scholarly journals Relapse and post-discharge body composition of children treated for acute malnutrition using a simplified, combined protocol: A nested cohort from the ComPAS RCT

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245477
Author(s):  
Natasha Lelijveld ◽  
Eunice Musyoki ◽  
Susan Were Adongo ◽  
Amy Mayberry ◽  
Jonathan C. Wells ◽  
...  

Introduction Severe and moderate acute malnutrition (SAM and MAM) affect more than 50 million children worldwide yet 80% of these children do not access care. The Combined Protocol for Acute Malnutrition Study (ComPAS) trial assessed the effectiveness of a simplified, combined SAM/MAM protocol for children aged 6–59 months and found non-inferior recovery compared to standard care. To further inform policy, this study assessed post-discharge outcomes of children treated with this novel protocol in Kenya. Methods Six ‘combined’ protocol clinics treated SAM and MAM children using an optimised mid-upper arm circumference (MUAC)-based dose of ready-to-use therapeutic food (RUTF). Six ‘standard care’ clinics treated SAM with weight-based RUTF rations; MAM with ready-to-use supplementary food (RUSF). Four months post-discharge, we assessed anthropometry, recent history of illness, and body composition by bioelectrical impedance analysis. Data was analysed using multivariable linear regression, adjusted for age, sex and allowing for clustering by clinic. Results We sampled 850 children (median age 18 months, IQR 15–23); 44% of the original trial sample in Kenya. Children treated with the combined protocol had similar anthropometry, fat-free mass, fat mass, skinfold thickness z-scores, and frequency of common illnesses 4 months post-discharge compared the standard protocol. Mean subscapular skinfold z-scores were close to the global norm (standard care: 0.24; combined 0.27). There was no significant difference in odds of relapse between protocols (SAM, 3% vs 3%, OR = 1.0 p = 0.75; MAM, 10% vs 12%, OR = 0.90 p = 0.34). Conclusions Despite the lower dosage of RUTF for most SAM children in the combined protocol, their anthropometry and relapse rates at 4 months post-discharge were similar to standard care. MAM children treated with RUTF had similar body composition to those treated with RUSF and neither group exhibited excess adiposity. These results add further evidence that a combined protocol is as effective as standard care with no evidence of adverse effects post-discharge. A simplified, combined approach could treat more children, stretch existing resources further, and contribute to achieving Sustainable Development Goal Two.

1995 ◽  
Vol 15 (5_suppl) ◽  
pp. 59-62 ◽  
Author(s):  
Sharon Stall ◽  
Nancy S. Ginsberg ◽  
Robert I. Lynn ◽  
Paul M. Zabetakis

There exists an imperative to monitor changes in body composition in all dialysis patients on a regular basis to avoid overt malnutrition. In this regard, the absolute measurement of the fat-free mass assessment may not be as crucial as the serial measurement of fat-free mass with the same modality. A significant difference in measured fat and fat-free mass should be expected if different techniques are employed. Therefore, when attempting to monitor patients over time or to assess the effects of changes in therapeutic regimens, a single methodology should be employed. Our data validate the use of BIA in the stable PD patient, indicating that BIA can predict the DXA results. Considering the ease with which BIA measurements can be obtained and the lack of dependency on operator interpretation, BIA is an ideal technique for use in the clinical setting. The applicability of this technique for use in monitoring longitudinal changes in body composition has, in fact, been well established (25,30,31). BIA appears to be an excellent method for routine fat-free mass measurement in dialysis patients. In as much as malnutrition continues to remain a significant problem in PD patients, measuring and monitoring body composition is strongly recommended.


2010 ◽  
Vol 54 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Alexis D. Guedes ◽  
Bianca Bianco ◽  
Mônica V. N. Lipay ◽  
Emmanuela Q. Callou ◽  
Marise L. Castro ◽  
...  

INTRODUCTION: Cardiovascular disease is one of the main causes for Turner syndrome (TS) mortality and the evaluation of its risk factors such as excess body fat and its distribution is considered one of the major aspects of the adult patient care. OBJECTIVE: To develop and validate a specific bioelectrical impedance analysis (BIA) equation to predict body composition in TS patients. SUBJECTS AND METHODS: Clinical and anthropometric data, dual-energy X-ray absorptiometry (DXA) for total fat-free mass (FFM) and BIA for resistance and reactance were obtained from 50 adult TS patients. Linear regression analysis was performed with multiple clinical and BIA data to obtain a predicting equation. RESULTS: The equation developed to estimate FFM in adult TS patients showed great consistency with DXA, elevated correlation (r = 0. 974) and determination (r² = 0. 948) coefficients and an adequate standard error estimate (SEE = 1.52 kg). CONCLUSIONS: The specific equation developed here allowed making an adequate FFM estimate in adult TS patients.


