Methodological agreement between two-compartment body-composition methods in children.

Increases in childhood obesity have emphasized the importance of accurate and accessible body composition assessment, especially in monitoring prevention and treatment efforts. Previous pediatric studies, comparing measures from air-displacement plethysmography (ADP) to dual-energy X-ray absorptiometry (DXA) and anthropometry (ANTH, skinfold measures), were performed in small numbers of children or in children across large age and body-size ranges. The objectives of this study were: 1) to compare body fat percentage (%BF), fat mass (FM), and fat-free mass (FFM) from ADP with DXA and ANTH, to determine the agreement between techniques; 2) to identify factors that influence agreement or lack of agreement; and 3) to determine if the agreement is constant over a range of body fatness. Healthy children (n = 125), 7-10 years old, participating in a longitudinal pediatric bone health study, were evaluated. Body composition was assessed by ADP, DXA, and ANTH to determine %BF, FM, and FFM. ADP underestimated %BF compared to DXA and ANTH by 5.0% and 1.4%, respectively. Agreement between techniques was influenced by body fatness, height, age, and gender (all P < 0.05). Relatively good agreement was observed between ADP and both DXA and ANTH for FM and FFM. In conclusion, the underestimation of %BF by ADP compared to DXA may be of a magnitude that is clinically significant, especially when using %BF in children to confirm a diagnosis of obesity. Further development of body-composition techniques for young children need to account for variability in age, gender, and level of fatness.

Statistical validation of air-displacement plethysmography for body composition assessment in children.

BACKGROUND: Body composition assessment of children has been hindered by the absence of a safe, quick, and easily tolerated gold standard technique. Existing validation studies of air-displacement plethysmography (ADP) have been based on small, narrowly defined samples, using simple linear regression or Bland-Altman analyses. AIM: Correlations within a multitrait-multimethod matrix (MTMM) and factor analytic methodologies were used to evaluate ADP as a valid and reliable body composition technique for children. SUBJECTS AND METHODS: Fat mass (FM), fat-free mass (FFM) and per cent body fat (%BF) were measured in 139 children, 7-10 years old, by ADP, dual energy X-ray absorptiometry (DXA) and anthropometry (ANTH). MTMM and factor analysis were used to compare assessment techniques. RESULTS: Reliability estimates were lower for ADP than for either ANTH or DXA. Convergent and discriminant correlations between ADP and ANTH or DXA were high for identical as well as non-identical measures. Two body composition factors (Fatness, Leanness) and two technique-related factors (Bod Pod, Anthropometry) were identified. CONCLUSION: ADP offers a valid and reliable means of assessing body composition in children but does not perform as well as ANTH or DXA. MTMM and factor analytic methodologies offer an effective alternative to assessing body composition.

Bone area and bone mineral content deficits in children with sickle cell disease.

OBJECTIVE: Children with sickle cell disease (SCD) experience poor growth, altered body composition, and delayed maturation. Deficits in bone mineral content (BMC) and bone area (BA) have not been well characterized. The objectives of this study were to assess whole-body BMC (WBBMC) and WBBA in children with SCD, type SS (SCD-SS), compared with healthy control subjects, adjusted for growth and body composition, and to determine the relationships of WBBMC and WBBA to bone age and hematologic parameters in children with SCD-SS. METHODS: WBBMC, WBBA, and lean mass were measured by dual-energy x-ray absorptiometry in children who were aged 4 to 19 years. Growth, sexual development, and bone age were assessed. Gender-specific z scores for WBBMC relative to age and height were generated from control data. RESULTS: Ninety children with SCD-SS and 198 healthy control subjects were evaluated. SCD-SS was associated with poor growth. WBBMC was significantly decreased in SCD-SS compared with control subjects, adjusted for age, height, pubertal status, and lean mass. WBBMC relative to age and WBBMC relative to height z scores were -0.95 +/- 0.99 and -0.54 +/- 0.97, respectively, and were associated with hemoglobin and hematocrit levels and history of delayed bone age. CONCLUSIONS: Children with SCD-SS have significant deficits in WBBMC that persist despite adjustment for poor growth and decreased lean mass. These children may be at increased risk for fragility fractures and suboptimal peak bone mass.

The relationship between blood leptin level and bone density is specific to ethnicity and menopausal status.

Leptin, the obesity hormone, has been linked to bone mineralization and tumorigenesis. In addition, both bone mineral density (BMD) and postmenopausal breast cancer are associated with obesity, but the interrelationships between obesity, leptin, BMD, and breast cancer are not yet clear. In particular, there is little published research comparing white and black women in terms of these variables. We obtained blood specimens for leptin analysis from a group of 320 breast cancer patients and controls with an ethnic composition of 49% white women and 51% black women. Distal and proximal radial BMD (DBMD and PBMD) were measured by dual-energy X-ray absorptiometry, and age- and ethnicity-specific standardized scores (Z-scores) were calculated for bone density. Blood leptin levels were determined by radioimmunoassay. Blood leptin level was not linked to breast cancer risk. Leptin levels were significantly higher in black women than in white women and were also significantly higher in obese and overweight women than in normal-weight women. Black women weighed more and had a higher body mass index (BMI) than white women. After controlling for BMI, leptin was correlated with DBMD ( r = .17; P < .05) and PBMD ( r = .21; P < .05) in whites, but not in blacks. Leptin was also correlated with both distal and proximal Z-scores in postmenopausal women ( r = .14 and .13; P < .05). Thus leptin may be a predictor for BMD in a population that is prone to have a low BMD, and this relationship is independent of the effect of body weight on leptin levels. Our results suggest that ethnicity and menopausal status should be considered when comparing results from different studies.

