E-Letter responses to:

perspective: Eric Ravussin PHYSIOLOGY: A NEAT Way to Control Weight? Science 2005; 307: 530-531 [Summary] [Full text] [PDF]

E-Letters: Submit a response to this article

Published E-Letter responses:

Reduced daily activity is associated with increased fat mass in renal transplant patients

Jeroen P. Kooman, Eugenie van den Ham, Annemie Schols, Johannes P. van Hooff   (21 April 2005)

Reduced daily activity is associated with increased fat mass in renal transplant patients 21 April 2005
Jeroen P. Kooman, internist/nephrologist university hospital maastricht; the Netherlands, Eugenie van den Ham, Annemie Schols, Johannes P. van Hooff Respond to this E-Letter: Re: Reduced daily activity is associated with increased fat mass in renal transplant patients	We read with interest the paper of Levine et al., in which significant differences in the daily life routines were observed between lean and obese sedentary subjects. Not only in the healthy population, but also in renal transplant patients, obesity is a problem. Whereas patients with terminal renal failure are often malnourished associated with depletion of lean body mass, a significant weight gain is observed after renal transplantation (1). However, we and other showed that this increase in body weight is predominantly due to an increase in body fat (2,3). Moreover, in a cross-sectional study in 77 renal transplant patients, we showed that more than 65% of the female renal transplant patients had a waist to hip ratio above 0.80. (4), which is, in the general population, associated with increased risk of metabolic abnormalities, hypertension, diabetes mellitus, and cardiovascular disease. Aggravation of these risk factors, which are commonly present in renal transplant patients, may have a deleterious effect on the already severely compromised cardiovascular risk profile in renal transplant patients (5). Indeed, obese renal transplant patients were shown to be at increased risk for posttransplant hypertension, diabetes mellitus, ischemic heart disease, and overall mortality (6). Despite restoration of renal function, renal transplant patients generally remain inactive. In a cross-sectional study in 77 renal transplant patients, we showed that, in female patients, leisure time physical activity, assessed with Baecke Questionnaire, was positively related with the percentage lean body mass (r=0.571, p=0.004) and inversely related with fat mass (r=-0.588, p=0.003), assessed by dual-x-ray absorptiometry (3). Nutrient intake and corticosteroid dosage were not related to body composition. These data show that, in this patient population with a greatly increased risk for cardiovascular mortality, low everyday physical activity is also associated with an increase in body fat mass. It remains to be elucidated whether it is sufficient to improve daily routines or whether large-scale training interventions are needed to improve body composition and cardiovascular risk profile in renal transplant recipients. 1. E. C. van den Ham et al.. Transpl. Int. 16, 300 (2003). 2. E. C. van den Ham et al., Transplantation 70, 241 (2000). 3. I. Isiklar et al., Transplant. Proc. 30, 831; E. C. van den Ham et al., Transplantation 69, 1591 (2000). 4. D. C. Wheeler et al., Transplantation 70 (11 Suppl), SS41 (2000). 5. A. E. el-Agroudy et al., Transplantation 77, 1381 (2004).