Mass Percent Body Fat Research Articles

Macronutrient intake during pregnancy in women with a history of obesity or gestational diabetes and offspring adiposity at 5 years of age

Background/objectivesThe impact of maternal macronutrient intake during pregnancy on offspring childhood adiposity is unclear. We assessed the associations between maternal macronutrient intake during and after pregnancy with offspring adiposity at 5 years of age. Additionally, we investigated whether gestational diabetes (GDM), BMI, or breastfeeding modified these associations.Subjects/methodsAltogether, 301 mother–child dyads with maternal prepregnancy BMI ≥ 30 and/or previous GDM participated in the Finnish Gestational Diabetes Prevention Study (RADIEL) and its 5 years follow-up. Macronutrient intakes (E%) were calculated from 3-day food records collected at 5–18 weeks’ gestation, in the third trimester, and at 12 months and 5 years after pregnancy. Offspring body fat mass (BFM) and fat percentage (BF%) at 5 years were measured by bioimpedance. Statistical analyses were multivariate linear regression.ResultsMean (SD) prepregnancy BMI was 33(4) kg/m2. GDM was diagnosed in 47%. In normoglycemic women, higher first half of pregnancy n-3 PUFA intake was associated with lower offspring BFM (g) (ß −0.90; 95% CI −1.62, −0.18) and BF% (ß −3.45; 95% CI −6.17, −0.72). In women with GDM, higher first half of pregnancy n-3 PUFA intake was associated with higher offspring BFM (ß 0.94; 95% CI 0.14, 1.75) and BF% (ß 3.21; 95% CI 0.43, 5.99). Higher SFA intake in the third trimester and cumulative intake across pregnancy (mean of the first half and late pregnancy) was associated with higher BFM and BF% (across pregnancy: ß 0.12; 95% CI 0.03, 0.20 and ß 0.44; 95% CI 0.15, 0.73, respectively). Higher carbohydrate intake across pregnancy was associated with lower BFM (ß −0.044; 95% CI −0.086, −0.003), and borderline associated with BF% (ß −0.15; 95% CI −0.31, 0.00).ConclusionsThe macronutrient composition of maternal diet during pregnancy is associated with offspring BFM and BF% at 5 years. GDM modifies the association between prenatal n-3 PUFA intake and offspring anthropometrics.

Change in appendicular lean mass in patients established on peritoneal dialysis as measured by dual x-ray absorptiometry (DXA) scanning.

Peritoneal dialysis (PD) patients are at increased risk of malnutrition and cachexia, definitions of which include weight loss. However, PD patients can absorb glucose from the dialysate and loss of muscle mass may be overlooked by fat weight gain. As such, we wished to review changes in body composition in prevalent PD patients. We compared changes in body composition measured by dual x-ray absorptiometry (DXA) in adult PD patients, and calculated glucose absorption based on 24-h collections of PD dialysate. Overall, 73 prevalent PD patients, 60.3% male, mean age 62.5 ± 16.4 years, had DXA scans a median of 24 (15-27) months apart. Weight did not change (70.7 ± 16.8 vs. 70.9 ± 16.8 kg), with a median 198 (88-295) mmol glucose absorbed/day. Appendicular lean mass (ALM) decreased in most of the male (59%) and female (52%) patients, and the change in ALM was negatively associated with the change in percentage body fat mass (%BFM) r = -0.54, p < 0.001. Overall, 56 patients (76.7%) were admitted to hospital with intercurrent illnesses. Women who lost ALM and gained %BFM had more hospital admissions and those with an increase in %BFM had more admissions due to PD peritonitis while, in males, these outcomes were not seen. Although overall weight did not change, the majority of PD patients lost ALM, and this loss of muscle mass was masked by a gain in fat mass. Definitions of malnutrition and cachexia, which include unintentional weight loss criteria will underestimate the prevalence of PD patients with loss of muscle mass.

