Body Composition Parameters Research Articles

Determination of body composition by dual x-ray absorptiometry in persons with haemophilia.

There is limited research on body composition in persons with haemophilia (PwH). The literature describes an increased body fat distribution and decreased lean mass in PwH compared to healthy controls using bioimpedance analysis. Using dual x-ray absorptiometry (DXA), which is known to be the most accurate method, this investigation aims to postulate reference data for body composition parameters within haemophilia severity phenotypes and age groups. Persons underwent whole body DXA screening using Horizon. Body fat percentage, estimated visceral adipose tissue (VAT), appendicular fat and lean mass, and lean and fat mass in relation to body height were assessed. Haemophilia severity and five age groups were distinguished. Two hundred and one persons with mild (n=44), moderate (n=41), or severe (n=116) haemophilia A/B (median age 40 [28-55; 1.IQ-3.IQ] years) were analysed. The median body fat percentage was 28.7% [25.5%-33.9%] and median estimated VAT was 657g [403-954g] with no significant difference between severity phenotypes (p=.474; p=.781). Persons with severe haemophilia had less lean mass compared to moderate and mild haemophilia (p=.013; p=.034). Total and appendicular fat is increased in older PwH (aged ≥40years) compared to younger PwH (aged ≤29years; p<.05). Lean mass did not differ between age groups. This study provides valuable reference data for body composition parameters in PwH. Persons with severe haemophilia show significantly less lean mass compared to persons with moderate or mild haemophilia. Body fat percentage and VAT did not differ between severity phenotypes, but increased with age.

The relationship between imaging-based body composition parameters and disease prognosis in patients with endometrial cancer.

Obesity is known as a risk factor for endometrial cancer (EC). Only a few studies investigate the relationship between sarcopenia and sarcopenic obesity and EC. In this study, our aim was to investigate the relationship between the cross-sectional imaging-based body composition parameters and the disease prognosis in low-grade (LG) and high-grade (HG) EC. We conducted a retrospective study in women diagnosed with low and high-grade EC between January 2014 and May 2022 who had abdominal MRI and thorax CT as a part of routine staging workup. We used the skeletal muscle index (SMI) at the level of the third lumbar vertebra to assess sarcopenia on CT. The T2-weighted sequence at the level of the L2-L3 intervertebral disc is used for visceral fat area (VFA), subcutaneous fat area (SFA), and total fat area (TFA). Two radiologists in consensus, calculated the parameters. A total of 250 EC patients (144 low-grade EC, 106 high-grade EC).Sarcopenia was observed in 122 (48.8%) patients, and sarcopenic obesity was found in 82 (32.8%) patients. Although there was an increase in VFA in cases with high-grade EC, there was no significant difference in terms of SFA. Additionally, the frequency of sarcopenia and sarcopenic obesity was higher in cases with high-grade EC. There was no association between sarcopenia and age, histological type, FIGO staging, or comorbidity in the univariate analysis. However, BMI was found to be associated with sarcopenia. Quantitative radiological measurement of sarcopenia, sarcopenic obesity, and body fat composition can be used as novel parameters in the prediction of disease prognosis in endometrial cancer.

Effects of Sulfonylureas and Dipeptidyl Peptidase 4 Inhibitors on Percentage Body Fat Change in Type 2 Diabetes Mellitus Patients on Metformin at 4 and 12 Weeks.

