. 2021 Nov 8;114(5):1583-1589.

doi: 10.1093/ajcn/nqab260.

Physical activity and fat-free mass during growth and in later life

Klaas R Westerterp¹, Yosuke Yamada^{2

3}, Hiroyuki Sagayama⁴, Philip N Ainslie⁵, Lene F Andersen⁶, Liam J Anderson^{5

7}, Lenore Arab⁸, Issaad Baddou⁹, Kweku Bedu-Addo¹⁰, Ellen E Blaak¹¹, Stephane Blanc^{12

13}, Alberto G Bonomi¹⁴, Carlijn V C Bouten¹⁵, Pascal Bovet¹⁶, Maciej S Buchowski¹⁷, Nancy F Butte¹⁸, Stefan G J A Camps¹¹, Graeme L Close⁵, Jamie A Cooper¹², Sai K Das¹⁹, Richard Cooper²⁰, Lara R Dugas²⁰, Ulf Ekelund²¹, Sonja Entringer^{22

23}, Terrence Forrester²⁴, Barry W Fudge²⁵, Annelies H Goris¹¹, Michael Gurven²⁶, Catherine Hambly²⁷, Asmaa El Hamdouchi⁹, Marije B Hoos¹¹, Sumei Hu²⁸, Noorjehan Joonas²⁹, Annemiek M Joosen¹¹, Peter Katzmarzyk³⁰, Kitty P Kempen¹¹, Misaka Kimura², William E Kraus³¹, Robert F Kushner³², Estelle V Lambert³³, William R Leonard³⁴, Nader Lessan³⁵, Corby K Martin³⁰, Anine C Medin^{6

36}, Erwin P Meijer¹¹, James C Morehen^{5

37}, James P Morton⁵, Marian L Neuhouser³⁸, Theresa A Nicklas¹⁸, Robert M Ojiambo^{39

40}, Kirsi H Pietiläinen⁴¹, Yannis P Pitsiladis⁴², Jacob Plange-Rhule¹⁰, Guy Plasqui⁴³, Ross L Prentice³⁸, Roberto A Rabinovich⁴⁴, Susan B Racette⁴⁵, David A Raichlen⁴⁶, Eric Ravussin³⁰, Rebecca M Reynolds⁴⁷, Susan B Roberts¹⁹, Albertine J Schuit⁴⁸, Anders M Sjödin⁴⁹, Eric Stice⁵⁰, Samuel S Urlacher⁵¹, Giulio Valenti¹¹, Ludo M Van Etten¹¹, Edgar A Van Mil⁵², Jonathan C K Wells⁵³, George Wilson⁵, Brian M Wood^{54

55}, Jack Yanovski⁵⁶, Tsukasa Yoshida⁴, Xueying Zhang^{27

28}, Alexia J Murphy-Alford⁵⁷, Cornelia U Loechl⁵⁷, Amy H Luke⁵⁸, Herman Pontzer^{59

60}, Jennifer Rood³⁰, Dale A Schoeller⁶¹, William W Wong¹⁸, John R Speakman^{27

28

62

63}; International Atomic Energy Agency Doubly Labeled Water database group

Collaborators, Affiliations

Collaborators

International Atomic Energy Agency Doubly Labeled Water database group:
Stefan Branth, Lisa H Colbert, Niels C De Bruin, Alice E Dutman, Sölve Elmståhl, Mikael Fogelholm, Tamara Harris, Rik Heijligenberg, Hans U Jorgensen, Christel L Larsson, Elisabet M Rothenberg, Margaret McCloskey, Gerwin A Meijer, Daphne L Pannemans, Sabine Schulz, Rita Van den Berg-Emons, Wim G Van Gemert, W Wilhelmine, Venne Verboeket-van de, Jeanine A Verbunt, Renaat M Philippaerts, Amy Subar, Minna Tanskanen, Ricardo Uauy, Erica J Velthuis-Te Wierik

