Predictive equation for assessing appendicular lean soft tissue mass using bioelectric impedance analysis in older adults: Effect of body fat distribution

BACKGROUND

Low muscle mass is associated with sarcopenia and increased mortality. Muscle mass, especially that of the limbs, is commonly estimated by dual-energy X-ray absorptiometry (DXA) or bioimpedance analysis (BIA). However, BIA-based predictive equations for estimating lean appendicular soft tissue mass (ALST) do not take into account body fat distribution, an important factor influencing DXA and BIA measurements.

OBJECTIVES

To develop and cross-validate a BIA-based equation for estimating ALST with DXA as criterion, and to compare our new formula to three previously published models.

METHODS

One-hundred eighty-four older adults (140 women and 44 men) (age 71.5 ± 7.3 years, body mass index 27.9 ± 5.3 kg/m²) were recruited. Participants were randomly split into validation (n = 118) and cross-validation groups (n = 66). Bioelectrical resistance was obtained with a phase-sensitive 50 kHz BIA device.

RESULTS

A BIA-based model was developed for appendicular lean soft tissue mass [ALST (kg) = 5.982 + (0.188 × S² / resistance) + (0.014 × waist circumference) + (0.046 × Wt) + (3.881 × sex) - (0.053 × age), where sex is 0 if female or 1 if male, Wt is weight (kg), and S is stature (cm) (R² = 0.86, SEE = 1.35 kg)]. Cross validation revealed r² of 0.91 and no mean bias. Two of three previously published models showed a trend to significantly overestimate ALST in our sample (p < 0.01).

CONCLUSIONS

The new equation can be considered valid, with no observed bias and trend, thus affording practical means to quantify ALST mass in older adults.

Leucine metabolites do not induce changes in phase angle, bioimpedance vector analysis patterns, and strength in resistance trained men

We aimed to assess the effects of off-the-shelf leucine metabolite supplements on phase angle (PhA), bioimpedance vector analysis (BIVA) patterns and strength during an 8-week resistance training protocol. Fifty-three male participants were allocated into 4 groups: α-hydroxyisocaproic acid (n = 12, age = 30.9 ± 9.3 years), β-hydroxy-β-methylbutyrate free acid (n = 12, age = 31.0 ± 9.3 years), calcium β-hydroxy-β-methylbutyrate (n = 15, age = 32.1 ± 5.2 years) or placebo (n = 14, age = 28.9 ± 6.6 years). Bioimpedance parameters and 1-repetition maximum (1RM) for back squat and bench press were assessed at baseline and at the end of weeks 4 and 8. Additionally, fat-free mass and fat mass were evaluated by dual-energy X-ray absorptiometry. No statistically group by time interactions were found, even adjusting for age. PhA and vector did not change over the training period, while time-dependent increases were observed for 1RM back squat and 1RM bench press. A direct association was observed between PhA and 1RM bench press changes (whole sample), while PhA and strength were correlated throughout the study, even when adjusting for fat-free mass and percentage of fat mass. Leucine metabolites have no effect on PhA, BIVA patterns or strength during an 8-week resistance training program, in resistance trained subjects. The trial was registered at ClincicalTrials.gov: NCT03511092. Novelty: Supplementation with leucine metabolites is not a supplementation strategy that improves bioelectrical phase angle, cellular health, and strength after an 8-week resistance training program. When consuming a high protein diet, none of the α-hydroxyisocaproic acid, β-hydroxy-β-methylbutyrate free acid, and calcium β-hydroxy-β-methylbutyrate metabolites resulted in an ergogenic effect in resistance trained men.

Comparison between health-related quality of life in normal-weight and overweight-obese children

Background

In Italy 32% of 6-10 aged children were overweight in 2017-2018. Measures of Health-Related Quality of Life (HRQoL) assess important aspects of health daily activities, physical symptoms, social interactions and emotional well-being. It is suggested that HRQoL is influenced by children's weight status. The aim of the study is to compare HRQoL among normal-underweight and overweight-obese children in an Italian sample.

Methods

A cross-sectional study was conducted in 2019 among 144 children, aged 6-10, recruited in a primary school in Bologna (Italy). Children were divided in Group1 (G1: normal-underweight) and Group2 (G2: overweight-obese) using the International Obesity Task Force cut points. HRQoL was assessed using 4.0 Italian version of PedsQL questionnaire. We obtained summary scores for children's total HRQoL and two subscales: one for physical health and one for emotional, social and school functioning.

