Background: The study of the relationship between anthropometry and visceral adipose tissue (VAT) is of great interest because VAT is associated with many risk factors for noncommunicable diseases and anthropometry is easy to perform in clinical practice. The studies hitherto available for children have, however, been performed on small sample sizes. Design: Pooling of the data of studies published from 1992 to 2004 as indexed on Medline. Aims: To assess the relationship between anthropometry and VAT and subcutaneous adipose tissue (SAT) as measured by magnetic resonance imaging (MRI) in children and to analyze the effect of age, gender, pubertal status and ethnicity. Subjects and methods: Eligible subjects were 7-16 year-old, with availability of VAT and SAT, gender, ethnicity, body mass index (BMI) and waist circumference (WC). A total of 497 subjects were collected from seven different investigators and 407 of them (178 Caucasians and 229 Hispanics) were analyzed. Results: Despite ethnic differences in MRI data, BMI, WC and age, no difference in VAT was found between Caucasians and Hispanics after correction for SAT and BMI. Univariate regression analysis identified WC as the best single predictor of VAT (64.8% of variance) and BMI of SAT (88.9% of variance). The contribution of ethnicity and gender to the unexplained variance of the VAT-WC relationship was low (p3%) but significant (Pp0.002). The different laboratories explained a low (p4.8%) but significant (Po0.0001) portion of the unexplained variance of the VAT-WC and SAT-BMI relationships. Prediction equations for VAT (VAT (cm 2 ) ¼ 1.1 Â WC (cm)À52.9) and SAT (SAT (cm 2 ) ¼ 23.2 Â BMI (kg/m 2 )À329) were developed on a randomly chosen half of the population and crossvalidated in the remaining half. The pure error of the estimate was 13 cm 2 for VAT and 57 cm 2 for SAT. Conclusions: WC can be considered a good predictor of VAT as well as BMI of SAT. The importance of ethnicity and gender on VAT estimation is not negligible.

OBJECTIVE: The objective of this study was to examine the in¯uence of body weight and body composition on aspects of aerobic ®tness. Our hypothesis was that increased body weight, speci®cally increased fat mass (FM), would not limit VO 2max relative to fat-free mass (FFM), but would reduce maximal and sub-maximal VO 2max relative to body weight. DESIGN: We used data from two ongoing studies. In Study 1 a cross-sectional analysis of 129 children across a wide spectrum of body composition was performed. In Study 2 we examined data from 31 overweight women before and after weight loss. METHODS: VO 2max was measured using a treadmill test. Sub-maximal aerobic capacity was evaluated with respiratory exchange ratio (RER), heart-rate (HR), and oxygen uptake relative to VO 2max at a given workload (%VO 2max ). Body composition was assessed using dual energy X-ray absorptiometry (DXA) (Study 1) and a fourcompartment model (Study 2). RESULTS: In Study 1, FFM was the strongest determinant of VO 2max (r 0.87; P`0.0001). After adjusting for FFM, there was no signi®cant in¯uence of FM on VO 2max . After separating children into lean and obese sub-groups, absolute VO 2max was signi®cantly higher in the obese (1.24 AE 0.27 vs 1.56 AE 0.40) and VO 2max relative to body weight was signi®cantly lower (44.2 AE 3.2 vs 32.0 AE 4.1 mla(kg-min)), whereas there was no signi®cant difference when expressed relative to FFM (57.9 AE 5.8 vs 59.2 AE 4.9 mla(kgFFM-min)). Sub-maximal aerobic capacity was signi®cantly lower in the obese children, as indicated by a higher HR and %VO 2max ; time to exhaustion was signi®cantly lower in the obese children (15.3 AE 2.9 vs 11.1 AE 2.1 min). In Study 2, FFM was also the strongest determinant of VO 2max before and after weight loss. The relationship between VO 2max and FFM was identical before and after weight loss so that VO 2max relative to FFM was identical before and after weight loss (43.8 AE 4.9 vs 45.5 AE 6.4 mla(kgFFM-min)). However, sub-maximal aerobic capacity was lower in the obese state, as indicated by a signi®cantly higher RER (0.85 AE 0.06 vs 0.79 AE 0.05), HR (124 AE 14 vs 102 AE 11 bpm), and %VO 2max (44% vs 36%). CONCLUSION: The major in¯uence of body weight on VO 2max is explained by FFM; FM does not have any effect on VO 2max . Fatness and excess body weight do not necessarily imply a reduced ability to maximally consume oxygen, but excess fatness does have a detrimental effect on submaximal aerobic capacity. Thus, fatness and VO 2max should be considered independent entities.

