New insights into body composition assessment in obese women.

During treatment of patients with non-insulin-dependent diabetes mellitus, there may be marked body weight loss. Therefore, body composition should be monitored to check for a decrease in fat mass alone, without an excessive decrease of both fat-free mass and total body water. Accordingly, it is useful to monitor the hydration of these patients. One method that allows us to check the status of body hydration is the multifrequency bioelectric impedance analysis (MFBIA). It makes use of formulas that estimate total body water on the basis of the concept that the human body may be approximated to a cylinder of length equal to body height. In normal subjects body water estimates are sufficiently accurate, but in obese subjects the true hydration status may be overestimated. In this report, we describe the accuracy of mathematical models previously described in the literature, and correct for the overestimation of total body water in obese subjects by means of a new equation based on a new model. The coefficients for each model have been recalculated by the weighing of our sample in order to test the accuracy of estimates obtained with the equations. This new model includes both body volume and two impedances at appropriate frequencies useful for identifying two terms strictly related to extra- and intra-cellular water. The new formulas do not include body weight, but they include the body volume, a parameter more closely related to the biophysical reference model. Fifty-five overweight females, body mass index ranging from 26.8 to 50.2 kg/m2, were enrolled in the study. The proposed equations, taking advantage of two impedance values at appropriate frequencies, better predict total body water in obese women. This was particularly evident when the results obtained with the multifrequency bioelectric impedance analysis and deuterium isotopic oxide dilution method were compared. Although this last method is considered the "gold standard," it is not suitable for use in routine clinical practice. In conclusion, evaluation of total body composition by means of bioelectric impedance analysis might be included in programs for the prevention of non-insulin-dependent diabetes and for monitoring weight loss during overt pathology.     

Regional body volumes, BMI, waist circumference, and percentage fat in severely obese adults

Objective: This study presents total body volume (TBV) and regional body volume, and their relationships with widely used body composition indices [BMI, waist circumference (WC), and percentage body fat (% fat)] in severely obese adults (BMI ≥35 kg/m²). Research Methods and Procedures: We measured TBV, trunk volume (TV), arm volume (AV), leg volume (LV), and WC and estimated % fat in 32 severely obese persons with BMI 36 to 62 kg/m² (23 women; age, 19 to 65 years; weight, 91 to 182 kg) and in 58 persons with BMI <35 kg/m² (28 women; age, 18 to 83 years; weight, 48 to 102 kg) using a newly validated 3‐day photonic image scanner (3DPS, Model C9036–02, Hamamatsu Co., Japan) and calculated TV/TBV, AV/TBV, and LV/TBV. Results: Men had significantly larger TBV and higher TV/TBV and AV/TBV, but significantly lower LV/TBV than women, independently of BMI. TV/TBV increased while AV/TBV and LV/TBV decreased with increasing BMI, WC, and % fat, and the rate of increase in TV/TBV per % fat was significantly greater in severely obese individuals than in individuals with BMI <35 kg/m². The relationships for TBV with % fat were much lower than with BMI or WC. Conclusion: Body volume gains were mainly in the trunk region in adults, irrespective of sex or BMI. For a given BMI, WC, or % fat, men had a significantly larger TV than women. The implication is that men could have higher health risks due to having higher trunk body weight as a proportion of total body weight compared with severely obese or less severely obese women.     

Body surface temperature distribution in relation to body composition in obese women

Adipose tissue levels and human obesity are known to be associated with increased heat production. At the same time, subcutaneous adipose tissue provides an insulating layer that impedes heat loss. The energy implications of obesity and body thermoregulatory mechanisms remain relatively poorly understood. This study attempted to examine the potential relationship between body composition (subcutaneous and visceral fat) determined by bioimpedance as well as BMI (body mass index), and skin surface temperature distribution recorded at rest.One specific aim of this study was to draw a thermal map of body areas in obese women and compare this with women of normal body mass, and thus to identify body regions within which heat transfer is particularly impeded. As high fat content is a good insulator, it could reduce the body‘s ability to respond effectively to changes in environmental temperature, which would be problematic for thermal homeostasis. Our results showed that core temperature did not differ between obese and normal body mass participants, while skin temperature of most body surfaces was lower in obese subjects.The results of regression analysis showed that the mean body surface temperature (T_mean) decreased with increasing percentage of body fat (PBF) of the abdominal area. The opposite relationship was observed for the front area of the hand (simultaneous increase in T_mean and PBF). We also found a negative correlation between BMI and T_mean of the thigh areas, both the front and the back. From this it could be concluded that the mean body surface temperature is dependent on body fat.     

