Cross-sectional associations between adipose tissue depots and areal bone mineral density in the UK Biobank imaging study.

The relationship between obesity and osteoporosis is poorly understood. In this study, we assessed the association between adiposity and bone. The fat-bone relationship was dependent on sex, body mass index classification, and menopausal status. Results highlight the importance of accounting for direct measures of adiposity (beyond BMI) and menopause status. INTRODUCTION: Assess the relationship between direct measures of adiposity (total body fat mass, visceral adipose tissue, and abdominal subcutaneous adipose tissue) with the whole body and clinically relevant bone sites of the lumbar spine, and femoral neck areal bone mineral density (aBMD) in men and women. METHODS: This cross-sectional analysis was conducted utilizing de-identified data from the UK Biobank on participants (n = 3674) with available dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI) data. Sex-stratified multiple linear regression was used to assess the relationship between adiposity measures and aBMD outcomes, controlling for age, race, total body lean mass (DXA), height, BMI class, physical activity, smoking, menopausal status (women), and hormone use (women). RESULTS: In men, significant interactions were observed between measures of adiposity and BMI on aBMD for the whole body and lumbar spine. Interactions indicated a positive relationship between adiposity and aBMD in men classified as normal weight, but an inverse relationship in men with elevated BMI. In women, significant interactions between adiposity measures and menopausal status were observed primarily for the whole body and femoral neck aBMD bone outcomes which indicated a negative relationship between adiposity and aBMD in premenopausal women, but a positive relationship in postmenopausal women. CONCLUSION: Total body adiposity, abdominal subcutaneous adipose tissue, and visceral adipose tissue were all significantly associated with aBMD in both men and women. The strength and direction of association were dependent on sex, BMI classification, and menopausal status (women).

Association of objectively measured physical activity and bone health in children and adolescents: a systematic review and narrative synthesis.

The influence of day-to-day physical activity on bone in adolescence has not been well characterized. Forty articles were identified that assessed the relationship between accelerometry-derived physical activity and bone outcomes in adolescents. Physical activity was positively associated with bone strength in peri-pubertal males, with less consistent evidence in females. Physical activity (PA) is recommended to optimize bone development in childhood and adolescence; however, the influence of day-to-day PA on bone development is not well defined. The aim of this review was to describe the current evidence for objectively measured PA on bone outcomes in healthy children and adolescents. MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, CINAHL, PsycInfo, and ClinicalTrials.gov were searched for relevant articles up to April 2020. Studies assessing the relationship between accelerometry-derived PA and bone outcomes in adolescents (6-18 years old) were included. Two reviewers independently screened studies for eligibility, extracted data, and rated study quality. Forty articles met inclusion criteria (25 cross-sectional, 15 longitudinal). There was significant heterogeneity in accelerometry methodology and bone outcomes measured. Studies in males indicated a significant, positive relationship between moderate to vigorous PA (MVPA) and bone outcomes at the hip and femur, particularly during the peri-pubertal years. The results for MVPA and bone outcomes in females were mixed. There was a paucity of longitudinal studies using pQCT and a lack of data regarding how light PA and/or impact activity influences bone outcomes. The current evidence suggests that objectively measured MVPA is positively associated with bone outcomes in children and adolescents, especially in males. However, inconsistencies in methodology make it difficult to determine the amount and type of PA that leads to favorable bone outcomes. Given that the majority of research has been conducted in Caucasian adolescents, further research is needed in minority populations.

Physical activity, sedentary time, and longitudinal bone strength in adolescent girls.

