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Robles B, Mota-Bertran A, Saez M, Solans M. Association between ultraprocessed food consumption and excess adiposity in children and adolescents: A systematic review. Obes Rev 2024:e13796. [PMID: 38956887 DOI: 10.1111/obr.13796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/17/2023] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
Ultraprocessed foods (UPF) consumption is associated with excess adiposity in adults, but this linkage remains unclear among children and adolescents. The present systematic review sought to address this research gap. Publications up to November 2023 were retrieved from PubMed, Web of Science, and Scopus databases. Outcomes included overweight/obesity anthropometric and body composition indicators; the exposure was UPF consumption based on the NOVA classification system. The review included 23 studies (i.e., 8 cohort and 15 cross-sectional); approximately half were carried out in Brazil. Inconclusive and heterogeneous evidence exists as few cohort studies found positive/mixed associations between UPF consumption and excess adiposity in pediatric populations, whereas most cross-sectional studies reported null associations. Such inconsistencies may be attributed to underlying methodological issues, especially heterogeneity in the outcomes assessed and UPF consumption operationalization and/or categorization. Future studies should adopt longitudinal designs with sufficiently extended follow-up periods, account for relevant confounding factors, employ validated and standardized measurement tools to assess dietary exposure, ensure consistent operationalization of variables, and encompass diverse geographic contexts. Ultimately, strengthening the quality of existing research evidence may better inform current and forthcoming policy and practice interventions aimed at mitigating the increasing prevalence of overweight/obesity in childhood and across the life course.
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Affiliation(s)
- Brenda Robles
- Department of Economics, University of Rovira i Virgili, Reus, Spain
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Mota-Bertran
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Solans
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Wang X, Gao L, Xiong J, Cheng H, Liu L, Dong H, Huang Y, Fan H, Wang X, Shan X, Xiao P, Liu J, Yan Y, Mi J. The life-course changes in muscle mass using dual-energy X-ray absorptiometry: The China BCL study and the US NHANES study. J Cachexia Sarcopenia Muscle 2024. [PMID: 38952048 DOI: 10.1002/jcsm.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/13/2024] [Accepted: 05/15/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Sarcopenia is an important indicator of ill health and is linked to increased mortality and a reduced quality of life. Age-associated muscle mass indices provide a critical tool to help understand the development of sarcopenia. This study aimed to develop sex- and age-specific percentiles for muscle mass indices in a Chinese population and to compare those indices with those from other ethnicities using the National Health and Nutrition Examination Survey (NHANES) data. METHODS Whole-body and regional muscle mass was measured by dual-energy X-ray absorptiometry (DXA) in participants of the China Body Composition Life-course (BCL) study (17 203 healthy Chinese aged 3-60 years, male 48.9%) and NHANES (12 663 healthy Americans aged 8-59 years, male 50.4%). Age- and sex-specific percentile curves were generated for whole-body muscle mass and appendicular skeletal muscle mass using the Generalized Additive Model for Location Scale and Shape statistical method. RESULTS Values of upper and lower muscle mass across ages had three periods: an increase from age 3 to a peak at age 25 in males (with the 5th and 95th values of 41.5 and 66.4 kg, respectively) and age 23 in females (with the 5th and 95th values of 28.4 and 45.1 kg, respectively), a plateau through midlife (30s-50s) and then a decline after their early 50s. The age at which muscle mass began to decline was 52 years in men with the 5th and 95th percentile values of 43.5 and 64.6 kg, and 51 years in women with the 5th and 95th percentile values of 31.6 and 46.9 kg. Appendicular skeletal muscle mass decreased earlier than whole body muscle mass, especially leg skeletal muscle mass, which decreased slightly after age 49 years in both sexes. In comparison with their US counterparts in the NHANES, the Chinese participants had lower muscle mass indices (all P < 0.001) and reached a muscle mass peak earlier with a lower muscle mass, with the exception of similar values compared with adult Mexican and White participants. The muscle mass growth rate of Chinese children decreased faster than that of other races after the age of 13. CONCLUSIONS We present the sex- and age-specific percentiles for muscle mass and appendicular skeletal muscle mass by DXA in participants aged 3-60 from China and compare them with those of different ethnic groups in NHANES. The rich data characterize the trajectories of key muscle mass indices that may facilitate the clinical appraisal of muscle mass and improve the early diagnosis of sarcopenia in the Chinese population.
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Affiliation(s)
- Xi Wang
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Liwang Gao
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- School of Public Health, Capital Medical University, Beijing, China
| | - Jingfan Xiong
- Children and Adolescents Chronic Disease Prevention and Control Department, Chronic Disease Prevention and Control Center, Shenzhen, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Li Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Hongbo Dong
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yiwen Huang
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hongmin Fan
- North China University of Science and Technology, Tangshan, China
| | - Xia Wang
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xinying Shan
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Pei Xiao
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Yinkun Yan
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jie Mi
- Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Salamh F, Habib SS, AlRouq F, Albarrak A, Al-Khlaiwi T, Khan A. Relationship of obesity indices with clinical severity and nerve conduction studies in females presenting with median nerve compression neuropathy at the wrist. J Family Med Prim Care 2024; 13:1291-1295. [PMID: 38827720 PMCID: PMC11142002 DOI: 10.4103/jfmpc.jfmpc_1253_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 06/04/2024] Open
Abstract
Background Carpal tunnel syndrome (CTS) is considered to be one of the most common peripheral nerve disorders with female preponderance which significantly reduces work efficacy and needs further research on its preventable factors, especially obesity. We studied the effects of obesity indices on Phalen's test duration and median nerve conduction study (NCS) parameters in patients presenting with CTS. Methods We examined 229 female patients presenting with clinical features of CTS. Clinical examinations including Phalen's test, median NCSs, and body composition were evaluated. Obesity indices and electrophysiological parameters were compared. Results There were significant associations of both body mass index (BMI) degrees and body fat percent (BF%) with clinical and NCS parameters with a linear relationship. BF% and BMI were strongly negatively correlated with Phalen's test duration (BF%; r = -0.334, BMI; r = -0.270 P = 0.001). On the other hand, BF% and BMI were positively correlated with median distal latency (BF%; r = 0.338, BMI; r = 0.372, P value = 0.001), M-latency (BF%; r = 0.264, BMI; r = 0.285, P = 0.001), median motor conduction velocity (MMCV) (BF%; r = 0.119, P = 0.072, BMI; r = 0.173, P = 0.009), median sensory conduction velocity (MSCV) (BF%; r = -0.195, P = 0.003, BMI; r = 0.327, P = 0.001), and sensory nerve action potential (SNAP amplitude) (BF%; r = -.239, BMI; r = -0.350, P = 0.001). Conclusions Nerve conduction parameters are significantly affected by obesity degree defined by BMI and BF%. Therefore, combining BMI and BF% assessments gives more clinical information regarding CTS severity and management. The true predictive value of these indices needs to be elucidated further.
