Excess Fat Mass Research Articles

Relationships Between Anthropometric Measures and Body Composition With Individual ACFT Event Performance Among Army Reserve Officers' Training Corps Cadets.

Thompson, MB, Lawson, DJ, Orr, RM, Lockie, RG, and Dawes, JJ. Relationships between anthropometric measures and body composition with individual ACFT event performance among army reserve officers' training corps cadets. J Strength Cond Res 38(4): 749-754, 2024-The U.S. military commonly uses body composition as an indicator of a soldier's potential to meet the physical demands required of their occupation. The purpose of this study was to determine whether significant relationships existed between select body composition variables and Army Combat Fitness Test (ACFT) performance among a cohort of university Army Reserve Officers' Training Corps (ROTC) cadets. Twenty-six male (20.4 ± 1.6 years, 81.8 ± 8.5 kg, 178.3 ± 7.8 cm) and 12 female (19.9 ± 1.4 years, 64.2 ± 6.7 kg, 161.9 ± 4.9 cm) cadets voluntarily participated in this study. Body composition was measured using bioelectrical impedance analysis, and ACFT event scores were recorded by the cadre using the U.S. Army standard protocol and provided to the investigators. Pearson's correlations were used to identify relationships between body composition variables and ACFT event performance with an alpha level of p ≤ 0.05. Moderate to strong relationships were observed between total body water, dry lean mass, lean body mass, skeletal muscle mass, body fat mass (FM), and body fat percentage and all event scores for the sample as a whole. Body mass index showed weak to moderate significant positive relationships with hand-release push-up and maximum hexagonal bar deadlift in the sample as a whole. No relationships were observed in the men of this sample. All body composition variables showed moderate, nonsignificant relationships with at least 1 ACFT event within the women of this sample. Considering the findings of this study, a multitude of variables could be useful to assess ROTC cadets as predictors for ACFT performance. Reserve Officers' Training Corps programs should emphasize attaining and maintaining functional lean mass, whereas reducing nonfunctional body mass (i.e., excess FM) among cadets to enhance health and performance across the occupational life span.

Gut microbiota in overweight and obesity: crosstalk with adipose tissue.

Overweight and obesity are characterized by excessive fat mass accumulation produced when energy intake exceeds energy expenditure. One plausible way to control energy expenditure is to modulate thermogenic pathways in white adipose tissue (WAT) and/or brown adipose tissue (BAT). Among the different environmental factors capable of influencing host metabolism and energy balance, the gut microbiota is now considered a key player. Following pioneering studies showing that mice lacking gut microbes (that is, germ-free mice) or depleted of their gut microbiota (that is, using antibiotics) developed less adipose tissue, numerous studies have investigated the complex interactions existing between gut bacteria, some of their membrane components (that is, lipopolysaccharides), and their metabolites (that is, short-chain fatty acids, endocannabinoids, bile acids, aryl hydrocarbon receptor ligands and tryptophan derivatives) as well as their contribution to the browning and/or beiging of WAT and changes in BAT activity. In this Review, we discuss the general physiology of both WAT and BAT. Subsequently, we introduce how gut bacteria and different microbiota-derived metabolites, their receptors and signalling pathways can regulate the development of adipose tissue and its metabolic capacities. Finally, we describe the key challenges in moving from bench to bedside by presenting specific key examples.

Incidence of the Risk of Malnutrition and Excess Fat Mass, and Gait Speed as Independent Associated Factors in Community-Dwelling Older Adults.

Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional reports, identified several risk factors associated with the prevalence and incidence of this condition. However, alterations in body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults. This is a secondary analysis of older adults (≥60 years) derived from the study "Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)", a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression. The cohort included 241 subjects. The average age was 75.6 ± 7.8 years, and 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in those with an excess fat mass, even after adjusting for several covariates. Regarding total lean tissue, the unadjusted model showed that RM was more likely to occur in men and women with a low TLT by the TLTI classification, compared to the normal group. However, after adjusting for several covariates (models 1 and 2), the association lost significance. Results on the association between gait speed and RM showed that this condition was also more likely to occur in subjects with low gait speed, according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance. RM diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, and a significant association emerged between low gait speed and RM after 4.1 years of follow-up in these community-dwelling older adults. These results confirm the association between some alterations of body composition and impaired physical performance with the risk of malnutrition and highlight that excess fat mass and low gait speed precede the risk of malnutrition, not vice versa.