Introduction Anti-diabetic drugs used for the treatment of type 2 diabetes mellitus (T2DM) have a unique effect on the body weight and fat distribution of a patient. This study aimed to find out the change inpercentage body fat and body composition with the addition of sulfonylureas or dipeptidyl peptidase 4 (DPP-4) inhibitors to metformin monotherapy. Methods An observational 12-week follow-up study was conducted with a sample size of 52 patients. All patients enrolled in the study were evaluated forbaseline percentage body fat and body composition parameters including total body weight, total body water, and skeletal muscle mass using the ACCUNIQ BC300, added on to either sulfonylureas or DPP-4 inhibitors over a stable dose of metformin; repeat assessment performed at 4 weeks and 12 weeks, and change in values was noted. Results Of the 52 patients, 28 patients were on sulfonylureas and 24 were on DPP-4 inhibitors. In the sulfonylurea group, there was an increase in percentage body fat from 31.97 ± 8.77% at baseline to 32.65 ± 8.94% at 12 weeks (p = 0.041), while in the DPP-4 inhibitor group, there was a decrease in percentage body fat from 31.87 ± 7.41% at baseline to 31.24 ± 8.5% at 12 weeks (p = 0.102). In the sulfonylurea group, there was a decrease in body weight from 67.25 ± 14.79 kilograms (kg) at baseline to 66.97 ± 14.62 kg at 12 weeks (p = 0.429). In the DPP-4 inhibitor group, there was a decrease in body weight from 66.56 ± 10.82 kg at baseline to 65.76 ± 12.56 kg at 12 weeks (p = 0.079). In the sulfonylureagroup, total body water decreased from32.54 ±6.65 L at baseline to 32.06 ±6.51 L at 12 weeks (p = 0.084), while in the DPP-4 inhibitor group, the total body water decreased from 32.46 ±5.39 L at baseline to 32.18 ±5.48 L at 12 weeks (p = 0.741).Skeletal muscle mass decreased from 24.78 ±5.12 kgto 24.4 ±5.04 kg (p = 0.041) in the sulfonylurea group and from 24.74 ±4.2 kgto 24.53 ±4.25 kg(p = 0.666) in the DPP-4 inhibitor group. Conclusion Our study shows that sulfonylureas are associated with an increase in percentage body fat, while there were no significant changes associated with DPP-4 inhibitors when given in addition to metformin. There are no significant changes in body weight associated with sulfonylureas or DPP-4 inhibitors in addition to metformin. Also, sulfonylureas are associated with a decrease in skeletal muscle mass after 12 weeks.

An Analysis of Body Composition and Physical status of middle aged Women

Background: Body composition and physical status are essential indicators of overall health, especially in middle-aged women. This group often undergoes significant physiological changes due to aging, hormonal shifts, and lifestyle factors, affecting their body composition, including fat mass, lean muscle mass, and bone density. Methodology: A total of 100 women from Varanasi city, comprising both employed individuals and housewives, participated in this study. These women were divided into two groups, each consisting of 100 subjects aged between 35 and 50 years. The selected variables for body composition analysis included total body fat, fat-free mass, bone mass, muscle mass, body mass index, and physical status. Results: The t-test for Equality of Means revealed a significant difference between the groups, t(198) = 1.660, with p-values indicating substantial differences in total body fat (p &lt; .001), fat-free mass (p &lt; .001), bone mass (p &lt; .000), muscle mass (p &lt; .001), and body mass index (p &lt; .001). Furthermore, there was a significant difference in physical activity levels, t(198) = 11.714, p &lt; .001). Conclusion: The study found a considerable difference in body composition parameters between employed women and housewives. Employed women exhibited lower total body fat and BMI, and higher muscle mass, fat-free mass, and bone mass compared to housewives. This suggests that employed women, likely due to more structured schedules and better access to physical exercise, maintain a healthier body composition.

Comparative analysis of basal metabolic rate measurement methods in overweight and obese individuals: A retrospective study.

