Physical frailty and body composition in obese elderly men and women

Muscle protein synthesis response to exercise training in obese, older men and women

INTRODUCTION

Physical activity and eating are two major physiological muscle growth stimuli. Although muscle protein turnover rates are not different in young and middle-aged men and women, we recently found that the basal rate of muscle protein synthesis is greater and the anabolic response to mixed-meal intake is blunted in 65- to 80-yr-old women compared with men of the same age. Whether older women are also resistant to the anabolic effect of exercise is not known.

METHODS

We measured the rate of muscle protein synthesis (both during basal, postabsorptive conditions and during mixed-meal intake) before and after 3 months of exercise training in obese, 65- to 80-yr-old men and women.

RESULTS

At the beginning of the study (before training) the basal, postabsorptive muscle protein fractional synthesis rate (FSR) was significantly greater in women than in men (0.064 ± 0.006%·h(-1) vs 0.039 ± 0.006%·h(-1), respectively, P < 0.01), whereas the meal-induced increase in the muscle protein FSR was greater in men than in women (P < 0.05). In men, exercise training approximately doubled the basal muscle protein FSR (P = 0.001) but had no effect on the meal-induced increase in muscle protein FSR (P = 0.78). In women, exercise training increased the muscle protein FSR by ~40% (P = 0.03) and also had no effect on the meal-induced increase in muscle protein FSR (P = 0.51).

CONCLUSIONS

These results suggest that there is significant sexual dimorphism not only in the basal, postabsorptive rate of muscle protein synthesis but also in the anabolic response to feeding and exercise training in obese, older adults.

A prospective examination of the relationship between physical activity and dementia risk in later life

PURPOSE

To examine the relationship between vigorous physical activity and dementia risk.

DESIGN

Prospective study design utilizing physical activity data from the Health and Retirement Study and cognitive outcome data from the Aging, Demographics, and Memory Study.

SETTING

Community-based.

SUBJECTS

Adults age 71 and over (N  =  808) with 3 to 7 years of physical activity information prior to dementia/no dementia diagnosis.

MEASURES

Physical activity was measured by participation in vigorous activities such as aerobics, sports, running, bicycling, and heavy housework three or more times per week (yes/no). Dementia diagnosis was based on an expert panel (e.g., neuropsychologists, neurologists, geropsychiatrists) who performed and reviewed a battery of neuropsychological tests.

ANALYSIS

Binary logistic regression models were used to account for demographic characteristics, genetic risk factors (one or two apolipoprotein E ε4 alleles), health behaviors (e.g., smoking, drinking alcohol), health indicators (body mass index), and health conditions (e.g., diabetes, heart disease) in a sequential model-building process.

RESULTS

The relationship between vigorous physical activity and dementia risk remained robust across models. In the final model, older adults who were physically active were 21% (p ≤ .05) less likely than their counterparts to be diagnosed with dementia.

CONCLUSION

Vigorous physical activity may reduce the risk for dementia independently of the factors examined here. This study's findings are important given that few preventative strategies for dementia have been explored beyond hormonal therapy and anti-inflammatory drugs.

The relationship between body weight, frailty, and the disablement process

OBJECTIVES

To prospectively examine the relationship between body weight, frailty, and the disablement process.

METHOD

Longitudinal data from the Health and Retirement Study (1998-2006) were used to examine the relationship between being underweight, overweight, or obese (compared with normal weight) and the onset and progression of functional limitations and disabilities in instrumental activities of daily living (IADL) and activities of daily living (ADL) among a nationally representative sample of community-dwelling older adults (aged 50 and older) with characteristics of frailty (n= 11,491). Nonlinear multilevel models additionally adjusted for demographic characteristics and intra-individual changes in body weight, socioeconomic status, health behaviors, and health conditions over the course of 8 years.

RESULTS

Compared with their nonfrail normal weight counterparts, prefrail obese respondents have a 16% (p ≤ 0.001) reduction in the expected functional limitations rate and frail overweight and obese respondents have a 10% (p ≤ 0.01) and 36% (p ≤ 0.001) reduction in the expected functional limitations rate, respectively. In addition, frail obese respondents have a 27% (p ≤ 0.05) reduction in the expected ADL disability rate.

DISCUSSION

This study's findings suggest that underweight, overweight, and obese status differentially affect the risk for functional limitations and disabilities in IADL and ADL. Among prefrail and frail adults, some excess body weight in later life may be beneficial, reducing the rate of functional limitations and disability.

Gait speed is limited but improves over the course of acute care physical therapy

BACKGROUND

Gait is a common focus of physical therapists' management of patients in acute care settings. Walking speed, the distance a patient covers per unit time, has been advocated as a "sixth vital sign." However, the feasibility of measuring walking speed and the degree to which walking speed is limited or improves over the course of therapy in the acute care setting are unclear.

PURPOSE

The purpose of this study of patients undergoing physical therapy during acute care hospitalization, therefore, was to determine whether walking speed can be measured in acute care and whether walking speed is limited and changes over the course of therapy.

METHODS

This was an observational cross-sectional study. Participants were 46 hospital inpatients, mean age 75.0 years (SD = 7.8), referred to physical therapy and able to walk at least 20 ft. Information regarding diagnosis, comorbidities, physical assistance, device use, body height, and weight was obtained. Speed was determined during initial and final physical therapy visits while patients walked at their self-selected speed over a marked course in a hospital corridor.

RESULTS

Therapists reported that walking speed was clinically feasible, requiring inexpensive, available resources, 4 minutes' additional time, and simple calculations for documentation. Initial walking speed was a mean of 0.33 m/s (SD = 0.21; 95% confidence interval [CI]: 0.27-0.39), whereas final speed was 0.37 m/s (SD = 0.20; 95% CI: 0.31-0.43). The Wilcoxon test showed the increase in walking speed (0.04 m/s) to be significant (P = .005) over a mean therapy period of 2.0 days (SD = 1.4) and total hospitalization period of 5.5 days (SD = 3.6). The effect size and standardized response mean were 0.19 and 0.36, respectively. Minimal detectable change was 0.18 m/s.

CONCLUSION

Walking speed is a feasible measure for patients admitted to an acute care hospital. It shows that patients walk slowly relative to community requirements but that their speed improves even over a short course of therapy.

Association of frailty syndrome in the elderly with higher blood pressure and other cardiovascular risk factors

BACKGROUND

Few studies have evaluated blood pressure (BP) and cardiovascular risk in older persons with frailty syndrome. The objective of the present study was to assess the cardiovascular risk factors of subjects with frailty syndrome with emphasis on BP, as compared with individuals without frailty or with prefrailty.

