Body Composition Fat Research Articles

Abstract 4134990: Body Fat Quantitation Predicts Progressive Cardiac Dysfunction with Age: Sex-Dependent Variations And Clinical Outcomes

Background: Among older adults whose body mass index (BMI) readings may be spuriously reduced due to loss of skeletal muscle, BMI alone may lack specificity for body fat quantitation. In addition, sex-based hormones differentially influence body fat composition between the sexes with aging. To evaluate the cardiometabolic effect of body fat on older adults, we hypothesize that sex would exert differential effects on baseline and progression of cardiac dysfunction in older adults. Methods: Community older adults without cardiovascular disease (CVD) underwent prospective transthoracic echocardiography with simultaneous body fat quantitation (body fat mass (BFM), percentage body fat (PBF), and waist-hip ratio (WHR) by bioimpedance, at baseline and five-year intervals. Mitral early diastolic inflow velocity to early diastolic annular tissue velocity (E/e') and early to late diastolic inflow velocity (E/A) ratios were recorded. Multivariable regression models were adjusted for significant clinical variables. Adverse clinical outcomes were defined as mortality or hospitalization during follow-up. Results: Baseline and interval annotation of 409 older adults (mean age 61±12.7 years, 52% females) demonstrated deteriorations in E/A ratios of -0.1 ± 0.3 and E/e' ratios of 1.8 ± 2.8, over a mean duration of 4.9 ± 0.4 years. Baseline BFM (β -0.01, p<0.001; β 0.023, p=0.352) and PBF (β -0.008, p=0.002; β -0.007, p=0.759) predicted interval changes in E/A but not E/e' respectively independent of covariates (Table 1). In sex-specific analyses, higher baseline PBF was associated with deteriorations in E/A (β 0.010, p=0.028) among women and E/e' among men (β -0.069, p=0.020). Increases in PBF over time were particularly associated with reductions in E/A among women (β -0.005, p=0.047) independent of higher baseline PBF, in addition to significant interactions between sex and PBF in predicting changes in E/A. (Figure 1). Higher baseline WHR predicted adverse clinical outcomes [w1] among women (HR 1.09, 95%CI 1.03-1.16, p=0.005). Conclusion: Baseline and longitudinal increases in fat quantity defined a trajectory of deteriorations in cardiac function among older adults, and prognosticated poorer future outcomes, particularly among women with central adiposity as represented by WHR. Refining CVD risk based upon quantitative sex-specific fat targets for older adults may be a strategy in the future.

Impact of exercise intervention with or without curcumin supplementation on body fat composition, glucose, and lipid metabolism in obese adults: A meta-analysis.

This study was carried out to systematically review and evaluate the influence of exercise with and without curcumin on body fat composition, glucose, and lipid metabolism in obese adults. Search for eligible studies through four databases, and then proceed with screening. The inclusion criteria are as follows: (1) obese adults; (2) randomized controlled trial (RCT); (3) classified the exercise intervention with curcumin supplementation as the exercise with curcumin (CU) group and without curcumin supplementation as the exercise without curcumin (EX) group; (4) Conducted pre- and post-training assessments, which include body fat composition, glucose and lipid metabolism parameters. Use the Cochrane bias risk assessment tool to evaluate the quality of the selected study. Select standardized mean difference (SMD) as the appropriate effect scale index, and use Revman 5.4 software to analyze the mean difference of the selected article data with a 95% confidence interval (CI). A total of seven studies fulfilled the inclusion criteria and were selected for the meta-analysis. The included studies involved 72 males and 111 females, where 94 belonged to the EX group and 89 from the CU group. The CU group benefited more from the reduced Fat% (SMD, 2.18 [0.12, 4.24], p < 0.05, I2 = 0%, p for heterogeneity = 0.98) than the EX group. The study demonstrated that the combined exercise intervention with curcumin supplementation significantly reduced Fat% in obese adults compared with exercise without supplementing curcumin.

