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Objectives: The digit ratio (2D:4D) is a possible marker of prenatal hormone exposure. The purpose of this study was to explore the relationships between digit ratio (2D:4D) and anthropometric indexes in Chinese children and adolescents. Methods: This study is a cross‐sectional study. A school‐based survey among 685 children and adolescents aged 8–15 years were conducted by stratified cluster sampling. The length of index finger (2D) and ring finger (4D) of the left hand, height, sitting height (ST), weight, chest circumference (CC), waist circumference (WC), hip circumference (HC), and abdominal skinfold thickness (AST) were measured. Pearson correlation and multivariate linear regression were used to analyze associations between 2D:4D and above indexes. Results: In girls, 2D:4D was positively related to WC, AST, waist‐to‐height (WHtR), waist‐to‐hip ratio (WHR) after adjusting for ages (p < 0.05). The WC, AST, WHtR, and WHR among girls with 2D:4D ≥ 1 were significantly higher than those among girls with 2D:4D < 1, respectively (p < 0.05). However, there was no correlations between digit ratio (2D:4D) and above anthropometric indexes in boys (p > 0.05). Conclusions: The 2D:4D was related to anthropometric indexes in girls, which suggests that the maternal prenatal hormone exposure might be related to the anthropometric indexes of their female offspring. [ABSTRACT FROM AUTHOR]

Background: Excess body adiposity and skin irregularities represent a major problem in today's society. Currently, radiofrequency‐based devices constitute an increasingly popular medical‐aesthetic application and a powerful non‐invasive method to combat this problem. Objective: This study aims to determine the efficacy and safety of the high‐frequency device Zionic™ (Termosalud, Inc., Gijón, Spain) in reducing body contouring and improving skin appearance in the abdomen/flanks or thighs. Materials and Methods: Thirty nine individuals were treated with the Zionic™ device in the abdomen/flanks or thighs. A total of 8 sessions of 40–50 min each, 72/96 h apart were performed. At baseline, body measurements were taken including photographs, body contours, and ultrasound scans to assess dermal thickness, dermal echogenicity, and subcutaneous fat thickness. The measurements were repeated after the eight sessions for comparison and analysis. Quantitative data was complemented with a customized survey to evaluate participants satisfaction level. Results: At the follow‐up visit, a significant average reduction of 3% in abdomen/flanks circumferences and 2% in thighs contours was noticed. Abdomen/flanks and thighs subcutaneous fat layer thickness was significantly reduced by 8% and 6%, respectively. Dermal echogenicity changes, related to skin collagen content and organization, showed non‐significant increasing tendencies of 7% for abdomen/flanks and 8% for thighs. Thighs dermal thickness was significantly increased by 6%. Results were associated to a high satisfaction level (80%) and no severe adverse events. Conclusion: Zionic™ treatment is a safe, effective, and well‐tolerated noninvasive procedure for body contouring and improvement of skin properties in abdomen, flanks, and thighs. [ABSTRACT FROM AUTHOR]

Summary: Background: The COVID‐19 pandemic has significantly changed the lifestyle and dietary habits of societies worldwide. The aim of the study was to assess changes in the distribution of fat tissue and skinfold thickness in adolescents (aged 11–15) from Kraków during the COVID‐19 pandemic period. Methods: Two cross‐sectional studies conducted in 2020 and 2022 (before and after the pandemic) involved 1662 adolescents from the Kraków population. Skinfold thickness measurements were taken. The trunk adiposity index, limbs‐to‐trunk fat ratio and limbs‐to‐total skinfold ratio were calculated. Statistical analysis employed a two‐way ANOVA, Tukey's HSD test and the Kruskal–Wallis test, depending on the normality of the distribution. Results: Higher skinfold thicknesses were observed in the majority of age groups in both sexes from the 2022 cohort in comparison with the 2020 cohort. Additionally, higher values of the trunk adiposity index and the limbs‐to‐total skinfold ratio in most age groups were observed. However, an inverse trend was observed in the limbs‐to‐trunk fat radio. Conclusions: The introduced restrictions such as lockdown, remote learning, reduced physical activity and changes in dietary habits could have influenced the distribution of fat tissue and skinfold thickness amongst adolescents from Kraków. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions Less than 50% of patients treated for hypertension reach a target office systolic blood pressure (SBP). We aimed to evaluate the role of adiposity on antihypertensive drug responses in newly diagnosed hypertensive patients.Estimated glomerular filtration rates, body mass index (BMI), skinfold thickness (SFT), body surface areas and waist circumferences of 150 hypertensive patients naïve to treatment were measured. Treatment protocols were started as combination of angiotensin converting enzyme inhibitor (ACE‐I) plus calcium channel blocker (CCB), angiotensin receptor blocker plus CCB or ACE‐I plus diuretic. Pre‐treatment and change in blood pressure (ΔBP) after 4 weeks treatment were determined. Multiple linear regression analysis was used to find independent predictors of Δblood pressure changes, and multivariable binary logistic regression analysis to find independent predictors of target SBP < 140 mmHg at 4 weeks.A total of 104 patients reached the target systolic pressure of <140 mmHg at 4 weeks. Triceps, mid‐abdomen and subscapular SFT were significantly thicker in the uncontrolled blood pressure group (P = .011, P = .006 and P = .016, respectively). Pretreatment SBP (r = 0.644), pretreatment diastolic blood pressure (DBP) (r = 0.188), subscapular SFT (r = −0.318), suprailiac SFT (r = −0.211) and ΔDBP (r = 0.433) were correlated with ΔSBP in correlation analysis. Pretreatment SBP (β = 0.644, 95% CI = 0.697–0.993, P < .001), subscapular SFT (β = −0.253, 95% CI = −0.886–−0.329, P < .001), pretreatment DBP (β = −0.380, 95% CI = −0.1001– −0.453, P = .001) and ΔDBP (β = 0.401, 95% CI = 0.377–0.796, P < .001) were independent predictors of ΔSBP in multivariable linear regression analysis. Subscapular SFT was an independent predictor of target SBP < 140 mmHg in multivariable logistic regression analysis (OR = 0.895, 95% CI = 0.832–0.963, P = .003).Subscapular SFT may be a valuable marker for prediction of response to antihypertensive drugs. [ABSTRACT FROM AUTHOR]

Background: Guatemala suffered from civil war and high levels of inequality and childhood stunting in the second half of the 20th century, but little is known about inequalities in secular trends in adiposity. Objectives: To investigate differences in childhood body mass index (BMI) and skinfold thickness trajectories from 1979 to 1999 between three groups of children: High socioeconomic position (SEP) Ladino, Low SEP Ladino, and Low SEP Indigenous Maya. Methods: The sample comprised 19 346 children aged 7–17 years with 54 638 observations. The outcomes were height, BMI, triceps skinfold thickness (TST), and subscapular skinfold thickness (SST) Z‐scores according to the Centers for Disease Control and Prevention (CDC) references. Sex‐specific multilevel models were used to estimate and compare mean trajectories from 1979 to 1999 between the three groups. Results: Mean Z‐scores were always highest for High SEP Ladino children and lowest for Low SEP Maya children. Despite their very short stature, the Low SEP groups had SST trajectories that were above the 50th centile. The BMI trajectories were relatively flat and within one major centile band of the CDC median, with differences between the three groups that were small (0.2–0.3 Z‐scores) and did not attenuate over time. Conversely, the TST Z‐score trajectories demonstrated larger positive secular trends (e.g., from −1.25 in 1979 to −0.06 in 1999 for Low SEP Maya boys), with differences between the three groups that were large (0.5–1.2 Z‐scores) and did attenuate over time (in boys). Secular trends and between‐group difference in the SST Z‐score trajectories were less pronounced, but again we found stronger evidence in boys that the estimated inequalities attenuated over time. Conclusions: Secular trends and inequalities in skinfolds differ from those for BMI in Guatemalan children. Differences between groups in skinfolds attenuated over time, at least in boys, but whether this is good news is questionable given the very short stature yet relatively large subscapular skinfolds of the Low SEP groups. [ABSTRACT FROM AUTHOR]

The 21st annual World Congress on Insulin Resistance, Diabetes and Cardiovascular Disease, held in Los Angeles, California in December 2023, covered various aspects of diabetes, obesity, and related complications. Presentations at the conference discussed topics such as fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD), the use of body mass index (BMI) as a measure of obesity, the relationship between BMI and cardiovascular disease, calorie restriction with intermittent fasting, and the development of hormone-based therapies for obesity. The presentations highlighted the complexities and potential treatments for obesity and its associated health risks. [Extracted from the article]

Summary: Obesity, especially central obesity is associated with increased risk of metabolic syndrome, non‐alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus. The study aimed to investigate the associations of the changes of abdominal fat thicknesses with changes of anthropometric indexes and improvements of metabolic phenotypes in patients with obesity and T2DM before and after bariatric surgery. Between April 2016 and January 2017, 34 adult patients with concurrent obesity and T2DM scheduled for different bariatric surgeries were prospectively evaluated by ultrasound before and 1‐year after bariatric surgery to determine abdominal fat thicknesses (mesenteric fat, preperitoneal fat and subcutaneous fat) and NAFLD. At 1 year, of the 25 patients that finished the study, significant decrease in mesenteric‐fat‐thickness was associated with significant reduction of obesity, that is, BMI (−24%, p <.001), remission of metabolic syndrome (32%, p =.008), NAFLD (60%, p <.001) and T2DM (44%, p <.001). Lower baseline mesenteric fat thickness was associated with remission of metabolic syndrome. Lower baseline mesenteric‐fat‐thickness may have the potential to predict metabolic syndrome remission after bariatric surgery. [ABSTRACT FROM AUTHOR]

