Higher Total Fat Research Articles

Industrially Produced Plant-Based Food Products: Nutritional Value and Degree of Processing.

The plant-based food market is rapidly growing, offering innovative options to meet consumer expectations. However, a comprehensive analysis of the nutritional quality of these foods is lacking. We aimed to characterize industrial plant-based food products' nutritional value and degree of processing. A cross-sectional study was conducted on two market-leading Portuguese food retail chains by assessing the nutritional composition of all the available pre-packaged plant-based food products (n = 407). These products were categorized into meal alternatives, dairy alternatives, and other products containing dairy/meat alternative ingredients including ready meals and desserts. The products' nutritional quality was assessed according to the cut-offs established by the Portuguese Directorate General of Health [DGS] on total fat, saturated fat, sugar, and salt, and considering the degree of processing using NOVA classification. One-tenth of the products were classified as having a high total fat, saturated fat, sugars, or salt content. In some sub-categories, half of foods were classified as high in saturated fat, and over two-thirds were considered high salt products. Less than one-third exhibit a good nutritional profile based on the national cut-offs. A total of 84.3% of plant-based food products were ultra-processed. These findings emphasize the need to improve the nutritional profile of plant-based options.

Bioactive Compounds and Nutrition of Thai Sauces in Retort Pouch and Physicochemical Properties Kinetics During Storage

The objectives of this study were to investigate the bioactive compounds, including carotenoids, flavonoids, total phenolics, antioxidant activity, and nutritional values of two ready-to-cook Thai sauces of stir-fry curry sauce (SCS) and spicy-sour sauce (SSS) in retort pouch and to investigate the kinetics of physicochemical properties, including lightness (L*), water activity, pH and total soluble solids, of the products during storage at 30°C and 55°C. The results showed that the temperature and time for sterilization of SCS (low acid foods) was 121°C for 43 minutes and SSS (acid foods) was 102°C for 31 minutes. The moisture content was between 57.9 and 63.2%. SCS had higher total fat, saturated fat, and calories because it contained soybean oil and chili paste, but SSS had higher sugar and sodium content than SCS. Trans fats and vitamin C were not detected in either product. SSS had a higher content of total phenols, carotenoids (especially capsanthin, zeaxanthin, and β-carotene) and antioxidants than SCS. The representation of the physicochemical properties of the products as a function of temperature and time resulted in a linear model (R2 = 0.7222 – 0.9772). L*, water activity, pH decreased, and TSS increased during the 90-day storage at both 30°C and 55°C. The change was more remarkable when stored at 55°C than 30°C.

Prevalence and risk factors associated with diabetes mellitus among middle-aged women in southern Brazil: a population-based study.

To investigate prevalence and clinical factors associated with diabetes among middle-aged women. In this cross-sectional population-based study, clinical and laboratory examinations were collected from 298 women. Participants wore a digital pedometer for 7 days to assess habitual physical activity. Abdominal computed tomography scans were performed to measure total fat area and visceral fat area. Mean age was 57.1 years (SD, 5.4 y); 78.7% of women were postmenopausal. The prevalence of diabetes was 17.1%. Women with diabetes were older (P = 0.02); worked fewer hours per week in the past month (P = 0.04); had an earlier age at menarche (P = 0.03); were more frequently inactive (P = 0.01); had higher body mass index (P = 0.01), higher waist circumference (P < 0.01), higher visceral (P < 0.01), and higher total fat (P < 0.01) but not subcutaneous fat (P = 0.14); and had higher systolic blood pressure (BP) (P < 0.01). There was a prevalence of 19.5% of current smoking, 32.5% of alcohol use, and 16.1% of current hormone therapy use, prevalence similar among the groups of women. There was a higher prevalence of metabolic syndrome (P < 0.01) and statin use (P < 0.01) in women with diabetes. A higher prevalence ratio of diabetes was associated with physical inactivity (prevalence ratio, 2.137; 95% CI, 1.056-4.325; P < 0.03). The odds of having diabetes increased by 12% for each year of earlier menarche and by 1.4% for each millimeter of mercury increase in systolic BP. The prevalence of diabetes was 17.1%. Age, physical inactivity, early age at menarche, and systolic BP were independently associated with higher prevalence of diabetes in this unselected population of middle-aged women.

