis (BIA) is a practical alternative to dual-energy X-ray absorptiometry (DXA) for determining body composition in children. Currently, there are no population specific equations available for predicting fat-free mass (FFM) in South African populations. We determined agreement between fat-free mass measured by DXA (FFMDXA) and FFM calculated from published multi-frequency bioelectrical impedance prediction equations (FFMBIA); and developed a new equation for predicting FFM for preadolescent black South African children. Cross-sectional data on a convenience sample of 84 children (mean age 8.5 ± 1.4 years; 44 {52%} girls) included body composition assessed using Dual X-ray Absorptiometry (FFMDXA) and impedance values obtained from the Seca mBCA 514 Medical Body Composition analyzer used to calculate FFM using 17 published prediction equations (FFMBIA). Only two equations yielded FFM estimates that were similar to the DXA readings (p > 0.05). According to the Bland–Altman analysis, the mean differences in FFM (kg) were 0.15 (LOA: −2.68; 2.37) and 0.01 (LOA: −2.68; 2.66). Our new prediction equation, FFM=105.20+0.807×Sex+0.174×Weight+0.01×Reactance+15.71×log(RI), yielded an adjusted R2 = 0.9544. No statistical shrinkage was observed during cross-validation. A new equation enables the BIA-based prediction of FFM in the assessment of preadolescent black South African children.
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Affiliation(s)
- Amanda van Zyl
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
| | - Zelda White
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa.
| | - Johan Ferreira
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa
| | - Friedeburg A M Wenhold
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
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Quadri M, Ariza AJ, Selvaraj K, Schaller K, Binns HJ. Percent Body Fat Measurement in the Medical Management of Children with Obesity. Pediatr Ann 2018; 47:e487-e493. [PMID: 30543377 DOI: 10.3928/19382359-20181116-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sustaining weight loss can be challenging, as physiological responses to weight loss, including metabolic and hormonal adaptations and decreased energy expenditure, promote weight regain. Paired with sustained dietary changes, physical activity can promote weight maintenance after successful weight loss, as physical activity can help maintain fat-free mass. We present several illustrative cases to highlight the potential use of body composition measurement using a bioelectrical impedance analysis (BIA) scale to augment obesity management counseling in a tertiary care pediatric weight-management clinic. BIA does require some interpretation, as it can be affected by hydration status and time of day, as well as patient age, sex, and body mass index. Nonetheless, BIA can be a helpful aid to obesity counseling. More research is needed to better understand how to use change in percent body fat over time as a motivational tool for management of children with obesity. [Pediatr Ann. 2018;47(12):e487-e493.].
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10
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Dordevic AL, Bonham M, Ghasem-Zadeh A, Evans A, Barber E, Day K, Kwok A, Truby H. Reliability of Compartmental Body Composition Measures in Weight-Stable Adults Using GE iDXA: Implications for Research and Practice. Nutrients 2018; 10:nu10101484. [PMID: 30321991 PMCID: PMC6213248 DOI: 10.3390/nu10101484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/05/2018] [Accepted: 10/10/2018] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to explore the reliability and precision of body compartment measures, in particular visceral adipose tissue, in weight stable adults over a range of BMIs using GE-Lunar iDXA. Weight-stable participants aged 18–65 years had a total body composition scan on GE-Lunar iDXA either on three separate occasions over a three month period (n = 51), or on a single occasion for duplicate scans with repositioning (n = 30). The coefficient of variation (CV%) and least significant change (LSC) of body compartments were calculated. The CV was higher for all measures over three months (range 0.8–5.9%) compared with same-day precision-scans (all < 2%). The CV for visceral adipose tissue (VAT) was considerably higher than all other body compartments (42.2% three months, 16.2% same day scanning). To accurately measure VAT mass using the GE iDXA it is recommended that participants have a BMI ≥ 25 kg/m2, or VAT mass > 500 g. Changes observed in VAT mass levels below 500 g should be interpreted with caution due to lack of precision and reliability. All other compartmental measures demonstrated good reliability, with less than 6% variation over three months.