Anthropometric measures, body composition, body fat distribution, and knee osteoarthritis in women

Objective: Increased BMI is a well‐recognized risk factor for radiographic knee osteoarthritis (rKOA); however, the contributions of the components of body composition, body fat distribution, and height to this association are not clear. Research Methods and Procedures: We examined 779 women ≥45 years of age from the Johnston County Osteoarthritis Project. Body composition was assessed using DXA, and rKOA was defined as Kellgren‐Lawrence grade ≥2. Logistic regression models examined the association between rKOA and the fourth compared with the first quartiles of anthropometric, body composition, and fat distribution measures adjusting for age, ethnicity, and prior knee injury. Results: The adjusted odds ratios and 95% confidence interval of BMI and weight were 5.27 (3.05, 9.13) and 5.28 (3.05, 9.16), respectively. In separate models, higher odds of rKOA were also found for fat mass [4.54 (2.68, 7.69)], percent fat mass [3.84 (2.26, 6.54)], lean mass [3.94 (2.22, 6.97)], and waist circumference [4.15 (2.45, 7.02)]. Waist‐to‐hip ratio was not associated with rKOA [1.45 (0.86, 2.43)], and percent lean mass was associated with lower odds [0.20 (0.11, 0.35)]. Taller women had higher odds of rKOA after adjustment for BMI [1.77 (1.05, 3.00)]. Discussion: This study confirms that BMI and weight are strongly associated with rKOA in women and suggests that precise measurements of body composition and measures of fat distribution may offer no advantage over the more simple measures of BMI or weight in assessment of risk of rKOA.     

Correlated responses in development and distribution of fat depots in mice selected for body composition traits

Summary Development of adipose tissue in five depots was investigated in mice selected for high or low 12-week epididymal fat pad weight as a percentage of body weight (HF and LF lines), or high or low 12-week hind carcass weight as a percentage of body weight (HL and LL lines). An unselected control line (RC) was maintained. Hind carcass (HC) and fat pads from subcutaneous hindlimb, subcutaneous forelimb, gonads, kidneys and mesentery were dissected and weighed at 4, 6, 9, 12 or 15 weeks of age. Generally, body weight (BW), daily gain (DG), feed intake (FI), feed efficiency (FE) and feed intake/metabolic body weight (FC) were higher (P0.05) in HF than in LF, and in LL than in HL. HF had more fat (as a percentage of BW) than LF in all depots (P-0.01), and asymmetry (P0.01) was detected for gonadal fat. LL consistently had a higher (P0.01) fat percentage than HL, and asymmetry (P0.01) was observed for perirenal fat. At age of selection, ranking of fat depot weights as a percentage of total fat depot weight was not changed by selection; however, gonadal fat accounted for more of the total fat in HF and LL compared with RC, while the opposite was found in LF and HL. HC percentage was higher (P0.01) in HL than LL, and higher (P0.01) in LF than HF. Growth rate of each fat depot relative to BW was not affected by selection. These results demonstrated that selection for proportion of fat in one depot or for HC percentage changed fat percentage in other depots. However, the rate of fat deposition in each depot relative to body weight gain was not altered.     

Changes in body composition in obese patients on a low-calorie diet

Energy balance was studied on 4 obese hospitalized subjects kept on hypocaloric diet (489 Kcal - 54% CHO, 10,6% Fat, 35,4% Protein) for 18 +/- 3,7 days. Energy expenditure was measured trough heart-rate monitoring (individual calibrations before and after the study were performed) and nitrogen balance was computed to establish protein loss. Individual qualitative composition of body weight loss was then assessed: 71,4 +/- 5,23% could be attributable to fat loss, 9,38 +/- 3,32% to protein loss, 18,2 +/- 5,5% to water loss. Part of this last figure could be attributable to a slight under-estimation of the method utilized to measure the energy expenditure (heart-rate monitoring).     

