Body Composition Trajectories Research Articles

Relation between Body Composition Trajectories from Childhood to Adolescence and Nonalcoholic Fatty Liver Disease Risk.

NAFLD has become the leading cause of chronic liver disease in children, as a direct consequence of the high prevalence of childhood obesity. This study aimed to characterize body composition trajectories from childhood to adolescence and their association with the risk of developing nonalcoholic fatty liver disease (NAFLD) during adolescence. The participants were part of the 'Chilean Growth and Obesity Cohort Study', comprising 784 children who were followed prospectively from age 3 years. Annual assessments of nutritional status and body composition were conducted, with ultrasound screening for NAFLD during adolescence revealing a 9.8% prevalence. Higher waist circumference measures were associated with NAFLD from age 3 years (p = 0.03), all skin folds from age 4 years (p < 0.01), and DXA body fat measurements from age 12 years (p = 0.01). The fat-free mass index was higher in females (p = 0.006) but not in males (p = 0.211). The second and third tertiles of the fat mass index (FMI) had odds ratios for NAFLD during adolescence of 2.19 (1.48-3.25, 95% CI) and 6.94 (4.79-10.04, 95% CI), respectively. Elevated waist circumference, skin folds, and total body fat were identified as risk factors for future NAFLD development. A higher FMI during childhood was associated with an increased risk of NAFLD during adolescence.

THE ROLE OF CASTRATION BEFORE OR AFTER PUBERTY ON SEX DIFFERENCES IN GROWTH AND LONGEVITY IN UM-HET3 MICE

Abstract Sex differences in human aging and longevity are well known. Mortality rates of males are higher throughout life with no definitive mechanisms identified. Previously, we reported that genetically heterogeneous mice have sex differences in longevity like those of humans. Here, we report that prepubertal castration significantly reduced early adulthood mortality and increased median lifespan by 12.6% (n=236/group) to match female levels. It also shifted growth trajectories toward the female pattern, including a reduced rate of body weight gain and a prolonged growth period. Our findings suggest that testicular hormones are critical for these sex differences. We next tested whether a) exposure to gonadal hormones from puberty throughout life is required or b) only hormone exposure during the short period of pubertal development is sufficient to cause these sex differences. We castrated or sham-operated mice (n = 60/group) prepubertally at 20 days, or after puberty at 60 or 240 days. Prepubertal castration prolonged the period of growth as before, with dramatically increased fat mass and reduced lean mass, which reduced the lean/body mass ratio to a level indistinguishable from that of females. Although post-pubertal castrated groups also had reduced lean/body mass ratios, they were significantly higher than prepubertally castrated mice, but were unchanged between 60d and 240d groups. These results suggest that the narrow window of testicular hormone exposure during puberty is necessary for the full expression of sex differences in body composition trajectories. Its effect on lifespan will be presented at the meeting when mice are old enough for assessment.

Early life predictors of body composition trajectories from adolescence to mid-adulthood.

Guatemala has experienced rapid increases in adult obesity. We characterized body composition trajectories from adolescence to mid-adulthood and determined the predictive role of parental characteristics, early life factors, and a nutrition intervention. One thousand three hundred and sixty-four individuals who participated as children in a nutrition trial (1969-1977) were followed prospectively. Body composition characterized as body mass index (BMI), fat mass index (FMI), and fat-free mass indices (FFMI), was available at four ages between 10 and 55 years. We applied latent class growth analysis to derive sex-specific body composition trajectories. We estimated associations between parental (age, height, schooling) and self-characteristics (birth order, socioeconomic status, schooling, and exposure to a nutrition supplement) with body composition trajectories. In women, we identified two latent classes of FMI (low: 79.6%; high: 20.4%) and BMI (low: 73.0%; high: 27.0%), and three of FFMI (low: 20.2%; middle: 55.9%; high: 23.9%). In men, we identified two latent classes of FMI (low: 79.6%; high: 20.4%) and FFMI (low: 62.4%; high: 37.6%), and three of BMI (low: 43.1%; middle: 46.9%; high: 10.0%). Among women, self's schooling attainment inversely predicted FMI (OR [being in a high latent class]: 0.91, 95% CI: 0.85, 0.97), and maternal schooling positively predicted FFMI (OR: 1.16, 95% CI: 0.97, 1.39). Among men, maternal schooling, paternal age, and self's schooling attainment positively predicted FMI. Maternal schooling positively predicted FFMI, whereas maternal age and paternal schooling were inverse predictors. The nutrition intervention did not predict body composition class membership. Parents' age and schooling, and self's schooling attainment are small but significant predictors of adult body composition trajectories.