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Affiliation(s)
- Aimee L Dordevic
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Maxine Bonham
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Ali Ghasem-Zadeh
- Department of Endocrinology, Department of Medicine, Austin Health, the University of Melbourne, West Heidelberg 3081, Australia.
| | - Alison Evans
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Elizabeth Barber
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Kaitlin Day
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Alastair Kwok
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Helen Truby
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
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Ramírez-Vélez R, Tordecilla-Sanders A, Correa-Bautista JE, González-Ruíz K, González-Jiménez E, Triana-Reina HR, García-Hermoso A, Schmidt-RioValle J. Validation of multi-frequency bioelectrical impedance analysis versus dual-energy X-ray absorptiometry to measure body fat percentage in overweight/obese Colombian adults. Am J Hum Biol 2017; 30. [PMID: 28987018 DOI: 10.1002/ajhb.23071] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/20/2017] [Accepted: 09/24/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To verify the validity of multi-frequency bioelectrical impedance analysis (mBCA) for predicting body fat percentage (BF%) in overweight/obese adults using dual-energy X-ray absorptiometry (DXA) as the reference method. METHODS Forty-eight adults participated (54% women, mean age = 41.0 ± 7.3 years old). The Pearson's correlation coefficient was used to evaluate the correlation between BIA and BF% assessed by DXA. The concordance between BF% measured by both methods was obtained with Lin's concordance correlation coefficient and Bland-Altman difference plots. RESULTS Measures of BF% were estimated as 39.0 (SD = 6.1) and 38.3 (SD = 6.5) using DXA and mBCA, respectively. The Pearson's correlation coefficient reflected a strong correlation (r =.921, P = .001). The paired t-test showed a significant mean difference between these methods for obese men BF% of -0.6 [(SD 1.95; 95% CI = -4.0 to 3.0), P =.037]. Overall, the bias of the mBCA was -0.6 [(SD 2.2; 95% CI = -5.0 to 3.7), P =.041], which indicated that the mBCA method significantly underestimated BF% in comparison to the reference method. Finally, in both genders, Lin's concordance correlation coefficient showed a strong agreement. More specifically the DXA value was ρc = 0.943 (95% CI = 0.775 to 0.950) and the mBCA value was ρc = 0.948 (95% CI = 0.778 to 0.978). CONCLUSIONS Our analysis showed a strong agreement between the two methods as reflected in the range of BF%. These results show that mBCA and DXA are comparable methods for measuring body composition with higher body fat percentages. However, due to broad limits of agreement, we can only recommend mBCA for groups of populations.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, 111221, Colombia
| | - Alejandra Tordecilla-Sanders
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, 111221, Colombia
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, 111221, Colombia
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoria de Investigaciones, Universidad Manuela Beltrán, Bogota, DC 110231, Colombia
| | - Emilio González-Jiménez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, University of Granada, Avda. De la Ilustración, 60, 18016 Granada, Spain.,Grupo CTS-436, Adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), University of Granada, 18071 Granada, Spain
| | - Hector Reynaldo Triana-Reina
- Grupo GICAEDS, Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogota, DC 110311, Colombia
| | - Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago 7500618, Chile
| | - Jacqueline Schmidt-RioValle
- Departamento de Enfermería, Facultad de Ciencias de la Salud, University of Granada, Avda. De la Ilustración, 60, 18016 Granada, Spain.,Grupo CTS-436, Adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), University of Granada, 18071 Granada, Spain
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Wollner M, Paulo Roberto BB, Alysson Roncally SC, Jurandir N, Edil LS. Accuracy of the WHO's body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil. J Public Health Res 2017; 6:904. [PMID: 29071256 PMCID: PMC5641638 DOI: 10.4081/jphr.2017.904] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/24/2017] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Obesity is defined by the World Health Organization (WHO) as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. However, the appropriate cut-off point of body mass index (BMI) based on body fat percentage (BF%) for classifying an individual as obese in middle-aged adults living in Rio de Janeiro remains unclear. MATERIALS AND METHODS This was a prospective cross-sectional study comprising of 856 adults (413 men and 443 women) living in Rio de Janeiro, Brazil ranging from 30-59 years of age. The data were collected over a two year period (2010-2011), and all participants were underwent anthropometric evaluation. The gold standard was the percentage of body fat estimated by bioelectrical impedance analysis. The optimal sensitivity and specificity were attained by adjusting BMI cut-off values to predict obesity based on the WHO criteria: BF% >25% in men and >35% in women, according to the receiver operating characteristic curve (ROC) analysis adjusted for age and for the whole group. RESULTS The BMI cut-offs for predicting BF% were 29.9 kg/m2 in men and 24.9 kg/m2 in women. CONCLUSIONS The BMI that corresponded to a BF% previously defining obesity was similar to that of other Western populations for men but not for women. Furthermore, gender and age specific cut-off values are recommended in this population.
