Contribution of serum inflammatory markers to changes in bone mineral content and density in postmenopausal women: a 1-year investigation.

Bone formation and resorption are influenced by inflammatory processes. We examined the relationships among inflammatory markers and bone mineral content (BMC) and density (BMD) and determined the contribution of inflammatory markers to 1-yr changes in BMC and BMD in healthy postmenopausal women. This analysis included 242 women at baseline from our parent Soy Isoflavones for Reducing Bone Loss project who were randomly assigned to 1 of 3 treatment groups: placebo, 80 mg/d soy isoflavones, or 120 mg/d soy isoflavones. BMD and BMC from the lumbar spine (LS), total proximal femur (hip), and whole body were measured by dual energy X-ray absorptiometry and the 4% distal tibia by peripheral quantitative computed tomography. Serum inflammatory markers (C-reactive protein, interleukin [IL]-1 beta, IL-6, tumor necrosis factor-alpha [TNF-alpha], and white blood cell count [WBC]) were measured at baseline, 6, and 12 mo. Because of attrition or missing values, data analysis at 12 mo includes only 235 women. Significant associations among IL-6, TNF-alpha, and WBC were observed with percent change in LS, hip, and whole body BMC and BMD. Multiple regression analysis indicated that in combination inflammatory markers accounted for 1.1-6.1% of the variance to the observed 12-mo changes in BMC and BMD. Our results suggest that modifying inflammatory markers, even in healthy postmenopausal women, may possibly reduce bone loss.

Addition of milk fat globule membrane-enriched supplement to a high-fat meal attenuates insulin secretion and induction of soluble epoxide hydrolase gene expression in the postprandial state in overweight and obese subjects.

CVD and associated metabolic diseases are linked to chronic inflammation, which can be modified by diet. The objective of the present study was to determine whether there is a difference in inflammatory markers, blood metabolic and lipid panels and lymphocyte gene expression in response to a high-fat dairy food challenge with or without milk fat globule membrane (MFGM). Participants consumed a dairy product-based meal containing whipping cream (WC) high in saturated fat with or without the addition of MFGM, following a 12 h fasting blood draw. Inflammatory markers including IL-6 and C-reactive protein, lipid and metabolic panels and lymphocyte gene expression fold changes were measured using multiplex assays, clinical laboratory services and TaqMan real-time RT-PCR, respectively. Fold changes in gene expression were determined using the Pfaffl method. Response variables were converted into incremental AUC, tested for differences, and corrected for multiple comparisons. The postprandial insulin response was significantly lower following the meal containing MFGM (P < 0·01). The gene encoding soluble epoxide hydrolase (EPHX2) was shown to be more up-regulated in the absence of MFGM (P = 0·009). Secondary analyses showed that participants with higher baseline cholesterol:HDL-cholesterol ratio (Chol:HDL) had a greater reduction in gene expression of cluster of differentiation 14 (CD14) and lymphotoxin ß receptor (LTBR) with the WC+MFGM meal. The protein and lipid composition of MFGM is thought to be anti-inflammatory. These exploratory analyses suggest that addition of MFGM to a high-saturated fat meal modifies postprandial insulin response and offers a protective role for those individuals with higher baseline Chol:HDL.

Monitoring changes in fat-free mass in HIV-positive men with hypotestosteronemia and AIDS wasting syndrome treated with gonadal hormone replacement therapy.

OBJECTIVE: To compare methods for assessing changes in body composition during gonadal hormone replacement therapy in a group of HIV-positive men with AIDS wasting syndrome. DESIGN: The study included a 21-day, double-blind, randomized, placebo-controlled inpatient intervention and a 12-week open-label intervention. The inpatient intervention included 18 men who were confined to a metabolic ward. Days 1-7 comprised weight stabilization and body composition measures followed by 14 days of nandrolone decanoate at either 65 or 195 mg weekly, or placebo, and repeat testing. The open-label intervention comprised 12 weeks of 200 mg nandrolone decanoate fortnightly with measurements of fat-free mass at 6 and 12 weeks. METHODS: The inpatient intervention measured nitrogen balance from 24 h urine and fecal collections and fat-free mass by dual energy x-ray absorptiometry (DEXA), bioimpedance spectroscopy (BIS) and D2O dilution. Nitrogen balance was calculated as the difference between dietary intake and urinary and fecal nitrogen excretion. Nitrogen was converted to fat-free mass using the constant of 32.5 g. Repeated measures analysis of variance was used to determine which methods were significantly different from the reference nitrogen balance technique. RESULTS: Nitrogen accretion of lean tissue was 0.55 and 0.85 kg weekly for low and high-dose groups, respectively. Estimated nitrogen retention during the open-label study was 0.42 kg weekly. Body weight increased with the estimated lean tissue accretion. DEXA, BIS and D2O methods demonstrated improvements in fat-free mass, although the BIS estimate of fat-free mass most closely matched the results of the nitrogen retention method. CONCLUSION: DEXA, BIS and D2O techniques demonstrated increases in fat-free mass. The BIS method is less costly, more convenient to use, and had results that more closely matched those from nitrogen balance and retention methods. BIS may be the preferred method to monitor changes in fat-free mass in AIDS patients and patients with malnutrition.