The global prevalence of overweight and obesity is on the rise, presenting significant health challenges worldwide. Obesity is associated with various chronic diseases and imposes substantial economic burdens on society. Accurate assessment of basal metabolic rate (BMR) is crucial for effective weight management strategies. This retrospective study, conducted at Baskent University Hospital between October 2019 and October 2023, analyzed data from 133 overweight and obese individuals. Various methods including indirect calorimetry (IC), predictive equations (Harris-Benedict and Mifflin-St Jeor), and bioelectrical impedance analysis (BIA) were used to estimate BMR. Additionally, demographic, clinical, and body composition data were recorded. The mean BMR measured using IC was 1581 ± 322 kcal/day, which was significantly lower than the BMR estimated by other methods such as BIA (1765.8 ± 344.09 kcal/day), Harris-Benedict (1787.64 ± 341.4 kcal/day), and Mifflin-St Jeor equations (1690.08 ± 296.36 kcal/day) (P < .001). Among the predictive equations, the Mifflin-St Jeor method provided BMR estimates closest to the gold standard IC. When BMR measurement methods were compared to IC, 36.8% of measurements with the Harris-Benedict equation method, 50.4% with the Mifflin-St Jeor equation method, and 36.1% with the BIA method were within ± 10% agreement with IC measurements. Significant correlations were found between BMR and body composition parameters such as fat-free mass, muscle mass, and fat mass (R = 0.681, P < .001; R = 0.699, P < .001; R = 0.595, P < .001, respectively). Regression analysis identified that variables such as weight, height, body mass index, and muscle mass significantly predicted BMR measured by IC, accounting for 69.1% of the variance. This study underscores the challenges in assessing BMR in overweight and obese individuals. While IC remains the gold standard, predictive equations and BIA offer alternative methods. The Mifflin-St Jeor equation emerged as a practical option, closely aligning with IC results. However, discrepancies between methods and the influence of body composition highlight the importance of individualized approaches to BMR assessment in weight management strategies.

Unraveling the puzzle of bone health in Klinefelter syndrome: association between dxa derived bone quality indexes and body composition parameters in a single center cohort

Unraveling the puzzle of bone health in Klinefelter syndrome: association between dxa derived bone quality indexes and body composition parameters in a single center cohort

Differential expression of miRNAs in type 1 diabetes patients: influence of age, diagnosis, body composition, and biochemical parameters

Differential expression of miRNAs in type 1 diabetes patients: influence of age, diagnosis, body composition, and biochemical parameters

An acceptance and commitment therapy and mindfulness group intervention for the psychological and physical well-being of adults with body mass indexes in the overweight or obese range: The Mind&Life randomized controlled trial

This trial aimed to assess the effect of an acceptance and commitment therapy (ACT) and mindfulness-based intervention on the various psychological and physical issues associated with obesity. A parallel group randomized controlled trial was conducted with 142 adults with body mass indexes in the overweight or obesity range seeking treatment. Participants were assigned either to the ACT and mindfulness-based group intervention (Mind&Life intervention) plus treatment as usual (TAU) or the TAU-only condition. Individuals receiving the Mind&Life intervention with TAU showed more adherence to the Mediterranean diet, and greater decrease in external eating, weight, and visceral fat both at posttreatment and at 6-month follow-up. Moreover, they displayed a greater reduction in total protein and animal protein intake and GPT enzymes level. By 6-month follow-up, the Mind&Life group experienced a lower impact of weight on quality of life than TAU participants. However, Mind&Life intervention completers showed greater restrained eating levels at follow-up. Overall, this study suggests that an ACT and mindfulness-based group intervention could produce improvements in the impact of weight on quality of life, some eating behaviors, dietary habits, and weight and body composition parameters of people facing weight-related challenges.

Comparative effects of time-restricted feeding versus normal diet on physical performance and body composition in healthy adults with regular exercise habits: a systematic review and meta-analysis

BackgroundTime-restricted feeding (TRF), a form of intermittent fasting, limits daily caloric intake to a 6–12 hour window and has been shown to effectively promote weight loss and improve overall health....

