Multiple Frequency Bioelectrical Impedance Analysis Research Articles

Dominant Somatotype Development in Relation to Body Composition and Dietary Macronutrient Intake among High-Performance Athletes in Water, Cycling and Combat Sports

Relevant properties of the somatotype as important indicators can be associated with the body composition characteristics as well as both metabolic and bio-mechanical efficiency of athletes in the sport concerned. The primary aim of this single cross-sectional study was to determine the somatotype profiles in association with body composition and nutritional profiles among Lithuanian elite athletes (n = 189) involved in water, cycling and combat sports. The body composition along with the somatotype profiles and the nutritional status of athletes were evaluated using a battery of multiple frequency (5, 50, 250, 550, and 1000 kHz) bioelectrical impedance analysis (BIA) and a 3-day food record analysis. In terms of the prediction for athletes to be classified as endomorphs, mesomorphs or ectomorphs, the linear discriminant analysis was conducted to assess the grouping of samples. Both the multiple linear regression and multivariate logistic regression statistical analyses were performed to explore the associations between the independent and dependent variables. The central tendency values for the somatotype components of endomorphy, mesomorphy and ectomorphy in athletes playing water, cycling and combat sports were 4.3–4.9–3.4, 4.3–4.8–3.4 and 4.5–5.5–2.9, respectively. The central mesomorph somatotype with a trend towards endomorphy was dominant and varied according to a high muscle-to-fat ratio in elite athletes. Significant (p ≤ 0.001) positive associations between both endomorphy and mesomorphy values and higher body fat percentage as well as lower and upper limb muscle mass were identified. The lower levels of trunk muscle mass were related to athletes’ endomorphy and mesomorphy, too. Furthermore, in the athletes’ sample under analysis, high-level mesomorphs were prone to consume low-carbohydrate (adjusted odd ratio (AOR) 0.5, 95% confidence interval (CI) 0.2; 0.9) and high-protein diets (AOR 2.5, 95% CI 1.1; 5.5). Contrastingly, the elite athletes with a higher expression of endomorphy were on high-carbohydrate (AOR 5.4, 95% CI 1.1; 8.3) and high-fat diets (AOR 4.6, 95% CI 1.5; 7.1) along with insufficient protein diet (AOR 0.3, 95% CI 0.1; 0.9). Finally, whilst nutrition goals as a mediator can play a significant role in undergoing the maintenance of balance between the optimal body composition for athletic performance and the development of an ecto-mesomorphic somatotype, the elite athletes with higher levels of endomorphy value should be aware of lowering the body fat percentage coupled with dietary fat reduction and higher protein intakes. The findings obtained from the study may serve as an antecedent for a more targeted management of the elite athletes’ training process. Somatotyping as an additional assessment method can be successfully deployed in choosing correct coaching techniques, contributing to talent recognition processes or identifying reference morphometric parameters in elite athletes competing in water, cycling and combat sports.

Comparison of Bioelectrical Impedance Analysis with DXA in Adolescents with Cystic Fibrosis before and after a Resistance Training Intervention.

Background: The purpose of this pilot study was to compare body composition metrics obtained by two portable bioelectrical impedance analysis (BIA) devices with dual-energy X-ray absorptiometry (DXA) among adolescents with cystic fibrosis (CF) before and after a resistance exercise training program. Methods: Participants with CF were assessed using DXA, single-frequency BIA (SFBIA), and multiple-frequency BIA (MFBIA) to quantify percent body fat (%Fat), fat mass (FM), and fat-free mass (FFM) at baseline and after a home-based resistance training intervention comprised of 36, 1 h sessions completed in 12–14 weeks. Repeated measures analysis of variance, paired samples t-tests, Cohen’s d effect sizes, and Pearson’s correlations were used to compare differences between and within methods at baseline and post-intervention. Results: Ten participants (15.8 ± 2.2 yr, 60.1 ± 15.1 kg) completed the assessments. At baseline, both SFBIA and MFBIA scales significantly underestimated %Fat and FM and overestimated FFM, with small to moderate effect sizes. Post-intervention, small, non-significant differences were found between DXA and both BIA scales for all body composition metrics. Significant changes in %Fat and FFM were observed with DXA. MFBIA displayed less constant error than SFBIA when compared to DXA for pre- and post-intervention assessments for %Fat (MFBIA: pre and post −2.8 and −0.8 vs. SFBIA: −4.6 and −2.0), FM (−0.4 and −0.4 vs. −3.0 and −1.1), and FFM (+0.8 and +0.6 vs. +3.1 and +1.3). Near-perfect correlations were observed at both time points between DXA and each BIA scale. Conclusions: Portable BIA results should be interpreted with caution, and further validation studies in CF patients are needed prior to clinical use.

