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Jhe GB, Egbert A, Ievers-Landis CE, Chaves E, Genuario K, Santos M, Burton ET. GLP-1 Receptor Agonists for Treatment of Pediatric Obesity: Behavioral Health Considerations. Child Obes 2025. [PMID: 40306953 DOI: 10.1089/chi.2024.0418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2025]
Abstract
Background: Despite the rapid increase in glucagon-like peptide-1 receptor agonist (GLP-1) use for management of weight among adolescents (ages 12-18 years), there is limited guidance on associated behavioral health considerations. Adolescents on GLP-1 therapy represent a potentially vulnerable population at risk of experiencing medical and psychosocial effects of obesity and comorbidities, as well as side effects and behavioral implications of the medications. Method: This perspective discusses behavioral and psychosocial considerations for adolescents seeking GLP-1s. The limited and developing literature on the use of GLP-1s for pediatric obesity treatment was reviewed to evaluate key aspects of psychosocial functioning and health behavior engagement and to stimulate discussion, research, clinical innovation, and advocacy to support best practices for youth seeking GLP-1s to address weight concerns. Results: There is currently sparse research on the effects of GLP-1s on adolescents' psychosocial functioning. In the context of clinical practice, it may be important to assess for symptoms of eating disorders/disordered eating behaviors, mood instability, and general psychosocial functioning as well as quality of life, social support, health behaviors, and readiness to change prior to the initiation of and throughout the course of GLP-1 treatment. Conclusions: This perspective serves as a call to action for research and clinical innovation to address the psychosocial effects of GLP-1s on adolescents. Screening, monitoring, and future research will be key to ensuring safe and effective use of GLP-1 therapy as well as optimal psychosocial outcomes for youth utilizing GLP-1 medications for obesity treatment.
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Affiliation(s)
- Grace B Jhe
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychology, Harvard Medical School, Boston, MA, USA
| | - Amy Egbert
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Carolyn E Ievers-Landis
- Division of Developmental/Behavioral Pediatrics & Psychology, Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Eileen Chaves
- Division of Neuropsychology and Pediatric Psychology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Kimberly Genuario
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Melissa Santos
- Division of Pediatric Psychology, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - E Thomaseo Burton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Vanzella LM, Lawand R, Shuaib M, Oh P, Corbett D, Marzolini S. Validity of Bioelectric Impedance in Relation to Dual-Energy X-Ray Absorptiometry for Measuring Baseline and Change in Body Composition After an Exercise Program in Stroke. J Strength Cond Res 2022; 36:3273-3279. [DOI: 10.1519/jsc.0000000000004287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cichosz SL, Rasmussen NH, Vestergaard P, Hejlesen O. Precise Prediction of Total Body Lean and Fat Mass From Anthropometric and Demographic Data: Development and Validation of Neural Network Models. J Diabetes Sci Technol 2021; 15:1337-1343. [PMID: 33190515 PMCID: PMC8655297 DOI: 10.1177/1932296820971348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Estimating body composition is relevant in diabetes disease management, such as drug administration and risk assessment of morbidity/mortality. It is unclear how machine learning algorithms could improve easily obtainable body muscle and fat estimates. The objective was to develop and validate machine learning algorithms (neural networks) for precise prediction of body composition based on anthropometric and demographic data. METHODS Cross-sectional cohort study of 18 430 adults and children from the US population. Participants were examined with whole-body dual X-ray absorptiometry (DXA) scans, anthropometric assessment, and answered a demographic questionnaire. The primary outcomes were predicted total lean body mass (predLBM), total body fat mass (predFM), and trunk fat mass (predTFM) compared with reference values from DXA scans. RESULTS Participants were randomly partitioned into 70% training (12 901) data and 30% validation (5529) data. The prediction model for predLBM compared with lean body mass measured by DXA (DXALBM) had a Pearson's correlation coefficient of R = 0.99 with a standard error of estimate (SEE) = 1.88 kg (P < .001). The prediction model for predFM compared with fat mass measured by DXA (DXAFM) had a Pearson's coefficient of R = 0.98 with a SEE = 1.91 kg (P < .001). The prediction model for predTFM compared with DXA measured trunk fat mass (DXAFM) had a Pearson's coefficient of R = 0.98 with a SEE = 1.13 kg (P < .001). CONCLUSIONS In this study, neural network models based on anthropometric and demographic data could precisely predict body muscle and fat composition. Precise body estimations are relevant in a broad range of clinical diabetes applications, prevention, and epidemiological research.
