Lower Fat Mass Index Research Articles

Study of malnutrition in patients with idiopathic pulmonary fibrosis

Background Although the interest in Idiopathic Pulmonary Fibrosis (IPF) has increased in recent years due to the appearance of new therapies however the interest has focused on pulmonary involvement with little concern for systemic manifestations such as the nutritional status abnormalities. Thus, our study assessed the malnutrition prevalence in patients with IPF and the best indicators for the assessment of malnutrition among them. Patients and methods This work was conducted on 110 stable IPF patients who attended the outpatient clinic of Ain Shams University Hospitals from October 2020 to July 2021. Data about the detailed history and nutritional assessment was collected. Results 22.7% and 20.9% were malnourished according to the definition of fat-free mass index (FFMI) and body mass index (BMI), respectively. Most malnourished patients according to low FFMI were female; not using PPI was a significant independent predictors of malnutrition. There was a statistically significant relation between low FFMI and low serum albumin, hemoglobin, and oxygen saturation. Our findings also revealed that measuring BMI and being less than or equal to 22.1 kg/m2 and mid-arm circumference (MAC) less than or equal 28.5 cm is significantly related to low free fat mass index (malnutrition) and increases that risk by 31.63 folds. Conclusion Nearly one-quarter of IPF patients were malnourished and it was found that measuring BMI less than or equal to 22.1 kg/m2 together with MAC less than or equal to 28.5 cm can predict low FFMI and that can be used in our clinical approach.

Breastfeeding duration is associated with favorable body composition and lower glycoprotein acetyls in later life.

The aim of the present study was to investigate associations between lifetime breastfeeding behaviors and cardiovascular risk in later reproductive years. This was a prospective 10-year longitudinal cohort study of 168 parous women. Health, lifestyle and infant feeding questionnaires, blood samples, anthropometry and body composition were collected. Cardiovascular risk was estimated using QRISK®3 and hierarchical multiple linear regression analysis performed. Mean age was 42.4 years (SD 3.8; range 31-50) and 98.7% (n = 156/158) were premenopausal. Ever breastfeeding rates were 72.6% (n = 122/168) and 37.5% (n = 63/168) lifetime ≥12 months breastfeeding duration. Median durations were 5.5 weeks for exclusive breastfeeding (IQR 35.8; range 0-190) and 30.5 weeks for any breastfeeding (IQR 84.0; range 0-488). Breastfeeding duration was not associated with QRISK®3 scores in adjusted models. Lower glycoprotein acetyls were associated with ever breastfeeding (P = 0.03), and lifetime breastfeeding ≥12 months (P = 0.001). Lifetime breastfeeding ≥12 months and longer exclusive breastfeeding were associated with lower fat mass index (P = 0.03, P = 0.01), tissue percentage fat (P = 0.02, P = 0.009) and visceral adipose tissue volume (P = 0.04, P = 0.025) after correcting for confounders including body mass index. Longer breastfeeding is associated with favorable body composition and lower glycoprotein acetyls, a novel inflammatory biomarker associated with cardiometabolic risk. Breastfeeding is a low-cost, health promoting behavior for women and infants. Pregnant women, especially those at higher risk of cardiovascular disease, should be counseled about the potential benefits of exclusive and longer breastfeeding duration.

Increased Expression of Proinflammatory Genes in Peripheral Blood Cells Is Associated with Cardiac Cachexia in Patients with Heart Failure with Reduced Ejection Fraction

