Body fat, cardiovascular risk factors and polymorphism in the FTO gene: randomized clinical trial and different physical exercise for adolescents

Abstract Objective: To investigate the effects of different physical exercise programs and polymorphisms of the FTO (fat mass and obesity-associated gene) on body composition and cardiovascular risk factors in adolescents with overweight and obesity. Methods: A randomized, parallel, double-blind clinical trial consisting of the adolescent overweight from the state public network, in a simple representative random sample, who participated in an aerobic exercise or weight training intervention for 10 weeks. Anthropometry, body composition, biochemical markers, sexual maturation, and rs9939609 polymorphism in the FTO gene were assessed. 347 adolescents had their characterization of nutritional status. 72 individuals with overweight and obesity were invited to participate. 39 remained for the start of the program and were randomly allocated to both types of intervention. In the end, 26 subjects participated in the intervention programs, with 12 and 14 in the aerobic and weight training programs, respectively. Results: Heterozygous and homozygous bearers of risk allele A participating in the aerobic program showed improvements in glycemia (p = 0.002) and total cholesterol (p = 0.023) and a reduction in body fat mass (p = 0.041). The weight training program reduced glycemia in patients with the risk allele A (p = 0.027). Cameron's stage four sexual maturation participants were 2.1 times more likely to improve their body fat (CI = 1.31-3.39). Conclusion: Aerobic exercises produced exclusively a significant decrease in fat mass and total cholesterol in patients with risk allele A. Distinct physical exercise programs may cause diverse changes in risk variables related to the health of adolescents.

Evaluation of the therapeutic effect of deuterium depleted water on gastroenteritis induced by 131I radiation in thyroid cancer treatment / 中国辐射卫生

Objective To investigate the therapeutic effect of oral administration of deuterium depleted water on gastroenteritis induced by 131I radiation in thyroid cancer treatment. Methods Fifty patients with papillary thyroid cancer treated with 131I in the Department of Nuclear Medicine of Changshu No.2 People’s Hospital from May 2022 to February 2023 were divided into control group and experimental group (25 patients in each group). Data were continuously collected throughout the study duration. The control group was orally administrated omeprazole enteric-coated capsules and purified water at 660 mL tid for 5 days. The experimental group received the same basic treatment as the control group except that deuterium depleted water was used instead of purified water. The incidence and alleviation of 131I radiation-induced gastroenteritis were observed and compared between the two groups using the Fisher’s exact test and Kaplan-Meier analysis. Results The number of gastroenteritis cases from day 1 to day 5 after 131I administration was 2 (8%), 5 (20%), 2 (8%), 1 (4%), and 0 (0%), respectively, in the experimental group, and 2 (8%), 8 (32%), 4 (16%), 3 (12%), and 1 (4%), respectively, in the control group. The incidence of gastroenteritis was significantly different between the two groups (χ2=4.064, P=0.044). After 5 days of treatment, the overall response rate of patients in the experimental group was 96%, which was significantly higher than 76% in the control group (χ2=9.105, P=0.025). Conclusion Oral administration of deuterium depleted water is effective in the relief of clinical symptoms of 131I radiation-induced gastroenteritis in thyroid cancer treatment. The clinical application of deuterium depleted water should be further investigated.

Nutritional status in children with cancer: comparison of deuterium oxide dilution with bioelectric impedance analysis and anthropometry / Estado nutricional em crianças com câncer: comparação entre diluição de deutério, impedância bioelétrica e antropometria

ABSTRACT Objective: To explore changes in the nutritional status of pediatric cancer patients before and after chemotherapy and evaluate the correlation between deuterium oxide dilution, bioelectric impedance analysis, and anthropometry for assessment of body composition. Methods: This study included 14 children (aged 5.6 to 13.6 years) and classified them as having hematologic or solid tumors. They had their body composition analyzed according to deuterium oxide, bioelectric impedance, and anthropometric measurements before the first chemotherapy cycle and after three and six months of therapy. Results: The patients in the hematologic tumor group had an increase in weight, height, body mass index, waist, hip, and arm circumference, subscapular skinfold thickness, and fat mass with the isotope dilution technique during chemotherapy. In the solid tumor group, the children showed a reduction in fat-free mass when assessed by bioimpedance analysis. We found a positive correlation between the triceps skinfold thickness and fat mass determined by bioimpedance analysis and deuterium oxide. The arm muscle circumference correlated with the fat-free mass estimated by bioimpedance analysis and deuterium oxide. Conclusions: Patients with hematologic tumors had an increase in body weight, height, and fat mass, which was not identified in the solid tumor group. The positive correlation between anthropometry (triceps skinfold thickness and arm muscle circumference), deuterium oxide dilution, and bioelectric impedance analysis shows the applicability of anthropometry in clinical practice.