The dynamic increment of epicardial adipose tissue is associated with reverse remodeling after guideline-directed medical treatment in dilated cardiomyopathy patients

Abstract Background/Introduction Epicardial adipose tissue (EAT) accumulation is associated with adverse prognosis in patients with HFpEF and a better prognosis in HFrEF patients. Whether EAT is playing a protective role in dilated cardiomyopathy (DCM) patients have been described sparingly. Purpose Aim to explore whether the epicardial fat would change along with the dynamic changes in cardiac function and volumes after receiving guideline-directed medical therapy (GDMT) in patients with DCM. Methods We prospectively enrolled 232 DCM patients who underwent complete baseline and follow-up Cardiac magnetic resonance (CMR) examinations. The measurement of the epicardial fat composition includes epicardial fat thickness, paracardial fat thickness, and paracardial fat volume, while the measurement of body fat composition includes subcutaneous and visceral abdominal fat, while We used univariable and multivariable logistic regression to evaluate the association between different body and cardiac fat depots with the changes in bi-ventricular structure (delta indexed EDV) and function (delta EF). Results The study included 232 patients (mean age 46.1±14.1 years, 157 (67.7%) males). After GDMT, we found that the visceral fat thickness and EAT (thickness and volume) tend to significantly increase. The increase in the (left ventricular reverse remodeling) LVRR group was significantly higher compared with the non-LVRR group. Independently with the changes of BMI and body fat depots, the increment of EAT was associated with the improvement in bi-ventricular function and volumes (significantly positively correlated with the improvement of LVEF (r = 0.499, p &amp;lt; 0.001), and RVEF (r = 0.482, p &amp;lt; 0.001), negatively correlated with delta LVEDVi (r = -0.407, p &amp;lt; 0.001), delta RVEDVi (r = -0.305, p &amp;lt; 0.001)). Conclusions After GDMT, the increment of EAT was positively correlated with the improvement of bi-ventricular structure and function, independent of the changes in BMI and body fat depots.Graphic Abstract

7975 TLR4 Signaling Modulates Reproductive and Metabolic Outcomes in a Mouse Model of Polycystic Ovary Syndrome

Abstract Disclosure: K.D. Wiggins: None. Z. Del Mundo: None. J.A. Ayala Angulo: None. M. Lopez: None. C. Garcia: None. C. Nguyen: None. J. De La Torre: None. A. Saba: None. D. Trinh: None. D. Nicholas: None. Polycystic Ovarian Syndrome (PCOS), characterized by disruptions in both reproductive and metabolic functions, is associated with abnormal immune system activity and chronic inflammation. Although the precise mechanistic drivers of chronic inflammation in PCOS are not fully elucidated, elevated serum levels of lipopolysaccharide (LPS) have been observed. We propose that Toll-like receptor 4 (TLR4) signaling, influenced by dysregulated LPS levels, is a central driver of chronic inflammation affecting both reproductive and metabolic pathways. To investigate this hypothesis, we subcutaneously implanted a nonsteroidal aromatase inhibitor, Letrozole (LET), in pubertal TLR4 knockout mice (TLR4KO) and C57BL/6J (wild type) mice. Our five-week LET treatment revealed that TLR4KO mice successfully entered all phases of the estrous cycle, with normalized Luteinizing Hormone (LH) and increased Follicle Stimulating Hormone (FSH) levels. These findings highlight TLR4's role in shaping cycling patterns and regulating fundamental hormonal pathways vital for reproductive health. Despite the genetic manipulation of the inflammatory pathway leading to a reduction in overall body weight gain, it had no discernible impact on the overall body composition of fat and lean mass. Additionally, our study found that dysregulation of blood glucose levels over time was independent of reduced body weight. TLR4KO mice demonstrated inefficient glucose clearance compared to wild-type mice, hinting at potential increases in insulin resistance, imbalances in adipose tissue inflammation, or possible alterations in the gut microbiota. Our study underscores the significance of disrupting the pro-inflammatory TLR4 pathway in shaping the reproductive and metabolic phenotypes in Letrozole-induced PCOS. The investigation into TLR4 becomes pivotal for comprehending the role of chronic inflammation in PCOS development or progression, offering valuable insights into potential therapeutic targets. Presentation: 6/2/2024

Body Composition, Nutritional Status, and Socio-Demographic Factors Among University Students and Teachers in Bangladesh: A Pilot Study