Assessment of fat-free mass in teen-agers: use of TOBEC methodology.

The accuracy of total-body electrical conductivity (TOBEC) for body composition assessment was examined in 50 teen-agers (33 males and 17 females) aged 11-19 y. Body composition measures included densitometry, hydrometry, bone mineral density of the one-third distal radius, and TOBEC. Fat-free mass (FFM) was calculated by using one-, two-, and three-compartment models: densitometry, FFMd; densitometry and hydrometry, FFMdw; and densitometry, hydrometry, and bone mineral density, FFMdwb. Correlations between TOBEC variables and the three calculations of FFM were highly significant (r = 0.88-0.95; P less than 0.01). No significant differences were observed (ANOVA) between the TOBEC estimate of FFM (FFMT) and FFMd, FFMdw, and FFMdwb. Similar results were observed when the data were analyzed by gender. The TOBEC estimate of FFM was equivalent to the estimates of FFM derived from one-, two-, and three-component models. Its ease of measurement and its prediction accuracy (R2 = 0.933; SEE = 2.45 kg) in teen-agers make it a preferred technique for body composition assessment.

Use of total-body electrical conductivity for the assessment of body composition in middle-aged and elderly individuals.

Body composition was predicted for 114 middle-aged and elderly individuals aged 35-90 y by using total-body electrical conductivity (TOBEC), densitometry, and hydrometry. Highly significant correlations were achieved between the TOBEC Phase value and fat-free mass (FFM) determined by densitometry (FFMd) and hydrometry (FFMdw) with values ranging from 0.713 to 0.981. TOBEC predicted FFM (FFMT) was consistently higher than either FFMd or FFMdw for both men and women in all age groups. A theoretical calculation of percent body fat was performed with a three-component model with body density, total body water, and bone mineral content. The recalculation of fat was used to estimate a new FFM (FFMnew). These calculations resulted in a decrease in fat and an increase in FFMnew. Because the TOBEC signal is unaffected by bone mineralization, FFMT may provide a more accurate estimation of body composition than do FFMd or FFMdw in this group of individuals.

Influence of cognitive eating restraint on total-body measurements of bone mineral density and bone mineral content in premenopausal women aged 18-45 y: a cross-sectional study.

BACKGROUND: We examined the relation between cognitive eating restraint (CER) and total-body measurements of bone mineral density (BMD) and bone mineral content (BMC). OBJECTIVE: Our objective was to determine whether women with CER had lower total-body BMD and BMC than did other women. DESIGN: Premenopausal women, 90-150% of ideal weight, had measurements of their BMD and BMC made and completed questionnaires on physical activity, weight history, body size satisfaction, dieting history, eating behavior, and childbearing history. Bone measurements were examined for differences between groups with low and high CER scores by using analysis of covariance and quartiles of body weight to adjust for body size differences. CER was assessed by using the Three-Factor Eating Inventory and was defined as a score > or =9; normal eating restraint (NER) was defined by a score <9. Total-body BMC, BMD, and fat and lean masses were measured by dual-energy X-ray absorptiometry. RESULTS: Fifty-two percent of the women were classified as having CER. Women with CER were significantly more dissatisfied with their bodies. Analysis of covariance, with weight as the covariate, indicated a significant difference in BMC between women in preplanned pairs from the 5 lowest and 5 highest CER levels. No significant differences in BMD were observed between groups. Significantly lower BMC was found in women with high CER scores and body weights <71 kg than in those with high CER scores and weights > or =71 kg. CONCLUSIONS: BMC was significantly differently between women with low and high CER scores. BMC was significantly lower in women with body weights <71 kg and classified with CER. Lower BMC in women with high CER scores may indicate an increased risk of osteoporosis.