Prognostic impact of body composition in hepatocellular carcinoma patients with immunotherapy

Objective This study aims to examine the possible relationship between body composition parameters, sarcopenia, and clinical outcomes in hepatocellular carcinoma (HCC) patients who received immune checkpoint inhibitor (ICI) treatment. Methods Three online databases, including Embase, PubMed, and the Cochrane Library, were thoroughly searched for literature describing the relationship between body composition parameters, sarcopenia, and outcomes of ICI-treated HCC patients from the start of each database to 21 January 2024. The Newcastle-Ottawa Scale was used to rate the quality of the studies. The assessed outcomes included hazard ratio (HR) for OS and PFS, as well as odds ratio (OR) for ORR and DCR. Results This analysis included a total of 15 articles with a combined patient cohort of 1543 individuals. The results demonstrated that HCC patients with low skeletal muscle index (SMI) had significantly inferior OS (HR: 1.68, p < 0.001), PFS (HR: 1.45, p < 0.001), ORR (OR: 0.64, p = 0.044), and DCR (OR: 0.58, p = 0.009) compared to those with high SMI. The presence of sarcopenia in HCC patients was significantly related to poorer OS (HR: 1.63, p < 0.001) and PFS (HR: 1.48, p < 0.001), as well as a lower ORR (OR: 0.64, p = 0.020) and DCR (OR: 0.58, p = 0.007) in comparison to those without sarcopenia. Subgroup analysis demonstrated that these findings were consistent with the multivariate analysis. Moreover, high subcutaneous adipose index (SAI) levels were associated with better OS (HR: 0.46, p = 0.001) and PFS (HR: 0.68, p = 0.021) than those with low SAI levels. Conclusion The presence of sarcopenia and low SMI in HCC patients undergoing treatment with ICIs was found to be related to inferior treatment response and reduced long-term effectiveness.

Body composition parameters in initial CT imaging of mechanically ventilated trauma patients: Single-centre observational study.

Body composition parameters provide relevant prognostic significance in critical care cohorts and cancer populations. Published results regarding polytrauma patients are inconclusive to date. The goal of this study was to analyse the role of body composition parameters in severely injured trauma patients. All consecutive patients requiring emergency tracheal intubation and mechanical ventilation before initial computed tomography (CT) at a level-1 trauma centre over a 12-year period (2008-2019) were reanalysed. The analysis included CT-derived body composition parameters based upon whole-body trauma CT as prognostic variables for 30-day mortality, intensive care unit length of stay (ICU LOS) and mechanical ventilation duration. Four hundred seventy-two patients (75% male) with a median age of 49years, median injury severity score of 26 and 30-day mortality rate of 22% (104 patients) met the inclusion criteria and were analysed. Regarding body composition parameters, 231 patients (49%) had visceral obesity, 75 patients had sarcopenia (16%) and 35 patients had sarcopenic obesity (7.4%). After adjustment for statistically significant univariable predictors age, body mass index, sarcopenic obesity, visceral obesity, American Society of Anesthesiologists classification ≥3, injury severity score and Glasgow Coma Scale≤8 points, the Cox proportional hazard model identified sarcopenia as significant prognostic factor of 30-day mortality (hazard ratio 2.84; 95% confidence interval 1.38-5.85; P=0.004), which was confirmed in Kaplan-Meier survival analysis (log-rank P=0.006). In a subanalysis of 363 survivors, linear multivariable regression analysis revealed no significant associations of body composition parameters with ICU LOS and duration of mechanical ventilation. In a multivariable analysis of mechanically ventilated trauma patients, CT-defined sarcopenia was significantly associated with 30-day mortality whereas no associations of body composition parameters with ICU LOS and duration of mechanical ventilation were observed.

