Normal Weight Obese Syndrome Research Articles

A cross-sectional study of the relationship between normal weight obesity and metabolic syndrome in older Korean adults

A cross-sectional study of the relationship between normal weight obesity and metabolic syndrome in older Korean adults

Normal-Weight Obesity and Metabolic Syndrome in Korean Adults: A Population-Based Cross-Sectional Study.

The disadvantage of using body mass index (BMI) as an obesity diagnostic tool is that it cannot distinguish between fat mass and lean mass, which may understate the impact of obesity on metabolic complications. This population-based cross-sectional study aimed to investigate the relationship between normal-weight obesity (NWO) and metabolic syndrome in Korean adults aged 20 years (5962 males and 6558 females) who took part in the Korea National Health and Nutrition Examination Surveys from 2008 to 2011. NWO was defined as having a BMI of 18.5 to 24.9 kg/m2 and a body fat percentage of 26.0% in males or 36.0% in females. Metabolic syndrome (MetS) was defined using the revised National Cholesterol Education Program definition, with a Korean-specific waist circumference threshold of >90 cm for males and >85 cm for females. NWO males and females were 2.7 times (p < 0.001) and 1.9 times (p < 0.001) more likely to develop metabolic syndrome than normal-weight non-obese males and females, respectively. Additionally, NWO females were 1.3 times (p = 0.027) more likely to develop MetS even after adjustments for all measured covariates. The current findings of the study show that NWO is a proxy biomarker of MetS to be considered for early intervention.

Investigating the Relationships of Adipokines and Cardiovascular Disease Risk Factors with Normal-Weight Obesity Syndrome Among Women

Background: Normal weight obesity (NWO), known as a syndrome, is characterized by normal weight and body mass index (BMI) but high adipose tissue (more than 30%). Objectives: The present study was conducted to investigate the relationship between adipokines and lipid factors as risk factors in cardiovascular diseases (CVDs) and NWO syndrome in women. Methods: In this case-control study, anthropometric data were obtained from 20 - 40-year-old women referring to nutrition and diet clinics in Ahvaz, Iran. Then, based on the inclusion criteria, including normal BMI and no physical or mental illness, the subjects were divided into the NWO (body fat percentage (BF%) &gt; 30) group and the non-NWO (BF% &lt; 30) group depending on their BF%. Twenty blood samples were taken from each group, and their chemerin and adipokine serum levels were measured using both the enzyme-linked immunosorbent assay (ELISA) method with high sensitivity and the sandwich and competitive ELISA techniques. Results: The serum levels of adipokine chemerin and IL-1α, IL-1β, IL-6, and tumor necrosis factor alpha (TNF-α), as well as the serum concentrations of triglyceride (TG), low-density lipoprotein (LDL), and total cholesterol, were significantly higher in the NWO group than in the control group (P &lt; 0.05). Conclusions: The findings of this study indicated a significant correlation between chemerin, adipokines, and lipid factors, as CVD risk factors, and NWO syndrome and fat tissue percentages in women. Therefore, fat tissue measurement is recommended as a more accurate index than BMI in predicting CVDs.

Bone mineral density and normal-weight obesity syndrome: beyond body weight and body mass index.

This study aimed to evaluate, for the first time, the bone profile of adult women and men with and without normal-weight obesity (NWO) syndrome and its association with bone health-related nutrient intake, anthropometry, and body composition. This was a cross-sectional study of adults aged between 20 and 59years with normal body weight, separated according to body fat (BF) percentage into NWO and non-NWO syndrome groups. BF > 30% and > 19% were considered high for women and men, respectively. Socioeconomic, physical activity, food consumption, anthropometric, and body composition data were evaluated. Student's t-test or Mann-Whitney test and Pearson's χ2 or Fisher's exact tests were applied for comparisons. Multiple linear regression models were developed, with bone parameters as the dependent variables and anthropometric, body composition, and food consumption data as the main independent variables. The sample consisted of 224 adults (69.2% women) with a median (interquartile range) age of 23 (21-25) years, 71% of whom had NWO syndrome. Compared with women, a higher percentage of men had a lower-than-expected spinal bone mineral density (BMD) Z-score for age (10%; p = 0.0214). Bone parameters were similar between groups. Spinal BMD was negatively associated with male sex and positively associated with body weight. The femoral BMD was negatively associated with BF percentage and positively associated with body mass index. The negative association of BMD with BF percentage may suggest a higher risk of bone alterations in individuals with NWO syndrome and should be monitored over time.