The association between baseline physical activity and sedentary time with 2-year longitudinal bone strength was evaluated. The effect of physical activity on bone depended on maturity status. Sedentary time did not negatively impact bone outcomes, regardless of maturity. Maturity should be considered when developing exercise interventions to improve bone outcomes. INTRODUCTION: Physical activity during adolescence is important to obtain peak bone mass; however, adolescents are increasingly sedentary, potentially increasing risk for osteoporosis later in life. The aim of this study was to assess the association of physical activity and sedentary time with 2-year longitudinal bone outcomes in adolescent females (69% Hispanic/31% non-Hispanic). METHODS: Bone strength was assessed at the 66% tibia, 20% femur, and 66% radius of 9- to 12-year-old girls (n = 131) using peripheral quantitative computed tomography at baseline and 2-year follow-up. Physical activity and sedentary time were assessed via accelerometry. Linear regression analyses were used to assess whether baseline vigorous physical activity (VPA), moderate physical activity (MPA), light physical activity (LPA), or sedentary time predict longitudinal bone outcomes, adjusting for relevant confounders. RESULTS: Significant interactions were found between maturity offset and physical activity. In weight-bearing bones, significant interactions were primarily identified between VPA and maturity offset. Interactions indicated that VPA was associated with favorable bone outcomes at the tibia and femur in girls further past the age of PHV. However, this favorable effect was not observed in girls closer to the age of PHV. At the radius, interactions were primarily observed between LPA and maturity offset. Again, LPA was more beneficial for girls further past the age of PHV. Sedentary time did not significantly influence bone outcomes. CONCLUSION: The effects of physical activity on bone may be dependent on maturity. Therefore, physical activity interventions, with attention to maturity status, may be required to optimize bone strength in girls.

Use of iDXA spine scans to evaluate total and visceral abdominal fat.

OBJECTIVES: Abdominal fat may be a better predictor than body mass index (BMI) for risk of metabolically-related diseases, such as diabetes, cardiovascular disease, and some cancers. We sought to validate the percent fat reported on dual energy X-ray absorptiometry (DXA) regional spine scans (spine fat fraction, SFF) against abdominal fat obtained from total body scans using the iDXA machine (General Electric, Madison, WI), as previously done on the Prodigy model. METHODS: Total body scans and regional spine scans were completed on the same day (N = 50). In alignment with the Prodigy-based study, the following regions of interest (ROI) were assessed from total body scans and compared to the SFF from regional spine scans: total abdominal fat at (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC); (3) total trunk fat; and (4) visceral fat in the android region. Separate linear regression models were used to predict each total body scan ROI from SFF; models were validated by bootstrapping. RESULTS: The sample was 84% female, a mean age of 38.5 ± 17.4 years, and mean BMI of 23.0 ± 3.8 kg/m2 . The SFF, adjusted for BMI, predicted L2-L4 and L2-IC total abdominal fat (%; Adj. R2 : 0.90) and total trunk fat (%; Adj. R2 : 0.88) well; visceral fat (%) adjusted R2 was 0.83. Linear regression models adjusted for additional participant characteristics resulted in similar adjusted R2 values. CONCLUSIONS: This replication of the strong correlation between SFF and abdominal fat measures on the iDXA in a new population confirms the previous Prodigy model findings and improves generalizability.

Dual energy X-ray absorptiometry spine scans to determine abdominal fat in postmenopausal women.

Body composition may be a better predictor of chronic disease risk than body mass index (BMI) in older populations. OBJECTIVES: We sought to validate spine fat fraction (%) from dual energy X-ray absorptiometry (DXA) spine scans as a proxy for total abdominal fat. METHODS: Total body DXA scan abdominal fat regions of interest (ROI) that have been previously validated by magnetic resonance imaging were assessed among healthy, postmenopausal women who also had antero-posterior spine scans (n = 103). ROIs were (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC), manually selected by two independent raters, and (3) trunk, auto-selected by DXA software. Intra-class correlation coefficients evaluated intra and inter-rater reliability on a random subset (N = 25). Linear regression models, validated by bootstrapping, assessed the relationship between spine fat fraction (%) and total abdominal fat (%) ROIs. RESULTS: Mean age, BMI, and total body fat were 66.1 ± 4.8 y, 25.8 ± 3.8 kg/m2 and 40.0 ± 6.6%, respectively. There were no significant differences within or between raters. Linear regression models adjusted for several participant and scan characteristics were equivalent to using only BMI and spine fat fraction. The model predicted L2-L4 (Adj. R2 : 0.83) and L2-IC (Adj. R2 : 0.84) abdominal fat (%) well; the adjusted R2 for trunk fat (%) was 0.78. Model validation demonstrated minimal over-fitting (Adj. R2 : 0.82, 0.83, and 0.77 for L2-L4, L2-IC, and trunk fat, respectively). CONCLUSIONS: The strong correlation between spine fat fraction and DXA abdominal fat measures make it suitable for further development in postmenopausal chronic disease risk prediction models. Am. J. Hum. Biol. 28:918-926, 2016. © 2016Wiley Periodicals, Inc.