Body composition assessment after pediatric liver transplant.

Pediatric liver transplantation generally restores metabolic function; yet after transplantation, some children remain malnourished, have increased adiposity, and develop obesity. Measurement of body composition in the assessment of nutrition status could reduce adverse consequences in children. Anthropometric measurements, multiple-frequency bioelectrical impedance analysis, air displacement plethysmography, and ultrasound measurements were conducted on children recruited from the liver transplant program at the University of Minnesota Masonic Children's Hospital. A cross-sectional study was conducted to describe the quality of weight gain in post-liver transplant children between the ages of 2 and 17 years using multiple assessment tools (air displacement plethysmography, multiple-frequency bioelectrical impedance analysis, and ultrasound) and to determine whether multiple-frequency bioelectrical impedance analysis and ultrasound accurately describe body composition and quality of weight gain. Mean percent body fat by air displacement plethysmography and multiple-frequency bioelectrical impedance analysis was 18.4% (±3.3) and 19.0% (±3.9), respectively (P > .99). There were insufficient data to examine the relationship between summed muscle and adipose thickness measures by ultrasound and percent body fat determined by air displacement plethysmography or multiple-frequency bioelectrical impedance analysis. Percent body fat, fat mass, and fat-free mass measures determined by air displacement plethysmography and multiple-frequency bioelectrical impedance analysis were not statistically different, which suggests the stand-on device used in this study could be a useful body composition assessment tool for the pediatric population.

Application of complex decongestion therapy in patients with upper limb lymphedema after breast cancer surgery

Objective To explore the application effects of complex decongestion therapy (CDT) in patients with upper limb lymphedema after breast cancer treatment. Methods From April 2015 to December 2016, a total of 52 cases of breast cancer patients with postoperative upper limb lymphedema were selected by convenience sampling method and treated with CDT for 1 course (20 times of CDT treatment) . Limb circumference measurements and multiple-frequency bioelectrical impedance analysis were applied to evaluate the degeneration degree of edema. Fugl-Meyer and Bathel index were applied to assess the motor function and living ability before and after treatment. Results The differences of circumference of different parts of the affected limb (including thumb web, 5cm proximal to rasceta, 10 cm distal to cubital crease, 10 cm proximal to cubital crease and axilla) before and after intervention were statistically significant (t=20.014, 10.114, 9.190, 6.995, 3.832; P<0.01) . The differences of circumferential ratio and tissue moisture ratio before and after intervention were statistically significant (t=34.058, 22.196; P<0.01) . The score of Fugl-Meyer on patients' limb movement function and the Bathel index both, and the differences were statistically significant (t=28.446, 38.285; P<0.01) . Conclusions CDT is an effective and safe treatment for upper limb lymphedema after breast cancer surgery, and worthy of clinical promotion. Key words: Breast neoplasms; Lymphedema; Limb function; Integrated lymphatic swelling treatment

Malnutrition Identified by the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Consensus Criteria and Other Bedside Tools Is Highly Prevalent in a Sample of Individuals Undergoing Treatment for Head and Neck Cancer.

