The mysterious values of adipose tissue density and fat content in infants: MRI-measured body composition studies.

Adipose tissue is a type of connective tissue composed of closely packed adipocytes with collagenous and elastic fibers. These adipocytes store triglycerides at a high percentage and the estimate of this amount is important for the calculation of body fat mass. For example, magnetic resonance imaging (MRI) measures adipose tissue volume, but adipose tissue density (fat content percentage and density) is required to calculate fat mass. However, in previously published studies, the conversion factor for white adipose tissue density varies from study to study. This paper aimed to investigate the different adipose tissue densities used as conversion factors to clarify differences between studies. Furthermore, we include a new proposal for adipose tissue density and fat content of infants based on the results of recent water-fat MRI studies. IMPACT: Magnetic resonance imaging (MRI) is one of the methods used to measure body composition in infants and the inherent density of tissue/organs is needed in order to calculate the mass of target organs and tissues. The conversion factor used for white adipose tissue density currently varies from study to study. This article includes a new recommendation for the adipose tissue density and fat content of infants based on the results of recent water-fat MRI studies.

The Fat Fraction Percentage of White Adipose Tissue at various Ages in Humans: An Updated Review.

We recently reported the fat fraction percentage of white adipose tissue in adolescents and adults measured by the water-fat separation method, but there was limited discussion about the change in adipose tissue fat fraction with growth. The purpose of this updated review was to examine the fat content of white (subcutaneous) adipose tissue during the process from birth to adulthood by adding the latest available data. A relevant database was searched through November 2020. Nineteen studies were included. We found that calculated mean values of fat fraction percentage in white adipose tissue were 72.2% in neonates, 87.2% in children, and 87.4% in adults. In contrast, fat fraction percentage of truncal white adipose tissue in the fetuses was from 10% to 24% (29 and 34 wk of gestational age, respectively). Our results suggest that the fat fraction percentage of white adipose tissue may not undergo large changes during the process from birth to adulthood (neonates = 72.2%, children = 87.2%, adults = 87.4%), which was different from the results of a study utilizing a biopsy. The mean value and range of fat fraction percentages for children over 7 years old were especially similar to adults. Further, the fat fraction percentage for neonates was relatively close to the results of children and adults. At the moment, the characteristics of the changes in fat fraction percentage of adipose tissue from birth to preschool children are unclear and future research is needed to clarify this issue.

Acute Muscular Responses to Practical Low-Load Blood Flow Restriction Exercise Versus Traditional Low-Load Blood Flow Restriction and High-/Low-Load Exercise.

CONTEXT: Blood flow restriction (BFR) increases muscle size and strength when combined with low loads, but various methods are used to produce this stimulus. It is unclear how using elastic knee wraps can impact acute muscular responses compared with using nylon cuffs, where the pressure can be standardized. OBJECTIVE: Investigate how elastic knee wraps compare with nylon cuffs and high-load (HL)/low-load (LL) resistance exercise. DESIGN: A randomized cross-over experimental design using 6 conditions combined with unilateral knee extension. SETTING: Human Performance Laboratory. PARTICIPANTS: A total of 9 healthy participants (males = 7 and females = 2) and had an average age of 22 (4) years. INTERVENTION: LL (30% of 1-repetition maximum [1-RM]), HL (70% 1-RM), BFR at 40% of arterial occlusion pressure (BFR-LOW), BFR at 80% of arterial occlusion pressure (BFR-HIGH), elastic knee wraps stretched by 2 in (PRACTICAL-LOW), and elastic knee wraps stretched to a new length equivalent to 85% of thigh circumference (PRACTICAL-HIGH). BFR and practical conditions used 30% 1-RM. MAIN OUTCOME MEASURES: Muscle thickness, maximum voluntary isometric contraction, and electromyography amplitude. Bayesian statistics evaluated differences in changes between conditions using the Bayes factor (BF10), and median and 95% credible intervals were reported from the posterior distribution. RESULTS: Total repetitions completed were greater for BFR-LOW versus PRACTICAL-HIGH (BF10 = 3.2, 48.6 vs 44 repetitions) and greater for PRACTICAL-LOW versus BFR-HIGH (BF10 = 717, 51.8 vs 36.3 repetitions). Greater decreases in changes in maximum voluntary isometric contraction were found in PRACTICAL-HIGH versus HL (BF10 = 1035, ∼103 N) and LL (BF10 = 45, ∼66 N). No differences in changes in muscle thickness were found between LL versus PRACTICAL-LOW/PRACTICAL-HIGH conditions (BF10 = 0.32). Greater changes in electromyography amplitude were also found for BFR-LOW versus PRACTICAL-HIGH condition (BF10 = 6.13, ∼12%), but no differences were noted between the other BFR conditions. CONCLUSIONS: Overall, elastic knee wraps produce a more fatiguing stimulus than LL or HL conditions and might be used as an alternative to pneumatic cuffs that are traditionally used for BFR exercise.

