Bioelectrical Impedance Vector Analysis and Muscular Fitness in Healthy Men

Glucose metabolism in gestational diabetes and their relationship with fat mass / muscle mass index

Introduction

During pregnancy, women experience metabolic changes that may induce insulin resistance, which can be traced to the blood glucose levels A number of factors may intervene in the metabolism of glucose in pregnant women; one of them is body composition. This factor is useful for studying metabolic diseases, for which the identification of the fat mass/muscle mass index (FMMMI) considered an especially relevant factor. Owing to their nature, techniques such as bioimpedance have been sparsely used for analysis during pregnancy.

Aim

This study aimed to identify the relationship between fat mass / muscle mass index and glucose metabolism in pregnant women.

Methods

This descriptive cross-sectional study included 231 women between the ages of 18 and 35 years and 24-28 weeks of gestation, who attended a state hospital for regular check-ups and exhibited risk factors for the development of gestational diabetes (GD) according to the Current Practice Guidelines in Primary Care. The participants underwent a physical examination, anthropometric measurements bio impedance were obtained, and oral glucose tolerance curves were constructed. FMMMI was calculated.

Results

The prevalence of gestational diabetes was observed to be 13.4%. Women with a GD diagnosis had a significantly higher FMMMI than in those with no GD (0.746 ± 0.168 vs 0.567 ± 0.167;p < 0.005). The assessment of the FMMMI tertiles revealed that GD prevalence was higher in tertile 3 than in tertiles 1 and 2 (tertile 1: 2.6%; tertile 2: 9.1%; tertile 3: 24%).

Conclusion

FMMMI is associated with glucose tolerance test response in pregnant women and a higher prevalence of GD.

Factors of Muscle Quality and Determinants of Muscle Strength: A Systematic Literature Review

Muscle quality defined as the ratio of muscle strength to muscle mass disregards underlying factors which influence muscle strength. The aim of this review was to investigate the relationship of phase angle (PhA), echo intensity (EI), muscular adipose tissue (MAT), muscle fiber type, fascicle pennation angle (θf), fascicle length (lf), muscle oxidative capacity, insulin sensitivity (IS), neuromuscular activation, and motor unit to muscle strength. PubMed search was performed in 2021. The inclusion criteria were: (i) original research, (ii) human participants, (iii) adults (≥18 years). Exclusion criteria were: (i) no full-text, (ii) non-English or -German language, (iii) pathologies. Forty-one studies were identified. Nine studies found a weak−moderate negative (range r: [−0.26]−[−0.656], p < 0.05) correlation between muscle strength and EI. Four studies found a weak−moderate positive correlation (range r: 0.177−0.696, p < 0.05) between muscle strength and PhA. Two studies found a moderate-strong negative correlation (range r: [−0.446]−[−0.87], p < 0.05) between muscle strength and MAT. Two studies found a weak-strong positive correlation (range r: 0.28−0.907, p < 0.05) between θf and muscle strength. Muscle oxidative capacity was found to be a predictor of muscle strength. This review highlights that the current definition of muscle quality should be expanded upon as to encompass all possible factors of muscle quality.

Can Phase Angle Be Associated With Muscle Strength in Healthy Male Army Cadets?

INTRODUCTION

Phase angle (PhA) determined by bioelectrical impedance (BIA) is related to body fluid balance and cell membrane integrity. Handgrip strength (HGS) is used to assess muscle strength and as an indicator of health. We aimed to determine the relationship between PhA and HGS in healthy young males and to verify whether this relationship is dependent on body components.

MATERIALS AND METHODS

Hundred and sixty-three healthy male army cadets (18.8 ± 0.6 years old) participated in the study. PhA was determined by BIA, HGS was assessed by a hydraulic dynamometer, and dual-energy X-ray absorptiometry determined: fat mass (FM), bone mineral content (BMC), and lean soft tissue (LST). Participants were divided according to the PhA tertile (first tertile: PhA < 7.14°, second tertile: 7.14° ≤ PhA < 7.83°, and third tertile: PhA ≥ 7.83°).

RESULTS

Youth from the first tertile of PhA had lower BMC (2.8 kg vs. 3.0 kg and vs. 3.1 kg) and LST (51.7 vs. 53.8 kg and vs. 57.6 kg) compared to youth from the second and third tertile of PhA (P < .001), respectively. Additionally, lower HGS (83.0 kg vs. 93.1 kg) was found in the first tertile compared to the third tertile of PhA (P < .001). PhA explained 3% of the HGS variation (R2 = 0.029), while LST and BMC explained 39% (R2 = 0.385) and 22% (R2 = 0.221), respectively. Furthermore, the correlation between PhA and HGS was dependent on LST (P = .567) and BMC (P = .182).