The Risk of Sarcopenia among Adults with Normal-Weight Obesity in a Nutritional Management Setting.

Normal-weight obesity (NWO) is a phenotype characterized by excessive body fat (BF) despite normal body weight. We aimed to assess the association between NWO and the risk of sarcopenia. Two groups of patients with a normal body mass index [BMI (20-24.9 kg/m2)] were selected from a large cohort of participants. Body composition was measured using dual-energy X-ray absorptiometry (DXA), and 748 participants were categorized as NWO or normal-weight without obesity (NWNO) and were classed according to whether or not they were at risk of sarcopenia. The "NWO group" included 374 participants (cases), compared to 374 participants (controls) in the "NWNO group", all of a similar BMI, age and gender. The participants in the "NWO group" displayed a higher prevalence of the risk of sarcopenia than the control group across both genders (0.6% vs. 14.1% in males; 1.4% vs. 36.5% in females). Regression analysis showed that being in the NWO category increased the risk of sarcopenia 22-fold in males (RR = 22.27; 95%CI: 3.35-147.98) and 25-fold in females (RR = 25.22; 95%CI: 8.12-78.36), compared to those in the NWNO category. In a "real-world" nutritional setting, the assessment of body composition to identify NWO syndrome is vital since it is also associated with a higher risk of sarcopenia.

Polymorphism PLIN1 11482 G>A interacts with dietary intake to modulate anthropometric measures and lipid profile in adults with normal-weight obesity syndrome.

Evidence shows that genetic polymorphisms in perilipin 1 gene (PLIN1) are associated with excessive accumulation of body fat and disturbances in cardiometabolic markers. Therefore, the aim of this study was to verify whether the SNP PLIN1 11482 G>A (rs894160) interacts with nutrient intake, anthropometric, body composition and cardiometabolic markers in adults with normal-weight obesity (NWO) syndrome. A cross-sectional study was carried out with 116 individuals aged 20-59 years, with normal BMI and high percentage of body fat. Anthropometric and body composition measures, glycaemic control and serum lipid markers, SNP PLIN1 11482 G>A and nutrient intake were evaluated. Interactions between nutrient intake and the SNP were determined by regression models and adjusted for potential confounders. The SNP frequency was 56·0 % GG, 38·8 % GA and 5·2 % AA. Anthropometric measures and biochemical markers were not different according to genotype, except for total cholesterol (TC), LDL-cholesterol and non-HDL-cholesterol concentrations. However, important interactions between the SNP and dietary intake were observed. Carbohydrate intake interacted with the SNP PLIN1 11482 G>A to modulate waist circumference (WC) and the homeostatic model assessment of insulin resistance index. Interaction of lipid intake and the SNP modulated TC and LDL-cholesterol concentrations, and the interaction between protein intake and the SNP tended to modulate weight, WC and BMI. The SNP PLIN1 11482 G>A seems to modulate responses in anthropometric and lipid profile biomarkers of subjects with NWO depending on the dietary macronutrient composition, which may have long-term impact on cardiometabolic markers.

Selenium Intake and Glycemic Control in Young Adults With Normal-Weight Obesity Syndrome.