BackgroundBody composition, particularly visceral fat content, is regarded as an important determinant of major metabolic disorder. People with similar BMI could have differential body fat and muscle composition with different metabolic outcome. Epidemiological research largely focuses on BMI or relative body weight across the range of height and waist hip ratio (WHR) as a index of central body shape; however, body composition has hitherto given little importance in Bangladesh. Therefore, we designed a small pilot cross sectional study to assess anthropometrics, the body composition by bioelectrical impedance and nutritional status and its differences among students and teacher of Islamic University, Bangladesh. MethodsA total of 133 participants (median age of 22.51±3.86 years), students and teachers, were recruited. In addition to BMI and waist-hip ratio (WHR), a body composition analyzer (based on bioelectrical impedance) was used to determine the body composition parameter. Descriptive statistics, chi-square, T test and Pearson correlations were done. ResultsConsiderable differences were observed among various age groups and genders. Most of the respondents had a higher metabolic age (definition) than the chronological age, and 42.86% had high fat percentage. Male had lower body fat (19.56% vs 26.29%) but more visceral fat (4.96% vs 4.32) than female. Visceral fat was significantly (p<0.001) raised in older age groups than younger ones (10.26% vs 4.33%, P<0.05). The cut-off values of BMI were normal in range for both genders, and WHR for male and female were 0.83 and 0.81 respectively. Body protein, muscle, water, moisture, and abio-salt content were higher at the age of 40 years, and female respondents had the lowest ones compared to males. ConclusionUnhealthy visceral fat was higher in male and older age group. A healthy level of all body composition parameters was observed in young age groups compared to the older ones.

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.

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.

Implementation of nutrition care process in Indonesian athletes and its effect on nutritional status and aerobic capacity performance

Introduction: Despite the critical function of a nutritionist, only a few sports training centres for students in Indonesia have one. This study aimed to determine the effect of the nutrition care process (NCP) on athletes’ nutritional status and aerobic capacity performance. Methods: This cohort study was conducted in 2022 (May–August) in four training centres (TC) in Indonesia. Subjects were athletes who have been dwelling in TC for at least three months, excluding those absent for &gt;14 days due to a competition or other commitments during the data collection period. NCP included the assistance of trained sports nutritionists. In total, 114 athletes participated in this study: 90 strength athletes and 24 endurance athletes. The participants were aged 14-19 years old with approximately (mean+SD) 6+2.5 years of experience in specific sports. Results: After three months of NCP, knowledge of nutrition (p=0.013), body fat composition (p&lt;0.001), skinfold thickness scores (p&lt;0.001), and performance (p&lt;0.001) of athletes significantly improved. In spite of good intakes of protein and fat, none of the intakes showed significant changes (p&gt;0.05). Furthermore, improved knowledge of sports nutrition and exercise science had a positive impact on dormitory meal choices. Conclusion: Overall, three months of NCP had a significant effect on athletes’ knowledge of nutrition, body fat composition, skinfold thickness, and also VO2Max.

A plasma proteomic signature links secretome of senescent monocytes to aging- and obesity-related clinical outcomes in humans.

Cellular senescence increases with age and contributes to age-related declines and pathologies. We identified circulating biomarkers of senescence associated with diverse clinical traits in humans to facilitate future non-invasive assessment of individual senescence burden and efficacy testing of novel senotherapeutics. Using a novel nanoparticle-based proteomic workflow, we profiled the senescence-associated secretory phenotype (SASP) in monocytes and examined these proteins in plasma samples (N = 1060) from the Baltimore Longitudinal Study of Aging (BLSA). Machine learning models trained on monocyte SASP associated with several age-related phenotypes in a test cohort, including body fat composition, blood lipids, inflammation, and mobility-related traits, among others. Notably, a subset of SASP-based predictions, including a 'high impact' SASP panel that predicts age- and obesity-related clinical traits, were validated in InCHIANTI, an independent aging cohort. These results demonstrate the clinical relevance of the circulating SASP and identify relevant biomarkers of senescence that could inform future clinical studies.

Distinct biophysiological effects of Ramadan fasting and traditional intermittent fasting on markers of body fat storage. A real-life study

