Changes in body composition and metabolic disease risk

Machine Learning Approach for Predicting Hypertension Based on Body Composition in South Korean Adults

(1) Background: Various machine learning techniques were used to predict hypertension in Korean adults aged 20 and above, using a range of body composition indicators. Muscle and fat components of body composition are closely related to hypertension. The aim was to identify which body composition indicators are significant predictors of hypertension for each gender; (2) Methods: A model was developed to classify hypertension using six different machine learning techniques, utilizing age, BMI, and body composition indicators such as body fat mass, lean mass, and body water of 2906 Korean men and women; (3) Results: The elastic-net technique demonstrated the highest classification accuracy. In the hypertension prediction model, the most important variables for men were age, skeletal muscle mass (SMM), and body fat mass (BFM), in that order. For women, the significant variables were age and BFM. However, there was no difference between soft lean mass and SMM; (4) Conclusions: Hypertension affects not only BFM but also SMM in men, whereas in women, BFM has a stronger effect than SMM.

Association of Questionnaire-Based Physical Activity Analysis and Body Composition Dynamics in Type 2 Diabetes: A Cross-Sectional Study

Background

Physical activity (PA) exerts an important influence on glycemic control in type 2 diabetes (T2D) patients. Alterations in body composition in patients with T2D may be involved in the overall pathophysiologic process, but PAs and alterations in body composition have been poorly studied.

Methods

A total of 615 patients with T2D were selected by convenient sampling. The patients were investigated with the International Physical Activity Questionnaire (IPAQ-S). Moreover, biochemical indices were collected, and the progression of the body composition of the subjects was determined via dual-energy X-ray absorptiometry (DXA). The variables included lumbar bone mineral density (LSBMD), femoral neck bone mineral density (FNBMD), hip bone mineral density (HBMD), whole-body bone mineral density (TBMD), limb skeletal muscle mass index (ASMI), whole-body fat percentage (B-FAT) and trunk fat percentage (T-FAT). Moreover, the levels of physical activity (high level of physical activity [H-PA], medium level of physical activity [M-PA] and low level of physical activity [L-PA]) were divided into three groups to analyze the changes in patient body composition with changes in physical activity level.

Results

One-way analysis of variance showed that β-CTX, TP1NP, HbA1c, B-FAT and T-FAT increased significantly (p<0.05), while 25(OH)D, LSBMD, FNBMD, HBMD, TBMD and ASMI decreased significantly (p<0.001) with the decrease of physical activity. However, there was no significant difference in serum lipids between lnHOMA-ir and lnHOMA-β (p>0.05). Multiple linear regression model was established to gradually adjust for clinical confounding factors. It was found that physical activity level was independently positively correlated with LSBMD, FNBMD, HBMD, TBMD, and ASMI, and was independently negatively correlated with B-FAT and T-FAT in patients with type 2 diabetes.

Conclusion

A lack of physical activity is an independent risk factor for decreased bone mineral density, decreased skeletal muscle content and increased fat content in patients with T2D.

Relationships between Circulating Biomarkers and Body Composition Parameters in Patients with Metabolic Syndrome: A Community-Based Study

Metabolic syndrome (MetS) is a complex disease involving multiple physiological, biochemical, and metabolic abnormalities. The search for reliable biomarkers may help to better elucidate its pathogenesis and develop new preventive and therapeutic strategies. In the present population-based study, we looked for biomarkers of MetS among obesity- and inflammation-related circulating factors and body composition parameters in 1079 individuals (with age range between 18 and 80) belonging to an ethnically homogeneous population. Plasma levels of soluble markers were measured by using ELISA. Body composition parameters were assessed using bioimpedance analysis (BIA). Statistical analysis, including mixed-effects regression, with MetS as a dependent variable, revealed that the most significant independent variables were mainly adipose tissue-related phenotypes, including fat mass/weight (FM/WT) [OR (95% CI)], 2.77 (2.01-3.81); leptin/adiponectin ratio (L/A ratio), 1.50 (1.23-1.83); growth and differentiation factor 15 (GDF-15) levels, 1.32 (1.08-1.62); inflammatory markers, specifically monocyte to high-density lipoprotein cholesterol ratio (MHR), 2.53 (2.00-3.15), and a few others. Additive Bayesian network modeling suggests that age, sex, MHR, and FM/WT are directly associated with MetS and probably affect its manifestation. Additionally, MetS may be causing the GDF-15 and L/A ratio. Our novel findings suggest the existence of complex, age-related, and possibly hierarchical relationships between MetS and factors associated with obesity.

Genetically predicted waist circumference and risk of atrial fibrillation

INTRODUCTION

Observational studies have revealed an association between waist circumference (WC) and atrial fibrillation (AF). However, it is difficult to infer a causal relationship from observational studies because the observed associations could be confounded by unknown risk factors. Therefore, the causal role of WC in AF is unclear. This study was designed to investigate the causal association between WC and AF using a two-sample Mendelian randomization (MR) analysis.

METHODS

In our two-sample MR analysis, the genetic variation used as an instrumental variable for MR was acquired from a genome-wide association study (GWAS) of WC (42 single nucleotide polymorphisms with a genetic significance of P <5 × 10 -8 ). The data of WC (from the Genetic Investigation of ANthropometric Traits consortium, containing 232,101 participants) and the data of AF (from the European Bioinformatics Institute database, containing 55,114 AF cases and 482,295 controls) were used to assess the causal role of WC on AF. Three different approaches (inverse variance weighted [IVW], MR-Egger, and weighted median regression) were used to ensure that our results more reliable.

RESULTS

All three MR analyses provided evidence of a positive causal association between high WC and AF. High WC was suggested to increase the risk of AF based on the IVW method (odds ratio [OR] = 1.43, 95% confidence interval [CI], 1.30-1.58, P = 2.51 × 10 -13 ). The results of MR-Egger and weighted median regression exhibited similar trends (MR-Egger OR = 1.40 [95% CI, 1.08-1.81], P = 1.61 × 10 -2 ; weighted median OR = 1.39 [95% CI, 1.21-1.61], P = 1.62 × 10 -6 ). MR-Egger intercepts and funnel plots showed no directional pleiotropic effects between high WC and AF.