Adiposity and the risk of dementia: A population‐based study

AbstractBackgroundA higher body mass during mid‐life is a well‐established risk factor for dementia, while a higher body mass during late‐life has been linked to a decreased dementia risk. Yet, body mass may be an inaccurate measure of adiposity, especially in elderly. We therefore differentiated between body mass, fat mass, fat free mass, android fat mass and gynoid fat mass and examined the association between these measures and the risk of dementia. We also determined trajectories of body composition before the diagnosis of dementia.MethodIn the population‐based Rotterdam Study, body composition was measured using dual X‐ray absorptiometry every 4‐5 years between 2002‐2016. Incident dementia was recorded until 2020. We assessed the association between the first body composition measure and the risk of dementia using Cox models, adjusted for sex, age, height, education, smoking, alcohol intake, physical activity, depressive symptoms, and APOE ε4 status. Trajectories of body composition for patients before dementia diagnoses were constructed using linear mixed models and for dementia‐free participants, matched on birth year and sex. All analyses were done for men and women separately.ResultOf the 3,408 men (mean age 66.4 years) and 4,563 women (mean age 66.5 years) with at least one body composition measure available, 293 men and 526 women developed dementia during a mean follow‐up of 10.3 years. Higher body mass, fat mass, android fat mass and gynoid fat mass, but not fat free mass, tended to associate with a decreased risk of dementia in both men and women (Figure 1). After excluding the first five years of follow‐up only the association of gynoid fat mass in women remained statistically significant (hazard ratio [95% confidence interval]: 0.85 [0.75‐0.97]). No major differences in trajectories of body composition were observed, although a slight trend of a decrease in total, android and gynoid fat mass was observed in women up to 2 years before diagnosis.ConclusionA higher body mass, fat mass, android fat mass and gynoid fat mass were associated with a decreased risk of dementia. These results may be explained by reverse causality or competing risks, although a protective effect of adiposity cannot be excluded.

Body Composition Trajectories During the First 23 Months of Life Differ by HIV Exposure Among Infants in Western Kenya: A Prospective Study

BackgroundInfants who are HIV-exposed and uninfected have suboptimal growth patterns compared to those who are HIV-unexposed and uninfected. However, little is known about how these patterns persist beyond 1 year of life. ObjectivesThis study aimed to examine whether infant body composition and growth trajectories differed by HIV exposure during the first 2 years of life among Kenyan infants using advanced growth modeling. MethodsRepeated infant body composition and growth measurements (mean: 6; range: 2–7) were obtained from 6 weeks to 23 months in the Pith Moromo cohort in Western Kenya (n = 295, 50% HIV-exposed and uninfected, 50% male). Body composition trajectory groups were fitted using latent class mixed modeling (LCMM) and associations between HIV exposure and growth trajectories were examined using logistic regression analysis. ResultsAll infants exhibited poor growth. However, HIV-exposed infants generally grew suboptimally than unexposed infants. Across all body composition models except for the sum of skinfolds, HIV-exposed infants had a higher likelihood of belonging to the suboptimal growth groups identified by LCMM than the HIV-unexposed infants. Notably, HIV-exposed infants were 3.3 times more likely (95% CI: 1.5–7.4) to belong to the length-for-age z-score growth class that remained at a z-score of < −2, indicating stunted growth. HIV-exposed infants were also 2.6 times more likely (95% CI: 1.2–5.4) to belong to the weight-for-length-for-age z-score growth class that remained between 0 and −1, and were 4.2 times more likely (95% CI: 1.9–9.3) to belong to the weight-for-age z-score growth class that indicated poor weight gain besides stunted linear growth. ConclusionsIn a cohort of Kenyan infants, HIV-exposed infants grew suboptimally compared to HIV-unexposed infants beyond 1 year of age. These growth patterns and longer-term effects should be further investigated to support the ongoing efforts to reduce early-life HIV exposure-related health disparities.