Using the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition (Academy/ASPEN) Consensus malnutrition definition, we estimated malnutrition prevalence in a sample of individuals with head and neck cancer (HNC) and compared it with the Patient-Generated Subjective Global Assessment (PG-SGA). We also investigated the utility of the 50-kHz phase angle (PA) and 200-kHz/5-kHz impedance ratio (IR) to identify malnutrition. Nineteen individuals (18 males, 1 female) scheduled to undergo chemoradiotherapy were seen at 5 time points during and up to 3 months after treatment completion. Multiple-frequency bioelectrical impedance analysis, PG-SGA, nutrition-focused physical examination, anthropometry, dietary intake, and handgrip strength data were collected. Using the Consensus, 67% were found to be malnourished before treatment initiation; these criteria diagnosed malnutrition with overall good sensitivity (94%) and moderate specificity (43%) compared with PG-SGA. Over all pooled observations, "malnourished" (by Consensus but not PG-SGA category) had a lower mean PA (5.2 vs 5.9; P = .03) and higher IR (0.82 vs 0.79; P = .03) than "well-nourished" categorizations, although the clinical relevance of these findings is unclear. PA and IR were correlated with higher PG-SGA score (r = -0.35, r = 0.36; P < .01) and handgrip strength (r = 0.48, r = -0.47; P < .01). The Academy/ASPEN Consensus and the PG-SGA were in good agreement. It is unclear whether PA and IR can be used as surrogate markers of nutrition status or muscle loss.

Comparison of the Effect of Sensory-Level and Conventional Motor-Level Neuromuscular Electrical Stimulations on Quadriceps Strength After Total Knee Arthroplasty: A Prospective Randomized Single-Blind Trial

ObjectiveTo compare sensory-level neuromuscular electrical stimulation (NMES) and conventional motor-level NMES in patients after total knee arthroplasty. DesignProspective randomized single-blind trial. SettingHospital total arthroplasty center: inpatients. ParticipantsPatients with osteoarthritis (N=66; mean age, 73.5±6.3y; 85% women) were randomized to receive either sensory-level NMES applied to the quadriceps (the sensory-level NMES group), motor-level NMES (the motor-level NMES group), or no stimulation (the control group) in addition to a standard rehabilitation program. InterventionsEach type of NMES was applied in 45-minute sessions, 5d/wk, for 2 weeks. Main Outcome MeasuresData for the quadriceps maximum voluntary isometric contraction, the leg skeletal muscle mass determined using multiple-frequency bioelectrical impedance analysis, the timed Up and Go test, the 2-minute walk test, the visual analog scale, and the range of motion of the knee were measured preoperatively and at 2 and 4 weeks after total knee arthroplasty. ResultsThe motor-level NMES (P=.001) and sensory-level NMES (P=.028) groups achieved better maximum voluntary isometric contraction results than did the control group. The motor-level NMES (P=.003) and sensory-level NMES (P=.046) groups achieved better 2-minute walk test results than did the control group. Some patients in the motor-level NMES group dropped out of the experiment because of discomfort. ConclusionsMotor-level NMES significantly improved muscle strength and functional performance more than did the standard program alone. Motor-level NMES was uncomfortable for some patients. Sensory-level NMES was comfortable and improved muscle strength and functional performance more than did the standard program alone.

Effects of Aerobic Exercise on Body Composition at Different Phases of the Menstrual Cycle