Sarcopenic obesity and its relation with muscle quality and mortality in patients on chronic hemodialysis

Sarcopenia is prevalent in patients with end-stage kidney disease (ESKD) on hemodialysis (HD), and is associated with poor outcomes, while obesity may be protective. Sarcopenic obesity is associated with increased frailty, morbidity and mortality in the general population. Myosteatosis, i.e., muscle fat infiltration, has major effects on muscle strength and physical performance, but is poorly investigated in the nephrology setting. In the present study we aimed to assess the association between sarcopenic obesity, as diagnosed by abdominal CT, and mortality. Moreover, the relationship between myosteatosis, sarcopenic obesity and mortality was also investigated. This is a retrospective study in which ESKD patients on HD submitted to unenhanced abdominal CT for clinical reasons at least 6 months after dialysis initiation were evaluated for sarcopenic obesity and myosteatosis, defined as intermuscular fat area and low attenuation muscle area. Sarcopenic obesity was diagnosed in cases of low abdominal skeletal muscle area and high total fat area. Receiver-operating characteristics (ROC) analysis with Youden index was used to determine the cut-off for high total fat area. Intermuscular fat area and low attenuation muscle area were evaluated by applying the Hounsfield unit of interest (-190;-30, and-29;+29 respectively). Cox regression analysis was used to evaluate the association between predictors and mortality risk. We enrolled 212 patients, aged 68.8 (±14.7) years, 65.5% (139/212) male. Median follow-up was 19.7 (interquartile range [IQR] 2.7-35) months. Sarcopenic obesity was diagnosed in 19.8% of patients and was associated with increased mortality (HR: 3.29 (1.72; 6.27), P<0.001), and with the presence of myosteatosis. Both intermuscular fat area and low attenuation muscle area were associated with increased mortality in adjusted analyses. Patients with sarcopenic obesity have increased myosteatosis. Sarcopenic obesity and myosteatosis are associated with increased mortality in patients on HD.

Associations of Fat Mass and Sarcopenia With All-Cause and Cancer-Specific Mortality in Cancer Survivors

Purpose of the study: The role of body composition in cancer outcomes is of great clinical interest. We investigated whether the risks of all-cause and cancer-specific mortality differ by levels of total fat mass and sarcopenia status in cancer survivors. Methods: Participants included 1682 adult cancer survivors who had undergone dual-energy x-ray absorptiometry (DXA) examination to measure body composition, gathered from the 1999–2006 and 2011–2018 National Health and Nutrition Examination Survey (NHANES). Total fat mass was categorized into tertiles (we assessed high vs. low tertiles), and sarcopenia was defined by appendicular skeletal muscle mass index (females &amp;lt; 5.45 kg/m2 and males &amp;lt; 7.26 kg/m2). Multivariable Cox proportional hazards models were performed to estimate adjusted hazard ratio (aHR) and 95% confidence interval (CI); we also stratified by race. In addition, we performed a restricted cubic spline analysis to assess the potential non-linear association between fat mass and all-cause mortality. Results: The mean age of study participants was 61.9 years, and they were followed up for an average of 9.67 years. Overall, sarcopenia was present in 304 (25.0%), and 561 (33.4%) of the participants had high total fat mass. Participants with higher fat mass had 30% increased risk of all-cause mortality (aHR = 1.30, 95% CI = 1.06–1.61) compared to participants with low fat mass, while participants with sarcopenia had a 51% higher risk (aHR = 1.51, 95% CI = 1.22–1.88) than participants with no sarcopenia. A restricted cubic spline analysis revealed a J-shaped association between fat mass and all-cause mortality. Further, sarcopenia was also associated with a higher risk of cancer-specific mortality (aHR = 1.74, 95% CI = 1.23–2.29) compared to non-sarcopenia. The association between sarcopenia and all-cause mortality was twice as strong in Non-Hispanic Blacks (aHR = 2.99, 95% CI = 1.39–6.06) compared to Non-Hispanic Whites (aHR = 1.53, 95% CI = 1.19–1.95). Conclusion: Our findings show opposing relations of fat mass and appendicular skeletal muscle mass index with mortality in a national sample of cancer survivors, and the relationships may differ by race. These results emphasize the importance of maintaining a healthy body composition among cancer survivors.

Relationship between a Low-Carbohydrate, High-Fat Diet and Risk of Metabolic Syndrome in Korean Women.

Prevalence of metabolic syndrome with aging is higher in women than in men, and it increases after menopause. Interventions to reduce the risk of metabolic syndrome in women are important. A low-carbohydrate, high-fat diet is effective in weight loss and improvement cardiovascular risk factors including abdominal circumference, blood pressure, and blood lipid profile. We aimed to determine the relationship between a low-carbohydrate, high-fat diet and the risk of metabolic syndrome in Korean women. This cross-sectional study was conducted using secondary data from the 2014-2018 Korean National Health and Nutrition Examination Survey. Overall, 8,222 women aged >19 yr were included. The effect of a low-carbohydrate, high-fat diet on the risk of metabolic syndrome was analyzed by multiple logistic regression analysis using a complex sampling procedure. The diet significantly reduced the likelihood of metabolic syndrome development (P=0.044). In addition, regardless of the fat type, the diet significantly reduced the likelihood of low high-density lipoprotein cholesterolemia (low-carbohydrate, high-total fat, P=0.013; low-carbohydrate, high-unsaturated fat, P=0.006; low-carbohydrate, high-saturated fat, P=0.006). A low-carbohydrate, high-fat diet is an important intervention that can reduce the risk of metabolic syndrome, and the reduced consumption of carbohydrates can decrease the risk of low high-density lipoprotein cholesterolemia regardless of fat type. Therefore, it is necessary to actively explore the potential of this diet, targeting Asians, including Koreans.

