Excess Fat Research Articles

The thin fat paradox: Understanding normal weight obesity and its clinical relevance

Obesity, defined by the World Health Organization (WHO) as an excess accumulation of body fat or body fat percentage (BFP) associated with clear health risks, presents a significant global challenge. While Body Mass Index (BMI) serves as a conventional metric for identifying obesity, it fails to account for body composition variations, such as distinguishing between fat-free mass and adipose tissue. Consequently, individuals with normal BMI may exhibit excessive body fat (BFP≥30%), termed Normal Weight Obesity (NWO). In contrast, others with normal BMI and normal body fat are termed Normal Weight Lean (NWL). NWO significantly elevates the risks of various metabolic disorders, including hyperglycemia, diabetes, hypertension, dyslipidemia, and reduced HDL levels. Moreover, NWO is associated with an increased risk of cardiovascular diseases (CVD), hypertension, low HDL, central obesity, and muscle weakness. Individuals with NWO face a heightened risk of developing cardiometabolic diseases, including atherosclerosis, coronary artery disease, stroke, and heart failure, due to the adverse effects of excess body fat on cardiovascular health. Furthermore, NWO is associated with insulin resistance, inflammation, and endothelial dysfunction, further exacerbating the risk of metabolic disorders and cardiovascular complications. Early identification of NWO is crucial for implementing preventive measures and lifestyle interventions to mitigate these health risks. Integrating body fat percentage measurements into nutritional screening protocols in healthcare facilities is essential for identifying individuals at risk of NWO and initiating appropriate interventions to prevent the onset of cardiometabolic diseases. This study aims to provide comprehensive insights into Normal-Weight Obesity (NWO) and its potential health implications.

The different association between fat mass distribution and intake of three major nutrients in pre- and postmenopausal women.

Obesity, characterized by excessive body fat accumulation, is associated with various chronic health conditions. Body fat plays a crucial role in health outcomes, and nutrient intake is a contributing factor. Menopause further influences body fat, but the precise relationships between nutrients and fat mass distribution in pre- and post-menopausal women are unclear. Data from 4751 adult women aged ≥18 years old (3855 pre-menopausal, 896 post-menopausal) with completed information were obtained from the National Health and Examination Survey (NHANES) from 2011 to 2018. Multivariate linear regression models were used to examine the associations between protein, carbohydrate, fat intake and total percent fat (TPF), android percent fat (APF), gynoid percent fat (GPF), android to gynoid ratio (A/G), subcutaneous adipose tissue mass (SAT), visceral adipose tissue mass (VAT). Subgroup analyses, stratified by menopausal status, were also conducted. Additionally, we employed smoothing curve fitting techniques to investigate potential non-linear relationships between fat mass distribution and nutrient intake. Compared with pre-menopausal women, post-menopausal women had higher body fat, BMI, and metabolic indicators but lower nutrient intake (All p<0.05). In the overall analysis, we found significant correlations between nutrient intake and fat mass. Specifically, protein intake was negatively correlated with TPF (β = -0.017, 95% CI: -0.030, -0.005), APF (β = -0.028, 95% CI: -0.044, -0.012), GPF (β = -0.019, 95% CI: -0.030, -0.008), while fat intake showed positive correlations with these measures (SAT: β = 2.769, 95% CI: 0.860, 4.678). Carbohydrate intake exhibited mixed associations. Notably, body fat mass-nutrient intake correlations differed by menopausal status. Generally speaking, protein intake showed negative correlations with body fat distribution in pre-menopausal women but positive correlations in post-menopausal women. Carbohydrate intake revealed significant negative associations with abdominal and visceral fat in post-menopausal women, while fat intake was consistently positive across all fat distribution indices, especially impacting visceral fat in post-menopausal women. Dietary intake plays a crucial role in body fat distribution, with menopausal status significantly influencing the impact of nutrients on specific fat distribution metrics. The study emphasizes the need for dietary guidelines to consider the nutritional needs and health challenges unique to women at different life stages, particularly concerning menopausal status, to effectively manage obesity.

