Multifrequency Bioelectrical Impedance Research Articles

Associations of body composition with physical activity, nutritional intake status, and chronotype among female university students in Japan

BackgroundHaving higher muscle mass in early adulthood is an important factor in preventing sarcopenia. However, university students undergo lifestyle changes compared to their high school years, which may lead to changes in body composition, such as an increase in body fat and a decrease in muscle mass. The study aimed to investigate the association between body composition and lifestyle behaviors, including chronotype, among Japanese female university students, due to the prevalence of underweight among young females in the country.MethodsThe physical activity level (PAL), daily dietary intake status, morningness-eveningness questionnaire (MEQ) score, and body composition of 230 students were assessed in this cross-sectional study. Body composition was measured using a multifrequency bioelectrical impedance analyzer, and body mass index (BMI), body fat percentage (%BF), and skeletal muscle mass index (SMI) were determined.ResultsIndividuals who were evening type (ET) had a higher %BF and lower SMI than those who were non-ET, but no differences in body weight or BMI were found. Although ET individuals had lower total energy intake, protein intake, and PALs than non-ETs, the differences were small. However, multiple regression analyses showed that SMI was significantly positively associated with MEQ and PAL, and %BF was significantly negatively associated with MEQ and PAL.ConclusionThese results suggest that female university students with lateness of chronotype and low physical activity have a body composition imbalance resulting in higher body fat and lower muscle mass. Therefore, young females may need to take chronotype-specific measures (especially ET individuals) to help them maintain an appropriate body composition.

Fat-free mass predictive equation using multifrequency bioelectrical impedance data in adolescent soccer athletes: development and cross-validation

Objectives: This study aimed to develop and cross-validate a fat-free mass (FFM) predictive equation using multifrequency bioelectrical impedance data (MF-BIA) in adolescent soccer athletes. Methods: Male adolescent soccer athletes (n=149; 13 to 19 years old) were randomly sorted using Excel and independently selected for development group (n=100) or cross-validation group (n=49). The FFM reference values were determined using dual-energy X-ray absorptiometry (DXA). Single-frequency BIA was used to plot tolerance ellipses. Multifrequency-BIA raw data were used as independent variables in regression models. Student's independent t-test was used to compare development and cross-validation groups. Stepwise multiple regression was used to develop the FFM predictive equation. Bland-Altman plots, Lin's concordance correlation coefficient (CCC), according to McBride criteria, precision, accuracy, and standard error of estimation (SEE) were calculated to evaluate the concordance and reliability of estimates. Bioelectrical impedance vector analysis (BIVA) was plotted to evaluate hydration status. Results: No differences (P>0.05) were observed between development and validation groups in chronological age, anthropometric data, bioelectrical impedance data, and FFM values obtained using DXA. BIVA tolerance showed that all participants presented adequate hydration status when compared with the reference population. The new FFM predictive equation developed and validated: FFM (kg)= 7.064+ 0.592 * Age (years)+ 0.554* Weight(kg) + 0.365 * Height²/Resistance (cm²/Ω), presented R²= 0.95; SEE= 1.76 kg; CCC= 0.95, accuracy= 0.98, and strength of concordance= 0.99. Conclusions: The present study developed and cross-validated an FFM predictive equation based on multifrequency bioelectrical data providing substantial FFM accuracy for male adolescent soccer athletes.

Comparison between Discrete Multi-Wavelength Near-Infrared Spectroscopy and Bioelectrical Impedance Analysis in the Assessment of Muscle Mass for Community-Dwelling Older People.

(1) Background: This study evaluated the clinical implications of a new measurement technique for muscle mass using discrete multi-wavelength near-infrared spectroscopy (DMW-NIRS) compared with multifrequency bioelectrical impedance analysis (BIA) in older adults. (2) Methods: In a cross-sectional study involving 91 participants aged 65 years, the agreement of total lean mass for each measurement was assessed using the intraclass correlation coefficient (ICC) and Pearson's correlation analysis. The study was conducted at a university hospital from 10 July 2023 to 1 November 2023. (3) Results: A total of 45 men (mean age, 74.1) and 46 women (mean age, 73.6) were analyzed. In the comparisons of total lean mass between DMW-NIRS and BIA, ICC (2.1) was 0.943 and Cronbach's α coefficient was 0.949 (p < 0.001). Across all segments of lean mass, we found excellent agreement with the ICCs (>0.90) and acceptable values of the correlation coefficients (>0.6) between DMW-NIRS and BIA. (4) Conclusions: This study confirmed agreement in the measurements of muscle mass between portable devices using DMW-NIRS and BIA among community-dwelling older adults. A simple screening of muscle mass in a home setting would help to detect early decreases in muscle mass.

