Fat Mass Index Research Articles

Cardiometabolic Health in Adolescents with Obesity: The Role of Protein Intake, Diet Quality, and Physical Activity.

Background: Although adolescents with obesity have an increased risk of cardiometabolic disease, a subset maintains a healthy cardiometabolic profile. Unhealthy lifestyle behaviors may determine cardiometabolic risk. We aimed to characterize the lifestyle behaviors of adolescents with obesity, compare differences between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO), and assess associations between lifestyle behaviors and cardiometabolic profiles. Methods: Participants aged 10-18 years with body mass index (BMI) ≥ 95th percentile were included. Dietary intake (DI) was estimated from 3-day food records, and diet quality (DQ) was assessed using the Healthy Eating Index-Canadian Adaptation. Physical activity (PA), body composition, anthropometrics, blood markers, and blood pressure (BP) were objectively measured. MUO was defined as having high triglycerides, BP, glucose, or low high-density lipoprotein. Regression analyses were performed between lifestyle behaviors and cardiometabolic markers. Results: Thirty-nine participants (BMI z-score 2.8 [2.5-3.5], age 12.5 [10.9-13.5] years, 56.4% female) were included. A high proportion of participants failed to meet lifestyle recommendations, particularly for DQ (94.7%, n = 36), fiber (94.7%, n = 36), and PA (90.9%, n = 30). No differences in lifestyle behaviors were found between MUO (59.0%, n = 22) and MHO (41.0%, n = 16). Protein intake was negatively associated with BMI and waist circumference z-scores, fat mass index, insulin resistance, low-density lipoprotein, and C-reactive protein, whereas higher DQ was associated with lower C-reactive protein. Higher light PA levels were associated with lower total cholesterol and triglycerides. Conclusion: Adolescents with either MUO or MHO displayed low adherence to DQ, DI, and PA recommendations; no differences in lifestyle behaviors were found. Protein intake, DQ, and PA were associated with a healthier cardiometabolic profile.

Nighttime eating during pregnancy and infant adiposity at 6 months of life.

Chrononutrition studies the relation between diet, circadian rhythms and metabolism, which may alter the metabolic intrauterine environment, influencing infant fat-mass (FM) development and possibly increasing obesity risk. To evaluate the association of chrononutrition in pregnancy and infant FM at 6 months. Healthy pregnant women and term-babies (n = 100pairs) from the OBESO cohort (2017-2023) were studied. Maternal registries included pregestational body-mass-index (BMI), gestational complications/medications, weight gain. Diet (three 24 h-recalls, 1 each trimester) and sleep-schedule (first and third trimesters) were evaluated computing fasting (hours from last-first meal), breakfast and dinner latencies (minutes between wake up-breakfast and dinner-sleep, respectively), number of main meals/day, meal skipping (≥1 main meal/d on three recalls) and nighttime eating (from 9:00 pm-5:59 am on three recalls). Neonatal weight, length, BMI/age were assessed. At 6 months, infant FM (kg, %; air-displacement plethysmography) was measured, and FM index (FMI-kgFM/length2) computed. Exclusive breastfeeding (EBF) was recorded. Multiple linear regression models evaluated the association between chrononutrition and 6 month infant FM. Mean fasting was 11.7 ± 1.3 h; breakfast, dinner latency were 87.3 ± 75.2, 99.6 ± 65.6 min, respectively. Average meals/day were 3.0 ± 0.5. Meal skipping was reported in 3% (n = 3) of women and nighttime eating in 35% (n = 35). Most neonates had normal BMI/age (88%, n = 88). Compared to those who did not, mothers engaged in nighttime-eating had infants with higher %FM (p = 0.019). Regression models (R 2 ≥ 0.308, p ≤ 0.001) showed that nighttime eating was positively associated with %FM (B: 2.7, 95%CI: 0.32-5.16). When analyzing women without complications/medications (n = 80), nighttime eating was associated with higher FM [%FM, B: 3.24 (95%CI: 0.59-5.88); kgFM, B: 0.20 (95%CI: 0.003-0.40); FMI, B: 0.54 (95%CI: 0.03-1.05)]. Infant sex and weight (6 months) were significant, while maternal obesity, pregnancy complications/medications, parity, energy intake, birth-BMI/age, and EBF were not. Maternal nighttime eating is associated with higher adiposity in 6 month infants.

