Body composition and aging: a study by in vivo neutron activation analysis

Mapping pathways to neuronal atrophy in healthy, mid-aged adults: From chronic stress to systemic inflammation to neurodegeneration?

Growing evidence implicates systemic inflammation in the loss of structural brain integrity in natural ageing and disorder development. Chronic stress and glucocorticoid exposure can potentiate inflammatory processes and may also be linked to neuronal atrophy, particularly in the hippocampus and the human neocortex. To improve understanding of emerging maladaptive interactions between stress and inflammation, this study examined evidence for glucocorticoid- and inflammation-mediated neurodegeneration in healthy mid-aged adults. N = 169 healthy adults (mean age = 39.4, 64.5% female) were sampled from the general population in the context of the ReSource Project. Stress, inflammation and neuronal atrophy were quantified using physiological indices of chronic stress (hair cortisol (HCC) and cortisone (HEC) concentration), systemic inflammation (interleukin-6 (IL-6), high-sensitive C-reactive protein (hs-CRP)), the systemic inflammation index (SII), hippocampal volume (HCV) and cortical thickness (CT) in regions of interest. Structural equation models were used to examine evidence for pathways from stress and inflammation to neuronal atrophy. Model fit indices indicated good representation of stress, inflammation, and neurological data through the constructed models (CT model: robust RMSEA = 0.041, robust χ2 = 910.90; HCV model: robust RMSEA <0.001, robust χ2 = 40.95). Among inflammatory indices, only the SII was positively associated with hair cortisol as one indicator of chronic stress (β = 0.18, p < 0.05). Direct and indirect pathways from chronic stress and systemic inflammation to cortical thickness or hippocampal volume were non-significant. In exploratory analysis, the SII was inversely related to mean cortical thickness. Our results emphasize the importance of considering the multidimensionality of systemic inflammation and chronic stress, with various indicators that may represent different aspects of the systemic reaction. We conclude that inflammation and glucocorticoid-mediated neurodegeneration indicated by IL-6 and hs-CRP and HCC and HEC may only emerge during advanced ageing and disorder processes, still the SII could be a promising candidate for detecting associations between inflammation and neurodegeneration in younger and healthy samples. Future work should examine these pathways in prospective longitudinal designs, for which the present investigation serves as a baseline.

Molecular and physical technologies for monitoring fluid and electrolyte imbalance: A focus on cancer population

Several clinical examinations have shown the essential impact of monitoring (de)hydration (fluid and electrolyte imbalance) in cancer patients. There are multiple risk factors associated with (de)hydration, including aging, excessive or lack of fluid consumption in sports, alcohol consumption, hot weather, diabetes insipidus, vomiting, diarrhea, cancer, radiation, chemotherapy, and use of diuretics. Fluid and electrolyte imbalance mainly involves alterations in the levels of sodium, potassium, calcium, and magnesium in extracellular fluids. Hyponatremia is a common condition among individuals with cancer (62% of cases), along with hypokalemia (40%), hypophosphatemia (32%), hypomagnesemia (17%), hypocalcemia (12%), and hypernatremia (1-5%). Lack of hydration and monitoring of hydration status can lead to severe complications, such as nausea/vomiting, diarrhea, fatigue, seizures, cell swelling or shrinking, kidney failure, shock, coma, and even death. This article aims to review the current (de)hydration (fluid and electrolyte imbalance) monitoring technologies focusing on cancer. First, we discuss the physiological and pathophysiological implications of fluid and electrolyte imbalance in cancer patients. Second, we explore the different molecular and physical monitoring methods used to measure fluid and electrolyte imbalance and the measurement challenges in diverse populations. Hydration status is assessed in various indices; plasma, sweat, tear, saliva, urine, body mass, interstitial fluid, and skin-integration techniques have been extensively investigated. No unified (de)hydration (fluid and electrolyte imbalance) monitoring technology exists for different populations (including sports, elderly, children, and cancer). Establishing novel methods and technologies to facilitate and unify measurements of hydration status represents an excellent opportunity to develop impactful new approaches for patient care.