Body composition trajectories from birth to 5 years and hepatic fat in early childhood

Adiposity is an established risk factor for pediatric nonalcoholic fatty liver disease (NAFLD), but little is known about the influence of body composition patterns earlier in life on NAFLD risk. We aimed to examine associations of body composition at birth and body composition trajectories from birth to early childhood with hepatic fat in early childhood. Data were from the longitudinal Healthy Start Study in Colorado. Fat-free mass index (FFMI), fat mass index (FMI), percentage body fat (BF%), and BMI were assessed at birth and/or ∼5 y in >1200 children by air displacement plethysmography and anthropometrics. In a subset (n=285), hepatic fat was also assessed at ∼5 y by MRI. We used a 2-stage modeling approach: first, we fit body composition trajectories from birth to early childhood using mixed models with participant-specific intercepts and linear slopes (i.e., individual deviations from the population average at birth and rate of change per year, respectively); second, associations of participant-specific trajectory deviations with hepatic fat were assessed by multivariable-adjusted linear regression. Participant-specific intercepts at birth for FFMI, FMI, BF%, and BMI were inversely associated with log-hepatic fat in early childhood in models adjusted for offspring demographics and maternal/prenatal variables [back-transformed β (95% CI) per 1 SD: 0.93 (0.88, 0.99), 0.94 (0.88, 0.99), 0.94 (0.89, 0.99), and 0.90 (0.85, 0.96), respectively]. Whereas, faster velocities for BF% and BMI from birth to ∼5 y were positively associated with log-hepatic fat [back-transformed β (95% CI) per 1 SD: 1.08 (1.01, 1.15) and 1.08 (1.02, 1.15), respectively]. These latter associations of BF% and BMI velocities with childhood hepatic fat were attenuated to the null when adjusted for participant-specific intercepts at birth. Our findings suggest that a smaller birth weight, combined with faster adiposity accretion in the first 5 y, predicts higher hepatic fat in early childhood. Strategies aiming to promote healthy body composition early in life may be critical for pediatric NAFLD prevention.This study was registered voluntarily atclinicaltrials.govas NCT02273297.

344-OR: Body Composition Trajectories from Birth to 5 Years and Hepatic Fat in Early Childhood

Adiposity is an established risk factor for pediatric nonalcoholic fatty liver disease (NAFLD) , but little is known about the influence of body composition changes earlier in life on future NAFLD risk. Here, we examined associations of body composition trajectories from birth to early childhood with hepatic fat (HF) in early childhood in the Colorado Healthy Start cohort. Fat-free mass index (FFMI) , fat mass index (FMI) , and percent fat mass (%FM) were assessed at birth and/or ∼5 yrs in 1,235 children by air displacement plethysmography. At ∼5 yrs, HF was assessed by magnetic resonance imaging in a sub-sample of 285 children. We used a two-stage modeling approach: first, FFMI, FMI, and %FM trajectories were estimated using mixed models with random intercepts and slopes; second, associations of participant-specific deviations with HF were assessed by linear regression adjusted for confounders. As shown in Table 1, random intercepts for FFMI, FMI, and %FM at birth were all inversely associated with HF in early childhood; whereas %FM slope (i.e., velocity) from birth to ∼5 years was associated with higher HF. These findings suggest that smaller weight at birth, followed by greater gains in %FM are associated with higher HF in early childhood. This supports an influence of early life body composition patterns on HF susceptibility and the importance of perinatal strategies aiming to promote healthy adiposity in infancy/childhood. Disclosure C.C. Cohen: None. S.P. Gilley: None. W. Perng: None. K.A. Sauder: None. K. Shankar: None. D.H. Glueck: None. D. Dabelea: None.