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Affiliation(s)
- Materko Wollner
- Biomedical Engineering Program, COPPE Institute, Federal University of Rio de Janeiro
- Laboratory of Human Movement Biodynamics, School of Physical Education, Federal University of Amapá, Macapá
| | - Benchimol-Barbosa Paulo Roberto
- Biomedical Engineering Program, COPPE Institute, Federal University of Rio de Janeiro
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro
| | - Silva Carvalho Alysson Roncally
- Biomedical Engineering Program, COPPE Institute, Federal University of Rio de Janeiro
- Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro
| | - Nadal Jurandir
- Biomedical Engineering Program, COPPE Institute, Federal University of Rio de Janeiro
| | - Luis Santos Edil
- Oswaldo Cruz Foundation, Fernandes Figueira Institute, Department of Food and Nutrition, Rio de Janeiro, Brazil
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Chula de Castro JA, Lima TRD, Silva DAS. Body composition estimation in children and adolescents by bioelectrical impedance analysis: A systematic review. J Bodyw Mov Ther 2017; 22:134-146. [PMID: 29332738 DOI: 10.1016/j.jbmt.2017.04.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/06/2017] [Accepted: 04/25/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) has commonly been used to assess the body composition of children and adolescents. BIA validation studies have found distinct correlation values with reference methods. OBJECTIVES To assess the reproducibility, correlation and mean differences in body composition estimated by BIA and reference methods, we systematically reviewed the literature in the pediatric population. METHOD The search for articles was conducted in March 2016 and was limited to articles published from 2005 to 2015 in the PubMed, Embase, EBSCO, Web of Science, Scopus and SciELO databases. Two reviewers independently performed data selection and extraction of studies that investigated the BIA validity, responsiveness, reliability and/or measurement error (reproducibility) to estimate body composition in children and adolescents with an average age ≤ 18 years. RESULTS The search produced 48 articles. Almost perfect reproducibility was found in the body fat percentage estimated by BIA, and there was almost perfect correlation between the BIA ratings and reference methods for fat mass and fat-free mass. Regarding component estimates, BIA underestimated the fat mass in both sexes. CONCLUSIONS The body fat percentage estimated by BIA exhibited almost perfect reproducibility. The fat mass and fat-free mass estimated by BIA correlated almost perfectly with the reference methods in both sexes. BIA underestimated the fat mass in both sexes.
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Affiliation(s)
- João Antônio Chula de Castro
- Universidade Federal de Santa Catarina, Centro de Desportos, Núcleo de Pesquisa em Cineantropometria e Desempenho Humano, Florianópolis, Santa Catarina, Brazil.