CONCLUSION

In this sample, PhA showed a small relationship with HGS, remaining dependent on BMC and LST values. These results reinforce the importance of maintaining a physically active lifestyle with great lean mass and muscle strength values.

Assessment of total and regional bone mineral density using bioelectrical impedance vector analysis in elderly population

This study aimed to investigate the relationship between bone mineral density (BMD) and height-adjusted resistance (R/H), reactance (Xc/H) and phase angle (PhA). A total of 61 male and 64 female subjects aged over 60 years were recruited from middle Taiwan. The R and Xc were measured using Bodystat Quadscan 4000 at a frequency of 50 kHz. BMD at the whole body, L2–L4 spine, and dual femur neck (DFN), denoted as BMD_Total, BMD_L2–L4, and BMD_DFN, were calculated using a Hologic DXA scanner. The R-Xc graph was used to assess vector shift among different levels of BMD. BMD was positively correlated with Xc/H and negatively correlated with R/H (p < 0.001). The General Linear Model (GLM) regression results were as follows: BMD_Total = 1.473–0.002 R/H + 0.007 Xc/H, r = 0.684; BMD_L2–L4 = 1.526–0.002 R/H + 0.012 Xc/H, r = 0.655; BMD_DFN = 1.304–0.002 R/H + Xc/H, r = 0.680; p < 0.0001. Distribution of vector in the R-Xc graph was significantly different for different levels of BMD_Total, BMD_L2–L4 and BMD_DFN. R/H and Xc/H were correlated with BMD in the elderly. The linear combination of R/H and Xc/H can effectively predict the BMD of the whole body, spine and proximal femur, indicating that BIVA may be used in clinical and home-use monitoring tool for screening BMD in the elderly in the future.

Association of phase angle with muscle strength and aerobic fitness in different populations: A systematic review

OBJECTIVES

The aim of this study was to summarize the evidence on the association of phase angle (PhA) with muscle strength and aerobic fitness in different populations.

METHODS

A systematic search on this topic was performed in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, ScienceDirect, MEDLINE, and Web of Science) in January 2021. Studies with different designs that permitted extraction of information about the relationships between PhA and muscle strength and between PhA and aerobic fitness were included. A total of 4446 studies were initially identified; 34 were included after reading of the title, abstract, full text, and references. Four of the studies included had a longitudinal design, with samples consisting of participants ages 6 to 92 years. Thirty-two of the 34 studies evaluated the relationship between PhA and muscle strength, two cross-sectional studies investigated only PhA and aerobic fitness, and three cross-sectional studies evaluated both components (muscle strength and aerobic fitness).

RESULTS

PhA was directly associated with muscle strength in 30 cross-sectional studies and two longitudinal studies; the two studies that did not find a direct relationship had a cross-sectional design. For aerobic fitness, the five studies identified reported a direct relationship with PhA.

CONCLUSIONS

PhA is directly associated with muscle strength and aerobic fitness in different age groups (children, adolescents, adults, and older adults) and in people with different health conditions (human immunodeficiency virus, Crohn's disease, chronic obstructive pulmonary disease, bariatric surgery, kidney transplant, cancer, hemodialysis, and sarcopenia).

Bioimpedance Vector Patterns according to Age and Handgrip Strength in Adolescent Male and Female Athletes

Bioelectric Impedance Vector Analysis (BIVA) can be used to qualitatively compare individuals’ hydration and cell mass independently of predictive equations. This study aimed to analyze the efficiency of BIVA considering chronological age and handgrip strength in adolescent athletes. A total of 273 adolescents (male; 59%) engaged in different sports were evaluated. Bioelectrical impedance (Z), resistance (R), reactance (Xc), and phase angle (PhA) were obtained using a single-frequency bioelectrical impedance analyzer. Fat-free mass (FFM) and total body water were estimated using bioimpedance-based equations specific for adolescents. Female showed higher values of R (5.5%, p = 0.001), R/height (3.8%, p = 0.041), Z (5.3%, p = 0.001), and fat mass (53.9%, p = 0.001) than male adolescents. Male adolescents showed higher values of FFM (5.3%, p = 0.021) and PhA (3.1%, p = 0.033) than female adolescents. In both stratifications, adolescents (older > 13 years or stronger > median value) shifted to the left on the R-Xc graph, showing patterns of higher hydration and cell mass. The discrimination of subjects older than 13 years and having higher median of handgrip strength values was possibly due to maturity differences. This study showed that BIVA identified age and strength influence in vector displacement, assessing qualitative information and offering patterns of vector distribution in adolescent athletes.