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Affiliation(s)
- Fawaz Salamh
- Department of Physiology, Clinical Physiology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Syed Shahid Habib
- Department of Physiology, Clinical Physiology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fawzia AlRouq
- Department of Physiology, Clinical Physiology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Anas Albarrak
- Department of Internal Medicine, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Thamir Al-Khlaiwi
- Department of Physiology, Clinical Physiology Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Adeena Khan
- Department of Radiology and Imaging, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Viegas ÂA, Santos T, Nobre JNP, Santos JMD, Silva Lage VKD, Fernandes AC, Peixoto MFD, Morais RLDS, Sartorio A, Mendonça VA, Lacerda ACR. Association between biomarkers of redox status and cytokines with different patterns of habitual physical activity in eutrophic and overweight/obese preschoolers: multivariate analysis of a cross-sectional study. BMC Public Health 2023; 23:2353. [PMID: 38017390 PMCID: PMC10683275 DOI: 10.1186/s12889-023-17295-y] [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: 02/08/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Although it is well known that obesity is frequently associated with reduced levels of habitual physical activity (HPA), which contributes to determining severe oxidative stress and inflammatory state, this association is however unknown in preschoolers so far. This study aimed to investigate the association between biomarkers of redox status and cytokines with different patterns of HPA according to the adiposity of preschoolers. METHODS A cross-sectional study was conducted in 50 preschoolers (25 overweight/obese, OW/OB and 25 eutrophic, EU), matched for age, sex, economic level, and maternal education. Total antioxidant capacity (TAC), superoxide dismutase (SOD) and catalase (CAT) activities, substances reactive to thiobarbituric acid (TBARS), soluble tumor necrosis factor receptors (sTNFRs), and leptin levels were evaluated. HPA levels were evaluated by accelerometry (ActiGraph GT9X accelerometer). Correlation, multiple linear regression, and partial least squares regression analysis were used to determine the association between redox status biomarkers and cytokines with different patterns of HPA (HPA level, bouts of moderate to vigorous physical activity [MVPA], and multivariate pattern of HPA) in EU and OW/OB preschoolers. RESULTS OW/OB preschoolers had lower CAT activity, higher levels of TAC, TBARS, and cytokines, and similar levels of HPA to EU preschoolers. In EU preschoolers, SOD activity exhibited a stronger negative association with moderate intensity ranges of HPA (R2 = 0.18), and negative correlation with sTNFRs (r = -0.40 to -0.46). TBARS had a stronger positive association with ranges of light intensity in the multivariate pattern of HPA (R2 = 0.10). In OW/OB preschoolers, the HPA multivariate associative pattern was predominantly from vigorous intensity ranges. Thus, SOD activity had a positive association with the multivariate pattern of HPA (R2 = 0.38) and MVPA bouts (β [95% CI] = 0.457 [0.0026. 0.0576]). TAC had a negative association with the multivariate pattern of HPA (R2 = 0.38) and MVPA bouts (β [95% CI] = -0.718 [-0.0025. -0.0003]). Additionally, leptin levels were lower in OW/OB preschoolers engaged in vigorous physical activity (VPA) (8000-9999 counts/min) for longer periods of time. CONCLUSION The results of this study indicate that OW/OB preschoolers have higher levels of oxidative stress biomarkers and pro-inflammatory cytokines compared to EU preschoolers. Moreover, VPA may exert antioxidative and anti-inflammatory effects in OW/OB preschoolers.
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Affiliation(s)
- Ângela Alves Viegas
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Thiago Santos
- Postgraduate Program in Animal Biology (PPGBA), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Juliana Nogueira Pontes Nobre
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Jousielle Márcia Dos Santos
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Vanessa Kelly da Silva Lage
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Amanda Cristina Fernandes
- Postgraduate Program in Rehabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Marco Fabrício Dias Peixoto
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Rosane Luzia De Souza Morais
- Postgraduate Program Health, Society and Environment (PPGSaSA), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Alessandro Sartorio
- Division of Auxology and Metabolic Diseases & Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Vanessa Amaral Mendonça
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Postgraduate Program in Rehabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil.
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil.
- Postgraduate Program in Rehabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil.
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Poveda NE, Adair LS, Martorell R, Patel SA, Ramirez-Zea M, Stein AD. Early life predictors of body composition trajectories from adolescence to mid-adulthood. Am J Hum Biol 2023; 35:e23952. [PMID: 37401888 PMCID: PMC10764641 DOI: 10.1002/ajhb.23952] [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: 02/18/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES Guatemala has experienced rapid increases in adult obesity. We characterized body composition trajectories from adolescence to mid-adulthood and determined the predictive role of parental characteristics, early life factors, and a nutrition intervention. METHODS One thousand three hundred and sixty-four individuals who participated as children in a nutrition trial (1969-1977) were followed prospectively. Body composition characterized as body mass index (BMI), fat mass index (FMI), and fat-free mass indices (FFMI), was available at four ages between 10 and 55 years. We applied latent class growth analysis to derive sex-specific body composition trajectories. We estimated associations between parental (age, height, schooling) and self-characteristics (birth order, socioeconomic status, schooling, and exposure to a nutrition supplement) with body composition trajectories. RESULTS In women, we identified two latent classes of FMI (low: 79.6%; high: 20.4%) and BMI (low: 73.0%; high: 27.0%), and three of FFMI (low: 20.2%; middle: 55.9%; high: 23.9%). In men, we identified two latent classes of FMI (low: 79.6%; high: 20.4%) and FFMI (low: 62.4%; high: 37.6%), and three of BMI (low: 43.1%; middle: 46.9%; high: 10.0%). Among women, self's schooling attainment inversely predicted FMI (OR [being in a high latent class]: 0.91, 95% CI: 0.85, 0.97), and maternal schooling positively predicted FFMI (OR: 1.16, 95% CI: 0.97, 1.39). Among men, maternal schooling, paternal age, and self's schooling attainment positively predicted FMI. Maternal schooling positively predicted FFMI, whereas maternal age and paternal schooling were inverse predictors. The nutrition intervention did not predict body composition class membership. CONCLUSIONS Parents' age and schooling, and self's schooling attainment are small but significant predictors of adult body composition trajectories.
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Affiliation(s)
- Natalia E Poveda
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta GA, USA
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Sakamornchai W, Dumrongwongsiri O, Phosuwattanakul J, Siwarom S. Measurement of body composition by deuterium oxide dilution technique and development of a predictive equation for body fat mass among severe neurologically impaired children. Front Nutr 2023; 10:1162956. [PMID: 37920288 PMCID: PMC10619656 DOI: 10.3389/fnut.2023.1162956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 09/29/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction Neurologically impaired (NI) children are at risk of malnutrition, which consequently impacts their health and quality of life. Accurate nutrition assessment is an important step in guiding appropriate nutrition support. Conventional anthropometric measurements among NI children have some limitations. Determining body composition requires more complex equipment, which is not routinely performed. This study was conducted to evaluate the association between anthropometric parameters and body composition assessed using the deuterium dilution technique (DDT) in NI children. Methods A cross-sectional study enrolled severe NI children aged 1-20 years who received home enteral nutrition for at least 3 months. Weight, length, and 4-site skinfold thickness were measured. Body composition was determined using DDT following the International Atomic Energy Agency (IAEA) protocol. Results A total of 37 NI children (56.76% male, median age 7.2 years) were enrolled. The prevalence of underweight, stunting, and overweight were 22, 38, and 35%, respectively. Body composition analysis showed the mean (SD) of total body water (TBW) and fat mass (FM) were 10.52 (4.51) kg and 9.51 (6.04) kg, respectively. Multivariate GLM analysis showed that the factors associated with FM were age (β = 0.07 [0.05,0.08]; p < 0.001), body mass index (BMI) (β = 0.82 [0.52, 1.12]; p < 0.001), biceps skinfold thickness (BSF) (β = 0.49 [0.23,0.75]; p = 0.001), and subscapular skinfold thickness (SSF) (β = -0.24 [-0.46,0.03]; p = 0.030). A predictive equation for FM was constructed. Conclusion A high prevalence of malnutrition was found among severe NI children despite enteral nutrition support. Our findings showed that age, BMI, BSF, and SSF were associated with FM. The predictive equation of FM was proposed and needed to be further validated and applied to clinical practice.
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Affiliation(s)
- Wirada Sakamornchai
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Pediatrics, Faculty of Medicine Chiang Mai University, Chiang Mai, Thailand
| | - Oraporn Dumrongwongsiri
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jeeraparn Phosuwattanakul
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sirinapa Siwarom
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Zemel BS, Shepherd JA, Grant SFA, Lappe JM, Oberfield SE, Mitchell JA, Winer KK, Kelly A, Kalkwarf HJ. Reference ranges for body composition indices by dual energy X-ray absorptiometry from the Bone Mineral Density in Childhood Study Cohort. Am J Clin Nutr 2023; 118:792-803. [PMID: 37598746 PMCID: PMC10579045 DOI: 10.1016/j.ajcnut.2023.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 08/08/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Body composition assessment aids evaluation of energy stores and the impact of diseases and interventions on child growth. Current United States pediatric reference ranges from the National Health and Nutrition Examination Survey (NHANES) include 20% of children with obesity, body mass index of ≥95th percentile. OBJECTIVES This study aimed to develop dual energy X-ray absorptiometry (DXA) based reference ranges in a diverse cohort with low-obesity prevalence from the Bone Mineral Density in Childhood Study (BMDCS). METHODS This is a secondary analysis of a longitudinal, prospective, observational cohort. Healthy children (height and BMI within 3rd to 97th percentiles, ages 5-19 y at enrollment), from 5 United States centers were measured annually for ≤7 visits. Whole body scans were acquired using Hologic scanners. A subsample underwent repeat measurements to determine precision. We generated reference ranges for appendicular and total lean soft tissue mass index (LSTM Index), fat mass index (FMI), and other body composition measures. Resulting curves were compared to NHANES and across subgroups. Sex and age-specific equations were developed to adjust body composition Z-scores for height Z score. RESULTS We obtained 9846 scans of 2011 participants (51% female, 22% Black, 17% Hispanic, 48% White, 7% Asian/Pacific Islander, and 6% with obesity). Precision (percent coefficient of variation) ranged from 0.7% to 1.96%. Median and-2 standard deviation curves for BMDCS and NHANES were similar, but NHANES +2 standard deviation LSTM Index and FMI curves were distinctly greater than the respective BMDCS curves. Subgroup differences were more extreme for appendicular LSTM Index-Z (mean ± SD: Asian -0.52 ± 0.93 compared with Black 0.77 ± 0.87) than for FMI-Z (Hispanic 0.29 ± 0.98 compared with Black -0.14 ± 1.1) and were smaller for Z-scores adjusted for height Z-score. CONCLUSIONS These reference ranges add to sparse normative data regarding body composition in children and adolescents and are based on a cohort with an obesity prevalence similar to current BMI charts. Awareness of subgroup differences aids in interpreting results.