Abstract 3036: Associations of total body fat mass and skeletal muscle index with all-cause and cancer-specific mortality in cancer survivors

Abstract Purpose of the Study: The purpose of the study was to investigate whether the risks of all-cause and cancer-specific mortality differ by levels of total fat mass and sarcopenia status in cancer survivors. Additionally, we conducted subgroup analysis to assess potential effect modification by race/ethnicity. The role of body composition in cancer outcomes is of great clinical interest, and measures of body composition that differentiate fat mass from skeletal muscle mass can help redefine our understanding of body composition for cancer survival. Methods: Participants included 1682 adult cancer survivors who had undergone dual-energy x-ray absorptiometry (DXA) examination to measure body composition, gathered from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Survey (NHANES). Total fat mass (weight of fat in the body) was categorized into tertiles (we assessed high vs. low tertiles), and sarcopenia was defined by appendicular skeletal muscle mass index (females &amp;lt; 5.45kg/m2 and males &amp;lt; 7.26kg/m2). Multivariable Cox proportional hazards models were performed to estimate adjusted hazard ratio (aHR) and 95% confidence interval (CI); we also stratified by race. In addition, we performed a restricted cubic spline analysis to assess the potential non-linear association between fat mass and all-cause mortality. Results: The mean age of study participants was 61.9 years, and they were followed up for an average of 9.67 years. Overall, sarcopenia was present in 304 (25.0%), and 561 (33.4%) of the participants had high total fat mass. Participants with higher fat mass had 30% increased risk of all-cause mortality (aHR=1.30, 95% CI=1.06-1.61) compared to participants with low-fat mass, while participants with sarcopenia had a 51% higher risk (aHR=1.51, 95% CI=1.22-1.88) than participants with no sarcopenia. A restricted cubic spline analysis revealed a J-shaped association between fat mass and all-cause mortality. Further, sarcopenia was also associated with a higher risk of cancer-specific mortality (aHR=1.74, 95% CI=1.23-2.29) compared to non-sarcopenia. The association between sarcopenia and all-cause mortality was twice as strong in Non-Hispanic Blacks (aHR=2.99, 95% CI=1.39-6.06) compared to Non-Hispanic Whites (aHR=1.53, 95% CI=1.19-1.95). Conclusion: Our findings show opposing relations of fat mass and appendicular skeletal muscle mass index with mortality in a national sample of cancer survivors, and the relationships may differ by race. These results emphasize the importance of maintaining a healthy body composition among cancer survivors. Citation Format: Livingstone Aduse-Poku, Shama D. Karanth, Meghann Wheeler, Danting Yang, Caretia Washington, Jesus Fabregas, Ting-Yuan David Cheng, Dejana Braithwaite. Associations of total body fat mass and skeletal muscle index with all-cause and cancer-specific mortality in cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3036.

Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors.

Purpose: The importance of body composition on cancer outcomes is of great clinical interest. Measures of body composition that differentiate fat mass from skeletal muscle mass can help redefine our understanding of body composition for cancer survival. We investigated whether the risk of all-cause and cancer-specific mortality differ by levels of total fat mass and sarcopenia status in cancer survivors. Our secondary aim was a subgroup analysis assessing the role of race within these associations. Methods: Participants included 1682 adult cancer survivors who had undergone a dual-energy X-ray absorptiometry (DXA) examination to measure body composition, from the 1999-2006 and 2011-2018 National Health and Nutrition Examination Survey (NHANES). Total fat mass was categorized into tertiles (we assessed high vs. low tertiles), and sarcopenia was considered as having an appendicular skeletal muscle mass index less than 7.26 kg/m2 for males and less than 5.45 kg/m2 for females. Multivariable Cox proportional hazard models estimated the adjusted hazard ratio (aHR) and 95% confidence interval (CI). Results: The mean age of study participants was 61.9 years, and they were followed up for an average of 9.67 years. The prevalence of sarcopenia was 25.0% (N = 304), and 33.4% (N = 561) had a high total fat mass. Participants with a higher fat mass (aHR = 1.30, 95% CI = 1.06-1.61) and with sarcopenia (aHR = 1.51, 95% CI = 1.22-1.88) had a 30% and 51% increased risk of all-cause mortality compared to participants with a low fat mass and with no sarcopenia, respectively. Further, sarcopenia (aHR = 1.74, 95% CI = 1.23-2.29) was associated with a higher risk of cancer-specific mortality in cancer survivors. The association between sarcopenia and all-cause mortality was twice as strong in Black people (aHR = 2.99, 95% CI = 1.39-6.06) compared to White people (aHR = 1.53, 95% CI = 1.19-1.95). Conclusions: Our findings show the opposing relations of fat mass and appendicular skeletal muscle mass index with mortality in a national sample of cancer survivors, and that the relationships may differ by race. These results emphasize the importance of maintaining a healthy body composition among cancer survivors.

