Anthropometric measurements in both sides of the body in the assessment of nutritional status in prepubertal children

OBJECTIVE: To analyze the impact of choosing the left or the right side of the body on the anthropometric measurements and derived nutritional indices, in prepubertal children. DESIGN: Cross-sectional pilot nutrition survey. SETTING: General prepubertal school-age population. SUBJECTS: One-hundred and sixty-four children (97 boys and 67 girls) aged 7-9 y. INTERVENTIONS: None. RESULTS: The agreement between anthropometric measurements in both sides of the body showed that in males and in females, suprailiac skinfold thickness and arm circumference were significantly higher in the left than in the right side of the body. The agreement between body composition assessed by anthropometric measurements in both sides of the body showed that only in males was arm muscle area significantly higher in the left than in the right side, and arm fat percentage was higher in the right than in the left side of the body. Total body fat percentage calculated from skinfold thickness did not show statistically significant differences when skinfolds were obtained in the both sides of the body, either in boys and in girls. CONCLUSIONS: Our results show that differences between the sides of the body were lower than the technical error of measurement of the anthropometric measurements obtained and seem not to be biologically significant in this age group. It is necessary to standardize the method of anthropometric assessment of the nutritional status in terms of body side.     

Fat-free mass in relation to stature: ratios of fat-free mass to height in children, adults, and elderly subjects

A cross-sectional relationship of fat-free mass to height expressed as a ratio (FFM:ht) is presented for 1103 people aged 6-86 y. Data are presented for 13 specific age groups by gender. By providing information for normal, healthy individuals, these data may be of comparative value for nutritionists and clinicians concerned with body composition of patients with wasting diseases. The data were collected over 20 y in our laboratory by using the same densitometric procedure. A significant increase in FFM:ht occurs during the preadolescent and adolescent years. The adolescent spurt continues for a longer period for boys than for girls, resulting in a significant gender difference beginning at approximately age 16 y and continuing throughout adulthood. A decline in FFM:ht, not statistically significant, appears to occur in men greater than 60 y of age, and a significant decline occurs among women greater than 50 y of age (alpha less than 0.01). Thus, both gender- and age-related trends that have implications for the interpretation of comparative body-composition status are suggested.     

Four-component model of body composition in children: density and hydration of fat-free mass and comparison with simpler models

BACKGROUND: Body composition in children is generally measured by 2-component (2C) models, which are subject to error arising from variation in fat-free mass (FFM) composition. The 4-component (4C) model, which divides body weight into fat, water, mineral, and protein, can overcome these limitations. OBJECTIVE: The aims of our study were to 1) describe 4C model data for children aged 8-12 y; 2) evaluate interindividual variability in the hydration, bone mineral content, and density of FFM; 3) evaluate the success with which 2C models and bedside techniques measure body composition in this age group with use of the 4C model as a reference. DESIGN: Dual-energy X-ray absorptiometry, underwater weighing, deuterium dilution, bioelectrical impedance analysis, and anthropometry were used to determine body composition in 30 children. The contribution of methodologic error to the observed variability in the hydration and density of FFM was evaluated by using propagation of error. RESULTS: Mean (+/-SD) FFM density and hydration were 1.0864+/-0.0074 kg/L and 75.3+/-2.2%, respectively, and were significantly different from adult values (P < 0.02). Relative to the 4C model, deuterium dilution and dual-energy X-ray absorptiometry showed no mean bias for fatness, whereas underwater weighing underestimated fatness (P < 0.025). Fatness determined by using skinfold-thickness and bioelectrical impedance analysis measurements along with published equations showed poor agreement with 4C model data. CONCLUSIONS: Biological variability and methodologic error contribute equally to the variability of FFM composition. Our findings have major implications for bedside prediction methods used for children, traditionally developed in relation to underwater weighing.     