The association of body composition and fat distribution with hypertension in community-dwelling older adults: the Bushehr Elderly Health (BEH) program

BackgroundA significant proportion of the global burden of disability and premature mortality has caused by hypertension. It seems that the relationship between obesity and hypertension is not only associated with excessive body fat mass (FM) but also with body adipose distribution patterns. The present study investigated the association between regional fat distribution using dual-energy X-ray absorptiometry and hypertension in older adults.MethodsThis cross-sectional study was performed using the data from Bushehr Elderly Health Program (BEH) on a total of 2419 participants aged 60 and over. Hypertension was defined as SBP of at least 140 mmHg and/or DBP of at least 90 mmHg. SBP between 120 and 139 mmHg and/or a DBP between 80 and 89 mmHg were considered prehypertension. Participants underwent body composition measurement by dual-energy x-ray absorptiometry to analyze FM, fat-free mass (FFM) in trunk and extremities composition.ResultsThe results showed that 460 (19.02%) of participants had prehypertension, and 1,818 (75.15% ) had hypertension. The odds of having prehypertension (OR: 1.06, 95%CI: 1.01–1.12) and hypertension (OR: 1.08, 95%CI: 1.03–1.13) increased with a rise in total body FM percentage. Moreover, people with a higher FM to FFM ratio had increased odds of being prehypertensive (OR: 9.93, 95%CI: 1.28–76.99) and hypertensive (OR: 16.15, 95%CI: 2.47-105.52). Having a higher android to gynoid FM ratio was related to increased odds of being prehypertensive and hypertensive.ConclusionsThis study showed that a higher body FM, particularly in the android region, is associated with higher odds of having hypertension in older adults.

Analysis of the role of education and sport in the heavy burden of obesity

Obesity has become the global pandemic of the world. The epidemiological rise has only happened in recent decades. Unfortunately, the disease affects people of all ages. The most prominent characteristics of the disorder are excessive fat accumulation, body mass index exceeding the number of 30, and general lowering of the quality of life. The consequences are observed in the whole organism. The disruptions affect one’s overall homeostasis. Certain diseases are specifically associated with excessive fat mass. When not properly managed, obesity leads to chronic illnesses and severe comorbidities, the most morbid one being death. Thus, effective therapeutic approaches are needed. Focus on education and physical activity are the best way to tackle this problem. The aim of this study is to check the factors and changes necessary to lose weight in obese patients in Poland. The main question regarded the role of sport and proper education in maintaining or losing weight in the Polish society. In order to analyse the issue, an Internet survey was prepared and disseminated in March and April 2023. Over half of the respondents have ever used a diet. Over 8 out of ten of them achieved the success in the set task. When asked about physical activity, the most respondents chose option 30-60 minutes per day. The preferred type of physical activity was most commonly walking. When asked if sport enabled the respondents to lose or maintain weight – 63,5% confirmed. 72% of respondents experienced education regarding healthy lifestyle, most commonly at home. Over 60% of respondents believed they were well informed about recommended behaviours. Over 50% of them confirmed their education is sufficient to lose weight. Maintaining healthy regimes is key to a healthy life. However, not all people are properly educated how to do that. In fact, there is a tendency of overestimation of one’s education in those topics. All in all, proper experience and routines are necessary.

Comprehensive analyses of circulating cardiometabolic proteins and objective measures of fat mass