Muscle density predicts changes in bone density and strength: a prospective study in girls.

OBJECTIVE: We sought to determine whether muscle density, an index of skeletal muscle fat content, was predictive of 2-year changes in weight-bearing bone parameters in young girls. METHODS: Two-year prospective data from 248 girls, aged 8-13 years at baseline. Peripheral quantitative computed tomography was used to measure changes in bone strength indices (bone strength index [BSI, mg(2)/mm(4)] and strength-strain index [SSIp, mm(3)]) and volumetric bone mineral density [vBMD, mg/cm(3)] at distal metaphyseal and diaphyseal regions of the femur and tibia, as well as calf and thigh muscle density (mg/cm(3)), and muscle cross-sectional area (MCSA, mm(2)), indices of skeletal muscle fat content and muscle force production, respectively. RESULTS: After controlling for potential confounders, greater gains in femur BSI (44%, P<0.002), total femur vBMD (114%, P<0.04) and femur trabecular vBMD (306%, P<0.002) occurred in girls in the lowest versus the highest groups of baseline thigh muscle density. Greater gains in tibial BSI (25%, P<0.03) and trabecular vBMD (190%, P<0.002) were also observed in the lowest versus the highest baseline calf muscle density groups. CONCLUSION: Baseline muscle density is a significant predictor of changes in bone density and bone strength in young girls during a period of rapid skeletal development.

Associations of physical activity duration, frequency, and load with volumetric BMD, geometry, and bone strength in young girls.

SUMMARY: More efficacious physical activity (PA) prescriptions for optimal bone development are needed. This study showed that PA duration, frequency, and load were all independently associated with bone parameters in young girls. Increased PA duration, frequency, and load are all important osteogenic stimuli that should be incorporated into future PA interventions. INTRODUCTION: This study evaluated the associations of physical activity (PA) duration, frequency, load, and their interaction (total PA score = duration × frequency × load) with volumetric bone mineral density, geometry, and indices of bone strength in young girls. METHODS: Four hundred sixty-five girls (aged 8-13 years) completed a past year physical activity questionnaire (PYPAQ) which inquires about the frequency (days per week) and duration (average minutes per session) of leisure-time PA and sports. Load (peak strain score) values were assigned to each activity based on ground reaction forces. Peripheral quantitative computed tomography was used to assess bone parameters at metaphyseal and diaphyseal sites of the femur and tibia of the non-dominant leg. RESULTS: Correlations across all skeletal sites between PA duration, frequency, load and periosteal circumference (PC), bone strength index (BSI), and strength-strain index (SSI) were significant (p ≤ 0.05), although low (0.10-0.17). A 2.7-3.7% greater PC across all skeletal sites was associated with a high compared to a low PYPAQ score. Also, a high PYPAQ score was associated with greater BSI (6.5-8.7%) at metaphyseal sites and SSI (7.5-8.1%) at diaphyseal sites of the femur and tibia. The effect of a low PYPAQ score on bone geometric parameters and strength was greater than a high PYPAQ score. CONCLUSIONS: PA duration, frequency, and load were all associated with bone geometry and strength, although their independent influences were modest and site specific. Low levels of PA may compromise bone development whereas high levels have only a small benefit over more average levels.

Ethnic differences in femur geometry in the women's health initiative observational study.

