Are unilateral and bilateral patellar tendinopathy distinguished by differences in anthropometry, body composition, or muscle strength in elite female basketball players?

Background: Overuse injury to the patellar tendon (patellar tendinopathy) is a major reason for interrupted training and competition for elite athletes. In both sexes, the prevalence of unilateral and bilateral tendinopathy has been shown to differ. It has been proposed that bilateral pathology may have a different aetiology from unilateral pathology. Investigation of risk factors that may be unique to unilateral and bilateral patellar tendinopathy in female athletes may reveal insights into the aetiology of this condition.
Objectives: To examine whether anthropometry, body composition, or muscle strength distinguished elite female basketball players with unilateral or bilateral patellar tendinopathy.
Methods: Body composition, anthropometry, and muscle strength were compared in elite female basketball players with unilateral (n = 8), bilateral (n = 7), or no (n = 24) patellar tendinopathy. Body composition was analysed using a dual energy x ray absorptiometer. Anthropometric measures were assessed using standard techniques. Knee extensor strength was measured at 180°/s using an isokinetic dynamometer. z scores were calculated for the unilateral and bilateral groups (using the no tendinopathy group as controls). z scores were tested against zero.
Results: The tibia length to stature ratio was approximately 1.3 (1.3) SDs above zero in both the affected and non-affected legs in the unilateral group (p<0.05). The waist to hip ratio was 0.66 (0.78) SD above zero in the unilateral group (p<0.05). In the unilateral group, leg lean to total lean ratio was 0.42 (0.55) SD above zero (p<0.07), the trunk lean to total lean ratio was 0.63 (0.68) SD below zero (p<0.05), and leg fat relative to total fat was 0.47 (0.65) SD below zero (p<0.09). In the unilateral group, the leg with pathology was 0.78 (1.03) SD weaker during eccentric contractions (p<0.07).
Conclusions: Unilateral patellar tendinopathy has identifiable risk factors whereas bilateral patellar tendinopathy may not. This suggests that the aetiology of these conditions may be different. However, interpretation must respect the limitation of small subject numbers.

Changes in body composition as determinants of longitudinal changes in bone mineral measures in 8 to 26 year old female twins

Between 1990 and 1998, we conducted a longitudinal study of 286 female twins aged 8 to 25 years at baseline (60 monozygotic (MZ) pairs, 44 dizygotic (DZ) pairs and 78 unpaired twins), measured on average 2.4 times (range 2–6) with an average of 1.8 years between measurements (range 0.7–6.7 years). Areal bone mineral density (ABMD) at the lumbar spine, total hip and femoral neck, total body bone mineral content (BMC), total body soft tissue composition (lean mass and fat mass) were measured by dual-energy X-ray absorptiometry, and height and menarchial status were also recorded. Median annual changes in height were negligible at 4 years post-menarche. During the “linear growth” period up to 4 years post-menarche, ABMD at the lumbar spine, total hip and femoral neck increased with annual change in lean mass by 1.7 (S.E. 0.1), 1.4 (0.1) and 1.0 (0.1) percent per kilogram per year, respectively (all p<0.001), independently of changes in fat mass or height. During the “post-linear growth” period, ABMD at the total hip and femoral neck increased with annual change in fat mass by 0.3 (0.1) and 0.5 (0.1) percent per kilogram per year (all p<0.01), independent of change in lean mass. Annual changes in total body BMC were associated with annual changes in lean mass (1.9 (0.2) percent per kilogram), in fat mass (1.3 (0.2) percent per kilogram) and in height (0.7) (0.2) percent per centimeter) during linear growth, and in fat mass (1.0 (0.1)) and lean mass (0.6 (0.1)) percent per kilogram post-linear growth (all p<0.001). We conclude that changes in bone mineral measures are strongly associated with changes in lean mass during linear growth, while post-linear growth, changes in fat mass are the predominant, although weaker, predictor. These findings suggest that the strong cross-sectional association between bone mineral measures and lean mass is established during growth and development, and that fat mass emerges as a more powerful determinant of bone change in healthy adult females.

