Anti-obesity effects of probiotics beyond BMI: a critical review of human clinical trials.

BMI: Does it really reflect body fat mass?

Objectives. The reliability of predictive body fat equations remains unclear due to their inappropriate use across different subject cohorts and conditions. The objective of this study was to validate and cross-validate equations to predict total and regional body fat in young physically active males. Material and methods. Three hundred and five young male participants were divided into the following groups: active validation (n=165), active cross-validation (n=70), or sedentary cross-validation ones (n=70). The study used a stratified random sampling based on weekly physical activity level. The total and regional body fat mass were measured using dual-energy X-ray absorptiometry (DEXA) after an overnight fast. Simultaneous measurements of height, body mass, skinfold thickness, body mass index, and body circumferences were taken. The total and regional body fat predictive equations were generated using multiple linear stepwise regression models. The coefficient of determination (R²) and standard error of estimation (SEE) were calculated to examine the accuracy of the predictive equations. Furthermore, cross-validation groups were analysed. Results. The percentage of total body fat, trunk fat, legs fat, arms fat, and body mass index of active cross-validation were found to be significantly lower than in the sedentary cross-validation groups. The total body fat percentage was highly associated with abdominal skinfold thickness (R=0.68-0.74, P<0.001), body mass index (R=0.55, P<0.001), and suprailiac skinfold thickness (R=0.67-0.71, P<0.001) in the active validation group. The predictive total and regional body fat equations of physically active men showed adjusted R² values ranging from 0.35 to 0.66, with standard error of estimation values between 2.74 to 4.35%. The standard error of estimation for the predictive percentage of total and regional body fat in the active cross-validation group was lower than in the sedentary cross-validation group. Conclusions. The findings demonstrate that new predictive total and regional body fat equations can be used to accurately estimate body fat in healthy young active males under fast conditions.

Objective To estimate the effects of climacteric modifications on body weight and fat distribution.Methods From 8764 women attending the authors' Menopause Clinic, 1075 untreated, normal healthy women were selected and divided into three groups: premenopausal (n = 380), perimenopausal (n = 263) and postmenopausal (n = 432). The total body fat tissue mass and distribution were analyzed using the dual energy X-ray method.Results Body weight and body mass index (BMI) were significantly higher in perimenopausal and postmenopausal than in premenopausal women. The mean total body fat and the percentage of fat with respect to soft tissue were significantly (p < 0.05) higher in the perimenopausal and postmenopausal groups than in the premenopausal group. The amount of fat tissue and the regional fat percentage with respect to total fat tissue were higher in the trunk (p < 0.05) and arm (p < 0.05) regions in perimenopausal and postmenopausal than in premenopausal women. In the postmenopausal group, the leg fat tissue was significantly (p < 0.05) less than in the premenopausal and perimenopausal groups. Total body and leg lean tissue was significantly (p < 0.01) less in postmenopausal than in premenopausal and perimenopausal women. In the premenopausal group, body weight and BMI were positively correlated with age (r = 0.37 and r = 0.54, respectively). No significant correlations were observed in the perimenopausal group. In postmenopausal women, body weight and BMI were loosely correlated with age (r = 0.13 and r = 0.11, respectively).In three groups of 63 age-matched women, with similar BMI, the percentage of total body fat with respect to soft tissue was significantly (p < 0.001) higher in the perimenopausal and postmenopausal groups than in the premenopausal group. Regarding body fat distribution, the percentage of fat with respect to total fat tissue was significantly higher in the trunk (p < 0.001) region in perimenopausal and postmenopausal women than in premenopausal women. In the leg region, the percentage of fat with respect to total fat tissue was significantly (p < 0.05) higher in the premenopausal group than in the postmenopausal group. In the arm region, a slight but not significant (p < 0.08) difference was shown in fat distribution among the three groups.Conclusions Climacteric changes rather than the aging process are relevant for prediction of body weight and fat distribution, especially for perimenopausal and postmenopausal women, who show a shift to a central, android fat distribution.

