Body Composition: Studies in the Human Being by the Dilution Principle

Daily energy requirements of male academy soccer players are greater than age-matched non-academy soccer players: A doubly labelled water investigation

This study aimed to test the hypothesis that the total daily energy expenditure (TDEE) of male academy soccer players is greater than players not enrolled on a formalised academy programme. English Premier League academy (ACAD: n = 8, 13 years, 50 ± 6 kg, 88 ± 3% predicted adult stature, PAS) and non-academy players (NON-ACAD: n = 6, 13 years, 53 ± 12 kg, 89 ± 3% PAS) were assessed for TDEE (via doubly labelled water) during a 14-day in-season period. External loading was evaluated during training (ACAD: 8 sessions, NON-ACAD: 2 sessions) and games (2 games for both ACAD and NON-ACAD) via GPS, and daily physical activity was evaluated using triaxial accelerometry. Accumulative duration of soccer activity (ACAD: 975 ± 23 min, NON-ACAD: 397 ± 2 min; p < 0.01), distance covered (ACAD: 54.2 ± 8.3 km, NON-ACAD: 21.6 ± 4.7 km; p < 0.05) and time engaged in daily moderate-to-vigorous (ACAD: 124 ± 17 min, NON-ACAD: 79 ± 18 min; p < 0.01) activity was greater in academy players. Academy players displayed greater absolute (ACAD: 3380 ± 517 kcal · d-1, NON-ACAD: 2641 ± 308 kcal · d-1; p < 0.05) and relative TDEE (ACAD: 66 ± 6 kcal · kg · d-1, NON-ACAD: 52 ± 10 kcal · kg · d-1; p < 0.05) versus non-academy players. Given the injury risk associated with high training volumes during growth and maturation, data demonstrate the requirement for academy players to consume sufficient energy (and carbohydrate) intake to support the enhanced energy cost of academy programmes.

Body composition techniques

Body composition is known to be associated with several diseases, such as cardiovascular disease, diabetes, cancers, osteoporosis and osteoarthritis. Body composition measurements are useful in assessing the effectiveness of nutritional interventions and monitoring the changes associated with growth and disease conditions. Changes in body composition occur when there is a mismatch between nutrient intake and requirement. Altered body composition is observed in conditions such as wasting and stunting when the nutritional intake may be inadequate. Overnutrition on the other hand leads to obesity. Many techniques are available for body composition assessment, which range from simple indirect measures to more sophisticated direct volumetric measurements. Some of the methods that are used today include anthropometry, tracer dilution, densitometry, dual-energy X-ray absorptiometry, air displacement plethysmography and bioelectrical impedance analysis. The methods vary in their precision and accuracy. Imaging techniques such as nuclear magnetic resonance imaging and computed tomography have become powerful tools due to their ability of visualizing and quantifying tissues, organs, or constituents such as muscle and adipose tissue. However, these methods are still considered to be research tools due to their cost and complexity of use. This review was aimed to describe the commonly used methods for body composition analysis and provide a brief introduction on the latest techniques available.

Development of methods for body composition studies

This review is focused on experimental methods for determination of the composition of the human body, its organs and tissues. It summarizes the development and current status of fat determinations from body density, total body water determinations through the dilution technique, whole and partial body potassium measurements for body cell mass estimates, in vivo neutron activation analysis for body protein measurements, dual-energy absorptiometry (DEXA), computed tomography (CT) and magnetic resonance imaging (MRI, fMRI) and spectroscopy (MRS) for body composition studies on tissue and organ levels, as well as single- and multiple-frequency bioimpedance (BIA) and anthropometry as simple easily available methods. Methods for trace element analysis in vivo are also described. Using this wide range of measurement methods, together with gradually improved body composition models, it is now possible to quantify a number of body components and follow their changes in health and disease.

Stable isotope tracer dilution for quantifying very low-density lipoprotein-triacylglycerol kinetics in man

BACKGROUND & AIM

A number of approaches have been employed in the past to measure very low-density lipoprotein (VLDL) triacylglycerol (TG) kinetics in humans in vivo, varying in the selection of tracer and mode of administration. All, however, make use of labeled TG precursors and more or less complicated mathematical models to derive the kinetic parameters of interest. The aim of the present study was to develop a conceptually straightforward method, based on the traditional tracer infusion technique, for quantifying VLDL-TG production rates in man using stable isotopes.