Effect of weight loss on bone mineral content and bone mineral density in obese women.

Studies of body-composition changes during weight loss have had conflicting results with regard to changes in bone mineral content (BMC) and bone mineral density (BMD). We examined BMC and BMD for changes during weight loss. Fourteen women enrolled in a 15-wk weight loss program. Dual-energy X-ray absorptiometry (DXA) measures of the total body were made at baseline (T1), the midpoint of weight loss (T2), and at the end of weight loss (T3). Body weight changed significantly throughout the 15 wk, declining from a high of 89.7+/-3.6 to 74.1+/-3.2 kg. Fat-free mass declined initially (47.8+/-1.7 kg at T1, 45.7+/-1.4 kg at T2, and 46.0+/-1.5 kg at T3) and then stabilized. Fat mass changed significantly during the study (39.2 kg at T1, 32.4 kg at T2, and 29.3 kg at T3). No significant differences were observed in BMC or bone areal measurement during the study. However, BMD declined significantly from baseline (1.217 g/cm2 at T1, 1.197 g/cm2 at T2, and 1.200 g/cm2 at T3). The changes in BMC and BA were in opposite directions, resulting in a significant decline in BMD without a loss of BMC. These data suggest that changes in BMD observed with weight loss may be the result of a lack of instrument sensitivity when body weight and composition change and are simply an artifact and not a physiologic change in BMD. Further research is needed to determine the full effect of weight loss on BMC, bone area, and BMD.

Longitudinal assessment of energy balance in well-nourished, pregnant women.

BACKGROUND: Clinicians often recommend an additional energy intake of 1250 kJ/d to their pregnant patients. Previous studies have shown considerable variation in the metabolic response to pregnancy and thus in the additional energy required to support a pregnancy. OBJECTIVE: The purpose of this study was to assess how well-nourished women meet the energy demands of pregnancy and to identify factors that predict an individual's metabolic response. DESIGN: Resting metabolic rate (RMR), diet-induced thermogenesis (DIT), total energy expenditure (TEE), activity energy expenditure (AEE), energy intake (EI), and body fat mass (FM) were measured longitudinally in 10 women preconception; at 8-10, 24-26, and 34-36 wk of gestation; and 4-6 wk postpartum. RESULTS: Compared with preconception values, individual RMRs increased from 456 to 3389 kJ/d by late pregnancy. DIT varied from -266 to 110 kJ/meal, TEE from -105 to 3421 kJ/d, AEE from -2301 to 2929 kJ/d, EI from -259 to 2176 kJ/d, and FM from a 0.6-kg loss to a 10.6-kg gain. The only prepregnant factor that predicted FM gain was RMR (r = 0.65, P < 0.05). Women with the largest cumulative increase in RMR deposited the least FM (r = -0.64, P < 0.05). CONCLUSIONS: Well-nourished women use different strategies to meet the energy demands of pregnancy, including reductions in DIT or AEE, increases in EI, and deposition of less FM than anticipated. The combination of strategies used by individual women is not wholly predictable from prepregnant indexes. The use of a single recommendation for increased energy intake in all pregnant women is not justified.

Use of total-body electrical conductivity for monitoring body composition changes during weight reduction.

The ability of a new total-body electrical conductivity instrument (TOBEC) to monitor changes in body composition during weight reduction was examined. Twelve moderately overweight women were confined to a metabolic unit for a period of 8 wk, 2-wk baseline and 6-wk reduction periods, during which changes in body composition were assessed by densitometry and hydrometry. Additionally, TOBEC measures were taken to predict lean body mass (LBM) changes. A total of 6.6 kg body weight was lost during the 6-wk reduction period. A decline in LBM was observed during the first 3 wk of reduction, from 47.4 to 45.7 kg, with no further LBM decline observed. Changes observed in the TOBEC phase value corresponded to the observed changes in LBM and total body water (TBW) during baseline and reduction periods. TOBEC was sensitive to small changes in LBM and TBW and may be useful for monitoring composition changes during nutritional intervention programs.