Purpose: To examine the associations of various parameters of obesity including adiposity with intraocular pressure (IOP) using nationally representative data of South Korean adults.Material and methods: This cross-sectional study analyzed the data from the 2008–2010 Korea National Health and Nutrition Examination Survey. A total of 15,271 subjects (6600 men and 8671 women) participated. Body mass index (BMI), waist circumference (WC), total body fat mass, and total and regional body fat percentage were measured as parameters of obesity.Results: IOP showed positive linear associations with BMI, WC, total fat mass, and total and regional body fat percentages in men, and with BMI, WC, total fat mass, and trunk fat percentage in women after adjusting for confounding variables. Men with higher BMI, WC, total fat mass, and total and regional body fat percentages exhibited increasing trends in odd ratios for having IOP ≥ 18 mmHg after adjusting for all confounding factors (p for trend <0.001 for BMI and total fat mass; p for trend = 0.038 for WC; 0.003 for total body fat percentage; 0.002 for trunk fat percentage; 0.004 for leg fat percentage). However, only BMI showed a significantly increasing trend in the risk of IOP ≥18 mmHg in women.Conclusions: In addition to BMI, WC and total fat mass, total and regional body fat percentage in men and trunk fat percentage in women are positively associated with IOP. Increased BMI, WC, and total and regional body fat are positively associated with a risk of higher IOP (IOP ≥18 mmHg), especially in Korean men.

Preliminary studies have reported an association between poor long-term outcome and lower total body fat percentage in weight-restored inpatients treated for anorexia nervosa (AN). A possible link between poor long-term outcome and higher trunk fat percentage has also been hypothesized. The aim was to assess the association between percentage and distribution of body fat at inpatient discharge and the maintenance of normal weight at 1-year follow-up in a sample of weight-restored females with AN. Fifty-four short-term weight-restored (body mass index (BMI; in kg/m(2)) ⩾18.5) adult females with AN treated in a specialist inpatient unit underwent dual-energy X-ray absorptiometry to determine total body fat and trunk fat percentages. Patients were contacted regularly following discharge, and at the end of the year clinical outcome was dichotomized as either 'full, good or fair' (a group that includes individuals with a BMI ⩾18.5 kg/m(2)) or 'poor' (BMI<18.5 kg/m(2)), using the modified Morgan-Russell criteria. No significant differences were found between 'full, good or fair' and 'poor' outcome groups in either total body fat or trunk fat percentages. Only lower BMI at inpatient discharge was associated with poor clinical outcome in the year following inpatient treatment. In short-term weight-restored adult females with AN, BMI, but not body fat percentage or distribution, at inpatient discharge is associated with long-term normal weight maintenance.

INTRODUCTION: Thyroid dysfunction affects lipid metabolism via lipoprotein transport. In this study, we compared the fasting lipid profile, body mass index and percentage of total body fat among patients with different thyroid status and its correlation with thyroid function test. MATERIALS AND METHODS: We conducted a cross sectional study over 28 months among patients with different thyroid status from Oncology Clinic and Endocrine Clinic at Hospital Universiti Sains Malaysia. Adult patients age 18 years to 80 years, hyperthyroid at least 6 months or hypothyroid at least 6 months or euthyroid at least 1 year were eligible. The total percentage of body fat was measured using DEXA scan. The thyroid function test and fasting lipid profiles were documented. Comparison of fasting lipid profile, BMI and percentage of total body fat among different thyroid status was performed using one-way ANOVA. Pearson correlation was used to analyse the aforementioned variables with the thyroid function test (TSH and free T4). RESULTS: A total of 159 patients were recruited. The majority were Malays (93.1%), female (68.6%) and hyperthyroid (42.8%). There was no significant mean difference of triglyceride (TG), total cholesterol (T-Chol), LDL, HDL, BMI and percentage of total body fat among patients with different thyroid status (p&gt;0.050). Among hypothyroid patients, T-Chol and HDL were positively correlated with TSH (r=0.43, r=0.36) but inversely correlated with free T4 (r=-0.42, r=-0.39). The free T4 was inversely correlated with the percentage of total body fat among patients with euthyroid status (r=-0.50). The TSH was negatively correlated with the percentage of total body fat among patients with hyperthyroid status (r=-0.28). CONCLUSION: A positive correlation between TSH with T-Chol and negative correlation between T4 with T-Chol among hypothyroidism status suggests a potential reduction of risk in the cardiovascular event among this group.