The relationship between resting metabolic rate and quality of life is moderated by age and body composition in women: a cross-sectional study

BackgroundHealth-related quality of life (HRQOL) is related to body composition, which is also related to resting metabolic rate (RMR). RMR can be increased by exercise and diet interventions that are not dependent on changes in body composition, so a link between RMR and HRQOL may provide interventions that directly improve HRQOL in women.MethodsOne hundred twenty women (median age 63.5 [IQR: 53.0–71.0] years) completed one-time measurement of body composition (multi-frequency bioelectrical impedance), RMR (handheld calorimetry), and HRQOL (RAND-36). Physical (PCS) and mental (MCS) composite scores were calculated for the RAND-36. Pearson correlations were used to identify relationships between RMR, body composition, and HRQOL. Variables at the p < .01 level were entered into multiple regression models.ResultsMedian body mass index was 26.1 [IQR: 23.2–30.9] kg/m2 and median lean mass index was 16.1 [IQR: 14.6–17.3] kg/m2. Body composition consisted of fat mass (median 27.2 [IQR: 20.3–34.7] kg) and lean mass (median 42.7 [IQR: 38.2–46.9] kg). Median RMR was 1165.0 [IQR: 1022.5–1380.0] kcal/day. Median HRQOL scores were PCS (84.0 [IQR: 74.0–93.0]) and MCS (85.0 [IQR: 74.3–90.0]). RMR was not directly related to PCS, but was directly and negatively related to MCS (p = .002). RMR was significantly and positively related to body composition (lean mass: p < .001; fat mass: p < .001), body mass index (p = .005), and lean mass index (p < .001); but only fat mass (PCS: p < .001; MCS: p < .001) and body mass index (PCS: p < .001; MCS: p < .001) were related to HRQOL, although the relationship was negative. In addition, age was found to be significantly negatively related to RMR (p < .001) and PCS (p = .003). Regression models confirmed the moderating influence of age and body composition on the relationship between RMR and HRQOL. RMR, age, fat mass, and body mass index explained 24% (p < .001) of variance in PCS; and RMR, fat mass, and body mass index explained 15% (p < .001) of variance in MCS.ConclusionIn women, the relationship between RMR and HRQOL is moderated by age and body composition. Understanding these pathways will allow clinicians and researchers to direct interventions more effectively.

Blood Concentration of Macro- and Microelements in Women Who Are Overweight/Obesity and Their Associations with Serum Biochemistry.

Risk elements in blood matrices can affect human health status through associations with biomarkers at multiple levels. The aim of this study was to analyze 15 macro- and microelements in the blood serum of women with overweight (BMI of ≥25 kg/m2) and obesity (BMI of ≥30 kg/m2) and to examine possible associations with biochemical, liver enzymatic parameters, and markers of oxidative stress. Based on the power calculation, the study involved women (in the postmenopausal stage) with overweight (n = 26) and obesity (n = 22), aged between 50-65 years. Multifrequency bioelectrical impedance analysis was used to measure body composition parameters. Concentrations of elements were determined by inductively coupled plasma optical emission spectrometry, and Hg was measured using cold-vapor atomic absorption spectroscopy. Individuals with obesity, as indicated by a higher BMI, percentage of body fat, and visceral fat area, had elevated serum levels of Ca, Mg, Fe, Al, Sr, Pb, and Hg. Concentrations of Al, Cu, K, Sb, Zn, and Pb significantly affected biochemical and liver function markers in women with overweight or obesity. Elements such as Cu and Al were associated with increased total cholesterol. The correlation analysis between total antioxidant status and Cu, Al, and Ni confirmed associations in both groups. Our findings underscore the importance of addressing excess body weight and obesity in relation to risk elements. The results of the research could be beneficial in identifying potential targets for the treatment or prevention of comorbidities in people with obesity.