The Bigger the Hand, the Bigger the Difference? Implications for Testing Strength With 2 Popular Handgrip Dynamometers.

CONTEXT: Studies developed the frail elderly handgrip strength (HGS) diagnostic criteria using multiple types of handgrip dynamometers. If different handgrip dynamometers report different values, then this would have the potential to misclassify people into the wrong diagnostic category. OBJECTIVE: To examine the characteristics of HGS measured by 2 standard handgrip dynamometers and to investigate the influence of hand size on HGS. SETTING: University research laboratory. PARTICIPANTS: A total of 87 young and middle-aged adults between the ages of 20 and 60 years participated in this study. MAIN OUTCOME MEASURES: Standard methods of HGS measurements were used for hydraulic and Smedley spring-type dynamometers, although the participants were instructed to maintain an upright standing position in both tests. RESULTS: Test-retest reliability of hydraulic and Smedley dynamometers provided comparable results to that observed with previous studies. However, the difference in HGS between the 2 dynamometers (Hydraulic-Smedley difference) was positively associated (r = .670, P < .001) with the mean of the 2 dynamometers. The participants who had relatively low HGS (at least <35 kg) produced similar HGS values when the 2 dynamometers were compared, whereas persons who had relatively higher HGS (at least >45 kg) produced greater strength values with the hydraulic compared with the Smedley. The hand and palm lengths were weakly correlated (r = .349 and r = .358, respectively, both Ps < .001) with the difference in HGS between the 2 dynamometers. CONCLUSIONS: Test-retest reliability of hydraulic and Smedley dynamometers provides comparable results to previous studies. However, the difference in HGS between the 2 dynamometers was positively associated with the mean of the 2 dynamometers. This Hydraulic-Smedley difference would not affect persons who have relatively low HGS (at least <35 kg), while when HGS is relatively high, the comparison between dynamometers should be done with caution.

Prediction and Validation of DXA-Derived Appendicular Fat-Free Adipose Tissue by a Single Ultrasound Image of the Forearm in Japanese Older Adults.