Body Composition and Selected Nutritional Indicators in Healthy Adults-A Cross-Sectional Study

Background

Body mass composition is subject to constant change and is multifactorially determined. Its analysis in different age groups allows a better understanding of the determinants of the human organism in health and disease.

Aim

The study was aimed to conduct cross-sectional assessment of body composition and selected nutritional indicators in healthy adults.

Methods

The cross-sectional study carried out from March 2016 to April 2018 was preceded by a monthly pilot study. All 1333 adults (women 795, 59.6%) aged 20–59 included in the study were from the urban and rural area of the Podkarpackie Province (Poland). These adults were classified into four 10-year age bands. To obtain reliable assessment, selected screening (anthropometry) and in-depth (bioelectrical impedance including phase angle and bioelectrical impedance vector analysis) methods were used.

Results

In women, the proportion of individuals affected by overweight and obesity increases significantly with age, with a less pronounced trend in men, as reflected in the observed differences in individual body composition components. A slight (0.45–0.60) correlation was also observed between body mass index (BMI) and percentage of fat mass (FM %) among men with an increasing strength of the association with age, decreasing in the 50–59 years group. In the female group, the correlations described are at a much higher level (0.80 or higher). The described changes in body composition were reflected in body type from athletic to obese, measured by means of the bioelectrical impedance vector analysis (BIVA) method.

Conclusions

Age and gender significantly differentiate body composition of the adult human body. The body composition analysis should be considered as complement screening assessment method, especially as a support for the assessment of nutritional status expressed by BMI.

The relevance of whole or segmental body bioelectrical impedance phase angle and physical performance in adolescent athletes

Objective. The physical condition of athletes can be assessed easily and quantitatively using objective indicators. Bioelectrical impedance measures the phase angle (PA), representing hydration and cell function, and is a potential clinical indicator of physical condition. This study aimed to investigate the association between PA and physical performance in adolescent athletes.Approach. Overall, 170 adolescent athletes underwent a sports medical check-up, including body composition measurements and physical performance tests. Whole-body and segmental PAs (arm and leg) were determined based on body composition values. Isometric grip power and knee isokinetic muscle strength were measured as parameters of muscle strength. Counter movement jump height and squat jump height were measured as jump parameters. Associations between PA and each muscle strength or jump parameters were analysed using Pearson product-moment correlation coefficient or Spearman's rank correlation coefficient.Main results. Whole-body and upper limb PAs were highly correlated with grip power (r= 0.70-0.80). Whole-body and lower limb PAs were correlated with knee isokinetic muscle strength (r= 0.43-0.59). Whole and all segmental PAs were correlated with counter movement jump height (r= 0.46-0.57) and squat jump height (r= 0.42-0.52).Significance. PA can be used to monitor physical condition and sports performance in adolescent athletes. Segmental PAs can help assess the condition of the corresponding body part.

A proposal for reference values of hand grip strength in women with different body mass indexes

OBJECTIVE

Hand grip strength (HGS) is frequently used in clinical practice, resulting in a potential marker of nutritional status. This study aimed to develop reference values of HGS in Italian women with different categories of body mass index (BMI). Additionally, the main predictors of HGS were identified.

METHODS

A cross-sectional study was conducted in Italian women between ages 16 and 55 y with different categories of BMI at the Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples Italy. The whole sample was divided into tertiles according to BMI: 15 to 17.29 kg/m² (T1), 17.3 to 19.9 kg/m² (T2), and 20 to 25 kg/m² (T3). Anthropometry, bioimpedance analysis, and muscle strength by an HGS test were evaluated. The cut-off values for HGS were developed for all participants and stratified by age group. Finally, a multivariate linear regression analysis was performed to assess the main predictors of HGS.

RESULTS

A total of 529 women with a mean age of 23.2 ± 7.0 y and an average BMI of 18.9 ± 2.5 kg/m² were analyzed. HGS was higher for the dominant hand than for the non-dominant hand in all BMI tertiles. On both sides, according to age groups, HGS increased with increasing age in T1 and T3, whereas it increased in the women between ages 20 and 30 y in T2 only. Multivariate linear regression analysis showed that predictors of HGS varied according to tertiles. Specifically, we found that body weight (R² = 0.252) was the main predictor in T1, whereas phase angle (PhA) was the main determinant in both T2 (R² = 0.240) and T3 (R² = 0.216).