CONCLUSIONS

Our findings suggest that greater WC is associated with an increased risk of AF. Taking measures to reduce WC may help prevent the occurrence of AF.

The Effects of Ketogenic Diet on Insulin Sensitivity and Weight Loss, Which Came First: The Chicken or the Egg?

The ketogenic diet (KD) is, nowadays, considered an interesting nutritional approach for weight loss and improvement in insulin resistance. Nevertheless, most of the studies available in the literature do not allow a clear distinction between its effects on insulin sensitivity per se, and the effects of weight loss induced by KDs on insulin sensitivity. In this review, we discuss the scientific evidence on the direct and weight loss mediated effects of KDs on glycemic status in humans, describing the KD's biochemical background and the underlying mechanisms.

Association of Bioelectrical Impedance Phase Angle with Physical Performance and Nutrient Intake of Older Adults

In recent years, the phase angle (PhA) as a raw bioelectrical impedance analysis variable has gained attention to assess cell integrity and its association to physical performance in either sports-related or clinical settings. However, data on healthy older adults are scarce. Therefore, data on body composition, physical performance and macronutrient intake from older adults (n = 326, 59.2% women, 75.2 ± 7.2 years) were retrospectively analyzed. Physical performance was evaluated by the Senior Fitness Test battery, gait speed, timed up and go and handgrip strength. Body composition was determined by the BIA and dual-energy X-ray absorptiometry (from a subgroup of n = 51). The PhA was negatively associated with the timed up and go test and age (r = -0.312 and -0.537, p < 0.001), and positively associated with the 6 min walk test, 30 s chair stand, handgrip strength, gait speed and physical performance score (r = 0.170-0.554, p < 0.05), but not protein intake (r = 0.050, p = 0.386). Hierarchical multiple regression analysis showed that especially age, sex, BMI, but also the PhA predicted the performance test outcomes. In conclusion, the PhA seems to be an interesting contributor to physical performance, but sex- and age-specific norm values still need to be determined.

CT-measured body composition radiomics predict lymph node metastasis in localized pancreatic ductal adenocarcinoma

BACKGROUND

To explored the value of CT-measured body composition radiomics in preoperative evaluation of lymph node metastasis (LNM) in localized pancreatic ductal adenocarcinoma (LPDAC).

METHODS

We retrospectively collected patients with LPDAC who underwent surgical resection from January 2016 to June 2022. According to whether there was LNM after operation, the patients were divided into LNM group and non-LNM group in both male and female patients. The patient's body composition was measured by CT images at the level of the L3 vertebral body before surgery, and the radiomics features of adipose tissue and muscle were extracted. Multivariate logistic regression (forward LR) analyses were used to determine the predictors of LNM from male and female patient, respectively. Sexual dimorphism prediction signature using adipose tissue radiomics features, muscle tissue radiomics features and combined signature of both were developed and compared. The model performance is evaluated on discrimination and validated through a leave-one-out cross-validation method.

RESULTS

A total of 196 patients (mean age, 60 years ± 9 [SD]; 117 men) were enrolled, including 59 LNM in male and 36 LNM in female. Both male and female CT-measured body composition radiomics signatures have a certain predictive power on LNM of LPDAC. Among them, the female adipose tissue signature showed the highest performance (area under the ROC curve (AUC), 0.895), and leave one out cross validation (LOOCV) indicated that the signature could accurately classify 83.5% of cases; The prediction efficiency of the signature can be further improved after adding the muscle radiomics features (AUC, 0.924, and the accuracy of the LOOCV was 87.3%); The abilities of male adipose tissue and muscle tissue radiomics signatures in predicting LNM of LPDAC was similar, AUC was 0.735 and 0.773, respectively, and the accuracy of LOOCV was 62.4% and 68.4%, respectively.

CONCLUSIONS

CT-measured body composition Radiomics strategy showed good performance for predicting LNM in LPDAC, and has sexual dimorphism. It may provide a reference for individual treatment of LPDAC and related research about body composition in the future.

First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes

Obese women are more likely to experience pregnancy complications. The distribution of fat, and more particularly the rise in visceral fat, is well established to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. We aim to examine the relationship between maternal visceral fat assessment in the first trimester and the appearance of adverse pregnancy outcomes. A prospective cohort study including 416 pregnant women was conducted. During the first trimester scan (11-13 + 6 weeks), all individuals had their visceral fat and subcutaneous thicknesses measured by ultrasonography. Blood samples were obtained, and maternal demographics and clinical information were documented. After delivery, the obstetric outcomes were evaluated. We contrasted two groups: one with healthy pregnancies and the other with adverse pregnancy outcomes (APO), defined as the development of at least one of the following complications: gestational diabetes mellitus, hypertensive disorders of pregnancy, abnormal fetal growth, preterm delivery or preterm premature rupture of membranes. Median maternal age was 33 and 34 years old for the uncomplicated and adverse pregnancy outcomes groups, respectively. We found that women with adverse pregnancy outcomes had higher VFT (median 30 vs. 26.5 mm, p = 0.001) and SFT (median 18.9 vs. 17.1 mm, p = 0.03). However, the visceral/subcutaneous fat ratio was not statistically different between groups. Finally, we performed a subanalysis for metabolic and placental vascular dysfunction complications. After performing a multivariate logistic regression analysis adjusted for maternal age, smoking, and mean arterial pressure, both the VFT (aOR 1.03, p < 0.001) and the ratio of visceral/subcutaneous fat (aOR 1.37, p = 0.04) were significantly associated with the development of adverse pregnancy outcomes; however, the associations of VFT and the VFT-to-SFT ratio were higher for the occurrence of gestational diabetes (aOR 1.07, p < 0.001; aOR 2.09, p = 0.001; respectively) and showed no relationships with placental complications. When conducting a first-trimester ultrasound assessment, sonographers may measure VFT without additional time or cost involved. Identification of pregnant women with increased VFT (>37 mm) may benefit from a close follow-up, especially for the development of gestational diabetes, independent of BMI.