Effects of creatine loading and prolonged creatine supplementation of body composition, fuel selection, sprint and endurance performance in humans

Most research on creatine has focused on short-term creatine loading and its effect on high-intensity performance capacity. Some studies have investigated the effect of prolonged creatine use during strength training. However, studies on the effects of prolonged creatine supplementation are lacking. In the present study, we have assessed the effects of both creatine loading and prolonged supplementation on muscle creatine content, body composition, muscle and whole-body oxidative capacity, substrate utilization during submaximal exercise, and on repeated supramaximal sprint, as well as endurance-type time-trial performance on a cycle ergometer. Twenty subjects ingested creatine or a placebo during a 5-day loading period (20g·day^-1) after which supplementation was continued for up to 6 weeks (2g·day^-1). Creatine loading increased muscle free creatine, creatine phosphate (CrP) and total creatine content (P<0.05). The subsequent use of a 2g·day^-1 maintenance dose, as suggested by an American College of Sports Medicine Roundtable, resulted in a decline in both the elevated CrP and total creatine content and maintenance of the free creatine concentration. Both short- and long-term creatine supplementation improved performance during repeated supramaximal sprints on a cycle ergometer. However, whole-body and muscle oxidative capacity, substrate utilization and time-trial performance were not affected. The increase in body mass following creatine loading was maintained after 6 weeks of continued supplementation and accounted for by a corresponding increase in fat-free mass. This study provides definite evidence that prolonged creatine supplementation in humans does not increase muscle or whole-body oxidative capacity and, as such, does not influence substrate utilization or performance during endurance cycling exercise. In addition, our findings suggest that prolonged creatine ingestion induces an increase in fat-free mass.

Body size, body composition, and fat distribution: a comparison of young New Zealand men of European, Pacific Island, and Asian Indian ethnicities

Aims To investigate body size and body fat relationships and fat distribution in young healthy men drawn from New Zealand European, Pacific Island, and Asian Indian populations.
Method A total of 114 healthy men (64 European, 31 Pacific Island, 19 Asian Indian) aged 17–30 years underwent measurements of height, weight, and body composition by total body dual-energy X-ray absorptiometry (DXA). Body mass index (BMI) was then calculated. Percent body fat (%BF), fat-free mass, bone mineral content, bone mineral density, abdominal fat, thigh fat, and appendicular skeletal muscle mass (ASMM) were obtained from the DXA scans.
Results For the same BMI, %BF for Pacific Island men was 4% points lower and for Asian Indian men was 7–8% points higher compared to Europeans. Compared to European men for the same %BF, BMI was 2–3 units higher for Pacific Island, and 3–6 units lower for Asian Indian. The ratio of abdominal fat to thigh fat, adjusted for height, weight, and %BF, was significantly higher for Asian Indian men than European (p=0.022) and Pacific Island (p=0.002) men. ASMM, adjusted for height and weight, was highest in Pacific Island and lowest in Asian Indian men.
Conclusions The relationship between %BF and BMI is different for European, Pacific Island, and Asian Indian men which may, at least in part, be due to differences in muscularity. Asian Indians have more abdominal fat deposition than their European and Pacific Island counterparts. Use of universal BMI cut-off points are not appropriate for comparison of obesity prevalence between these ethnic groups.

Body composition changes, metabolic fuel use and energy expenditure during extended fasting in subantarctic fur seal (Arctocephalus tropicalis) pups at Amsterdam Island

The fasting metabolism of 71- to 235-d-old subantarctic fur seal (Arctocephalus tropicalis) pups from Amsterdam Island, southern Indian Ocean, was investigated during the long foraging trips of their mothers. Body lipid reserves were proportionally greater in female than male pups and higher in postmoult (37%) than premoult (10%) animals. The mass-specific rate of mass loss did not differ between the sexes but was lower than observed in other species. Daily mass loss was estimated to 56% fat, 10% protein, and 34% water. The rate of protein catabolism (15 g d⁻¹) was negatively related to the size of initial lipid stores and accounted for 9% (±1%) of total energy expenditure. However, body composition changes during the fast were not equal between the sexes, with females relying more on protein catabolism than males (11% and 5% of total energy expenditure, respectively). Energy expenditure (270 kJ kg⁻¹ d⁻¹) and metabolic water production (11.5 mL kg⁻¹ d⁻¹) rates are the lowest reported for an otariid species. These results suggest that subantarctic fur seal pups greatly reduce activity levels to lower energy expenditure in addition to adopting protein-sparing metabolic pathways in order to survive the extreme fasts they must endure on Amsterdam Island.