CONCLUSION

This study defined the normal reference values of HGS in Italian women with different BMI ranges, stratifying the sample group by age. Additionally, the main predictors of HGS were assessed for each BMI tertile. In primary malnutrition (T1), the main predictor of HGS was body weight, whereas in the other two tertiles (T2, T3), the PhA was the main predictor of HGS.

Relationship Between Bioelectrical Impedance Parameters and Appendicular Muscle Functional Quality in Older Adults from South-Western Poland

Purpose

The aim of this research was to assess the correlations between the impedance components and the appendicular skeletal muscle strength and functional quality indices in older adults. The use of the impedance parameters as potential identifiers characterizing the functional state of muscles could improve methods of monitoring “healthy ageing”.

Patients and Methods

A total of 346 subjectively healthy adults aged 50–83 years were subjected to tests. Body mass and height, hand grip strength and knee extensor strength were measured. Resistance, reactance and phase angle were measured using the bioelectrical impedance method. The relationship between the impedance parameters and the appendicular skeletal muscle strength and quality indices was evaluated using stepwise multiple regression.

Results

Participants aged ≥65 years were found to be characterized by lower values of the impedance parameters and the appendicular skeletal muscle strength and functional quality indices than participants 10 years younger. In both groups of sexes, the relative percentage differences in limb strength between the age groups were 3–6 times greater than the differences in appendicular skeletal muscle mass. Significant regression models for muscle strength and quality, with strong age, sex and reactance prediction and a weaker phase angle effect, were obtained.

Conclusion

The impedance components explain the part of changes in muscle strength which is independent of the decline in skeletal muscle mass. Phase angle and reactance can be suitable for diagnosing and preventing dangers connected with the decline in muscle quality, but it is necessary to establish their normalized reference values for older adults.

Leucine metabolites do not induce changes in phase angle, bioimpedance vector analysis patterns, and strength in resistance trained men

We aimed to assess the effects of off-the-shelf leucine metabolite supplements on phase angle (PhA), bioimpedance vector analysis (BIVA) patterns and strength during an 8-week resistance training protocol. Fifty-three male participants were allocated into 4 groups: α-hydroxyisocaproic acid (n = 12, age = 30.9 ± 9.3 years), β-hydroxy-β-methylbutyrate free acid (n = 12, age = 31.0 ± 9.3 years), calcium β-hydroxy-β-methylbutyrate (n = 15, age = 32.1 ± 5.2 years) or placebo (n = 14, age = 28.9 ± 6.6 years). Bioimpedance parameters and 1-repetition maximum (1RM) for back squat and bench press were assessed at baseline and at the end of weeks 4 and 8. Additionally, fat-free mass and fat mass were evaluated by dual-energy X-ray absorptiometry. No statistically group by time interactions were found, even adjusting for age. PhA and vector did not change over the training period, while time-dependent increases were observed for 1RM back squat and 1RM bench press. A direct association was observed between PhA and 1RM bench press changes (whole sample), while PhA and strength were correlated throughout the study, even when adjusting for fat-free mass and percentage of fat mass. Leucine metabolites have no effect on PhA, BIVA patterns or strength during an 8-week resistance training program, in resistance trained subjects. The trial was registered at ClincicalTrials.gov: NCT03511092. Novelty: Supplementation with leucine metabolites is not a supplementation strategy that improves bioelectrical phase angle, cellular health, and strength after an 8-week resistance training program. When consuming a high protein diet, none of the α-hydroxyisocaproic acid, β-hydroxy-β-methylbutyrate free acid, and calcium β-hydroxy-β-methylbutyrate metabolites resulted in an ergogenic effect in resistance trained men.

Nutritional Status Plays More Important Role in Determining Functional State in Older People Living in the Community than in Nursing Home Residents

The aim of this study was to verify whether the relationship between nutritional and functional status differs between seniors in the community and those in long-term care institutions. One hundred nursing home (NH) residents aged 60 years and above and 100 sex- and age-matched community-dwelling (CD) older adults were examined. Functional status was assessed using the Comprehensive Geriatric Assessment (CGA) and nutritional status using anthropometric measures, the Mini Nutritional Assessment questionnaire (MNA) and bioimpedance analysis (BIA). Significant environmental interactions were observed with resting metabolic rate (RMR), extracellular water (ECW) and intracellular water (ICW) ratio, skeletal muscle mass (SMM), skeletal muscle index (SMI) and impedance (Z) and resistance (R) to the results of the Timed Up and Go (TUG) test. The two groups demonstrated different relationships between Z and R and handgrip strength and between Geriatric Depression Scale (GDS) score and fat free mass (FFM), body density, total body water (TBW) and phase angle (PhA). Nutritional status seems to be more important for functional state in CD older people than in NH residents. Therefore, to ensure the functional independence of seniors living in the community, it is crucial to maintain the correct nutritional parameters. Further studies are necessary to account for the fact that this relationship is less significant among NH residents and to identify other factors that may contribute to these discrepancies between community and institutional environments.