Small birth weight and later body composition and fat distribution in adolescents: the Avena study

Objective: To assess the association between birth weight and body composition and fat distribution in adolescents, and to test the possible sex‐specific effect in these relationships. Methods and Procedures: A total of 1,223 adolescents 13–18.5 years old (553 male adolescents and 670 female adolescents) born at >35 weeks, were selected from a cross‐sectional multicenter study conducted in five Spanish cities in 2000–2002. BMI was calculated from weight and height. Triceps and subscapular skinfold thickness (ST) were measured on the left side, and fat mass (FM) and fat‐free mass (FFM) were estimated according to the equations of Slaughter et al. Subscapular skinfold adjusted by tricipital (ST) and waist circumference were used as markers of central adiposity. Results: Birth weight Z‐score was positively associated with FFM in female adolescents (P < 0.001), but not in male adolescents, after controlling for age, pubertal stage, gestational age, socioeconomic status, physical activity, and current height (P < 0.001 for interaction between adjusted birth weight Z‐score and sex). Adjusted birth weight Z‐score was inversely associated with central adiposity in male and female adolescents as measured by ST (P = 0.026). Discussion: These results provide further evidence that gender has an important influence on the programming effect of birth weight on later FFM in adolescents because the effect was only observed in female adolescents. Our results suggest that small size for gestational age at birth could program more central subcutaneous fat deposition in adolescents of both sexes, but further research is needed on this issue.     

Effects of diet macronutrient composition on body composition and fat distribution during weight maintenance and weight loss

Objective: Neurotransmitter systems participate in the regulation of food intake, and their activities are expected to influence eating behavior. Design and Methods: We investigated possible associations between body mass index (BMI) and central noradrenaline, serotonin, and dopamine activities, as reflected by the cerebrospinal fluid levels of their main metabolites methoxyhydroxyphenylglycol (MHPG), 5‐hydroxyindoleacetic acid (5‐HIAA), and homovanillic acid (HVA), respectively. We studied 192 subjects (111 males, 81 females) admitted to neurologic clinic for diagnostic investigations that included CSF analysis, and were found not to suffer from any major neurological disease. Subjects were categorized in three groups, namely in lower, in the two middle, and in upper BMI quartiles, the limits calculated separately for males and females. Results: No differences were found in MHPG levels between groups, while subjects in the upper BMI quartile showed significantly elevated levels of 5‐HIAA and HVA compared to the levels of subjects in lower and middle quartiles. Conclusions: The results provide evidence that in overweight subjects there are enhanced demands in serotoninergic and dopaminergic signaling for their reward system that may lead to increased motivation for food consumption. The implication of reward centers in eating behavior supports the hypothesis of common mechanisms in obesity and drug addiction.     

Comparison of metabolic risk factors between severely and very severely obese patients

Objective: A prospective clinical intervention study was performed to estimate the metabolic risk factors in patients with very severe obesity (VSO) vs. severe obesity (SO). Research Methods and Procedures: Two hundred twenty‐eight VSO (BMI ≥ 50 kg/m²) and 221 SO patients (BMI = 40 to 49.9 kg/m²) participated in the study (367 women and 82 men). Metabolic measurements included plasma lipids, glucose and insulin, hemoglobin A_1c, leptin, and sex hormones, as well as hepatic steatosis in a subgroup of patients. Subgroups of patients with non–insulin‐dependent diabetes and hyperlipidemia (HLP) were examined. Results: The most unexpected result of our study was that VSO men showed significantly better lipid profiles than SO men. Furthermore, 18% of VSO men had no metabolic aberrations, whereas all SO men did. The advantageous metabolic status of VSO men was associated with sex hormone changes that favor gynoid fat distribution. The beneficial metabolic situation with VSO seems to be sex specific for men. Discussion: This study shows that the metabolic situation in VSO is not more severe than in the less obese cohort. These findings distinctly differ from the positive associations that have previously been reported between BMI, lipids, and other metabolic indices among individuals whose BMI is <40 kg/m².     