Association of Cesarean Delivery with Trajectories of Growth and Body Composition in Preschool Children.

This study aimed to examine the association of cesarean delivery with trajectories of growth and body composition in preschool children. This ambidirectional cohort study was conducted between 2017 and 2020 in China. Information on the delivery mode, weight, and length/height of the children measured at routine healthcare visits was obtained from maternal and child health records. For three years while in kindergarten, children’s body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and percentage of body fat (FM%) were repeatedly measured. A BMI z score (zBMI) was calculated and standardized to WHO measures, and overweight and obesity were defined using the WHO reference. After adjustment for maternal age, maternal education, annual family income, prepregnancy BMI, gestational weight gain, gravidity, parity, gestational age, child sex, birthweight, breastfeeding duration, and the parent-reported dietary intake of the children, children born via cesarean delivery (n = 1992) versus those born vaginally (n = 1578) had higher zBMI growth rates beyond 36 months (β: 0.003; 95% CI: 0.001, 0.005 SD units/month) and elevated levels of FMI (β: 0.097; 95% CI: 0.026, 0.168 kg/m2), FM% (β: 0.402; 95% CI: 0.058, 0.745%) and zBMI (β: 0.073; 95% CI: 0.012, 0.133 units), but not FFMI (β: 0.022; 95% CI: −0.022, 0.066 kg/m2). The adjusted OR of overweight and obesity was 1.21 (95% CI: 1.04, 1.40). Cesarean delivery likely elevated zBMI growth rates and increased the risk of overweight and obesity in preschool children, with the elevation of fat mass but not fat-free mass.

Growth and body composition trajectories in infants meeting the WHO growth standards study requirements.

While the World Health Organization (WHO) developed postnatal growth standards for infants, corresponding body composition data remains scarce. This study explores growth and body composition trajectories in infants meeting the WHO Multicentre Growth Reference Study (MGRS) eligibility criteria. Infants enrolled in this longitudinal cohort underwent anthropometric and body composition measurement by air displacement plethysmography (ADP) at 6 weeks, 12 weeks, and 5 months postnatally. Age and sex-specific growth and body composition percentiles were generated using GAMLSS, with extrapolated data at 5 months for those exceeding ADP weight limits. We evaluated which anthropometric measure (body mass index (BMI), weight for length or mid upper arm circumference) was most closely related to adiposity. Of the 225 infants with body composition measures, 187 met the WHO MGRS criteria. Their length and weight curves were comparable with WHO growth curves. Trajectory curves for fat and fat-free mass were developed. Of the anthropometric measures, BMI z score was most closely related to fat mass index z score at all timepoints. This study presents body composition trajectories for infants meeting the WHO growth standard criteria. BMI z score is the best anthropometric metric to estimate adiposity in infants. While postnatal growth standards derived from the WHO Multicentre Growth Reference Study (MGRS) exist for the routine clinical assessment of infant growth, this study fills the previous gap in the availability of corresponding body composition data for term-born, healthy, breastfed infants meeting the MGRS criteria. Extrapolation was used to obtain body composition values for infants exceeding the weight limit of the ADP device, to avoid construction of biased body composition curves. Sex-specific growth curves for fat mass, fat-free mass, fat mass index, and fat-free mass index are presented for a population meeting the World Health Organization growth standard criteria.

Body Composition Assessment by Air-Displacement Plethysmography Compared to Dual-Energy X-ray Absorptiometry in Full-Term and Preterm Aged Three to Five Years.