| | - Tiago Rodrigues de Lima
- Universidade Federal de Santa Catarina, Centro de Desportos, Núcleo de Pesquisa em Cineantropometria e Desempenho Humano, Florianópolis, Santa Catarina, Brazil
| | - Diego Augusto Santos Silva
- Universidade Federal de Santa Catarina, Centro de Desportos, Núcleo de Pesquisa em Cineantropometria e Desempenho Humano, Florianópolis, Santa Catarina, Brazil
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Vitamin D receptor Cdx-2-dependent response of central obesity to vitamin D intake in the subjects with type 2 diabetes: a randomised clinical trial. Br J Nutr 2015; 114:1375-84. [PMID: 26346470 DOI: 10.1017/s0007114515003049] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study aimed to investigate the effects of daily intake of vitamin D-fortified yogurt drink (doogh) on central obesity indicators in subjects with type 2 diabetes (T2D) and the possible modulation of this effect by vitamin D receptor (VDR) Cdx-2 genotypes. A total of sixty T2D subjects were randomly allocated to two groups to receive either plain doogh (PD; n 29, containing 170 mg Ca and no vitamin D/250 ml) or vitamin D3-fortified doogh (FD; n 31, containing 170 mg Ca and 12·5 μg/250 ml) twice a day for 12 weeks. 25-hydroxyvitamin D (25(OH)D), glycaemic as well as adiposity indicators were evaluated before and after the intervention. VDR-Cdx-2 genotypes in extended number of T2D subjects in the FD group (n 60) were determined as AA, GA and GG. After 12 weeks, in FD compared with PD, serum 25(OH)D increased (+35·4 v. -4·8 nmol/l; P<0·001) and mean changes of waist circumference (WC; -1·3 v. +1·6 cm; P=0·02), body fat mass (FM; -1·9 v. +0·60 %; P=0·008), truncal fat (TF; -1·1 v. 0·13 %; P=0·003) and visceral adipose tissue (-0·80 v. +0·37 AU; P<0·001) decreased significantly. Circulating 25(OH)D was raised only in the AA group (34·8 nmo/l in AA group v. -6·4 nmol/l in AG and -1·6 nmol/l in GG groups; P<0·001), which was accompanied by a significant decrease in changes of WC (P=0·004), FM% (P=0·01) and TF% (P<0·001) in the AA genotype. Daily intake of vitamin D-FD for 12 weeks improved the central obesity indices in T2D subjects, and the improvement was more pronounced in the carriers of the AA genotype of VDR-Cdx-2.
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Identifying Overweight and Obese Children. TOP CLIN NUTR 2015. [DOI: 10.1097/tin.0000000000000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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[Measurements of location of body fat distribution: an assessment of colinearity with body mass, adiposity and stature in female adolescents]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:63-71. [PMID: 25623729 PMCID: PMC4436958 DOI: 10.1016/j.rpped.2014.11.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/10/2014] [Indexed: 12/04/2022]
Abstract
OBJECTIVE : To verify the correlation between body fat location measurements with the body
mass index (BMI), body fat percentage (BF%) and height, according to the
nutritional status in female adolescents. METHODS : A controlled cross-sectional study was carried out with 113 adolescents (G1: 38
with normal weight, but with high body fat level, G2: 40 with normal weight and
G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following
measures were assessed: weight, height, waist circumference (WC), umbilical
circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip
ratio (WHR), waist-to-height ratio (WHtR), waist-to-thigh ratio (WTR), conicity
index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central (CS)
and peripheral skinfolds (PS). The BF% was assessed by tetrapolar electric
bioimpedance. RESULTS : The increase in central fat, represented by WC, UC, WHtR, SAD, CD and CS, and
the increase in peripheral fat indicated by HC and thigh circumference were
proportional to the increase in BMI and BF%. WC and especially the UC showed the
strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and
CS/PS with adiposity were observed. The height showed correlation with almost all
the fat location measures, being fair or weak with waist measurements. CONCLUSIONS : The results indicate colinearity between body mass and total adiposity with
central and peripheral adipose tissue. We recommend the use of UC for assessing
nutritional status of adolescents, as it showed the highest capacity to predict
adiposity in each group, and also showed fair or weak correlation with height.
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Ethnic variability in body size, proportions and composition in children aged 5 to 11 years: is ethnic-specific calibration of bioelectrical impedance required? PLoS One 2014; 9:e113883. [PMID: 25478928 PMCID: PMC4257615 DOI: 10.1371/journal.pone.0113883] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/31/2014] [Indexed: 11/22/2022] Open
Abstract
Background Bioelectrical Impedance Analysis (BIA) has the potential to be used widely as a method of assessing body fatness and composition, both in clinical and community settings. BIA provides bioelectrical properties, such as whole-body impedance which ideally needs to be calibrated against a gold-standard method in order to provide accurate estimates of fat-free mass. UK studies in older children and adolescents have shown that, when used in multi-ethnic populations, calibration equations need to include ethnic-specific terms, but whether this holds true for younger children remains to be elucidated. The aims of this study were to examine ethnic differences in body size, proportions and composition in children aged 5 to 11 years, and to establish the extent to which such differences could influence BIA calibration. Methods In a multi-ethnic population of 2171 London primary school-children (47% boys; 34% White, 29% Black African/Caribbean, 25% South Asian, 12% Other) detailed anthropometric measurements were performed and ethnic differences in body size and proportion were assessed. Ethnic differences in fat-free mass, derived by deuterium dilution, were further evaluated in a subsample of the population (n = 698). Multiple linear regression models were used to calibrate BIA against deuterium dilution. Results In children <11 years of age, Black African/Caribbean children were significantly taller, heavier and had larger body size than children of other ethnicities. They also had larger waist and limb girths and relatively longer legs. Despite these differences, ethnic-specific terms did not contribute significantly to the BIA calibration equation (Fat-free mass = 1.12+0.71*(height2/impedance)+0.18*weight). Conclusion Although clear ethnic differences in body size, proportions and composition were evident in this population of young children aged 5 to 11 years, an ethnic-specific BIA calibration equation was not required.