Anthropometric estimates of muscle and fat mass in relation to cardiac and cancer mortality in men: the Paris Prospective Study

BACKGROUND: The associations of different components of body mass with disease outcomes are not well defined. OBJECTIVE: We investigated the effects of body composition on risk of death from cardiac causes and cancer in adult men. DESIGN: Middle-aged men (n = 7608) in the Paris Prospective Study were followed up for 15 y. At study entry, the following measurements were obtained: sagittal diameter, sum of midarm and midthigh circumferences, sum of 3 trunk skinfold thicknesses (estimate of trunk subcutaneous fat), and sum of 3 extremity skinfold thicknesses (estimate of extremity subcutaneous fat). To assess their relative contributions to cardiac and cancer mortality, we used multivariate Cox models in which the sagittal diameter adjusted for trunk skinfold thicknesses was used as an estimate of intraabdominal fat and the sum of midarm and midthigh circumferences adjusted for extremity skinfold thicknesses was used as an estimate of muscle mass. RESULTS: In multivariate analyses in both smokers and nonsmokers, the sagittal diameter was the only significant predictor of cardiac death. The sum of midarm and midthigh circumferences was negatively associated and sagittal diameter was positively associated with cancer death, whereas extremity skinfold thicknesses exhibited a U-shape relation. Exclusion of subjects who died from cancer in the first 5 y of follow-up did not change these results. CONCLUSIONS: Intraabdominal fat appears to be the main body compartment involved in risk of cardiac death, whereas increased risk of cancer death is associated with lower muscle mass and lower subcutaneous fat, independent of smoking and after the exclusion of early mortality. Increased central fat distribution may confer additional risk of death from cancer.     

Weight loss of 5% or more predicts loss of fat-free mass during palliative chemotherapy in patients with advanced cancer: a pilot study

The cutoff value of critical weight loss is still subject of discussion. In this pilot study, we investigated whether ≥5% weight loss in the past year predicts changes in nutritional status in patients with advanced cancer during treatment with palliative chemotherapy. In 20 patients with advanced cancer undergoing palliative (combination) chemotherapy, body weight, fat free mass (FFM), and cachexia were measured prior to the start and at 9 wk of treatment. History of weight loss was used to test differences in development of nutritional parameters during chemotherapy with use of independent sample t-tests. At baseline, 10 of 20 patients had lost ≥5% body weight during the past year and 5 patients were cachectic. The change in FFM in the first 9 wk of chemotherapy was significantly worse in patients with ≥5% weight loss compared to patients with <5% weight loss [mean difference: 3.5?kg (P = 0.001)]. Data also suggest that ≥5% weight loss predicts shorter survival (P = 0.03). We found that patients with ≥5% weight loss prior to chemotherapy have a deterioration in nutritional status during chemotherapy and may have a shorter survival. These results have to be confirmed in a larger study including a robust survival analysis.     

Age-appropriate body mass index in children with achondroplasia: interpretation in relation to indexes of height

BACKGROUND: Achondroplasia is the most common short stature skeletal dysplasia, with an estimated worldwide prevalence of 250 000. Body mass index (BMI)-for-age references are required for weight management guidance for children with achondroplasia, whose body proportions are unlike those of the average stature population. OBJECTIVE: This study used weight and height data in a clinical setting to derive smoothed BMI-for-age percentile curves for children with achondroplasia and explored the relation of BMI with its components, weight and height. DESIGN: This was a longitudinal observational study of anthropometric measures of children with achondroplasia from birth through 16 y of age. RESULTS: The analysis included 1807 BMI data points from 280 children (155 boys, 125 girls) with achondroplasia. As compared with the BMI of peers of average stature, the BMI in children with achondroplasia is higher at birth, lacks a steep increase in infancy and a later nadir between 1 and 2 y of age, and remains substantially higher through 16 y of age in both sexes. Patterns of change in height and weight in children with achondroplasia are unique in that there is no overlap in the height distribution after 6 mo of age and no spike in height velocity during infancy or puberty-the 2 periods of greatest linear growth in individuals of average stature. CONCLUSIONS: Sex- and age-specific BMI curves are available for children with achondroplasia (birth to 16 y of age) for health surveillance and future research to determine associations with health outcomes (eg, cardiovascular disease, diabetes, and indication for and outcome of surgery).     