Family support for healthy dietary changes in children with obesity: A systematic review

Background: The World Health Organization (WHO) defines overweight or obesity as a condition of abnormal or excessive fat accumulation that can affect a person's health. In Indonesia, children and adolescents have bad eating habits, namely consuming foods and drinks that are high in sugar, salt and fat, eating less vegetables and fruit. Purpose: To investigate the intervention of family support in dietary adjustments against healthy dietary changes in children with obesity. Method: The method applied in the article is a systematic review with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). This article analyses the results of different types of studies to provide a more complete and comprehensive picture. Information was collected from Proquest, Pubmed sources published between 2019 and 2023. Results: The review of 8 articles recommended that family support interventions on dietary regulation on changing healthy eating patterns in obese children as an effective intervention in changing healthy eating habits of obese children. Conclusion: Family support intervention on dietary regulation on healthy eating changes in obese children as an effective intervention in changing healthy eating habits of obese children.

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.

The Association between Sarcopenic Obesity and DXA-Derived Visceral Adipose Tissue (VAT) in Adults.

Many people with overweight and obesity are affected by sarcopenia, which is represented by a phenotype known as sarcopenic obesity (SO), characterized by excessive body fat (BF), combined with reduced muscle mass and strength. In this population, it is vital to identify the factors associated with SO. With this aim in mind, we investigated the association between visceral adipose tissue (VAT) mass and SO in patients with overweight or obesity in a nutritional setting. A total of 256 participants (23.8% female) with overweight or obesity were involved and completed a body composition assessment, including VAT mass, using dual-energy X-ray absorptiometry (DXA). The sample was initially categorized according to whether the individual had the SO phenotype; they were then classified according to their VAT mass into three tertiles (lowest, medium, and highest). Among the 256 participants, who had a median body mass index (BMI) of 29.3 (interquartile range (IQR): 27.0-32.4) kg/m2 and a median age of 51.0 (IQR: 47.0-54.0) years, 32.4% were identified as having SO, and they displayed a higher median VAT mass (517.0 (IQR: 384.5-677.0) vs. 790.0 (IQR: 654.0-1007.0) g; p < 0.05). The logistic regression model that accounted for age, sex and BMI revealed that a higher VAT mass increases the risk of SO (odds ratio (OR) = 1.003; 95% confidence interval (CI): 1.001-1.004; p < 0.05). In conclusion, VAT mass appears to be an independent factor associated with SO in people with overweight or obesity. However, due to the cross-sectional design, no information regarding any causality between higher VAT mass and SO can be provided. Additional longitudinal research in this direction should therefore be conducted.

Beneficial Effects of Capybara Oil Supplementation on Steatosis and Liver Apoptosis in Obese Mice.

Obesity is a complex chronic disease characterized by excess body fat (adipose) that is harmful to health and has been a major global health problem. It may be associated with several diseases, such as nonalcoholic fatty liver disease (NAFLD). Polyunsaturated fatty acids (PUFA) are lipid mediators that have anti-inflammatory characteristics and can be found in animals and plants, with capybara oil (CO) being a promising source. So, we intend to evaluate the hepatic pathophysiological alterations in C57Bl/6 mice with NAFLD, caused by obesity, and the possible beneficial effects of OC in the treatment of this disease. Eighteen 3-month-old male C57Bl/6 mice received a control or high-fat diet for 18 weeks. From the 15th to the 18th week, the animals received treatment-through orogastric gavage-with placebo or free capybara oil (5 g/kg). Parameters inherent to body mass, glucose tolerance, evaluation of liver enzymes, percentage of hepatic steatosis, oxidative stress, the process of cell death with the apoptotic biomarkers (Bax, Bcl2, and Cytochrome C), and the ultrastructure of hepatocytes were analyzed. Even though the treatment with CO was not able to disassemble the effects on the physiological parameters, it proved to be beneficial in reversing the morphological and ultrastructural damage present in the hepatocytes. Thus, demonstrating that CO has beneficial effects in reducing steatosis and the apoptotic pathway, it is a promising treatment for NAFLD.

THE RELATIONSHIP OF FAMILY EATING PATTERNS WITH THE INCIDENCE OF OBESITY IN SCHOOL CHILDREN AT RT. 006 RW. 069 KELURAHAN 16 ULU PALEMBANG

Background: Obesity is a pathological condition, namely the accumulation of excess fat than is required for normal body function. However, there are still many opinions in society that think that obese children are healthy. Objective: This research aims to analyze the relationship between family diet and the incidence of obesity in school children in RT 006 RW. 069 Subdistrict 16 Ulu Palembang. Methodology: The research method is collecting data by direct interviews with respondents and analyzing the data. Results: There were 75% of respondents adopting eating patterns that were not good for their children and 25% of respondents adopting eating patterns that were good for their children. Conclusion: This research shows a p value of 0.016, meaning there is a relationship between eating patterns and incidents. obesity in children with an OR of 8.31, meaning that children who adopt poor eating patterns have an 8.31 chance of experiencing obesity.