Chitinase-3 like-protein-1, a prognostic biomarker in patients with hepatocellular carcinoma and concomitant myosteatosis

BackgroundChitinase-3 like-protein-1 (CHI3L1) is a member of the mammalian chitinase-like proteins and elevated serum CHI3L1 level has been proved to be associated with poor prognosis in hepatocellular carcinoma (HCC). This study aimed to investigate the relationship between serum CHI3L1 levels and body composition parameters in patients with HCC after liver transplantation (LT).MethodsThis retrospective study enrolled 200 patients after LT for HCC. Blood samples were collected and serum concentrations of CHI3L1 were measured by enzyme-linked immunosorbent assay. Computer tomography (CT) were used to estimate skeletal muscle and adipose tissue mass. Spearman’s rank correlation test was performed to assess associations between serum CHI3L1 levels and these body composition parameters. A Cox proportional-hazards regression model was performed to identify independent prognostic factors. Overall survival (OS) and recurrence-free survival (RFS) curves were constructed using the Kaplan-Meier method and compared by the log-rank test.ResultsTotal 71 patients (35.5%) were diagnosed with myosteatosis according to skeletal muscle radiation attenuation (SMRA). The 5-year OS rates were 66.9% in non-myosteatosis group, significantly higher than 49.5% in myosteatosis group (p = 0.025), while the RFS of myosteatosis group (5-year RFS: 52.6%) or non-myosteatosis group (5-year RFS: 42.0%) shown no significant difference (p = 0.068). The serum CHI3L1 level were significantly negative correlated with SMRA (r = -0.3, p < 0.001). Interestingly, in patients with myosteatosis, Kaplan-Meier analysis revealed that elevated serum CHI3L1 levels were associated with worse OS (p < 0.001) and RFS (p = 0.047). However, in patients without myosteatosis, Kaplan-Meier analysis found elevated serum CHI3L1 levels were not associated with OS (p = 0.070) or RFS (p = 0.104).ConclusionsElevated CHI3L1 was negatively correlated with SMRA, and predicted poorer prognosis in Chinese population after LT for HCC, especially in those patients with concomitant myosteatosis. Monitoring serum CHI3L1 can predict prognosis and effectively guide individual nutrition intervention.

Somatic Structure and Ultrasound Parameters of the Calcaneus Bone in Combat Sports Athletes in Relation to Vitamin D3 Levels.

Background/Objectives: Physical activity is widely recognized for its beneficial effects on bone density during adolescence, which could lead to enhanced bone density in later life, thus acting as a health-promoting activity with long-lasting implications. However, not all studies are conclusive regarding the type, intensity, duration, and frequency of the most effective physical activities. This study focuses on combat sports athletes and examines the relationship between their somatic build and heel bone parameters using ultrasound (USG) and their vitamin D3 levels. Methods: The study included 40 male athletes specializing in various combat sports. The measurements of body height, body mass, skinfold thickness, and bone widths at multiple sites were performed to estimate the somatic build. The USG parameters of the heel bone and the blood levels of vitamin D3 were also recorded. Statistical significance was determined using one-way ANOVA, with differences among sports disciplines also examined. Results: The study found significant differences in the body composition and USG bone parameters among athletes from different combat sports (p ≤ 0.05). The calcaneus stiffness index (SI) and speed of sound (SOS) were significantly higher in athletes with normal vitamin D3 levels compared to those with below-normal levels (p = 0.0015 and p = 0.001, respectively). These findings suggest that vitamin D3 may influence bone stiffness and density. Conclusions: The study underscores the importance of maintaining adequate vitamin D3 levels to support bone mineralization in athletes, particularly those training indoors with limited exposure to sunlight. It also highlights the potential of using USG as a non-invasive method to assess bone health, aiding in the optimization of training programs to prevent injuries and improve performance.

The correlation of CT-derived muscle density, skeletal muscle index, and visceral adipose tissue with nutritional status in severely injured patients.

