Body fat percentage assessment by skinfold equation, bioimpedance and densitometry in older adults

BACKGROUND: Body fat estimation allows measuring changes over time attributed to interventions and treatments in different settings such as hospitals, clinical practice, nursing homes and research. However, only few studies have compared different body fat estimation methods in older adults with inconsistent results. We estimated body fat percentage (%BF) and the level of agreement among dual energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA) and Durnin & Womersley’s skinfold eq. (SF) in older Brazilian adults aged 60 years and older from the Elderly Project Goiânia, Brazil. METHODS: The analytical sample comprised of 132 participants who had DXA data. The level of agreement for the %BF estimated by BIA, SF and DXA i.e. reference method, was examined using Bland and Altman’s and Lin’s plot. RESULTS: Overall, women had higher body mass index and %BF values measured by all three methods used. BIA and SF equation showed strong concordance to estimate body fat percentage in all participants (CCC = 0.857 and 0.861, respectively) and among women (CCC = 0.788 and 0.726, respectively) when compared to DXA. However, both methods underestimated body fat percentage in women and men with high body fat percentage. A strong level of agreement was observed between DXA and the anthropometric equation developed by Durnin & Womersley in men (CCC = 0.846), while BIA had a moderate concordance (CCC = 0.505) in this group. CONCLUSION: The examined methods indicated different body fat estimates. However, the best agreement was observed between DXA and the anthropometric SF equation for men. Future research in older adults should develop new SF equations considering different ethnic groups

Body fat percentage prediction in older adults: Agreement between anthropometric equations and DXA

BACKGROUND: It is difficult to measure body fat percentage in clinical settings. Equations using anthropometric measures are more feasible and can be used to estimate body fat. However, there is a need to analyze their accuracy in older adults. Our study aims to validate the use of anthropometric equations to estimate body fat percentage in older men and women. METHODS: This study evaluated data from 127 Brazilian individuals aged between 60 and 91 years. Weight, height, skinfold thickness and waist and hip circumferences were measured. Seventeen anthropometric equations were tested using the crossed validity criteria suggested by Lohman and the graph analysis proposed by Bland and Altman and by Lin was also performed. The gold-standard method for comparing the anthropometric equations was the dual-energy absorptiometry X-ray (DXA). RESULTS: The average body fat percentage was 30.2 ± 8.6% in men and 43.4 ± 7.9% in women (p < 0.001). In men, the equations which used skinfold thickness presented amplitude of 11.48%, while in women, amplitude's constant error (CE) was 22.88%. The equations based on circumferences and BMI presented CE variation from -5.3% to 29.68% on the estimation of body fat percentage, which means that a same male individual can have the total body adiposity diagnosed with 34.98% of variation, depending on the selection of the employed equation. For women this CE variation was 12.44%. CONCLUSION: Overall, all the equations yielded different results from the DXA. However, the best equations for male were the one of Lean et al. (1996), which uses the waist circumference, and for women the one of Deurenberg et al. (1991), developed from the body mass index. The need of developing specific equations for older adults still remains, since even the two best equations showed considerable limitations on predicating body fat percentage

How the 'plates' of a health system can shift, change and adjust during economic recessions: A qualitative interview study of public and private health providers in Brazil's Sao Paulo and Maranhao states

Background: Economic recessions carry an impact on population health and access to care; less is known on how health systems adapt to the conditions brought by a downturn. This particularly matters now that the COVID-19 epidemic is putting health systems under stress. Brazil is one of the world’s most affected countries, and its health system was already experiencing the aftermath of the 2015 recession. Methods: Between 2018 and 2019 we conducted 46 semi-structured interviews with health practitioners, managers and policy-makers to explore the impact of the 2015 recession on public and private providers in prosperous (São Paulo) and impoverished (Maranhão) states in Brazil. Thematic analysis was employed to identify drivers and consequences of system adaptation and coping strategies. Nvivo software was used to aid data collection and analysis. We followed the Standards for Reporting Qualitative Research to provide an account of the findings. Results: We found the concept of ‘health sector crisis’ to be politically charged among healthcare providers in São Paulo and Maranhão. Contrary to expectations, the public sector was reported to have found ways to compensate for diminishing federal funding, having outsourced services and adopted flexible–if insecure–working arrangements. Following a drop in employment and health plans, private health insurance companies have streamlined their offer, at times at the expenses of coverage. Low-cost walk-in clinics were hit hard by the recession, but were also credited for having moved to cater for higher-income customers in Maranhão. Conclusions: The ‘plates’ of a health system may shift and adjust in unexpected ways in response to recessions, and some of these changes might outlast the crisis. As low-income countries enter post-COVID economic recessions, it will be important to monitor the adjustments taking place in health systems, to ensure that past gains in access to care and job security are not eroded