Objectives: Laparoscopic adrenalectomy has been the gold standard surgical procedure. However, the adaptation criteria for malignant tumors and predictors of perioperative outcomes are not well defined. Therefore, this study tried to identify valid predictors for perioperative outcomes of laparoscopic adrenalectomy and consider the adaptation criteria. Methods: We retrospectively reviewed the preoperative and perioperative data of 216 patients who underwent transperitoneal laparoscopic adrenalectomy in our hospital. Preoperative factors associated with perioperative outcomes were analyzed using multiple regression analysis. Results: Among 216 patients, 165 (76.4%), 26 (12.0%), and 25 (11.6%) were suspected of having benign tumors, pheochromocytoma, and malignant tumors, respectively. Median tumor size was 25.0 mm (interquartile range 18.0–35.0); median perirenal fat thickness was 9.2 mm (interquartile range 4.9–15.6) on preoperative computed tomography scans. The median operative time was 145.5 min (interquartile range 117.5–184.0) and the median estimated blood loss was 0.0 mL (interquartile range 0.0–27.3). Perirenal fat thickness (p < 0.001), tumor size (p < 0.001), and malignant tumors (p = 0.020) were associated with operative time, and perirenal fat thickness (p = 0.038) and malignant tumors (p = 0.002) were associated with estimated blood loss. Conclusions: Perirenal fat thickness, tumor size, and malignant tumors are valid predictors of the surgical outcomes of transperitoneal laparoscopic adrenalectomy. As only perirenal fat thickness is associated with both surgical outcomes except for malignant tumors, it is a powerful predictor. Transperitoneal laparoscopic adrenalectomy for large malignant adrenal tumors with thick perirenal fat should be performed with caution. [ABSTRACT FROM AUTHOR]

Purpose: Improved understanding of the factors that predispose TKA patients to infection has considerable economic and medical impact. BMI is commonly used as a proxy for obesity to determine the risk of postoperative infection. However, this metric appears to be fraught with inconsistency in this application. BMI is a simple calculation which provides general insight into body habitus. But it fails to account for anatomic distribution of adipose tissue and the proportion of the mass that is skeletal muscle. Our objective was to review the literature to determine if local adiposity was more predictive than BMI for infection following TKA. Methods: A database search was performed for the following PICO (Population, Intervention, Comparison, and Outcome) characteristics: local measurements of adiposity (defined as soft tissue thickness or fat thickness or soft tissue envelope at the knee) in patients over 18 years of age treated with total knee arthroplasty used to determine the relationship between local adiposity and the risk of infection (defined as prosthetic joint infection or wound complication or surgical site infection). Quality was assessed using the GRADE framework and bias was assessed using ROBINS-I. Results: Six articles (N=7081) met the inclusion criteria. Four of the six articles determined that adiposity was more associated with or was a better predictor for infection risk than BMI. One of the six articles concluded that increased adiposity was protective for short term infection and that BMI was not associated with the outcome of interest. One of the six articles determined that BMI was more strongly associated with PJI risk than soft tissue thickness. Conclusion: The use of adiposity as a proxy for obesity in preoperative evaluation of TKA patients is an emerging concept. Although limited by heterogeneity, the current literature suggests that local adiposity may be a more reliable predictor for infection than BMI following primary TKA. Level of evidence: IV systematic review [ABSTRACT FROM AUTHOR]

Background: Obesity and excess body fat are known health issues and a major aesthetic concern. Numerous modalities have been developed to address unwanted deposits of adiposity, including the development of various noninvasive methods overcoming the limitations and risks of invasive alternatives. Cryoadipolysis, also known commonly as cryolipolysis, involves the harnessing of selective cryolysis, the selective cold‐based damaging of subcutaneous fat cells which die via apoptosis, and are removed naturally by the body over time. Aims: To provide a brief but comprehensive summary of the literature supporting two related cryoadipolysis devices that are only available outside of North America, Cooltech and Cooltech Define (Sinclair). Results/Discussion: Review of 10 available clinical studies evaluating the two devices, specifically, showed both devices to be safe, with side effects profiles comparable to those of similar platforms in the armamentarium. Both operate by non‐invasively lowering the temperature of localized subcutaneous fat and maintaining it at or below a threshold that causes disruption of adipocytes via crystallization, inducing apoptosis (programmed cell death). Over time, clinically significant reductions in fat thickness and circumference of the treated area were noted. Patient satisfaction is high. The literature also highlights the necessity of adherence to patient selection and device use guidelines to minimize potential for rare paradoxical adipose hyperplasia and maximize patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Noninvasive body contouring is becoming more popular in the United States as an alternative to liposuction. The most popular of these methods, cryolipolysis, uses precisely controlled cooling to reduce focal adiposities. The number of cryolipolysis procedures performed annually has experienced rampant growth in United States markets, and the indications have likewise diversified. In light of this change, it is imperative to perform an updated review of available US safety and efficacy data on cryolipolysis. Aims: To examine the safety and efficacy of cryolipolysis treatments in the United States using data extracted from research performed exclusively at US‐based sites. Methods: In order to identify relevant studies, a literature search was conducted on PubMed using the terms "CoolSculpting" OR "cryolipolysis" OR "lipocryolysis." Articles were manually reviewed to exclude literature reviews, research not performed on humans, studies on experimental combinations of techniques, and any studies not performed in the United States. Results: The initial literature search returned 246 results. Following manual review, a total of 18 studies were selected for data extraction. Mean reduction in fat thickness by ultrasound was 2.0–5.1 mm or 19.6%–32.3%; mean reduction by body caliper was 2.3–7 mm or 14.9%–21.5%. Side effects were mild and transient. Four instances of PAH were documented in 3453 treatment cycles. Conclusions: Cryolipolysis is a safe, modestly effective method for reducing focal adiposity. Complications are rare and treatable. However, US‐based studies are few in number and often of low power and/or quality. More high‐quality research is needed for all aspects of cryolipolysis. [ABSTRACT FROM AUTHOR]

Summary: Background: Molecular biomarkers of maternal leptin resistance associated with infant weight are needed. Objectives: To evaluate gene expression of leptin receptor (LEPR), suppressor of cytokine signalling 3 (SOCS3) and insulin receptor in peripheral blood mononuclear cells (PBMCs) of lactating women and their relationship with infant body weight and adiposity. Methods: At day 10 postpartum, maternal gene expression in PBMCs as well as leptin and insulin concentrations in plasma and milk were assessed (n = 68). Infant weight and BMI z‐scores, skinfolds and arm circumference were obtained at 10 days and/or at 3 months old. Results: In mothers with pre‐pregnancy overweight or obesity (OW/OB), LEPR expression was reduced (p = 0.013) whereas plasma and milk leptin and milk insulin concentrations were elevated. LEPR expression was positively related with infant weight z‐score (Beta (95% CI): 0.40 (0.17, 0.63), p = 0.001) but not with leptin concentrations. SOCS3 expression was positively related with infant weight z‐score (Beta (95% CI): 0.28 (0.04, 0.51), p = 0.024) and arm circumference (Beta (95% CI): 0.57 (0.32, 0.82), p < 0.001). Relationships remained significant after adjusting for maternal and infant confounders. Conclusions: LEPR and SOCS3 gene expression in PBMCs are novel maternal molecular biomarkers that reflect leptin resistance and are associated with infant body weight and adiposity. [ABSTRACT FROM AUTHOR]

Background: Currently, skinfold thickness in studies on arm venous access ports and the effect of venous access port application are unknown. Materials and Methods: A total of 256 cancer patients who underwent primary venous access port placement in the Fourth Hospital of Hebei Medical University from September 2022 to March 2023 were selected as the study subjects. Two hundred fifty‐six patients were divided into normal skinfold thickness group and high skinfold thickness group according to skinfold thickness. The success rate of primary catheterization of arm venous port catheterization, catheterization operation time, catheterization length and incidence rate of adverse reactions were compared. Results: There was no significant difference in the basic data between the two groups. There was no significant difference in the success rate of primary catheterization between the two groups (p > 0.05), the catheterization operation time in the normal skinfold thickness group was significantly lower than that in the high skinfold thickness group (p < 0.05), the total length of the implanted catheter in the normal skinfold thickness group was significantly lower than that in the high skinfold thickness group (p < 0.05), and the incidence of adverse reactions in the normal skinfold thickness group was significantly lower than that in the high skinfold thickness group (p < 0.05). Conclusion: In cancer patients, skinfold thickness can significantly affect the application effect of arm venous port, and normal skinfold thickness for arm venous port has shorter operation time, total length of implanted catheter and lower incidence of adverse reactions. [ABSTRACT FROM AUTHOR]

Ultrasound has been demonstrated to be a highly accurate and reliable tool for measuring subcutaneous adipose tissue thickness and is robust against changes in hydration status or acute food or fluid intake. However, the effect of prior acute exercise is unexamined. This study examined the impact of an acute endurance exercise and resistance exercise session on standardised brightness‐mode ultrasound measurements of subcutaneous adipose tissue thickness compared to skinfolds and dual‐energy X‐ray absorptiometry body composition estimates. In a randomised cross‐over design, 30 active adults (24.2 ± 4.9 years) undertook physique assessment via standardised brightness‐mode ultrasound, skinfolds and dual‐energy X‐ray absorptiometry before, immediately and 45 min after an acute endurance or resistance exercise session. The mean sum of eight subcutaneous adipose tissue thickness measured via standardised brightness‐mode ultrasound increased (0.6 mm, p = 0.04) immediately postendurance exercise but was not meaningful when evaluated against the technical error of measurement of the investigator. A significant (p = 0.01) but not meaningful decrease in the sum of eight skinfolds occurred immediately (−1.1 ± 0.4 mm) and 45 min (−1.3 ± 0.4 mm) postresistance exercise. Comparatively, endurance exercise elicited a meaningful decrease of total mass (460 ± 30 g) and trunk lean mass (680 ± 90 g) dual‐energy X‐ray absorptiometry estimates. Findings from this study indicate standardised client presentation may be unnecessary when employing either standardised brightness‐mode ultrasound or skinfolds for body composition assessment unlike dual‐energy X‐ray absorptiometry. [ABSTRACT FROM AUTHOR]

Objective: Complications related to triceps after total elbow arthroplasty (TEA) have become a major surgical concern. The triceps‐preserving approach has the advantage of not disturbing the insertion of triceps but is disadvantaged by the reduced exposure of the elbow joint. The aim of this study was to investigate the clinical and radiological outcomes of TEA with a triceps‐preserving approach and to compare the outcomes of TEA to treat arthropathy with that of TEA to treat acute distal humerus fracture. Methods: From January 2010 to December 2018, 23 patients undergoing primary TEAs were retrospectively reviewed with a mean follow‐up time of 92.6 months (range, 52–136 months). Each TEA was performed using the triceps‐preserving approach with a semi‐constrained Coonrad–Morrey prosthesis. Patient demographics, range of motion (ROM), pain visual analogue scale (VAS), and triceps strength (Medical Research Council [MRC] scale) were compared before and after surgery. The Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiographic outcome, and complications were evaluated at follow‐up. Results: In total, seven males and 16 females were included in this study, with a mean age of 66.1 years (range:46–85 years). By the last follow‐up, pain had been significantly relieved in all patients. The average MEPS in the arthropathy group and fracture group were 90.8 ± 10.3 points (range: 68–98 points) and 91.7 ± 0.4 (range: 76–100 points), respectively. The average DASH of the arthropathy group and fracture group was 37.3 ± 18.8 points (range: 18–52 points) and 38.4 ± 20.1 (range: 16–60 points). At the last follow‐up after surgery, the mean flexion arcs in the arthropathy group and fracture group were 100.4° ± 24.1° and 97.8° ± 28.1°, respectively. The mean pro‐supination arcs in the arthropathy group and fracture group were 142.4° ± 15.2° and 139.2° ± 17.5°, respectively. There were no significant differences in clinical outcomes between the two groups (P ≥ 0.05). Triceps strength was normal (MRC grade V) in 15 elbows and good in eight elbows. None of the cases experienced weakness of the triceps strength, infection, periprosthetic fractures, or prosthesis breakage. Conclusions: The clinical and radiographical outcomes of TEA with the triceps‐preserving approach were satisfactory in patients with distal humerus fracture, osteoarthritis and rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Sirt1 is an enzyme involved in several anti-aging pathways. Associations between Sirt1, age, and body fat (BF) were assessed in master sprinters (MS; n = 35 ; 50.25 ±5.93 yr.), untrained young non-athletes (UY; n = 32 ; 23.78 ±3.98 yr.), and untrained middle-aged (UMA; n = 24 ; 47.29 ±8.04 yr.). BF was assessed using a skinfold protocol, and Sirt1 was measured in plasma by using commercial kits. Sirt1 of MS (17.18 ±4.77 ng/mL) was higher than UMA (6.36 ±2.29 ng/mL; p<0.0001) and did not differ from UY (20.26 ±6.20 ng/mL). Relative BF of MS was lower than UMA (12.71 ±4.07% vs. 22.13 ±4.18%; p<0.0001). Sirt1 was negatively correlated with chronological age (r = −0.735; p<0.0001) when combining UY and UMA in the analysis. However, when Sirt1 of MS and UY was analyzed together, no significant relationship between Sirt1 and chronological age was observed (r = −0.243; p = 0.083). Sirt1 correlated inversely with BF (r = −0.743; p<0.0001) for UY and UMA. Stepwise multiple regression revealed that being either a young or master athlete and body adiposity are possible predictors of Sirt1 levels. MS and UY were associated with higher levels of Sirt1, while UMA and increased BF were associated with lower levels of this enzyme. The relationships among Sirt1, BF, and chronological age of young and middle-aged non-athletes were not statistically significant when the middle-aged participants were MS. These findings suggest possible links between Sirt1 and body composition, which may play roles in the rate of biological aging. Highlights Lower levels of Sirt1 are associated with higher body fat. Master athlete lifestyle seems to promote higher Sirt1 Levels. [ABSTRACT FROM AUTHOR]

Background: Currently, even individuals who do physical activity regularly have some degree of dissatisfaction with their own bodies. The electromagnetic field for supramaximal muscle contraction has been the subject of research. High‐intensity supramaximal muscle stimulation (HI‐SMS) is a non‐invasive technology used to strengthen, firm, and tone the abdominal muscles, arms, buttocks, and thighs and has been indicated for aesthetic purposes. Aims: The present study aimed to examine the safety and efficacy of HI‐SMS used in the abdominal muscles of patients through the analysis of clinical evaluation, biochemical serum profile, and patient satisfaction with the procedure. Patients/Methods: This is retrospective non‐randomized and non‐controlled study collected in a private clinic; all data from healthy participants (n = 25), aged between 18 and 55 years, were compiled and analyzed. All received eight 30 min sessions of electromagnetic field ONIX HI‐SMS (intensity of the 90%–100%) located in abdominal, twice a week with intervals of 2–3 days. Results: The results show that BMI, fat thickness, and waist circumference improved the body contour after the treatment. There was no statistical difference in the data referring to the values of AST, ALT, ALP, creatinine, cholesterol, LDL‐C, VLDL‐C, HDL‐C, glycemia, LDH, CK, and IL‐6. However, there was a reduction of "non‐esterified" free fatty acids when compared to baseline. This treatment provided high levels of tolerance, comfort, and high level of satisfaction. Conclusions: Thus, it can be suggested that the treatment with HI‐SMS in abdominal muscles proves to be a safe technology with potential for non‐invasive therapy for aesthetic purposes. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency and HIFEM have been used as standalone modalities in body contouring. The novel device allows their synchronous emission simultaneously in a single applicator. Objectives: This prelusive trial aims to investigate the safety and efficacy of such treatment when used on multiple body parts on the same day for a full‐body remodeling. Methods: Three female subjects (21.0 ± 2.0 years) underwent 4 treatment sessions. The treatment was applied to the abdomen, saddlebags, inner thighs, and buttocks, during each visit, lasting 30 min for each site. The outcomes were assessed through examination of MRI images acquired at baseline and 3 months post‐treatment. Fat and muscle thickness were measured at predefined locations. Weight and waist, hip, and thigh circumference records along with digital photographs were also taken. Results: Fat thickness measurement showed a reduction of 17.57 ± 3.22 mm in the saddlebag region, 12.43 ± 1.93 mm in inner thighs, and 10.65 ± 1.26 mm in the abdomen. The fat in the buttock region showed negligible changes. The muscle thickness increased on average by 2.98 ± 0.60 mm for rectus abdominis and 7.42 ± 1.56 mm for gluteus maximus. The circumferential reduction was also observed on the waist (7.83 ± 2.25 cm), at the level of outer thighs (2.83 ± 1.53 cm), and inner thighs (3.58 ± 1.84 cm). Digital photographs showed noticeable improvement in the overall body appearance. The treatments were safe, and no side effects were noted. Conclusion: The preliminary outcomes indicate that the procedure delivering HIFEM and RF simultaneously on multiple body areas on the same day could be an effective and comfortable treatment for fat reduction on multiple body parts, thickening of underlying muscles, and overall improved aesthetic appearance. [ABSTRACT FROM AUTHOR]

