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Body composition in elderly persons: A critical review of needs and methods
Abstract
Significant changes in body composition that have important health related effects are believed to occur in the elderly. Knowledge of these changes is important for diagnoses, prognoses, and treatment of health problems. Many health problems in the elderly could be prevented or alleviated by nutritional modulation, but better understanding of the nature, extent, and underlying physiology of body compositional changes is needed for such interventions to be successful. There are currently few data for body composition in the elderly, especially for those greater than 75 y in age, partly because conventional methods of assessing body composition are difficult to apply for technical and conceptual reasons. As a result, little is known regarding the relationships of body composition to nutritional, functional or health status in non-hospitalized, free-living elderly persons. Knowledge of the "natural history" of body compositional changes and their relationships to other nutritional and health factors could lead to new insights on prevention and treatment, the reduction of morbidity and extension of the quality of life of older persons.
... A widely used 4-compartment body-composition model assumes that the body consists of fat, protein, water, and mineral compartments (30,31). FFM (FFM 4C , in kg) was calculated from this model as follows: ...
... As discussed by Baumgartner (30), the assumed nitrogen content of protein (1 g N = 6.25 g protein) and the ratio of osseous to nonosseous mineral (0.84) involved in these calculations are applicable to subjects in this age range. ...
... Similarly, hydration of FFM was estimated by expressing TBW as a percentage of FFM SKF . These measures were included to assess their potential contribution to intermethod differences in body-composition measurement because variance in these FFM components is known to affect body density and can thereby reduce the accuracy of 2-compartment models (26,30,31). ...
Skeletal muscle mass (SMM) and fat-free mass (FFM) are important variables in nutritional studies. Accurate techniques for measuring these variables have not been thoroughly validated in elderly subjects.
The objectives of this study were to 1) compare SMM values derived from dual-energy X-ray absorptiometry (DXA) with those calculated by a nuclear method from total body potassium (TBK) and total body nitrogen (TBN) measurement (both: KN) in older subjects, and 2) assess the accuracy of FFM measurement by DXA in these subjects.
TBK, TBN, DXA (model XR36; Norland, Fort Atkinson, WI), bioimpedance, and anthropometric measurements were performed on healthy women (n = 50) and men (n = 25) aged 51-84 y.
Mean SMM by KN was not significantly different from SMM by DXA in either sex. SMM by KN predicted SMM by DXA with an SEE of 2.1 kg (r = 0.95, P < 0.0001 for women and men together). In the men, FFM by DXA agreed well with FFM estimated by TBK, skinfold thicknesses, bioimpedance analysis, and a multicompartment model. In women, FFM by DXA was 4-5 kg less than that by the other methods (P < 0.01). Truncal fat was related to intermethod FFM differences (r = 0.58, P < 0.0001).
These data indicate that 1) either the nuclear or the DXA method can be applied to estimate SMM in healthy older subjects, and 2) the Norland DXA instrument significantly underestimates FFM in older women, in part, because of the influence of truncal adiposity.
... NOWLEDGE of the actual body composition changes associated with aging and the relationship of these changes with nutritional and health factors are required for valid medical diagnoses and prognoses or nutritional and pharmacological treatment (1). The assessment of body composition is important in determining elderly people's nutritional status, protein mass, skeletal mineral status, energy expenditure, and relative level of hydration (2)(3)(4). Changes within these factors may signal declines in organ function, metabolism, nutrient intake and utilization, and resistance to traumatic and disease stresses (1). Being overfat (i.e., obese) is a wellknown contributor to medical conditions such as diabetes, cardiovascular disease, and hypertension. ...
... Durnin and Womersley and Deurenberg and colleagues utilized these age ranges with the expectation of building general equations that may be used on subjects of virtually any age. However, in body composition analysis, especially methods that utilize anthropometric measures, the predictive equations must be population specific if measure validity and reliability are of interest (2,3). ...
... The use of hydrodensitometry as a means of deriving criterion measures on elderly adults has been criticized by some (2). Baumgartner reports that the changes in bone mineral, body hydration, and loss of lean mass (i.e., muscle) will cause overestimates of elderly body density when hydrodensitometry is used (2). ...
The purpose of this study was to develop and validate anthropometric body composition prediction equations for elderly (i.e., > or =65 years old) men. This was necessary because of a lack of accurate and reliable predictive equations specifically developed for this population.
Seventy-five elderly men were randomly assigned to either an equation development sample (on = 50) or an equation validation sample (n = 25). Subject anthropometric measures were analyzed in a regression procedure with hydrodensitometry-determined body density, percentage of fat, fat-free mass, and fat weight to develop prediction equations for each body composition variable. The equation estimates were then validated against the hydrostatically determined measures.
Four equations were developed and validated for the estimation of elderly male body composition variables [one each for body density (R2 = .66, SEE = +/- .01, where SEE is the standard error of estimate), percentage of fat (R2 = .66, SEE = +/- 4.43), fat-free mass (R2 = .88, SEE = +/- 3.94, and fat weight (R2 = .90, SEE = +/- 4.11)]. The equations provided estimates of body density, percentage of fat, fat-free mass, and fat weight, which were not statistically different from the hydrostatically determined criterion variables.
The results of this study indicate that accurate and reliable anthropometric predictive equations can be developed for an active and healthy elderly male population. These equations may be used for accurate epidemiological testing of this group's body composition variables.
... Blood samples were collected after 12-14 h fasting to evaluate serum TG, HDL-C and FBS, which were measured via enzymatic methods using standard protocols. DNA's extraction was accomplished by a high-salt method as described previously [20]. PCR-RFLP method was used to determine CAV-1 rs3807992 genotypes polymorphisms. ...
... Noteworthy, the present mediation analysis is especially interesting in that the arguable link which is present between visceral and total body fat is known. A close relation is present among anthropometric values and FD; the risk of developing MetS increases in persons who have fat deposition in visceral adipose than total body fat deposition [20]. The importance of visceral adipose tissue in the pathophysiology of metabolic disorders can be hallmarked by comparing speci cations of VAT with SAT. ...
Background: Metabolic syndrome (MetS) carries increased risk of the mortality of almost all chronic diseases. The most frequently used methods for calculation of a continuous MetS (cMetS) score have used the MetS severity z- score. Caveolin-1 (CAV-1(is one of the gens that is suggested by some authors that has a great effect on the visceral fat. This study was designed to investigate the relationship between CAV-1 markers and cMetS, the associations between CAV-1 rs3807992 and FD; and to assess FD mediators of the predicted association between CAV-1 and cMetS.
Methods: The current cross-sectional study was conducted on 404 overweight and obese females. The CAV-1 rs3807992 and anthropometric data were measured by the PCR-RFLP method and bioelectrical impedance analysis (BIA), respectively. Serum profiles (HDL-C, TG, FPG, and Insulin) were measured by standard protocols.
Results: Individuals with GG allele had significantly lowered (Z-MAP (p=0.02), total cMetS (p=0.03)) and higher Z-HDL (p=0.001) compared with A allele carrier. There was a significant specific indirect effect (standardized coefficient = 0.19; 95% CI: 0.01–0.4) of VFL. Although, total body fat was significantly associated with CAV-1 rs3807992 and cMetS, the specific indirect effect was not significant (standardized coefficient = 0.21; 95% CI: (-0.006,0.44). Visceral fat level contributed to significant indirect effects of 35% on the relationship between CAV-1 and cMetS.
Conclusion: Higher visceral adipose tissue may affect the relationship between CAV-1 and MetS. Although CAV-1 rs3807992 is linked to visceral fat in our study, the influence of this polymorphism on MetS is not via total fat.
... In addition to well-known gender differences in body composition, body composition changes with ageolder people have less muscle mass, less bone mass, expanded extracellular fluid volumes and reduced body cell mass compared to younger adults. 13,14 A small proportion of older people are simultaneously obese and sarcopenic ("sarcopenic obesity") and therefore at high risk of disability. 15 Conversely, up to 70% of older adults are obese or overweight, 5 and potential candidates for intentional weight loss to reduce risk factors for cardiovascular disease and diabetes and improve physical function. ...
... We selected 1990 as a conservative estimate for the earliest likely publication of a systematic review on this topic, as this pre-dates some of the earliest work in this field. 13,14 Additionally, extending the search as far back as 1990 will help to allow us to identify whether a review is an update of a previous review. The following electronic peer-reviewed databases will be used: Medline, EMBASE, CINAHL, Scopus, the Cochrane Library (the Cochrane Library search will encompass the Cochrane Database of Systematic Reviews), Database of Reviews of Effects (DARE), ...
Review question/Objective
What is the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community, and what are these people's qualitative perceptions and experiences?
The objectives of this umbrella review are to measure and compare the overall effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to better understand how they perceive and experience the nutritional interventions.