PURPOSE: To determine the behaviour of body composition, especially body water in females in relation to their menstrual cycle and in response to aerobic exercise. METHODS: Eight females (age = 20.4 ± 1.6 yrs) performed four sessions of aerobic activity at 70% of their calculated VO2max. VO2max was determined by utilizing the Bruce Protocol. The speed for each subject’s aerobic activity was then calculated using the ACSM metabolic running equation. The four sessions of aerobic activity were identical in format and performed on days 1, 7, 14, and 21 of each subject’s menstrual cycle. Sessions began with measurements of body weight, body fat, extracellular fluid (ECF), intracellular fluid (ICF), and fat-free mass (FFM) via single-frequency and multiple-frequency bio-electrical impedance analysis (BIA) prior to aerobic activity. Subjects then completed 30 minutes of aerobic activity at the calculated speed to yield an intensity of 70% VO2max. Following the aerobic activity, all measures taken pre-exercise were measured again at three separate time points post-exercise; post-0min, post-15min, and post-30min. This combined for a total of 4 separate time points at which measurements were taken; pre, post-0min, post-15min, and post-30 min. RESULTS: Significance was seen for a condition difference in body mass (p<0.04) and for a time difference in ECF (p<0.01) and body fat (p<0.01). Body mass significantly decreased from Day 1 to Day 7 and ECF volume was significantly changed from time point pre to post-0min and post-15min on all days. No condition main effects were seen for body water measurements, but a trend for condition*time interaction was seen in ICF difference pre-post (p=0.09). CONCLUSIONS: Body water responses to aerobic exercise varied across the days of the menstrual cycle, which caused fluctuations in body weight, ECF, and ICF. The percent changes in ICF values from pre to post-30min were increased by 3.2% on day 14 and decreased by 5.6% on day 7. ICF behaviour on different days suggests that the menstrual cycle may have impacts on performance. Further investigation is required to back up such claims. Future studies should investigate the effects of different duration and/or intensity of aerobic exercises on body composition along with blood pressure, heart rate, and RPE.

Effects of nucleos(t)ide analogs on body composition in HBV-infected men: An age- and BMI-matched, cross-sectional study

ObjectiveChronic hepatitis B (CHB) requires long-term treatment with nucleos(t)ide analogs (NAs). The goal of the present study was to evaluate the effects of long-term treatment with NAs on body composition in men with CHB. MethodWe performed a cross-sectional study of men infected with hepatitis B virus (HBV) who have never been on NAs with high HBV-DNA (naïve group; n = 30), those on NAs for 7 y with virologic suppression (NA-treated group; n = 50), and healthy men (control group; n = 30) matched by age and body mass index (BMI) to evaluate whether body composition differed. Body composition was assessed by multiple-frequency bioelectrical impedance analysis. All patients and healthy controls underwent anthropometric measures, dietary intake, and physical activity level survey. ResultsBody fat mass (BFM) and visceral fat area (VFA) were significantly lower in HBV-infected men naïve to NAs than in controls (P < 0.05). With virology suppression after treatment with NAs, BFM, VFA, and waist-to-hip ratio (WHR) were significantly increased in the NA-treated group compared with the naïve group (P < 0.05). Although there were no significant differences in BFM, VFA, and WHR between NA-treated men and controls (P > 0.05), WHR in the NA-treated group was 0.94 ± 0.06, indicating central obesity. Liver function, liver stiffness measurement, dietary intake, and physical activity level were the same between NA-treated and naïve men with CHB. ConclusionsBFM and VFA is elevated in CHB men on NAs with virologic suppression compared with age and BMI-matched NA-naïve CHB men, which suggests that NAs may increase BFM and VFA of CHB men by virologic suppression. Further study is needed to clarify the adverse effects related to metabolic complications of lipid metabolism due to NA therapy.

218 Body composition estimation by bioelectrical impedance: Validation of an equation adapted to children with cystic fibrosis

