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  • Original Article
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Body composition and pulmonary function in the elderly: a 7-year longitudinal study

Abstract

Objective:

To evaluate over a 7-year follow-up period the relationships between changes in body composition, fat distribution and pulmonary function in a sample of elderly men and women.

Design:

Longitudinal clinical study.

Subjects:

A total of 47 women and 30 men aged 71.6±2.3 and 71.7±2.2 years, respectively, at baseline with body mass index (BMI) values of 24.96±3.28 and 27.04±3.35 kg m−2 were followed for 7 years.

Measurements:

Body weight, waist circumference, sagittal abdominal diameter (SAD), fat-free mass (FFM) and fat mass as measured by dual energy X-ray absorptiometry (DXA) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) by spirometry were evaluated at baseline and after a 7-year mean follow-up.

Results:

In women as in men there were no significant changes in weight, SAD and BMI. A significant decrease in height and FFM was observed in both women and men. Height-adjusted FEV1 and FVC decreased significantly in women and men over the 7-year follow-up. Changes in SAD were the most powerful predictors of 7-year follow-up of FEV1 and FVC after taking into account, respectively, baseline FEV1 and FVC. Linear regression analysis, performed by using 7-year follow-up lung function variables as dependent variables and changes in body composition variables as independent variables, showed that 1 cm SAD increase predicted a decrease in FEV1 and FVC of 31 and 46 ml, respectively, and 1 kg FFM decrease predicted a decrease in FVC of 38 ml. After subdividing our study population into four categories of change in FFM and SAD, patients with decreased FFM and increased SAD showed the highest probability of having a worsening in FEV1 and FVC.

Conclusion:

Increase in abdominal fat and FFM decline are significant predictors of lung function decline in the elderly. Old subjects developing both abdominal fat gain and FFM loss show the highest probability of developing worsening in lung function.

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References

  1. Baumgartner RN, Stauber PM, McHugh D, Koehler KM, Garry PJ . Cross-sectional age differences in body composition in persons 60+ years of age. J Gerontol A Biol Sci Med Sci 1995; 50: M307–M316.

    Article  CAS  Google Scholar 

  2. Kehayias JJ, Fiatarone MA, Zhuang H, Roubenoff R . Total body potassium and body fat: relevance to aging. Am J Clin Nutr 1997; 66: 904–910.

    Article  CAS  Google Scholar 

  3. Zamboni M, Armellini F, Harris T, Turcato E, Micciolo R, Bergamo-Andreis IA et al. Effects of age on body fat distribution and cardiovascular risk factors in women. Am J Clin Nutr 1997; 66: 111–115.

    Article  CAS  Google Scholar 

  4. Forbes GB . Longitudinal changes in adult fat-free mass: influence of body weight. Am J Clin Nutr 1999; 70: 1025–1031.

    Article  CAS  Google Scholar 

  5. Newman AB, Lee JS, Visser M, Goodpaster BH, Kritchevsky SB, Tylavsky FA et al. Weight change and the conservation of lean mass in old age: the health, aging and body composition study. Am J Clin Nutr 2005; 82: 872–878.

    Article  CAS  Google Scholar 

  6. Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 2006; 61: 1059–1064.

    Article  Google Scholar 

  7. Tockman MS . Aging of the respiratory system. In: Hazzard WR, Bierman EL, Blass JP, Ettinger Jr WH, Halter JB (eds). Principles of Geriatric Medicine and Gerontology. McGraw Hill: New York, 1994, pp 499–507.

    Google Scholar 

  8. Beaty TH, Newill CA, Cohen BH, Tockman MS, Bryant SH, Spurgeon HA . Effects of pulmonary function on mortality. J Chronic Dis 1985; 8: 703–710.

    Article  Google Scholar 

  9. Kannel WB, Hubert H, Lew EA . Vital capacity as predictor of cardiovascular disease: the Framingham Study. Am Heart J 1983; 105: 311–315.

    Article  CAS  Google Scholar 

  10. Hole DJ, Watt GC, Davey Smith G, Hart CL, Gillis CR, Hawthorne VM . Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ 1996; 313: 711–715.

    Article  CAS  Google Scholar 

  11. Cotes JE, Chinn DJ, Reed JW . Body mass, fat percentage, and fat free mass as reference variables for lung function: effects on terms for age and sex. Thorax 2001; 56: 839–844.

    Article  CAS  Google Scholar 

  12. Santana H, Zoico E, Turcato E, Tosoni P, Bissoli L, Olivieri M et al. Relation between body composition, fat distribution, and lung function in elderly men. Am J Clin Nutr 2001; 73: 827–831.

    Article  CAS  Google Scholar 

  13. Wannamethee SG, Shaper AG, Whincup PH . Body fat distribution, body composition, and respiratory function in elderly men. Am J Clin Nutr 2005; 82: 996–1003.

    Article  CAS  Google Scholar 

  14. Amara CE, Koval JJ, Paterson DH, Cunningham DA . Lung function in older humans: the contribution of body composition, physical activity and smoking. Ann Hum Biol 2001; 28: 522–536.

    Article  CAS  Google Scholar 

  15. Zamboni M, Turcato E, Armellini F, Kahn HS, Zivelonghi A, Santana H et al. Sagittal abdominal diameter as a pratical predictor of visceral fat. Int J Obes Relat Metab Disord 1998; 22: 655–660.

    Article  CAS  Google Scholar 

  16. Kohrt WM . Preliminary evidence that DEXA provides an accurate assessment of body composition. J Appl Physiol 1998; 84: 372–377.

    Article  CAS  Google Scholar 

  17. Tylavsky F, Lohman T, Blunt BA, Schoeller DA, Fuerst T, Cauley JA et al. QDR 4500A DXA overestimates fat-free mass compared with criterion methods. J Appl Physiol 2003; 94: 959–965.

    Article  Google Scholar 

  18. Schoeller DA, Tylavsky FA, Baer DJ, Chumlea WC, Earthman CP, Fuerst T et al. QDR 4500A dual-energy X-ray absorptiometer underestimates fat mass in comparison with criterion methods in adults. Am J Clin Nutr 2005; 81: 1018–1025.

    Article  CAS  Google Scholar 

  19. Fantin F, Di Francesco V, Fontana G, Zivelonghi A, Bissoli L, Zoico E et al. Longitudinal body composition changes in old men and women: interrelationships with incident disability. J Gerontol: Med Sci 2007; 62: 1375–1381.

    Article  Google Scholar 

  20. American Thoracic Society. Standardization of spirometry: 1994 update. Am J Respir Crit Care Med 1995; 152: 1107–1136.

  21. Cole TJ . Linear and proportional regression models in the prediction of ventilatory function: with discussion. J R Stat Soc Ser A 1975; 138: 258–272.

    Article  Google Scholar 

  22. Istituto Nazionale della Nutrizione. Tabelle di composizione degli alimenti. (National Institute of Nutrition: tables of nutritional composition). Litho Delta: Milano, 1989 (in Italian).

  23. The Italian Longitudinal Study on Aging Working Group. Prevalence of chronic diseases in older Italians: comparing self-reported and clinical diagnoses. Int J Epidemiol 1997; 26: 995–1002.

  24. SPSS Inc. SPSS-X User's Guide, 2nd edn. McGraw-Hill: New York, 1986.

  25. Burr ML, Phillips KM, Hurst DN . Lung function in the elderly. Thorax 1985; 40: 54–59.

    Article  CAS  Google Scholar 

  26. Ray CS, Sue DY, Bray G, Hansen JE, Wasserman K . Effects of obesity on respiratory function. Am Rev Respir Dis 1983; 128: 501–506.

    Article  CAS  Google Scholar 

  27. Jenkins SC, Moxham J . The effects of mild obesity on lung function. Respir Med 1991; 85: 309–311.

    Article  CAS  Google Scholar 

  28. Chen Y, Rennie D, Cormier YF, Dosman J . Waist circumference is associated with pulmonary function in normal-weight, overweight, and obese subjects. Am J Clin Nutr 2007; 85: 35–39.

    Article  CAS  Google Scholar 

  29. Rubinstein I, Zamel N, DuBarry L, Hoffstein V . Airflow limitation in morbidly obese, non-smoking men. Ann Intern Med 1990; 112: 828–832.

    Article  CAS  Google Scholar 

  30. Sahebjami H, Gartside P . Pulmonary function in obese subjects with normal FEV1/FVC ratio. Chest 1996; 110: 1425–1429.

    Article  CAS  Google Scholar 

  31. Enzi G, Gasparo M, Biondetti PR, Fiore D, Semisa M, Zurlo F . Subcutaneous and visceral fat distribution according to sex, age and overweight, evaluated by computed tomography. Am J Clin Nutr 1986; 44: 739–746.

    Article  CAS  Google Scholar 

  32. Zamboni M, Mazzali G, Zoico E, Harris TB, Meigs JB, Di Francesco V et al. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes 2005; 29: 1011–1029.

    Article  CAS  Google Scholar 

  33. Engelen MPKJ, Schols AMWJ, Baken WC, Wesseling GJ, Wouters EFM . Nutritional repletion in relation to respiratory and peripheral skeletal muscle functions in out-patients with COPD. Eur Respir J 1994; 7: 1793–1797.

    Article  CAS  Google Scholar 

  34. Nishimura Y, Tsutsumi M, Nakata H, Tsunenari T, Maeda H, Yokoyama M . Relationship between respiratory muscle strength and lean body mass in men with COPD. Chest 1995; 107: 1232–1236.

    Article  CAS  Google Scholar 

  35. Enright P, Kronmal R, Manolio T, Schenker M, Hyatt R . Respiratory muscle strength in the elderly: correlates and reference values. Am Rev Respir Dis 1994; 149: 430–438.

    Article  CAS  Google Scholar 

  36. Chan ED, Welsh CH . Geriatric respiratory medicine. Chest 1998; 114: 1704–1733.

    Article  CAS  Google Scholar 

  37. Baumgartner RN . Body composition in healthy aging. Ann N Y Acad Sci 2000; 904: 437–448.

    Article  CAS  Google Scholar 

  38. Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS . Sarcopenia. J Lab Clin Med 2001; 137: 231–243.

    Article  CAS  Google Scholar 

  39. Baumgartner RN, Wayne JW, Waters DL, Janssen I, Gallagher D, Morley JE . Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 2004; 12: 1995–2004.

    Article  Google Scholar 

  40. Lazarus R, Gore CJ, Booth M, Owen N . Effects of body composition and fat distribution on ventilatory function in adults. Am J Clin Nutr 1998; 68: 35–41.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Bret H Goodpaster from the Departments of Health and Physical Activity and Medicine, University of Pittsburgh, Pittsburgh, PA, USA, for the support in the critical review of the manuscript.

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Correspondence to M Zamboni.

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Rossi, A., Fantin, F., Di Francesco, V. et al. Body composition and pulmonary function in the elderly: a 7-year longitudinal study. Int J Obes 32, 1423–1430 (2008). https://doi.org/10.1038/ijo.2008.103

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