Background
The World Health Organization (WHO) defines healthy ageing (active ageing) as "the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age " .1 (p.12) Further: "Active ageing applies to both individuals and population groups. It allows people to realize their potential for physical, social, and mental wellbeing throughout the life course and to participate in society according to their needs, desires and capacities, while providing them with adequate protection, security and care when they require assistance."1 (p.12)
Nutrition (healthy eating) is a key behavioral determinant of healthy ageing.1-3 Importantly, both cross-sectional and longitudinal studies have shown that improved dietary patterns and nutritional intake is possible, and can reduce the effect of chronic disease in older adults.3
Nutrition-related risks to healthy ageing tend to focus on the increasing prevalence of overweight and obesity and the link with chronic conditions of cardiovascular disease, metabolic syndrome and cognitive decline.3 Other health outcomes that are known to be food and/or nutrition related are bone health and cancer.3 Interventions to prevent or treat overweight or obesity commonly involve diet and exercise, and may also include surgical interventions, psychological interventions (cognitive behavior therapy and behaviour therapy), acupuncture, pharmaceutical, and commercial weight loss products.
Conversely, being underweight can be a significant health risk in older people. Oral health problems, reduced appetite and anorexia can affect dietary intake and lead to malnutrition in older people, significantly increasing risks of poorer outcomes including frailty, which has been defined as: a medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing increased dependency and/or death".4 (p.392)
Physical frailty can be potentially prevented or treated with specific interventions, including protein/calorie supplementation, vitamin D, exercise and reduction of polypharmacy.4 Sarcopenia (reduced muscle mass) is a common component of frailty.
Body Mass Index (BMI) is a simple index calculated from height and weight information, using the equation:
JOURNAL/jbisris/04.03/01938924-201412110-00004/math_4MMU1/v/2024-01-18T212147Z/r/image-jpeg
Although there are some limitations to their use and interpretation (discussed in more detail below), BMI ranges are commonly used to classify underweight, normal weight, overweight and obesity (Table 1 ). In 2011-12, 63.4% of Australians aged 18 years and over were overweight or obese, comprised of 35.0% overweight and 28.3% obese (Table 1 ).5 A further 35.2% were of normal weight. Proportionally, in older Australians (aged 65 or greater) there were slightly more overweight and obese older Australians (71.9%), and slightly less underweight (1.1%) than the whole population (Table 1 ). Although sample size is low for underweight Australians, potentially limiting the validity of the data, in those 75 years and over the prevalence of underweight was 1.9%. Further, using the definition of frailty (above), it is estimated that in those 65 years and older, the prevalence of frailty ranges from 4-17% (mean 9%), with a higher prevalence when psychosocial frailty is also present.6 The prevalence of frailty was almost twice as great in women (9.6%) than men (5.2%), and increases markedly in persons older than 80 years of age.4
Although BMI has been a useful measure to raise awareness about health risks in the general population, limitations in the usefulness of BMI as a marker for risk of health harms due to overweight and underweight have been widely raised7-10 For example, it is more appropriate to define obesity as an excess accumulation of body fat, as it is the excess adipose tissue, not the excess weight, which causes chronic co-morbid conditions such as cardiovascular disease.7 Similarly, as discussed by Lukaski,11 there are some protections from metabolic and cardiovascular diseases conferred to 'metabolically healthy obese' people, who have a high level of insulin sensitivity, normal lipids, low inflammation and no hypertension, but a BMI classified as obese. Instead, measures of body composition are proposed as being more informative for assessment of nutrition status and health risks.
Body composition measurement involves precise and accurate measurement of both the soft tissue composition (i.e. fat, and fat-free or lean mass) and the bone mineral (mass and quality). These variables provide in vivo measurements of body energy stores (fat or adipose tissue), structure (bone) and functional capacity (muscle mass or body cell mass).7, 9 The common measures of body composition include fat-free soft mass (FFSM), per cent body fat, skeletal muscle, fat mass (FM), bone mineral content (BMC) and bone mineral density (BMD).8, 10, 12
Broadly, there are two models of measurement of body composition proposed: a more widely used two-compartment model partitioning the body into fat mass and fat-free mass, and a less frequently used four-compartment model of body mass, total body volume, total body water (TBW) and bone mineral.9, 10 There are a range of non-invasive methods of body composition measurement methods including traditional techniques such as skinfolds, bioelectrical impedance, dilution techniques, air displacement plethysmography, dual energy X-ray absorptiometry and magnetic resonance spectroscopy.10 More recently developed techniques include three dimensional photonic scanning and quantitative magnetic resonance.10
Optimal body composition
There are a number of factors to consider when attempting to define what constitutes "optimal" body composition. In addition to well-known gender differences in body composition, body composition changes with age - older people have less muscle mass, less bone mass, expanded extracellular fluid volumes and reduced body cell mass compared to younger adults.13, 14 A small proportion of older people are simultaneously obese and sarcopenic ("sarcopenic obesity") and therefore at high risk of disability.15 Conversely, up to 70% of older adults are obese or overweight,5 and potential candidates for intentional weight loss to reduce risk factors for cardiovascular disease and diabetes and improve physical function. However, intentional weight loss has not been widely advocated for older, community dwelling adults because of uncertainty as to whether the benefits outweigh the risks.16, 17 This uncertainty has been partly ascribed to the association of unintentional weight loss, which accompanies many diseases affecting older people, with increased mortality in observational studies.18, 19 Although there are documented adverse effects of intentional weight loss on some body composition measures (muscle and bone), there is a lack of evidence documenting benefits in mortality or disability and only limited evidence from small clinical trials about reductions in risk factors for cardiovascular disease and diabetes.18 In practice, healthcare providers are reluctant to recommend weight loss in overweight and obese adults, with rates of weight loss advice provision to people with obesity, even those with obesity-related health problems, being less than 50%.18 This may also be related to the perceived intransigence of the problem of obesity in older people.20
Current practice relating to optimizing body composition in older adults through health promotion, nutrition and health care policy is therefore more strongly weighted to alleviating malnutrition and frailty in vulnerable people than to addressing the high prevalence of overweight and obesity.18, 20 Despite some confusion about the latter group, there are a number of position statements from US-based organisations advocating intentional weight loss for overweight and/or obese older adults. The National Heart, Lung and Blood Institute recommended that treatment for obesity should be offered to older people: "Age alone should not preclude treatment for obesity in adult men and women".21 (p41) Similarly, the American Society for Nutrition and the Obesity Society recommend weight loss therapy for older adults who are obese and who have functional impairments or medical complication that could be improved by weight loss. The therapy should minimise muscle and bone loss.22 Australian guidelines, while acknowledging that weight loss improves functional mobility and physical performance in older people, do not give explicit advice on weight loss for older people apart from advice that approaches to increasing physical activity be individualized.23
In summary, while the benefits of weight gain on key health outcomes such as morbidity and mortality for those who are underweight are generally clearly defined, the benefits of weight loss in overweight or obese people are somewhat less clear, particularly for older people. While our understanding of relationships between nutritional status and health outcomes including mortality and morbidity (such as the development of cardiovascular disease, metabolic syndrome and cognitive decline) improves, and there are a number of systematic reviews that examine the effectiveness of: (i) single intervention (such as nutritional supplementation or caloric restriction) or (ii) combined interventions (such as diet and exercise) in improving the nutritional status of people, there are no current umbrella reviews that collate and summarize the evidence from all relevant, high quality systematic reviews. It is proposed that this review will address this deficit, by focusing on:
The focus of this review is the effectiveness of nutritional interventions. Participants' perspectives and experiences of the interventions will have a strong impact on adherence and sustainability of any treatment plans. Therefore, the qualitative perceptions and experiences of older people exposed to a nutritional interventional will also be included as a secondary outcome in this review. A scoping search identified a large number of relevant existing systematic reviews, indicating the need for an overview of reviews, otherwise known as an 'umbrella review'.25
... With aging, total body fat increases as well as the risks associated with such gains. 23,24,27 However, elderly people also have less muscle mass, expanded extracellular fluid volumes, and reduced body cell mass compared to younger adults. 24,27 This illustrates the importance of both fat and non-fat components in influencing the health of the elderly. ...
... 23,24,27 However, elderly people also have less muscle mass, expanded extracellular fluid volumes, and reduced body cell mass compared to younger adults. 24,27 This illustrates the importance of both fat and non-fat components in influencing the health of the elderly. Body composition alterations in the elderly are due to a complicated combination of factors, including hormonal changes that regulate metabolism, dietary intake, and nutrient absorption. ...