Affiliations

¹ School of Nutrition and Translational Research in Metabolism, University of Maastricht, Maastricht, The Netherlands.
² National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
³ Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan.
⁴ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
⁵ Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
⁶ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
⁷ Crewe Alexandra Football Club, Crewe, United Kingdom.
⁸ David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
⁹ Unité Mixte de Recherche en Nutrition et Alimentation, CNESTEN-Université Ibn Tofail URAC39, Regional Designated Center of Nutrition Associated with African Regional Agreement for Research/International Atomic Energy Agency, Rabat, Morocco.
¹⁰ Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹¹ Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
¹² Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
¹³ Institut Pluridisciplinaire Hubert Curien. CNRS Université de Strasbourg, UMR7178, Strasbourg, France.
¹⁴ Phillips Research, Eindhoven, The Netherlands.
¹⁵ Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands.
¹⁶ University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
¹⁷ Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
¹⁸ Department of Pediatrics, Baylor College of Medicine, USDA/Agricultural Research Service Children's Nutrition Research Center, Houston, TX, USA.
¹⁹ Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
²⁰ Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA.
²¹ Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
²² Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
²³ Department of Pediatrics, University of California Irvine, Irvine, CA, USA.
²⁴ Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica.
²⁵ Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
²⁶ Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA.
²⁷ Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, United Kingdom.
²⁸ State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
²⁹ Central Health Laboratory, Ministry of Health and Wellness, Port Louis, Mauritius.
³⁰ Pennington Biomedical Research Center, Baton Rouge, LA, USA.
³¹ Department of Medicine, Duke University, Durham, NC, USA.
³² Department of Medicine, Northwestern University, Chicago, IL, USA.
³³ Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
³⁴ Department of Anthropology, Northwestern University, Evanston, IL, USA.
³⁵ Imperial College London Diabetes Centre, Imperial College London, London, United Kingdom.
³⁶ Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
³⁷ The FA Group, Burton-Upon-Trent, United Kingdom.
³⁸ Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and School of Public Health, University of Washington, Seattle, WA, USA.
³⁹ Department of Medical Physiology, Moi University, Eldoret, Kenya.
⁴⁰ Department of Biomedical Sciences, University of Global Health Equity, Butaro, Rwanda.
⁴¹ Helsinki University Central Hospital, Helsinki, Finland.
⁴² Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, United Kingdom.
⁴³ Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, The Netherlands.
⁴⁴ Department of Respiratory Medicine, University of Edinburgh, Edinburgh, United Kingdom.
⁴⁵ Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
⁴⁶ Biological Sciences and Anthropology, University of Southern California, Los Angeles, CA, USA.
⁴⁷ Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
⁴⁸ School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands.
⁴⁹ Department of Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark.
⁵⁰ Department of Psychiatry, Stanford University, Stanford, CA, USA.
⁵¹ Department of Anthropology, Baylor University, Waco, TX, USA.
⁵² Faculty of Health, Medicine and Life Sciences, and Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands.
⁵³ Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
⁵⁴ Department of Antropology, University of California Los Angeles, Los Angeles, CA, USA.
⁵⁵ Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.
⁵⁶ Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA.
⁵⁷ Nutritional and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
⁵⁸ Division of Epidemiology, Department of Public Health Sciences, Loyola University School of Medicine, Maywood, IL, USA.
⁵⁹ Evolutionary Anthropology, Duke University, Durham, NC, USA.
⁶⁰ Duke Global Health Institute, Duke University, Durham, NC, USA.
⁶¹ Biotech Center and Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
⁶² Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
⁶³ CAS Center of Excellence in Animal Evolution and Genetics, Kunming, China.

PMID: 34477824
PMCID: PMC8574623
DOI: 10.1093/ajcn/nqab260

Physical activity and fat-free mass during growth and in later life

Klaas R Westerterp et al. Am J Clin Nutr. 2021.

. 2021 Nov 8;114(5):1583-1589.

doi: 10.1093/ajcn/nqab260.

Authors

Collaborators

International Atomic Energy Agency Doubly Labeled Water database group:
Stefan Branth, Lisa H Colbert, Niels C De Bruin, Alice E Dutman, Sölve Elmståhl, Mikael Fogelholm, Tamara Harris, Rik Heijligenberg, Hans U Jorgensen, Christel L Larsson, Elisabet M Rothenberg, Margaret McCloskey, Gerwin A Meijer, Daphne L Pannemans, Sabine Schulz, Rita Van den Berg-Emons, Wim G Van Gemert, W Wilhelmine, Venne Verboeket-van de, Jeanine A Verbunt, Renaat M Philippaerts, Amy Subar, Minna Tanskanen, Ricardo Uauy, Erica J Velthuis-Te Wierik