TOBEC methodology for body composition assessment: a cross-validation study.

The accuracy of prediction equations for estimating lean body mass (LBM) from total-body electrical conductivity (TOBEC) was examined by cross-validation. Two samples of adults, aged 18-35 yr, were drawn from separate geographic locations. LBM was determined by densitometry and TOBEC was measured with TOBEC II instrument. LBM and TOBEC were highly correlated in both samples (r = 0.96 and 0.97). Cross-validation of LBM prediction equations was accomplished by exchanging equations and comparing predicted LBM values. There was a mean difference of 0.974 kg LBM between the two equations (p less than 0.0001). Thus, data from 157 subjects were pooled and one equation was developed that incorporated height (cm), sex (males = 0, females = 1), and the zero-, first-, and second-order Fourier coefficients (FC0, FC1, and FC2) of the TOBEC phase value: LBM, kg = -36.410 + (-1.324 X sex) + (0.01185 X (FC1(0.5)xht)) + (12.347 X FC2(0.5)) + (0.0627 X FC0)-(0.9232 X FC2) This equation, developed from 157 subjects, accounted for 96% of the variability in LBM and had a standard error of estimate of 2.17 kg LBM.

The fatness-specific bioelectrical impedance analysis equations of Segal et al: are they generalizable and practical?

The fatness-specific bioelectrical impedance analysis (BIA) equations of Segal et al (Am J Clin Ntr 1988;47: 7-14; Segal equations) have been shown to be generalizable across sex, ethnicity, age, and degrees of adiposity. However, these fatness-specific equations require an a priori determination of percentage body fat (%BF) by using a skinfold equation or densitometry to categorize subjects into obese or nonobese groups. These procedures negate the use of BIA as a fast and simple method. It was hypothesized that the average of the Segal nonobese and obese fatness-specific equations (BIA average method) could be used in lieu of the skinfold method for categorizing subjects who are not obviously lean or obese. In phase 1 these three methods were compared for a subsample of 59 women who were not obviously lean or obese. The %BF of 75% of these subjects was accurately estimated within 3.5%BF by using the BIA average method whereas only 71% and 46% were accurately estimated by fusing the densitometric and skinfold methods, respectively. In phase 2, the predictive accuracy of the Segal fatness-specific equations, used in combination with the BIA average method, was compared with other BIA equations published previously for 602 American Indian, Hispanic, and white women and men. The Segal fatness-specific equations yielded the smallest prediction error (SEE = 2.22 kg for women and 3.59 kg for men) and the %BF of 70% of the subjects was accurately estimated within 3.5%BF compared with 24-59% for other BIA equations. Therefore, we recommend using the Segal fatness-specific and average equations to assess body composition in heterogeneous populations.

A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses.

To clarify the role of the intestine, kidney, and bone in maintaining calcium homeostasis during pregnancy and lactation and after the resumption of menses, a longitudinal comparison was undertaken of 14 well-nourished women consuming approximately 1200 mg Ca/d. Measurements were made before conception (prepregnancy), once during each trimester of pregnancy (T1, T2, and T3), early in lactation at 2 mo postpartum (EL), and 5 mo after resumption of menses. Intestinal calcium absorption was determined from the enrichment of the first 24-h urine sample collected after administration of stable calcium isotopes. Bone mineral of the total body and lumbar spine was measured by dual-energy X-ray absorptiometry and quantitative computerized tomography, respectively. Twenty-four-hour urine and fasting serum samples were analyzed for calcium, calcitropic hormones, and biochemical markers of bone turnover. Despite an increase in calcium intake during pregnancy, true percentage absorption of calcium increased from 32.9+/-9.1% at prepregnancy to 49.9+/-10.2% at T2 and 53.8+/-11.3% at T3 (P < 0.001). Urinary calcium increased from 4.32+/-2.20 mmol/d at prepregnancy to 6.21+/-3.72 mmol/d at T3 (P < 0.001), but only minor changes in maternal bone mineral were detected. At EL, dietary calcium and calcium absorption were not significantly different from that at prepregnancy, but urinary calcium decreased to 1.87+/-1.22 mmol/d (P < 0.001) and trabecular bone mineral density of the spine decreased to 147.7+/-21.2 mg/cm3 from 162.9+/-25.0 mg/cm3 at prepregnancy (P < 0.001). Calcium absorption postmenses increased nonsignificantly to 36.0+/-8.1% whereas urinary calcium decreased to 2.72+/-1.52 mmol/d (P < 0.001). We concluded that fetal calcium demand was met by increased maternal intestinal absorption; early breast-milk calcium was provided by maternal renal calcium conservation and loss of spinal trabecular bone, a loss that was recovered postmenses.