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Affiliation(s)
- Simon Lebech Cichosz
- Department of Health Science and
Technology, Aalborg University, Denmark
- Simon Lebech Cichosz PhD, Department of
Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D2,
Aalborg, DK-9220, Denmark.
| | | | - Peter Vestergaard
- Steno Diabetes Center North Denmark,
Aalborg University Hospital, Denmark
| | - Ole Hejlesen
- Department of Health Science and
Technology, Aalborg University, Denmark
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Kerchberger AM, Sheth AN, Angert CD, Mehta CC, Summers NA, Ofotokun I, Gustafson D, Weiser SD, Sharma A, Adimora AA, French AL, Augenbraun M, Cocohoba J, Kassaye S, Bolivar H, Govindarajulu U, Konkle-Parker D, Golub ET, Lahiri CD. Weight Gain Associated With Integrase Stand Transfer Inhibitor Use in Women. Clin Infect Dis 2020; 71:593-600. [PMID: 31504324 PMCID: PMC7384314 DOI: 10.1093/cid/ciz853] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/26/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Integrase strand-transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for human immunodeficiency virus (HIV) management. Although studies have suggested associations between INSTIs and weight gain, women living with HIV (WLHIV) have been underrepresented in research. We evaluated the effect of switching or adding INSTIs among WLHIV. METHODS Women enrolled in the Women's Interagency HIV Study (WIHS) from 2006-2017 who switched to or added an INSTI to ART (SWAD group) were compared to women on non-INSTI ART (STAY group). Body weight, body mass index (BMI), percentage body fat (PBF), and waist, hip, arm, and thigh circumferences were measured 6-12 months before and 6-18 months after the INSTI switch/add in SWAD participants, with comparable measurement time points in STAY participants. Linear regression models compared changes over time by SWAD/STAY group, adjusted for age, race, WIHS site, education, income, smoking status, and baseline ART regimen. RESULTS We followed 1118 women (234 SWAD and 884 STAY) for a mean of 2.0 years (+/- 0.1 standard deviation [SD]; mean age 48.8 years, SD +/- 8.8); 61% were Black. On average, compared to the STAY group, the SWAD group experienced mean greater increases of 2.1 kg in body weight, 0.8 kg/m2 in BMI, 1.4% in PBF, and 2.0, 1.9, 0.6, and 1.0 cm in waist, hip, arm, and thigh circumference, respectively (all P values < .05). No differences in magnitudes of these changes were observed by INSTI type. CONCLUSIONS In WLHIV, a switch to INSTI was associated with significant increases in body weight, body circumferences, and fat percentages, compared to non-INSTI ART. The metabolic and other health effects of these changes deserve further investigation.
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Affiliation(s)
| | - Anandi N Sheth
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christine D Angert
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, Georgia, USA
| | - C Christina Mehta
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, Georgia, USA
| | - Nathan A Summers
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ighovwerha Ofotokun
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Deborah Gustafson
- Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Sheri D Weiser
- Department of Medicine, Division of Human Immunodeficiency Virus, Infectious Diseases, and Global Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Adaora A Adimora
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Audrey L French
- Department of Medicine, Division of Infectious Diseases, Stroger Hospital of Cook County, Chicago, Illinois, USA
| | - Michael Augenbraun
- Department of Medicine, Division of Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Jennifer Cocohoba
- Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, California, USA
| | - Seble Kassaye
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA
| | - Hector Bolivar
- Department of Medicine, Division of Infectious Diseases, University of Miami Health System, Miami, Florida, USA
| | - Usha Govindarajulu
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Deborah Konkle-Parker
- Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center Jackson, Mississippi, USA
| | - Elizabeth T Golub
- Division of General Epidemiology and Methodology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cecile D Lahiri
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
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Woolcott OO, Bergman RN. Relative Fat Mass as an estimator of whole-body fat percentage among children and adolescents: A cross-sectional study using NHANES. Sci Rep 2019; 9:15279. [PMID: 31649287 PMCID: PMC6813362 DOI: 10.1038/s41598-019-51701-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 10/07/2019] [Indexed: 02/07/2023] Open
Abstract