Mental health from childhood to adolescence predicts excessive weight and body composition at 18 years

ObjectiveTo investigate the association of mental health in childhood and adolescence with four outcomes at 18 years: ultra-processed food (UPF) consumption, body mass index (BMI), excessive weight (EW), and body composition, including fat mass (FM) and fat free mass (FFM) in kg, FM index (FMI) and FFM index (FFMI) in kg/m2. MethodsCohort study in which The Development and Well-Being Assessment (DAWBA) (6 and 11 years) and the MINI International Neuropsychiatric Interview (MINI) (18 years) provided information on internalizing (INT), externalizing (EXT) and any mental disorder (ANY). The exposure was classified in: “never”, “at 6 and/or 11 years”, “at 18 years only” and “at 6, 11, and 18 years”. Linear and logistic regression were run. All analyses were stratified by sex. ResultsA total of 2722 participants were analyzed. At 18 years, female with EXT disorders at 6 and/or 11 years presented higher BMI (β: 1.70; 0.18–3.23), FM (β: 4.74; 1.42–8.06), and FMI (β: 1.53; 0.28–2.79) than those who never had. The odds of EW at 18 years was also higher in females with EXT disorders at 6 and/or 11 years (OR: 3.39; 1.56–7.36) and at the three time points (OR: 7.08; 1.69–29.59). Males with EXT disorders at 6 and/or 11 years presented higher FM (β: 4.45; 1.85–7.06) and FMI (β: 1.47; 0.63–2.31). ConclusionsAmong children and adolescents showing symptoms of EXT disorders, weight should be monitored carefully, thus ultimately contributing to reduce the burden of EW in adolescence.

Effectiveness of Nutritional Supplementation in Liver Transplant Recipients during Early Postoperative Course: A Systematic Review and Meta-Analysis

Abstract Background Nutrition is an integral part of health maintenance. The liver is the largest and most important metabolic organ, playing a pivotal role in integrating several biochemical pathways of carbohydrate, fat, protein, and vitamin metabolism. Malnutrition is a common complication of end- stage liver disease (ESLD). Progressive deterioration of nutritional status has been associated with poor outcome in cirrhotic patients. Liver transplantation (LT) revolutionized the management of liver disease. Nutritional therapy is an integral part of liver transplant care. Objective To identity the efficacy of different dietary nutritional supplements as zinc, vit D and immunonutrients (glutamine, omega 3, arginine and ribonucleic acid) for recipient at early post operative course. Material and Methods In this systematic review and meta-analysis we enrolled a total of 7 studies for assessing the clinical outcomes of ICU patients underwent liver transplantation surgery and supplied with dietary supplements during early postoperative period. The studies also assessed the laboratory assessment of patients postoperatively during ICU admission period. Results Regarding postoperative dietary supplementations with HMB, we found significant difference for appendicular skeletal muscle mass (ASMI) regarding the baseline and the postoperative ASMI in the intervention group with HMB. But we did not report significant difference regarding the baseline and the postoperative Fat-free mass index (FFMI) in both intervention and control group with HMB. Also we did not find significant difference between base line and postoperative in both groups for Mid-arm muscle-circumference (MAMC), Fat mass index (FMI), 6-minute walk test (6MWT), and Handgrip (HG). Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Conclusion BCAA as dietary supplementation showing a significant favorable effect regarding the baseline and the postoperative BTR levels, also for BCAA levels, Tyrosine levels, prealbumin levels, retinol binding protein and PTINR levels in both intervention and control groups. For HMB, we found significant difference for appendicular skeletal muscle mass (ASMI) regarding the baseline and the postoperative ASMI in the intervention group with HMB. But we did not report significant difference regarding the baseline and the postoperative Fat-free mass index (FFMI) in both intervention and control group with HMB.

Lower subjective social status is associated with increased adiposity and self-reported eating in the absence of hunger due to negative affect among children reporting teasing distress.

Low social standing and teasing are independently associated with increased body mass index (BMI) and overeating in children. However, children with low social status may be vulnerable to teasing. We tested the statistical interaction of subjective social status (SSS) and subjective socioeconomic status (SSES) and teasing distress on BMI, fat mass index (FMI), and eating in the absence of hunger (EAH) in children (Mage = 13.09 years, SD = 2.50 years; 27.8% overweight/obese). Multiple linear regressions identified the main effects of self-reported SSS (compared to peers in school), distress due to teasing, and their interaction on BMI (n = 115), FMI (n = 114), and child- (n = 100) and parent-reported (n = 97) EAH. Teasing distress was associated with greater BMI, FMI, and child-reported EAH due to negative affect (a subscale of EAH) and total EAH scores. There were no associations of SSS with these outcomes. However, there was an interaction between SSS and teasing distress for BMI, FMI, and EAH from negative affect such that lower SSS was associated with higher BMI, FMI, and EAH from negative affect in the presence of teasing distress. However, there were no main effects or interactions (with teasing distress) of SSES on the outcomes. These findings suggest that the relationship between lower SSS and increased adiposity and overeating behaviors may be exacerbated by other threats to social standing, such as teasing. Children exposed to multiple social threats may be more susceptible to eating beyond physiological need and obesity than those who experience a single form of perceived social disadvantage.

