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2. Chorioamnionitis induces hepatic inflammation and time-dependent changes of the enterohepatic circulation in the ovine fetus

Author

Heymans, C., den Dulk, M., Lenaerts, K., Heij, L.R., de Lange, I.H., Hadfoune, M., van Heugten, C., Kramer, B.W., Jobe, A.H., Saito, M., Kemp, M.W., Wolfs, T.G.A.M., van Gemert, W.G., Heymans, C., den Dulk, M., Lenaerts, K., Heij, L.R., de Lange, I.H., Hadfoune, M., van Heugten, C., Kramer, B.W., Jobe, A.H., Saito, M., Kemp, M.W., Wolfs, T.G.A.M., and van Gemert, W.G.

Abstract

Chorioamnionitis, inflammation of fetal membranes, is an important cause of preterm birth and a risk factor for the development of adverse neonatal outcomes including sepsis and intestinal pathologies. Intestinal bile acids (BAs) accumulation and hepatic cytokine production are involved in adverse intestinal outcomes. These findings triggered us to study the liver and enterohepatic circulation (EHC) following intra-amniotic (IA) lipopolysaccharide (LPS) exposure. An ovine chorioamnionitis model was used in which circulatory cytokines and outcomes of the liver and EHC of preterm lambs were longitudinally assessed following IA administration of 10 mg LPS at 5, 12 or 24h or 2, 4, 8 or 15d before preterm birth. Hepatic inflammation was observed, characterized by increased hepatic cytokine mRNA levels (5h – 2d post IA LPS exposure) and increased erythropoietic clusters (at 8 and 15 days post IA LPS exposure). Besides, 12h after IA LPS exposure, plasma BA levels were increased, whereas gene expression levels of several hepatic BA transporters were decreased. Initial EHC alterations normalized over time. Concluding, IA LPS exposure induces significant time-dependent changes in the fetal liver and EHC. These chorioamnionitis induced changes have potential postnatal consequences and the duration of IA LPS exposure might be essential herein.

Published
2021

3. Chorioamnionitis induces enteric nervous system injury: Effects of timing and inflammation in the ovine fetus

Author

Heymans, C., de Lange, I.H., Lenaerts, K., Kessels, L.C.G.A., Hadfoune, M., Rademakers, G., Melotte, V., Boesmans, W., Kramer, B.W., Jobe, A.H., Saito, M., Kemp, M.W., van Gemert, W.G., Wolfs, T.G.A.M., Heymans, C., de Lange, I.H., Lenaerts, K., Kessels, L.C.G.A., Hadfoune, M., Rademakers, G., Melotte, V., Boesmans, W., Kramer, B.W., Jobe, A.H., Saito, M., Kemp, M.W., van Gemert, W.G., and Wolfs, T.G.A.M.

Abstract

Background Chorioamnionitis, inflammation of the chorion and amnion, which often results from intrauterine infection, is associated with premature birth and contributes to significant neonatal morbidity and mortality, including necrotizing enterocolitis (NEC). Recently, we have shown that chronic chorioamnionitis is associated with significant structural enteric nervous system (ENS) abnormalities that may predispose to later NEC development. Understanding time point specific effects of an intra-amniotic (IA) infection on the ENS is important for further understanding the pathophysiological processes and for finding a window for optimal therapeutic strategies for an individual patient. The aim of this study was therefore to gain insight in the longitudinal effects of intrauterine LPS exposure (ranging from 5 h to 15 days before premature delivery) on the intestinal mucosa, submucosa, and ENS in fetal lambs by use of a well-established translational ovine chorioamnionitis model. Methods We used an ovine chorioamnionitis model to assess outcomes of the fetal ileal mucosa, submucosa and ENS following IA exposure to one dose of 10 mg LPS for 5, 12 or 24 h or 2, 4, 8 or 15 days. Results Four days of IA LPS exposure causes a decreased PGP9.5- and S100β-positive surface area in the myenteric plexus along with submucosal and mucosal intestinal inflammation that coincided with systemic inflammation. These changes were preceded by a glial cell reaction with early systemic and local gut inflammation. ENS changes and inflammation recovered 15 days after the IA LPS exposure. Conclusions The pattern of mucosal and submucosal inflammation, and ENS alterations in the fetus changed over time following IA LPS exposure. Although ENS damage seemed to recover after prolonged IA LPS exposure, additional postnatal inflammatory exposure, which a premature is likely to encounter, may further harm the ENS and influence functional outcome. In this context, 4 to 8 days of IA LPS exposure may fo

Published
2020

4. Prophylactic Intra-Uterine β-Cyclodextrin Administration during Intra-Uterine Ureaplasma parvum Infection Partly Prevents Liver Inflammation without Interfering with the Enterohepatic Circulation of the Fetal Sheep

Author

Heymans, C., Heij, L.R., Lenaerts, K., den Dulk, M., Hadfoune, M., van Heugten, C., Spiller, O.B., Beeton, M.L., Stock, S.J., Jobe, A.H., Payne, M.S., Kemp, M.W., Kramer, B.W., Plat, J., van Gemert, W.G., Wolfs, T.G.A.M., Heymans, C., Heij, L.R., Lenaerts, K., den Dulk, M., Hadfoune, M., van Heugten, C., Spiller, O.B., Beeton, M.L., Stock, S.J., Jobe, A.H., Payne, M.S., Kemp, M.W., Kramer, B.W., Plat, J., van Gemert, W.G., and Wolfs, T.G.A.M.

Abstract

Chorioamnionitis can lead to inflammation and injury of the liver and gut, thereby predisposing patients to adverse outcomes such as necrotizing enterocolitis (NEC). In addition, intestinal bile acids (BAs) accumulation is causally linked to NEC development. Plant sterols are a promising intervention to prevent NEC development, considering their anti-inflammatory properties in the liver. Therefore, we investigated whether an intra-amniotic (IA) Ureaplasma parvum (UP) infection affected the liver and enterohepatic circulation (EHC) and evaluated whether an IA administered plant sterol mixture dissolved in β-cyclodextrin exerted prophylactic effects. An ovine chorioamnionitis model was used in which liver inflammation and the EHC were assessed following IA UP exposure in the presence or absence of IA prophylactic plant sterols (a mixture of β-sitosterol and campesterol dissolved in β-cyclodextrin (carrier)) or carrier alone. IA UP exposure caused an inflammatory reaction in the liver, histologically seen as clustered and conflated hepatic erythropoiesis in the parenchyma, which was partially prevented by IA administration of sterol + β-cyclodextrin, or β-cyclodextrin alone. In addition, IA administration of β-cyclodextrin prior to UP caused changes in the expression of several hepatic BAs transporters, without causing alterations in other aspects of the EHC. Thereby, the addition of plant sterols to the carrier β-cyclodextrin did not have additional effects.

Published
2020

5. Corrigendum: Chronic Intra-Uterine Ureaplasma parvum infection induces injury of the enteric Nervous System in Ovine Fetuses

Author

Heymans, C., de Lange, I. H., Hütten, M.C., Lenaerts, K., de Ruijter, N.J.E., Kessels, L.C.G.A., Rademakers, G., Melotte, V., Boesmans, W., Saito, M., Usuda, H., Stock, S.J., Spiller, O.B., Beeton, M.L., Payne, M.S., Kramer, B.W., Newnham, J.P., Jobe, A.H., Kemp, M.W., van Gemert, W.G., Wolfs, T.G.A.M., Heymans, C., de Lange, I. H., Hütten, M.C., Lenaerts, K., de Ruijter, N.J.E., Kessels, L.C.G.A., Rademakers, G., Melotte, V., Boesmans, W., Saito, M., Usuda, H., Stock, S.J., Spiller, O.B., Beeton, M.L., Payne, M.S., Kramer, B.W., Newnham, J.P., Jobe, A.H., Kemp, M.W., van Gemert, W.G., and Wolfs, T.G.A.M.

Abstract

Michael L. Beeton was not included as an author in the published article. The corrected Author Contributions Statement appears below.

Published
2020

6. Energy, substrate and protein metabolism in morbid obesity before, during and after massive weight loss

Author

van Gemert, W.G., van Gemert, W.G., Westerterp, K.R., van Acker, B.A.C., Wagenmakers, A.J.M., Halliday, D., Greve, J.W.M., Soeters, P.B., van Gemert, W.G., van Gemert, W.G., Westerterp, K.R., van Acker, B.A.C., Wagenmakers, A.J.M., Halliday, D., Greve, J.W.M., and Soeters, P.B.

Abstract

OBJECTIVE: To investigate the effect of surgically induced weight loss on energy, substrate and protein metabolism of morbidly obese patients. DESIGN: A prospective, clinical intervention study of morbidly obese patients before and after surgical treatment. SUBJECTS: Eight morbidly obese patients (BMI 47.88 +/- 7.03). METHODS: Total energy expenditure (TEE; doubly labeled water method), sleeping metabolic: rate (SMR; respiration chamber), body composition (deuterium oxide component of doubly labeled water), substrate metabolism (48 h dietary records, 48 h urine collection and gaseous exchange in the respiration chamber) and whole body protein turnover (primed-continuous infusion of L-[1-C-13]-leucine) were measured before, 3 and 12 months after vertical banded gastroplasty (VBG). RESULTS: The TEE decreased as a result of a decreased SMR (64%) and non-SMR (36%; P = 0.0011, SMR as a function of fat-free mass (FFM) decreased after weight loss (P <0.05). The physical activity index (PAI), defined as TEE/SMR, was low and was not influenced by weight loss. Protein and carbohydrate oxidation decreased significantly after VBG (P <0.05), although 3 months after VBG protein oxidation did not decrease enough to prevent loss of FFM. The energy used for protein turnover was approximately 24% of SMR and did not change after weight loss. CONCLUSIONS: Compensatory processes that oppose weight loss of morbidly obese patients exist, as demonstrated by the disproportional reduction of SMR, and a low PAI, Protein turnover is not a major contributor to the disproportional reduction of SMR.

Published
2000

7. Reduction of sleeping metabolic rate after vertical banded gastroplasty.

Author

van Gemert, W.G., van Gemert, W.G., Westerterp, K.R., Greve, J.W.M., Soeters, P.B., van Gemert, W.G., van Gemert, W.G., Westerterp, K.R., Greve, J.W.M., and Soeters, P.B.

Abstract

Department of Surgery, University Hospital Maastricht, The Netherlands. OBJECTIVE: To investigate whether long-term weight loss after vertical banded gastroplasty (VBG) results in a sustained reduction of sleeping metabolic rate (SMR) as a persistent risk factor for weight regain. DESIGN: Longitudinal clinical intervention study of morbidly obese patients undergoing VBG. PATIENTS: Group I: Six patients in which body composition and SMR were measured before and at 3, 6 and 12 months after VBG. Group II (long-term effect): nine patients in which body mass (BM) was measured before VBG, and body composition and SMR were measured 98+/-30 months after VBG. MEASUREMENTS: Body composition was assessed by deuterium dilution and hydrostatic weighing. SMR was measured (SMRm) in a respiration chamber and predicted (SMRp) based on body composition. RESULTS: In group I, fat mass and fat free mass decreased significantly after VBG (P < 0.05). SMRm decreased from 11.1+/-1.8 (s.d.) MJ/d before VBG to 8.1+/-0.9 MJ/d (P < 0.05) at 12 months after VBG. In group II at a mean of 98 months after VBG, the SMRm (6.9+/-0.7 MJ/d) was lower than the preoperative value of group I (P < 0.05). SMRm was lower than SMRp at all intervals after VBG (P < 0.05). The ratio measured vs predicted SMR was in group I: 1.02+/-0.05 before VBG, 0.91+/-0.08 at 12 months after VBG (P<0.05), and in group 11: 0.94+/-0.08 at a mean of 98 months after VBG (P < 0.05). CONCLUSION: The reduction of SMR adjusted for body composition after VBG is sustained as long as weight loss is maintained. The sustained and disproportional reduction of SMR may reflect the persistent susceptibility of the postobese to weight regain.

Published
1998

8. Transvaginal posterior colporrhaphy combined with laparoscopic ventral mesh rectopexy for isolated Grade III rectocele: a prospective study of 27 patients

Author

van der Hagen, S.J., van Gemert, W.G., Soeters, P.B., de Wet, H., Baeten, C.G.M.I., Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis

Subjects
colporrhaphy, transvaginal, MULTICENTER, OBSTRUCTED DEFECATION SYNDROME, CONSTIPATION, Rectopexie, rectocele, INCONTINENCE, SAFETY, SEXUAL FUNCTION, TRANSANAL REPAIR, EPIDEMIOLOGY, INTERNAL RECTAL PROLAPSE, COMPLEX RECTOCELE
Abstract

Aim: The aim of this study was to evaluate prospectively transvaginal posterior colporrhaphy (TPC), combined with laparoscopic ventral mesh rectopexy (LVR), in patients with a symptomatic isolated rectocele. Method: Patients with these complaints underwent dynamic and static MRI. All consecutive patients with a grade III (4 or more cm) rectocele and without internal/external rectal prolapse, enterocele and external sphincter damage were operated on. The patients completed the Obstructed Defecation (ODS) Score system and the Cleveland clinic incontinence (CCIS) score. All tests were repeated after treatment. Dynamic disorders of the pelvic floor detected by MRI were recorded. Results: In 27 patients (median age 67 (46-73) years, TPC combined with LVR was feasible. Complications were limited to port site infection in two patients. Sexual discomfort due to prolapse diminished in six (75%) patients and in one (4%) de novo dyspareunia developed after treatment. The median follow up was 12 (10-18) months. The median CCIS was 12 (10-16) before treatment and 8 (7-10) after (p

Published
2012

9. Sacral nerve modulation for defaecation and micturition disorders in patients with spina bifida

Author

Lansen-Koch, S.M., Govaert, B., Oerlemans, D., Melenhorst, J., Vles, J.S.H., Cornips, E., Weil, E.H.J., van Heurn, L.W.E., Baeten, C.G.M.I., van Gemert, W.G., RS: NUTRIM - R2 - Gut-liver homeostasis, RS: NUTRIM - R1 - Metabolic Syndrome, Klinische Neurowetenschappen, Neurochirurgie, RS: MHeNs School for Mental Health and Neuroscience, and Surgery

Abstract

Aim: Sacral nerve modulation is a well accepted method for the treatment of defaecation disorders and voiding dysfunction. Results of sacral nerve modulation in patients with spinal cord lesions are not well assessed, but preliminary results look poor. Therefore, the purpose of this study was to assess the effectiveness of sacral nerve modulation for defaecation disorders and voiding dysfunction in patients with spina bifida. Method: Consecutive patients with spina bifida suffering from a myelomeningocele and combined faecal and urinary functional disorders that were eligible for peripheral nerve evaluation were studied. A permanent sacral nerve modulation implantation was performed after successful peripheral nerve evaluation (PNE). Results: Ten patients (four females) were included in this study with a median age of 26.4 (range 11.1-41.0) years. In two the PNE was not possible. The median faecal incontinence days (6.0 vs. 3.5) and episodes (8.5 vs. 3.5) per 21 days decreased significantly during the 3 week period of PNE (p=0.033). Only 3/10 (30%) patients had a more than 50% improvement and proceeded to a permanent sacral nerve modulation implantation. In one patient it was not possible to perform the permanent implant. Conclusions: Preliminary results of sacral nerve modulation in a subgroup of spina bifida patients with combined faecal and urinary functional disorders look promising, but long-term results in larger patient groups need to be studied.