Usual dietary intake, physical activity, weight loss, and body composition after five years of Roux-en-Y gastric bypass.

To estimate usual dietary intake (UDI), physical activity (PA), and their association with weight loss and body composition in patients who underwent Roux-en-Y gastric bypass (RYGB) after five years in the Federal District, Brazil. We assessed anthropometry and body composition using bioimpedance, and dietary intake and PA with three nonconsecutive 24-h recalls. PC-Side was used to estimate UDI. Dietary patterns (DPs) were identified through principal component analysis, and association between UDI and PA with percentage of total weight loss (%TWL) and fat-free mass (FFM) through multinomial logistic regression. Sample (n = 124) presented mean (SD) age of 48.9 (9.4) years, median (IQR) of 9 years (7-10) post RYGB, current BMI = 32.3 kg/m² (28.8-35.7), %TWL = 24.7% (10.9), and FFM = 45.1 kg (41.1-51.9). Mean usual energy intake of 1556 kcal/d, with adequate protein intake, poor fiber intake, and excessive carbohydrate, total fat, and added sugar intake, compared to dietary guidelines. Calcium, vitamins C, D, and E presented the greatest inadequacy (15%, 24%, 32%, and 49% of individuals, respectively, reported usual intake below EAR); 83 participants were considered active/very active, according PA. DP with high energy, protein, total fat, saturated fat, and sodium intake, was negatively associated with %TWL (OR = 0.545, p = 0.037). Protein intake was positively associated with FFM (OR = 1.091, p = 0.004). PA was not associated with %TWL or FFM. Participants demonstrated intake of carbohydrate, fat, fiber, added sugar not in accordance with guidelines. A DP rich in energy, protein, total fat, saturated fat, and sodium appears to decrease TWL. However, protein intake appears to increase FFM.

Breast cancer and dietary fat quality indices in Iranian women: A case-control study.

The association between breast cancer (BC) and different indices of dietary fats has not been well-studied. Thus, this study aimed to investigate the association between BC and dietary fat quality (DFQ) indices in Iranian women. This case-control study was conducted on 120 women with breast cancer and 240 healthy women in Tehran, Iran. Food Frequency Questionnaire and nutritionist IV software were used to assess the intake of dietary fats and to calculate the DFQ indices. The patients with BC had a higher total fat (TF) (P < 0.01) and a lower ratio of polyunsaturated fatty acids (PUFAs) omega-3 to PUFAs omega-6 (ω-3/ω-6) compared with the controls (P < 0.001). TF had a significant association with BC risk (OR: 1.16; 95% CI: 1.01-1.33, P < 0.001). No significant association was found between BC and PUFA/saturated fatty acid ratio or the ω-3/ω-6 ratio. The patients with BC had a lower ω-3/ω-6 ratio and a higher total dietary fat intake than the healthy women. Total dietary fat intake was also directly associated with the risk of BC. Thus, low-fat diets may have beneficial effects for BC prevention. Further longitudinal studies are warranted.

Prevalence of obesity among undergraduate medical students at the tertiary care center of North India

Background: Obesity can negatively impact the overall quality of life and reduce life expectancy. It is often associated with an increased risk of cardiovascular diseases, hypertension, dyslipidemia, diabetes mellitus Type 2, obstructive sleep apnea, cancers, osteoarthritis, and psychological issues. The prevalence of obesity is rising among medical students. Since obesity and its related complications are emerging as a major global health concern, we designed to study the prevalence of obesity in medical students. This study might promote positive health awareness among medical students. Aims and Objectives: The aim of the study was to study the prevalence of obesity among undergraduate medical students at the tertiary care center of North India. Materials and Methods: This was a cross-sectional and observational study of 399 undergraduate medical (MBBS) students at Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. The medical students were informed about the study, and written consent was taken from all the students. Both body mass index (BMI) and body fat composition were measured. The collected data were assessed using the Statistical Package for the Social Sciences software version 20. Results: Our study had 261 (65%) males and 138 (35%) females. BMI results showed overweight in 75 students (18.79%) and obesity in 156 students (39.09%). Out of 261 male students, 102 (39%) had a waist circumference &gt;90 cm and among 138 female students, 75 (54%) had a waist circumference &gt;80 cm. Among 261 male students, 182 (70%) had high total body fat measurements. Out of 138 female students, 88 (63.7%) had high total body fat composition. Conclusion: Obesity can result from a combination of genetic, environmental, social, behavioral, and metabolic factors. The prevalence of overweight and obesity is rising among medical students. This study showed the prevalence of obesity in medical students at our center. This might promote positive health awareness among medical students.