Low vitamin D status in children with sickle cell disease.

OBJECTIVES: To examine vitamin D status in children with sickle cell disease (SCD)-SS and its relation to season and dietary intake. STUDY DESIGN: Growth, dietary intake, 25-hydroxyvitamin D (25-OHD), and parathyroid hormone levels were measured. Children with low and normal vitamin D status were compared. Low vitamin D status was defined as a serum concentration of 25-OHD <27.5 nmol/L. Serum 25-OHD and parathyroid hormone levels were compared among children with SCD-SS and healthy children. RESULTS: Children with SCD-SS (n=65), 5 to 18 years of age, were evaluated. Mean (+/-SD) serum 25-OHD concentration was 25.5 +/- 12.8 nmol/L; 65% of subjects had low vitamin D status. Low vitamin D prevalence was highest during spring (100%). Children with SCD-SS were at higher risk for low vitamin D status than healthy children. Vitamin D intake was lower in subjects with SCD-SS and low vitamin D than those with normal serum vitamin D status (P <.05). CONCLUSIONS: Low serum vitamin D status was highly prevalent in black children with SCD-SS. Vitamin D status was associated with season and dietary intake.

Effect of a modified milk fat and calcium in purified diets on cholesterol metabolism in hamsters.

Modification of milk fat both by partially replacing saturated FA with oleic acid (18:1) and by increasing calcium intake independently reduces plasma cholesterol. Whether modification of both factors together would synergistically reduce plasma cholesterol is unknown. Seventy-two male golden Syrian hamsters were separated into four diet treatment groups (n = 18/group) and fed ad libitum for 7 wk. Diets contained either modified milk fat (MMF) or regular milk fat (RMF) with either 0.5% (MMF and RMF) or 1.3% calcium (w/w) (MMFC and RMFC). All diets contained 11% test fat, 4% soybean oil, and 0.15% cholesterol (w/w). During the last week, feces were collected for three consecutive days for analysis of fecal FA, cholesterol, and calcium excretion. Overnight-fasted animals were sacrificed, and plasma and livers were collected for lipid analysis. Neither MMF nor additional calcium significantly affected plasma lipids. However, significant interactions existed between MMF and additional calcium for the ratio of LDL cholesterol to HDL cholesterol (LDL/HDL), indicating that increased calcium intake reduced this ratio only in RMF animals. In addition, MMF reduced LDL/HDL relative to RMF. MMF significantly increased hepatic total and esterified cholesterol. Additional calcium significantly increased fecal calcium and saturated FA (SFA) excretion, whereas MMF significantly reduced SFA excretion. RMFC induced the highest excretion of 16:0 among all groups. Replacement of SFA with 18:1 in the MMF reduced the impact of high calcium on LDL/HDL. Additional calcium reduced LDL/HDL only in the presence of RMF, which may be achieved through an increased excretion of 16:0.

Augmenting leptin circadian rhythm following a weight reduction in diet-induced obese rats: short- and long-term effects.

The current study sought to examine whether leptin injections following a weight reduction in diet-induced obese rats would reduce both the enhanced food intake and body weight (BW) regain observed during the refeeding phase. Female Wistar rats (n = 100, 20 per group) were divided into 5 groups: (1) LEP rats were fed a high-fat (HF) diet (35% wt/wt) for 8 weeks to induce obesity and were then food-restricted (50% ad libitum) with a fortified high-fat diet for 2 weeks to induce a 20% BW loss. These rats were then refed the HF diet ad libtum for another 11 weeks. They were given leptin injections (200 microg/kg BW, twice daily, intraperitoneally ) for 19 days concomitant with the onset of refeeding. (2) SAL rats were treated in the same manner as LEP rats except that they were given saline injections; (3) PF rats were treated like SAL rats except that they were pair-fed with the LEP rats; (4) HFC rats were fed HF diet ad libitum; and (5) LFC rats were fed a low-fat (LF) diet (AIN-93M) ad libitum. Ten rats from each group were killed after leptin treatment and at the end of the study. Food and caloric intakes were monitored, and body composition and plasma glucose, insulin, and leptin levels were assessed at death. Leptin injections after a weight reduction briefly reduced energy intake during the first week only. After 19 days of treatment and to the end of the study, LEP and SAL rats were similar in energy intake, BW (LEP: 393 +/- 11.2 g, SAL: 371 +/- 14.1; difference not significant [NS]) and total body fat percent (LEP: 19.3 +/- 1.5, SAL: 17.6 +/- 1.5; NS). Leptin treatment induced hyperinsulinemia and insulin resistance. All of the metabolic abnormalities observed at the end of treatment period disappeared at the end of the study (8 weeks post-leptin injection). We conclude that bolus leptin injections to manipulate leptin circadian rhythm in diet-induced obese rats after a weight reduction caused temporary insulin resistance and hyperinsulinemia, and were ineffective in influencing food intake, BW, and fat content. Leptin resistance was evident following 1 week of treatment in this study. Leptin treatment had no effect on body fat content both short-term and long-term. Exogenous leptin treatment may, in the long run, increase leptin resistance in diet-induced obese animals. Hence, long-term leptin treatment may not be beneficial to obese individuals consuming a HF diet.

