Evaluation of zinc status in subjects with Crohn's disease

Zinc status was evaluated in 30 subjects with Crohn's disease. Intestinal resection had previously been performed in 23 of the subjects. The concentrations of zinc were determined in plasma, erythrocytes, percutaneous muscle biopsies, and in urine collected during 24 hours. The results were compared with those in 19 healthy controls. Most of the patients had a normal zinc status. The levels of zinc were, however, reduced (i.e., less than mean -2 SD for controls) in plasma for five, in erythrocytes for two, and in muscle biopsies for six subjects with Crohn's disease. The mean concentrations of zinc in plasma and erythrocytes were reduced (P less than 0.05), whereas the mean content of zinc in muscle biopsies and the mean urinary excretion of zinc were not significantly different, in subjects with Crohn's disease. The various zinc parameters did not correlate to each other. The results indicate that some subjects with Crohn's disease had an intracellular zinc depletion, which, however, was not reflected by a reduction in levels of zinc in plasma.     

Dose-Response Relationships Between Body Composition Indices and All-Cause Mortality in Older Japanese Adults

ObjectivesWe examined the dose-response relationships of body composition indices with mortality and identified the best predictor.Design and settingKusatsu Longitudinal Study and Hatoyama Cohort Study, Japan.ParticipantsIn total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) participated.MeasurementsBody mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI) were determined by segmental multifrequency bioelectrical impedance analysis. The main outcome was all-cause mortality. We determined multivariate-adjusted hazard ratios for mortality relative to sex-specific medians of each body composition index and examined the association shapes.ResultsDuring the median follow-up of 5.3 years, 128 (13.3%) men and 75 (7.4%) women died. Compared with median BMIs (23.3 kg/m² in men and 22.8 kg/m² in women), a BMI >23.3 and ≤26.1 kg/m² was associated with significantly lower mortality risk in men, and a BMI <22.8 kg/m² was associated with significantly higher mortality risk in women. The inverse dose-response relationship with mortality was clearer for FFMI [hazard ratios (95% confidence interval) of 10th and 90th percentiles: 1.58 (1.23–2.03) and 0.58 (0.44–0.79), respectively, in men and 1.56 (1.12–2.16) and 0.68 (0.51–0.91), respectively, in women] and SMI [1.57 (1.22–2.01) and 0.60 (0.45–0.80), respectively, in men and 1.45 (1.05–2.01) and 0.77 (0.61–0.96), respectively, in women] than for BMI [1.30 (0.92–1.83) and 0.65 (0.41–1.03), respectively, in men and 1.87 (1.18–2.95) and 0.88 (0.54–1.42), respectively, in women]. FMI was not associated with mortality in either sex.Conclusions and ImplicationsFFMI and SMI were more definitive predictors of mortality than were BMI and FMI. The lower mortality risk with higher FFMI, regardless of FMI, may explain the age-related weakening of the association between higher BMI and mortality (the “obesity paradox”). FFMI and SMI evaluation should be introduced to clinical assessments of older adults because mortality risk might be reduced by maintaining muscle mass.     

Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women

Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.     

The Relationship between Body Composition,Dietary Intake,Physical Activity,and Pulmonary Status in Adolescents and Adults with Cystic Fibrosis

Measures of body fat and lean mass may better predict important clinical outcomes in patients with cystic fibrosis (CF) than body mass index (BMI). Little is known about how diet quality and exercise may impact body composition in these patients. Dual X-ray absorptiometry (DXA) body composition, 24-h dietary recall, and physical activity were assessed in a cross-sectional analysis of 38 adolescents and adults with CF and 19 age-, race-, and gender-matched healthy volunteers. Compared with the healthy volunteers, participants with CF had a lower appendicular lean mass index (ALMI), despite no observed difference in BMI, and their diets consisted of higher glycemic index foods with a greater proportion of calories from fat and a lower proportion of calories from protein. In participants with CF, pulmonary function positively correlated with measures of lean mass, particularly ALMI, and negatively correlated with multiple measures of body fat after controlling for age, gender, and BMI. Higher physical activity levels were associated with greater ALMI and lower body fat. In conclusion, body composition measures, particularly ALMI, may better predict key clinical outcomes in individuals with CF than BMI. Future longitudinal studies analyzing the effect of dietary intake and exercise on body composition and CF-specific clinical outcomes are needed.     