Milk consumption, body composition and pre-weaning growth rates of Australian fur seal

Pre-weaning growth rates, body composition, milk consumption and mass gain efficiency were measured in Australian fur seal Arctocephalus pusillus doriferus pups born in two consecutive breeding periods. Australian fur seals have the highest birth mass of any fur seal species (male 8.3 kg; female 7.2 kg). While their absolute pre-weaning growth rate (male 62 g·day⁻¹; female 53 g·day⁻¹) is similar to that of other temperate latitude fur seals, they have the longest birth-mass doubling time of any otariid species (134–136 days). Daily milk consumption increased from 400 g·day−1 (5 MJ·day−1) after birth to 675 g·day⁻¹ (13.7 MJ·day⁻¹) at age 210 day. However, mean mass-specific milk consumption (41 g·kg⁻¹) is substantially lower than in other otariid species (58–70 g·kg⁻¹) and, combined with a low mass gain efficiency (0.12 g·g⁻¹), contributes to the low mass-specific growth rates observed. There were no significant differences in either absolute or mass-specific milk consumption between the sexes. Significant differences, however, were found between the sexes in the body composition of pups with females generally having larger body lipid stores than males for any given mass. Peak milk yield by Australian fur seal females is estimated at 0.60 MJkg−0.75, substantially less than in Antarctic fur seals. The low level of maternal energy transfer in Australian fur seals may reflect the relatively low marine productivity of their foraging areas.

Green tea, black tea, and epigallocatechin modify body composition, improve glucose tolerance, and differentially alter metabolic gene expression in rats fed a high-fat diet

The mechanisms of how tea and epigallocatechin-3-gallate (EGCG) lower body fat are not completely understood. This study investigated long-term administration of green tea (GT), black tea (BT), or isolated EGCG (1 mg/kg per day) on body composition, glucose tolerance, and gene expression related to energy metabolism and lipid homeostasis; it was hypothesized that all treatments would improve the indicators of metabolic syndrome. Rats were fed a 15% fat diet for 6 months from 4 weeks of age and were supplied GT, BT, EGCG, or water. GT and BT reduced body fat, whereas GT and EGCG increased lean mass. At 16 weeks GT, BT, and EGCG improved glucose tolerance. In the liver, GT and BT increased the expression of genes involved in fatty acid synthesis (SREBP-1c, FAS, MCD, ACC) and oxidation (PPAR-α, CPT-1, ACO); however, EGCG had no effect. In perirenal fat, genes that mediate adipocyte differentiation were suppressed by GT (Pref-1, C/EBP-β, and PPAR-γ) and BT (C/EBP-β), while decreasing LPL, HSL, and UCP-2 expression; EGCG increased expression of UCP-2 and PPAR-γ genes. Liver triacylglycerol content was unchanged. The results suggest that GT and BT suppressed adipocyte differentiation and fatty acid uptake into adipose tissue, while increasing fat synthesis and oxidation by the liver, without inducing hepatic fat accumulation. In contrast, EGCG increased markers of thermogenesis and differentiation in adipose tissue, while having no effect on liver or muscle tissues at this dose. These results show novel and separate mechanisms by which tea and EGCG may improve glucose tolerance and support a role for these compounds in obesity prevention.