Non-Alcoholic Fatty Liver Disease and the Risk of Future Hepatocarcinoma

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver condition characterized by excess fat accumulation in the liver in the absence of significant alcohol consumption. While NAFLD itself is generally considered benign, it can progress to more severe forms such as non-alcoholic steatohepatitis, which can ultimately lead to liver cirrhosis and hepatocarcinoma, a type of liver cancer. The risk of developing hepatocarcinoma in individuals with NAFLD is considerably higher than in the general population. Factors such as obesity, diabetes, insulin resistance, and inflammation contribute to the development and progression of NAFLD and its subsequent transformation into hepatocarcinoma. Regular monitoring, lifestyle modifications, and timely treatment of co-existing conditions are crucial in mitigating the risk of hepatocarcinoma among patients with NAFLD. Further research into the underlying mechanisms linking NAFLD to hepatocarcinoma is essential for developing effective preventive strategies and treatments for this increasingly prevalent condition.

Vasculoendothelial dysfunction and bone health in obese children: A connection with cancers

Obesity in children, a growing global epidemic, is not merely characterized by excessive body fat but also by a cascade of metabolic and functional derangements with significant musculoskeletal consequences. One of the key underpinnings of these detrimental effects is vasculoendothelial dysfunction (VED), a multifaceted pathological process characterized by impaired endothelial cell function. The endothelium, lining the vasculature, plays a pivotal role in regulating vascular tone, inflammation, and coagulation, and its dysfunction in obese children leads to a plethora of downstream complications with profound implications for musculoskeletal and bone health. Diagnosing VED in obese children remains a challenge. Traditional cardiovascular risk factors such as hypertension and dyslipidemia are often detected long after the occurrence of endothelial dysfunction. In the context of bone sarcoma, the interaction between cancer cells and vascular endothelium in the bone microenvironment is critical. The bone is a highly vascularized tissue, and the vascular endothelium plays a role in regulating bone homeostasis. In the presence of cancer cells, altered bone microenvironment provides a milieu favorable to tumor growth and invasion. The relationship between the vascular endothelium and cancer is complex and can vary depending on the type of cancer and its microenvironment. Understanding the interactions between vascular endothelium and bone sarcoma is crucial for developing targeted therapies. New molecular and cellular mechanisms involved in these interactions are awaiting to be uncovered, shedding light on potential therapeutic strategies for cancer treatment. On a relevant note, emerging vasculoendothelial markers hold promise for early detection and intervention. Early identification of VED, through the detection of vasculoendothelial markers, opens doors for timely interventions aimed at preventing its detrimental effects on musculoskeletal and bone health in obese children

Safety of white adipose tissue activator cyclophilin A intracellular peptide (Pep19™) in healthy dogs

Oral consumption of Pep19™, a 10 amino acid intracellular peptide, has been associated with weight loss in rodents and humans via induction of nonshivering thermogenesis. This study aimed to test its safety and tolerance in dogs. Eight healthy adult neutered university owned beagles (4 female and 4 male) were individually housed in runs and fed an extruded kibble in a quantity historically associated with weight stability. They were administered Pep19™ (5 mg/dog/day, 0.32 – 0.49 mg/kg/day) as a once daily oral dose for 28 days. Health screening, including physical examination, body weight, body condition score (BCS), complete blood count, chemistry, total thyroxine, thyroid stimulating hormone, and urinalysis were collected at baseline, day 14, and day 28. Faecal score, appetite, and overall animal temperament and condition were assessed daily. At baseline, average age, weight, and BCS were 3.8 ± 0.3 years, 12.68 ± 2.11 kg, and 6.4 ± 0.7/9, respectively. There were no adverse effects and all blood and urine analyses remained normal. At study termination, average weight, and body condition score (BCS) were 12.53 ± 2.01 kg, and 5.6 ± 0.7/9, respectively. Despite no changes in diet or calorie intake, seven of the dogs lost between 0.7% and 3.8% of their body weight (p<0.01); this was associated with a reduction in body condition score (p<0.05). This initial study shows that Pep19™ is safe for dogs. Future clinical research should investigate its utility as a new approach to reduce excess body fat in dogs.