BackgroundThe underlying molecular pathways for the effect of excess fat mass on cardiometabolic diseases is not well understood. Since body mass index is a suboptimal measure of body fat content, we investigated the relationship of fat mass measured by dual-energy X-ray absorptiometry with circulating cardiometabolic proteins.MethodsWe used data from a population-based cohort of 4950 Swedish women (55–85 years), divided into discovery and replication samples; 276 proteins were assessed with three Olink Proseek Multiplex panels. We used random forest to identify the most relevant biomarker candidates related to fat mass index (FMI), multivariable linear regression to further investigate the associations between FMI characteristics and circulating proteins adjusted for potential confounders, and principal component analysis (PCA) for the detection of common covariance patterns among the proteins.ResultsTotal FMI was associated with 66 proteins following adjustment for multiple testing in discovery and replication multivariable analyses. Five proteins not previously associated with body size were associated with either lower FMI (calsyntenin-2 (CLSTN2), kallikrein-10 (KLK10)), or higher FMI (scavenger receptor cysteine-rich domain-containing group B protein (SSC4D), trem-like transcript 2 protein (TLT-2), and interleukin-6 receptor subunit alpha (IL-6RA)). PCA provided an efficient summary of the main variation in FMI-related circulating proteins involved in glucose and lipid metabolism, appetite regulation, adipocyte differentiation, immune response and inflammation. Similar patterns were observed for regional fat mass measures.ConclusionsThis is the first large study showing associations between fat mass and circulating cardiometabolic proteins. Proteins not previously linked to body size are implicated in modulation of postsynaptic signals, inflammation, and carcinogenesis.

Impact of surgical treatment of obesity on metabolic parameters and course of non-alcoholic fatty liver disease

The aim of the study was to study the literature data on the effect of liposuction and abdominoplasty on metabolic parameters and the course of NAFLD. In recent years, technologies for the surgical treatment of obesity have been actively developed, the final stage of which is often liposuction and abdominoplasty. Surgical removal of excess fat mass leads to an improvement in the metabolic profile of patients. In patients with non-alcoholic fatty liver disease on the background of obesity after bariatric interventions, there is a regression of structural and functional changes in the liver. Modern literature convincingly shows the positive effect of bariatric surgery on the course of non-alcoholic fatty liver disease, however, there are no similar data on liposuction and abdominoplasty, which makes further research in this area relevant.

Placental AA/EPA Ratio Is Associated with Obesity Risk Parameters in the Offspring at 6 Years of Age.

During pregnancy, maternal polyunsaturated fatty acids (PUFA) are transferred to the fetus through the placenta by specific FA transporters (FATP). A higher perinatal exposure to n-6 over n-3 PUFA could be linked to excess fat mass and obesity development later in life. In this context, we aimed to assess the associations between long chain PUFAs (LC-PUFAs) (n-6, n-3, and n-6/n-3 ratios) measured in the placenta at term birth with obesity-related parameters in the offspring at 6 years of age and assess whether these associations are dependent on the placental relative expression of fatty acid transporters. As results, the PUFAn-6/PUFAn-3 ratio was 4/1, which scaled up to 15/1 when considering only the arachidonic acid/eicosapentaenoic acid ratio (AA/EPA ratio). Positive associations between the AA/EPA ratio and offspring's obesity risk parameters were found with weight-SDS, BMI-SDS, percent fat mass-SDS, visceral fat, and HOMA-IR (r from 0.204 to 0.375; all p < 0.05). These associations were more noticeable in those subjects with higher expression of fatty acid transporters. Therefore, in conclusion, a higher placental AA/EPA ratio is positively associated with offspring's visceral adiposity and obesity risk parameters, which become more apparent in subjects with higher expressions of placental FATPs. Our results support the potential role of n-6 and n-3 LC-PUFA in the fetal programming of obesity risk in childhood. For the present study, 113 healthy pregnant women were recruited during the first trimester of pregnancy and their offspring were followed up at 6 years of age. The fatty acid profiles and the expression of fatty acid transporters (FATP1 and FATP4) were analyzed from placental samples at birth. Associations between LC-PUFA (n-6, n-3, and n-6/n-3 ratios) and obesity risk parameters (weight, body mass index (BMI), percent fat mass, visceral fat, and homeostatic model assessment of insulin resistance (HOMA-IR)) in the offspring at 6 years of age were examined.

Long-term effects of GH therapy in adult patients with Prader-Willi syndrome: a longitudinal study.

