Prevalence of Malnutrition Assessed by Bioimpedance Analysis and Anthropometry in Children on Peritoneal Dialysis

2001 ◽  
Vol 21 (2) ◽  
pp. 172-179 ◽  
Author(s):  
Alberto Edefonti ◽  
Marina Picca ◽  
Beatrice Damiani ◽  
Rosanna Garavaglia ◽  
Silvana Loi ◽  
...  

Objective To evaluate the sensitivity of anthropometry and bioelectrical impedance analysis (BIA) in detecting alterations in body composition of children treated with peritoneal dialysis (PD), and to determine the prevalence of malnutrition in this population, in short- and long-term PD duration, using anthropometric and BIA-derived indices. Patients Eighteen children treated with automated PD (11 males, 7 females; mean age 8.7 ± 4.7 years). Design Eighteen patients were studied using anthropometry and BIA at the start (t0) and after 6 months (t1) of PD, 15 of these patients at 12 months (t2), and 8 at 24 months (t3) of PD. Midarm muscle circumference (MAMC), arm muscle area (AMA), and arm fat area (AFA) were calculated from anthropometric measures according to Frisancho (FrisanchoAR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 1981; 34:2540–5.). The bioelectrical measures of resistance (R) and reactance (Xc) were obtained directly from the impedance signal; phase angle (PA) and distance (D) were calculated using mathematical formulas. Nutritional status was assessed by anthropometric measurements and BIA-derived indices, expressed as standard deviation scores (SDS), and by a score system based on BIA and anthropometric parameters. The percentage of children with values of anthropometric and BIA-derived indices below the 3rd percentile or between the 3rd and 25th percentiles, and the percentage of children with scores of 7 – 12 and 4 – 6 were calculated in order to detect patients with severe or moderate derangement of nutritional status. Results The mean SDS values of Xc, PA, and D significantly improved ( p = 0.05, p = 0.001, p = 0.02) during the first 6 months of PD and remained almost stable during the following months. The SDS values of the anthropometric indices were less compromised than those of the BIA-derived indices, particularly at the start of dialysis. By 6 months, the percentages of children with values of BIA and anthropometric indices below the 3rd percentile had decreased. The percentages of patients with moderate and severe derangement of BIA and anthropometric indices remained substantially unchanged after 12 months. However, at 24 months, the percentage of patients with moderate derangement of BIA indices increased. All these findings were confirmed by the nutritional score system. Conclusion BIA is more sensitive than anthropometry in detecting alterations in body composition of children on PD. The prevalence of malnutrition, high at the commencement of PD, decreases during the first year of treatment but not over the long term.

Author(s):  
R. F. Rakhmaeva ◽  
A. A. Kamalova ◽  
V. A. Ayupova

Children with cerebral palsy (CP) often develop nutritional disorders, their incidence reaches 80% (according to the literature data).Purpose. To analyze the frequency of nutritional disorders and features of nutritional status in children with CP.Characteristics of children and research methods. We studied the anthropometric indicators (weight, height, body mass index, triceps and subscapular skin fold thickness), physical development characteristics depending on the motor abilities of the child according to the Gross Motor Function Classification System scale and body composition by bioelectrical impedance.Results. Nutritional status disorders were detected in 88.8% of patients, while the diagnostic was based on a reduced physical development in 55.5% of patients. 22.2% of patients had protein-energy deficiency of the first degree, 15.5% of patients had protein-energy deficiency of the second degree, 6.7% of patients had protein-energy deficiency of the third degree, 11.1% of patients suffered from overweight. Besides, nutritional disorders were diagnosed in 33.3% of patients with normal physical development, but with altered body composition, namely, with the imbalance of fat and lean body weight, the isolated increase of the percentage of fat mass, the decrease of active cellular and musculoskeletal weight. These patients also require nutritional correction.Conclusion. These data confirm the dependence of physical development and body composition on the patient’s motor activity and demonstrate the need for complex comprehensive study of nutritional status in children with CP.