Background:The prevalence of obesity is higher in black than in white women. Differences in energy economy and physical activity may contribute to this difference. Objective: The objective of this study was to compare free-living energy expenditure and physical activity in black and white women before and after weight loss. Design: Participants were 18 white and 14 black women with body mass indexes (in kg/m 2 ) between 27 and 30. Diet, without exercise, was used to achieve a weight loss of ≥ 10 kg and a body mass index < 25. After 4 wk of energy balance in overweight and normal-weight states, body composition was assessed by using a 4-compartment model, sleeping and resting energy expenditures were assessed by using a chamber calorimeter, physiologic stress of exercise and exercise economy were measured by using standardized exercise tasks, and daily energy expenditure was assessed by using doubly labeled water. Results: Weight loss averaged 12.8 kg. Sleeping and resting energy expenditures decreased in proportion to changes in body composition. Weight reduction significantly improved physiologic capacity for exercise in both groups of women, making it easier for them to be physically active. Black women had lower body composition-adjusted energy requirements than did white women-both before and after weight loss-during sleep (9% lower, 519 kJ/d; P < 0.001), at rest (14% lower, 879 kJ/d; P < 0.001), during exercise (6% lower; P < 0.05), and as a daily total (9% lower, 862 kJ/d; P < 0.06). By contrast, free-living physical activity was similar between the groups. Conclusions: Weight-reduced women had metabolic rates appropriate for their body sizes. Black women had lower resting and nonresting energy requirements in both overweight and normalweight states than did white women and did not compensate with greater physical activity, potentially predisposing them to greater weight regain.

OBJECTIVE: To examine the relationship of intra-abdominal adipose tissue (IAAT) and subcutaneous abdominal adipose tissue (SAAT) with body composition and anthropometry in children. DESIGN: Cross-sectional data analysis. SUBJECTS: 113 healty Caucasian and African-American, pre-pubertal children aged 4 ± 10 y. MEASUREMENTS: IAAT and SAAT by single slice computed tomography at the level of the umbilicus; total fat and trunk fat by dual energy X-ray absorptiometry (DEXA); anthropometric evaluation by skinfolds and circumferences. RESULTS: IAAT was most strongly correlated with abdominal skinfold (r 0.88) and trunk fat by DEXA (r 0.87), and SAAT with trunk fat by DEXA (r 0.96), total fat by DEXA (r 0.93) and waist circumference (r 0.93). In stepwise regression, IAAT was best predicted by trunk fat from DEXA, total fat from DEXA, and abdominal skinfold (R 2 0.85); SAAT was best predicted by trunk fat from DEXA, body weight, waist circumference and abdominal skinfold (R 2 0.96). In the absence of DEXA data, IAAT was best predicted by abdominal skinfold, ethnicity and subscapular skinfold (R 2 0.82) and SAAT was best predicted by waist circumference subscapular skinfold, height and abdominal skinfold (R 2 0.92). The prediction equations with and without DEXA were successfully cross-validated in an independent sample of 12 additional measures of IAAT and SAAT. CONCLUSION: These data provide useful information that can help in the interpretation of anthropometric data with regard to body fat distribution. IAAT and SAAT can be accurately estimated in Caucasian and African-American prepubertal children from anthropometry with and without the availability of DEXA data.

The objectives of this study were 1) to examine interrelations among intraabdominal adipose tissue (IAAT) and other adiposity indexes, 2) to identify a visceral obesity index that is independent of total adiposity, and 3) to examine sex and ethnic (white compared with African American) differences in IAAT. We measured IAAT and subcutaneous abdominal adipose tissue (SAAT) using computed tomography, and total fat mass (FM) by dual-energy X-ray absorptiometry in a heterogenous sample of 101 children aged 7.7 +/- 1.6 y weighing 33.2 +/- 12.6 kg. IAAT was highly variable (mean +/- SE; 31 +/- 22 cm2; range: 7-107 cm2) and related to SAAT (r = 0.87) and FM (r = 0.81). The regression slope between IAAT and SAAT was significantly lower in African Americans (0.17 +/- 0.02 cm2 IATT/cm2 SAAT) than in whites (0.23 +/- 0.02 cm2 IAAT/cm2 SAAT). Within each ethnic group there was no effect of sex on IAAT adjusted for SAAT (mean +/- SE: 40.2 +/- 3.1 and 43.2 +/- 2.7 cm2 in white boys and girls, respectively; 26.4 +/- 1.9 and 25.1 +/- 1.6 cm2 in African American boys and girls, respectively). We conclude that in children 1) there is wide variation in visceral fatness; 2) IAAT relative to SAAT is an index of visceral fat, independent of FM, allowing examination of the unique effects of IAAT; and 3) the relative distribution of adipose tissue in the intraabdominal compared with the subcutaneous abdominal region is significantly lower in African Americans than in whites.