We evaluated the ability of the Relative Fat Mass (RFM) to estimate whole-body fat percentage among children and adolescents who participated in the National Health and Nutrition Examination Survey from 1999 through 2006 (n = 10,390). The RFM equation for adults (64 − (20 × height/waist circumference) + (12 × sex)) may be used for adolescents 15 to 19 years of age. For children and adolescents 8 to 14 years of age, we suggest a modified RFM equation, named as the RFMp (RFM pediatric): 74 − (22 × height/waist circumference) + (5 × sex). In both equations, sex equals 0 for boys and 1 for girls. RFMp was more accurate than BMI to estimate whole-body fat percentage (measured by dual energy X-ray absorptiometry, DXA) among girls (percentage of estimates that were <20% of measured body fat percentage, 88.2% vs. 85.7%; P = 0.027) and boys 8 to 14 years of age (83.4% vs. 71.0%; P < 0.001). RFM was more accurate than BMI among boys 15 to 19 years of age (82.3% vs. 73.9%; P < 0.001) but slightly less accurate among girls (89.0% vs. 92.6%; P = 0.002). Compared with BMI-for-age percentiles, RFMp had lower misclassification error of overweight or obesity (defined as a DXA-measured body fat percentage at the 85th percentile or higher) among boys 8 to 14 years of age (6.5% vs. 7.9%; P = 0.018) but not girls (RFMp: 8.2%; BMI-for-age: 7.9%; P = 0.681). Misclassification error of overweight or obesity was similar for RFM and BMI-for-age percentiles among girls (RFM: 8.0%; BMI-for-age: 6.6%; P = 0.076) and boys 15 to 19 years of age (RFM: 6.9%; BMI-for-age: 7.8%; P = 0.11). RFMp for children and adolescents 8 to 14 years of age and RFM for adolescents 15 to 19 years of age were useful to estimate whole-body fat percentage and diagnose body fat-defined overweight or obesity.
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Affiliation(s)
- Orison O Woolcott
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
| | - Richard N Bergman
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
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Woolcott OO, Bergman RN. Relative fat mass (RFM) as a new estimator of whole-body fat percentage ─ A cross-sectional study in American adult individuals. Sci Rep 2018; 8:10980. [PMID: 30030479 PMCID: PMC6054651 DOI: 10.1038/s41598-018-29362-1] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/09/2018] [Indexed: 02/06/2023] Open
Abstract
High whole-body fat percentage is independently associated with increased mortality. We aimed to identify a simple anthropometric linear equation that is more accurate than the body mass index (BMI) to estimate whole-body fat percentage among adult individuals. National Health and Nutrition Examination Survey (NHANES) 1999–2004 data (n = 12,581) were used for model development and NHANES 2005–2006 data (n = 3,456) were used for model validation. From the 365 anthropometric indices generated, the final selected equation was as follows: 64 − (20 × height/waist circumference) + (12 × sex), named as the relative fat mass (RFM); sex = 0 for men and 1 for women. In the validation dataset, compared with BMI, RFM better predicted whole-body fat percentage, measured by dual energy X-ray absorptiometry (DXA), among women and men. RFM showed better accuracy than the BMI and had fewer false negative cases of body fat-defined obesity among women and men. RFM reduced total obesity misclassification among all women and all men and, overall, among Mexican-Americans, European-Americans and African-Americans. In the population studied, the suggested RFM was more accurate than BMI to estimate whole-body fat percentage among women and men and improved body fat-defined obesity misclassification among American adult individuals of Mexican, European or African ethnicity.
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Affiliation(s)
- Orison O Woolcott
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
| | - Richard N Bergman
- Sports Spectacular Diabetes and Obesity Wellness and Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
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Pekmezi D, Ainsworth C, Holly T, Williams V, Benitez T, Wang K, Rogers LQ, Marcus B, Demark-Wahnefried W. Rationale, design, and baseline findings from a pilot randomized trial of an IVR-Supported physical activity intervention for cancer prevention in the Deep South: the DIAL study. Contemp Clin Trials Commun 2018; 8:218-226. [PMID: 29503878 PMCID: PMC5830176 DOI: 10.1016/j.conctc.2017.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Telephone-delivered interventions do not require frequent clinic visits, literacy, or costly technology and thus may represent promising approaches to promoting physical activity in the Deep South, a largely rural U.S. region, with generally lower physical activity, income, and education levels. Building on past Interactive Voice Response (IVR) system-based HIV studies and extensive formative research (11 focus groups on physical activity intervention needs/preferences in the Deep South), the resulting IVR-supported physical activity intervention is now being tested in a randomized controlled trial with a waitlist control. The sample (n=63) includes mostly obese (Mean BMI=30.1) adults (Mean age=43 years) in Birmingham, AL. Both genders (55.6% male) and African Americans (58.7%) are well-represented. Most participants reported at least some college (92%), full time employment (63.5%), and household income <$50,000 per year (61.9%). Baseline physical activity (Mean=39.6 minutes/week, SD=56.4), self-efficacy, self-regulation, and social support were low. However, high physical activity enjoyment and outcome expectations bode well. Self-report physical activity was associated with physical activity enjoyment (r=.36) and social support (friends r=.25, p's<.05) at baseline. Consequently, these may be important variables to emphasize in our program. Depression and anxiety were negatively correlated with some early indicators of behavior change (e.g., physical activity self-regulation; r's =-.43 and -.46, respectively, p's<.01) and thus may require additional attention. Such technology-supported strategies have great potential to reach underserved populations and address physical activity-related health disparities in this region.