Phase Angle Association with Dietary Habits and Metabolic Syndrome in Diabetic Hypertensive Patients: A Cross-Sectional Study

Phase angle (PhA) levels are often lower than normal because both disease-specific parameters and disease-related inflammatory status, metabolic syndrome (MetS) included, can affect PhA. Therefore, the aim of this cross-sectional study was to compare body composition, metabolic profile and dietary patterns of participants with arterial hypertension (AH), type 2 diabetes mellitus (T2DM) and MetS with regard to PhA values. A total of 208 participants were included, of whom 53.6% were males. For each participant, data about body composition and anthropometric parameters, clinical and laboratory parameters, as well as food frequency questionnaire (FFQ) and Mediterranean Diet Serving Score (MDSS) were obtained. MC-780 Multi Frequency Segmental Body Mass Analyzer (Tanita) was used to assess body composition. Furthermore, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. The results showed that 75 (36.06%) participants had low PhA values and 133 (63.94%) had high PhA values. Participants with higher PhA values had significantly higher body fat percentage (p = 0.04), fat-free mass (kg; p < 0.001), muscle mass (kg; p < 0.001), skeletal muscle mass (% and kg; p < 0.001), sarcopenic index (SMI; p < 0.001) and mid-upper arm circumference (MUAC; p = 0.04), as well as lower fat mass percentage (p = 0.04). Regarding food frequency consumption, significantly higher intakes of red meat (p = 0.003), poultry (p = 0.02) and fast food (p = 0.003) were noticed in participants with higher PhA values. Adherence to the Mediterranean Diet (MeDi) was exceptionally low in both groups of participants, with significantly higher fish intake noticed in participants with high PhA (p = 0.03). In conclusion, our results showed that body composition could be the indicator of PhA in MetS as well as overall low adherence to the MeDi principles. These findings highlight the importance of adequate nutritional strategies and novel approaches to maintaining optimal body composition and adopting proper eating habits within the framework of one’s disease.

Fat-to-muscle ratio as a predictor for dyslipidaemia in transitional-age youth

Background

Although dyslipidaemia may have a crucial impact on cardiovascular health in adults, there is a lack of specific data in transitional-age youth. Therefore, this study attempted to evaluate the association of dyslipidaemia with fat-to-muscle ratio (FMR), and establish FMR thresholds for diagnosing dyslipidaemia in transitional-age youth.

Methods

One thousand six hundred sixty individuals aged 16 to 24 years from the baseline of a subcohort in the Northwest China Natural Population Cohort: Ningxia Project were analysed. Anthropometric characteristics were gauged by a bioelectrical impedance analyser, and dyslipidaemia components were measured using a Beckman AU480 chemistry analyser. Additionally, this study used logistic regression to estimate the risk of dyslipidaemia based on FMR quintiles, and calculate the gender-specific ideal cut-off values of dyslipidaemia and its components by the receiver operating characteristic (ROC) curve.

Results

Of the 1660 participants, aged 19.06 ± 1.14 years, 558 males and 1102 females. The prevalence of dyslipidaemia was 13.4% and was significantly associated with FMR quintiles among all participants (P < 0.05). The ideal values of FMR in diagnosing dyslipidaemia were 0.2224 for males and 0.4809 for females, while males had a higher AUC than females (0.7118 vs. 0.6656). Meanwhile, high FMR values were significantly associated with adverse outcomes of dyslipidaemia, hypercholesterolemia and hypertriglyceridaemia (P < 0.05).

Conclusions

The FMR was positively correlated with the prevalence of dyslipidaemia. The FMR can be used as an effective body composition index for diagnosing dyslipidaemia, especially in males, and preventive strategies should be initiated in transitional-age youth to decrease obesity-related dyslipidaemia.

Human total, basal and activity energy expenditures are independent of ambient environmental temperature

Lower ambient temperature (Ta) requires greater energy expenditure to sustain body temperature. However, effects of Ta on human energetics may be buffered by environmental modification and behavioral compensation. We used the IAEA DLW database for adults in the USA (n = 3213) to determine the effect of Ta (-10 to +30°C) on TEE, basal (BEE) and activity energy expenditure (AEE) and physical activity level (PAL). There were no significant relationships (p > 0.05) between maximum, minimum and average Ta and TEE, BEE, AEE and PAL. After adjustment for fat-free mass, fat mass and age, statistically significant (p < 0.01) relationships between TEE, BEE and Ta emerged in females but the effect sizes were not biologically meaningful. Temperatures inside buildings are regulated at 18-25°C independent of latitude. Hence, adults in the US modify their environments to keep TEE constant across a wide range of external ambient temperatures.

Plant-based diets and body composition in Chinese omnivorous children aged 6-9 years old: A cross-sectional study

Evidence suggests that plant-based diets are beneficial for alleviating metabolic diseases. Childhood is a crucial period for body growth and development. However, it is unknown whether adherence to a plant-based diet is related to a healthy body composition in children. We aimed to assess the relationship between a plant-based diet and body composition in children. A total of 452 Chinese children aged 6–9 years old participated in this cross-sectional study. Lean mass (LM), fat mass, and fat mass percentage (FMP) were assessed via dual-energy X-ray absorptiometry. An age- and sex-specific abdominal FMP ≥85th percentile was defined as abdominal obesity. Handgrip strength was measured using a hydraulic hand dynamometer. A validated 79-item food frequency questionnaire was used to collect dietary information. Overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) scores were calculated. After adjusting for potential covariates, a higher hPDI score (per 10-score increment) was associated with a higher LM in the android area (0.038 kg, 3.2%), gynoid area (0.048 kg, 1.9%), and trunk (0.102 kg, 1.2%) and with a lower FMP (1.18%) in the android area. In contrast, a higher uPDI score (per 10-score increment) was associated with a lower LM in the trunk (0.091 kg, 1.1%) and android area (0.023 kg, 1.9%) and with a higher FMP (0.74%) in the android area. No significant associations were observed between the overall PDI and body composition or abdominal obesity. After stratifying by sex, higher (vs. lower) hPDI scores was associated with lower abdominal obesity risk in girls and higher handgrip strength in boys. In conclusion, in this cross-sectional study, we found that stronger adherence to a healthful plant-based diet, and less adherence to an unhealthful plant-based diet was associated with better body composition in Chinese omnivorous children aged 6–9 years old. Our results highlight the need to distinguish between healthy and unhealthy plant foods within investigating how to obtain a healthy body composition in children.