Background: An increasing demand of minimally‐invasive aesthetic procedures of the forehead concomitantly leads to higher numbers of adverse events. Adequate application of anatomical knowledge is required to increase safety and efficacy of different minimally‐invasive aesthetic procedures in this anatomical region. Objective: To describe the layered anatomy of the forehead soft tissues with respect to their thicknesses and how they relate to different minimally‐invasive aesthetic treatments. Methods: A total of n = 85 healthy study participants (69 females and 16 males) with a mean age of 40.84 ± 10.9 years and a mean body mass index of 22.65 ± 2.6 kg/m2 were investigated with ultrasound‐based imaging to measure the thickness of different forehead soft tissues. Results: The mean overall soft tissue thickness of the forehead was measured to be 4.18 ± 0.7 mm for the entire study population. Increasing BMI values correlated statistically significantly with increasing thickness of all measured forehead soft tissues with exception of the frontalis muscle. On a statistically significant level, males showed thicker forehead soft tissues than females, with exception of the retrofrontalis fat and the frontalis muscle. Conclusion: On basis of the findings obtained in this study, basic treatment principles can be derived and improved for the injection of neuromodulators, hyaluronic acid as well as the application of polydiaxonane (PDO) threads and micro‐focused ultrasound. Precise knowledge and thorough understanding of the layers and soft tissues of the forehead is required to guarantee safe and effective procedures in this aesthetically important facial region. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the rate of increase in thickness and cross‐section area (CSA) of the ossification in thoracic myelopathy with or without cervical and lumbar spinal ligament ossification. Methods: A total of 24 patients with 170 segments (47 ligamentum flavum [OLF] and 123 cases of ossification of the posterior longitudinal ligament [OPLL]) of spinal ligament ossification between January 2012 and March 2019 at a single institution were retrospectively reviewed. Demographic data, classification of OPLL, Sato classification of OLF, pre‐ and postoperative neurological function and complications were recorded. The thickness and CSA at the segment of maximum compression were measured with Image J software on the axial CT image. Results: Twelve female and 12 male patients with thoracic myelopathy and spinal ligament ossification were enrolled in the study. The mean age of the patients was 54.0 ± 11.9 years with an average follow‐up of 22.2 ± 23.5 months. Overall, the mean rate of progression in thickness and CSA was 1.2 ± 1.6 and 18.4 ± 50.6 mm2/year, respectively. Being female, aging (≥45 years), and lower BMI (<28 kg/m2) predisposed patients to have faster ossification growth in thickness and CSA. The difference between the rate of OPLL and OLF progression in thickness and CSA was not significant. However, the rate of OPLL progression in the thoracic spine was significantly higher than that in the cervical spine regarding thickness (1.4 ± 1.9 vs. 0.6 ± 0.7 mm/year) and CSA (27.7 ± 72.0 vs. 7.3 ± 10.3 mm2/year). Conclusion: This is the first study to investigate ligament ossification progression in patients with thoracic myelopathy. The difference between the rate of OPLL and OLF progression in thickness and CSA was not significant. However, the rate of thoracic OPLL progression in thickness and CSA was significantly higher than that in the cervical spine. [ABSTRACT FROM AUTHOR]

Objectives: This study of Samburu pastoralists (Kenya) employs a same‐sex sibling design to test the hypothesis that exposure in utero to severe drought and maternal psychosocial stress negatively influence children's growth and adiposity. As a comparison, we also hypothesized that regional climate contrasts would influence children's growth and adiposity based on ecogeographical patterning. Materials and Methods: Anthropometric measurements were taken on Samburu children ages 1.8–9.6 years exposed to severe drought in utero and younger same‐sex siblings (drought‐exposed, n = 104; unexposed, n = 109) in two regions (highland, n = 128; lowland, n = 85). Mothers were interviewed to assess lifetime and pregnancy‐timed stress. Results: Drought exposure associated to lower weight‐for‐age and higher adiposity. Drought did not associate to tibial growth on its own but the interaction between drought and region negatively associated to tibial growth in girls. In addition, drought exposure and historically low rainfall associated to tibial growth in sensitivity models. A hotter climate positively associated to adiposity and tibial growth. Culturally specific stressors (being forced to work too hard, being denied food by male kin) associated to stature and tibial growth for age. Significant covariates for child outcomes included lifetime reported trauma, wife status, and livestock. Discussion: Children exposed in utero to severe drought, a hotter climate, and psychosocial stress exhibited growth differences in our study. Our results demonstrate that climate change may deepen adverse health outcomes in populations already psychosocially and nutritionally stressed. Our results also highlight the value of ethnography to identifying meaningful stressors. [ABSTRACT FROM AUTHOR]

Background: Limb circumference predicts the pressure needed for complete occlusion. However, that relationship is inconsistent at moderate pressures typical of effective blood flow restriction (BFR) training. The purpose of this study was to investigate the influence of subject factors on BFR at low restriction pressures in the arm. Methods: Fifty subjects had arm anthropometrics assessed by peripheral quantitative computed tomography (pQCT), sum of skinfold thickness (sumSKF) and Gulick tape (Gulick tape circumference [Gulick Circ.]) at cuff level. Blood flow (BF) was measured with ultrasound at baseline and five restrictive pressures (20, 30, 40, 50 and 60 mmHg). Relationships between subject characteristics and BFR were assessed using Pearson's correlations and hierarchical regression. Results: BF decreased (p < 0.05) at each incremental pressure. Regression models including percent muscle composition (%Muscle), pQCT circumference and systolic blood pressure (SBP), were significant at all five pressures (R2 = 0.18–0.49). %Muscle explained the most variance at each pressure. Regression models including sumSKF, Gulick Circ. and SBP, were significant at 30–60 mmHg (R2 = 0.28–0.49). SumSKF explained the most variance at each pressure. Conclusions: At low pressures (20–60 mmHg), there is considerable variability in the magnitude of BFR across individuals. Arm composition factors (muscle and fat) explained the greatest variance at each cuff pressure and may be the most important consideration when using BFR protocols. [ABSTRACT FROM AUTHOR]

Objectives: Human body height differs within a wide range and has conventionally been associated with genetic, nutritional, and environmental conditions. In this study, we try to broaden this perspective and add the evolutionary aspect of height differences. Sample and Method: We revisited height from archeological data (10 000–1000 BC), and historical growth studies (1877–1913). We analyzed height, weight, and skinfold thickness of 1666 Indonesian schoolchildren from six representative rural and urban elementary schools in Bali and West Timor with a stunting prevalence of up to 50%. Results: Stature in the Holocene prehistory of the Near East and Europe varied with maxima for women usually ranging below 160 cm, and maxima for men between 165 and 170 cm. Stature never rose above 170 cm. European and white US‐American schoolchildren of the 19th and 20th century were generally short with average height ranging between −1.5 and −2.2 hSDS, yet in the absence of any evidence of chronic or recurrent undernutrition or frequent illness, poverty, or disadvantageous living conditions. The same is found in contemporary Indonesian schoolchildren. Conclusion: Stunting is frequently observed not only in the poor, but also in affluent and well‐nourished social strata last 10 000 years. Only in very recent history, and only in a few democratic, modern societies, stature has increased beyond the long‐lasting historic height average. Viewed from an evolutionary perspective, and considering adaptive plasticity of and community effects on growth, competitive growth and strategic growth adjustments, stunting appears to be the natural condition of human height. [ABSTRACT FROM AUTHOR]

Background: High‐intensity focused ultrasound (HIFU) has been recently introduced as a non‐invasive therapeutic modality for controlling excessive subcutaneous fat. Objective: The efficacy and safety of the HIFU device for sculpting the abdomen, upper arm, and thigh were evaluated. Materials and Methods: Ten subjects with more than 10 mm of subcutaneous fat in the abdomen, upper arm, and/or thigh were recruited. We evaluate mean change in the thickness and circumference of subcutaneous fat of each treated area measured using ultrasound 12 weeks after the procedure, the degree of pain, and subject and practitioner satisfaction 12 weeks after the procedure. Results: The mean change of subcutaneous fat thickness in the abdomen, upper arm, and thigh measured using ultrasound 12 weeks after the procedure was −4.33 ± 2.42, −1.86 ± 1.35, and −1.86 ± 1.35 mm, respectively. Compared with pretreatment, subcutaneous fat thickness of the abdomen and upper arm was significantly reduced (p = 0.0020 and p = 0.0004, respectively), but not in the thigh (p = 0.0716). Highest patient satisfaction was for the abdomen. Pain was generally tolerable. Conclusion: The results from the present study indicate HIFU can be an effective and safe therapeutic modality for removing excessive subcutaneous fat in humans. [ABSTRACT FROM AUTHOR]

Summary: Background and Objectives: Early life is a critical window for adiposity programming. Metabolic‐profile in early life may reflect this programming and correlate with later life adiposity. We investigated if metabolic‐profile at 3 months of age is predictive for body composition at 2 years and if there are differences between boys and girls and between infant feeding types. Methods: In 318 healthy term‐born infants, we determined body composition with skinfold measurements and abdominal ultrasound at 3 months and 2 years of age. High‐throughput‐metabolic‐profiling was performed on 3‐month‐blood‐samples. Using random‐forest‐machine‐learning‐models, we studied if the metabolic‐profile at 3 months can predict body composition outcomes at 2 years of age. Results: Plasma metabolite‐profile at 3 months was found to predict body composition at 2 years, based on truncal: peripheral‐fat‐skinfold‐ratio (T:P‐ratio), with a predictive value of 75.8%, sensitivity of 100% and specificity of 50%. Predictive value was higher in boys (Q2 = 0.322) than girls (Q2 = 0.117). Of the 15 metabolite variables most strongly associated with T:P‐ratio, 11 were also associated with visceral fat at 2 years of age. Conclusion: Several plasma metabolites (LysoPC(22:2), dimethylarginine and others) at 3 months associate with body composition outcome at 2 years. These results highlight the importance of the first months of life for adiposity programming. [ABSTRACT FROM AUTHOR]