2017 ◽  
Vol 80 (1) ◽  
pp. 85-102 ◽  
Author(s):  
Sampriti Debnath ◽  
Nitish Mondal ◽  
Jaydip Sen

AbstractUpper arm anthropometry has a potential role to provide useful estimations of body composition and nutritional status. Aims of the present cross-sectional study were to assess body composition and nutritional status of rural school-going children using upper arm anthropometric measures such as upper arm muscle area-by-height (UAMAH) and mid-upper arm circumference (MUAC) for-height. The present cross-sectional study was conducted among 1281 children of West Bengal, India (boys 619, girls 662) aged 5-12 years and selected using a stratified random sampling method. Anthropometric measurements of height, weight, MUAC and triceps skinfold (TSF) were recorded. Body composition and nutritional status were assessed using upper arm muscle area (UMA), upper arm fat area (UFA), UAMAH and MUAC-forheight. Age-sex-specific overall adiposity in TSF, UFA, arm fat index and upper-arm fat area estimates were higher among girls than boys (p<0.01), but UMA and upper-arm muscle area estimates were observed to be higher among boys than girls (p<0.05). High prevalence of undernutrition was found among both boys (53.15%) and girls (41.69%) using UAMAH (p<0.01). The overall prevalence of low MUAC-forheight was higher among boys (28.59%) than girls (25.68%) (p>0.05). Upper arm anthropometric measures, UAMAH and MUAC-for-height are useful for assessment of body composition and nutritional status among children.


2017 ◽  
Vol 27 (3) ◽  
pp. 207-215 ◽  
Author(s):  
Consuelo Pontón-Vázquez ◽  
Edgar Manuel Vásquez-Garibay ◽  
Erika Fabiola Hurtado-López ◽  
Adriana de la Torre Serrano ◽  
Germán Patiño García ◽  
...  

2018 ◽  
Author(s):  
Carla M Prado ◽  
Camila LP Oliveira ◽  
M Cristina Gonzalez ◽  
Steven B Heymsfield

Body composition assessment is an important tool in both clinical and research settings able to characterize the nutritional status of individuals in various physiologic and pathologic conditions. Health care professionals can use the information acquired by body composition analysis for the prevention and treatment of diseases, ultimately improving health status. Here we describe commonly used techniques to assess body composition in healthy individuals, including dual-energy x-ray absorptiometry, bioelectrical impedance analysis, air displacement plethysmography, and ultrasonography. Understanding the key underlying concept(s) of each assessment method, as well as its advantages and limitations, facilitates selection of the method of choice and the method of the compartment of interest. This review contains 5 figures, 3 tables and 52 references Key words: air displacement plethysmography, bioelectrical impedance analysis, body composition, disease, dual-energy x-ray absorptiometry, health, muscle mass, nutritional status, obesity, sarcopenia, ultrasound fat mass


2020 ◽  
Vol 83 (3) ◽  
pp. 239-250
Author(s):  
Aleksandra John ◽  
Joanna Goździk-Spychalska ◽  
Magdalena Durda-Masny ◽  
Wojciech Czaiński ◽  
Marta Gębala ◽  
...  

AbstractThe study aimed to assess: (1) differences in nutritional status and lung function between CF patients and the control group; (2) differences in body composition and lung function between groups of patients with CF designated by type of mutation; (3) the relationship between lung function and body composition in CF patients.We studied 37 CF patients aged 19 to 51 years, and 41 healthy non-CF volunteers. Nutritional status was evaluated based on the BMI and the bioelectrical impedance analysis. The lung function was described by FEV1%. CF patients were classified according to the CFTR genotype based on five classes of mutations. BMI were lower in CF patients compared to reference group (women: Z = 3.76, p <0.001, men: Z = 3.06, p = 0.002). CF patients had a lower mean content of particular body components, as well as FEV1% values. BMI differed significantly depending on the type of mutation in females (H = 10.33, p = 0.006) and males (H = 8.26, p = 0.016). The lowest values of BMI were observed in the group of patients with severe types of mutations. Also, variables describing body composition were statistically significantly lower in patients with a severe type of mutations. The CFTR gene mutation type statistically significantly differentiated FEV1% (H = 23.22, p <0.000). The results of the logistic regression analysis showed that the likelihood of dropping FEV1% below the norm was twice as high in undernourished females and males. To assess the nutritional status of CF patients, more informative methods describing the proportions of body components are required.


Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1716 ◽  
Author(s):  
Ramona De Amicis ◽  
Alessandro Leone ◽  
Chiara Lessa ◽  
Andrea Foppiani ◽  
Simone Ravella ◽  
...  