Eight-Year Longitudinal Changes in Body Composition in Healthy Swiss Adults

Objective: Significant changes in body composition occur during lifetime. This longitudinal study (8.0 ± 0.8 yrs) in a cohort of healthy sedentary and physically active men (n = 78) and women (n = 53), aged 20 to 74 yr describes: 1) the longitudinal changes in weight and body composition and 2) their associations with age and physical activity.

Method: Fat-free mass (FFM) and body fat (BF) were assessed by bioelectrical impedance analysis (BIA). Subjects who regularly performed >3 hours per week of endurance type physical activity were classified as “Active”. Others were classified as “Sedentary”. Subjects were also separated by age (<45 yr vs ≥45 yr).

Results: FFM increased by 1.7 ± 2.8 kg in men <45 yr who gained 4.0 ± 5.0 kg of body weight and was maintained (0.5 ± 1.6 kg) in women <45 y who gained 1.6 ± 3.0 kg of weight. A weight gain of 1.2 ± 3.3 kg in men ≥45 yr was accompanied by stable FFM (?0.1 ± 2.3 kg), and of 1.0 ± 3.2 kg was accompanied by a loss of FFM in women ≥45 yr. In active men ≥45 yr, maintenance of FFM was associated with smaller weight gains than in sedentary; sedentary men ≥45 yr decreased FFM with larger weight gains than active subjects. Sedentary women <45 yr were able to gain FFM; the active women maintained, but did not gain FFM with smaller weight gains than in sedentary women. FFM decreased in ≥45 yr women despite of small weight gains.

Conclusion: Weight change is clearly associated with a change in FFM. Weight gain is necessary to offset age-related FFM loss between 20 and 74 yrs. In active men, a FFM increase was associated with less weight gain than sedentary men. Future studies should evaluate the threshold of weight change and the level of physical activity necessary to prevent age-related losses of FFM.     

Body Composition of Infants Born with Intrauterine Growth Restriction: A Systematic Review and Meta-Analysis

Intrauterine growth restriction (IUGR) may predispose metabolic diseases in later life. Changes in fat-free mass (FFM) and fat mass (FM) may explain this metabolic risk. This review studied the effect of IUGR on body composition in early infancy. Five databases and included studies from all countries published from 2000 until August 2021 were searched. Participants were IUGR or small-for-gestational age (SGA) infants, and the primary outcomes were FFM and FM. Eighteen studies met the inclusion criteria, of which seven were included in the meta-analysis of primary outcomes. Overall, intrauterine growth-restricted and SGA infants were lighter and shorter than normal intrauterine growth and appropriate-for-gestational age infants, respectively, from birth to the latest follow up. They had lower FFM [mean difference −429.19 (p = 0.02)] and FM [mean difference −282.9 (p < 0.001)]. The issue of whether lower FFM and FM as reasons for future metabolic risk in IUGR infants is intriguing which could be explored in further research with longer follow-up. This review, the first of its kind can be useful for developing nutrition targeted interventions for IUGR infants in future.     

Bioelectrical Impedance Analysis for the Assessment of Body Composition in Sarcopenia and Type 2 Diabetes

Sarcopenia is emerging as a severe complication in type 2 diabetes (T2DM). On the other hand, it has been documented that nutritional aspects, such as insufficient protein or total energy intake, increase sarcopenia risk. The analysis of body composition is a relevant approach to assess nutritional status, and different techniques are available. Among such techniques, bioelectrical impedance analysis (BIA) is particularly interesting, since it is non-invasive, simple, and less expensive than the other techniques. Therefore, we conducted a review study to analyze the studies using BIA for body composition analysis in T2DM patients with sarcopenia or at risk of catching it. Revised studies have provided important information concerning relationships between body composition parameters (mainly muscle mass) and other aspects of T2DM patients’ conditions, including different comorbidities, and information on how to avoid muscle mass deterioration. Such relevant findings suggest that BIA can be considered appropriate for body composition analysis in T2DM complicated by sarcopenia/muscle loss. The wide size of the patients’ cohort in many studies confirms that BIA is convenient for clinical applications. However, studies with a specific focus on the validation of BIA, in the peculiar population of patients with T2DM complicated by sarcopenia, should be considered.     