Background: Thoracic gas volume either measured (mTGV) or predicted by the BodPod® (bpTGV) is used during air‐displacement plethysmography to obtain a better estimate of percent body fat. Evidence suggests that bpTGV underestimates mTGV for young adults and this is especially evident for young males. Aims: We developed, validated, and cross‐validated a TGV prediction model (pTGV) for males and females 18–30 years of age to address this underestimation. Materials & Methods: Participants (N = 181; 18–30 years) that had their body composition assessed with the BodPod® were retrospectively randomly assigned to one of two independent subgroups, a validation (n = 145) or cross‐validation (n = 36) sample. Ten iterations of the k‐fold validation procedure were performed to assess the internal replicability of pTGV within the validation sample. External replicability of pTGV was evaluated by assessing the difference and standard error of the estimate (SEE) compared to mTGV in the cross‐validation group. Results: The model using height, sex and body mass yielded the highest adjusted R2 (0.627) and the lowest SEE (0.56 L): pTGV = 0.615338 × Sex (0 = Female, 1 = Male) + 0.056267 × Height (cm) – 0.011006 × Body Mass (kg) – 5.358839. R2 remained stable across 10 iterations of the k‐fold procedure (average R2 = 0.64). Differences between pTGV and mTGV were not significantly different than zero for the total cross‐validation sample (−0.06 ± 0.7 L; SEE = 3.0%), for males (−0.11 ± 0.7 L; SEE = 3.7%), or for females (−0.02 ± 0.7 L; SEE = 5.3%). Conclusion: We recommend that when it is impractical to obtain mTGV, the strong internal and external replicability of the new prediction model supports its use for males and females ages 18–30 years old during air‐displacement plethysmography. [ABSTRACT FROM AUTHOR]

Objectives: Studies have shown that children develop a higher body weight during summer months. This has been demonstrated repeatedly using the body mass index (BMI), but the effect of season on other weight-related anthropometric measurements is still unclear., Methods: Measurements of height, weight, waist circumference (WC), triceps, and subscapular skinfolds (TSF and SSF), collected from September till May in a cross-sectional sample of 4-16-year-old children and adolescents (n = 4525) from the Bergen Growth Study 1 (BGS1). Differences in z-score by season were tested with linear models adjusted for age group and separately for sex. Overall differences were tested with a one-way between-group analysis of variance., Results: The girls had higher BMIz (+0.12, p = .03) and WCz (+0.18, p = .002) in fall compared with spring. TSFz (-0.19, p < .001) and SSFz (-0.18, p < .001) were lower in winter in girls, and in boys both in fall (TSFz -0.10, p = .046; SSFz - 0.16, p < .001), and winter (TSFz -0.15, p = .004; SSFz -0.14, p = .003), when compared with spring., Conclusions: Seasonal variation was detected for all anthropometric measures, but differences in the direction of the effect between measures of global (BMI), central (WC) or subcutaneous (SF) adiposity suggest a more complex mechanism that needs further exploration., (© 2024 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.)

Background: Pediatric liver transplantation generally restores metabolic function; yet after transplantation, some children remain malnourished, have increased adiposity, and develop obesity. Measurement of body composition in the assessment of nutrition status could reduce adverse consequences in children. Methods: Anthropometric measurements, multiple‐frequency bioelectrical impedance analysis, air displacement plethysmography, and ultrasound measurements were conducted on children recruited from the liver transplant program at the University of Minnesota Masonic Children's Hospital. A cross‐sectional study was conducted to describe the quality of weight gain in post–liver transplant children between the ages of 2 and 17 years using multiple assessment tools (air displacement plethysmography, multiple‐frequency bioelectrical impedance analysis, and ultrasound) and to determine whether multiple‐frequency bioelectrical impedance analysis and ultrasound accurately describe body composition and quality of weight gain. Results: Mean percent body fat by air displacement plethysmography and multiple‐frequency bioelectrical impedance analysis was 18.4% (±3.3) and 19.0% (±3.9), respectively (P >.99). There were insufficient data to examine the relationship between summed muscle and adipose thickness measures by ultrasound and percent body fat determined by air displacement plethysmography or multiple‐frequency bioelectrical impedance analysis. Conclusion: Percent body fat, fat mass, and fat‐free mass measures determined by air displacement plethysmography and multiple‐frequency bioelectrical impedance analysis were not statistically different, which suggests the stand‐on device used in this study could be a useful body composition assessment tool for the pediatric population. [ABSTRACT FROM AUTHOR]

Objective: Body mass index (BMI) is used to identify trajectories of adiposity in youth, but it does not distinguish fat‐ from fat‐free‐mass. There are other inexpensive measures of adiposity which might better capture fat‐mass in youth The objective of this study is to examine differences between sex‐specific trajectories of BMI and other adiposity indicators (subscapular and triceps skinfold thickness, waist circumference, waist‐to‐height ratio) which may better capture fat‐mass in youth. Methods: Data come from four cycles of a longitudinal cohort of 1293 students in Montréal, Canada at ages 12, 15, 17 and 24. Group‐based trajectory models identified sex‐specific adiposity trajectories among participants with data in ≥3 cycles (n = 417 males; n = 445 females). Results: There were six trajectory groups in males and females for all five indicators, except for waist circumference (seven) in both sexes and triceps skinfold thickness (four) and waist‐to‐height ratio (five) in females. Most trajectories indicated linear increases; only the skinfold thickness indicators identified a decreasing trajectory. While all indicators identified a trajectory with high levels of adiposity, they differed in the number and relative size of trajectories pertaining to individuals in lower half of the adiposity distribution. Conclusion: BMI is a satisfactory indicator of adiposity in youth if the aim of the trajectory analysis is to identify youth with excess adiposity, a known risk factor for cardiometabolic outcomes in adulthood. [ABSTRACT FROM AUTHOR]

The present study examined cross‐sectional and longitudinal relationships between total and segmental subcutaneous tissue thicknesses from ultrasonography (US) and total and segmental fat mass (FM) estimates from dual‐energy X‐ray absorptiometry (DXA). Traditional US FM estimates were also examined. Twenty resistance‐trained males (mean ± SD; age: 22.0 ± 2.6 years; body mass: 74.8 ± 11.5 kg; DXA fat: 17.5 ± 4.5%) completed a 6‐week supervised resistance training programme while consuming a hypercaloric diet. Pre‐ and post‐intervention body composition was assessed by DXA and B‐mode US. Data were analysed using Pearson's correlation (r), Lin's correlation coefficient (CCC), paired t‐tests, Wilcoxon signed‐rank tests and Bland–Altman analysis, as appropriate. Cross‐sectionally, correlations were observed between total DXA FM and total subcutaneous tissue thickness (r = 0.88). Longitudinally, a correlation was observed between total DXA FM changes and total subcutaneous tissue changes (r = 0.49, CCC = 0.38). Correlations of similar magnitudes were observed for the upper body and trunk estimates, but DXA FM changes were unrelated to subcutaneous tissue changes for the lower body and arms. Cross‐sectionally, US 2‐compartment FM and DXA FM were correlated (r = 0.91, CCC = 0.83). Longitudinally, a weaker correlation was observed (r = 0.47, CCC = 0.33). In summary, longitudinal associations between US and DXA are weaker than cross‐sectional relationships; additionally, correlations between US subcutaneous tissue and whole‐body DXA FM appear to be driven by the trunk region rather than appendages. Reporting raw skinfold thicknesses rather than FM estimates alone may improve the utility of techniques based on subcutaneous tissue thickness, such as US and skinfolds. [ABSTRACT FROM AUTHOR]

Background: Assessing body weight in older adults may be challenging. Hence, the present study aimed to develop and cross‐validate updated and reproducible equations to estimate body weight in a large sample of older adults, namely among the older‐old. Methods: In total, 1456 individuals aged ≥ 65 years, from the Nutrition UP 65 study, were included in the present analysis. The participants were randomly assigned to one of two sub‐samples: development (n = 991) and validation samples (n = 465). Prediction equations using height, mid‐upper arm circumference (MUAC), waist circumference (WC), calf circumference (CC) and triceps skinfold thickness (TST) were generated for the development sample using multiple regression analysis and then validated using the validation sample. Results: The model with five predictor variables generated the following equations: females 65–79 years: −114.682 + 0.522 × height (cm) + 0.620 × MUAC (cm) + 0.517 × WC (cm) + 0.893 × CC (cm) + 0.111 × TST (mm) (adjusted r2 = 0.883, standard error of the estimate (SEE) = 4.4); females ≥ 80 years: −110.806 + 0.494 × height (cm) + 0.637 × MUAC (cm) + 0.500 × WC (cm) + 0.986 × CC (cm) + 0.021 × TST (mm) (adjusted r2 = 0.890, SEE = 3.9); males 65–79 years: −114.875 + 0.558 × height (cm) + 0.073 × MUAC (cm) + 0.671 × WC (cm) + 0.717 × CC (cm) + 0.182 × TST(mm) (adjusted r2 = 0.820, SEE=5.0); and males ≥ 80 years: −128.789 + 0.546 × height (cm) + 0.202 × MUAC (cm) + 0.612 × WC (cm) + 1.236 × CC (cm) + 0.093 × TST (mm) (adjusted r2 = 0.906, SEE = 3.5). Conclusions: Body weight can be estimated with good accuracy in older adults using these sex‐ and age‐specific equations generated from regression models using three to five anthropometric predictor variables. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine (a) the relationship of body fat (BF) assessed by bioimpedance analysis (BIA) and skinfold thickness (SKF) and (b) the variation of BF by age depending on the assessment method. Participants were 32 women and 134 men recreational marathon runners, who were tested for BF using both assessment methods (BIA and SKF). Rc between BIA and SKF assessment methods was 0.803 (95% CI; 0.640, 0.897) in women and 0.568 (95% CI; 0.481, 0.644) in men. A large main effect of the assessment method on BF was observed (p < 0.001 , η 2 = 0.156) with SKF presenting higher BF than BIA by 2.9%. The difference between SKF and BIA was 3.9 ± 2.7 % (95% confidence intervals, CI; 3.4; 4.3, p < 0.001) in men, whereas no difference was found in women (− 0.9 ± 2.9 % ; 95% CI; -1.9; -0.2, p = 0.101). BF correlated with age with small magnitude (BIA, r = 0.18 , p = 0.036 ; SKF, r = 0.23 , p = 0.007) in men, i.e., the older the age, the higher the BF. A similar trend of moderate magnitude was observed in women for BIA (r = 0.45 , p = 0.011), but not for SKF (r = 0.33 , p = 0.067). In conclusion, practitioners involved in the training of recreational runners would be advised to consider that BIA elicits a lower BF value than the SKF method in men. [ABSTRACT FROM AUTHOR]