The classical ketogenic diet (cKD) is an isocaloric, high fat, very low-carbohydrate diet that induces ketosis, strongly influencing leptin and ghrelin regulation. However, not enough is known about the impact of a long-term cKD. This study evaluated the effects of a 12-month cKD on ghrelin and leptin concentrations in children, adolescents and adults affected by the GLUT1-Deficiency Syndrome or drug resistant epilepsy (DRE). We also investigated the relationship between the nutritional status, body composition and ghrelin and leptin variations. We carried out a longitudinal study on 30 patients: Twenty-five children and adolescents (15 females, 8 ± 4 years), and five adults (two females, 34 ± 16 years). After 12-monoths cKD, there were no significant changes in ghrelin and leptin, or in the nutritional status, body fat, glucose and lipid profiles. However, a slight height z-score reduction (from −0.603 ± 1.178 to −0.953 ± 1.354, p ≤ 0.001) and a drop in fasting insulin occurred. We found no correlations between ghrelin changes and nutritional status and body composition, whereas leptin changes correlated positively with variations in the weight z-score and body fat (ρ = 0.4534, p = 0.0341; ρ = 0.5901, p = 0.0135; respectively). These results suggest that a long-term cKD does not change ghrelin and leptin concentrations independently of age and neurological condition.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Natália Tomborelli Bellafronte ◽  
Lorena Vega-Piris ◽  
Paula Garcia Chiarello ◽  
Guillermina Barril Cuadrado

Abstract Background and Aims Chronic kidney disease (CKD) patients frequently have an altered body composition driven by metabolic disorders from the uremic syndrome that usually leads to increased protein catabolism, with obesity and muscle impairment being common conditions associated with worse clinical prognosis and high mortality rates. Therefore, with increased mortality and disability rates of CKD patients in the last quarter of a century and the association of a poor body composition with low survival, routine and longitudinal assessment of body composition could improve clinical outcomes. Due to limited availability of reference methods to assess nutritional status, alternative methods are used. In view of the above, our goal was to evaluate the agreement between multifrequency bioelectrical impedance spectroscopy (BIS) and Dual-energy X-ray Absorptiometry (DXA) for assessment of body composition in CKD. Method Cross-sectional and prospective analyses by DXA (Hologic, GE®) and BIS (BCM, Fresenius Medical Care®) in whole-body (BISWB) and segmental (BISSEG) protocols were performed in CKD non-dialysis-dependent, hemodialysis and peritoneal dialysis (for at least 3 months), and renal transplantation (for at least 6 months) adult (18 ≤ age ≤ 60 years old) patients. Measurements were performed consecutively by the same professional after an 8-hour fast, drainage of the peritoneal dialysate and just after the midweek hemodialysis session. Intraclass correlation coefficient (ICC) and Bland-Altman plots were evaluated for agreement analysis in group and individual levels, respectively; linear regression analysis was performed for bias assessment and development of new equations; ROC curve was constructed for diagnosis of inadequate error tolerance (DXA - BIS &gt; ± 2kg). Results A total of 266 patients were included: 137 men (M) and 129 women (W); 81 were in non-dialysis-dependent treatment, 83 in hemodialysis, 24 in peritoneal dialysis, and 80 had renal transplantation. Total sample had a mean age of 47 ± 10 years old. CKD was secondary to systemic arterial hypertension in 29% of the total sample, to glomerulonephritis in 25%, to diabetes mellitus in 10%, to polycystic kidney in 7%, to glomerulosclerosis and systemic syndromes in 8%, and to other causes and unknown etiology in 20%. Fourteen patients (4 M and 10 W) were in automated and 9 (4 M and 5 W) in continuous ambulatory PD. KTx was by living donor in 18 (14 M and 4 W) and by deceased donor in 63 (34 M and 29 W) patients. The agreement with DXA was greater for BISWB than BISSEG; for fat mass (FM) (ICC in M = 0.89; ICC in W = 0.93) than for fat free mass (FFM) (ICC in M = 0.57; ICC in W = 0.52). Bland-Altman plots showed high limits of agreement (FFM: from -9.51 to 15.64kg; FM: from -7.71 to 7.32kg) with greater bias for FFM as muscular mass increases and for FM in extremes of body fat. The agreement was lower when using the prospective data (body change analysis) (ICC for FFM in M = 0.20; ICC for FFM in W = 0.49; ICC for FM in M = 0.46; ICC for FM in W = 0.58). The factors that interfered in bias between methods were extra to intracellular water ratio (ECW/ICW), body mass index, fat mass index, waist circumference, resistance and reactance (adjusted r2 for FFM = 0.90; r2 for FM = 0.87). FFM had poorer agreement in the last tertile of ECW/ICW sample (ICC in M = 0.69, 0.68 and 0.51; ICC in W = 0.71, 0.74 and 0.38 for first, second and third tertiles, respectively). An ECW/ICW cut-off point of &gt; 0.725 for inadequate error tolerance was determined. New prediction equations for FFM (r2 = 0.91) and FM (r2 = 0.89) presented adequate error tolerance in 55% and 63% in the validation sample compared to 30% and 39% of the original equation, respectively. Conclusion For body composition evaluation in CKD, BIS applied using the whole-body protocol, in normal hydration CKD patients is as reliable as DXA; BIS must be used with caution among overhydrated patients with ECW/ICW &gt; 0.725. The newly developed equations are indicated for greater precision.


