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BACKGROUND Data from the NHANES indicate that BMI has increased in some subgroups of children and adolescents in the United States over the past 20 y; however, BMI is an indirect measure of body fatness. OBJECTIVES We assessed changes in DXA-derived measures of adiposity in a nationally representative population of US children and adolescents aged 8-19 y from 1999-2006 to 2011-2018. METHODS Using data from the NHANES, we compared the means and distributions of DXA-derived percentage body fat (%BF) and fat mass index (FMI; fat mass/height2 in kg/m2) between 1999-2006 (n = 10,231) and 2011-2018 (n = 6923) among males and females by age group, race and Hispanic origin, and BMI categories. Estimates were standardized by age and race and Hispanic origin. RESULTS From 1999-2006 to 2011-2018, mean %BF increased from 25.6% to 26.3% (change in %BF: 0.7%; 95% CI: 0.2%, 1.2%; P

A significant number of pancreatic cancer cases are due to modifiable risk factors, with many being attributed to increased body fatness. This has sparked investigators to examine the role played by high dietary fat intake in pancreatic cancer development and the mechanisms driving this connection. However, there is currently no consensus on how dietary fat quantity and composition specifically affect pancreatic carcinogenesis. The objective of this narrative review is to discuss the link between high total fat consumption and fatty acid composition (saturated, mono-, or poly-unsaturated fats) with pancreatic cancer incidence and progression. Following our detailed analysis of the strengths and weaknesses of recent preclinical and human studies, we discuss existing research gaps and opportunities, and provide recommendations for future studies. Numerous studies suggest that diets high in omega-3 polyunsaturated fatty acids are associated with reduced pancreatic cancer risk. However, the current evidence appears insufficient for a general conclusion regarding the impact of other types of fat in pancreatic carcinogenesis, with many studies providing inconclusive findings due to study limitations. Thus, we recommend future studies to include detailed methodology of the animal experiments, not limited to the diet composition, type of ingredients, formulations, and administration of the diets. Moreover, human studies should include a diverse population and well-characterized biomarkers for accurate determination of dietary fat intake. Ultimately, this will aid the study rigor, and improve our understanding of the impact of fat quantity and composition in pancreatic carcinogenesis.

Background: Advanced prostate cancer etiology is poorly understood. Few studies have examined associations of anthropometric factors (e.g. early adulthood obesity) with advanced prostate cancer risk.Patients and methods: We carried out pooled analyses to examine associations between body fatness, height, and prostate cancer risk. Among 830 772 men, 51 734 incident prostate cancer cases were identified, including 4762 advanced (T4/N1/M1 or prostate cancer deaths) cases, 2915 advanced restricted (same as advanced, but excluding localized cancers that resulted in death) cases, 9489 high-grade cases, and 3027 prostate cancer deaths. Cox proportional hazards models were used to calculate study-specific hazard ratios (HR) and 95% confidence intervals (CI); results were pooled using random effects models.Results: No statistically significant associations were observed for body mass index (BMI) in early adulthood for advanced, advanced restricted, and high-grade prostate cancer, and prostate cancer mortality. Positive associations were shown for BMI at baseline with advanced prostate cancer (HR = 1.30, 95% CI = 0.95-1.78) and prostate cancer mortality (HR = 1.52, 95% CI = 1.12-2.07) comparing BMI >= 35.0 kg/m(2) with 21-22.9 kg/m(2). When considering early adulthood and baseline BMI together, a 27% higher prostate cancer mortality risk (95% CI = 9% to 49%) was observed for men with BMI = 30.0 kg/m(2) at baseline compared with BMI = 110 cm with = 1.00 with = 1.90 m withConclusion: Our findings suggest that height and total and central adiposity in mid-to-later adulthood, but not early adulthood adiposity, are associated with risk of advanced forms of prostate cancer. Thus, maintenance of healthy weight may help prevent advanced prostate cancer.

Body composition and body weight at mating plays an important role in reproductive performance and longevity of the sows, and therefore the dietary supply of protein and energy during rearing of the gilts are manipulated to obtain a more optimal body weight and composition at mating. The objective of the present study was to design a smaller but fatter gilt through different levels of dietary protein and different feeding strategies. It was hypothesized that gilts fed a low dietary protein concentration and had a high energy intake would have a lower BW and higher body fatness compared with gilts fed higher dietary protein levels with low energy intake. A total of 44 gilts entered the experiment at a BW of 47.6 ± 2.6 kg and were randomly allotted to one of six treatments in a 3 × 2 factorial experiment. The six dietary treatments consisted of three dietary protein levels (low (LP), medium (MP), high (HP)) and two energy levels (high (HE) and low (LE)). The BW of the gilts was recorded weekly for 84 days and back fat (BF) thickness was measured at day 1, 42 and 84. The body composition of the gilts was measured at day 1 and 84 by dual-energy x-ray absorptiometry (DXA) scans. At day 84 gilts fed HP and HE had the greatest BW (136 kg) and gilts fed LP and MP at LE had the least BW (107–109 kg; P P P

BACKGROUND: The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) released in 2007 eight recommendations for cancer prevention on body fatness, diet and physical activity. Our aim is to evaluate the relation between adherence to these recommendations and colorectal cancer (CRC) risk. METHODS: We pooled data from two Italian case-control studies including overall 2419 patients with CRC and 4723 controls. Adherence to the WCRF/AICR guidelines was summarised through a score incorporating seven of the WCRF/AICR recommendations, with higher scores indicating higher adherence to the guidelines. Odds ratios (ORs) of colorectal cancer were estimated using multiple logistic regression models. RESULTS: Higher adherence to the WCRF/AICR recommendations was associated with a significantly reduced CRC risk (OR 0.67, 95% confidence interval, CI, 0.56-0.80 for a score ≥5 versus

Objective To estimate the prevalence of low handgrip strength (HGS) levels and sociodemographic characteristics, health behaviours and body fatness status related in adolescents. Method Cross-sectional epidemiological study with 636 adolescents aged 14–19 years in a city in southern Brazil. HGS was measured by dynamometer. Sociodemographic and behavioural data were collected using self-report questionnaires. Body mass and height was measured by Body Mass Index. Results Prevalence of low HGS levels was 47% (63.5% boys, 37.7% girls). Boys aged 14–16 years were more likely to have low HGS levels. Girls who were of higher socioeconomic status and who were less physically active were more likely to have low HGS levels. Overweight girls were less likely to have low HGS levels. Conclusions High prevalence of low HGS levels was observed in adolescents. Increased HGS levels should be focused on younger boys and normal-weight girls with higher socioeconomic status and lower levels of physical activity.

