Computerized measurement of anticipated anxiety from eating increasing portions of food in adolescents with and without anorexia nervosa: Pilot studies.

Dieting and excessive fear of eating coexist in vulnerable individuals, which may progress to anorexia nervosa [AN], but there is no objective measure of this fear. Therefore, we adapted a computer program that was previously developed to measure the satiating effects of foods in order to explore the potential of food to induce anxiety and fear of eating in adolescent girls. Twenty four adolescents (AN) and ten healthy controls without eating disorders rated pictures of different types of foods in varying sized portions as too large or too small and rated the expected anxiety of five different portions (20-320 kcal). Two low energy dense (potatoes and rice) and two high energy dense (pizza and M&Ms) foods were used. The regression coefficient of line lengths (0-100 mm) marked from "No anxiety" to "this would give me a panic attack", regressed from portions shown, was the measure of "expected anxiety" for a given food. The maximum tolerated portion size [kcal] (MTPS), computed by method of constant stimulus from portions shown, was significantly smaller for high energy dense foods, whereas the expected anxiety response was greater, for all foods, for patients compared to controls. For both groups, expected anxiety responses were steeper, and maximum tolerated portion sizes were larger, for low, than high, energy dense foods. Both maximum tolerated portion size and expected anxiety response were significantly predicted by severity of illness for the patients. Those who had larger maximum tolerated portion sizes had smaller anticipated anxiety to increasing portion sizes. Visual size had a greater influence than energy content for these responses. This method could be used to quantify the anxiety inducing potential of foods and for studies with neuro-imaging and phenotypic clarifications.

Relation of BMI to fat and fat-free mass among children and adolescents.

OBJECTIVE: Although the body mass index (BMI, kg/m2) is widely used as a surrogate measure of adiposity, it is a measure of excess weight, rather than excess body fat, relative to height. We examined the relation of BMI to levels of fat mass and fat-free mass among healthy 5- to 18-y-olds. METHODS AND PROCEDURES: Dual-energy X-ray absorptiometry was used to measure fat and fat-free mass among 1196 subjects. These measures were standardized for height by calculating the fat mass index (FMI, fat mass/ht2) and the fat-free mass index (FFMI, fat-free mass/ht2). RESULTS: The variability in FFMI was about 50% of that in FMI, and the accuracy of BMI as a measure of adiposity varied greatly according to the degree of fatness. Among children with a BMI-for-age > or =85th P, BMI levels were strongly associated with FMI (r=0.85-0.96 across sex-age categories). In contrast, among children with a BMI-for-age <50th P, levels of BMI were more strongly associated with FFMI (r=0.56-0.83) than with FMI (r=0.22-0.65). The relation of BMI to fat mass was markedly nonlinear, and substantial differences in fat mass were seen only at BMI levels > or =85th P. DISCUSSION: BMI levels among children should be interpreted with caution. Although a high BMI-for-age is a good indicator of excess fat mass, BMI differences among thinner children can be largely due to fat-free mass.

Pencil-beam versus fan-beam dual-energy X-ray absorptiometry comparisons across four systems: appendicular lean soft tissue.

Dual-energy X-ray absorptiometry (DXA) provides an important opportunity for estimating total body skeletal muscle (SM) mass from DXA-measured appendicular lean soft tissue (ALST). A DXA SM prediction model was developed with magnetic resonance imaging as the reference and ALST (i. e., sum of arm plus leg lean soft tissue) as a main predictor variable. In the present study we examined whether ALST estimates are comparable across systems (i. e., penciland fan-beam) and manufacturers. Pencil-beam systems (Lunar DPX and DPX-L) are usually considered more accurate but slower than fan-beam systems (Lunar Prodigy and Hologic Delphi A). In this study we compared ALST estimates in 35 healthy adults across these four systems. The methods gave similar group mean (+/-SD) values and were highly intercorrelated. There was no significant bias detected across the four systems. ALST estimates from the evaluated DXA systems are comparable and thus appear interchangeable as methods for quantifying total body SM in vivo.

The relationship between body mass index and body cell mass in African-American, Asian, and Caucasian adults.