Numerous endogenous functions related to antioxidant processes, reproduction, and thyroid metabolism, as well as actions related to glycemic control, have been attributed to selenium. This study aimed to evaluate whether dietary selenium consumption is associated with variables of glycemic control in a sample of young Brazilian adults with Normal-Weight Obesity (NWO) syndrome. This was a cross-sectional study that evaluated 270 individuals with adequate body weight and excess body fat, who had their body composition assessed by dual-energy X-ray absorptiometry. Socioeconomic, health, and lifestyle questionnaires and three 24-h food records were applied. Glycemic control markers were also evaluated. The prevalence of inadequate selenium intake was analyzed by the Estimated Average Requirement (EAR) cut-point method. The prevalence of disturbances in glycemic control markers according to selenium consumption was compared by either the chi-square or the Fisher's exact test, with individuals classified according to the EAR values for selenium. The associations were evaluated by multiple linear regressions, using the backward strategy. The mean ± standard deviation (SD) age was 23.7 ± 3.3 years, and the mean ± SD daily selenium intake was 59.2 ± 26.4 μg. The overall prevalence of inadequate selenium intake was 59.2%. Individuals with selenium intakes below the EAR (≤45 μg/day) showed higher concentrations of glycated hemoglobin (HbA1c) (P = 0.002) and a higher prevalence of disturbances in HbA1c than those with selenium intakes above the EAR (>45 μg/day) (P = 0.001). Dietary selenium intake was directly associated with female sex (β = 19.95, 95% CI 5.00 to 34.89; P = 0.001) and weight (β = 6.69, 95% CI 0.56 to 12.81; P = 0.010), and inversely associated with the percentage of total body fat (β = −0.80, 95% CI −1.56 to −0,04; P = 0.010) and HbA1c (β = −7.41, 95% CI −13.06 to −1.75; P = 0.010). Considering the noticeable young age of the individuals evaluated and the high frequency of disturbances in HbA1c concentrations in those with selenium consumption below the recommendation, it is suggested that adequate dietary intake or supplementation of this micronutrient should be guaranteed to prevent future possible complications associated with glycemic control disturbances.

The effect of 12 weeks of euenergetic high-protein diet in regulating appetite and body composition of women with normal-weight obesity: a randomised controlled trial.

Normal-weight obesity (NWO) syndrome is associated with metabolic diseases. The present study aimed to investigate the effects of 12 weeks of a high-protein (HP) v. a standard protein (SP) diet on appetite, anthropometry and body composition in NWO women. In this clinical trial, fifty NWO women were randomly allocated to HP (n 25) or SP (n 25) diet groups. Women in the HP and SP groups consumed 25 and 15 % of their total energy intake from protein for 12 weeks. Weight, fat mass (FM), lean body mass (LBM), waist circumference (WC) and appetite were evaluated at baseline and following their 3-month intervention. After 12 weeks, the LBM was higher in HP compared with no significant changes in the SP group (mean between-group difference = 1·5 kg; 95 % CI 3·1, 0·01; effect size (d) = 0·4). Furthermore, the HP group had lower FM (mean between-group difference -1·1 kg; 95 % CI 1, -3·3; d = -0·2), body fat percentage (BFP) (mean between-group difference -2 %; 95 % CI 0·7, -5·2; d = -0·3) and WC (mean between-group difference -1·4 cm; 95 % CI 0·6, -3·6; d = -0·2) at the end of the study in comparison with the SP group. In both groups, weight and appetite were unchanged over time without significant differences between groups. Twelve weeks of euenergetic diets with different dietary protein contents resulted in no significant weight loss in women with NWO. However, an HP diet significantly improved body composition (LBM, FM, BFP and WC) in this population.

Normal-Weight Obesity Is Associated with Poorer Cardiometabolic Profile and Lower Physical Fitness Levels in Children and Adolescents.