The primary purpose of this study was to propose and test a mediation model of changes in physical self-efficacy, physical self-perceptions, and affect as mediators by which a single bout of exercise improves state body image. A secondary purpose was to identify how long improvements in state body image are sustained post-exercise. Sixty university-aged women (19.57 ± 1.37 y) with pre-existing body image concerns, and who exercised regularly, were randomized to perform 30 min of moderate-to-vigorous intensity exercise or quiet reading. State body image, physical self-efficacy, physical self-perceptions and affect were assessed. Mediational analyses revealed self-perceptions of body fatness (95% CI [0.03, 0.44], κ 2 = 0.13, ab ps = 0.20) and strength (95% CI [0.15, 0.60], κ 2 = 0.23, ab ps = 0.33) mediated improvements in state body image which were sustained at least 20 min post-exercise. These results contribute to the development of a model explaining the effects of exercise on body image and practical recommendations for the use of exercise to improve body image.

Background Although the prevalence of a body mass index [BMI (in kg/m2)] ≥30 has tripled among US adults since the 1960s, BMI is only moderately correlated with body fatness. Because skinfolds can more accurately estimate body fatness than can BMI, it is possible that skinfolds could be useful in monitoring secular trends in body fatness. Objective We examined whether there were similar secular trends for skinfolds (triceps and subscapular), BMI, and waist circumference between US adults. Design This study was an analysis of 45,754 adults who participated in the NHANES from 1988-1994 through 2009-2010. Approximately 19% of the subjects were missing ≥1 skinfold-thickness measurement. These missing values were imputed from other characteristics. Results Trends in mean levels and in the prevalence of high levels of the 4 body size measures were fairly similar between men, with mean levels increasing by ≥5% from 1988-1994 through 2009-2010. Slightly larger increases were seen in women for BMI and waist circumference (7-8%), but trends in skinfolds were markedly different. The mean triceps skinfold, for example, increased by 2 mm through 2003-2004, but subsequently decreased so that the mean in 2009-2010 did not differ from that in 1988-1994. Compared with obese women in 1988-1994, the mean BMI of obese women in 2009-2010 was 1 higher, but mean levels of both skinfolds were 5-10% lower. Conclusions Although there were fairly similar trends in levels of BMI, waist circumference, and skinfold thicknesses in men in the United States from 1988-1994 through 2009-2010, there were substantial differences in women. Our results indicate that it is unlikely that skinfold thicknesses could be used to monitor trends in obesity.

Background Fish is an important source of long-chain n-3 fatty acids in the diets of female adolescents, which may affect adipose tissue deposition. Objective The purpose of this study was to evaluate fish intake in Asian and white female adolescents, and to determine whether fish intake was associated with changes in body fatness and body fat distribution in this population. Design A cross-sectional analysis of fish intake using 3-day food records (n=200), and a prospective analysis of baseline fish intake on anthropometric measurements 2 years later was conducted (n=103). Participants/setting Participants included female adolescents (aged 9 to 14 years) who were recruited from the Kaiser Permanente Oahu membership database in 2000-2001 as part of the Female Adolescent Maturation study (N=349). Statistical analysis Fish intake and the proportion of participants eating 8 oz fish per week was compared between Asian, white, and mixed Asian/white ethnic groups using Kruskal-Wallis test, Wilcoxon rank sum test, and χ 2 test, respectively. The effect of fish intake on anthropometric measurements was assessed using Spearman's rank correlation coefficient and linear regression analyses, adjusting for demographic, pubertal, anthropometric, activity, and dietary parameters. Results Asians consumed more fish (0.85 oz/wk [range=0.00 to 4.74 oz/wk]) than whites (0.00 oz/wk [0.00 to 0.40 oz/wk]; P =0.0001), and were more likely to eat 8 oz fish per week (13 of 68 vs 2 of 51, respectively; P =0.014). Greater fish intake corresponded to smaller changes in waist circumference when controlling for age, ethnicity, puberty, activity, energy intake, and baseline waist circumference ( P =0.026), but not after adjusting for parental and additional dietary parameters ( P >0.10). Conclusions Most female adolescents did not consume the recommended amount of fish, a problem that was more common in whites than Asians. The protective effect of fish intake on abdominal obesity warrants further study.

Objectives: Body composition can be evaluated using a variety of methods to estimate body fat percentage, but methods tend to vary in precision. The aim of our study is to compare skinfold thickness measurement and bioelectrical impedance analysis to dual-energy x-ray absorptiometry for the estimation of body fat percentage in healthy adults. Methods: A cross-sectional study design was used to examine and compare body fatness percentage of health adult men and women with three different assessment methods: skinfold thickness measurement (caliper, West Sussex, UK; equations, Jackson and Pollock's and Peterson et al.’s), bioelectrical impedance analysis (Tanita BC 541, Tanita Co., Tokyo, Japan), and dual-energy x-ray absorptiometry (Medix DR, Medilink, France). Results: Sixty-eight healthy adults aged 19–73 years (34 ± 14.5 years) participated. Mean body fat percentage assessed by DXA (23.2 ± 5.4%) was much less than the body fat percentage estimated by Skinfold using Peterson et al.’s formula (31.7 ± 6.6%), but the relationship between the two was the strongest (r = 0.903, P = 0.000). Bioelectrical impedance analysis (24.9 ± 8.1%) and Skinfold with J&P's (26.3 ± 9.7%) tended to underestimate DXA-derived body fat percentage in lean and overestimate it in overweight. Body fat percentage produced by Medix DR DXA showed different pattern comparing with other studies in literature, which indicates that more caution should be taken when comparing with other manufactures’ results.

Brown adipose tissue (BAT) is a site of adaptive non-shivering thermogenesis after cold exposure, and is involved in the regulation of energy expenditure and body fatness. BAT can be activated and recruited by not only cold exposure but also by various food ingredients including capsaicin in chili pepper and catechins in green tea, which would be easily and safely applicable to our daily life for preventing obesity.

Preclinical studies suggest that abrupt hormone deprivation caused by oophorectomy, leads to obesity and its metabolic sequelae. The purpose of the current study was to examine the association between oophorectomy and body fatness in a nationally representative sample of women.The association between prior oophorectomy and nine adiposity measures was examined using data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). The analytic population included cancer-free women age 40 or older (N=3549) who underwent standardized body measurements and reported on whether or not they had a bilateral oophorectomy. Multivariate linear and polytomous logistic regressions were used to evaluate the association of oophorectomy with multiple measures of adiposity.Mean percent body fat, skinfold thickness, waist circumference and body mass index were significantly higher in women with oophorectomy before age 40 compared to those with intact ovaries, but no difference was observed in women with oophorectomy at an older age. Women who underwent an early oophorectomy were nearly three times more likely than women with intact ovaries to have percent body fat in the highest tertile compared to the lowest tertile (OR=2.82, 95% CI 1.39-5.75). Excluding hormone therapy (HT) users yielded stronger associations.Bilateral oophorectomy in young women is strongly associated with an increase in percent body fat, a well-established risk factor for cancer and other chronic diseases. Measuring body fat in addition to BMI may provide a more comprehensive assessment of adiposity in these women.