The objective of this study was to investigate the relationship between body mass index (BMI, kg/m(2)) and body cell mass (BCM) estimated from total body potassium (TBK) measured by whole body (40)K counting in healthy 284 African-Americans (AA), 269 Asians (A) and 536 Caucasians (C) aged 18-107 years and to study the effects of age, sex, and race on the relationship. Body fat and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DXA). There was a significant positive correlation between BCM and BMI. For a given BMI, A had lower BCM but decreased less per year of age than AA and C, and males had higher BCM than females in each ethnic group. The fraction, BCM/FFM decreased with BMI in all subgroups by race, sex, and age, and males decreased more per age and AA decrease more than A and C. Not only the BCM-BMI relationship but also BCM/FFM vs. BMI is important to health.

Prepubertal girls with premature adrenarche have greater bone mineral content and density than controls.

Body composition in premature adrenarche (PA) has not been described. We hypothesized that the increased adrenal androgens in PA would have a trophic effect on lean body components. We studied 14 PA subjects and 16 controls, all prepubertal Hispanic girls. The body composition parameters tested included height, weight, bone mineral density (BMD), bone mineral content (BMC), nonbone fat-free mass, total body potassium, total body water, and extracellular water. Bone age was determined in all PA subjects. Compared with controls, PA subjects had significantly higher BMC (P = 0.02) and BMD (P = 0.03) when adjusted for age, weight, height, and fat mass, but were not different in the following lean body components: fat-free mass, total body potassium, total body water, and extracellular water. There was no difference in BMD or BMC between the PA subjects with and without advanced bone age. These data suggest a specific effect of PA on bone mineral, but not on other lean body components. The absence of a correlation between bone age and bone mineral in this small group leads us to propose there are separate promoters of bone age advancement and bone mineral accrual. Candidate hormones for these processes include adrenal androgens, E, and IGF-I. The findings of this study suggest that hormonal alterations associated with PA affect bone mineral accrual and may elucidate the mechanisms involved in this process.

An efficacious recombinant subunit vaccine against the salmonid rickettsial pathogen Piscirickettsia salmonis.

Piscirickettsia salmonis is the aetiological agent of salmonid rickettsial septicaemia, an economically devastating rickettsial disease of farmed salmonids. Infected salmonids respond poorly to antibiotic treatment and no effective vaccine is available for the control of P. salmonis. Bacterin preparations of P. salmonis were found to elicit a dose-dependent response in coho salmon (Oncorhynchus kisutch), which varied from inadequate protection to exacerbation of the disease. However, an outer surface lipoprotein of P. salmonis, OspA, recombinantly produced in Escherichia coli elicited a high level of protection in vaccinated coho salmon with a relative percent survival as high as 59% for this single antigen. In an effort to further improve the efficacy of the OspA recombinant vaccine, T cell epitopes (TCE's) from tetanus toxin and measles virus fusion protein, that are universally immunogenic in mammalian immune systems, were incorporated tandemly into an OspA fusion protein. Addition of these TCE's dramatically enhanced the efficacy of the OspA vaccine, reflected by a three-fold increase in vaccine efficacy. These results represent a highly effective monovalent recombinant subunit vaccine for a rickettsia-like pathogen, P. salmonis, and for the first time demonstrate the immunostimulatory effect of mammalian TCE's in the salmonid immune model. These results may also be particularly pertinent to salmonid aquaculture in which the various subspecies are outbred and of heterologous haplotypes.

OspA, a lipoprotein antigen of the obligate intracellular bacterial pathogen Piscirickettsia salmonis.

No effective recombinant vaccines are currently available for any rickettsial diseases. In this regard the first non-ribosomal DNA sequences from the obligate intracellular pathogen Piscirickettsia salmonis are presented. Genomic DNA isolated from Percoll density gradient purified P. salmonis, was used to construct an expression library in lambda ZAP II. In the absence of preexisting DNA sequence, rabbit polyclonal antiserum raised against P. salmonis, with a bias toward P. salmonis surface antigens, was used to identify immunoreactive clones. Catabolite repression of the lac promoter was required to obtain a stable clone of a 4,983 bp insert in Escherichia coli due to insert toxicity exerted by the accompanying radA open reading frame (ORF). DNA sequence analysis of the insert revealed 1 partial and 4 intact predicted ORF's. A 486 bp ORF, ospA, encoded a 17 kDa antigenic outer surface protein (OspA) with 62% amino acid sequence homology to the genus common 17 kDa outer membrane lipoprotein of Rickettsia prowazekii, previously thought confined to members of the genus Rickettsia. Palmitate incorporation demonstrated that OspA is posttranslationally lipidated in E. coli, albeit poorly expressed as a lipoprotein even after replacement of the signal sequence with the signal sequence from lpp (Braun lipoprotein) or the rickettsial 17 kDa homologue. To enhance expression, ospA was optimized for codon usage in E. coli by PCR synthesis. Expression of ospA was ultimately improved (approximately 13% of total protein) with a truncated variant lacking a signal sequence. High level expression (approximately 42% tot. prot.) was attained as an N-terminal fusion protein with the fusion product recovered as inclusion bodies in E. coli BL21. Expression of OspA in P. salmonis was confirmed by immunoblot analysis using polyclonal antibodies generated against a synthetic peptide of OspA (110-129) and a strong antibody response against OspA was detected in convalescent sera from coho salmon (Oncorhynchus kisutch).