METHODS

This was a cross-sectional study in which 77 frail, prefrail, and nonfrail older subjects were selected according to the criteria of Fried et al.: self-reported weight loss, low grip strength, low energy, slow gait speed, and low physical activity. Anthropometric and BP measurements were obtained in the office, and home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) were also performed. Fasting glucose and plasma lipids were collected. Data were analyzed by linear fixed effects model and ANOVA.

RESULTS

Mean age was 74.5 ± 7.5 years. There was no difference in office BP or HBPM between groups, but ABPM of frail group demonstrated higher systolic and diastolic BP values over the 24 h (135/74 mm Hg, P = 0.02 and P = 0.04) and during sleep (135/74 mm Hg, P = 0.01 and P = 0.02) than nonfrail group (122/68 mm Hg and 120/67 mm Hg, respectively). Body mass index and fasting glucose were similar among groups, although abdominal circumference was greater (P = 0.04) and high-density lipoproteins (HDL) were lower (P = 0.03) in the frail group than nonfrail one (P = 0.04).

CONCLUSIONS

Subjects with frailty syndrome had higher BP evaluated by ABPM and other cardiovascular risk factors such as lower HDL and more abdominal fat than nonfrailty group.

Total and regional relationship between lean and fat mass with increasing adiposity--impact for the diagnosis of sarcopenic obesity

BACKGROUND/OBJECTIVE

Besides the effect of age used to define sarcopenia, there is need to understand the impact of adiposity on the relationship between lean (fat-free mass, FFM) and fat mass (FM) in order to diagnose sarcopenic obese phenotypes. More importantly, the regional distribution of skeletal muscle (SM) to adipose tissue (AT) or the composition of FFM (that is, SM proportion of lean mass) may also depend on adiposity.

SUBJECTS/METHODS

In a large database (n=1737) of healthy males and females (age 11-84 years, BMI 13.5-52.5 kg/m(2)) we investigated changes in the relationship between FFM and FM (normalized by height as fat-free mass index and fat mass index: FFMI and FMI, kg/m(2) assessed by densitometry) with increasing adiposity and age. In a subgroup (n=263) we analyzed the relationship between regional SM and (i) AT (by magnetic resonance imaging) or (ii) lean soft tissue (by dual X-ray absorptiometry) with increasing adiposity.

RESULTS

The relationship between lean and FM was influenced by adiposity, age and gender. With increasing adiposity, SM/AT declined faster at the trunk in men and at the extremities in women. The contribution of appendicular SM to lean soft tissue of arms and legs tended to decrease at a higher adiposity in both genders (FMI >6.97 kg/m(2) in women; FMI>7.77 kg/m(2) in men).

CONCLUSION

Besides age and gender, adiposity and body region should be considered when evaluating the normal relationship between lean and FM, SM/FFM and SM/AT.

Obesity in Older Adults: Technical Review and Position Statement of the American Society for Nutrition and NAASO, The Obesity Society

Obesity causes serious medical complications and impairs quality of life. Moreover, in older persons, obesity can exacerbate the age-related decline in physical function and lead to frailty. However, appropriate treatment for obesity in older persons is controversial because of the reduction in relative health risks associated with increasing body mass index and the concern that weight loss could have potential harmful effects in the older population. This joint position statement from the American Society for Nutrition and NAASO, The Obesity Society reviews the clinical issues related to obesity in older persons and provides health professionals with appropriate weight-management guidelines for obese older patients. The current data show that weight-loss therapy improves physical function, quality of life, and the medical complications associated with obesity in older persons. Therefore, weight-loss therapy that minimizes muscle and bone losses is recommended for older persons who are obese and who have functional impairments or medical complications that can benefit from weight loss.

Lower extremity muscle quality and gait variability in older adults

BACKGROUND

it is not clear if gait variability is linked to muscle strength or muscle quality (MQ). This study examined the relation between leg strength and lower extremity MQ and gait variability in healthy ambulatory older adults.

METHODS

seventy-two older adults (43 females and 29 males; age: 69.5 ± 6.1 years) underwent assessments of gait, leg strength and body composition. Leg strength was assessed with an isokinetic dynamometer and body composition by dual-energy X-ray absorptiometry (DXA). MQ was calculated from the information muscle strength and body composition. Gait was assessed by having the subjects walk down a pressure sensitive walkway at self-selected normal speed. Variability of spatial and temporal parameters of gait was calculated.

RESULTS

there were minimal correlations between muscle strength and spatial parameters. However, both lower leg and upper leg MQ were negatively associated with spatial (r's = -0.24 to -0.49, P < 0.05) and temporal gait variability (r's = -0.27 to -0.35, P < 0.05). Also, lower leg MQ was found to be a better predictor of gait variability than upper leg MQ.

CONCLUSIONS

the results highlight that MQ may be an important determinant of gait function, even in healthy older adults.

Scoping review report: obesity in older adults

Obesity is associated with an increased risk for early death, heart disease and stroke, disability and several other comorbidities. Although there is concern about the potential burden on health-care services with the aging demographic and the increasing trend of obesity prevalence in older adults, evidence on which to base management strategies is conflicting for various reasons. The analytic framework for this review is based on a scoping review methodology, and was conducted to examine what is known about the diagnosis, treatment and management of obesity in older adults. A total of 492 relevant research articles were identified using PubMed, Scirus, EBSCO, Clinicaltrials.gov, Cochrane Reviews and Google Scholar. The findings of this review indicate that the current WHO (World Health Organization)-recommended body mass index, waist circumference and waist-to-hip ratio obesity thresholds for the general adult population may not be appropriate for older adults. Alternatively, weight change or physical fitness may be more useful measures of mortality and health risk in obese older adults. Furthermore, although obesity in older adults is associated with several disorders that increase functional disability, epidemiological evidence suggests that obesity is protective against mortality in seniors. Consequently, the trend toward increasing prevalence of obesity in older adults will lead to an increase in unhealthy life years and health-care costs. The findings from this review also suggest that treatment strategies for obese older adults should focus on maintaining body weight and improving physical fitness and function rather than weight loss, and that a combination of aerobic and resistance exercise appears to be the most effective strategy. In conclusion, this review demonstrates the need for more research to clarify the definition of obesity in older adults, to establish criteria for evaluating when to treat older adults for obesity, and to develop effective treatment strategies focused on functional outcomes in obese older adults.