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Affiliation(s)
- Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
| | - John A Shepherd
- Cancer Center, University of Hawaii, Honolulu, HI, United States
| | - Struan F A Grant
- Division of Human Genetics, The Children's Hospital of Philadelphia, Department of Pediatrics, and Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Joan M Lappe
- Department of Medicine, Creighton University, Omaha, NB, United States
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Columbia University Medical Center, New York, NY, United States
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Karen K Winer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Andrea Kelly
- Division of Pediatric Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Heidi J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati Medical Center, Cincinnati, OH, United States
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Paavilainen E, Niinikoski H, Parkkola R, Koskensalo K, Nikkinen H, Veijola R, Vääräsmäki M, Loo BM, Tossavainen P, Rönnemaa T, Tertti K. Metformin versus insulin for gestational diabetes: Adiposity variables and adipocytokines in offspring at age of 9 years. Diabetes Res Clin Pract 2023:110780. [PMID: 37331522 DOI: 10.1016/j.diabres.2023.110780] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
AIMS To compare body composition, visceral adiposity, adipocytokines, and low-grade inflammation markers in prepubertal offspring of mothers who were treated with metformin or insulin for gestational diabetes mellitus (GDM). METHODS 172 offspring of 311 mothers randomized to receive metformin (n=82) or insulin (n=90) for GDMwere studied at 9 years of age (follow-up rate 55%). Measurements included anthropometrics, adipocytokines, markers of the low-grade inflammation, abdominal magnetic resonance imaging (MRI), magnetic liver spectrometry (MRS), and whole body dual-energy X-ray absorptiometry (DXA). RESULTS Serum markers of low-grade inflammation, visceral adipose tissue volume, total fat percentage, and liver fat percentage were similar between the study groups. Serum adiponectin concentration was higher in children in the metformin group compared to insulin group (median 10.37 vs 9.50 µg/ml, p = 0.016). This difference between groups was observed in boys only (median 12.13 vs 7.50 µg/ml, p<0.001). Leptin/adiponectin-ratio was lower in boys in the metformin group than in the insulin group (median 0.30 vs 0.75; p = 0.016). CONCLUSIONS Maternal metformin treatment for GDM had no effects on adiposity, body composition, liver fat, or inflammation markers in prepubertal offspring compared to maternal insulin treatment but was associated with higher adiponectin concentration and lower leptin/adiponectin-ratio in boys.
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Affiliation(s)
- Elisa Paavilainen
- Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland.
| | - Harri Niinikoski
- Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Kalle Koskensalo
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Hilkka Nikkinen
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Riitta Veijola
- Department of Pediatrics, Research Unit of Clinical Medicine, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Britt-Marie Loo
- Joint Clinical Biochemistry Laboratory of University of Turku and Turku University Hospital, Turku, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, Research Unit of Clinical Medicine, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Tapani Rönnemaa
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Kristiina Tertti
- Department of Obstetrics and Gynecology, University of Turku and Turku University Hospital, Turku, Finland
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9
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Radecka A, Lubkowska A. The Significance of Dual-Energy X-ray Absorptiometry (DXA) Examination in Cushing's Syndrome-A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13091576. [PMID: 37174967 PMCID: PMC10178172 DOI: 10.3390/diagnostics13091576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/13/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
In recent years, the usefulness of dual-energy X-ray absorptiometry (DXA) as a valuable complementary method of assessing the content and distribution of adipose and lean tissue as well as bone mineral density and estimating the risk of fractures has been increasingly confirmed. The diagnosis and treatment of Cushing's syndrome remain challenging, and monitoring the effects of treatment is often necessary. DXA tests offer a potential solution to many problems related to the availability of a quick, detailed, and reliable analysis of changes in the content and distribution of individual body composition components. The article discusses total body DXA scans (FMI, VAT, ALMI), lumbar spine scans (VFA, TBS), and osteoporosis scans (BMD, T-score, Z-score)-all are of potential interest in Cushing's syndrome. The article discusses the use of the most important indicators obtained from a DXA test (FMI, VAT, ALMI, BMD, T-score, Z-score, VFA, TBS) and their clinical significance in Cushing's syndrome was verified. The literature from the last decade was used for the study, available in MEDLINE, Web of Science, and ScienceDirect.
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Affiliation(s)
- Aleksandra Radecka
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Żołnierska 54, 71-210 Szczecin, Poland
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10
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Clayton P, Trak-Fellermeier MA, Macchi A, Galván R, Bursac Z, Huffman-Ercanli F, Liuzzi J, Palacios C. The association between hydration status and body composition in healthy children and adolescents. J Pediatr Endocrinol Metab 2023; 36:470-477. [PMID: 37006164 PMCID: PMC10174625 DOI: 10.1515/jpem-2022-0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 02/27/2023] [Indexed: 04/04/2023]
Abstract
OBJECTIVES Children 10-20 years old in the US are currently obese, showing suboptimal hydration as 60% fail to meet the US Dietary Reference Intakes for water. Studies have shown a significant inverse association between hydration status and body composition in children, although most failed to use the Dual-X-Ray Absorptiometry Scan (DEXA), the gold standard for body composition. Limited studies used an objective marker to measure hydration, such as urine specific gravity (USG) from a 24-h urine collection. Therefore, this study aimed to examine the association between hydration status (measured from USG in a 24-h urine sample and assessed from three 24-h dietary recalls) and body fat % and lean mass (assessed from a DEXA scan) in children (10-13 years, n=34) and adolescents (18-20 years, n=34). METHODS Body composition was measured using DEXA, total water intake (mL/d) was assessed from three 24-h dietary recalls and analyzed using the Nutrition Data System for Research (NDSR). Hydration status was objectively measured using USG via 24-h urine collection. RESULTS Overall body fat % was 31.7 ± 7.31, total water intake was 1746 ± 762.0 mL/d, and USG score was 1.020 ± 0.011 uG. Linear regressions showed significance between total water intake and lean mass (B=12.2, p<0.05). Logistic regressions showed no significant association between body composition and USG and total water intake. CONCLUSIONS Findings showed total water intake was significantly associated with lean mass. Future research should be conducted to explore other objective markers of hydration and with a larger sample.