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Wang L, Hui SSC, Wong SHS. Validity of bioelectrical impedance measurement in predicting fat-free mass of Chinese children and adolescents. Med Sci Monit 2014; 20:2298-310. [PMID: 25398209 PMCID: PMC4245105 DOI: 10.12659/msm.890696] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background The current study aimed to examine the validity of various published bioelectrical impedance analysis (BIA) equations in estimating FFM among Chinese children and adolescents and to develop BIA equations for the estimation of fat-free mass (FFM) appropriate for Chinese children and adolescents. Material/Methods A total of 255 healthy Chinese children and adolescents aged 9 to 19 years old (127 males and 128 females) from Tianjin, China, participated in the BIA measurement at 50 kHz between the hand and the foot. The criterion measure of FFM was also employed using dual-energy X-ray absorptiometry (DEXA). FFM estimated from 24 published BIA equations was cross-validated against the criterion measure from DEXA. Multiple linear regression was conducted to examine alternative BIA equation for the studied population. Results FFM estimated from the 24 published BIA equations yielded high correlations with the directly measured FFM from DEXA. However, none of the 24 equations was statistically equivalent with the DEXA-measured FFM. Using multiple linear regression and cross-validation against DEXA measurement, an alternative prediction equation was determined as follows: FFM (kg)=1.613+0.742×height (cm)2/impedance (Ω)+0.151×body weight (kg); R2=0.95; SEE=2.45kg; CV=6.5, 93.7% of the residuals of all the participants fell within the 95% limits of agreement. Conclusions BIA was highly correlated with FFM in Chinese children and adolescents. When the new developed BIA equations are applied, BIA can provide a practical and valid measurement of body composition in Chinese children and adolescents.
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Affiliation(s)
- Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China (mainland)
| | - Stanley Sai-chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Stephen Heung-sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Talma H, Chinapaw MJM, Bakker B, HiraSing RA, Terwee CB, Altenburg TM. Bioelectrical impedance analysis to estimate body composition in children and adolescents: a systematic review and evidence appraisal of validity, responsiveness, reliability and measurement error. Obes Rev 2013; 14:895-905. [PMID: 23848977 DOI: 10.1111/obr.12061] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 05/31/2013] [Accepted: 05/31/2013] [Indexed: 12/21/2022]
Abstract
Bioelectrical impedance analysis (BIA) is a practical method to estimate percentage body fat (%BF). In this systematic review, we aimed to assess validity, responsiveness, reliability and measurement error of BIA methods in estimating %BF in children and adolescents.We searched for relevant studies in Pubmed, Embase and Cochrane through November 2012. Two reviewers independently screened titles and abstracts for inclusion, extracted data and rated methodological quality of the included studies. We performed a best evidence synthesis to synthesize the results, thereby excluding studies of poor quality. We included 50 published studies. Mean differences between BIA and reference methods (gold standard [criterion validity] and convergent measures of body composition [convergent validity]) were considerable and ranged from negative to positive values, resulting in conflicting evidence for criterion validity. We found strong evidence for a good reliability, i.e. (intra-class) correlations ≥0.82. However, test-retest mean differences ranged from 7.5% to 13.4% of total %BF in the included study samples, indicating considerable measurement error. Our systematic review suggests that BIA is a practical method to estimate %BF in children and adolescents. However, validity and measurement error are not satisfactory.