Regional Fat Distribution and Sleep Apnea: Sex Makes a Difference

Obesity is considered one of the most serious public health problems of the 21st century in children and adolescents. The percentile or Z-score of the body mass index is widely used in children and adolescents to define and assess overweight and obesity, but it does not determine the percentage of total body fat. Other anthropometric measurements that determine total body fat are skinfold thickness and methods of body composition assessment such as bio impedance analysis, both of which are rapid and inexpensive. The aim of the study was to correlate the percentage of body fat determined by the Slaughter equation with the percentage of body fat determined by the bio impedance analysis technique, and the body mass index in schoolchildren. The design of the study is cross-sectional and it was performed on a random selection of 74 children (9.47 ± 1.55 years old) attending a primary school in Colima, Mexico during 2011. The percentage of body fat was measured by the Slaughter equation and bio impedance analysis technique. Body mass index was calculated. Inferential statistics were performed with the non-paired Student's t test, Pearson's correlation for quantitative variables (percentage of body fat by the Slaughter equation and bio impedance analysis) and the Fisher exact test for qualitative variables. A significant correlation (r = 0.74; p < 0.001) was identified between the percentage of fat measured by the Slaughter equation and bio impedance analysis. We also identified a significant correlation between the percentage of fat measured by the Slaughter equation and body mass index (r = 0.85; p < 0.001) and the percentage of fat measured by bio impedance analysis and body mass index (r = 0.78; p < 0.001). Given that we identified a significant positive correlation between BIA and STE, we conclude that both are adequate alternatives for measuring the percentage of body fat among schoolchildren in our population.

Body Composition and Fat Deposition in Children with Cushing Disease and Associations with Cardiometabolic Risk Factors.

Background Systemic inflammation is the continuous phenomenon of inflammatory response which can promote tissue damage. Systemic inflammation is characterized by circulatory elevation of many inflammatory mediators such as (CRP, IL-6 and TNF-α). This state plays a pivotal role in all stages of type 2 diabetes. Stages include pathogenicity and progression and chronic complication development. This study aimed at investigating the risk of systemic inflammation among type 2 diabetic patients according to glycemic control. Objectives This work aimed to investigate the risk of systemic inflammation among type 2 diabetic patients in relation to body fat accumulation and distribution among patients with controlled glycaemia versus poorly controlled patients. Subjects/Methods Study protocol and tools were approved by the research ethics committee; Institutional Review Board (IRB) at Jordan University of Science and Technology (JUST). Patients were recruited from out-patient endocrinology unit at King Abdullah University Hospital (KAUH), Jordan University of Science and Technology Health Center and major private endocrinology clinics in North of Jordan. Initial screening included 1500 patients diagnosed with type 2 diabetes. Due to the multiple co-variation nature of the relationship of interest, about 75% of the initially screened patients were excluded from the study. A total of 198 male and female patients diagnosed with type 2 diabetes participated in this cross-sectional. Patients’ weight, height, waist circumference, total body fat and truncal fat percent were measured. Venous blood specimen were collected and levels of HbA1c, serum hs-CRP, serum IL-6 were determined. A 10-ml sample of venous blood was collected from each patient by a registered nurse. HbA1c blood samples collected in Ethylene-Diamine-Tetra-Acetic acid (EDTA) tubes and measured in whole blood using the Immuno-inhibition test for the quantitative determination of glycosylated hemoglobin (Beckman Coulter AU analyzers). Blood samples of hs-CRP and IL-6 collected in Z-Clot activator tubes. Samples were allowed to clot before centrifugation for 15 minutes at 1000 × g. Aliquot of serum stored at ≤ -22°C in a sterile small tubes prior to biochemical assay. Immuno-turbidimetric test was used to determine hs-CRP levels (Beckman Coulter AU analyzers). IL-6 was measured using a human immunoassay kit from RD patients with healthy body fat percentages had lower hs-CRP (6.30 ± 0.66) compared to patients with obese patients (11.89 ± 1.30). Trunk fat mean seems to be significantly associated with patients’ hs-CRP serum levels regardless of the glycemic control groups (P-value = 0.05). Among patients with poor glycemic control, higher levels of serum IL-6 were detected in obese patients (6.10 ± 0.93) compared to those with normal body weight patients (4.06 ± 1.82). Similar trend is found with regard to WC where patients with poor glycemic control continue to have higher levels of IL-6 with higher WC (P = 0.018). Positive relationship was found between IL-6 serum levels and trunk fat percentage among all patients regardless of glycemic control. Conclusion Findings of the current study indicate that high subcutaneous intraperitoneal fat induces the risk of systemic inflammation regardless of glycemic control. General obesity is associated with systemic inflammation only among patients with poor glycemic control. This study had several strengths including the tough selection procedure of the participants to rule out any response to acute response to inflammation. Several blood measurements were performed on the patients including HbA1c, CRP, and IL-6 which add to the validity of our hypothesis testing. Moreover, the study operationalized obesity in different ways BMI, WC, total and truncal fat%. However, findings of this study is limited due to the cross-sectional nature of the study design.