Objectives Nutritional status is an important factor which determines the respiratory outcome in cystic fibrosis (CF) patients. Body composition (BC), and more specifically fat free mass (FFM), impacts on respiratory function in adults; however data concerning pediatric cohorts are sparse. The gold standard method to estimate BC is dual X-Ray absorptiometry (DXA), but it is radiating, time consuming and frequently unavailable. Bioelectrical impedance analysis (BIA) is reproducible and easily feasible. Our objective is to validate an equation adapted to the pediatric CF population in order to calculate FFM by BIA. We also aim to investigate the correlation between BC and pulmonary function testing (PFT). Methods CF children and non-CF controls are evaluated prospectively using four-electrode multiple-frequency BIA (Aminostats Bio-ZM II). DXA (Hologic QDR 4500) is performed a few minutes later without modification of patients’ hydration status. Results of FFM obtained by BIA are compared to those calculated by DXA in order to validate the accuracy of the BIA equation. Correlation between FFM and PFT (FEV1, maximum inspiratory pressure) is also evaluated. Results The equation proves accurate in CF children. BC of CF patients is under evaluation and will be compared to that of controls matched for age and sex. Correlation between BC and PFT will be presented. Conclusion BIA is a helpful method to estimate BC. We have validated an equation adapted to the pediatric CF population. Repetitive measures of BC will allow clinicians to adjust nutritional care in order to improve the respiratory outcome of CF patients.

The problem of multiple-frequency bioelectrical impedance analysis on nutritional assessment in patients with malnutrition.

The problem of multiple-frequency bioelectrical impedance analysis on nutritional assessment in patients with malnutrition.

신체 성분 분석을 위한 다 주파수 생체전기 임피던스 분석 시스템 구현

In this paper, we introduce the multiple frequency bio-electrical impedance analysis method for body composition analysis. And then we implement the multiple frequency bio-electrical impedance analysis system. Overall system consists of: multiple frequency alternating current signal generator contained alternating current signal, phase signal detector, voltage signal detector, micro controller, in-out device(key-pad LCD), conductivity electrodes, system power. We explain the architecture of the system and required theory to implement the system. In order to investigate the clinical significance of the body composition data, compare to the data measured by the expert body composition analyzer which provide high reproduction and precision. Finally, experimental results which are the correlation between the measured data show the very high reproduction performance of the body composition analysis in the proposed system.

Body composition of Cameroonian lactating women determined by anthropometry, bioelectrical impedance, and deuterium dilution

Objective This study compared body composition estimates using deuterium dilution, multiple-frequency bioelectrical impedance analysis (BIA), and skinfold thickness techniques in a group of Cameroonian lactating women. Methods Body fat, fat-free mass, and total body water in 44 Cameroonian lactating women (2.63 ± 1.31 mo postpartum) were assessed by deuterium dilution, the Siri or black-specific derived Durnin-Womerley equation, and 12 BIA-prediction equations developed in samples of subjects of white, black, black-and-white, or unspecified racial background, respectively. Results Compared with deuterium dilution, anthropometry and BIA-based predictive equations overestimated body fat by 2.7 to 11.7 kg; thus, fat-free mass and total body water were underestimated. In all cases, the significant biases resulted in large 95% limits of agreement, yielding unacceptable potential bias at the level of the individual. However, the exclusion of suprailiac skinfold in the calculation, yielding to non-significant ( P < 0.05) bias, improved the prediction of body composition in Cameroonian lactating women using the Durnin-Womersley and Siri equations. Conclusion It is essential to adjust the Durnin-Womersley equation before using it in the Siri equation for the prediction of body composition in lactating women. Further development and cross-validation of prediction equations from BIA specific to lactating women is needed.

Visceral Fat, Arterial Stiffness, and Endothelial Function in Peritoneal Dialysis Patients