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Affiliation(s)
- H Talma
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Makkes S, Renders CM, Bosmans JE, van der Baan-Slootweg OH, Seidell JC. Cardiometabolic risk factors and quality of life in severely obese children and adolescents in The Netherlands. BMC Pediatr 2013; 13:62. [PMID: 23607651 PMCID: PMC3639189 DOI: 10.1186/1471-2431-13-62] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 04/02/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The prevalence of severe obesity in children and adolescents is increasing. However, little is known about cardiometabolic risk factors and quality of life of children with severe obesity.Therefore, the aim of this study was to assess the demographic characteristics and the prevalence of cardiometabolic risk factors and quality of life in severely obese children and adolescents undergoing intensive inpatient treatment for obesity. METHODS Data were collected between August 2009 and April 2011 on 16 children (8-13y) and 64 adolescents (13-19y) with severe obesity (SDS-BMI >= 3.0 or SDS-BMI >= 2.3 and comorbidity) participating in an RCT evaluating two intensive inpatient treatment programs for obesity. Demographic, anthropometric, clinical characteristics and two components of the EuroQol for the assessment of quality of life are described. RESULTS Eighty percent of participants in this study had at least one cardiometabolic risk factor in addition to severe obesity. Low HDL-cholesterol and hypertension were most prevalent (65.0% respectively 31.2%). The highest significant correlations were found between SDS-BMI and SDS-waist circumference, fasting plasma insulin and HOMA-IR (correlation coefficients respectively 0.80, 0.49, and 0.48). With regard to quality of life, the mean utility score of the participants was 0.79 on a scale of 0.0 to 1.0 on the EuroQol questionnaire and their mean individual valuation was 69.1 on a scale of 0 to100. CONCLUSION Cardiometabolic risk factors are already highly prevalent in this group of severely obese children and adolescents. The score of 69.1 found for quality of life in this study suggests that participants experience important limitations in their quality of life. However, quality of life is not associated with the prevalence of cardiometabolic risk factors. TRIAL REGISTRATION Netherlands Trial Register (NTR1678, registered 20-Feb-2009).
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Affiliation(s)
- Sabine Makkes
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
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Li YC, Li CI, Lin WY, Liu CS, Hsu HS, Lee CC, Chen FN, Li TC, Lin CC. Percentage of body fat assessment using bioelectrical impedance analysis and dual-energy X-ray absorptiometry in a weight loss program for obese or overweight Chinese adults. PLoS One 2013; 8:e58272. [PMID: 23573189 PMCID: PMC3613423 DOI: 10.1371/journal.pone.0058272] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 02/05/2013] [Indexed: 11/18/2022] Open
Abstract
The current study aimed to compare the estimates of body fat percentage (%BF) by performing bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) in a sample of obese or overweight Chinese adults who participated in a weight-loss randomized control trial stratified by gender to determine whether or not BIA is a valid measurement tool. Among 189 adults [73 males, 116 females; age = 41 to 74 years; mean body mass index (BMI) = 27.3 kg/m(2)], assessments of %BF at the baseline and six months from the baseline were conducted by performing BIA and DXA. Bland-Altman analyses and multiple regression analyses were used to assess the relationships between %BFBIA and %BFDXA. Compared with DXA, BIA underestimated %BF [in males: 4.6, -2.4 to 11.7 (mean biases, 95% limit of agreement) at the baseline, 1.4, -7.4 to 10.2 at the endpoint, and 3.2, -4.8 to 11.3 in changes; in females: 5.1, -2.4 to 12.7; 2.2, -6.1 to 10.4; and 3.0, -4.8 to 10.7, respectively]. For males and females, %BFDXA proved to be a significant predictor of the difference between DXA and BIA at the baseline, the endpoint, and in changes when BMI and age were considered (in males: p<0.01 and R (2) = 23.1%, 24.1%, 20.7%, respectively; for females: p<0.001 and R (2) = 40.4%, 48.8%, 25.4%, respectively). The current study suggests that BIA provides a relatively accurate prediction of %BF in individuals with normal weight, overweight, or obesity after the end of weight-loss program, but less accurate prediction of %BF in obese individuals at baseline or weight change during the weight-loss intervention program.