Prader-Willi syndrome (PWS) is a complex disorder resulting from the failure of expression of paternal alleles in the PWS region of chromosome 15. The PWS phenotype resembles that observed in the classic non-PWS GH deficiency (GHD), including short stature, excessive fat mass, and reduced muscle mass. To date, a small number of studies on the long-term effects of GH treatment are available in adult subjects with PWS. In this longitudinal study, 12 obese subjects with PWS (GHD/non-GHD 6/6) were treated for a median of 17 years, with a median GH dose of 0.35 mg/day. The median age was 27.1 years. Anthropometric, body composition, hormonal, biochemical, and blood pressure variables were analyzed in all subjects. Waist circumference was significantly lower at the end of the treatment period (p-value=0.0449), while body mass index (BMI) did not differ significantly. Compared to the baseline, a highly significant reduction of Fat Mass % (FM%) was observed (p-value=0.0005). IGF-I SDS values significantly increased during GH therapy (p-value=0.0005). A slight impairment of glucose homeostasis was observed after GH therapy, with an increase in the median fasting glucose levels, while insulin, HOMA-IR, and HbA1c values remained unchanged. Considering GH secretory status, both subjects with and without GHD showed a significant increase in IGF-I SDS and a reduction of FM% after GH therapy (p-value= 0.0313 for all). Our results indicate that long-term GH treatment has beneficial effects on body composition and body fat distribution in adults with PWS associated with obesity. However, the increase in glucose values during GH therapy should be considered, and continuous surveillance of glucose metabolism is mandatory during long-term GH therapy, especially in subjects with obesity.

Sarcopenic Obesity: Involvement of Oxidative Stress and Beneficial Role of Antioxidant Flavonoids.

Sarcopenic obesity, which refers to concurrent sarcopenia and obesity, is characterized by decreased muscle mass, strength, and performance along with abnormally excessive fat mass. Sarcopenic obesity has received considerable attention as a major health threat in older people. However, it has recently become a health problem in the general population. Sarcopenic obesity is a major risk factor for metabolic syndrome and other complications such as osteoarthritis, osteoporosis, liver disease, lung disease, renal disease, mental disease and functional disability. The pathogenesis of sarcopenic obesity is multifactorial and complicated, and it is caused by insulin resistance, inflammation, hormonal changes, decreased physical activity, poor diet and aging. Oxidative stress is a core mechanism underlying sarcopenic obesity. Some evidence indicates a protective role of antioxidant flavonoids in sarcopenic obesity, although the precise mechanisms remain unclear. This review summarizes the general characteristics and pathophysiology of sarcopenic obesity and focuses on the role of oxidative stress in sarcopenic obesity. The potential benefits of flavonoids in sarcopenic obesity have also been discussed.

32 Exercise versus feed restriction: What is the most efficient weight loss option for your fat horse?

In first world countries, 45–75% of domesticated horses are considered overweight. Accumulation of excessive fat mass puts horses at risk for co-morbidities such as systemic inflammation and osteoarthritis. The objective was to characterize weight loss in overweight horses during 10 weeks of feed restriction, exercise, or both. Thirty-two horses, 4 geldings and 28 mares, mean age of 14 ± 4, with a body condition score (BCS) of at least 7/9, were fed controlled, individualized hay feedings 3 times a day with a concentrate meal. Diets were based on horse's body weight (BW) (kg) and calculated using FeedXL. Horses were randomly allocated into one of 4 treatment groups, Daily Exercise (E), Feed Restriction (FR), Feed Restriction & Daily Exercise (FRE), or unrestricted sedentary Control (C). The C and E horses were fed 100% of their Digestible Energy (DE) requirements, while FR and FRE horses were fed 85%. The E and FRE groups underwent submaximal unridden exercise, with a consistent working heart rate of 150 bpm, for 20 min, 5 times a week, with a walking warm-up and cooldown, with the approximate DE loss of 15% based on the NRC. In wk 1, 5 and 10, morphometric measurements were recorded, including BW (kg, via weight tape), cresty neck score (CN) (/5), whole body BCS (/9) and individual BCS (/9) for 8 different anatomical locations. Original mean BCS for all treatment groups was 7 ±0.2. Original BW (kg) for each of the treatment groups are as follows: C 486 ± 11, E 501 ± 11, FR 485 ± 12, and FRE 469 ± 11. Statistical analysis was performed using SAS Studio. Data were analyzed using 1-Way RM ANOVA for individual treatments and 2-Way RM ANOVA to determine significant (P ≤ 0.05) effects of and interactions between time and treatment. There was a reduction in BW across time for all groups (P < 0.0001). The mean weight loss (kg) for each treatment group are as follows: C 28kg, E 31kg, FR 27kg, FRE 36kg. The CN score was reduced in E and FRE horses (P = 0.01; P = 0.02). Whole body BCS was reduced in E (P < 0.0001), FR (P = 0.001) and FRE (P < 0.0001). Treatment group affected anatomical BCS of the tailhead and shoulder (P = 0.05 and P = 0.01), with FRE having the greatest reduction (P = 0.0005 and P = 0.001,). Anatomical BCS loss at the withers was found to have an interaction between time and treatment (P = 0.02). In conclusion, although all horses lost BW, there were differences in how the treatment groups lost fat mass, with exercise programs having a significant effect on the change in CN, tailhead and shoulder fat mass. Therefore, the most efficient weight loss program, is that of combining both daily exercise and feed restriction.