This study explored if computerized tomography-derived body composition parameters (CT-BCPs) are related to malnutrition in severely injured patients admitted to the Intensive Care Unit (ICU). This prospective cohort study included severely injured (Injury Severity Score ≥ 16) patients, admitted to the ICU of three level-1 trauma centers between 2018 and 2022. Abdominal CT scans were retrospectively analyzed to assess the CT-BCPs: muscle density (MD), skeletal muscle index (SMI), and visceral adipose tissue (VAT). The Subjective Global Assessment was used to diagnose malnutrition at ICU admission and on day 5 of admission, and the modified Nutrition Risk in Critically ill at admission was used to assess the nutritional risk. Seven (11%) of the 65 analyzed patients had malnutrition at ICU admission, increasing to 23 patients (35%) on day 5. Thirteen (20%) patients had high nutritional risk. CT-BCPs were not related to malnutrition at ICU admission and on day 5. Patients with high nutritional risk at admission had lower MD (median (IQR) 32.1 HU (25.8-43.3) vs. 46.9 HU (37.7-53.3); p < 0.01) and higher VAT (median 166.5 cm2 (80.6-342.6) vs. 92.0 cm2 (40.6-148.2); p = 0.01) than patients with low nutritional risk. CT-BCPs do not seem related to malnutrition, but low MD and high VAT may be associated with high nutritional risk. These findings may prove beneficial for clinical practice, as they suggest that CT-derived parameters may provide valuable information on nutritional risk in severely injured patients, in addition to conventional nutritional assessment and screening tools. Level III, Prognostic/Epidemiological.

The role of IGF1 in determining body composition in children and adolescents with growth hormone deficiency and those with idiopathic short stature.

Treatment with recombinant human growth hormone (rhGH) increases insulin growth factor-1 (IGF1) levels, therefore, monitoring both IGF1 and growth constitutes an acceptable parameter of therapeutic safety and efficacy. We aimed to investigate the relationship between IGF1 level and body composition in children and adolescents undergoing rhGH therapy for growth hormone deficiency (GHD) and idiopathic short stature (ISS). This observational retrospective study included the bioimpedance analysis (BIA) reports (n = 305) of 135 pediatric patients (age 5-18 years), 64 with GHD and 71 with ISS, conducted as part of routine clinic visits. Sociodemographic and clinical data were extracted from medical records. Generalized estimating equations linear models were used to explore the contributing factors for body composition components of fat percentage (FATP), appendicular skeletal muscle mass (ASMM) z-score, and muscle-to-fat ratio (MFR) z-score while adjusting for cumulative doses of rhGH. Subjects with GHD exhibited higher body mass index z-scores (p < 0.001), higher FATP and truncal FATP scores, lower MFR z-score, and higher diastolic blood pressure percentiles than the ISS group (p = 0.010, p = 0.027, p = 0.050, and p = 0.050, respectively). Female sex (p < 0.001) and a GHD diagnosis (p < 0.001), were major contributors to higher FATP scores; female sex (p = 0.049) and ISS diagnosis (p = 0.005) were major contributors to higher MFR z-scores; and female sex (p < 0.001), older age (p < 0.001) and higher insulin-like growth factor 1 z-scores (p = 0.021) were major contributors to higher ASMM z-scores. Socioeconomic position and cumulative rhGH dose were not significant contributors to body composition parameters. Children with GHD, including those undergoing rhGH treatment, may be at risk for increased adiposity and associated metabolic implications. Sex- and age-adjusted IGF1 levels were related to muscle mass but not to adiposity. Hence, rhGH treatment aimed at increasing IGF1 levels may alleviate these effects by promoting muscle growth.

Oral Semaglutide in Type 2 Diabetes: Clinical-Metabolic Outcomes and Quality of Life in Real-World Practice.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a novel class of incretin mimetics for treating type 2 diabetes (T2D). This study evaluated the impact of semaglutide, the first oral GLP-1RA, on glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body composition and anthropometric parameters. Additionally, the effects on cardiovascular risk factors and quality of life (QoL) in T2D patients were assessed. Methods: A prospective observational study with a six-month follow-up was conducted. Clinical parameters, including HbA1c, FPG, anthropometric measurements, blood pressure, cardiovascular risk factors, Diabetes Treatment Satisfaction Questionnaire (DTSQ) responses, and Short Form (36) Health Survey (SF-36) responses, were collected at baseline (T0) and at six months (T1). Results: Sixty-one subjects were enrolled, with there being an average T2D duration of 4.67 ± 3.93 years. Significant decreases were observed in HbA1c (µ = -1.24; SD = 1.33; p < 0.05), FPG (µ = -31.01 mg/dL; SD = 41.71; p < 0.05), body composition and anthropometric parameters (p < 0.05), and cardiovascular risk factors (p < 0.05), with an increase in DTSQ scores (p < 0.05). Conclusions: The administration of 14 mg/day oral semaglutide improved several clinical parameters after six months of treatment. These findings suggest semaglutide is effective in improving glycemic control, weight management, and some cardiovascular risk factors in T2D patients.

