Body composition in young female eating-disorder patients with severe weight loss and controls: evidence from the four-component model and evaluation of DXA

Abstract

Background/Objectives:Whether fat-free mass (FFM) and its components are depleted in eating-disorder (ED) patients is uncertain. Dual energy X-ray absorptiometry (DXA) is widely used to assess body composition in pediatric ED patients; however, its accuracy in underweight populations remains unknown. We aimed (1) to assess body composition of young females with ED involving substantial weight loss, relative to healthy controls using the four-component (4C) model, and (2) to explore the validity of DXA body composition assessment in ED patients.Subjects/Methods:Body composition of 13 females with ED and 117 controls, aged 10–18 years, was investigated using the 4C model. Accuracy of DXA for estimation of FFM and fat mass (FM) was tested using the approach of Bland and Altman.Results:Adjusting for age, height and pubertal stage, ED patients had significantly lower whole-body FM, FFM, protein mass (PM) and mineral mass (MM) compared with controls. Trunk and limb FM and limb lean soft tissue were significantly lower in ED patients. However, no significant difference in the hydration of FFM was detected. Compared with the 4C model, DXA overestimated FM by 5±36% and underestimated FFM by 1±9% in ED patients.Conclusion:Our study confirms that ED patients are depleted not only in FM but also in FFM, PM and MM. DXA has limitations for estimating body composition in individual young female ED patients.

Metabolic rate of major organs and tissues in young adult South Asian women

“…Fat mass (FM) was derived using the 4-component model of body composition assessment, as described previously 21. Dual-energy X-ray absorptiometry (DXA; Lunar Prodigy, GE Medical Systems, Madison, WI, USA) was used to quantify SMM.…”

Application of a Sub-set of Skinfold Sites for Ultrasound Measurement of Subcutaneous Adiposity and Percentage Body Fat Estimation in Athletes

“…Likewise, 3-compartment model evaluation of athlete %BF with Dual Energy X-ray Absorptiometry (DXA) has its limitations. Of particular relevance is the significant degree of error in %BF estimation of leaner individuals [24][25][26]. The radiation dose administered with DXA is comparatively low to other imaging modalities.…”

Mental health is biological health: Why tackling “diseases of the mind” is an imperative for biological anthropology in the 21st century

“…Despite the fact that most biological anthropologists interested in health conduct fieldwork in low‐ and middle‐income countries, however, and that mental disorders are the first or second ranked cause of disability burden in most of these countries (see Figure ), only a handful of biological anthropological studies have focused on mental health. These include Hadley and colleagues' work on depression and anxiety (Hadley & Patil, , ; Patil & Hadley, ); Sullivan's biocultural research on schizophrenia in Palau (Sullivan et al, ; Sullivan, Allen, Otto, Tiobech, & Nero, ; Sullivan, Andres, Otto, Miles, & Kydd, ); McDade's investigation on social status, psychosocial stress, and culture change in Samoa (McDade, ); Flinn et al's work on the stress response (Flinn, Nepomnaschy, Muehlenbein, & Ponzi, ; Flinn, Quinlan, Decker, Turner, & England, ); Stieglitz et al's research on depression and immune function (Stieglitz et al, ); Wells et al's research on eating disorders (Wells et al, ), and several others (Adair et al, ; Fuller, Mccarty, Gravlee, & Mulligan, ; Mulligan, ; Patil, Maripuu, Hadley, & Sellen, ; Reyes‐Garcı'a et al, ). In addition, many biological anthropologists and behavioral scientists have investigated how humans cognitively and behaviorally respond to environments of varying risk using a life history theory (LHT) framework (Belsky & Pluess, ; Ellis & Bjorklund, ; Nettle, ; Pepper & Nettle, ; Quinlan, Dira, Caudell, & Quinlan, ), which has implications for many symptoms of mental disorders.…”