Age-dependent Pdgfrβ signaling drives adipocyte progenitor dysfunction to alter the beige adipogenic niche in male mice

Perivascular adipocyte progenitor cells (APCs) can generate cold temperature-induced thermogenic beige adipocytes within white adipose tissue (WAT), an effect that could counteract excess fat mass and metabolic pathologies. Yet, the ability to generate beige adipocytes declines with age, creating a key challenge for their therapeutic potential. Here we show that ageing beige APCs overexpress platelet derived growth factor receptor beta (Pdgfrβ) to prevent beige adipogenesis. We show that genetically deleting Pdgfrβ, in adult male mice, restores beige adipocyte generation whereas activating Pdgfrβ in juvenile mice blocks beige fat formation. Mechanistically, we find that Stat1 phosphorylation mediates Pdgfrβ beige APC signaling to suppress IL-33 induction, which dampens immunological genes such as IL-13 and IL-5. Moreover, pharmacologically targeting Pdgfrβ signaling restores beige adipocyte development by rejuvenating the immunological niche. Thus, targeting Pdgfrβ signaling could be a strategy to restore WAT immune cell function to stimulate beige fat in adult mammals.

Regular smoking of male ancestors in adolescence and fat mass in young adult grandchildren and great-grandchildren.

Background:Previous studies using the Avon Longitudinal Study of Parents and Children (ALSPAC) have shown that if men commenced smoking prior to the onset of puberty their sons, their granddaughters and great-granddaughters were more likely to have excess fat (but not lean) mass during childhood, adolescence and early adulthood. In this study we assess associations between ancestral smoking during adolescence (ages 11-16 years) with fat and lean mass of subsequent generations at two ages. Methods: We analysed data on exposures of grandparents and great-grandparents collected by ALSPAC. The outcomes were the fat masses of their grandchildren and great-grandchildren measured at ages 17 and 24. Measures of lean mass were used as controls. Adjustment was made for 8-10 demographic factors using multiple regression. Results: We found associations between adolescent smoking of the paternal grandfathers and the adjusted fat mass of their grandchildren, but no associations with the grandchildren's lean mass. Grandchildren at age 17 had an average excess fat mass of +1.65 [95% CI +0.04, +3.26] Kg, and at age 24 an average excess of +1.55 [95% CI -0.27, +3.38] Kg. Adolescent smoking by the maternal grandfather showed similar, but weaker, associations: at 17 an average excess fat mass of +1.02 Kg [95% CI -0.20, +2.25] Kg, and at 24 an average excess of +1.28 [95% CI -0.11, +2.66] Kg. There were no pronounced differences between the sexes of the children. For the great-grandparents there were few convincing results, although numbers were small. Conclusions: We have shown associations between grandfathers' smoking in adolescence and increased fat (but not lean) mass in their children. Confirmation of these associations is required, either in a further data set or by demonstrating the presence of supportive biomarkers.

Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes.

