Body Fat Distribution Glucocorticoids Testosterone women Physical inactivity

Body Fat Distribution Glucocorticoids Testosterone (women) Physical inactivity Smoking Growth hormone Oestrogen Testosterone (men) Lower body obesity Genetics Upper body / visceral obesity Insulin resistance insulin extraction Triglycerides HDL : LDL ratio

waist–hip ratio � WHO states that abdominal obesity is defined as a waist–hip ratio above 0. 90 for males and above 0. 85 for females, or a body mass index (BMI) above 30

(Body composition) ﺑﺪﻥ ﺗﺮکﻴﺐ � 1. Indirect methods � MAC (Midarm circumference) � MAMC (Midarm muscle circumference) � TSF (Triceps skin fold) � Useful in the assessment of individuals overtime but not in critical and acute care settings

Bioelectrical Impedance Analysis (BIA) Very popular � Safe � Noninvasive � Portable � Rapid �

Bioelectrical Impedance Analysis (BIA) � � Aim: To study body composition Mechanism: Relative to water, lean tissue has a higher electrical conductivity and lower impedance than fatty tissue (because of its electrolyte content) BIA is more reliable measurement of body composition (fat-free mass and fat mass) when compared with BMI, skin-fold measurements or even height and weight measurement

Bioelectrical Impedance Analysis (BIA) For accurate results � � � Patient should be well hydrated No exercise in the past 4 -6 hrs If dehydrated=a higher percentage of body fat than really exists is measured Drinking two to four glasses of water app. 2 hrs before the test Emptying the bladder just before the test