Purpose: The purpose of this study is to determine if components of body composition differ between elite competitive older athletes and community-dwelling ambulatory controls and to examine the relationships between the components of body composition and the relationship between the components and strength.Methods: One-hundred Senior Athletes from the 2005 National Senior Games and 86 healthy controls participated. Body composition was measured by dual-energy x-ray absorptiometry (DXA). The DXA scans provided measures of bone mineral density (BMD), bone mass, mineral free lean mass percentage (MFLP), and fat mass percentage (FMP) including regional measures (trunk, legs and arms) of body composition. Isometric strength of the quadriceps and hamstrings was measured. Results: One factor ANOVAs (á=.05) were performed to assess regional FMP and regional MFLP. Controls had a significantly higher FMP in every body region than athletes. Athletes had a significantly higher MFLP of the arm and leg than controls. Correlational analyses (á=.05) were also performed to examine the relationship between MFLP and strength, MFLP and BMD, and FMP and BMD. Athletes had a stronger correlation between flexion strength values and MFLP of the leg and Controls showed a stronger correlation between extension strength values and MFLP of the leg. Significant correlations were found for the relationship between MFLP and BMD, with stronger correlations in the athlete group. Significant correlations between BMD and FMP were found in all regions except the trunk for all groups.Discussion: Our predominant findings were that, as expected, all regional measures of body fat were higher in control subjects than in athletes. This study showed that all regional measures of lean muscle mass were greater in athletes than in control subjects. This indicates that physical activity may help to prevent the decrements associated with the aging process even well in to the 7th decade of life.
... The loss of muscle mass with aging has been documented in a number of studies using a variety of methods, and it appears to occur even in relatively healthy elderly people (1,11,24,25). At present, there are insufficient data for forming any consensus on what constitutes "deficient" muscle mass or sarcopenia Criteria for estimating prevalences of sarcopenia are needed for public health planning purposes. ...
... In summary, the present study confirms reports from other, previous studies (1,11,24,25) that relative muscle mass is significantly lower in elderly persons than in younger adults and that it decreases with age among persons older than 65 years. We have provided a method for estimating the prevalence of "deficient" relative muscle mass, or sarcopenia, in population studies that is more sensitive than other approaches currently available. ...
Muscle mass decreases with age, leading to “sarcopenia, ” or low relative muscle mass, in elderly people. Sarcopenia is believed
to be associated with metabolic, physiologic, and functional impairments and disability. Methods of estimating the prevalence
of sarcopenia and its associated risks in elderly populations are lacking. Data from a population-based survey of 883 elderly
Hispanic and non-Hispanic white men and women living in New Mexico (the New Mexico Elder Health Survey, 1993–1995) were analyzed
to develop a method for estimating the prevalence of sarcopenia. An anthropometric equation for predicting appendicular skeletal
muscle mass was developed from a random subsample(n = 199) of participants and was extended to the total sample. Sarcopenia was defined as appendicular skeletal muscle mass
(kg)/height2 (m2) being less than two standard deviations below the mean of a young reference group. Prevalences increased from 13–24% in
persons under 70 years of age to >50% in persons over 80 years of age, and were slightly greater in Hispanics than in non-Hispanic
whites. Sarcopenia was significantly associated with self-reported physical disability in both men and women, independent
of ethnicity, age, morbidity, obesity, income, and health behaviors. This study provides some of the first estimates of the
extent of the public health problem posed by sarcopenia. Am J Epidemiol 1998; 147: 755–63.
... The analysis was done using SPSS Process Andrew 3.3 with 5000 bootstrap samples. Statistically significant paths do NOT contain zero between lower and upper level confidence intervals TBF deposition [32]. Of particular note, the present mediation analysis is especially interesting in that the metabolic difference which is present between visceral and TBF is known [33]. ...
Background : Metabolic syndrome (MetS) is associated with an increased risk of
morbidity and mortality in almost all chronic diseases. The most frequent methods for
the calculation of a continuous MetS (cMetS) score have used the standardized
residuals in linear regression (z-score). Recently, emerging data suggest that one of
the main genetic targets is the CAV1 , which plays a crucial role in regulating body fat
distribution. This study is designed to investigate the relationship between CAV1
rs3807992 genotypes and cMetS, and to determine whether body fat distribution (FD)
plays a mediating role in this regard.
Methods: The current cross-sectional study was conducted on 386 overweight and
obese females. The CAV1 rs3807992 and body composition were measured by the
PCR-RFLP method and bioelectrical impedance analysis (BIA), respectively. Serum
profile of HDL-C, TGs, FPG, and Insulin were measured by standard protocols.
Results: GG allele carriers had significantly lowered Z-MAP (p=0.02), total cMetS
(p=0.03) and higher Z-HDL (p=0.001) compared with (A) allele carriers. There was a
significant specific indirect effect (standardized coefficient = 0.19; 95% CI: 0.01–0.4) of
Visceral fat level (VFL). Although, total body fat (TBF) was significantly associated with
CAV1 rs3807992 and cMetS, the specific indirect effect was not significant
(standardized coefficient = 0.21; 95% CI:
-0.006, 0.44). VFL contributed to significant indirect effects of 35% on the relationship
between CAV1 and cMetS.
Conclusion: Higher visceral adipose tissue may affect the relationship between CAV1
and cMetS. Although CAV1 rs3807992 is linked to VFL in our study, the influence of
this polymorphism on MetS is not via total fat.
... Fat-free mass (kg) was determined by body mass (kg) minus fat mass (kg). 23 ...
Background:
Qigong exercise represents one type of traditional Chinese exercise that might positively affect physical and psychological functioning, slow down disease development and improve quality of life. However, study findings are somewhat conflicting and mechanisms contributing to expected beneficial effects are rather poorly known.
Objective:
This study aims to evaluate the effects of qigong exercise training for 8 weeks on selected physical, cognitive, and biochemical outcomes in young sedentary females.
Method/design:
Quasi-experimental design, placebo-controlled study.
Setting:
The study was performed at the Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Bangsean, Chonburi province, Thailand.
Participants:
Participants were 41 females with sedentary lifestyles.
Interventions:
41 sedentary females were allocated to qigong exercise (QG, n = 20) or to the control group (CG, n = 21).
Primary outcome measures:
VO2 max predicted from step testing, aspects of cognitive functions (e.g., digit span forward, DSF, and digit span backward, DSB, task), hematological and biochemical parameters, and body composition were assessed in both groups before and after the 8-week training period.
Results:
Physical performance (estimated VO2 max) significantly increased after qigong training compared to the CG (P < .001). Working memory (DSB) increased after intervention only within the QG (P = .009) but changes did not reach significance between the groups. Changes in neutrophils (potential mediators of inflammation) tended to be improved in the QG in comparison to the CG (P = .075). Body composition remained unchanged.
Conclusion:
These findings indicate that 8 weeks of qigong training increased aerobic capacity and tended to improve working memory in otherwise sedentary young females. Neutrophils tended to decrease within the QG. Thus, it was speculated that enhanced oxygen supply to the brain and the decrease of neutrophils adhering to cortical capillaries might have contributed to improved cognitive function.
... Knowledge of biological anthropology especially, nutritional anthropology, could be effectively utilized in sport activities to achieve the most favourable benefit in the desired direction. It appears that there exist some sort of relation between body composition, limb proportion, other anthropometric traits and sport activities (Jaiswal 2019).It is well reported that anthropometry is an essential, non-invasive and inexpensive tool to assess physique or nutritional status of individuals or populations (Baumgartner 1995;WHO 1995). Anthropometric and body composition characteristics are related to the genetic makeup, socio-economic status (Perissinotto et al. 2002), physical environment, lifestyle and health conditions of sports persons, which are regarded as essential components to get success in any sports events. ...
Anthropometric traits, body composition and physical fitness are considered as important indicators of health and generally executed in different sports to achieve the goal. In view, the objectives of the present study are to evaluate anthropometric characteristics, body composition components and physical fitness index (PFI) of the young college students, to assess nutritional status, and also to find out relationship between anthropometric traits, body composition and PFI of the participants of Haldia, Purba Medinipur, West Bengal. Present cross-sectional study was conducted among 42 college students including 18 College level footballers and 24 non-sports persons. Different anthropometric and body composition traits were measured following standard methods and instruments. Body Mass Index (BMI) was used to assess nutritional status of the study participants. PFI was measured by Harvard Step Test (HST). Descriptive statistics, t-statistics and correlation were used to analyze the data. BMI values indicate that the majority of the footballers were normal weight, while higher percentages of non-sports persons were underweight and overweight. Significantly lower mean values were observed among footballers in anthropometric traits like skinfold thicknesses; bi-iliac diameter; total fat and regional fat percentages than non-sports persons. However, PFI performance was ‘poor’ for both footballers and non-sports persons. PFI shows significant correlation with different anthropometric and body composition traits among non-sports persons, while sports persons show significant correlation between different anthropometric and body composition traits. The study shows the trend that footballers possess better health traits than non-sports persons but footballers have scope for improvement in PFI values.
... For example, use of BMI in older adults may underestimate risks of sarcopenia [3,4]. The increase in central adiposity along with the decrease in height commonly seen with aging may mask the loss of appendicular lean mass characteristic of sarcopenia [5]. Without a means of selectively measuring arm and leg composition, the risk of frailty and muscle loss may be overlooked. ...