Poster 391: Injury Risk Cut-offs for Bone Density and Body Composition in Professional Female Ballet Dancers

Objectives: Female professional ballet performers are a unique population that undergo substantial physiologic stresses related to training, performance, and, at times, reduced energy availability that can result in elevated incidences of injury relative to their male counterparts and, even more so, the general population. However, there are currently no population-specific cut-offs based on dual energy X-ray absorptiometry (DEXA), bone mineral density (BMD), bone mineral content (BMC), and body composition (lean mass, LM; fat mass, FM) in relation to injury risk for appropriate screening and identification of those who might benefit from nutritional or activity-based interventions for injury prevention. The objective of this investigation was to develop population-specific DEXA cut-offs for BMD and body composition in professional female ballet performers based on injury risk. Methods: All procedures for this investigation were approved by the IRB. A total of 132 DEXA scans among 48 female professional ballet dancers from a single dance company taken during yearly physicals between 2017-2022 were collected for BMD and body composition (body mass, lean mass, fat mass). The electronic hospital record (EHR) was reviewed for each performer. The year of injury, level of injury, anatomic location, and diagnosis were collected if an injury was identified for the year following DEXA and physical. Level of injury was recorded. The data was de-identified and categorized by gender and year of injury. A female ballet population-matched Z-score was generated for total and regional BMD and body composition measures whereby Zb = (Measure – Ballet Population Measure) / SD of the ballet population. Logistic regression was used to determine Zb-score cut-offs whereby a significant increase in injury metrics (frequency & severity) would occur. Next, a T-test was used to compare injury severity scores between those above and below the cut-off. Chi-square analysis was then used to compare injury level frequencies between those above and below the cut-off. Significance was set at p<0.05 for all analyses. Corresponding BMD and body composition measures to each established Zb cut-off were also calculated. Results: Results are presented in Figure 1. Analysis revealed a strong association between Zb-scores for body mass index (BMI, kg/m2) and increased incidence of level 1 injuries. Weaker associations for Zb-scores for total BMD and total lean mass index (LMI, kgLM/m2) with all-cause injury severity and frequency rates (P<0.05) were also found. For total BMD, a Zb-score threshold of -0.5 was observed to be the point at which injury severity (P=0.039) and frequency of higher-level injuries (Level 2& 3, P<0.05) was observed to significantly increase. This cut-off corresponded to a total BMD value of 1.100 g/cm2. For total LMI, a Zb-score threshold of -0.5 was observed to be the point at which injury severity (P=0.046) and overall injury frequency (P=0.023) was observed to increase. This cut-off corresponded to a total LMI value of 13.86 kgLM/m2. For BMI, a Zb-score threshold of -0.4 was observed to be the point at which injury severity (P=0.047) and frequency of level higher level injuries (>Level 1, P=0.002) was observed to significantly increase. No significant injury cut-offs for % body fat or fat mass index were observed. This cut-off corresponded to a BMI value of 18.40 kg/m2. Conclusions: Reduced total bone density (BMD <1.100 g/cm2), lean mass (LMI < 13.86 kgLM/m2), and body mass (BMI < 18.40 kg/m2) may increase injury risk in elite professional female ballet performers. The cut-offs identified here may be used to better evaluate injury risk (as it pertains to DEXA assessment) in a manner that is specific to this population as opposed to generalizing to general population norms. Investigation remains ongoing regarding male dancers as well as how regional DEXA measures may relate to specific injury locations. The methods used here may also be utilized to find similar body composition and BMD injury risk cut-offs among other athlete populations and may greatly enhance the value of densitometry-based screening.

Impact of sarcopenia and obesity on overall survival in patients with head and neck cancer receiving radiotherapy: A longitudinal study

PurposeTo analyze the impact of sarcopenia and obesity on overall survival (OS) in patients with head and neck cancer (HNC) receiving radiotherapy (RT). MethodsThis prospective longitudinal study recruited 494 patients using convenient sampling. Weight and body composition were assessed before RT (T1), and at the end of RT (T2) using bioelectrical impedance analysis (BIA). The appendicular skeletal mass index was used to define sarcopenia, while the body mass index and fat mass index were used to define obesity. Patient OS was followed and described using Kplan-Meier analysis. Cox proportional hazard regression was used to analyze influencing factors of OS. ResultsThe median follow-up time was 26.2 months (IQR: 18.4–34.4 months). Multivariable models indicated that sarcopenia/obesity type assessed at T1 was not significantly associated with OS. Multivariable models involving body composition at T2 showed that age (P < 0.001), tumor site (P = 0.003), tumor stage (P = 0.024), and sarcopenia/obesity type (P = 0.040) were significantly associated with OS, while sarcopenic patients without obesity at T2 had worse OS. ConclusionsPatients with sarcopenia and no obesity at the end of RT might have worse OS. Healthcare professionals should enhance HNC patients’ management during RT, helping them maintain a certain amount of muscle mass and fat mass to improve their survival.