Prediction and discrimination of skeletal muscle function by bioelectrical impedance vector analysis using a standing impedance analyzer in healthy Taiwanese adults

Background

Bioelectrical impedance vector analysis (BIVA) has been used for prediction of muscle performance. However, little is known about BIVA in Asian adults, and even less is known about using standing BIVA devices. Standing impedance analyzer allows quicker and more convenient way to gather data than conventional supine analyzer and is more suitable for clinical practice. This study aimed to investigate the relations between muscle function and BIVA parameters measured with a standing impedance analyzer in healthy Taiwanese adults.

Methods

A total of 406 healthy subjects (age 34.5 ± 17.3 years, body mass index 24.1 ± 4.1 kg/m²) were recruited for BIVA and handgrip strength (HGS) measurements. Impedance parameters, including resistance (R) and reactance (Xc), were measured and normalized to body size by dividing by height (H). The resulting phase angle (PhA) was calculated. HGS in the dominant, left, and right hands were referred to as HGS_DH, HGS_LH, and HGS_RH, respectively. All subjects were divided into 5 grades according to HGS.

Results

Muscle strength in the dominant, right, and left arms was correlated with variables in the order of sex, weight, age, height, Xc/H, and R/H (all, p < 0.001). Using all 6 variables, the determination coefficients were 0.792, 0.782, and 0.745, respectively, whereas the standard errors of estimates were 56.89, 58.01, and 56.67 N for HGS_DH, HGS_LH, and HGS_RH, respectively. HGS was positively correlated with PhA, and negatively correlated with Xc/H and R/H.

Conclusions

BIVA parameters measured with a standing impedance analyzer and anthropometric variables can predict and discriminate muscle function with good performance in healthy Asian adults.

Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults

Normal-weight obesity (NWO) has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in early adulthood. The aim of this study was to investigate the associations between NWO and cardiometabolic risk factors in a large population of Colombian young adults. A cross-sectional study was conducted on 1354 subjects (61% women), aged from 18 to 30. Anthropometric data, including body mass index (BMI) and waist circumference (WC), were estimated, and the percentage of fat mass was measured through bioelectrical impedance analysis (BIA). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). A cardiometabolic risk Z-score was derived by assessing WC, triglycerides, high-density lipoprotein cholesterol (HDL-C) cholesterol, fasting glucose, and systolic blood pressure. NWO was defined by the combination of excess %BF (over 25.5% for men and 38.9% for women) and a BMI < 25 kg/m². The overall prevalence of NWO was 29.1%. Subjects with NWO have an increased risk of cardiometabolic risk compared to the normal-weight lean group (OR = 3.10). Moreover, NWO was associated with an increased risk of presenting low HDL-C (OR = 2.34), high abdominal obesity (OR = 7.27), and low NGS (OR = 3.30), p < 0.001. There is a high prevalence of NWO in American Latin young adults and this condition is associated with an increased cardiovascular risk, high blood pressure, low HDL-C, high abdominal obesity, and low muscular strength early in life. Screening for adiposity in subjects with a normal BMI could help to identify young adults at a high risk of cardiometabolic abnormalities.

BIA-assessed cellular hydration and muscle performance in youth, adults, and older adults

BACKGROUND & AIMS

Alterations in body hydration can have an impact on muscle performance, with consequences not only at a sporting level, but on overall health and daily functional competence. Given that the estimation of body water from BIA is based on prediction equations involving assumptions on tissue hydration and body geometry, it is unclear if phase angle (PhA), which is not influenced by assumptions, is a better marker of muscle performance than the BIA estimated parameters of body water. Therefore, the aims of this investigation were to analyze the relationships of BIA-estimated body water compartments with muscle performance among youth, adults, and older adults, and to assess the added value of PhA as a marker of muscle performance.

METHODS

BIA assessments were completed on 263 youth (ages 6-17), 249 adults (ages 18-64), and 75 older adults (ages 65+). Muscle performance was assessed by jumping mechanography (power and force) and handgrip strength. Partial correlations were used to compare the degree of association among the BIA measures with muscle performance for each age group, controlling for sex, age, and body weight.