Correlation of Triglyceride/HDL-Cholesterol Ratio and Visceral Adiposity Index with 25(OH)D in Obese Female

Obesity is a condition of excess body fat mass with cardiometabolic complications. The levels of serum 25-hydroxyvitamin D (25(OH)D) decrease in obesity because it is stored in adipose tissue compartments and is related to dyslipidemia conditions. A high triglyceride/HDL-cholesterol (TG/HDL-C) ratio in obesity is related to dyslipidemia. Visceral Adiposity Index (VAI) is one of the parameters indicating central obesity related to visceral fat distribution in dyslipidemia conditions. This study aimed to prove a correlation between TG/HDL-C ratio and VAI with 25(OH)D levels in obese females. Observational study with cross-sectional design in 66 female patients. HDL-C examinations and triglyceride using the enzymatic colorimetry method. The TG/HDL-C ratio was calculated by dividing TG by HDL. The equation obtained visceral adiposity index (WC/(36.58+(1.89xBMI)) x (TG/0.81) x (1.52/HDL). 25(OH)D examinations used the Enzyme Linked Fluorescent Immunoassay (ELFA) method. Relationship status used the spearman rank test (p&lt;0.05). Median 25(OH) levels were 9.75 (8-18.6)ng/mL. There was a weak negative correlation between TG/HDL-C ratio with 25(OH)D levels in obese females (p=0.020; r= -0.287) and VAI with 25(OH)D in obese females (p=0.019; r= 0.287). There was a weak negative correlation between TG/HDL ratio and VAI with 25(OH)D in obese female patients.

A Systematic Review of the Prognostic Significance of the Body Mass Index in Idiopathic Pulmonary Fibrosis.

The identification of novel prognostic biomarkers might enhance individualized management strategies in patients with idiopathic pulmonary fibrosis (IPF). Although several patient characteristics are currently used to predict outcomes, the prognostic significance of the body mass index (BMI), a surrogate measure of excess fat mass, has not been specifically investigated until recently. We systematically searched PubMed, Web of Science, and Scopus, from inception to July 2022, for studies investigating associations between the BMI and clinical endpoints in IPF. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the risk of bias. The PRISMA 2020 statement on the reporting of systematic reviews was followed. Thirty-six studies were identified (9958 IPF patients, low risk of bias in 20), of which 26 were published over the last five years. Significant associations between lower BMI values and adverse outcomes were reported in 10 out of 21 studies on mortality, four out of six studies on disease progression or hospitalization, and two out of three studies on nintedanib tolerability. In contrast, 10 out of 11 studies did not report any significant association between the BMI and disease exacerbation. Our systematic review suggests that the BMI might be useful to predict mortality, disease progression, hospitalization, and treatment-related toxicity in IPF (PROSPERO registration number: CRD42022353363).

Саркопеническое ожирение у детей: клиническое значение, подходы к диагностике и терапии

Sarcopenic obesity (SO) is a functional and clinical condition characterized by excess fat mass and low skeletal muscle mass (sarcopenia). The double negative effect of obesity and sarcopenia on human health is manifested by a high risk of developing numerous chronic non-communicable diseases and low therapeutic effectiveness. It was previously believed that SO develops predominantly in older adults, however its prevalence in children has increased over the last decade. To date, there is no standard diagnostic criteria for SO. In contemporary pediatric practice, measurements of muscle mass quantity and quality are used to detect SO. In adults, physical performance is assessed in addition to muscle mass in the diagnosis of sarcopenia. Approaches to the treatment of SO in children are limited to non-pharmaceutical methods, with adequate protein intake and strength and aerobic training being the most important. This review summarizes the current understanding of the prevalence, pathogenesis, and clinical significance of SO in children, as well as the methods of its diagnosis and treatment. Key words: obesity, sarcopenia, children, adolescents, muscle mass

Fat mass to fat- free mass ratio and body composition in participants with chronic leg problems

Background &amp; aim: Low fat-free mass (FFM) or high fat mass (FM) in older adults are abnormal body composition phenotypes associated with morbidity. The dual burden of excessive FM and low FFM may lead to a higher risk of cardiovascular and other diseases and disability and lower physical performance compared with individuals with normal body composition or low FFM or high FM alone. Both conditions lead to poorer health and can be identified by a high FM/FFM ratio. Because few studies have examined the effects of abnormal body composition using the FM/FFM ratio, the aim of this study is to determine the FM/FFM values by gender in patients with knee and hip pathologies and compare them with body composition parameters. This condition is important when surgery is required because abnormal body composition leads to an increase in infections and other postoperative complications. Methods: A total of 93 participants aged 64.71 ± 7.71 years in women and 65.9 ± 9.9 years in men with a body mass index (BMI) ≥25 kg/m2 were recruited from the Valdoltra Orthopaedic Hospital (Ankaran, Slovenia). The waist circumference (WC) and anthropometric data (BMI), as well as body composition data (FM, FFM, % of body water, estimated by bioelectrical impedance - BIA) were measured. In addition, the body composition phenotypes (FM/FFM ratio) were calculated. Results: The FM/FFM index was higher in females. The female group with FM/FFM (0.68) and those with a higher FM/FFM (0.92) correlated positively with WC. Male participants were excluded for further analysis because only two males had FM/FFM &gt; 0.80. The FM/FFM of the remaining male participants was 0.53 ± 0.09. Conclusions: FM/FFM provide information on patient body composition and identify individuals at risk of body composition abnormalities in women only.