OBJECTIVES: To develop regression-based equations for estimating dual-energy x-ray absorptiometry (DXA) derived appendicular fat-free adipose tissue (FFAT) using a single ultrasound image in the forearm, and to investigate the validity of those equations to calculate FFAT-free appendicular lean mass (aLM-minus-FFATappendicular ) in 311 Japanese adults aged 60 to 79 years. METHODS: Subjects were randomly separated into two groups: 215 in the model-development group (91 men and 124 women) and 96 in the cross-validation group (42 men and 54 women). Appendicular fat mass and aLM were measured by the DXA, and subcutaneous adipose tissue (AT-forearm) and muscle (MT-ulna) thicknesses were measured by ultrasound. Appendicular FFAT was calculated based on the results of a previous study (appendicular FFAT = appendicular fat mass/0.85 x 0.15). The aLM was estimated from MT-ulna using a previously published equation (aLM = 4.89 x MT-ulna x body height - 9.15). Stepwise linear regression analysis was used to determine predictive models for DXA-derived appendicular FFAT from AT-forearm, sex, age, and anthropometrical variables. The best ultrasound prediction equation for estimation of appendicular FFAT was developed and then cross-validated in a subsample of older adults. RESULTS: There was no significant difference between the DXA-derived and ultrasound-predicted aLM-minus-FFATappendicular . A strong correlation was observed between the DXA-derived and ultrasound-predicted aLM-minus-FFATappendicular (r = 0.935, P < .001). Bland-Altman analysis did not indicate a bias in the prediction of the aLM-minus-FFATappendicular for the validation group. CONCLUSIONS: Our results indicated that a single ultrasound forearm measurement can be used to accurately estimate DXA-derived aLM-minus-FFATappendicular in Japanese older adults, which may be advantageous for community-based physical examinations.

Influence of relative blood flow restriction pressure on muscle activation and muscle adaptation.

INTRODUCTION: The aim of this study was to investigate the acute and chronic skeletal muscle response to differing levels of blood flow restriction (BFR) pressure. METHODS: Fourteen participants completed elbow flexion exercise with pressures from 40% to 90% of arterial occlusion. Pre/post torque measurements and electromyographic (EMG) amplitude of each set were quantified for each condition. This was followed by a separate 8-week training study of the effect of high (90% arterial occlusion) and low (40% arterial occlusion) pressure on muscle size and function. RESULTS: For the acute study, decreases in torque were similar between pressures [-15.5 (5.9) Nm, P = 0.344]. For amplitude of the first 3 and last 3 reps there was a time effect. After training, increases in muscle size (10%), peak isotonic strength (18%), peak isokinetic torque (180°/s = 23%, 60°/s = 11%), and muscular endurance (62%) changed similarly between pressures. CONCLUSION: We suggest that higher relative pressures may not be necessary when exercising under BFR.

Effects of age on arterial stiffness and central blood pressure after an acute bout of resistance exercise.

PURPOSE: To investigate the influence of age on arterial stiffness and blood pressure after performing a resistance exercise bout. METHODS: Recreationally active men were separated into young (YG, n = 12, 26.5 ± 3.3 years), middle (MG, n = 14, 49.4 ± 5.7 years), and old (OG, n = 10, 67.4 ± 6.3 years)-aged groups. In a randomized cross-over design, participants performed control and exercise conditions with at least 3 days separating conditions. The exercise condition consisted of leg press, chest press, knee flexion, lat pulldown and knee extension at ~65% one-repetition maximum for three sets of 10 repetitions. Brachial and central blood pressures, augmented pressure, augmentation index, central and peripheral pulse wave velocities were measured prior to each condition and starting at 5 min post-exercise. RESULTS: Brachial systolic blood pressure (SBP) significantly increased similarly after exercise for all age groups (YG, 8 ± 8 mmHg; MG, 5 ± 5 mmHg; OG, 5 ± 6 mmHg; p < 0.05). However, central SBP did not significantly increase for any age group after exercise. Augmentation index significantly increased after exercise only in the YG (11 ± 8%, p < 0.05). Central pulse wave velocity did not significantly increase in any age group after exercise when compared to the control condition. CONCLUSIONS: When performing a whole body moderate resistance exercise bout, acute changes in arterial stiffness and blood pressure appear to be minimally affected by age.

Comparative Effects of Vigorous-Intensity and Low-Intensity Blood Flow Restricted Cycle Training and Detraining on Muscle Mass, Strength, and Aerobic Capacity.