Do Body Composition and Values of Selected Nutritional Status Indices Influence the Glycaemic Index Values of Vegetarian Dishes? A Pilot Study in a Group of Older Women

An ageing population brings with it the need for public policy to respond to the demands and health needs of this group of people. The ageing process has been shown to be associated with changes in body composition. These mainly concern a decrease in muscle mass and an increase in body fat. Body composition and other indicators of nutritional status are important factors differentiating carbohydrate management. Glycaemic index (GI) values may be affected by differences resulting from individual metabolism. The rate of carbohydrate digestion is also influenced by a number of factors, including the degree to which the product is processed, the structure of the starch, and the presence of protein, fat and dietary fibre. Available studies do not provide information on the glycaemic response following the consumption of specific products by older people with varying BMI and body composition. Therefore, the aim of this study was to evaluate the effect of the body mass index (BMI) values of women aged 50-80 years on the glycaemic response after eating vegetarian meals and the influence of selected indices of nutritional status on their GI values. It has been shown that the areas under the glycaemic curves after the consumption of the tested foods, both traditional and modified, are higher in the group of overweight and obese women. Nevertheless, the GI of meals consumed by those with a BMI ≥ 25.0 kg/m² is lower than that of foods consumed by women with normal values of this index. In the group of women with BMI 18.5-24.9 kg/m², on the basis of an analysis of the obtained correlations, it was observed that the GI value of modified products depends on the percentage of body fat (FM%) (p = 0.0363) and the percentage of fat free mass (FFM%) (p = 0.0363), and, in the case of traditional products, also on the percentage of total body water (%) (p = 0.0133). In the group of women with a BMI ≥ 25.0 kg/m², significant correlations were only found between the GI of modified foods and the waist-to-hip ratio (WHR) (p = 0.0363) and the ratio of waist circumference to height (WHtR) (p = 0.0369) indices. The GI values of food set solely with the participation of young, healthy people should not be the basis for the nutrition planning of all groups of people.

Three-dimensional optical body shape and features improve prediction of metabolic disease risk in a diverse sample of adults

OBJECTIVE

This study examined whether body shape and composition obtained by three-dimensional optical (3DO) scanning improved the prediction of metabolic syndrome (MetS) prevalence compared with BMI and demographics.

METHODS

A diverse ambulatory adult population underwent whole-body 3DO scanning, blood tests, manual anthropometrics, and blood pressure assessment in the Shape Up! Adults study. MetS prevalence was evaluated based on 2005 National Cholesterol Education Program criteria, and prediction of MetS involved logistic regression to assess (1) BMI, (2) demographics-adjusted BMI, (3) 85 3DO anthropometry and body composition measures, and (4) BMI + 3DO + demographics models. Receiver operating characteristic area under the curve (AUC) values were generated for each predictive model.

RESULTS

A total of 501 participants (280 female) were recruited, with 87 meeting the criteria for MetS. Compared with the BMI model (AUC = 0.819), inclusion of age, sex, and race increased the AUC to 0.861, and inclusion of 3DO measures further increased the AUC to 0.917. The overall integrated discrimination improvement between the 3DO + demographics and the BMI model was 0.290 (p < 0.0001) with a net reclassification improvement of 0.214 (p < 0.0001).

CONCLUSIONS

Body shape measures from an accessible 3DO scan, adjusted for demographics, predicted MetS better than demographics and/or BMI alone. Risk classification in this population increased by 29% when using 3DO scanning.

Loss of Skeletal Muscle Mass and Intracellular Water as Undesired Outcomes of Weight Reduction in Obese Hyperglycemic Women: A Short-Term Longitudinal Study

The current study is focused on the influence of hyperglycemia on weight loss in obese premenopausal women. Specifically, the study evaluated the impact of a six-month individualized low-calorie diet combined with moderate exercise on weight reduction and glucose metabolism in obese women with normoglycemia compared to obese women with moderate hyperglycemia. The results indicated that patients with normoglycemia achieved a successful weight loss, which was connected to a decrease in adipose tissue and reflected by diminished content of visceral fat area (VFA) and percent body fat. In contrast, weight reduction in patients with hyperglycemia was connected not only to the loss of VFA but also to undesired decrease in skeletal muscle mass as well as intracellular and total body water. These unfavorable outcomes were observed despite normalization of glucose metabolism reflected by statistically significant lowering glucose, fructosamine, advanced glycation end-products, and HOMA-IR levels. Overall, the obtained results indicate the importance of the measurement of the carbohydrate profile in obese women and the need for an early introduction of weight reduction strategies before the development of hyperglycemia.