RESUMO Objetivo: Verificar mudanças no estado nutricional de crianças com câncer antes e após o tratamento quimioterápico e avaliar a correlação entre diluição de óxido de deutério, análise de impedância bioelétrica (BIA) e dados antropométricos. Métodos: Quatorze crianças (entre 5,6 e 13,6 anos de idade) foram incluídas e classificadas como tendo tumores hematológicos ou sólidos. A composição corporal foi medida pelo óxido de deutério, impedância bioelétrica e medidas antropométricas antes da primeira quimioterapia e após três e seis meses de terapia. Resultados: Os pacientes do grupo de tumores hematológicos aumentaram o peso, a estatura, o índice de massa corporal, a circunferência da cintura, quadril e braço, dobra cutânea subescapular e a massa gorda com a técnica de diluição isotópica durante o tratamento quimioterápico. No grupo de tumores sólidos, as crianças mostraram uma redução na massa magra quando avaliadas por análise de impedância. Houve uma correlação positiva entre a dobra cutânea tricipital e a massa gorda determinadas pela análise de impedância e pelo óxido de deutério. A circunferência muscular do braço correlacionou-se com a massa magra estimada pela análise de impedância e pelo óxido de deutério. Conclusões: Pacientes com tumores hematológicos tiveram aumento no peso corporal, estatura e massa gorda, o que não foi observado naqueles com tumores sólidos. A boa correlação entre a antropometria (dobra cutânea tricipital e circunferência muscular do braço), a diluição do óxido de deutério e a análise da impedância bioelétrica mostra a aplicabilidade da antropometria na prática clínica.

Effect of deuterium depleted water combined with platelet-rich plasma on wound healing of diabetic ulcer in rats / 上海交通大学学报（医学版）

Objective: To observe the effect of deuterium depleted water combined with platelet-rich plasma on wound healing of diabetic ulcer in rats, and to explore its possible mechanism. Methods: Male SD rats were randomly divided into two groups, normal control group (group A, n=20) and diabetic group (n=80). Rats in the diabetic group were fed with high-fat diet for 4 weeks, and the rat diabetic ulcer model was replicated by intraperitoneal injection of streptozotocin (STZ) + skin full-thickness resection; then randomly divided into diabetic model group (group B), platelet-rich plasma group (group C), deuterium depleted water group (group D), and deuterium depleted water combined platelet-rich plasma group (group E), with 18 rats for each group. Group A with common feed was fed for 4 weeks after intraperitoneal injection of an equal volume of citric acid-sodium citrate buffer + skin full-thickness resection to replicate the normal ulcer model. The animals were sacrificed after treatment for 3, 7 and 14 d, and the random blood glucose was measured at each corresponding time point. The wound surface and wound margin tissue were taken to observe the wound healing and local histomorphology of each group. The contents of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the wound tissue of each group were detected by enzyme-linked reaction adsorption method. Results: Random blood glucose in group D and group E was lower than that before intervention. The inflammatory response of the wounds in each diabetic group was slower than that in group A. The granulation ripening effect of group E was faster than that of group B, C, and D. The effect was best in each intervention group, and the neovascularization and fibroblasts appeared earlier and in large quantities. The content of TIMP-1 in group A was significantly higher than that in group B, C, D and E (P<0.05). The content of TIMP-1 in group B was significantly lower than that in group C, D and E (P<0.05). The content of TIMP-1 was significantly higher than that of group C and D (P<0.05). The content of MMP-9 in group B was significantly higher than that in group A, C, D and E (P<0.05). The content of MMP-9 in group E was significantly lower than that in group C and D (P<0.05). Conclusion: Deuterium depleted water can promote the healing of diabetic ulcer wounds. Deuterium depleted water combined with platelet-rich plasma can significantly promote the healing of diabetic ulcer wounds, which may be related to the decrease of random blood glucose, the increase of TIMP-1 and the inhibition of MMP-9 expression.

Relación entre indicadores antropométricos y masa grasa medida por deuterio en escolares costarricenses / Relationship between anthropometric indicators and fat mass measured by deuterium in Costa Rican schoolchildren / Relação entre indicadores antropométricos e massa gordurosa medida por deutério em crianças da escola costarriquenhos

El propósito de este estudio fue identificar la relación entre la masa grasa expresada como porcentaje de grasa corporal (%GC) medida por el método de deuterio (D2O) e indicadores antropométricos en escolares costarricenses. Se trata de un estudio descriptivo transversal en el que participaron 54 niños y 49 niñas de 6 a 9 años. Se realizaron medidas antropométricas: peso, talla, índice de masa corporal, circunferencia de brazo, circunferencia de cintura, circunferencia abdominal, pliegue cutáneo subescapular y pliegue cutáneo tricipital. El análisis del %GC se realizó por medio del método de referencia del D2O. Se realizó una estadística descriptiva y se aplicó un análisis de coeficiente de correlación de Pearson para identificar la relación entre las mediciones antropométricas y el %GC obtenido por D2O. En el grupo de escolares, las niñas presentaron valores mayores de talla y pliegue cutáneo tricipital (p<0,05) y %GC obtenida por D2O (p<0,001). Se observó una fuerte correlación entre el %GC medido por D2O y el índice de masa corporal, la circunferencia de cintura y la circunferencia abdominal tanto en los niños como en las niñas. Se concluye que la circunferencia de cintura y la circunferencia abdominal podrían ser utilizadas conjuntamente con el IMC como herramientas para el diagnóstico de sobrepeso y obesidad en población escolar, cuando no se cuente con metodologías más precisas que determinen el %GC.