Background & aims:
Segmental body composition may be an important indicator of health and nutritional status in conditions where variations in fat and lean mass are frequently isolated to a particular body segment (e.g. paralysis, sarcopenia). Until recently, segment-specific body composition could only be assessed using invasive and expensive methods such as dual-energy x-ray absorptiometry (DXA), magnetic resonance imaging (MRI), or computed tomography (CT). Bioelectrical impedance analysis (BIA) may be a rapid, inexpensive alternative for assessing segmental composition, but it has not been fully validated for this purpose. The purpose of this study was to compare segmental estimates of lean and fat mass using BIA versus a criterion standard of DXA.
Methods:
A cross-sectional pilot study was conducted in n = 30 healthy adults. Outcome measures included total mass, fat mass and lean mass of arm, leg and trunk. Pearson correlation coefficients (r) and paired-samples t-tests (t) were used to assess relationships between each outcome as measured by BIA and DXA.
Results:
Although the methods were strongly correlated for all measures, (r > .87 for all segments) BIA routinely overestimated lean mass for arm and trunk (mean difference arm: 0.97 kg, p = .008; trunk: 5.58 kg, p < .0001); and underestimated fat mass for arm and leg (mean difference arm: 0.42 kg, p < .0001; leg: 1.94 kg p < .0001). BIA overestimated total body lean mass in 93% of participants and underestimated total body fat mass in 90% of participants.
Conclusions:
Significant discrepancies were noted between DXA and BIA in all body segments. Further research is needed to refine BIA methods for segmental composition estimates in heterogeneous samples and disease-specific populations before this methods can be used reliably in a clinical setting.
... It also denotes the loss of muscle mass, gain of fat mass and redistribution of adipose tissue. 1 These are highly reliable in determining and evaluating the prognosis of both acute and chronic disease in adults and assist to guide medical intervention in the elderly. 2,3,4 At present, many countries of the world have conflicts such as wars, earthquakes, flood disasters etc. which have led to partial or total disruption of family life in the form of internally displaced persons (IDPs) and refugees. This has created socio-economic problems with attendant worsening health indices. ...
Background of the study: Globally, lifestyle modification as a veritable tool of preventing various non-communicable diseases is a current topic in the medical world. Efforts to regulate nutrition and maintain optimal body shape and statistics are being widely encouraged. A study of anthropometric and nutritional status of adults in peaceful environments will be helpful in extrapolating its consequences in conflicts periods. This will enable adequate preventive measures to be established to enhance appropriate intervention. Objectives: To determine the socio-demographic, waist-hip ratio and body mass index of adults in a normal population. Methods: A cross-sectional survey of adults between 20 to 60 years of age was undertaken in an oil-producing non-conflict environment of Delta North senatorial district of Nigeria. The study recruited 432 eligible consented healthy adults using multistage sampling methods after ethical approvals were obtained from relevant authority and community leaders. Socio-demographic factors, blood pressure, waist-hip ratio and body mass index were determined using appropriate instruments and methods. Results: The results were analyzed using Statistical Package for Social Sciences SPSS version 18. The statistical significance was set at p˂0.05. It showed the prevalence of obesity, stage 1 and stage 2 hypertension among the subjects to be 16.7%, 13.7% and 5.3% respectively. Conclusion: The study concluded that there is a high prevalence of obesity and pre-hypertension even in rural communities. This calls for concern because these are "precursors" of serious cardiovascular diseases with its attendant high morbidity and mortality.
... Anthropometric evaluation performed by trained health workers is inexpensive, non-invasive, and provides detailed information on the different components of body structure, especially muscular and fat components and can assist in assessing the nutritional status of a population. 1 The aging process involves physiological and nutritional changes that are manifested by height (at 1 cm per decade); 2 and weight loss, 3 fat-free mass loss (sarcopenia), 4,5 by the loss of cells from different tissues and organs, as well as by skeleton demineralization. 6 It also involves adipose tissue redistribution, with fat accumulation in the trunk and viscera. ...
Background: The study of the interrelations between body mass index (BMI) and body composition measures is of much interest in health sciences.
... For example, older people have less muscle mass, less bone mass, expanded extracellular fluid volumes and reduced body cell mass compared to younger adults. 10,11 Up to 70% of older adults are obese or overweight, 12 and are potential candidates for intentional weight loss to reduce risk factors for cardiovascular disease and diabetes, and to improve physical function. However, intentional weight loss has not been widely advocated for older, community dwelling adults because of uncertainty as to whether the benefits outweigh the risks. ...
Background:
Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people.
Objectives:
This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions.
Inclusion criteria types of participants:
The participants were older adults, 60 years of age or older, living in the community.
Types of interventions:
The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education.
Types of studies:
This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews).
Types of outcomes:
The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status.
Phenomena of interest:
The phenomena of interestwere the qualitative perceptions and experiences of participants.
Search strategy:
We developed an iterative search strategy for nine bibliometric databases and gray literature.
Methodological quality:
Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified.
Data extraction:
Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute data extraction tool.
Data summary:
Only quantitative studies of effectiveness were included. The strength of evidence assessing the effectiveness of interventionswas graded using a traffic light system (green, amber, red). An overall assessment of the quality of the evidence for each comparison was undertaken.
Results:
More systematic reviews investigating weight gain than those investigating weight loss were included. Studies onweight gain showed improved body composition for oral nutritional supplements on its own, for oral nutritional supplements in combination with resistance exercise training, and for oral nutritional supplements in combination with nutrition counselling. Studies on weight loss showed that diet in combination with exercise, diet in combination with exercise and nutrition counselling, and nutrition counselling on its own all can lead to reduced weight in older people. The outcomes of lean mass and weight/BMI were responsive to nutritional interventions, but fat mass did not vary. There were no qualitative reviews identified.
Conclusions:
Although effective interventions for weight gain and weight loss to optimize body composition of older people in the community were identified,making long term, clinically relevant changes in body composition is difficult. Multiple interventions are more effective than single interventions.
... Las modificaciones morfológicas y funcionales que se observan durante el proceso del envejecimiento conducen a una alteración del estado nutricional del individuo a medida que se hace más viejo; el conocimiento de estos cambios es de interés para el diagnóstico, pronóstico y tratamiento de los problemas de salud del adulto mayor (Roe, 1990;Baumgartner, 1993). La pérdida considerable de su masa muscular, densidad ósea y agua corporal total, entre otras subfracciones del compartimiento magro, es de gran relevancia, porque aparejado con ésta ocurre una disminución de las necesidades energéticas, fuerza y capacidad funcional, aumentando el riesgo de enfermedades como la DMNID y la osteoporosis, así como el incremento de fracturas (Evans, 1992) . ...
Se realizó un estudio transversal en 1499 adultos con el propósito de desarrollar ecuaciones cubanas para estimar la estatura, dirigidas a mejorar el diagnóstico del estado de nutrición de individuos discapacitados y adultos mayores. Se tomaron como punto de partida las mediciones del peso, estatura, braza, hemibrazas (derecha e izquierda), longitud hombro-codo y altura de la rodilla en hombres y mujeres (europoides y mestizos de europoide-negroide), de tres estratos de edades: 20 - 39, 40 - 59 y mayores de 60 años. Se observaron las tendencias de la reducción de la estatura y las modificaciones de las otras dimensiones físicas por el proceso involutivo, analizándose además el efecto combinado de las cohortes con el envejecimiento. Las discrepancias encontradas con la utilización de medidas sustitutas directas y los modelos generados para otras poblaciones, confirmaron la necesidad de obtener ecuaciones propias para la población cubana. Se hallaron las ecuaciones de mejor ajuste para la predicción de la estatura en cada subgrupo y las generalizadas por sexos. Estos resultados permiten proponer las dimensiones alternativas (braza, hemibraza derecha, hemibraza izquierda y la combinación de la altura de la rodilla con la longitud hombro-codo, entre otras), aplicables en diferentes circunstancias a personas donde no sea posible o recomendable obtener directamente la talla y se requiera una valoración de su estado físico con fines de salud o con otros propósitos.
... 8,9 A antropometria tem se mostrado como importante instrumento na avaliação nutricional do idoso, tanto na prática clínica como em pesquisas epidemiológicas, uma vez que proporciona informações de diferentes componentes da estrutura corporal, principalmente gordura e massa muscular. 10 As mudanças corporais decorrentes do processo de envelhecimento acontecem de forma diferenciada entre homens e mulheres e nas diferentes fases do envelhecimento; consequentemente, não é aconselhável que padrões antropométricos derivados de uma população adulta sejam utilizados para a avaliação da população idosa. 11 Estudos com idosos descrevendo algumas informações acerca de suas características antropométricas vêm sendo realizados há algum tempo, principalmente em países desenvolvidos. ...