Coexistence of osteoporosis, sarcopenia and obesity in community-dwelling adults – The Yishun Study

ObjectivesTo 1) report prevalence of ‘osteosarcopenia’ (OS) and osteosarcopenic obesity (OSO) entities using evidence-based diagnostic techniques and definitions, 2) examine if OSO offers additional predictive value of functional decline over its components, and 3) identify associated factors in a multi-racial Southeast Asian population. MethodsWe performed a cross-sectional study of a representative sample of 542 community-dwelling adults (21–90 years old), and assessed anthropometry, cognition, functional performance, and self-report sociodemographic, health and lifestyle questionnaires. Low muscle mass, and the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, were used to assess sarcopenia. Obesity was defined using percentage body fat and fat mass index. Osteopenia/osteoporosis was determined using lumbar spinal bone mineral density. Associated factors were examined using logistic regression, and OSO’s value investigated using linear regressions with functional performance. ResultsOS and OSO prevalence were 1.8% and 0% (21–59 years), 12.9% and 2.8% (≥ 60 years), 17.3% and 4.1% (≥ 65 years), and 25.5% and 7.0% (≥75 years), respectively. OSO entity as defined was not a significant predictor (P > 0.05) and did not improve explanations for functional decline over sarcopenia or sarcopenic obesity. Age, sex, race and body mass index (BMI) were associated with OS, while age, sex, race and alcoholism were associated with OSO. ConclusionsOur results do not support OSO as a distinct entity in relation to functional decline. Aside from biological age, sex, and race, amenable lifestyle factors such as BMI and alcohol intake are important variables that can influence the co-existence of osteopenia/osteoporosis, sarcopenia and obesity.

High percent body fat mass predicts lower risk of cardiac events in patients with heart failure: an explanation of the obesity paradox

BackgroundAlthough high body mass index (BMI) is a risk factor of heart failure (HF), HF patients with a higher BMI had a lower mortality rate than that in HF patients with normal or lower BMI, a phenomenon that has been termed the “obesity paradox”. However, the relationship between body composition, i.e., fat or muscle mass, and clinical outcome in HF remains unclear.MethodsWe retrospectively analyzed data for 198 consecutive HF patients (76 years of age; males, 49%). Patients who were admitted to our institute for diagnosis and management of HF and received a dual-energy X-ray absorptiometry scan were included regardless of left ventricular ejection fraction (LVEF) categories. Muscle wasting was defined as appendicular skeletal muscle mass index < 7.0 kg/m2 in males and < 5.4 kg/m2 in females. Increased percent body fat mass (increased FM) was defined as percent body fat > 25% in males and > 30% in females.ResultsThe median age of the patients was 76 years (interquartile range [IQR], 67–82 years) and 49% of them were male. The median LVEF was 47% (IQR, 33–63%) and 33% of the patients had heart failure with reduced ejection fraction. Increased FM and muscle wasting were observed in 58 and 67% of the enrolled patients, respectively. During a 180-day follow-up period, 32 patients (16%) had cardiac events defined as cardiac death or readmission by worsening HF or arrhythmia. Kaplan-Meier survival curves showed that patients with increased FM had a lower cardiac event rate than did patients without increased FM (11.4% vs. 22.6%, p = 0.03). Kaplan-Meier curves of cardiac event rates did not differ between patients with and those without muscle wasting (16.5% vs. 15.4%, p = 0.93). In multivariate Cox regression analyses, increased FM was independently associated with lower cardiac event rates (hazard ratio: 0.45, 95% confidence interval: 0.22–0.93) after adjustment for age, sex, diabetes, muscle wasting, and renal function.ConclusionsHigh percent body fat mass is associated with lower risk of short-term cardiac events in HF patients.

Relative influence of overall and central body adiposity on lung function and development of lung function predictive model for adolescents in Tripura