The Relationship of Central Obesity to Vitamin D Levels in Medical Faculty Students of Udayana University in Year 2023

Background: Central obesity is defined as the accumulation of excess fat in the abdomen as a result of an energy imbalance caused by genetic and environmental factors. Obesity may contribute to vitamin D deficiency (&lt;20 ng/mL) and insufficiency (20–29.9 ng/mL). Vitamin D is an important vitamin for the body and is fat-soluble. It can be synthesized by exposure to ultraviolet B light by converting 7-dehydrocholesterol into 1,25-dihydroxyvitamin D3 through hydroxylation in the liver and kidneys and then binding to the vitamin D receptor to carry out its function. Based on previous research, the mechanism for decreasing vitamin D levels in obese people can be explained through three theories: volumetric dilution, sequestration theory, and degradation theory. Method: The purpose of this study is to determine the relationship between central obesity and vitamin D levels in college students at the Faculty of Medicine, Udayana University, in 2023. This study used a quantitative analytical methodology with a cross-sectional design. The study's dependent variable was waist circumference, while the independent variable was vitamin D levels. A total of 60 college students (28 men and 30 women) as research subjects were taken using a purposive sampling technique. The research was carried out by selecting and collecting identity and anthropometric data on research subjects through questionnaires. Then, research subjects who meet the criteria will have their blood samples taken and their waist circumference measured. Blood samples were examined for vitamin D levels using the BT Lab brand ELISA Kit at the Biochemistry Laboratory, Faculty of Medicine, Udayana University. The research lasted for 4 months, starting in November 2023 and ending in February 2024. Results: This research found a very weak but not significant positive correlation between body height and vitamin D levels (r = 0.035; p = 0.793). There is a very weak but not significant positive relationship between height and vitamin D levels (r = 0.036; p = 0.783). There is a very weak but not significant inverse relationship between BMI and vitamin D levels (r = -0.034; p = 0.796). In this study, there was an insignificant relationship and a very weak positive correlation between waist circumference, as an indicator of central obesity, and vitamin D levels (r = 0.001 and p = 0.992). Conclusion: In this study, it can be concluded that there is no relationship between central obesity and vitamin D levels. Apart from that, a correlation coefficient was obtained, which showed a very weak correlation and a directly proportional relationship. Keywords: central obesity, waist circumference, vitamin D deficiency, students at the Faculty of Medicine, Udayana University

Association of Body Composition Changes with the Development of Diabetes Mellitus: A Nation-Wide Population Study.

We investigated the association between body composition changes and new-onset diabetes mellitus (DM) development according to the body mass index (BMI) in a longitudinal setting in the general Korean population. From 2010 to 2011 (1st) and 2012 to 2013 (2nd), we included 1,607,508 stratified random sample participants without DM from the National Health Insurance Service-Health Screening dataset of Korean. The predicted appendicular skeletal muscle mass index (pASMMI), body fat mass index (pBFMI), and lean body mass index (pLBMI) were calculated using pre-validated anthropometric prediction equations. A prediction equation was constructed by combining age, weight, height, waist circumference, serum creatinine levels, alcohol consumption status, physical activity, and smoking history as variables affecting body composition. Decreased pASMMI (men: hazard ratio [HR], 0.866; 95% confidence interval [CI], 0.830 to 0.903; P<0.001; women: HR, 0.748; 95% CI, 0.635 to 0.881; P<0.001), decreased pLBMI (men: HR, 0.931; 95% CI, 0.912 to 0.952; P<0.001; women: HR, 0.906; 95% CI, 0.856 to 0.959; P=0.007), and increased pBFMI (men: HR, 1.073; 95% CI, 1.050 to 1.096; P<0.001; women: HR, 1.114; 95% CI, 1.047 to 1.186; P=0.007) correlated with the development of new-onset DM. Notably, only in the overweight and obese BMI categories, decreases in pASMMI and pLBMI and increases in pBFMI associated with new-onset DM, regardless of gender. Decreased pASMMI and pLBMI, and increased pBFMI with excess fat accumulation may enhance the risk of newonset DM. Therefore, appropriate changes in body composition can help prevent new-onset DM.

