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      Adiposity and postural balance control: Correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women

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          Abstract

          OBJECTIVE:

          The purpose of this study was to investigate the correlation between body adiposity and postural control in elderly women.

          INTRODUCTION:

          Aging and obesity account for a significant portion of healthcare spending. Life expectancy is increasing worldwide, and Rio de Janeiro has the largest proportion of elderly residents of all Brazilian states.

          METHODS:

          A total of 45 women underwent bioelectrical impedance analysis, waist circumference measurements, weight and height measurements, and stabilometric tests in eight different stance conditions (opened and closed bases with both eyes opened and closed and right and left tandem and unilateral stances with eyes opened). During unilateral stances, the number of hand or foot contacts was counted.

          RESULTS:

          Weight, body mass index, waist circumference, fat percentage, and fat mass showed statistically significant ( p<0.05) and positive correlations with the number of contacts made during unilateral stances. The subjects with greater fat mass showed significantly higher anterior-posterior standard deviation and range when their eyes were closed. The sway area was also greater for this group in opened base when their eyes were closed.

          DISCUSSION:

          The results relating body adiposity and postural control can be explained by the difficulty of maintaining a greater quantity of body fat mass within the limits of the individual support base, especially while assuming a unilateral stance.

          CONCLUSION:

          The subjects with a greater fat mass exhibited poor balance control, indicating that body adiposity level was associated with postural control in the elderly women examined in the present study.

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          Most cited references108

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          Bioelectrical impedance analysis--part I: review of principles and methods.

          U KYLE (2004)
          The use of bioelectrical impedance analysis (BIA) is widespread both in healthy subjects and patients, but suffers from a lack of standardized method and quality control procedures. BIA allows the determination of the fat-free mass (FFM) and total body water (TBW) in subjects without significant fluid and electrolyte abnormalities, when using appropriate population, age or pathology-specific BIA equations and established procedures. Published BIA equations validated against a reference method in a sufficiently large number of subjects are presented and ranked according to the standard error of the estimate. The determination of changes in body cell mass (BCM), extra cellular (ECW) and intra cellular water (ICW) requires further research using a valid model that guarantees that ECW changes do not corrupt the ICW. The use of segmental-BIA, multifrequency BIA, or bioelectrical spectroscopy in altered hydration states also requires further research. ESPEN guidelines for the clinical use of BIA measurements are described in a paper to appear soon in Clinical Nutrition.
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            Health consequences of obesity in the elderly: a review of four unresolved questions.

            Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.
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              Body composition estimates from NHANES III bioelectrical impedance data.

              Body composition estimates for the US population are important in order to analyze trends in obesity, sarcopenia and other weight-related health conditions. National body composition estimates have not previously been available. To use transformed bioelectrical impedance analysis (BIA) data in sex-specific, multicomponent model-derived prediction formulae, to estimate total body water (TBW), fat-free mass (FFM), total body fat (TBF), and percentage body fat (%BF) using a nationally representative sample of the US population. Anthropometric and BIA data were from the third National Health and Nutrition Examination Survey (NHANES III; 1988-1994). Sex-specific BIA prediction equations developed for this study were applied to the NHANES data, and mean values for TBW, FFM, TBF and %BF were estimated for selected age, sex and racial-ethnic groups. Among the non-Hispanic white, non-Hispanic black, and Mexican-American participants aged 12-80 y examined in NHANES III, 15 912 had data available for weight, stature and BIA resistance measures. Males had higher mean TBW and FFM than did females, regardless of age or racial-ethnic status. Mean TBW and FFM increased from the adolescent years to mid-adulthood and declined in older adult age groups. Females had higher mean TBF and %BF estimates than males at each age group. Mean TBF also increased with older age groups to approximately 60 y of age after which it decreased. These mean body composition estimates for TBW, FFM, TBF and %BF based upon NHANES III BIA data provide a descriptive reference for non-Hispanic whites, non-Hispanic blacks and Mexican Americans in the US population.
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                Author and article information

                Journal
                Clinics (Sao Paulo)
                Clinics
                Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
                1807-5932
                1980-5322
                September 2011
                : 66
                : 9
                : 1513-1518
                Affiliations
                Augusto Motta University Center (UNISUAM) - Postgraduate Program of Rehabilitation Sciences, Rio de Janeiro, Brazil.
                Author notes
                E-mail: miriam.mainenti@ 123456hotmail.com Tel.: 55 21 3882-9841
                Article
                cln_66p1513
                10.1590/S1807-59322011000900001
                3164396
                22179151
                34f87ab8-6d40-48f1-83ce-d843d8c2ec85
                Copyright © 2011 Hospital das Clínicas da FMUSP

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 January 2011
                : 28 March 2011
                : 12 May 2011
                Page count
                Pages: 6
                Categories
                Clinical Science

                Medicine
                body composition,biomechanics,body fat distribution,musculoskeletal equilibrium,aging
                Medicine
                body composition, biomechanics, body fat distribution, musculoskeletal equilibrium, aging

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