Published
2012

10. Sacral neuromodulation: long term outcome and quality of life in patients with faecal incontinence

Author

Uludag, Ö, Melenhorst, J., Koch, S.M., van Gemert, W.G., Dejong, C.H.C., Baeten, C.G.M.I., RS: NUTRIM - R2 - Gut-liver homeostasis, and Surgery

Subjects
Quality of life, REPAIR, sacral neurostimulation, faecal incontinence, MULTICENTER, NERVE-STIMULATION, THERAPY, sacral neuromodulation, PREVALENCE
Abstract

Aim Since 1994 sacral neuromodulation (SNM) has increasingly been used for the treatment of faecal incontinence, but no long-term data in a large group of patients have so far been published. We report long-term outcome and quality of life in the first 50 patients treated by permanent SNM for faecal incontinence. Method We began to use SNM in 2000. Data from the first 50 patients with faecal incontinence who underwent permanent SNM are presented. Efficacy was assessed using a bowel diary and the Quality of Life score was assessed by the Faecal Incontinence Quality of Life questionnaire (FIQOL) and the standard short form health survey questionnaire (SF-36). Results Over a median follow up of 7.1 (5.6-8.7) years, forty-two (84%) patients had an improvement in continence of over 50%. Median incontinent episodes and days of incontinence per week decreased significantly during follow up (P

Published
2011

11. Autologous platelet-derived growth factors (platelet-rich plasma) as an adjunct to mucosal advancement flap in high cryptoglandular perianal fistulae: a pilot study

Author

van der Hagen, S.J., Baeten, C.G.M.I., Soeters, P.B., van Gemert, W.G., Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis

Subjects
REPAIR, TRANSSPHINCTERIC FISTULAS, GEL, COMPLEX ANAL FISTULAS, SURGERY, REGENERATION, mucosal advancement flap, platelet-rich plasma, GRAFTS, SMOKING, Growth factors, BONE, FIBRIN GLUE
Abstract

AIM: The aim of this study was to explore autologous platelet-rich plasma as an adjunct to the staged mucosal advancement flap in the treatment of perianal fistulae. METHOD: Between February 2006 and May 2007, 10 patients with fistula tracts transversing from the middle-third or upper part of the anal sphincter were treated for at least 3 months with noncutting setons prior to definitive closure by autologous platelet-rich plasma as an adjunct to a mucosal advancement flap. Five patients smoked tobacco. RESULTS: The study group consisted of six women and four men with a median age of 44 (range 30-75) years and a median follow up of 26 (range 17-32) months. One (10%) patient had a recurrent fistula. No new continence disorders developed after definitive treatment in both groups. CONCLUSION: Platelet-rich plasma as an adjunct to a staged mucosal advancement flap for the treatment of perianal cryptoglandular fistulae is a promising treatment modality and seems to establish a high healing rate.

Published
2011

12. The role of reprogramming in sacral nerve modulation for faecal incontinence

Author

Govaert, B., Rietveld, M.P., van Gemert, W.G., Baeten, C.G., Algemene Heelkunde, Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis

Abstract

Purpose After implantation of the sacral nerve modulation (SNM) for faecal incontinence (FI), patients are subjected to a rigid follow-up schedule. In case of symptom recurrence, reprogramming of stimulation parameters may be necessary. The purpose of this study was to assess the need for reprogramming in patients with SNM for FI. Methods All patients from January 2000 till February 2008 with a permanent SNM for FI were analysed. Patients were subjected to a rigid follow-up schedule at 1 month, 3 months, 6 months, 12 months and yearly thereafter. SNM stimulator settings and changes at every.visit were collected and added to the database. Also, the number of patients that needed parameter setting reprogramming were analysed. Results 155 patients (11 males) were analysed. Mean age was 57.7 +/- 11.9 years. Median follow-up was 28.1 months (range 1.0-93.6). The mean voltage increased significantly from 1.8V at 1 month to 2.0V at 3 months. 39 patients (25.2%) required no reprogramming in any follow-up visits while 51 patients (32.9%) required reprogramming at 1 to 25% of their visits, 42 patients (27.1%) at 26 to 50% of the visits, 14 (9.0%) patients at 51 to 75% of the visits, and 9 (5.8%) patients at 76 to 100% of the visits. Conclusions Physicians and patients need to be aware of the fact that reprogramming of the SNM stimulator needs to be done at least once during follow-up in the majority of all patients. Trained physicians or specialist nurses are imperative for correct patient follow-up and SNM reprogramming.