The present study was designed to compare the body composition and indicators of chronic inflammatory grade, such as leptin, adiponectin, and resistin concentrations in irregularly active and active SCI subjects. Thirty-two male subjects participated in this study. They were divided into three groups: able-bodied control irregularly active (control, n = 11), irregularly active with SCI (SCI-IA, n = 8), and physically active with SCI (SCI-PA, n = 13). The enzyme-linked immunosorbent assay (ELISA) assessed serum concentrations of leptin, adiponectin, and resistin. All volunteers performed the maximum oxygen uptake (VO2max) test, 24 h total energy expenditure (TEE), and body composition by skinfold thicknesses. Leptin concentrations were higher in the SCI-IA group when compared to the other groups, while no significant differences were found between the SCI-PA and control cohorts. In addition, no significant differences were found among groups for serum adiponectin and resistin concentrations either. The SCI-PA group showed significantly higher values for TEE and VO2max when compared to the other groups. Percentages of body fat and circumference were decreased in the control and SCI-PA groups when compared to the SCI-IA cohort. Associations between leptin and cardiorespiratory capacity and anthropometric markers were also observed. Our findings highlight that the lack of physical activity in the SCI subjects leads to poor general physical fitness and higher levels of body adiposity, which may induce hyperleptinemia, an essential marker for cardiometabolic disorders. [ABSTRACT FROM AUTHOR]

Cost‐effective and efficient body composition measurement devices that are reliable and valid are necessary for identifying health risk as well as for understanding the effectiveness of lifestyle interventions. The objective of this study was to evaluate the test–retest reliability and validity of three body composition measurement devices. Forty‐nine adults (mean age (SD) = 31.5 (10.7) y; BMI = 23.5 (3.0) kg/m2) completed a reference air displacement plethysmography (ADP) measure, and duplicate measures using skinfold callipers (Lange), ultrasound (BodyMetrix A‐mode) and a 3‐dimensional photonic scanner (3DPS; Fit3D ProScanner). Skinfold thickness was measured at seven sites using callipers and ultrasound; percent body fat (%BF) was then estimated using population‐specific algorithms. The 3DPS was used to measure body circumferences, and then %BF was estimated using its beta‐software. While skinfold callipers showed poor absolute reliability (mean differences (Δ) [95% CI] = 0.54% [0.22, 0.87], standard error of measurement (SEM) = 0.63%), ultrasound and the 3DPS showed excellent absolute (Δ = 0.17% [−0.25, 0.58], SEM = 0.78%; and Δ = −0.01% [−0.43, 0.40], SEM = 0.67%, respectively) and relative reliability (ICC2,1 = 0.988 [0.979, 0.993]; and ICC2,1 = 0.983 [0.968, 0.991], respectively). Compared to ADP (n = 43), skinfold callipers underestimated %BF (Δ = −4.53 [−7.72, −1.34]; p = 0.003), while ultrasound (Δ = −0.32 [−3.51, 2.87]; p = 0.99) and the 3DPS (Δ = 1.06 [−2.12. 4.26]; p = 0.77) were not significantly different. Bland–Altman plots showed a minimal bias of ultrasound [95% limit of agreement (LOA) = −7.87, 7.23] and the 3DPS [95% LOA = −6.66, 8.79]. In conclusion, estimating %BF from subcutaneous fat measurements using ultrasound and body circumferences using a 3DPS may be reliable and valid methods that require minimal technician expertise. [ABSTRACT FROM AUTHOR]

Objective: This study tested whether substrate concentrations or fatty acid storage proteins predict storage of endogenous lipids in visceral adipose tissue (VAT) and upper body subcutaneous adipose tissue (UBSQ) fat.Methods: The day prior to surgery, 25 patients undergoing bariatric procedures received an infusion of autologous [1-14 C]triolein-labeled very low-density lipoprotein (VLDL) particles, and during surgery, they received a continuous [U-13 C]palmitate infusion/bolus [9,10-3 H]palmitate tracer. VAT and UBSQ fat were collected to measure VLDL-triglyceride (TG) storage, direct free fatty acid (FFA) storage rates, CD36 content, lipoprotein lipase (LPL), acyl-CoA synthetase, diacylglycerol acetyl-transferase, and glycerol-3-phosphate acyltransferase activities.Results: Storage of VLDL-TG and FFA-palmitate in UBSQ and VAT was not different. Plasma palmitate concentrations correlated with palmitate storage rates in UBSQ and VAT (r = 0.46, P = 0.02 and r = 0.46, P = 0.02, respectively). In VAT, VLDL-TG storage was correlated with VLDL concentrations (r = 0.53, P < 0.009) and LPL (r = 0.42, P < 0.05). In UBSQ, VLDL-TG storage was correlated with LPL (r = 0.42, P < 0.05). CD36, acyl-CoA synthetase, glycerol-3-phosphate acyltransferase, and diacylglycerol acetyl-transferase were not correlated with VLDL-TG or palmitate storage.Conclusions: Adipose storage of VLDL-TG is predicted by VLDL-TG concentrations and LPL; FFA concentrations predict direct adipose tissue FFA storage rates. [ABSTRACT FROM AUTHOR]

Cryolipolysis is a nonsurgical body sculpting technique that uses controlled cooling for localized fat reduction. The aim of the present study was to assess whether an intensive regimen of CoolSculpting based on multiple cycles/sessions on the same body area(s) could yield greater (more clinically significant) improvements in body contour. This was a prospective analysis of consecutive, healthy, adult patients undergoing CoolSculpting in routine practice across a variety of treatment areas. Patients underwent ≤4 cycles of CoolSculpting per body area during an initial treatment session, and ≤4 further cycles 4 weeks later (if required). They were followed up for ≥12 weeks. Twenty‐eight patients were enrolled (n = 26 female; mean age: 51.6 ± 9.0 years; mean body weight: 69.4 ± 13.7 kg). They were treated across 58 body areas: 48 in a single session; 10 across two sessions. The mean number of cycles per area was 2.8 ± 1.5. Twenty‐seven patients (54 body areas) were considered as treatment "responders." In these individuals, mean skinfold thickness decreased from 35.4 ± 9.9 mm pretreatment to 22.2 ± 7.6 mm at 12 weeks (mean change: −40%; P <.001). Mean change in skinfold thickness was greater with ≥3 vs 1 to 2 cycles of CoolSculpting (P =.01). Patient satisfaction was high (n = 51/58; 88%). No adverse events were recorded. The study shows that multiple cycles/sessions of CoolSculpting can safely improve overall treatment benefit in body contouring, with greater decreases in skinfold thickness than have typically been previously observed. [ABSTRACT FROM AUTHOR]

Background: Pancreatic fistula after pancreaticoduodenectomy is one of the most severe complications with mortality rates as high as 45%, and the prediction of most severe form of fistula (grade C) is crucial for successful management of patients who are to undergo cephalic pancreatoduodenectomy. It has been found that the amount of abdominal fat may predict grade C postoperative pancreatic fistula. In this study, we analysed the value of retrorenal fat thickness in the prediction of grade C pancreatic fistula. Methods: A total of 140 patients who underwent pancreaticoduodenectomy were retrospectively analysed. Retrorenal fat thickness and intra‐abdominal fat, expressed as total fat area, visceral fat area and subcutaneous fat area, were determined from computed tomography slices using the known range of attenuation values (−190 to −30). Blood loss, operating time, pancreatic texture and main pancreatic duct diameter as well as body mass index were also analysed. Results: Retrorenal fat thickness (P = 0.0004), duct diameter (P = 0.0008), subcutaneous fat area (P = 0.023) and total fat area (P = 0.014) were found to be significant predictors of grade C pancreatic fistula. Conclusion: Although retrorenal fat tissue thickness may seem robust, it is a simple measure that can be used to predict the most severe grade of pancreatic fistula after pancreaticoduodenectomy. Prediction of the most severe form of postoperative pancreatic fistula is crucial for successful management of patients who are to undergo cephalic pancreatoduodenectomy. Measurement of retrorenal fat tissue thickness is a simple measure that may help to predict the most severe grade of pancreatic fistula after pancreaticoduodenectomy. [ABSTRACT FROM AUTHOR]