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Affiliation(s)
- Dori Pekmezi
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, US 35294
| | - Cole Ainsworth
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, US 35294
| | - Taylor Holly
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, US 35294
| | - Victoria Williams
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, US 35294
| | - Tanya Benitez
- University of California, San Diego, 9500 Gilman Drive, 0628, La Jolla, CA. 92093-0628
| | - Kaiying Wang
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, US 35294
| | - Laura Q Rogers
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, US 35294
| | - Bess Marcus
- Brown University, 121 S Main St, Providence, RI 02903
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Ramírez-Vélez R, Tordecilla-Sanders A, Correa-Bautista JE, González-Ruíz K, González-Jiménez E, Triana-Reina HR, García-Hermoso A, Schmidt-RioValle J. Validation of multi-frequency bioelectrical impedance analysis versus dual-energy X-ray absorptiometry to measure body fat percentage in overweight/obese Colombian adults. Am J Hum Biol 2017; 30. [PMID: 28987018 DOI: 10.1002/ajhb.23071] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/20/2017] [Accepted: 09/24/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To verify the validity of multi-frequency bioelectrical impedance analysis (mBCA) for predicting body fat percentage (BF%) in overweight/obese adults using dual-energy X-ray absorptiometry (DXA) as the reference method. METHODS Forty-eight adults participated (54% women, mean age = 41.0 ± 7.3 years old). The Pearson's correlation coefficient was used to evaluate the correlation between BIA and BF% assessed by DXA. The concordance between BF% measured by both methods was obtained with Lin's concordance correlation coefficient and Bland-Altman difference plots. RESULTS Measures of BF% were estimated as 39.0 (SD = 6.1) and 38.3 (SD = 6.5) using DXA and mBCA, respectively. The Pearson's correlation coefficient reflected a strong correlation (r =.921, P = .001). The paired t-test showed a significant mean difference between these methods for obese men BF% of -0.6 [(SD 1.95; 95% CI = -4.0 to 3.0), P =.037]. Overall, the bias of the mBCA was -0.6 [(SD 2.2; 95% CI = -5.0 to 3.7), P =.041], which indicated that the mBCA method significantly underestimated BF% in comparison to the reference method. Finally, in both genders, Lin's concordance correlation coefficient showed a strong agreement. More specifically the DXA value was ρc = 0.943 (95% CI = 0.775 to 0.950) and the mBCA value was ρc = 0.948 (95% CI = 0.778 to 0.978). CONCLUSIONS Our analysis showed a strong agreement between the two methods as reflected in the range of BF%. These results show that mBCA and DXA are comparable methods for measuring body composition with higher body fat percentages. However, due to broad limits of agreement, we can only recommend mBCA for groups of populations.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, 111221, Colombia
| | - Alejandra Tordecilla-Sanders
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, 111221, Colombia
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física «CEMA», Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, DC, 111221, Colombia
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoria de Investigaciones, Universidad Manuela Beltrán, Bogota, DC 110231, Colombia
| | - Emilio González-Jiménez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, University of Granada, Avda. De la Ilustración, 60, 18016 Granada, Spain.,Grupo CTS-436, Adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), University of Granada, 18071 Granada, Spain
| | - Hector Reynaldo Triana-Reina
- Grupo GICAEDS, Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogota, DC 110311, Colombia
| | - Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago 7500618, Chile
| | - Jacqueline Schmidt-RioValle
- Departamento de Enfermería, Facultad de Ciencias de la Salud, University of Granada, Avda. De la Ilustración, 60, 18016 Granada, Spain.,Grupo CTS-436, Adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), University of Granada, 18071 Granada, Spain
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9
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Pekmezi D, Ainsworth C, Joseph R, Bray MS, Kvale E, Isaac S, Desmond R, Meneses K, Marcus B, Demark-Wahnefried W. Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a home-based, individually-tailored physical activity print intervention for African American women in the Deep South. Contemp Clin Trials 2016; 47:340-8. [PMID: 26944022 PMCID: PMC4821007 DOI: 10.1016/j.cct.2016.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/22/2016] [Accepted: 02/28/2016] [Indexed: 10/22/2022]
Abstract
African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD=4.7), a BMI of 32.1 kg/m(2) (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 min/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health.