This study aimed to describe the anthropometric information on elderly people in Campina Grande, PB, Brazil. It is a populational, cross-sectional household-based study. Data were presented as means, standard deviations and percentiles (5th, 10th, 25th, 50th, 75th, 90th and 95th) for weight, stature, body mass index (BMI), mid upper arm circumference (MAC), triceps skinfold thickness (TST), arm muscle circumference (AMC), calf circumference (CC) and waist circumference (WC). The analyses included Student t test to detect differences in mean values of the variable between both sexes. Age impact was investigated by ANOVA. A total of 806 elderly people were interviewed. The mean values of the all variables presented differences statistically significant. The mean values of weight, stature, AMC, CC and WC were higher in men, whereas the mean values of BMI, MAC and TST were higher in women. All variables showed a decrease in average values and percentile (50th) with advanced age. The anthropometric and body composition data of the elderly in the present study showed similar trend of others studies, but with different values. Thereby, such values could be useful in the anthropometric assessment of elderly people.
... Se ha demostrado en diversos estudios que los PA proporcionan una estimación cuantitativa muy fiable para la valoración del estado nutricional. Además, constituyen un método de realización fácil, rápido, inofensivo, fiable y económico 4,5,9,10 . Estas características han hecho de los PA una prueba de gran valor orientativo en clínica ya que el organismo, en momentos de necesidad o carencia, utiliza las reservas energéticas provenientes de lípidos y proteínas, con la concomitante variación asociada en los PA. ...
The purpose of the present study has been to determi- ne, in a population group over 80 years of age in a pu- blicly-funded geriatric institution, the anthropometric parameters that represent reference values for the study of nutritional status. These parameters allow detection of alterations in the nutritional status which, once co- rrected, will contribute to maintaining an appropriate quality of life in a population group that is highly sensiti- ve to the associated morbidity and mortality processes. In order to carry out this study, a sample of 56 healthy elderly individuals was selected (13 men and 43 women) with a mean age of 86.5 ± 4.8 years and a range from 80 to 101 years. The parameters measured were: weight, height, tricipital fold, brachial perimeter and the following values calculated on the basis of these figures: body mass index, percentage of body fat, brachial mus- cular area, brachial muscular perimeter, brachial adipo- se area and the ratio of muscle to adipose tissue. These values were processed statistically with the assistance of the RSB-SIGMA computer software, with calculation of the percentiles, the mean, and the comparison between the sexes. The criterion for statistical significance was set at p < 0.05. Our results confirm the presence of significant diffe- rences in the muscle parameters, which are greater in men than in women, whereas the fat parameters are hig- her in the latter. Thus, it is concluded that weight, height, brachial muscle area and brachial muscle peri- meter are significantly higher in men whereas tricipital fold, percentage of body fat, the brachial adipose area and the muscle to adipose tissue ratio are significantly superior among women. There are no significant diffe- rences by gender in the body mass index and the bra- chial perimeter. (Nutr Hosp 2002, 17:244-250)
... Anthropometric standards have been developed using the data collected from adults aged 18-74 years during the National Health and Nutrition Examination Survey (NHANES), from 1971 to 1974 (Bishop et al. 1981;Frisancho, 1981;Bishop, 1984;Najjar & Rowland, 1987). As ageing itself leads to significant modifications of body composition that are unrelated to nutritional status (Steen, 1988;Baumgartner, 1993;Going & Lohman, 1994), for a reliable evaluation of individuals aged 75 years and over, age-specific reference values are required. The Cincinnati Anthropometric Survey for the Elderly (Falciglia et al. 1988) has provided anthropometric statistics for Americans aged 80-89 years, but norms for older subjects are scant and almost 20 years old, making them no longer representative of the current generation of over-90-year old Americans (Chumlea etal. ...
Available anthropometric reference values for elderly people do not include specific norms for over-90-year-old subjects despite their increasing number. In the present study, weight, height and a number of anthropometric variables related to body muscle and fat mass were collected from fifty-seven nonagenarian and forty-one centenarian healthy, non-institutionalized subjects living in an Italian area. Recumbent anthropometry was used to avoid errors associated with impaired mobility. Nonagenarians and centenarian men were taller and heavier than women of corresponding age and had a greater amount of muscle and trunk fat, whereas women showed a marked peripheral adipose distribution. Anthropometric values of both age-groups were generally lower than published norms for 70–89-year-old American and European elderly people. However, differences were less marked when comparing Italian nonagenarians and centenarians with French and British people aged 85 years and over than when comparing Italian subjects with American octogenarians and younger European elderly people. Taken together these findings suggest a dramatic loss of muscle and fat mass in over-90-year-old subjects with respect to younger elderly people. However, changes between successive generations and geographical influences cannot be excluded. The need for local and age-specific norms in nutritional assessment of over-90-year-old people is emphasized. It is also suggested that current anthropometric indices may not be reliable when evaluating the oldest elderly subjects.
... Going et al. explored the importance of race/ethnicity as a covariate in body composition analysis by BIA among adolescent girls and concluded that race/ethnicity influences measurement results [11]. Though similar comparisons have been made in several populations [2,6,[12][13][14][15][16], to our knowledge, no study has specifically compared these two methods within a Hispanic diabetic population. The purpose of this study is to validate the Tanita-BIA system (Model TBF-310, Tanita Corporation of America, Inc, Arlington Heights, IL) against fan beam DXA (Hologic Discovery A v12.6) in a population of Hispanic diabetics. ...
OBJECTIVE: The purpose of this study was to compare Tanita tetrapolar foot-to-foot bioelectrical impedance analysis (Model TBF-310, Tanita Corporation of America, Inc, Arlington Heights, IL; Tanita-BIA) and fan beam dual-energy X-ray absorptiometry (Hologic Discovery A v12.6, Waltham, MA; DXA) in diabetic patients. METHODS: Seventy Hispanic diabetic participants (23 male, 47 female; mean age: 53.03 ± 10.32 yrs; mean weight: 81.45 ± 17.65 kg; and mean body mass index: 31.40 ± 6.80 kg/m(2)) were selected from the Loma Linda University En Balance culturally-sensitive Spanish diabetes education program using the baseline data. RESULTS: DXA vs Tanita-BIA fat mass (FM), percent fat mass (%FM), and fat-free mass (FFM) were compared using Pearson's (FM: 0.96, %FM: 0.91, and FFM: 0.95), and Spearman's rank (FM: 0.94, %FM: 0.91, and FFM: 0.93) correlation coefficients. Bland-Altman analyses were also used to compare the difference (DXA - BIA) vs average of DXA and BIA results and showed general agreement between the two methods. When Tanita-BIA was regressed onto DXA, the adjusted R(2) was: FM=0.91; %FM=0.83; FFM=0.90. Gender combined concordance correlations with 95% confidence intervals were calculated using a bootstrap re-sampling of the data and found high associations [FM: 0.93 (95% CI: 0.89, 0.96)], [%FM: 0.86 (95% CI: 0.79, 0.90)], and [FFM: 0.93 (95% CI: 0.89, 0.96)]. CONCLUSION: Tanita-BIA may provide valid measures of fat, percent body fat and fat-free mass in Hispanic diabetics, and could be a convenient and practical approach for assessment in community-based research.
... Therefore, the results of this study suggest that subtle depletion of BCM masked by FFM measurement is not severe in patients with COPD, since it does not affect exercise capacity to a great extent. However , we cannot exclude the possibility that the present study underestimates the effect of muscle mass depletion on exercise performance due to the methodology used, i.e. measurement of BCM by ICW, because it should be remarked that ECW also represents a part of muscle [5]. The relationship between TL,CO and peak V 'O 2 is evident , since it represents lung parenchymal damage. ...
In several studies a correlation between body weight and peak exercise capacity has been found in patients with chronic obstructive pulmonary disease (COPD). In the present study a thorough analysis of the relationship between body composition and peak exercise performance was executed in 62 patients with clinically stable COPD. This was based on the hypothesis that particularly muscle mass, as the largest constituent of both fat-free mass (FFM) and body cell mass, is related to exercise capacity. Body composition was assessed using deuterium and bromide dilution techniques, to measure total body water (TBW) and extracellular water. From these measurements FFM:TBW/0.73, the ratio of ECW/intracellular water (ICW) and ICW-index (ICW/height2) were calculated. Peak exercise performance was measured using an incremental cycle ergometry test. The transfer factor of the lung for carbon monoxide (TL,CO) intrathoracic gas volume (ITGV), maximal expiratory and inspiratory mouth pressure, forced expiratory volume in one second (FEV1), FFM-index (FFM/height2), body mass index (weight/height2) and ICW-index correlated strongly (p<0.01) to peak oxygen consumption (V'O2). The ratio ECW/ICW correlated only weakly, but significantly, with peak V'O2 (r=-0.25, p<0.05). Stepwise regression analysis demonstrated that FFM-index and TL,CO explained 53% of the variation in peak V'O2. The results of this study furthermore indicate that severe FFM depletion is related to a blunted tidal volume response to peak exercise, a decreased peak oxygen pulse and an early anaerobic metabolism in patients with COPD. Depletion of muscle mass, measurable by assessment of fat-free mass, significantly effects peak oxygen consumption, ventilatory response, the oxygen pulse and anaerobic energy metabolism in patients with chronic obstructive pulmonary disease.