Normal-weight obesity (NWO) syndrome has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in Latin American children and adolescents. The aim of this study was two-fold: (i) to investigate whether Colombian youth with NWO syndrome have a poorer cardiometabolic profile and physical fitness performance than normal-weight lean (NWL) peers; and (ii) to determine if physical fitness levels are related to prevalence of normal-weight obesity in youth. This was an analytical cross-sectional study of 1919 youths (9–179 years old, 53.0% girls) in the capital area of Colombia. NWO was defined as a body mass index < 25 kg/m2 and a validated body fat percentage above the sex-age-specific 90th percentile for Colombian children and adolescents. Body fat was estimated using bioelectrical impedance analysis, cardiorespiratory fitness (CRF) was estimated using the 20-meter shuttle run test, and muscular fitness with the handgrip test. Biochemical profile blood samples were collected for cardiometabolic risk factors. After adjusting for chronological age, pubertal stage, and Mediterranean diet adherence, the NWO group (boys and girls) had significantly higher values for cardiometabolic risk factors, and waist circumference (WC) than the NWL group. The prevalence of NWO was lower in youth classified with healthy CRF (boys, odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.37 to 0.78; girls, OR = 0.35, 95% CI 0.24 to 0.50), p < 0.001. Our findings indicate that using only body mass index for the assessment of cardiometabolic risk likely misrepresents true adiposity and suggest the need to include the assessment of body fat in the routine clinical evaluation of individuals during childhood and adolescence.

Anthropometric, body composition, and somatotype characteristics of Japanese young women: Implications for normal-weight obesity syndrome and sarcopenia diagnosis criteria.

AimsThe purpose of this study was to examine the anthropometric, body composition, and somatotype characteristics of Japanese young women and to focus on normal-weight obesity syndrome and sarcopenia diagnosis criteria.MethodsA total of 124 Japanese university freshmen women were measured at body mass index (BMI), percent body fat and skeletal muscle index (SMI), usual gait test, and handgrip strength. The subjects were divided into obesity (≥30% body fat; BMI: ≥25.0 kg/m2), normal-weight obesity (≥30% body fat; BMI: 18.5–24.9 kg/m2), sarcopenia (handgrip, <18 kg; gait speed: ≤0.8 m/s; SMI: <5.7 kg/m2), or presarcopenia (SMI: <5.7 kg/m2). There were no subjects below the sarcopenia diagnosis criteria in usual gait speed, but not for handgrip (0.8%) and SMI (36.3%).ResultsThe prevalence of presarcopenia group (36.3%) is higher than in the normal-weight obesity (16.9%) and obesity (4.8%) groups. Anthropometry and sarcopenia diagnosis assessments were significantly higher in normal-weight obesity and standard groups compared with presarcopenia group.DiscussionThe number of young women was higher in the presarcopenia group than in the normal-weight obesity group, suggesting that the improvement of intrinsic skeletal muscle mass rather than fat mass is important for Japanese young women.

Dietary and Biochemical Characteristics Associated with Normal-Weight Obesity.

Background: Inflammation and oxidative stress have been reported to be higher in subjects with normal weight obesity (NWO) syndrome [normal body mass index (BMI) (<25kg/m2) but excessive body fat (for women≥30% and for men≥20%) according to World Health Organization (WHO) definitions]; however, it is unclear whether this is due to inadequate dietary antioxidant intake or the pathophysiology of NWO. The aim of present study was to assess the association between dietary factors and body antioxidant status with NWO syndrome in male university students. Methods: This study was a case-control study carried out on ninety age-matched male university students [30 normal weights (NW), 30 NWO and 30 overweight-obese (OB)]. A validated food frequency questionnaire (98 items) and 3-day 24-h recalls were used for dietary assessment. Total antioxidant capacity (TAC) of diet and serum and high-sensitive C-reactive protein (hs-CRP) concentrations were also measured. Results: Dietary intake of fruits (frequency factor (FF)=2.3 vs 2.9, p<0.05), legumes (FF=0.7 vs 1.3, p<0.01), nuts and seeds (FF=0.4 vs 0.8, p<0.05), beta-cryptoxanthin (p<0.05), lycopene (p<0.05) and serum TAC levels (p<0.01) were significantly lower in NWO compared to the NW group. No significant differences in these parameters were observed between NWO and OB group. A significant negative correlation was observed between serum TAC levels and BMI (r=-0.57, p<0.001) and body fat percent (r=-0.52, p<0.001). Conclusions: This study shows that NWO male subjects consume lower amounts of dietary antioxidants and share the same low body antioxidant status as obese individuals, although they appear lean.