The relationship between overweight or obesity and mortality in peritoneal dialysis (PD) patients remains controversial. Both pulse-wave velocity (PWV) and endothelial dysfunction are related to an increased risk of cardiovascular disease. However, the association between PWV, endothelial dysfunction, and visceral adipose tissue in PD patients is not well-understood. One hundred and sixteen PD patients were enrolled in this cross-sectional study. The overall fat ratio and visceral-fat level of PD patients were measured by multiple-frequency bioelectrical impedance analysis (BIA). Carotid-femoral pulse-wave velocity (C-F PWV) was measured as an indicator of aortic stiffness. Endothelial function was evaluated by brachial-artery flow-mediated dilation (FMD). The association between these monitored parameters was assessed by statistical analyses. Bivariate correlation analysis showed that C-F PWV was positively correlated with visceral-fat level (r = 0.343, P < .001), whereas FMD was negatively correlated with visceral-fat level (r = -0.354, P < .01). Multiple regression analysis indicated that age, diabetic status, visceral-fat level, and duration of dialysis were determinants of PWV (adjusted R(2) = 0.316, P < .001), whereas visceral-fat level and glucose load were the determinants of FMD (adjusted R(2) = 0.130, P < .01). Visceral-fat level was an independent predictor of PWV and FMD in PD patients, and could be considered one of the risk factors for cardiovascular disease in PD patients.

Validity of segmental multiple-frequency bioelectrical impedance analysis to estimate body composition of adults across a range of body mass indexes

Objective We compared body composition estimates using an eight-electrode, segmental, multiple-frequency bioelectrical impedance analysis (segmental MF-BIA) and dual x-ray absorptiometry (DXA) in a group of healthy adults with a range of body mass indexes (BMIs). Methods Percentage of body fat (%BF), fat-free mass, and fat mass assessed by DXA and segmental MF-BIA in 132 healthy adults were classified by normal (N; 18.5–24.9 kg/m 2), overweight (OW; 25–29.9 kg/m 2), and obese (OB; 30–39.9 kg/m 2) BMI. Results Compared with DXA, segmental MF-BIA overestimated %BF in the OB BMI group (3.4%; P < 0.0001). MF-BIA overestimated %BF among men (0.75%; P < 0.006) and women (0.87%; P < 0.006) and underestimated it in the N BMI group (−1.56%; P < 0.0001); %BF was not different between methods in the OW BMI group. Error in %BF determined by segmental MF-BIA and DXA increased as %BF increased ( r = 0.42, P < 0.0001). Waist circumference was the only significant predictor of systematic error in %BF between MF-BIA and DXA ( r = 0.60, P < 0.0001). Conclusion Eight-electrode, segmental MF-BIA is a valid method to estimate %BF in adults with BMI classified as N and OW, but not as OB. Estimation of trunk resistance with current segmental MF-BIA devices may explain the underestimation of %BF in the adults with OB BMI. Further examination of the effect of waist circumference and body fat distribution on the accuracy of BIA measurements is warranted.

The Impact of New Comorbidities on Nutritional Status in Continuous Ambulatory Peritoneal Dialysis Patients

Objective: To study the prevalence and risk factors for malnutrition in a peritoneal dialysis (PD) center with an active PD program. Methods: We assessed the nutritional status in 205 continuous ambulatory peritoneal dialysis (CAPD) patients, including stable and unstable patients, by subjective global assessment (SGA), dietary diaries and biochemistry index. Serum C-reactive protein (CRP) levels were examined as inflammatory marker. Fluid status including extracellular water (ECW), intracellular water, and total body water (TBW) was evaluated by multiple-frequency bioelectrical impedance analysis and brachial blood pressure was measured. New comorbidities included systemic infection, congestive heart failure and trauma that occurred within 1 month or less. Cardiovascular disease (CVD) was recorded too. Dialysis adequacy and residual renal function were calculated by a standard technique. Results: Based on SGA, 15.6% of our CAPD patients were malnourished. The malnourished patients had advanced age, higher CRP and ECW/TBW levels than normally nourished patients (age: 68.78 ± 11.92 vs. 59.26 ± 13.46 years, p = 0.001; CRP: 11.98 ± 20.22 vs. 5.56 ± 8.30 mg/l, p = 0.004; ECW/TBW: 0.55 ± 0.16 vs. 0.52 ± 0.04, p = 0.049). Patients with malnutrition were more prone to have CVD (53.13 vs. 31.79%, p = 0.004) and new comorbidities (65.62 vs. 4.62%, p = 0.023). Multivariate analysis showed new comorbidities, mostly systemic infection, which were associated with nutritional status (p < 0.001). Both ECW/TBW and new comorbidities were associated with serum CRP, CVD and malnutrition (p < 0.001–0.05). In contrast, some traditional factors which were recognized as contributing to malnutrition such as residual renal function, dialysis adequacy, metabolic acidosis, total protein loss, diabetes and Charlson indexes were not different between normally nourished and malnourished patients in the present study. Conclusions: Our results suggest that only 15.6% of patients were malnourished in our PD program. Old age, inflammation, CVD, fluid overload and new comorbidities were all associated with malnutrition, with new comorbidities, mostly systemic infections, being the most significant risk factor. However, many traditional factors such as residual renal function, dialysis adequacy and diabetes were not.