Background: Population-specific reference values are necessary for maintaining the reliability of pulmonary function evaluation. There are very few studies that have included body adiposity markers as the predictors of lung function, instead of age and height. Objectives: A gender-specific lung function predictive model of adolescents was developed using overall and central adiposity markers. The relative influences of both markers on pulmonary functions were also evaluated. Methods: Anthropometric and pulmonary function parameters of the subjects were recorded. The percentage body fat, fat mass (FM), fat-free mass (FFM), and body density were calculated. Statistical analysis was done using SPSS 16.0. Results: Significant differences between sexes for anthropometric measures were observed. The mean values of waist circumference (71.94 ± 2.33 mm for female vs. 71.37 ± 2.25 mm for male; P < 0.0005), body composition (5.83 ± 1.27 mm for female vs. 4.71 ± 0.83 mm for male; P < 0.0005), and sum of skinfolds (35.71 ± 4.48 mm for female vs. 34.66 ± 3.01 mm for male; P < 0.0005) were higher in female in comparison to male. Males had significantly higher subscapular skinfold thickness (9.39 ± 1.05 mm, compared with 9.17 ± 1.05 mm for females; P = 0.003). Mean values of central adiposity markers such as waist-hip-ratio (0.88 ± 0.01 for female vs. 0.87 ± 0.01, for male; P < 0.0005) and waist-to-height ratio (0.47 ± 0.004 for female vs. 0.47 ± 0.01, for male; P = 0.002) as well as overall adiposity markers such as percentage body fat (23.81 ± 1.11 for female vs. 18.98 ± 1.20, for male; P = 0.001) and FM (11.27 ± 1.83 kg for female vs. 8.94 ± 1.16, kg for male; P < 0.0005) were significantly higher in female compared to male. Mean FFM (38.17 ± 4.38 mm for male vs. 35.81 ± 3.93 mm for female; P < 0.0005) was significantly higher in male. All the pulmonary function parameters were significantly higher in male compared to female. Results showed the existence of significant mean differences in pulmonary function measures across the three body fat percentage groups in both sexes, with linear decrease of mean values of lung function with the increase of body fat percentage. Post hoc pair-wise multiple comparisons were done to compare the lung function between groups. Conclusion: Overall adiposity marker would explain variation in the pulmonary function parameters better than central adiposity markers in adolescents of both sexes.

Energy Expenditure, Cardiorespiratory Fitness, and Body Composition Following Arm Cycling or Functional Electrical Stimulation Exercises in Spinal Cord Injury: A 16-Week Randomized Controlled Trial.

Background: Physical deconditioning and inactivity following spinal cord injury (SCI) are associated with multiple cardiometabolic risks. To mitigate cardiometabolic risk, exercise is recommended, but it is poorly established whether arm cycling exercise (ACE) or functional electrical stimulation (FES) leg cycling yields superior benefits. Objectives: To determine the adaptations of 16 weeks of FES cycling and ACE on exercise energy expenditure (EEE), cardiorespiratory fitness (CRF), and obesity after SCI. Methods: Thirteen physically untrained individuals were randomly assigned to FES (n = 6) or ACE (n = 7) exercise 5 days/week for 16 weeks. Pre- and post-intervention EEE, peak oxygen consumption (absolute and relative VO2Peak), and work were assessed using indirect calorimetry, while body composition was measured by dual-energy x-ray absorptiometry. Results: Main effects were found for peak power (p < .001), absolute (p = .046) and relative (p = .042) VO2Peak, and peak work (p = .013). Compared to baseline, the ACE group increased in EEE (+85%, p = .002), peak power (+307%, p < .001), VO2Peak (absolute +21%, relative +22%, p ≤ .024), peak work (19% increase, p = .003), and total body fat decreased (-6%, p = .05). The FES group showed a decrease in percentage body fat mass (-5%, p = .008). The ACE group had higher EEE (p = .008), peak power (p < .001), and relative VO2Peak (p = .025) compared to postintervention values in the FES group. Conclusion: In the current study, ACE induced greater increases in EEE and CRF, whereas ACE and FES showed similar results on body fat. Exercise promotional efforts targeting persons with SCI should use both FES and ACE to reduce sedentary behavior and to optimize different health parameters after SCI.