The purpose of this study was to identify the relationship between fat mass (FM) expressed as body fat percentage (%BF) measured by the deuterium method (D2O) and anthropometric indicators in Costa Rican schoolchildren. A cross-sectional descriptive study was performed and the participants were 54 boys and 49 girls of ages between six and nine years old. The anthropometric measurements recorded were weight, height, body mass index (BMI), arm circumference (AC), waist circumference (WC), abdominal circumference (AC), subscapular skinfold (SSF), and tricipital skinfold (TSF). The analysis of %BF was performed by means of D2O reference method. Descriptive statistics and the application of Pearson correlation coefficient analysis identified the relationship between anthropometric measurements and %BF obtained by D2O. From the group of schoolchildren, the girls showed greater values for height and tricipital skinfold (p<0.05) and %BF obtained by D2O (p<0.001). This study evidences a strong correlation between %BF measured by D2O and BMI, WC and AC in both girls and boys. It is concluded that WC and AC could be used together with the IMC as tools for the diagnosis of overweight and obesity in schoolchildren, when there are no more precise methodologies that determine the %BF.

O objetivo deste estudo foi identificar a relação entre a massa gordurosa (MG), expressa como percentagem de gordura corporal (%GC) medida pelo método de deutério (D2O) e indicadores antropométricos em escolas da Costa Rica. Trata-se de um estudo descritivo transversal, no qual participaram 54 meninos e 49 meninas com idade entre seis e nove anos. Foram realizadas medidas antropométricas: peso, tamanho, índice de massa corporal (IMC), circunferência do braço (CB), circunferência da cintura (CC), circunferência abdominal (CA), prega cutânea subescapular (PCS) e prega cutânea tricipital (PCT). A análise da %GC foi realizada pelo método de referência D2O, realizou-se uma estatística descritiva e foi aplicada análise coeficiente de correlação de Pearson para identificar a relação entre as medições antropométricas e a %GC obtida por meio do D2O. No grupo de escolares, as meninas apresentaram maiores valores de estatura e PCT (p<0,05) e %GC obtida por D2O (p<0,001). Observou-se uma importante correlação entre %GC medida por D2O e IMC, CC e CA tanto nos meninos quanto nas meninas. Conclui-se que a CC e a CA poderiam ser utilizadas conjuntamente com o IMC como ferramenta para o diagnóstico de sobrepeso e obesidade em população escolar, quando não se conte com metodologias mais precisas que determinem o %GC.

Comparison of Breastfeeding Practice using Deuterium Oxide Dose to Mother Technique with Maternal Recall Breastfeeding Practice among Mothers in Klang Valley / Jurnal Sains Kesihatan Malaysia

@#The assessment of exclusive breastfeeding is important to invest the efforts to promote and support breastfeeding practices. Hence this study was carried out to compare breastfeeding practices among mothers using deuterium dose to mother technique with maternal recall breastfeeding practice. A total of 30 mother-infant pairs from a university hospital and government health clinics in Klang Valley participated and completed the study. Mother-infant pairs were recruited into the study when infants were aged 3 months ± 1 week. Anthropometric measurements (height, weight, waist circumference for mother; length and weight for infant) were carried out. Socio-demographic questionnaire was self-administered while breastfeeding practices were interview administered using maternal recall breastfeeding practice questionnaire (MRBF). This was followed by baseline saliva collection of mother-infant pairs before dose and 6 days after mothers were given 30 ± 0.01g of D2O. The post dose saliva sample of mother-infant pairs were collected 6 times at day 1,2,3,4,13 and 14. The results showed that majority of mothers (57%) were university graduates but majority were stay at home mothers. Meanwhile, mothers had BMI with mean 25 ± 4 kg/m2. The results from MRBF questionnaire showed that all mothers were practising exclusive breastfeeding and their infant never received any water sources other than their breast milk. However, the deuterium dose to mother technique revealed only 3% of mothers were actually practising exclusive breastfeeding. From the isotopic data, the calculated mean intake of milk was 721 ± 243 g/day while the mean non-milk oral intake of 122 ± 22 g/ day. In contrast exclusive breastfeeding infants received only 10 g/day non milk oral intake, demonstrating exclusive breastfeeding practice of mothers. There were different breastfeeding practice reported from mother using deuterium oxide dose to mother technique with maternal recall breastfeeding practice.

Evaluación antropométrica y composición corporal por medio de óxido de deuterio en escolares costarricenses / Anthropometric evaluation and body composition by means of deuterium oxide in Costa Rican schoolchildren