Overnutrition, Hyperinsulinemia and Ectopic Fat: It Is Time for A Paradigm Shift in the Management of Type 2 Diabetes

The worldwide incidence of prediabetes/type 2 has continued to rise the last 40 years. In the same period, the mean daily energy intake has increased, and the quality of food has significantly changed. The chronic exposure of pancreatic β-cells to calorie excess (excessive energy intake) and food additives may increase pancreatic insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing chronic hyperinsulinemia and peripheral insulin resistance. Chronic calorie excess and hyperinsulinemia may promote lipogenesis, inhibit lipolysis and increase lipid storage in adipocytes. In addition, calorie excess and hyperinsulinemia can induce insulin resistance and contribute to progressive and excessive ectopic fat accumulation in the liver and pancreas by the conversion of excess calories into fat. The personal fat threshold hypothesis proposes that in susceptible individuals, excessive ectopic fat accumulation may eventually lead to hepatic insulin receptor resistance, the loss of pancreatic insulin secretion, hyperglycemia and the development of frank type 2 diabetes. Thus, type 2 diabetes seems (partly) to be caused by hyperinsulinemia-induced excess ectopic fat accumulation in the liver and pancreas. Increasing evidence further shows that interventions (hypocaloric diet and/or bariatric surgery), which remove ectopic fat in the liver and pancreas by introducing a negative energy balance, can normalize insulin secretion and glucose tolerance and induce the sustained biochemical remission of type 2 diabetes. This pathophysiological insight may have major implications and may cause a paradigm shift in the management of type 2 diabetes: avoiding/reducing ectopic fat accumulation in the liver and pancreas may both be essential to prevent and cure type 2 diabetes.

Lactobacillus rhamnosus 069 and Lactobacillus brevis 031: Unraveling Strain-Specific Pathways for Modulating Lipid Metabolism and Attenuating High-Fat-Diet-Induced Obesity in Mice.

Obesity is a global health crisis, marked by excessive fat in tissues that function as immune organs, linked to microbiota dysregulation and adipose inflammation. Investigating the effects of Lactobacillus rhamnosus SG069 (LR069) and Lactobacillus brevis SG031 (LB031) on obesity and lipid metabolism, this research highlights adipose tissue's critical immune-metabolic role and the probiotics' potential against diet-induced obesity. Mice fed a high-fat diet were treated with either LR069 or LB031 for 12 weeks. Administration of LB031 boosted lipid metabolism, indicated by higher AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) phosphorylation, and increased the M2/M1 macrophage ratio, indicating LB031's anti-inflammatory effect. Meanwhile, LR069 administration not only led to significant weight loss by enhancing lipolysis which evidenced by increased phosphorylation of hormone-sensitive lipase (HSL) and adipose triglyceride lipase (ATGL) but also elevated Akkermansia and fecal acetic acid levels, showing the gut microbiota's pivotal role in its antiobesity effects. LR069 and LB031 exhibit distinct effects on lipid metabolism and obesity, underscoring their potential for precise interventions. This research elucidates the unique impacts of these strains on metabolic health and highlights the intricate relationship between gut microbiota and obesity, advancing our knowledge of probiotics' therapeutic potential.

Sarcopenic Obesity and Cardiovascular Disease: An Overlooked but High-Risk Syndrome.

Sarcopenic obesity (SO), defined as the coexistence of excess fat mass and reduced skeletal muscle mass and strength, has emerged as an important cardiovascular risk factor, particularly in older adults. This review summarizes recent findings on the diagnosis, prevalence, health impacts, and treatment of SO. Growing evidence suggests SO exacerbates cardiometabolic risk and adverse health outcomes beyond either condition alone; however, the heterogeneity in diagnostic criteria and the observational nature of most studies prohibit the evaluation of a causal relationship. This is concerning given that SO is increasing with the aging population, although that is also difficult to assess accurately given wide-ranging prevalence estimates. A recent consensus definition proposed by the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity provides a framework of standardized criteria to diagnose SO. Adopting uniform diagnostic criteria for SO will enable more accurate characterization of prevalence and cardiometabolic risk moving forward. Although current management revolves around diet for weight loss coupled with resistance training to mitigate further muscle loss, emerging pharmacologic therapies have shown promising results. As the global population ages, diagnosing and managing SO will become imperative to alleviate the cardiovascular burden.

The Impact of Bariatric Surgery on Nitrogen Balance at Six months Post-surgery.