Thermodynamic properties of microorganisms: determination and analysis of enthalpy, entropy, and Gibbs free energy of biomass, cells and colonies of 32 microorganism species

Thermodynamic analysis is an important part of chemical engineering. However, its application in biotechnology has been hampered by lack of data on thermodynamic properties of microorganism biomass. In this paper, a review was made of methods for estimation of thermodynamic properties of biomass, including standard enthalpy of combustion h_C⁰, enthalpy of formation h_f⁰, entropy s⁰, and Gibbs free energy of formation g_f⁰. These parameters were calculated on molar and mass specific basis for 32 microorganism species, including 14 bacteria, 7 yeast and 11 algae species. It was found that h_f⁰, s⁰, g_f⁰ are, respectively, similar for all the analyzed species, due to the fact that all living organisms have a common ancestor and thus a similar chemical composition. Furthermore, all the analyzed microorganisms have negative h_f⁰, originating from partial oxidation of all other elements by oxygen and nitrogen. A brief review was given of microorganism endogenous and growth metabolic rates. Finally, based on the determined thermodynamic properties, entropy of individual E. coli and Pseudomonas cells were determined and entropy of a Pseudomonas colony during its lifespan was calculated and analyzed. Three periods can be distinguished in the existence of a microorganism colony: (a) accumulation period when cell number, mass and entropy increase, (b) steady state period when they are approximately constant, and (c) decumulation period when they decrease.

From chemical analysis of the body...to metabolic insights provided by the new methodology

It is by no means an exaggeration to say that Dr Widdowson is one of the pioneers of body composition research and her studies in the 1940s and 1950s have laid the foundations of body composition science today. These have included both animal and human studies, although this paper will focus only on the latter. Together with Professor McCance and Christine Spray she was responsible for the analysis of three entire adult human cadavers and that of a 4-year-old child (Widdowson et al. 1951). Further work with Dr Dickerson explored the composition of specific tissues and organs of the body (Widdowson & Dickerson, 1964). These studies provide some of the best direct data on human body composition. Moreover the findings from this work form the basis of the indirect techniques which are used so widely today.

Total body carbon and oxygen masses: evaluation of dual-energy x-ray absorptiometry estimation by in vivo neutron activation analysis

Oxygen and carbon are the first and second abundant elements, respectively, in the human body by mass. Although many physiological and pathological processes are accompanied with alteration of total body oxygen (TBO) and carbon (TBC) masses, in vivo measurements of the two elements are limited. Up to now, almost all available information of TBC and TBO is based on in vivo neutron activation (IVNA) analysis which is very expensive and involves moderate radiation exposure. The aim of the present study was to develop and evaluate an alternative strategy for TBC and TBO estimation. Mechanistic models were derived for predicting TBC and TBO masses from dual-energy x-ray absorptiometry (DXA) and total body water (TBW). Twenty-eight adult subjects were studied. IVNA-measured TBC and TBO masses were used as the criterion. TBC masses predicted by DXA-alone and by DXA-TBW models were 20.8 ± 7.1 kg and 20.6 ± 6.8 kg, respectively, close to the IVNA-measured value (19.5 ± 6.3 kg). There were strong correlations (both with r > 0.95, P < 0.001) between the predicted and measured TBC masses. TBO masses predicted by DXA-alone and by DXA-TBW models were 46.0 ± 9.8 kg and 46.5 ± 9.9 kg, respectively, close to the IVNA-measured value (48.0 ± 10.4 kg). Correlations (both with r > 0.97, P < 0.001) were strong between the predicted and measured TBO masses. Bland-Altman analysis validated the applicability of DXA-based models to predict TBC and TBO masses. As both DXA and TBW dilutions are widely available, low-risk, low-cost techniques, the present study provides a safe and practical method for estimating elemental composition in vivo.

Lower-limb and whole-body tissue composition assessment in healthy active older women

AIM

The study evaluated, in active elderly women, the accuracy and bias of anthropometry and bioelectrical impedance analysis (BIA) for lower-limb and whole-body tissue composition measures using dual-energy X-ray absorptiometry (DXA) as the criterion method.