Childhood Obesity and Incorrect Body Posture: Impact on Physical Activity and the Therapeutic Role of Exercise

Obesity is associated with various dysfunctions of the organism, including musculoskeletal problems. In this narrative review, we aim to consider postural problems in children and adolescents with obesity, focusing on the relationship with its negative impact on physical activity, and to discuss the role of exercise as a therapeutic approach. The body reacts to excess weight by changing its normal balance, and the somatosensory system of children with obesity is forced to make major adjustments to compensate for postural problems. These adaptations become more difficult and tiring if activities that require continuous postural changes and multi-tasking are engaged in. Children with obesity have less body control and functional ability due to the excess fat mass, which reduces their ability to perform motor skills and take part in physical activity. Appropriate early interventions for the management of musculoskeletal problems are needed to ensure healthy growth and to prevent comorbidities in childhood and adulthood. Prevention programs must be based not only on the reduction of body weight but also on the definition of correct postural habits from an early age. It is equally important to provide correct information on the types and doses of physical activity that can help prevent these problems.

Predictors of Sarcopenia in Outpatients with Post-Critical SARS-CoV2 Disease. Nutritional Ultrasound of Rectus Femoris Muscle, a Potential Tool.

Background and Objectives: The loss of muscle mass in post-critical COVID-19 outpatients is difficult to assess due to the limitations of techniques and the high prevalence of obesity. Ultrasound is an emerging technique for evaluating body composition. The aim is to evaluate sarcopenia and its risk factors, determining ultrasound usefulness as a potential tool for this purpose according to established techniques, such as the bioimpedance vector analysis (BIVA), handgrip strength, and timed up-and-go test. Methods: This is a transversal study of 30 post-critical COVID-19 outpatients. We evaluated nutritional status by ultrasound (Rectus Femoris-cross-sectional-area (RF-CSA), thickness, and subcutaneous-adipose-tissue), BIVA, handgrip strength, timed up-and-go test, and clinical variables during admission. Results: According to The European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN&EASO) Consensus for Sarcopenic and Obesity, in terms of excess fat mass and decreased lean mass, the prevalence of class-1 sarcopenic obesity was 23.4% (n = 7), and class-2 sarcopenic obesity was 33.3% (n = 10) in our study. A total of 46.7% (n = 14) of patients had a handgrip strength below the 10th percentile, and 30% (n = 9) achieved a time greater than 10s in the timed up-and-go test. There were strong correlations between the different techniques that evaluated the morphological (BIVA, Ultrasound) and functional measurements of muscle. Intensive care unit stay, mechanical ventilation, and age all conditioned the presence of sarcopenia in COVID-19 outpatients (R2 = 0.488, p = 0.002). Predictive models for sarcopenic diagnosis based on a skeletal muscle index estimation were established by RF-CSA (R2 0.792, standard error of estimate (SEE) 1.10, p < 0.001), muscle-thickness (R2 0.774, SEE 1.14, p < 0.001), and handgrip strength (R2 0.856, SEE 0.92, p < 0.001). RF-CSA/weight of 5.3 cm2/kg × 100 was the cut-off value for predicting sarcopenia in post-critical COVID-19 outpatients, with 88.2 sensitivity and 69.2% specificity. Conclusion: More than half of the post-critical COVID-19 survivors had sarcopenic obesity and functional impairment of handgrip strength. Intensive care unit stay, age, and mechanical ventilation all predict sarcopenia. An ultrasound, when applied to the assessment of body composition in post-critical COVID-19 patients, provided the possibility of assessing sarcopenia in this population.