Age and Training-Related Changes on Body Composition and Fitness in Male Amateur Cyclists

Master athletes are considered as a model of healthy aging because they can limit the age-related decline of physiological abilities compared to sedentary individuals. The main objective of this study is to analyze age-related changes and annual training on body composition (BC) and cardiorespiratory fitness (CRF) parameters. The participants in this retrospective cross-sectional study were 176 male cyclists, aged 40-60 years. BC was evaluated through anthropometric measurements and CRF was determined by an incremental cycle ergometer test to exhaustion. A comparative study between age groups was carried out through a one-way ANOVA test and the associations between the variables were assessed by Spearman's correlation coefficients and multiple regression analysis to estimate the performance. Training was generally associated with a decrease in both body weight and body fat (p < 0.05). A decrease in resting heart rate was observed as a vagal effect of kilometers cycled per year (p < 0.05). Kilometers cycled per year were associated with an increase in peak power output, which was larger in the master 40 group (p < 0.05) with a non-significant upward in VO2max (p > 0.05). In the performance prediction model, the included variables explained 52% of the variance. In summary, the changes induced by age were minimal in BC and negligible in CRF, whereas HR decreased with age. Training load was generally associated with a decrease in body weight, BMI and body fat percentage that was particularly notable in the abdominal skin folds. A decrease in HRrest was observed as a vagal effect due to kilometers cycled per year, and age did not seem to have a significant effect. The annual cycling kilometers were associated with to high PPO that is greater in the M40 group and a non-significant upward trend in VO2max.

Body Composition and Metabolomics in the Alberta Physical Activity and Breast Cancer Prevention Trial

BACKGROUND

Obesity is correlated with many biomarkers, but the extent to which these correlate with underlying body composition is poorly understood.

OBJECTIVES

Our objectives were to 1) describe/compare distinct contributions of fat/lean mass with BMI-metabolite correlations and 2) identify novel metabolite biomarkers of fat/lean mass.

METHODS

The Alberta Physical Activity and Breast Cancer Prevention Trial was a 2-center randomized trial of healthy, inactive, postmenopausal women (n = 304). BMI (in kg/m2) was calculated using weight and height, whereas DXA estimated fat/lean mass. Ultra-performance liquid chromatography and mass spectrometry measured relative concentrations of serum metabolite concentrations. We estimated partial Pearson correlations between 1052 metabolites and BMI, adjusting for age, smoking, and site. Fat mass index (FMI; kg/m2) and lean mass index (LMI; kg/m2) correlations were estimated similarly, with mutual adjustment to evaluate independent effects.

RESULTS

Using a Bonferroni-corrected α level <4.75 × 10-5,  we observed 53 BMI-correlated metabolites (|r| = 0.24-0.42). Of those, 21 were robustly correlated with FMI (|r| > 0.20), 25 modestly (0.10 ≤ |r| ≤ 0.20), and 7 virtually null (|r| < 0.10). Ten of 53 were more strongly correlated with LMI than with FMI. Examining non-BMI-correlated metabolites, 6 robustly correlated with FMI (|r| = 0.24-0.31) and 2 with LMI (r = 0.25-0.26). For these, correlations for fat and lean mass were in opposing directions compared with BMI-correlated metabolites, in which correlations were mostly in the same direction.

CONCLUSIONS

Our results demonstrate how a thorough evaluation of the components of fat and lean mass, along with BMI, provides a more accurate assessment of the associations between body composition and metabolites than BMI alone. Such an assessment makes evident that some metabolites correlated with BMI predominantly reflect lean mass rather than fat, and some metabolites related to body composition are not correlated with BMI. Correctly characterizing these relations is important for an accurate understanding of how and why obesity is associated with disease.

Selection of candidate genes for differences in fat metabolism between cattle subcutaneous and perirenal adipose tissue based on RNA-seq

The site of fat deposition plays an important role in meat quality and body health. Biologically, the perirenal visceral fat (PF) and back subcutaneous fat (BF) are distinct. Angus and Simmental cattle (Bos taurus) were used as models. HE staining, triglyceride assay kit and RNA-seq were used to analyze the differences in tissue morphology and lipid accumulation, co-genes, and differentially expressed genes (DEGs) between the two tissues. According to the findings, BF has a smaller cell area and greater lipid deposition ability than PF. RNA-seq generated approximately 10.99 Gb of data in each library, and 23,472 genes were identified. The genes FABP4, ADIRF, and SCD that are related to adipose deposition were highly expressed in four tissues. There were 1678 DEGs and 1955 DEGs between BF and PF in Angus and Simmental cattle respectively. Gene Ontology function analysis identified several DEGs involved in metabolism. KEGG pathway analysis showed that four pathways related to fat metabolism were enriched. In the BF, seven genes (COL1A1, COL1A2, COL3A1, COL2A1, RXRA, C1QTNF7, and MOGAT2) were up-regulated. Five genes (ADRB3, ABHD5, CPT1B, CD36, LPIN1) were down-regulated. This study identified candidate genes that led to differences in fat metabolism, which could be useful in cattle breeding.

Personalized Diet in Obesity: A Quasi-Experimental Study on Fat Mass and Fat-Free Mass Changes

Considering that the prevalence of overweight and obesity in Southeast of Spain is high, the aim of this work was to analyze the relation between the adherence to a personalized diet and the effectiveness of changes in the body composition in overweight and obese adults in this region. This quasi-experimental study presents the following selection criteria: attendance at the consultation between 2006 and 2012, subjects ≥ 19 years of age with overweight or obesity. In total, 591 overweight or obese individuals were involved in this study, attending 4091 clinic consultations in total. Most of the sample consisted of subjects who attended >3 consultations (>1.5 months), and were females aged 19-64 years who obtained clinically significant changes in fat mass (FM, ≥5%) and recommended changes in fat-free mass (FFM, ≥0%). Based on the results obtained and the experience gained from this research, the following recommendations are established: (i) record fat mass and fat-free mass index as a complement to body mass index; (ii) use FM and FFM to evaluate effectiveness of interventions with the aim of obtaining body composition changes; (iii) use personalized diet to achieve significant changes in FM and avoid non-recommended changes in FFM.

Intramuscular and Intermuscular Abdominal Fat Infiltration in COPD: A Propensity Score Matched Study

Purpose

Low-attenuation muscle area (LAMA) and normal-attenuation muscle area (NAMA) indicate lipid-rich and lipid-poor skeletal muscle areas, respectively. Additionally, intermuscular adipose tissue (IMAT) indicates localized fat between muscle groups. In this study, we aimed to evaluate the intramuscular and intermuscular fat infiltration in individuals with chronic obstructive pulmonary disease (COPD) by performing quantitative assessment of the LAMA, NAMA, and IMAT observed on abdominopelvic computed tomography (APCT) images.