Obesity, defined as abnormal or excessive fat accumulation that presents a risk to health, rose from 8.6 to 10.5% in Singapore's residents. Bariatric surgery, the primary treatment for severe obesity, induces fat and muscle loss. Adequate protein intake is vital for preventing muscle loss. This study examines nitrogen balance in individuals with obesity pre- and post-surgery. Sixteen participants with severe obesity (BMI ≥ 32.5kg/m2) undergoing bariatric surgery (14 sleeve gastrectomy, 2 Roux-en-Y gastric bypass) and 20 normal-weight controls (BMI < 25kg/m2) were recruited. Nitrogen balance, calculated from dietary protein intake and urine nitrogen excretion, was assessed. Participants with obesity were re-evaluated 6months post-surgery. Data were analyzed using parametric methods. At baseline, controls had a BMI of 20.8 ± 2.1kg/m2; those with obesity had 40.9 ± 7.3. Daily calorie and protein intake for participants with obesity were not statistically significantly different from controls (calorie intake at 1467 ± 430 vs. 1462 ± 391kcal, p = 0.9701, protein intake 74.2 ± 28.7 vs. 64.6 ± 18.3g, p = 0.2289). Post-surgery, BMI, fat-free mass, fat mass, total energy intake, carbohydrate, and protein intake decreased significantly (p < 0.01). Protein oxidation and urine nitrogen excretion did not change after bariatric surgery. However, nitrogen balance significantly reduced from 2.62 ± 5.07 to - 1.69 ± 5.07g/day (p = 0.025). Dietary protein intake is inadequate in individuals with obesity at 6months post-bariatric surgery and contributes to a state of negative nitrogen balance.

Sarcopenia Prevalence among Hospitalized Patients with Severe Obesity: An Observational Study.

Background: Sarcopenic obesity (SO) is the combination of excess fat, skeletal muscle and muscular strength/function deficit. The ESPEN/EASO have proposed new diagnostic criteria, but the SO prevalence in patients with severe obesity remains to be established. The aim of this study was to establish the SO prevalence in a large cohort of inpatients with obesity, considering sex, age, BMI, type, and number of concomitant diseases. Methods: Patient data of both genders aged between 18 and 90 years with a body mass index (BMI) of ≥30 kg/m2 underwent hospital evaluation including bioelectrical impedance analysis (BIA) and handgrip strength (HS). QoL scores were obtained by the Psychological General Well-Being Index questionnaire. The study was approved by the institutional Ethic Committee. Results: Among the 3858 patients, 444 (11.51%) exhibited a strength deficit, while 3847 (99.71%) had skeletal muscle mass deficit. The prevalence of SO was then 11.48%, with higher rates in women (12.39%), in individuals aged >70 years (27%), and in those reporting a 'poor' QoL (12.6%). No significant difference in SO prevalence was found when stratifying by BMI (30-40 kg/m2 vs. >40 kg/m2, p = 0.1710). In SO patients, osteoarticular diseases (57%), hypertension/heart failure (38%), type 2 diabetes mellitus (34%), and obstructive sleep apnea (32%) were the more frequent comorbidities. Conclusions: The application of ESPEN/EASO-SO criteria in a cohort of inpatients with severe obesity revealed 11.48% SO prevalence, which was associated with age (particularly > 70 years), gender (women), but not BMI, as determinants. Disease staging and QoL screening may improve the identification of SO high-risk patients.

NUTRITIONAL STATUS AND SOME RELATED FACTORS IN MEDICAL STUDENTS

Background: Today, the global challenge of malnutrition encompasses both undernutrition and overweight, particularly prevalent in low and middle-income nations. Excessive body fat accumulation poses health risks for overweight and obese individuals. Objectives: To assess nutritional status and identify related factors among Can Tho University of Medicine and Pharmacy (CTUMP) medical students. Materials and methods: A cross-sectional study was conducted on 137 first-year medical students at CTUMP to evaluate their body fat percentage using the Harpenden Skinfold Caliper. Skinfold measurements were taken from the bicipital, tricipital, subscapular, and suprailiac sites. Furthermore, physical activity levels were classified using the World Health Organization (WHO) Global Physical Activity Questionnaire (GPAQ) consisting of 16 questions on 4 domains. The research was carried out at CTUMP from December 2022 to June 2023. Results: Compared to urban areas, a higher percentage of male students engage in physical activity in rural areas; however, this trend is not observed among female students. Additionally, female students exhibited thicker skin folds in four areas (biceps, triceps, suprailiac, and subscapular) compared to male students. Conversely, the fold thickness in the suprailiac region was greater in female students. The mean body fat percentage was 20.40±4.61% in male students and 30.48±4.32% in female students. Non-obese students comprised the majority in this study, with 84.3% of male students being non-obese. Among female students, 53.7% were classified as obese and 46.3% as non-obese. There was insufficient evidence to indicate differences between residential student groups and physical activity levels. Conclusions: The study reveals that the majority of participating students are non-obese. Furthermore, the average body fat percentage among women is found to be higher compared to both men and the general population. However, there is inadequate evidence to show variances among student groups residing in diverse areas or partaking in varying levels of physical activity.