Impact of body composition parameters, age, and tumor staging on gastric cancer prognosis.

Research studies on gastric cancer have not investigated the combined impact of body composition, age, and tumor staging on gastric cancer prognosis. To address this gap, we used machine learning methods to develop reliable prediction models for gastric cancer. This study included 1,132 gastric cancer patients, with preoperative body composition and clinical parameters recorded, analyzed using Cox regression and machine learning models. The multivariate analysis revealed that several factors were associated with recurrence-free survival (RFS) and overall survival (OS) in gastric cancer. These factors included age (≥65 years), tumor-node-metastasis (TNM) staging, low muscle attenuation (MA), low skeletal muscle index (SMI), and low visceral to subcutaneous adipose tissue area ratios (VSR). The decision tree analysis for RFS identified six subgroups, with the TNM staging I, II combined with high MA subgroup showing the most favorable prognosis and the TNM staging III combined with low MA subgroup exhibiting the poorest prognosis. For OS, the decision tree analysis identified seven subgroups, with the subgroup featuring high MA combined with TNM staging I, II showing the best prognosis and the subgroup with low MA, TNM staging II, III, low SMI, and age ≥65 years associated with the worst prognosis. Cox regression identified key factors associated with gastric cancer prognosis, and decision tree analysis determined prognoses across different risk factor subgroups. Our study highlights that the combined use of these methods can enhance intervention planning and clinical decision-making in gastric cancer.

The Impact of Body Composition and Physical Fitness on Parasympathetic Reactivation in Firefighters

Objective: Firefighting involves aerobic and anaerobic physical activities that cause heart rates to rise from submaximal to above maximal levels. These varying demands can occur with each call firefighters respond to during their shift, imposing both acute and cumulative cardiovascular loads. Heart rate is commonly used to measure cardiovascular responses during disasters, emergencies, firefighting, and firefighting simulations. There is substantial evidence suggesting that heart rate recovery (HRR) parameters are associated with body composition and aerobic fitness. Therefore, the primary aim of this study is to determine the relationship between body composition, physical fitness, and HRR parameters in firefighters. Method: This cross-sectional descriptive study was conducted among firefighters working in a metropolitan municipality. Using the G-Power 3.1 program, seventy-four firefighters (age = 32.61 ± 8.9 years, height = 1.76 ± 0.6 cm, weight = 83.9 ± 13 kg) volunteered to participate in this study. Body mass index (BMI), waist circumference (WC), and body fat percentage (BFP) were recorded for each subject. To determine aerobic fitness (VO2max), each participant performed a submaximal exercise test on a treadmill. HRR was calculated as the difference between peak heart rates post-exercise (HRmax) and heart rates at the first and second minutes of the recovery phase, recorded as HRR1 and HRR2, respectively. Results: The mean VO2max and BMI of the participants were 48.32 ± 9.18 ml/kg/min and 27.10 ± 3.49 kg/m², respectively. No significant relationship was found between the HRR1 and HRR2 parameters and the variables of BMI, WC, and BFP in firefighters (p&amp;gt;0.05). However, positive significant relationships were detected between HRR1 and HRR2 and VO2max (p&amp;lt;0.05). A statistically significant negative relationship was found between VO2max and the variables of BMI, WC, BFP, and weight (p&amp;lt;0.05). These findings indicate that higher aerobic capacity is associated with better heart rate recovery and lower body fat percentage. Conclusion: The results of this study demonstrate that cardiovascular autonomic function is significantly related to maximum aerobic fitness. However, no measure of body composition appears to affect the overall HRR response of the firefighters. This research provides important insights into how the aerobic capacity of firefighters affects their heart rate recovery responses. These findings offer a crucial foundation for improving the physical fitness levels and maintaining the cardiovascular health of firefighters.