PMON220 Women With Polycystic Ovary Syndrome Have Worse Lifestyle Behaviors Compared to Controls: A Systematic Review and Meta-Analysis of 36,360 Women

Abstract Women with polycystic ovary syndrome (PCOS) exhibit a propensity for obesity and weight gain during their reproductive years. Accordingly, lifestyle (dietary and/or physical activity [PA]) modification is recommended as first-line therapy to manage PCOS. However, current recommendations are based on healthy lifestyle practices for the general public since evidence for unique lifestyle approaches in PCOS is limited and low-quality. We synthesized evidence on dietary and PA behaviors between women with PCOS and those without PCOS to identify any unique lifestyle behaviors that could underlie the propensity of weight gain and obesity and be targeted for precision nutrition and PA interventions in PCOS. Primary outcomes were diet quality, energy intake, and PA. Secondary outcomes included macronutrients, micronutrients, food groups, foods, glycemic indices, sedentary time, and sitting levels. Databases of MEDLINE, Web of Science, Scopus, and CINAHL were searched until June 1, 2021, to identify observational studies documenting diet and PA between women with and without PCOS (18-50yrs). Data were pooled by random-effects models and expressed as (standardized) mean differences (S[MD]) and 95%CIs. Risk of bias was assessed by the Newcastle-Ottawa scale (NOS). Forty-five studies (N=36,360 participants; [n=7,348 PCOS; 29,012 Controls]) were eligible (NOS scores≥7). Women with PCOS had higher energy (MD: 132.91; 95%CI: 4.34 to 261.47 kcal/d; I2=96%), lower folic acid (MD: -25.11; 95%CI: -49.60 to -0.62 µg/d; I2=72%) and lower zinc (MD: -1.41; 95%CI: -2.76 to -0.07 mg/d; I2=96%) intakes (All: P≤0.04), and a tendency for lower total PA (SMD: -0.40; 95%CI: -0.80 to 0.00; I2=98%; P=0.05) vs. Controls. On subgroup analyses, lower intakes of magnesium (MD: -38.98; 95%CI: -69.44 to -8.53 mg/d; I2=37%) were noted in younger PCOS populations (&amp;lt;30yrs.), and higher total fat (SMD: 0.20; 95%CI: 0.02 to 0.38; I2=45%) and polyunsaturated fatty acids (PUFA; SMD: 0.29; 95%CI: 0.10 to 0.48; I2=0%) was evident in PCOS when food records were used (All: P≤0.03). Conversely, macronutrients (carbohydrate, protein, fiber), alcohol, micronutrients (vitamin D, iron, calcium, sodium), glycemic index, and glycemic load were similar. Most eligible studies reported lower total adherence to healthy eating patterns or poorer consumption of major food groups (grains, fruits, vegetables, proteins, seeds, nuts, dairy), as described narratively since variable study methodology did not permit meta-analyses. Collective evidence supports that women with PCOS have lower overall diet quality, poorer dietary intakes (higher energy, total fat, and PUFA, and lower folic acid, zinc, and magnesium), and a tendency for lower total PA vs. those without PCOS. Considerable heterogeneity among studies reinforces the need for research to address any relative contributions of other factors (e.g., genetic, metabolic, or sociodemographic) to observed differences. These clarifications may improve lifestyle behaviors and associated weight management and obesity-related complications (infertility, diabetes, cardiovascular disease) in this high-risk population and may contribute to future evidence-based guideline recommendations on managing PCOS in the emerging era of precision lifestyle medicine. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Comprehensive assessment of neurocognitive function, inflammation markers, and adiposity in treated HIV and control.