Determining the ideal measurement site and respiratory condition for liver transient elastography: toward clinical practice standardization

ObjectivesLiver transient elastography (TE) has been endorsed by the WHO as the first-line diagnostic tool for liver diseases. Although unreliable and invalid results caused by intercostal space (ICS)-associated factors (including excessive subcutaneous fat and a narrow ICS relative to the transducer size) and operator inexperience are not uncommon, no standard guidelines for ideal probe placement are currently available. Herein, we conducted a prospective observational study to identify an ideal measurement site and respiratory condition for TE by characterizing anatomical and biomechanical properties of the ICSs using ultrasound B-mode and elasticity imaging.MethodsIntercostal ultrasound was performed pointwise at four specific sites in 59 patients to simultaneously measure the width, stiffness, and skin‒liver capsule distance (SCD) of the ICSs over the liver, under end-inspiratory and end-expiratory conditions. Intersections between the 8th ICS and anterior axillary line, the 7th ICS and anterior axillary line, the 8th ICS and mid-axillary line, and the 7th ICS and mid-axillary line were defined as Sites 1 to 4, respectively.ResultsResults indicated that Sites 2 and 3 presented greater intercostal width; Sites 3 and 4 displayed lower intercostal stiffness; Sites 2 and 3 exhibited a shorter SCD. The ICSs were significantly wider and stiffer at end-inspiration. Additionally, the liver was more easily visualized at Sites 1 and 3.ConclusionWe recommend Site 3 for TE probe placement owing to its greater width, lower stiffness, and smaller abdominal wall thickness. Performing TE at end-inspiration is preferred to minimize transducer-rib interferences. This study paves the way toward a standardized TE examination procedure.Critical relevance statementA standardized measurement protocol for WHO-recommended liver TE was first established to improve the success and efficiency of the examination procedure.Key PointsWHO-recommended TE is unreliable or fails due to intercostal space-related factors.The 8th intercostal space on the mid-axillary line and end-inspiration are recommended.This standardized protocol aids in handling challenging cases and simplifies operational procedures.Graphical

Improving dietary patterns in obese mice: Effects on body weight, adiposity, anhedonia-like behavior, pro-BDNF expression and 5-HT system

IntroductionThe excessive fat accumulation in obesity, resulting from an unbalanced diet, can lead to metabolic and neurological disorders and increase the risk of developing anxiety and depression. AimAssess the impact of dietary intervention (DI) on the serotonergic system, brain-derived neurotrophic factor (BDNF) expression and behaviors of obese mice. MethodsMale C57BL/6 mice, 5 weeks old, received a high-fat diet (HFD) for 10 weeks for the induction of obesity. After this period, for 8 weeks, half of these animals received a control diet (CD), group obese (OB) + control diet (OB + CD, n = 10), and another half continued being fed HFD, group obese + HFD (OB + HFD, n = 10). At the end of the eighth week of intervention, behavioral tests were performed (sucrose preference test, open field, novel object recognition, elevated plus maze and tail suspension). Body weight and food intake were assessed weekly. Visceral adiposity, the hippocampal and hypothalamic protein expression of BDNF, 5-HT1A (5-HT1A serotonin receptor) and TPH2 (key enzyme in serotonin synthesis), were evaluated after euthanasia. ResultsThe dietary intervention involved changing from a HFD to a CD over an 8-week period, effectively reduced body weight gain, adiposity, and anhedonia-like behavior. In the OB + HFD group, we saw a lower sucrose preference and shorter traveled distance in the open field, along with increased pro-BDNF expression in the hypothalamus compared to the OB + CD mice. However, the levels of TPH2 and 5-HT1A remained unchanged. ConclusionThe HFD model induced both obesity and anhedonia, but the dietary intervention successfully improved these conditions.