Introduction Cancer causes one in eight deaths worldwide and is rapidly becoming a global pandemic. Diet, nutrition and physical activity play a key role in the prevention of cancer and other non-communicable diseases (NCDs). Evidence-based recommendations are necessary to help people make informed lifestyle choices in their daily lives to reduce their cancer risk. This talk will present the main global findings from World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) Third Expert Report (2018) on Diet, Nutrition, Physical Activity and Cancer which was built upon the WCRF/AICR Second Expert Report (2007), including the updated Cancer Prevention Recommendations and will suggest future research directions. Material and methods The Third Expert Report brings together the very latest research from the Continuous Update Project’s (CUP) rigorous systematic review of the accumulated best available, scientific and worldwide evidence on cancer prevention and survival related to diet, nutrition and physical activity. The Recommendations are derived from the evidence of 18 systematic literature reviews and a review of evidence on energy balance and body fatness, supported by expert reviews on the experimental evidence from human and animal studies that could plausibly explain a causal link between an exposure and cancer. A Panel of independent international experts assessed and judged the body of evidence, drew conclusions and made recommendations for a global audience, taking into account regional and special circumstances. Results and discussions This talk will present the latest evidence on the links between body fatness, physical activity and cancer risk highlighting the updated relevant Recommendations. Additionally, associations of cancer risk with consumption of specific foods such as wholegrains, vegetables, processed foods, red meat, sugar sweetened drinks and alcohol will be also presented. Finally, this talk will touch upon the latest evidence linking cancer risk to lifecourse exposures and will suggest future research priorities. Conclusion As evidence accrues, conclusions regarding the relation of diet, nutrition, physical activity to cancer are mostly strengthened to before, though with some change in emphasis. A number of future research directions have been identified including a better understanding of the mechanistic links of lifecourse factors to cancer and more global representative research on specific exposures in relation to cancer.

Background It is unclear to what extent factors affecting energy balance contribute to the development of body fatness in youth. The objective of the current study was to describe the relationship of physical activity, energy intake, and sedentary behavior to BMI, fat free–mass index (FFMI), and fat mass index (FMI) in children aged 10–18 years. Methods In the subsample studied, participants were 245 girls and 227 boys (aged ≥10 years at entry or during follow-up assessments, or aged 11–14 years at entry) followed for 4 years from entry at ages 8, 11, or 14 years. At baseline and anniversary examinations, trained interviewers used a questionnaire to assess time spent daily in moderate-to-vigorous physical activity (MVPA), sedentary behavior, and energy intake (kcal/day). Sexual maturation was assessed by direct observation of pubic-hair development (Tanner Stages 1–5). Triplicate recordings of height and weight were used to estimate BMI by the standard formula (kg/m 2 ); bioelectric impedance was used to estimate percent body fat for calculating FFMI and FMI (kg/m 2 ). Multilevel models were used to examine the association of MVPA, energy intake, and sedentary behavior with BMI, FFMI, and FMI. Data were analyzed in 2007–2008. Results Energy intake was unrelated to FMI or FFMI in models adjusted for age or sexual maturation or in any model to BMI. Sedentary behavior was unrelated to FMI in any model or to FFMI or BMI in models adjusted for age or sexual maturation. MVPA was inversely related to FMI. Conclusions In children aged 10–18 years, MVPA was inversely associated with fat mass and with BMI. Investigations in youth of dietary intake and physical activity, including interventions to prevent or reverse overweight as represented by BMI, should address its fat and lean components and not BMI alone.

Background Longitudinal data on the normal development of blood lipids and its relationships with body fatness in children and adolescents are limited. Objectives of the current analysis were to estimate trajectories related to age for four blood lipid components and to examine the impact of change in body fatness on blood lipid levels, comparing estimated effects among adiposity indices, in children and adolescents. Methods Three cohorts, with a total of 678 children (49.1% female, 79.9% nonblack) initially aged 8, 11, and 14 years, were followed at 4-month intervals (1991–1995). Total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride levels were determined in blood samples taken following fasting. Body fatness was measured by five adiposity indices—BMI; percent body fat (PBF); abdominal circumference; and the sums of six and of two skinfold thicknesses. Trajectories of change in blood lipid levels from ages 8 to 18 years were estimated by gender and race. The impact of change in body fatness on lipid levels was evaluated for each index, adjusting for gender, race, and age. Results All lipid components varied significantly with age. Total cholesterol decreased by ∼19 mg/dL from ages 9 to 16 years in girls and more steeply from ages 10 to 17 years in boys. LDL-C decreased monotonically, more steeply in boys than in girls. It was higher among nonblacks than among blacks. HDL-C increased monotonically in girls, mainly from ages 14 to 18 years, but fluctuated sharply among boys. Levels of HDL-C were higher among blacks than among nonblacks. The levels of triglycerides increased from ages 8 to 12 years among girls and, almost linearly, from ages 8 to 18 years among boys. The levels of triglycerides were higher among nonblacks than among blacks. Increase in body fatness was significantly associated with increases in total cholesterol, LDL-C, and triglyceride levels. Significant interactions between the adiposity indices (except for BMI) and gender indicated smaller impacts of change in body fatness on total cholesterol and LDL-C in girls than in boys. The estimated impact on triglycerides was weaker among blacks than among nonblacks, except for PBF. Change in body fatness was negatively associated with HDL-C. The results remained essentially unchanged after adjustments for energy intake, physical activity, and sexual maturation. Conclusions Patterns of change with age in blood lipid components vary significantly among gender and racial groups. Increase in body fatness among children is consistently associated with adverse change in blood lipids. Evaluation of blood lipid level should take into account variation by age, gender, and race. Intervention through body-fat control should help prevent adverse lipid levels in children and adolescents.

Background: Television (TV) viewing in children is associated with a higher body mass index, but it is unknown whether this reflects body fatness, and, if it does, why. Objective: The objective was to investigate whether TV viewing is associated with body fatness, physical activity, and total energy expenditure in preschool children. Design: Eighty-nine children were recruited into a cross-sectional study. Total daily energy expenditure (TEE) was measured by doubly labeled water, body composition by dual-energy X-ray absorptiometry, and physical activity by accelerometry. Results: There was a significant positive association between fat mass (corrected for fat-free body mass) and TV viewing (F = 9.05, P = 0.004). Each extra hour of watching TV was associated with an extra 1 kg of body fat. Children who watched more TV were also significantly less physically active (F = 5.16, P = 0.026). Independent of body composition and sex, children with greater physical activity levels had higher TEE (F = 5.15, P = 0.029); however, physical activity did not mediate the relation between TV viewing and adiposity (P > 0.05). Conclusions: Preschool children who watch more TV are fatter and are less active, and activity influences TEE. However, despite TV viewing being linked to lower physical activity, the relation between TV viewing and fatness is not mediated by physical activity. The results suggest that a relation between TV viewing and fatness is more likely to be due to an effect on food intake.

