Bioelectrical impedence, anthropometry and body composition in stunted and non-stunted children

Bioelectrical impedance (BIA) and anthropometric measurements were taken of 129 stunted and 32 non-stunted children aged 9-24 months in Kingston, Jamaica. The reliability of BIA in such young children was examined and the relationships between impedance and anthropometry were determined. The stunted children had significantly lower body mass index (BMI) and smaller triceps skinfolds than the non-stunted children, suggesting differences in body composition between the groups. Resistance was significantly higher in the stunted children than the non-stunted children and nutritional group (stunted or non-stunted) contributed significantly to the variance in resistance after controlling for length, weight, mid-upper arm circumference, triceps and subscapular skinfolds, age and sex. This suggests that there were differences in body composition and/or body shape between the groups beyond that measured by the anthropometric indices used. Total body water (TBW) was estimated using an equation for Jamaican children of comparable age. As a percentage of body weight the TBW estimates were the same for the two groups, a finding which is inconsistent with the anthropometric data.(AU)

Water distribution (total body water and extracellular water) and plasma-volume in Curacaoan newborn infants measured by a triple indicator method - abstract

The postnatal weight loss of normal Curacaoan term infants is approximately 4-5 per cent of the birth weight whereas the average Caucasian term infant will lose ñ 10 percent of the birthweight. As part of a study to investigate the influence of the neonatal body (water) compartments on the postnatal weight loss, the "water distribution" (the total body water, extracellular water), and the plasma volume in a group of 13 Curacaoan neonates were measured simultaneously, using a triple indicator (deuterium oxide, sucrose and evans blue), single injection dilution technique. The high precision of the method used to determine extracellular water volume (ECW) allows the use of very small samples in the neonates. Mean neonatal total body water volume (75.1 percent) on the first day use of life in this group of term Curacaoan in fants corresponds to values presented in other studies. However, the distribution of the total water volume between the intracellular (43.9 percent) and extracellular (31.1 percent) space showed, in comparison with studies in term-AGA infants from other countries, an increased proportion of total water occupied by the intracellular compartment at the expense of the extracellular space (AU)

Total body water in malnutrition: the possible role of energy intake

Total body water (TBW) was measured using tritiated water in sixty-five children. The measurements were distributed throughout rehabilitation in order to define the effect of changing energy intakes. Oedematous children had a high TBW which decreased to the normal range during loss of oedema providing they were not receiving more than maintenance amounts of energy during this period. Marasmic children who had not received greater than maintenance amounts of energy had a normal TBW. Treatment with a high-energy diet was associated with an initial increase in TBW. The possible mechanisms for this phenomenon are discussed.(AU)

Lipid metabolism in rats fed different fats during rehabilitation from malnutrition

Little is known of the effects of malnutrition on the composition of adipose tissue in children. Total body fat is severely depleted in most cases but it is not known how this affects the structure and subsequent regeneration and metabolic activity of the tissue. There is evidence that during normal growth in both children and animals that there are sensitive periods during which the cell number and cell size in adipose tissue may be altered by nutritional factors. This study was designed first to develop methodology for use in the analysis of small samples of tissues and then to study the composition of adipose tissue of rats which had been malnourished and then refed with high fat diets. Two different fats, peanut oil and coconut oil were used in order to investigate whether the type of fat in the diet infleunced the tissue composition. The available literature has been reviewed and the results of the measurement of DNA, protein and fat content of the tissue, of total body fat and of total body water are presented. The study has shown that: (a) adipose tissue of rats fed a protein-free diet containing peanut oil was more depleted of fat than if the diet contained coconut oil; (b) the accumulation of fat in the tissue of malnourished rats which had been refed with a diet containing peanut oil was more rapid than in those which were fed coconut oil. The increase in adipose tissue mass in both cases occurred by an increase in cell size rather than cell number; (c) total body water and total body fat were lower than normal in the malnourished rats. There was a progressive increase in total body fat as refeeding continued. Total body water increased very rapidly in the early stages of refeeding with peanut oil. Greater than normal values were attained only after 4 days refeeding. These values thereafter declined to normal. There was a slower increase to normal in the rats fed coconut oil. Total body fat was measured in children recovering from malnutrition on high energy diets containing either peanut oil or coconut oil. There was a tendency for the total body fat to increase more slowly in those fed coconut oil (Summary)

Muscle mass and composition in malnourished infants and children and changes seen after recovery

A method of measuring muscle mass in children with [15N]creatinine has been used to study changes in muscle after recovery from protein-energy malnutrition. Creatinine pool size, muscle mass, total muscle cell number, muscle cell size, and total body water have been measured in seven malnourished and eight recovered children. After recovery there was a significant reduction in the muscle concentration (micrograms mg[-1] wet wt muscle) of creatine (4.21 to 3.12), and a trend towards reduction in noncollagen protein (155 to 136) and DNA (2.13 to 1.34). The fractional turnover rate of creatine did not change but the creatine pool size increased significantly (4.2 to 5.6 g). Average muscle mass almost doubled (1.00 to 1.91 kg) and made up a greater percentage of body weight (16 to 22 percent). When muscle mass was expressed as a percentage of the expected muscle mass for a normal child of the same height the increase with recovery was from 49 percent to 92 percent. Total muscle noncollagen protein (NCP) increased after recovery (153 to 265 g) and accounted for a greater percentage of total body solids (6.6 to 8.5 percent). The average total muscle DNA was 2.049 g in the malnourished and 2.380 g in the recovered children and the ratio of NCP:DNA increased from 92 to 110 on recovery. Total body water as a percentage of body weight was not significantly different after recovery. Values for muscle mass in recovered children were similar to those reported for normal children of the same weight, height, and age. (Summary)