In vivo assessment of subcutaneous fat in dogs by real-time ultrasonography and image analysis

Background

Systems for estimating body condition score (BCS) are currently used in canine practice to monitor fatness levels. These tools are cheap and easy to use but lack the necessary precision to monitor small changes in body fat, particularly during weight control treatments or in research. The present work aims to study the application of real-time ultrasonography (RTU) together with image analysis in the assessment of subcutaneous fat depots in dogs. Ultrasound images were collected from five anatomical locations (chest, flank, abdomen, thigh and lumbar) from 28 healthy dogs of different breeds and with a body weight (BW) ranging from 5.2 to 33.0 kg. BCS was collected by visual appraisal using a 5-point scale. Subcutaneous fat thickness (SFT) was estimated from RTU images, using the average of three measurements taken in fat deposits located above the muscles represented in each image. Correlations were established between SFT and BW or BCS as well as a classification of BCS-based fatness [overweight (BCS = 4), ideal (BCS = 3) and lean (BCS = 2)].

Results

SFT was found to differ between the five regions considered (P < 0.001). Abdomen and thigh were the areas displaying the widest variation for the different dogs included in the study and also those correlating most with BW, in contrast to the chest, which showed the least variation. Overall, a strong correlation was found between BCS and SFT. The highest correlations were established for the flank, abdomen and lumbar areas. In every anatomical area, a decrease in SFT was observed across all three BCS classes, ranging from 48 to 65 % among overweight and ideal dogs, and from 46 to 83 % among ideal and lean dogs.

Conclusions

Preliminary data showed that within this population there was a strong correlation between BCS and SFT estimated from RTU images. It was also observed that RTU measurements for fat thickness differed among the anatomical points surveyed suggesting differences in their sensitivity to a change in BCS. The images displaying the best prediction value for fatness variations were those collected at the lumbar and abdomen areas.

     

Genetic evidence for obesity loci involved in the regulation of body fat distribution in obese type 2 diabetes rat, OLETF

The Otsuka Long-Evans Tokushima Fatty (OLETF) rat is an animal model for obese type 2 diabetes in human. Obesity is essential for the onset of type 2 diabetes in this rat. Our present investigation was designed to identify quantitative trait loci (QTLs) contributing to obesity by performing a whole-genome search using 214 F(2) intercross progeny between OLETF and F344 rats. We have identified six QTLs responsible for adiposity indices of fat pads on rat chromosomes 2 (Obs1 for mesenteric fat), 4 (Obs2 for retroperitoneal fat), 8 (Obs3 for mesenteric fat), 9 (Obs4 for retroperitoneal fat), and 14 (Obs5 and Obs6 for retroperitoneal fat), demonstrating that the adiposity indices of individual fat pads were under the control of different genes. As expected, the OLETF allele corresponds to increased adiposity indices for all QTLs, except for Obs3, in which the F344 allele leads to an increase in the index.     

Use of NMR for measurement of total body water and estimation of body fat

A nuclear magnetic resonance (NMR) method is described for quantitatively measuring total body water (TBW) and for estimating the fat content of baboons. The hydrogen associated with water was measured as the amplitude of the free-induction decay voltage following a series of 90 degree radio frequency pulses at the Lamour frequency for hydrogen with a pulse length of 14 microseconds and a peak measuring time of 50 microseconds. TBW was calculated by multiplying the peak amplitude (volts) by the experimentally determined constant for a water standard (g water/V). This NMR method yielded TBW contents similar to those obtained in the same baboons by direct gravimetric procedures. In contrast, the widely used 3H2O-dilution method usually and variably overestimated body water. By providing an accurate measure of body water, this NMR procedure provides a rapid, noninvasive, reasonably accurate way of estimating body fat content.