SUMMARY: Participants in the observational study of the Women's Health Initiative (WHI) were studied to determine if ethnic differences in femur geometry can help to explain differences in hip fracture rates. Structural differences in femurs of African and Mexican-American women appear to be consistent with lower rates of hip fractures vs. whites. INTRODUCTION: Ethnic origin has a major influence on hip fractures, but the underlying etiology is unknown. We evaluated ethnic differences in hip fracture rates among 159,579 postmenopausal participants in the WHI then compared femur bone mineral density (BMD) and geometry among a subset with dual X-ray absorptiometry (DXA) scans of the hip and total body. METHODS: The subset included 8,206 non-Hispanic whites, 1,476 African-American (AA), 704 Mexican-American (MA), and 130 Native Americans (NA). Femur geometry derived from hip DXA using hip-structure analysis (HSA) in whites was compared to minority groups after adjustment for age, height, weight, percent lean mass, neck-shaft angle and neck length, hormone use, chronic disease (e.g., diabetes, rheumatoid arthritis, cancer), bone active medications (e.g., corticosteroids, osteoporosis therapies), and clinical center. RESULTS: Both AA and MA women suffered hip fractures at half the rate of whites while NA appeared to be similar to whites. The structural advantage among AA appears to be due to a slightly narrower femur that requires more bone tissue to achieve similar or lower section moduli (SM) vs. whites. This also underlies their higher BMD (reduces region area) and lower buckling ratios (buckling susceptibility). Both MA and NA women had similar advantages vs. whites at the intertrochanter region where cross-sectional area and SM were higher but with no differences at the neck. NA and MA had smaller bending moments vs. whites acting in a fall on the hip (not significant in small NA sample). Buckling ratios of MA did not differ from whites at any region although NA had 4% lower values at the IT region. CONCLUSION: Differences in the geometry at the proximal femur are consistent with the lower hip fracture rates among AA and MA women compared to whites.

Changes in soft tissue composition are the primary predictors of 4-year bone mineral density changes in postmenopausal women.

UNLABELLED: Changes in body weight influence bone mineral density, but the role of body composition is not clear in postmenopausal women. Body weight and soft tissue composition predicted bone changes independent of calcium supplementation and exercise frequency, indicating that soft tissue composition should be measured in clinical trials. INTRODUCTION: The purpose of this study was to examine the relationship between changes in body weight and composition and changes in 4-year bone mineral density (BMD) after accounting for age, 4-year exercise frequency (EX), and 4-year calcium supplement intake (CA) in postmenopausal women with and without hormone therapy (HT). METHODS: Postmenopausal women (aged 40-65 years) either using HT (for 1-3.9 years) or not using HT (for > or =1 year) were recruited to the study. EX and CA was monitored throughout the study and 167 women completed 4 years. BMD and soft tissue composition measurements were made using dual-energy X-ray absorptiometry. Regression was used to predict 4-year BMD changes from EX, CA, age, baseline and 4-year changes in body weight and composition. HT users (n = 115, 55.3 +/- 4.3 years) and non-users (n = 52, 57.5 +/- 4.7 years) were analyzed separately. RESULTS: The models predicting regional BMD changes that included soft tissue composition changes explained the most variation compared with those with body weight or EX and CA alone. Larger amounts of variation in BMD changes were explained in the no HT group. CONCLUSION: Body composition changes are important positive predictors of BMD changes independent of EX and CA supplementation, but their contribution varies according to bone site and with HT use.

Basal metabolic rate of Brazilians living in the Southwestern United States.

Estimation of energy requirements relies on adequate values of basal metabolic rate (BMR). Prediction equations recommended for international use have been shown to overestimate BMR in populations living in the tropics. We have previously shown the inadequacy of these equations in samples of Brazilians living in tropical and temperate regions of the country. We sought to investigate whether BMR could adequately be estimated by prediction equations in a sample of Brazilians living in a different setting: the Sonoran desert of the Southwestern USA. BMR was measured under standard conditions in 33 subjects (14 men). Mean bias (estimated-measured) varied from 404.4 to 708.6 kJ day(-1) in women and 566.8 to 1122.8 kJ day(-1) in men, representing 8.5-15 and 8.9-17.6% overestimation, respectively, using the Schofield equations. Bland and Altman analyses showed large, relevant limits of agreement. The results using the recommended equations for the American population (IOM, 2005) were only 2% different from the Schofield equations. The Harris and Benedict equations yielded higher overestimations (15.0 and 16.8% for women and men, respectively) and the Henry and Rees equations also overestimated BMR (8.5 and 8.9%) even though they were developed for populations from the tropics, although to a lesser degree. It is concluded that the equations currently recommended for international use are not appropriate for Brazilians living in the Southwestern USA.

