Body Composition and Its Relationship to Growth and Bone Mass in Patients with Thalassemia

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3890-3890
Author(s):  
Ellen Fung ◽  
Yan Xu ◽  
Janet Kwiatkowski ◽  
Sylvia Titi Singer ◽  
Ashutosh Lal ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Nutritional Status ◽  
Bone Mass ◽  
Body Fat ◽  
Lean Mass ◽  
Bone Health ◽  
Calcium Intake ◽  
Z Score ◽  
Percentage Body Fat

Abstract Optimal nutritional status is imperative for achieving the genetic potential for growth and development in children as well as for robust immune function and bone health in adults. Patients with thalassemia (Thal) are known to have abnormal growth, altered development and immune function and deficits in bone mass. For children, weight and height is commonly used to assess overall nutritional status, whereas for adults, body composition is a gross marker of an individual’s overall nutritional health. Nutritional status and body composition has not been explored in patients with Thal. To examine this, we have assessed body composition (fat, lean) and bone density by dual energy x-ray absorptiometry (DXA, Hologic Delphi A) in 370 subjects enrolled in a cross-sectional study of the Thal Clinical Research Network (TCRN), a North American collaborative research group. In addition to DXA, weight and height were measured, medical history obtained and a brief calcium food frequency and physical activity questionnaire completed. The total sample was divided into 2 groups: (TxThal) 257 transfused thalassemia major and E-beta thal patients (23.7 ± 11 yr, 131 male), and (NTxThal) 113 never or minimally transfused patients with other thalassemia syndromes (21.3 ± 13 yr, 50 male). Body mass index (BMI) was calculated (kg/m2) and cutoffs determined for children (<17=underweight, ≥30 obese) and adults (<18.5=underweight, ≥30 obese). As expected there was a high correlation between BMI and fat and lean mass by DXA (r=0.7 to 0.86, p<0.001). 6.2% of adults and 39.3% of children were classified as underweight by BMI and nearly 1/3 of children with Thal had abnormally low percentage body fat; while only 3.4% of adults and 2.2% of children were considered obese. Compared to median data from NHANES, adult patients with Thal are much leaner (BMI: 22.8±0.4) compared to contemporary adult Americans (28.1±0.2, p<0.0001). TxThal had more total body fat mass (14.3 vs 11.4 g, p<0.0001) and percentage body fat (27.3% vs. 24.9% p=0.007) compared to NTxThal. As has been observed in epidemiological studies of healthy subjects, calcium intake was inversely related to fat mass (p=0.009) as well as lean mass (p=0.007) after controlling for the effects of age, gender and diagnosis. Current physical activity level was a strong predictor of reduced body fat (p=0.007), whereas hemoglobin level was positively related to lean mass (p=0.001). Moreover, body fat was a positive predictor for height Z-score (p<0.0001). Low bone mass (BMD Z-Score <−2.0) was found in 50% of subjects, and BMD Z-score was moderately correlated with height Z-score (p<0.0001) and weight Z-score (p<0.0001). Though the majority of patients with Thal were classified as having a healthy body composition with very few obese patients, nearly 40% of the children in this sample were underweight. NTxThal appear at particular risk for underweight. These results suggest that an adequate amount of body fat is necessary for optimal growth and bone health in patients with Thal, and that calcium intake is associated with optimal body composition. These preliminary findings support the need for more careful study of nutritional status and its relationship to overall health in patients with thalassemia.

scholarly journals Factors Associated With Bone Health Status of Malaysian Pre-adolescent Children in the PREBONE-kids Study

2020 ◽  
Author(s):  
Chung Yuan Chang ◽  
Kanimolli Arasu ◽  
Soon Yee Wong ◽  
Shu Hwa Ong ◽  
Wai Yew Yang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Vitamin D ◽  
Body Composition ◽  
Health Status ◽  
Bone Mineral ◽  
Lean Mass ◽  
Bone Health ◽  
Calcium Intake ◽  
Mineral Density ◽  
25 Oh Vitamin D