... Some authors report increased risk associated with the loss of an absolute amount of weight 43 , whilst others refer to a significant percentage weight loss 3 . A weight loss of less than 5% is likely to be associated with the natural loss of body weight with advancing age 44 . The findings from the current study suggest that between 5 and 10% weight loss over two years is associated with a 57% and 73% increased risk of limitation in physical function and mobility, respectively. ...
To evaluate, in terms of function and mobility, the predictive value of commonly adopted anthropometric 'definitions' used in the nutritional assessment of older adults, in a cohort of older Australians.
Prospective cohort study - Australian Longitudinal Study of Ageing (ALSA).
Adelaide, South Australia (1992-1994).
Data were analysed from 1272 non-institutionalised (685 males, 587 females) older adults > or =70 years old in South Australia. Seven 'definitions' commonly used in the anthropometric assessment of both under- and overnutrition (including four using body mass index (BMI), waist-to-hip ratio, waist circumference and percentage weight change) were evaluated at baseline, for their ability to predict functional and mobility limitation assessed (by self-report questionnaire) at two years follow-up. All questionnaires were administered and anthropometry performed by trained investigators. The associations between the definitions and decline in mobility and physical function were evaluated over two years using multiple logistic regression.
A BMI >85th percentile or >30 kg m-2 or a waist circumference of >102 cm in males and >88 cm in females increased risk of functional and mobility limitations. Over two years, a loss of 10% body weight significantly increased the risk of functional and mobility limitations.
Maintaining weight within older adults, irrespective of initial body weight, may be important in preventing functional and mobility limitations. Excessive weight is associated with an increased risk of limitation in function and mobility, both key components of health-related quality of life.
... Various methods with different validity exist for measurement of body composition, the most accurate ones being too costly and time consuming for large-scale population studies. 17 Bioelectrical impedance measurement is an inexpensive, simple, and reasonably accurate technique for the assessment of fat and fat-free mass in epidemiological studies, 18,19 but whether or not it is superior to measurements of height, weight, and waist circumference is controversial. [20][21][22] In the present study, a regression model considering body composition estimated from impedance measurements and waist circumference was only slightly more predictive of smoking-adjusted all-cause mortality than a model considering the simple measures, waist circumference and BMI. ...
Waist circumference is directly related to all-cause mortality when adjusted for body mass index (BMI). Body fat and fat-free body mass, when mutually adjusted, show with increasing values an increasing and decreasing relation to all-cause mortality. We investigated the association of waist circumference and body composition (body fat and fat-free mass), mutually adjusted, to all-cause mortality.
A Danish prospective cohort study with a median follow-up period of 5.8 y.
In all, 27 178 men and 29 875 women, born in Denmark, aged 50-64 y, and without diagnosis of cancer at the time of invitation.
Waist circumference and body composition estimated from impedance measurements. Cox's regression models were used to estimate the mortality rate ratios (RR).
Waist circumference was strongly associated with all-cause mortality after adjustment for body composition; the mortality RR was 1.36 (95% confidence intervals (CI): 1.22-1.52) times higher per 10% larger waist circumference among men and 1.30 (95% CI: 1.17-1.44) times higher among women. Adjustment for waist circumference eliminated the association between high values of the body fat mass index (BFMI) and all-cause mortality. The association between fat-free mass index (FFMI) and mortality remained unaltered.
Waist circumference accounted for the mortality risk associated with excess body fat and not fat-free mass. Waist circumference remained strongly and directly associated with all-cause mortality when adjusted for total body fat in middle-aged men and women, suggesting that the increased mortality risk related to excess body fat is mainly due to abdominal adiposity.
... Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly123. Anthropometric evaluation performed by trained health workers is inexpensive, non-invasive and provides detailed information on the different components of body structure, especially muscular and fat components, and can assist in assessing the nutritional status of a pop- ulation [4]. Anthropometric measures are highly reliable for determining the nutritional status when compared with more sophisticated methodologies (hydrodensitometry , dilution techniques, measuring K-40 by whole body counting and electronic bioimpedance), the use of which is restricted by complexity and cost in population studies [5]. ...
Anthropometric evaluation is an essential feature of geriatric nutritional evaluation for determining malnutrition, being overweight, obesity, muscular mass loss, fat mass gain and adipose tissue redistribution. Anthropometric indicators are used to evaluate the prognosis of chronic and acute diseases, and to guide medical intervention in the elderly. We evaluated anthropometric measurements and nutritional status as they relate to age and gender in healthy elderly people.
The study analyzed data from the national survey "Health needs and health service use by older-than-60-year-old beneficiaries of the Mexican Institute of Social Security (IMSS)". The present study included only individuals who reported no chronic disease in the last 20 years and had no hospital admission in the two months prior to the survey. Anthropometric measurements included weight, height, body mass index (BMI), body circumference (arm, waist, hip and calf), waist to hip ratio (WHR), elbow amplitude and knee-heel length.
Application of the inclusion criteria resulted in a study population elderly of 1,968, representing 12.2% of the original number in the national survey in urban areas beneficiaries of the IMSS. The study population comprised 870 women and 1,098 men, with a mean age of 68.6 years. The average weights were 62.7 kg for women and 70.3 kg for men (p < 0.05), and the mean heights were 1.52 m for women and 1.63 m for men (p < 0.05). Age related changes in anthropometric values were identified. BMI values indicated that 62.3% of the population was overweight, and 73.6% of women and 16.5% of men had high fat tissue distribution.
Our findings suggest that applying the BMI thresholds that identify being overweight in the general adult population may lead to an overestimation in the number of overweight elderly Similar problems appear to exist when assessing waist circumference and WHR values. Prospective studies are required to determine the associations between health and BMI, waist circumference and WHR in the elderly.
Ahirwar A. K., Sharma A. N. and Gautam R. K., Use of MUAC and BMI to assess the nutritional status of
elderly Gond in Sagar district, Madhya Pradesh, India - Antrocom J. of Anthropology 19-2 (2023) pp. 213-221
Anthropometric techniques have always been the preferred method of assessing nutrition
to determine malnutrition, overweight and obesity. The use of BMI and MUAC is widely
accepted, although the MUAC requires validation. The present cross-sectional study was
conducted among a total of 552 elderly respondents of Gond tribe selected from 30 villages
of Kesli block of Sagar district (M.P.) including 273 males and 278 females. Weight, height
and mean upper arm circumference were measured, and the relationships between mean
upper arm circumference and BMI were analyzed. Receiver operating characteristic (ROC)
analysis was performed and the area under the ROC curve was assessed. Sensitivity and
specificity for different values of mid-upper arm circumference were calculated. The MUAC
was found to have a significant and positive correlation with body weight (r=0.727), height
(r=0.314) and BMI (r=0.626). The cut-off value was < 23.0 cm. It can be concluded that
there is a positive and significant correlation between BMI and MUAC in both men and
women. The study also attempted to establish a suitable cut-off value for the detection of
malnutrition using BMI and MUAC in the elderly Gond tribal population of central India
Background and Purpose: Distribution and volume of total and regional fat and fat percentage is important to monitor diet and exercise in adult women. A prediction formula for adult women by examining Body Mass Index (BMI), quotas obtained from Skinfold Thickness (ST) sites and body composition compartments determined by using Dual X-ray Absorptiometry (DXA) was aimed. Participants and Method: Sixty female participants (average age 46.4 ± 3.2 years; Range 40-55 years) were assessed by using DXA (Lunar Model DPX) to determine body fat percentage (%BF DXA), Fat Mass (FM DXA), and Lean Body Mass (LBM-DXA). Skinfold thickness sites were measured by using Skinfold Caliper (Holtain Caliper, UK). Results: A low positive correlation coefficients were found between %BF obtained from DXA and quota of suprailium ST (r=0.30 p<0.05). The highest correlation coefficient was between %BF DXA and BMI: r = 0.83 (p<0.001). Three different Regression Equations were derived to predict %BF: BMI Model %BF = 7.162 + 0.23 * BMI (R 2 =0.68 and SEE=2.892); Anthropometric 1, %BF = 7.346 + 0.835 * BMI + 0.169 * LE ST (R 2 = 0.80 and SEE = 2.341); Anthropometric 2, %BF = 8.179 + 0.714 * BMI + 0.167 * LE ST + 0.114 * Chest ST (R 2 = 0.80 and SEE = 2.341). Analysis of variance and confidence intervals and Bland & Altman Analysis were used to determine the validity. Intra Class Correlation (ICC) was used to determine reliability of the prediction equation. Discussion: The %BF DXA findings of the present study was 38.29 ± 5.09 and %BF by Generalized Equation was 35.69 ± 4.79, are like in underestimating those in the previous scientific studies. Anthropometry Model 1, has predictors of BMI, is more advantegous having the least ST sites (mid-thigh and medial calf) than anthropometry Model 2. Otherwise BMI model is recommended. Conclusion: BMI, LE ST (sum of the medial calf and mid-thigh) and chest ST values but not other ST quotas were good predictors for prediction equations. Derived models in predicting %BF using DXA of BMI model, Anthropometric 1, Anthropometric 2 were moreover valid and reliable. While the Generalized Equation was valid, it is not reliable for the adult women population.