Asymmetry in Body Composition Variables of Youth Athletes

Assessing bilateral differences in paired anthropometric features is an important methodological problem in sports anthropology. The present study included 128 adolescent female athletes (59 rhythmic gymnasts, 58 tennis players, and 11 swimmers). Body composition components were determined using multi-frequency bioelectrical impedance measurements (analyzer InBody 170). Asymmetry coefficients of muscle and fat mass accumulation in the upper (AA) and lower (AL) limbs were calculated using the Nacheva` equation (1986). The percentiles method was applied to distribute the bilaterally studied anthropometric features according to the mean values of the units of asymmetry (UA). Wilkoxon-test was used to assess the statistically significant differences in paired variables. Kruskal-Wallis test was applied to determine the differences in UA between three assessed athlete groups, depending on their age. The differences in body composition components between rhythmic gymnasts (RG), tennis players (TP), and swimmers (SW) were well expressed in all assessed age groups. The most considerable inter-group differences were observed in terms of the asymmetry coefficient in the lean body mass (LBM) with a right direction and body fat mass with a left direction for upper limb fat mass (%, kg), which have signed the highest values in the tennis players group, followed by the RG on the same age. Swimmers had significantly the lowest values of UA for all body segments. A close relation was found between asymmetry in body composition variables and the type of sports activity. Tennis was found as a sport with more pronounced inter-limbs asymmetry.

Body Composition Analyses in Older Adults May Vary Significantly Depending on the Bioelectrical Impedance Analyzer Modality

This study aimed to investigate the effects of aging on body composition analyses detected by a single-frequency (SF-BIA) and a multifrequency bioelectrical impedance analyzer (MF-BIA). Forty older patients and 42 young subjects were included in the study. Body composition was measured using an SF-BIA and an MF-BIA consecutively. Significant differences were found between the analyses of SF-BIA and MF-BIA in older patients. Handgrip strength values were found to correlate more strongly with the skeletal muscle mass index detected by MF-BIA. MF-BIA may be preferable to SF-BIA in older adults due to its higher correlation coefficient with handgrip strength.

Bioelectrical Impedance Phase Angle Value and Prolongations of PR and Corrected QT Intervals in Patients Undergoing Dialysis

Introduction: Phase angle value, derived from bioelectrical impedance analysis, represents the body cell mass and nutritional status of patients undergoing hemodialysis. Although the phase angle value has clinical significance in these patients, its relationship with electrocardiogram (ECG), another clinically relevant bioelectrical examination, has not yet been well clarified. Methods: Two hundred and twenty-four patients undergoing dialysis (80 females and 144 males; mean ± SD, 72.2 ± 12.0 years old; 117 diabetic and 107 nondiabetic patients) were studied retrospectively. Multifrequency bioelectrical impedance analysis was performed immediately after the end of dialysis therapy. The phase shift was geometrically converted into a phase angle value. The ECG was recorded simultaneously, and the upper limits of the PR interval, QRS width, and corrected QT interval (QTc) were set at 0.20, 0.12, and 0.44 s, respectively. The geriatric nutritional risk index (GNRI), a representative nutritional index, was also determined. In addition, we examined the incidence of cardiac events, including heart failure, myocardial infarction, cardiac revascularization procedure, cardiac arrhythmia, and cardiac death, or all-cause death. Results: Of 224 patients undergoing dialysis, the prolongation of the PR interval, QRS width, and QTc was found in 30.7, 17.4, and 62.1%, respectively. The prevalence of QTc prolongation was higher in females and diabetic patients than in males and nondiabetic patients. An inverse relationship between phase angle value and QTc was observed only in males and nondiabetic patients. The relationships of GNRI both with phase angle value and QTc were stronger in males and nondiabetic patients. In addition, PR interval was inversely correlated with a phase angle value only in nondiabetic patients. No significant correlation was found between phase angle value and QRS width. Five-year survival probability for the composite endpoints was significantly worse in patients with lower phase angle values. QTc prolongation was associated with survival in males and nondiabetic patients. Prolonged PR was associated with survival in nondiabetic patients. Discussion: Relationships between phase angle value and ECG findings were demonstrated in patients undergoing dialysis, especially in males and nondiabetic patients. Although the phase angle value has been considered as an index for evaluating nutritional status, another clinical application of phase angle value in predicting cardiac complications seems to be useful.