1990 ◽  
Vol 259 (2) ◽  
pp. E233-E238 ◽  
Author(s):  
N. K. Fukagawa ◽  
L. G. Bandini ◽  
J. B. Young

The relationship between fat-free mass (FFM) and resting metabolic rate (RMR) was compared in young men (n = 24; age 18-33 yr), old men (n = 24; 69-89 yr), and old women (n = 20; 67-75 yr). Body composition was assessed using anthropometry, bioelectrical impedance analysis (BIA), and isotope dilution with 18O-labeled water. RMR was measured at least twice using an open-circuit indirect calorimetry system with a ventilated hood. The results indicate that the different methods for assessing body composition vary substantially and should not be used interchangeably. Anthropometry was not adequate to assess group differences in body fatness, although skinfold measures may be appropriate for within-group comparisons. BIA correlated well with the isotope-dilution technique and may be a useful measure of FFM. Finally, RMR was lower in the old men than the young (1.04 +/- 0.02 vs. 1.24 +/- 0.03 kcal/min, P less than 0.001) and remained lower even when adjusted for FFM estimated by isotope dilution (P less than 0.001). RMR in the women was also lower (0.84 +/- 0.02 kcal/min), but in contrast to the difference between young and old men, RMR adjusted for FFM did not differ (P = 0.16) between old men and women. Therefore, it is clear that differences in FFM cannot fully account for the lower RMR in the old, suggesting that aging is associated with an alteration in tissue energy metabolism.


2017 ◽  
Vol 1 (S1) ◽  
pp. 38-38
Author(s):  
Hayley Billingsley ◽  
Salvatore Carbone ◽  
Justin M. Canada ◽  
Leo Buckley ◽  
Dave L. Dixon ◽  
...  

OBJECTIVES/SPECIFIC AIMS: Nonalcoholic steatohepatitis (NASH) is a common cause of chronic liver disease in the United States characterized by fat accumulation, inflammation, and fibrosis. Higher amounts of fat-free mass (FFM) and lower amounts of fat mass (FM) have been associated with better outcomes in several chronic diseases, recently also in NASH. Body composition is highly influenced by diet. However, the role of diet on body composition in patients with NASH is largely unknown. We hypothesized that consumption of polyunsaturated fatty acids (PUFA), healthy fatty acids mainly found in fish, nuts, and some vegetable oils, is associated with improved body composition, specifically greater FFM and lower FM, in NASH patients. METHODS/STUDY POPULATION: In total, 13 patients with histologically confirmed NASH underwent body composition testing via bioelectrical impedance analysis to estimate FFM% (% of body weight), FM% (% of body weight), and FFM/FM ratio. PUFA and saturated fat consumption was determined by standardized 5-pass 24-hour dietary recall. Correlations were computed using the Spearman rank test. RESULTS/ANTICIPATED RESULTS: Median body mass index (BMI) was 35.7 kg/m2 (32.8–42.7), median age of the sample was 50 years (46.3–57.3), and 73% were female. Median percent of calories from polyunsaturated fat was 6.8% (5.4–9.6). Percent of calories from PUFA was positively and significantly associated with greater FFM% (R=0.56, p=0.049), lower FM% (R=−0.59, p=0.035), and greater FFM/FM ratio (R=0.58, p=0.037). Additionally, a higher PUFA to saturated fatty acids ratio was also significantly correlated with greater FFM% (R=0.58, p=0.039), lower FM% (R=−0.64, p=0.020), and greater FFM/FM ratio (R=0.57, p=0.043). DISCUSSION/SIGNIFICANCE OF IMPACT: In patients with NASH, the consumption of PUFA is associated with higher FFM and lower FM, which suggests a protective role of these nutrients on body composition. A larger study on patients with NASH is warranted to confirm our findings on PUFA consumption and body composition, as well as to determine whether these effects will improve clinical outcomes.


