Predictors of body satisfaction: differences between older men and women's perceptions of their body functioning and appearance.

OBJECTIVE: This article examines the predictors of body satisfaction among older men and women. METHOD: A self-reported questionnaire on body satisfaction (focused on body appearance and functioning), health, physical activity, and sociodemographic characteristics was completed by 384 older adults twice, at a year's interval. Women (n = 243) were on average 70.3 ± 7.9 years old, and men 70.9 ± 7.5 years old. RESULTS: Body mass index was found to be the strongest predictor of satisfaction with body appearance for both genders, along with body functioning in the case of men. Regarding satisfaction with body functioning, functional limitations were women's most important predictor of satisfaction, whereas for men body appearance was more important. DISCUSSION: Men seemed to link satisfaction with body appearance more closely to body functioning than did women. Gender differences suggest that interventions to improve body satisfaction must be gender specific, particularly those relating to body functioning.

Ultrasound measurement of total body fat in obese adolescents.

BACKGROUND/AIMS: To compare body fat (BF) measurements obtained with a new ultrasound method with those assessed by dual-energy X-ray absorptiometry (DEXA) in obese adolescents. METHODS: In 94 adolescents (57 females and 37 males) aged 12-19 years and body mass index (BMI) exceeding 30 kg.m(-2), the z-score BMI for age was 6.7 (adolescent girls) and 6.6 (adolescent boys) >97th percentile. BF was measured using DEXA and a method based on ultrasound measurements, body weight, height, abdominal circumference and mid-thigh circumference. RESULTS: Obesity class I was noted in 39%, II in 28% and III in 33% of the patients. BF by ultrasound correlated closely with BF by DEXA, in both females (r = 0.958) and males (r = 0.981), with standard errors of the estimates (SEE) being 2.9 and 2.5 kg, respectively. The ultrasound method was more accurate than the skinfold technique (n = 24; SEE: 2.2 vs. 6.5 kg, respectively). In 13 adolescents who had marked weight loss after 6 months of treatment, the decrease in DEXA-measured BF correlated closely with the decrease in ultrasound-measured BF (r = 0.95). CONCLUSIONS: Our innovative portable ultrasound technique has advantages in terms of reliability, reproducibility, accuracy and costs for screening and monitoring obese adolescents. A patent application has been submitted. Our method should prove valuable for epidemiological studies.

Validation of ultrasound techniques applied to body fat measurement. A comparison between ultrasound techniques, air displacement plethysmography and bioelectrical impedance vs. dual-energy X-ray absorptiometry.

AIMS: To evaluate the accuracy of body fat percentage (BF%) estimates from a portable, non-traumatizing ultrasound device with high accuracy and reliability compared to dual-energy X-ray absorptiometry (DEXA), the reference technique. DESIGN: Cross-validation between ultrasound technique (UT), DEXA, air displacement plethysmography (ADP) and bioelectrical impedance (BIA) was developed in the study. SUBJECTS: A total of 89 healthy subjects (41 women, 48 men), aged 48.4 +/- 17.7 (mean +/- SD), with Body mass index (28.5 +/- 7.7 kg/m(2)) and body fat DEXA (29.6 +/- 10.8 kg) participated. METHODS: BF% was measured using an UT associated with anthropometric parameters and simultaneously, with the DEXA reference technique, BIA and ADP. RESULTS: UT estimates of BF% were better correlated with those of DEXA in both males and females (r = 0.98, SEE = 2.0) than with ADP (r = 0.94, SEE = 3.7) or BIA (r = 0.92, SEE = 4.4). The UT in both genders was better (TE = 1.0) than BIA (TE = 2.6) and ADP (TE = 3.0). The 95% limits of agreement were also better for the UT (-2%; 2%) than with BIA (-5.1%; 4.9%) and ADP (-6.3%; 5.3%). CONCLUSIONS: The limits of agreement with BIA and ADP are unacceptably high compared to a DEXA measure criterion. The use of a new portable device based on a UT produced a very accurate BF% estimate in relation to the DEXA reference technique.

Optimal standards for fetal biometry: to each measurement its fitting model.

OBJECTIVE: To determine the best mathematical model to construct charts of fetal abdominal circumference (AC) and femur length (FL). METHODS: Ultrasound measurements were made on 1,336 normal fetuses in one center. Four mathematical models were compared (a linear-quadratic model, a linear-cubic model, the Rossavik model and a new two-phase model, which has been found to best fit fetal head data). RESULTS: The best fitting of AC and FL data was obtained with the linear-quadratic model without separate computing for gender. Centile charts have been computed. CONCLUSION: Fetal growth of AC and FL is much simpler than that of the head. Therefore, a unique mathematical model should not be used to fit all measurements.

Biometry of face and brain in fetuses with trisomy 21.