Reference values for whole body and cerebral multi-frequency bio-impedance data in neonates less than 12 h postpartum

Multiple frequency bio-electrical impedance analysis (MFBIA) may be useful for monitoring fluid balance in newborn infants or to provide early prediction of the outcome following perinatal asphyxia. A reference range of data is needed for identification of babies with abnormal impedance values. This was a cross-sectional observational study in 84 term and near-term healthy neonates less than 12 h postpartum. Whole body and cerebral MFBIA measurements were performed at the bedside in the post-natal ward. Gestational age, post-natal age, gender, birthweight, head circumference and foot length measures were recorded. Reference values for impedance at the characteristic frequency (ZC) and resistance at zero frequency (R0) are reported for whole body and cerebral impedance. Significant correlations (p < 0.05) were observed between whole body impedance and birthweight, footlength and head circumference. Females had a significantly higher whole body R0 than males. Cerebral impedance did not correlate significantly with any of the demographic measures and there were no gender differences observed for cerebral impedance. The reference range for whole body multi-frequency bio-impedance values in term and near-term infants within the first 12 h postpartum can be calculated from the footlength (FL) using the following equations: ZC = (942.9 − 4.818*FL) ± 124.6 Ω; R0 = (1042 − 4.520*FL) ± 135.5 Ω. For cerebral impedance the reference range is 29.5–48.7 Ω for ZC and 33.7–58.0 Ω for R0.

Sequential changes of body composition in patients with enterocutaneous fistula during the 10 days after admission.

To investigate the sequential changes of body composition in the metabolic response that occurred in a group of patients with enterocutaneous fistula after admission to the hospital. Sixty-one patients with enterocutaneous fistula admitted to our hospital had measurements of body composition by multiple-frequency bioelectrical impedance analysis after admission and 5, 10 days later. Sequential measurements of plasma constitutive proteins were also made. The body weight, fat-free mass, body mass index, and body cell mass were initially well below the normal range, especially the body mass index and body cell mass. And all the data gradually moved up over the 10-day study period, only a highly significant difference was found in body cell mass. Once the patients received nutrition supplement, ECW began to return to normal range slowly as well as ICW and TBW began to rise up, and ECW/TBW significantly declined to near normal level by day 10 in either male or female patients. There was a reprioritization of plasma constitutive protein synthesis that was obligatory and independent of changes in FFM. Serial measurements can quantify the disturbance of body composition in enterocutaneous fistula patients. The early nutritional intervention rapidly ameliorates the abnormal distribution of body water while the state-of-the-art surgical management prevents the further deterioration in cellular composition.

Fluid shifts resulting from exercise in rats as detected by bioelectrical impedance.