To compare the neurocognitive scores between persons living with human immunodeficiency virus (PLWH) and persons without human immunodeficiency virus (HIV) and assess the relationship between neurocognition, HIV status and variables, inflammation, and body composition measures. Cross-sectional study involving 225 participants (126 PLWH on antiretroviral therapy [ART] and 99 persons without HIV). For the first time in HIV, we used Cognivue®, an food and drug administration (FDA)-approved computer-based test to assess cognitive function. The test was calibrated to individuals’ unique cognitive ability and measured 6 cognitive domains and 2 performance parameters. Markers of inflammation, immune activation, insulin resistance, and body fat composition (using dual-energy X-ray absorptiometry scan) were collected. Classical t tests, chi-square tests, and spearman correlations were used to compare and explore relationships between variables. Inverse probability weighting adjusted average treatment effect models were performed to evaluate the differences between PLWH and persons without HIV, adjusting for age, race, sex, and heroin use. Overall, 64% were male, 46% were Black, with a mean age of 43 years. Among PLWH, 83% had an undetectable HIV-1 RNA level (≤20 copies/mL). Compared persons without HIV, PLWH performed poorer across 4 domains: visuospatial (P = .035), executive function (P = .029), naming/language (P = .027), and abstraction (P = .018). In addition, PLWH had a significantly longer processing speed time compared to controls (1686.0 ms vs 1606.0 ms [P = .007]). In PLWH, lower cognitive testing domain scores were associated with higher inflammatory markers (high sensitivity C-reactive protein [hsCRP]) and with higher total fat and visceral adipose tissue (P < .05). Neurocognitive impairment (NCI) in HIV is associated with inflammation and total and central adiposity.

Postural stability, body composition and functional ability of the lower extremity in patients with lumbar degenerative spondylolisthesis

Although patients accessing rehabilitation services had been reported to have better functional ability of the lower limbs, postural stability, and low cardiovascular disease risk factors, updated data from developing countries is however vital for clinical practices. Hence, the aim of this study was to present the association between lower extremity functional ability (LEFA), stability, and body composition profiles in rehabilitative lumbar degenerative spondylolisthesis (LDS) patients considering age and gender. One hundred and twenty-four participants (45 females, 79 males), with a mean age of 56.45±11.13 years, volunteered for the study. Weight, height body fat percent (BFP), visceral fat, body mass index (BMI), resting systolic and diastolic blood pressure, and resting heart rate were measured while functional ability and stability tests were conducted on the participants. 53.4% were at least overweight; LEFA was below average, stability of both dominant and nondominant legs was very poor, blood pressure and heart rate were high. Women had high total body fat and visceral fat. Significant differences were observed in BMI (p=0.044) and BFP (p=0.035) based on age classification as well as BMI (p=0.000), BFP (p=0.000) and visceral fat (p=0.000) by gender. Overweight, high blood pressure, poor LEFA, and postural stability are crucial comorbidities of Ghanaian LDS patients in this study. Educationally and pragmatically comprehensive healthy lifestyle interventions of regular exercise regimes, adequate and quality nutrition, and occupational stress reduction would play major complementary roles in chiropractic treatment.

Nutrient intake and adherence to the Nordic nutrition recommendations in a Swedish cohort with abdominal obesity.

The Nordic Nutrition Recommendations (NNR) are developed to promote public health and to prevent food-related diseases such as obesity and cardiovascular diseases. To investigate the nutrient intake and adherence to the NNR in a Swedish cohort with abdominal obesity. Dietary intake data were collected using 3-day food diaries and anthropometry and clinical chemistry parameters were measured at baseline of a long-term intervention studying weight-loss management. Eighty-seven subjects with abdominal obesity successfully completed a 3-day food diary. Twelve of these subjects were excluded for further analysis due to implausible low-energy reporting. The remaining 75 subjects (76% females) had mean age of 52.3 ± 10.1 years and a mean body mass index of 34.3 ± 3.1 kg/m2. Mean total fat intake (41.2 ± 7.0E%) was exceeded by 56% of the sample size compared to the maximum recommended intake (RI) of 40E%, whereas mean carbohydrate intake (40.4 ± 8.0E%) was lower than the RI (45-60E%). The intake of saturated fatty acids was high compared to the NNR with only 2 women and none of men reported intakes within the RI of <10 E%. Adherence to the RI for dietary fibre was very low (16.0% and 13.3% when expressed as g/d and g/MJ, respectively). Analyses of micronutrient intake showed lowest adherences for vitamin D and sodium. The nutrient intake in our subjects compared to NNR was rather low with a high total fat intake, particularly too high intake of saturated fatty acids, high salt consumption, and very low dietary fibre and vitamin D intake. More effort is clearly needed to promote healthy dietary habits among subjects with obesity.

Prevalence of sarcopenia in women at stable weight phase after Roux-en-Y gastric bypass.