Serum afamin and its implications in adult growth hormone deficiency: a prospective GH-withdrawal study.

Adult growth hormone deficiency (AGHD) is associated with a high prevalence of metabolic syndrome (MS), which contributes to the unfavorable cardiovascular risk profile in these patients. Insulin like growth factor-1 (IGF-1) is a widely used biomarker, however it does not always reflect the cardiometabolic risk and has a poor relationship with clinical efficacy endpoints. Consequently, there is an unmet need for biomarkers to monitor responses to GH-replacement. Afamin is a hormone-like glycoprotein, expressed in the liver. Higher afamin levels are strongly associated with MS and insulin resistance (IR). Although both MS and IR are very common in AGHD, afamin has not been investigated in these patients. To investigate afamin as a potential biomarker in patients with AGHD. Participants included 20 AGHD patients (11 GH-substituted and 9 GH-unsubstituted) and 37 healthy controls. Subjects underwent routine laboratory examinations, anthropometric measurements, body composition analysis using multi-frequency bioelectrical impedance analysis (InBody720) and measurement of serum afamin concentrations. In GH-substituted subjects, GH-substitution was withdrawn for 2 months. Measurements were carried out right before GH-withdrawal, at the end of the 2-month withdrawal period, and 1 month after reinstituting GH-replacement therapy (GHRT). GH-unsubstituted patients demonstrated higher afamin levels compared to controls (p=0.03). Afamin positively correlated with skeletal muscle mass, bone mineral content, total body water, extracellular- and intracellular water content, insulin (all, p<0.01), HOMA-IR (p=0.01) and C-peptide (p=0.03) levels in AGHD but not in healthy controls. In GH-substituted patients 2-month of GH-withdrawal caused significant changes in body composition, including decreased fat-free mass, skeletal muscle mass, total body water, and intracellular water content (all, p<0.01); but these changes almost fully recovered 1 month after reinstituting GHRT. Unexpectedly, afamin levels decreased after GH-withdrawal (p=0.03) and increased with reinstitution (p<0.01). Changes of afamin levels during GH-withdrawal positively correlated with changes of HOMA-IR (r=0.80; p<0.01) and changes of insulin (r=0.71; p=0.02). Higher afamin levels in unsubstituted AGHD patients might indicate severe metabolic dysregulation. Significant changes accompanying GH-withdrawal and reinstitution, along with strong correlations with measures of IR, suggest that afamin could be a promising biomarker to monitor GHRT-associated changes of insulin sensitivity.

COMPARISON OF FOUR BODY COMPOSITION METHODS

BACKGROUND High-frequency (500Khz) direct segmental multifrequency bioelectrical impedance analysis (BIA) accurately calculates total water mass and body fat% (BF%), but it is unknown whether higher frequencies (1000Khz) increase measurement accuracy. PURPOSE: This study compared BIA 500Khz, BIA 1000Khz, the Department of Defense DoD Circumference Method (CM), and the reference standard DEXA. METHODS A total of 62 participants from the military healthcare system (n=25 males, 38.8±11.4yrs, n=37 females 43.7±15.95yrs) were measured. BF% was estimated via DEXA, BIA 500, BIA 1000, and CM to identify the relationship between methods using Pearson Correlation, Intraclass Correlation Coefficients, and Bland Altman Plots (p &amp;lt;.05). RESULTS CM BF% estimates displayed significant moderate correlations with BIA 500 (males r=.63, ICC=.76; females r=.77, ICC=.85), BIA 1000 (males r=.59, ICC=. 74; females r=.77, ICC=.85), and DEXA (males r=.62, ICC=.62; females r=.73, ICC=.82). BIA 500 BF% displayed significant strong correlations with BIA 1000 (males r=.99, ICC=.99; females r=.99, ICC=.99) and DEXA (males r=.93, ICC=.94; females r=.89, ICC=.89). Lastly, BIA 1000 BF% also showed a significant strong correlation DEXA (males r=.93, ICC=.94; females r=.84, ICC=.90). Evaluating proportional bias using a Bland-Altman analysis confirmed an overall mean bias of -1.72% (CM and DEXA) in the female group, indicating the tendency of DEXA to underestimate BF% compared to CM, limits of agreement from -14.24 to 10.8. There was an upward slope of .33 as the CM BF% decreased and the DEXA BF% increased. There was agreement of BF% to 32%, but after 32%, there was more dispersion from the mean and outliers and with a significant trend for a greater difference in BF% between CM and DEXA (p&amp;lt;.05). CONCLUSIONS The correlation was higher between BIA 500 and BIA 1000 to DEXA when compared to CM. There was proportional bias between DEXA and CM in the female group with CM underestimating BF% compared to DEXA.When compared to BIA methods, BF% estimated via CM methods do not correlate well with BF% from DEXA. However, it does not seem as though higher BIA frequencies better predict BF%. The views expressed in this abstract are those of the author(s) and do not necessarily reflect the official policy of the Department of Army, Navy, Defense, or any other agency of the U.S. Government, nor should any official endorsement be inferred by the Department of Defense, or the U.S. Government.