Total body water, extracellular, and plasma volume compartments in sickle cell anaemia

The total body water (TBW), plasma (PV) and extracellular fluid volumes (ECFV) of twenty-nine subjects with sickle cell anaemia, ten of whom were in painful crisis, were studied. During asymtomatic periods (the steady state), the ECFV of subjects with the anaemia is increased when compared with normal controls, because of plasma volume expansion; the interstitial fluid volume (ISFV) is normal, and intra cellular water (ICFV) is diminished by 5 percent of weight. During painful crisis, there was a marked tendency to loss of plasma volume into the interstitial fluid compartment, and the data also suggested that there was acute cellular distruction. Most of the patients in this study managed, however, presumably by compensatory changes in renal function and fluid intake, to maintain a normal plasma volume during painful crisis (AU)

Body composition studies in children admitted to hospital with protein-energy malnutrition

Thirteen children who were suffering from protein energy malnutrition were studied in an effort to determine their body composition on admission to hospital, while they were rapidly growing and when they had fully recovered. A review of the available methods for measuring body composition, the methods which are applicable to malnourished children, those used in this project, the results obtained and the difficulties encountered from the body of this report. The main aims of this study were (i) to validate the use of simple anthropometric measurements in body composition studies, and (ii) to see whether the children who recovered from malnutrition were depositing tissue in normal proportions when fed on the high calorie dietary regime. The results are encouraging and have opened up new areas for future reseach. The main findings can be summerised as follows:- (1) the values for total body fat calculated from anthropometric measurements are not significantly different from those calculated from total body water measurement. In the malnourished phase total body fat (TBF) was found to be 14.3 percent and 10.2 percent of body weight from TBW and skinfold measurements respectively. While values for the rapidly growing stage were 16.7 percent and 15.9 percent and in the recovered stage these values were 22.8 percent and 22.5 percent. (2) The measurement of 24 hour urinary creatinine excretions is not a reliable indicator of muscle mass in malnourished children. (3) The serial measurements of TWB should carried out at carefully timed intervals which relate to the energy intake on admission, during rapid growth and at recovery. (4) The faecal energy losses of the 5 children studied on nitrogen balance were variable. In the malnourished stage these values were 5.1 percent, 37.4 percent and 45.3 percent of the energy intake. In the rapidly growing phase the values ranged from 8.1 percent - 58.9 percent of the intake. In the recovered stage there was less variation but the values were higher than those reported in the literature(39.1 percent - 43.1 percent of the intake). (5) Simple anthropometric measurements (arm circumference, triceps skinfold) can be used to estimate the nutritional status of children, and as a measure of recovery from malnutrition (Summary)

Amount and rate of disappearance of liver fat in malnourished infants in Jamaica

The fat content of the liver has been measured in 163 biopsy specimens taken from 95 malnourished children in Jamaica within a few days of admission to hospital and at various stages of recovery. The fat content was also measured in 38 samples from children who died. Severe degrees of fatty infiltration, up to 50 percent of the wet weight, were found. Fatty liver of this degree of severity may be a cause of death. The increase in fat was accompanied by an increase in water content. Repeat biopsies were done within 6 weeks of admission in 26 children. The average rate of clearance of fat expressed as a fraction of the amount present at any time was 5.5 percent per day. An attempt was made by more frequent biopsies to determine whether the rate of decrease was influenced by the protein content of the diet, but the results were inconclusive.(AU)

Total body water in malnourished infants

Total body water has been estimated with tritiated water in 24 malnourished infants under the age of 2 years: the changes during recovery have been followed. On admission, the mean total body water was 84.5 per cent. of body weight: after recovery, this value fell to 62.6 per cent. Measurements have also shown an absolute decrease in body solids compared with normal for age. It is possible by this method to estimate the extent of tissue depletion (SUMMARY)

Total body water in malnourished infants

Total body water has been studied in 24 malnourished infants by the method of isotope dilution, using tritium administered parenterally as tritiated water: urinary activity has been measured in a gas flow counter designed for accurate measurement of low energy radiation. The results show: 1. A great increase in proportion of water in the malnourished child as compared with normal: average 84.5 percent of body weight on admission and 62.6 percent on recovery (the normal TBW percent body weight varies slightly with age but is approximately 60 percent). 2. A gross depletion of body solids. On admission the average body solids were only 29 percent (range 11-70 percent) of normal for age. The results were consistent with nitrogen balance data (AU)

Total body water in malnourished infants - abstract

Total body water has been studied in 24 malnourished infants by the method of isotope dilution, using tritium administered parenterally as tritiated water: urinary activity has been measured in a gas flow counter designed for accurate measurement of low energy radiation. The results show:- 1.A great increase in proportion of water in the malnourished child as compared with normal: average 84.5 percent of body weight on admission and 62.6 percent on recovery (the normal TBW percent body weight varies slightly with age but is approximately 60 percent). 2.A gross depletion of body solids. On admission the average body solids were only 29 percent (range 11- 70 percent) of normal age. The results are consistent with nitrogen balance data (AU)