METHODS

Nineteen individuals (66.1 +/- 4.2 years) participated in the study. Whole-body fat mass (FM) and fat-free mass (FFM) were measured by anthropometry, BIA and DXA. Lower-limb volume (LLV) and lower-limb FFM (LLFFM) were assessed by anthropometry and DXA.

RESULTS

LLV and LLFFM were significantly overestimated by anthropometry vs. DXA (p < 0.05 and p < 0.001, respectively) but significant relationships were observed [coefficient of determination (R(2)) > 0.25, p < 0.05]. No significant difference was observed between FM(A) (where (A) stands for anthropometry) vs. FM(DXA) and FFM(A) vs. FFM(DXA) and significant relationships were observed [R(2) = 0.93, p < 0.001, coefficient of variation (CV) = 7.3%; and R(2) = 0.85, p < 0.001, CV = 4.4%, respectively]. No significant difference was observed between FM(BIA) and FM(DXA) and a significant relationship was observed (R(2) = 0.80, p < 0.001, CV = 11.6%). FFM was significantly underestimated by BIA vs. DXA (p < 0.01).

CONCLUSIONS

In active elderly women, (i) compared with DXA, anthropometry overestimates LLV and LLFFM; (ii) anthropometry can be an accurate method for assessing whole-body composition; and (iii) despite a non-significant bias for the FM measurement, the BIA tends to overestimate FM and underestimate FFM.

Monte Carlo simulation of neutron irradiation facility developed for accelerator based in vivo neutron activation measurements in human hand bones

The neutron irradiation facility developed at the McMaster University 3 MV Van de Graaff accelerator was employed to assess in vivo elemental content of aluminum and manganese in human hands. These measurements were carried out to monitor the long-term exposure of these potentially toxic trace elements through hand bone levels. The dose equivalent delivered to a patient during irradiation procedure is the limiting factor for IVNAA measurements. This article describes a method to estimate the average radiation dose equivalent delivered to the patient's hand during irradiation. The computational method described in this work augments the dose measurements carried out earlier [Arnold et al., 2002. Med. Phys. 29(11), 2718-2724]. This method employs the Monte Carlo simulation of hand irradiation facility using MCNP4B. Based on the estimated dose equivalents received by the patient hand, the proposed irradiation procedure for the IVNAA measurement of manganese in human hands [Arnold et al., 2002. Med. Phys. 29(11), 2718-2724] with normal (1 ppm) and elevated manganese content can be carried out with a reasonably low dose of 31 mSv to the hand. Sixty-three percent of the total dose equivalent is delivered by non-useful fast group (> 10 keV); the filtration of this neutron group from the beam will further decrease the dose equivalent to the patient's hand.

Evaluation of body composition: practical guidelines

The measurement of body composition in the truest sense allows for the estimation of body tissues, organs, and their distributions in living persons without inflicting harm. It is important to recognize that there is no single measurement method that is error-free. Furthermore, bias can be introduced if a measurement method makes assumptions related to body composition proportions and characteristics that are inaccurate across different populations. Some methodologic concerns include hydration of fat-free body mass changes with age and differences across ethnic groups [73]; the density of fat-free body mass changes with age and differences between men and women [74, 75]; total body potassium decreases with age [73] and fatness [76] and differences between African Americans and Caucasians [77]; the mass of skeletal muscle differences across race group [63]; and VAT differences across sex [78] and race [67, 79, 80] groups, independent of total adiposity. These between-group differences influence the absolute accuracy of methods for estimating fatness or FFM that involve the two-compartment model approach. The clinical significance of the body compartment to be measured should be determined before a measurement method is selected, because the more advanced techniques are less accessible and more costly.