Study of Body Composition by Biphotonic X-ray Absorptiometry in a Moroccan Female Population, an Indicator of Obesity?

Our purpose was to study the body composition in a healthy female Moroccan adult group, and to help physicians to evaluate nutritional status. Five hundred and nineteen healthy women aged from 20 to 80 years were included in the study. Bone mineral density at the hip and lumbar spine and the body composition parameters were measured by dual-energy X-ray absorptiometry: fat mass (FM), fat-free mass (FFM), and percentage (%) of body fat. The FFM index (FFMI) and the FM index (FMI) were calculated. We analyzed the population by age and body mass index (BMI) defined groups. The mean age of the population was 53.14 ± 13.69 years with an average BMI of 29.30 ± 5.04 kg/m2. Means of FM and FFM were 33.93 ± 9.18 kg and 36.91 ± 5 kg, respectively, with FM and FFMI of 13.65 ± 3.66 kg/m2 and 14.85 ± 1.91 kg/m2, respectively. The % FM, FFM, and their corresponding indices increased with age; a statistically significant difference was observed between the 20 and 39 age categories and the two other categories. The BMI category analysis showed that FFMI and FMI increased in obese women with a statistically significant difference between the four groups. Age and BMI were correlated significantly with the different parameters. This is the first Moroccan study to present body composition indexes in healthy Moroccan female adults. These reference values may be useful for the clinical evaluation of body composition and nutritional status.

Nutritional Status and Body Composition at Diagnosis, of South Indian Children with Acute Lymphoblastic Leukaemia (ALL).

Accurate estimation of body composition, particularly, Body Cell Mass (BCM), which is independent of hydration status is important in children with cancer. This study aimed to accurately measure the anthropometry and body composition of children with Acute Lymphoblastic Leukaemia (ALL) at diagnosis and compare them with healthy children from South India. This was a cross-sectional study in children aged 2 to 8 y with ALL from St. John's Medical College Hospital, Bengaluru, and age and sex-matched, normal-weight children recruited as controls from communities. Anthropometry (weight, height, circumferences), skinfolds and body composition measurements using a whole-body potassium counter were performed. Body mass index-for-age, weight and height for age z-scores were calculated using WHO child growth standards. Biochemical markers, dietary intake and physical activity details were recorded. Categorical and continuous variables were analyzed by chi-square and independent t-tests respectively. Results: The mean age of the children with ALL (n = 39) was 4.6±1.9 y and control group (n=39) was 4.7±1.9 y; 61.5% were boys. The prevalence of underweight, overweight/obesity and stunting were 17.9%, 7.7%, and 10.3% respectively. The mean weight and height, of children with ALL and children in the control group were 16.8±6.2 kg and 16.4±4.1 kg, 104.3±14.9 cm and 105.1±12.2 cm, respectively with no statistical difference. Children with ALL showed lower body cell mass index kg/m2 (4.6± 0.8), compared to children in the control group (4.7±0.9) p=0.527, but higher fat mass index kg/m2 (3.6±1.1 vs. 3.4±0.8) p=0.276. At diagnosis, anthropometric and body composition measurements were similar between children with ALL and children in the control group. The BCM showed a non-significant trend of being lower in children with ALL, which requires close monitoring during treatment. Evaluating early-stage nutritional status and body composition can help in planning appropriate interventions during treatment to prevent long term non-communicable diseases.

PRISE EN CHARGE DES PERSONNES ATTEINTES DE TROUBLES MUSCULO SUELETTIQUES ET DE MALADIES CHRONIQUES NON TRANSMISSIBLES PAR DES ACTIVITES PHYSIQUES ADAPTEES SANTE (APS) DURANT LE CONFINEMENT EN PERIODE DE COVID 19 AU SENEGAL