Estimation of the appendicular skeletal muscle mass and phase angle cut-off values from a young Turkish reference population using multifrequency bioelectrical impedance analysis.

Population-specific muscle mass cut-off values are recommended for the diagnosis of sarcopenia. In this study, we aimed to determine the appendicular muscle mass index (ASMI) and phase angle (PA) cut-off values for the Turkish population using multi-frequency bioelectrical impedance analysis (mBIA). A total of 250 healthy volunteers aged 18-40 years were included in the study between September 2020 and December 2021. PA was measured by mBIA, and appendicular skeletal muscle mass (ASM) was calculated by the Sergi formula using the resistance and reactance measurements from mBIA. ASMI was calculated as ASM (kg)/(height in meters)2. Two standard deviations (SD) below the mean values were accepted as cut-off points. 134 women and 116 men were included in the study (26.0±5.6 years). The ASMI cut-offs for men and women were 5.86 and 4.36 kg/m2, respectively. The PA cut-offs were 5.66° in men and 4.38° in women. The present study reported the ASMI and PA cut-off values specific to the Turkish population using the Sergi formula, which was suggested by the European Working Group on Sarcopenia in Older People (EWGSOP).

Co-Occurrence of Sarcopenia and Frailty in Acutely Admitted Older Medical Patients: Results from the Copenhagen PROTECT Study

BackgroundSarcopenia and frailty are often used interchangeably in clinical practice yet represent two distinct conditions and require different therapeutic approaches. The literature regarding the co-occurrence of both conditions in older patients is scarce as most studies have investigated the prevalence of sarcopenia and frailty separately.ObjectivesWe aim to evaluate the prevalence and co-occurrence of sarcopenia and frailty in a large sample of acutely admitted older medical patients.DesignSecondary analyses using cross-sectional data from the Copenhagen PROTECT study.SettingPatients were included from the acute medical ward at Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark, between November 2019 and November 2021.ParticipantsAcutely admitted older medical patients (≥65 years).MeasurementsHandgrip strength (HGS) was investigated using a handheld dynamometer. Lean mass (SMI) was investigated using direct-segmental multifrequency bioelectrical impedance analyses (DSM-BIA). Low HGS, low SMI, and sarcopenia were defined according to the recent definitions from the European Working Group on Sarcopenia in Older People (EWGSOP2). The Clinical Frailty Scale (CFS) was used to evaluate frailty, with a value > 5 indicating the presence of frailty. Patients were enrolled and tested within 24 hours of admission.ResultsThis study included 638 patients (mean age: 78.2±7.6, 55% female) with complete records of SMI, HGS, and the CFS. The prevalence of low HGS, low SMI, sarcopenia, and frailty were 39.0%, 33.1%, 19.7%, and 39.0%, respectively. Sarcopenia and frailty co-occurred in 12.1% of the patients.ConclusionsIt is well-known that sarcopenia and frailty represent clinical manifestations of ageing and overlap in terms of the impairment in physical function observed in both conditions. Our results demonstrate that sarcopenia and frailty do not necessarily co-occur within the older acutely admitted patient, highlighting the need for separate assessments of frailty and sarcopenia to ensure the accurate characterization of the health status of older patients.