A review of psychosocial pre-treatment predictors of weight control.

Prompted by the large heterogeneity of individual results in obesity treatment, many studies have attempted to predict weight outcomes from information collected from participants before they start the programme. Identifying significant predictors of weight loss outcomes is central to improving treatments for obesity, as it could help professionals focus efforts on those most likely to benefit, suggest supplementary or alternative treatments for those less likely to succeed, and help in matching individuals to different treatments. To date, however, research efforts have resulted in weak predictive models with limited practical usefulness. The two primary goals of this article are to review the best individual-level psychosocial pre-treatment predictors of short- and long-term (1 year or more) weight loss and to identify research needs and propose directions for further work in this area. Results from original studies published since 1995 show that few previous weight loss attempts and an autonomous, self-motivated cognitive style are the best prospective predictors of successful weight management. In the more obese samples, higher initial body mass index (BMI) may also be correlated with larger absolute weight losses. Several variables, including binge eating, eating disinhibition and restraint, and depression/mood clearly do not predict treatment outcomes, when assessed before treatment. Importantly, for a considerable number of psychosocial constructs (e.g. eating self-efficacy, body image, self-esteem, outcome expectancies, weight-specific quality of life and several variables related to exercise), evidence is suggestive but inconsistent or too scant for an informed conclusion to be drawn. Results are discussed in the context of past and present conceptual and methodological limitations, and several future research directions are described.

Pretreatment predictors of attrition and successful weight management in women.

OBJECTIVE: This study analyzed baseline behavioral and psychosocial differences between successful and nonsuccessful participants in a behavioral weight management program. Success was defined by commonly used health-related criteria (5% weight loss). Noncompletion was also used as a marker of a failed attempt at weight control. SUBJECTS: A total of 158 healthy overweight and obese women (age, 48.0+/-4.5 y; BMI, 31.0+/-3.8 kg/m(2); body fat, 44.5+/-5.3%). INTERVENTION: Subjects participated in a 16-week lifestyle weight loss program consisting of group-based behavior therapy to improve diet and increase physical activity, and were followed for 1 y after treatment. METHODS: At baseline, all women completed a comprehensive behavioral and psychosocial battery assessing dieting/weight history, dietary intake and eating behaviors, exercise, self-efficacy, outcome evaluations, body image, and other variables considered relevant for weight management. Participants who maintained a weight loss of 5% or more at 16 months (or 10% or more of initial fat mass) were classified as successful. Nonsuccessful participants were those who dropped out and completers who had not lost weight at follow-up. RESULTS: Of all participants, 30% (n=47) did not complete initial treatment and/or missed follow-up assessments (noncompleters). Noncompletion was independently associated with more previous weight loss attempts, poorer quality of life, more stringent weight outcome evaluations, and lower reported carbohydrate intake at baseline. In logistic regression, completion status was predicted correctly in 84% of all cases (chi(2)=45.5, P<0.001), using baseline information only. Additional predictors of attrition were initial weight, exercise minutes, fiber intake, binge eating, psychological health, and body image. A large variation in weight loss/maintenance results was observed (range: 37.2 kg for 16-month weight change). Independent baseline predictors of success at 16 months were more moderate weight outcome evaluations, lower level of previous dieting, higher exercise self-efficacy, and smaller waist-to-hip ratio. Success status at follow-up was predicted correctly in 74% of all starting cases (chi(2)=33.6, P<0.001). CONCLUSION: Psychosocial and behavioral variables (eg, dieting history, dietary intake, outcome evaluations, exercise self-efficacy, and quality of life) may be useful as pretreatment predictors of success level and/or attrition in previously overweight and mildly obese women who volunteer for behavioral weight control programs. These factors can be used in developing readiness profiles for weight management, a potentially important tool to address the issue of low success/completion rates in the current management of obesity.

Effects of exercise training on bone remodeling, insulin-like growth factors, and bone mineral density in postmenopausal women with and without hormone replacement therapy.