Determination of human body composition

This thesis deals with two electrical methods designed to enable rapid, safe and noninvasive measurement of body composition, both for clinical and community use. The first section provides a review of the literature related to measurement of body composition in humans and outlines the approach of the research project. The second section deals with established methods of determining body composition, the two most important being hydrostatic densitometry and deuterium oxide dilution. In this part of the report, a novel method for measuring lung volume by hydrogen dilution at the time of underwater weighing is described. The main findings of the thesis are contained in the third section which deals with the assessment of body opposition by electrical means. There are two components to this part of the study. The first involved the testing of a commercially available bioelectric impedance analyser (BIA) which measures impedance to a flow of current through the body. Studies on the reproducibility and reliability of measurements were performed. Results showed the importance of correct electrode placement and revealed that subjects can consume a light meal and a drink before being measured with the BIA without adversely affecting impedance readings. Results suggested, however, that subjects empty their bladders before measurements are made. Strong correlations were found between height 2/ resistance and measurements of total body water (r = 0.839) and fat-free weight derived from densitometry (r = 0.821), Moderate correlations (r = 0.6 to 0.7) were also found when height /resistance was related to fat-free weight derived from anthropometric measurements. The second and major consonant of the third section deals with the development of a method based on the absorption of energy from a weak electromagnetic field established in a capacitor or chamber large enough to accommodate an adult human subject. The method involves measurement of the effect of the body on the electromagnetic field, and is based on differential absorption of energy by body fat and fat-free tissues. Regression equations were developed for predicting the weight of fat and fat-free tissue in the body from measurement of electromagnetic field effects in a test capacitor and in a resonating chamber. The test capacitor comprised a large aluminum cylinder with a copper rod as a central conductor. The following equation was derived for the relationship of fat-free weight (FEW) based on body density, with measurements of change in resonant frequency (ΔfR), height (H) and weight (W) : FFW = -4.39 + 0.690 W + 19.9 H + 37.6 ΔfR In a study of 17 subjects, a value of 0.891 was found for R2, and S.E.E. was 1.63. The resonating chamber consisted of a large enclosed aluminium cylinder with a copper rod as a central conductor. The following equation was derived for the relationship of fat weight (FW) based on the mean of estimates from body density and total body water, with measurements of change in signal attenuation (ΔA), change in resonant frequency (ΔfR), and height (H) and weight (W) : FW = 73.48 + 0.291 (W/√(ΔA) - 49.2 H - 0.53 ΔfR In a study of 27 subjects, a value of 0.956 was found for R2, and S.E.E. was 1.97. In these equations, variables were measured in the following units : FEW, FW and W (kg), ΔfR (MHz) and H (m).

Body build : its influence on anthropometric measurements, fat distribution, body composition and carbohydrate metabolism

Examines the interrelationships between body build and body composition and carbohydrate and lipid metabolism in healthy young men and women. Results indicate that in women a low relative sitting height may be an early marker of susceptibility to abdominal obesity and its consequences, non insulin dependent diabetes and coronary heart disease.

Relationships between measures of fitness, physical activity, body composition and vascular function in children

Background : The prevalence of obesity and physical inactivity in Western countries has increased rapidly. Both are modifiable risk factors for cardiovascular disease. Atherosclerosis begins in childhood and endothelial dysfunction is its earliest detectable manifestation.

Methods : We assessed flow-mediated dilation (FMD) in 129 children (75 female; 10.3 + 0.3 yrs; 54 male; 10.4; 0.3 yrs). FMD was normalised for differences in the eliciting shear rate stimulus between subjects (SR_AUC). Fitness was assessed as peak oxygen uptake during an incremental treadmill exercise test (VO₂peak). Body composition was measured using a dual-energy X-ray absorptiometry (DEXA) scan. Physical activity (PA) was assessed using Actigraph accelerometers. The cohort was split into tertiles according to FMD% and also FMD% corrected for SR_AUC to gain insight into the determinants of vascular function.

Results : Across the cohort, significant correlations were observed between FMD%/SR_AUC and DEXA percentage fat (r = −0.23, p = 0.009) and percentage lean mass (r = 0.21, p = 0.008), and also with PA performed at moderate-to-high intensity (r = 0.363, p = 0.001). For children in the lowest FMD%/SR_AUC tertile, a stronger relationship with all PA measures was observed, particularly with high intensity PA (r = 0.572, P = 0.003). Regression analysis revealed that high intensity PA was the only predictor of impaired FMD%/SR_AUC.

Conclusions : These data suggest that traditional risk factors for CHD in adult populations impact upon vascular function in young people. Furthermore, it appears that individuals with impaired FMD may benefit from performing high intensity PA, whereas no relationships exist between FMD and lower intensities of PA or between PA and FMD in those subjects who possess preserved vascular function a priori.

Lifetime psychiatric disorders and body composition : a population-based study

Background This study aimed to investigate the relationship between depressive and anxiety disorders and indices of adiposity, including body fat mass and percent body fat, as measured by dual energy X-ray absorptiometry.

Methods In this observational study of 979 randomly-selected women aged 20–93 years, psychiatric history was ascertained using a structured clinical interview (SCID-I/NP). Total body fat was assessed using dual-energy X-ray absorptiometry and weight, height and waist circumference were measured. Medication use and lifestyle factors were self-reported.

Results Those with a lifetime history of depression had increased fat mass (+ 7.4%) and percent body fat (+ 4.3%), as well as greater mean weight (+ 3.3%), waist circumference (+ 2.9%) and BMI (+ 3.5%) after adjustment for age, anxiety, alcohol consumption, physical activity and past smoking. Furthermore, those meeting criteria for a lifetime history of depression had a 1.7-fold increased odds of being overweight or obese (BMI ≥ 25), a 2.0-fold increased odds of being obese (BMI ≥ 30) and a 1.8-fold increased odds of having a waist circumference ≥ 80 cm. These patterns persisted after further adjustment for psychotropic medication use, smoking status and energy intake. No differences in any measures of adiposity were observed among those with anxiety disorders compared to controls.

Limitations There is potential for unrecognised confounding, interpretations are limited to women and a temporal relationship could not be inferred.

Conclusions Depression was associated with greater adiposity. The difference in body fat mass was numerically greater than differences in indirect measures of adiposity, suggesting that the latter may underestimate the extent of adiposity in this population.

The influence of body build on estimates of body composition from anthropometric measurements in premenopausal women

Objective: To assess the influence of body build on the bias and limits of agreement for estimates of body fat obtained from anthropometric prediction equations when compared with the same data obtained by dual energy X-ray absorptiometry (DEXA).

Survey design and subjects: Ninety-one premenopausal women, aged between 20 and 54 years, were chosen to represent a range of skeletal body build (relative silting height 0.50-0.56) and body fatness [body mass index (BMI) 18-34 kg/m²]. Measurements of weight, sitting height, stature, skinfold thickness, waist, umbilical and hip circumference and total body resistance and reactance were made on all subjects by standard techniques after an overnight fast. A DEXA measurement of total body fat, fat-free soft tissue and total body bone mineral mass was also obtained within 2 weeks of the anthropometric assessment.

Results: At the group level the mean difference (bias) between DEXA and the anthropometric estimates of body fat was similar for all three anthropometric estimates ranging from 2.7 kg with impedance to 1.8 kg with skinfold thickness. The 95% limits of agreement were also similar, ranging from ±5.3 kg with body mass index to ±4.1 kg with impedance. Umbilical circumference, BMI and the amount of bone mineral expressed as a proportion of the fat-free soft-tissue mass were all significantly (P < 0.01) correlated with the level of bias between DEXA and the anthropometric estimates of body fat. This was not the case for relative sitting height or measures of body fat distribution. Regression equations which included BMI or umbilical circumference in combination with the predicted estimates of body fat essentially eliminated the association between the level of bias in predicted body fat and the level of body fatness. They also reduced the 95% limits of agreement between DEXA and the anthropometric estimates of body fat.

Conclusions: Using DEXA estimates of body fat as the standard of reference our results suggest that the comparability and precision of body fat estimates derived from age- and/or sex-specific anthropometric prediction equations based on skinfolds and BMI, but not impedance, can be improved by adjusting for differences in BMI and umbilical circumference respectively.