Background: Cardiac cachexia (CC) in chronic heart failure with reduced ejection fraction (HFrEF) is characterized by catabolism and inflammation predicting poor prognosis. Levels of responsible transcription factors like signal transducer and activator of transcription (STAT)1, STAT3, suppressor of cytokine signaling (SOCS)1 and SOCS3 in peripheral blood cells (PBC) are underinvestigated in CC. Expression of mediators was related to patients’ functional status, body composition (BC) and metabolic gene expression in skeletal muscle (SM). Methods: Gene expression was quantified by qRT-PCR in three cohorts: non-cachectic patients (ncCHF, n = 19, LVEF 31 ± 7%, BMI 30.2 ± 5.0 kg/m2), cachectic patients (cCHF; n = 18, LVEF 27 ± 7%, BMI 24.3 ± 2.5 kg/m2) and controls (n = 17, LVEF 70 ± 7%, BMI 27.6 ± 4.6 kg/m2). BC was assessed by dual-energy X-ray absorptiometry. Blood inflammatory markers were measured. We quantified solute carrier family 2 member 4 (SLC2A4) and protein degradation by expressions of proteasome 20S subunit beta 2 and calpain-1 catalytic subunit in SM biopsies. Results: TNF and IL-10 expression was higher in cCHF than in ncCHF and controls (all p < 0.004). cCHF had a lower fat mass index (FMI) and lower fat-free mass index (FFMI) compared to ncCHF and controls (p < 0.05). STAT1 and STAT3 expression was higher in cCHF vs. ncCHF or controls (1.1 [1.6] vs. 0.8 [0.9] vs. 0.9 [1.1] RU and 4.6 [5.5] vs. 2.5 [4.8] vs. 3.0 [4.2] RU, all ANOVA-p < 0.05). The same applied for SOCS1 and SOCS3 expression (1.1 [1.5] vs. 0.4 [0.4] vs. 0.4 [0.5] and 0.9 [3.3] vs. 0.4 [1.1] vs. 0.8 [0.9] RU, all ANOVA-p < 0.04). In cCHF, higher TNF and STAT1 expression was associated with lower FMI (r = 0.5, p = 0.053 and p < 0.05) but not with lower FFMI (p > 0.4). In ncCHF, neither cytokine nor STAT/SOCS expression was associated with BC (all p > 0.3). SLC2A4 was upregulated in SM of cCHF vs. ncCHF (p < 0.03). Conclusions: Increased STAT1, STAT3, SOCS1 and SOCS3 expression suggests their involvement in CC. In cCHF, higher TNF and STAT-1 expression in PBC were associated with lower FMI. Increased SLC2A4 in cachectic SM biopsies indicates altered glucose metabolism.

The Associations of Breastfeeding Status at 6 Months with Anthropometry, Body Composition, and Cardiometabolic Markers at 5 Years in the Ethiopian Infant Anthropometry and Body Composition Birth Cohort

(1) Background: Breastfeeding (BF) has been shown to lower the risk of overweight and cardiometabolic disease later in life. However, evidence from low-income settings remains sparse. We examined the associations of BF status at 6 months with anthropometry, body composition (BC), and cardiometabolic markers at 5 years in Ethiopian children. (2) Methods: Mother–child pairs from the iABC birth cohort were categorised into four BF groups at 6 months: 1. “Exclusive”, 2. “Almost exclusive”, 3. “Predominantly” and 4. “Partial or none”. The associations of BF status with anthropometry, BC, and cardiometabolic markers at 5 years were examined using multiple linear regression analyses in three adjustment models. (3) Results: A total of 306 mother–child pairs were included. Compared with “Exclusive”, the nonexclusive BF practices were associated with a lower BMI, blood pressure, and HDL-cholesterol at 5 years. Compared with “Exclusive”, “Predominantly” and “Almost exclusive” had shorter stature of −1.7 cm (−3.3, −0.2) and −1.2 cm (−2.9, 0.5) and a lower fat-free mass index of −0.36 kg/m2 (−0.71, −0.005) and −0.38 kg/m2 (−0.76, 0.007), respectively, but a similar fat mass index. Compared with “Exclusive”, “Predominantly” had higher insulin of 53% (2.01, 130.49), “Almost exclusive” had lower total and LDL-cholesterol, and “Partial or none” had a lower fat mass index. (5) Conclusions: Our data suggest that children exclusively breastfed at 6 months of age are overall larger at 5 years, with greater stature, higher fat-free mass but similar fat mass, higher HDL-cholesterol and blood pressure, and lower insulin concentrations compared with predominantly breastfed children. Long-term studies of the associations between BF and metabolic health are needed to inform policies.

Association of fat mass and fat-free mass with all-cause and cause-specific mortality in Asian individuals: A prospective cohort study.