The purpose of this study was to determine the effects of 12 months of weight bearing and resistance exercise on bone mineral density (BMD) and bone remodeling (bone formation and bone resorption) in 2 groups of postmenopausal women either with or without hormone replacement therapy (HRT). Secondary aims were to characterize the changes in insulin-like growth factors-1 and -2 (IGF-1 and -2) and IGF binding protein 3 (IGFBP3) in response to exercise training. Women who were 3-10 years postmenopausal (aged 40-65 years) were included in the study. Women in the HRT and no HRT groups were randomized into the exercise intervention, resulting in four groups: (1) women not taking HRT, not exercising; (2) those taking HRT, not exercising; (3) those exercising, not taking HRT; and (4) women exercising, taking HRT. The number of subjects per group after 1 year was 27, 21, 25, and 17, respectively. HRT increased BMD at most sites whereas the combination of exercise and HRT produced increases in BMD greater than either treatment alone. Exercise training alone resulted in modest site-specific increases in BMD. Bone remodeling was suppressed in the groups taking HRT regardless of exercise status. The bone remodeling response to exercise training in women not taking HRT was not significantly different from those not exercising. However, the direction of change suggests an elevation in bone remodeling in response to exercise training, a phenomenon usually associated with bone loss. No training-induced differences in IGF-1, IGF-2, IGF-l:IGF-2 (IGF-1 : IGF-2), and IGFBP3 were detected.

Validity of self-reported energy intake in lean and obese young women, using two nutrient databases, compared with total energy expenditure assessed by doubly labeled water.

OBJECTIVE: To compare self-reported total energy intake (TEI) estimated using two databases with total energy expenditure (TEE) measured by doubly labeled water in physically active lean and sedentary obese young women, and to compare reporting accuracy between the two subject groups. DESIGN: A cross-sectional study in which dietary intakes of women trained in diet-recording procedures were analyzed using the Minnesota Nutrition Data System (NDS; versions 2.4/6A/21, 2.6/6A/23 and 2.6/8.A/23) and Nutritionist III (N3; version 7.0) software. Reporting accuracy was determined by comparison of average TEI assessed by an 8 day estimated diet record with average TEE for the same period. RESULTS: Reported TEI differed from TEE for both groups irrespective of nutrient database (P<0.01). Measured TEE was 11.10+/-2.54 and 11.96+/-1.21 MJ for lean and obese subjects, respectively. Reported TEI, using either database, did not differ between groups. For lean women, TEI calculated by NDS was 7.66+/-1.73 MJ and by N3 was 8.44+/-1.59 MJ. Corresponding TEI for obese women were 7.46+/-2.17 MJ from NDS and 7.34+/-2.27 MJ from N3. Lean women under-reported by 23% (N3) and 30% (NDS), and obese women under-reported by 39% (N3) and 38% (NDS). Regardless of database, lean women reported higher carbohydrate intakes, and obese women reported higher total fat and individual fatty acid intakes. Higher energy intakes from mono- and polyunsaturated fatty acids were estimated by NDS than by N3 in both groups of women (P< or =0.05). CONCLUSIONS: Both physically active lean and sedentary obese women under-reported TEI regardless of database, although the magnitude of under-reporting may be influenced by the database for the lean women. SPONSORSHIP: USDA Hatch Project award (ARZT-136528-H-23-111) to LB Houtkooper and WH Howell.

Nutritional status of U.S. elite female heptathletes during training.

This study describes the body composition, dietary nutrient intake, dietary practices, and biochemical indices of iron status of elite female American heptathletes during training. Four-day diet records and dietary practice questionnaires were obtained from 19 female heptathletes (26 +/- 3 years) during the training season. Anthropometric measurements and fasting blood samples were obtained at the lowest phase of the training cycle. These athletes had a low body fat (13.8 +/- 2.7%) and high fat-free mass to height ratios (33.0 +/- 2.0 kg/m). Average nutrient intakes were > 67% of the reference intakes for all nutrients except vitamin E. Most dietary nutrient densities were higher than NHANES III nutrient densities for women 20-29 years old. More than 50% of the athletes took vitamin supplements and monitored their hydration status. Fifteen of the 17 athletes reported a normal menstrual cycle. Markers of biochemical iron status were all within the normal range. On average, these athletes were lean with high levels of fat free mass, adequate nutrient intakes, and normal biochemical indices of iron status. However, individual data reveals considerable variability within this group.