2020 ◽  
Vol 40 (1) ◽  
pp. 41-46
Author(s):  
Thalita L Melo ◽  
Marion S Meireles ◽  
Maria A Kamimura ◽  
Lilian Cuppari

Background: Decreased appetite is a symptom often found in chronic kidney disease. Poor appetite may negatively affect food intake, what in long-term may contribute to the development of protein–energy malnutrition. Methods: An Appetite and Food Satisfaction Questionnaire (AFSQ) was developed consisting of a question that assesses the level of appetite through a facial hedonic scale and five other questions adapted from the Buckner and Dwyer tool that assess some aspects related to food satisfaction. Each question received an arbitrary score of 0 to 3. The sum of the scores ranged from 0, the best, to 18, the worst condition. Nutritional status was assessed through seven-point SGA, bioelectrical impedance, anthropometry, and handgrip strength (HGS). Results: Eighty-four patients on peritoneal dialysis (PD; 58.3% women, mean age 54.7 ± 14.2 years, and body mass index (BMI) of 26.0 ± 4.8 kg/m2) were evaluated. Median AFSQ score was 4.0 (1.0–6.8; median and IQ). Patients were divided into tertiles according to the AFSQ score. Comparing the third tertile (score ≥ 6) with the first tertile (score < 2), the prevalence of malnutrition was greater (32.1% vs. 6.7%, respectively, p = 0.005), HGS adequacy was lower (74.6% vs. 87.3%, p = 0.001), and body cell mass index (5.7% vs. 7.4%, p = 0.001) and lean BMI were lower (11% vs. 13.4%, p = 0.001) in the third tertile. Conclusion: Poor appetite and food satisfaction determined by the questionnaire was related to worse nutritional markers, indicating AFSQ as a valid easy-to-use tool to be applied as an initial screening to identify PD patients with potential risk of malnutrition.


2012 ◽  
Vol 3 (4) ◽  
pp. 245-252 ◽  
Author(s):  
S. H. Kehoe ◽  
G. V. Krishnaveni ◽  
S. R. Veena ◽  
J. C. Hill ◽  
C. Osmond ◽  
...  

There is evidence of a reduction in children's physical activity in India in the last decade. Our objective was to assess whether size and body composition at birth are associated with physical activity in school-aged children. Children from a prospective observational cohort study born in Mysore, South India between 1997 and 1998 (n = 663) had neonatal anthropometric measurements made within 72 h of delivery [weight, mid-upper arm circumference (MUAC), chest, abdomen and head circumference, crown–heel, crown–buttock and leg length, triceps and subscapular skinfolds]. At 6–10 years, children (n = 449) were asked to wear AM7164 or GT1M Actigraph accelerometers for 7 days. Body composition was measured within 6 months of activity monitoring. Arm muscle area at birth and time of activity monitoring was calculated from MUAC and skinfold measurements.Activity outcome measures were: mean accelerometer counts per minute (cpm); counts per day and proportion of time spent in moderate and vigorous activity. The mean (s.d.) number of days with ⩾500 min of recorded accelerometer data was 7.0 (1.1). Linear regression models showed no significant associations between any of the neonatal anthropometric measures and the activity variables. Body fat percentage at 7.5 years was negatively associated with all activity variables (B = −4.69, CI: −7.31, −2.07 for mean cpm).In conclusion, this study showed no associations between body size and skinfold thickness at birth and objectively measured physical activity in childhood.


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