The study's objective was to investigate the association of fat mass index (FMI) and fat-free mass index (FFMI) with all-cause mortality and cause-specific mortality in the Chinese population. A total of 422,430 participants (48.1% men and 51.9% women) from the Taiwan MJ Cohort with an average follow-up of 9 years were included. The lowest (Q1) and highest (Q5) quintiles of FMI and FFMI were associated with increased all-cause mortality. Compared with those in the third quintile (Q3) group of FMI, participants in Q1 and Q5 groups of FMI had hazard ratios and 95% CI of 1.32 (1.24-1.40) and 1.13 (1.06-1.20), respectively. Similarly, compared with those in Q3 group of FFMI, people in Q1 and Q5 groups of FFMI had hazard ratios of 1.14 (1.06-1.23) and 1.16 (1.10-1.23), respectively. In the restricted cubic spline models, both FMI and FFMI showed a J-shaped association with all-cause mortality. People in Q5 group of FFMI had a hazard ratio of 0.72 (0.58-0.89) for respiratory disease. The mortality risk increases in those with excessively high or low FMI and FFMI, yet the associations between FMI, FFMI, and the risk of death varied across subgroups and causes of death.

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

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

Differential impacts between fat mass index and fat-free mass index on patients with COPD

BackgroundDifferences in the clinical impacts of fat mass index (FMI) and fat-free mass index (FFMI) remain unclear in patients with chronic obstructive pulmonary disease (COPD). We hypothesized that FMI and FFMI have different impacts on 1) emphysema and 2) pulmonary function and health-related quality of life of COPD patients. MethodsPatients with COPD (n = 228), enrolled in a multicenter prospective 3-year cohort were classified into four groups based on baseline median FMI and FFMI values. Emphysema assessed as the ratio of low attenuation area to total lung volume (LAA%) on computed tomography, pulmonary function, and health-related quality of life assessed using the St. George's Respiratory Questionnaire (SGRQ) were compared. ResultsThe four groups had statistically significant differences in LAA%, pulmonary function, and SGRQ scores. The Low FMI Low FFMI group exhibited the highest LAA%, lowest pulmonary function, and worst SGRQ scores among the four groups. In addition, these differences were consistent over 3 years. Multivariate analysis showed that low FMI was associated with high LAA%, low inspiratory capacity/total lung capacity (IC/TLC), and carbon monoxide transfer coefficient (KCO). In contrast, low FFMI was associated with these factors as well as worse SGRQ scores. ConclusionFMI and FFMI have different effects on the clinical manifestations of COPD. Both low fat and muscle mass contributed to severe emphysema, whereas only low muscle mass contributed to worse health-related quality of life in patients with COPD.

Changes in skeletal muscle mass index and fat mass index during rehabilitation for traumatic brain injury and stroke measured by bioelectrical impedance analysis.

Although malnutrition may negatively impact the outcomes of rehabilitation and increase the cost of care, there are still no valid nutritional assessment methods appropriate for specific groups of patients undergoing rehabilitation. This study aimed to determine if a multifrequency bioelectrical impedance is suitable for monitoring the changes in body composition of brain-injured patients for whom individualized nutritional goals were set during rehabilitation. Fat mass index (FMI) and skeletal muscle mass index (SMMI) were examined by Seca mBCA515 or portable Seca mBCA525 device within 48 h of admission and before discharge in 11 traumatic brain injury (TBI) and 11 stroke patients with admission Nutritional Risk Screening 2002 scores ≥2. The changes in outcomes and plausible interactions were examined between the admission values and the values estimated for the 18th day (minimum length of stay in the sample) using a repeated measure mixed-sample analysis of covariance. In patients with low FMI at admission (mainly younger, TBI patients, with longer ICU stay), there was no change over time whereas, in those with high admission FMI (older, stroke patients, with shorter ICU stay), a decrease was observed (significant interaction F(1,19) = 9.224 P = 0.007 Part. η² = 0.327). The SMMI significantly increased over time (F(1,19) = 5.202 P = 0.034 Part. η² = 0.215) independently of gender, age, days spent in ICU and cause of brain injury. Our results suggest that bioelectrical impedance analysis is feasible and informative for monitoring the changes in body composition during rehabilitation, which also requires consideration of demographic and pre-rehabilitation characteristics.