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Affiliation(s)
- Priscilla Clayton
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - María Angélica Trak-Fellermeier
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Alison Macchi
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Rodolfo Galván
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Fatma Huffman-Ercanli
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Juan Liuzzi
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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11
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Bandyopadhyay S, Puttaswamy D, Gabriel MP, J J, Finkelstein JL, Selvam S, Kurpad AV, Kuriyan R. Estimation of Hydration and Density of Fat-Free Mass in Indian Children Using a 4-Compartment Model: Implications for the Estimation of Body Composition Using 2-Compartment Models. J Nutr 2023; 153:435-442. [PMID: 36894236 DOI: 10.1016/j.tjnut.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Accurate methods are needed to measure body fat mass (FM), particularly in South Asian children who are thought to have greater adiposity for a given body size. The accuracy of simple 2-compartment (2C) models of measuring FM depends on the primary measurement of the fat free mass (FFM) and the validity of assumed constants for FFM hydration and density. These have not been measured in this particular ethnic group. OBJECTIVES To measure FFM hydration and density in South Indian children using a 4-compartment (4C) model and to compare FM estimates from this 4C-model with 2C-model-based estimates from hydrometry and densitometry, using literature-reported FFM hydration and density in children. METHODS This study included 299 children (45% boys), aged 6-16 y from Bengaluru, India. Total body water (TBW), bone mineral content (BMC), and body volume were measured using deuterium dilution, dual-energy X-ray absorptiometry, and air displacement plethysmography, respectively, to calculate the FFM hydration and density, and the FM using 4C and 2C models. The agreement between FM estimates from 2C and 4C models was also evaluated. RESULTS Mean FFM hydration and density were 74.2% ± 2.1% and 71.4% ± 2.0% and 1.095 ± 0.008 kg/L and 1.105 ± 0.008 kg/L in boys and girls respectively, which were significantly different from published values. Using the presently estimated constants, the mean hydrometry-based FM (as % body weight) estimates decreased by 3.5% but increased by 5.2% for densitometry-based 2C methods. When 2C-FM (using previously reported FFM hydration and density) were compared with 4C-FM estimates, the mean difference was -1.1 ± 0.9 kg for hydrometry and 1.6 ± 1.1 kg for densitometry. CONCLUSIONS Previously published constants of hydration and density of FFM may induce errors of -12% to +17% in FM (kg) when using different 2C models in comparison to the 4C models in Indian children. J Nutr 20xx;x:xx.
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Affiliation(s)
- Sulagna Bandyopadhyay
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Deepa Puttaswamy
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Mamatha Philip Gabriel
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Jayakumar J
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Julia L Finkelstein
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India; Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Sumithra Selvam
- Division of Epidemiology and Biostatistics, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Anura V Kurpad
- Department of Physiology, St. John's Medical College, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Rebecca Kuriyan
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.
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12
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Dassios T, Mitakidou MR, Dhawan A, Papalexopoulou N, Gupta A, Greenough A. Physical activity and liver disease affect the fat-free mass in adolescents with cystic fibrosis. Eur J Pediatr 2023; 182:769-775. [PMID: 36478293 PMCID: PMC9899174 DOI: 10.1007/s00431-022-04752-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
UNLABELLED Cystic fibrosis (CF) is predominantly a lung disease but is also characterised by impaired skeletal muscularity and a reduction in fat-free mass. We aimed to test the hypothesis that clinical and anthropometric parameters would determine fat-free mass impairment in adolescents with CF. We measured the fat-free mass index (FFMI) using bioelectrical impedance, the lung function using spirometry, the number of shuttles as a measure of exercise tolerance and the reported physical activity in children and young people with CF in a tertiary centre at King's College Hospital, London, UK. CF-related liver disease was diagnosed by abnormal liver enzymes and/or ultrasonography. We studied 28 children and young people (11 male) with a median (interquartile range (IQR)) age of 15 (13-17) years. They had a median (IQR) FFMI of 13.5 (11.6-15.1) kg/m2. The FFMI significantly correlated with age (rho = 0.568, p = 0.002), number of shuttles (rho = 0.691, p < 0.001) and reported hours of activity per day (rho = 0.426, p = 0.024). The median (IQR) FFMI was significantly higher in male [15.1 (13.1-18.6) kg/m2] compared to female participants [12.7 (11.6-14.1) kg/m2, p = 0.008]. The median (IQR) FFMI was significantly lower in the 10 (36%) participants with liver disease [11.9 (11.5-13.4) kg/m2] compared to the FFMI in the remaining 18 participants without liver disease [14.4 (12.5-15.9) kg/m2, p = 0.027]. CONCLUSION Fat-free mass increases with increasing age and growth in adolescents with CF. Physical activity exerts a beneficial effect on fat-free mass, and CF-related liver disease negatively affects fat-free mass in adolescents with CF. WHAT IS KNOWN • Health behaviours in adolescence influence lifelong health in cystic fibrosis (CF). • A normal body mass index in CF might fail to reveal a low fat-free mass (FFM), and quality of life in CF is strongly associated with a reduced FFM. WHAT IS NEW • FFM increases with increasing age and growth in adolescents with CF. • Physical activity exerts a beneficial effect, and liver disease negatively affects FFM in adolescents with CF.
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Affiliation(s)
- Theodore Dassios
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. .,Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, 4th Floor Golden Jubilee Wing, London, SE5 9RS, UK.
| | - Maria Rafaela Mitakidou
- grid.13097.3c0000 0001 2322 6764Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Anil Dhawan
- grid.46699.340000 0004 0391 9020Pediatric Liver, GI & Nutrition Centre and Mowat Labs, King’s College Hospital, London, UK ,grid.13097.3c0000 0001 2322 6764Institute of Liver Studies, King’s College London, London, UK
| | - Niovi Papalexopoulou
- grid.13097.3c0000 0001 2322 6764Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Atul Gupta
- grid.429705.d0000 0004 0489 4320Pediatric Respiratory Medicine, Kings College Hospital NHS Foundation Trust, London, UK
| | - Anne Greenough
- grid.13097.3c0000 0001 2322 6764Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Asthma UK Centre in Allergic Mechanisms of Asthma, King’s College London, London, UK ,grid.451056.30000 0001 2116 3923NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, UK
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13
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Hudda MT, Wells JCK, Adair LS, Alvero-Cruz JRA, Ashby-Thompson MN, Ballesteros-Vásquez MN, Barrera-Exposito J, Caballero B, Carnero EA, Cleghorn GJ, Davies PSW, Desmond M, Devakumar D, Gallagher D, Guerrero-Alcocer EV, Haschke F, Horlick M, Ben Jemaa H, Khan AI, Mankai A, Monyeki MA, Nashandi HL, Ortiz-Hernandez L, Plasqui G, Reichert FF, Robles-Sardin AE, Rush E, Shypailo RJ, Sobiecki JG, Ten Hoor GA, Valdés J, Wickramasinghe VP, Wong WW, Riley RD, Owen CG, Whincup PH, Nightingale CM. External validation of a prediction model for estimating fat mass in children and adolescents in 19 countries: individual participant data meta-analysis. BMJ 2022; 378:e071185. [PMID: 36130780 PMCID: PMC9490487 DOI: 10.1136/bmj-2022-071185] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the performance of a UK based prediction model for estimating fat-free mass (and indirectly fat mass) in children and adolescents in non-UK settings. DESIGN Individual participant data meta-analysis. SETTING 19 countries. PARTICIPANTS 5693 children and adolescents (49.7% boys) aged 4 to 15 years with complete data on the predictors included in the UK based model (weight, height, age, sex, and ethnicity) and on the independently assessed outcome measure (fat-free mass determined by deuterium dilution assessment). MAIN OUTCOME MEASURES The outcome of the UK based prediction model was natural log transformed fat-free mass (lnFFM). Predictive performance statistics of R2, calibration slope, calibration-in-the-large, and root mean square error were assessed in each of the 19 countries and then pooled through random effects meta-analysis. Calibration plots were also derived for each country, including flexible calibration curves. RESULTS The model showed good predictive ability in non-UK populations of children and adolescents, providing R2 values of >75% in all countries and >90% in 11 of the 19 countries, and with good calibration (ie, agreement) of observed and predicted values. Root mean square error values (on fat-free mass scale) were <4 kg in 17 of the 19 settings. Pooled values (95% confidence intervals) of R2, calibration slope, and calibration-in-the-large were 88.7% (85.9% to 91.4%), 0.98 (0.97 to 1.00), and 0.01 (-0.02 to 0.04), respectively. Heterogeneity was evident in the R2 and calibration-in-the-large values across settings, but not in the calibration slope. Model performance did not vary markedly between boys and girls, age, ethnicity, and national income groups. To further improve the accuracy of the predictions, the model equation was recalibrated for the intercept in each setting so that country specific equations are available for future use. CONCLUSION The UK based prediction model, which is based on readily available measures, provides predictions of childhood fat-free mass, and hence fat mass, in a range of non-UK settings that explain a large proportion of the variability in observed fat-free mass, and exhibit good calibration performance, especially after recalibration of the intercept for each population. The model demonstrates good generalisability in both low-middle income and high income populations of healthy children and adolescents aged 4-15 years.