BODY COMPOSITION USING DXA VERSUS BIA IN A MIXED COHORT OF COLLEGE STUDENTS

BACKGROUND Body composition assessment is an important clinical and research tool. Dual energy x-ray absorptiometry (DXA) is the ‘gold standard’ and useful in the research environment, however, it is expensive, reliant on a trained technician, requires a large space, and is immoveable. Bioelectrical impedance (BIA) measurements have improved with the application of 8-electrode multifrequency units and could offer faster, cheaper, and portable alternative if measurements are comparable. The purpose of this study was to determine how well bone mineral content (BMC), lean body mass (LBM), and fat mass measurements made with BIA compared to those made with DXA. METHODS 46 (36 female) college students [avg 21.2 yr, 167.2 cm, 67.2 kg, 28.9% fat; 6 Asian, 4 Hispanic, 3 Black] had their BIA and DXA whole body composition measured within minutes of each other. Three compartments were compared BIA vs DXA: BMC, fat mass, and LBM. Pearson’s correlation coefficients were determined. RESULTS Absolute fat mass (r=0.95), lean mass (r=0.98), and BMC (r=0.91) were highly correlated between the assessment methods. CONCLUSIONS A quadripolar multifrequency BIA device can be a valid body composition surrogate in research environments using college students when a DXA machine is impractical to use.w

Effect of body fat mass loss on prognosis of radical resection for pancreatic ductal adenocarcinoma based on bioelectrical impedance analysis

BackgroundFew reports have performed a prognostic analysis based on bioelectrical impedance analysis in patients with radical resection of pancreatic ductal adenocarcinoma (PDAC), and its usefulness in prognostic analysis remains unclear. This study aimed to evaluate body composition changes in patients undergoing radical resection for PDAC and analyze its impact on prognosis.MethodsThe medical records of radical resection for patients with PDAC were retrospectively reviewed, and the parameters of body composition, including body weight, skeletal muscle mass, body fat mass (BFM), and extracellular water-total body water ratio, from preoperatively to 12 months postoperatively, for each surgical procedure were measured based on direct segmental multifrequency bioelectrical impedance analysis with an InBody 770 (InBody Inc., Tokyo, Japan) device. The clinicopathological and prognostic factors were analyzed.ResultsAmong 79 patients who underwent radical resection for PDAC, 36 (46%), 7 (8%), and 36 (46%) underwent pancreatoduodenectomy, total pancreatectomy, and distal pancreatectomy, respectively. The multivariate overall survival analysis demonstrated that BFM loss percentage at 1 month postoperatively ≧14% (p = 0.021), lymph node metastasis (p = 0.014), and non-adjuvant chemotherapy (p < 0.001) were independent poor prognostic factors. Multivariate analysis revealed that preoperative BFM < 12 kg and preoperative albumin < 3.5 g/dL were independently associated with BFM loss percentage at 1 month postoperatively ≧14% (p = 0.021 and p = 0.047, respectively).ConclusionsLoss of BFM in the early postoperative period may have a poor prognosis in radical resection of PDAC.

The choice of diagnostic modality influences the proportion of low muscle strength, low muscle mass, and sarcopenia in colorectal cancer patients

Low muscle strength, low muscle mass, and sarcopenia have a negative impact on health outcomes in colorectal cancer (CRC) patients. Different diagnostic modalities are used to identify these conditions but it is unknown how well the modalities agree. The aim of this study was to compare different diagnostic modalities by means of calculating the proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients, and to investigate the agreement for sarcopenia between the various modalities. Men and women participating in the Norwegian Dietary Guidelines and colorectal cancer Survival (CRC-NORDIET) study were included in the analyses. Cut-off values for low muscle strength, low muscle mass, and sarcopenia were defined according to the second consensus set by the European Working Group on Sarcopenia in Older People (EWGSOP2). The diagnostic modalities used to assess muscle strength were handgrip strength and the sit-to-stand test. For muscle mass, computed tomography, dual-energy X-ray absorptiometry (DXA), multi-frequency bioelectrical impedance analysis (MF-BIA), and single-frequency BIA (SF-BIA) were applied. Cohen's kappa was calculated to determine the agreement for low muscle strength and confirmed sarcopenia between diagnostic modalities. Five hundred and three men and women (54% men, mean age of 66 (range 50-80) years old) were included in the analysis. As much as 99% (n=70) of the population was identified with low muscle mass by MF-BIA, while the other modalities identified 9-49% as having low muscle mass. Handgrip strength identified a lower proportion of low muscle strength as compared with the sit-to-stand test (4% vs. 8%). When applying various combinations of diagnostic modalities for low muscle strength and low muscle mass, the proportion of sarcopenia was found to be between 0.3 and 11.4%. There was relatively poor agreement between the different diagnostic modalities with Cohen's Kappa ranging from 0.0 to 0.55, except for the agreement between SF-BIASergi and MF-BIASergi, which was 1. The proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients varied considerably depending on the diagnostic modalities used. Further studies are needed to provide modality-specific cut-off values, adjusted to sex, age and body size.

