Predictive equation for assessing appendicular lean soft tissue mass using bioelectric impedance analysis in older adults: Effect of body fat distribution.

BACKGROUND: Low muscle mass is associated with sarcopenia and increased mortality. Muscle mass, especially that of the limbs, is commonly estimated by dual-energy X-ray absorptiometry (DXA) or bioimpedance analysis (BIA). However, BIA-based predictive equations for estimating lean appendicular soft tissue mass (ALST) do not take into account body fat distribution, an important factor influencing DXA and BIA measurements. OBJECTIVES: To develop and cross-validate a BIA-based equation for estimating ALST with DXA as criterion, and to compare our new formula to three previously published models. METHODS: One-hundred eighty-four older adults (140 women and 44 men) (age 71.5 ±â€¯7.3 years, body mass index 27.9 ±â€¯5.3 kg/m2) were recruited. Participants were randomly split into validation (n = 118) and cross-validation groups (n = 66). Bioelectrical resistance was obtained with a phase-sensitive 50 kHz BIA device. RESULTS: A BIA-based model was developed for appendicular lean soft tissue mass [ALST (kg) = 5.982 + (0.188 × S2 / resistance) + (0.014 × waist circumference) + (0.046 × Wt) + (3.881 × sex) - (0.053 × age), where sex is 0 if female or 1 if male, Wt is weight (kg), and S is stature (cm) (R2 = 0.86, SEE = 1.35 kg)]. Cross validation revealed r2 of 0.91 and no mean bias. Two of three previously published models showed a trend to significantly overestimate ALST in our sample (p < 0.01). CONCLUSIONS: The new equation can be considered valid, with no observed bias and trend, thus affording practical means to quantify ALST mass in older adults.

Leucine metabolites do not induce changes in phase angle, bioimpedance vector analysis patterns, and strength in resistance trained men.

We aimed to assess the effects of off-the-shelf leucine metabolite supplements on phase angle (PhA), bioimpedance vector analysis (BIVA) patterns and strength during an 8-week resistance training protocol. Fifty-three male participants were allocated into 4 groups: α-hydroxyisocaproic acid (n = 12, age = 30.9 ± 9.3 years), ß-hydroxy-ß-methylbutyrate free acid (n = 12, age = 31.0 ± 9.3 years), calcium ß-hydroxy-ß-methylbutyrate (n = 15, age = 32.1 ± 5.2 years) or placebo (n = 14, age = 28.9 ± 6.6 years). Bioimpedance parameters and 1-repetition maximum (1RM) for back squat and bench press were assessed at baseline and at the end of weeks 4 and 8. Additionally, fat-free mass and fat mass were evaluated by dual-energy X-ray absorptiometry. No statistically group by time interactions were found, even adjusting for age. PhA and vector did not change over the training period, while time-dependent increases were observed for 1RM back squat and 1RM bench press. A direct association was observed between PhA and 1RM bench press changes (whole sample), while PhA and strength were correlated throughout the study, even when adjusting for fat-free mass and percentage of fat mass. Leucine metabolites have no effect on PhA, BIVA patterns or strength during an 8-week resistance training program, in resistance trained subjects. The trial was registered at ClincicalTrials.gov: NCT03511092. Novelty: Supplementation with leucine metabolites is not a supplementation strategy that improves bioelectrical phase angle, cellular health, and strength after an 8-week resistance training program. When consuming a high protein diet, none of the α-hydroxyisocaproic acid, ß-hydroxy-ß-methylbutyrate free acid, and calcium ß-hydroxy-ß-methylbutyrate metabolites resulted in an ergogenic effect in resistance trained men.

Ethnic differences in body image perception in patients with type 2 diabetes.

BACKGROUND: The present study compared the prevalence of obesity, fat distribution, body image perception and lifestyle among diabetic African and Albanian immigrants living in Italy, as well as diabetic Italians, aiming to identify health risks and their possible causes. METHODS: The study sample consisted of 200 diabetic subjects living in Italy. A questionnaire regarding socio-demographic and lifestyle information was administered to participants, and anthropometric measurements and body image perception were assessed. Proper perception of weight status and the degree of dissatisfaction in body image perception were valued. RESULTS: Italians showed a higher health risk, both with regard to anthropometric characteristics and lifestyle, whereas African immigrants showed a lower one. All of the male groups underestimated their weight and Albanians were the most dissatisfied. Women perceived their current body image as heavier than their desired body image, showing a dissatisfaction toward their weight. Subjects of both sexes belonging to the overweight and obese categories generally underestimated themselves; this was particularly true in obese Africans. People with a higher body mass index were more likely to be dissatisfied than those with a lower one. Body image dissatisfaction increased when people estimated themselves as being overweight. Among lifestyle habits, being an ex-smoker increased body image dissatisfaction. CONCLUSIONS: The underestimation of weight detected in the present study requires attention. Nevertheless, the high percentage of overweight/obese people, coupled with the higher frequency of people dissatisfied with their high weight, suggests an awareness of the problem that could be more effective for weight loss.