Improvement of metabolism among obese breast cancer survivors in differing weight loss regimens.

OBJECTIVE: To compare the efficacy of different weight loss regimens on body weight loss and metabolic improvement in breast cancer survivors. RESEARCH METHODS AND PROCEDURES: Forty-eight obese breast cancer survivors were randomly divided into four groups and were followed for 1 year: 1) the Control group (subjects did not receive specific nutrition counseling); 2) the Weight Watchers group (subjects were given free coupons to attend weekly Weight Watchers meetings); 3) the Individualized group (a registered dietitian provided one-on-one nutritional counseling); and 4) the Comprehensive group (subjects received individualized dietary counseling and free coupons for the weekly Weight Watchers meetings). At baseline and 3-, 6-, and 12-month data collection visits, a fasting blood sample was obtained for assays. A three-day dietary record was kept during the week before these visits and dietary intake was analyzed. RESULTS: Subjects in the three intervention groups lost weight (Control: 1.1 +/- 1.7 kg; Weight Watchers: -2.7 +/- 2.1 kg; Individualized: -8.0 +/- 1.9 kg; Comprehensive: -9.5 +/- 2.7 kg) and percentage body fat, but only the Individualized and Comprehensive groups had significant losses. Subjects in the Comprehensive group showed the most improvement in cholesterol levels and had reductions in blood leptin levels. DISCUSSION: Because insulin resistance and high blood leptin levels are associated with breast cancer, losing weight to improve these parameters may reduce the risk of recurrence. Only subjects in the Comprehensive group showed significant reductions in body weight and fat, energy intake, and leptin levels. For breast cancer survivors, different weight loss strategies should be considered to assist them in losing weight.

Differential effects of fatty acids and exercise on body weight regulation and metabolism in female Wistar rats.

High-fat diets made with different fats may have distinct effects on body weight regulation and metabolism. In the present study, the metabolic effects of high-fat (HF) diets made with fish oil, palm oil, and soybean oil were compared with a low-fat diet in female Wistar rats that were either exercised (EX, swimming) or that remained sedentary as controls. Each adult rat was exposed to the same diet that their dams consumed during pregnancy and lactation. When they were 9 weeks old, rats began an EX regimen that lasted for 6 weeks. Twenty-four hours after the last EX bout, rats were sacrificed in a fasted state. It was observed that HF feeding of soybean oil induced more body weight and fat gain, as well as insulin resistance, as indicated by insulin/glucose ratios, than other oils. Female rats fed a HF diet made with fish oil had body weight and insulin sensitivity not different from that observed in low fat fed control rats. For rats fed HF diets made with soybean oil or palm oil, EX also exerted beneficial effects by reducing body fat %, blood insulin, triglyceride and leptin levels, as well as improving insulin sensitivity.

Effects of dietary fatty acids and exercise on body-weight regulation and metabolism in rats.

OBJECTIVE: To assess the interaction of high-fat diets (HF) made with different dietary fatty acids and exercise on body-weight regulation, adiposity, and metabolism. RESEARCH METHODS AND PROCEDURES: Male Wistar rats born to dams fed HF diets (40% w/w) made with either fish oil (FO), soybean oil (SO), or palm oil (PO) were fed diets similar to their dams and divided randomly into exercise (EX, swimming) or sedentary control (SD) groups when they were 9 weeks old. EX lasted for 6 weeks. Twenty-four hours after the last EX bout, fasted rats were killed by decapitation. Chemical analyses and body composition analysis were conducted. RESULTS: The results demonstrated that different fatty acids had different effects on body weight, composition, and metabolism. SO-fed rats gained the most weight and fat. EX reduced body weight of FO- and PO-fed rats, but SO-fed rats were still heavier and fatter than other rats. Data from SO- and PO-fed rats suggested that they are insulin resistant and that EX normalized this abnormality. Of the three HF diets used, FO produced the least adverse effects compared with PO and SO. DISCUSSION: Not only the quantity of dietary fat, but also the type of fat used, will produce different effects on body weight and metabolism. EX ameliorates the suggested insulin resistance induced in rats fed either highly saturated or n-6 polyunsaturated fatty acids. Long-chain n-3 polyunsaturated fatty acids, as found in fish oil, are more beneficial than n-6 polyunsaturated fatty acids when fed in high amounts to rats.