El objetivo del estudio fue determinar elestado nutricional de escolares costarricenses de seis a nueve años. Participaron 103 escolares (54 niños y 49 niñas) con un promedio de edad de 7,8 ± 0,9 años. Se evaluó peso, talla, talla sentado, circunferencia de cintura (CC), índice de masa corporal (IMC), índice córmico (IC) y relación cintura-talla (IC/T). Se utilizó el óxido de deuterio (D2O) para evaluar la composición corporal: % agua corporal total (% ACT), masa libre de grasa (MLG), masa grasa (MG) y % de grasa corporal (% GC). El sobrepeso/obesidad se determinó utilizando el IMC y el método de clasificación de McCarthy para % GC de acuerdo a sexo y edad. Los valores medios para niños y niñas fueron: peso (29,1 ± 7,2 vs 31,0 ± 6,7 kg), talla (124.7 ± 6.7 vs 127.5 ± 7.1 cm), talla sentado (64.4 ± 3.7 vs 65.6 ± 3.5 cm), IMC (18.5 ± 3.11 vs 18.9 ± 2.7 kg/m2), CC (62.1 ± 8.6 vs 63.8±7.8 cm), IC (51.6 ± 1.6 vs 51.5 ± 1.6), I.C/T (0.52 ± 0.1 vs 0.51 ± 0.1), % ACT (56.5 ± 5.7 vs 51.9 ± 4.5 %), MLG (21.0 ± 3.5 vs 20.5 ± 3.6 kg), MG (8.1 ± 4.2 vs 10.5 ± 3.6 kg), % GC (26.3 ± 7.3 vs 33.2 ± 5.7 %), respectivamente. La edad, talla, MG, % GC y % ACT fueron significativamente mayores (p<0.05) en las niñas. Los escolares presentan un crecimiento adecuado junto a una alta prevalencia de sobrepeso/obesida(AU)

The aim of the study was to determine the nutritional status of Costa Rican schoolchildren from six to nine years old. Participants were 103 schoolchildren (54 boys and 49 girls) with an average age of 7.8 ± 0.9. Each participant was assessed for weight, height, sitting height, waist circumference (WC), body mass index (BMI), cormic index (CI), and waist-height ratio (WHtR). Deuterium oxide dilution (D2O) was used to assess body composition; total body water % (TBW%), fat-free mass (FFM), fat mass (FM), and body fat % (BF %). Overweight/obesity was determined by the use of BMI and McCarthy's classification scheme for BF % in terms of sex and age. Mean values for boys and girls were: age (7.6 ± 0.9 vs 8.0 ± 1.0 years), weight (29.1 ± 7.2 vs 31.0 ± 6.7 kg), height (124.7 ± 6.7 vs 127.5 ± 7.1 cm), sitting height (64.4 ± 3.7 vs 65.6 ± 3.5 cm), BMI (18.5 ± 3.11 vs 18.9 ± 2.7 kg/m2), WC (62.1 ± 8.6 vs 63.8 ± 7.8 cm), CI (51.6 ± 1.6 vs 51.5 ± 1.6), WHtR (0.52 ± 0.1 vs 0.51 ± 0.1), TBW % (56.5 ± 5.7 vs 51.9 ± 4.5 %), FFM (21.0 ± 3.5 vs 20.5 ± 3.6 kg), FM (8.1 ± 4.2 vs 10.5 ± 3.6 kg), BF% (26.3 ± 7.3 vs 33.2 ± 5.7 %), respectively. Age, height, FM, BF %, and TBW % were significantly higher (p<0.05) in girls. Schoolchildren show adequate growth along with high prevalence of overweight/ obesity(AU)

Research progress of biological effects of deuterium-depleted water / 上海交通大学学报（医学版）

When the deuterium concentration of water is lower than 0.015%, the water is known as deuterium-depleted water (DDW), deuterium-poor water or super light water. Deuterium-depleted water may affect the biochemical and metabolic processes of living organisms, for it has some biological effects such as anticancer effect, antioxidant effect, hypoglycemic effect, antidepressant effect and so on. Deuterium-depleted water appears to have little toxic side effects and is convenient to administer, so it may act as an adjuvant therapeutic agent in clinical treatment of diseases. In this paper, advances in research on biological effects of deuterium-depleted water were reviewed.

Principio y práctica de la ciencia nuclear en salud: evaluación del agua corporal total y la composición corporal, en población residente de gran altitud, La Paz, Bolivia / Principle and practice of nuclear science in health: evaluation of total body water and body composition, in high altitude resident population, La Paz, Bolivia

Mediante la utilización de la Ciencia Nuclear es posible hacer uso de los isótopos estables, identificados como trazadores, que permiten la aplicación del principio fisiológico de "dilución isotópica" en el organismo y con él se puede medir el agua corporal total. En los estudios de fisiología de altura, también se aplica el fundamento que aporta la ley de conservación de masas en un organismo. La práctica de este método permite generar conocimiento en altitud, haciendo bien las cosas correctas, por lo que se logra ser efectivo en los estudios realizados en diferentes grupos poblacionales habitantes permanentes de gran altitud. La técnica nuclear, ha permitido mediante el análisis del deuterio en sujetos estudiados, establecer la composición corporal, determinando el porcentaje del agua corporal total y la masa grasa corporal. Se estima que los habitantes permanentes de gran altitud presentarían una composición corporal con menor porcentaje de agua corporal que los habitantes de nivel del mar.

Using the Nuclear Science it is possible to make use of stable isotopes, identified as tracers, which allow the application ofthe physiological principle of "isotopic dilution" in the organism and with it the total body water can be measured. In the studies of physiology at high altitude, the foundation that the law of conservation of masses in an organism is also applied. The practice of this method allows to generate knowledge at altitude doing the right things well, so it is effective in studies conducted in different population groups permanent inhabitants of high altitude. The nuclear technique, has allowed by means of the analysis of the deuterium in studied subjects, to establish the corporal composition, determining the percentage of the total corporal water and the body  fat mass. It is estimated that permanent inhabitants of high altitude would have a body composition with a lower percentage of body water than sea level inhabitants.