The appearance of the coronavirus (COVID-19) in China, and more specifically in Wuhan, triggered a pandemic, declared by the World Health Organization (WHO) on March 11, 2020, which rapidly spread around the world, causing several thousand deaths. All countries have taken preventive measures, including containment, which reduces the mobility of populations. Consequently, inactivity among individuals, especially the elderly and women suffering from certain pathologies, further increases the risk of certain non-transmissible chronic diseases, as well as musculoskeletal and cardiovascular disorders. Thus, our study consisted in providing a remedy during the period of relief from restrictive measures or decontainment through a health adapted physical activity program (APAS). Anthropometric variables and musculoskeletal disorders in 11 Senegalese women, all suffering from musculoskeletal disorders and some from chronic non-transmissible diseases (diabetes, sickle-cell anemia AS, osteoarthritis) aged between 31 and 55, were measured before and at the end of a month-long program consisting of treadmill walking combined with muscle-strengthening exercises. Students t-tests performed to compare the mean values of variables measured in our sample before and at the end of the physical activity program revealed no statistically significant differences, although the women showed an absolute reduction in weight, body fat and Body Mass Index, a remarkable reduction in musculoskeletal disorders and a stabilization of chronic non-transmissible diseases.

A STUDY OF ASSOCIATION AMONG BODY COMPOSITION AND KHAT CHEWING AMONG THE EMPLOYEES OF UNIVERSITY OF SCIENCE AND TECHNOLOGY, SANA’A, YEMEN

Catha edulis (khat) is a plant grown commonly in the Republic of Yemen. The leaves of small khat are chewed by the people for its stimulant action. Association between body composition, khat chewing is little known. We recruited 300 individuals 19-70 years of age from University of Science and Technology, Sana’a, Yemen. Demographic, body composition and physical activity data were collected using structured questionnaires and anthropometric measurements devices. Muscle mass (kg), body fat (kg), visceral fat (kg), waist circumference (cm) and body Mass index (kg/m2) were estimated. Participants in habit of khat chewing were 170 (56.7%) of Chewer and 130 (43.3%) of non-chewer. Participants’ mean ± SD of age was 38.7±9 years, 217 (72.3%) and 83 (27.7%) were males and females, respectively. Including 40 (13.3%) smokers and 260 (86.7%) non-smokers. Whereas 151 (88.8%) of the men and 19 (11.2%) of the women take khat, including 39 (22.9%) academics and 131 (77.1%) non-academics. In addition, 46 (27.1%) have low activity and 105 (61.8%) %) had moderate activity and 19 (11.2%) had high activity. Participants in daily khat chewing were 77 (45.3%) while 14 (8.2%), 43 (25.3%), 36 (21.2%) were 4-6 times/week, 2-3 times/week and Once/week, respectively. Participants spent an average of 4.5±2 hours per day in khat chewing sessions, with 52.9% spending 1-4 hours, 43.5% spending 5-8 hours, and 3.5% spending more than 8 hours. The majority of khat chewers reported spending around 2000 Yemeni Riyals (Y.R.) per day on khat. In terms of the impact on meal schedules, 38.8%. Khat chewers had higher muscle mass (33±6), lower body fat percentages (27.8±9), higher levels of visceral fat (9.3±4), larger waist circumferences (88.4±10) and slightly higher BMI values (25.9±4) compared with non-chewers were muscle mass (29.9±7), body fat percentages (31±12 levels of visceral fat (7.8±4), waist circumferences (82.6±11) and BMI values (24.9±4). In addition to, males khat chewers had higher muscle mass, higher visceral fat levels and higher waist circumferences values in compared with females where were muscle mass, visceral fat levels and waist circumferences low. There is no significant association between khat chewers’ status and excess body fat.

Force magnitude and distribution during impacts to the hip are affected differentially by body size and body composition

Hip fractures are a severe health concern among older adults. While anthropometric factors have been shown to influence hip fracture risk, the low fidelity of common body composition metrics (e.g. body mass index) reduces our ability to infer underlying mechanisms. While simulation approaches can be used to explore how body composition influences impact dynamics, there is value in experimental data with human volunteers to support the advancement of computational modeling efforts. Accordingly, the goal of this study was to use a novel combination of subject-specific clinical imaging and laboratory-based impact paradigms to assess potential relationships between high-fidelity body composition and impact dynamics metrics (including load magnitude and distribution and pelvis deflection) during sideways falls on the hip in human volunteers.Nineteen females (<35 years) participated. Body composition was assessed via DXA and ultrasound. Participants underwent low-energy (but clinically relevant) sideways falls on the hip during which impact kinetics (total peak force, contract area, peak pressure) and pelvis deformation were measured. Pearson correlations assessed potential relationships between body composition and impact characteristics.Peak force was more strongly correlated with total mass (r = 0.712) and lean mass indices (r = 0.510–0.713) than fat mass indices (r = 0.401–0.592). Peak deflection was positively correlated with indices of adiposity (all r > 0.7), but not of lean mass. Contact area and peak pressure were positively and negatively associated, respectively, with indices of adiposity (all r > 0.49). Trochanteric soft tissue thickness predicted 59 % of the variance in both variables, and was the single strongest correlate with peak pressure. In five-of-eight comparisons, hip-local (vs. whole body) anthropometrics were more highly associated with impact dynamics.In summary, fall-related impact dynamics were strongly associated with body composition, providing support for subject-specific lateral pelvis load prediction models that incorporate soft tissue characteristics. Integrating soft and skeletal tissue properties may have important implications for improving the biomechanical effectiveness of engineering-based protective products.