A better understanding of the nutritional needs of both healthy and sick infants is important. Not only does too much or too little nutrition during early life have long-term effects on health, but periods of rapid growth during the first year of life also have long-term consequences. Knowledge of the changes in body composition in early life can help to better define nutritional needs at these ages. Several methods are available for measuring body composition of neonates and infants. Most focus on an assessment of either body fatness or bone mineralization; only a few can monitor the quality of the non-fat lean tissues. This paper provides an evaluation of the different approaches currently available to monitor infant body composition, identifying both their strengths and limitations.

Changes in body fatness may impact the accuracy of dual energy X-ray absorptiometry (DXA) measures of bone mineral content (BMC) and bone mineral density (BMD). The aim of this study was to determine if DXA can accurately assess BMC and BMD with changes in exogenous fat (lard) placed to simulate weight change. Whole body (WB), lumbar spine (LS), and proximal femur (PF) DXA scans (Hologic QDR 4500A) were performed on 30 elderly (52-83 yr) and 60 young (18-40 yr) individuals (i.e., 45 females and 45 males) of varying body mass index (mean+/-standard deviation: 26.1+/-4.9 kg/m2). When scans were repeated with lard packets (2.54 cm thick, 25.4x17.8 cm, 1 kg), WB BMD decreased 1.1% and 1.6% after chest and thigh packet placement, respectively (p=0.001), PF BMD increased 0.7% (p=0.02) and LS BMD decreased 1.6% (p=0.001) primarily due to a 2.2% reduction in LS BMC (p

Objective: To compare rates of change in South Australian children's body composition between 1997 and 2002 in subsamples based on location of residence and socio-economic status. Methods: Year 6 children from randomly selected South Australian schools in 1997 (32 schools, n=1,423) and 2002 (29 schools, n=992) were compared on: body mass index (BMI), sum of triceps and abdominal skinfolds (skinfold sum) and waist girth. Samples were partitioned into urban (population >20,000) and rural (

Nearly 50% of women report dieting to lose weight, but the ability of cognitive eating restraint (CER) scores to separate women based on indicators of restricted intake has not been adequately demonstrated. We examined the ability of the CER subscale of the eating inventory to distinguish differences in resting energy expenditure (REE), body composition, cortisol, dietary intake, and physical activity, in a group of women. Subjects (20.4+/-2.3 years) were divided into high (score9; n=31) and low (scoreor =9; n=34) CER groups based on questionnaire responses. Indirect calorimetry was used to measure REE and dual-energy X-ray absorptiometry to measure body composition. Salivary and 24-hour urinary cortisol were measured by bioassays. Food frequency questionnaires and 4-day food records, physical activity recalls, and anthropometric measures were completed. Women in the high CER group possessed more fat mass (p0.05) and higher body fat percent (p0.05) and consumed more servings of fruits and vegetables per day (p0.05) compared to women in the low CER group. Differences in other indicators were not observed between CER groups. Our findings suggest that cognitive restraint and body fatness may not be independent of one another.

Background: Little is known about how simpler and more available methods to measure change in body fatness compare with criterion methods such as dual-energy X-ray absorptiometry (DXA) in children. Objective: Our objective was to determine the ability of airdisplacement plethysmography (ADP) and formulas based on triceps skinfold thickness (TSF) and bioelectrical impedance analysis (BIA) to estimate changes in body fat over time in children. Design: Eighty-six nonoverweight and overweight boys (n 34) and girls (n 52) with an average age of 11.0 2.4 y underwent ADP, TSF measurement, BIA, and DXA to estimate body fatness at baseline and 1 0.3 y later. Recent equations were used to estimate percentage body fat by TSF measurement (Dezenberg equation) and by BIA (Suprasongsin and Lewy equations). Percentage body fat estimates by ADP, TSF measurement, and BIA were compared with those by DXA. Results: All methods were highly correlated with DXA (P 0.001). No mean bias for estimates of percentage body fat change was found for ADP (Siri equation) compared with DXA for all subjects examined together, and agreement between body fat estimation by ADP and DXA did not vary with race or sex. Magnitude bias was present for ADP relative to DXA (P 0.01). Estimates of change in percentage body fat were systematically overestimated by BIA equations (1.37 6.98%; P 0.001). TSF accounted for only 13% of the variance in percentage body fat change. Conclusion: Compared with DXA, there appears to be no noninvasive and simple method to measure changes in children’s percentage body fat accurately and precisely, but ADP performed better than did TSF or BIA. ADP could prove useful for measuring changes in adiposity in children. Am J Clin Nutr 2004;80:64 –9.

Background: Within the past 10 y, dual-energy X-ray absorptiometry (DXA) has become one of the most widely used methods of measuring human body composition. However, DXA has not been fully evaluated against an independent criterion method of measuring body fatness in young females. Objective: Our objective was to determine the bias and agreement between DXA and a 4-compartment model in predicting the percentage of fat mass (%FM) in a multiethnic group of young females. Design: The %FM values measured by DXA of 73 white, 43 African American, 14 Hispanic, and 11 Asian females with a mean (± SD) age of 13.0 ± 1.9 y were compared with the 4-compartment values, which were based on measurements of body density, body water, and bone mineral content. Results: The %FM values measured by the 2 methods were correlated at r = 0.90 with an SEE of 3.3%; Bland-Altman analysis indicated an average bias of 3.9%. After nullification of the average bias, an individual estimate of %FM by DXA could be underestimated or overestimated by 6.7% when compared with the 4-compartment value. Conclusions: DXA is an appropriate method for estimating body composition in a group of young females because its bias and limits of agreement are independent of age, ethnicity, and body fatness. However, the limits of agreement of 6.7% could cause an individual FM value to be underestimated or overestimated by 28% relative to the 4-compartment value. Therefore, DXA may not be the optimal method of measuring the body fatness of young females.