Results

Of 144 children, 98 (68%) and 46 (32%) were respectively in G1 and G2. HRQoL total scores were 73.10±1.30 in G1 and 69.28±1.96 in G2 (p = 0.051). We analysed separately children in Grade 1 and Grade 3-4. In Grade 1, there were 68 children: 48 (71%) in G1 and 20 (29%) in G2. In grade 3-4 there were 76 children: 50 (66%) in G1 and 26 (34%) in G2. HRQoL total scores in grade 3-4 were: 73.28±1.63 in G1 and 72.66±2.32 in G2 (p = 0.41). In Grade 1, HRQoL total scores were 72.92±2.05 in G1 and 64.89±3.15 in G2 (p = 0.02); at subscale levels, means for physical health were 77.73±1.92 in G1 and 72.5±3.58 in G2 (p = 0.08) and means for emotional, social and school functioning were 70.35±2.48 in G1 and 60.83±4.04 in G2 (p = 0.02).

Conclusions

The effects of child overweight and obesity on health-related QOL was more evident in children aged 6-7, especially regarding emotional, social and school functioning. Prevention of childhood overweight and obesity is important not only to avoid health consequences of weight but also to improve children' quality of life.

Key messages

Overweight is a public health problem in Italy not only among adults, but even among children. Overweight has a negative impact on quality of life, therefore a healthy lifestyle should be promoted.

Ethnic differences in body image perception in patients with type 2 diabetes

BACKGROUND

The present study compared the prevalence of obesity, fat distribution, body image perception and lifestyle among diabetic African and Albanian immigrants living in Italy, as well as diabetic Italians, aiming to identify health risks and their possible causes.

METHODS

The study sample consisted of 200 diabetic subjects living in Italy. A questionnaire regarding socio-demographic and lifestyle information was administered to participants, and anthropometric measurements and body image perception were assessed. Proper perception of weight status and the degree of dissatisfaction in body image perception were valued.

RESULTS

Italians showed a higher health risk, both with regard to anthropometric characteristics and lifestyle, whereas African immigrants showed a lower one. All of the male groups underestimated their weight and Albanians were the most dissatisfied. Women perceived their current body image as heavier than their desired body image, showing a dissatisfaction toward their weight. Subjects of both sexes belonging to the overweight and obese categories generally underestimated themselves; this was particularly true in obese Africans. People with a higher body mass index were more likely to be dissatisfied than those with a lower one. Body image dissatisfaction increased when people estimated themselves as being overweight. Among lifestyle habits, being an ex-smoker increased body image dissatisfaction.

CONCLUSIONS

The underestimation of weight detected in the present study requires attention. Nevertheless, the high percentage of overweight/obese people, coupled with the higher frequency of people dissatisfied with their high weight, suggests an awareness of the problem that could be more effective for weight loss.

Participation in sports, body composition, and fitness characteristics in children according to ethnic background

Participation in sports has important implications, being associated with health and social features. The objectives of this study were to verify whether there were any differences in sport participation between immigrant and Italian children and whether there was any relation with their body composition and fitness characteristics. A survey was conducted on 1432 children attending primary school in the Emilia-Romagna (northern Italy). Anthropometric measurements, fitness characteristics, and data about participation in sports were considered. Italian children were more likely to participate in sports than immigrants and boys than girls. Among immigrants, the lowest values were observed in Asians. Eastern European males and Latin American females displayed the widest dimensions. Eastern Europeans generally showed the highest values of strength, while Latin Americans had the highest values of flexibility. Asian children showed the highest values of centripetal fat, and a high percentage of them exceeded the %F reference. These aspects, together with the low frequency of practicing sports, place Asians at greater risks for health. Sex and ethnic group are the most informative variables associated with participation in sports by children. Interventions including health education lessons and promoting the participation in sports for immigrant children attending schools need to be encouraged.

Food habits and nutritional status of adolescents in Emilia-Romagna, Italy

INTRODUCTION

The prevalence of childhood and adolescent obesity is increasing, with negative medical and psychosocial consequences.

AIMS

This study examines the association between weight status and nutrient intake, sport and leisure habits of middle school students in Bologna (Italy).

METHODS

Anthropometric data (height, weight) of 598 subjects (321 males and 277 females) 11-14 years old were collected. Questionnaires on nutrient intake, sport and leisure behaviour were administered.

