Skinfold thickness versus isotope dilution for body fat assessment during simulated microgravity: results from three bed-rest campaigns in men and women with and without countermeasures.

Because body composition is altered during head-down bed rest (HDBR), body mass can not be used as an index of energy balance. Consequently diet allowances should not be based on body mass evolution but on fat mass changes. Though criticized, skinfold thickness (ST) is the costless, easiest and fastest method to use for such an objective. The aim of this study was to compare the percentage of body fat (%BF) estimated by ST with the isotope dilution of H2 18O. We compiled data from three HDBR campaigns, one on women (n=8) in November 1998 and two on the same men (n=8) in December 1997 (without countermeasure) and January 1998 (with thigh-cuffs countermeasure), according to a crossover design. Body composition was assessed before and after 6 days of HDBR. %BF was derived from the biceps, triceps, sub-scapular and sup-iliac ST according to Durnin and Wormersly (1974). Fat-free mass was measured on the same day by H2 18O dilution and fat mass was calculated by the difference with body mass and expressed as a percentage. Based on precision tests, the minimum measurable change by ST was 1.1%BF for single measurement point. Both intercepts (F (4,30)=0.89, P=0.45) and slopes (F (4,30)=0.74; P=0.57) of the ST versus dilution relationships were not affected by the periods (December vs January), experimental conditions (control vs HDBR vs HDBR + thigh cuffs) or sex allowing the derivation of a common relationship %BF(st)=0.94 x %BF(dil) (F (1,47)=97.9, P<0.0001; non-significant intercept excluded) with a bias between methods of -1.7+/-2.0 %BF (95% CI: -5.8, 2.4 %BF). ST can be used to measure %BF during HDBR provided great care is placed on training and changes are higher than 1.1 %BF. If the method can be applied for in-flight energy balance monitoring given the high observed energy deficit, a tight monitoring of the individual nutritional status as needed during simulation appears, however, dubious based on this solely method.

Assessment of the calf vein cross section change during stand-test after a 90 day bed rest by echography.

OBJECTIVE: To evaluate the contribution of the calf veins distension during stand test to orthostatic intolerance (OI). METHOD: The population consisted of a control group (Co, n=9) and an exercise (Fly-Wheel) counter-measure group (CM, n=9). Calf vein cross section area was assessed by echography during pre and post HDT stand-tests. RESULTS: Tibial, and muscular vein section at rest did not change during HDT in both groups. From supine to standing, the Tibial and muscular vein section increased significantly more at post HDT in non tolerant subjects, compare to pre HDT (tibial V: +122% from pre-HDT, muscular V: +145% p<005). In tolerant subjects the vein cross section increase from supine to stand was similar pre and post HDT. CONCLUSION: Fly-Wheel CM, did not reduce OI. High calf vein section increase at post-HDT stand-test compare to pre-HDT was significantly correlated with OI but not with CM.

The physical price of a ticket into space.

As a direct consequence of exposure to microgravity astronauts experience a number of physiological changes, which can have serious medical implications when they return to Earth. Most immediate and significant are the head-ward shift of body fluids and the removal of gravitational loading from bone and muscles, which lead to progressive changes in the cardiovascular and musculoskeletal systems. Cardiovascular adaptations result in an increased incidence of orthostatic intolerance (fainting) post-flight, decreased cardiac output and reduced exercise capacity. Changes in the musculoskeletal system contribute significantly to the impaired functions experienced in the post-flight period. The underlying factor producing these changes is the absence of gravity. Countermeasures, therefore, are designed primarily to simulate Earth-like movements, stresses and system interactions. Exercise is one approach that has received wide operational use and acceptance in both the US and Russian space programmes, and has enabled humans to stay relatively healthy in space for well over a year. Although it remains the most effective countermeasure currently available, significant physiological degradation still occurs. The development of other countermeasures will therefore be necessary for longer duration missions, such as the human exploration of Mars.

Medical concerns for exploration-class missions.

The Space Exploration Initiative will challenge life scientists with a diverse set of crew medical risks. The varied sources of this cumulative risk are identified and briefly discussed in terms of risk assessment and preliminary plans for risk management. The roles of Space Station Freedom and other flight programs are discussed in the context of exploration medical objectives; and the significant differences between Space Station era (second generation) and exploration medical support systems (third generation) are reviewed.

Assessment of the efficacy of medical countermeasures in space flight.

Changes in body fluids, electrolytes, and muscle mass are manifestations of adaptation to space flight and readaptation to the 1-g environment. The purposes of this paper are to review the current knowledge of biomedical responses to short- and long-duration space missions and to assess the efficacy of countermeasures to 1-g conditioning. Exercise protocols, fluid hydration, dietary and potential pharmacologic measures are evaluated, and directions for future research activities are recommended.