Investigation of Protonated and Lithiated Leucine-Enkephalin by Hydrogen/Deuterium Exchange and Theoretical Calculations / 分析化学

Differences of protonated and lithiated leucine-enkephalin(LE) were investigated by hydrogen deuterium exchange-mass spectrometry(HDX-MS) combined with quantum chemistry calculation. The results revealed that the protonated ions possessed very high product yield with all hydrogen atoms being exchanged, while the reaction of lithiated LE stopped after exchanging five hydrogen atoms in the same experimental conditions. The different HDX behaviours probably indicated their conformational differences. To further clarify the experimental results, the most stable conformations of protonated and lithiated leucine-enkephalin were calculated by density functional theory. It was found that terminal amino group was the most thermodynamically stable protonation site,while Li+in coordination of four carbonyl oxygen atoms formed the most favourable lithiated LE. The reaction field reduction of lithium LE was probably due to the less acidity of hydrogen atoms and the increasing rigid conformation change induced by lithium ion.

Design and synthesis of deuterium-labeled vorapaxar / 中国药科大学学报

Vorapaxar,a novel antagonist of the protease-activated receptor 1 (PAR-1 ),can inhibit the clotting process. Deuterium-labeled vorapaxar was required for the analysis of clinical sample as an internal stand-ard. Starting for unlabeled vorapaxar,four-step reactions including hydrolysis,condensation,transesterification and hydrogen-deuterium exchange were carried out to synthesize [D8]vorapaxar effectively for the first time. All intermediates and final products were confirmed by NMR and high resolution mass spectrometry (HRMS).Impor-tantly,the prepared [D8]vorapaxar could meet the requirements of sample analysis as the internal standard.

Research progress of biological effects of deuterium-depleted water / 上海交通大学学报（医学版）

When the deuterium concentration of water is lower than 0.015％,the water is known as deuterium-depleted water (DDW),deuterium-poor water or super light water.Deuterium-depleted water may affect the biochemical and metabolic processes of living organisms,for it has some biological effects such as anticancer effect,antioxidant effect,hypoglycemic effect,antidepressant effect and so on.Deuterium-depleted water appears to have little toxic side effects and is convenient to administer,so it may act as an adjuvant therapeutic agent in clinical treatment of diseases.In this paper,advances in research on biological effects of deuterium-depleted water were reviewed.

Validation of anthropometric and bioelectrical impedance analysis (BIA) equations to predict total body water in a group of Cameroonian preschool children using deuterium dilution method

BACKGROUND: Little information is available on the validity of anthropometry or impedance-based equations for prediction of total body water (TBW) in African children. This study was designed to validate and develop equations to predict total body water in Cameroonian children. METHODS: TBW was measured by deuterium dilution in 102 children between 24 and 60 months of age and compared with the ones predicted by 5 anthropometric and 7 BIA equations. Multiple linear regression analysis was used to develop prediction equations for TBW from anthropometric parameters. RESULTS: Unacceptable discrepancies in the estimates of TBW at individual level were noted with all the equations tested. The following new anthropometry and BIA equations for the estimation of TBW were respectively developed: TBW = 6.488 + 0.434 × sex−0.039 × age + 0.670 × weight−0.081 × MUAC (cm)−0.372 × BMI (adjustedR2= 0.71,RMSE = 3.6), and TBW =−6.206 + 0.0037 × height2/Z−0.041 × age + 0.265 × weight + 0.1214 × height (adjustedR2=0.68, RMSE = 1.4). The cross-validation procedures revealed that the predicted values of TBW compared with measured values are accurate at a group level. CONCLUSION: The current published anthropometric and BIA equations are invalid for the estimation of TBW in Cameroonian preschool children. The newly developed anthropometry or BIA prediction equations are valid for use in Cameroonian children aged 24­60 months

Dilución isotópica con deuterio para determinar ingesta de leche humana y composición corporal materna / Deuterium-oxide turnover technique to assess breast milk intake and maternal body composition / Diluição isotópica com deutério para determinar a ingestão de leite humano e a composição corporal materna

El objetivo del trabajo fue describir la aplicación de la técnica de dilución isotópica con deuterio de dosis a la madre para determinar la ingesta de leche materna y la composición corporal de las madres, en distintos tipos de lactancia. El método analítico se aplicó en cuatro casos modelo de pares madre-lactante en los cuales las madres recibieron una dosis oral de agua deuterada, recolectándose 6 muestras de saliva de ambos durante 15 días. El enriquecimiento de deuterio se determinó en un espectrómetro FTIR-Shimadzu-Affinity obteniéndose la ingesta de leche materna (ILM) y de agua de otras fuentes (Fd). Se observó una variación del enriquecimiento de deuterio en la saliva del lactante, asociada al tipo de lactancia recibida, siendo mayor en el caso de lactancia materna exclusiva (LME). Asimismo, a medida que aumentó Fd, disminuyó ILM. Además, fueron determinadas el agua corporal, la masa libre de grasa y la masa grasa materna. La transferencia de las habilidades técnicas y del conocimiento a través de metodologías innovadoras para determinar la ingesta de leche materna es de utilidad como herramienta de evaluación de la alimentación del lactante y para investigar en qué medida la lactancia natural es reemplazada por la ingesta de otros alimentos. Mejorar la estimación de la LME contribuye al conocimiento de la recomendación de OMS y UNICEF de mantener la misma hasta el sexto mes de vida.