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Affiliation(s)
- Mohammed T Hudda
- Population Health Research Institute, St George's University of London, London, SW17 0RE, UK
| | - Jonathan C K Wells
- Population, Policy, and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Linda S Adair
- Department of Nutrition, University of North Carolina Schools of Public Health and Medicine, NC, USA
| | | | - Maxine N Ashby-Thompson
- Department of Pediatrics, New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, NY, USA
| | | | - Jesus Barrera-Exposito
- Biodynamic and Body Composition Laboratory, Faculty of Education Sciences, University of Málaga, Málaga, Spain
| | - Benjamin Caballero
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elvis A Carnero
- Translational Research Institute, Adventhealth Orlando, Orlando, FL, USA
| | - Geoff J Cleghorn
- Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Peter S W Davies
- Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Malgorzata Desmond
- Population, Policy, and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Dympna Gallagher
- Department of Medicine and Institute Human Nutrition, Division of Endocrinology, New York Nutrition Obesity Research Center, Columbia University Medical Center, New York, NY, USA
| | - Elvia V Guerrero-Alcocer
- Centro Universitario UAEM Amecameca, Universidad Autónoma del Estado de México, Amecameca de Juárez, Mexico
| | | | - Mary Horlick
- Body Composition Unit, St Luke's-Roosevelt Hospital, New York, NY, USA
| | - Houda Ben Jemaa
- Nutrition Department, Higher School of Health Sciences and Techniques, University of Tunis El Manar, Tunis, Tunisia
| | - Ashraful I Khan
- International Centre for Diarrheal Disease Research, Dhaka 1212, Bangladesh
| | - Amani Mankai
- Nutrition Department, Higher School of Health Sciences and Techniques, University of Tunis El Manar, Tunis, Tunisia
| | - Makama A Monyeki
- Physical Activity, Sport, and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Hilde L Nashandi
- School of Nursing and Public Health, Faculty of Health Sciences and Veterinary Medicine, University of Namibia, Windhoek, Namibia
| | - Luis Ortiz-Hernandez
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City, Mexico
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, NUTRIM, Maastricht University, Maastricht, Netherlands
| | - Felipe F Reichert
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Alma E Robles-Sardin
- Coordinación de Nutrición, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Mexico
| | - Elaine Rush
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Roman J Shypailo
- Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Jakub G Sobiecki
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Gill A Ten Hoor
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Jesús Valdés
- Departamento de Bioquímica, Centro de Investigación y de Estudios Avanzados del IPN, Mexico City, Mexico
| | | | - William W Wong
- Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Richard D Riley
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's University of London, London, SW17 0RE, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, SW17 0RE, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George's University of London, London, SW17 0RE, UK
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14
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Abstract
PURPOSE OF REVIEW Approximately 370 million children and adolescents worldwide showed overweight or obesity in 2016. The risk of developing severe comorbidities depends on the age of onset and the duration of obesity. This review discusses available methodologies to detect excess body fat in children as well as the early life factors that predict excess body fat and its development. RECENT FINDINGS Factors, such as parental nutritional status, maternal weight gain during pregnancy, maternal malnutrition, maternal smoking during pregnancy, low and high birth weight, rapid weight gain, and short infant sleep duration have been independently and positively associated with neonatal, infant, and children adiposity. Early detection of excess body fat in children through the use of various tools is the first step in preventing nutrition-related diseases in adulthood. SUMMARY The early detection of excess body fat and the implementation of efficient interventions to normalize the weight of children and adolescents at obesity risk are essential to prevent diseases in adult life.
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Affiliation(s)
- Diana Paola Córdoba-Rodríguez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá DC, Colombia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
| | - Gerardo Rodriguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
- Área de Pediatría, Universidad de Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III Madrid, Madrid, Spain
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15
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Sevelsted A, Gürdeniz G, Rago D, Pedersen CET, Lasky-Su JA, Checa A, Zhang P, Wheelock CE, Normann SS, Kristensen DM, Rasmussen MA, Schullehner J, Sdougkou K, Martin JW, Stokholm J, Bønnelykke K, Bisgaard H, Chawes B. Effect of perfluoroalkyl exposure in pregnancy and infancy on intrauterine and childhood growth and anthropometry. Sub study from COPSAC2010 birth cohort. EBioMedicine 2022; 83:104236. [PMID: 36030647 PMCID: PMC9434040 DOI: 10.1016/j.ebiom.2022.104236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Perfluoroalkyl substances PFOS and PFOA are persistent and bioaccumulative exogenous chemicals in the human body with a range of suspected negative health effects. It is hypothesised that exposure during prenatal and early postnatal life might have particularly detrimental effects on intrauterine and childhood growth. In a Danish longitudinal mother-child cohort we investigate effect of PFOS and PFOA in pregnancy and infancy on intrauterine and childhood growth and anthropometry. METHODS COPSAC2010 is an ongoing population based mother-child cohort of 738 pregnant women and their children followed from 24 week gestation with longitudinal deep clinical phenotyping until age 10 years. In this observational cohort sub study plasma PFOS and PFOA concentrations were semi-quantified by untargeted metabolomics in the mothers at week 24 and 1 week postpartum and in the children at ages 6 and 18 months and calibrated using a targeted pipeline. We examined associations to intrauterine and childhood growth and anthropometry, including interactions with child sex. Untargeted and targeted blood metabolomics profiles were integrated to investigate underlying mechanisms. FINDINGS Pregnancy plasma PFOA concentrations were associated with lower birth size -0.19 [-0.33; -0.05] BMI z-score per 1-ng/mL and increased childhood height (z-scored) at age 6: 0.18 [0.05; 0.31], but there was no association between childs' own infancy plasma PFOA concentration and height. Pregnancy plasma PFOS concentrations were also associated with lower birth BMI (-0.04 [-0.08; -0.01]), but in childhood pregnancy plasma PFOS concentration interacted with child sex on BMI and fat percentage at 6 years with negative associations in girls and positive in boys. The effect of maternal plasma PFOS concentration on lower girl BMI was borderline mediated through increasing child plasma lactosyl-ceramide levels (p-mediation=0.08). Similarly the effect of maternal plasma PFOS concentration on higher boy fat percentage was borderline mediated through increasing child plasma lactosyl-ceramide levels (p-mediation=0.07). Infancy concentrations of plasma PFOS associated with lower height in childhood, -0.06 z-score at age 6 [-0.19; -0.03]. INTERPRETATION Higher PFOS and PFOA plasma concentrations during pregnancy had detrimental effects on fetal growth. The effects on childhood growth were not similar as PFOA increased child height, opposite of PFOS in multipollutant models suggesting a differing fetal programming effect. Sex specific growth effects were borderline mediated through an altered lactosyl-ceramide metabolism, proposing a possible mechanism of PFOS that has long-lasting health consequences in this observational study. FUNDING All funding received by COPSAC are listed on www.copsac.com. The Lundbeck Foundation (Grant no R16-A1694); The Novo Nordic Foundation (Grant nos NNF20OC0061029, NNF170C0025014, NNF180C0031764) The Ministry of Health (Grant no 903516); Danish Council for Strategic Research (Grant no 0603-00280B) and The Capital Region Research Foundation have provided core support to the COPSAC research center. Effort from JALS is supported by R01HL123915, R01HL141826, and R01HL155742 from NIH/NHLBI. CEW was supported by the Swedish Heart Lung Foundation (HLF 20180290, HLF 20200693). BC has received funding for this project from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No. 946228). The funding agencies did not have any role in design and conduct of the study; collection, management, and interpretation of the data; or preparation, review, or approval of the manuscript.