2012 ◽  
Vol 109 (4) ◽  
pp. 639-647 ◽  
Author(s):  
Saijuddin Shaikh ◽  
Kerry J. Schulze ◽  
Anura Kurpad ◽  
Hasmot Ali ◽  
Abu Ahmed Shamim ◽  
...  

Equations for predicting body composition from bioelectrical impedance analysis (BIA) parameters are age-, sex- and population-specific. Currently there are no equations applicable to women of reproductive age in rural South Asia. Hence, we developed equations for estimating total body water (TBW), fat-free mass (FFM) and fat mass in rural Bangladeshi women using BIA, with 2H2O dilution as the criterion method. Women of reproductive age, participating in a community-based placebo-controlled trial of vitamin A or β-carotene supplementation, were enrolled at 19·7 (sd 9·3) weeks postpartum in a study to measure body composition by 2H2O dilution and impedance at 50 kHz using multi-frequency BIA (n 147), and resistance at 50 kHz using single-frequency BIA (n 82). TBW (kg) by 2H2O dilution was used to derive prediction equations for body composition from BIA measures. The prediction equation was applied to resistance measures obtained at 13 weeks postpartum in a larger population of postpartum women (n 1020). TBW, FFM and fat were 22·6 (sd 2·7), 30·9 (sd 3·7) and 10·2 (sd 3·8) kg by 2H2O dilution. Height2/impedance or height2/resistance and weight provided the best estimate of TBW, with adjusted R2 0·78 and 0·76, and with paired absolute differences in TBW of 0·02 (sd 1·33) and 0·00 (sd 1·28) kg, respectively, between BIA and 2H2O. In the larger sample, values for TBW, FFM and fat were 23·8, 32·5 and 10·3 kg, respectively. BIA can be an important tool for assessing body composition in women of reproductive age in rural South Asia where poor maternal nutrition is common.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Kulapong Jayanama ◽  
Supanee Putadechakun ◽  
Praopilad Srisuwarn ◽  
Sakda Arj-Ong Vallibhakara ◽  
Prapimporn Chattranukulchai Shantavasinkul ◽  
...  

Background. Body composition measurement is very important for early nutritional care in hemodialysis patients. Dual-energy X-ray absorptiometry (DXA) is a gold standard test, but clinically limited. Bioelectrical impedance analysis (BIA) with multifrequency technique is a practical and reliable tool. Objective. This cross-sectional study was aimed to compare the agreement of BIA with DXA in measurement of body composition in hemodialysis patients and to evaluate their associated factors. Methods. Body composition was measured by 2 BIA methods (InBody S10 and InBody 720) and DXA after a hemodialysis session. A total of 69 measurements were included. Pearson’s correlation and Bland and Altman analysis were used to determine the correlation of body composition between methods and to compare the methods agreement, respectively. Results. The correlation coefficients of body compositions were strong between DXA and InBody S10 (fat mass index (FMI): r=0.95, fat-free mass index (FFMI): r=0.78) and also between DXA and InBody 720 (FMI: r=0.96, FFMI: r=0.81). Comparing to DXA, the means of each body composition measured by InBody S10 method were not significantly different in each gender, but differences were found in FM, %FM, and FMI measured by InBody 720. Conclusions. In maintenance hemodialysis patients, the measurement of body composition with DXA and both BIA methods had highly significant correlations; practically, BIA method could be used as an instrument to follow FM and FFM and to measure the edematous stage. Further studies with large populations are warranted.


2020 ◽  
Vol 9 (4) ◽  
pp. 1210
Author(s):  
Justyna Wyszyńska ◽  
Piotr Matłosz ◽  
Agnieszka Szybisty ◽  
Paweł Lenik ◽  
Katarzyna Dereń ◽  
...  

Detailed associations between physical activity (PA) and body composition in preschoolers remain unclear. The aim of this study was to assess body composition among preschool children differentiated according to their levels of PA and to assess whether meeting the current PA recommendations is associated with a lower risk of obesity, determined by body mass index (BMI) and body fat percentage (BFP). Free-living PA was measured using accelerometers for 7 days in children aged 5 to 6 years. Bioelectrical impedance analysis was used to estimate body composition. Significant differences in content of BFP, fat-free mass (FFM), and total body water (TBW) were found between boys meeting and not meeting moderate-to-vigorous PA (MVPA) recommendations. Meeting the MVPA recommendation was associated with a twofold lower risk of obesity determined by BFP in boys but not in girls. In contrast, the total number of recommended steps per day was not related to adiposity in boys or girls. No statistically significant differences were observed in body composition indices and quintiles of MVPA. Boys in the 3rd–5th quintiles of steps per day presented significantly lower BFP and higher muscle mass and TBW than their peers in quintile 1. However, different associations were observed between body composition indices and quintiles of PA.