The aim of this study was to describe the application of the dose-to-the-mother deuterium-oxide turnover technique to determine the breast milk intake and body composition of mothers in different types of breastfeeding. This analytical method was performed in four mother-infant pairs at 4 months from birth. Mothers received an oral dose of deuterated water, collecting 6 samples of saliva from mother and baby during a period of 15 days. Deuterium enrichment was determined in a Shimadzu FTIR-spectrometer-Affinity to obtain the intake of breast milk and water from non-breast milk sources. In this study, a variation of the enrichment of deuterium in the saliva of the infant was observed, being higher when the infant was exclusively breastfed. As non-breast milk water increased, the intake of human milk decreased. Furthermore, maternal total body water, fat free mass and fat mass were determined. To improve technical skills and knowledge through innovative methods of breast milk measurement can be useful as an assessment tool for evaluating infant feeding and investigating the extent to which breast milk is being replaced by the consumption of other foods in order to estimate exclusive breastfeeding in the future. This would contribute to the knowledge of maintaining breastfeeding until the sixth month of life, as it is recommended by WHO and UNICEF.

O objetivo deste estudo foi descrever a aplicação da técnica de diluição isotópica com deutério de dose à mãe para determinar a ingestão de leite materno e a composição corporal das mães, em diferentes tipos de aleitamento. O método analítico foi aplicado em quatro casos modelo de pares mães-lactante nos quais as mães receberam uma dose oral de água deuterada, coletando-se 6 amostras de saliva de ambos (mães e lactantes) durante 15 días. O enriquecimento de deutério foi determinado em um espectrômetro FTIR-Shimadzu-Affinity, sendo obtida a ingestão de leite materno (ILM) e de água proveniente de outras fontes (Fd). Observou-se uma variação do enriquecimento de deutério na saliva do lactante, associada ao tipo de aleitamento recebido, sendo maior no caso de aleitamento materno exclusivo (AME). Também, na medida que aumentou Fd, diminuiu ILM. Além disso, a água corporal, a massa livre de gordura y a massa gorda materna foram determinadas. A transferência das habilidades técnicas e do conhecimento através de metodologias inovadoras para determinar a ingestão de leite materno é de utilidade como ferramenta de avaliação da alimentação do lactante e para investigar em que medida o aleitamento natural é substituído pela ingestão de outros alimentos. Melhorar a avaliação do AME contribui ao conhecimento da recomendação da OMS e UNICEF de manter a mesma até o sexto mês de vida.

Deuterium oxide dilution and body composition in overweight and obese schoolchildren aged 6-9 years / Diluição do óxido de deutério e composição corporal em escolares de seis a nove anos com sobrepeso e obesidade

ABSTRACT OBJECTIVE: To correlate different methods of body composition assessment in overweight or obese schoolchildren, using deuterium oxide (D2O) dilution as a reference. METHODS: Percentage of total body water (%TBW), fat free mass (%FFM), and body fat (%BF) were assessed by D2O and tetrapolar electrical bioimpedance analysis (BIA) in 54 obese and overweight students aged 6-9 years. Skinfold thickness (ST), body mass index (BMI), conicity index (CI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip (WHR) ratio were also used. RESULTS: Mean values for body composition were 38.4% ± 8.4% BF, 44.9% ± 6.1% TBW and 61.6% ± 8.4% FFM. There was no significant difference in body weight, body fat mass (FM), TBW, and FFM between genders. Regarding D2O, ST underestimated %BF, and overestimated %FFM in both genders (p < 0.05). BIA overestimated %TBW in the group as a whole and in males (p < 0.05). The only positive and strong correlations occurred in females regarding the WC (s= 0.679), CI (r = 0.634), and WHtR (r = 0.666). CONCLUSIONS: In this sample of obese and overweight children, there were strong correlations between body composition measured by D2O and some indices and anthropometric indicators in females, but there was no positive and strong correlation of fat tissue with the indices/indicators at all ages and in both genders.

RESUMO OBJETIVO: Correlacionar diferentes métodos para avaliação de composição corporal em escolares diagnosticados com sobrepeso e obesos com o uso como referência da diluição de óxido de deutério (D2O). MÉTODOS: O percentual de água corporal total (%ACT), massa livre de gordura (%MLG) e gordura corporal (%GC) foi obtido pelo D2O e pela bioimpedância elétrica tetrapolar (BIA), em 54 estudantes com sobrepeso e obesos, entre seis-nove anos. O método das dobras cutâneas (DC) com o uso de triciptal e panturrilha, índice de massa corporal (IMC), índice de conicidade (IC), circunferência de cintura (CC), relação cintura/estatura (RCE) e relação cintura/quadril (RCQ) também foi usado. RESULTADOS: Os valores médios para composição corporal aferidos pelo D2O foram 38,4 ± 8,4%GC, 44,9 ± 6,1%ACT e 61,6 ± 8,4%MLG. Não houve diferença significativa entre peso corporal, massa corporal de gordura (MG), ACT e MLG entre os sexos. Considerando o D2O, DC subestimou o %GC e superestimou o %MLG em ambos os sexos (p < 0,05); BIA superestimou %ACT no grupo como um todo e no masculino (p < 0,05). As únicas correlações fortes e positivas ocorreram no grupo feminino nas variáveis CC (s = 0,679), IC (r = 0,634) e RCE (r = 0,666). CONCLUSÕES: Nessa amostra de crianças obesas e com sobrepeso, houve fortes correlações entre a composição corporal mensurada pelo D2O e alguns índices e indicadores antropométricos nas meninas, mas nenhuma correlação forte e positiva do tecido adiposo foi encontrada com os índices/indicadores em todas as idades e ambos os sexos.