Genç Kadın Voleybol Oyuncularında Vücut Kompozisyonu, Çeviklik ve Dikey Sıçrama Performansı Arasındaki İlişki

Objective: The purpose of this study was to investigate the relationship between body composition, agility and vertical jump performance in young female volleyball players. Material and Methods: For this purpose, 23 healthy young female volleyball players (Age: 14.79±0.58 years, height: 169.70±5.62 cm, body weight: 61.44±7.92 kg.) voluntarily participated in this study. The volleyball team was assessed for total body and regional estimates of body composition by using dual-energy X-ray absorptiometry. Vertical jump performance was analyzed by using the Squat Jump (SJ) and Counter Movement Jump (CMJ) tests and agility performance was measured using the Tagility test. The normality of the data was tested with the Shapiro-Wilk test. The relationship between body composition, agility and vertical jump performance was analyzed with Pearson correlation coefficient. Significance level was ≤0.05. Results: According to the statistical analyses, there was a significant negative correlation between SJ and CMJ percentage of body fat (BF%) leg fat (LF%) arm fat (AF%), trunk fat (TF%) and fat mass (kg) (p˂0.05). There was also a significant correlation between agility test percentage of BF, LF and TF. No significant correlation was found among agility, SJ and CMJ with total/regional body composition. Conclusion: The results indicated that increased total/regional BF might be a detriment to the SJ, CMJ and agility performance in young female volleyball players. It is recommended that coaches should not allow female volleyball players to increase their BF so that physical performance loss can be avoided.

BODY COMPOSITION OF SCHOOL AGE CHILDREN IN BOSNIA AND HERZEGOVINA

Considering the growing global problem and the lack of obesity data in Bosnia and Herzegovina (BH) the main aim of this paper was to determine BH school-age children body composition and determine the differences in body composition between girls and boys classified in underweight, normal weight and overweight according to the body mass index (BMI) score. 2524 participants 1763 girls and 761 boys (aged 10-13 yrs.) from 32 elementary schools were randomly selected and divided to 3 BMI groups by WHO cut-off points. InBody 370 Body Composition Analyzer (BioSpace, Seoul, Korea), a segmental bioelectrical impedance analysis (BIA) device was used to gather data. The results showed ~38% of the sample were classified as overweight whilst gender differences showed higher body fat mass and fat percentages in arms, trunk and legs in underweight and normal weight girls and higher skeletal muscle mass in normal weight and overweight boys.

Elbow plank exercise improves immunocyte function and physical fitness in an elderly male: a case study

Background: The elbow plank is a common exercise that can easily be done at home, but its effects on physical fitness and immunocyte function in elderly people are unknown. This prior study was conducted to analyze the changes in health-related physical fitness and immunocytes in an elderly male subject after performing elbow plank exercises. Methods: The participant was a 61-year-old man who had no experience in performing the elbow plank. Elbow plank exercises were performed for 30 min a day, 5 days a week, for 4 weeks. The intensity of was checked daily with ratings of perceived exertion (RPE). His goal was to reach an RPE between 12 and 14, at which a 1 min rest was given before repeating the process with a progressively higher RPE every 10 min. Results: Compared with pre-values, (1) health related physical fitness factors increased after 4 weeks. (2) Body weight, skeletal muscle mass, and basal metabolic rate increased, whereas body fat mass and fat percentage decreased. (3) Certain variables of complete blood count showed positive changes, while others did not. Specifically, NK cells (CD56) and cytotoxicity were improved. Conclusions: This study confirmed that performing elbow plank exercises improved all factors of physical fitness and the immunocyte function in an elderly male. Therefore, 20.73 min (9.27 min of rest) of plank exercise is recommended for elderly men to prevent deterioration of physical fitness and immunocyte function while staying at home, especially during the COVID-19 pandemic.

Associations of active travel with adiposity among children and socioeconomic differentials: a longitudinal study

ObjectivesExamine longitudinal associations between modes of travel to school and adiposity.SettingThe UK.Participants8432 children surveyed at ages 7, 11 and 14 years from the UK Millennium Cohort Study.Primary and secondary outcomesObjective...