BackgroundRamadan Intermittent fasting (RIF) exerts beneficial metabolic effects and improves gastrointestinal motility. However, a comparison between RIF and the traditional 16-hours intermittent fasting (16IF), a strategy for weight loss, is lacking. MethodsA total of 34 subjects (median age 32.5 years, range 18–63 years; median BMI 24.5 Kg m-1², range 18.6–37.6 Kg m-1²) were assigned to RIF (N = 18) or 16IF (N = 16) for 30 days. We measured variations in anthropometric measures (BMI, waist, and abdominal circumference), serum insulin, glucose, cortisol, non-esterified fatty acid (NEFA), body fat composition (bioelectrical impedance analysis), and the ultrasonographic measurements of liver steatosis (Hepatorenal index, HRI) and thickness of subcutaneous (SAT) and visceral (VAT) fats. ResultsAt baseline, BMI, rates of liver steatosis and distribution of normal weight, overweight, and obese subjects were comparable between the two groups. Body weight significantly decreased at the end of fasting in both RIF (-4.2 % vs baseline, P = 0.002) and 16IF (-2.1 % vs baseline, P = 0.002). Waist and abdominal circumferences significantly decreased only in RIF as well as the amount of body fat. In subjects with liver steatosis, SAT and VAT significantly decreased following RIF, but not 16h-IF, as well as the ultrasonographic HRI. ConclusionBoth 16IF and RIF are able, during 1-month, to reduce body weight. However, RIF but not 16IF also generates marked beneficial effects in terms of reduced subcutaneous fat and liver steatosis. Further studies urge to verify the effects of different models of IF in weight-cycling and long-term management of obesity and related dysmetabolic conditions, such as ectopic fat over-storage.

Case Report: The Effect of Ajwa Date Consumption on Total Cholesterol Levels in Perimenopausal Women

Based on the 2016 Riskesdas, the prevalence of high cholesterol in Indonesia among women aged 35-59 years was 52.9%, and among those aged ≥60 years, it was 58.7%. According to provincial data, the highest percentage of patients with high cholesterol levels at Posbindu and FKTP in Indonesia was in West Papua Province, reaching up to 70%. The concentration of cholesterol levels in women's blood tends to increase with age, particularly for those over 40 years old, due to hormonal factors, especially the decrease in estrogen production and function. The decline in estrogen levels leads to an increase in lipids or total cholesterol, resulting in changes in body fat composition associated with hypercholesterolemia. This case report aims to investigate the impact of consuming Ajwa dates on the total cholesterol levels of perimenopausal women. Results: Ajwa dates contain higher polyphenol concentrations with an impressive nutritional profile that enhances blood lipoproteins. Additionally, dates can increase estrogen levels due to the estradiol and estrone present in their pollen. Several experimental studies have shown a significant difference in total cholesterol levels in subjects before and after consuming Ajwa dates. Conclusion: There is a notable difference in total cholesterol levels before and after the administration of Ajwa dates.

Influence of body fat tissue on outcomes in patients undergoing hepatectomy or liver transplantation.

The purpose of this study is to investigate potential associations between body fat composition and postoperative outcomes in patients with hepatectomy or liver transplantation. Three online databases, including Embase, PubMed, and the Cochrane Library, were thoroughly searched for literature describing the relationship between body fat composition and outcomes of patients with liver surgery from the start of each database to October 29, 2023. The Newcastle-Ottawa Scale was used to rate the quality of the studies. This analysis included a total of 29 articles with a combined patient cohort of 6,435 individuals. The results demonstrated that patients with high intramuscular fat content (IMFC) had significantly inferior OS (HR: 2.07, 95% CI: 1.69-2.53, P < 0.001) and RFS (HR: 1.61, 95% CI: 1.20-2.16, P = 0.002) and a higher risk of major complications (HR: 2.20, 95% CI: 1.59-3.05, P < 0.001). We also found that the presence of high visceral-to-subcutaneous fat tissue ratio (VSR) in patients with liver surgery was significantly related to poorer OS (HR: 1.70, 95% CI: 1.44-2.00, P < 0.001) and PFS (HR: 1.29, 95% CI: 1.11-1.50, P = 0.001) and a higher major complication rate (HR: 2.31, 95% CI: 1.17-4.56, P = 0.016). Besides, the synthesized findings indicated there is no significant correlation between visceral fat tissue and survival outcomes or postoperative complications. In summary, preoperative IMFC and VSR have the potential to forecast poorer OS and RFS and a higher risk of complications for patients undergoing hepatectomy or liver transplantation.

Curcumin-Rich Diet Mitigates Non-Alcoholic Fatty Liver Disease (NAFLD) by Attenuating Fat Accumulation and Improving Insulin Sensitivity in Aged Female Mice under Nutritional Stress.