It is important to monitor body composition longitudinally, especially in children with atypical body composition trajectories. Dual-energy X-ray absorptiometry (DXA) can be used and reference values are available. Air-displacement plethysmography (ADP) is a relatively new technique, but reference values are lacking. In addition, estimates of fat-free mass density (Dffm), needed in ADP calculations, are based on children aged >8 years and may not be valid for younger children. We, therefore, aimed to investigate whether DXA and ADP results were comparable in young children aged 3–5 years, either born full-term or preterm, and if Dffm estimates in the ADP algorithm could be improved. In 154 healthy children born full-term and 67 born < 30 weeks of the inverse pressure-volume gestation, aged 3–5 years, body composition was measured using ADP (BODPOD, with default Lohman Dffm estimates) and DXA (Lunar Prodigy). We compared fat mass (FM), fat mass percentage (FM%) and fat-free mass (FFM), between ADP and DXA using Bland–Altman analyses, in both groups. Using a 3-compartment model as reference method, we revised the Dffm estimates for ADP. In full-term-born children, Bland–Altman analyses showed considerable fixed and proportional bias for FM, FM%, and FFM. After revising the Dffm estimates, agreement between ADP and DXA improved, with mean differences (LoA) for FM, FM%, and FFM of −0.67 kg (−2.38; 1.04), −3.54% (−13.44; 6.36), and 0.5 kg (−1.30; 2.30), respectively, but a small fixed and proportional bias remained. The differences between ADP and DXA were larger in preterm-born children, even after revising Dffm estimates. So, despite revised and improved sex and age-specific Dffm estimates, results of ADP and DXA remained not comparable and should not be used interchangeably in the longitudinal assessment of body composition in children aged 3–5 years, and especially not in very preterm-born children of that age.

Gestational weight change and childhood body composition trajectories from pregnancy to early adolescence.

A mother-child dyad trajectory model of weight and body composition spanning from conception to adolescence was developed to understand how early life exposures shape childhood body composition. African American (49.3%) and Dominican (50.7%) pregnant mothers (n = 337) were enrolled during pregnancy, and their children (47.5% female) were followed from ages 5 to 14. Gestational weight gain (GWG) was abstracted from medical records. Child weight, height, percentage body fat, and waist circumference were measured. GWG and child body composition trajectories were jointly modeled with a flexible latent class model with a class membership component that included prepregnancy BMI. Four prenatal and child body composition trajectory patterns were identified, and sex-specific patterns were observed for the joint GWG-postnatal body composition trajectories with more distinct patterns among girls but not boys. Girls of mothers with high GWG across gestation had the highest BMI z score, waist circumference, and percentage body fat trajectories from ages 5 to 14; however, boys in this high GWG group did not show similar growth patterns. Jointly modeled prenatal weight and child body composition trajectories showed sex-specific patterns. Growth patterns from childhood though early adolescence appeared to be more profoundly affected by higher GWG patterns in females, suggesting sex differences in developmental programming.

Why do humans undergo an adiposity rebound? Exploring links with the energetic costs of brain development in childhood using MRI-based 4D measures of total cerebral blood flow

BackgroundIndividuals typically show a childhood nadir in adiposity termed the adiposity rebound (AR). The AR serves as an early predictor of obesity risk, with early rebounders often at increased risk; however, it is unclear why this phenomenon occurs, which could impede understandings of weight gain trajectories. The brain’s energy requirements account for a lifetime peak of 66% of the body’s resting metabolic expenditure during childhood, around the age of the AR, and relates inversely to weight gain, pointing to a potential energy trade-off between brain development and adiposity. However, no study has compared developmental trajectories of brain metabolism and adiposity in the same individuals, which would allow a preliminary test of a brain-AR link.MethodsWe used cubic splines and generalized additive models to compare age trajectories of previously collected MRI-based 4D flow measures of total cerebral blood flow (TCBF), a proxy for cerebral energy use, to the body mass index (BMI) in a cross-sectional sample of 82 healthy individuals (0–60 years). We restricted our AR analysis to pre-pubertal individuals (0–12 years, n = 42), predicting that peak TCBF would occur slightly after the BMI nadir, consistent with evidence that lowest BMI typically precedes the nadir in adiposity.ResultsTCBF and the BMI showed inverse trajectories throughout childhood, while the estimated age at peak TCBF (5.6 years) was close but slightly later than the estimated age of the BMI nadir (4.9 years).ConclusionsThe timing of peak TCBF in this sample points to a likely concordance between peak brain energetics and the nadir in adiposity. Inverse age trajectories between TCBF and BMI support the hypothesis that brain metabolism is a potentially important influence on early life adiposity. These findings also suggest that experiences influencing the pattern of childhood brain energy use could be important predictors of body composition trajectories.

