B. Morio

The study evaluated, in active elderly women, the accuracy and bias of anthropometry and bioelectrical impedance analysis (BIA) for lower-limb and whole-body tissue composition measures using dual-energy X-ray absorptiometry (DXA) as the criterion method. Nineteen individuals (66.1 +/- 4.2 years) participated in the study. Whole-body fat mass (FM) and fat-free mass (FFM) were measured by anthropometry, BIA and DXA. Lower-limb volume (LLV) and lower-limb FFM (LLFFM) were assessed by anthropometry and DXA. LLV and LLFFM were significantly overestimated by anthropometry vs. DXA (p < 0.05 and p < 0.001, respectively) but significant relationships were observed [coefficient of determination (R(2)) > 0.25, p < 0.05]. No significant difference was observed between FM(A) (where (A) stands for anthropometry) vs. FM(DXA) and FFM(A) vs. FFM(DXA) and significant relationships were observed [R(2) = 0.93, p < 0.001, coefficient of variation (CV) = 7.3%; and R(2) = 0.85, p < 0.001, CV = 4.4%, respectively]. No significant difference was observed between FM(BIA) and FM(DXA) and a significant relationship was observed (R(2) = 0.80, p < 0.001, CV = 11.6%). FFM was significantly underestimated by BIA vs. DXA (p < 0.01). In active elderly women, (i) compared with DXA, anthropometry overestimates LLV and LLFFM; (ii) anthropometry can be an accurate method for assessing whole-body composition; and (iii) despite a non-significant bias for the FM measurement, the BIA tends to overestimate FM and underestimate FFM.

To investigate alterations in whole body fat oxidation after 7 and 14 weeks of progressive endurance training in sedentary elderly subjects. Longitudinal, 14 weeks of progressive endurance training on a cycle ergometer (3 training sessions per week). Full sets of measurements were performed before, and after 7 and 14 weeks of training. 13 healthy sedentary subjects (5 men, 8 women) (age 62.8 +/- 2.3 y). 24 h indirect calorimetric measurements under standardised conditions: light-activity programme, fixed food composition, neutral daily energy balance. Body composition (by isotope dilution and skinfold thicknesses). Maximal oxygen consumption. Loss of 0.7 kg fat mass in the first 7 weeks of training and a further 2.4 kg of fat in the second 7 weeks. There was a transient increase in sleeping fat oxidation after 7 weeks of training (+26.1%), associated with transient increase in daily fat oxidation (+/- 11.9%), but fat oxidation then returned to baseline values in the second 7 weeks. There was a correlation between within-subject changes in sleeping fat oxidation after 7 weeks of training and variations in FFM (r = 0.62, P = 0.02) and maximal oxygen consumption (r = -0.56, P < 0.05). In sedentary elderly subjects, progressive endurance training was associated with a transient increase in sleeping fat oxidation and daily fat oxidation. In free-living conditions, possible changes in daily fat oxidation may have induced a negative fat balance, as judged by fat mass loss.

Parkinson's disease is a neurodegenerative disorder clinically characterized by motor impairments (tremor, bradykinesia, rigidity and postural instability) associated or not with non-motor complications (cognitive disorders, dysautonomia). Most of patients loose weight during evolution of their disease. Dysregulations of hypothalamus, which is considered as the regulatory center of satiety and energy metabolism, could play a major role in this phenomenon. Deep brain stimulation of the subthalamic nucleus (NST) is an effective method to treat patients with advanced Parkinson's disease providing marked improvement of motor impairments. This chirurgical procedure also induces a rapid and strong body weight gain and sometimes obesity. This post-operative weight gain, which exceeds largely weight lost recorded in non-operated patient, could be responsible of metabolic disorders (such as diabetes) and cardiovascular diseases. This review describes body weight variations generated by Parkinson' disease and deep brain stimulation of the NST, and focuses on metabolic disorders capable to explain them. Finally, this review emphasizes on the importance of an adequate nutritional follow up care for parkinsonian patient.

To assess the occurrence of weight gain in patients with Parkinson's disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation. We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson's disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m(2) 3 months after surgery and 2.02 (0.36) kg/m(2) 16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m(2) and 2.11 (0.49) kg/m(2). This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the "off" dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001). Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson's disease.

The study evaluated, in active elderly women, the accuracy and bias of anthropometry and bioelectrical impedance analysis (BIA) for lower-limb and whole-body tissue composition measures using dual-energy X-ray absorptiometry (DXA) as the criterion method. Nineteen individuals (66.1 +/- 4.2 years) participated in the study. Whole-body fat mass (FM) and fat-free mass (FFM) were measured by anthropometry, BIA and DXA. Lower-limb volume (LLV) and lower-limb FFM (LLFFM) were assessed by anthropometry and DXA. LLV and LLFFM were significantly overestimated by anthropometry vs. DXA (p < 0.05 and p < 0.001, respectively) but significant relationships were observed [coefficient of determination (R(2)) > 0.25, p < 0.05]. No significant difference was observed between FM(A) (where (A) stands for anthropometry) vs. FM(DXA) and FFM(A) vs. FFM(DXA) and significant relationships were observed [R(2) = 0.93, p < 0.001, coefficient of variation (CV) = 7.3%; and R(2) = 0.85, p < 0.001, CV = 4.4%, respectively]. No significant difference was observed between FM(BIA) and FM(DXA) and a significant relationship was observed (R(2) = 0.80, p < 0.001, CV = 11.6%). FFM was significantly underestimated by BIA vs. DXA (p < 0.01). In active elderly women, (i) compared with DXA, anthropometry overestimates LLV and LLFFM; (ii) anthropometry can be an accurate method for assessing whole-body composition; and (iii) despite a non-significant bias for the FM measurement, the BIA tends to overestimate FM and underestimate FFM.