Published
2011

13. Zelf retrograad spoelen: behandeling van fecale incontinentie na lage anterieure resectie

Author

Baeten, C.G., Govaert, B., van Gemert, W.G., Algemene Heelkunde, and RS: NUTRIM - R2 - Gut-liver homeostasis

Subjects
digestive system diseases
Abstract

Two patients, a woman aged 75 and a man aged 63 years, developed faecal incontinence after low anterior resection. Their external sphincter function was intact. They were advised to irrigate their bowel with normal tap water and reached complete pseudocontinence. Faecal incontinence is not always due to sphincter dysfunction. One of the other causes of incontinence is the lack of compliance of the rectum, as seen in patients with a low anterior resection. The part of the colon that has replaced the original rectum is not able to distend in the same manner as the rectum. Irrigation of the colon is a simple means of allowing the patient to achieve pseudocontinence. When the colon is cleaned it will take one or two days before new faeces arrive and a risk for incontinence occurs. It is important to irrigate with safe tap water at a temperature of around 37 degrees C. Most patients treated in this way feel safe to go out again. The irrigation can be performed in patients without the need for extensive diagnostics. This method of irrigation can be used in other forms of faecal incontinence as well.

Published
2009

18. Postoperative abscesses

Author

Soeters, P.B., van Gemert, W.G., Dejong, C.H.C., Greve, J.W.M., Gouma, GJ, Kreis, GJ, Tytgat, GN, Finkel, T, Algemene Heelkunde, and RS: NUTRIM School of Nutrition and Translational Research in Metabolism

Published
2004

28. Determination of therapeutic threshold in sacral nerve modulation for faecal incontinence.

Author

Koch, S.M.P., van Gemert, W.G., and Baeten, C.G.M.I.

Subjects
*NEURAL stimulation, *THRESHOLD (Perception), *SACRAL nerves, *THERAPEUTICS, *FECAL incontinence, *DEFECATION disorders
Abstract

Determines the therapeutic stimulation threshold in patients with successful sacral nerve modulation for fecal incontinence. Determination of sensitivity threshold and motor threshold and their correlation to therapeutic response; Production of a therapeutic below the sensitivity threshold with sacral nerve modulation.

Published
2005
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29. Physical activity and fat-free mass during growth and in later life

Author

Westerterp, Klaas R, Yamada, Yosuke, Sagayama, Hiroyuki, Ainslie, Philip N, Andersen, Lene F, Anderson, Liam J, Arab, Lenore, Baddou, Issaad, Bedu-addo, Kweku, Blaak, Ellen E, Blanc, Stephane, Bonomi, Alberto G, Bouten, Carlijn V C, Bovet, Pascal, Buchowski, Maciej S, Butte, Nancy F, Camps, Stefan G J A, Close, Graeme L, Cooper, Jamie A, Das, Sai K, Cooper, Richard, Dugas, Lara R, Ekelund, Ulf, Entringer, Sonja, Forrester, Terrence, Fudge, Barry W, Goris, Annelies H, Gurven, Michael, Hambly, Catherine, El hamdouchi, Asmaa, Hoos, Marije B, Hu, Sumei, Joonas, Noorjehan, Joosen, Annemiek M, Katzmarzyk, Peter, Kempen, Kitty P, Kimura, Misaka, Kraus, William E, Kushner, Robert F, Lambert, Estelle V, Leonard, William R, Lessan, Nader, Martin, Corby K, Medin, Anine C, Meijer, Erwin P, Morehen, James C, Morton, James P, Neuhouser, Marian L, Nicklas, Theresa A, Ojiambo, Robert M, Pietiläinen, Kirsi H, Pitsiladis, Yannis P, Plange-rhule, Jacob, Plasqui, Guy, Prentice, Ross L, Rabinovich, Roberto A, Racette, Susan B, Raichlen, David A, Ravussin, Eric, Reynolds, Rebecca M, Roberts, Susan B, Schuit, Albertine J, Sjödin, Anders M, Stice, Eric, Urlacher, Samuel S, Valenti, Giulio, Van etten, Ludo M, Van mil, Edgar A, Wells, Jonathan C K, Wilson, George, Wood, Brian M, Yanovski, Jack, Yoshida, Tsukasa, Zhang, Xueying, Murphy-alford, Alexia J, Loechl, Cornelia U, Luke, Amy H, Pontzer, Herman, Rood, Jennifer, Schoeller, Dale A, Wong, William W, Speakman, John R, Branth, Stefan, Colbert, Lisa H, De Bruin, Niels C, Dutman, Alice E, Elmståhl, Sölve, Fogelholm, Mikael, Harris, Tamara, Heijligenberg, Rik, Jorgensen, Hans U, Larsson, Christel L, Rothenberg, Elisabet M, Mccloskey, Margaret, Meijer, Gerwin A, Pannemans, Daphne L, Schulz, Sabine, Van Den Berg-emons, Rita, Van Gemert, Wim G, Wilhelmine, W, Verboeket-van De, Venne, Verbunt, Jeanine A, Philippaerts, Renaat M, Subar, Amy, Tanskanen, Minna, Uauy, Ricardo, Velthuis-te Wierik, Erica J, International Atomic Energy Agency Doubly Labeled Water database group, Branth, S., Colbert, L.H., De Bruin, N.C., Dutman, A.E., Elmståhl, S., Fogelholm, M., Harris, T., Heijligenberg, R., Jorgensen, H.U., Larsson, C.L., Rothenberg, E.M., McCloskey, M., Meijer, G.A., Pannemans, D.L., Schulz, S., Van den Berg-Emons, R., Van Gemert, W.G., Wilhelmine, W., Verboeket-van de, V., Verbunt, J.A., Philippaerts, R.M., Subar, A., Tanskanen, M., Uauy, R., Velthuis-Te Wierik, E.J., Clinicum, Department of Medicine, HUS Abdominal Center, Cell-Matrix Interact. Cardiov. Tissue Reg., ICMS Core, Executive Board, Humane Biologie, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Nutrition and Movement Sciences, RS: NUTRIM - R3 - Respiratory & Age-related Health, FSE Campus Venlo, and RS: FSE UCV

Subjects
Adipose Tissue/metabolism, Male, Aging, IMPACT, Medicine (miscellaneous), Medical and Health Sciences, LONGITUDINAL CHANGES, RC1200, 0302 clinical medicine, Engineering, energy expenditure, Faculty of Science, 80 and over, Medicine, WATER, 030212 general & internal medicine, Child, International Atomic Energy Agency Doubly Labeled Water database group, Aged, 80 and over, Nutrition and Dietetics, Middle Aged, 3142 Public health care science, environmental and occupational health, Editorial, Adipose Tissue, Child, Preschool, Female, physical activity level, Peak bone mass, Adult, Adolescent, Physical activity, BONE MASS, 030209 endocrinology & metabolism, Doubly labeled water, Fat mass, VDP::Medisinske Fag: 700::Helsefag: 800::Ernæring: 811, 03 medical and health sciences, Young Adult, Animal science, Total energy expenditure, Fat free mass, Clinical Research, BENEFITS, Humans, Resting energy expenditure, Preschool, Exercise, Nutrition, Aged, body composition, Nutrition & Dietetics, Body Composition, Cross-Sectional Studies, Energy Metabolism, age, doubly labeled water, business.industry, Prevention, Physical activity level, 3141 Health care science, LEAN BODY-MASS, YOUNG, WEIGHT, business, human activities
Abstract

Background Physical activity may be a way to increase and maintain fat-free mass (FFM) in later life, similar to the prevention of fractures by increasing peak bone mass. Objectives A study is presented of the association between FFM and physical activity in relation to age. Methods In a cross-sectional study, FFM was analyzed in relation to physical activity in a large participant group as compiled in the International Atomic Energy Agency Doubly Labeled Water database. The database included 2000 participants, age 3–96 y, with measurements of total energy expenditure (TEE) and resting energy expenditure (REE) to allow calculation of physical activity level (PAL = TEE/REE), and calculation of FFM from isotope dilution. Results PAL was a main determinant of body composition at all ages. Models with age, fat mass (FM), and PAL explained 76% and 85% of the variation in FFM in females and males

Published
2021

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