The high incidence of metabolic syndrome in the elderly poses a significant challenge to the healthcare system, emphasizing the need for interventions tailored to geriatric patients. Given the limited focus on females in previous studies, this research aimed to evaluate the effects of dietary curcumin on obesity and NAFLD outcomes in naturally aged (18-month-old) female mice. Female C57BL/6 mice aged 18 months were fed a normal chow diet (NCD) and a HFHSD, with or without curcumin (0.4% w/w), for an 8-week period. Parameters included food intake, body weight, insulin tolerance test (ITT), glucose tolerance test (GTT), percentage fat mass, hepatic triglyceride, and cholesterol levels, and a histological examination for NAFLD detection, qPCR, and immunoblotting analyses were performed. The cumulative body weight gain after 8 weeks in the aged female mice supplemented with curcumin and fed an HFHSD was significantly lower (10.84 ± 1.09 g) compared to those fed a HFHSD alone (15.28 ± 1.26 g). Curcumin supplementation also resulted in reduced total body fat (HFHSD group 50.83 ± 1.71% vs. HFHSD+CUR 41.46 ± 3.21%), decreased epidydimal fat mass (HFHSD: 3.79 ± 0.29 g vs. HFHSD+CUR: 2.66 ± 0.30 g), and repaired adipogenic signaling in the white adipose tissue. Furthermore, curcumin lowered triglyceride and cholesterol deposition in the liver, preventing hepatic steatosis and improving hepatic insulin sensitivity. Curcumin demonstrates the ability to ameliorate the deleterious effects of HFHSD in aged female mice by reducing body fat composition, modulating adipogenic signaling in the white adipose tissue, and improving insulin homeostasis and non-alcoholic fatty deposition in the liver.

Differences in Aerobic Capacity and Running Speed Across Various Somatotype Structures and Body Fat Compositions among Professional Football Athletes in Indonesia

Highlights:1. This study emphasizes the significance of understanding professional football players' various somatotype structures and body fat compositions as an important contribution to the area of sports science.This study lays the groundwork for future research to better understand the intricate interactions between somatotype structures, body composition, and athletic performance.2. Since a one-size-fits-all approach may not be successful, this study advocates for tailored evaluations of training regimens to cater to athletes' unique requirements and skills, which may lead to higher overall performance. Abstract This study investigated the effects of somatotype structures and body fat composition on professional football athletes' aerobic capacities and running speed. This study used an analytical observational design with a cross-sectional approach. The subjects comprised 27 professional football athletes from Bhayangkara Football Club, located in Bekasi, Indonesia. This study measured several variables, i.e., players' age, playing position, somatotype structures assessed using the Somatotype Rating Form and Heath-Carter Somatochart, body fat composition measured using Brozek and Siri formulas, aerobic capacities determined by the maximum rate of oxygen (VO2 max) through the Yo-Yo Intermittent Recovery Test Level 2, and running speed over a 30 m distance. The data were presented as mean ± standard deviation (SD), frequency (n), and percentage. The Shapiro-Wilk was used to determine the normality of the data distribution. The statistical analyses were conducted using one-way analysis of variance (ANOVA) followed by the post-hoc least significant difference (LSD) test, the Kruskal-Wallis test followed by the post-hoc Mann-Whitney test, as well as the independent t-test, the Mann-Whitney test, and Pearson's or Spearman's correlation tests. A value of p&lt;0.05 was considered statistically significant. The athletes exhibited a predominant somatotype structure of mesomorph-endomorph (88.9%). Notable associations were found between mesomorphy rating and running speed (r=-0.548; p=0.003), body fat composition and aerobic capacity (r=-0.448; p=0.019), as well as age and aerobic capacity (r=-0.515; p=0.006). Notably, differences in aerobic capacity were observed among various age groups (p=0.031). There were also differences in body fat composition (p=0.003) and running speed (p=0.036) between two distinct somatotype structures. These findings underscore the importance of considering individualized training and conditioning programs that account for athletes' unique body compositions and ages.

Impact of Body Mass Index in the Cardioverter Efficacy of Amiodarone in Persistent Atrial Fibrillation.