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Affiliation(s)
- Dori Pekmezi
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States.
| | - Cole Ainsworth
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States
| | - Rodney Joseph
- Arizona State University, 500 N. 3rd Street, Phoenix, AZ 85004, United States
| | - Molly S Bray
- University of Texas at Austin, 103 W. 24th Street, Austin, TX 78712, United States
| | - Elizabeth Kvale
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States
| | - Shiney Isaac
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States
| | - Renee Desmond
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States
| | - Karen Meneses
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States
| | - Bess Marcus
- University of California, San Diego, 9500 Gilman Drive, 0628, La Jolla, CA 92093-0628, United States
| | - Wendy Demark-Wahnefried
- University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL US 35294, United States
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10
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A comparison study of portable foot-to-foot bioelectrical impedance scale to measure body fat percentage in Asian adults and children. BIOMED RESEARCH INTERNATIONAL 2014; 2014:475659. [PMID: 25258711 PMCID: PMC4167454 DOI: 10.1155/2014/475659] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 08/06/2014] [Accepted: 08/08/2014] [Indexed: 11/19/2022]
Abstract
Objective. To compare the measurements of body fat percentage (BF%) using the foot-to-foot bioelectrical impedance analysis (FTF-BIA) with the direct segmental multifrequency BIA (DSM-BIA). Methods. There were 36 men and 52 women (37.1 ± 14.3 years) with 57% Malays, 30% Chinese, and 13% Indian. For children, there were 45 boys and 26 girls (11.5 ± 2.5 years) with 52% Malay, 15% Chinese, and 33% Indian. Results. Mean height for men was 168.4 cm, 11 cm taller than women. Men were 10 kg heavier than women at 70 kg. BF% in women was 32% and 33% whereas BF% in men was 23% and 25% when measured using FTF-BIA and DSM-BIA, respectively. In children, BF% measured with FTF-BIA and DSM-BIA was 49% and 46%, respectively. The correlations were significant for men (r = 0.92, SEE = 2.80), women (r = 0.91, SEE = 3.31), boys (r = 0.95, SEE = 5.44), and girls (r = 0.96, SEE = 5.27). The BF% in underweight/normal (r = 0.92, SEE = 2.47) and that in overweight/obese adults (r = 0.89, SEE = 3.61) were strongly correlated. The correlations were significant in normal/underweight (r = 0.94, SEE = 3.78) and obese/overweight children (r = 0.83, SEE = 6.49). All ethnic groups showed significant correlation with BF%. Malay adults (r = 0.92, SEE = 3.27) and children (r = 0.94, SEE = 0.88) showed significant mean differences in BF%. Conclusion. The FTF-BIA showed higher accuracy for all normal/underweight and Chinese group with acceptable overestimation in children and underestimation in adults. Caution should be taken when interpreting BF% depending on gender, BMI, and ethnicity.