Total and regional fat and serum cardiovascular disease risk factors in lean and obese children and adolescents.

OBJECTIVE: This study was conducted to evaluate the association of total and central adiposity with serum cardiovascular disease (CVD) risk factors in lean and obese Portuguese children and adolescents. RESEARCH METHODS AND PROCEDURES: A total of 87 girls (13.2 +/- 1.6 years old, 29.9 +/- 6.4% body fat [mean +/- SD]) and 72 boys (13.2 +/- 1.6 years old, 20.8 +/- 9.9% body fat) volunteered for the study. Whole-body composition and fat distribution, from DXA and anthropometry, and serum lipids, lipoproteins, and apolipoproteins were evaluated. RESULTS: The sum of three trunk skinfolds (STS) was highly correlated with total trunk fat mass measured by DXA (p < 0.001). Body mass index, DXA-measured percentage of body fat, trunk fat mass, STS, and the waist-to-height ratio were generally found to be associated with triacylglycerol, the ratio of total cholesterol (TC) to high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and apolipoprotein B levels, (significant age-adjusted r between 0.16 and 0.27, p < 0.05). Body mass index, STS, and the waist circumference were also associated with HDL-C (p < 0.05), whereas no body composition variable significantly correlated with TC or apolipoproteins A-I. The STS was significantly correlated with HDL-C (p < 0.01), TC/HDL-C (p < 0.05), and apolipoproteins A-I (p < 0.05) independently of whole-body fatness. Obese subjects (n = 73) had higher TC, LDL-C, TC/HDL-C, and apolipoprotein B than did non-obese subjects (n = 86), and significant associations between central adiposity and some lipid variables (triacylglycerol and HDL-C) were found in obese children and adolescents that were not present in leaner individuals. DISCUSSION: DXA- and anthropometry-based whole-body and central fat measures are associated with serum CVD risk factors in Portuguese boys and girls. Obese children and adolescents have a poorer lipid profile than do their leaner counterparts. Trunk skinfolds, which are easy to obtain even in large samples, predict CVD risk factors to the same extent as DXA-based variables, in some cases, independently of total fatness.

Body composition profiles of elite American heptathletes.

This study characterized body composition profiles of elite American heptathletes and cross-validated skinfold (SKF) and bioelectrical impedance analysis (BIA) field method equations for estimation of percent body fat (%Fat) using dual energy x-ray absorptiometry (DXA) as the criterion. Weight, height, fat mass (FM), fat-free mass (FFM), bone mineral density (BMD), and %Fat were measured in 19 heptathletes using standard measurement protocols for DXA, SKFs and BIA. The ages, heights, and weights were respectively 25.5 +/- 3.5 years, 175.0 +/- 6.6 cm, 67.3 +/- 7.1 kg. DXA estimates of mean +/- SD values for body composition variables were 57.2 +/- 6.1 kg FFM, 10.1 +/- 2.6 kg FM, 114 +/- 7% BMD for age/racial reference group, and 15 +/- 3.0 %Fat. Ranges of bias values for %Fat (DXA minus SKF or BIA) were, respectively, -0.5 to 1.6% and -5.5 to -1.2%. Ranges for standard errors of estimate and total errors were, respectively, SKF 2.4-2.5%, 2.4 - 2.8% and BIA 3.0%, 5.0-6.5%. Regression analyses of the field methods on DXA were significant (p < .05) for all SKF equations but not BIA equations. This study demonstrates that elite American heptathletes are lean, have high levels of BMD, and that SKF equations provide more accurate estimates of %Fat relative to DXA than estimates from BIA equations.

Weight loss attempts and attitudes toward body size, eating, and physical activity in American Indian children: relationship to weight status and gender.