Patients and Methods

We performed a cross-sectional study using data of subjects who underwent a general health examination with APCT at Ulsan University Hospital between March 2014 and June 2019. We classified the subjects into control and COPD groups based on age, smoking history, and pulmonary function results. We compared the attenuation and body mass index adjusted area of intra-abdominal components between the two groups using propensity score matching. We also evaluated these outcomes in COPD subgroups (mild and moderate stage subjects).

Results

Overall, 6,965 subjects were initially enrolled, and 250 pairs of control and COPD subjects were selected after propensity score matching. The NAMA attenuation (unstandardized β=−1.168, P<0.001) was lower, and the IMAT (unstandardized β=0.042, P=0.006) and LAMA (unstandardized β=0.120, P<0.001) indexes were greater in the COPD group than in the control group. In subgroup analysis, those with mild and moderate COPD also had high IMAT (unstandardized β=0.037, P=0.009 and unstandardized β=0.045, P<0.001) and LAMA (unstandardized β=0.089, P=0.002 and unstandardized β=0.147, P<0.001) indexes compared to the control subjects. However, the NAMA attenuation (unstandardized β=−1.075, P<0.001) and NAMA index (unstandardized β=−0.133, P=0.015) were significantly lower in moderate COPD subjects only.

Conclusion

Our study showed that intramuscular and intermuscular abdominal fat infiltration could be present in subjects with mild COPD, and it might be exacerbated in those with moderate COPD.

Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study

BACKGROUND

Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice.

OBJECTIVE

We examined the association between a decrease in intake of red meat accompanied by an increase in other major dietary protein sources and risk of T2DM.

METHODS

We prospectively followed 27,634 males in the Health Professionals Follow-up Study, 46,023 females in the Nurses' Health Study, and 75,196 females in the Nurses' Health Study II. Diet was assessed by a validated FFQ and updated every 4 y. Cox proportional hazards models adjusted for T2DM risk factors were used to model the food replacements. We calculated HRs and 95% CIs for the T2DM risk associated with replacements of 1 daily serving of red meat with another protein source.

RESULTS

During 2,113,245 person-years of follow-up, we identified 8763 incident T2DM cases from 1990 to 2013. In the pooled analyses, a decrease in total red meat intake during a 4-y period replaced with another common protein food was associated with a lower risk of T2DM in the subsequent 4-y period. The HR (95% CI) per 1 serving/d was 0.82 (0.75, 0.90) for poultry, 0.87 (0.77, 0.98) for seafood, 0.82 (0.78, 0.86) for low-fat dairy, 0.82 (0.77, 0.86) for high-fat dairy, 0.90 (0.81, 0.99) for eggs, 0.89 (0.82, 0.98) for legumes, and 0.83 (0.78, 0.89) for nuts. The associations were present for both unprocessed and processed red meat, although stronger for the replacement of processed red meat.

CONCLUSIONS

Replacing red meat consumption with other protein sources was associated with a lower risk of T2DM.

Reference values of skeletal muscle mass, fat mass and fat-to-muscle ratio for rural middle age and older adults in western China

BACKGROUND

Skeletal muscle mass (SMM), fat mass (FM) and fat-to-muscle ratio (FMR) are significant indicators in epidemiology studies and clinical settings. The aim of this study was to establish age-related and sex-specific reference values for skeletal muscle mass index (SMMI), fat mass index (FMI) and FMR by bioelectrical impedance analysis (BIA) for healthy rural adults in western China.

METHODS

This study is a cross-sectional study from Ningxia cohort study, included 13,790 individuals aged 35 to 74 years. Bioelectrical impedance analysis (BIA) was performed to measure body composition. Lambda-mu-sigma method was used to establish age-related and sex-specific percentile curves for SMMI, FMI and FMR.

RESULTS

Overall, men had higher SMMI, but lower FMI and FMR than women for all ages. The SMMI decreased rapidly with age for men and women after 55 years and 45 years, respectively. FMI in men remain stable until 70 years; women's FMI showed a rapidly increasing after 50 years. The FMR increased consistently after 35 years for both men and women. These age-related and sex-specific reference values were established with the mean ± SD as the normal reference range.

CONCLUSIONS

These reference values could be used as simple tools to identify age-specific low SMMI or high FMI and facilitate earlier identification sarcopenia or sarcopenic obesity in rural Chinese adults.

Relationship Between Skeletal Muscle Mass to Visceral Fat Area Ratio and Cardiovascular Risk in Type 2 Diabetes

PURPOSE

Either visceral fat or muscle mass is identified to be correlated with cardiometabolic diseases, especially in type 2 diabetes (T2DM). But, the synergistical effect of visceral fat along with skeletal muscle on the risk of cardiovascular diseases (CVD) in T2DM still remains controversial. Thus, we investigated the relationship between skeletal muscle mass to visceral fat area ratio (SVR) and 10-yr CVD risk scores.

PATIENTS AND METHODS

A total of 291 T2DM patients aged 40-80 years were enrolled in the current study. SVR was evaluated based on bioelectrical impedance measurements. Both Framingham risk score system and China-PAR risk model were applied to estimate future 10-yr CVD risk in T2DM population.

RESULTS

The 10-yr CVD risk scores increased with the decreased SVR tertiles in T2DM (All P<0.001). SVR value was obviously lower in the high-risk group than that of low- or moderate-risk group (All P<0.05). However, no significant differences were observed in BMI among different CVD risk groups. Besides, SVR was correlated with Framingham risk score (r=-0.408; P<0.001) and China-PAR risk score (r=-0.336; P<0.001). HOMA-IR, triglycerides and blood pressure were also inversely related to SVR (All P<0.05). Furthermore, SVR value was independently correlated with both Framingham 10-yr CVD risk score (β=-0.074, P=0.047) and China-PAR risk score (β=-0.100, P=0.004) after adjustment for confounding factors, including age, gender, BMI, FPG, HbA1c, diabetes duration, albumin, creatinine, uric acid, smoking, blood pressure and blood lipid. The linear regression analysis was also conducted for men and women, respectively, indicating that the negative relationship between SVR and 10-yr CVD risk was observed in men but not in women.