Enhanced sensitivity of skeletal muscle growth in offspring of mice long-term selected for high body mass in response to a maternal high-protein/low-carbohydrate diet during lactation

Aim

To investigate the effects of a high-protein/low-carbohydrate diet fed to mice of different genotypes during pregnancy and/or lactation on offspring skeletal muscle growth and metabolism.

Methods

Pregnant mice from strains selected for high body mass (DU6) or endurance running performance (DUhLB) and from an unselected control strain (DUK) were fed iso-energetic diets containing 20 % (C) or 40 % protein and low carbohydrate (HP) from mating to weaning at day 21 of age. At birth, offspring were cross-fostered resulting in different exposure to maternal prenatal-preweaning diets (C–C, HP–C, C–HP, HP–HP). Rectus femoris muscle of male mice (n = 291) was examined at day 23, 44, 181 and 396 of age for cellular growth and metabolism.

Results

At day 23 of age, body and muscle growth was retarded by 30–40 % (P < 0.0001) in response to the C–HP and HP–HP, but not to the HP–C diet, due to reduced fibre size (P < 0.0001) but not fibre number. DNA was highly reduced in DU6, less in DUhLB, but not in DUK muscle (strain × diet; P < 0.0001). Despite some compensation, muscle growth was still impaired (P < 0.001) in adulthood (day 44; day 181), but at senescence only in DU6 mice (strain × diet; P < 0.05). Only at weaning, isocitrate and lactate dehydrogenase activities were increased or decreased (P < 0.0001), respectively, without influence on fibre type composition.

Conclusion

A high-protein/low-carbohydrate diet fed to dams during lactation, but not during pregnancy, retards skeletal muscle growth in offspring with greater response of a heavy, obese compared with a physically fit and a control genotype and causes a transient shift towards oxidative versus glycolytic muscle metabolism.     

Low relative skeletal muscle mass indicative of sarcopenia is associated with elevations in serum uric acid levels: Findings from NHANES III

Background  Sarcopenia may be related to increases in reactive oxygen species formation and inflammation, both of which are associated with elevations in serum uric acid. Objective  To test the hypothesis that a reduced skeletal muscle mass index, indicative of sarcopenia, is related to elevations in uric acid. Design  Cross-sectional analysis of nationally representative data. Setting  Third National Health and Nutrition Examination Survey, 1988–1994. Patients  7544 men and women 40 years of age and older who had uric acid, skeletal muscle mass, and select covariate information. Measurements  Skeletal muscle mass assessment was based on a previously published equation including height, BIA-resistance, gender, and age. Absolute skeletal muscle mass was calculated for all study population individuals and compared against the sex-specific mean for younger adults. Serum uric acid data were gathered from the NHANES laboratory file. Results  A logistic regression analysis revealed that elevations in serum uric acid are significantly related to sarcopenia status. For every unit (mg/dL) increase in uric acid, the odds ratio of manifesting a skeletal muscle mass index at least one standard deviation below the reference mean was 1.12. Participants in the highest grouping (>8 mg/dL) of serum uric acid concentration had 2.0 times the odds of manifesting sarcopenia compared to the lowest grouping (<6 mg/dL) (p<0.01) after adjusting for the additional covariates. Limitations  This study design was limited in its cross-sectional nature. Potential selection, measurement, and recall bias may have occurred, and methodology used to classify sarcopenia status based on skeletal muscle mass index is not validated. Conclusion  This observation provides support for the theory that elevations in uric acid may lead to sarcopenia, although the proposed mechanism needs further experimental support.     

