Age- and sex-related growth patterns of the craniofacial complex in European children aged 3-6 years.

BACKGROUND: Craniofacial growth changes in young children are not yet completely understood. Up-to-date references for craniofacial measurements are crucial for clinical assessment of orthodontic anomalies, craniofacial abnormalities and subsequent planning of interventions. AIM: To provide normal reference data and to identify growth patterns for craniofacial dimensions of European boys and girls aged 3-6 years. SUBJECTS AND METHODS: Using standard anthropometric methodology, body weight, body height and 23 craniofacial measurements were acquired for a cross-sectional sample of 681 healthy children (362 boys and 319 girls) aged 3-6 years from Germany, Italy and Lithuania. Descriptive statistics, correlation coefficients, percentage annual changes and percentage growth rates were used to analyse the dataset. RESULTS: Between the ages of 3-6 years, craniofacial measurements showed age- and sex-related patterns independent from patterns observed for body weight and body height. Sex-related differences were observed in the majority of craniofacial measurements. In both sexes, face heights and face depths showed the strongest correlation with age. Growth patterns differed by craniofacial measurement and can be summarised into eight distinct age- and sex-related patterns. CONCLUSION: This study provided reference data and identified sex- and age-related growth patterns of the craniofacial complex of young European children, which may be used for detailed assessment of normal growth in paediatrics, maxillofacial reconstructive surgery and possibly for forensic age assessment.

Accuracy of a portable multisensor body monitor for predicting resting energy expenditure in older people: a comparison with indirect calorimetry.

BACKGROUND: Accurate and comfortable methods are needed to determine resting energy expenditure (REE) in older people who are characterized by a lowered metabolic rate. The portable SenseWear® armband (SWA) body monitor, worn on the right upper arm, can easily be used by this age group in an ambulatory manner. OBJECTIVE: The purpose of this study was to evaluate the reliability and accuracy of the SWA armband in determining REE in healthy, normal-weight older people. METHODS: Participants were 49 older, community-dwelling volunteers aged 60-87 years. Reliability was tested in all subjects. Accuracy was analyzed in 32 subjects by comparing REE estimated by SWA against REE measured by indirect calorimetry as a criterion method. Data were simultaneously and continuously recorded for 20 min in the morning. In the same subjects, REE determined by SWA from night recording was evaluated for accuracy against indirect calorimetry. The agreement between methods was assessed by the Bland-Altman procedure. RESULTS: (1) REE measured by SWA was reliable when comparing 2 consecutive measurements (typical error: 1.9%). (2) REE calculated from morning recording (1,543 ± 181 kcal/24 h) was higher than REE from night recording (1,564 ± 192 kcal/24 h; p = 0.018). (3) Compared with REE by indirect calorimetry (1,377 ± 228 kcal/24 h) for accuracy, the SWA overestimated mean REE in the older people by 12 and 14%, respectively, for morning and night recording (each p < 0.001). CONCLUSIONS: The SWA provides a reliable estimate of REE in healthy older subjects and has the advantage of easy handling. The 20-min recording time, which was recommended by the manufacturer, can be applied. However, the SWA overestimates REE in this group, possibly due to age-related changes in skin conductance and thermoregulation, both being measured by sensors of the SWA armband. This requires improving the SWA by developing better fitting algorithms for predicting REE in older people.

Validation of the BIOPAC indirect calorimeter for determining resting energy expenditure in healthy free-living older people.

The BIOPAC indirect calorimeter for measuring resting energy expenditure (REE) is less cumbersome than many other calorimeters. We tested the hypothesis that the BIOPAC calorimeter is as well suited for determining REE in older people as traditional calorimeters. In 50 healthy persons (24 men and 26 women; age range, 61-83 years), REE by BIOPAC was validated against Vmax Spectra indirect calorimeter as a criterion method. Resting energy expenditure by BIOPAC was recorded at 2 different time intervals to find optimal conditions for older persons. Also, REE by 7 published equations was validated. The Bland-Altman procedure was used to test agreement between methods. Multiple regression analysis was applied to develop a new equation for predicting REE from BIOPAC. The BIOPAC calorimeter and most empirical equations significantly overpredicted mean REE in both sexes. Mifflin's equation best-predicted mean REE. Limits of agreement were wide for BIOPAC and narrow for most empirical equations. The Lührmann and Müller equations had smallest limits of agreement in men (+/-950 kJ/24 h) and the Harris-Benedict and Müller equations in women (+/-672 kJ/24 h). A new equation was developed for the BIOPAC device improving both predictions of mean and individual REE (R(2) = 0.671, standard error of the estimate = 136 kJ/24 h). Using this equation, 72.9% of subjects were lying within 10% of measured REE, compared with only 12.5% when using the manufacturer's algorithm. In conclusion, the BIOPAC calorimeter is suitable for measuring REE in healthy older adults when the new prediction equation is applied. This calorimeter is not applicable to frail older persons.