The contribution of changes in body fatness and aerobic fitness to changes in blood lipids after aerobic exercise training was investigated. The sample included 295 men (77 black, 218 white) and 355 women (131 black, 224 white), aged 17 to 65 years, from the HERITAGE Family Study. Participants underwent measurements at baseline and after 20 weeks of supervised exercise training on a cycle ergometer. Body fat mass (FM, in kilograms) was determined by underwater weighing, and aerobic fitness (maximal oxygen uptake, VO(2max), in milliliters per minute) was assessed by cycle ergometry. Blood lipid measurements included fasting plasma levels of high-density lipoprotein cholesterol (HDL-C), HDL(2)-C, HDL(3)-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (CHOL), CHOL/HDL, and triglycerides (TG). A composite lipid change index (LCI) was derived by subjecting the Delta scores for the individual blood lipids to principal components analysis. The exercise training was accompanied by a mean increase of 17.5% in VO(2max) and a mean decrease of 3.3% in FM. Partial correlations, controlled for age, between absolute changes in VO(2max) and changes in the blood lipids were consistently low and nonsignificant. On the other hand, absolute changes in FM were significantly (P

When protective clothing is worn that restricts evaporative heat loss, it is not valid to assume that the higher sweat rates associated with improvements in aerobic fitness will increase heat tolerance. An initial study compared thermoregulatory and cardiovascular responses to both compensable and uncompensable heat stress before and after 8 weeks of endurance training in previously sedentary males. Despite a 15% improvement in VO2peak, and lower heart rates and rectal temperature (T(re)) responses while wearing combat clothing, no changes were noted when subjects wore a protective clothing ensemble. Tolerance times were unchanged at approximately 50 min. A subsequent short-term training model that used daily 1-h exercise sessions for 2 weeks also failed to show any benefit when the protective clothing was worn in the heat. Cross-sectional comparisons between groups of high and low aerobic fitness, however, have revealed that a high aerobic fitness is associated with extended tolerance time when the protective clothing is worn. The longer tolerance time is a function of both a lower starting T(re) and a higher T(re) tolerated at exhaustion. Improvements in cardiovascular function with long-term training may allow higher core temperatures to be reached prior to exhaustion. Conversely, elevations in core temperature that occur with normal training sessions may familiarize the more fit subjects to the discomforts of exercise in the heat. Other factors such as differences in body fatness may account for a faster increase in tissue temperature at a given metabolic rate for less fit individuals.

Trained people exhibit low plasma concentrations of triacylglcyeride (TAG) in both fasted and postprandial states. This mainly reflects enhanced uptake of TAG into skeletal muscle, via enhanced activity of lipoprotein lipase, the rate-limiting step in TAG removal. Endurance athletes possess a large, well-vascularised muscle mass and this may contribute through the increased availability of endothelial binding sites for LPL. However, each session of exercise stimulates a delayed increase in LPL activity so that prior exercise enhances uptake into muscle. Intramuscular TAG is one source of energy for muscular contraction so this may serve to replenish muscle nutrient stores which have been diminished by exercise. Regular, frequent aerobic exercise may oppose the atherogenic disturbances to lipoprotein metabolism evident during the postprandial period. It may also, by favouring the disposition of dietary fatty acids in muscle, improve the matching of fat oxidation to fat intake and hence help with maintenance of a desirable level of body fatness.

The role that energy expenditure plays in pediatric obesity was somewhat confused by early research purporting to show that, as a group, obese children have lower energy intakes than do lean children. On the basis of this intake data, the conclusion was drawn that obese persons are somehow energy efficient, leading to weight gain. More recent research examining energy expenditure has shown clearly that, as a group, obese children have higher energy expenditures than do their lean counterparts. With the advent of the doubly labeled water method for determining free-living energy expenditure, it has been shown that obese children underreport intake significantly more than do lean children. When measurements are properly adjusted for differences in body size, there are generally no major differences in energy expenditure between lean and obese groups. However, in some cross-sectional studies, a low level of physical activity has been shown to be related to current body fatness. In addition, longitudinal studies have shown that a low level of energy expenditure, particularly energy expended in physical activity, is associated with both body fatness and weight gain.

Selection for genotypes of pigs with increased growth rate, larger mature size, reduced levels of body fatness and greater prolificacy has resulted in a need to reassess nutritional requirements of primiparous sows, there being a substantial effect on all phases of the reproductive cycle. These effects are greater than in the multiparous sow, probably because of marked differences in growth ambitions which create a conflict of interest for the metabolism of the immature breeding sow. Where feeding is adequate and conception not premature, there is no evidence to support special increases or decreases in nutrient supply to enhance ovulation rate, embryo survival, or late gestation foetal growth. There is no proven influence of gestation feed intake on lactation feed intake independent of body fatness at parturition. Lactation feed intake limitation renders the primiparous sow prone to severe maternal lipid and protein losses required in the support of lactation. Conventional intakes are usually below those required daily to attain energy and nitrogen balance. Excessive negative balances will utilise available labile body lipid and body protein, and reproductive efficacy is compromised. Overall, it would appear unwise to allow P2 backfat depth to fall below 14 mm or to rise above 25 mm (lipid:protein ratio > 1:1 and

The present investigation utilized dual-energy X-ray absorptiometry (DEXA) as a means of assessing the relation between regional percent body fat and selected thermoregulatory variables. Tissue insulation (I) , rectal temperature ( T re ), mean skin temperature ( T ¯ sk ), and regional distribution of fat (i.e., arm, leg, trunk, abdomen) were examined utilizing a sample of seven Caucasian males ( X ¯ ± SE age=23.7 ± 1.9 years) who were exposed to 8°C air for 120 min. The strongest relationships between I , T ¯ sk , T re , and the fatness variables were determined utilizing the all-possible regressions procedure. The strongest relationship existed between the combination of abdominal and leg adiposity and I ( R 2 = 0.958, p T ¯ sk was described using the linear combination of trunk, abdominal, and arm fatness ( R 2 = 0.979, p T re used the combination of trunk, abdominal, and leg fatness ( R 2 = 0.946, p > .05). Based on these data utilizing the DEXA, one may describe important relationships between thermoregulatory variables and distribution of percent fat. Also, abdominal fatness was repeatedly influential in describing relationships between body fatness and thermoregulatory variables.