Traditional high-intensity aerobic training has been shown to improve muscle protein synthesis and aerobic capacity; however, recent research indicates that low-intensity aerobic training with blood flow restriction (BFR) may have similar effects. The purpose of this study was to compare the effects of vigorous-intensity (VI) cycling vs. low-intensity cycling with BFR (LI-BFR) on muscle mass, strength, and aerobic capacity after training and subsequent detraining. Thirty-one physically active subjects were assigned to one of 3 groups: VI (n = 10, 60-70% heart rate reserve [HRR]), LI-BFR (n = 11, 30% HRR with BFR at 160-180 mm Hg), and no exercise control (n = 10, no exercise). Subjects in VI and LI-BFR cycled 3 times per week for 6 weeks (total 18 sessions). Body composition, muscle mass, strength, and aerobic capacity were measured pre, post, and after 3 weeks of detraining. A group × time interaction (p = 0.019) effect for both knee flexion and leg lean mass was found. For both VI and LI-BFR groups, knee flexion strength was significantly increased between pre and post (p = 0.024, p = 0.01) and between pre and 3 week-post (p = 0.039, p = 0.003), respectively. For the LI-BFR group, leg lean mass was significantly increased between pre and 3 week-post (p = 0.024) and between post and 3 week-post (p = 0.013). However, there were no significant differences between groups for any variables. The LI-BFR elicits an increase in the knee flexion muscle strength over time similar to the VI. An increase in the leg lean mass over time was seen in the LI-BFR, but not in VI and CON.

Effects of exercise with and without different degrees of blood flow restriction on torque and muscle activation.

INTRODUCTION: An unresolved question in resistance training combined with blood flow restriction (BFR) is what percentage of estimated arterial occlusion pressure provides the most robust acute muscular response. METHODS: Forty participants were assigned to Experiments 1, 2, or 3. Each experiment completed exercise protocols differing by pressure, exercise load, and/or volume. Torque was measured pre- and postexercise, and muscle activation was measured pre- and during each set. RESULTS: Pressure and load did not affect torque greatly. Muscle activation increased in all conditions (P < 0.05) and was higher with 30% 1RM compared with 20% 1RM. Pressure appeared to increase muscle activation from 40% to 50% arterial occlusion [66% vs. 87% maximal voluntary contraction (30% 1RM)] but was not further increased with higher pressure. CONCLUSION: Different levels of BFR may alter the acute muscular response to a degree, although higher pressures do not appear to augment these changes.

Blood flow restriction in the upper and lower limbs is predicted by limb circumference and systolic blood pressure.

PURPOSE: To determine what factors should be accounted for when setting the blood flow restriction (BFR) cuff pressure for the upper and lower body. METHODS: One hundred and seventy one participants visited the laboratory for one testing session. Arm circumference, muscle (MTH) and fat (FTH) thickness were measured on the upper arm. Next, brachial systolic (SBP) and diastolic (DBP) blood pressure measurements were taken in the supine position. Upper body arterial occlusion was then determined using a Doppler probe. Following this, thigh circumference and lower body arterial occlusion were determined. Models of hierarchical linear regression were used to determine the greatest predictor of arterial occlusion in the upper and lower body. Two models were employed in the upper body, a Field (arm size) and a Laboratory model (arm composition). RESULTS: The Laboratory model explained 58 % of the variance in arterial occlusion with SBP (ß = 0.512, part = 0.255), MTH (ß = 0.363, part = 0.233), and FTH (ß = 0.248, part = 0.213) contributing similarly to explained variance. The Field model explained 60 % of the variance in arterial occlusion with arm circumference explaining the greatest amount (ß = 0.419, part = 0.314) compared to SBP (ß = 0.394, part = 0.266) and DBP (ß = 0.147, part = 0.125). For the lower body model the third block explained 49 % of the variance in arterial occlusion with thigh circumference (ß = 0.579, part = 0.570) and SBP (ß = 0.281, part = 0.231) being significant predictors. CONCLUSIONS: Our findings indicate that arm circumference and SBP should be taken into account when determining BFR cuff pressures. In addition, we confirmed our previous study that thigh circumference is the greatest predictor of arterial occlusion in the lower body.