Weight and Muscle Mass Loss Associated with Acute Disease Can be Reversed with Appropriate Nutrition Therapy and Exercise in a Patient with Amyotrophic Lateral Sclerosisa: A Case Report.

Introduction Nutritional interventions targeting weight loss are useful for the treatment of amyotrophic lateral sclerosis (ALS). However, the changes in body composition after nutritional intervention remain unclear. We herein present a patient with ALS who experienced an increased weight and muscle mass owing to nutritional therapy and physical exercise. Case Presentation An 86-year-old man presented with dysphagia and dysarthria. The patient was diagnosed with bulbar-type ALS. As weight loss progressed, a gastrostomy was performed. After 21 months of disease onset, gastrointestinal bleeding due to a bumper ulcer led to further weight loss (from 40.2 kg to 36.8 kg). The patient experienced difficulty walking and ingesting food orally. Although the total daily energy expenditure (TDEE) was estimated to be 1,122 kcal/day, an intake of 1,500 kcal/day beyond the calculated TDEE was administered. The patient continued to perform daily voluntary exercises in addition to his usual rehabilitation. After 5 months, his weight increased from 36.8 kg to 40.4 kg. Muscle mass increased from 25.1 kg to 30.1 kg, as measured using a multifrequency bioelectrical impedance device. Muscle strength improved from 8.5/10.0 kg to 15.0/18.0 kg in grip strength and from 15.2 kPa to 20.4 kPa in tongue pressure. The patient's physical and swallowing functions also improved. Conclusion In patients with ALS, a decreased body weight and muscle mass due to acute disease may be improved by appropriate nutritional therapy and physical exercise.

Exploring the Relationship between Physical Activity and Segmental Body Composition Parameters in Office Workers: A Multi-Frequency Bioelectrical Impedance Analysis Approach

This research aimed to determine the relationship between physical activity levels and body composition parameters in office workers. The study was carried out with 60 individuals who agreed to participate in the study and met the inclusion criteria, among the office workers who had sedentary jobs, at the Rector's Office of a university in the Eastern Region of the Republic of Turkey between June 2021 and January 2022. Informed Voluntary Consent Forms and the International Physical Activity Questionnaire were administered to participants. Body compositions were measured with the TANITA MC-780 Bioelectrical impedance device. The study found a positive relationship between lean body mass (kg), muscle mass in the right leg (kg), muscle mass in the left leg (kg), muscle mass in the right arm (kg), muscle mass in the left arm (kg), and trunk muscle (kg) with all Phase Angle (PhA) measures (p&amp;lt;0.05). Moreover, the study determined a correlation between lean mass in the right leg (kg), lean mass in the left leg (kg), lean mass in the right arm (kg), and lean mass in the left arm (kg) with vigorous activity scores (p&amp;lt;0.05). The study's results add to the existing literature on segmental body composition values in individuals with prolonged sedentary behavior.

Evaluation of Multi-Frequency Bioelectrical Impedance Analysis against Dual-Energy X-ray Absorptiometry for Estimation of Low Muscle Mass in Older Hospitalized Patients.