Lithium target performance evaluation for low-energy accelerator-based in vivo measurements using gamma spectroscopy

The operating conditions at McMaster KN Van de Graaf accelerator have been optimized to produce neutrons via the (7)Li(p, n)(7)Be reaction for in vivo neutron activation analysis. In a number of earlier studies (development of an accelerator based system for in vivo neutron activation analysis measurements of manganese in humans, Ph.D. Thesis, McMaster University, Hamilton, ON, Canada; Appl. Radiat. Isot. 53 (2000) 657; in vivo measurement of some trace elements in human Bone, Ph.D. Thesis. McMaster University, Hamilton, ON, Canada), a significant discrepancy between the experimental and the calculated neutron doses has been pointed out. The hypotheses formulated in the above references to explain the deviation of the experimental results from analytical calculations, have been tested experimentally. The performance of the lithium target for neutron production has been evaluated by measuring the (7)Be activity produced as a result of (p, n) interaction with (7)Li. In contradiction to the formulated hypotheses, lithium target performance was found to be mainly affected by inefficient target cooling and the presence of oxides layer on target surface. An appropriate choice of these parameters resulted in neutron yields same as predicated by analytical calculations.

Segmentation of fat and muscle from MR images of the thigh by a possibilistic clustering algorithm

Physical training is proved to induce changes in physical capacity and body composition. We propose in this article a fast, unsupervised and fully three-dimensional automatic method to extract muscle and fat volumes from magnetic resonance images of thighs in order to assess these changes. The technique relies on the use of a fuzzy clustering algorithm and post-processings to accurately process the body composition of thighs. Results are compared on 11 healthy voluntary elderly people with those provided on the same data by a validated method already published, and its reliability is assessed on repeated measures on three subjects. The two methods statistically agree when computing muscle and fat volumes, and clinical implications of this fully automatic method are important for medicine, physical conditioning, weight-loss programs and predictions of optimal body weight.

Magnitude and variation of ratio of total body potassium to fat-free mass: a cellular level modeling study

Potassium is an essential element of living organisms that is found almost exclusively in the intracellular fluid compartment. The assumed constant ratio of total body potassium (TBK) to fat-free mass (FFM) is a cornerstone of the TBK method of estimating total body fat. Although the TBK-to-FFM (TBK/FFM) ratio has been assumed constant, a large range of individual and group values is recognized. The purpose of the present study was to undertake a comprehensive analysis of biological factors that cause variation in the TBK/FFM ratio. A theoretical TBK/FFM model was developed on the cellular body composition level. This physiological model includes six factors that combine to produce the observed TBK/FFM ratio. The ratio magnitude and range, as well as the differences in the TBK/FFM ratio between men and women and variation with growth, were examined with the proposed model. The ratio of extracellular water to intracellular water (E/I) is the major factor leading to between-individual variation in the TBK/FFM ratio. The present study provides a conceptual framework for examining the separate TBK/FFM determinants and suggests important limitations of the TBK/FFM method used in estimating total body fat in humans and other mammals.

Age-related decline in body cell mass in elderly men and women, determined by a noninvasive nuclear technique: effects of physical activity and dietary potassium intake

The body cell mass (BCM) represents the actively metabolizing cellular components of the human body. In this study, the hypothesis was tested that physical activity and a sufficient dietary intake of potassium attenuate the age-related decline in BCM in the elderly. Cross-sectional data were collected in 82 male and 79 female non-institutionalized elderly (60-90 years) from Mainz, Germany, and were analyzed by age groups. BCM was calculated from total body potassium, measured by whole-body counting of naturally occurring 40K. Physical activity level (PAL) was assessed by a standardized questionnaire. Dietary intake of potassium (DIP) was estimated from a 7-day food diary. The results showed the following trends: (1) BCM decreased continuously from age 60 to 90 years by 11.2% (men) and 7.0% (women). BCM was inversely correlated with age in both sexes (men, P < 0.001; women, P < 0.05), but significant age group differences only existed for men (P < 0.01, one-way analysis-of-variance). Women had less BCM than men in all age groups (P < 0.001, t tests). (2) Correlation analyses demonstrated that in both sexes PAL declined with advancing age (P < 0.05), whereas DIP did not change significantly with age. (3) In both sexes, BCM showed a strong positive correlation with PAL (P < 0.001), but did not correlate significantly with DIP. Multiple linear regression analysis (independent variables were PAL, DIP, age, height, weight) demonstrated that PAL, age, and height explained 45% of the variability in BCM in men. In women, PAL was the only significant predictor of BCM, explaining 23% of the variance. The study supports the hypothesis that the level of physical activity is associated with the decline of BCM in the elderly.