RESULTS

TBW, ICW, and PhA were associated with muscle performance at the lower and upper limbs in all age groups (p < 0.05), with the exception of PhA with handgrip strength in adults and older adults and TBW with lower limb total force in the older adults. In youth, the highest associations observed were PhA with lower limb muscle power (r = 0.45, CI:0.35-0.54, p < 0.05) and with handgrip strength (r = 0.42, CI:0.32-0.52, p < 0.05). In adults and older adults, the major associations observed were those of ICW with lower limb muscle power (adults, r = 0.53, CI:0.43-0.61, p < 0.05; older adults, r = 0.52, CI = 0.33-0.67, p < 0.05). ECW had significantly lower associations (p < 0.05) with both lower limb force and power in adults and older adults compared to youth. In the older adults, ECW was negatively associated with lower limb total force (r = -0.24; p < 0.05).

CONCLUSIONS

BIA derived hydration parameters may be useful markers of muscle performance in all age groups. In particular, the ICW compartment was a better predictor of muscle performance in adults and older adults compared to youth. In youth, PhA had stronger associations with muscle performance than those of ICW. Thus, phase angle appears to be a useful marker of muscle performance, particularly in youth.

Handgrip strength attenuates the adverse effects of overweight on cardiometabolic risk factors among collegiate students but not in individuals with higher fat levels

The aims of this study are to (i) examine a clustered metabolic syndrome composite score (MetScore) and fatness among college students across body mass index (BMI) categories, and (ii) determine whether fit individuals have lower MetScores, fewer individual metabolic syndrome components, and lower fatness than unfit individuals across BMI categories. A total of 1,795 participants aged  >18 years who participated in The FUPRECOL Study were selected for the present analyses. Handgrip strength was tested by a grip dynamometer and used to classify adults as fit or unfit. Among all participants, MetScore, percentage of body fat, and visceral adiposity increased linearly across the BMI categories among college students (all P < 0.001). Individuals who were overweight and fit had a lower MetScore (-0.6 SD; P = 0.02), body fat percentage (-2.6%; P < 0.001) and visceral adiposity (-0.2; P = 0.01) than unfit peers. Moderately fit obese individuals had significantly lower visceral fat levels than unfit obese peers (-3.0; P = 0.03). These results suggest that having adequate handgrip strength-a proxy of overall strength capacity-may attenuate obesity-related cardiometabolic risk. Moreover, weight loss should be recommended to all individuals with obesity, even among those who are currently considered fit.

Body composition and phase angle as an indicator of nutritional status in children with juvenile idiopathic arthritis

BACKGROUND

Juvenile idiopathic arthritis (JIA) is the most common chronic, systemic autoimmune connective tissue disease diagnosed in children and adolescents. An important aspect of monitoring of children with JIA is a precise assessment of the nutritional status to identify children and adolescents at risk of malnutrition. The aim of the study was to assess the body composition and phase angle in children diagnosed with JIA in comparison to age and sex matched healthy children since there are scarce reports in paediatric patients.

METHODS

A total of 46 children and adolescents aged 4-18 years, with JIA were included in the cross-sectional study. Controls were selected from the group of healthy children and adolescents. Children with diagnosed JIA and healthy children were strictly matched for age and gender. In both groups BIA with phase angle calculation was performed.

RESULTS

Phase angle score was significantly lower in the study group compared to control group (5.45 ± 0.64 vs. 5.85 ± 0.80, p = 0.010). Also lower percentage of body cell mass (50.63 ± 3.46 vs. 52.70 ± 4.06, p = 0.010) and muscle mass (46.02 ± 6.32 vs. 49.53 ± 6.67, p = 0.005) were revealed. In the analysis of subtypes of JIA we found significant differences between children and adolescents with polyarthritis compared to control group, while no significant differences were found between patients with oligoarthritis and control group.

CONCLUSIONS

The obtained results indicate a higher risk of malnutrition in children and adolescents with JIA compared to healthy peers, predominantly in patients with polyarthritis.

Effects of Single Set Resistance Training With Different Frequencies on a Cellular Health Indicator in Older Women

The main purpose of this study was to compare the effects of resistance training (RT) performed two versus three times per week on phase angle (a cellular health indicator) in older women. A total of 39 women (69.1 ± 5.5 years) were randomly assigned to perform a RT program two (G2X) or three (G3X) days per week for 12 weeks. The RT was a whole-body program (eight exercises, one set, 10-15 repetitions). Phase angle, resistance, reactance, and total body water were assessed by bioimpedance spectroscopy. Intracellular water, reactance, and phase angle increased significantly in G2X (2.1%, 3.0%, and 5.6%, respectively) and G3X (5.0%, 6.9%, and 10.3%, respectively) from pretraining to posttraining, with no significant difference between groups. Bioimpedance resistance decreased similarly in both groups (G2X = -1.7% vs. G3X = -3.2%). We conclude that a single set RT program with a frequency of 2 days per week may be sufficient to promote an improvement in cellular health in older women.