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Affiliation(s)
- Yi-Chun Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hua-Shui Hsu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chun Lee
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Fei-Na Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Barreira TV, Staiano AE, Katzmarzyk PT. Validity assessment of a portable bioimpedance scale to estimate body fat percentage in white and African-American children and adolescents. Pediatr Obes 2013; 8:e29-32. [PMID: 23239610 PMCID: PMC3602331 DOI: 10.1111/j.2047-6310.2012.00122.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 09/13/2012] [Accepted: 10/18/2012] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective of the study was to determine accuracy of the Tanita SC-240 body composition analyser to measure paediatric percent body fat (%BF). METHODS Eighty-nine African-American and white 5-18-year-olds participated in this study. %BF was estimated by dual-energy X-ray absorptiometry (DXA) and by the Tanita SC-240. RESULTS Overall %BF was 33.5 ± 10.5% (Tanita SC-240) vs. 34.5 ± 8.7% (DXA). There was no significant difference between the two measures (P = 0.52, average error = -1.0%, average absolute error = 3.9%). The Tanita mean %BF estimates significantly differed from the DXA mean %BF in white boys (P = 0.001, Cohen's d = 0.40) and white girls (P = 0.006, Cohen's d = 0.48), but differences were of small effect. No differences in %BF estimates were found for African-American boys or girls. CONCLUSIONS In this sample, the Tanita SC-240 demonstrated acceptable accuracy for estimating %BF when compared with DXA, supporting its use in field studies.
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Affiliation(s)
- T. V. Barreira
- Pennington Biomedical Research Center; Baton Rouge; Louisiana; USA
| | - A. E. Staiano
- Pennington Biomedical Research Center; Baton Rouge; Louisiana; USA
| | - P. T. Katzmarzyk
- Pennington Biomedical Research Center; Baton Rouge; Louisiana; USA
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Makkes S, Halberstadt J, Renders CM, Bosmans JE, van der Baan-Slootweg OH, Seidell JC. Cost-effectiveness of intensive inpatient treatments for severely obese children and adolescents in the Netherlands; a randomized controlled trial (HELIOS). BMC Public Health 2011; 11:518. [PMID: 21718471 PMCID: PMC3141469 DOI: 10.1186/1471-2458-11-518] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 06/30/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intensive combined lifestyle interventions are the recommended treatment for severely obese children and adolescents, but there is a lack of studies and their cost-effectiveness. The objective of this study is to compare the cost-effectiveness of two intensive one-year inpatient treatments and usual care for severely obese children and adolescents. METHODS/DESIGN Participants are 40 children aged 8-13 and 40 adolescents aged 13-18 with severe obesity (SDS-BMI ≥ 3.0 or SDS-BMI ≥ 2.3 with obesity related co-morbidity). They will be randomized into two groups that will receive a comprehensive treatment program of 12 months that focuses on nutrition, physical activity and behavior change of the participant and their parents. The two programs are the same in total duration (12 months), but differ in inpatient treatment duration. Group A will participate in a 6 month intensive inpatient treatment program during weekdays, followed by six monthly return visits of 2 days. Group B will participate in a 2 month intensive inpatient treatment program during weekdays, followed by biweekly return visits of 2 days during the next four months, followed by six monthly return visits of 2 days. Several different health care professionals are involved, such as pediatricians, dieticians, psychologists, social workers, nurses and physiotherapists. Results will also be compared to a control group that receives usual care. The primary outcome is SDS-BMI. Secondary outcomes include quality of life using the EQ-5D and cardiovascular risk factors. Data will be collected at baseline and after 6, 12 and 24 months. An economic evaluation will be conducted alongside this study. Healthcare consumption will be based on actual resource use, using prospective data collection during 2 years through cost diaries. Quality Adjusted Life Years (QALYs) will be calculated using the EQ-5D. DISCUSSION This study will provide useful information on the effectiveness and cost-effectiveness of inpatient treatment in severely obese children and adolescents. Valuable information on long term effects, after 2 years, is also included. TRIAL REGISTRATION Netherlands Trial Register (NTR): NTR1678.
