Loss Of FFM Research Articles

Changes in Body Composition and Insulin Sensitivity in Severely Obese Subjects After Laparoscopic Adjustable Silicone Gastric Banding (LASGB).

Laparoscopic adjustable silicone gastric banding (LASGB) is a viable therapeutic approach to achieve stable body weight reduction in severe obesity. The aim of this study was to evaluate body composition and metabolic features in morbidly obese patients before and after LASGB. There were 15 severely obese patients (Ob) (M/F: 4/11; mean age: 32.5 +/- 3.8 years) and 16 age-and sex-matched healthy lean controls (C) (M/F: 4/12; mean age: 39.5 +/- 2 years). Body mass index (BMI), waist circumference, waist-to-hip ratio, blood pressure, lipid profile, serum glucose and insulin during OGTT, and HOMA-IR were evaluated in all subjects. Body composition and fat distribution were measured using dual energy X-ray absorptiometry (DEXA). Patients were assessed before and six months after LASGB. The obese subjects showed several metabolic alterations. There were also positive correlations between waist, fat mass (FM), and HOMA-IR at baseline. After LASGB, mean BMI fell from 42.2 kg/m2 to 33.2 kg/m2; waist circumference and abdominal FM% decreased significantly. FM% declined, whereas FFM% increased. The ratio of FM loss to FFM loss was 3.7:1. Serum glucose and insulin levels during OGTT diminished slightly after weight loss and triglyceride levels fell dramatically. After LASGB, fasting insulin and HOMA-IR declined. LASGB induced a significant improvement in insulin sensitivity and a redistribution of body composition with a relative increase of FFM.

Body composition in early onset eating disorders.

Body mass index (BMI) or equivalent weight for height indices are the most widely used measures of body composition in early onset and adolescent eating disorders. Although of value as screening instruments the limitation in disease states is their inability to discriminate fat and fat-free components of body weight. To compare height-adjusted fat and fat-free components of body composition in children and young adolescents with different types of eating disorders with those of age matched reference children. Weight, height, triceps and subscapular skinfold thickness were measured in 172 children (aged 7-16 y) with eating disorders receiving specialist treatment. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated using Slaughter's and Deurenberg's equations and normalisation for height. Using data from 157 normal children, representative of the UK 1990 growth reference data, reference curves for FMI and FFMI+/-2 s.d. were derived. Results for patient groups were superimposed on these reference curves. FMI and FFMI were both reduced in eating disorders associated with malnutrition, including anorexia nervosa (AN). AN subjects did not differ from other subjects with comparable degrees of malnutrition. Children with eating disorders of normal weight, such as bulimia nervosa and selective eating, did not differ significantly from reference children in their relative FM and FFM. FM and FFM merit independent consideration in disorders of malnutrition in children, rather than expressing data as percentage body fat or percentage BMI. The implications of loss of FFM on growth and development merit further investigation.

Tissue depletion and health related quality of life in patients with chronic obstructive pulmonary disease

The relationship between tissue depletion and decreased exercise performance has been well established in patients with COPD. In this study we investigated the influence of the pattern of tissue depletion on health related quality of life (HRQL) and their mutual relationship with exercise capacity and dyspnoea.Patients with low body weight and/or low fat-free mass (FFM; using bioelectrical impedance) were categorized in three groups according to type of tissue depletion: loss of both FFM and fat mass (FM), and loss of FFM or FM only. Handgrip strength (HGS) was used as a functional outcome measure of tissue depletion. Exercise performance was assessed by 12 min walking distance (12MWD) and dyspnoea by visual analogue scale (VAS). HRQL was measured with the St George's Respiratory Questionnaire (SGRQ) and the Medical Psychological Questionnaire for Lung diseases (MPQL).Patients with depletion of FFM irrespective of body weight showed greater impairment in 12MWD, HGS, the ‘activity’ and ‘impact’ scores of the SGRQ and the domain ‘invalidity’ of the MPQL, in comparison with depleted patients with relative preservation of FFM. Exercise performance and dyspnoea were also significantly related to these subscores of HRQL. In addition, dyspnoea related significantly to the domain ‘symptoms’ of the SGRQ. Tissue depletion pattern remained significantly related to SGRQ-scores and the domain ‘invalidity’ of the MPQL when dyspnoea and walking distance were added to the model as a covariates.Tissue depletion is an important determinant of HRQL independent of exercise capacity and dyspnoea.

EFFECT OF ORAL CREATINE DURING ENERGY RESTRICTION IN ATHLETES

365 Anaerobic performance and body protein have been shown to decrease with energy restriction. The purpose of this study was to determine whether oral creatine supplementation during energy restriction would affect performance or body composition changes. Sixteen males resistance trainers were tested with anaerobic cycle test (10 sprints of 6 s with 30 s between) before and after 4 d of energy restriction (18 kcal/kg formula) with daily creatine or placebo supplement. Body composition change was assessed with hydrostatic weighing and nitrogen balance. A control group did performance test and hydrostatic testing only and showed no changes over time. Muscle biopsies taken before and after energy restriction showed a 6 and 8% reduction in total creatine and creatine phosphate in P and a 16 and 17% increase in these metabolites in Cr. Cr and P similarly decreased their body weight (−2.5 kg), fat (−7.5 %), nitrogen (−654.6 mg/kg N), but Cr had less reduction in fat-free mass than P (−1.4% vs −2.4%) during energy restriction. CrS tended to perform 3.8% more and P 0.5% less total work during the post performance test (p <0.1). In conclusion, energy restriction in athletes caused a significant reduction in muscle creatine that was reversed by oral creatine. This enhancement of muscle metabolites was not reflected in a benefit on body fat or nitrogen balance but tended to improve anaerobic performance and reduce FFM loss during weight loss. Supported by grants from National Strength and Conditioning Association and Gatorade Sports Science Institute