Evaluating the prevalence of sarcopenia in women submitted to bariatric surgery - Roux-en-Y gastric bypass. Design: Observational, cross-sectional study. Women (18-65 years old) who underwent bariatric surgery (BG) ≥ 2 years and reached stable weight ≥ 6 months, were investigated. Control group (CG) comprised non-operated matched women with obesity. Body composition was determined through dual-energy X-ray absorptiometry. Low lean mass (LLM) was defined as appendicular lean mass index (ALM kg/height m2) < 5.5 kg/m2. Physical strength was assessed through dynamometer and sit-to-stand test (SST), whereas performance was assessed through 4-m gait speed and Short Physical Performance Battery Tests (SPPB). Sarcopenia was diagnosed in the presence of LLM and low strength. One-hundred and twenty women (60 in each group, 50 ± 9.7 years old) were investigated. All anthropometric and body composition parameters were lower in BG than in CG, whereas strength and performance were similar between groups. Women with reduced strength presented high total fat mass and low physical activity level (p < 0.005). LLM was observed in 35% of BG and in 18.3% of CG (p = 0.04), whereas sarcopenia was diagnosed in 28.3% of BG and in 16.6% of CG (p = 0.12). Sarcopenic women in BG had better performance both in SST (p = 0.001) and SPPB (p = 0.004). Total lean mass (OR:1.41, 95% CI [1.18; 1.69], p < 0.001) and obesity (OR: 38.2 [2.27; 644.12], p < 0.001) were associated with sarcopenia in the multivariate analysis. Despite great weight loss, sarcopenia prevalence did not increase in BG and its presence was influenced by total lean mass and obesity.

Relationship between Access to Nutrition and Visceral Adiposity in Stable Long-Term Inner City Kidney Transplant Recipients (KTRs)

ObjectivesHigher % body fat has been associated with increased risk for multiple diseases especially if it has a visceral distribution. We studied body fat patterns in a population of inner-city KTRs at risk for food scarcity to explore access to nutrition and its relationship to % body fat.MethodsA random sample of 16 stable long-term pts from kidney transplant clinic were studied using the InBody S10 body composition analyzer at a regularly scheduled appointment. Pts were seated and electrodes were attached to the middle fingers, thumbs and below each ankle. Food scarcity was assessed by a standardized survey.Results63% (10) pts had body fat >25% (HIFAT). They did not differ from pts with body fat <25% (6 pts, LOFAT) in time since transplant (mean 10.6 ± 4.0 yrs), race, education, or annual income. 12 (75%) pts identified as black, 2 (12.5%) white and 2 (12.5%) other. The majority (56.3%) had an annual income < $20 k. HIFAT pts had higher visceral fat (14.0 ± 1.3 vs 5.1 ± 1.3, p < 0.001), higher BMI (34.8 ± 1.25 vs 27.7 ± 1.7, p = 0.002), and body weight (227.1 ± 12.6 vs 180.5 ± 12.1, p = 0.01), but no difference in skeletal muscle mass. HIFAT pts were more likely to be male (70% vs 30%, p = 0.039) and were older (53.9 ± 2.7 vs 43.5 ± 2.5 yrs, p = 0.01). Pts with diabetes were more likely to be HIFAT than those without (100% vs 50%, p = 0.037). 50% of pts in the LOFAT group reported they had cut down or skipped meals because there wasn't enough money for food vs none of the HIFAT pts (p = 0.018). Additionally, 100% of pts who received food from a bank, church or pantry in the last year were LOFAT (p = 0.004). There was no difference in SNAP use between the two groups.ConclusionsIn our population of long-term inner-city KTRs a majority of patients had high total body fat, meeting the definition of obesity by BMI and pts with higher body fat weighed more overall with more visceral fat but not higher skeletal muscle mass. Patients with lower body fat reported more food scarcity and reliance on food pantries. Lower body fat in this population may not be related to better dietary habits and education regarding nutritional lifestyle changes that might improve body composition is important in this population at high risk for cardiovascular disease and diabetes.Funding SourcesUnfunded.

Plasma Short-Chain Fatty Acid (SCFA) Concentrations Are Related to Cognition and Adipose Tissue Mass but Not Muscle Function in Older Adults

ObjectivesShort-chain fatty acids (SCFA) are considered beneficial for overall health and daily functioning but large human trials investigating the relationship between SCFA concentrations and peripheral parameters are scarce. We now tested in a large scale study whether SCFA concentrations correlate to cognitive function, psychological well-being, muscle function, and body composition. MethodsWe selected 232 participants > 50 y from the MEDIT database consisting of healthy adults and adults with ≥1 stable chronic disease. We measured postabsorptive plasma SCFA concentrations (acetate (C2), propionate (C3), butyrate (C4), valerate (C5), isovalerate (Ci5)) by GC-MS and body composition (DXA), respiratory muscle strength (mouth pressure device), handgrip and leg muscle strength and endurance (dynamometry). We assessed cognitive function and severity of depressive symptoms by questionnaires and performed stats by ANCOVA (covariates age, sex, BMI, presence of comorbidity) with significance level P < 0.05. ResultsC2 was the main SCFA correlating with cognitive function tests. A higher C2 concentration was associated with a lower depression score (P = 0.040) and emotional distress (P = 0.018), higher semantic (P = 0.002) and phonemic (P < 0.0001) fluencies, as well as higher mental flexibility (P = 0.054) and selective attention (P = 0.012). In contrast, an elevated C3 concentration was related to higher emotional distress (P = 0.045) and reduced phonemic fluency (P = 0.015), and a higher Ci5 concentration correlated with a lower categorical fluency (P = 0.045). Low C2 (P = 0.027) and high Ci5 (P = 0.004) and C5 (P = 0.008) concentrations correlated with high visceral adipose tissue mass and high C5 concentration with high total fat mass. None of the SCFA concentrations were associated with lean mass, bone mineral density, or muscle function parameters (all P > 0.05). ConclusionsAs the dominant SCFA in the systemic circulation, acetate appears to be crucial for cognitive functioning and emotional well-being. In contrast, high isovalerate and valerate concentrations (products of colonic bacterial amino acid fermentation) are negatively associated with health. Hence, the role of the different SCFA on health is diverse and should be considered separately. Funding SourcesNone