Reflexiones sobre la memoria del agua y los espectros infrarrojos en el area de salud: a propósito de determinar la composición corporal con isótopos estables / Reflections on water memory and infrared spectra in the health area: a purpose of determining body composition with stable isotopes

Se presenta conceptos sobre la determinación de la composición corporal a través del uso de la técnica de isótopos estables, como el deuterio, mediante el uso de muestras de saliva en escolares de gran altitud. Dichas muestras se encuentran enriquecidas por el óxido de deuterio en todo el cuerpo del escolar y son analizadas con la espectrometría infrarroja con transformada de Fourier. En la actualidad, en el campo de la electromagnética, se hace hincapié sobre una nueva propiedad de las secuencias de ADN bacteriano que inducen a la producción de ondas electromagnéticas, resaltando la memoria que tiene el agua al poder mantener los fragmentos de ADN por largo tiempo, que son generadores de señales, definidos como Biomarcadores, que permitirían la detección de infecciones bacterianas crónicas en el organismo humano a través del uso de la electromagnética. La reflexión a la que se llega, es que muestras de saliva contaminadas con microorganismos, como las bacterias, interfieren con la medición del enriquecimiento de deuterio identificada por el equipo FTIR. Se deja como lección aprendida, el insistir sobre la higiene oral previa a la hora de tomar muestras de saliva, que minimice la contaminación con microorganismos, para lograr determinar el enriquecimiento alcanzado con el deuterio, y así no incurrir en el error de medición que daría resultados no reales del agua corporal total de los sujetos estudiados.

This workpresents concepts about determining body composition byusing the stable isotope technique, as deuterium, using saliva samples in school children at high altitude. These samples are achieved by the enrichment of deuterium oxide in the whole body of the school children and then are analyzed with Fourier transform infrared spectrometer. Currently there is an emphasis on a new property of the bacterial DNA sequences that induce the production of electromagnetic waves, that highlights the water memory to be able to maintain the DNA fragments, signal generators that are defined as Biomarkers, which allow the detection of chronicle bacterial infections in the body. A reflection is that saliva samples contaminated with microorganisms such as bacterias interfere with the measurement of the deuterium enrichment identified by FTIR equipment. The learnt lesson is about oral hygiene, which minimizes contamination with microorganisms from the saliva samples to determine the enrichment achieved with deuterium, and not to make the mistake of measuring actual results would total body water of the subjects studied.

Utilidad de las técnicas nucleares en nutrición: evaluación de la masa grasa corporal y de la ingesta de leche materna / Nuclear techniques in nutrition: assessment of body fat and intake of human milk in breast-fed infants

Las técnicas nucleares aplicables al área de nutrición son inocuas dado que utilizan isótopos estables. En particular, la dilución isotópica con deuterio evalúa la composición corporal y la ingesta de leche materna. Es un método de referencia para conocer grasa corporal y validar herramientas de bajo costo debido a su exactitud, facilidad de aplicación y por la base de antecedentes de su utilización en adultos y niños. Es no invasiva ya que utiliza saliva como muestra de análisis, lo que la hace aplicable a poblaciones pediátricas. Modificaciones en la grasa se asocian a enfermedades no transmisibles y existen individuos con peso normal pero mayor depósito de grasa. Por ello, es de utilidad analizar sus cambios como instrumento de evaluación en clínica y en programas de salud. Además, esta técnica es la forma exacta de determinar si los lactantes son amamantados exclusivamente mediante seno materno, establecer lactancia materna exclusiva y validar métodos convencionales basados en encuestas a las madres.

The application of nuclear techniques in the area of nutrition is safe because they use stable isotopes. The deuterium dilution method is used in body composition and human milk intake analysis. It is a reference method for body fat and validates inexpensive tools because of its accuracy, simplicity of application in individuals and population and the background of its usefulness in adults and children as an evaluation tool in clinical and health programs. It is a non-invasive technique as it uses saliva, which facilitates the assessment in pediatric populations. Changes in body fat are associated with non-communicable diseases; moreover, normal weight individuals with high fat deposition were reported. Furthermore, this technique is the only accurate way to determine whether infants are exclusively breast-fed and validate conventional methods based on surveys to mothers.