Although a variety of studies have reported the association between age related changes in muscle mass and the functional impairments of the elderly, few have reported on the modifiable lifestyle factors that are related to sarcopenia. Three thousand five hundred ninety-eight men in nationally representative cross-sectional, population-representative sampled survey using data from the KNHANES IV aged 19 years and older who completed a body composition using a dual energy X-ray absorptiometry (DXA) were measured. To determine whether there are any associations between physical activities, nutritional status and sarcopenia were examined in 1156 men among those over 60 years of age. Appendicular skeletal muscle mass (ASM) was calculated as the sum of skeletal muscle in the arms and legs. Sarcopenia was defined as the ASM/Ht(2) of less than two standard deviations (SD) below the sex-specific normal mean for the younger reference group. The prevalence of sarcopenia in Korean men aged 60 years and older was 9.9%. Sarcopenia was negatively associated with the third quartile (OR=0.40, 95% CI=0.20-0.80) and fourth quartile of PA (OR=0.24, 95% CI=0.11-0.52), and negatively associated with the highest quartile of protein intake (OR=0.32, 95% CI=0.14-0.76). In logistic regression models, sarcopenia was negatively associated with walking PA (OR=0.49, 95% CI=0.29-0.83) after an adjustment for age, smoking habits, alcohol drinking, family income, education status and protein intake. Sarcopenia was associated with PA, especially walking PA.
Aging is associated with changes in body composition that have important consequences on health and physical function. Thus,
studying body composition changes is of increasing interest in geriatric research, and measures are being developed to favourably
influence body composition in old age, in addition to exercise and diet.
The present study compares results of direct numerical simulations of thermal convection within a rectangular geometry with Rayleigh-Benard convection in thin fluid layers and cylindrical geometries. It is shown that boundary layer thicknesses show similar tendencies in the rectangular geometry and a thin fluid layer, but the quasi two-dimensional geometry of the container delays the onset of convection significantly. Analysis of the thermal dissipation rates indicates that there are three distinct regimes, of the small scale contribution grows rap-idly as Rayleigh number is increasing, whereas the large scale contribution remains almost constant.
Male aging is associated with alterations in plasma levels of antioxidants such as Coenzyme Q(10) (CoQ(10)) , and with a decrease of the fat-free body mass (FFM). In order to reveal, whether these changes can affect CoQ(10) metabolism, 73 non-obese, healthy males were studied, in age range 22-100 years, divided in 4 age groups: 20-55 (n = 23); 56-70 (n = 20); 71-90 (n = 8) and 91-100 (n =22). Serum CoQ(10) was measured by HPLC technique. Body composition was assessed by multifrequency bioimpedance analysis. Subjects aged 91-100 years displayed lower serum CoQ(10) levels and FFM than the other age-groups (p <0.001). Linear regression analysis revealed significant correlations between FFM and age (r = -0.82, p < 0.00001), serum CoQ(10) and age (r = -0.35, p <0.01). and serum CoQ(10) and FFM (r = -0.49, p < 0.001). Multiple regression analysis confirmed the correlation between serum CoQ(10) and FFM (p < 0.01), but did not for serum CoQ(10) and age. The proportion of FFM decreases with age. CoQ10 levels are also lower in older people, but they seem to be linked to FFM and not to aging itself. Since muscle tissue is the major component of FFM, and a reduction of the metabolic rate is another feature of aging, serum CoQ(10) may be an indirect index of metabolic activity in the elderly.
Obesity and body fat distribution (FD) are established risk factors for chronic diseases. The body mass index (BMI) and the waist/hip circumference ratio (WHR) are used conventionally as indices of obesity and FD in epidemiological studies. Although some general limitations of these indices are recognized, others that affect their use in relative risks for disease are not well recognized. These include effects of sex, ethnicity, and especially age on the relationships between these indices and body composition, which can result in substantial misclassification of obesity and FD. There is considerable variability in body composition for any BMI, and some individuals with low BMIs have as much fat as those with high BMIs. This results in poor sensitivity for classifying levels of body fatness (e.g., too many "false negatives," or overweight individuals classified as not overweight), and relative risks are attenuated across all categories of BMI. A more serious problem, however, is that at different ages the same levels of BMI correspond to different amounts of fat and fat-free mass. Data from the Rosetta Study and the New Mexico Aging Process Study show that older adults have, on average, more fat than younger adults at any BMI, due to the loss of muscle mass with age. As a result, the sensitivity of BMI cutpoints with respect to body fatness decreases with age, and the use of a fixed cutpoint for all ages results in "differential misclassification bias." Taken together, these issues suggest that the increases with age in the prevalences of overweight and obesity, and in the risks for chronic diseases, may be mis-estimated using BMI. Similar issues may affect the use of WHR for estimating prevalences and associated risks of FD. New field methods for estimating body composition are available that can be applied in large, epidemiologic follow-up studies of chronic diseases. These methods will allow epidemiologists to consider, for example, whether it is increased fat, or the replacement of fat-free mass with fat, with age that is associated with risk for chronic disease.
Associations of fat and muscle masses with bone mineral status were studied in 301 men and women aged > or = 65 y. Bone mineral and soft tissue composition were estimated by using dual-energy X-ray absorptiometry. Univariate correlations suggested that muscle is associated more closely than fat with bone mineral content (BMC) as well as with bone mineral density (BMD) in men. In women, however, correlations of BMC with muscle were only slightly greater than those with fat and correlations with BMD were consistently greater with fat than with muscle. This suggests that correlations of BMC with muscle are influenced by bone and body size, especially in women. A multiple-regression model was developed that adjusts BMC for bone area, knee height, age, and the independent effects of fat and muscle. In men, muscle remained more closely associated with adjusted BMC than with fat. In women, fat mass was associated significantly with BMC but muscle mass was not. The exception was for women taking estrogen, in whom neither fat nor muscle was associated significantly with adjusted BMC. This study suggests that body fatness may be more important than muscle in maintaining bone mineral in elderly women not taking estrogen.
The study of human body composition is now a distinct research area consisting of three interconnected parts: the five-level model and associated rules that govern the relations between components, body-composition methodology, and biological factors that influence body composition. In this overview we summarize fundamental concepts that relate to the five-level model and body-composition methods. We show how these concepts can be used to outline the essential features needed to critically evaluate the bioelectrical impedance analysis method. Body-composition research is a rapidly expanding area and in-depth systematic evaluation of new methods is a vital aspect of the field's growth.
Understanding the mechanisms that govern sarcopenia (depletion of muscle mass with age) may suggest ways to preserve lean tissue and functional capacity, and to maintain quality of life in the elderly. We investigated the body-composition changes in normal aging in a cross-sectional study of 188 healthy volunteers aged 20-89 y, which examines the differences in body cell mass and fat as a function of age. In aging, the assumptions of indirect body-composition-measurement techniques, such as the "constant" hydration coefficient of lean body mass or the "constant" density of fat-free mass, may not hold. Therefore, we selected body-composition-measurement techniques that are not sensitive to assumptions about the composition of lean tissue. Cellular mass, lean body mass, and fat were assessed "directly" by total body potassium (TBK) measurements and neutron inelastic scattering. Our results show that TBK content declines at a rate of 7.20 +/- 1.00 mg K.kg body wt-1.y-1 for females (r = 0.601, P < or = 0.001) and 9.16 +/- 0.96 mg K.kg body wt-1.y-1 for males (r = 0.710, P < or = 0.001). Body fat measurements by neutron inelastic scattering have shown a significant increase of percentage body fat with age for female volunteers between the ages of 20 and 50 y and a continuous increase for male volunteers throughout adult life.
Patients with advanced lung disease (ALD) demonstrate changes in body composition characteristically manifested by a progressive loss of body weight. This ''pulmonary cachexia'' is associated with a decline in clinical status and predicts accelerated mortality.(102) Careful assessment of body composition can demonstrate evidence of this wasting syndrome in obese as well as normal and undernourished patients. The relationship between ALD and cachexia has prompted enthusiasm for nutritional support as a major therapeutic initiative in both stable and unstable (intensive care unit) patients. A relationship, however, does not assure that treatment will alter the prognosis in a favorable manner. In most medical conditions, nutritional status is tightly linked to the underlying disease state and indices of nutritional state may serve simply as markers of disease severity. This review addresses current knowledge regarding the relationship between nutrition and ALD. The majority of investigative effort has been directed to the patient with chronic obstructive pulmonary disease (COPD) and that disorder therefore provides the focus of discussion. Treatment guidelines are outlined based upon our current understanding of the pulmonary cachexia syndrome.