Vitamin D status in infancy and cardiometabolic health in adolescence

Vitamin D deficiency is associated with obesity-related conditions, but the role of early life vitamin D status on the development of obesity is poorly understood. We assessed whether serum 25-hydroxyvitamin D [25(OH)D] at age 1 y was related to metabolic health through adolescence. We quantified serum 25(OH)D in samples obtained at age 1 y from 306 participants in a cohort study in Santiago, Chile. Anthropometry was performed at ages 5, 10, and 16/17 y. At 16/17 y, we determined body composition using DXA and quantified metabolic parameters in a blood sample. We examined the associations of infancy 25(OH)D with BMI-for-age z-score (BMIZ) at ages 5, 10, and 16/17 y; with percentage fat and percentage lean body mass at age 16/17 y; and with a metabolic syndrome (MetS) score and its components at age 16/17 y. Infancy 25(OH)D was inversely associated with BMIZ in childhood. Every 25-nmol/L difference in 25(OH)D was related to an adjusted 0.11 units lower BMIZ at age 5 y (95% CI: -0.20, -0.03; P=0.01) and a 0.09 unit lower BMIZ change from ages 1 to 5 y (95% CI: -0.17, -0.01; P=0.02). Also, every 25-nmol/L 25(OH)D in infancy was associated with an adjusted 1.3 points lower percentage body fat mass (95% CI: -2.2, -0.4; P=0.005) and an adjusted 0.03 units lower MetS score (95% CI: -0.05, -0.01; P=0.01) at age 16/17 y, through inverse associations with waist circumference and the HOMA-IR. Serum 25(OH)D at age 1 y is inversely associated with childhood BMIZ, percentage body fat at age 16/17 y, and a MetS score at age 16/17 y. Intervention studies are warranted to examine the effects of vitamin D supplementation in early life on long-term cardiometabolic outcomes.

Secular Changes in Body Build and Body Composition in Czech Preschool Children in the Context of Latent Obesity.

Changes in lifestyle can be significantly reflected in growth and development. Adaptations to reduced levels of physical activity, together with non-corresponding nutritional intakes, can result in body build and body composition changes at an early age. The present cross-sectional study aimed to evaluate the secular trend of modifications of body composition and body mass index (BMI) in Czech preschoolers over the last two to three decades. Boys and girls (386 boys and 372 girls) aged 4 to 6 years in 2014–2019 were measured. Outcome data were compared with the reference sample of preschoolers from 1990: 911 boys and 896 girls. Body height, BMI, and percentage of body fat, muscle, and bone mass were evaluated. Height and BMI have not changed. Body fat increased in both genders (p < 0.01), and contrarily, a significant reduction of muscle and skeletal mass was revealed (p < 0.001). Significant changes in body composition and unchanged BMI indicate the development of latent obesity during the last few decades. Due to latent obesity in a recent cohort, the differences in the prevalence of overweight and obesity markers according to BMI and fat percentage were tested. The prevalence of overweight and obesity was higher by 7.2% in boys, and by 6.5% in girls, as compared to children evaluated according to only their BMI results. Secular changes in preschoolers’ physical builds over the last 25 years are not reflected in body height and BMI, but in body composition. Insufficient development of active, lean body mass proportionally compensated by increased fat mass was also indicated.

Impact of adiposity on clinical outcomes in people living with a Fontan circulation

BackgroundTo assess the association between body composition and the risk of adverse outcomes in Fontan patients. MethodsParticipants from the Australian and New Zealand Fontan Registry with dual-energy X-ray absorptiometry scans were included. Appendicular lean mass (ALM), appendicular lean mass index (ALM divided by height squared; ALMI) and total body fat mass percentage (%BF) were calculated. ALMI and %BF z-scores were derived using age- and sex-matched reference ranges. The primary outcome was Fontan failure (death, transplantation, New York Heart Association functional class III/IV, protein-losing enteropathy, and plastic bronchitis) or moderate-or-severe ventricular dysfunction. Results144 patients were included. Mean %BF was 29% (SD 10) with 50% having increased adiposity. Mean ALMI z-score was −1.4 (SD 1.1); one third of patients had skeletal muscle deficiency (ALMI z-score < −1 and −2) and another third had Fontan-associated myopaenia (ALMI z-score < −2). Age and %BF were associated with the risk of the endpoint in univariable regression (age: HR 1.09 per year, 95% CI 1.02–1.17, p = 0.01; %BF: HR 1.08, 95% CI 1.01–1.17, p = 0.03). On multivariable regression, every 1% increase in %BF was associated with a 10% increased risk of reaching the clinical endpoint (HR 1.10, 95% CI 1.01–1.19; p = 0.03). ALM was not associated with the endpoint (HR 1.02 per kg, 95% CI 0.88–1.20, p = 0.77). ConclusionsIncreased adiposity is associated with higher risk for adverse outcomes. Prospective studies to assess lifestyle interventions to optimise body composition should be prioritised.