2020 ◽  
Vol 11 (1) ◽  
pp. 26-30
Author(s):  
Maria Alessandra Gammone ◽  
Nicolantonio D’Orazio

AbstractBackgroundYoung ballet dancers are at risk of health issues associated with altered nutritional status and of relative energy deficiency in sport compared to the general population.AimTo evaluate the nutritional status and body composition in ballet dancers.Materials and methodsThe study group consisted of 40 young ballet dancers (mean age 19.97 years). Height and weight were measured and body mass index was calculated in all subjects (mean BMI value 19.79 kg/m2, SD: 2.051). Body composition was estimated using the bioelectrical impedance method.ResultsThe dancers’ fat-free mass was 47.33 kg (SD: 5.064) and, on the average, body fat represented the 15.92% (SD: 16.91) of their body weight.ConclusionsBallet dancers, who usually show significantly lower BMI values compared to the general population, also displayed body fat values under the suggested range. Some screening for altered nutritional status should be performed. In addition, education programs should be recommended in young ballet dancers, in order to inform about energy and nutrition requirements for health and training and to prevent malnutrition-related problems.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2735
Author(s):  
Kurt Z. Long ◽  
Johanna Beckmann ◽  
Christin Lang ◽  
Harald Seelig ◽  
Siphesihle Nqweniso ◽  
...  

(1) Background: Early childhood malnutrition may result in increased fat mass (FM) among school-aged children in low- and middle-income countries (LMICs). We explored whether South African children with shorter stature have greater overall and abdominal FM compared to normal stature children. (2) Methods: Baseline assessments of body composition and weight were determined among school-aged children enrolled in a randomized controlled trial in Port Elizabeth, South Africa, using bioelectrical impedance analysis. Multiple linear regression models tested associations of children’s height and degree of stunting with FM, fat free mass (FFM), truncal fat mass (TrFM), and truncal fat free mass (TrFFM) overall and by sex. (3) Results: A total of 1287 children (619 girls, 668 boys) were assessed at baseline. Reduced child height was associated with higher FM and lower FFM and TrFFM, but these associations were reversed with increases in height. Girls classified as mildly or moderately/severely stunted had higher FM and TrFM but lower FFM and TrFFM, while no association was found for boys. (4) Conclusions: Our study suggests that efforts to reduce the non-communicable disease burden in LMICs should target growth-impaired children who may have greater overall FM and greater abdominal FM.


Author(s):  
Beatriz Rael ◽  
Nuria Romero-Parra ◽  
Víctor M. Alfaro-Magallanes ◽  
Laura Barba-Moreno ◽  
Rocío Cupeiro ◽  
...  

Purpose: The influence of female sex hormones on body fluid regulation and metabolism homeostasis has been widely studied. However, it remains unclear whether hormone fluctuations throughout the menstrual cycle (MC) and with oral contraceptive (OC) use affect body composition (BC). Thus, the aim of this study was to investigate BC over the MC and OC cycle in well-trained females. Methods: A total of 52 eumenorrheic and 33 monophasic OC-taking well-trained females participated in this study. Several BC variables were measured through bioelectrical impedance analysis 3 times in the eumenorrheic group (early follicular phase, late follicular phase, and midluteal phase) and on 2 occasions in the OC group (withdrawal phase and active pill phase). Results: Mixed linear model tests reported no significant differences in the BC variables (body weight, body mass index, basal metabolism, fat mass, fat-free mass, and total body water) between the MC phases or between the OC phases (P > .05 for all comparisons). Trivial and small effect sizes were found for all BC variables when comparing the MC phases in eumenorrheic females, as well as for the OC cycle phases. Conclusions: According to the results, sex hormone fluctuations throughout the menstrual and OC cycle do not influence BC variables measured by bioelectrical impedance in well-trained females. Therefore, it seems that bioimpedance analysis can be conducted at any moment of the cycle, both for eumenorrheic women and women using OC.


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