This study was designed to investigate the immediate effect of exercise intensity and duration on body fluid volumes in rats throughout a 3-wk exercise program. Changes in the extracellular water (ECW) and total body water (TBW) volumes of rats were measured preexercise and postexercise using multiple frequency bioelectrical impedance analysis. Groups of rats were exercised at two intensities (6 m.min(-1) and 12 m.min(-1)) for two exercise times (60 min and 90 min) 5 d.wk(-1) during a 3-wk period. Changes in plasma electrolytes, glucose, and lactate resulting from the exercise were also measured on 3 d of each week. Each group of animals showed significant losses in ECW and TBW as a direct result of daily exercise. The magnitude of fluid loss was directly related to the intensity of the exercise, but not to exercise duration; although the magnitude of daily fluid loss at the higher intensity exercise (12 m.min(-1)) decreased as the study progressed, possibly indicating a training effect. At low-intensity exercise, there is a small but significant loss in both TBW and ECW fluids, and the magnitude of these losses does not change throughout a 3-wk exercise program. At moderate levels of exercise intensity, there is a greater loss of both TBW and ECW fluids. However, the magnitudes of these losses decrease significantly during the 3-wk exercise program, thus demonstrating a training effect.

Comparison of soft tissue body composition in postmenopausal women with or without hormone replacement therapy considering the influence of reproductive history and lifestyle

OBJECTIVES: To examine long-term effects of at least 5 years' conventional hormone replacement therapy (HRT), reproductive history and lifestyle on fat mass and muscle mass in postmenopausal women. RESEARCH DESIGN AND METHODS: A cross-sectional retrospective approach was used, including 64 healthy women (56-69 years, mean age 63.4 years). Hormone users were compared with age-matched non-users with respect to (a) type of HRT used (oestrogen vs oestrogen plus gestagen vs no hormones), (b) categories of oestrogens used (oestradiol-based oestrogens vs conjugated equine oestrogens vs no oestrogens) and (c) categories of gestagens used (testosterone derivatives vs progesterone derivatives vs no gestagens). Data on hormone use, reproductive history (age at menarche, age at menopause, number of years postmenopausal, number of children) and lifestyle (physical activity level, alcohol consumption, smoking habits) were collected by questionnaires. Body composition was analysed by multiple-frequency bioelectrical impedance analysis, estimating fat mass, fat-free mass and body cell mass as absolute values (FM, FFM, BCM, respectively) and percentages of body weight (% FM, % FFM, % BCM). RESULTS: Analysis of covariance, adjusting body composition variables for body mass index, showed that (a) unopposed oestrogen users, oestrogen plus gestagen users and non-users did not differ significantly in body composition variables, (b) users of oestradiol-based oestrogens had significantly more BCM than oestrogen abstainers (p < 0.05), (c) users of testosterone-based gestagens had more BCM than gestagen abstainers (p = 0.05). Stepwise multiple regression analyses, including HRT-related, reproductive and lifestyle variables, indicated that the duration of HRT (p < 0.05) and physical activity level (p = 0.01) were significant positive predictors of % BCM, whereas the number of children significantly positively predicted FM and % FM (each p < 0.05). No significant associations between fat-free mass and HRT were found. CONCLUSIONS: The results suggest that conventional doses of oestrogens and gestagens used in HRT might be a factor in preserving muscle mass after long-term administration. It is recommended that BCM is used instead of FFM as an indicator of muscle mass. Studies relating muscle mass to HRT in postmenopausal women should consider physical activity as a possible confounding variable.

Identification and monitoring of disordered water balance: bioelectrical impedance analysis as an alternative to the target weight procedure.

Many psychiatric patients present with disorders of water balance manifested by polydipsia or polyuria. Multiple frequency bioelectrical impedance analysis (MFBIA) was investigated as a suitable method for the assessment of body water in such patients. Whole body bioelectrical impedance, total body water and extracellular water and serum sodium were measured in 10 chronic psychiatric inpatients with polydipsia. Fluid volumes predicted by MFBIA correlated significantly (P < 0.002) with those obtained by reference methods but the relatively high limits of agreement (2.2 L) suggest that the method is not yet sufficiently accurate for random screening purposes. However, owing to the simplicity and non-invasive nature of the technique, it warrants further investigation and development, particularly for routine patient monitoring.