Anthropometry in body composition. An overview.

Anthropometry is a simple reliable method for quantifying body size and proportions by measuring body length, width, circumference (C), and skinfold thickness (SF). More than 19 sites for SF, 17 for C, 11 for width, and 9 for length have been included in equations to predict body fat percent with a standard error of estimate (SEE) range of +/- 3% to +/- 11% of the mean of the criterion measurement. Recent studies indicate that not only total body fat, but also regional fat and skeletal muscle, can be predicted from anthropometrics. Our Rosetta database supports the thesis that sex, age, ethnicity, and site influence anthropometric predictions; the prediction reliabilities are consistently higher for Whites than for other ethnic groups, and also by axial than by peripheral sites (biceps and calf). The reliability of anthropometrics depends on standardizing the caliper and site of measurement, and upon the measuring skill of the anthropometrist. A reproducibility of +/- 2% for C and +/- 10% for SF measurements usually is required to certify the anthropometrist.

Dual X-Ray absorptiometry in pediatric studies: changing scan modes alters bone and body composition measurements.

The use of dual X-ray absorptiometry (DXA) for measurement of bone mineral and body composition in pediatric subjects faces a major technical issue: body size dictates choice of scan mode. However, different scan modes change results in the same subject, thus affecting the accuracy of bone/body composition measurements and especially the capacity to measure changes owing to either growth or intervention. To evaluate the effect of scan mode selections on measurements of bone mineral and body composition, 13 children with weights at the cutoff point between the pediatric large and adult medium scan modes of Lunar DPX or DPXL (Lunar, Madison, WI) with software 3.6 g (35.3 +/- 0.9 kg or 77.7 +/- 2.0 lb) were scanned by both modes. Adult medium mode gave significantly higher results than pediatric large mode for total body fat mass (11.1%), fat% (10.5%), bone mineral content (8.1%), and bone area (1.3%) (p < 0.02). The differences between pediatric large and adult medium modes in fat measurements increased with increasing body mass index ([BMI], kg/m(2)), body surface area ([BSA], m(2)), and trunk size (mm), whereas the differences in bone mineral measurement tended to be greater only with increasing BMI and BSA. None of the differences were correlated to body weight. This study suggests that scan mode selections based on trunk size, BMI, or BSA instead of body weight may improve continuity of bone and body composition measurements by the DXA technique in pediatric subjects.

Relation between body fat and age in 4 ethnic groups.

BACKGROUND: Previous studies of the relation between age and body fat reached differing conclusions concerning the question of whether body fat is lower in the elderly than in middle-aged persons. OBJECTIVE: The objectives of this study were to characterize the relation between age and body fat in 4 ethnic groups and test the hypothesis that body fat is lower in the elderly than in middle-aged persons. DESIGN: Body fat was measured in a sample of 1324 volunteers aged 20-94 y by using a 4-component model of body composition. Four ethnic groups were studied: Asians, blacks, Puerto Ricans, and whites. Regression models were developed for fat mass and fat percentage as functions of age. RESULTS: In all but one of the groups, a highly significant curvilinear relation between age and body fat was found, indicating a peak amount of body fat in late middle age and lower amounts of body fat at younger and older ages (P < 0.001). The age at which maximum body fat was predicted in the various groups ranged from 53 to 61 y for fat mass and from 55 to 71 y for fat percentage. In Puerto Rican men there was no significant relation between age and fat mass, and the relation between age and fat percentage was linear and positively correlated. CONCLUSIONS: This study provided data on the relation between age and body fat in 4 ethnic groups and supported the hypothesis that body fat is lower in the elderly than in middle-aged persons.

