Abstracts:
Appropriate technology in body composition: a brief review
JVGA Durnin
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 1-5
This paper attempts to link the particular method to be used for body composition measurements to the objectives of the study. There is often inadequate attention paid to the real requirement for different degrees of precision, and excessive amounts of time and labour are spent on quite unnecessary minutiae of technology. Special attention is paid to bio-electrical impedance, skinfold thicknesses, stable isotope techniques, and methods for assessing fat distribution.
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Body composition - what is measurable?
Alun H Beddoe
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 7-10
In 1878 Behnke noted that 'nothing is measured with greater error than the human body'. Over the intervening period measurement techniques have been developed which range from the relatively simple anthropometric methods to those based on sophisticated radiation and nuclear physics technologies. Nevertheless, despite the undoubted progress, it is important that we ask ourselves whether Behnke's observation might still have some validity.
Many reviews have concentrated on the problems and limitations of given techniques with particular emphasis on achievable precision (because precision is easy to measure). However a straight-forward analysis of published data, especially of that relating to indirect techniques, shows that measurement precision is frequently small in magnitude compared to biological precision, the latter being simply a reflection of Nature's refusal to conform to imposed regression relationships. In this paper the body composition technologies are reviewed in the context of achievable accuracy and precision.
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Bone densitometry: relevance to health care
Ego Seeman
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 11-13
Since low bone density is a risk for fracture, the relevance of bone densitometry as a basis for health care assessment needs to be elucidated. Most patients with fractures are in the lower two quartiles of bone density. Bone densitometry can be used to provide a quantitative estimate of fracture risk and a measurable response to aging, disease or medical treatment in the individual. Some difficulties concerning the efficacy of screening the whole population are discussed, for instance in terms of the success of treatment. Screening to prevent fractures should be advocated in women considering HRT. Research into defining bone quality is needed, as are further studies on the pathogenesis of low bone density and on the contributions of low peak bone density and rates of loss to bone density in adults.
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Using low-cost body composition technology for health surveillance
D Prijatmoko and BJG Strauss
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 15-17
Standards for skinfold thickness and abdominal/hip ratio have been published which facilitate the evaluation of body composition as an index of health risk and can be used to determine the degree to which lifestyle modification may be required. This study provides information on body composition including fat distribution in a Javanese population living in Jember, Indonesia. The sample consisted of 122 adults (71m, 51f), aged between 20 and 60 years, selected randomly from the Indonesian Government identification list. Data collected were compared with that obtained from the Melbourne Body Composition Study a representative sample of Australians living in Melbourne. Body fatness was assessed from the skinfold measurement at four sites: triceps, biceps, subscapular and supra iliac and converted using the Durnin and Womersley equation. Body fat distribution was assessed from the ratio of the smallest waist and the maximal gluteal circumference. The body composition profile of these two populations were also measured by the BIA method. The cross-sectional data showed that there are significant differences between the two populations in the degree of fatness and fat distribution. However, Melbourne Australians and Jember Indonesians were similar in biceps skinfold thickness of males and females, and in the subscapular skinfold thickness in females. The use of skinfold thickness of measuring body composition differences between populations is a valuable instrument, provided more than a single site is used. A low-cost technique like BIA provides additional information. A single skinfold thickness may still be valuable provided standards appropriate to the ethnic group are used. The difference in body composition profiles between the two populations suggests the evaluation of the association between fat mass and fat distribution and health risk should be based on standards appropriate to the ethnic group studied. This requires longitudinal studies of body composition, and health outcome specific to each population.
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Low-cost appropriate technologies for body composition assessment: a field researcher's view
Noel W Solomons and Manolo Mazariegos
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 19-22
The field setting, as distinct from the clinical and laboratory settings, relates to the study of populations and subpopulations. It can involve either free-living or institutionalized individuals. The concept of 'body composition' goes beyond the traditional assumptions of screening anthropometrics, although it includes many of the same measures. The principal practical considerations for the selection of measurement techniques are ethics and cost. The quantitative considerations are the precision and accuracy of the measures. The biological considerations relate to the interpretation of the measure in terms of underlying body constituents; do the values mean what we hope them to mean?
