Indirect Indicators of Muscle Mass in Malnourished Infants

Standard, K. L.; Wills, V. G.; Waterlow, J. C.

doi:10.1093/ajcn/7.3.271

Cited by 78 publications

(23 citation statements)

References 13 publications

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“…Marked atrophy of the skeletal musculature is a prominent characteristic of severe undernutrition and acute starvation. In marasmic infants, muscle mass was 30% of normal (Standard et al, 1959). The proportion of muscle in FFM decreases because other tissues remain unchanged.…”

Section: Discussionmentioning

confidence: 95%

“…Studies have been conducted under experimental conditions (Keys et al, 1950), in undernourished populations (Barac-Neito et al, 1979), in juvenile malnutrition (Standard et al, 1959;Ashworth, 1969) and in clinical settings in anorexic patients (Russel et al, 1983;Forbes et al, 1984;Nunez et al, 1994). In the Minnesota experiment (Keys et al, 1950) in the ®rst three months of rehabilitation, there was a mean gain at 50% of the loss sustained during semistarvation; the body fat content increased markedly, paralleling the caloric intake and this recovery was more rapid than that of muscles.…”

Section: Introductionmentioning

confidence: 99%

“…During the treatment of malnourished children, gains of weight tend to be more rapid in the early part of the recovery phase, only to fall off later on (Ashworth, 1969). In the later stage there is a tendency to lay down more fat (Standard et al, 1959). Reports of body composition in the course of weight restoration in AN indicate that fat represents 32±77% of the total weight gained during recovery (Mitchell & Truswell, 1987).…”

Section: Introductionmentioning

confidence: 99%

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Body composition changes in anorexia nervosa

Polito¹,

Cuzzolaro

Raguzzini³

et al. 1998

Eur J Clin Nutr

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Objective: To assess the body composition changes in anorexia nervosa and after medium term recovery. Design: A descriptive study. Setting: Rome, Italy. Subjects: Twenty women affected by anorexia nervosa (AN) with a BMI [weight (kg)aheight (m 2 )] below 17 kgam 2 and weight-stable for at least three months, were compared with 10 well nourished control women (CO) and nine rehabilitated subjects (R-AN), who had a BMI above 18.5 kgam 2 stable for at least the last six months. Interventions: Body fat was assessed by underwater weighing, muscle mass by urinary creatinine, total body water (TBW) by impedance parameters (50 kHz and 800 mA), skeletal mass by anthropometry and radius bone mineral density by dual photon absorptiometry in ultra-distal (UD-BMD) and medio-distal (MD-BMD) sites. Results: The AN group, as compared to the control group, had a signi®cantly lower weight, body mass index (BMI kgam 2 ) and percent body fat (P`0.0000). Creatinine urinary excretion was lowest in absolute term and when expressed as creatinine height index or per kg fat free mass (FFM) (P`0.0000); muscle mass per kg body weight was 13% lower (P`0.01). Ultra distal bone mineral density (UD-BMD) was 6% lower (not signi®cant). TBW as percent of body weight was signi®cant higher (P`0.001): however TBWaFFM % was not statistically different with large inter-individual variability. An altered distribution of extra and intra-cellular water was suggested by the phase angle (AN: 4.4 AE 0.8 ; CO: 6.1 AE 0.4 ; (P`0.0000). In rehabilitated anorexic patients (R-AN) the fat mass represented 53% of the weight gain. Their creatinine excretion remained still below the mean value of the controls (P`0.001). The impedance parameters were not signi®cantly different between the R-AN and the CO groups, however, the phase angle of the R-AN (5.0 AE 0.7 ) remained lower than in the CO group, indicating that the water distribution was still altered. Conclusions: This study shows that AN is a condition of reduced body fat as well as of muscle mass, with a slightly reduced bone mass. In the course of rehabilitation, most of the weight regained is represented by fat, while the muscle mass appears to lag behind, at least in the medium term.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body composition changes in anorexia nervosa

Polito¹,

Cuzzolaro

Raguzzini³

et al. 1998

Eur J Clin Nutr

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“…In the Minnesota experiment (Keys et al, 1950), for instance, during the first 3 months of weight recovery healthy men regained 50% of the loss due to previous controlled semistarvation, with body fat content increasing more rapidly than muscle mass; after 5 months, total body weight exceeded the pre-starvation value, but the active tissue mass was still 8% below control value. Similarly, during the treatment of malnourished children weight gain was more rapid in the early recovery, with a tendency to lay down more fat in following phases (Standard et al, 1959). As far as refed anorectic patients are concerned, cross-sectional and longitudinal studies have given fairly contradictory results, indicating that FM represents, on average, 21 -77% of the weight regained (Russel & Mezey, 1962;Forbes et al, 1984;Pirke et al, 1986;Mitchell & Truswell, 1987;Vaisman et al, 1988;Krahn et al, 1993;Waller et al, 1996;Orphanidou et al, 1997;Polito et al, 1998;Probst et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Body composition changes in patients with anorexia nervosa after complete weight recovery