METHOD

Our approach involves ingestion of [U-13C3]glycerol to endogenously label the glycerol in VLDL-TG, plasmapheresis, isolation of the newly 13C-labeled VLDL from plasma, and administration within the next 2-3 days via a primed constant autologous reinfusion. This procedure produces enough tracer for a priming dose plus 2-3 h of infusion. In the physiological conditions examined (basal and hyperglycemic states, fat- and carbohydrate-rich diets), with almost 3-fold ranging VLDL-TG pool sizes, a steady state in plasma VLDL-TG glycerol tracer-to-tracee ratio was readily achieved within 2 h. Consequently, calculations are made according to the isotope dilution principle, thus avoiding assumptions implicit in more complicated models.

CONCLUSION

The stable isotope VLDL-TG tracer dilution method offers an alternative and reliable tool for the determination of endogenous VLDL-TG kinetics in man under a variety of metabolic states.

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.

Techniques of body composition assessment: a review of laboratory and field methods

Body composition is one of the major health-related components of fitness. Thus, it is important for health and fitness professionals to have a general understanding of the most commonly used techniques for assessing body composition. This review presents the developmental background and underlying principles and theory of four laboratory (hydrodensitometry, air displacement plethysmography, isotope dilution, and dual-energy x-ray absorptiometry) and four field (bioelectrical impedance analysis, near-infrared interactance, skinfolds, and anthropometry) methods of body composition assessment. In addition to a description of the methods, the validity, and reliability, strengths, and limitations of each measurement tool are examined. Highlights of the laboratory methods include the relatively new Bod Pod air displacement device, which is a promising assessment tool more convenient than hydrodensitometry but still lacking substantial validity testing and the ability of dual-energy x-ray absorptiometry to measure regional composition making it an attractive method for clinicians. Advancements in segmental and multifrequency bioelectrical impedance for compartmental analysis have enhanced the value of this field method, but research continues to show that commercially available near-infrared interactance units are invalid. With this knowledge, the clinician and researcher should be able to make an informed decision regarding the most appropriate measurement device for their body composition assessments.

Fourier transform infrared spectroscopy measures 1H/2H ratios of native water with a precision comparable to that of isotope ratio mass spectrometry

A fast and easy method is described which uses Fourier transform infrared spectroscopy (FT-IR) to measure the 1H/2H ratio of aqueous samples of less than 100 microliters with high precision (+/- 0.2-0.5% in the range of 89 to 2680 microliters/l). Using a thermostat-controlled CaF2 cell, low resolution absorption specta (8 cm-1) are measured. The integral of absorption in the range of 2600 and 2460 cm-1 (O2H vibration) is used to analyse the 2H content of the sample. For measurements at low enrichment five standards are used (SLAP: 89.00 microliters/l, GISP: 126.3 microliters/l, V-SMOW: 156.0 microliters/l, all from the International Atomic Energy Agency, Vienna, Austria, standard 1: 183.3 microliters/l, standard 2: 222.5 microliters/l, both prepared by weighing and controlled by isotope ratio mass spectrometry (IR-MS)). For measurements at high enrichment three standards are used (standard 2: 222.5 microliters/l, standard 3: 1323 microliters/l, standard 4: 2680 microliters/l, all prepared by weighing and controlled by IR-MS). Measured and reported 2H concentrations coincide very well, two samples for quality control (145 and 1612 microliters/l) were measured with a precision of 0.3 and 0.4% corresponding to +/- 0.5 and 5.9 microliters/l.