Amiodarone is an anti-arrhythmic drug that has extensive tissue distribution and substantial storage in the fat tissue. Different studies have described some implications of body fat composition in its pharmacokinetics and pharmacodynamics. However, no clinical studies have described its implications for clinical efficacy. We studied 878 patients with persistent atrial fibrillation (AF) treated with a regimen of amiodarone and referred to electrical cardioversion (ECV), included prospectively in two Spanish registries. We analyzed the influence of body mass index (BMI), as well as overweight and obesity, in the efficacy of amiodarone for achieving pharmacologic cardioversion to sinus rhythm (SR) before ECV. A total of 185 patients (21.1%) reverted to SR before ECV. Patients who reverted to SR had a lower BMI than those who did not revert (27.45 ± 4.36 kg/m2 vs. 29.11 ± 4.09 kg/m2; p < 0.001). We observed a progressively lower probability of reverting to SR in overweight and obese patients (normal weight 28.3%, overweight 21.3%, obesity 13.1%; p < 0.001). In the logistic regression, BMI (kg/m2) adjusted for other related variables remained as the main factor inversely related to reversion to SR (OR = 0.904 × kg/m2); CI 75% 0.864-0.946). We observed a negative relationship between an increased BMI and the efficacy of amiodarone for reversion to SR, suggesting a negative clinical impact of excess body fat in its efficacy.

#1131 Significant reno-cardio-metabolic protection by the food additive Flexovital in a murine model combining unilateral nephrectomy and Western diet

Abstract Background and Aims Cardiovascular complications are major threats in advanced renal failure and metabolic dysfunction with several unmet medical needs. This study aimed to investigate the therapeutic effects of a special food additive (FLEXOVITAL) in a newly developed mouse model of reno-cardio-metabolic disease, induced by moderate renal failure in combination with a special Western diet. Method Male C57BL/6J mice (4 weeks old, n = 18) were subject to unilateral nephrectomy (UNX), fed a Western diet rich in fat carbohydrates and salt (WD), and were followed for 12 weeks compared with SHAM-operated mice on standard chow (n = 19). One group of UNX+WD mice (n = 8) was fed a food additive (FLEXOVITAL; FLX) containing extracts of Rhodiola rosea, beetroot, and the amino acids arginine and citrulline. Body weight (BW), blood pressure (tail-cuff), endothelial-dependent vasorelaxation (myograph), glucose metabolism (IPGTT), body fat and lean mass composition (DEXA), adipocyte area, renal function (Glomerular Filtration Rate (GFR) by plasma clearance of FITC-inulin), and mitochondrial function (Oroboros, High-resolution respirometry) were measured together with biochemical analysis of heart injury (Troponin-I), inflammation (IL6) and histological analyses of the kidney and heart. Results BW gain was seen in the UNX+WD and SHAM group, and was 25% less in the FLX group (p &amp;lt; 0.05). The fat/lean-mass ratio increased by 17% (p &amp;lt; 0.01) and the adipocyte area by 31% (p &amp;lt; 0.001) in the UNX+WD group but was virtually normalized in the FLX group (p &amp;lt; 0.01). Fasting and non-fasting glucose levels became elevated in the UNX+WD group and were reduced in the FLX group (p &amp;lt; 0.05). Impaired glucose clearance in the UNX+WD group, was partially prevented by FLX. BP significantly increased in the UNX+WD group (MAP = 78 → 90 mmHg, p &amp;lt; 0.001), and was largely prevented by FLX (MAP = 82 mmHg, p &amp;lt; 0.01). Endothelial function was significantly impaired in the UNX+WD group (p &amp;lt; 0.01) and partially preserved in the FLX group (p &amp;lt; 0.05). GFR was reduced by almost 60% in the UNX+WD group but improved with a 75% protective effect in the FLX group (p &amp;lt; 0.05). Significant glomerular injuries with mesangial proliferation were observed in the UNX+WD group (p &amp;lt; 0.001) but were less pronounced in the FLX group (p &amp;lt; 0.01). Tubular injury score (1-10) increased from 1 in SHAM to 6.5 in the UNX+WD group and was partly protected (4.5) in the FLX group (p &amp;lt; 0.05). Troponin-I levels were 15 pg/ml in the SHAM group, markedly increased in the UNX+WD group (p &amp;lt; 0.001), whereas completely reversed in the FLX group (p &amp;lt; 0.01). No significant histological cardiac injuries or deviations could be demonstrated. Inflammatory activity (IL6) increased by 88% in the UNX+WD there was a trend of reduction in mice with FLX. Mitochondrial oxygen efficiency (P/O ratio) was improved in the kidneys of the FLX group compared to the UNX+WD group (p &amp;lt; 0.05). Conclusion In the present multiorgan disease model, significant renal, cardiovascular, and metabolic dysfunction/injuries emerge in mice with a moderate reduction of renal function when fed a Western diet rich in fat, carbohydrates, and salt. Protective effects were noted by dietary FLX treatment in most functional assessments made in the model. This indicates FLX is a potential new treatment in patients with reno-cardio-metabolic disease. The next phase involves confirming these findings in the clinical setting.