Energy expenditure and physical performance in overweight women: response to training with and without caloric restriction.

The metabolic effects of exercise training and the influence of a moderate calorie restriction on the training response were examined in overweight women. Ten healthy women, 119% to 141% of desirable weight, completed the 14-week study. After a 2-week stabilization period, in which diets were designed to maintain body weight (BW), five women were assigned to a 12-week experimental program of diet and exercise (D + EX) that included a 50% reduction in energy intake and a program of moderate intensity aerobic exercise 6 days per week. The other five women were assigned to the same daily exercise (EX) and continued to consume the stabilization diet. Periodic measurements of resting metabolic rate (RMR), thermic effect of food (TEF), energy cost of exercise, and predicted maximal aerobic capacity (VO2 max) were obtained, and the respiratory quotient (RQ) was determined during rest and exercise. Body composition was monitored weekly. Tests of strength and anaerobic capacity were conducted. D + EX lost an average of approximately 1.1 kg/wk, which was 67% fat, 33% lean. EX lost approximately 0.5 kg/wk, which was 86% fat, 14% lean. In both groups, the exercise program resulted in an 11% to 13% improvement in VO2 max and an 8% to 16% decrease in energy expenditure at submaximal workloads. The caloric restriction significantly increased fat utilization during exercise. The RMR declined 9% in D + EX, from 1,550 to 1,411 kcal/d, whereas it was maintained in EX, 1,608 to 1,626 kcal/d. The decrease in RMR observed in D + EX was consistent with the loss of fat-free mass (FFM).(ABSTRACT TRUNCATED AT 250 WORDS)

Fat mass deposition during pregnancy using a four-component model.

Estimates of body fat mass gained during human pregnancy are necessary to assess the composition of gestational weight gained and in studying energy requirements of reproduction. However, commonly used methods of measuring body composition are not valid during pregnancy. We used measurements of total body water (TBW), body density, and bone mineral content (BMC) to apply a four-component model to measure body fat gained in nine pregnant women. Measurements were made longitudinally from before conception; at 8-10, 24-26, and 34-36 wk gestation; and at 4-6 wk postpartum. TBW was measured by deuterium dilution, body density by hydrodensitometry, and BMC by dual-energy X-ray absorptiometry. Body protein was estimated by subtracting TBW and BMC from fat-free mass. By 36 wk of gestation, body weight increased 11.2 +/- 4.4 kg, TBW increased 5.6 +/- 3.3 kg, fat-free mass increased 6.5 +/- 3.4 kg, and fat mass increased 4.1 +/- 3.5 kg. The estimated energy cost of fat mass gained averaged 44,608 kcal (95% confidence interval, -31, 552-120,768 kcal). The large variability in the composition of gestational weight gained among the women was not explained by prepregnancy body composition or by energy intake. This variability makes it impossible to derive a single value for the energy cost of fat deposition to use in estimating the energy requirement of pregnancy.

Fluid changes during pregnancy: use of bioimpedance spectroscopy.

The increase in body water during pregnancy is responsible for the largest portion of weight gain and is of interest of clinical practitioners. However, assessing changes in body fluids is not easily accomplished during pregnancy. The purpose of this study was to examine the accuracy of bioelectrical impedance spectroscopy for estimating fluid volumes before, during, and after pregnancy. Ten healthy adult women were recruited for the study. Total body water (TBW) and extracellular fluid (ECF) volume were measured at baseline (preconception); 8-10, 24-26, and 34-36 wk of gestation; and 4-6 wk postpartum by deuterium oxide and NaBr dilution, respectively. Estimates of TBW and ECF were also obtained by bioimpedance spectroscopy (BIS). At baseline, mean values for dilution and BIS estimates of TBW and ECF were 33.2 +/- 4.6 (SD) vs. 31.6 +/- 6.2 liters and 15.2 +/- 1.3 vs. 16.9 +/- 2.3 liters, respectively. TBW and ECF estimated by BIS were not significantly different from the dilution values at any time point. These results suggest that BIS may be useful in estimating volumes of ECF and TBW during pregnancy.