Body Composition Trajectories and Their Determinants Among Infants of Smoking and Ex-Smoking Mothers: Preliminary Result from a Pilot Study

Body Composition Trajectories and Their Determinants Among Infants of Smoking and Ex-Smoking Mothers: Preliminary Result from a Pilot Study

Perfluoroalkyl and Polyfluoroalkyl Substances and Body Size and Composition Trajectories: the Study of Women’s Health Across the Nation 1999-2018

BACKGROUND AND AIM: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been suggested as obesogens but epidemiologic evidence is limited. We examined associations of serum PFAS concentrations with longitudinal trajectories of weight, waist circumference (WC), fat mass and proportion fat in midlife women. METHODS: This study included 1,381 midlife women, with a total of 15,000 repeated measures from the multi-racial/ethnic Study of Women’s Health Across the Nation between 1999 and 2018. The average follow-up was 14.9 (range: 0-18.6) years. Body size (objectively measured weight and WC) and body composition from dual-energy X-ray absorptiometry were assessed at near-annual visits. Linear mixed models with piecewise linear splines were utilized to model non-linear trajectories of body size and composition. RESULTS:After multivariable adjustment, PFAS concentrations were positively associated with weight, WC, fat mass, and proportion fat at baseline and during follow-up. Comparing the highest to the lowest tertiles of PFAS concentrations, adjusted geometric mean weight was 73.9 kg vs. 69.6 kg for PFOS (P0.0001), and 74.0 vs. 69.4 kg for linear PFOA (P0.0001) at baseline. Women with the highest tertile of PFOS had an annual increase rate of 0.33% (95% CI: 0.27%, 0.40%) in weight, compared to the lowest tertile with 0.10% (95% CI: 0.04%, 0.17%) (P0.0001). PFOS was also significantly related to higher increase rates in WC (difference=0.12% per year, P=0.002) and fat mass (difference=0.25% per year, P=0.0002). EtFOSAA and MeFOSAA showed similar effects to PFOS. Although PFHxS was not related to body size or fat at baseline, PFHxS was significantly associated with accelerated increases in weight (P0.0001), WC (P=0.003), fat mass (P0.0001), and proportion fat (P=0.0009). No significant results were found for PFNA. CONCLUSIONS:Certain PFAS were positively associated with large body size and body fat, and higher increase rates over time. PFAS may be an underappreciated contributing factor to obesity risk. KEYWORDS: PFAS, Obesity and metabolic disorders

Area-level and family-level socioeconomic position and body composition trajectories: longitudinal analysis of the UK Millennium Cohort Study