Effects of d-amphetamine and haloperidol on latent inhibition in healthy male volunteers.

Latent inhibition (LI) refers to a retardation of learning about the consequences of a stimulus when that stimulus has been passively presented a number of times without reinforcement. Acute positive-symptom schizophrenics, normal volunteers who score high on questionnaire measures of schizotypy and non-patients or animals treated with dopamine agonists show reduced LI. Neuroleptic drugs, such as haloperidol, administered at low doses, potentiate LI and effectively reverse disruption of LI induced by dopamine agonists in animals. However, a high dose of haloperidol, administered on its own, has been found to reduce LI. We examined the effects on LI of acute oral administration of an indirect dopamine-agonist, d-amphetamine (5 mg), and a nonselective dopamine receptor antagonist, haloperidol (5 mg), in normal male volunteers, using an associative learning task. Replicating previous reports, we found that d-amphetamine reduced LI; haloperidol also reduced LI, but only in subjects who scored low on the Psychoticism scale of the Eysenck Personality Questionnaire. In a subsequent study, no effect was found of 2 mg oral haloperidol administration on LI. The effect of 5 mg haloperidol on LI is interpreted as similar to that observed with a high dose of haloperidol in rats.

Correlations between skeletal muscle mass and bone mass in children 6-18 years: influences of sex, ethnicity, and pubertal status.

A constant sex-specific relationship between skeletal muscle mass and bone mass was observed in healthy adults based on TBK/TBCa, using TBK (total body potassium) by 40K counting and TBCa (total body calcium) by in-vivo neutron activation analysis (Ellis and Cohn, 1975). We revisited this topic in children by studying correlations between TBK and TBCa, and by comparing TBK/TBCa between sexes, pubertal groups (prepubertal and pubertal) and ethnic groups in 141 white, 101 black, and 62 Asian healthy children, aged 6 - 18 years, living in New York City. TBK was measured by 40K counting, and TBCa by dual energy x-ray absorptiometry. TBK and TBCa were significantly correlated from 6 to 18 years (r > 0.93), but the correlation equations varied by gender and ethnicity. Boys had significantly more TBK and greater TBK/TBCa than girls at a given age and weight, reflecting greater skeletal muscle mass in boys from 6 years, the age at which the study started. TBK/TBCa in blacks was significantly smaller than whites and Asians in both sexes in prepuberty and puberty, and pubertal black girls had the smallest mean TBK/TBCa. No significant differences were found between whites and Asians. TBK/TBCa decreased as body weight increased in prepubertal girls, and decreased as body weight and age increased in pubertal girls, but did not change with body weight or age in boys of any subgroup. The inverse relationship between TBK/TBCa and age in pubertal girls suggests greater increase in TBCa compared to TBK than in other groups, while the constant TBK/TBCa in boys reflects proportional increases in TBK and TBCa. Thus TBK/TBCa can be used as an index of relative growth in skeletal muscle mass and bone mass in white, black, and Asian children according to sex, age and pubertal status.

Population-based prediction equations for neurobehavioral tests.

Quantitative assessment of neurobehavioral function appraises brain injury from inhaled chemicals. Contemporary predicted values for tests useful in epidemiological studies have been developed with step-wise linear regression. In instances in which age and education do not match those of control groups, these equations assist in the interpretation of results of examinations of individual subjects and pilot studies. In this study, investigators considered brain function tests to be analogous in concept to pulmonary function tests. The authors used the tests to assess 293 adults in three unexposed groups from different areas of the United States. The subjects, who were contacted at random from voter registration rolls, were compensated for their time. The tests included balance, reaction time, strength, hearing, visual performance and cognitive recall, and perceptual motor and memory functions. Regression equations modeled the performance of each test and the influences of demographic factors. The investigators retained all influential factors in the equations. Age was a significant predictor for most tests. Education attainment was not a factor in any of the physiological measures, but it was a determinant in many psychological tests. Prediction equations assist investigators in the quantitative testing of chemically exposed individuals and other brain-injured individuals. The investigators verified the equations against other groups, including additional unexposed populations.

A field method for blink reflex latency R-1 (BRL R-1) and prediction equations for adults and children.

