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The altered fluid distribution in obesity may reflect plasma hypertonicity

European Journal of Clinical Nutrition volume 61, pages 190–199 (2007)Cite this article

Abstract

Objective:

This study explored whether the increased extracellular relative to intracellular fluid (ECF/ICF) ratio in obesity might reflect osmotic effects of elevated plasma solute concentrations.

Design:

Cross-sectional, epidemiological survey.

Setting and subjects:

The present analysis used nationally representative data from the Third National Health and Nutrition Examination Survey on community-dwelling adults (aged 40–59 years) in the US without evidence of glucose dysregulation or chronic disease (n=1285).

Intervention:

Body mass index (BMI) was estimated from measured height and weight. Total body reactance, an index of body fluid distribution, was determined by bioelectrical impedance analysis. Plasma tonicity (the cumulative index of osmotically effective plasma solute) was estimated from plasma glucose, sodium and potassium. Sex-specific relative odds of lower reactance (⩽50 Ω/m for women, ⩽40 Ω/m for men) and plasma hypertonicity (tonicity ⩾295 mmol/l) associated with overweight (25⩽BMI <30) and obesity (BMI⩾30) were estimated using logistic regression models that controlled for sociodemographic variables, smoking, leisure-time physical activity, total energy intake, serum creatinine, plasma insulin and glucose. Multinomial logistic regression models tested for associations between weight status and specific serum solute.

Results:

Independent of covariates, in men and women, overweight and obesity were associated with increased odds of lower reactance and hypertonicity. Overweight and obese individuals with lower reactance had significantly higher serum sodium than normal weight individuals.

Conclusions:

Elevated plasma solute concentrations are associated with obesity in free-living adults. Physicians and researchers should be alert to a possible link between hypertonicity and obesity.

Descriptors:

Hydration, body water, hypertonicity, obesity, ECF/ICF ratio, sodium.

Sponsorship:

Grants from the NIH, Nestle Waters.

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Notes

  1. According to Liedtke (1998), the BIA electrical signal leaks through protein channels in the cell membrane and charges the inside of the cells lipid bilayer. As the same charge with opposite polarity exists on the outside of the cell bilayer, the cell membrane acts as a capacitor that can store a charge of electrons for a period of time. Capacitors give circuits reactance and cause electrical current to lag. The amount of charge a capacitor will hold is proportional to the area of the charged membrane.

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Acknowledgements

The National Center for Health Statistics is the original source of the NHANES III data. Funding for this analysis was provided by Public Health Service NRSA No. 5 T32 HL 07034 from the NHLBI and an unrestricted grant from Nestle Waters.

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Authors and Affiliations

  1. Children's Hospital of Oakland Research Institute, Oakland, CA, USA

    J D Stookey

  2. Nestle Research Center, Switzerland

    D Barclay

  3. School of Medicine, University of California, San Francisco, CA, USA

    A Arieff

  4. Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA

    B M Popkin

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  1. J D Stookey
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Correspondence to J D Stookey.

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Stookey, J., Barclay, D., Arieff, A. et al. The altered fluid distribution in obesity may reflect plasma hypertonicity. Eur J Clin Nutr 61, 190–199 (2007). https://doi.org/10.1038/sj.ejcn.1602521

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