Infant Red Blood Cell Arachidonic to Docosahexaenoic Acid Ratio Inversely Associates with Fat-Free Mass Independent of Breastfeeding Exclusivity

The prevalence of childhood obesity has increased nearly ten times over the last 40 years, influenced by early life nutrients that have persistent effects on life-long metabolism. During the first six months, infants undergo accelerated adipose accumulation, but little is known regarding infant fatty acid status and its relationship to infant body composition. We tested the hypothesis that a low arachidonic to docosahexaenoic acid ratio (AA/DHA) in infant red blood cells (RBCs), a long-term indicator of fatty acid intake, would associate with more infant fat-free mass (FFM) and/or less adipose accumulation over the first 4 months of life. The fatty acid and composition of breastmilk and infant RBCs, as well as the phospholipid composition of infant RBCs, were quantified using targeted and unbiased lipid mass spectrometry from infants predominantly breastfed or predominantly formula-fed. Regardless of feeding type, FFM accumulation was inversely associated with the infant’s RBC AA/DHA ratio (p = 0.029, R² = 0.216). Infants in the lowest AA/DHA ratio tertile had significantly greater FFM when controlling for infant sex, adiposity at 2 weeks, and feeding type (p < 0.0001). Infant RBC phospholipid analyses revealed greater peroxisome-derived ether lipids in the low AA/DHA group, primarily within the phosphatidylethanolamines. Our findings support a role for a low AA/DHA ratio in promoting FFM accrual and identify peroxisomal activity as a target of DHA in the growing infant. Both FFM abundance and peroxisomal activity may be important determinants of infant metabolism during development.     

孕期体脂百分比对妊娠期妇女糖尿病影响因素分析

目的 探索孕中期妇女体成分与妊娠期糖尿病(GDM)的关联.方法 采用病例对照研究,以2018年4月至2019年4月在北京市某妇幼保健院进行产检孕妇为研究对象,在妊娠24～28周进行口服糖耐量试验,以明确是否存在GDM,并使用人体成分分析仪测定孕妇体成分.最终获得124例诊断GDM的孕妇作为病例组,130例血糖正常孕妇作...     

山东某社区7岁儿童体重状态及肥胖类型与体成分的关系

目的 分析不同性别、体重状态、肥胖类型学龄儿童的体成分差异,探讨体重状态和肥胖类型对瘦体重与脂肪质量比值(MFR)、体脂百分比(FMP)的影响。 方法 2019-2020年随访山东莱州湾出生队列440名7岁儿童,用体成分仪测量并计算得到总体成分、去脂体重和体脂肪相关的12种体成分指标。依据BMI分为3种体重状态,依据体重指数(BMI)及腰围身高比分为4种肥胖类型,分析其与体成分的关系。 结果 体成分性别差异分析表明,男女生的MFR、FMP差异无统计学意义(t=1.16、0.39,P＞0.05)。MFR在正常、超重、肥胖组间递减,在非肥胖、腹型肥胖、一般性肥胖、复合型肥胖组间也递减(F=141.65、63.96,P＜0.05),而其他体成分指标在各组间呈递增趋势(P＜0.05)。多重线性回归表明肥胖组比正常组儿童的MFR低3.28(95%CI:-3.69~-2.87,P<0.001),FMP高17.25%(95%CI:16.07~18.43,P<0.001);复合型肥胖组比非肥胖组儿童的MFR低3.18(95%CI:-3.65~-2.71,P<0.001),FMP高17.55%(95%CI:16.15~18.95,P<0.001)。 结论 肥胖儿童的增重主要归于体脂肪的增加,复合型肥胖儿童的肌肉和脂肪平衡失调,提示在儿童期防控复合型肥胖对降低其健康风险具有重要的公共卫生学意义。     

Long-Term Effect of Gluten-Free Diets on Nutritional Status,Body Composition,and Associated Factors in Adult Saudi Females with Celiac Disease

This cross-sectional study examines the influence of long-term gluten-free diet (GFD) consumption on nutritional status, body composition, and associated factors in adult Saudi females with celiac diseases (CD). Fifty-one patients who have been diagnosed with CD and have been on GFD for more than 1 year were included in this study where data regarding their dietary pattern, as well as a complete analysis of their anthropometric parameters, vitamins B12 and D levels, and complete blood count (CBC), were collected. Data have shown that all included patients showed a reduced intake in all micro and macro-nutrients, as well as vitamin D, folate, calcium, and iron. However, the vast majority of all measured hematological parameters and blood indices were within the expected reference range. In addition, 51%, 43.1%, and 60.8% of the patients showed low waist/hip ratio (WHR), decreased level of total body fat (BF), and decreased level of visceral fat (VF), respectively, whereas 33.3% were slim. The poor educational level and some psychosocial factors were associated with the poor nutritional status of the patients. In conclusion, the GFD-dependent intake by female patients with CD adversely affects their nutritional intake and anthropometric indices and leads to a deficiency in major nutrients, vitamins, and ions.     