Estudo da composição corporal de idosas ativas pelos métodos óxido de deutério e antropométrico / Study of body composition in elderly active women by the anthropometric and deuterium oxide methods

Com o envelhecimento, ocorrem alterações na composição corporal, observando-se uma redução da massa magra (MM) e um aumento progressivo da massa gorda (MG). O objetivo deste estudo foi descrever a composição corporal de mulheres idosas ativas, pelos métodos de antropometria e óxido de deutério e verificar a concordância do método antropométrico com o método óxido de deutério, considerado como referência nesse estudo. Participaram do estudo 22 idosas independentes, com faixa etária entre 65 a 75 anos. O peso corporal foi avaliado usando balança digital e a altura usando um estadiômetro em barra vertical. Para identificar o nível de atividade física foi usado o questionário internacional de atividade física (IPAQ, versão longa). A composição corporal foi avaliada pela antropometria pelas equações de Jackson et al. e Durnin e Womersley e pelo método de óxido de deutério (²H2O). Para análise estatística, usaram-se o coeficiente de concordância de Lin e o gráfico de Bland e Altman. A média de idade foi 69,3±3,6 anos, o peso 67,2±10,6Kg, a altura 1,55±0,04m e o índice de massa corporal 27,9±5,0 kg/m². Os coeficientes de concordância obtidos pelas equações de Jackson et al. e Durnin e Womersley comparados ao deutério foram: %GC 0,72 e 0,71; MG 0,90 e 0,91; e MM 0,46 e 0,57. As equações utilizadas neste estudo apresentaram boa concordância com o deutério, sendo que, a equação de Durnin e Womersley apresentou melhores resultados para avaliar a composição corporal de idosas ativas.

Aging is accompanied by changes in body composition, including a decrease the free fat mass (FFM) and a progressive increase in the body fat (FM). The objective this study was to report the body composition in elderly active women, using the anthropometric and deuterium oxide methods, and to analyze the concordance between them, the last one being considered the gold standard. Twenty two non-dependent elderly women aging 65-75 years old were evaluated. Body weight was assessed using a digital scale (Filizola) and height was measured with a vertical bar stadiometer. The level of physical activity was evaluated using the international physical activity questionnaire (IPAQ-long version). Body composition was assessed by anthropometry, using the equations of Jackson et al. and Durnin and Womersley, and by the deuterium oxide (²H2O). Statistical analysis was done using the Lin concordance correlation coefficient and the Bland and Altman graphs. Mean age was 69.3 ± 3.6 years, weight 67.2 ± 10.6 kg, height 1.55 ± 0.04 m and body mass index 27.9 ± 5.0 kg/m². The concordance correlation coefficient obtained by the equations of Jackson et al. and Durnin and Womersley, compared with the deuterium were: %FM 0.72 and 0.71; FM 0.90 and 0.91; and FFM 0.46 and 0.57. The equations used in this study showed good concordance between the anthropometry and deuterium, but the equation of Durnin and Womersley showed better results in the assessment of body composition in elderly active women.

Body Composition of Bangladeshi Children: Comparison and Development of Leg-to-Leg Bioelectrical Impedance Equation.

The aim of this study was to investigate the validity of the Tanita TBF 300A leg-to-leg bioimpedance analyzer for estimating fat-free mass (FFM) in Bangladeshi children aged 4-10 years and to develop novel prediction equations for use in this population, using deuterium dilution as the reference method. Two hundred Bangladeshi children were enrolled. The isotope dilution technique with deuterium oxide was used for estimation of total body water (TBW). FFM estimated by Tanita was compared with results of deuterium oxide dilution technique. Novel prediction equations were created for estimating FFM, using linear regression models, fitting child’s height and impedance as predictors. There was a significant difference in FFM and percentage of body fat (BF%) between methods (p<0.01), Tanita underestimating TBW in boys (p=0.001) and underestimating BF% in girls (p<0.001). A basic linear regression model with height and impedance explained 83% of the variance in FFM estimated by deuterium oxide dilution technique. The best-fit equation to predict FFM from linear regression modelling was achieved by adding weight, sex, and age to the basic model, bringing the adjusted R2 to 89% (standard error=0.90, p<0.001). These data suggest Tanita analyzer may be a valid field-assessment technique in Bangladeshi children when using populationspecific prediction equations, such as the ones developed here.

Body composition measures of obese adolescents by the deuterium oxide dilution method and by bioelectrical impedance

The objectives of the present study were to describe and compare the body composition variables determined by bioelectrical impedance (BIA) and the deuterium dilution method (DDM), to identify possible correlations and agreement between the two methods, and to construct a linear regression model including anthropometric measures. Obese adolescents were evaluated by anthropometric measures, and body composition was assessed by BIA and DDM. Forty obese adolescents were included in the study. Comparison of the mean values for the following variables: fat body mass (FM; kg), fat-free mass (FFM; kg), and total body water (TBW; percent) determined by DDM and by BIA revealed significant differences. BIA overestimated FFM and TBW and underestimated FM. When compared with data provided by DDM, the BIA data presented a significant correlation with FFM (r = 0.89; P < 0.001), FM (r = 0.93; P < 0.001) and TBW (r = 0.62; P < 0.001). The Bland-Altman plot showed no agreement for FFM, FM or TBW between data provided by BIA and DDM. The linear regression models proposed in our study with respect to FFM, FM, and TBW were well adjusted. FFM obtained by DDM = 0.842 x FFM obtained by BIA. FM obtained by DDM = 0.855 x FM obtained by BIA + 0.152 x weight (kg). TBW obtained by DDM = 0.813 x TBW obtained by BIA. The body composition results of obese adolescents determined by DDM can be predicted by using the measures provided by BIA through a regression equation.