Use of slow atomization ramp in high resolution continuum source graphite furnace atomic absorption spectrometry for the simultaneous determination of Cd and Ni in slurry powdered chocolate samples

A methodology for simultaneous (not sequential) determination of Cd and Ni in powder chocolate samples by high-resolution continuum source graphite furnace atomic absorption spectroscopy (HR–CS–GF-AAS) and slurry sample analysis was developed. Acid digestion of the samples was not necessary, considering the high total fat content of this type of matrix (above 10 %), and no apparent deterioration of the graphite tubes was even observed once these samples were subjected to analysis. Despite the volatilities of both elements are quite different, simultaneous quantification was achieved using a slow heating ramp atomization, covering a convenient and wide temperature gradient for Cd volatilization at low temperatures and subsequent atomization of Ni at elevated temperatures, using the same heating program without an apparent change in sensitivity. This slow heating ramp was essayed between 200 and 1500 °C·s−1 and optimized at 400 °C·s−1, achieving the simultaneous measuring of Cd in the principal line (228.8018 nm) and using a secondary for Ni (228.9984 nm). No stop events for sequential changes in wavelength or temperature additional steps were involved in the method and molecular spectral interferences overlapping the analyte signals were corrected appropriately by a pragmatic strategy taking advantage of the fine structure signals adjacent to analyte signals within the same spectrum recorded. Palladium matrix modifier and aqueous standards were used for the calibration and determination of both elements in the samples. The method accuracy was successfully confirmed using a reference material (NIST SRM 1573a). An improvement in the sensitivity of Ni was found using a greater number of pixels for signal integration, central and five adjacent pixels (CP ± 5), while a lengthening of the linear range of Cd was obtained by using an attenuated signal (±2) or using only one pixel (CP). The limits of detection were 0.027 μg g−1 and 0.22 μg g−1 for Cd and Ni respectively by this simple methodology using aqueous standards for calibration and the simultaneous determination of both elements in the same measurement. The respective limits of quantification for Cd and Ni were 0.090 and 0.72 μg g−1 and the relative standard deviations in samples (n = 5) were about 4–20% and 0.3–11% for Cd and Ni respectively. The optimized method was used for the determination of both elements in real samples purchased from retail supermarkets finding variable concentrations between 0.5 and 5.7 μg g−1 for Cd and 2.1–10.9 μg g−1 for Ni, comparable to levels reported in the literature referred to elsewhere in the world.

Computed tomography based analyses of body mass composition in HER2 positive metastatic breast cancer patients undergoing first line treatment with pertuzumab and trastuzumab

Body composition parameters (BCp) have been associated with outcome in different tumor types. However, their prognostic value in patients with HER2-positive metastatic breast cancer (BC) receiving first line treatment with dual anti-HER2 antibody blockade is unknown. Preclinical evidences suggest that adipocytes adjacent to BC cells can influence response to anti-HER2 treatments. We retrospectively analyzed Computed Tomography (CT)-based BCp from 43 patients with HER2-positive metastatic BC who received first line pertuzumab/trastuzumab-based treatment between May 2009 and March 2020. The impact of baseline CT-based BCp on progression-free survival (PFS) was tested using Kaplan–Meier estimates and univariate and multivariate Cox regression models. We found a significantly worse PFS for patients with high baseline subcutaneous fat index (median 7.9 vs 16.1 months, p = 0.047, HR = 2.04, 95%CI 1–4.17) and for those with high total abdominal fat index (8.1 vs 18.8 months, p = 0.030, HR = 2.17, 95%CI 1.06–4.46). Patients with baseline sarcopenia did not show shorter PFS compared to those without sarcopenia (10.4 vs 9.2 months, p = 0.960, HR = 0.98, 95%CI 0.47–2.03). Total abdominal fat index remained a significant predictor of PFS at multivariate analysis. Our findings suggest that a high quantity of total abdominal fat tissue is a poor prognostic factor in patients receiving trastuzumab/pertuzumab-based first-line treatment for HER2-positive metastatic BC.