Background Excess childhood body fatness, overweightness, and obesity are a major public health challenge in the UK. Accurate assessments, usually based on body-mass index (BMI), are crucial. However, recent studies have demonstrated that BMI underestimates body fatness in South Asian children and overestimates it in black African children. These errors are a concern in these ethnic minority populations, particularly UK South Asians, who are at high risk of obesity, type 2 diabetes, and cardiovascular disease. We aimed to develop BMI adjustments for these children to ensure that BMI relates to body fatness in the same way as for white European children. Methods Four recent UK population-based studies, which used deuterium dilution assessments of fat mass as a reference method, were pooled to include 1725 children (52% girls) aged 4–12 years (mean 9·3, SD 1·6) of white European, South Asian, and black African origins. A height-standardised fat-mass index (FMI) was derived to represent body fatness. Linear regression models were fitted, separately by sex, to quantify ethnic differences in BMI–FMI associations and to provide ethnic-specific BMI adjustments. Findings The FMI derived for this study population and used in analyses was fat mass/height 5 , which was independent of height for the 4–12-year age-group. BMI consistently underestimated body fatness in South Asians, requiring a BMI adjustment of +1·12 kg/m 2 (95% CI 0·83–1·41) for boys and +1·07 (0·74–1·39) for girls, irrespective of age and FMI. BMI overestimated body fatness in black Africans. However, adjustments for black African children were more complex, with statistically significant interactions between black African ethnicity and FMI (p=0·004 boys, p=0·003 girls) and between FMI and age-group (p 2 for boys and between −0·22 and −2·86 kg/m 2 for girls for unadjusted BMI values of 13 kg/m 2 in 10–12 year-olds and 25 kg/m 2 in 4–6 year-olds, respectively. Interpretation BMI underestimated body fatness in South Asians and overestimated it in black Africans. Ethnic-specific adjustments—increasing BMI in South Asians and reducing BMI in black Africans—can improve the accuracy of body fatness assessment in these children. Funding This work was supported by the British Heart Foundation (grant ref PG/15/19/31336) and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (South London) (grant ref CLAHRC-2013-10022). Primary data collection was funded by the British Heart Foundation (PG/11/42/28895), BUPA Foundation (TBF-S09-019), Child Growth Foundation (GR 10/03), and Wellcome Trust (WT094129MA). MF is supported by Great Ormond Street Hospital Childrens' Charity.

The effects of breed and slaughter weight on the profile and accumulation of fatty acids in the subcutaneous adipose tissue of wethers were investigated. Dorper (earlier maturing breed) and SA Mutton Merino (later maturing breed) wethers were randomly allocated to a 22 factorially arranged experiment (2 breeds × 2 slaughter weights × 12 replicates). Wethers were slaughtered at either of the two predetermined slaughter weights of 37 or 43 kg. Subcutaneous adipose tissue was sampled for subsequent fatty acid analysis. Thickness of the subcutaneous adipose tissue differed between breeds (P < 0.05) and increased with increasing slaughter weight (P < 0.05). Breed influenced the proportions of myristic (C14:0), heptadecenoic (C17:l) and oleic (C18:1cis) acids, while the effect of slaughter weight was not significant. When breeds were compared at equal body fatness the differences in thickness of the subcutaneous adipose tissue and proportions of heptadecenoic acid (C17:1) and oleic acid (C18:1) were negligible. Concentrations of fatty acids (C14:0, C16:0, C16:1, C18:0 and C18:1) increased (P < 0.05) with increasing live weight. Similar differences were observed between maturity types (breeds) even when compared at an equal degree of maturity, which suggests a genetic basis for differences between these particular sheep breeds.

Measurements of total energy expenditure (TEE) by the doubly labeled water method were compiled from 22 studies to identify the range of variation and significant determinants of energy requirements in healthy adults. The 126 male and 173 female subjects (aged 18-78 y) were separated into four groups: athletes, Pima Indians, people in developing countries, and others. The groups differed significantly (P < 0.001) with respect to TEE, TEE/BMR, TEE-BMR divided by weight, and TEE-BMR. Stepwise multiple regression demonstrated that fat-free mass (FFM) and age are significant variables that can explain 65% of the variation in TEE. These data demonstrate that total daily energy expenditure varies dramatically among healthy, free-living adults. The relationship between body fatness and nonbasal energy expenditure was negative at high energy outputs but considerable variation in body fatness was present among sedentary individuals, suggesting that a low rate of nonbasal energy expenditure is a permissive factor for obesity.

The prevalence of obesity was examined among Saudi female medical and nursing students. The analysis was made on 222 students whose ages ranged from 18–25 years. Standard procedures for measuring weight, height and triceps skinfold measurements were conducted. The criteria for obesity used in the present study were: (i) body mass index (W/H 2 ) in kg/m 2 ≥ 25 and (ii) triceps skinfold measurement of ≥ 25 mm (≥ 85 th percentile for ages 18–24 years). The prevalence rate of obesity by body mass index was found to be 30.6% with more girls falling in the Grade I (26.1%) than the Grade II (4.5%) category. Using the skinfold measurement as a standard, a smaller proportion (16.8%) of students was observed to be obese indicating variation in the sensitivity of the two indices as measures of body fatness. Irrespective of the method used for estimation, the prevalence of obesity in these young Saudi women was notably high and supports findings of earlier studies for a common occurrence of female obesity in this region. Preventive programmes for weight control and a healthy lifestyle among Saudi females should be emphasised from young adulthood or perhaps earlier.

This study applied contemporary self-esteem theory to investigate the relationship between dietary restraint and a range of self-perceptions from the specific to the global level. Subjects were 108 girls and 113 boys aged 12.6±0.41 years who were involved in a longitudinal paediatric project. Reported eating behaviour was assessed using the three subscale Dutch Eating Behaviour Questionnaire. Self-perceptions were assessed using subscales from Harter's Self-Perception Profile for Adolescents and items designed to measure specific attributes related to the body. In addition, a comprehensive anthropometric profile which included body fatness was available. Results indicated that self-esteem was highly related to perceptions of appearance, particularly for girls. Girls also reported higher levels of dietary restraint than boys (2.36 vs 2.10). Dietary restraint was correlated strongly with perceived overfatness in girls ( r =0.58, P r =0.52, P

The impact of two different modes of training on body fatness and skeletal muscle metabolism was investigated in young adults who were subjected to either a 20-week endurance-training (ET) program (eight men and nine women) or a 15-week high-intensity intermittent-training (HIIT) program (five men and five women). The mean estimated total energy cost of the ET program was 120.4 MJ, whereas the corresponding value for the HIIT program was 57.9 MJ. Despite its lower energy cost, the HIIT program induced a more pronounced reduction in subcutaneous adiposity compared with the ET program. When corrected for the energy cost of training, the decrease in the sum of six subcutaneous skinfolds induced by the HIIT program was ninefold greater than by the ET program. Muscle biopsies obtained in the vastus lateralis before and after training showed that both training programs increased similarly the level of the citric acid cycle enzymatic marker. On the other hand, the activity of muscle glycolytic enzymes was increased by the HIIT program, whereas a decrease was observed following the ET program. The enhancing effect of training on muscle 3-hydroxyacyl coenzyme A dehydrogenase (HADH) enzyme activity, a marker of the activity of beta-oxidation, was significantly greater after the HIIT program. In conclusion, these results reinforce the notion that for a given level of energy expenditure, vigorous exercise favors negative energy and lipid balance to a greater extent than exercise of low to moderate intensity. Moreover, the metabolic adaptations taking place in the skeletal muscle in response to the HIIT program appear to favor the process of lipid oxidation.