RESULTS

Protein, carbohydrate and total fat intakes of the adolescents were higher than the recommended ranges in all age groups and in both sexes. The proportion of energy from protein and total fat was higher than recommended, but the percentage from carbohydrate was lower. A significant proportion of the adolescents had a cholesterol intake above the Italian RDA and lower than recommended intakes for micronutrients. The prevalence of overweight and obesity is higher in males than in females at all ages (overweight: 35.2 vs 31.6 at 11 yrs.; 27.5 vs 20.2 at 12 yrs.; 18.6 vs 17.8 at 13 yrs.; 18.7 vs 10.9 at 14 yrs.; obesity: 5.5 vs 3.2 at 12 yrs.; 3.9 vs 1.1 at 13 yrs.; 5.3 vs 3.6 at 14 yrs.), except in subjects 11 years old (obesity: 7.4 vs 10.5). The overweight and obese adolescents consumed less carbohydrates and less fibre than their normal weight and underweight counterparts.

CONCLUSION

The results of the present study indicate an unbalanced diet of the Bologna adolescents, which could damage their health and quality of life.

Growth of Chinese Italian infants in the first 2 years of life

BACKGROUND

Numerous studies have been carried out on the growth of human migrant populations. However, studies on the auxological pattern of Chinese migrant population are limited in Italy.

AIMS

In this paper we examine the growth pattern from birth to 24 months and the body composition of Chinese infants born and living in Bologna (north Italy).

SUBJECTS AND METHODS

A longitudinal study was conducted recruiting 224 healthy Chinese children. The anthropometric measurements were collected when the children were immunized. Body mass index (BMI), Arm Muscle Area and Arm Fat Area were calculated.

RESULTS

The growth of Chinese Italian children is adequate, being within the normal limits according to the NCHS reference standard. In comparison with Chinese children living in China and abroad, their body length is greater. Comparisons with growth curves for Italian children (Emilia-Romagna) show that weight and length values are higher in Chinese children than in Italians until 12 months, and comparable thereafter. The weight and length growth velocities are similar to those reported for Italian children.

CONCLUSION

As a whole, the results of the present study support the hypothesis that Chinese children born and living in Italy grow in an appropriate environment to achieve their growth potential.

Leaping ability and body composition in rhythmic gymnasts for talent identification

AIM

Aim of this study was to investigate leaping ability and morphological characteristics in rhythmic gymnastics, in order to verify which parameters are useful indicators for the talent identification.

METHODS

Twenty-five national gymnasts of international level (age 14.7+/-2.2 years) underwent three testing sessions: anthropometric measurements, vertical jumps (counter movement jump and hopping test), and three technical split leaps with stretched legs (SL), with ring (RG) and with back bend of the trunk (BBT).

RESULTS

Elite had significantly different values (P < 0.05) of stature (1.65+/-0.03 vs 1.55+/-0.09 m), thigh length (0.42+/-0.03 vs 0.39+/-0.02 m) and FFM(42.42+/-2.81 vs 35.84+/-5.66 kg) compared to sub-elite. The height of hopping test was significantly higher in elite than sub-elite gymnasts (0.34+/-0.05 vs 0.27+/-0.04 m; P < 0.05), but no significant differences in counter movement jump between two groups were found. Ground contact time of hopping test was significantly correlated (P < 0.01) with SL (r = 0.613), RG (r = 0.632), and BBT (r = 0.542) values. By multiple regression analysis, among anthropometric and vertical jump variables, the hopping ground contact time was the strongest predictor of ground contact time of the three technical leaps (SL, RG, BBT) accounting for 26-37% of variance.

CONCLUSION

Some anthropometric measurements are good indicators for the better performance in rhythmic gymnastics. Level of muscle compliance (stiffness) evaluated by hopping test is a good parameter for athletes selection and for monitoring leaps training.

Growth and malnutrition of rural Zimbabwean children (6-17 years of age)

The rural environment is an important factor in delayed growth in developing countries. The aim of this study was to investigate the effects of poor rural living conditions on the growth of a Shona sample in Zimbabwe. In total, 982 subjects aged 6-17 years were analyzed. Mean values of height, weight, skinfolds (triceps, subscapular, suprailiac, biceps, medial calf), cormic index, body mass index (BMI), arm composition (total upper arm area, upper arm muscle area, arm fat area, and arm fat index), fat percentage (%F), centripetal fat ratio (CFR), and the contribution of each skinfold to the adiposity of the trunk and upper limbs are presented. Weight, height, BMI, cormic index, SSCP, TRCP, arm circumference, and arm composition are compared with NHANES percentiles. Boys and girls showed stunting and underweight at ages 11-15 and 8-15, respectively; boys presented particularly severe malnutrition and their means of height and weight were below the 10th percentile. The means of arm circumference, UMA, UFA, and TRCP were below the 15th percentile in both sexes. The contribution of the skinfolds generally showed an overall prevalence of TRCP in both sexes; the contribution of SSCP was prevalent only for the 16- to 17-year-old boys. Males presented a higher CFR than girls after 14 years while females showed an irregular pattern. There was a high incidence of brachycormia and mesocormia in females and males, respectively. Height, weight, and BMI were similar to the values observed in other sub-Saharan countries, although body size was slightly larger than in South Africa and smaller than in Tanzania. The results provide a useful database for future comparisons.