Relationship between Normal Weight Obesity and Metabolic Syndrome Risk in Community-dwelling People aged 65–74 Years

Relationship between Normal Weight Obesity and Metabolic Syndrome Risk in Community-dwelling People aged 65–74 Years

Can Chronic Probiotic Intake Modulate Psychological Profile, Gut Microbiota and Body Composition of Women Affected by Normal Weight Obese Syndrome and Obesity? A Double-Blind Randomized Clinical Trial

Background: Evidence of probiotics effects on gut function, brain activity and emotional behaviour were provided. Aim: Given the link between gut microbiota, body composition, and the risk of psychiatric illness, we investigated whether chronic probiotic intake could modulate psychological state, eating behavior, and body composition of normal weight obese (NWO) and preobese-obese (PreOB/OB) compared to normal weight lean women (NWL). Methods: 60 women were enrolled. We categorized the subjects according to BMI, and % of total body fat (TBFat) into three groups: NWL, (BMI 2, %TBFat2, %TBFat ≥30); PreOB/OB, (BMI ≥25 kg/m2, %TBFat ≥30). At baseline and after 4 week of a probiotic oral suspension (POS) intake all subjects underwent to: anthropometric evaluation (body weight, height, waist and hip circumferences); body composition by dual X-ray absorptiometry (DXA); gut microbiota evaluation by Glucose Breath Hydrogen test (GHBT). Moreover, all patients were also assessed by means of self-report questionnaries (i.e. Eating Disorder Inventory, Beck Depression Inventory, State and Trait Anxiety inventory, and Body Uneasiness Test). POS contained Streptococcus thermophilus, Bifidobacterium animalis subsp Lactis, Streptococcus thermophiles, Lactobacillus bulgaricus, Lactococcus lactis subsp Lactis, Lactobacillus acidophilus, Lactobacillus Plantarum, Lactobacillus Reuteri (1.5 ×1010 colony-forming unit CFU for each/day). Multivariate of interest analyses, Pearson or Spearman's rank correlation, and Partial Least Squares (PLS) were performed. Trial Registraton: ClinicalTrials.gov Id: NCT01890070. Results: Of the 60 women initially recruited, 8 did not meet inclusion criteria, 4 dropped out of the study voluntarily. We found a 22% of NWO, 26% of NWL, and 48% of PreOB/OB women. Significant differences (p). Conclusion: Four-week intake of selected probiotic, by modulating body composition, bacterial contamination, psychopathological scores and eating behavior of women affected by NWO syndrome and obesity, offers a tractable approach to problems related to obesity, psychological state and unhealthy eating. Further research is needed on a larger population and for longer period of treatment before definitive conclusions can be made.Table: Table. Results of lactulose breath testTable: Table. Symptoms in patients before and after therapy

APOE genotype associates with food consumption and body composition to predict dyslipidaemia in Brazilian adults with normal-weight obesity syndrome