Sarcopenic obesity: A Critical appraisal of the current evidence

Sarcopenic obesity (SO) is assuming a prominent role as a risk factor because of the double metabolic burden derived from low muscle mass (sarcopenia) and excess adiposity (obesity). The increase in obesity prevalence rates in older subjects is of concern given the associated disease risks and more limited therapeutic options available in this age group. This review has two main objectives. The primary objective is to collate results from studies investigating the effects of SO on physical and cardio-metabolic functions. The secondary objective is to evaluate published studies for consistency in methodology, diagnostic criteria, exposure and outcome selection. Large between-study heterogeneity was observed in the application of diagnostic criteria and choice of body composition components for the assessment of SO, which contributes to the inconsistent associations of SO with cardio-metabolic outcomes. We propose a metabolic load:capacity model of SO given by the ratio between fat mass and fat free mass, and discuss how this could be operationalised. The concept of regional fat distribution could be incorporated into the model and tested in future studies to advance our understanding of SO as a predictor of risk for cardio-metabolic diseases and physical disability.

A prospective study of frailty in nephrology-referred patients with CKD

BACKGROUND

Frailty is a construct developed to characterize a state of reduced functional capacity in older adults. However, there are limited data describing the prevalence or consequences of frailty in middle-aged patients with chronic kidney disease (CKD).

STUDY DESIGN

Observational study.

SETTING & PARTICIPANTS

336 non-dialysis-dependent patients with stages 1-4 CKD with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m(2) (by the CKD-EPI [CKD Epidemiology Collaboration] serum creatinine-based equation) or evidence of microalbuminuria enrolled in the Seattle Kidney Study, a clinic-based cohort study. Findings were compared with community-dwelling older adults in the Cardiovascular Health Study.

OUTCOME

Prevalence and determinants of frailty in addition to its association with the combined outcome of all-cause mortality or renal replacement therapy.

MEASUREMENTS

We defined frailty according to established criteria as 3 or more of the following characteristics: slow gait, weakness, unintentional weight loss, exhaustion, and low physical activity. We estimated kidney function using serum cystatin C concentrations (eGFR(cys)) to minimize confounding due to relationships of serum creatinine levels with muscle mass and frailty.

RESULTS

The mean age of the study population was 59 years and mean eGFR(cys) was 51 mL/min/1.73 m(2). The prevalence of frailty (14.0%) was twice that of the much older non-CKD reference population (P < 0.01). The most common frailty components were physical inactivity and exhaustion. After adjustment including diabetes, eGFR(cys) categories of <30 and 30-44 mL/min/1.73 m(2) were associated with a 2.8- (95% CI, 1.3-6.3) and 2.1 (95% CI, 1.0-4.7)-fold greater prevalence of frailty compared with GFR(cys) ≥60 mL/min/1.73 m(2). There were 63 events during a median 987 days of follow-up. After adjustment, the frailty phenotype was associated with an estimated 2.5 (95% CI, 1.4-4.4)-fold greater risk of death or dialysis therapy.

LIMITATIONS

Cross-sectional study design obscures inference regarding temporal relationships between CKD and frailty.

CONCLUSIONS

Frailty is relatively common in middle-aged patients with CKD and is associated with lower eGFR(cys) and increased risk of death or dialysis therapy.

Sarcopenic indices in community-dwelling older adults

BACKGROUND

Sarcopenic (SP) indices are used to estimate loss of skeletal lean mass and function and to determine the prevalence of SP in older adults. It is believed that older women and men with lower skeletal lean mass will be weaker and have more functional limitations.

PURPOSE

(1) To classify community-dwelling older adults using 2 common SP indices: appendicular lean mass/height² (ALM/ht²) and skeletal muscle index (SMI), and (2) to determine each indices value as indicators of lower extremity strength and physical function.

METHODS

The sample consisted of 154 community-dwelling older adults (111 women and 43 men; mean age = 82.4, SD = 3.6 years; mean body mass index = 25.8, SD = 4.4 kg/m). Each underwent whole-body dual-energy x-ray absorptiometry to assess lean mass. The 9-item modified Physical Performance Test and self-selected walking speed were used to evaluate function. Lower extremity strength was measured bilaterally using isokinetic dynamometry.

RESULTS

The ALM/ht² index classified 75 participants (49%) as SP and 79 (51%) as nonsarcopenic (NSP). The SMI classified 129 participants (84%) as SP and 25 (16%) as NSP. There were no differences in functional measures between groups by gender using either index after classification. The ALM/ht index was more strongly correlated with peak torque of all lower extremity muscle groups (r = 0.276-0.487) compared with the SMI (r = 0.103-0.344). There was no relationship between SP index and physical function.

DISCUSSION

There were marked differences in how 2 SP indices classified community-dwelling older adults. Lower extremity strength was lower in older women classified as SP than NSP using the ALM/ht index, but LE strength was not different in older men. However, no lower extremity strength differences were observed between SP and NSP men or women using the SMI classification. None of the SP index uniformly identified community-dwelling older adults with functional or strength deficits.

CONCLUSIONS

Detection of strength deficits using SP indices alone may be gender-specific and may not reflect strength or functional decline in community-dwelling men aged 80 years or older. Given associations between lower extremity strength and physical function, strength measures remain a better predictor of physical performance than SP indices for community-dwelling older men and women.

Epidemiologic behavior of obesity in the Maracaibo City metabolic syndrome prevalence study

Introduction

Obesity is a worldwide public health issue. Since the epidemiological behaviour of this disease is not well established in our country, the purpose of this study was to determinate its prevalence in the Maracaibo City, Zulia State- Venezuela.

Materials and Methods

A cross-sectional study was undertaken using the data set from the Maracaibo City Metabolic Syndrome Prevalence Study. The sample consists of 2108 individuals from both genders and randomly selected: 1119 (53.09%) women and 989 (46.91%) men. The participants were interrogated for a complete clinical history and anthropometric measurements. To classify obesity, the WHO criteria for Body Mass Index (BMI), and Waist Circumference (WC) from the IDF/NHLBI/AHA/WHF/IAS/IASO-2009 (IDF-2009) and ATPIII statements were applied.

Results

For BMI, obesity had an overall prevalence of 33.3% (n = 701), and according to gender women had 32.4% (n = 363) and men had 34.2% (n = 338). Overweight had a prevalence of 34.8% (n = 733), Normal weight had 29.8% (n = 629), and Underweight had 2.1% (n = 45). Adding Obesity and Overweight results, the prevalence of elevated BMI (>25 Kg/m²) was 68.1%. Using the IDF-2009 WC's cut-off, Obesity had 74.2% prevalence, compared to 51.7% using the ATPIII parameters.