CONCLUSION

T2DM populations who have lower SVR value are more likely to increase CVD risk. SVR levels show marked and inverse correlation with estimated 10-yr CVD risk in T2DM, indicating that SVR could be a valuable parameter to assess the risk of CVD events in clinical practice, especially in men.

A High Incidence of Metabolic Syndrome Traits in Mexicans Points at Obesity-Related Metabolic Dysfunction

INTRODUCTION

Metabolic Syndrome (MS) is a construct relating to a series of metabolic dysfunctions attributable to insulin resistance and obesity. Here, we estimate the incidence of MS according to their individual components using a Mexican open-population cohort.

METHODS

We evaluated data of 6144 Mexicans amongst whom 3340 did not have MS either by IDF or ATP-III definitions using data from an open-population cohort. We estimated the incidence of MS and each of its traits after a median follow-up of 2.24 (IQR 2.05-2.58) years and evaluated risk factors for MS incidence and each of its traits. We also explored individuals without any MS trait to evaluate trait and MS incidence after follow-up.

RESULTS

We observed a high incidence of MS-IDF (115.11 cases per 1000 person-years, 95% CI 107.76-122.47), followed by MS-ATP-III (75.77 cases per 1000 person-years, 95% CI). The MS traits with the highest incidence were low HDL-C and abdominal obesity, which was consistent for subjects without MS and those without any MS trait. When assessing predictors of MS incidence, obesity, insulin resistance, and increased apolipoprotein B levels predicted MS incidence. Weight loss >5% of body weight and physical activity were the main protective factors. Obesity was a main determinant for incident MS traits in our population, with weight loss being also a protective factor for most MS traits.

CONCLUSION

We observed a high incidence of MS in apparently healthy Mexican adults. Low HDL-C and abdominal obesity were the most frequent incident MS traits, with obesity being the main determinant of its incidence.

Validity of a 3-dimensional body scanner: comparison against a 4-compartment model and dual energy X-ray absorptiometry

Three-dimensional (3D) body scanner technology for body composition assessment is expanding. The aim of this study was to assess the validity of a 3D body scanner. One hundred and ninety-four participants (43% male; age: 23.52 ± 5.47 years; body mass index: 23.98 ± 3.24 kg·m^-2) were measured using 3D scanner and a 4-compartment (4C) model utilizing dual-energy X-ray absorptiometry (DXA), air displacement plethysmography, and bioelectrical impedance spectroscopy. Dependent t tests, validity statistics including total error (TE), standard error of the estimate, constant error, and Bland-Altman analyses were utilized. Compared with 4C, 3D scanner fat mass (FM) [mean difference (MD; 3D-4C): 2.66 kg ± 3.32 kg] and percent body fat (%BF) (MD: 4.13% ± 5.36%) were significantly (p < 0.001) over-predicted; fat free mass (FFM) was significantly underpredicted (MD: -3.15 kg ± 4.75 kg; p < 0.001). 3D demonstrated poor validity indicated by TE (%BF: 5.61%; FM: 4.50 kg; FFM: 5.69 kg). In contrast, there were no significant differences between 3D and DXA measures; 3D scanner demonstrated acceptable measurement for %BF (TE: 4.25%), FM (TE: 2.92 kg), and lean mass (TE: 3.86 kg). Compared with the 4C criterion, high TE values indicated 3D estimates were not valid. In contrast, 3D estimates produced acceptable measurement agreement when compared with DXA; an average overestimation of %BF by 5.31% (vs. 4C) and 4.20% (vs. DXA) may be expected. Novelty: 3D body composition estimates are not valid compared with the 4-C criterion model. 3D estimates appeared to be more valid in females, compared with males. When compared with DXA, 3D estimates were acceptable.

Polymorphic Appetite Effects on Waist Circumference Depend on rs3749474 CLOCK Gene Variant

Chronobiological aspects controlled by CLOCK genes may influence obesity incidence. Although there are studies that show an association between the expression of these genes and energy intake, waist circumference or abdominal obesity phenotypes, interactions with appetite have been insufficiently investigated in relation to chrononutrition. The objective was to identify interactions between CLOCK genetic variants involved in appetite status. A total of 442 subjects (329 women, 113 men; aged 18 to 65 years) were recruited. Anthropometric, dietary and lifestyle data were collected by trained nutritionists. Participants were classified according to their appetite feelings with a Likert scale. Multiple linear regression models were used to examine associations of the type genotype x appetite status on adiposity-related variables. p values were corrected by the Bonferroni method. A significant influence was found concerning the effects of appetite on waist circumference with respect to rs3749474 CLOCK polymorphism (p < 0.001). An additive model analysis (adjusted by age, gender, exercise and energy intake) showed that risk allele carriers, increased the waist circumference around 14 cm (β = 14.1, CI = 6.3-22.0) by each increment in the level of appetite. The effects of appetite on waist circumference may be partly modulated by the rs3749474 CLOCK polymorphism.

Reference values of body composition parameters and visceral adipose tissue (VAT) by DXA in adults aged 18-81 years-results from the LEAD cohort

Background

Increasing attention has been drawn on the assessment of body composition phenotypes, since the distribution of soft tissue influences cardio-metabolic risk. Dual-energy X-ray absorptiometry (DXA) is a validated technique to assess body composition. European reference values from population-based cohorts are rare.

Aims

To provide age- and sex-related reference values of body composition parameters and visceral adipose tissue (VAT) mass, and for lean mass index (LMI) with regard to fat mass index (FMI) quantities and BMI categories.

Methods

GE-Lunar Prodigy DXA scans of 10.894 participants, aged 18–81 years, recruited from 2011 to 2019 by the Austrian LEAD study, a population-based cohort study, have been used to construct reference curves using the LMS method. Parameters assessed are FMI, LMI, appendicular LMI, fat mass ratios android/gynoid and trunk/limbs, and VAT.