OBJECTIVE: This study examined dieting, weight perceptions, and self-efficacy to eat healthy foods and engage in physical activity and their relationships to weight status and gender among American Indian elementary schoolchildren. RESEARCH METHODS AND PROCEDURES: Data for this study were collected as part of the baseline examination for the Pathways study. Participants were 1441 second- through third-grade American Indian children in 41 schools representing seven tribes in Arizona, New Mexico, and South Dakota who filled out a questionnaire and had heights and weights taken. RESULTS: Forty-two percent of the children were overweight or obese. No differences were found between overweight/obese and normal weight children for healthy food intentions or self-efficacy. Heavier children (especially those with body mass index > 95th percentile) were more likely to have tried to lose weight or were currently trying to lose weight. No gender differences were found. Normal weight children chose a slightly heavier body size as most healthy compared with overweight/obese children. DISCUSSION: The results indicate that children are concerned about their weight and that weight modification efforts are common among overweight American Indian children. School, community, and family-based programs are needed to help young people adopt lifelong healthful eating and physical activity practices.

Subcutaneous central fat is associated with cardiovascular risk factors in men independently of total fatness and fitness.

The purpose of this study was to analyze the single and independent associations of whole body composition and fat distribution with cardiovascular disease (CVD) risk factors and fitness in middle-aged men. Sixty-two healthy Caucasian men (37.6 +/- 2.9 yr, 81.8 +/- 11.3 kg, 171.5 +/- 4.9 cm) participated in the study. Dual-energy x-ray absorptiometry (DXA) was used to assess total and regional body composition. The triceps, biceps, midthigh, calf, subscapular, chest, abdominal and suprailiac skinfolds, and the waist, hip and midthigh circumferences, and sagittal diameter were estimated. Cardiovascular fitness was estimated with a submaximal test. Bivariate and partial correlation analysis were used to study the association of total body percent fat (%fat), DXA trunk fat and trunk skinfolds (sum of subscapular, chest, abdominal, and suprailiac) and fitness with insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), TC/HDL-C, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein AI (apo AI), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], and diastolic and systolic blood pressure. All anthropometric and DXA body composition variables were significantly correlated with TC/HDL-C (from .26 to .50, P < .05). Similar relationships were found for insulin, HDL-C, and systolic blood pressure (r from .26 to .47, P < .05). Cardiovascular fitness was significantly (P < .05) associated with insulin (r = -.36), HDL-C (r = .27), TC/HDL (r = -.27), and with systolic blood pressure (r = -.37). After controlling for trunk skinfolds, none of the anthropometric and DXA body composition variables were correlated with any of the CVD risk factors. Similarly, when controlling for trunk skinfolds, cardiovascular fitness was not related to any of the metabolic variables. After adjusting for %fat, DXA trunk fat, and cardiovascular fitness, trunk skinfolds remained significantly (P < .05) related to insulin (r = .35), HDL-C (r = -.40), TC/HDL-C (r = .43), and apo AI (r = -.39). In conclusion, this study suggests that subcutaneous truncal fat, as estimated by skinfolds, is an independent predictor of CVD risk factors, and that the association between cardiovascular fitness and these risk factors may be mediated by the levels of abdominal subcutaneous fat in Caucasian middle-aged men.

Comparison of methods for assessing body-composition changes over 1 y in postmenopausal women.

BACKGROUND: Advances in dual-energy X-ray absorptiometry (DXA) software algorithms have improved the accuracy of this method for body-composition measurement. OBJECTIVE: Our objective was to compare the utility of DXA, underwater weighing (UWW), and a multicomponent model (MC) for assessing changes in body composition. DESIGN: : Previously sedentary women aged 40-66 y were randomly assigned to exercise training (ET; n = 36) and no exercise training (NT; n = 40). ET subjects exercised 3 d/wk; NT subjects remained sedentary. Changes in body mass, fat mass, and fat-free mass over 1 y were assessed by the 3 methods. RESULTS: Correlations among methods were significant and large (0.73-0.97). Body weight did not change significantly in either group. In the ET group, fat-free mass increased significantly as assessed by DXA (0.7 +/- 1.0 kg) but changes assessed by MC and UWW were not significant. Changes in fat mass and percentage body fat in the ET group were not significant. SDs for changes in fat mass and percentage body fat, respectively, from DXA were 2.5 kg and 2.7%; for MC, 5.5 kg and 7.1%; and for UWW, 4.4 kg and 5.8%. In the NT group, changes in fat-free mass, fat mass, and percentage body fat were significant (P