Infection, nutritional status, and body composition: Associations at birth and 6 months postnatally in Soweto, South Africa.

The impact of infection on infant nutritional status, body size, and growth is well documented. However, research into the impact of infection on infant body composition is limited. Greater understanding is, therefore, needed on the effects of infection in early life. Associations between a composite morbidity index consisting of the sum of the cumulative tallies for a range of symptoms representing infection and morbidity in the infants and nutritional status (height-for-age (HAZ), and weight-for-height (WHZ)), and body composition (fat-free mass (FFM), fat mass (FM), fat-free mass index (FFMI), and fat mass index (FMI)) at 6 months of age were investigated using hierarchical regression analysis. The sample comprised data between birth and 6 months postnatally, of 156 infants who were a priori born healthy in Soweto, South Africa. Morbidity, over the cumulative period of birth to 6 months, was associated with lower FMI (β = -1.77) and lower FM (β = -0.61), and conversely with higher FFM (β = 0.94), in infants at 6 months. No associations were found between the morbidity index and FFMI, HAZ, and WHZ. Increased birthweight was associated with a higher FFM (β = 0.66), HAZ (β = 1.14), and WHZ (β = 0.87). Finally, safely managed sanitation facilities, representative of reduced environmental exposure to fecal-oral transmission pathways were associated with a higher HAZ (β = 1.21). Reduction in FMI and FM and exposure to inflammatory cytokines associated with mounting an immune response could alter phenotypic trajectories during to this period of plasticity. From a public health perspective, these results imply that it is important to intensify efforts to prevent infection in infants in the first 6 months postnatally, and that these efforts should concentrate on access to safely managed sanitation facilities.

Association between maternal and infant screen time with child growth and development: A longitudinal study.

Sedentary screen time is an early, modifiable risk factor for obesity and poor child development. To examine the relationship between maternal and infant screen time with child growth and development. Pregnant women were recruited for a cohort study related to maternal and infant development. Screen time was assessed in mothers during pregnancy, and subsequently in children at 3 months, 12 months, and 24 months of age. Child anthropometry was measured, and nuclear magnetic resonance quantified child fat mass. Fat mass index (FMI) was calculated. The Bayley Scales of Infant Development-III were used to assess child development. Linear regression models were used to assess the relationship between screen time and child growth and development, adjusted for covariates and stratified by sex. Mother/child dyads (n = 89) were mainly white (92.1%), and half were boys (52%). Both sexes increased screen time between 12 months and 24 months (ps <0.05). Child screen time was positively associated with FMI and negatively associated with development scores. In adjusted models, screen time was positively associated with FMI in boys, and meeting the screen time guideline was associated with lower FMI in girls. Greater infant screen time was related to higher adiposity. Though few relationships emerged, a cautionary approach to screen time early in life may benefit child health.

Temporal and periorbital depressions identified by 3D images are correlated with malnutrition phenotypes in cancer patients: A pilot study.

Prompt diagnosis of malnutrition and appropriate interventions can substantially improve the prognosis of patients with cancer; however, it is difficult to unify the tools for screening malnutrition risk. 3D imaging technology has been emerging as an approach to assisting in the diagnosis of diseases, and we designed this study to explore its application value in identifying the malnutrition phenotype and evaluating nutrition status. Hospitalized patients treating with maintenance chemotherapy for advanced malignant tumor of digestive system were recruited from the Department of Oncology, whose NRS 2002 score > 3. Physical examination and body composition data of patients at risk for malnutrition were analyzed by physicians trained to complete a subjective global assessment. The facial depression index was recognized using the Antera 3D® system, temporal and periorbital depression indexes were acquired using the companion software Antera Pro. This software captures quantitative data of depression volume, affected area, and maximum depth of temporal and periorbital concave areas. A total of 53 inpatients with malnutrition-related indicators were included. The volume of temporal depression was significantly negatively correlated with upper arm circumference (r = -0.293, p = 0.033) and calf circumference (r = -0.285, p = 0.038). The volume and affected area of periorbital depression were significantly negatively correlated with fat mass index (r = -0.273, p = 0.048 and r = -0.304, p = 0.026, respectively) and percent body fat (r = -0.317, p = 0.021 and r = -0.364, p = 0.007, respectively). The volume and affected area of temporal depression in patients with muscle loss phenotype (low arm circumference/low calf circumference/low handgrip strength/low fat-free mass index) were significantly higher than those in patients without muscle loss. Moreover, patients with fat mass loss phenotype (low fat mass index) showed a significant increase in the volume and affected area of periorbital depression. The facial temporal region, and periorbital depression indicators extracted by 3D image recognition technology were significantly associated with the phenotype of malnutrition-related muscle and fat loss and showed a trend of grade changes in the population of different subjective global assessment nutritional classifications.