Conclusions

These results show a high prevalence of abdominal obesity in our locality defined by the WHO, IDF-2009 and ATPIII criteria, which were not designed for Latin-American populations. We suggest further investigation to estimate the proper values according to ethnicity, genetic background and sociocultural aspects.

The frailty syndrome: a comprehensive review

The frailty syndrome is defined as unintentional weight and muscle loss, exhaustion, and declines in grip strength, gait speed, and activity. Evidence with respect to the clinical definition, epidemiology, mechanisms, interactions, assessment, prevention, and treatment of frailty in the older adult is reviewed.

A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus

OBJECTIVES

To evaluate the relationships between body composition and physical frailty in community-dwelling older adults with the human immunodeficiency virus (HIV) (HOA).

DESIGN

Cross-sectional.

SETTING

Academic hospital-based infectious disease clinic in Rochester, New York.

PARTICIPANTS

Forty community-dwelling HOA aged 50 and older undergoing antiretroviral therapy who were able to ambulate without assistive devices with a mean age of 58, a mean BMI of 29.0 kg/m(2), mean CD4 count of 569 cells/mL, and a mean duration since HIV diagnosis of 17 years; 28% were female and 57% Caucasian.

MEASUREMENTS

Subjective and objective measures of functional status were evaluated using the Physical Performance Test (PPT), the graded treadmill test, knee strength, gait speed, balance, and the Functional Status Questionnaire (FSQ). Body composition was evaluated using dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI).

RESULTS

Sixty percent (25/40) of the participants met standard criteria for physical frailty. Frail (FR) and nonfrail (NF) participants were comparable in age, sex, CD4 count, and viral load. FR HOA had greater impairments in PPT, peak oxygen uptake, FSQ, walking speed, balance, and muscle quality than NF HOA. FR HOA had a greater body mass index (BMI), fat mass, and truncal fat with lipodystrophy. Moreover, PPT score was inversely related to trunk fat (correlation coefficient (r) = -0.34; P = .04) and ratio of intermuscular fat to total fat (r = -0.60; P = .02) after adjusting for covariates.

CONCLUSION

HOA represent an emerging cohort of older adults who frequently experience frailty at a much younger age than the general older population. Central obesity and fat redistribution are important predictors of frailty in community-dwelling HOA. These findings suggest that physical frailty in HOA may be amenable to lifestyle interventions, especially exercise and diet therapy.

The impact of severe obesity on post-acute rehabilitation efficiency, length of stay, and hospital costs

Background and Objective. The purpose of this retrospective observational study was to examine the influence of severe obesity on length of stay (LOS), rehabilitation efficiency, and hospital costs post-acute rehabilitation in a population-based, tertiary care, publicly-funded regional rehabilitation center. Participants. 42 severely obese subjects (mean age 53 y; mean BMI 50.9 kg/m(2)) and 42 nonobese controls (mean age 59 y; mean BMI 23.0 kg/m(2)) matched by sex and admitting diagnosis. Main Outcome Measures. Total LOS, rehab LOS, waiting for transfer LOS, Fuctional Independence Measure (FIM) efficiency, and hospital costs. Results. Compared to controls, severely obese subjects experienced longer total LOS (98.4 vs. 37.4 days; P = 0.03), rehabilitation LOS (55.8 vs. 37.4 days; P = 0.04), and waiting for transfer LOS (42.6 vs. 0 days; P = 0.006); increased hospital costs ($115,822 vs. $43,969; P = 0.03); and similar FIM efficiency (0.58 vs. 0.67; P = 0.27). Severe obesity was an independent predictor of total LOS (beta-coefficient 0.51; P = 0.03), rehab LOS (0.46; P = 0.02) but not FIM efficiency (-0.63; P = 0.06). Conclusion. Severe obesity adversely affects rehabilitation LOS and expenditures. Targeted interventions in severely obese individuals to optimize post-acute rehabilitation care delivery are needed.

Obese elderly women exhibit low postural stability: a novel three-dimensional evaluation system

OBJECTIVE

The aim of this study was to evaluate the multisegmental static postural balance of active eutrophic and obese elderly women using a three-dimensional system under different sensory conditions.

METHODS

A cross-sectional study was conducted on 31 elderly women (16 eutrophic and 15 obese) aged 65 to 75 years. The following anthropometric measurements were obtained: weight, height, waist and hip circumference, and handgrip strength. The physical activity level was evaluated using the International Physical Activity Questionnaire. Body composition was measured using the deuterium oxide dilution technique. The Polhemus(®) Patriot (three-dimensional) equipment was used to measure the parameters of postural balance along the anteroposterior and laterolateral axes. The data acquisition involved one trial of 60 s to test the limit of stability and four trials of 90 s each under the following conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; and (4) eyes closed, unstable surface.

RESULTS

For the limit of stability, significant differences were observed in the maximum anteroposterior and laterolateral displacement (p<0.01) and in the parameter maximum anteroposterior displacement in the eyes closed stable surface condition (p<0.01) and maximum anteroposterior and laterolateral displacement in the eyes open unstable surface (p<0.01 and p = 0.03) and eyes closed unstable surface (p<0.01 and p<0.01) conditions.

CONCLUSIONS

Obese elderly women exhibited a lower stability limit (lower sway area) compared with eutrophic women, leaving them more vulnerable to falls.

Dietary protein and beef consumption predict for markers of muscle mass and nutrition status in older adults

OBJECTIVE

To determine the relationship of beef and protein intake to nutrition status, body composition, strength, and biochemical measures of vitamin and mineral status, inflammation and blood lipids in older adults.

DESIGN

Cross-sectional observational study.

SETTING

State of Ohio, U.S.A.

PARTICIPANTS

142 adults ages 60-88.

MEASUREMENTS

Subjects completed a Diet History Questionnaire, and questionnaires related to nutrition status and activity. Subjects also underwent measurements of body composition and strength, and a subset took part in a blood draw for biochemical measurements.