Normal-Weight Obesity Syndrome has been characterized by a normal body mass index and high percentage of body fat. It is associated with an increased risk of cardiovascular disease development. This study aimed to evaluate whether apolipoprotein E (APOE) genotypes and food consumption are related to the lipid profiles of adults with Normal-Weight Obesity Syndrome. Analytical cross-sectional study, including adults with Normal-Weight Obesity Syndrome. Socioeconomic, health and lifestyle questionnaires were administered. Anthropometric variables, body composition and blood pressure were evaluated. Dietary intake, lipid profile and genotyping of polymorphisms rs7412 and rs429358 in the APOE gene were evaluated. Only 6.0% of women and none of the men had increased waist circumference (≥80cm for women and ≥94cm for men). No women and 6.2% of men had altered blood pressure (systolic blood pressure ≥130mmHg and/or diastolic blood pressure ≥85mmHg). When the traditional lipid profile was assessed, 52.5% of individuals presented dyslipidaemia. When the levels of apolipoproteins A1 and B were included, the prevalence was 73.0%. Regression analysis showed a positive relationship between the presence of allele ε2 and apolipoprotein A1 levels (95% CI=4.2 to 38.3; p=0.015) and between the ε4 allele and apolipoprotein B (ε4 versus ε2: 95% CI=0.08 to 29.5; p=0.049 and ε4 versus ε3: 95% CI=0.6 to 17.6; p=0.036). Carriers of the ε2 allele had a 75.0% lower probability of presenting dyslipidaemia compared with ε3ε3 individuals (95% CI=0.04 to 0.8; p=0.027). Relationships between body fat, food consumption and lipid profile were observed and differed among genotypes. APOE genotype and food consumption were associated with lipid profile. This was the first study to evaluate the APOE genotype and to analyze relationships between genetic profile, food intake and lipid profile of subjects with Normal-Weight Obesity Syndrome.

Can psychobiotics intake modulate psychological profile and body composition of women affected by normal weight obese syndrome and obesity? A double blind randomized clinical trial

BackgroundEvidence of probiotics effects on gut function, brain activity and emotional behaviour were provided. Probiotics can have dramatic effects on behaviour through the microbiome–gut–brain axis, through vagus nerve. We investigated whether chronic probiotic intake could modulate psychological state, eating behaviour and body composition of normal weight obese (NWO) and preobese–obese (PreOB/OB) compared to normal weight lean women (NWL).Methods60 women were enrolled. At baseline and after a 3-week probiotic oral suspension (POS) intake, all subjects underwent evaluation of body composition by anthropometry and dual X-ray absorptiometry, and psychological profile assessment by self-report questionnaires (i.e. EDI-2, SCL90R and BUT). Statistical analysis was carried out using paired t test or a non-parametric Wilcoxon test to evaluate differences between baseline and after POS intake, one-way ANOVA to compare all three groups and, where applicable, Chi square or t test were used to assess symptoms.ResultsOf the 48 women that concluded the study, 24% were NWO, 26% were NWL and 50% were PreOB/OB. Significant differences in body composition were highlighted among groups both at baseline and after a POS (p < 0.05). After POS intake, a significant reduction of BMI, resistance, FM (kg and %) (p < 0.05), and a significant increase of FFM (kg and %) (p < 0.05) were observed in all subjects in NOW and PreOB/OB. After POS intake, reduction of bacterial overgrowth syndrome (p < 0.05) and lower psychopathological scores (p < 0.05) were observed in NWO and PreOB/OB women. At baseline and after POS intake, all subjects tested were negative to SCL90R_GSI scale, but after treatment subjects positive to BUT_GSI scale were significantly reduced (8.33%) (p < 0.05) compared to the baseline (33.30%). In NWO and PreOB/OB groups significant differences (p < 0.05) in response to the subscales of the EDI-2 were observed. Significant improvement of the orocecal transit time was observed (p < 0.05) after POS intake. Furthermore, significant differences were observed for meteorism (p < 0.05) and defecation frequency (p < 0.05).ConclusionsA 3-week intake of selected psychobiotics modulated body composition, bacterial contamination, psychopathological scores of NWO and PreOB/OB women. Further research is needed on a larger population and for a longer period of treatment before definitive conclusions can be made.Trial registration ClinicalTrials.gov Id: NCT01890070

Normal-weight obesity syndrome: diagnosis, prevalence, and clinical implications.