PURPOSE: To develop a field worthy apparatus for blink reflex latency R-1 (BRL R-1), to compare mechanical and electrical stimulation, to define a standardized measurement of BRL R-1, to test a field worthy procedure and to produce population-based prediction equations. METHODS: A special low voltage electromyographic (EMG) recording system was constructed which is uninfluenced by electrical and magnetic field. The supraorbital notches were stimulated mechanically using a small hammer and electrically using a stimulus of 2.0 ms duration and 2-5 mA 13. A computer program was developed which substracts the baseline for all data points and sums R-1 for 10 tests by identifying the noise floor or baseline of the EMG recording and the noise envelope. The beginning of R-1 and R-2 is defined as 2 times the noise amplitude of this envelope. BRL R-1 was compared after tap and after electrical stimulation in 16 subjects. Prediction equations were developed from data of 240 adults and 163 children unexposed to chemicals. RESULTS: Mechanically and electrically elicited mean BRL R-1 in 16 subjects was identical at 12.6 ms on the right and 12.7 ms vs 12.5 on the left. In adults, BRL R-1 depended on age. In children BRL R-1 was age, weight and height dependent. CONCLUSION: BRL R-1 elicited by supraorbital tap is field worthy, computer defined and identical to electrical BRL.

Anthropometric equations for studying body fat in pregnant women.

Anthropometric data from 200 pregnant women were used to estimate body fat at gestation weeks 14 and 37 and changes in body fat from week 14 to week 37 with four formulas from the literature. The resulting estimates were evaluated against the estimation of fat by a four-compartment model that determined fat from weight, total body water, bone mineral mass, and body density. The estimates of fat by existing anthropometric models were statistically different from those by the four-compartment model in both early and late pregnancy. Most importantly, the change in body fat estimated by the anthropometric models (all > 4 kg) was considerably higher than that estimated by the four-compartment model (3.3 kg). Two new anthropometric equations were developed, both of which used the four-compartment model as the reference method. The equation for predicting change in fat mass from week 14 to 37 of pregnancy was as follows: 0.77 (change in weight, kg)+ 0.07 (change in thigh skinfold thickness, mm)-6.13 (r2 = 0.73). The equation for determining fat (kg) at term was as follows: 0.40 (weight at week 37, kg)+ 0.16 (biceps skinfold thickness at week 37, mm) + 0.15 (thigh skinfold thickness at week 37, mm)-0.09 (wrist circumference at week 37. mm)+ 0.10 (prepregnancy weight.kg)-6.56 (r2 = 0.89). Both equations were derived on a randomly selected half of the total sample and validated on the remaining half. Both equations were found to be valid for use in studying pregnant women with different prepregnancy body mass indexes, different gestational weight gains, different ethnicities, and different socioeconomic status.

Anthropometrics do not influence dual X-ray absorptiometry (DXA) measurement of fat in normal to obese adults: a comparison with in vivo neutron activation analysis (IVNA).

Dual-energy X-ray absorptiometry (DXA) is now a commonly used method for the determination of bone mineral status and body composition in humans. The purposes of this study were to compare fat mass by in vitro neutron activation analysis (FMIVNA) with that by DXA (FMDXA) in an anthropometrically heterogeneous sample of healthy adult men (n = 33) and women (n = 36) (19 < or = BMI < or = 39), and to determine whether differences in fat mass estimates between the two methods (delta FM) were attributable to subject anthropometry as defined by several circumference (waist, iliac crest, thigh) and skinfold thickness (umbilical, suprailiac, abdominal) measurements. No significant differences between FMDXA and FMIVNA were observed in men (p = 0.46) or women (p = 0.09). The two methods were very highly correlated in both sexes (women r2 = 0.97, p < 0.001, men r2 = 0.91, p < 0.001), although the regression line for men was significantly different from the line of identity (p = 0.043). These results suggest modest trends toward underestimation of FMDXA in men when FMIVNA < 18 kg, and overestimation in men when FMIVNA > 18 kg. delta FM (IVNA-DXA) was not significantly related to any combination of skinfold thickness and circumferences in either gender. Age explained 27% of the variance in delta FM for the men (p = 0.008). Furthermore, delta FM was not significantly related to inter-method disparity in total-body bone mineral measurements in men or women (p < 0.05). The present study demonstrates strong correlation in fat measurements between IVNA and DXA in men and women ranging from normal to markedly obese. Correction for subject anthropometry does not significantly improve this relationship.