RESULTS

Beef intake (g/d) was positively correlated to muscle mass measured by mid-arm muscle area (R=0.128, p=0.030). From multiple linear regression analysis, a 1oz/d (~28g/d) increase in beef consumption predicts for a 2.3cm(2) increase in mid-arm muscle area. Beef intake was negatively correlated to total (R=-0.179, p=0.035) and HDL (R=-0.247, p=0.004) cholesterol, and there was no association between beef and LDL-cholesterol, triglycerides, liver enzymes, or inflammatory markers. Protein intake (% of total energy) was positively correlated to nutrition status measured by the Mini Nutrition Assessment (R=0.196, p=0.020), and calf circumference (R=0.190, p=0.024), and these correlations remained when potential confounders were accounted for in multiple linear regression models. Protein intake was also positively correlated with BMI when analyzed with multiple linear regression.

CONCLUSIONS

Beef intake was positively associated with mid-arm muscle area, and protein intake was positively associated with nutrition status, calf circumference, and BMI in older adults. Consuming lean cuts of beef in moderation may be a healthy way in which older adults can increase protein intake, preserve muscle mass and improve nutrition status.

A systematic review of the literature concerning the relationship between obesity and mortality in the elderly

INTRODUCTION

Obesity is a risk factor for chronic diseases and premature mortality, but the extent of these associations among the elderly is under debate. The aim of this systematic literature review (SR) is to collate and critically assess the available information of the impact of obesity on mortality in the elderly.

METHODS

In PubMed, there are three-hundred twelve papers on the relationship between obesity and mortality among older adults. These papers were analysed on the basis of their abstracts, and sixteen studies were considered suitable for the purpose of the study. It was possible to perform a pooled estimate for aggregated data in three different studies.

CONCLUSION

The results of this SR document that an increased mortality in obese older adults. The limitation of BMI to index obesity and the noted protective action of a moderate increase in BMI on mortality are highlighted. Waist circumference is an indicator of central adiposity and potentially as good a risk factor for mortality as BMI in obese elderly adults.

Sarcopenia and obesity

Four body composition phenotypes exist in older adults: normal, sarcopenic, obese, and a combination of sarcopenic and obese. There is no consensus, however, on the definitions and classifications of these phenotypes and their etiology and consequences continue to be debated. The lack of standard definitions, particularly for sarcopenia and sarcopenic obesity, creates challenges for determining prevalence across different populations. The etiology of these phenotypes is multifactorial with complex covariate relationships. This review focuses on the current literature addressing the classification, prevalence, etiology, and correlates of sarcopenia, obesity, and the combination of sarcopenia and obesity, referred to as sarcopenic obesity.

Age-related changes of body composition and abdominal adipose tissue assessed by bio-electrical impedance analysis and computed tomography

Only scarce information is available on body composition changes with age measured simultaneously by electrical impedance and computed tomography.

AIM

We aimed to describe the age-related changes of the body composition and adipose tissue distribution in Bulgarians.

MATERIAL AND METHODS

This cross-sectional study included 130 participants (mean age 53±9.8 years, range 35-65), divided according to their body mass index (BMI): BMI <25.0 kg/m(2) (18 women, 12 men); BMI 25.0-34.9 kg/m(2) (50 women, 50 men). Body composition was assessed by bioelectrical impedance on a Tanita TBF-215 analyzer (Tanita Corp., Tokyo, Japan). The abdominal fat was measured by computed tomography on a CT/L scanner (GE Medical Systems, USA).

RESULTS

Increasing age was associated with a mean decrease in body weight by 268 g per year in the normal weight subjects and by 390 g in the overweight ones as well as with a fat-free mass decrease of 321 g and of 291 g per year respectively (p<0.001). One year of increasing age was associated with a mean increase of visceral adipose tissue by 2.43 cm(2) in the overweight group and by 2.68 cm(2) in the normal weight subjects and with a decrease of the subcutaneous adipose tissue by 2.30 cm(2) per year in the latter group (p<0.001). The association of fat mass and fat-free mass with age in men and women was best described by quadratic equations (both increased until the age of 45-50 and decreased thereafter).

CONCLUSIONS

Our data showed a significant association between age and decreasing fat-free mass, increasing fat mass and abdominal fat accumulation.

Is fat mass distribution related to impaired mobility in older men and women? Nutrition as a determinant of successful aging: the Quebec longitudinal study

It is established that a high level of fat mass (FM) is related to mobility impairment in older adults. However, FM distribution has received very little attention. In this study, 904 well-functioning older adults aged between 68 and 82 years old were recruited to examine the association between waist circumference, trunk FM, leg FM, and mobility. The results show that waist circumference was the only measure of body fat distribution independently associated with mobility (p ≤ .001). Therefore, the use of objective measures of FM distribution may not be necessary to examine the impact of FM distribution on mobility.

Optimal cutoff values for high-risk waist circumference in older adults based on related health outcomes

The authors aimed to explore optimal cutoffs for high-risk waist circumference (WC) in older adults to assess the health risks of obesity. Prospective data from 4,996 measurements in 2,232 participants aged ≥70 years were collected during 5 triennial measurement cycles (1992/1993-2005/2006) of a population-based cohort study, the Longitudinal Aging Study Amsterdam (Amsterdam, the Netherlands). Cross-sectional associations of WC with pain, mobility limitations, incontinence, knee osteoarthritis, cardiovascular disease, and diabetes were studied. Generalized estimating equations models were fitted with restricted cubic spline functions in order to carefully study the shapes of the associations. Model fits for applying different cutoffs to categorize WC in the association with all outcomes were tested using the quasi-likelihood under the Independence Criterion (QIC). On the basis of the spline regression curves, potential WC cutoffs of approximately 109 cm in men and 98 cm in women were proposed. Based on the model fit, cutoffs between 100 cm and 106 cm were equally applicable in men but should not be higher. In women, the QIC confirmed an optimal cutoff of 99 cm.

Sex differences in the association between muscle quality, inflammatory markers, and cognitive decline

OBJECTIVE

Aspects of frailty such as sarcopenia and dementia are associated with a proinflammatory state; however, little research has examined the concurrence of these pathologies. This study examined sex-specific differences in the relationship between low muscle quality and impaired cognitive functioning, while considering the role of inflammatory markers.

DESIGN

The nationally representative sample was drawn from a cross-sectional study.

PARTICIPANTS

Four hundred forty-five females and four hundred twenty-two males over age 60 from the National Health and Nutrition Examination Survey for 2001-2002 were included.

MEASUREMENTS

Muscle quality was calculated as isokinetic strength per unit muscle mass. Skeletal muscle mass of the legs was measured using dual energy x-ray absorptiometry and isokinetic strength of the knee extensors was estimated using a Kin-Com dynamometer. Participants were assessed for cognitive functioning using the Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) Digit Symbol - Coding module. High sensitivity C-reactive protein (CRP) assays were performed on blood samples using a Behring Nephelometer to estimate levels of inflammation. Sex stratified ordinary least squares regression models were utilized to estimate the relationship between muscle quality and cognitive functioning, while examining CRP as a possible mechanism and controlling for potential confounds.