Differences between Four Skinfold Calipers in the Assessment of Adipose Tissue in Young Adult Healthy Population

Background: The aim of this study was to analyze the validity of four different skinfold calipers, as well as to establish the differences between them in a healthy young adult population. Methods: The present study followed a cross-sectional design, including 138 participants, with 69 males (21.46 ± 2.52 years) and 69 females (22.19 ± 2.85 years). The measurement protocol included basic measurements of body mass and stretch stature and eight skinfolds with a Harpenden, Holtain, Slim Guide, and Lipowise. The ∑6 and ∑8 skinfolds and fat mass were calculated. The order in which the skinfold calipers were used was randomized. Results: No significant differences were found in either the Σ6 and Σ8 skinfolds or masses and fat percentages calculated with the skinfolds obtained with the different calipers (p > 0.05), and the inclusion of the covariates of sex, BMI, and hydration status of the participants showed no effect on the differences. The Bland–Altman test showed significant differences between the calipers (p < 0.001). Conclusion: It has been observed that the analyzed calipers have shown validity for the assessment of adiposity-related variables in a male and female sample of non-overweight, young healthy adults, but they are not interchangeable with each other when the assessment is meant to be compared over time or with other samples.     

Phantoms for Cross-Calibration of Dual Energy X-ray Absorptiometry Measurements in Infants

Objective: To test the suitability of phantoms to cross-calibrate body composition measurements in small subjects among different dual energy X-ray absorptiometry (DXA) instruments.

Methods: A set of four phantoms with total weights 1520g, 3140g, 4650g and 7490g were made with low cost and easily available materials. Each phantom was made from assembling polyethylene bottles (100 to 1000 mL) filled with either pure olive oil or electrolyte solution in different combinations, and borosilicate tubes (3 and 5 mL) and flexible polypropylene tubing filled with calcium carbonate. Triplicate measurements of each of the four phantoms were performed with three pencil beam densitometers made by the same manufacturer (Hologic Inc., Waltham, MA): two QDR 2000 (University of Liege, Liege, Belgium, and Wayne State University, Detroit, Michigan) and a QDR1500 (University Children’s Hospital, Greifswald, Germany) using infant whole body-scanning mode and analyzed with software V5.73P.

Results: DXA measured total weight, or bone, lean and fat masses, from one center were highly predictive of DXA measurements from the other centers with an adjusted r² of 0.94 to 1.00, p < 0.001. This was the case whether the measurements from single scan or from average of triplicate scans were used in the analysis.

Conclusions: Systematic corrections, in the form of linear transformations, are possible to allow comparison of clinical data generated from different centers. Different size phantoms can be made to accommodate the varying range of weights and body composition of study subjects.     

Body composition by X-ray absorptiometry and bioelectrical impedance in chronic respiratory insufficiency patients

Nutrition assessment is important during chronic respiratory insufficiency to evaluate the level of malnutrition or obesity and should include body composition measurements. The appreciation of fat-free and fat reserves in patients with chronic respiratory insufficiency can aid in designing an adapted nutritional support, e.g., nutritional support in malnutrition and food restriction in obesity. The purpose of the present study was to cross-validate fat-free and fat mass obtained by various bioelectric impedance (BIA) formulas with the fat-free and fat mass measured by dual-energy X-ray absorptiometry (DXA) and determine the formulas that are best suited to predict the fat-free and fat mass for a group of patients with severe chronic respiratory insufficiency. Seventy-five patients (15 women and 60 men) with chronic obstructive and restrictive respiratory insufficiency aged 45–86 y were included in this study. Body composition was calculated according to 13 different BIA formulas for women and 12 for men and compared with DXA. Because of the variability, calculated as 2 standard deviations, of ± 5.0 kg fat-free mass for women and ± 6.4 kg for men for the best predictive formula, the use of the various existing BIA formulas was considered not clinically relevant. Therefore disease-specific formulas for patients with chronic respiratory insufficiency should be developed to improve the prediction of fat-free and fat mass by BIA in these patients.     