Pharmacokinetics of ethanol in plasma and whole blood: estimation of total body water by the dilution principle

The pharmacokinetics of ethanol in plasma and whole blood have been investigated and the results used to estimate the volume of total body water (TBW) by means of the dilution principle. Fifteen men (mean age 62 y) were given 0.6 g ethanol/kg body weight as an intravenous infusion over 1 h. The peak concentration of ethanol in plasma was 120 mg.dl-1 compared to 108 mg.dl-1 for whole blood. The disappearance rate of ethanol from plasma was 18.6 mg.dl-1.h-1 compared to 17.0 mg.dl-1.h-1 for the whole blood concentration-time data. The apparent volume of distribution of ethanol (Vz) was 0.54 l.kg-1 according to plasma kinetics compared to 0.59 l.kg-1 for the kinetics derived from whole blood. The mean area under the curve (AUC) was 294 mg.dl-1 x h for plasma kinetics compared to 266 mg.dl-1 x h for whole blood. The TBW was 40.9 l or 50.9% of body weight for the plasma concentration-time data. This agreed well with the 40.3 l or 50.1% of body weight obtained using whole blood.

How does displacement of albumin-bound tryptophan cause sustained increases in the free tryptophan concentration in plasma and 5-hydroxytryptamine synthesis in brain?

Models of tryptophan catabolism and binding to serum albumin are presented to explain the observed effect of displacement of tryptophan from albumin on the concentrations of free and bound tryptophan and on the rate of 5-hydroxytryptamine (5-HT) synthesis from tryptophan in the brain. A rapid rate of dissociation of tryptophan from albumin (compared to the transit time of tryptophan through the liver) and a large fractional extraction of the free pool of tryptophan during passage through the liver are shown to be necessary factors in determining the effects observed. Because of the low fractional extraction of free tryptophan in the brain, the synthesis of 5-HT will be dependent only upon the free pool of tryptophan. Dissociation of tryptophan from albumin only causes a sustained increase in 5-HT synthesis in the brain because of the effect that this dissociation has on hepatic tryptophan catabolism and thereby on the free pool of tryptophan.

Carcass minerals in chickens (Gallus domesticus) during growth

Moisture, sodium, potassium, calcium, phosphate and magnesium were determined in the carcass of male chickens (Gallus domesticus) between the ages of 1 and 70 days. Moisture decreased rapidly during the first 3 days of life, followed by a more moderate decline. Sodium and potassium concentrations decreased with age, but not in a parallel fashion. Some of the changes with age could be explained on the basis of an extra- and intracellular fluid shifts. Calcium and phosphate concentration increased with age, reflecting skeletal calcification. Carcass magnesium concentration increased during the first 3 days of life and did not change significantly thereafter.

A method for simultaneous measurements of body water compartments and potassium pool in anuric subjects

A method is described for simultaneous measurement of total body water, extracellular body water, plasma volume, exchangeable potassium pool employing radioactive tracers (3H2O, Na235SO4, 42KCl and 125I human serum albumin). Some suggestions are made that are particularly applicable to routine use in anuric and/or dialyzed patients. The observed values fit well with the values predicted for a reference subject.

Severe hypokalaemia with paralysis induced by small doses of liquorice

A patient, who presented with a flaccid quadriplegia due to profound hypokalaemia, is described. Hypokalaemia and myoglobinuria were caused by the ingestion of small amounts of liquorice contained in a laxative preparation. Subsequent controlled administration of small amounts of this preparation induced marked hypokalaemia. This was associated with sodium retention and potassium loss confirming a mineralocorticoid-like action. The sodium retention was associated with suppression of plasma levels of renin and aldosterone.

Intravenous bolus of 125I labeled meglumine diatrizoate. Early extravascular distribution

A mixture of 125I labeled meglumine diatrizoate and 131I labeled human serum albumin was injected into the femoral vein of 26 anesthetized male rats. Measurements of the activities in cardiac blood and in different tissues of the lower extremity and in the testis were performed at time intervals ranging from 5 s to 5 min after injection. The determination of tissue uptake and distribution volumes of diatrizoate showed widely differing accumulation of contrast medium. Over 50 per cent of the intravenous bolus of diatrizoate was extravascular at 40 s.