Influence of various factors on the measurement of multifrequency bioimpedance

Body impedance values at various frequencies (from 1 to 100 kHz) were determined in 104 subjects on seven separate days over a two-week period. The variability of body impedance in different measurement conditions was studied. In particular, the effects of the electrode locations, the ingestion of some substances (sugar, alcohol, mineral salts), body spatial geometry, the time spent in the supine position and the menstrual cycle were assessed. Under standardized conditions (in the morning, in the fasting state, with an empty bladder and with the body in a standardised spatial position), the within-subject day-to-day variability was 3-14 Ohms. Under different experimental conditions, the within-subject variability was generally much higher. This was particularly evident for female subjects. We observed significant mean variations in relation to the different experimental factors introduced one at a time, with the exception of the menstrual cycle. For example, half an hour after the intake of various substances, body impedance had generally increased by 6-17 Ohms in comparison with values in the fasting state. Changes in body impedance during the menstrual cycle, however, were small and never statistically significant. The impedance variations obviously caused significant changes in estimated parameters of body composition. It is concluded that controlled conditions and standardization of multifrequency bioimpedance analysis (MBIA) methods are indispensable for the application of this technique.

Body size, composition, and blood pressure of high-altitude Quechua from the Peruvian Central Andes (Huancavelica, 3,680 m)

Although much information is available about the effects of high altitude on physiological characteristics, less is know about its effect on body composition. In the present study, anthropometric and body composition variables were investigated in a sample of 77 adult Quechua males from the Peruvian Central Andes (Huancavelica, 3,680 m). The subjects are shorter in relation to body weight than other ethnic groups, whereas body proportions are macrocormic (indicating a long trunk relative to the lower extremities), with intermediate values of the acromial-iliac index. All skinfold thicknesses are low (approximately 15th percentiles of NHANES reference values for the triceps and subscapular skinfolds), but tend to be higher than in the other Quechua populations. Similar results are obtained when percentage fat is estimated. Somatotypes are dominant in mesomorphy with very low ectomorphy. Comparison with a sample of high-altitude Kirghiz (3,200 m), previously studied with the same methods, shows higher values in the Peruvian sample for all variables related to adiposity. The presence of low adiposity in the Quechua population could be associated with stresses of the high-altitude environment. Mean values of blood pressure are very low and there is no correlation with age.

Remarks on methods for estimating body composition parameters: reliability of skinfold and multiple frequency bioelectric impedance methods

A sample of 104 adults underwent testing of body composition by multiple frequency bioelectric impedance analysis (MBIA) under controlled conditions, by anthropometric methods (skinfold thicknesses and BMI) and by the urinary creatinine method. The statistical comparison of body composition parameters (Fat, FFM, TBW), estimated by different methods for the same subjects, pointed out significant differences in mean values. The precision of skinfold and MBIA measurements was evaluated by a second control measurement. Concerning the MBIA, the reliability increased with increasing frequencies. Nevertheless, measurement reliability is higher for skinfolds than for MBIA. Under the condition that there is a real anthropometric technical ability, we affirm that the body composition parameters may at present be better estimated by the skinfold method.

Body composition in Central Asia populations: Fat patterning variation in the Kazakhs of the Tien Shan mountains and the Uighurs of Semericia

Eleven anthropometric variables related to fat patterning were analyzed in two populations of Central Asia, the Kazakhs of the Tien Shan mountains (2100 m) and the Uighurs of the Semericia plains. Subjects were healthy unrelated males, 122 Kazakhs and 79 Uighurs, 19-65 years. Comparisons were done with a preliminary analysis of variance and then by covariance analysis, taking into account the influence of age. The Uighurs, independently of age, show higher values than Kazakhs for all of the characteristics related to fat patterning, but principal components analysis suggests a similar somatic structure in the two samples. The presence of lower adiposity in the Kazakhs than in the Uighurs could be related to stress, probably associated with nutrition and lifestyle in a mountain environment. Am. J. Hum. Biol. 10:241-247, 1998. © 1998 Wiley-Liss, Inc.