RESULTS

In the first model a statistically significant positive relationship was found between cognitive functioning and muscle quality for both sex groups. In the second model, CRP was found to have a statistically significant negative association with cognitive functioning for females but not males. Furthermore, the inclusion of CRP in the second model significantly reduced the predictive power of muscle quality for females, as compared to model 1.

CONCLUSION

Measures of sarcopenia are associated with lower cognitive functioning in older adults, and for females, this association may be partly due to systemic inflammation. Further research is need to examine the relationship between these frailty-related pathologies, which have substantial health and economic implications.

Weight loss in older persons

Weight loss is common in older people. It is associated with increased morbidity and mortality, particularly when unintentional, excessive (>5% body weight), or associated with low body weight (body mass index <22 kg/m(2)). It is often unrecognized, the associated adverse effects not appreciated, and underlying causes not addressed. Intentional weight loss by overweight older people is probably appropriate only when functional problems have resulted from the excess weight. It is important to include, wherever possible, exercise in weight-loss measures to preserve skeletal muscle mass.

Undernutrition at baseline and health services utilization and mortality over a 1-year period in older adults receiving Medicare home health services

OBJECTIVE

Older adults receiving Medicare home health services who experience undernutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a 1-year period in older adults receiving Medicare home health services.

DESIGN

This was a longitudinal study using questionnaires and anthropometric measures designed to assess nutritional status (Mini-Nutritional Assessment) at baseline and health services utilization and mortality status at 6-month and 1-year follow-ups.

SETTING

Participants were evaluated in their homes.

PARTICIPANTS

A total of 198 older adults who were receiving Medicare home health services.

RESULTS

Based on Mini-Nutritional Assessment, 12.0% of patients were malnourished, 51.0% were at risk for malnourishment, and 36.9% had normal nutritional status. Based on body mass index, 8.1% of participants were underweight, 37.9% were normal weight, 25.3% were overweight, and 28.8% were obese. Using multivariate binary logistic regression analyses, participants who were malnourished or at risk for malnourishment were more likely to experience subsequent hospitalization, emergency room visit, home health aide use, and mortality for the entire sample and hospitalization and nursing home stay for overweight and obese participants.

CONCLUSIONS

Experiencing undernutrition at the time of receipt of Medicare home health services was associated with increased health services utilization and mortality for the entire sample, and with increased health services utilization only for the overweight and obese subsample. Opportunities exist to address risk of undernutrition in patients receiving home health services, including those who are overweight or obese, to prevent subsequent adverse health outcomes.

Obese frailty, physical performance deficits, and falls in older men with biochemical recurrence of prostate cancer on androgen deprivation therapy: a case-control study

OBJECTIVES

To test the hypothesis that early androgen deprivation therapy (ADT) has no proven survival advantage in older men with biochemical recurrence (BCR) of prostate cancer (PCa), and it may contribute to geriatric frailty.

METHODS

We conducted a case-control study of men aged 60+ years with BCR on ADT (n = 63) vs PCa survivors without recurrence (n = 71). Frailty prevalence, "obese" frailty, Short Physical Performance Battery (SPPB) scores, and falls were compared. An exploratory analysis of frailty biomarkers (C-reactive protein, erythrocyte sedimentation rate, hemoglobin, albumin, and total cholesterol) was performed. Summary statistics and univariate and multivariate regression analyses were conducted.

RESULTS

More patients on ADT were obese (body mass index >30; 46.2% vs 20.6%; P = .03). There were no statistical differences in SPPB (P = .41) or frailty (P = .20). Using a proposed "obese" frailty criteria, 8.7% in ADT group were frail and 56.5% were "prefrail," compared with 2.9% and 48.8% of controls (P = .02). Falls in the last year were higher in the ADT group (14.3% vs 2.8%; P = .02). In analyses controlling for age, clinical characteristics, and comorbidities, the ADT group trended toward significance for "obese" frailty (P = .14) and falls (OR = 4.74, P = .11). Comorbidity significantly increased the likelihood of "obese" frailty (P = .01) and falls (OR 2.02, P = .01).

CONCLUSIONS

Men with BCR on ADT are frailer using proposed modified "obese" frailty criteria. They may have lower performance status and more falls. A larger, prospective trial is necessary to establish a causal link between ADT use and progression of frailty and disability.

Weight loss, exercise, or both and physical function in obese older adults

BACKGROUND

Obesity exacerbates the age-related decline in physical function and causes frailty in older adults; however, the appropriate treatment for obese older adults is controversial.

METHODS

In this 1-year, randomized, controlled trial, we evaluated the independent and combined effects of weight loss and exercise in 107 adults who were 65 years of age or older and obese. Participants were randomly assigned to a control group, a weight-management (diet) group, an exercise group, or a weight-management-plus-exercise (diet-exercise) group. The primary outcome was the change in score on the modified Physical Performance Test. Secondary outcomes included other measures of frailty, body composition, bone mineral density, specific physical functions, and quality of life.

RESULTS

A total of 93 participants (87%) completed the study. In the intention-to-treat analysis, the score on the Physical Performance Test, in which higher scores indicate better physical status, increased more in the diet-exercise group than in the diet group or the exercise group (increases from baseline of 21% vs. 12% and 15%, respectively); the scores in all three of those groups increased more than the scores in the control group (in which the score increased by 1%) (P<0.001 for the between-group differences). Moreover, the peak oxygen consumption improved more in the diet-exercise group than in the diet group or the exercise group (increases of 17% vs. 10% and 8%, respectively; P<0.001); the score on the Functional Status Questionnaire, in which higher scores indicate better physical function, increased more in the diet-exercise group than in the diet group (increase of 10% vs. 4%, P<0.001). Body weight decreased by 10% in the diet group and by 9% in the diet-exercise group, but did not decrease in the exercise group or the control group (P<0.001). Lean body mass and bone mineral density at the hip decreased less in the diet-exercise group than in the diet group (reductions of 3% and 1%, respectively, in the diet-exercise group vs. reductions of 5% and 3%, respectively, in the diet group; P<0.05 for both comparisons). Strength, balance, and gait improved consistently in the diet-exercise group (P<0.05 for all comparisons). Adverse events included a small number of exercise-associated musculoskeletal injuries.