Participation in sports, body composition, and fitness characteristics in children according to ethnic background.

Participation in sports has important implications, being associated with health and social features. The objectives of this study were to verify whether there were any differences in sport participation between immigrant and Italian children and whether there was any relation with their body composition and fitness characteristics. A survey was conducted on 1432 children attending primary school in the Emilia-Romagna (northern Italy). Anthropometric measurements, fitness characteristics, and data about participation in sports were considered. Italian children were more likely to participate in sports than immigrants and boys than girls. Among immigrants, the lowest values were observed in Asians. Eastern European males and Latin American females displayed the widest dimensions. Eastern Europeans generally showed the highest values of strength, while Latin Americans had the highest values of flexibility. Asian children showed the highest values of centripetal fat, and a high percentage of them exceeded the %F reference. These aspects, together with the low frequency of practicing sports, place Asians at greater risks for health. Sex and ethnic group are the most informative variables associated with participation in sports by children. Interventions including health education lessons and promoting the participation in sports for immigrant children attending schools need to be encouraged.

Anthropometric variables, lifestyle and sports in school-age children: comparison between the cities of Bologna and Crotone.

Weight disorders are rapidly increasing in childhood. In Italy a strong geographic North-South gradient of overweight and obesity has been reported. The purpose of this study is to examine anthropometric variables, physical activity and lifestyles in school-age children in the cities of Bologna and Crotone. The sample consists of 963 children attending primary schools, aged 6-10 years. Height, weight, triceps, and subscapular skinfolds were measured for each child; body mass index (BMI) and percentage of fat mass were calculated. Physical activity was determined through an interview with each child. Another questionnaire was submitted to parents, in order to obtain information on sleep duration, means of transport and type of physical activity. In the city of Bologna, the mean values of anthropometric variables were: height (boys - 1,335 mm, girls - 1,332 mm), BMI (boys - 17.8 kg/m(2), girls - 17.3 kg/m(2)), and the proportion of overweight and obese individuals was: boys - 20.6%, girls - 12.7%. In Crotone the mean values were: height (boys - 1,275 mm, girls - 1,265 mm), BMI (boys - 19.4 kg/m(2), girls - 19.3 kg/m(2)), and the proportion of overweight and obese individuals was: boys - 46.7%, girls - 49.0%. The results have demonstrated significant correlations of lifestyle and physical activity with children's weight status. In Crotone there is a larger variation of weight disorders with higher percentages of overweight children than in Bologna. The children in Crotone are engaged in sedentary activities for a significantly longer time than children in Bologna, who are more physically active. The data show a strong North-South gradient concerning not only distribution of weight status, but also lifestyles especially including participation in sports and sedentary behavior. Our study also provides meaningful suggestions how to define lifestyles in order to achieve an optimal health status during growth.

Food habits and nutritional status of adolescents in Emilia-Romagna, Italy.

INTRODUCTION: The prevalence of childhood and adolescent obesity is increasing, with negative medical and psychosocial consequences. AIMS: This study examines the association between weight status and nutrient intake, sport and leisure habits of middle school students in Bologna (Italy). METHODS: Anthropometric data (height, weight) of 598 subjects (321 males and 277 females) 11-14 years old were collected. Questionnaires on nutrient intake, sport and leisure behaviour were administered. RESULTS: Protein, carbohydrate and total fat intakes of the adolescents were higher than the recommended ranges in all age groups and in both sexes. The proportion of energy from protein and total fat was higher than recommended, but the percentage from carbohydrate was lower. A significant proportion of the adolescents had a cholesterol intake above the Italian RDA and lower than recommended intakes for micronutrients. The prevalence of overweight and obesity is higher in males than in females at all ages (overweight: 35.2 vs 31.6 at 11 yrs.; 27.5 vs 20.2 at 12 yrs.; 18.6 vs 17.8 at 13 yrs.; 18.7 vs 10.9 at 14 yrs.; obesity: 5.5 vs 3.2 at 12 yrs.; 3.9 vs 1.1 at 13 yrs.; 5.3 vs 3.6 at 14 yrs.), except in subjects 11 years old (obesity: 7.4 vs 10.5). The overweight and obese adolescents consumed less carbohydrates and less fibre than their normal weight and underweight counterparts. CONCLUSION: The results of the present study indicate an unbalanced diet of the Bologna adolescents, which could damage their health and quality of life.