Abstract Background: Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods: Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results: The mean calcium intake was 348.8 ± 180.1 mg/day and mean serum 25-OH vitamin D level was 43.9 ± 14.5nmol/L. In boys, lean mass (LM) was significantly associated with LSBMC (β = 0.539, p<0.001), LSBMD (β=0.607, p<0.001), TBBMC (β=0.675, p<0.001) and TBBMD (β= 0.481, p<0.01). Height was significantly associated with LSBMC (β =0.346, p<0.001) and TBBMC (β =0.282, p<0.001) while fat mass (FM) (β=0.261, p=0.034) and MET score (β =0.163, p=0.026) were significant predictors of TBBMD. Among girls, LM was significantly associated with LSBMC (β = 0.620, p<0.001), LSBMD (β=0.700, p<0.001), TBBMC (β=0.542, p<0.001) and TBBMD (β= 0.747, p<0.001). Calcium intake was a significant predictor of LSBMC (β=0.102, p=0.034), TBBMC (β=0.122, p<0.001) and TBBMD (β=0.196, p=0.002) in girls. Lean mass (LM) was weakly correlated with MET scores (r = 0.205, p = 0.001) but not protein (r = 0.055, p = 0.393) or energy intake (r = 0.101, p = 0.117). MET score (β = 0.207, p = 0.043) was a significant predictor of LM in boys but no factor was found to predict LM in girls. Conclusion: LM is the major determinant of BMC and BMD among pre-adolescent Malaysian children and physical activity is a significant predictor of LM in boys. Encouraging physical activity, calcium intake and optimum diets that build lean body mass should be the focus for developing public health guidance to ensure optimal bone health status during rapid growth.

Body Composition, Dietary Intake, and Iron Status of Female Collegiate Swimmers and Divers

2006 ◽  
Vol 16 (3) ◽  
pp. 281-295 ◽  
Author(s):  
Heidi L. Petersen ◽  
C. Ted Peterson ◽  
Manju B. Reddy ◽  
Kathy B. Hanson ◽  
James H. Swain ◽  
...  
Keyword(s):  
Body Composition ◽  
Dietary Intake ◽  
Body Fat ◽  
Lean Mass ◽  
Iron Status ◽  
Dietary Quality ◽  
Whole Body ◽  
Vitamin B ◽  
Percentage Body Fat ◽  
X Ray

This study determined the effect of training on body composition, dietary intake, and iron status of eumenorrheic female collegiate swimmers (n = 18) and divers (n = 6) preseason and after 16 wk of training. Athletes trained on dryland (resistance, strength, fexibility) 3 d/wk, 1.5 h/d and in-water 6 d/wk, nine, 2-h sessions per week (6400 to 10,000 kJ/d). Body-mass index (kg/m2; P = 0.05), waist and hip circumferences (P ≤ 0.0001), whole body fat mass (P = 0.0002), and percentage body fat (P ≤ 0.0001) decreased, whereas lean mass increased (P = 0.028). Using dual-energy X-ray absorptiometry, we found no change in regional lean mass, but fat decreased at the waist (P = 0.0002), hip (P = 0.0002), and thigh (P = 0.002). Energy intake (10,061 ± 3617 kJ/d) did not change, but dietary quality improved with training, as refected by increased intakes of fber (P = 0.036), iron (P = 0.015), vitamin C (P = 0.029), vitamin B-6 (P = 0.032), and fruit (P = 0.003). Iron status improved as refected by slight increases in hemoglobin (P = 0.046) and hematocrit (P = 0.014) and decreases in serum transferrin receptor (P ≤ 0.0001). Studies are needed to further evaluate body composition and iron status in relation to dietary intake in female swimmers.

scholarly journals Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1636
Author(s):  
Teresa Nestares ◽  
Rafael Martín-Masot ◽  
Carlos de Teresa ◽  
Rocío Bonillo ◽  
José Maldonado ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mediterranean Diet ◽  
Bone Mineral ◽  
Lean Mass ◽  
Bone Health ◽  
Gluten Free ◽  
Z Score ◽  
Mineral Density ◽  
Diet Adherence ◽  
Mediterranean Diet Adherence

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.

scholarly journals The Relationship between Body Composition, Dietary Intake, Physical Activity, and Pulmonary Status in Adolescents and Adults with Cystic Fibrosis