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Affiliation(s)
- Astrid Sevelsted
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Gözde Gürdeniz
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Daniela Rago
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Casper-Emil Tingskov Pedersen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jessica A Lasky-Su
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - Antonio Checa
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171-77, Sweden
| | - Pei Zhang
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171-77, Sweden; Gunma University Initiative for Advanced Research (GIAR), Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Craig E Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171-77, Sweden; Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm 141-86, Sweden; Gunma University Initiative for Advanced Research (GIAR), Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan
| | - Stine S Normann
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - David M Kristensen
- Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark; Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Morten Arendt Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jörg Schullehner
- Department of Groundwater and Quaternary Geology Mapping, Geological Survey of Denmark and Greenland, Aarhus, Denmark; Research Unit for Environment, Work and Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Kalliroi Sdougkou
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, Stockholm 114 18, Sweden
| | - Jonathan W Martin
- Science for Life Laboratory, Department of Environmental Science, Stockholm University, Stockholm 114 18, Sweden
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
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Trends in BMI Percentile and Body Fat Percentage in Children 12 to 17 Years of Age. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9050744. [PMID: 35626921 PMCID: PMC9140085 DOI: 10.3390/children9050744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 12/15/2022]
Abstract
This study evaluates the cross-sectional trends in body fat percentage (BF%) and body mass index (BMI) percentile rank, and the relationship between the two in 332 (177 boys, 155 girls) 12- to 17-year-old children. Body mass index (BMI) was calculated using measured height and body mass, and sex-specific BMI for age percentile rank was determined using CDC growth charts. Body fat percentage (BF%) was measured with DEXA. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated by normalizing the fat mass and fat-free mass for height. Compared to boys of the same age, girls had significantly higher BF% and FMI values and lower FFMI values. Compared to boys, at a given BMI percentile rank, females had a higher BF% and FMI, and a lower FFMI. In both boys and girls, there was an exponential increase in adiposity above the 70th percentile rank. BMI percentile rank is not an equivalent indicator of body fatness in boys and girls. Other measures of body composition can further inform the practitioner of a child’s adiposity.
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17
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Higgins S, Zemel BS, Khoury PR, Urbina EM, Kindler JM. Visceral fat and arterial stiffness in youth with healthy weight, obesity, and type 2 diabetes. Pediatr Obes 2022; 17:e12865. [PMID: 34668336 PMCID: PMC8923972 DOI: 10.1111/ijpo.12865] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/15/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Visceral fat is associated with increased cardiovascular risk in adults, but studies in youth are limited. We assessed associations between visceral fat and arterial stiffness in youth with healthy weight, obesity and type 2 diabetes and determined whether relationships were independent of clinical estimates of body fatness. METHODS This cross-sectional sample included youth ages 10-23 years (67% female, 56% non-black) with healthy weight (body mass index [BMI] = 5th-85th percentile, n = 236), obesity (BMI ≥ 95th percentile, n = 224) and type 2 diabetes (BMI ≥ 95th percentile, n = 145). Visceral fat was assessed via dual-energy X-ray absorptiometry. Carotid-femoral pulse wave velocity (PWV) was assessed via applanation tonometry. Obesity and type 2 diabetes groups were combined for final analyses. Analyses accounted for age, sex, ancestry and mean arterial pressure. RESULTS Visceral fat and PWV were greater in youth with obesity versus healthy weight (p < 0.001). In youth with obesity, but not healthy weight, visceral fat was positively associated with PWV (p < 0.001) and was predictive of PWV beyond BMI and waist circumference. CONCLUSIONS Visceral fat likely contributes to subclinical cardiovascular complications in youth. Since cardiovascular health tracks from adolescence to adulthood, longitudinal studies in youth with obesity are required to define the role of visceral fat in lifelong cardiovascular disease risk.
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Affiliation(s)
- Simon Higgins
- Department of Exercise Science, Elon University, Elon, NC, USA
| | - Babette S. Zemel
- Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Philip R. Khoury
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Elaine M. Urbina
- The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, OH, USA
| | - Joseph M. Kindler
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
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18
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Wright CM, Cole TJ, Fewtrell M, Williams JE, Eaton S, Wells JC. Body composition data show that high BMI centiles overdiagnose obesity in children aged under 6 years. Am J Clin Nutr 2021; 116:122-131. [PMID: 34967839 PMCID: PMC9257461 DOI: 10.1093/ajcn/nqab421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Most authorities define childhood overweight/obesity as a BMI exceeding the same high centile cutoff at all ages, but it seems unlikely that true obesity prevalence (excess body fat) is constant throughout childhood. OBJECTIVES We investigated how fat mass (FM) and lean mass (LM), adjusted for height, relate to BMI and each other across childhood, using a uniquely large database of body composition measures, estimated using gold standard methods. METHODS Cross-sectional and cohort data were collated from representative samples of healthy children aged 6 wk to 20 y and children attending obesity clinics aged 7-16 y. Body composition was measured by deuterium dilution up to age 4 y, and by either deuterium or the criterion 4-component model from 4 to 20 y. FM and LM were expressed, respectively, as fat mass index (FMI; FM/height2) and lean mass index (LMI; LM/height2). RESULTS There were 2367 measurements of weight, height, and body composition from 1953 individuals. Before age 6 y, the variability in FMI, LMI, and BMI was much less than after; FMI was low (mainly <8 kg/m2) and FMI and LMI were weakly negatively correlated. From mid-childhood, upper limits for both BMI and FMI rose, but FMI in children with BMI <91st centile still rarely exceeded 8. With increasing age, the correlation of FMI with LMI rose to 0.5-0.7, driven mainly by children with a high FMI also having a high LMI. CONCLUSIONS Raised fat levels are much less common at younger than older ages, and young children with a high BMI centile have lower FMI than older children with the same BMI centile. Current BMI centile cutoffs thus overdiagnose obesity in younger groups. More stringent cutoffs are required for children aged <6 y, matching the WHO recommendation for 0-5 y.
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Affiliation(s)
| | - Tim J Cole
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Mary Fewtrell
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jane E Williams
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Simon Eaton
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jonathan C Wells
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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19
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O'Callaghan KM, Shanta SS, Fariha F, Harrington J, Mahmud AA, Emdin AL, Gernand AD, Ahmed T, Abrams SA, Moore DR, Roth DE. Effect of maternal prenatal and postpartum vitamin D supplementation on offspring bone mass and muscle strength in early childhood: follow-up of a randomized controlled trial. Am J Clin Nutr 2021; 115:770-780. [PMID: 34849536 PMCID: PMC8895216 DOI: 10.1093/ajcn/nqab396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Maternal vitamin D status during pregnancy and lactation is a modifiable factor that may influence offspring musculoskeletal outcomes. However, few randomized trials have tested the effects of prenatal or postpartum vitamin D supplementation on offspring bone and muscle development. OBJECTIVES The aim was to examine hypothesized effects of improvements in early-life vitamin D status on childhood musculoskeletal health in Dhaka, Bangladesh. METHODS In a previously completed, double-blind, dose-ranging trial, healthy pregnant women (n = 1300) were recruited at 17-24 weeks' gestation and randomly assigned to a prenatal/postpartum regimen of 0/0, 4200/0, 16,800/0, 28,000/0, or 28,000/28,000 IU cholecalciferol (vitamin D3)/wk until 26 wk postpartum. In this new report, we describe additional follow-up at 4 y of age (n = 642) for longer-term outcomes. Bone mineral content (BMC) and areal bone mineral density (aBMD) were measured by DXA. Grip strength was tested using a hand-held dynamometer. The primary comparison was children of women assigned to 28,000 IU/wk prenatally compared with placebo. Differences are expressed as means and 95% CIs. RESULTS Total-body-less-head (TBLH) BMC, TBLH aBMD, and grip strength were similar in the combined high-dose prenatal (28,000/0 and 28,000/28,000 IU/wk) compared with placebo groups (mean difference [95% CI] = 0.61 g [-10.90, 12.13], 0.0004 g/cm2 [-0.0089, 0.0097], and 0.02 kg [-0.26, 0.31], respectively). In dose-ranging analyses, TBLH BMC and aBMD, whole-body BMC and aBMD, and grip strength in each of the prenatal vitamin D groups were not significantly different from placebo (P > 0.05 for all comparisons). Only head aBMD was greater in children of women assigned to the 28,000/28,000-IU regimen compared with placebo (mean difference [95% CI] = 0.024 g/cm2 [0.0009, 0.047], P = 0.042); the effect was attenuated upon adjustment for child height, weight, and sex (P = 0.11). CONCLUSIONS Maternal prenatal, with or without postpartum, vitamin D supplementation does not improve child BMC, aBMD, or grip strength at 4 y of age. The MDIG trial and present follow-up study were registered prospectively at www.clinicaltrials.gov as NCT01924013 and NCT03537443, respectively.