Effect of zinc supplements on the intestinal absorption of calcium.

Pharmacologic doses of zinc are widely used as zinc supplements. As calcium and zinc may compete for common absorption sites, a study was carried out on the effect of a pharmacologic dose of zinc on the intestinal absorption of calcium in adult males. The analyzed dietary zinc intake in the control studies was normal, averaging 14.6 mg/day. During the high zinc study, 140 mg zinc as the sulfate was added daily for time periods ranging from 17 to 71 days. The studies were carried out during both a low calcium intake averaging 230 mg/day and during a normal calcium intake of 800 mg/day. Calcium absorption studies were carried out during the normal and high zinc intake by using an oral tracer dose of Ca47 and determining plasma levels and urinary and fecal excretions of Ca47. The study has shown that, during zinc supplementation, the intestinal absorption of calcium was significantly lower during a low calcium intake than in the control study, 39.3% vs 61% respectively, p less than 0.001. However, during a normal calcium intake of 800 mg/day, the high zinc intake had no significant effect on the intestinal absorption of calcium. These studies have shown that the high zinc intake decreased the intestinal absorption of calcium during a low calcium intake but not during a normal calcium intake.     

不同出生体重儿体格发育水平与营养状况的出生队列研究

[目的]了解不同出生体重儿婴幼儿期身长、体重和体质指数（body mass index,BMI）的动态变化及营养不良、超重和肥胖的发生率.[方法]对2 547名婴幼儿0～30个月的体检资料进行统计分析,计算BMI值并采用身高别体重中位数百分比法来判定营养不良、超重和肥胖.[结果]在0～30月中,巨大儿在各年龄的体重、身长和BMI均为3组之最,其次为正常出生体重儿,低出生体重儿处于最低水平.不同出生体重儿的超重和肥胖发生率在出生后头3个月呈上升趋势,于3个月时达到高峰.巨大儿组在出生后各年龄段的营养不良发生率在三组中处于最低水平,低出生体重儿组营养不良发生率在出生后第3年有明显上升趋势.[结论]宫内生长与儿童早期生长有密切的关系,在重视预防婴幼儿超重和肥胖的同时也要加强营养不良的预防.     

Action of ornithine alpha-ketoglutarate,ornithine hydrochloride,and calcium alpha-ketoglutarate on plasma amino acid and hormonal patterns in healthy subjects.

Ornithine alpha-ketoglutarate (OKG) has been useful as an adjuvant of enteral and parenteral nutrition. However, its metabolism and mechanism of action remain unclear although it is known that alpha-ketoglutarate (alpha KG) and ornithine (ORN) follow, in part, common metabolic pathways. Six fasting healthy male subjects underwent three separate oral load tests: (i) they received 10 g of OKG (i.e., 3.6 g of alpha KG and 6.4 g of ORN); (ii) 6.4 g of ORN as ornithine hydrochloride, and (iii) 3.6 g of alpha KG as calcium alpha-ketoglutarate. Blood was drawn 15 times over a five-hour period for measurements of plasma amino acids, alpha KG, insulin, and glucagon. After OKG and ORN administration, plasma ORN peaked at 60-75 min (494 +/? 91 and 541 +/? 85 mumol/L). The increase in plasma alpha KG was very small. OKG, alpha KG, and ORN all increased glutamate concentrations at 60 min (mean: +43%, +68%, +68%, respectively, p less than 0.05 compared to basal values). However, only OKG increased proline and arginine levels at 60 min (mean: +35%, p less than 0.01 and mean: +41%, p less than 0.05). Furthermore, glutamate, proline, and arginine concentrations correlated linearly with ornithine levels at 60 min. Finally, OKG increased insulinemia and glucagonemia (mean: +24% at 15 min, p less than 0.05 and +30% at 60 min, p less than 0.01, respectively). These data provide evidence that the combination of ORN and alpha KG modifies amino acid metabolism in a way which is not observed when they are administered separately. In addition, the OKG-mediated increase in insulin levels probably does not appear to result from a direct action of ORN on pancreatic secretion.