Associations of fat mass index with hot flashes and lean mass index with insomnia in middle-aged women

Objective This cross-sectional study examined the relationship between body composition and physical and mental symptom severity in middle-aged women. Methods The first-visit records of 554 women aged 40–64 years were examined. The fat mass index (FMI) and lean mass index (LMI) were defined as fat mass and lean mass divided by the height squared, respectively. The participants were divided into two groups according to their median values. Results The only menopausal symptom with significantly different severity between the high and low FMI groups was hot flashes (HF) on the Menopausal Health-Related Quality of Life Questionnaire. The factors associated with severe HF were investigated using multiple logistic regression analysis. After adjusting, the FMI (kg/m2) was independently positively associated with severe HF (odds ratio, 1.08; 95% confidence interval, 1.02–1.15). Insomnia was the only menopausal symptom with significantly different severity between the LMI groups (defined as Athens Insomnia Scale score ≥10 points). The factors associated with moderate-to-severe insomnia were investigated using multiple logistic regression analysis. After adjusting, the LMI (kg/m2) was independently negatively associated with moderate-to-severe insomnia (odds ratio, 0.72; 95% confidence interval, 0.55–0.94). Conclusions The FMI was positively associated with severe HF, whereas the LMI was negatively associated with moderate-to-severe insomnia in middle-aged women.

Longitudinal associations of movement behaviours with body composition and physical fitness from 4 to 9 years of age: structural equation and mediation analysis with compositional data

BackgroundThe associations of movement behaviours (physical activity [PA], sedentary behaviour [SB], and sleep) with body composition and physical fitness from pre-school to childhood, as well as the direction of the associations, could provide important information for healthy lifestyle promotion in children. This study investigated the longitudinal and bidirectional associations of movement behaviours with body composition and physical fitness measured at 4 and 9 years of age.MethodsThis longitudinal study included baseline (n = 315, 4.5 [SD = 0.1] years) and follow-up data (n = 231, 9.6 [SD = 0.1] years) from the MINISTOP study. Movement behaviours were measured for 7 days using wrist-worn accelerometers, body composition with air-displacement plethysmography, and physical fitness with the ALPHA health-related fitness test battery. Cross-lagged panel models and mediation analyses were performed in combination with compositional data analysis.ResultsWe did not observe direct associations of the movement behaviours at 4 years with either body composition or physical fitness at 9 years (all P > 0.05). However, fat mass index at 4 years was negatively associated with vigorous PA (VPA), relative to remaining behaviours (VPA, β = − 0.22, P = 0.002) and light PA (LPA), relative to SB and sleep (β = − 0.19, P = 0.016) at 9 years. VPA (relative to remaining), moderate PA (MPA) (relative to LPA, SB, and sleep), and SB (relative to sleep) tracked from 4 to 9 years (all β ≥ 0.17, all P < 0.002), and these behaviours shared variance with fat mass index (all|β| ≥ 0.19, all P < 0.019), and aerobic, motor, and muscular fitness (all|β| ≥ 0.19, all P < 0.014) at 9 years. Mediation analysis suggested that the tracking of VPA (relative to remaining behaviours) from 4 to 9 years was negatively associated with fat mass index (β ≥ − 0.45, P = 0.012), and positively with aerobic fitness at 9 years (β ≥ 1.64, P = 0.016).ConclusionPA and SB tracked from the pre-school years into childhood. Fat mass index at 4 years of age was negatively associated with VPA (relative to remaining behaviours) and LPA (relative to SB and sleep) at 9 years of age. The tracking of VPA was associated with lower fat mass index and higher aerobic fitness at 9 years of age. These findings suggest that higher levels of VPA in pre-school age, if maintained throughout childhood, may support the development of healthy body composition and aerobic fitness levels in later childhood.