SummaryBackgroundInequalities in the trajectories of body composition in childhood and adolescence have been infrequently studied. Despite the importance of environmental factors in obesity development, little research has looked at area-level socioeconomic position, independent of family socioeconomic position. We aimed to assess how inequalities in body composition develop with age.MethodsThe Millennium Cohort Study is a longitudinal study of 19 243 families who had a child born between 2000 and 2002 in the UK. Multilevel growth curve models were applied to examine change in fat mass index (FMI), fat free mass index (FFMI; using the Benn index), and fat mass to fat free mass ratio (FM:FFM), measured using Bioelectrical Impedance Analysis, from ages 7 years to 17 years by the Index of Multiple Deprivation (IMD) and household income at baseline.FindingsInequalities in FMI and FM:FFM ratio are evident at age 7 years and widen with age. At age 17 years, adolescents in the most disadvantaged IMD group had FMI 0·57 kg/mB (B=Benn parameter; 95% CI 0·43 to 0·70) higher and FM:FFM ratio 0·037 (95% CI 0·026 to 0·047) higher compared with the most advantaged group. Disadvantaged socioeconomic position is associated with higher FFMI but is reversed in adolescence after adjustment for FMI. Inequalities were greater in girls at age 7 years (mean FMI 0·22 kg/mB; 95% CI 0·13 to 0·32) compared with boys of the same age (0·05 kg/mB; –0·04 to 0·15, p=0·3), but widen fastest in boys, especially for FMI, in which there was over an 11 times increase in the inequality from age 7 years of 0·05kg/mB (95% CI –0·04 to 0·15) to 0·62 kg/mB at 17 years (0·42 to 0·82). Inequalities for the IMD were similar to income, and persisted at age 17 years independent of family socioeconomic position.InterpretationChildhood and adolescence is an important period to address inequalities in body composition, as they emerge and widen. Policies should consider FFM as well as FM, and inequalities in the environment.FundingMedical Research Council, Economic and Social Research Council.

Perfluoroalkyl and polyfluoroalkyl substances and body size and composition trajectories in midlife women: the study of women's health across the nation 1999-2018.

Background/Objectives:Perfluoroalkyl and polyfluoroalkyl substances (PFAS) have been suggested as obesogens but epidemiologic evidence is limited. We examined associations of serum PFAS concentrations with longitudinal trajectories of weight, waist circumference (WC), fat mass and proportion fat in midlife women.Subjects/Methods:This study included 1,381 midlife women, with a total of 15,000 repeated measures from the multi-racial/ethnic Study of Women’s Health Across the Nation between 1999 and 2018. The average follow-up was 14.9 (range: 0–18.6) years. Body size (objectively measured weight and WC) and body composition from dual-energy X-ray absorptiometry were assessed at near-annual visits. Linear mixed models with piecewise linear splines were utilized to model non-linear trajectories of body size and composition.Results:After multivariable adjustment, PFAS concentrations were positively associated with weight, WC, fat mass, and proportion fat at baseline and during follow-up. Comparing the highest to the lowest tertiles of PFAS concentrations, adjusted geometric mean weight was 73.9 kg vs. 69.6 kg for PFOS (P<0.0001), and 74.0 vs. 69.4 kg for linear PFOA (P<0.0001) at baseline. Women with the highest tertile of PFOS had an annual increase rate of 0.33% (95% CI: 0.27%, 0.40%) in weight, compared to the lowest tertile with 0.10% (95% CI: 0.04%, 0.17%) (P<0.0001). PFOS was also significantly related to higher increase rates in WC (difference=0.12% per year, P=0.002) and fat mass (difference=0.25% per year, P=0.0002). EtFOSAA and MeFOSAA showed similar effects to PFOS. Although PFHxS was not related to body size or fat at baseline, PFHxS was significantly associated with accelerated increases in weight (P<0.0001), WC (P=0.003), fat mass (P<0.0001), and proportion fat (P=0.0009). No significant results were found for PFNA.Conclusions:Certain PFAS were positively associated with greater body size and body fat, and higher rates of change over time. PFAS may be an underappreciated contributing factor to obesity risk.

Distinct Body Mass Index Trajectories to Young-Adulthood Obesity and Their Different Cardiometabolic Consequences.

[Figure: see text].

Functional Decline and Body Composition Change in Older Adults With Alzheimer Disease: A Retrospective Cohort Study at a Japanese Memory Clinic.