Somatotype in 6-11-year-old Italian and Estonian schoolchildren.

The study of somatotypes can contribute to the understanding of variability in human body build. The aim of this study was to compare the somatotypes of Italian and Estonian schoolchildren in order to evaluate factors that might lead to variability in somatotypes. The sample consisted of 762 Italian and 366 Estonian children aged 6-11 years. They were somatotyped by the Heath-Carter anthropometric method. Data on organised extra-curricular physical activity and hours of weekly training were also collected. One-way ANOVA was used to evaluate country-related variations of somatotype in each age/sex group, while factorial ANOVA was used to test the influence of country and organised physical activity on the variability of the anthropometric characteristics and somatotype components. There are significant differences in mean somatotypes between the Italian and Estonian children in many age classes and a different constitutional trend in children from the two different countries is observed. The Italian children are more endomorphic and less mesomorphic and ectomorphic than the Estonian children. On the other hand, it emerges from factorial ANOVA, that the somatotype components do not present significant variations related to organised physical activity and to the interaction between the country of origin and sport practice. Moreover, the results of the forward stepwise discriminant analyses show that mesomorphy is the best discriminator between the two countries, followed by ectomorphy. Our findings suggest that the observed differences between Italian and Estonian children could be related mainly to country rather than to the practice of organised physical activity in the two countries.

Two-stage study (1990-2002) of North African immigrants in Italy.

The objective of the present study was to investigate the psycho-social health and weight status of two samples of North African immigrants measured in 1990 (166 males) and in 2000-2002 (173 males and females), respectively. In addition to the cross-sectional study, we conducted a repeated study on a sub-sample of 21 males measured both in 1990 and in 2000-2002. The study was carried out in Italian health and care dedicated centres spread all over the Bologna administrative areas, that belong to the AUSL (Azienda Unità Sanitaria Locale, Administrative Local Health Unit). To evaluate the health and weight status, we calculated the body mass index (BMI) and measured systolic and diastolic blood pressure. Questionnaires were used to assess the psycho-social status. The mean BMI increased significantly (p<0.05) after immigration, as the prevalence of overweight (BMI>25) was higher after a decade. There was a significant increase (p<0.001) in stress-related factors and in the desire to return home. We also recorded an increase in weight disorders, as the length of time since immigration was an important risk factor for overweight. Therefore, immigrants may have a high risk of obesity-related co-morbidities. However, the factors related to malnutrition and stress had only weak effects on blood pressure.

Leaping ability and body composition in rhythmic gymnasts for talent identification.

AIM: Aim of this study was to investigate leaping ability and morphological characteristics in rhythmic gymnastics, in order to verify which parameters are useful indicators for the talent identification. METHODS: Twenty-five national gymnasts of international level (age 14.7+/-2.2 years) underwent three testing sessions: anthropometric measurements, vertical jumps (counter movement jump and hopping test), and three technical split leaps with stretched legs (SL), with ring (RG) and with back bend of the trunk (BBT). RESULTS: Elite had significantly different values (P < 0.05) of stature (1.65+/-0.03 vs 1.55+/-0.09 m), thigh length (0.42+/-0.03 vs 0.39+/-0.02 m) and FFM(42.42+/-2.81 vs 35.84+/-5.66 kg) compared to sub-elite. The height of hopping test was significantly higher in elite than sub-elite gymnasts (0.34+/-0.05 vs 0.27+/-0.04 m; P < 0.05), but no significant differences in counter movement jump between two groups were found. Ground contact time of hopping test was significantly correlated (P < 0.01) with SL (r = 0.613), RG (r = 0.632), and BBT (r = 0.542) values. By multiple regression analysis, among anthropometric and vertical jump variables, the hopping ground contact time was the strongest predictor of ground contact time of the three technical leaps (SL, RG, BBT) accounting for 26-37% of variance. CONCLUSION: Some anthropometric measurements are good indicators for the better performance in rhythmic gymnastics. Level of muscle compliance (stiffness) evaluated by hopping test is a good parameter for athletes selection and for monitoring leaps training.

Growth and malnutrition of rural Zimbabwean children (6-17 years of age).