Results

All lean mass and fat mass parameters indicating central fat accumulation were higher in men, whereas other fat mass indices were higher in women. LMI differed between each FMI subgroup (low vs. normal, low vs. high, normal vs. high), and BMI category in all ages and LMI increased with FMI and BMI classes. VAT mass was higher in men compared with women and increased across all age groups within both sexes.

Conclusion

The present study provides age- and sex-related reference values for European adults aged 18–81 years for body composition parameters and VAT mass for Lunar Prodigy DXA. In addition, this study reports LMI reference values with regard to fat mass quantities, showing a positive association with increasing FMI percentiles and BMI categories.

High birthweight was not associated with altered body composition or impaired glucose tolerance in adulthood

AIM

To investigate whether a high birthweight was associated with an increased proportion of body fat or with impaired glucose tolerance in adulthood.

METHODS

Our cohort comprised 27 subjects with birthweights of 4500 g or more, and 27 controls with birthweights within ±1 standard deviation scores, born at Uppsala University Hospital 1975-1979. The subjects were 34-40 years old at the time of study. Anthropometric data was collected, and data on body composition was obtained by air plethysmography and bioimpedance and was estimated with a three-compartment model. Indirect calorimetry, blood sampling for fasting insulin and glucose as well as a 75 g oral glucose tolerance test were also performed. Insulin sensitivity was assessed using homoeostasis model assessment 2 and Matsuda index.

RESULTS

There were no differences in body mass index, body composition or insulin sensitivity between subjects with a high birthweight and controls.

CONCLUSION

In this cohort of adult subjects, although limited in size, those born with a moderately high birthweight did not differ from those with birthweights within ±1 standard deviation scores, regarding body composition or glucose tolerance.

Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition

(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition.

Visceral adiposity index outperforms common anthropometric indices in predicting 10-year diabetes risk: Results from the ATTICA study

BACKGROUND

Visceral adiposity index (VAI) is a novel marker of visceral adipose tissue accumulation and dysfunction. The study aim was to explore the association of VAI with the 10-year type 2 diabetes mellitus (T2DM) incidence in apparently healthy individuals and compare its T2DM predictive ability against common anthropometric indices.

METHODS

In 2001 to 2002, the ATTICA study (Greece) recruited a random sample of 1514 and 1528 CVD-free men (18-87 years old) and women (18-89 years old), respectively. Sociodemographic, lifestyle, clinical, and biochemical characteristics of participants were measured at baseline, and the 10-year follow-up was performed during 2011 to 2012. After excluding participants with diabetes at baseline and participants without complete follow-up information regarding diabetes status and/or baseline VAI values, the working sample consisted of 1049 participants. In this sample, the predictive value of baseline VAI value was studied in relation to 10-year diabetes incidence.

RESULTS

One hundred thirty-three incident cases of diabetes were documented (10-year incidence: 12.7%). In the fully adjusted model, VAI significantly increased diabetes risk by 22% (OR per 1-unit increase =1.22; 95%CI, 1.09-1.37). Markers of oxidative stress and inflammation were found to, at least partly, mediate this relationship. Also, a moderating effect of menstruation status was revealed among women. VAI showed the highest predictive ability and contributed the most, along with waist-to-height ratio, to the correct classification of participants who developed diabetes.

CONCLUSIONS

The present findings suggest that VAI may be a useful index for predicting long-term diabetes development and may exhibit better predictive ability to commonly used anthropometric indices.

Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic

The precise etiology of multiple sclerosis (MS) is unknown but epidemiologic evidence suggests this immune-mediated, neurodegenerative condition is the result of a complex interaction between genes and lifetime environmental exposures. Diet choices are modifiable environmental factors that may influence MS disease activity. Two diets promoted for MS, low saturated fat Swank and modified Paleolithic Wahls Elimination (WahlsElim), are currently being investigated for their effect on MS-related fatigue and quality of life (NCT02914964). Dr. Swank theorized restriction of saturated fat would reduce vascular dysfunction in the central nervous system (CNS). Dr. Wahls initially theorized that detailed guidance to increase intake of specific foodstuffs would facilitate increased intake of nutrients key to neuronal health (Wahls™ diet). Dr. Wahls further theorized restriction of lectins would reduce intestinal permeability and CNS inflammation (WahlsElim version). The purpose of this paper is to review the published research of the low saturated fat (Swank) and the modified Paleolithic (Wahls™) diets and the rationale for the structure of the Swank diet and low lectin version of the Wahls™ diet (WahlsElim) being investigated in the clinical trial.

Maternal Pre-Pregnancy Cardiovascular Risk Factors and Offspring and Grandoffspring Health: Bogalusa Daughters

Both maternal pre-pregnancy body mass index (BMI) and gestational weight gain have been associated with cardiovascular health in the offspring beyond two generations. A total of 274 daughters (aged 12⁻54) of 208 mothers who participated in the Bogalusa Heart Study were interviewed about their reproductive history. Mothers' data was taken from the original study, and cardiovascular measures at the visit prior to pregnancy were correlated with daughter's measures. Maternal pre-pregnancy BMI, skinfold, and waist circumference were examined as a predictor of daughters' blood pressure, lipids, and glucose, as well as a predictor of birthweight and gestational age of grandchildren. Maternal pre-pregnancy BMI was associated with higher blood pressure and lower low-density lipoprotein (LDL) and cholesterol in the daughters. Most maternal cardiometabolic risk factors were not associated with grandchildren's birth outcomes, even though higher cholesterol and LDL was associated with lower gestational age, and higher BMI and skinfold thickness with an increased risk of preterm birth. In this pilot study, some associations were found between maternal adiposity and cardiovascular risk, daughters' cardiovascular risk, and grandchild birth outcomes. Lack of conclusive associations could be due to a true lack of effect, effects being primarily mediated through daughter's BMI, or the low power of the study.