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Clinical needs and opportunities in assessing body composition
Vichai Tanphaichitr and Preeya Leelahagul
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 23-24
Protein-energy malnutrition (PEM) and obesity are hazardous to health with high morbidity and mortality rates. The assessment of body composition is essential to prevent, diagnose and determine the severity of these disorders as well as their response to therapy.
Body weight is the sum of fat and fat-free mass (FFM) whereas its chemical model consists of triglyceride, protein, water, and minerals. Thus one must recognize the appropriate method to assess each compartment of body composition. In clinical practice, the method must be simple, accurate, noninvasive and inexpensive. Body mass index (BMI) is a practical anthropometric parameter to assess protein-energy status in adults because it can easily be calculated from weight in kg divided by (height in meter)2, and correlates with fatness and mortality. Total body fat can be estimated by measuring the amount of subcutaneous fat by measuring the thickness of the subcutaneous fat layer at different sites of the body by a skinfold caliper or near-infrared interactance. A high waist-over-hip circumference ratio (WHR) can be used to diagnose abdominal obesity. Upper arm muscle circumference can be employed to measure muscle mass. However, whenever these methods are used to assess body composition their limitations should be recognized.
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The elite athlete - assessing body shape, size, proportion and composition
DA Kerr, TR Ackland, AB Schreiner
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 25-29
In the quest to optimize performance of the elite athlete the sport scientist has sought to determine the ideal physique for a given sport or event. For some sports. specific structural characteristics offer definite performance advantages; for example in rowing, in addition to height, a large arm span has been identified as important. In other sports, such as long distance running, low levels of adiposity or 'fatness' appear to be linked with faster running times. There are four areas where appraisal of the athlete's physique can provide useful information: (1) identification of talented athletes; (2) to assess and monitor the growing athlete; (3) to monitor training and performance; and (4) to determine 'race weight' in weight-category sports. As a research tool a particular method must be reliable and valid. Other considerations include how expensive the method is, if it is suitable for a field situation and if large amounts of data on a number of subjects can be collected quickly. The method should be safe for both the athlete and the tester and provide useful feedback for the athlete or coach. Anthropometry, with training is able to fulfil most of these criteria and is the most widely used method of physique assessment in sports science. Large anthropometric data bases have been collected on elite athletes at Olympic games and world championships according to a standard protocol. Kinanthropometry, which has developed from anthropometry, is concerned with measurement and evaluation of different aspects of human movement and individual variation in body shape, size, proportion and composition. For the assessment of adiposity a sum of skinfolds, usually over six sites, is most commonly used rather than percentage body fat formulae. Muscle mass can be assessed indirectly through girth and corrected girth measurements. Limb lengths and breadths are used to assess skeletal structure and proportional differences in limb size. The anthropometric methods most commonly used to describe the physique of the athlete, which appraise shape, size, proportion and composition, will be discussed.
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Role of body protein as a prognostic indicator in wasting disease
BJ Allen, CA Pollock, J Russell, C Oliver and R Smith
Asia Pacific Journal of Clinical Nutrition (1995) Volume 4, Number 1: 31-33
Malnutrition is associated with many chronic diseases, though its extent and effect is not well known. Measurement of body protein provides a quantitative and reproducible means of monitoring malnutrition Results for anorexia nervosa, end stage renal failure value and asymptomatic and symptomatic HIV positive subjects are presented to show that, with the exception of asymptomatic HIV subjects, substantial protein depletion does occur.
A more difficult problem is to determine the relation between body protein, the effects of treatment and prognosis In the ease of CAPD patients, 20% protein depletion was found to be associated with a poor prognosis. For anorexia nervosa subjects, readmission probability was found to be correlated with body protein however monitored refeeding and exercise achieved a more normal body composition and quality of life The critical effect of protein depletion in AIDS remains to be determined, but once ascertained, the role of enteral and parenteral supplementation can then be quantitatively examined.
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Copyright © 1995 [Asia Pacific Journal of
Clinical Nutrition]. All rights reserved.
Revised: January 19, 1999.