Cafeteria diet increases liquid intake and serum creatinine levels in rats

Introduction: Important changes in human dietary pattern occurred in recent decades. Increased intake of processed foods leads to obesity, which is related with the development of chronic diseases such as type 2 diabetes mellitus, hypertension, as well as cardiovascular and chronic kidney diseases. The prevalence of hypertension has also dramatically increased in recent years, and high sodium intake contributes to this scenario. In healthy individuals, kidneys are the primary end-organs that regulate sodium homeostasis. This study aims to evaluate renal function parameters and systolic blood pressure measurements in an animal model of obesity. Methods: Sixty-day-old male Wistar rats (n=30) were divided into two groups: standard (SD) and cafeteria diet (CD). Cafeteria diet was altered daily and was composed by crackers, wafers, sausages, chips, condensed milk, and soda. All animals had free access to water and chow and the experiment was carried out for 6 weeks. Weight gain, sodium and liquid intake control, systolic blood pressure measurements, and renal function parameters were evaluated.Results: Animals exposed to cafeteria diet had an increase of 18% in weight compared to the control group. Sodium intake was increased by cafeteria diet and time (F(1,28)= 773.666, P=0.001 and F(5,28)= 2.859, P=0.02, respectively) and by the interaction of both factors (F(6,28)= 2.859, P=0.02). On liquid intake occurred only effect of cafeteria diet and time (F(1,28)= 147.04, P=0.001 and F(5,28)=3.996, P=0.003, respectively). Cafeteria diet exposure also induced an increase on creatinine serum levels (P=0.002), however this effect was not observed on creatinine urine levels (P>0.05) nor on systolic pressure measurements (Students’ t test, P>0.05).Conclusions: Obesity induced by cafeteria diet exposure increases liquid intake and alters creatinine serum levels, an important renal function marker. Considering the high consumption of hypercaloric food currently in the world, further studies are required to elucidate the modifications on renal function triggered by this diet over time.Key-words: Hypertension; kidney; renal function; obesity; hypercaloric diet

Grounding language in perception for scene conceptualization in autonomous robots

In order to behave autonomously, it is desirable for robots to have the ability to use human supervision and learn from different input sources (perception, gestures, verbal and textual descriptions etc). In many machine learning tasks, the supervision is directed specifically towards machines and hence is straight forward clearly annotated examples. But this is not always very practical and recently it was found that the most preferred interface to robots is natural language. Also the supervision might only be available in a rather indirect form, which may be vague and incomplete. This is frequently the case when humans teach other humans since they may assume a particular context and existing world knowledge. We explore this idea here in the setting of conceptualizing objects and scene layouts. Initially the robot undergoes training from a human in recognizing some objects in the world and armed with this acquired knowledge it sets out in the world to explore and learn more higher level concepts like static scene layouts and environment activities. Here it has to exploit its learned knowledge and ground language into perception to use inputs from different sources that might have overlapping as well as novel information. When exploring, we assume that the robot is given visual input, without explicit type labels for objects, and also that it has access to more or less generic linguistic descriptions of scene layout. Thus our task here is to learn the spatial structure of a scene layout and simultaneously visual object models it was not trained on. In this paper, we present a cognitive architecture and learning framework for robot learning through natural human supervision and using multiple input sources by grounding language in perception

Urinary incontinence related to perineal muscle strength in the first trimester of pregnancy: cross-sectional study

Objective To analyze pelvic floor muscle strength (PFMS), urinary continence and quality of life related to urinary incontinence (UI) of women in the first trimester of pregnancy. Method Cross-sectional study with a sample of 500 women who started prenatal care in a complementary healthcare facility in Guarulhos, state of São Paulo, from 2012 and 2013. Pelvic floor muscle strength was evaluated through perineometry. The pregnant women who presented UI answered the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Results It was found that maternal age (OR=1.06; CI95% 1.02-1.11) and prior UI (OR=15.12; 95%CI 8.19-27.92) are the variables that, in tandem, best explain the occurrence of UI at the beginning of pregnancy. The mean score on the ICIQ-SF was 8.2 (SD=3.9), considered a moderate impact on quality of life. Conclusion Older pregnant women with prior UI are more likely to have UI in the first trimester of pregnancy.
</jats:p

Produção orgânica de rabanete em plantio direto sobre cobertura morta e viva.

O objetivo deste trabalho foi avaliar o uso de plantas espontâneas e cobertura viva de amendoim forrageiro(Arachis pintoi), associado à aplicação de composto orgânico na produção orgânica do rabanete em plantio direto. O experimento foi instalado na Universidade Federal do Acre, em Rio Branco-AC, de 15/06 a 14/07/2007. O delineamento experimental utilizado foi em blocos casualizados com parcelas subdivididas 4x3, em quatro repetições. As parcelas corresponderam ao sistema de plantio direto com cobertura viva de amendoim forrageiro, cobertura viva de planta espontânea, cobertura morta de planta espontânea e sistema de plantio em canteiro com solo descoberto. As subparcelas foram compostas pelas doses de composto orgânico de 5, 10 e 15 t ha-1 (base seca). O plantio direto na palha de plantas espontâneas teve desempenho semelhante ao preparo convencional do solo, ambos superiores ao plantio sobre as coberturas vivas. A produtividade do rabanete cv. Cometo, não foi afetada pelas doses crescentes de composto orgânico, podendo aplicar-se apenas 5 t ha-1, enquanto em preparo convencional do solo, o aumento da produtividade ultrapassa o plantio direto na palha apenas na dose maior de composto (15 t ha-1)