Responsiveness to healthy television (TV) food advertisements/commercials is only evident in children under the age of seven with low food neophobia

Exposure to television advertisements for unhealthy foods has been shown to subsequently increase the amount of snack food consumed in children between the ages of five and eleven. However, it has yet to be elucidated whether healthy food television advertisements have a different effect on subsequent food intake in children. The current study explored the role of food neophobia in 'responsiveness' to food adverts in children between the ages of five and seven. Sixty-six children were exposed to unhealthy food adverts, healthy food adverts and toy adverts embedded into a cartoon in a counterbalanced order on three different occasions. Following the cartoon, children were offered a snack consisting of six food items (chocolate, jelly sweets, potato crisps, Snack-a-Jacks, green seedless grapes and carrot sticks). Food advert exposure, irrespective of content (either unhealthy or healthy food items), increased food intake by 47 kcal (11%) in high food neophobic children. Children who scored lower on the food neophobia scale ate significantly more (63 kcal, 14%) following the unhealthy food adverts only. In the healthy advert condition low food neophobic children consumed less chocolate (p=0.003) but did not increase their consumption of fruit and vegetables. Presentation of healthy foods does not alter food preferences in the short-term. Children with low levels of food neophobia appear to respond to healthy food messages but children with higher levels of food neophobia do not. Instead, high food neophobic children will continue to consume more chocolate following exposure to food adverts irrespective of the healthy or unhealthy message they contain.     

Nutritional assessment of a group of Japanese elementary school children in Tokyo: with special emphasis on growth, anemia, and obesity.

Anthropometric data, nutrient intake data, and blood biochemical parameters were analyzed for 66 elementary school children living in Tokyo, Japan, and their nutritional status was evaluated focusing on three problems: (1) zinc nutriture and growth, (2) anemia with iron deficiency, and (3) lipid nutriture and obesity. The subjects' mean energy and protein intakes met the recommended levels for Japanese children. However, their zinc intake levels were inadequate at 7.2, 8.3, and 8.5 mg in grades 2 (mean age: 8 yr), 4 (10 yr), and 6 (12 yr), respectively. Mean serum zinc concentration was 0.82 +/- 0.15 microgram/ml; the percentages of subjects who showed serum zinc concentration lower than 0.68 microgram/ml, the lower limit of the normal serum zinc concentration, were 28.6, 15.4, and 5.0% in grades 2, 4, and 6, respectively. These serum zinc concentrations indicated the existence of marginal zinc deficiency in some children, particularly in grade 2, though it was not severe enough to retard growth. Their iron intake levels (8.2, 10.2, and 10.2 mg for grades 2, 4, and 6, respectively) in combination with the proportion of iron intake from animal foods (37%) were judged to be adequate because no children showed serum ferritin, serum iron, or transferrin saturation levels lower than the criteria levels recommended for iron deficiency. Moreover, no definitely anemic children were found. Daily lipid intakes were 65.7, 74.5, and 78.3 g in grades 2, 4, and 6, respectively, and the mean percentage of energy intake from lipid to total energy intake, 32%, exceeded the level recommended. Mean serum total cholesterol concentrations and the percentage of subjects with elevated cholesterol levels (greater than or equal to 200 mg/dl) were high compared with the reported values. Means of the body mass index (BMI) and Rohrer Index (RI) for the subjects were slightly higher than Japanese standards. With these parameters for obesity, triglycerides and atherogenic index were positively correlated and HDL cholesterol and HDL cholesterol percentage to total cholesterol were negatively correlated.     

Lead sources, behaviors, and socioeconomic factors in relation to blood lead of native american and white children: a community-based assessment of a former mining area

Lead poisoning prevention requires knowledge of lead sources and of appropriate residential lead standards. Data are severely lacking on lead sources for Native American children, many of whom live in rural areas. Further, the relation of mining waste to blood lead concentrations (BPbs) of rural children is controversial. In collaboration with the eight tribes of northeastern Oklahoma, we assessed lead sources and their effects on BPbs for rural Native American and White children living in a former mining region. Venous blood lead, residential environmental (soil, dust, paint, water), and caregiver interview (e.g., hand-to-mouth behaviors, socioeconomic conditions) data were obtained from a representative sample of 245 children 1-6 years of age. BPbs ranged from 1 to 24 microg/dL. There were no ethnic differences in BPbs (p= 0.48) nor any patterns of excess lead sources for Native American or White children. Multiple linear regression analyses indicated that mean soil lead, mean floor lead loading, mouthing behaviors, caregivers' education, and residence in former mining towns were all strongly associated with BPbs. Logistic regression results showed mean floor dust lead loading greater than or equal to 10.1 microg/ft(2) (odds ratio [OR], 11.4; 95% confidence interval [CI], 3.5-37.3), and yard soil lead >165.3 mg/kg (OR, 4.1; CI, 1.3-12.4) were independently associated with BPbs greater than or equal to 10 microg/dL. We also found strong interactions between soil lead and poverty (p= 0.005), and dust and soil sources (p= 0.02). Our findings indicate that soil and dust lead derived largely from mining waste pose a health hazard to Native American and White children, and that current residential dust lead standards are insufficient to adequately protect children. Moreover, our finding that poor children are especially vulnerable to lead exposures suggests that residential standards should consider interactions among socioeconomic conditions and lead sources if environmental justice is to be achieved.     