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Li YC, Li CI, Lin WY, Liu CS, Hsu HS, Lee CC, Chen FN, Li TC, Lin CC. Percentage of body fat assessment using bioelectrical impedance analysis and dual-energy X-ray absorptiometry in a weight loss program for obese or overweight Chinese adults. PLoS One 2013; 8:e58272. [PMID: 23573189 PMCID: PMC3613423 DOI: 10.1371/journal.pone.0058272] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 02/05/2013] [Indexed: 11/18/2022] Open
Abstract
The current study aimed to compare the estimates of body fat percentage (%BF) by performing bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) in a sample of obese or overweight Chinese adults who participated in a weight-loss randomized control trial stratified by gender to determine whether or not BIA is a valid measurement tool. Among 189 adults [73 males, 116 females; age = 41 to 74 years; mean body mass index (BMI) = 27.3 kg/m(2)], assessments of %BF at the baseline and six months from the baseline were conducted by performing BIA and DXA. Bland-Altman analyses and multiple regression analyses were used to assess the relationships between %BFBIA and %BFDXA. Compared with DXA, BIA underestimated %BF [in males: 4.6, -2.4 to 11.7 (mean biases, 95% limit of agreement) at the baseline, 1.4, -7.4 to 10.2 at the endpoint, and 3.2, -4.8 to 11.3 in changes; in females: 5.1, -2.4 to 12.7; 2.2, -6.1 to 10.4; and 3.0, -4.8 to 10.7, respectively]. For males and females, %BFDXA proved to be a significant predictor of the difference between DXA and BIA at the baseline, the endpoint, and in changes when BMI and age were considered (in males: p<0.01 and R (2) = 23.1%, 24.1%, 20.7%, respectively; for females: p<0.001 and R (2) = 40.4%, 48.8%, 25.4%, respectively). The current study suggests that BIA provides a relatively accurate prediction of %BF in individuals with normal weight, overweight, or obesity after the end of weight-loss program, but less accurate prediction of %BF in obese individuals at baseline or weight change during the weight-loss intervention program.
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Affiliation(s)
- Yi-Chun Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hua-Shui Hsu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chun Lee
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Fei-Na Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
- Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Lopez Y, O'Connor DP, Ledoux TA, Lee RE. Analysis of body composition methods in a community sample of African American women. Women Health 2011; 51:709-23. [PMID: 22185287 PMCID: PMC4552332 DOI: 10.1080/03630242.2011.623222] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The purposes of the authors in this study were: (1) to determine whether published body mass index and bioelectrical impedance analysis equations agreed with dual energy x-ray absorptiometry body fat percentage measures and (2) to estimate new body mass index and bioelectrical impedance analysis equations in a sample of African American women. Linear regression was used to determine how well 10 body mass index and bioelectrical impedance analysis equations reflected dual energy x-ray absorptiometry body fat percentage measures in this sample of 74 African American women; new body mass index and bioelectrical impedance analysis equations were created using dual energy x-ray absorptiometry body fat percentage measures as the dependent variable. Participants (M = 47.6 years, SD = 7.7) were classified as overweight or obese (BMI Mean BF% = 35.4, SD = 8.2; BIA Mean BF% = 43.3, SD = 6.9; DXA Mean BF% = 41.5, SD = 6.1). R(2) and SEE values indicated that all body mass index and bioelectrical impedance analysis equations were a poorer fit with less precision, and the new bioelectrical impedance analysis equation discussed in this article was a better fit and was more precise. All 10 body mass index and bioelectrical analysis equations inaccurately estimated dual energy x-ray absorptiometry body fat percentage measures in our sample. The new body mass index equation discussed in this article had less estimation bias and more precision than the published body mass index equations and may be a more accurate equation in African American women.
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Affiliation(s)
- Ygnacio Lopez
- Texas Obesity Research Center, Department of Health and Human Performance, University of Houston, Houston, Texas, USA
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Lloret Linares C, Ciangura C, Bouillot JL, Coupaye M, Declèves X, Poitou C, Basdevant A, Oppert JM. Validity of Leg-to-Leg Bioelectrical Impedance Analysis to Estimate Body Fat in Obesity. Obes Surg 2010; 21:917-23. [DOI: 10.1007/s11695-010-0296-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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14
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Nunes RR, Clemente ELDS, Pandini JA, Cobas RA, Dias VM, Sperandei S, Gomes MDB. [Reliability of the classification of nutritional status obtained through the BMI and three different methods of body fat percentage in patients with type 1 diabetes mellitus]. ACTA ACUST UNITED AC 2010; 53:360-7. [PMID: 19578599 DOI: 10.1590/s0004-27302009000300011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Accepted: 11/29/2008] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To assess the reliability of classification of nutritional status (NS) obtained through the body mass index (BMI) and three different methods of body composition (BC) in individuals type 1 diabetics (T1D) and non-diabetic subjects. METHODS 84 patients with T1D and 37 controls were evaluated. Anthropometric data was collected to calculate BMI and assessment of BC was performed through the methods of skinfold thickness (SF), bipolar (BI) and tetrapolar (TT) bioelectrical impedance. The agreement between the scores of each method was determined by Kappa (K) coefficient. RESULTS Considering all the patients, only 48 (57.1%) presented classification of BMI that agreed with the SF method, 58 (69%) with the BI and 45 (53.5%) with the TT. The K results for individuals with T1D was DC = 0.261, BI = 0.320 and TT = 0.174. The controls had higher values (DC = 0.605, BI = 0.360 and TT = 0.400). However, all values were considered low. CONCLUSIONS The method of BMI showed little sensitivity to BC changes in patients with T1D. Appropriated methods for the assessment of BC should be used to classify the NS of this population.