The Association between Anthropometric Measurements and Body Composition with Hand Grip Strength among the Elderly Population in Indonesia.

Background/Objectives: Hand grip strength (HGS) is a crucial measure for evaluating muscle function and general physical ability, and it may be associated with several diseases. Previous studies have demonstrated inconsistent associations between anthropometric measurement and body composition with HGS. This study aims to investigate the association between anthropometric measurement and body composition with HGS in the elderly population residing in Indonesia. Methods: This is a cross-sectional study on older adults aged between 60 and 82 years who live in the community. Anthropometric parameters assessed in this study comprised the body mass index (BMI), mid-upper arm circumference (MUAC), calf circumference (CC), and waist circumference (WC). Subsequently, body composition measurements, including fat mass (FM), fat-free mass (FFM), muscle mass (MM), skeletal muscle mass (SMM), and the appendicular skeletal mass index (ASMI), were assessed using a body composition analyzer. Last, the measurement of HGS was conducted using a hand dynamometer. Results: A total of 109 participants were involved in this study. Our study demonstrates a significant association between anthropometric parameters, namely CC and HGS. Subsequently, several body composition parameters, including FFM, SMM, ASMI, and MM in the four extremities, are also significantly associated with HGS. However, in a multivariate analysis, only CC and FFM were able to significantly predict HGS. Conclusions: Improving CC and maintaining FFM may enhance muscle strength in older adults. This suggests that targeted exercise and nutrition programs could increase muscle mass and strength, thereby mitigating age-related decline and improving quality of life.

Applicability of Global Leadership Initiative on Malnutrition (GLIM) criteria in nutrition risk screening for patients over 60 years old with digestive system tumors – A retrospective study

ObjectiveThis study aimed to identify the most effective nutritional risk screening tool for elderly patients with digestive system tumors. MethodsNutritional risk screening was performed using Nutritional Risk Screening 2002 (NRS2002), prognostic nutritional index (PNI) and Geriatric Nutritional Risk Index (GNRI) for elderly patients who underwent surgical resection of digestive tumor. Comparative analysis of each nutritional screening tool was conducted through Kappa test and ROC curve. ResultsMalnourished individuals diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria had lower levels of hematological parameters (serum albumin, pre-albumin, total protein and hemoglobin) and poorer body composition parameters (body mass index, body fat percentage, edema index, upper arm muscle circumference, skeletal muscle index, and phase angle; P<0.05). NRS2002 demonstrated a sensitivity of 75.56% and specificity of 38.16% under the GLIM criteria, showing moderate agreement (Kappa=0.346, P<0.001). PNI had an average sensitivity of 71.11% and the highest specificity at 87.23%, but exhibited no consistency with GLIM (Kappa=0.152, P=0.062). GNRI showed the highest sensitivity at 91.11% and general specificity at 37.14%, aligning closely with GLIM criteria (Kappa=0.711, P<0.001). GNRI had the highest predictive value (AUC=0.870, 95% CI: 0.801–0.939), followed by NRS2002 (AUC=0.687, 95% CI: 0.589–0.785). Patients diagnosed with malnutrition via GNRI-GLIM exhibited higher rates of surgical site infection (χ2=15.534, P<0.001) and 3-month readmission (χ2=4.499, P=0.034). ConclusionGNRI and NRS2002 demonstrate good performance as GLIM criteria for nutritional screening in elderly patients with digestive tumors, with GNRI being potentially more suitable. Moreover, GNRI-GLIM can predict short-term prognosis in these patients.