The rural environment is an important factor in delayed growth in developing countries. The aim of this study was to investigate the effects of poor rural living conditions on the growth of a Shona sample in Zimbabwe. In total, 982 subjects aged 6-17 years were analyzed. Mean values of height, weight, skinfolds (triceps, subscapular, suprailiac, biceps, medial calf), cormic index, body mass index (BMI), arm composition (total upper arm area, upper arm muscle area, arm fat area, and arm fat index), fat percentage (%F), centripetal fat ratio (CFR), and the contribution of each skinfold to the adiposity of the trunk and upper limbs are presented. Weight, height, BMI, cormic index, SSCP, TRCP, arm circumference, and arm composition are compared with NHANES percentiles. Boys and girls showed stunting and underweight at ages 11-15 and 8-15, respectively; boys presented particularly severe malnutrition and their means of height and weight were below the 10th percentile. The means of arm circumference, UMA, UFA, and TRCP were below the 15th percentile in both sexes. The contribution of the skinfolds generally showed an overall prevalence of TRCP in both sexes; the contribution of SSCP was prevalent only for the 16- to 17-year-old boys. Males presented a higher CFR than girls after 14 years while females showed an irregular pattern. There was a high incidence of brachycormia and mesocormia in females and males, respectively. Height, weight, and BMI were similar to the values observed in other sub-Saharan countries, although body size was slightly larger than in South Africa and smaller than in Tanzania. The results provide a useful database for future comparisons.

Weight status and body image perception in Italian children.

BACKGROUND: Previous research suggests there is a tendency in overweight subjects to underestimate their weight status. This study investigated the perception of body image in Italian children, with particular regard to overweight children. METHODS: Primary school children (n = 866) were recruited for this cross-sectional nutritional survey in northern Italy. Anthropometric measurements were performed to determine body mass index (BMI). Body image perception was assessed with the Body Silhouette Chart for preadolescent children shown to the children and to their mothers (n = 778) during an interview. A new scheme to identify wrong (F.1, F.2) or inappropriate (F.3) self figure responses in overweight subjects was used. RESULTS: More than one-third of the Italian children examined were above the normal BMI range (prevalence of overweight: 35.8%, girls; 37.2%, boys). A higher degree of dissatisfaction was expressed by girls than by boys, and the percentage increased in overweight/obese children. A discrepancy between the self figure perception and the real nutritional status of the subject occurred in 6-9% of the overweight/obese children. CONCLUSION: The comparison of body image perception and anthropometric assessment of nutritional status could play an important role in future programs of nutritional surveillance as they provide indications of dissatisfaction and body image disturbances.

Growth of Chinese Italian infants in the first 2 years of life.

BACKGROUND: Numerous studies have been carried out on the growth of human migrant populations. However, studies on the auxological pattern of Chinese migrant population are limited in Italy. AIMS: In this paper we examine the growth pattern from birth to 24 months and the body composition of Chinese infants born and living in Bologna (north Italy). SUBJECTS AND METHODS: A longitudinal study was conducted recruiting 224 healthy Chinese children. The anthropometric measurements were collected when the children were immunized. Body mass index (BMI), Arm Muscle Area and Arm Fat Area were calculated. RESULTS: The growth of Chinese Italian children is adequate, being within the normal limits according to the NCHS reference standard. In comparison with Chinese children living in China and abroad, their body length is greater. Comparisons with growth curves for Italian children (Emilia-Romagna) show that weight and length values are higher in Chinese children than in Italians until 12 months, and comparable thereafter. The weight and length growth velocities are similar to those reported for Italian children. CONCLUSION: As a whole, the results of the present study support the hypothesis that Chinese children born and living in Italy grow in an appropriate environment to achieve their growth potential.

Influence of various factors on the measurement of multifrequency bioimpedance.

Body impedance values at various frequencies (from 1 to 100 kHz) were determined in 104 subjects on seven separate days over a two-week period. The variability of body impedance in different measurement conditions was studied. In particular, the effects of the electrode locations, the ingestion of some substances (sugar, alcohol, mineral salts), body spatial geometry, the time spent in the supine position and the menstrual cycle were assessed. Under standardized conditions (in the morning, in the fasting state, with an empty bladder and with the body in a standardised spatial position), the within-subject day-to-day variability was 3-14 Ohms. Under different experimental conditions, the within-subject variability was generally much higher. This was particularly evident for female subjects. We observed significant mean variations in relation to the different experimental factors introduced one at a time, with the exception of the menstrual cycle. For example, half an hour after the intake of various substances, body impedance had generally increased by 6-17 Ohms in comparison with values in the fasting state. Changes in body impedance during the menstrual cycle, however, were small and never statistically significant. The impedance variations obviously caused significant changes in estimated parameters of body composition. It is concluded that controlled conditions and standardization of multifrequency bioimpedance analysis (MBIA) methods are indispensable for the application of this technique.