Scalfi¹,

Polito

Bianchi

et al. 2002

Eur J Clin Nutr

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Objective: To assess body composition changes occurring in female anorectic patients after complete weight recovery. Design: Longitudinal study. Subjects: Ten female patients with anorexia nervosa (age at baseline: 19.7 AE 5.8 y) were studied both when undernourished (body mass index, BMI 14.8 AE Interventions: Fat mass and fat-free mass were determined by dual-energy X-ray absorptiometry. Skinfold thicknesses and circumferences were also measured. Arm muscle area and arm fat area were calculated by standard formulas. Results: The undernourished patients had lower fat-free mass, fat mass, skinfold thicknesses and circumferences. After refeeding, fat mass represented 25 -71% (mean 56%) of the mass regained, this percentage being directly related to the extent of weight gain. The increases in skinfolds and circumferences depended upon the site considered and were correlated to a various extent with those in weight or BMI. Skinfolds at biceps and abdominal sites and the waist-to-hip ratio remained significantly higher, whereas arm muscle circumference was significantly lower, in the refed group than in the control one. Conclusion: The percentage of fat in the weight regained by refed female anorectic patients was directly related to the extent of body mass increase. Refed anorectic patients appear to preferentially regain fat in the abdominal and triceps regions. Abnormalities in skinfolds (at biceps and abdominal sites), arm muscle area and waist-to-hip ratio still persist in refed anorectic patients in comparison to control healthy controls.

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“…Apesar destas aproximações, estudos radiográficos 15 , e mais recentemente estudos com tomografia computadorizada 12 , têm demonstrado alta correlação entre os valores calculados pela antropometria e os valores calculados por aquelas técnicas mais refinadas. A utilização das medidas das áreas "muscular" e "adiposa" do braço encontra papel sobretudo em permitir o acesso à investivação das reservas proteicas e calóricas do organismo, sendo o tecido muscular entendido como reserva de proteínas não só por representar o componente principal da massa magra do organismo 15 , como também pelas evidências que comprovam seu decréscimo na vigência de processo de desnutrição 25,30) , quando a massa muscular passa a fornecer aminoácidos para a neoglicogênese e a sín-tese de proteínas no fígado 1 .…”

Section: -Introduçãounclassified

Estudo antropométrico-nutricional de pré-escolares de áreas de baixa renda do Estado de São Paulo, Brasil

et al. 1984

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RESUMO: Com o objetivo de avaliar o estado nutricional na idade pré-escolar em áreas de baixa renda do Estado de São Paulo, 1.359 crianças de dois a seis anos de idade foram submetidas a exame antropométrico que incluiu peso e altura e medidas das áreas "muscular" e "adiposa" da seção transversal do braço esquerdo. A análise das medidas observadas foi feita por comparação a medidas que foram simultaneamente tomadas em população de pré-escolares de alto nível sócio-econômico do município de São Paulo. Foram comparadas médias segundo faixa etária e, a seguir, por meio de análises de regressão em função da idade, foram comparadas as velocidades de expansão das várias medidas. As análises efetuadas indicam que, ao chegar ao final da idade pré-escolar, as crianças das áreas de baixa renda apresentam pronunciado retardo no seu crescimento (aproximadamente 5 cm de altura e 5 kg de peso). A seção transversal do braço daquelas crianças estaria, no mesmo momento, diminuída tanto em tecido muscular quanto em tecido adiposo (em torno de 2 cm 2 e 4 cm 2 , respectivamente). As mesmas análises indicam cronologias diferentes para os vários déficits constatados ao final da idade pré-escolar. Os déficits de altura e de "área muscular" do braço ocorreriam predominantemente antes dos dois anos de idade enquanto os déficits de peso e de "área adiposa" do braço aconteceriam predominantemente já na idade pré-escolar. Como implicações dos achados obtidos, surgem indicações de que, antes dos dois anos, a interação agentehospedeiro, responsável pelo aparecimento da desnutrição, determine prejuízos sobretudo à síntese de proteínas. No período pré-escolar, aquela interação determinaria prejuízos sobretudo à síntese das reservas calóricas. Modificações a nível do agente e/ou a nível do hospedeiro poderiam ser responsáveis pelas diferenças observadas nos dois períodos. Para a compreensão das mesmas, fatores como a adequação calórica e protéica das dietas, a incidência e severidade das doenças infecciosas e os mecanismos adaptativos do organismo deveriam ser investigados. De qualquer forma, a diversidade do comprometimento do estado nutricional nos dois períodos deveria ser levada em conta na formulação dos programas de nutrição dirigidos às várias idades.

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Indirect Indicators of Muscle Mass in Malnourished Infants

Cited by 78 publications

References 13 publications

Body composition changes in anorexia nervosa

Body composition changes in anorexia nervosa

Body composition changes in patients with anorexia nervosa after complete weight recovery

Estudo antropométrico-nutricional de pré-escolares de áreas de baixa renda do Estado de São Paulo, Brasil

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