Elevated resting energy expenditure in adolescents with sickle cell anemia.

OBJECTIVE: To assess the reliability of standard prediction equations in estimating resting energy expenditure (REE) values in adolescents with sickle cell anemia. SUBJECTS/DESIGN: Body composition and metabolic measurements were performed in 8 adolescents, aged 11 to 18 years, with homozygous sickle cell anemia. REE was measured by indirect calorimetry under standard conditions, and measurements were compared with 4 prediction formulas (Harris-Benedict, Schofield, Mayo Clinic, and Food and Agriculture Organization/World Health Organization/United Nations University). Fat-free mass was measured to assess REE per unit of actively metabolizing tissue. Fat-free mass was expressed as a mean of values obtained by densitometry, deuterium dilution, 40K-counting, and total body electrical conductivity. STATISTICAL ANALYSES: Repeated measures analysis of variance was performed to determine whether measured REE values and predicted values differed. The Fischer test was used to identify which predicted values differed significantly from the measured REE. RESULTS: All 4 prediction formulas significantly underestimated REE. Group mean values for the prediction formulas ranged from 83% to 89% of the measured value. REE averaged 47.7 +/- 10.0 kcal/kg fat-free mass per day, which is 30% to 50% higher than reported values in healthy adolescent populations. CONCLUSIONS: These data suggest that REE is elevated in adolescents with sickle cell anemia. Standard equations used to predict REE are unreliable in these patients. APPLICATIONS: REE in patients with sickle cell anemia is best determined by indirect or direct measurement of energy expenditure. Clinically useful formulas to estimate REE should be developed for patients with conditions, including sickle cell anemia, where the metabolic rate may be altered.

Effects of physical activity, body weight and composition, and muscular strength on bone density in young women.

OBJECTIVE: The purpose of this study was to examine the relationship between body weight and composition, muscular strength, physical activity, and bone mineral density (BMD) in eumenorrheic college-aged women. METHODS: BMD and bone mineral content (BMC) of the total body, and BMD of the lumbar spine (L2-L4) and femoral neck (via dual energy x-ray absorptiometry), as well as body composition and muscular strength, were measured in 60 college-aged women. The women were divided into three groups: 1) low body weight athletes involved in weight-bearing, collegiate sports (N = 20), 2) matched low body weight and sedentary (N = 20), and 3) average body weight and sedentary (N = 20). All groups were matched for height, age, and age at menarche. RESULTS: The athletes had significantly greater (P < 0.05) (mean +/- SD) total body BMD (1.164 +/- 0.06 g x cm[-2]), L2-L4 BMD (1.240 +/- 0.13 g x cm[-2]), femoral neck BMD (1.144 +/- 0.13 g x cm[-2]) and total body BMC (2.44 +/- 0.30 kg) than the low body weight, sedentary (LWS) group, but were only greater than the average body weight sedentary group (AWS) for femoral neck BMD. Significant correlations were found between lean body mass (LBM) and all BMD variables (P < 0.001). A significant correlation (P < 0.01) was found between fat mass and all BMD variables in the sedentary subjects alone (N = 40), but with inclusion of the athletes (N = 60), none of the correlations between fat mass and BMD were significant. Arm and leg strength isometric torque values corrected for muscle + bone cross-sectional area (M + B CSA) were not significantly different between the athletes and LWS group, but the athletes were greater (P < 0.05) than the AWS group for both arm and leg strength/M + B CSA. No significant, site-specific correlations were found between strength/M + B and BMD. CONCLUSIONS: In summary, the athletes had significantly greater BMD, BMC, and LBM than the LWS group and, except for a greater femoral neck BMD, similar BMD, BMC, and LBM as the AWS group. These results suggest that LBM and weight-bearing exercise both enhance BMD in eumenorrheic young adult women.

Evaluation of body composition by dual energy x-ray absorptiometry and two different software packages.