The aim of this study was to specify the early setting of the particular craniofacial morphology in Down syndrome during the fetal period from data based on postmortem examinations. The study included 1277 fetuses at 15-38 gestational weeks (GW): 922 control fetuses and 355 fetuses with trisomy 21, selected from fetopathology units in Paris. Body weight (BW) and nine dimensions of the face, skull, and brain were recorded: the outer and inner canthal distances (OCD, ICD), biparietal diameter (BPD), head circumference (HC), brain weight (BrW), occipitofrontal diameters of left and right hemispheres (lOFD, rOFD), weight of the infratentorial part of the brain (IBW), and maximal transversal diameter of the cerebellum (CTD). Four ratios were computed: BPD/HC, OCD/BPD, BrW/BW, IBW/BrW. Differences between trisomic fetuses and control fetuses were tested by age interval. Results showed that BW, rOFD, and lOFD were lower in trisomic fetuses as early as 15 GW. Cerebellar hypoplasia included lower IBW and CTD in trisomic fetuses. The IBW/BrW ratio was higher in trisomic fetuses, showing that growth restriction affected the infratentorial part of the brain less than the supratentorial part. Early brachycephaly was found in trisomic fetuses, with higher values of BPD and BPD/HC from 15 GW. ICD and OCD were not significantly different in the two groups, but OCD/DBP ratio was lower in trisomic fetuses. These results confirm the early phenotypical expression of trisomy 21 on craniofacial morphology, associated with a marked restriction of brain growth, especially in the supratentorial part.

Cranial sutures and craniometric points detected on MRI.

The main goal of the study was to determine on MRI the cranial sutures, the craniometric points and craniometric measurements, and to correlate these results with classical anthropometric measurements. For this purpose, we reviewed 150 cerebral MRI examinations considered as normal (Caucasian population aged 20-49 years). For each examination we individualized 11 craniometric landmarks (Glabella, Bregma, Lambda, Opisthocranion, Opisthion, Basion, Inion, Porion, Infra-orbital, Eurion) and three measurements. Measurements were also calculated independently on 498 dry crania (Microscribe 3-DX digitizer). To validate the MRI procedure, we measured four dry crania by MRI and with compass or digital caliper gauges. Cranial sutures always appeared without signal (black), whatever the MRI sequence used, and they are better visualized with a 5 mm slice thickness (compact bone overlapping). Slice dynamic analysis and multiplanar reformatting allowed the detection of all craniometric points, some of these being more difficult to detect than others (Porion, Infra-orbital). The measurements determined by these points were as follows: Vertex-Basion height=135.66+/-6.56 mm; Eurion-Eurion width=141.17+/-5.19 mm; Glabella-Opisthocranion length=181.94+/-6.40 mm. On the midline T1-weighted sagittal image, all median craniometric landmarks can be individualized and the Glabella-Opisthocranion length, Vertex-Basion height and parenchyma indices can be calculated. Craniometric points and measurements between these points can be estimated with a standard cerebral MRI examination, with results that are similar to anthropometric data.

Only two-phase models, computed independently for males and females, are appropriate to describe fetal head growth.

OBJECTIVE: To establish an accurate mathematical model describing fetal head growth, taking into account gender differences and changes in growth rate during gestation. METHODS: Ultrasound measurements of head circumference and biparietal diameter were made on 1,336 normal fetuses (684 males and 652 females) in the Maternité Régionale de Nancy (France). A new two-phase model, taking into account an alteration in growth kinetics at 30 gestational weeks, was computed independently for male and female data. The accuracy of this model was tested and compared with three current mathematical models: a linear-quadratic, a linear-cubic, and the Rossavik and Deter (1984) models. RESULTS: In all models, including ours, the coefficients of determination (R(2)) were high (> or =0.999), so long as male and female data were computed separately. However, the standard error estimates (SEE) of our two-phase model were much lower (0.13 < or = SEE < or = 0.57) than the SEE of the three other models when computed over the whole gestational period (0.49 < or = SEE < or = 2.69); nevertheless, when these three other models were computed for these two successive periods, their SEE decreased, and data fitting was improved. CONCLUSION: Only two-phase mathematical models, computed independently for male and female data, accurately describe the kinetics of fetal head growth. They should be used to calculate growth standards and to perform an exact diagnosis of impaired growth.

Standards for dysmorphological diagnosis in human fetuses.

This study provides new standards for some fetal dimensions frequently concerned with dysmorphological syndromes. Seven dimensions were included: the outer and inner canthal distances (OCD and ICD), the anteroposterior and transversal ocular diameters, the biparietal diameter and head circumference, and the inter-nipple distance. Subjects came from a large data set including more than 4000 fetuses autopsied in fetopathology units of pediatric hospitals in Paris between 1986 and 2001. From this data set, 673 subjects were carefully selected by exclusion of multiple pregnancies, macerated and malformed fetuses, and subjects with abnormal karyotypes and severe infections. Fetal ages ranged from 11 to 42 gestational wk, with a very large sample of fetuses in the first half of gestation. The standards of each dimension were computed in relation to age, as well as the ratio ICD/OCD. The mathematical models used to fit the percentile growth curves were carefully selected for each variable. This study supplies a set of accurate standards of specific dimensions useful for dysmorphological diagnosis in fetuses.

Organ weights in human fetuses after formalin fixation: standards by gestational age and body weight.

This study provides new standards of fetal organ weights (brain, heart, liver, pancreas, spleen, lungs, kidneys, adrenals, thymus, and thyroid) and body dimensions (crown-heel and crown-rump lengths, head circumference, and foot length). Subjects came from a large dataset including more than 4,000 fetuses autopsied in fetopathology units of pediatric hospitals in Paris between 1986 and 2001. From this dataset, 673 subjects were carefully selected by exclusion of multiple pregnancies, macerated and malformed fetuses, subjects with abnormal karyotypes, and those with severe infections. Fetal age ranged from 9 to 42 gestational weeks, with a very large sample of fetuses in the first half of gestation. Each organ was weighed after fixation in formalin. The standards were computed in relation to age and body weight. The mathematical models used to fit the percentile growth curves were carefully selected for each organ or dimension. This study, based on reliable methodology, affords a whole set of accurate growth standards useful for pathologists.