Identifying low muscle mass in patients with hip fracture: Validation of bioelectrical impedance analysis and anthropometry compared to dual energy X-ray absorptiometry

Background

Older hip fracture patients often have reduced muscle mass, which is associated with adverse outcomes. Dual energy X-ray absorptiometry (DXA) can determine muscle mass, but is not practical in the acute phase. We investigated bioelectrical impedance analysis (BIA) and anthropometry compared against DXA for detecting low muscle mass in hip fracture patients.

Methods

This was a cross-sectional validation study at two Norwegian hospitals on 162 hip fracture patients aged ≥ 65 years. Appendicular lean mass (ALM) was determined by DXA, BIA and anthropometry 3 months after hip fracture. ALM by BIA was calculated by the Kyle, Janssen, Tengvall and Sergi equations, and ALM by anthropometry by the Heymsfield and Villani equations. The area under the receiver operating characteristic curve (AUC) was used to compare BIA and anthropometry for determining low ALM (≤5.67 kg/m² for women and ≤7.25kg/m² for men).

Results

Mean age was 79 years (SD 7.9), 74% were female. Mean ALM by DXA was 14.8 kg (SD 2.3) for women and 20.8 kg (SD 4.2) for men and 45% of women and 60% of men had low ALM. BIA (Kyle) in women (AUC 0.81, 95% confidence interval 0.72–0.89) and BIA (Sergi) in men (AUC 0.89, 95% CI 0.80–0.98) were best able to discriminate between low and normal ALM. Anthropometry (Heymsfield) was less accurate than BIA in women (AUC 0.64, 95% CI 0.54–0.75), and equal to BIA in men (AUC 0.72, 95% CI 0.72 0.56–0.87).

Conclusion

BIA (Sergi, Kyle and Tengvall) and anthropometry (Heymsfield) can identify low muscle mass in hip fracture patients.

     

Evaluation of diet and growth in children with and without atopic eczema: follow-up study from birth to 4 years

Current research into dietary factors contributing to the development of allergic diseases is directed towards new active approaches instead of passive elimination diets. The present study aimed to investigate the explanatory role of the diet in a probiotic intervention study on the appearance of atopic eczema (AE) in childhood and the safety of perinatal supplementation with probiotics (Lactobacillus rhamnosus strain GG; ATCC 53 103). A prospective follow-up study from birth to 48 months of children (n 159) with a family history of allergic disease was carried out. Outcome measures included growth, dietary intake assessed with 4 d food diaries and their association with AE by logistic regression models. Increased intakes of retinol, Ca and Zn, with perinatal administration of probiotics, reduced the risk of AE, whilst an increase in intake of ascorbic acid increased the likelihood of AE. Perinatal administration of probiotics was safe, as it did not influence the height (mean difference 0.04 (95 % CI -0.33, 0.40) sd scores, P=0.852) or the weight-for-height (mean difference -3.35 (95 % CI -7.07, 0.37)%, P=0.077) of the children at 48 months with and without perinatal administration of probiotics. Up to 48 months, AE did not affect height (mean difference -0.05 (95 % CI -0.42, 0.33) sd scores, P=0.815), but mean weight-for-height in children with AE was -5.1 % (95 % CI -8.9, -1.2 %) lower compared with children without (P=0.010). The joint effects of nutrients and probiotics need to be considered in active prevention and management schemes for allergic diseases.