Body water spaces and cellular hydration during healthy aging

Age-related changes in the proportions of intracellular or extra-cellular water to total body water and in the ratio of total body water to fat-free mass are debatable. These are important issues both for medical reasons (dehydration is a threat in the diseased elderly) and for methodological reasons (most techniques for assessing of body composition assume constant hydration of the fat-free mass). This study compared hydration in young and elderly (60 years) people. In the first part of the study, we analyzed the literature and computed the ratio of total body water over fat-free mass, Hf. Eligible studies involved independent measurements of fat-free mass and total body water. Hf did not appear to change with age. The second part of this study computed Hf in 103 individuals studied in our laboratory. The mean values were not different in young (73.2 +/- 2.4%) and elderly people (73.4 +/- 2.4%). At all ages, the proportion of intracellular or extracellular water (as measured by bromide dilution) to total body water (as measured by oxygen 18 dilution) was similar. The same finding holds for the proportion of intracellular water to fat-free mass. We conclude that hydration of fat-free mass and cellular hydration are not affected in healthy aging.

Human body composition: in vivo methods

In vivo methods used to study human body composition continue to be developed, along with more advanced reference models that utilize the information obtained with these technologies. Some methods are well established, with a strong physiological basis for their measurement, whereas others are much more indirect. This review has been structured from the methodological point of view to help the reader understand what can be examined with each technique. The associations between the various in vivo methods (densitometry, dilution, bioelectrical impedance and conductance, whole body counting, neutron activation, X-ray absorptiometry, computer tomography, and magnetic resonance imaging) and the five-level multicompartment model of body composition are described, along with the limitations and advantages of each method. This review also provides an overview of the present status of this field of research in human biology, including examples of reference body composition data for infants, children, adolescents, and adults.

Relation between body fat and age in 4 ethnic groups

BACKGROUND

Previous studies of the relation between age and body fat reached differing conclusions concerning the question of whether body fat is lower in the elderly than in middle-aged persons.

OBJECTIVE

The objectives of this study were to characterize the relation between age and body fat in 4 ethnic groups and test the hypothesis that body fat is lower in the elderly than in middle-aged persons.

DESIGN

Body fat was measured in a sample of 1324 volunteers aged 20-94 y by using a 4-component model of body composition. Four ethnic groups were studied: Asians, blacks, Puerto Ricans, and whites. Regression models were developed for fat mass and fat percentage as functions of age.

RESULTS

In all but one of the groups, a highly significant curvilinear relation between age and body fat was found, indicating a peak amount of body fat in late middle age and lower amounts of body fat at younger and older ages (P < 0.001). The age at which maximum body fat was predicted in the various groups ranged from 53 to 61 y for fat mass and from 55 to 71 y for fat percentage. In Puerto Rican men there was no significant relation between age and fat mass, and the relation between age and fat percentage was linear and positively correlated.

CONCLUSIONS

This study provided data on the relation between age and body fat in 4 ethnic groups and supported the hypothesis that body fat is lower in the elderly than in middle-aged persons.

Body composition measurements during wasting diseases

Body wasting is a common feature of severe chronic diseases. Determination of body compartments is essential in the evaluation of patients with wasting diseases in order to optimize their nutritional support. The main methods described together with their advantages and disadvantages are anthropometric measurements, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, total body water, total body potassium and in-vivo neutron activation analysis. The combination of dual-energy X-ray absorptiometry to measure bone and fat mass and bioelectrical impedance analysis to determine total body water and fat-free mass permits evaluation of body composition and periodic follow-up of body compartments in various pathologies. Total body potassium, total body water and in-vivo neutron activation analysis are research methods that elucidate the abnormal consequences of chronic pathologies on hydration status and body cell mass.