The possible effects of regular aerobic exercise on musculoskeletal components in a group of healthy postmenstrual women were investigated. The combination of total body potassium and total body nitrogen measurements yielded muscle mass estimates which distinguished active from less active women. Additionally, the dual energy X-ray absorptiometry (DEXA)-derived bone mineral parameters were greater in the active group. The effects of regular exercise on body composition should be considered in studies of ageing, as exercise can be confounding variable, masking the declines in muscle mass and bone mineral content which are known to be an overall feature of ageing.
We present population data on percentage body fat (%BF) by bioelectrical impedance analysis (BIA) in 12,287 men and 6657 women aged 30-69 y. In addition, we examined relationships among BMI, %BF and serum lipids (total-cholesterol (TC), HDL-cholesterol (HDLC), TC/HDLC ratio, LDL-cholesterol (LDLC) and triglycerides (TG)) in order to determine whether body mass index (BMI, kg/m2) or %BF by BIA better reflected lipid metabolism. Women had larger %BF than men in all age groups. On the other hand, women aged < 60 y had smaller BMI than corresponding men. Regardless of age, BMI was obviously correlated with %BF (r = 0.743-0.924). As previously reported, high BMI and high %BF were strongly associated with high serum TC/HDLC ratio and TG, and low serum HDLC rather than high serum TC and LDLC. Compared with BMI, %BF by BIA was better correlated with the serum indices except for serum HDLC. These results were found in both sexes, and there was a trend in which younger subjects had stronger correlations among BMI, %BF and serum lipids. Consequently, %BF by BIA (an index of body composition) better reflects serum lipid profile than BMI.
Malnutrition, a common feature among patients with COPD, has adverse effects on the immune system. Delayed type of hypersensitivity (DTH) tests have been used to evaluate the nutritional and immune status of patients and to predict outcome in various conditions. DTH is known to be and late allergic reaction (LAR) has been suggested to be dependent on T-lymphocyte function.
To compare DTH and LAR tests in COPD patients and healthy controls, to investigate whether skin tests have any value in estimating nutritional status and outcome in COPD patients, and to see whether there is any relationship between DTH and LAR.
Twenty-five patients with stable COPD and 20 healthy controls were tested for DTH and LAR. The patients were investigated with spirometry and anthropometric measurements and were followed for 1 year.
Both the LAR and DTH reactions were diminished in the patient group (p < 0.001) compared with controls. The skin tests did not correlate with anthropometric parameters. DTH correlated to lung function, which was expressed as FEV(1) (percent predicted) (r = 0.56; p < 0.01), and LAR correlated to the number of exacerbations (at 3 months, r = - 0.61; p < 0.01). No correlation was found between LAR and DTH reactions.
We conclude that patients with COPD in stable condition have diminished DTHs and LARs. Our results indicate that the magnitude of the LAR may be a prognostic marker in patients with COPD.
To examine patterns of muscle mass change with aging and to estimate the prevalence of sarcopenia.
Cross-sectional survey.
Population-based study in Rochester, Minnesota.
Age-stratified sample of men and women from the community.
Muscle mass estimated from total body scans by dual-energy X-ray absorptiometry. Sarcopenia was defined as muscle mass more than 2 standard deviations below the sex-specific young-normal mean.
Total lean body mass (exclusive of bone) and total skeletal muscle mass both were greater in men than women and declined linearly with age as judged from these cross-sectional data. Adjustment for height reduced the gender difference. The age- and sex-adjusted prevalence of sarcopenia varied from 6 to 15% among subjects 65 years of age or over, depending on the muscle mass parameter that was evaluated, but prevalence rates were quite sensitive to the normal values used to define cutoff levels. Subjects with sarcopenia appeared to have more physical limitations than the others.
Late in life, a substantial portion of the population reaches low levels of muscle mass that are associated with increased physical disability. However, additional efforts are needed to validate an operational definition of sarcopenia.
Health risks in elderly people cannot be evaluated simply in conventional terms of body fatness or fat distribution. Elderly people have less muscle and bone mass, expanded extracellular fluid volumes, and reduced body cell mass compared to younger adults. These nonfat components of body composition play critical roles, influencing cognitive and physical functional status, nutritional and endocrine status, quality of life, and comorbidity in elderly people. Different patterns of "disordered body composition" have different relationships to these outcomes and may require different, tailored approaches to treatment that combine various exercise regimens and dietary supplements with hormone replacement or appetite-stimulating drugs. Skeletal muscle atrophy, or "sarcopenia," is highly prevalent in the elderly population, increases with age, and is strongly associated with disability, independent of morbidity. Elders at greatest risk are those who are simultaneously sarcopenic and obese. The accurate identification of sarcopenic obesity requires precise methods of simultaneously measuring fat and lean components, such as dual-energy X-ray absorptiometry.
To determine whether body mass index (BMI, kg/m2) or percentage body fat (%BF) by bioelectrical impedance analysis (BIA) better reflects the cardiovascular risk profile, we examined the associations among BMI, %BF by BIA, and cardiovascular risk factors (systolic blood pressure (SBP), diastolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), LDL-C/HDL-C ratio, and triglycerides (TG)) in 1,217 Japanese male office workers aged 25 to 59 years. From stepwise regression analyses of cardiovascular risk factors on age, BMI, alcohol intake, and cigarette smoking, significant correlates were, in the order of relative importance: age, BMI, and alcohol intake for SBP and DBP (the cumulative percentage of variation; 14.9% and 21.3%, respectively); age, BMI, and alcohol intake (negative) for LDL-C (11.0%); BMI (negative), alcohol, and cigarette smoking (negative) for HDL-C (19.9%); BMI, alcohol intake (negative), age, and cigarette smoking for LDL-C/HDL-C ratio (23.1%); and BMI, age, cigarette smoking, and alcohol intake for Log TG (21.7%). From stepwise regression analyses using %BF by BIA as an independent factor, %BF by BIA was also significantly associated with each cardiovascular risk factor, but the decrease in explained variance for each cardiovascular risk factor was 0.2-4.5%, compared with the model using BMI as an independent factor. These results suggest that BMI may better reflect blood pressure or serum lipid profile than %BF by BIA.
To investigate whether the association between BMI and all-cause mortality could be disentangled into opposite effects of body fat and fat-free mass (FFM).
All-cause mortality was studied in the Danish follow-up study "Diet, Cancer and Health" with 27,178 men and 29,875 women 50 to 64 years old recruited from 1993 to 1997. By the end of year 2001, the median follow-up was 5.8 years, and 1851 had died. Body composition was assessed by bioelectrical impedance. Cox regression models were used to estimate the relationships among body fat mass index (body fat mass divided by height squared), FFM index (FFM divided by height squared), and mortality. All analyses were adjusted for smoking habits.
Men and women showed similar associations. J-shaped associations were found between body fat mass index and mortality adjusted for FFM and smoking. The mortality rate ratios in the upper part of body fat mass were 1.12 per kg/m2 (95% confidence interval: 1.07, 1.18) in men and 1.06 per kg/m2 (95% confidence interval: 1.02, 1.10) in women. Reversed J-shaped associations were found between FFM index and mortality with a tendency to level off for high values of FFM.
Our findings suggest that BMI represents joint but opposite associations of body fat and FFM with mortality. Both high body fat and low FFM are independent predictors of all-cause mortality.
The objective of this study was to clarify the clinical significance and usefulness of measuring percent body fat (PBF) when compared with body mass index (BMI) in the Japanese population. A total of 2,483 Japanese individuals (1,380 men and 1,103 women) who underwent a medical checkup from 1999-2002 were employed. PBF was determined using bioelectrical impedance analysis (BIA). Relationships of age, BMI and PBF with several metabolic parameters, including blood pressure, lipids and plasma glucose levels were assessed in both genders separately. In men, PBF was a stronger determinant of total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG) compared with age and BMI, whereas in women, age was the strongest determinant of TC and LDL-C. In both genders, BMI was the strongest determinant of serum HDL-C among age, PBF and BMI. Based on these data, we suggest that measuring PBF by BIA is superior to BMI for predicting TC, LDL-C and TG in Japanese men.
Procedures for the analysis of free alpha-keto acids in human fluids (i.e. plasma, cerebrospinal fluid, urine, etc.) as well as for studying the dynamic free alpha-keto acid pools in differentiated tissues and organ cells have been the subject of growing clinical interest in the study of metabolic regulatory and pathophysiological phenomena. Due to the high instability and polarity of the alpha-keto acids being examined, the development of a quantitative and reproducible analysis of metabolically relevant intracellular alpha-keto acids still presents a substantial methodological challenge. The aim of small sample size, rapid, non-damaging and "metabolism-neutral" cell isolation, careful sample preparation and stability, as well as reproducible analytics technology is not often achieved. Only few of the methods described can satisfy the rigorous demands for an ultra-sensitive, comprehensive and rapid intracellular alpha-keto acid analysis.
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