The accuracy of multi-frequency (MF) bioelectrical impedance analysis (BIA) to estimate low muscle mass in older hospitalized patients remains unclear. This study aimed to describe the ability of MF-BIA to identify low muscle mass as proposed by The Global Leadership Initiative on Malnutrition (GLIM) and The European Working Group on Sarcopenia in Older People (EWGSOP-2) and examine the association between muscle mass, dehydration, malnutrition, and poor appetite in older hospitalized patients. In this prospective exploratory cohort study, low muscle mass was estimated with MF-BIA against dual-energy X-ray absorptiometry (DXA) in 42 older hospitalized adults (≥65 years). The primary variable for muscle mass was appendicular skeletal muscle mass (ASM), and secondary variables were appendicular skeletal muscle mass index (ASMI) and fat-free mass index (FFMI). Cut-off values for low muscle mass were based on recommendations by GLIM and EWGSOP-2. MF-BIA was evaluated against DXA on the ability to estimate absolute values of muscle mass by mean bias, limits of agreement (LOA), and accuracy (5% and 10% levels). Agreement between MF-BIA and DXA to identify low muscle mass was evaluated with sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV). The association between muscle mass, dehydration, malnutrition, and poor appetite was visually examined with boxplots. MF-BIA overestimated absolute values of ASM with a mean bias of 0.63 kg (CI: -0.20:1.46, LOA: -4.61:5.87). Agreement between MF-BIA and DXA measures of ASM showed a sensitivity of 86%, specificity of 94%, PPV of 75% and NPV of 97%. Boxplots indicate that ASM is lower in patients with malnutrition. This was not observed in patients with poor appetite. We observed a tendency toward higher ASM in patients with dehydration. Estimation of absolute ASM values with MF-BIA should be interpreted with caution, but MF-BIA might identify low muscle mass in older hospitalized patients.

Association between fat-free mass and survival in critically ill patients with COVID-19: A prospective cohort study.

Most critically ill patients with COVID-19 experience malnutrition and weight loss associated with negative clinical outcomes. Our primary aim was to assess body composition during acute and late phase of illness in these patients in relation to clinical outcome and secondary to tailored nutrition support. This prospective cohort study included adult critically ill patients with COVID-19. Body composition (fat-free mass [FFM] [exposure of interest], fat mass [FM], skeletal muscle mass [SMM], and phase angle [PA]) was determined with multifrequency bioelectrical impedance analyses in the acute and late phase. Nutrition support data were collected simultaneously. Clinical outcome was defined as intensive care unit (ICU) survival (primary outcome) and 30-90 days thereafter, duration of mechanical ventilation, and length of ICU stay and length of hospital stay (LOS). Nonparametric tests and regression analyses were performed. We included 70 patients (73% male, median age 60 years). Upon admission, median BMI was 30 kg/m2 , 54% had obesity (BMI > 30 kg/m2 ). Median weight change during ICU stay was -3 kg: +3 kg FM and -6 kg FFM (-4 kg SMM). Body composition changed significantly (P < 0.001). Regarding clinical outcome, only low PA was associated with prolonged LOS (odds ratio = 0.83, 95% CI = 0.72-0.96; P = 0.015). Patients with optimal protein intake (>80%) during acute phase maintained significantly more FFM (2.7 kg, P = 0.047) in the late phase compared with patients who received <80%. FFM decreased significantly during acute and late phase of illness, but we observed no association with ICU survival. Only low PA was associated with prolonged LOS. FFM wasting likely occurred because of disease severity and immobility.

Sedentary Behavior and Phase Angle: An Objective Assessment in Physically Active and Inactive Older Adults.

The purpose of the present study was to investigate the associations of the objectively assessed total sedentary behavior (SB) amount and SB patterns with phase angle (PhA) in older populations and to conduct a comparison analysis for those who are physically active (meet 150 min/week) and inactive (less than 150 min/week). During May to August 2023, a convenience sampling was used to recruit older adults (aged ≥ 65 years) living in a community in Taiwan. The total SB amount (minutes/day), SB patterns (including SB bouts and breaks), and physical activity were assessed by a triaxial accelerometer. A multifrequency bioelectrical impedance analyzer (BIA) was used to measure PhA. Multiple linear regression analysis was employed to examine the associations between SB and PhA in the total number of participants and stratified in the physically active and inactive groups. For the whole sample (n = 166; mean age: 72.1 ± 5.5 years), the total SB amount and patterns of SB were not associated with PhA. For those physically active, the total SB amount and SB patterns were not associated with PhA. Among those physically inactive, the total SB amount was negatively related to PhA (B: -0.059, 95% CI: -0.118, 0.000). This study underscores the importance of minimizing the total SB amount in physically inactive older adults, providing evidence for future interventions targeting SB and PhA in this population.