Affiliations

¹ School of Nutrition and Translational Research in Metabolism, University of Maastricht, Maastricht, The Netherlands.
² National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
³ Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan.
⁴ Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
⁵ Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
⁶ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
⁷ Crewe Alexandra Football Club, Crewe, United Kingdom.
⁸ David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
⁹ Unité Mixte de Recherche en Nutrition et Alimentation, CNESTEN-Université Ibn Tofail URAC39, Regional Designated Center of Nutrition Associated with African Regional Agreement for Research/International Atomic Energy Agency, Rabat, Morocco.
¹⁰ Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
¹¹ Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
¹² Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
¹³ Institut Pluridisciplinaire Hubert Curien. CNRS Université de Strasbourg, UMR7178, Strasbourg, France.
¹⁴ Phillips Research, Eindhoven, The Netherlands.
¹⁵ Department of Biomedical Engineering and Institute for Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, The Netherlands.
¹⁶ University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
¹⁷ Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, TN, USA.
¹⁸ Department of Pediatrics, Baylor College of Medicine, USDA/Agricultural Research Service Children's Nutrition Research Center, Houston, TX, USA.
¹⁹ Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
²⁰ Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA.
²¹ Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
²² Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
²³ Department of Pediatrics, University of California Irvine, Irvine, CA, USA.
²⁴ Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica.
²⁵ Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
²⁶ Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA.
²⁷ Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, United Kingdom.
²⁸ State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
²⁹ Central Health Laboratory, Ministry of Health and Wellness, Port Louis, Mauritius.
³⁰ Pennington Biomedical Research Center, Baton Rouge, LA, USA.
³¹ Department of Medicine, Duke University, Durham, NC, USA.
³² Department of Medicine, Northwestern University, Chicago, IL, USA.
³³ Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
³⁴ Department of Anthropology, Northwestern University, Evanston, IL, USA.
³⁵ Imperial College London Diabetes Centre, Imperial College London, London, United Kingdom.
³⁶ Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
³⁷ The FA Group, Burton-Upon-Trent, United Kingdom.
³⁸ Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and School of Public Health, University of Washington, Seattle, WA, USA.
³⁹ Department of Medical Physiology, Moi University, Eldoret, Kenya.
⁴⁰ Department of Biomedical Sciences, University of Global Health Equity, Butaro, Rwanda.
⁴¹ Helsinki University Central Hospital, Helsinki, Finland.
⁴² Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, United Kingdom.
⁴³ Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, The Netherlands.
⁴⁴ Department of Respiratory Medicine, University of Edinburgh, Edinburgh, United Kingdom.
⁴⁵ Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
⁴⁶ Biological Sciences and Anthropology, University of Southern California, Los Angeles, CA, USA.
⁴⁷ Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
⁴⁸ School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands.
⁴⁹ Department of Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark.
⁵⁰ Department of Psychiatry, Stanford University, Stanford, CA, USA.
⁵¹ Department of Anthropology, Baylor University, Waco, TX, USA.
⁵² Faculty of Health, Medicine and Life Sciences, and Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands.
⁵³ Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
⁵⁴ Department of Antropology, University of California Los Angeles, Los Angeles, CA, USA.
⁵⁵ Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.
⁵⁶ Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA.
⁵⁷ Nutritional and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
⁵⁸ Division of Epidemiology, Department of Public Health Sciences, Loyola University School of Medicine, Maywood, IL, USA.
⁵⁹ Evolutionary Anthropology, Duke University, Durham, NC, USA.
⁶⁰ Duke Global Health Institute, Duke University, Durham, NC, USA.
⁶¹ Biotech Center and Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
⁶² Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
⁶³ CAS Center of Excellence in Animal Evolution and Genetics, Kunming, China.

PMID: 34477824
PMCID: PMC8574623
DOI: 10.1093/ajcn/nqab260

Abstract

Background: Physical activity may be a way to increase and maintain fat-free mass (FFM) in later life, similar to the prevention of fractures by increasing peak bone mass.

Objectives: A study is presented of the association between FFM and physical activity in relation to age.

Methods: In a cross-sectional study, FFM was analyzed in relation to physical activity in a large participant group as compiled in the International Atomic Energy Agency Doubly Labeled Water database. The database included 2000 participants, age 3-96 y, with measurements of total energy expenditure (TEE) and resting energy expenditure (REE) to allow calculation of physical activity level (PAL = TEE/REE), and calculation of FFM from isotope dilution.

Results: PAL was a main determinant of body composition at all ages. Models with age, fat mass (FM), and PAL explained 76% and 85% of the variation in FFM in females and males < 18 y old, and 32% and 47% of the variation in FFM in females and males ≥ 18 y old, respectively. In participants < 18 y old, mean FM-adjusted FFM was 1.7 kg (95% CI: 0.1, 3.2 kg) and 3.4 kg (95% CI: 1.0, 5.6 kg) higher in a very active participant with PAL = 2.0 than in a sedentary participant with PAL = 1.5, for females and males, respectively. At age 18 y, height and FM-adjusted FFM was 3.6 kg (95% CI: 2.8, 4.4 kg) and 4.4 kg (95% CI: 3.2, 5.7 kg) higher, and at age 80 y 0.7 kg (95% CI: -0.2, 1.7 kg) and 1.0 kg (95% CI: -0.1, 2.1 kg) higher, in a participant with PAL = 2.0 than in a participant with PAL = 1.5, for females and males, respectively.

Conclusions: If these associations are causal, they suggest physical activity is a major determinant of body composition as reflected in peak FFM, and that a physically active lifestyle can only partly protect against loss of FFM in aging adults.

Keywords: age; body composition; doubly labeled water; energy expenditure; physical activity level.

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Figures

**FIGURE 2**
FFM, FM, and PAL, plotted as a function of age. Values for 2000 participants—1182 females (left) and 818 males (right)—with a 4th-order polynomial curve fit. FFM, fat-free mass; FM, fat mass; PAL, physical activity level.

See this image and copyright information in PMC

Comment in

Can increasing physical activity prevent aging-related loss of skeletal muscle?
Heymsfield SB, Fearnbach N. Heymsfield SB, et al. Am J Clin Nutr. 2021 Nov 8;114(5):1579-1580. doi: 10.1093/ajcn/nqab283. Am J Clin Nutr. 2021. PMID: 34476475 Free PMC article. No abstract available.

References

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1. Janz KF, Letuchy EM, Eichenberger Gilmore JM, Burns TL, Tomer JC, Willing MC, Levy SM. Early physical activity provides sustained bone health benefits later in childhood. Med Sci Sports Exerc. 2010;42(6):1072–8. - PMC - PubMed
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Physical activity and fat-free mass during growth and in later life

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Physical activity and fat-free mass during growth and in later life

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