Extensive studies have identified potential adverse effects on semen quality of obesity, based on body mass index, but the association between body fat distribution, a more relevant indicator for obesity, and semen quality remains less clear. We conducted a longitudinal study of 4304 sperm donors from the Guangdong Provincial Human Sperm Bank (Guangzhou, China) during 2017–2021. A body composition analyzer was used to measure total and local body fat percentage for each participant. Generalized estimating equations were employed to assess the association between body fat percentage and sperm count, motility, and morphology. We estimated that each 10% increase in total body fat percentage (estimated change [95% confidence interval, 95% CI]) was significantly associated with a 0.18 × 106 (0.09 × 106–0.27 × 106) ml and 12.21 × 106 (4.52 × 106–19.91 × 106) reduction in semen volume and total sperm count, respectively. Categorical analyses and exposure-response curves showed that the association of body fat distribution with semen volume and total sperm count was stronger at higher body fat percentages. In addition, the association still held among normal weight and overweight participants. We observed similar associations for upper limb, trunk, and lower limb body fact distributions. In conclusion, we found that a higher body fat distribution was significantly associated with lower semen quality (especially semen volume) even in men with a normal weight. These findings provide useful clues in exploring body fat as a risk factor for semen quality decline and add to evidence for improving semen quality for those who are expected to conceive.

BACKGROUND Physically fit individuals may desire to have well defined abdominal muscles (also known as “6 Pack Abs”). They seek to obtain 6 Pack Abs through numerous exercises that strengthen and tone the abdominal muscles. It has also been purported that to have 6 Pack Abs an individual must have low amounts of total body fat. However, there has been little to no research to determine the amount of body fatness or abdominal muscle strength necessary to have 6 Pack Abs. PURPOSE: The aim of this study was to evaluate the relationship between total and regional body fatness, abdominal muscle strength, and the aesthetic quality of an individual's abs. METHODS: 56 male and 31 female subjects between the ages of 19 and 35 years old were recruited for measurement of body composition via dual-energy x-ray absorptiometry, abdominal skinfold measurement, abdominal muscle strength assessment through a 60 second sit up test, and a photograph of the subject’s bare abdomens. The photographs were then scored on a 10 point scale for overall quality of 6 Pack Abs based on visual appearance for symmetry, muscle mass, and definition (total possible score of 30 points). Regression analysis was used to determine what factors predict 6 Pack Ab score. RESULTS: The strongest predictor of 6 pack ab score for women was having a low percent of android body fat (r2 = 0.52), followed by total percent body fat (r2 = 0.46), abdominal skinfold thickness (r2 = 0.45), and percent of gynoid body fat (r2 = 0.33). The strongest predictor of 6 pack ab score for males was having a low percent of android body fat (r2 = 0.43), followed by total percent body fat (r2 = 0.38) and then abdominal skinfold thickness (r2 = 0.33). 1 minute sit up performance did not significantly predict 6 pack ab score. CONCLUSION: The present data suggest that the strongest predictor of 6 pack ab score is having a low percent of android body fat followed by total percent body fat. Since total body fatness can be influenced by diet and exercise, but body fat distribution is determined by genetics, 6 pack abs may be an unattainable goal for some individuals. Furthermore, the present data indicate that performance on the 1 minute sit up test is not a significant predictor of 6 pack ab score, suggesting that abdominal muscle strength is not a significant influence on 6 pack abs in physically active individuals.

Background/Aim: Despite evidence linking type of obesity with subsequent organ malfunction, such a link with renal malfunction has not been widely researched. The aim of this study was to investigate percentage of total body fat (%TBF), and body fat distribution in relation to the renal function in overweight/obese subjects. Methods: Body mass index (BMI), waist-to-hip ratio (WHR), TBF (by bioelectric impedance), and albumin excretion rate (AER) were determined in 77 subjects: 48 overweight/obese (BMI ≧27.8 for men and ≧27.3 for women) and 29 controls (BMI <27.8 for men and <27.3 for women). Obese subjects were subdivided into those (n = 33) with central fat distribution (WHR ≧0.81 for women and ≧0.92 for men) and those (n = 15) with peripheral fat distribution (WHR <0.81 for women and <0.92 for men). Results: Obesity, irrespective of type, was significantly related to increased AER. Furthermore, in subjects who did not differ in %TBF, the age-adjusted relative risk of abnormal AER was 18 times greater in centrally obese subjects as compared with controls, while only four times greater in peripherally obese subjects. Conclusion: A significant difference in risk of renal malfunction was observed in individuals having the same %TBF, but differing in the distribution of this fat, with a central fat pattern being the greater risk.