Assessing the efficacy of nutritional support

This review outlines the conventional methods of assessing nutritional status and their limitations in the presence of acute trauma and sepsis. It also discusses the problems of attempting to improve or at least maintain nutritional status in the presence of an inflammatory stimulus. Most of the conventional markers of nutritional status are altered in trauma and sepsis with decreases in plasma protein concentrations and muscle strength, an apparent depression of immune function and an increase in extracellular fluid volume. It also appears to be impossible to improve nutritional status in the presence of a severe inflammatory stimulus, and the most one can hope for is to attenuate the rate of decline. The evidence for these observations is discussed.

Gender differences in energy expended during activities and in daily energy expenditure of elderly people

Gender effects on energy expended during light seated activities, walking, cycling, and sleep and their consequences on daily energy expenditure (EE) were examined in 11 men and 15 women aged 66.4 +/- 7.1 yr. Two open-circuit whole body calorimeters were used for EE measurements, except for cycling, during which EE was measured separately with the use of a face mask. Lean body mass (determined using H218O dilution method), fat mass, usual physical activity level, and activity intensity (e.g., walking speed and cycling power output) were taken as covariates in the analysis of EE variations before studying gender effects. Sleeping metabolic rate (SMR) and daily EE, adjusted for differences in all covariates, were 11.2 (P = 0.005) and 8.7% (P = 0.071) lower in women than in men, respectively. No gender-related differences were found in the various physical activity EEs above SMR (e.g., gross EE-SMR) [light seated activities (P = 0.790), walking (P = 0.263), and cycling (P = 0.287)] and daily physical activity EE above SMR (P = 0.587) after adjustment for differences in all covariates. Therefore, the lower adjusted daily EE of women could be related to their lower SMR, the most reliable criterion of whole body metabolic rate.

Cross-validation of anthropometric and bioelectrical resistance prediction equations for body composition in older people using the 4-compartment model as a criterion method

OBJECTIVE

To cross-validate existing equations in the literature for their accuracy and precision for estimating body fat in older people from anthropometric measures and height2/resistance, using the 4-compartment model as a criteria method, and to propose new practical equations with improved accuracy and precision.

DESIGN

Measurement of body composition in a cross-sectional cohort of healthy men and women and comparison by cross-validation techniques against existing prediction equations.

SETTING

The study was performed on subjects admitted to a General Clinical Research Center.

PARTICIPANTS

The subjects were 41 healthy women (68.2 +/- 6.6 years; 64.1 +/- 10.2 kg) and 41 healthy men (70.2 +/- 7.0 years; 74.9 +/- 11.0 kg).

MEASUREMENTS

The criteria method for total body composition was the 4-compartment model based on measurement of total body density by underwater weight, total body water by isotope dilution, and total bone mineral from dual energy X-ray absorptiometry. The other techniques examined for accuracy and validity were body fat estimates derived by skinfolds using the Durnin and Womersley Equations; waist circumference and age using the Lean Equations; and bio-electrical resistance using five published equations, including two derived in the older population.

RESULTS

When compared with data derived from the 4-compartment model, the skinfold equation of Durnin and Womersley was cross-validated successfully in women but not in men. The Baumgartner equation was the only bioelectrical resistance equation that met the criteria for successful cross-validation in men and women, although in women the intercept (4.0 +/- 2.1 kg) was close to significantly different from zero (P = .06). Error in the estimates of body fat using the Durnin and Womersley and the Baumgartner equations was significantly and inversely related to fat mass (r = -.39 to r = -.56). In our data, the significant predictors of fat mass were hip circumference, calf skinfold, gender, body weight, height2/resistance, and biceps skinfold, explaining 84% of the variance.

CONCLUSIONS

The Durnin and Womersley equation is accurate for women and the Baumgartner equation is accurate for both men and women if a correction of +4 kg is made in women; however, for both equations the error in the estimate is inversely related to fat mass. We suggest new anthropometric equations for estimating body fat in older people, which may improve accuracy and precision. The new equations will need to be tested in independent cross-validation studies.

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

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