Preservation of fat mass at the expense of lean mass in children with end-stage chronic liver disease.

Sarcopenia predicts morbidity and mortality in end-stage chronic liver disease (ESCLD). Here, we describe changes in body composition in children with ESCLD before and after liver transplantation (LT). Retrospective analysis of whole body DXA scans performed before and after LT over 4 years. Appendicular and whole-body fat mass and lean mass were expressed as fat mass (FMI) and lean mass (LMI) index z-scores. Sarcopenia was defined as leg LMI z-score <-1.96. Eighty-three DXA scans of children before or after LT were studied. Sarcopenia had a positive correlation with weight (0.8, p < .01), height (0.48, p < .05), and BMI z-score (0.77, p < .01), as well as arm, trunk, and total mean mass indices. It correlated negatively with indices of hypersplenism: PLTs (-0.57, p < .01), Neu (-0.50, p < .05), WCC (-0.44, p < .05), and days to discharge (-0.46, p < .05). At baseline: 13/25 (52%) children were sarcopenic and stayed in the hospital after LT for longer. Eight were stunted with a higher WCC and Ne/Ly ratio. All had normal FM indices. One year after LT, 12/26 children remained sarcopenic. Seven were stunted. Two years after LT, 5/15 were sarcopenic, and 5 were stunted. Three years after LT, 1/10 was sarcopenic, and 2 were stunted. By 4 years after LT, 1/7 was sarcopenic, and the same one was stunted. FM indices remained normal. Sarcopenic patients stayed longer in the hospital after LT. Lean mass indices were mostly within the normal range by 4 years after LT. 32% of children were stunted, and markers of inflammation were correlated with stunting. Fat mass was preserved at the cost of lean mass.

A Multicenter Evaluation of Treatment-associated Changes in Body Composition in Men With Germ Cell Tumors of the Testis: Implications for Adverse Events and Complications

ObjectivesTo characterize changes in body composition following cytotoxic chemotherapy for germ cell carcinoma of the testis (GCT) and quantify associations between body composition metrics and chemotherapy-associated adverse events (AEs) and post-retroperitoneal lymph node dissection (RPLND) complications. Materials and MethodsThis retrospective multi-center study included 216 men with GCT treated with cytotoxic chemotherapy and/or RPLND (2005-2020). We measured body composition including skeletal muscle (SMI), visceral adipose (VAI,), subcutaneous adipose (SAI), and fat mass (FMI) indices on computed tomography. We quantified chemotherapy-associated changes in body composition and evaluated associations between body composition and incidence of grade 3+ AEs and post-RPLND complications on multivariable logistic regression analyses. Results182 men received a median of 3 cycles of cisplatin-based chemotherapy. Following chemotherapy, median change in SMI was -6% (p=<0.0001), while VAI, SAI, and FMI increased by +13% (p=<0.0001), +11% (p=<0.0001), and +6% (p=<0.0001), respectively. 79 patients (43%) experienced at least one grade 3+ AE. A decrease in SMI following chemotherapy was associated with increased risk of grade 3+ AEs (p=0.047). 103 men with a median age of 28.5 years (IQR 23-35.5) underwent RPLND of whom 22 (21.3%) experienced at least one grade 3+ post-RPLND complication. No baseline body composition metrics were associated with post-RPLND complications. ConclusionsIn men with GCT of the testis, chemotherapy was associated with 6% loss of lean muscle mass and gains in adiposity. Lower skeletal muscle was associated with a higher incidence of chemotherapy-associated AEs. Body composition was not associated with the incidence of post-RPLND complications.

Body morphometry may predict parastomal hernia following radical cystectomy with ileal conduit.