Body size, composition, and blood pressure of high-altitude Quechua from the Peruvian Central Andes (Huancavelica, 3,680 m).

Although much information is available about the effects of high altitude on physiological characteristics, less is know about its effect on body composition. In the present study, anthropometric and body composition variables were investigated in a sample of 77 adult Quechua males from the Peruvian Central Andes (Huancavelica, 3,680 m). The subjects are shorter in relation to body weight than other ethnic groups, whereas body proportions are macrocormic (indicating a long trunk relative to the lower extremities), with intermediate values of the acromial-iliac index. All skinfold thicknesses are low (approximately 15th percentiles of NHANES reference values for the triceps and subscapular skinfolds), but tend to be higher than in the other Quechua populations. Similar results are obtained when percentage fat is estimated. Somatotypes are dominant in mesomorphy with very low ectomorphy. Comparison with a sample of high-altitude Kirghiz (3,200 m), previously studied with the same methods, shows higher values in the Peruvian sample for all variables related to adiposity. The presence of low adiposity in the Quechua population could be associated with stresses of the high-altitude environment. Mean values of blood pressure are very low and there is no correlation with age.

Body composition in Central Asia populations: Fat patterning variation in the Kazakhs of the Tien Shan mountains and the Uighurs of Semericia.

Eleven anthropometric variables related to fat patterning were analyzed in two populations of Central Asia, the Kazakhs of the Tien Shan mountains (2100 m) and the Uighurs of the Semericia plains. Subjects were healthy unrelated males, 122 Kazakhs and 79 Uighurs, 19-65 years. Comparisons were done with a preliminary analysis of variance and then by covariance analysis, taking into account the influence of age. The Uighurs, independently of age, show higher values than Kazakhs for all of the characteristics related to fat patterning, but principal components analysis suggests a similar somatic structure in the two samples. The presence of lower adiposity in the Kazakhs than in the Uighurs could be related to stress, probably associated with nutrition and lifestyle in a mountain environment. Am. J. Hum. Biol. 10:241-247, 1998. © 1998 Wiley-Liss, Inc.

Remarks on methods for estimating body composition parameters: reliability of skinfold and multiple frequency bioelectric impedance methods.

A sample of 104 adults underwent testing of body composition by multiple frequency bioelectric impedance analysis (MBIA) under controlled conditions, by anthropometric methods (skinfold thicknesses and BMI) and by the urinary creatinine method. The statistical comparison of body composition parameters (Fat, FFM, TBW), estimated by different methods for the same subjects, pointed out significant differences in mean values. The precision of skinfold and MBIA measurements was evaluated by a second control measurement. Concerning the MBIA, the reliability increased with increasing frequencies. Nevertheless, measurement reliability is higher for skinfolds than for MBIA. Under the condition that there is a real anthropometric technical ability, we affirm that the body composition parameters may at present be better estimated by the skinfold method.

Body composition and blood pressures in school children 6-14 years of age.

The relationship between parameters of estimated body composition (FFM = fat free mass, FM = fat mass, %F = percentage fat) and blood pressure was examined in a sample of 1418 school-children (712 males, 706 females), 6-14 years of age from L'Aquila and its province (Abruzzo), Italy. Systolic and diastolic blood pressures increased from 6-14 years in both sexes (males: systolic pressure 93.08 ± 14.95 to 122.29 ± 13.27 mm Hg; diastolic pressure: 59.60 ± 11.60 to 74.83 ± 8.35 mm Hg; females: systolic pressure: 97.12 ± 13.16 to 120.56 ± 8.02 mm Hg; diastolic pressure: 61.93 ± 10.23 to 76.67 ± 4.85 mm Hg). FFM and FM estimated by anthropometry and bioelectrical impedance, exhibited similar growth trends (Anthropometry: in males, FFM: 20.55-47.20 kg and FM: 4.14-12.01 kg; in females, FFM: 19.95-41.90 kg and FM: 5.03-15.84 kg; Impedance: in males, FFM: 18.40-47.30 kg and FM: 6.26-11.91 kg; in females, FFM: 17.47-36.97 kg and FM: 7.61-20.77 kg). Correlations between body composition parameters and blood pressures were generally significant. In particular, there was a strong relationship between systolic blood pressure and both FM and %F, the correlations being higher when the body composition parameters were estimated by anthropometry. Am. J. Hum. Biol. 9:535-544, 1997. © 1997 Wiley-Liss, Inc.