Body composition and fatty tissue distribution in women with various menstrual status

Background. Menopause, also referred to as climacterium, is a period of multiple changes in the structure and functions of a woman organism. Objective. Determination of differences in body composition and fatty tissue distribution in women from groups discriminated based on their menstrual status. Material and Methods. The survey covered 312 women aged 38-75 years. Menstrual status of the surveyed women was established according to WHO guidelines based on answers to a questionnaire, and three groups were discriminated: women in the premenopausal period (group 1), in the perimenopausal period (group 2), and in the postmenopausal period (group 3). The following anthropomological measurements were taken: body height, body mass, waist and hip circumference, and thickness of 6 skinfolds. Their results enabled evaluating the somatic built of women in the separated groups. Fatty tissue distribution was determined based on TER distribution index calculated as a ratio of the sum of trunk skinfolds (TSS) to the sum of extremity skinfolds (ESS). Body composition of the women, including percentage of body fat, lean body mass, soft tissue mass, and total body water, was assessed using an IOI 353 analyzer by JAWON MEDICAL. In addition, percentages of women with underweight, normal content of fatty tissue, and these with overweight and obesity were calculated. The WHR index was computed in the case of obese women. Results. The highest values of body mass, hip circumference and most of the skinfolds were determined in the perimenopausal group, whereas the postmenopausal women were characterized by the highest percentage of body fat (PBF) and by the lowest contents of lean tissue, soft tissue, and total water content in the body. The highest percentage of obese women was found in the postmenopausal group, including 40% of them having visceral type obesity. The occurrence of the menopause contributed to changes in fatty tissue distribution, causing its shift from extremities toward the trunk. Conclusions. The study showed differences in the somatic built and body composition in groups of women distinguished based on their menstrual status.Wprowadzenie. Menopauza, zwana inaczej przekwitaniem, to okres licznych zmian w budowie i funkcjonowaniu organizmu kobiety. Cel. Określenie wielkości różnic w składzie ciała i rozmieszczeniu tkanki tłuszczowej u kobiet w grupach wydzielonych na podstawie statusu menstruacyjnego. Materiał i metody. Badaniom poddano 312 kobiet w wieku 38-75 lat. Na podstawie odpowiedzi udzielonych na pytania ankiety określono status menstruacyjny badanych kobiet zgodnie z zaleceniami WHO. Wydzielono trzy grupy kobiet będących w okresie premenopauzalnym (grupa 1- 69 kobiet ), perimenopauzalnym (grupa 2 – 45 kobiet) i postmenopauzalnym (grupa 3- 198 kobiet). Wykonano pomiary antropologiczne: wysokości ciała, masy ciała, obwodu pasa i bioder oraz grubości 6 fałdów skórno-tłuszczowych w celu oceny budowy somatycznej kobiet w wydzielonych grupach. W celu określenia dystrybucji tkanki tłuszczowej obliczono wskaźnik dystrybucji TER, będący stosunkiem sumy fałdów skórno-tłuszczowych na tułowiu (TSS) do sumy fałdów skórno-tłuszczowych na kończynach (ESS). Skład ciała oceniono przy pomocy analizatora składu ciała IOI 353 z oprogramowaniem JAWON MEDICAL. Pozwoliło to na określenie m.in. procentowej zawartości tkanki tłuszczowej, beztłuszczowej masy ciała, masy tkanek miękkich oraz całkowitej zawartości wody. Obliczono również odsetek osób z niedowagą, prawidłową zawartością tkanki tłuszczowej oraz z nadwagą i otyłością. U otyłych kobiet obliczono wskaźnik WHR. Wyniki. Najwyższe wartości masy ciała, obwodu bioder i większości fałdów skórno-tłuszczowych wystąpiły w grupie perimenopauzalnej, a w grupie postmenopauzalnej – najwyższe wartości całkowitej zawartości tkanki tłuszczowej (PBF), przy równoczesnym najniższym poziomie tkanki beztłuszczowej, tkanek miękkich i całkowitej zawartości wody w organizmie. Najwyższy odsetek otyłych kobiet wystąpił w grupie postmenopauzalnej, przy czym u 40% badanych z tej grupy była to otyłość wisceralna. Wystąpienie menopauzy przyczyniło się do zmian w rozmieszczeniu tkanki tłuszczowej, powodując przesunięcie jej z kończyn w kierunku tułowia. Wnioski. Stwierdzono występowanie różnic w budowie somatycznej i składzie ciała kobiet w grupach wydzielonych na podstawie statusu menstruacyjnego

The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans

Background: The “Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies” (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. Methods: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3–9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0–1.2 g/kg body weight, energy intake of 25–30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. Results: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. Conclusion: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations