J. V. G. A. Durnin

A comparison of the skinfold method with extent of ‘overweight’ and various weight-height relationships in the assessment of obesity

1. Body-weight, height, skinfold thickness and body density measurements were made on 245 men and 324 women aged between 17 and 72 years. The body fat content of each individual was calculated from his density measurement using equations similar to that of Siri (1956) but appropriate to age, muscular development, and extent of obesity. Regression equations were then derived for separate age-groups for the prediction of body fat from (1) weight–height (W–H) relationships (W:H, W:H2 W:H3, W0.33:H, H:W0.33), (2) ‘percentage overweight’ (body-weight:mean body-weight; W:W;) and ‘percentage desirable weight’ body-weight: ‘desirable weight’ (mean weights for men and women aged 20-24 years); (W:DES), (3) the independent variables weight and height incorporated in a regression equation, (4) skinfold measurements.2. The correlations between height and indices, W:H, W:H3, W0.33:H and H:W0.33: were substantially different from those between height and body fat estimated by densitometry.3. The method having the highest correlation with body fat estimated by densitometry was the skinfold method, although in the older groups of women other methods sometimes gave equally good correlations. The index H:W0.33 had a negative correlation with body fat, and the indices W:H, W0.33:H and W:H3 had a lower correlation with body fat estimated by densitometry than did the other indices. These indices are therefore unsuitable measures of obesity, and this is in agreement with the findings of other workers.4. The correlations betweeen body fat estimated by densitometry and the indices W:H2, W:W, W:DES and the equations incorporating the independent variable weight and height are all very similar, although it is not appropriate to use the index W:W; as a measure of obesity in groups of people of widely different ages.5. The standard error of prediction of body fat from skinfold measurement may be of the same order of magnitude as the standard error of prediction of body fat by densitometry. It is therefore probably inappropriate to assess the accuracy of the skinfold method by comparison with the density method alone.6. From the distribution patterns obtained, it was evident that compared with the density method, all methods tended to over-estimate body fat in very lean individuals. The skinfold method however showed this tendency to only a relatively small extent.

Determination of the total daily energy expenditure in man by indirect calorimetry: assessment of the accuracy of a modern technique

Selenium and dental depigmentation 41 incidence of liver necrosis, it had no apparent effect on the depigmentation of the rats’ incisors which takes place if these animals are fed on a diet deficient in tocopherol, and which is prevented only by this vitamin. 4. The parallelism between the effect of selenium and of vitamin E, both of which prevent liver necrosis and prolong the survival time of deficient rats, therefore does not extend to the disturbance causing dental depigmentation.

Thermic effect of food in man: Effect of meal composition, and energy content

The effect of meal composition and energy content on the thermic effect of food (TEF) was investigated in sixteen adult, non-obese female subjects. Each subject consumed four different test meals, each meal on a different day. Meals were of high-carbohydrate-low-fat (HCLF) with 0.70, 0.19 and 0.11 of the energy content from carbohydrate, fat and protein respectively, and low-carbohydrate-high-fat (LCHF) with 0.24, 0.65 and 0.11 of the energy content from carbohydrate, fat and protein respectively. The energy contents of the test meals for each composition were 2520 kJ (600 kcal) and 5040 kJ (1200 kcal). The basal metabolic rate (BMR) and the postprandial metabolic rate (PP-MR) were measured by open-circuit indirect calorimetry using the Douglas bag technique while the subjects were in the supine position. The mean BMR value was 3.63 (SE 0.07) kJ/min (0.87 kcal/min (SE 0.017)). The 5 h-TEF value for the 2520 kJ (600 kcal) HCLF meal was 228 (SE 11.8) kJ (54 kcal (SE 2.8)) and for the LCHF meal was 228 (SE 9.6) kJ (54 kcal (SE 2.3)). The corresponding values for the 5040 kJ (1200 kcal) meals were 356 (SE 20.4) kJ (85 kcal (SE 4.9)) and 340 (SE 15.8) kJ (81 kcal (SE 3.8)). There was no significant (P = 0.49) effect of meal composition on TEF, but the energy content of the meals had a significant (P less than 0.001) effect on TEF. In all subjects and for all meals, PP-MR had not returned to premeal level 5 h after a meal, indicating that the TEF values measured underestimate total TEF. The present study suggests that TEF is significantly influenced by the energy content of a meal but not by meal composition.

The energy expenditure and food intake of middle-aged Glasgow housewives and their adult daughters.

Benedict, F. G. & Carpenter, T. M. (1918). Publ. Curneg. Instn, no. 261. Booth, G. & Strang, J. M. (1936). Arch intern. Med. 57, 533. Brobeck, J. R. (1948). YaleJ. Biol. Med. 20, 545. Brobeck, J. R. (1956). Int. physiol. Congr. xx. Brussels, p. 133. Burton, A. C. & Edholm, 0. G. (1955). Man in u Cold Environment. London: Edward Arnold. Magnus-Levy, A. (1894). Pjliig. Arch. ges. Physiol. 55, I. Magnus-Levy, A. (1907). In Metabolism and Practical Medicine, p. 208. [C. von Norden, editor.]

The effect of alcohol on resting metabolic rate.

1. There was a significant increase in oxygen consumption in ten women after small intakes of alcohol. 2. No significant difference was found between the average increase in metabolic rate over 3 h after an isoenergetic meal of food or of food plus alcohol. However, during the last half of the 3 h postprandial period, the increased O2 consumption was significantly greater after the meal including alcohol. 3. Possible explanations for the contradictory results in the literature are discussed.

The food intake and energy expenditure of elderly women living alone

The increasing population of elderly people in many countries makes it more necessary than ever to have information on their nutritional requirements. At present few data are available on the nutrition of the elderly, a fact on which several national and international organizations have commented (Durnin, 1960). The elderly, together with the adolescent, are groups particularly vulnerable when food is in short supply. Even when there is no widespread shortage, elderly men and women living alone are more likely to suffer from nutrient deficiencies than the general population since they may often find cooking too much trouble and they may have insufficient money to buy enough of the correct food. We have previously investigated the food intake and energy expenditure of young and of middle-aged women (Durnin, Blake & Brockway, 1957) and were interested in obtaining comparable information for elderly women, especially since conflicting results have been reported by other investigators. For instance, Pyke, Holmes, Harrison & Chamberlain (1947) found that the mean calorie intake of women aged about 60 was 1500 kcal/day. Baines & Hollingsworth (1955) described National Food Survey estimates which apparently show the calorie value of the foods purchased by women in Britain, aged between 60 and 69 and living alone, to be about 2900 kcallday. On the other hand, Bransby & Osborne (1953), in an investigation of women in the same age range and who were either living alone or with their husbands, estimated their calorie intakes at I 800-1900 kcal/day. However, the few and occasionally divergent experimental data on the food intake of elderly women are in contrast to the surprising uniformity of the recommendations of calorie requirements proposed by various official bodies. For example, the (U.S.A.) National Research Council: Food and Nutrition Board (1958) recommended that for women aged 65 and weighing about 130 lb an intake of 1850 kcal/day is desirable. The FAO: Committee on Calorie Requirements (1957) advised an intake of 1920 kcal/day. A study of the food intake and, as a check on calorie requirements, of the total energy expenditure of a group of elderly women living alone was undertaken in the Glasgow area. The subjects also kept records of their food purchases, by a budgetary method similar to that used for the National Food Survey in Britain before 1951, the results of which will be published by Durnin & Blake in another paper.