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Affiliation(s)
- Karen M O'Callaghan
- Centre for Global Child Health and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Shaila S Shanta
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Farzana Fariha
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jennifer Harrington
- Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Abdullah Al Mahmud
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abby L Emdin
- Centre for Global Child Health and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA, USA
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Steven A Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas at Austin, Austin, TX, USA
| | | | - Daniel E Roth
- Centre for Global Child Health and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada,Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
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20
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Yin L, Song C, Cui J, Wang N, Fan Y, Lin X, Zhang L, Zhang M, Wang C, Liang T, Ji W, Liu X, Li W, Shi H, Xu H. Low fat mass index outperforms handgrip weakness and GLIM-defined malnutrition in predicting cancer survival: Derivation of cutoff values and joint analysis in an observational cohort. Clin Nutr 2021; 41:153-164. [PMID: 34883304 DOI: 10.1016/j.clnu.2021.11.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS The optimal thresholds to define a survival-related low fat mass index (FMI) in Asian oncology populations remains largely unknown. This study sought to derive the sex-specific FMI cutoffs and analyze the independent and joint associations of a low FMI, handgrip weakness, and the Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition with cancer survival. METHODS We performed a multicenter cohort study including 2376 patients with cancer. The FMI was measured by bioelectrical impedance analysis and the best thresholds were determined using an optimal stratification (OS) method. Low handgrip strength (HGS) and malnutrition were defined based on the Asian Working Group for Sarcopenia 2019 framework and the GLIM, respectively. The associations of a low FMI, handgrip weakness and malnutrition with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HRs). RESULTS The study enrolled 1303 women and 1073 men with a mean age of 57.7 years and a median follow-up of 1267 days. The OS-defined FMI cutoffs were <5 kg/m2 in women and <7.7 kg/m2 in men. A low FMI, low HGS and malnutrition were identified in 1188 (50%), 1106 (46.5%) and 910 (38.3%) patients, respectively. A low FMI was adversely associated with the nutritional status, physical performance, quality of life and hospitalization costs. A low FMI (HR = 1.50, 95%CI = 1.16 to 1.92) and malnutrition (HR = 1.31, 95%CI = 1.08 to 1.59) were independently associated with mortality. Overall, the FMI plus GLIM-defined malnutrition showed the maximal joint prognostic impact, and patients with a combined low FMI and malnutrition had the worst survival (HR = 1.93, 95%CI = 1.48 to 2.52). CONCLUSIONS Low FMI-indicated fat depletion outperforms and strengthens the prognostic value of handgrip weakness and GLIM-defined malnutrition for cancer survival. These findings indicate the importance of including fat mass assessment during routine cancer care to help guide strategies to optimize survival outcomes.
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Affiliation(s)
- Liangyu Yin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China; Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Jiuwei Cui
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Nanya Wang
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Yang Fan
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Xin Lin
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Ling Zhang
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Mengyuan Zhang
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China
| | - Chang Wang
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Tingting Liang
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Wei Ji
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Xiangliang Liu
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021, China.
| | - Hanping Shi
- Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042, China.
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21
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Alja'nini Z, Merlino-Barr S, Brumfiel A, McNelis K, Viswanathan S, Collin M, Groh-Wargo S. Effect of parenteral nutrition duration on patterns of growth and body composition in very low-birth-weight premature infants. JPEN J Parenter Enteral Nutr 2021; 45:1673-1682. [PMID: 34638161 DOI: 10.1002/jpen.2278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Parenteral nutrition (PN) is essential to support premature infants' growth and varies with enteral nutrition (EN) advancement rates. Data on PN duration's impact on premature infants' growth are limited. The aim of this multicenter observational study was to determine the effect of early PN duration on body composition at term corrected gestational age (CGA) in very low-birth-weight (VLBW) premature infants. METHODS VLBW infants exposed to PN in the first week of life and exposed to significantly different EN regimens were divided into two groups on the basis of early PN duration. Infants with a birth weight (BW) <1000 g and PN duration <28 days and infants with a BW 1000-1500 g and PN duration <14 days were assigned to the "short-PN" group. Infants receiving PN for longer durations were assigned to the "long-PN" group. Body composition was assessed via air displacement plethysmography at term CGA or before discharge. RESULTS Sixty-two and 53 infants were assigned to the short-PN and long-PN groups, respectively. The two groups were significantly different in BW and GA, so a nested case-control study was conducted after matching 36 infant pairs. Infants in the long-PN group had significantly lower fat-free mass (FFM) z-scores, but both groups had comparable fat mass (FM) z-scores. Long PN was a significant negative predictor of FFM z-score in the multivariate regression analysis. CONCLUSION In VLBW premature infants, PN duration is negatively associated with FFM z-scores at term CGA without affecting FM z-scores.
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Affiliation(s)
- Zaineh Alja'nini
- Department of Pediatrics, MetroHealth Medical Center affiliated with Case Western Reserve University, Cleveland, Ohio, USA
| | - Stephanie Merlino-Barr
- Department of Pediatrics, MetroHealth Medical Center affiliated with Case Western Reserve University, Cleveland, Ohio, USA
| | - Alexa Brumfiel
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kera McNelis
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Sreekanth Viswanathan
- Division of Neonatology, Department of Pediatrics, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Marc Collin
- Department of Pediatrics, MetroHealth Medical Center affiliated with Case Western Reserve University, Cleveland, Ohio, USA
| | - Sharon Groh-Wargo
- Department of Pediatrics, MetroHealth Medical Center affiliated with Case Western Reserve University, Cleveland, Ohio, USA
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Gätjens I, Schmidt SCE, Plachta-Danielzik S, Bosy-Westphal A, Müller MJ. Body Composition Characteristics of a Load-Capacity Model: Age-Dependent and Sex-Specific Percentiles in 5- to 17-Year-Old Children. Obes Facts 2021; 14:593-603. [PMID: 34818246 PMCID: PMC8738913 DOI: 10.1159/000518638] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Body composition assessment is superior to the use of body mass index (BMI) to characterize the nutritional status in pediatric populations. For data interpretation, suitable reference data are needed; hence, we aimed to generate age-dependent and sex-specific body composition reference data in a larger population of children and adolescents in Germany. METHODS This is a cross-sectional study on a representative group of 15,392 5- to 17-year-old children and adolescents. Body composition was assessed by bioelectrical impedance analysis using a population-specific algorithm validated against air displacement plethysmography. Age- and sex-specific percentiles for BMI, fat mass index (FMI), fat-free mass index (FFMI), and a "load-capacity model" (characterized by the ratios of fat mass [FM]/ fatt-free mass [FFM] and FM/FFM2) were modeled using the LMS method. RESULTS BMI, FMI, FFMI, FM/FFM, and FM/FFM2 curves showed similar shapes between boys and girls with steady increases in BMI, FMI, and FFMI, while FM/FFM2-centiles decreased during early childhood and adolescence. Sex differences were observed in FMI and FM/FFM percentiles with increases in FMI up to age 9 years followed by a steady decrease in FM/FFM during and after puberty with a fast-growing FFMI up to age 17 in boys. The prevalence of low FFM relative to FM reached more than 60% in overweight children and adolescents. CONCLUSION These pediatric body composition reference data enable physicians and public health scientists to monitor body composition during growth and development and to interpret individual data. The data point out to an early risk of sarcopenia in overweight children and adolescents.
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Affiliation(s)
- Isabel Gätjens
- Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany
| | | | | | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany,
| | - Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany
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Zhu Y, Ye H, Feng Y, Pan L, Fu H, Liu Y, Fei J, Hong L. Assessment of nutritional status in paediatric outpatients using bioelectrical impedance analysis and anthropometric z-scores. J Paediatr Child Health 2021; 57:1274-1280. [PMID: 33749969 PMCID: PMC8451919 DOI: 10.1111/jpc.15450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/09/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Abstract
AIM To investigate paediatric outpatients' nutritional status using bioelectrical impedance analysis and anthropometric z-scores. METHODS A retrospective data analysis of tertiary paediatric hospital outpatients from 2017 to 2019 was conducted. Patients were categorised into three groups (non-illness, illness and simple obesity) according to clinical diagnoses. The nutritional status was evaluated using anthropometric and bioelectrical impedance analysis. In addition, body composition measurements of patients in three subgroups of the illness group and age- and gender-matched healthy controls were compared. RESULTS A total of 2015 paediatric outpatients were enrolled. According to body mass index z-scores, undernutrition prevalence among participants was 14.0% (non-illness group, 21.3%; illness group, 11.4%). Body composition measurements indicated that 41.6% of participants had a low fat-free mass index, and the proportions of participants with a low fat-free mass index in the non-illness, illness and simple obesity groups were 48.4, 47.0 and 10.7%, respectively. Compared with healthy controls, the haematology and oncology subgroup had a significantly lower fat-free mass index and fat mass index; the nephrology and rheumatology subgroup had significantly lower height-for-age z-scores but higher fat mass index; and the gastroenterology subgroups had lower fat mass index, fat-free mass index and body mass index z-scores. CONCLUSIONS The results suggested the low fat-free mass index prevalence was greater than the low body mass index z-score prevalence among paediatric outpatients, and body composition parameters varied across different illnesses. Body composition analysis is recommended in nutrition clinics for accurate paediatric outpatient nutritional assessment, thereby providing timely individualised nutritional interventions.