Fat-to-Muscle Ratio: A New Anthropometric Indicator as a Screening Tool for Metabolic Syndrome in Young Colombian People

Fat-to-muscle ratio has been proposed as an alternative approach for assessing body fat. The objective of this study was to explore fat-to-muscle ratio thresholds in metabolic syndrome (MetS) diagnosis; it was hypothesised that the fat-to-muscle ratio is a good predictive indicator of MetS in a large population of young Colombian adults. For this purpose, a cross-sectional study was conducted on 1416 subjects (66.6% female), aged from 18.1 to 25.1. As part of the study, measurements of the subjects’ anthropometric indicators, serum lipid indices, blood pressure, and fasting plasma glucose were taken. Body composition was measured through bioelectrical impedance analysis (BIA). A new variable (ratio of fat mass to muscle mass, in kg) was calculated. Following the International Diabetes Federation (IDF) definition, MetS includes three or more metabolic abnormalities. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of the fat-to-muscle ratio to predict MetS. According to the IDF, the best fat-to-muscle ratio cut-off point for detecting MetS in men was 0.225 kg, with an area under the curve (AUC) of 0.83, sensitivity of 80%, and specificity of 70%. For women, the fat-to-muscle ratio cut-off point was 0.495 kg, the AUC was 0.88, and the sensitivity and specificity were 82% and 80%, respectively. In conclusion, our results showed that the fat-to-muscle ratio cut-off points from ROC analyses demonstrate good discriminatory power for detecting MetS in young Colombian adults.

Acute Effects of High Intensity, Resistance, or Combined Protocol on the Increase of Level of Neurotrophic Factors in Physically Inactive Overweight Adults: The BrainFit Study

The purpose of this study was to compare the neurotrophic factor response following one session of high-intensity exercise, resistance training or both in a cohort of physically inactive overweight adults aged 18–30 years old. A randomized, parallel-group clinical trial of 51 men (23.6 ± 3.5 years; 83.5 ± 7.8 kg; 28.0 ± 1.9 kg/m²) who are physically inactive (i.e., < 150 min of moderate-intensity exercise per week or IPAQ score of <600 MET min/week for >6 months) and are either abdominally obese (waist circumference ≥90 cm) or have a body mass index, BMI ≥25 and ≤ 30 kg/m² were randomized to the following four exercise protocols: high-intensity exercise (4 × 4 min intervals at 85–95% maximum heart rate [HRmax] interspersed with 4 min of recovery at 75–85% HRmax) (n = 14), resistance training (12–15 repetitions per set, at 50–70% of one repetition maximum with 60 s of recovery) (n = 12), combined high-intensity and resistance exercise (n = 13), or non-exercising control (n = 12). The plasma levels of neurotrophin-3 (NT-3), neurotrophin-4 (also known as neurotrophin 4/5; NT-4 or NT-4/5), and brain-derived neurotrophic factor (BDNF) were determined before (pre-exercise) and 1-min post-exercise for each protocol session. Resistance training induced significant increases in NT-3 (+39.6 ng/mL [95% CI, 2.5–76.6; p = 0.004], and NT-4/5 (+1.3 ng/mL [95% CI, 0.3–2.3; p = 0.014]), respectively. Additionally, combined training results in favorable effects on BDNF (+22.0, 95% CI, 2.6–41.5; p = 0.029) and NT-3 (+32.9 ng/mL [95% CI, 12.3–53.4; p = 0.004]), respectively. The regression analysis revealed a significant positive relationship between changes in BDNF levels and changes in NT-4/5 levels from baseline to immediate post-exercise in the combined training group (R² = 0.345, p = 0.034) but not the other intervention groups. The findings indicate that acute resistance training and combined exercise increase neurotrophic factors in physically inactive overweight adults. Further studies are required to determine the biological importance of changes in neurotrophic responses in overweight men and chronic effects of these exercise protocols.

Trial Registration: ClinicalTrials.gov, NCT02915913 (Date: September 22, 2016).

Active commuting to and from university, obesity and metabolic syndrome among Colombian university students

Background

There is limited evidence concerning how active commuting (AC) is associated with health benefits in young. The aim of the study was to analyze the relationship between AC to and from campus (walking) and obesity and metabolic syndrome (MetS) in a sample of Colombian university students.