Body composition profile of young inline speed skaters

The aim of this work was to determine the body composition profile of children and young roller skaters. 516 athletes (361 males and 155 females) between the ages of 5 and 21 years old, who belong to official clubs in Colombia and Venezuela, were evaluated longitudinally. The anthropometric variables were taken according to ISAK, using the Holtain© caliper for the skin folds (triceps, anterior thigh and medial leg) and the Sanny© tape for the perimeters (relaxed arm, medial thigh and leg). The treatment for the estimation of the percentage of body fat (%F) and muscle mass (%MM) was performed under the protocol of the GREC and processed by means of SPSS 24.0. The results point to the existence of significant differences (p&lt;0.05) between sexes for %F and %MM. For the development of the profile the methodology of smoothed curves was used with the application of the software LMS Chart Maker© and to generate cut points for the percentiles 3, 10, 75, 90 and 97. It is concluded, that the classification for the proposed body composition, without trying to be a unique norm to establish the typification of the status of the body composition of a skater, allows to distinguish and to categorize with rigor and objecti-vity, the characteristics of the body composition of the skaters independently of the age and competitive level. This work is recommended as a starting point for future studies in larger populations with established probability sampling and ethnicity.

Association of waist circumference with muscle and fat mass in adults with a normal body mass index.

BACKGROUND/OBJECTIVESWe aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently.SUBJECTS/METHODSWe analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates.RESULTSWe observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5–18.3), 21.0 (20.6–21.5), 22.1 (21.5–22.8), and 25.1 (24.2–26.1) in men and 29.7 (29.4–30.0), 32.0 (31.6–32.3), 32.9 (32.4–33.4), and 34.7 (33.2–36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m2) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51–7.59), 7.62 (7.56–7.68), 7.65 (7.56–7.74), and 7.22 (7.04–7.41) in men and 5.83 (5.80–5.85), 5.96 (5.92–6.00), 6.03 (5.96–6.10), and 5.88 (5.73–6.03).CONCLUSIONSThere was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.

Combination of resistance and aerobic exercise for six months improves bone mass and physical function in HIV infected individuals: A randomized controlled trial.

To evaluate the effect of combined resistance and aerobic training (RT+AT) on regional bone mineral density (BMD) and physical performance in people living with HIV (PLWH). Forty PLWH (20 men and 20 women) were randomized into RT+AT group (n=20; age = 38.3 ± 4.9) or non-exercise control group (n=20; age = 37.9 ± 5.1). The RT+AT group was required to perform a nonlinear periodized resistance training program targeting large muscle groups followed by 20 min aerobic exercise at 65-80% of maximal heart rate. Participants in RT+AT performed three supervised sessions per week for 6-months, whereas participants in the control group were instructed to continue with their current lifestyle habits. The primary outcome was bone mineral density (lumbar spine (L2-L4), femoral neck, and distal 1/3 radius). Secondary outcomes included physical function, anthropometry, inflammatory markers, and growth factors. The RT+AT group demonstrated a significant increase in BMD at follow-up for the Lumbar spine (L2-L4), femoral neck, and 1/3 radius (all, P <.05), and There were no gender differences in the training response between men and women for any of the BMD regions. Similar findings were also observed for lean body mass, IGF1and Adiponectin (P<.001). We observed a decrease in percent body fat, fat mass, IL-6, TNF-α, and myostatin in the RT+AT group (P<.001). Finally, there was a significant increase in handgrip strength and gait speed for both women and men in the RT+AT group (P <.001). A combination of resistance and aerobic training appears to be a feasible and effective means for counteracting bone loss and improving various inflammatory markers, physical function, and growth hormones in PLWH.