Objective: Relatively little is known about sources of variation in human breastmilk composition. Previous research posits that composition may be affected by the low oxygen environment found at high altitude (HA). Our objective is to compare the milk composition of a sample of HA Andeans to previously published data on HA Tibetans and low altitude (LA) Peruvians. Methods: Mid‐feed milk samples were collected from 22 women and tested for lipid, carbohydrate and protein content in addition to dietary surveys and anthropometric measures. We examined relationships between maternal and infant characteristics (maternal BMI, adiposity, age, skinfold thickness, infant age) and milk composition using multiple regression analyses. A Welch‐Satterthause t‐test was used to compare summary measures from Andean sample and Tibetan samples. Results: Milk fat, sugar, and true protein content were correlated with different maternal and infant characteristics, with only waist to hip ratio negatively affecting fat and positively affecting sugar content in full models. Nuñoan and LA Peruvian milk exhibited significantly lower lactose levels (6.01 ±.89 g/100 mL and 6.38 ± 0.03 g/100 mL) than Tibetans (7.25 ± 0.35 g/100 mL). Fat content among Nuñoans was similar to that of Tibetans (4.5 ± 0.78 g/100 mL and 4.6 ± 1.51 g/100 mL, respectively), and higher than those of LA Peruvians. Conclusions: Both HA populations demonstrate relatively high fat content and both Peruvian samples exhibited relatively higher protein and lower lactose than Tibetan samples, suggesting that both population‐based differences in feeding behavior and climatic differences may influence composition. [ABSTRACT FROM AUTHOR]

The aim was to examine the bidirectional association between cardiorespiratory fitness (CRF) and fatness in a 2‐year longitudinal study conducted in young people. A total of 1082 children (512 females) and 727 adolescents (342 females) with complete data at baseline and follow‐up were included. CRF was determined by the 20‐m shuttle run test. Height and weight were measured, and body mass index and fat mass index (kg/m2) were calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Bidirectionality was tested by including CRF and each fatness index as exposures and outcomes, alternatively, in different regression models. CRF was prospectively associated with fatness index levels (ß from −0.186 to −0.528; P <.001), remaining significant in children after adjusting for baseline fatness indices. Fatness indices were prospectively associated with CRF (ß from −0.207 to −0.479; P <.001), with no substantial changes observed in children and female adolescents when baseline CRF was considered. Changes in CRF were prospectively associated with several fatness indices, regardless of body fatness at baseline (ß from −0.062 to −0.220; P <.05). Body fatness changes were associated with future CRF levels, independently of baseline CRF, especially in children of both sexes and male adolescents (ß from −0.079 to −0.260; P <.05). Overall, a bidirectional association was observed between CRF and fatness in children and adolescents. The attainment of optimal CRF and fatness levels in early ages should be promoted since it could result in favorable future fatness and CRF levels, respectively, which are two key determinants of health status. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association of lipoprotein lipase (LPL) polymorphisms with cardiovascular disease (CVD) risk factors in European adolescents, along with the influence of physical activity on these associations. Methods: A total of 13 LPL polymorphisms were genotyped in 1.057 European adolescents (12‐18 years old) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross‐Sectional Study. Serum lipids, glucose, insulin, and leptin (LEP) levels were measured and a CVD risk score was computed. We also measured body weight and height, waist and hip circumferences, and triceps and subscapular skinfold thickness. Physical activity was objectively measured by accelerometry for 7 days. Results: The rs1534649, rs258, rs320, and rs328 polymorphisms were associated with several CVD risk factors (ie, body mass index, triglycerides [TG], LEP, and cholesterol/high‐density lipoprotein [HDL], low‐density lipoprotein [LDL]/HDL, TG/HDL ratios). TG and TG/HDL were associated with haplotype blocks 3 (rs282, rs285 polymorphisms) and 4 (rs3126, rs320, rs328, rs10099160 polymorphisms), being the latter also associated with the CVD risk score. Physical activity modulated the association of adiposity with rs1534649 and rs258 polymorphisms. Conclusions: Polymorphisms rs1534649, rs258, rs320 and rs328, and two haplotypes of LPL were significantly associated with CVD risk factors in European adolescents. Higher levels of moderate to vigorous physical activity may attenuate the effects of rs1534649 and rs258 polymorphisms on adiposity. [ABSTRACT FROM AUTHOR]

Attempts have been made to estimate body fat using anthropometry, and most of them are country-specific. This study was designed to develop and cross-validate anthropometric predictive equations to estimate the total body fat percentage (TBFP) of Sri Lankan adult women. A cross-sectional study was conducted in Galle, Sri Lanka, with two groups: Group A (group for equation development) and Group B (cross-validation group) (n = 175 each) of randomly selected healthy adult women aged 30–60 years. TBFP (%) was quantified with total body DXA (TBFPDXA). Height (m), weight (kg), and skinfold thickness (SFT, mm) at six sites and circumferences (cm) at five sites were measured. In the first step, four anthropometric equations were developed based on the data obtained from multiple regression analyses (TBFPDXA = dependent variable and anthropometric measurements and age = independent variables) with Group A. They were developed on the basis of circumferences (TBFP1), SFTs (TBFP2), circumferences and SFTs (TBFP3), and highly significant circumferences and SFTs (r ≥ 0.6) (TBFP4). In the second step, the newly developed equations were cross-validated using Group B. Three equations (TBFP1, TBFP2, and TBFP4) showed the agreement with cross-validation criteria. There were no differences between TBFPDXA and TBFP estimated by these equations (p > 0.05). They showed higher measurement concordance with TBFPDXA; correlation between measured TBFP with DXA and estimated with TBFP1, TBFP2, and TBFP4, respectively, was 0.80 (R2 = 0.65, SEE = 3.10), 0.83 (R2 = 0.69, SEE = 2.93), and 0.84 (R2 = 0.72, SEE = 2.78). Three anthropometric measurements based on predictive equations were developed and cross-validated to satisfactorily estimate the TBFP in adult women. [ABSTRACT FROM AUTHOR]

Objectives: The study goals were to (a) characterize the cultural model of fatherhood among the BaYaka, a community of egalitarian foragers in the Republic of the Congo; (b) test if BaYaka fathers' quality in relation to the cultural model predicts their children's energetic status; and (c) compare the variance in BaYaka children's energetic status to that of children of neighboring Bondongo fisher‐farmers, among whom there is less cooperative caregiving, less resource sharing, and greater social inequality. Methods: We used informal interviews to establish the cultural model of fatherhood, which we used to build a peer ranking task to quantify father quality. Children's energetic status was assessed by measuring height, weight, and triceps skinfold thickness. We then tested for associations between father quality scores derived from the ranking task and children's energetic status using ordinary least squares regression. Equality of variance tests were used to compare BaYaka and Bondongo children's energetic statuses. Results: The BaYaka described fathers as responsible for acquiring resources and maintaining marital harmony, welcoming others to the community and sharing well with them, and teaching their children about the forest. Agreement on men's quality in these domains was high, but father quality did not significantly predict children's energetic status. BaYaka children had lower variance in energetic status overall compared to Bondongo children. Conclusions: We suggest that the core BaYaka values and practices that maintain egalitarian social relations and distribution of resources help buffer children's health and well‐being from variation in their fathers' qualities in culturally valued domains. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to analyze the tracking of indicators of health‐related physical fitness between childhood and adulthood. Methods: The study presents a longitudinal design, with the first phase of data collection occurring annually between 2002 and 2006, and the second phase carried out in 2016. A total of 142 young adults, aged between 21 and 25 years, of both sexes participated in the study. Were evaluated body mass, stature, skinfold thickness, sit and reach test; abdominal resistance/strength test, and 20‐m shuttle run test. Results: The intraclass correlation coefficient (ICC) indicated that all health‐related physical fitness variables presented values considered moderate to high tracking (0.37‐0.67; P < 0.005) between the analyzed periods. It was verified that in all variables, tracking was higher in the female group, except for the result of the running test related to the cardiorespiratory fitness component which demonstrated greater tracking in the male group (ICC = 0.37 vs ICC = 0.50). The result of the running test for males was the only variable presenting a discrepancy in the values observed between baseline and follow‐up (P < 0.05; k = 0.110). Conclusions: It was concluded that the indicators of body fat, abdominal and running tests demonstrated moderate tracking, while the sit and reach test presented high tracking. [ABSTRACT FROM AUTHOR]

Summary: Objectives: To investigate the importance of time in pregnancy and neonatal sex on the association between maternal metabolic parameters and neonatal sum of skinfolds. Methods: This was a longitudinal, secondary analysis of the vitamin D and lifestyle intervention for gestational diabetes mellitus study, conducted in nine European countries during 2012 to 2015. Pregnant women with a pre‐pregnancy body mass index (BMI) of ≥29 kg/m2 were invited to participate. We measured 14 maternal metabolic parameters at three times during pregnancy: <20 weeks, 24 to 28 weeks, and 35 to 37 weeks of gestation. The sum of four skinfolds assessed within 2 days after birth was the measure of neonatal adiposity. Results: In total, 458 mother‐infant pairs (50.2% female infants) were included. Insulin resistance (fasting insulin and HOMA‐index of insulin resistance) in early pregnancy was an important predictor for boys' sum of skinfolds, in addition to fasting glucose and maternal adiposity (leptin, BMI and neck circumference) throughout pregnancy. In girls, maternal lipids (triglycerides and fatty acids) in the first half of pregnancy were important predictors of sum of skinfolds, as well as fasting glucose in the second half of pregnancy. Conclusions: Associations between maternal metabolic parameters and neonatal adiposity vary between different periods during pregnancy. This time‐dependency is different between sexes, suggesting different growth strategies. [ABSTRACT FROM AUTHOR]