259 Effect of very low calcium diet supplemented with microbial phytase in post-weaning piglets

Abstract Young piglets have an immature intestine that provides limited gastric acidity to digest nutrients compared with later stages of growth. Food has the intrinsic capacity to modify gastric acidity, particularly in relation to their concentrations of limestone, the ingredient with the greatest capacity to bind to acid. An experiment was conducted to evaluate the impacts of reducing dietary calcium (Ca) by reducing calcium supplementation immediately after weaning; compared with the recommendations of the NRC (2012), in association with phytase supplementation. The treatments were distributed during 3 phases [Phase 1 (P1, d 0-9), 2 (P2, d 10-16) and 3 (P3, d 17-35)]. Treatments were: 1) a diet low Ca that did not contained limestone during phase 1 (LowCa), P1 to P3 respectively, 0.51-0.60-0.65 % Ca and 0.48-0.43-0.38 % standardized ileal digestible P (STTD P), 2), diet 1 with microbial phytase (LowCa+PhytM); P1 to P3 respectively, 0.51-0.60-0.65 % Ca and 0.48-0.43-0.38% STTD P with 750 FTU phytase, and 3) a diet fulfilling requirement (NormalCa+PhytM) P1 to P3 respectively, 0.85-0.80-0.70 % Ca and 0.48-0.43-0.38 % STTD P with 750 FTU phytase. Piglets (n = 120) were allocated to 6 pens of 5 piglets per treatment in function of initial body weight (BW; 6.12 ± 0.028 kg). On d 0, 15 and 36, dual X-ray (DXA) bone densitometry was used to measure body fat, lean and mineral content (BMC) compositions using 8 piglets per treatment. At the end of phase 1 (d 9) a blood sample was collected. Data were analyzed using the SAS MIXED procedure with Tukey’s test to compare means. No differences were observed in growth performance or DXA measurements during the first phase. On d 9, LowCa piglets showed signs of hypocalcaemia with reduced plasma Ca (P = 0.03), increased plasma P (P = 0.02) and a lower Ca:P ratio in plasma (P = 0.04). From d 9-15, piglets that had received LowCa+PhytM showed greater average daily gain (ADG; P = 0.002) while other criteria did not differ between treatments. On d 15, the body composition evaluated by DXA showed no difference among dietary treatments. During phase 3, final BW and average daily feed intake were not modified by dietary treatments, while average daily gain and feed efficiency were greater in LowCa than in NormalCa+PhytM (+7.3 and 6.7%, respectively), and LowCa+PhytM was intermediate. Body composition on d 35 showed no difference among treatments while a tendency (P = 0.095) for greater BMC deposition (g/d) in LowCa in comparison with NormalCa+PhytM (+1.3 %). The implemented LowCa strategy resulted in momentary hypocalcemia which probably activated homeostatic mechanisms allowing piglets to be more efficient in using minerals and possibly other nutrients leading to better growth performance, without impact on bone mineralization.

PSV-19 Impact of precision feeding and bump feeding strategy during gestation on the performance of post-weaning pigs