The effects of single infusion of hypertonic sodium bicarbonate on body composition in neonates with acidosis

Acid-base equilibrium and plasma and red blood cell water and solute were evaluated in a group of asphyxiated, acidotic neonates prior to and following infusion of hypertonic NaHCO3. The dose was calculated to correct the deficit of base in a bicarbonate space of 400 ml/kg and was given at a rate of 0.3 mM NaHCO3/kg/minute. All of the infants with RDS and two of the five with other forms of asphyxia received ventilatory assistance during the infusion. The quantity of base infused was sufficient to alter acid-base balance and shift whole blood and red blood cell pH values toward normal. The changes in body composition 3 minutes following the infusion indicate that the osmotic load imposed by the hypertonic NaHCO3 caused a shift of solute-free water into the interstitial and intravascular fluids. During the period from 3 to 30 minutes following the infusion there was redistribution of extracellular water and solute so that plasma volume and [Na]PL decreased. Since there was no evidence of an intracellular shift of solute, we hypothesize that the changes in body composition between 3 and 30 minutes postinfusion were in part the consequence of gradual penetration of transcellular fluids by Na. Osmotic inactivation of ECF Na by sequestration with connective tissue polyelectrolytes may also play a role. These studies' do not provide an answer to the clinical problem of whether the beneficial effects of prompt correction metabolic acidosis outweigh the potenially harmful effect of the osmotic alterations that accompany rapid infusion of hypertonic NaHCO3.

Determination of extracellular fluid volume in the dog with ferrocyanide

The suitability of ferocyanide as an indicator for the measurement of extracellular fluid volume was tested. Added ferrocyanide could be recovered completely from urine, plasma and blood. In in vitro experiments ferrocyanide did not penetrate into erythrocytes, nor did it adhere to the red cell membrane. In gel filtration and electrophoresis experiments binding of ferrocyanide to plasma proteins could not be demonstrated. In in vivo experiments on dogs, the urinary recovery of intravenously administered ferrocyanide was 98.9 +/- 2.1% (n = 14). The partition ratio of ferrocyanide between lymph water and plasma water was 0.99 +/- 0.02 (n = 20). Ferrocyanide could not be detected in cerebrospinal fluid or red cells of dogs after administration by intravenous infusion. No untoward effects of the infused ferrocyanide were observed during or after the experiments. In nephrectomized dogs ferrocyanide reached its ultimate distribution volume 2 hrs after intravenous administration of a single dose and remained constant for up to 10 hrs. The average distribution volume was 224 +/- 17 ml-kg-1 body mass (n = 6). In intact dogs continuously infused with indicator, ferrocyanide also reached its ultimate distribution volume in 2 hrs and remained constant thereafter for up to 7 hrs after the start of the infusion. The average distribution volume was 237 +/- 27 ml-kg-1 body mass (n = 14). It is concluded that ferrocyanide fulfils the requirements to be met by an indicator for the measurement of the extracellular volume, and is well suited for repeated determinations of the extracellular fluid volume in one and the same experiment.

The measurement of total body water in living pigs by deuterium oxide dilution and its relation to body composition

1. Deuterium oxide was used to estimate body water in twenty-four pigs of widely differing body composition and of average weight 83·9 kg.

2. After infusion of the isotope, blood samples were collected every 30 min for 4 h. The resulting plasma was purified by a heat-distillation procedure, after which it was analysed for D2O by infrared spectroscopy.

3. Approximately 24 h after infusion of the D2O each pig was killed, and its composition determined both by chemical analysis and physical dissection.

4. Equilibration of D2O in the body was found to be complete within 2 h of injection of the tracer.

5. The mean D2O space was found to be 8·6% greater than the mean empty body water space, but only 2·2% greater than the total body water space.

6. Empty body water and total body water were estimated from the regression lines with residual standard deviations of 2·7 and 1·9% respectively. Similarly, the residual standard deviations of the regressions involving the other fat-free components were 6·3% for dissectible lean, 3·2% for fat-free mass, and 5·6% for crude protein.

7. The residual standard deviations of the regressions in which the weights of dissectible fat and total body lipid were predicted were 6·0 and 6·7% respectively.

Potassium depletion in severe heart disease

Exchangeable sodium and potassium, total body water, and sulphate space were measured in 42 patients with severe valvular heart disease who were free of oedema. Compared with normal subjects of the same height, no increase in exchangeable sodium was found but a mean potassium depletion of 27% was shown. This depletion was not related to diuretic therapy, and no relationship between the degree of depletion and postoperative arrhythmias was found. It is concluded that the major cause of the low exchangeable potassium is the reduction in cell mass that occurs in chronic heart disease, and that there is no significant fall in the intracellular potassium concentration.