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 310
Author(s):  
Kevin J. Scully ◽  
Laura T. Jay ◽  
Steven Freedman ◽  
Gregory S. Sawicki ◽  
Ahmet Uluer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystic Fibrosis ◽  
Body Composition ◽  
Dietary Intake ◽  
Healthy Volunteers ◽  
Clinical Outcomes ◽  
Body Fat ◽  
Lean Mass ◽  
Cross Sectional ◽  
Adolescents And Adults

Measures of body fat and lean mass may better predict important clinical outcomes in patients with cystic fibrosis (CF) than body mass index (BMI). Little is known about how diet quality and exercise may impact body composition in these patients. Dual X-ray absorptiometry (DXA) body composition, 24-h dietary recall, and physical activity were assessed in a cross-sectional analysis of 38 adolescents and adults with CF and 19 age-, race-, and gender-matched healthy volunteers. Compared with the healthy volunteers, participants with CF had a lower appendicular lean mass index (ALMI), despite no observed difference in BMI, and their diets consisted of higher glycemic index foods with a greater proportion of calories from fat and a lower proportion of calories from protein. In participants with CF, pulmonary function positively correlated with measures of lean mass, particularly ALMI, and negatively correlated with multiple measures of body fat after controlling for age, gender, and BMI. Higher physical activity levels were associated with greater ALMI and lower body fat. In conclusion, body composition measures, particularly ALMI, may better predict key clinical outcomes in individuals with CF than BMI. Future longitudinal studies analyzing the effect of dietary intake and exercise on body composition and CF-specific clinical outcomes are needed.

scholarly journals Long-Term Effects of a Classic Ketogenic Diet on Ghrelin and Leptin Concentration: A 12-Month Prospective Study in a Cohort of Italian Children and Adults with GLUT1-Deficiency Syndrome and Drug Resistant Epilepsy

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1716 ◽  
Author(s):  
Ramona De Amicis ◽  
Alessandro Leone ◽  
Chiara Lessa ◽  
Andrea Foppiani ◽  
Simone Ravella ◽  
...  
Keyword(s):  
Body Composition ◽  
Nutritional Status ◽  
Body Fat ◽  
Deficiency Syndrome ◽  
Drug Resistant ◽  
Z Score ◽  
Glut1 Deficiency ◽  
Glut1 Deficiency Syndrome ◽  
Drug Resistant Epilepsy

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.

Attending After-School Physical Activity Club 2 Days a Week Attenuated an Increase in Percentage Body Fat and a Decrease in Fitness Among Adolescent Girls at Risk for Obesity

2020 ◽  
Vol 34 (5) ◽  
pp. 500-504 ◽  
Author(s):  
Lorraine B. Robbins ◽  
Jiying Ling ◽  
Fujun Wen
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Body Fat ◽  
Controlled Trial ◽  
Vigorous Physical Activity ◽  
Intervention Group ◽  
After School ◽  
Z Score ◽  
Mixed Effect ◽  
Percentage Body Fat

Purpose: To evaluate the effect of a 17-week intervention, including an after-school physical activity (PA) club 3 d/wk, on moderate-to-vigorous physical activity (MVPA), body mass index (BMI) z score, percentage body fat (%BF), and cardiorespiratory fitness (CRF) among fifth to eighth grade girls having a BMI z score ≥0, and explore whether intervention outcomes varied by club attendance (1 vs 2 vs 3 d/wk). Design: Secondary analysis of data from a group randomized controlled trial (N = 1519, 10- to 15-year-old girls: n = 753 intervention; n = 766 control). Setting: Twenty-four Midwestern US schools (n = 12 intervention; n = 12 control). Sample: Subsample (n = 1194 girls) from trial’s intervention (n = 593 girls) and control (n = 601 girls) groups having BMI z scores ≥0. Measures: Moderate-to-vigorous physical activity (min/h), BMI z score, %BF, and CRF ([Formula: see text]: mL/kg/min) were estimated at baseline and postintervention. Analysis: Linear mixed-effect models. Results: Intervention group gained less %BF ( B = −0.35, P = .016), and their CRF decreased less ( B = 0.22, P = .010) than the control. Marginally significant findings showed girls attending the club an average of 1 d/wk had greater increases in %BF ( B = 0.33, P = .087) and MVPA ( B = 0.20, P = .083) and a greater decrease in CRF ( B = −0.20, P = .061) than girls attending 3 d/wk. No differences occurred between girls who attended 2 versus 3 d/wk for any outcomes. Conclusions: The intervention attenuated an increase in %BF and a decrease in CRF among girls at risk for obesity from baseline to postintervention. Offering the after-school PA club 2 d/wk may be adequate for achieving outcomes.

