Original ArticleBody Composition Parameters in Healthy Brazilian Women Differ From White, Black, and Hispanic American Women Reference Range
Introduction
Bone mineral mass, lean mass, and fat mass are the usual components of body composition (BC) (1). Various techniques are used to measure BC, but dual-energy X-ray absorptiometry (DXA) has become the preferred method and is considered one of the most reliable techniques to estimate body fat (BF) percentage 2, 3. The information on BF is important for the evaluation of certain clinical conditions because the amount of fat in the body and its distribution are important factors for the development of obesity and metabolic syndrome. BF measurements can be useful in the evaluation of cardiovascular disease and also for monitoring the impact of disease, nutrition, and physical activity on body tissues 4, 5, 6, 7. BC analysis may eventually also be used as an indicator for disability. Significant changes in BC occur with age 8, 9. Loss of lean body mass, particularly muscle mass or sarcopenia, is associated with aging. Prevalent in the elderly, sarcopenia is strongly associated with disability, regardless of ethnicity, socioeconomic status, and morbidity 10, 11. The elderly at highest risk for disability are both obese and sarcopenic 12, 13.
Unlike body mass index (BMI), DXA is capable of separating body mass in lean and fat components and thus allows the assessment of fat mass without the influence of other components. The use of fat mass index (FMI), the ratio between fat mass measured by DXA and squared height, has been proposed. Using FMI, the abnormalities in fat mass can be assessed without interference from other unrelated components (14).
Reference values for fat and lean mass are essential for the correct interpretation of BC analysis. BC differs between populations and thus there is no universal reference data to be applied (15). Significant differences in the percentage of BF mass have been found between Japanese and Australians (3). It has also been demonstrated that for the same BMI, Asians have a higher amount of total BF as well as higher prevalence of metabolic syndrome (16). Based on the need for regional normative values, we propose in this study to determine the reference values for BC in Brazilian women and investigate potential differences compared with other reference population.
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Materials and Methods
A total of 500 healthy Brazilian women living in the greater São Paulo area, Brazil, were consecutively selected to participate in the present study. Women were selected by convenience between caregivers and relatives of patients seen at the Outpatient Clinics in the Federal University of São Paulo/Escola Paulista de Medicina or employees working at the Institution from October 2009 to July 2011. Volunteers answered a detailed questionnaire designed to determine their eligibility for the study.
Results
The following results refer to the 500 Brazilian women included in our study. A total of 245 women were premenopausal at the inclusion in the study. All variables for the total population and for each age group showed normal distribution. Anthropometric parameters, TLM, ALM, SMI, and fat mass (g and %) for healthy Brazilian women are shown in Table 1.
Table 2 shows the correlation between BC parameters and anthropometric variables. Age, weight, height, and BMI all correlated with BC. Significant
Discussion
In the present study, values for BC (lean and fat mass) measured by DXA are presented for healthy Brazilian women. Our data confirm the role of the ethnic background as an important determinant of BC. BC for Brazilian women differed significantly from that published for American women in a significant number of age groups.
Body weight increases with age reaching the highest levels between 60 and 65 yr, when a progressive decrease begins to be observed. More than two-thirds of the population older
References (44)
- et al.
Total body composition by DXA of 241 HIV-negative men and 162 HIV-infected men: proposal of reference values for defining lipodystrophy
J Clin Densitom
(2005) - et al.
Human immunodeficiency virus-associated lipodystrophy: an objective definition based on dual-energy x-ray absorptiometry-derived regional fat ratios in a South Asian population
Endocr Pract
(2012) - et al.
Clinical applications of body composition measurements using DXA
J Clin Densitom
(2003) - et al.
Evaluation of Lunar Prodigy dual-energy X-ray absorptiometry for assessing body composition in healthy persons and patients by comparison with the criterion 4-component model
Am J Clin Nutr
(2006) - et al.
Predictors of skeletal muscle mass in elderly men and women
Mech Ageing Dev
(1999) - et al.
Ethnic differences in body composition and the associated metabolic profile: a comparative study between Asians and Caucasians
Maturitas
(2010) - et al.
Age, weight and obesity
Maturitas
(2012) - et al.
Elderly Mexicans have less muscle and greater total and truncal fat compared to African-Americans and Caucasians with the same BMI
J Nutr Health Aging
(2009) - et al.
Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index
Am J Clin Nutr
(2000) - et al.
Body composition in French women 75+ years of age: the EPIDOS study
Mech Ageing Dev
(2003)
Sarcopenia—consequences, mechanisms, and potential therapies
Mech Ageing Dev
Sarcopenia in the elderly: diagnosis, physiopathology and treatment
Maturitas
iDXA, Prodigy, and DPXL dual-energy X-ray absorptiometry whole-body scans: a cross-calibration study
J Clin Densitom
Validation of a dual energy X-ray absorptiometer: measurement of bone mass and soft tissue composition
Eur J Appl Physiol Occup Physiol
Measuring body fat distribution and content in humans
Curr Opin Clin Nutr Metab Care
Body composition and anthropometry in Japanese and Australian Caucasian males and Japanese females
Asia Pac J Clin Nutr
Cross-sectional age differences in body composition in persons 60+ years of age
J Gerontol A Biol Sci Med Sci
Epidemiology of sarcopenia among the elderly in New Mexico
Am J Epidemiol
Epidemiology of sarcopenia
J Am Geriatr Soc
Sarcopenia: alternative definitions and associations with lower extremity function
J Am Geriatr Soc
Body composition in healthy aging
Ann N Y Acad Sci
Dual energy X-Ray absorptiometry body composition reference values from NHANES
PLoS One
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