Egg Introduction during Infancy is Associated with Lower Fat Mass Index in Females at Early Adolescence

BackgroundEgg consumption may play an important role in early-life growth given their high-quality protein, essential fatty acids, and micronutrients. ObjectivesStudy objectives were to examine the longitudinal associations of infant age at egg introduction with obesity outcomes in early childhood, middle childhood (mid-childhood), and early adolescence. MethodsWe used existing data from 1089 mother-child dyads from Project Viva to estimate age at egg introduction through a questionnaire completed by mothers at ∼1 y postpartum (mean ± SD, 13.3 ± 1.2 mo). Outcome measures included height and weight (early childhood, mid-childhood, and early adolescence), body composition including total fat mass, trunk fat mass, and lean mass (mid-childhood and early adolescence), and plasma adiponectin and leptin (early and mid-childhood and early adolescence). We defined childhood obesity as sex- and age-specific BMI ≥ 95th percentile. We estimated the associations of infant age at egg introduction with risk of obesity using multivariable logistic regression and multivariable linear regression models for BMI-z-score, body composition measures, and adiposity hormones; adjusted for maternal prepregnancy BMI and sociodemographics. ResultsAmong females, those introduced to egg by the 1-y survey had a lower total fat mass index (confounder-adjusted mean difference, −1.23 kg/m2; 95% CI: −2.14, −0.31), and trunk fat mass index (confounder-adjusted mean difference, −0.57 kg/m2; 95% CI: −1.01, −0.12) in early adolescence compared to those not introduced (reference group). However, no associations between infant age at egg introduction and risk of obesity were observed among males (confounder-adjusted odd ratio [aOR], 1.97; 95% CI: 0.90, 4.30) or females (aOR, 0.68; 95% CI: 0.38, 1.24) across all ages. Egg introduction in infancy was associated with lower plasma adiponectin among females (confounder-adjusted mean difference, −1.93 μg/mL; 95% CI: −3.70, −0.16) in early childhood only. ConclusionsEgg introduction during infancy among females is associated with lower total fat mass index in early adolescence and plasma adiponectin in early childhood. This trial was registered at clinicaltrials.gov as NCT02820402.

Maternal iron status in early pregnancy and childhood body fat measures and cardiometabolic risk factors: A population-based prospective cohort

BackgroundWhether maternal iron status during pregnancy is associated with cardiometabolic health in the offspring is poorly known. ObjectivesWe aimed to assess the associations of maternal iron status during early pregnancy with body fat measures and cardiometabolic risk factors in children aged 10 y. MethodsIn a population-based cohort study among 3718 mother–child pairs, we measured ferritin, transferrin, and transferrin saturation during early pregnancy. We obtained child BMI, fat mass index, and android/gynoid fat mass ratio by DXA, subcutaneous fat index, visceral fat index, pericardial fat index, and liver fat fraction by magnetic resonance imaging and assessed systolic and diastolic blood pressure, serum lipids, glucose, insulin, and CRP at 10 y. ResultsA one-standard deviation score (SDS) higher maternal ferritin was associated with lower fat mass index [difference −0.05 (95% CI: −0.08, −0.02) SDS] and subcutaneous fat index [difference −0.06 (95% CI: −0.10, −0.02) SDS] in children. One-SDS higher maternal transferrin was associated with higher fat mass index [difference 0.04 (95% CI: 0.01, 0.07) SDS], android/gynoid fat mass ratio [difference 0.05 (95% CI: 0.02, 0.08) SDS], and subcutaneous fat index [difference 0.06 (95% CI: 0.02, 0.10) SDS] in children. Iron status during pregnancy was not consistently associated with organ fat and cardiometabolic risk factors at 10 y. ConclusionsMaternal lower ferritin and higher transferrin in early pregnancy are associated with body fat accumulation and distribution but are not associated with cardiometabolic risk factors in childhood. Underlying mechanisms and long-term consequences warrant further study.

Body Composition in Late Midlife as a Predictor of Accelerated Age-associated Deficit-accumulation From Late Midlife into Old Age: ALongitudinal Birth Cohort Study.

