Original Article
Body Composition Parameters in Healthy Brazilian Women Differ From White, Black, and Hispanic American Women Reference Range

https://doi.org/10.1016/j.jocd.2013.01.005Get rights and content

Abstract

Body composition (BC) seems to vary between populations, suggesting the need for regional reference data. The objective of this study was to determine BC in Brazilian women. Five hundred healthy non-black Brazilian women aged 20 yr or older were included. Women with fractures, chronic diseases, medications affecting bone and mineral metabolism, coronary heart disease, pregnancy, silicone prosthesis, and Asians or Indians were excluded. BC by dual-energy X-ray absorptiometry (DXA) included total lean mass, appendicular lean mass, skeletal muscle index, and total body fat (BF). Reference values were made for 10-yr age groups. Lean mass decreased with age reaching the lowest values in women aged 80 yr and older. BF showed a bimodal distribution: increased with age until 50–59 yr, with a slight subsequent decrease. BF in Brazilian women did not differ from American women, except in the age groups 75–79 and 80–84 yr, where BF was lower (p < 0.05). Fat mass index was consistently higher between African and Hispanic American women (p < 0.05). Lean mass was consistently lower in Brazilian women compared with Americans in almost all age and ethnic groups (p < 0.05). BC in Brazilian women differs from American reference data. Our findings support the notion that BC varies according to ethnicity.

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.

Section snippets

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

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