Abstract The objective of this study was to evaluate the post-weaning growth performance of piglets from sows of parities 1 to 3 fed with 4 different feeding programs during gestation; Flat feeding (FF, constant concentration and feed intake), Bump feeding (BF, constant concentration and variable feed intake), precision feeding by parity (PFP, variable concentration and variable feed intake using the average weight per parity), individual precision feeding (PFI, variable concentration and variable feed intake using the weight of each sow at breeding). At weaning of each parity, five litters from each of the dietary treatments were selected and five average piglets from each of these litters were transferred to a nursery building with 20 pens. All pens received the same feeding program in 3 phases of 14 d each. Piglets were weighed at the beginning and end of each feeding phase. The quantity of feed was noted for each phase. At the end of phases 1 and 3, one piglet per pen was scanned on the DXA to assess its body lean, fat, and bone mineral composition. During phase 1, average daily gain (ADG) was greater for piglets from parity 1 sows than those from parity 2 and 3 while average daily feed intake (ADFI) and feed conversion (FC) were greater for piglets from parity 3 sows (P &amp;lt; 0.05; Table). Dietary treatments during gestation did not affect performances in phase 1. In phase 2, ADG and ADFI were greater while FC was decreased for piglets from sows of parity 2 and 3 (P&amp;lt; 0.001). Piglets from FF treatment had a greater ADG and a lesser FC (P &amp;lt; 0.05) than piglets from BF, piglets from PFP and PFI being intermediate. In phase 3, piglets from parity 2 sows and those from FF treatment had greater ADG and ADFI than piglets from PFI treatment, piglets from PFP and BF treatments being intermediate (P &amp;lt; 0.005). For all post-weaning period, piglets from parity 2 sows had greater ADG, ADFI and body weight at 42 d (P &amp;lt; 0.001) while piglets from the FF treatment had better ADG and weight at 42 d (P &amp;lt; 0.05) than those from BF and PFI (P &amp;lt; 0.05), PFP being intermediate. The lean ADG was greater for piglets from FF treatment (P &amp;lt; 0.021) than piglets from PFI, piglets from BF and PFP being intermediate. Piglets from sows of parity 2 and 3 had also greater lean ADG (P &amp;lt; 0.001). Fat ADG was also higher for piglets from parity 2 sows (P &amp;lt; 0.010) than piglets from parity 1 sows, piglets from parity 3 sows being intermediate. Piglets from parity 2 sows clearly had better post-weaning performances. The FF treatment during gestation led to better post-weaning performance, suggesting that energy or nutrient intake in early gestation affects offspring growth and development in post-weaning period.

High Compliance with the Lifestyle-Modification Program "Change 10 Habits" Is Effective for Obesity Management.

Low compliance (LC) with lifestyle modification is a very common obstacle in obesity management. The purpose of the current study was to investigate the effectiveness of obesity management according to compliance with a lifestyle-modification program. The "Change 10 Habits" program was administered four times over 12 weeks. Eighty-seven participants were divided into LC and high compliance (HC) groups for analysis after intervention. Then, to assess the program's effectiveness based on compliance, we conducted t-tests and linear regression modeling. In week 12, the scores of two dietary habits-specifically, "eat three meals regularly, adequate amount" and "do not eat after 9:00 PM"-were significantly higher in the HC group than in the LC group. Changes in leg and total body fat percentages were significantly improved in the HC group (-0.2%±0.3% vs. 0.9%±0.3%, P<0.05; -0.1%±0.3% vs. 1.1%±0.5%, P<0.05, respectively). The body mass index was also significantly lower in the HC group than in the LC group (26.7±1.8 kg/m2 vs. 27.7±2.1 kg/m2, P<0.05) at final follow-up. Finally, the systolic blood pressure, triglyceride, and very-low-density lipoprotein cholesterol values of the HC group also decreased significantly (from 117.9±12.2 to 114.3±15.0 mmHg, P<0.05; from 121.7±74.9 to 105.7±60.9 mg/dL, P<0.05; and from 24.3±15.0 to 21.1±12.2 mg/dL, P<0.05, respectively). HC with the study program effectively improved the dietary habits, body fat composition, blood pressure, and lipid profile of adults with mild obesity.

Abdominal ultrasonography as a tool to quantify adipose tissue in critically ill patients

Adipose tissue has important roles in both healthy and disease states. Quantifying adipose tissue composition and distribution may help predict outcomes and guide management in intensive care unit patients. Computed tomography is the preferred method for measuring adipose tissue but has drawbacks, such as radiation exposure and the need to transport patients. Ultrasonography is a safer, more convenient alternative for bedside assessment of body fat composition. This review examines the relevance of adipose tissue in critical illness and describes ultrasound techniques to quantify subcutaneous, visceral, and epicardial adipose tissue depots. Standardized protocols to measure subcutaneous fat thickness at multiple sites and approaches to estimate visceral fat using the supraumbilical or xipho-umbilical lines are discussed. A technique to quantify epicardial fat thickness using transthoracic echocardiography is also presented. While more research is needed, bedside ultrasonography shows promise for monitoring adipose tissue changes and their potential associations with outcomes in critically ill patients. Key words: Ultrasonography, critical illness, body composition, subcutaneous adipose tissue, visceral adipose tissue, epicardial adipose tissue