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Affiliation(s)
- Yuan Zhu
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hong Ye
- Department of PaediatricFujian Province Children's Hospital, Fujian Provincial Maternity and Children's Hospital, Fujian Medical UniversityFujianChina
| | - Yi Feng
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Li‐ya Pan
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Huan‐huan Fu
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yun‐man Liu
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jun Fei
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Li Hong
- Department of Clinical NutritionShanghai Children's Medical Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
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Stierman B, Ogden CL, Yanovski JA, Martin CB, Sarafrazi N, Hales CM. Changes in adiposity among children and adolescents in the United States, 1999-2006 to 2011-2018. Am J Clin Nutr 2021; 114:1495-1504. [PMID: 34291279 PMCID: PMC8645193 DOI: 10.1093/ajcn/nqab237] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/22/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Data from the NHANES indicate that BMI has increased in some subgroups of children and adolescents in the United States over the past 20 y; however, BMI is an indirect measure of body fatness. OBJECTIVES We assessed changes in DXA-derived measures of adiposity in a nationally representative population of US children and adolescents aged 8-19 y from 1999-2006 to 2011-2018. METHODS Using data from the NHANES, we compared the means and distributions of DXA-derived percentage body fat (%BF) and fat mass index (FMI; fat mass/height2 in kg/m2) between 1999-2006 (n = 10,231) and 2011-2018 (n = 6923) among males and females by age group, race and Hispanic origin, and BMI categories. Estimates were standardized by age and race and Hispanic origin. RESULTS From 1999-2006 to 2011-2018, mean %BF increased from 25.6% to 26.3% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P < 0.01) among all males, whereas mean %BF increased from 33.0% to 33.7% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P = 0.01) and mean FMI increased from 7.7 to 8.0 fat mass kg/m2 (change in FMI: 0.3 fat mass kg/m2; 95% CI: 0.0, 0.6 fat mass kg/m2; P = 0.02) among all females. Changes were not consistent across all age, race and Hispanic origin, and BMI categories. Both %BF and FMI increased among Mexican-American children and adolescents, but not other race and Hispanic origin groups. CONCLUSIONS Among US children and adolescents, DXA-derived measures of adiposity increased from 1999-2006 to 2011-2018, albeit not consistently in every age, race and Hispanic origin, and BMI subgroup. These data reinforce the need to consider other measures, besides BMI categories, when studying adiposity in children and adolescents.
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Affiliation(s)
| | - Cynthia L Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD, USA
| | - Crescent B Martin
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Neda Sarafrazi
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Craig M Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA,United States Public Health Service, Rockville, MD, USA
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Seo YG, Kim Y, Lim H, Kang MJ, Park KH. Relationship Between Bone Mineral Density and Body Composition According to Obesity Status in Children. Endocr Pract 2021; 27:983-991. [PMID: 34144210 DOI: 10.1016/j.eprac.2021.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To analyze the relationship between body composition, metabolic parameters, and bone mineral density (BMD) according to sex and the degree of obesity in children and adolescents. METHODS A total of 236 subjects with obesity, aged 10 to 15 years (36.9% girls), were enrolled. Obesity was classified into simple (SmOb) and extreme (ExOb) forms. The BMD of the total body, less head, was measured by dual energy x-ray absorptiometry, and the BMD z-score was used to evaluate the relationship of body composition with metabolic parameters. RESULTS BMD z-scores were higher in subjects with ExOb than in those with SmOb. Lean mass index (LMI), body mass index z-score, and vitamin D intake showed positive relationships, whereas percentage of body fat and serum leptin level showed negative relationships with BMD z-scores in boys. In girls, LMI and body mass index z-score showed positive relationships with BMD z-scores. In multivariable linear regressions, serum leptin level showed negative relationships with BMD z-score, only in boys. In addition, positive relationships of LMI and negative relationships of percentage of body fat with BMD z-scores were observed in subjects with SmOb. However, positive relationships of LMI with BMD z-scores were attenuated in subjects with ExOb. CONCLUSION High BMD appears to be positively associated with lean mass in children and adolescents with obesity, which might be a natural protective mechanism to withstand the excess weight. However, excessive body fat appears to be negatively associated with BMD, which might attenuate the positive relationship between lean mass and BMD in subjects with ExOb.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin, Republic of Korea
| | - Min Jae Kang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
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Duggan CP, Kurpad A, Stanford FC, Sunguya B, Wells JC. Race, ethnicity, and racism in the nutrition literature: an update for 2020. Am J Clin Nutr 2020; 112:1409-1414. [PMID: 33274358 PMCID: PMC7727473 DOI: 10.1093/ajcn/nqaa341] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 01/06/2023] Open
Abstract
Social disparities in the US and elsewhere have been terribly highlighted by the current COVID-19 pandemic but also an outbreak of state-sponsored violence. The field of nutrition, like other areas of science, has commonly used 'race' to describe research participants and populations, without the recognition that race is a social, not a biologic, construct. We review the limitations of classifying participants by race, and recommend a series of steps for authors, researchers and policymakers to consider when producing and reading the nutrition literature. We recommend that biomedical researchers, especially those in the field of nutrition, abandon the use of racial categories to explain biologic phenomena but instead rely on a more comprehensive framework of ethnicity; that authors consider not just race and ethnicity but many social determinants of health, including experienced racism; that race and ethnicity not be conflated; that dietary pattern descriptions inform ethnicity descriptions; and that depersonalizating language be avoided.
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Affiliation(s)
- Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Anura Kurpad
- Department of Nutrition, St. John’s Research Institute, St. John’s National Academy of Health Sciences, Bangalore, India
| | - Fatima C Stanford
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Bruno Sunguya
- Directorate of Research and Publications, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, University College London, London, United Kingdom
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28
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Di Credico A, Gaggi G, Ghinassi B, Mascherini G, Petri C, Giminiani RD, Di Baldassarre A, Izzicupo P. The Influence of Maturity Status on Anthropometric Profile and Body Composition of Youth Goalkeepers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8247. [PMID: 33171648 PMCID: PMC7664635 DOI: 10.3390/ijerph17218247] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022]
Abstract
The anthropometric profile assessment is an important aspect to consider during the growth stages of youth sport practitioners due to its usefulness in controlling maturity status and overall health. We performed an anthropometric profile evaluation in a sample of youth goalkeepers (n = 42) during a training camp, dividing them into three categories based on their years from peak height velocity (YPHV). We also checked if the selection of goalkeepers was associated with the birth quartile. The results showed that most of the participants' anthropometric parameters followed the normal trend according to the maturation stages. However, several subjects showed an overweight/obese condition and/or high waist circumference. Non-optimal values were found, mostly in the group of goalkeepers around the PHV. In addition, no selection based on birth quartile was seen. Therefore, the anthropometric profile and body composition of youth goalkeepers are physiologically affected by maturity status. However, several subjects were found to be overweight/obese and at cardiometabolic risk, suggesting that children and adolescents, although practicing sport, should pay attention to potentially contributing factors such as the attainment of the recommended levels of physical activity, lowering sedentary time, and adopt a healthy lifestyle.
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Affiliation(s)
- Andrea Di Credico
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Giulia Gaggi
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Barbara Ghinassi
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy; (G.M.); (C.P.)
| | - Cristian Petri
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, Italy; (G.M.); (C.P.)
| | - Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (A.D.C.); (G.G.); (B.G.); (P.I.)
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Wells JCK. Promoting ethnic parity in health, leaving behind "race": a challenge for the global community in 2020. Am J Clin Nutr 2020; 112:505-506. [PMID: 32869066 DOI: 10.1093/ajcn/nqaa189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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