Aim: To examine the effect of a family-oriented multidisciplinary intervention programme to curtail weight increase in young children with obesity.Methods: Children who weighed more than one kilogram above the 97th percentile for height at the preschool assessment in Oppland County, Norway, were identified. Parents residing in one part of the county were invited to participate in a group-based three-year intervention programme while the rest had no interventions. Body mass index (BMI) and family characteristics at entry and measurements at birth were explanatory variables, and change in BMI standard deviation score (SDS) the outcome measure. For the intervention group, outcome was also related to skinfold thicknesses, waist-to-height ratio and physical ability.Results: The programme was completed by 31 families in the intervention and 33 in the control group. At entry, the respective median (interquartile) age was 5.83 (0.36) and 5.74 (0.66) years, and the BMI SDS 2.35 (1.06) and 1.95 (0.49), P = .012. The median decrease in BMI SDS was 0.19 in both groups. The decline increased with increasing BMI SDS at entry, but irrespective of group. Social or behavioural factor or other anthropometric measures were not associated with outcome.Conclusion: The intervention programme had no effect on BMI SDS. [ABSTRACT FROM AUTHOR]

Introduction: The objective of the present study is to compare the sonographic measurement of subcutaneous adipose thickness and visceral adipose thickness during 1st trimester screening for aneuploidies between non-diabetic pregnant women and patients who develop 1st trimester or 2nd trimester gestational diabetes mellitus (GDM).Material and Methods: Adipose thickness was measured by transabdominal ultrasound imaging in pregnant women attending our clinic for screening for fetal aneuploidies between 11 and 13 weeks of gestation. During the 1st trimester all patients were evaluated for fasting glycemia in accordance with the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations. Patients with confirmed fasting glycemia (FPG) ≥92 mg/dL were diagnosed as 1st trimester GDM. Patients with FPG <92 mg/dL underwent a 75-g oral glucose tolerance test between 24 and 28 weeks.Results: The study population included 238 non-diabetic women, 29 women with 1st trimester GDM and 28 women with 2nd trimester GDM. Mean subcutaneous adipose thickness and visceral adipose thickness values in non-diabetic women were 9.8 mm (standard deviation [SD = 4.9) and 7.2 mm (SD = 3.5), respectively. Values in women with 1st trimester GDM were 12.8 mm (SD = 6.5) and 9.9 mm (SD = 4.4). In the 2nd trimester GDM group, the mean subcutaneous adipose thickness was 11.1 mm (SD = 4.6) and the mean visceral adipose thickness 10.5 mm (SD = 5.3). Multiple logistic regression analysis showed that visceral adipose thickness, but not subcutaneous adipose thickness, was significantly and independently associated with both 1st trimester GDM (OR 1.15, 95% CI 1.02-1.29) and 2nd trimester GDM (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.05-1.34).Conclusions: Sonographic thickness of maternal visceral adipose tissue was greater in women with GDM than in non-diabetic patients, independently of other known risk factors associated with GDM in the 1st and in the 2nd trimester of pregnancy. Thus, this measurement may be considered of clinical use in 1st trimester screening. [ABSTRACT FROM AUTHOR]

Objective: The adipokine omentin‐1 has been suggested to be inversely associated with obesity and insulin resistance in humans. We studied the relationships between omentin‐1, parameters of fat mass, insulin resistance, lipids and blood pressure in children with obesity in a longitudinal study. Methods: We analysed omentin‐1 concentrations in 23 normal‐weight children and in 82 children with obesity participating in a one‐year lifestyle intervention. In the children with obesity, omentin‐1, bioactive and conventional leptin, thyroid hormones (thyroid‐stimulating hormone, free thyroxine 4, free triiodothyronine), body mass index, waist circumference, body fat based on skin‐fold measurements and bioimpedance analyses, lipids, insulin resistance as homeostatic model assessment of insulin resistance (HOMA‐IR) and blood pressure were determined at baseline and 1 year later. Furthermore, we measured omentin‐1 concentrations 1 year after the end of the lifestyle intervention. Results: The omentin‐1 concentrations were significantly (P =.008) lower in children with obesity compared to normal‐weight children (296 ± 108 ng ml−1 vs. 232 ± 99 ng ml−1). Omentin‐1 concentrations increased significantly (P <.001) in children with obesity and substantial weight loss (35 ± 55 ng ml−1), while omentin‐1 concentrations did not change significantly (P =.750) in children with obesity without weight loss (−5 ± 108 ng ml−1) during the intervention. Substantial weight loss after the end of intervention led to a significant (P <.001) increase of omentin‐1 concentrations (+64 ± 14 ng ml−1). Omentin‐1 was significantly and negatively associated with HOMA‐IR both in cross‐sectional (r = −.27, P =.006) and longitudinal analyses (r = −.33, P =.001). Omentin‐1 concentrations were not related to pubertal stage, sex or thyroid hormones. Conclusions: Our data do support the hypothesis that omentin‐1 is reversibly decreased in obesity and is a link between obesity and insulin resistance. [ABSTRACT FROM AUTHOR]

Summary: Background: Few studies have investigated how lifestyle is associated with body composition in children born very low birth weight (VLBW, <1500 g), a population at increased risk of obesity and metabolic syndrome in later life. Objectives: Determine how time spent in physical activity, sedentary time, and sleep are associated with body composition in children born VLBW. Methods: In this prospective cohort study of 5.5‐year‐old children born VLBW, height, weight, body composition (skinfolds, air displacement plethysmography), and 7 days of movement data (logbooks and accelerometers) were collected. Results: Of 158 participants, 53% were male, and mean (SD) birth weight was 1013 (264) g. Only 52% achieved 60 minutes/day of moderate‐to‐vigorous physical activity, but 96% achieved sleep recommendations. Reallocating 30 minutes of sedentary time to light physical activity (LPA) was associated with 0.20 kg/m2 (95% CI, 0.02 to 0.37) greater fat‐free mass index. An equivalent inverse association was found when reallocating LPA to sedentary time. No associations were found for other movement behaviours. Conclusions: Promoting LPA and reducing sedentary time may be an important strategy in reducing the elevated risk of obesity and metabolic syndrome amongst those born VLBW by supporting lean mass accretion. Funded by CIHR (FHG 129919) and SickKids Restracomp. [ABSTRACT FROM AUTHOR]

Summary: Background: The relationships between eating habits, behaviours, and the development of obesity in preschool children is not well established. Objective: As children of mothers with obesity are themselves at risk of obesity, we examined these relationships in a cohort of 482 three‐year‐old children of mothers with obesity from the UK Pregnancy Better Eating and Activity Trial (UPBEAT). Method: Dietary patterns were derived using factor analysis of an 85‐item food frequency questionnaire (FFQ). Eating behaviours were assessed using the Children's Eating Behaviour Questionnaire (CEBQ). Measures of body composition included age‐specific BMI cut‐offs, WHO z scores, sum of skinfolds, waist and arm circumferences, and body fat percentage. Using adjusted regression analysis, we examined associations between dietary patterns, eating behaviours, and measures of body composition. Results: Three distinct dietary patterns were defined: "healthy/prudent," "African/Caribbean," and "processed/snacking." The "processed/snacking" pattern was associated with greater odds of obesity; OR 1.53 (95% CI, 1.07‐2.19). The "African/Caribbean" and the "healthy/prudent" patterns were associated with a lower arm circumference (β = −0.23 cm [−0.45 to −0.01]) and sum of skinfolds (β = −1.36 cm [−2.88 to −0.37]), respectively. Lower enjoyment of food and food responsiveness, and greater slowness in eating and satiety, were associated with lower arm and waist circumferences, WHO z scores, and obesity (all P <.05). Conclusion: In children of mothers with obesity, those who had higher scores on a "processed/snacking" dietary pattern had greater odds of obesity. In contrast, slowness in eating was associated with lower measures of body composition. These novel findings highlight modifiable behaviours in high‐risk preschool children which could contribute to public health strategies for prevention of childhood obesity. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Commonly used statistical models to predict body fat percentage currently rely on skinfold measures, anthropometric measures, or some combination of the two but do not account for the wide ranges of age and body mass index (BMI) present in the American adult population. The objective of this study was to develop a statistical regression model to predict in vivo body fat percentage (dual energy X‐ray) in men and women across significant age and obesity ranges. Methods: This study included 228 adults between the ages of 21 and 70, with BMI between 18.5 and 40.0 kg m−2. The study population was split into training (n = 163) and validation (n = 65) groups, which were used to develop and validate the prediction models. The models were developed on the training group using a backwards stepwise regression analysis, with the initial predictors including age, BMI, and several anthropometric and skinfold measurements. Results: The final statistical regression models included age, BMI, anthropometric measures, and skinfold measures with significant effects following the stepwise process. The models predicted body fat percentage in the testing group with average errors of less than 0.10% body fat in males and females, while the four previously existing methods (Durnin, Hodgdon, Jackson, and Woolcott) significantly underestimated or overestimated body fat in both genders, with errors ranging between 2% and 10%. Conclusions: The final models included hand thickness, and the female model was dependent on waist circumference and two of the skinfold measures, while the male model used hip and thigh circumferences, along with three skinfold measures. By including the skinfold measurements separately, instead of only as sums like previous models have done, these models can account for the different relative contributions of each site to total body fat. [ABSTRACT FROM AUTHOR]