Body Fat in Children with Chronic Kidney Disease - A Comparative Study of Bio-impedance Analysis with Dual Energy X-ray Absorptiometry.

Introduction:Nutritional impairment in patients with chronic kidney disease (CKD) is due to decreased body stores of both protein and fat. We need a tool that can be used in clinics to determine and monitor fat composition with a special focus on normalizing fat measurements to height in these children. Bio-impedance analysis (BIA), a portable and simple tool, has been used to estimate body fat in children with CKD but needs validation against the reference tool dual energy X-ray absorptiometry (DXA). The purpose of the cross-sectional study was to estimate the prevalence of low body fat in children with stages 2-5 CKD (non-dialysis) and CKD 5D (dialysis), and to compare fat measures from two different methods namely BIA and DXA.Method:Children in stages 2–5 CKD (n = 19) and in CKD 5D (n = 14) were recruited for assessment of fat mass (FM, Kg) by BIA and DXA, from which percent body fat (BF %) and fat mass index (FMI, Kg/M2) were obtained. Low body fat was defined as <5th age and gender centile for BF% or FMI by DXA and BF% by BIA.Results:Low body fat was detected equally using BF% and FMI in 18% of children by DXA while only 12% were detected using BF% by BIA. In children with CKD2–5, a good degree of reliability was found with FMI measurements (ICC 0.76 CI [0.48,0.9]) and poor reliability in children with CKD 5D (ICC 0.58 CI [0.1,0.84]). BF% had poor to fair reliability in the children with CKD 2-5 and CKD 5D (ICC 0.64 [0.28,0.84] and 0.53 [0.02,0.82]), respectively. Comparing BF% and FMI obtained by BIA and DEXA, BIA overestimated BF% by 3.5% in comparison to DXA.Conclusion: In children with CKD, body fat is preserved in the majority. Among the two measures of fat, BF% estimated by BIA did not compare well with DXA while FMI measure was comparable with a lower bias. However, due to lack of reference values in Indian children for FMI obtained by BIA, BIA cannot be used to measure fat in this population.

Psycho-Physiological Responses to a 4-Month High-Intensity Interval Training-Centered Multidisciplinary Weight-Loss Intervention in Adolescents with Obesity.

BackgroundTo evaluate the impact of 4 months of a high-intensity interval training (HIIT)-centered weightmanagement intervention on health-related quality of life (HR-QOL), health perception (HP) and physical selfperception (PSP) in adolescents with obesity.MethodsFifty-six adolescents with obesity (28 girls; mean body mass index [BMI], 35±4.89 kg/m2; z-BMI, 2.3±0.3; 11?17 years) followed a multidisciplinary weight-management intervention composed of nutritional counseling, HIIT program, and health-related therapeutic education. Anthropometric parameters, body composition (dual X-ray absorptiometry), and maximal aerobic capacities (maximal oxygen consumption [VO2peak]) were assessed, and self-reported questionnaires were used to assess HR-QOL (36-item short form survey), HP and PSP at baseline (T0) and post-intervention (T1).ResultsBody weight (92.6±18.9 to 85.9±16.2 kg), BMI (35.0±4.8 to 32.1±4.5 kg/m2), z-BMI (2.3±0.3 to 2.1±0.3) and fat mass percentage (36.0%±9.1% to 30.4%±7.8%) were significantly decreased (P<0.001) between T0 and T1. There was a tendency for VO2peak to increase from 26.35±5.81 mL/kg/min at T0 to 28.79±6.59 mL/kg/min at T1 (P=0.06). Physical functioning (P=0.002), physical limitation (P=0.048), general health (P<0.001) and bodily pain (P=0.030) were improved at T1. A significant improvement occurred in dimensions of HP such as physical condition (P=0.001), adiposity (P<0.001), alimentation (P<0.001), general health (P=0.038), and perceived general health (P=0.001). In addition, there was an improvement in items of PSP such as self-perceived coordination (P=0.022), endurance (P=0.001) and activity (P=0.001), global self-concept (P=0.015), and appearance (P=0.016). Physical but not mental HR-QOL domains, HP and PSP were associated with weight reduction.ConclusionWhile HIIT favors improved HR-QOL, HP status and PSP in adolescents with obesity, physical but not mental HR-QOL, HP and PSP were associated with weight reduction.