The Effects of Body Composition, Dietary Intake, and Physical Activity on Calcaneus Quantitative Ultrasound in Spanish Young Adults

2016 ◽  
Vol 18 (4) ◽  
pp. 439-444 ◽  
Author(s):  
María Correa-Rodríguez ◽  
Jacqueline Schmidt Rio-Valle ◽  
Emilio González-Jiménez ◽  
Blanca Rueda-Medina
Keyword(s):  
Physical Activity ◽  
Young Adults ◽  
Body Composition ◽  
Bone Mass ◽  
Dietary Intake ◽  
Lean Mass ◽  
Quantitative Ultrasound ◽  
Early Adulthood ◽  
Broadband Ultrasound Attenuation ◽  
Modifiable Factors

Identifying modifiable factors that influence bone gain during early adulthood in order to maximize peak bone mass (PBM) is a potential primary strategy in the prevention of osteoporosis in later life. The present study examined the relationships between body composition, dietary intake and physical activity (PA), and bone health measured by quantitative ultrasound (QUS) at the right calcaneus. The study population consisted of 781 Spanish men and women (age 19.1 ± 3.6). Body composition, dietary intake, PA, and bone strength were assessed. Calcaneus QUS was significantly correlated with age, height, weight, body mass index, lean mass, fat mass, protein intake, and moderate and high PA. No significant correlation between calcium intake and broadband ultrasound attenuation (BUA, dB/MHz) was detected. Linear regression analyses revealed that independent variables accounted for 18.8% of the total variance of calcaneus BUA ( p = .000). Lean mass and high PA were significant predictors of BUA variance in young adults ( p = .000 and p = .045, respectively). Results indicate that lifestyle choices and their consequences during early adulthood could influence bone mass, particularly PA and lean mass. Furthermore, this study provides novel data about bone mass as indicated by the QUS measurements at the time of PBM acquisition.

scholarly journals Gordura corporal e perfil lipídico de gêmeos monozigóticos discordantes para resistência à insulina

2016 ◽  
Vol 18 (6) ◽  
pp. 690
Author(s):  
Timothy Gustavo Cavazzotto ◽  
Marcos Roberto Queiroga ◽  
Sandra Aires Ferreira ◽  
Eduardo Kokubun ◽  
Maria Raquel De Oliveira Bueno ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Physical Fitness ◽  
Body Fat ◽  
Monozygotic Twins ◽  
Fat Percentage ◽  
Percentage Body Fat ◽  
Insulin Resistant ◽  
Discordant Group ◽  
Gestational Stage

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n6p690 The study investigated alterations in body fat and metabolic profile of adolescent monozygotic twins, resulting from discordance for insulin resistance, adjusted for physical activity, physical fitness and heredity. Thirty-eight pairs of monozygotic twins were assessed for anthropometric measurements to estimate body fat. Physical fitness was estimated with treadmill test and use of ergospirometer. Daily physical activity was estimated from the daily count of steps measured by a pedometer during 3 days. Fasting blood samples were used to determine blood glucose, insulin, lipid parameters. The Homa-IR and HOMA-β indexes were calculated. Twins with measures higher than 2.5 were considered insulin resistant. When both brothers were below or above cutoffs, the pair was allocated to the concordant group. When one brother was insulin resistant and the other was not, the pair was allocated in the discordant group. Twins were compared using paired test. In the discordant group, it was observed that insulin-resistant twins had higher birth weight values, bodyweight, BMI, waist circumference, body fat percentage, body fat (sum of skinfolds), Homa-β index and lower HDL compared to their corresponding pair. Insulin-resistant twins showed higher values in anthropometry and body composition, as well as in the glycemia and insulin index and lower HDL. These events may have been unchained by metabolic alterations possibly originating from gestational stage, however, modulated by body composition. 