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Affiliation(s)
- Raquel Ramalho Nunes
- Departamento de Medicina, Disciplina de Diabetes e Metabologia, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro(Uerj), Rio de Janeiro, RJ, Brasil.
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15
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Fakhrawi DH, Beeson L, Libanati C, Feleke D, Kim H, Quansah A, Darnell A, Lammi-Keefe CJ, Cordero-MacIntyre Z. Comparison of body composition by bioelectrical impedance and dual-energy x-ray absorptiometry in overweight/obese postmenopausal women. J Clin Densitom 2009; 12:238-44. [PMID: 19285894 DOI: 10.1016/j.jocd.2009.01.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 01/19/2009] [Accepted: 01/20/2009] [Indexed: 01/30/2023]
Abstract
The purpose of this study was to compare the Rudolph J. Liedtke (RJL) Sciences Quantum II system bioelectrical impedance analyzer (BIA) with the fan beam Hologic dual-energy X-ray absorptiometry (DXA, software V8.26a) for assessing body composition in postmenopausal obese women. Thirty-three postmenopausal overweight/obese females (mean age: 53.9+/-6.0 yr; mean weight: 91.3+/-17.5 kg; and mean body mass index [BMI]: 33.1+/-5.7 kg/m2) were evaluated for comparison of body weight (BW), fat mass (FM), percent FM (%FM), and fat free mass (FFM). The comparison was assessed by RJL Quantum 2 Cyprus 2.6 (Clinton Township, MI) BIA vs fan beam DXA Hologic QDR-4500A software V8.26a (ODR 4500 Hologic, Inc., Waltham, Mass). RJL-BIA and DXA measurements were performed at the same time. BW was measured using a balance scale (Detecto; Web City, MO) and these results were used for the RJL-BIA analysis. Balance weight was compared with DXA BW. Correlations between DXA and RJL-BIA for BW, FM, %FM, and FFM were 0.998, 0.980, 0.782, and 0.926 (p<0.01), respectively. Bland-Altman plots demonstrated general agreement between methods for BW, FM, %FM, and FFM. However, for the latter 3 metrics of body composition, one unit change using BIA does not correspond to one unit change using DXA, as there were systematic disagreements at either end of the range of values. But RJL-BIA could be a valid method for assessing body composition of overweight/obese postmenopausal women once appropriate validated regression equations have been developed.
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Affiliation(s)
- Dina H Fakhrawi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
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Van Horn L, McCoin M, Kris-Etherton PM, Burke F, Carson JAS, Champagne CM, Karmally W, Sikand G. The evidence for dietary prevention and treatment of cardiovascular disease. ACTA ACUST UNITED AC 2008; 108:287-331. [PMID: 18237578 DOI: 10.1016/j.jada.2007.10.050] [Citation(s) in RCA: 171] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Indexed: 12/31/2022]
Abstract
During the past few decades numerous studies have reported the atherogenic potential of saturated fatty acids, trans-fatty acids, and cholesterol, and beneficial effects of fiber, phytostanols/phytosterols, n-3 fatty acids, a Mediterranean diet, and other plant-based approaches. The purpose of this article is to provide a comprehensive and systematic review of the evidence associated with key dietary factors and risk of cardiovascular disease-an umbrella term encompassing diseases that affect the heart and blood vessels, including coronary heart disease, coronary artery disease, dyslipidemia, and hypertension-in conjunction with the work of the American Dietetic Association Evidence Analysis Library review on diet and lipids, updated with new evidence from the past 2 years. The criteria used and results cited provide scientific rationale for food and nutrition professionals and other health professionals for counseling patients. Details of these searches are available within the American Dietetic Association Evidence Analysis Library online (http://adaevidencelibrary.com). Potential mechanisms and needs for future research are summarized for each relevant nutrient, food, or food component.
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Affiliation(s)
- Linda Van Horn
- Preventive Medicine, Northwestern University Freinberg School of Medicine, Chicago, IL 60611, USA.
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