There is a dearth of longitudinal data on body composition, function, and physical performance in persons with Alzheimer's disease (AD). The aim was to describe the trajectories of function, body composition, and physical performance in older adults with AD. In this retrospective cohort study, data were collected from older adults (n=1402) diagnosed with AD (mean age: 78.1 y old, women: 69.3%). Cognitive function was assessed using the mini-mental state examination. Proxy-reported instrumental and basic activities of daily living were assessed using the Lawton and Barthel indexes. Body composition was assessed using bioelectrical impedance analysis. Physical performance was assessed using the timed up and go test and grip strength. Median (interquartile range) of follow-up time was 2.2 (1.2 to 3.6) years. Participants' mini-mental state examination score, Barthel index, and Lawton index declined over time. Skeletal muscle mass index and physical performance (timed up and go test and grip strength) decreased, while fat mass index increased with time. No significant changes or slight decline in weight and body mass index was observed. Muscle mass and physical performance are likely to decline in older adults with AD. Clinicians should assess muscle mass and physical performance trajectories regularly in these patients and intervene appropriately.

Trajectories of Body Composition during Advanced Aging in Consideration of Diet and Physical Activity: A 20-Year Longitudinal Study.

This prospective study investigates age-dependent changes in anthropometric data and body composition over a period of two decades in consideration of physical activity and diet in community-dwelling subjects ≥60 years. Overall, 401 subjects with median follow-up time of 12 years were examined. Fat-free mass (FFM) and fat mass (FM) were analyzed using bioelectrical impedance analysis. Physical activity was assessed via a self-administered questionnaire. Dietary intake was examined by 3-day dietary records. Linear mixed-effects models were used to analyze the influence of age, sex, physical activity and energy/protein intake on anthropometric data and body composition by considering year of entry, use of diuretics and diagnosis of selected diseases. At baseline, median values for daily energy and protein intakes were 8.5 megajoule and 81 g and physical activity index was 1.7. After adjusting for covariates, advancing age was associated with parabolic changes indicating overall changes from age 60 to 90 years in women and men in body mass: −4.7 kg, −5.0 kg; body mass index: +0.04 kg/m2, −0.33 kg/m2; absolute FFM: −2.8 kg, −3.5 kg; absolute FM: −1.8 kg, −1.2 kg and waist circumference: +16 cm, +12 cm, respectively. No age-dependent changes were found for upper arm circumference and relative (%) FFM. Dietary and lifestyle factors were not associated with changes in anthropometric or body composition parameters. In summary, the results indicate non-linear age-dependent changes in anthropometric data and body composition, which are largely unaffected by the degree of habitual physical activity and dietary protein intake in well-nourished community-dwelling subjects.

Weight Loss After Sleeve Gastrectomy: Does Type 2 Diabetes Status Impact Weight and Body Composition Trajectories?

Sleeve gastrectomy (SG), the most frequently performed bariatric procedure, induces marked weight-loss, but with high inter-individual variability. Since type 2 diabetes (T2D) negatively impacts weight-loss outcomes after Roux-en-Y gastric bypass (RYGB), we herein aimed to evaluate whether and how T2D status may influence weight-loss and body composition changes in individuals with or without T2D after SG. We retrospectively included individuals with obesity operated from SG and prospectively followed at our center: 373 patients including 152 with T2D (40%). All subjects' clinical characteristics were collected before and during 4years of follow-up post-SG. Linear mixed models were applied to analyze weight-loss trajectories post-surgery. Compared to individuals with obesity but no T2D, those with T2D before SG displayed lower weight-loss at 1year (21 vs. 27% from baseline, p < 10-3). This difference was accentuated in patients with poorer glucose control (HbA1c > 7%) at baseline. Furthermore, patients with T2D underwent less favorable body composition changes at 1-year post-SG compared to individuals without T2D (% fat mass reduction: 28 vs. 37%, p < 10-3 respectively). When undergoing SG, subjects with obesity and T2D who have poor pre-operative glycemic control display reduced weight-loss and less improvement in body composition compared to patients with obesity but without T2D. This result suggests that glycemic control prior to surgery is important to take into account for the outcome of bariatric surgery.