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Affiliation(s)
- Sabine Makkes
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
| | - Jutka Halberstadt
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
| | | | - Jacob C Seidell
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
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Esco MR, Olson MS, Williford HN, Lizana SN, Russell AR. The Accuracy of Hand-to-Hand Bioelectrical Impedance Analysis in Predicting Body Composition in College-Age Female Athletes. J Strength Cond Res 2011; 25:1040-5. [DOI: 10.1519/jsc.0b013e3181cc224a] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Telford RD, Cunningham RB, Daly RM, Reynolds GJ, Lafferty ARA, Gravenmaker KJ, Budge MM, Javaid A, Bass SL, Telford RM. Discordance of international adiposity classifications in Australian boys and girls – The LOOK study. Ann Hum Biol 2009; 35:334-41. [DOI: 10.1080/03014460802014625] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mathew RP, Byrne DW, Linton MF, Vaughan DE, Fazio S, Russell WE. Evidence of metabolic syndrome in lean children with premature pubarche at diagnosis. Metabolism 2008; 57:733-40. [PMID: 18502254 DOI: 10.1016/j.metabol.2008.01.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2007] [Accepted: 01/07/2008] [Indexed: 01/19/2023]
Abstract
We investigated for evidence of early metabolic syndrome irrespective of body mass index (BMI) in subjects with premature pubarche (PP). Ten children with PP were compared with controls matched for age, sex, ethnicity, and BMI. Congenital adrenal hyperplasia and other known causes of PP were excluded by standard methods. Anthropometry, blood pressure (BP), dual-energy x-ray absorptiometry body scan, fasting blood lipid profile, and cytokines were obtained. The children were divided into 2 groups: (1) the total group of children with PP, and their age-, sex-, ethnicity-, and BMI-matched controls and (2) those with PP and normal BMI (<19 kg/m(2)) and their matched controls selected from the original groups. The PP subjects with normal BMI (S(1)) showed significantly higher systolic BP (P = .028), diastolic BP (P = .028), and mean arterial pressure (P = .018) compared with matched controls (C(1)). Nevertheless, for both groups, all the above parameters were statistically not significant when corrected for height. Fat distribution in PP subjects indicated significantly higher android (P = .047) and android-gynoid ratio (P = .013). Normal-BMI PP children had significantly higher android-gynoid ratio fat distribution compared with their matched controls (P = .037). Trunk fat percentage (p: 0.04) and trunk fat (grams) (P = .007) were significantly elevated in PP children compared with matched controls. Again, for both groups, all the above parameters were not statistically significant when corrected for height. The PP subjects had significantly higher tumor necrosis factor (TNF)-alpha (P = .038) and interleukin-8 (picograms per milliliter) (P = .05) compared with matched controls. Normal-BMI PP children also had higher TNF-alpha (P = .028) compared with matched controls. When corrected for height, TNF-alpha was higher in the total (P = .037) and normal-BMI (P = .043) PP children. Premature pubarche can be linked to markers of the metabolic syndrome in lean children.
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Affiliation(s)
- Revi P Mathew
- Department of Pediatrics, Vanderbilt University, Nashville, TN 37232, USA.
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Cleary J, Daniells S, Okely AD, Batterham M, Nicholls J. Predictive Validity of Four Bioelectrical Impedance Equations in Determining Percent Fat Mass in Overweight and Obese Children. ACTA ACUST UNITED AC 2008; 108:136-9. [DOI: 10.1016/j.jada.2007.10.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Indexed: 01/01/2023]
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28
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Ricciardi R, Talbot LA. Use of bioelectrical impedance analysis in the evaluation, treatment, and prevention of overweight and obesity. ACTA ACUST UNITED AC 2007; 19:235-41. [PMID: 17489956 DOI: 10.1111/j.1745-7599.2007.00220.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE To present an overview of bioelectrical impedance analysis (BIA) and to familiarize nurse practitioners (NPs) with the potential benefits of using BIA in prevention, monitoring, and long-term follow-up of healthy individuals and those with chronic conditions (e.g., obesity). DATA SOURCES Original research articles and comprehensive review articles identified through Medline, CINAHL, OVID, and electrical engineering databases. CONCLUSIONS Obtaining serial measurements of percent body fat using BIA can identify patients at greatest health risk and gives NPs an additional tool to assess treatment response in patients seeking to lose or maintain body weight and/or increase muscle mass. IMPLICATIONS FOR PRACTICE Traditionally, height/weight tables and body mass index have been used to assess body composition and diagnose overweight and obesity. More recently, BIA has emerged as a portable and simple-to-operate instrument to evaluate body composition in the clinical setting.
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