CONCLUSIONS

These findings suggest that a combination of weight loss and exercise provides greater improvement in physical function than either intervention alone. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT00146107.).

Physical aspects of healthy aging: assessments of three measures of balance for studies in middle-aged and older adults

Objectives. To investigate the reliability and correlations with age of the balance components of the EPESE, NHANES, and the Good Balance Platform System (GBPS) in a normal population of adults. Design. Cross-sectional. Setting. Urban Medical Center in the Pacific. Participants. A random sample of 203 healthy offspring of Honolulu Heart Program participants, ages 38–71. Measurements. Subjects were examined twice at visits one week apart using the balance components of the EPESE, NHANES, and the good balance system tests. Results. The EPESE and NHANES batteries of tests were not sufficiently challenging to allow successful discrimination among subjects in good health, even older subjects. The GBPS allowed objective quantitative measurements, but the test-retest correlations generally were not high. The GBPS variables correlated with age only when subjects stood on a foam pad; they also were correlated with anthropometric variables. Conclusion. Both EPESE and NHANES balance tests were too easy for healthy subjects. The GBPS had generally low reliability coefficients except for the most difficult testing condition (foam pad, eyes closed). Both height and body fat were associated with GBPS scores, necessitating adjusting for these variables if using balance as a predictor of future health.

Delivery and outcomes of a yearlong home exercise program after hip fracture: a randomized controlled trial

BACKGROUND

Hip fracture affects more than 1.6 million persons worldwide and causes substantial changes in body composition, function, and strength. Usual care (UC) has not successfully restored function to most patients, and prior research has not identified an effective restorative program. Our objective was to determine whether a yearlong home-based exercise program initiated following UC could be administered to older patients with hip fracture and improve outcomes.

METHODS

A randomized controlled trial of 180 community dwelling female patients with hip fracture, 65 years and older, randomly assigned to intervention (n = 91) or UC (n = 89). Patients were recruited within 15 days of fracture from 3 Baltimore-area hospitals from November 1998 through September 2004. Follow-up assessments were conducted at 2, 6, and 12 months after fracture. The Exercise Plus Program was administered by exercise trainers that included supervised and independently performed aerobic and resistive exercises with increasing intensity. Main outcome measures included bone mineral density of the contralateral femoral neck. Other outcomes included time spent and kilocalories expended in physical activity using the Yale Physical Activity Scale, muscle mass and strength, fat mass, activities of daily living, and physical and psychosocial functioning. The effect of intervention for each outcome was estimated by the difference in outcome trajectories 2 to 12 months after fracture.

RESULTS

More than 80% of participants received trainer visits, with the majority receiving more than 3 quarters (79%) of protocol visits. The intervention group reported more time spent in exercise activity during follow-up (P < .05). Overall, small effect sizes of 0 to 0.2 standard deviations were seen for bone mineral density measures, and no significant patterns of time-specific between-group differences were observed for the remaining outcome measures.

CONCLUSION

Patients with hip fracture who participate in a yearlong, in-home exercise program will increase activity level compared with those in UC; however, no significant changes in other targeted outcomes were detected.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00390741.

Obesity paradox in elderly patients with cardiovascular diseases

Many elderly people are affected by cardiovascular diseases (CVD) and the majority of CVD patients are elderly people. For both patient populations, studies have shown that a high body mass index (BMI) is associated with lower mortality when compared to normal weight subjects, a fact commonly known as the "obesity paradox". Whether the correlation between obesity and better survival is based on methodological influences and other non-causal factors alone, or whether there is a causal link between obesity and a better survival in these subjects remains widely unexplored. The interrelation between aging, obesity, CVD, frailty and inflammation is a current issue of intensive research. For the elderly, parameters which include measures of body composition, fat and fat-free mass are of greater importance than BMI. Weight management in elderly people with cardiovascular diseases should aim at improvement and maintenance of physical function and quality of life rather than prevention of medical problems associated with obesity in younger and middle aged patients. Although many studies have shown that weight loss in elderly patients is associated with a poor prognosis, recent data demonstrate that intentional weight reduction in obese elderly people ameliorates the cardiovascular risk profile, reduces chronic inflammation and is correlated with an improved quality of life. An individual approach to weight management that includes the participation of the patient, co-morbidity, functional status, and social support should be aspired.

Regular multicomponent exercise increases physical fitness and muscle protein anabolism in frail, obese, older adults

Aging is associated with a decline in strength, endurance, balance, and mobility. Obesity worsens the age-related impairment in physical function and often leads to frailty. The American College of Sports Medicine recommends a multicomponent (strength, endurance, flexibility, and balance) exercise program to maintain physical fitness. However, the effect of such an exercise program on physical fitness in frail, obese older adults is not known. We therefore determined the effect of a 3-month long multicomponent exercise training program, on endurance (peak aerobic capacity (VO(2) peak)), muscle strength, muscle mass, and the rate of muscle protein synthesis (basal rate and anabolic response to feeding) in nine 65- to 80-year-old, moderately frail, obese older adults. After 3 months of training, fat mass decreased (P < 0.05) whereas fat-free mass (FFM), appendicular lean body mass, strength, and VO(2) peak increased (all P < 0.05). Regular strength and endurance exercise increased the mixed muscle protein fractional synthesis rate (FSR) but had no effect on the feeding-induced increase in muscle protein FSR (~0.02%/h increase from basal values both before and after exercise training; effect of feeding: P = 0.02; effect of training: P = 0.047; no interaction: P = 0.84). We conclude that: (i) a multicomponent exercise training program has beneficial effects on muscle mass and physical function and should therefore be recommended to frail, obese older adults, and (ii) regular multicomponent exercise increases the basal rate of muscle protein synthesis without affecting the magnitude of the muscle protein anabolic response to feeding.