Two amounts of energy intake (12.6 and 16.3 MJ DE/day, respectively) above maintenance requirement were given to entire male pigs from 25 to 105 kg body weight. Slaughter, dissection and chemical analysis in three body fractions on 25, 65 and 105 kg live weight allowed calculation of tissue deposition and tissue partitioning in two weight ranges. On average, 57% of total protein deposition was deposited into the LEAN fraction. Moreover, 68% of total lipid deposition was deposited into the non-lean carcass parts on average. An increase in energy intake resulted in an increase in both lipid and protein deposition. Of this extra protein deposition and extra lipid deposition, 42 and 75% respectively were directed to the non-lean carcass parts in the live weight range 25–65 kg. Above 65 kg live weight, these respective percentages were 71% and 82% on average. Thus, despite the relatively low intake levels, the major part of extra tissue deposition was deposited into non lean carcass tissue. The effect of a 40 kg increase in body weight on protein and lipid deposition rates was small as compared to the effect of an extra 250 g of feed. Thus, for the used feeding regimen, partitioning of protein within the body was mainly effected by nutrition, and not by body weight. It was concluded that a nutrition induced increase in lean tissue deposition rate will be coincided with a substantial increase in body fatness. This is due to an increase in lipid deposition accompanying an increase in protein deposition. Furthermore, an increase in protein deposition enhanced the partitioning of protein to tissues other than lean.

To determine the reliability of the measurement of postprandial thermogenesis by indirect calorimetry and to clarify further the relationship of obesity to thermogenesis in men, the thermic effect of a 720-kcal, mixed liquid meal was compared in 13 lean men (mean +/- SEM, 11.2% +/- 1.4% body fat), 10 average men (22.4% +/- 1.6% body fat), and 12 obese men (33.4% +/- 1.6% body fat) on two occasions. Resting metabolic rate (RMR) was measured for 3 hours: (1) in the fasted state, and (2) after a 720-kcal mixed liquid meal, on two occasions. The thermic effect of the meal, calculated as the postprandial energy expenditure minus the fasting RMR (kcal/3h), was greater for the lean and average men than for the obese men during both trials (P less than .001), but was only marginally different between the lean and average groups (P = .16). The mean values for the two trials were similar and the measurement of thermogenesis was highly reproducible with a reliability coefficient of r = .932 (P less than .001). Across all groups, thermogenesis correlated strongly with percent body fat (r = -.64, P less than .01), but within the average men, thermogenesis was uncorrelated with percent body fat (r = .09) but highly correlated with the glucose response to the meal (r = -.75, P less than .05). Thus, factors other than body fatness, such as insulin sensitivity, may determine thermogenesis within this heterogeneous middle group.(ABSTRACT TRUNCATED AT 250 WORDS)

In a national survey of 515 apparently healthy Dutch elderly people aged 65 through 79 years, interrelationships among weight, height, weight-for-height indexes (especially the Quetelet index), body fatness (assessed by skinfold measurements), and 24-hour urinary creatinine excretion were investigated in various age groups. Body weight, body height, and 24-hour urinary creatinine excretion (absolute and per kilogram body weight) were lower in older age groups. In men the correlation coefficient between weight and body fatness was .54 for the group aged 65 through 69 years and .33 for the group aged 75 through 79 years. In women the correlation between weight and percentage of body fat varied from .52 to .70 among the age groups. In comparison with results reported for younger adults, a lower correlation between the Quetelet index and body fatness was observed (r=.49 in men, r=.64 in women). The correlation of the Quetelet index with both height and urinary creatinine excretion tended to be higher in the older age groups. We concluded that some of the associations found were inconsistent and that there may be some doubt about the adequacy of the Quetelet index as a measure of body fatness among the elderly. However, no convenient alternative weight-for-height index is presently available. Perhaps circumferences are a better option to choose for elderly people.

The body fatness, television viewing time and calorie-intake estimate of 773 sixth grade, Caucasian children in 12 Pennsylvania school districts were examined to ascertain whether or not relationships existed among these variables. Triceps skinfold and body mass index (BMI) computed as wt/ht2 served as body fatness indicators. Television viewing reported by boys and girls, respectively, averaged 29.6 ± 12.5 and 27.1 ± 11.9 hours/week. Multiple regression models using data from a subsample of 489 children, for whom body fatness measures made three years earlier were available, explained 73% and 58% of the variance in BMI and triceps skinfold, respectively. Television viewing time contributed significantly to each model, but calorie-intake estimate did not. The relationship between television viewing and triceps skinfold emerged among both boys and girls but only in the less affluent school districts, while the relationship between television viewing and BMI occurred only among girls in moderately and less affluent districts. We hypothesize that where television viewing was related to body fatness, its influence was likely mediated through energy expenditure rather than energy intake. This emphasizes the importance of physical activity programs for school children.

Summary Eighteen multiparous Quarter Horse mares were utilized in a study to determine whether nutritionally-induced obesity, initiated during gestation, would adversely affect milk yield and milk composition. Mares were assigned to one of two treatment groups during gestation: 1) control (n=11): fed to maintain a moderate degree of body fatness (mean postpartum condition score ± SE = 6.1 ± 0.2) and 2) obese (n=7): fed to achieve (prepartum) and then maintain (postpartum) an extremely high degree of body fatness (mean postpartum condition score ± SE = 8.8 ± 0.2). Foal growth was monitored at weekly intervals until the study was terminated on Day 63 of lactation. Foals were not allowed access to supplemental feed. A weigh-suckle-weigh technique was used to estimate milk yield on Days 30 and 60 of lactation. Samples for laboratory analysis of milk composition were collected on Days 31 and 61 of lactation. The 63-d total gain in body weight, heart girth, and third metacarpal bone circumference was greater (p 0.05). Milk yield tended to be greater in control as compared to obese mares (14.4 vs 13.0 kg/d, SE=0.5, p