Introduction:Conjugated linoleic acid (CLA) is a food supplement that is proposed as an anti-obesity supplement in animal and human studies. Animal studies have shown a significant anti-obesity effect of CLA, but results in humans were inconsistent, where some of the studies found an anti-obesity effect while other studies failed to find any decline in obesity markers after CLA supplementation. This meta-analysis aimed to determine if oral CLA supplementation has been shown to reduce obesity-related markers in women.Method:Pub Med, Cochrane Library, and Google Scholar were used to identify the eligible trials using two main searching strategies: the first one was to search eligible trials using keywords “Conjugated linoleic acid”, “CLA”, “Women”, and the second strategy was to extract the eligible trials from previously published systematic reviews and meta-analyses. The eligible trials were placebo control trials where women supplemented with CLA mixture in the form of oral capsules for 6 months or less. Furthermore, eligible trials reported body weight (BW), body mass index (BMI), total body fat (TBF), percentage body fat (BF%), and/ or lean body mass (LBM). The quality of each included study was assessed using both JADAD scale and an adapted CONSERT checklist.Results:Meta-analysis of 8 eligible trials showed that CLA supplementation was significantly associated with reduced BW (Mean ± SD, 1.2 ± 0.26 kg, p &lt; 0.001), BMI (0.6 ± 0.13kg/m2, p &lt; 0.001) and TBF (0.76 ± 0.26 kg, p = 0.003) in women, when supplemented over 6–16 weeks. Subgroup meta-analysis demonstrated a significant reduction in BW (1.29 ± 0.31 kg, p &lt; 0.001), BMI (0.60 ± 0.14 kg/m2, p &lt; 0.001) and TBF (0.82 ± 0.28 kg, p = 0.003) in the trials that had recruited overweight-obese women. The second subgroup meta-analysis, that considered the menopausal status of the participants, found that CLA was significantly associated with reduced BW (1.35 ± 0.37 kg, p &lt; 0.001; 1.05 ± 0.36 kg, p = 0.003) and BMI (0.50 ± 0.17 kg/m2, p = 0.003; 0.75 ± 0.2 kg/m2, p &lt; 0.001) in both pre and post-menopausal age women, respectively. A reduction in TBF (1.09 ± 0.37 kg, p = 0.003) was only significant in post-menopausal women.Discussion:This meta-analysis suggests a moderate anti-obesity effect of CLA on BW, BMI and TBF reduction in women, when supplemented over 6–16 weeks, particularly in overweight-obese women and post-menopausal women. More well-designed trials are required to confirm this meta-analysis results.

SummaryIn this study of postmenopausal women in Malaysia, total adiposity was inversely associated with total BMD, while regional associations varied. No differences were detected across Malay, Chinese, and Indian ethnicities. Low BMD contributes substantially to morbidity and mortality, and increasing adiposity levels globally may be contributing to this.PurposeTo investigate associations of total and regional adiposity with bone mineral density (BMD) among a multi-ethnic cohort of postmenopausal women.MethodsDual X-ray absorptiometry (DXA) imaging was undertaken for 1990 postmenopausal women without prior chronic diseases (30% Malay, 53% Chinese, and 17% Indian) from The Malaysian Cohort (TMC). The strength of the associations between standardized total and regional body fat percentages with total and regional BMD was examined using linear regression models adjusted for age, height, lean mass, ethnicity, education, and diabetes. Effect modification was assessed for ethnicity.ResultsWomen with a higher total body fat percentage were more likely to be Indian or Malay. Mean (SD) BMD for the whole-body total, lumbar spine, leg, and arm were 1.08 (0.11), 0.96 (0.15), 2.21 (0.22), and 1.36 (0.12) g/cm2, respectively. Total body and visceral fat percentage were inversely associated with total BMD (− 0.02 [95% CI − 0.03, − 0.01] and − 0.01 [− 0.02, − 0.006] g/cm2 per 1 SD, respectively). In contrast, subcutaneous and gynoid fat percentages were positively associated with BMD (0.007 [0.002, 0.01] and 0.01 [0.006, 0.02] g/cm2, respectively). Total body fat percentage showed a weak positive association with lumbar BMD (0.01 [0.004, 0.02]) and inverse associations with leg (− 0.04 [− 0.06, − 0.03]) and arm (− 0.02 [− 0.03, − 0.02]) BMD in the highest four quintiles. There was no effect modification by ethnicity (phetero > 0.05).ConclusionTotal adiposity was inversely associated with total BMD, although regional associations varied. There was no heterogeneity across ethnic groups suggesting adiposity may be a risk factor for low BMD across diverse populations.