Obesity and weight management in the elderly

Our population is ageing, and obesity is increasing in the elderly bringing massive and rapidly changing burdens of ill health related to increased body weights and fat as well as the main drivers of poor diet and inactivity. Overweight and obesity, and a static body mass index (BMI) commonly conceal sarcopenia (gain in body fat but loss of muscle mass and functional capacity) in older people, aggravated by inactivity. A systematic computerized literature search using an iterative manipulation process of the keywords: obesity, elderly, weight loss. The following databases were accessed on 20 October 2010: Medline, Cochrane Collaboration, Ovid and Scholar Google. A large number of clinical consequences of overweight and obesity are particularly problematic for elderly individuals, including type 2 diabetes mellitus, arthritis, urinary incontinence and depression. The observation that the BMI value associated with the lowest relative mortality is slightly higher in older than in younger adults has often been misinterpreted that obesity is not as harmful in the elderly. BMI may be a less appropriate index in the elderly. All the medical consequences of obesity are multi-factorial but all are alleviated by modest, achievable weight loss (5-10 kg) with an evidence-based maintenance strategy. Since sarcopenic obesity is common in the elderly, a combination of exercise and modest calorie restriction appears to be the optimal method of reducing fat mass and preserving muscle mass. Reduction in polypharmacy is a valuable target for weight management. Age is not an obstacle to weight management interventions using moderate calorie restriction and exercise, and the currently licensed drug orlistat appears to have no age-related hazards. Overall balance of clinical outcomes has not been evaluated. In older people the risks from bariatric surgery outweigh benefits. Obesity, and specifically sarcopenic obesity, should also be prevented not only from younger age, but also during major life transitions including retirement, to improve better health outcomes and quality of life in later years, with a focus on those in 'obese families', where the main increases in obesity are located. Randomized controlled trials to determine health benefits and risks from long-term weight management in obese elderly are necessary.

Influência da circunferência abdominal sobre o desempenho funcional de idosas

O objetivo do estudo foi comparar o desempenho funcional de idosas segundo a medida de suas circunfêrencias abdominais (CA). Foram avaliadas 48 idosas, divididas nos grupos 1, com CA>88 cm, e grupo 2, de CA<88 cm. A funcionalidade foi avaliada pelo teste de caminhada de seis minutos (TC6') e pelo teste de desempenho físico modificado (TDFM), não-dependente de condicionamento cardiovascular. O grupo 1, cujos valores de peso e índice de massa corporal foram estatisticamente superiores (p<0,05) aos do grupo 2, percorreu distância média menor, quando comparado ao grupo 2 (p<0,05), e obteve escores médios inferiores no TDFM (p<0,05). Os dados mostram que mulheres idosas com circunferência abdominal superior a 88 cm tiveram pior desempenho nos testes funcionais, sugerindo que a obesidade abdominal pode contribuir para o declínio funcional precoce e conseqüente incapacidade nessa população.

The association between the ratio of visceral fat to thigh muscle area and metabolic syndrome: the Korean Sarcopenic Obesity Study (KSOS)

OBJECTIVE

A relationship between visceral fat accumulation and metabolic syndrome (MetS) has been established. However, the effect of a relative increase in visceral fat and a decrease in muscle mass on metabolic disorders has not been investigated. The aim of the present study was to examine the association between the ratio of visceral fat to thigh muscle area (VMR) and MetS in Korean adults. STUDY SUBJECT/MEASUREMENTS: A total of 264 age-and gender-matched subjects recruited from the Korean Sarcopenic Obesity Study (KSOS), an ongoing prospective observational cohort study, were categorized into four groups based on their body mass index (BMI) and VMR. We measured visceral fat area and thigh muscle area using computed tomography.

RESULTS

Subjects with MetS showed a significantly higher VMR than those without MetS. In both obese and nonobese groups, the subjects with a higher VMR had a higher prevalence of MetS than those in the lower VMR groups. VMR was significantly related to components of the metabolic syndrome, especially in women, and was positively correlated with a number of MetS components in both men and women. In multiple logistic regression analysis, the odds ratio for MetS was 6·72 (highest vs lowest quartile, 95% confidence interval, 1·60-28·14) after an adjustment of potential confounders, including BMI and waist-to-hip ratio.

CONCLUSION

VMR is significantly increased in subjects with MetS and independently associated with MetS. These results suggest that the VMR may be a potential indicator for MetS risk in Korean adults.

Models of accelerated sarcopenia: critical pieces for solving the puzzle of age-related muscle atrophy

Sarcopenia, the age-related loss of skeletal muscle mass, is a significant public health concern that continues to grow in relevance as the population ages. Certain conditions have the strong potential to coincide with sarcopenia to accelerate the progression of muscle atrophy in older adults. Among these conditions are co-morbid diseases common to older individuals such as cancer, kidney disease, diabetes, and peripheral artery disease. Furthermore, behaviors such as poor nutrition and physical inactivity are well-known to contribute to sarcopenia development. However, we argue that these behaviors are not inherent to the development of sarcopenia but rather accelerate its progression. In the present review, we discuss how these factors affect systemic and cellular mechanisms that contribute to skeletal muscle atrophy. In addition, we describe gaps in the literature concerning the role of these factors in accelerating sarcopenia progression. Elucidating biochemical pathways related to accelerated muscle atrophy may allow for improved discovery of therapeutic treatments related to sarcopenia.

Composição corporal de idosas diabéticas tipo 2: antropometria vs absorcimetria de raios-X de dupla energia

Objetivo Comparar a antropometria ao exame de Raios-x de dupla varredura para estimativa da composição corporal de idosas diabéticas tipo 2. Métodos A composição corporal de 51 voluntárias de 60 a 70 anos de idade e índice de massa corporal de 19 a 43kg/m² foi avaliada pelas medidas antropométricas das dobras cutâneas do tríceps, suprailíaca e coxa e associadas ao exame de Raios-x de dupla varredura, considerado o padrão ouro. Os intervalos de concordância de Bland e Altman foram os valores do desvio-padrão do coeficiente de variação do exame de Raios-x de dupla varredura e os valores da antropometria deviam estar nessa faixa. Foram comparadas as médias (teste t de Student) e feita a correlação de Pearson. Resultados Os intervalos de concordância foram os seguintes: peso (kg) Média (M)=0,3, Desvio-Padrão (DP)=0,1, massa corporal magra (kg) M=3,0, DP=1,9, massa corporal gorda (kg) M=5,0, DP=3,1, percentual de gordura corporal (%GC) M=5,0, DP=3,1. As médias entre os métodos eram iguais e estavam dentro do intervalo de concordância; em média, a antropometria superestimava a massa corporal magra em 2,31kg, e subestimava a massa corporal gorda e o percentual de gordura corporal em -0,93 kg e -2,7% respectivamente; a correlação entre as estimativas eram significativas (P, r=0,99; MCM, r=0,79; MCG, r=0,93; %GC, r=0,72; p<0,0001). Conclusão Os resultados da antropometria e do exame de Raios-x de dupla varredura foram consistentes. Embora tivesse parte dos resultados da massa corporal gorda e do percentual de gordura corporal fora do intervalo de concordância, os outros resultados foram correspondentes, sugerindo o uso da antropometria para avaliação da composição corporal nessa população.