The growing concern about the impact of overweight on health has led to studies that shed light on types of obesity other than the classic model based on body mass index. Normal-weight obesity syndrome is characterized by excess body fat in individuals with adequate body mass index (18.5-24.9 kg/m(2)). This condition increases the risk of cardiovascular morbidity and mortality and other conditions associated with chronic diseases, such as insulin resistance, hypertension, and dyslipidemia. The aims of this review are to define the diagnostic criteria for normal-weight obesity syndrome and to examine the risks associated with this condition in order to promote preventive measures and early treatment for affected individuals.

Circuit resistance training in women with normal weight obesity syndrome: body composition, cardiometabolic and echocardiographic parameters, and cardiovascular and skeletal muscle fitness.

Normal weight obesity (NWO) syndrome has been characterized in subjects with normal Body Mass Index (BMI) and high body fat mass percentage (BF%>30 for women) being a risk factor for cardiometabolic dysregulation and cardiovascular mortality. This study evaluated whether circuit resistance training (CRT) improves body composition, heart size and function, cardiometabolic parameters, and cardiorespiratory, cardiovascular and skeletal muscle fitness in women with NWO. Data are means (95% Confidence Interval). Twenty-three women participated: 10 NWO-CRT (baseline: BMI=22.4 [21.4-23.3] kg/m2; BF%=44.5 [41.0-48.0]%) performed CRT; and 13 untrained NWO-control (baseline: BMI=21.7 [20.8-22.7] kg/m2; BF%=37.8 [34.6-41.1]%). At baseline and after 10 weeks were performed/measured dual-energy X-ray absorptiometry, echocardiography, blood tests, arterial pressure, exercise testing, and total-overload-by-training-session (TOL). At baseline, the NWO-CRT exhibited larger BF (27.28 [23.9-30.6] kg) than NWO-control (22.41 [19.5-25.3] kg) (P=0.0227). After training, NWO-CRT: reduced 8 kg of BF (P=0.000002); became BF% lower than NWO-control (33.1 [30.1-36.0] <37.0 [34.3-39.6]%, P=0.0423), with 30% of NWO-CRT subjects becoming without-obesity; reduced 3 kg in trunk fat mass (P=0.000005); showed fasting glucose (72.8 [69.4-76.2] mg/dL) smaller than NWO-control (81.7 [78.6-84.8] mg/dL) (P=0.004); increased TOL (5087.5 [4142.5-6032.5] to 6963.3 [6226.4-7700.2] rep.kg, P=0.0004); increased load at VO2peak (122.5 [106.8-138.2] to 137.5 [118.18-156.82] W, P=0.0051); reduced double product/load at VO2peak ratio (277.4 [222.1-332.8] to 237.7 [194.2-281.2] mmHg.bpm/W, P=0.0015); and increased left ventricular mass/body surface area ratio (84.29 [78.98-89.6] to 90.29 [81.45-99.12] g/m2, P=0.0215). CRT reduced BF% and generated cardiometabolic, cardiac, skeletal muscle and cardiovascular benefits, being a useful strategy to combat the normal weight obesity syndrome in women.

Role of body composition and metabolic profile in Barrett's oesophagus and progression to cancer.

Background and aimsThe aim of this study was to evaluate the risk for Barrett’s oesophagus (BE) on the basis of body composition, metabolic pathways, adipokines and metabolic syndrome (MS), as well as their role in cancer progression.MethodsIn patients with and without BE at gastroscopy, data on MS, BMI, waist/hip ratio for abdominal obesity (AO) and body fat percentage by bioimpedance were obtained. Fasting plasma glucose, insulin, HbA1c, lipid, serum adiponectin and leptin levels were measured. The homoeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. Histological findings for BE were correlated with the above parameters. Risk factors for BE identified using univariate analysis were entered into a multivariate logistic regression analysis.ResultsA total of 250 patients and 224 controls (F/M: 189/285, mean age 58.08±15.51 years) were enroled. In the BE and control groups, 39.6 versus 31.3% were overweight, 32 versus 22.8% were obese, 75.6 versus 51.3% had AO, and 28.1 versus 18.9% were metabolically obese, respectively. AO [odds ratio (OR) 3.08], increased body fat percentage (OR 2.29), and higher BMI (overweight: OR 2.04; obese: OR 2.26) were significantly associated with BE. A positive trend was found in Normal Weight Obese Syndrome (OR 1.69). MS was associated with BE (overweight: OR 3.05; obese: OR 5.2; AO: OR 8.08). Insulin levels (P=0.05) and HOMA-IR (P<0.001) were higher in BE. AO was the only independent risk factor associated with BE (OR 1.65; P=0.02) and high-grade dysplasia (OR 2.44) on multivariate analysis.ConclusionAO was strongly associated with BE and dysplasia. BE was associated with MS and higher insulin/HOMA-IR, suggesting the activation of specific metabolic pathways in patients with altered body composition.