scholarly journals Physical activity, sedentary time and bone tissue: effects of an 8-months interdisciplinary program with overweight/obese children

2019 ◽  
Vol 23 ◽  
pp. 1-7
Author(s):  
Júlio Brugnara Mello ◽  
Luís Filipe Gomes Barbosa Pereira de Lemos ◽  
Luísa Maria Aires ◽  
Gustavo Silva ◽  
Rafael Miranda Tassitano ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Body Composition ◽  
Bone Mass ◽  
Bone Tissue ◽  
Bone Mineral ◽  
Sedentary Time ◽  
Vigorous Physical Activity ◽  
Z Score ◽  
Mineral Density

Moderate to vigorous physical activity plays a recognized osteogenic effect on bone. Moreover, sedentary time, and fat accumulation are unfavorable to bone health. Our study aimed (1) to examine changes in body composition, bone tissue, physical activity, and sedentary time; and (2) to explore whether changes in physical activity intensities and in sedentary time are associated with changes in bone outcomes after a school-based interdisciplinary intervention program. A total of 53 overweight/obese students (10.6 ± 3.5 year-olds; 26 girls) participated in physical activity classes. Bone area, bone mass, and bone mineral density z-score, body composition (fat mass, fat lean mass), physical activity, sedentary time and potential confounders (vitamin D and maturational status) were assessed at baseline, and 8 months later. General Linear Models were carried out and significance level was set at 5%. Changes in moderate to vigorous physical activity were positively correlated with changes in all bone mass indicators. We observed a significant overall effect of the intervention on bone mineral density z-score changes, however after adjustments for changes in sedentary time and moderate to vigorous physical activity, no effect was observed. Finally, variations in sedentary time and in moderate to vigorous physical activity play an important role in bone mass density in those participants of the interdisciplinary program.

scholarly journals Maternal and child factors associated with child body fatness in a Ghanaian cohort

2019 ◽  
Vol 23 (2) ◽  
pp. 309-318
Author(s):  
Sika M Kumordzie ◽  
Harriet Okronipa ◽  
Mary Arimond ◽  
Seth Adu-Afarwuah ◽  
Maku E Ocansey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Body Fat ◽  
Dietary Patterns ◽  
Body Fatness ◽  
Percentage Body Fat ◽  
Child Factors ◽  
Maternal Bmi ◽  
Dietary Data

AbstractObjective:We aimed to identify factors (child diet, physical activity; maternal BMI) associated with body composition of Ghanaian pre-school children.Design:Longitudinal analysis of the International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-Ghana randomized trial, which enrolled 1320 pregnant women at ≤20 weeks’ gestation and followed them and their infants until 6 and 18 months postpartum, respectively. At follow-up, child age 4–6 years, we collected data on body composition (by 2H dilution), physical activity and diet, extracted dietary patterns using factor analysis, and examined the association of children’s percentage body fat with maternal and child factors by regression analysis.Setting:Eastern Region, Ghana.Participants:Children 4–6 years of age.Results:The analysis included 889 children with percentage body fat and dietary data at follow-up. We identified two major dietary patterns, a snacking and a cooked foods pattern. Percentage body fat was positively associated (standardized β (se)) with maternal BMI at follow-up (0·10 (0·03); P = 0·003) and negatively associated with physical activity (−0·15 (0·05); P = 0·003, unadjusted for child gender), but not associated with the snacking (0·06 (0·03); P = 0·103) or cooked foods (−0·05 (0·07); P = 0·474) pattern. Boys were more active than girls (1470 v. 1314 mean vector magnitude counts/min; P < 0·0001) and had lower percentage body fat (13·8 v. 16·9 %; P < 0·0001).Conclusions:In this population, maternal overweight and child physical activity, especially among girls, may be key factors for addressing child overweight/obesity. We did not demonstrate a relationship between the dietary patterns and body fatness, which may be related to limitations of the dietary data available.

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