Combined resistance and aerobic exercise intervention improves fitness, insulin resistance and quality of life in survivors of childhood haemopoietic stem cell transplantation with total body irradiation

To investigate the effects of a supervised combined resistance and aerobic training programme on cardiorespiratory fitness, body composition, insulin resistance and quality of life (QoL) in survivors of childhood haematopoietic stem cell transplantation (HSCT) with total body irradiation (TBI). HSCT/TBI survivors (n=20; 8 females). Mean (range) for age at study and time since HSCT/TBI was 16.7 (10.9-24.5) and 8.4 (2.3-16.0) years, respectively. After a 6-month run-in, participants undertook supervised 45- to 60-minute resistance and aerobic training twice weekly for 6 months, with a 6-month follow-up. The following assessments were made at 0, 6 (start of exercise programme), 12 (end of exercise programme) and 18 months: Body composition via dual energy X-ray absorptiometry, homeostatic model assessment of insulin resistance (HOMA-IR), cardiorespiratory fitness (treadmill-based peak rate of oxygen uptake (VO2 peak) test), QoL questionnaires (36-Item Short Form Health Survey (SF-36) and Minneapolis-Manchester Quality of Life Instrument (MMQL). Results expressed as mean (standard deviation) or geometric mean (range). There were significant improvements in VO2 peak (35.7 (8.9) vs 41.7 (16.1) mL/min/kg, P=0.05), fasted plasma insulin (16.56 (1.48-72.8) vs 12.62 (1.04-54.97) mIU/L, P=0.03) and HOMA-IR (3.65 (0.30-17.26) vs 2.72 (0.22-12.89), P=0.02) after the exercise intervention. There were also significant improvements in the SF-36 QoL general health domain (69.7 (14.3) vs 72.7 (16.0), P=0.001) and the MMQL school domain (69.1 (25.2) vs (79.3 (21.6), P=0.03) during the exercise intervention. No significant changes were observed in percentage body fat, fat mass or lean mass. The supervised 6-month combined resistance and aerobic exercise programme significantly improved cardiorespiratory fitness, insulin resistance and QoL in childhood HSCT/TBI survivors, with no change in body composition, suggesting a metabolic training effect on muscle. These data support a role for targeted physical rehabilitation services in this group at high risk of diabetes and cardiovascular disease.

Effects of body composition on the procoagulant imbalance in obese patients.

Obesity is associated with increased thrombotic risk and hypercoagulability whose main driver is an excess of coagulation factor VIII relative to protein C. The aims of this study were to evaluate the association between factor VIII, protein C, factor VIII-to-protein C ratio and bioimpedance parameters of body composition in obese patients. We analysed blood from 69 obese patients and 23 non-obese healthy controls. Plasma levels of factor VIII, protein C, and factor VIII-to-protein C ratio were correlated with total fat, visceral fat, and muscle mass. Compared to controls, obese patients had significantly higher factor VIII (110.5% vs 78.05%, p < 0.001), protein C (120.99% versus 110.51%, p = 0.014), and factor VIII-to-protein C ratio (0.93 versus 0.73, p = 0.002). In obese patients, factor VIII correlated with body-mass index, body fat percentage, muscle mass percentage, and fat-to-muscle ratio, whereas protein C had significant relationships with body fat percentage, muscle mass percentage and fat-to-muscle ratio, but not with body-mass index. Factor VIII-to-protein C ratio > 1 was significantly associated with body-mass index (odds ratio 1.08, 95% CI 1.02 to 1.14) and fat-to-muscle ratio (odds ratio 2.47, 95% CI 1.10 to 5.55). Factor VIII-to-protein C ratio strongly correlated with D-dimer levels in the overall population (rho 0.44, p < 0.001) and obese patients (rho 0.41, p < 0.001). In obese patients, bioimpedance measures of body fat and muscle mass percentage were associated with factor VIII and protein C. Factor VIII-to-protein C ratio was strongly associated with fat-to-muscle ratio and only modestly related to BMI.