Dual energy x-ray absorptiometry (DXA) measures body composition, tissue distribution, bone mineral content (BMC), and bone mineral density (BMD). Differences are possible due to software versions. This investigation examined body composition, tissue distribution, BMC, and BMD measurements using a DXA (Lunar Corp., Madison, WI) with different software packages (versions 3.4 and 3.6R). Fifteen women, ages 20-40 yr, enrolled in a weight-loss study (body mass index = 28) and volunteered for body composition assessment by densitometry. BMC, BMD, and tissue distribution measurements were made using DXA. Results were analyzed once each with software versions 3.4 and 3.6R. BMC + total soft tissue, measured using DXA, was comparable to measured body weight (3.4 = 76.3 kg; 3.6R = 76.5 kg; weight = 76.5 kg). Lower BMC and BMD (5.5% and 1.8%, P < 0.01) were observed with 3.6R. Arm tissue mass was lower (1,530 g; P < 0.01) and fat declined (1,069 g; P < 0.01) with 3.6R. Leg tissue mass decreased 487 g (P < 0.01), but fat tissue increased (526 g, P < 0.01) with 3.6R. A larger fat mass (1,492 g) and lower lean mass (1,115 g) were observed with 3.6R compared with 3.4. Percent fat values by densitometry using DXA 3.4 and 3.6R were 38.1%, 39.9, and 41.9%, respectively. These results demonstrated differences in total body composition, lean and fat tissue distribution, and bone measurements from DXA software versions.

Use of multi-frequency bioelectrical impedance analysis for the estimation of extracellular fluid.

Thomasset (Lyon Medicine (1962): 207, 107-118; (1963): 209, 1325-1350; (1965): 214, 131-143) and others suggested that low-frequency impedance measurements could be used to estimate extracellular fluid and that high-frequency measurements could be used for the assessment of total body water. It was the purpose of this study to examine the relationship between body fluid compartments and multi-frequency bioelectrical impedance analysis (MF-BIA). Total body water (TBW) and extracellular fluid (ECF) were measured using deuterium and sodium bromide dilution procedures. Intracellular fluid volume (ICF) was calculated as the difference between TBW and ECF. A tetrapolar arrangement of surface electrodes was used to measure whole-body resistance (R), reactance (Xc), impedance (Z), and phase angle (P) at 25 frequencies ranging from 1 kHz to 1.35 MHz. Subjects (n = 60; 40 male and 20 female) were between the ages of 19 and 65 years. Mean ratios (+/- SEM) of ECF/ICF and ECF/TBW were 0.83 +/- 0.021 and 0.45 +/- 0.011, respectively. Individuals with the largest fat-free mass (FFM) had the highest ECF value. Whole-body resistive index values most correlated to ECF were at 224, 300, 400, 548 and 1 kHz with correlations ranging from 0.93 to 0.84. All possible subset regression analysis was used to develop a prediction equation for ECF: R2 = 0.924 and SEE = 1.061: ECF = 5.17753 + (0.09989*RI224) + (0.09322*WT) - (1.3962*SEX), where RI = resistive index (HT2/R) at the specific frequency of 224kHz; WT = weight in kilograms; sex was dummy-coded, males = 0, females = 1.

Body composition assessment: dual-energy X-ray absorptiometry (DEXA) compared to reference methods.

The use of dual energy X-ray absorptiometry (DEXA) for the assessment of body composition was examined in 55 adults (26 male & 29 female) ranging in age from 19 to 65 years. DEXA measures of bone mineral content (BMC, g), bone mineral density (BMD, g/cm2) and soft tissue (ST) were based on differential energy attenuation at dual energy levels of 40 and 70 keV. The ratio of the low- to high-energy attenuation in ST was used to quantify fat (%FatDEXA) and fat-free mass minus the bone component (FFMDEXA). BMC and BMD were significantly correlated (r = 0.82 and 0.60) with densitometric fat-free mass (FFMD). No significant differences were observed between the sum of FFMDEXA + BMC versus FFMD for either the males or females (males: FFMDEXA + BMC = 61.7 kg; FFMD = 59.1 kg; females: FFMDEXA + BMC = 43.8 kg; FFMD = 42.8 kg). Percentage body fat from DEXA for the women was equivalent to percentage fat from density (%FatDEXA = 30.8 versus %FatD = 32.2); however, significant differences were observed for the men (%FatDEXA = 19.4 versus %FatD = 23.5). Percentage fat differences for the men may be due to classification of individual soft tissue pixels. DEXA is reliable, easy to use, and appears to give accurate values for the estimation of FFM for both men and women. Additional research is needed to ascertain the cause of the differences in the estimation of percent body fat for men.