To investigate whether preoperative body morphometry analysis can identify patients at risk of parastomal hernia (PH), which is a common complication after radical cystectomy (RC). All patients who underwent RC between 2010 and 2020 with available cross-sectional imaging preoperatively and at 1 and 2 years postoperatively were included. Skeletal muscle mass and total fat mass (FM) were determined from preoperative axial computed tomography images obtained at the level of the L3 vertebral body using Aquarius Intuition software. Sarcopenia and obesity were assigned based on consensus definitions of skeletal muscle index (SMI) and FM index (FMI). PH were graded using both the Moreno-Matias and European Hernia Society criteria. Binary logistic regression and recursive partitioning were used to identify patients at risk of PH. The Kaplan-Meier method with log-rank and Cox proportional hazards models included clinical and image-based parameters to identify predictors of PH-free survival. A total of 367 patients were included in the final analysis, with 159 (43%) developing a PH. When utilising binary logistic regression, high FMI (odds ratio [OR] 1.63, P < 0.001) and low SMI (OR 0.96, P = 0.039) were primary drivers of risk of PH. A simplified model that only relied upon FMI, SMI, and preoperative albumin improved the classification of patients at risk of PH. On Kaplan-Meier analysis, patients who were obese or obese and sarcopenic had significantly worse PH-free survival (P < 0.001). Body morphometry analysis identified FMI and SMI to be the most consistent predictors of PH after RC.

Higher adiposity predicts greater intra-individual inconsistencies in postprandial glycemic measurements-an analysis of three randomized controlled trials in Asian populations.

Acute glycemic responses offer important insights into glucose homeostasis although the repeatability of these measurements particularly in Asian populations remains unclear. This research aimed to critically investigate the inconsistencies of the postprandial glycemic profile within individuals, and identify potential variables predicting greater inconsistencies. This was a secondary analysis of three randomized controlled trials which fed subjects with glucose (and other carbohydrate-rich foods), and measured postprandial blood glucose at regular intervals. Intra-individual rank-order consistency in the glycemic profile between acute glucose treatments was evaluated and compared against demographic, anthropometric and cardio-metabolic health related indicators to delineate potential confounding variables. Correlations between the incremental area under curve at 120 min (iAUC120 min) for glucose and the carbohydrate-rich foods were further explored. Rank-order consistency was identified to be moderate, with intra-individual inconsistencies marginally lower than inter-individual inconsistencies. Notably, greater inconsistencies within individuals were directly correlated with BMI and fat-mass index (P < 0.01) albeit non-significant for age, ethnicity, and other cardio-metabolic health-related risk indicators. Across the trials, there were positive monotonic correlations between the iAUC120 min for glucose and simple sugars (sucrose, isomaltulose), as well as different varieties of rice (jasmine white, Bapatla brown, Bapatla white; p < 0.05). However, there were a lack of associations between iAUC120 min for glucose with pastas (semolina and wholegrain penne, spaghetti) and mee pok noodles. There are inherent inconsistencies in postprandial glycemic measurements within individuals, particularly among those with higher adiposity. These confounders need to be kept in mind for appropriate and meaningful interpretations of glycemia.

Secular trends and determinants of ad libitum energy intake measured in a research setting from 1999-2020.

Historically, secular and seasonal trend analyses have been examined using self-report measures of intake. Rarely are objective measures and known determinants of dietary intake used in these analyses. Our objective was to quantify the seasonal and secular differences in an objective ad libitum intake paradigm while considering the contribution of determinants, such as fat-free mass (FFM) index and spontaneous physical activity (SPA) limited to the restricted space of a whole-room calorimeter. For this study, recruitment of N = 292 healthy, diabetes free, adults occurred from 1999 to 2020. Assessment during their 10-day stay included body composition (by DXA), SPA (by an approximately 24-h stay in whole-room calorimetry), and ad libitum intake (by a vending machine for 3 days). This secondary analysis used general linear models (GLM) to investigate secular and seasonal differences while adjusting for sex, age, FFM index, FM (fat mass) index, SPA, and race/ethnicity. FFM index and SPA were positively associated with all intake measures (p < 0.05). In all adjusted seasonal models, season did not affect intake. Adjusted secular trends models (kcals/year) demonstrated a decrease in total kcals (β = -55), intake as percent weight maintaining energy needs (β = -2), protein kcals (β = -10), fat kcals (β = -27), and carbohydrates kcals (β = -22) (all p < 0.05). After further adjustment for SPA, significance remained in all intake measures (p < 0.05). Secular trends in body composition revealed no changes in weight, BMI, and percent body fat (all p > 0.20). Our results indicate that over time, ad libitum intake decreased in this controlled research setting and remained significant even after accounting for positive determinants of intake. A significant ad libitum decrease, coupled with no change in body composition, may highlight a participant bias toward calorie restriction in a controlled setting over time and deserves further investigation.