Association of body composition and eating behavior in the normal weight obese syndrome.

Our aim was to identify psychological and behavioral characteristics of women affected by normal weight obese (NWO) syndrome. Anthropometric, body composition, eating behavior and physical activity were evaluated in 79 women. 48.10 % of the subjects were found to be normalweight obese (NWO), 22.79% normalweight lean (NWL), and 29.11 % pre-obese-obese (PreOB/OB) according to BMI and body composition. Significant differences (p<0.001) among the groups were identified on analysis of the subscales of the Eating Disorder Inventory-2 (EDI-2), suggesting progressively increased presence of psychopathology relative to body composition. In a further analysis, results of the subscales of the EDI-2 were compared with body composition parameters, revealing that BMI co-varied with body composition variables and psychological responses. %TBFat co-varied exclusively with body composition variables (height, weight, BMI, KgTBFat, and a decrease of KgTBLean (R (2)=0.96; Q (2)=0.94). The NWO was discriminated from PreOB/OB group (compared to BMI) only on the basis of body composition variables (R (2)=0.68; Q (2)=0.60). NWO women appeared to find themselves at a cognitive crossroads, attaining intermediate scores on the EDI-2 between normal weight lean women and pre-obese or obese women, in particular in terms of drive for thinness and body dissatisfaction. The NWO syndrome not only conveys an increased risk of cardiovascular and metabolic disease, but may also significantly overlap with other eating disorders in terms of psychological symptomatology, the correct identification of which may be the key in the successful management of these patients. ClinicalTrials.gov NCT01890070.

Dietary and lifestyle characteristics associated with normal-weight obesity: the National FINRISK 2007 Study

The aim of the present study was to compare the lifestyle (leisure-time physical activity, smoking habits and alcohol consumption) and dietary (energy-yielding nutrients, dietary fibre and foods) factors of Finns with a new syndrome called normal-weight obesity (NWO) with those of lean and overweight Finns. The representative population-based study included 4786 participants (25-74 years) from the National FINRISK 2007 Study with a health examination and questionnaires. Food intake was assessed using a validated FFQ. NWO was defined to include those with a normal BMI (<25 kg/m²) but excessive body fat (for men ≥20 % and for women ≥30 %) according to WHO definitions. The proportion of participants with a normal BMI was 28 % in men and 42 % in women. Of these, 34 % of the men and 45 % of the women had the NWO syndrome (among all the participants, 10 and 19 %, respectively). The waist circumference of the NWO participants was between that of the lean and overweight participants. Some potential risk factors, such as physical inactivity, (ex)-smoking and alcohol consumption, were related to NWO. In general, the intakes of energy-yielding nutrients were not associated with NWO. Instead, some healthy dietary factors (e.g. low intakes of meat and soft drinks) as well as unhealthy factors (e.g. low intakes of root vegetables, cereals and fish and high intake of confectionery) were related to NWO. The findings might explain why the NWO participants were of normal weight, but had an excessive body fat percentage. In conclusion, the proportion of normal-weight participants with an excessive body fat percentage was surprisingly high. The identification of NWO people may be of importance because although they appear lean, they have some unhealthy lifestyle and dietary habits related to obesity and overall health.