Body mass index (BMI) may not be an optimal predictor of frailty as its constituents, lean and fat mass, may have opposite associations with frailty. A linear mixed model analysis was performed in the Helsinki Birth Cohort Study (n=2 000)spanning from 57 to 84years. A39-item frailty index (FI) was calculated on three occasions over 17years. Body composition in late midlife included BMI, percent body fat (%BF), waist-to-hip ratio (WHR), lean mass index (LMI), and fat mass index (FMI). Mean FI levels increased by 0.28%/year among men and by 0.34%/year among women. Among women, per each kg/m2 higher BMI and each unit higher %BF the increases in FI levels per year were 0.013 percentage points (PP) steeper (95% CI=0.004, 0.023) and 0.009 PP steeper (95% CI=0.002, 0.016) from late midlife into old age. Among men, per each 0.1-unit greater WHR the increase in FI levels was 0.074 PP steeper per year (95% CI=-0.0004, 0.148). Cross-sectionally, greater FMI and LMI in late midlife were associated with higher FI levels but the direction of the association regarding LMI changed after adjustment for FMI. The categories "high FMI and high LMI" and "high FMI and low LMI" showed the highest FI levels relative to the category "low FMI and low LMI". In late midlife, greater adiposity (%BF) among women and abdominal obesity (WHR) among men may predispose to higher levels of frailty from late midlife into old age. Greater lean mass alone may be protective of frailty, but not in the presence of high fat mass.

Cheese Intake Exhibits an Alteration of Glycolipid Profile and Impacts on Non-Alcoholic Fatty Liver in Bahraini Older Adults.

Background: Metabolic syndrome (MetS) is a multifactorial condition characterized by a complex interrelation between genetic and environmental factors that heighten the risk of cardiovascular diseases and all-cause mortality. It is hypothesized that diet may play an important role in the regulation of metabolic syndrome factors and influence the process. Therefore, the main objective of this study was to investigate the specific dietary patterns associated with metabolic syndrome markers and quantify the possible effects of dietary patterns among Bahrain older adults. Methods: This is a cross-sectional study that included 151 Bahraini patients diagnosed with MetS, 89 (58.7%) were females and 62 (41.3%) males. Results: The prevalence of Non-Alcoholic Fatty Liver was 89%. Statistically significant correlations were found between dairy products with low fat and SBP (r = 0.182, p < 0.001) body mass index (BMI) (r = −0.195; p < −0.01). Higher chicken consumption was associated with reduction of BMI (r = −0.273; p < −0.01). A higher consumption of ricotta and cheddar cheese (high in fat) was associated with higher levels of triglycerides (p < 0.01). Higher frequent consumption of rice (basmati) was associated with lower glucose levels (r = −0.200; p < −0.01). Fatty liver has been associated with high consumption of cream cheese (p < 0.01). Conclusion: In older Bahraini adults with metabolic syndrome, higher frequency of food consumption of full-fat cheese was linked with a derangement of lipid profile and Non-Alcoholic Fatty Liver. Positive effects on BMI have been recorded with higher-frequency consumption of basmati rice and chicken.

Egg Introduction During Infancy Is Associated with Lower Fat Mass Index in Early Adolescent Females