Background The accurate assessment of overweight–obesity prevalence in UK children of South Asian and black African origin (in whom its consequences are especially adverse) is an important challenge. However, body-mass index (BMI), the marker of body fatness used in most national surveys, differs in its association to body fatness between ethnic groups, which biases ethnic comparisons of body fatness based on BMI. We recalibrated BMI values for ethnicity to assess overweight–obesity prevalence more accurately in UK South Asian and black African children in recent survey data from the National Child Measurement Programme (NCMP), an inclusive assessment programme in English primary schools. Methods Deuterium dilution measurements of body fat and BMI were collated from four recent UK population-based studies (three in schools selected to provide balanced ethnic representation) in 873 children of South Asian, black African, and white European origin aged 9−11 years. Data were analysed with linear regression models to determine the age-adjusted and sex-adjusted BMI differences in South Asian and black African children compared with white Europeans at an equivalent level of body fatness (denoted by fat mass index [kg/m 5 ], which is uncorrelated with height). These BMI adjustments were applied to NCMP 2012–13 survey data in 489 146 children aged 10–11 years to determine ethnic-specific overweight–obesity prevalences; standard NCMP overweight–obesity definitions were used. Findings BMI adjustments for equivalent body fatness were +1·11 kg/m 2 and +0·98 kg/m 2 for South Asian boys and girls, respectively, and −1·20 kg/m 2 and −1·66 kg/m 2 for black African boys and girls, respectively; these adjustments were applied to NCMP data for South Asian and black African children. Overweight–obesity was recorded in 14 538 of 38 201 South Asian children (38·1%, 95% CI 37·6–38·5) and 9839 of 22 672 black African children (43·4%, 42·8–44·0) before BMI adjustment and in 18 145 of 38 201 (47·5%, 47·0–48·0) and 7065 of 22 672 (31·2%, 30·6–31·8), respectively, after adjustment; overweight–obesity was recorded in 92 002 of 292 467 white European children (31·5%, 95%CI 31·3–31·6). Interpretation Use of ethnic-specific BMI adjustments to obtain comparable assessments of body fatness substantially changed observed overweight–obesity prevalences in ethnic minority groups. Adjusted BMI particularly emphasised the substantial overweight–obesity burden in South Asian children, an important priority for prevention. Funding This research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London and by grants from the British Heart Foundation (PG/11/42/28895), the Child Growth Foundation (GR 10/03), and the Wellcome Trust (WT094129MA).

Rationale: Optimal body weight and relative body fatness are important for optimal performance by athletes. Several methods to estimate fat free mass [FFM] have been developed in a general population. However, athletes may have a higher relative FFM. Therefore, the aim of this study is to compare different methods for assessment of FFM in recreational athletes. Methods: 92 (M = 56, F = 36) recreational athletes were included (age 30±11 years; weight 70±10 kg; BMI 22±2 kg/m2). Subjects had regular exercise for 5±2 times per week, covering 9±5 hours of exercise per week. FFM (%) was measured by 4[4SF] and 7-point [7SF] skinfold measurement, BIA (Tanita [TAN] and Tanita Athletic [TANAT]) and BIS (Bodyscout) and compared with air-displacement plethysmography [ADP] as reference method. A repeated measures ANOVA was used to analyse differences between the means. Accuracy (within 5% error), bias, and RMSE were calculated and a Limits of Agreement analysis was performed. Results:At group level, only mean FFMbyTAN (82.6±6.6%FFM) was not significantly different from ADP (83.6±6.4%FFM, p = 0.22). TAN had highest accuracy (72%), lowest bias (1.1±4.5%) and lowest RMSE (4.0%FFM) and was better than TANAT (accuracy 65%; Bias 2.9±4.6%; RMSE 4.4%FFM). 7SF resulted in better FFM estimation than 4SF (accuracy 67% vs. 51%; Bias 3.5±4.1% vs. 3.6±4.3%; RMSE 4.3%FFM vs. 4.7%FFM). Conclusion: For assessment of fat free mass in recreational athletes a relatively simple device as Tanita can provide reasonably accurate values. However, one should be careful with individual application, because a considerable error is present. Without BIA device, the 7SF method is preferred over the usual 4SF method.

Gelber et al. ([1][1]) make an important contribution in comparing anthropometric measurements as predictors of cardiovascular disease (CVD). These authors and an editorialist ([2][2]), accept that “fatness” relates to CVD, and point out the controversy regarding total fat content versus some

Background: Consumption of sugar-sweetened beverages (SSBs) was thought to promote weight gain. Finding suitable alternatives for SSBs is crucial for obesity prevention in children and adolescents. Objectives: The purpose of this study was to examine the effects of different types of beverage consumption and the effects of replacing SSBs with water, coffee/tea, milk, and 100% fruit juice on changes in body fatness over 6-y. Design: A cohort of 9-year-old children (n = 358) who participated in the Danish part of the European Youth Heart Study was followed for 6-y. Multivariate linear regression was used to examine the association between beverage consumption at baseline and changes in body fatness (body mass index zscore (BMI z-score), waist circumference (WC), and sum of four skinfolds ( 4SF)) over 6-y. A substitution model was used to evaluate the effects of substituting various beverages for SSBs, controlling for total beverage intake, energy from non-beverage sources, physical activity, socioeconomic status, and pubertal status. Results: Consumption of SSBs at age 9 y, but not other beverages, was positively associated with subsequent 6-y changes in BMI z-score and 4SF. Substitution of 100 g of water for SSBs was negatively associated with changes in BMI z-score (P = 0.04), WC (P = 0.04) and 4SF (P = 0.03) over 6y. Substitution of 100 g of milk for SSBs was also negatively associated with changes in BMI z-score (P = 0.02), WC (P = 0.05) and 4SF (P = 0.06). No effect was observed for substitution of SSBs by 100% fruit juice. Conclusions: Our results suggest SSBs consumption is associated with long term changes in body fatness from childhood to adolescence, and replacing SSBs with water or milk has beneficial effects on changes in body fatness.

Background: Consumption of sugar-sweetened beverages (SSBs) was thought to promote weight gain. Finding suitable alternatives for SSBs is crucial for obesity prevention in children and adolescents. Objectives: The purpose of this study was to examine the effects of different types of beverage consumption and the effects of replacing SSBs with water, coffee/tea, milk, and 100% fruit juice on changes in body fatness over 6-y. Design: A cohort of 9-year-old children (n = 358) who participated in the Danish part of the European Youth Heart Study was followed for 6-y. Multivariate linear regression was used to examine the association between beverage consumption at baseline and changes in body fatness (body mass index zscore (BMI z-score), waist circumference (WC), and sum of four skinfolds ( 4SF)) over 6-y. A substitution model was used to evaluate the effects of substituting various beverages for SSBs, controlling for total beverage intake, energy from non-beverage sources, physical activity, socioeconomic status, and pubertal status. Results: Consumption of SSBs at age 9 y, but not other beverages, was positively associated with subsequent 6-y changes in BMI z-score and 4SF. Substitution of 100 g of water for SSBs was negatively associated with changes in BMI z-score (P = 0.04), WC (P = 0.04) and 4SF (P = 0.03) over 6y. Substitution of 100 g of milk for SSBs was also negatively associated with changes in BMI z-score (P = 0.02), WC (P = 0.05) and 4SF (P = 0.06). No effect was observed for substitution of SSBs by 100% fruit juice. Conclusions: Our results suggest SSBs consumption is associated with long term changes in body fatness from childhood to adolescence, and replacing SSBs with water or milk has beneficial effects on changes in body fatness.