Objectives: To assess the accuracy of the Scho®eld, Scho®eld & James (1985) equations and those of Hayter & Henry (1994) for the prediction of the basal metabolic rate (BMR), of young Australians. Design: BMR was measured by indirect calorimetry, while fat free mass (FFM) and fat mass (FM) were measured by bioelectric impendence analysis (BIA) in 128 volunteers (39 men and 89 women), aged between 18 and 30 y. Setting: Deakin Institute of Human Nutrition, Deakin University, Melbourne, Australia. Results: The measured BMR of Australian men and women were signi®cantly lower (P 0.001) than the predicted BMR using the Scho®eld et al (1985) equation, with a mean (s.d.) bias (bias measured 7 predicted BMR) of 7406 (513) kJ/d in men and 7124 (348) kJ/d in women. The measured BMR of Australian men and women were similar to the predicted BMR using the equations of Hayter & Henry (1994) and bias was unrelated to body weight. BMR adjusted for FFM and FM was signi®cantly higher by three percent in women on oral contraceptive agents (OCA) as compared to those not on OCA. Conclusions: The Scho®eld et al (1985) equations are not valid for the prediction of BMR of young Australian men and women. The equations of Hayter & Henry (1994) for North Europeans and Americans, provide an accurate estimate of the BMR of Australian men and women at the group level. However, in young women not using OCA a correction factor of 0.97 applied to the predicted BMR provides a better estimate.

The use of oral contraceptive agents by women may be a factor that contributes to the observed inter-individual variability in the BMR. We, therefore, measured the BMR, body build and composition in two groups of young women and also assessed their self-reported level of physical activity. One group had been using oral contraceptive agents for a period of 6 months or more (OCA, n 24), while the other group had never used oral contraceptives (NOCA, n 22). There were no significant differences in age, body build or composition. The absolute BMR in the two groups were not significantly different when compared using an unpaired t test (OCA: 5841 (SD 471) Y. NOCA: 5633 (SD 615)kJ/d). However, using an analysis of covariance, with either body weight or a combination of fat and fat free mass as covariates, the OCA group had a BMR almost 5 % higher than that of the NOCA group (OCA: 5871 Y. NOCA: 5601 kJ/d; P = 0.002). When those subjects with high self-reported levels of physical activity were excluded, the difference in BMR between the two groups persisted (P = 0401). An ANOVA of oral contraceptives use and phase of menstrual cycle showed sigmcant differences in BMR with use of oral contraceptives (P=O@O4) but no difference in BMR between phases of the menstrual cyde. In conclusion, the ose of oral contraceptive agents deserves consideration when conducting and analysing data from studies on energy metabolism in young women, as it results in a significantly higher BMR.Basal metabolic rate: Body composition: Oral contraceptive agents Many studies over the years have demonstrated that the intra-individual variability in the BMR is remarkably small, with a CV of about

The simple and full model equations for handgrip strength had high predictive power in the sub-adults, while they were less predictive in adults. The equations will be of particular use in physiological studies assessing muscle strength and in clinical investigations of patients with malnutrition and neuromuscular disorders.

Objectives: To determine whether the socioeconomic and nutritional status of cured leprosy patients with residual deformity, and their household members, was lower than that of cured leprosy patients without deformity. Design: Cross-sectional study. Subjects: One hundred and ®fty-®ve index cases with deformity, 100 without deformity. Also 616 household members comprising 48% of the total members enumerated. Measurements: Nutritional status was evaluated using anthropometry. Disease characteristics, socio-economic parameters and household information were recorded using a questionnaire. Results: Index cases with deformity had lower community acceptance (P`0.001), and employment (P`0.001) than those cases without deformity. Households of index cases with deformity had a lower income (P`0.01) and a lower expenditure on food (P`0.05). The presence of deformity (odds ratio (OR): 2.1 ± 3.2, P`0.01), unemployment (OR: 2.3 ± 4.3, P`0.01) and female gender (OR: 2.4, P`0.01) signi®cantly increased the risk of index cases being undernourished, as judged by body mass index (BMI) alone, or BMI and mid-upper arm circumference. A low BMI (`18.5) in the index case signi®cantly increased the odds of other adults (OR 2.2), adolescents (OR 2.9 ± 3.8) and children (OR 2.2) in the household being undernourished. Conclusions: Cured leprosy index cases with physical deformity are more undernourished than index cases without deformity. This is associated with a reduced expenditure on food, possibly brought on by increased unemployment, and a loss of income. Undernutrition in the index case increases the risk of undernutrition in other members of the family.

Because of the large numbers of leprosy patients with disability and the lirnited resources available, it is important that socio-econornic rehabilitation (SER) is targeted towards those who are most in need. Towards this purpose, current assess ments of leprosy patients prior to initiating SER inc1ude the evaluation of income, assets and household possessions. Conspicuously absent is the nutritional assessment of the patient. In the absence of weight loss associated with illness, population studies indicate that undemutrition refiects poor socio-econornic conditions. In this study of 151 cured leprosy patients with disability, 57% of the patients were found to be undemourished using body mass index (kg/m 2) derived from body weight and height, and 10% of the patients were severely undemourished (grade 1lI). Undemutrition in the patients was poorly though significantly correlated with personal income (r = 0.18, P < 0.05). Total household income, reported arnount of money spent on food and estimated cereal intakes were not correlated with the BMI ofthe patient, possibly due to reporting bias and other methodological issues. We propose the inc1usion of nutritional status evaluation by anthropometry as part of the initial screening of leprosy patients prior to instituting SER. We believe that this simple and objective evaluation can add to the assessment of 'threat' of econornic deprivation or actual econornic 'dislocation', and thus help in the prioritization of leprosy patients for SER. While considerable efforts have been made to reduce the development of disability in leprosy patients, there are still a large number of cured leprosy patients with residual deformity. l In