The use of surface area and of body-weight as standards of reference in studies on human energy expenditure

In assessing the nutritional status of populations, it is becoming increasingly common to measure not only the total food intake but also the energy expenditure of groups of individuals. I t is often difficult to compare the results obtained by different authors in such studies of energy expenditure because of the diverse ways in which these results may be expressed. The metabolic cost of a period of work, or of any particular activity, may be given as gross Cal. or net Cal.; net Cal. may involve a deduction for basal metabolism (B.M.R.) or for specific dynamic action (s.D.A.) or for both. These results may then appear as Cal./h or Cal./min; they may be expressed as Cal./m2 body surface area or as Cal./kg body-weight; they may be Cal. per gross body-weight or per fat-free body-weight. For example, Carpenter & Benedict (1909) express their results as gross Cal./h. Cathcart & Orr (1919) express theirs as gross Cal./h and gross Cal./m2/h. Orr & Leitch (1937-8) list the energy expenditure of general activities (e.g. knitting, washing, shoemaking, mining) as Cal./h after deduction of the expenditure in basal metabolism and after subtraction of 10% of the energy expenditure as due to S.D.A. Granati & Busca (1941) give energy expenditure for a specific activity as Cal./Io min work with a deduction for the metabolism of rest. Marro, Milani & Vigliani (1954) use gross Cal./m2/h. Lehmann, Muller & Spitzer (1950) use net Cal. with a deduction for B.M.R. Christensen & Hogberg (1950) and Christensen (1953) quote results as gross Cal./min. Insull (1954) uses gross Cal./min. Buskirk, Kreider, Brebbia, Morana, Daniels, Welch, Mann, Insull & Friedemann (1956) express results as Cal./kg bodyweight/h and as Cal./m2/h. Welch, Marcinek, Buskirk & Iampietro (1957) give results as net Cal./min with deductions for B.M.R. and S.D.A. Therefore, before data from different sources can be compared much recalculation must be done. Passmore & Durnin (1955) had this difficulty when they drew up tables to express energy expenditure in different activities in a consistent manner. There would often appear to be little reason for this diversity. The present paper discusses this problem with especial regard to the use of surface area and of body-weight as the particular standard of reference.

The food intake and energy expenditure of some elderly men working in heavy and light engineering.

It is a commonplace to state that elderly people and the old are becoming an increasingly important group in the community in most countries of the world. Nutritionally, at least, it is not yet a commonplace to investigate them. Durnin, Blake, Brockway & Drury (1961) give the results of measurements on the food intake and energy expenditure of seventeen elderly women living alone in their separate households. The present paper describes, as part of a large-scale study on elderly people in Scotland, similar measurements on some elderly men working in three different types of engineering. Only the mean results of the study of energy expenditure are referred to briefly here; the details of the type of work and of the results obtained are given separately (Durnin & Blake, 1962).

A comparison of the food intake of elderly women estimated by the individual inventory and the National Food Survey methods.

In a previous paper (Durnin, Blake, Brockway & Drury, 1961) we reported the energy expenditure and the intake of calories and of nutrients by seventeen elderly women, aged between 60 and 69 years, living alone. Their mean intake and expenditure of calories were about 1900 kcal/day. Intake of nutrients was assessed by the individual-inventory method, in which the separate items of food are weighed immediately before eating, and any plate wastage remaining after the meal is deducted; the mean result obtained by this method for these elderly women agreed within 5 % with their mean energy expenditure. A value of 1900 kcallday also approximates closely to the supposed physiological requirements of women of this age and bodyweight (61 kg), and to several official recommendations for calorie allowances. However, 1900 kcal/day is very much lower than results obtained in the National Food Survey (NFS) in Britain (Ministry of Agriculture, Fisheries and Food: National Food Survey Committee, 1960), indicating that the food purchases of elderly women, living alone and aged 60-69 years, averaged about 2900 kcal/day. Even if losses in preparation and plate wastage are allowed for, this seems a surprisingly large amount, as has been noted by Baines & Hollingsworth (1955) when considering previous similar findings of the NFS. The subjects in the study mentioned (Durnin et al. 1961) recorded their food purchases by the NFS method, as well as having their food intake and energy expenditure measured, in order to allow a direct comparison between the methods. Other subjects, not dealt with in the previous paper, recorded only their food purchases so that any possible bias, caused by the several sets of concurrent recordings, might be elicited. The present paper reports and discusses the results obtained on both groups of women.

The diets of middle-aged Glasgow housewives and their adult daughters.

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