Bioelectrical impedance analysis (BIA) is the most commonly used body composition technique in published studies. Herein we review the theory and assumptions underlying the various BIA and bioelectrical impedance spectroscopy (BIS) models, because these assumptions may be invalidated in clinical populations. Single-frequency serial BIA and discrete multifrequency BIA may be of limited validity in populations other than healthy, young, euvolemic adults. Both models inaccurately predict total body water (TBW) and extracellular water (ECW) in populations with changes in trunk geometry or fluid compartmentalization, especially at the level of the individual. Single-frequency parallel BIA may predict body composition with greater accuracy than the serial model. Hand-to-hand and leg-to-leg BIA models do not accurately predict percent fat mass. BIS may predict ECW, but not TBW, more accurately than single-frequency BIA. Segmental BIS appears to be sensitive to fluid accumulation in the trunk. In general, bioelectrical impedance technology may be acceptable for determining body composition of groups and for monitoring changes in body composition within individuals over time. Use of the technology to make single measurements in individual patients, however, is not recommended. This has implications in clinical settings, in which measurement of individual patients is important.
Dehydration not only reduces athletic performance, but also places athletes at risk of health problems and even death. For athletes, monitoring hydration has significant value in maximising performance during training and competition. It also offers medical personnel the opportunity to reduce health risks in situations where athletes engage in intentional weight loss. Simple non-invasive techniques, including weight monitoring and urine tests, can provide useful information. Bioimpedance methods tend to be easy to use and fairly inexpensive, but generally lack the precision and accuracy necessary for hydration monitoring. Blood tests appear to be the most accurate monitoring method, but are impractical because of cost and invasiveness. Although future research is needed to determine which hydration tests are the most accurate, we encourage sports teams to develop and implement hydration monitoring protocols based on the currently available methods. Medical personnel can use this information to maximise their team's athletic performance and minimise heat- and dehydration-related health risks to athletes.
Decades of epidemiological research have established that breastfeeding is associated with a modest reduction in risk of later overweight and obesity. However, no systematic effort has been made to delineate the mechanisms that may explain this association. This review summarizes evidence from a variety of disciplines to understand the potential mechanisms underlying this association. One possibility is that this association is spurious and that confounding factors fully or partially explain this association. Additionally, breastfeeding could confer protection by: encouraging the infant's emerging capabilities of self-regulation of intake; reducing problematic feeding behaviors on the part of caregivers that interfere with the infant's self-regulation of intake; and providing bioactive factors that regulate energy intake, energy expenditure, and cellular chemistry. These three protective effects may promote slower growth and lower body fat levels in breastfed infants, which reduce risk of overweight and obesity later in life.
Many parents, grandparents, and clinicians have associated a baby's ability to eat and gain weight as a sign of good health, and clinicians typically only call significant attention to infant growth if a baby is failing to thrive or showing severe excesses in growth. Recent evidence, however, has suggested that pediatric healthcare providers should pay closer attention to growth patterns during infancy. Both higher weight and upward crossing of major percentile lines on the weight-for-age growth chart during infancy have long term health consequences, and are associated with overweight and obesity later in life. Clinicians should utilize the numerous available opportunities to discuss healthy growth and growth charts during health maintenance visits in the first two years after birth. Further, providers should instruct parents on strategies to promote healthy behaviors that can have long lasting obesity preventive effects. KeywordsObesity; Prevention; Infant; Breastfeeding; Sleep Weight Gain during Infancy and Long-Term EffectsAre chubby babies healthy babies? While most appear well during infancy, evidence is increasing that heavier babies have a poorer long-term health trajectory than their trimmer counterparts. Data have emerged over the past two decades that early life growth patterns and behaviors play an important role in the etiology of obesity, yet there has been very little focus on the primary prevention of obesity during infancy by the medical, behavioral health, and public health communities. A recent report from the National Health and Nutrition Examination Survey (NHANES) highlighted the need for very early intervention when it revealed that between 2003-2006, a Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The Institute of Medicine publication, "Preventing Childhood Obesity: Health in the Balance," stated that the prevention of obesity in children should be a national public health priority. 5 More specific to younger children was the summary of the "Conference on Preventing Childhood Obesity," where it was remarked, "The prenatal period, infancy, and early childhood may be stages of particular vulnerability to obesity development because they are unique periods for cellular differentiation and development. This unique vulnerability might make it possible for actions taken at these stages to determine the future course of adiposity." 6 This statement has been magnified by the numerous studies demonstrating the association between rapid or accelerated infant weight gain and subsequent obesity, 7-24 as well as hypertension, 25-28 coronary heart di...
Decades of epidemiological research have established that breastfeeding is associated with a modest reduction in risk of later overweight and obesity. However, no systematic effort has been made to delineate the mechanisms that may explain this association. This review summarizes evidence from a variety of disciplines to understand the potential mechanisms underlying this association. One possibility is that this association is spurious and that confounding factors fully or partially explain this association. Additionally, breastfeeding could confer protection by: encouraging the infant's emerging capabilities of self-regulation of intake; reducing problematic feeding behaviors on the part of caregivers that interfere with the infant's self-regulation of intake; and providing bioactive factors that regulate energy intake, energy expenditure, and cellular chemistry. These three protective effects may promote slower growth and lower body fat levels in breastfed infants, which reduce risk of overweight and obesity later in life.
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