Methods

A total of 784 university students (78.6% women, mean age = 20.1 ± 2.6 years old) participated in the study. The exposure variable was categorized into AC (active walker to campus) and non-AC (non/infrequent active walker to campus: car, motorcycle, or bus) to and from the university on a typical day. MetS was defined in accordance with the updated harmonized criteria of the International Diabetes Federation criteria.

Results

The overall prevalence of MetS was 8.7%, and it was higher in non-AC than AC to campus. The percentage of AC was 65.3%. The commuting distances in this AC from/to university were 83.1%, 13.4% and 3.5% for < 2 km, 2-5 km and > 5 km, respectively. Multiple logistic regressions for predicting unhealthy profile showed that male walking commuters had a lower probability of having obesity [OR = 0.45 (CI 95% 0.25–0.93)], high blood pressure [OR = 0.26 (CI 95% 0.13–0.55)] and low HDL cholesterol [OR = 0.29 (CI 95% 0.14–0.59)] than did passive commuters.

Conclusions

Our results suggest that in young adulthood, a key life-stage for the development of obesity and MetS, AC could be associated with and increasing of daily physical activity levels, thereby promoting better cardiometabolic health.

Bioelectrical Impedance Phase Angle as an Indicator of Malnutrition in Hospitalized Children with Diagnosed Inflammatory Bowel Diseases-A Case Control Study

The phase angle (PhA) seems to be a reliable screening tool for the identification of malnutrition risk in hospitalized children with inflammatory bowel disease (IBD). The aim of the present study was to assess the body composition and nutritional status of hospitalized children and adolescents with IBD by using bioelectrical impedance analysis (BIA) with phase angle (PhA) calculation, which has not been evaluated in hospitalized children with IBD yet. A total of 59 children and adolescents aged 4–18 years, with IBD: 34 ulcerative colitis (UC) and 25 Crohn’s disease (CD) were included in the study. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. In both groups, BIA was performed and PhA was calculated. IBD patients had significantly lower PhA (UC: 5.34 ± 1.34 vs. 5.96 ± 0.76, p = 0.040; CD: 5.16 ± 1.18 vs. 5.90 ± 0.62, p = 0.009) compared to the control subjects. Significant changes in selected body composition parameters were observed particularly in CD, especially in fat free mass components. Lower phase angle score together with lower body composition parameters and selected nutrition indicators in children and adolescents with IBD demonstrate their worse nutritional and functional status compared to healthy subjects.

Tri-Ponderal Mass Index vs. Fat Mass/Height³ as a Screening Tool for Metabolic Syndrome Prediction in Colombian Children and Young People

Tri-ponderal mass index (TMI) and fat mass index (FMI) have been proposed as alternative approaches for assessing body fat since BMI does not ensure an accurate screening for obesity and overweight status in children and adolescents. This study proposes thresholds of the TMI and FMI for the prediction of metabolic syndrome (MetS) in children and young people. For this purpose, a cross-sectional study was conducted on 4673 participants (57.1% females), who were 9–25 years of age. As part of the study, measurements of the subjects’ weight, waist circumference, serum lipid indices, blood pressure and fasting plasma glucose were taken. Body composition was measured by bioelectrical impedance analysis (BIA). The TMI and FMI were calculated as weight (kg)/height (m³) and fat mass (kg)/height (m³), respectively. Following the International Diabetes Federation (IDF) definition, MetS is defined as including three or more metabolic abnormalities. Cohort-specific thresholds were established to identify Colombian children and young people at high risk of MetS. The thresholds were applied to the following groups: (i) a cohort of children where the girls’ TMI ≥ 12.13 kg/m³ and the boys’ TMI ≥ 12.10 kg/m³; (ii) a cohort of adolescents where the girls’ TMI ≥ 12.48 kg/m³ and the boys’ TMI ≥ 11.19 kg/m³; (iii) a cohort of young adults where the women’s TMI ≥ 13.21 kg/m³ and the men’s TMI ≥ 12.19 kg/m³. The FMI reference cut-off values used for the different groups were as follows: (i) a cohort of children where the girls’ FMI ≥ 2.59 fat mass/m³ and the boys’ FMI ≥ 1.98 fat mass/m³; (ii) a cohort of adolescents where the girls’ FMI ≥ 3.12 fat mass/m³ and the boys’ FMI ≥ 1.46 fat mass/m³; (iii) a cohort of adults where the women’s FMI ≥ 3.27 kg/m³ and the men’s FMI ≥ 1.65 kg/m³. Our results showed that the FMI and TMI had a moderate discriminatory power to detect MetS in Colombian children, adolescents, and young adults.