Abstract Objectives Egg consumption may play an important role in early-life growth given their high-quality protein, essential fatty acids, and micronutrients. The objective of this study was to examine the longitudinal associations of infant age at egg introduction with obesity outcomes in early childhood, middle childhood, and early adolescence. Methods We used existing data from 1,089 mother-child dyads from Project Viva to estimate age at egg introduction through a questionnaire completed by mothers at about 1 year postpartum (mean ± SD, 13.3 ± 1.2 months). Outcome measures included height and weight, body composition including total fat mass, trunk fat mass, and lean mass, as well as plasma adiponectin and leptin in early childhood, mid-childhood, and early adolescence. We defined childhood obesity as sex- and age-specific body mass index (BMI) ≥95th percentile. We estimated the associations of infant age at egg introduction with risk of obesity using multivariable logistic regression and multivariable linear regression models were used for BMI z-score, body composition measures, and adiposity hormones, adjusting for maternal pre-pregnancy BMI and socio-demographics. Results Among females only, those introduced to eggs by the 1-year survey had a lower total fat mass index (confounder-adjusted mean difference, −1.23 kg/m2 [95% confidence interval, −2.14, −0.31]) and trunk fat mass index (−0.57 kg/m2 [−1.01, −0.12]) in early adolescence compared with those not introduced. Similarly, among females, egg introduction in infancy was associated with lower plasma adiponectin (confounder-adjusted mean difference, −1.93 μg/mL [−3.70, −0.16]) in early childhood. However, no associations between infant age at egg introduction and risk of obesity were observed among males (confounder-adjusted odd ratio, 1.97 [95% confidence interval, 0.90, 4.30]) or females (0.68 [0.38, 1.24]) across all ages. Conclusions Egg introduction during infancy among females was associated with lower total fat mass index in early adolescence and adiponectin in early childhood. Funding Sources Egg Nutrition Center/American Egg Board.

Body Fat Distribution in Children and Adolescents With Cerebral Palsy

To evaluate the body fat distribution in children with cerebral palsy (CP). The present study focusses on a monocentric retrospective analysis of body fat distribution from children diagnosed with CP. The children participated in a rehabilitation program. Reference centiles were calculated based on data from the National Health and Nutrition Examination Survey (NHANES, 1999–2004). Z-scores for trunk-to-leg fat ratio were calculated. Further, fat mass index (FMI) was evaluated based on percentiles that have already been published. 237 males and 194 females with CP were considered (mean age: 11 years and 11 months [SD 3 years]). These were compared to 1059 males and 796 females from the NHANES (mean age: 14 years and 7 months [SD 3 years and 4 months]). The z-scores for trunk-to-leg fat ratio showed the following values: mean –0.47 (SD 1.50) for males, –0.49 (SD 1.11), for females, –0.48 (SD 1.34) for all. The z-scores for FMI showed the following values: mean –0.29 (SD 0.70) for males, –0.88 (SD 2.0) for females, –0.55 (SD 1.46) for all. The results showed rather a gynoid fat distribution and a lower FMI in children with CP than in the reference population (NHANES 1999–2004).

Anthropometrics and fat mass, but not fat-free mass, are compromised in infants requiring parenteral nutrition after neonatal intestinal surgery

ABSTRACTBackgroundChildren with intestinal failure (IF) receiving long-term parenteral nutrition (PN) have altered body composition (BC), but data on BC changes from start of PN onwards are lacking.ObjectivesWe aimed to assess growth and BC in infants after neonatal intestinal surgery necessitating PN and at risk of IF, and to explore associations with clinical parameters.MethodsA prospective cohort study in infants after intestinal surgery. IF was defined as PN dependency for >60 d. SD scores (SDS) for anthropometry were calculated until 6-mo corrected age. In a subgroup, fat mass (FM) and fat-free mass (FFM) were measured with air-displacement plethysmography at 2- and 6-mo corrected age. SDS for length-adjusted FM index and FFM index were calculated. Associations between cumulative amount of PN and BC parameters were analyzed with linear mixed-effect models.ResultsNinety-five neonates were included (54% male, 35% born <32 wk) and 39 infants (41%) had IF. Studied infants had compromised anthropometric parameters during follow-up. At 6-mo corrected age, they remained smaller (median weight-for-age SDS –0.9 [IQR –1.5, 0.1], P < 0.001) than the normal population. In 57 infants, 93 BC measurements were performed. FM index SDS was lower than in healthy infants at 2- and 6-mo corrected age (–0.9 [–1.6, –0.3], P < 0.001 and –0.7 [–1.3, 0.1], P = 0.001, respectively), but FFM index SDS did not differ. A higher cumulative amount of PN predicted a higher FM index in female infants but lower FM index in male infants.ConclusionsIn this cohort of infants receiving PN after intestinal surgery, compromised anthropometrics, decreased FM, and adequate FFM were observed during the first 6 mo. Male and female infants seemed to respond differently to PN when it comes to FM index. Continuing growth monitoring after the age of 6 mo is strongly recommended, and further research should explore the benefit of incorporating ongoing BC monitoring during follow-up.