Movement behaviour typologies and their associations with adiposity indicators in children and adolescents: a latent profile analysis of 24-h compositional data

ObjectivesGrowing evidence supports the important role of 24-hour movement behaviours (MB) in preventing childhood obesity. However, research to understand the heterogeneity and variability of MB among individuals and what kind of typologies of individuals are at risk of developing obesity is lacking. To bridge this gap, this study identified typologies of 24-hour MB in children and adolescents and investigated their associations with adiposity indicators.MethodsIn this cross-sectional study, 374 children and 317 adolescents from the Czech Republic wore wrist-worn accelerometers for seven consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep was quantified using raw accelerometery data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Bias-adjusted latent profile analysis was used on the 24-hour MB data to identify MB typologies and their associations with adiposity indicators. The models were adjusted for potential confounders. The identified typologies were labelled to reflect the behavioural profiles of bees to aid interpretability for the general public.ResultsTwo typologies were identified in children: highly active Workers characterised by high levels of MVPA and LPA, and inactive Queens characterised by low levels of MVPA and LPA, high levels of SB and longer sleep duration compared to Workers. In adolescents, an additional typology labelled as Drones was characterised by median levels of MVPA, LPA, SB and longest sleep duration. After controlling for covariates, we found that children labelled as Queens were associated with 1.38 times higher FM%, 1.43 times higher FMI, and 1.67 times higher VAT than Workers. In adolescents, Drones had 1.14 times higher FM% and Queens had 1.36 higher VAT in comparison with Workers, respectively.ConclusionOur study highlights the importance of promoting active lifestyles in children and adolescents to potentially reduce adiposity. These findings can provide insights for interventions aimed at promoting healthy MB and preventing childhood obesity.Graphical

Estimating the Total and Regional Body Fat of Physically Active Men Is Not Appropriate for Sedentary Men

Objectives. The reliability of predictive body fat equations remains unclear due to their inappropriate use across different subject cohorts and conditions. The objective of this study was to validate and cross-validate equations to predict total and regional body fat in young physically active males. Material and methods. Three hundred and five young male participants were divided into the following groups: active validation (n=165), active cross-validation (n=70), or sedentary cross-validation ones (n=70). The study used a stratified random sampling based on weekly physical activity level. The total and regional body fat mass were measured using dual-energy X-ray absorptiometry (DEXA) after an overnight fast. Simultaneous measurements of height, body mass, skinfold thickness, body mass index, and body circumferences were taken. The total and regional body fat predictive equations were generated using multiple linear stepwise regression models. The coefficient of determination (R²) and standard error of estimation (SEE) were calculated to examine the accuracy of the predictive equations. Furthermore, cross-validation groups were analysed. Results. The percentage of total body fat, trunk fat, legs fat, arms fat, and body mass index of active cross-validation were found to be significantly lower than in the sedentary cross-validation groups. The total body fat percentage was highly associated with abdominal skinfold thickness (R=0.68-0.74, P&lt;0.001), body mass index (R=0.55, P&lt;0.001), and suprailiac skinfold thickness (R=0.67-0.71, P&lt;0.001) in the active validation group. The predictive total and regional body fat equations of physically active men showed adjusted R² values ranging from 0.35 to 0.66, with standard error of estimation values between 2.74 to 4.35%. The standard error of estimation for the predictive percentage of total and regional body fat in the active cross-validation group was lower than in the sedentary cross-validation group. Conclusions. The findings demonstrate that new predictive total and regional body fat equations can be used to accurately estimate body fat in healthy young active males under fast conditions.

Sex-specific relationship patterns between body morphology and maturity status with change of direction and agility in elite adolescent volleyball players

This study explored sex-specific patterns in the relationship between maturity, body morphology, and change of direction (COD) and agility (AG) in adolescent volleyball players. The sample comprised 22 males and 24 females aged 15–17 with at least 4 years of sports experience. Measurements included body height, weight, muscle and fat mass, leg length, and center of mass. The study determined the Age of Peak Height Velocity (APHV) and evaluated sensorimotor ability through pre-planned COD and not-planned AG five-time shuttle runs, measuring the time difference as the index of reactivity. Positive correlations were found between COD and AG with fat mass index (FMI) in boys, while negative relative lower limb length (rLL) correlated with COD. In females, age of peak height velocity (APHV) showed a significant negative relationship with sensorimotor ability. Linear and polynomial regressions confirmed predictive and curvilinear relationships, respectively. Cluster analysis identified different associations in boys and girls, emphasizing sex-specific patterns. Body fat percentage had a negative impact on COD-AG in boys, while the optimal lower limb length proportion positively influenced COD due to enhanced maneuverability. Maturation affected sensorimotor abilities in girls. The findings suggest a need for a tailored approach to COD-AG development based on sex-specific considerations in adolescent volleyball players.