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Longitudinal changes in body composition are associated with all-cause mortality in patients on peritoneal dialysis.
Kim, C, Kim, JK, Lee, HS, Kim, SG, Song, YR
Clinical nutrition (Edinburgh, Scotland). 2021;(1):120-126
Abstract
BACKGROUND & AIMS Peritoneal dialysis (PD) is associated with a number of adverse body compositional changes, including fat gain and muscle wasting. Whether body compositional changes are associated with the long-term prognosis is uncertain. The purpose of this study was to analyze the effects of longitudinal changes in body composition on all-cause mortality in PD patients. METHODS PD patients were subjected to bioimpedance spectroscopy (BIS) and handgrip strength (HGS) at baseline and after 2 years. Among 160 patients, 131 patients were tested with a repeat BIS and HGS. Lean tissue index (LTI) loss and fat tissue index (FTI) gain were defined as a 10% decline in LTI and a 10% gain in FTI, respectively after 2 years. RESULTS The prevalence of sarcopenia at baseline was 13.8%. After 2 years, LTI loss and FTI gain were observed in 40 (30.5%) and 58 (44.3%) patients, respectively. Baseline clinical factors did not predict longitudinal body compositional changes, and there was a negative association between changes in the LTI and FTI (r = -0.574, p < 0.001). Low LTI and low HGS at baseline were significant predictors of all-cause mortality after adjusting for demographic and biochemical parameters, but not when cardiovascular factors were included in the multivariate analysis. However, LTI loss and FTI gain were independent risk factors for all-cause mortality after adjusting for demographic, biochemical, and cardiovascular parameters. CONCLUSIONS In PD patients, longitudinal changes in LTI and FTI were more strongly associated with all-cause mortality than single values in LTI and FTI.
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Body mass does not reflect the body composition changes in response to similar physical training in young women and men.
Foulis, SA, Hughes, JM, Walker, LA, Guerriere, KI, Taylor, KM, Proctor, SP, Friedl, KE
International journal of obesity (2005). 2021;(3):659-665
Abstract
INTRODUCTION U.S. Army Basic Combat Training (BCT) prepares new recruits to meet soldier physical demands. It also serves as a model of physical changes in healthy young nonobese women and men during an intensive 10-week training program without diet restriction. In this prospective observational study, we quantified the changes in lean mass and body fat induced by BCT in a large sample of men and women undergoing the same physical training program. METHODS Young women (n = 573) and men (n = 1071) meeting Army health and fitness recruitment standards volunteered to provide DXA-derived body composition data at the beginning and end of BCT. RESULTS During BCT, there was no change in body mass in women and a 1.7-kg loss in men. Relative body fat (%BF) declined by an average of 4.0 ± 2.4 and 3.4 ± 2.8 percentage points (±SD) for women and men, respectively. The greatest predictor of change in %BF during BCT for both sexes was %BF at the beginning of training. Women and men gained an average 2.7 ± 1.6 kg and 1.7 ± 2.0 kg of lean mass during BCT. CONCLUSIONS Army BCT produced significant effects on body composition despite minimal changes in total body mass. These findings demonstrate the ability of a 10-week sex-integrated physical training program to positively alter body composition profiles of young adults.
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Body composition, muscle function and biochemical values in patients after pancreatic surgery: An observational study.
Petrolo, M, Rangelova, E, Toilou, M, Hammarqvist, F
Clinical nutrition (Edinburgh, Scotland). 2021;(6):4284-4289
Abstract
BACKGROUND & AIMS The complex nature of pancreatic operation makes it a high-risk and technically demanding major abdominal procedure, resulting in early pathophysiological alterations. This study aims to observe changes in body composition, muscle function and biochemical values in patients during the early postoperative days (PODs) following pancreaticoduodenectomy or total pancreatectomy. METHODS Assessment of body composition by bioimpedance spectroscopy, muscle function by peak expiratory flow rate (PEFR) and maximum handgrip strength (HGS), and biochemical values were measured in patients the day before surgery and on PODs 3, 6 and 9. RESULTS Significant changes occurred among 34 patients on POD 3 in body weight +2.3 (0.8-3.6) kg, total body water +2.8 (1.1-5.9) L, extracellular water +2.5 (1.2-3.7) L, intracellular water +1.1 (-0.4-1.9) L, phase angle -1.0 (-1.2 to -0.7)°, PEFR -250.0 (-407.5 to -125.0) L/m and HGS -4.8 (-7.3 to -3.0) kg, C-reactive protein +78.0 (41.0-102.8) mg/L, haemoglobin -34.5 (-45.8 to -26.0) g/L, albumin -12 (-16.5 to -10.0) g/L. CONCLUSIONS Changes in water distribution, phase angle, initial reduced muscle function and altered biochemical values were observed during the first 9 PODs.
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Prognostic Role of Malnutrition Diagnosed by Bioelectrical Impedance Vector Analysis in Older Adults Hospitalized with COVID-19 Pneumonia: A Prospective Study.
Da Porto, A, Tascini, C, Peghin, M, Sozio, E, Colussi, G, Casarsa, V, Bulfone, L, Graziano, E, De Carlo, C, Catena, C, et al
Nutrients. 2021;(11)
Abstract
BACKGROUND Little is known on the clinical relevance of the nutritional status and body composition of patients hospitalized with SARS-CoV-2 infection. The aim of our study was to assess the prevalence of malnutrition in patients with COVID-19 pneumonia using bioelectrical impedance vector analysis (BIVA), and to evaluate the relationship of their nutritional status with the severity and outcome of disease. METHODS Among 150 consecutive patients who were hospitalized with COVID-19 pneumonia, 37 (24.3%) were classified as malnourished by BIVA, and were followed-up for 60 days from admission. Outcome measures were differences in the need for invasive mechanical ventilation, in-hospital mortality, and the duration of hospital stay in survivors. RESULTS During 60 days of follow-up, 10 (27%) malnourished patients and 13 (12%) non-malnourished patients required invasive mechanical ventilation (p = 0.023), and 13 (35%) malnourished patients and 9 (8%) non-malnourished patients died (p < 0.001). The average duration of the hospital stay in survivors was longer in patients with malnutrition (18.2 ± 15.7 vs. 13.2 ± 14.8 days, p < 0.001). In survival analyses, mechanical ventilation free (log-rank 7.887, p = 0.050) and overall (log-rank 17.886, p < 0.001) survival were significantly longer in non-malnourished than malnourished patients. The Cox proportional ratio showed that malnutrition was associated with an increased risk of mechanical ventilation (HR 4.375, p = 0.004) and death (HR 4.478, p = 0.004) after adjusting for major confounders such as age, sex, and BMI. CONCLUSIONS Malnutrition diagnosed with BIVA was associated with worse outcomes in hospitalized patients with COVID-19 pneumonia.
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BIOELECTRICAL VECTOR ANALYSIS IN OBESE ADOLESCENTS.
Oliveira Filho, JM, Bernardes, PS, Serpa, GHC, Siqueira, GDJ, Noll, M, Venâncio, PEM, Soares, V
Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo. 2020;:e2019017
Abstract
OBJECTIVE To evaluate the hydration of obese and non-obese adolescents by vectorial bioimpedance analysis, in addition to verifying the associations between obesity and bioelectrical impedance vectorial analysis (BIVA) parameters. METHODS A cross-sectional study with adolescents between 14 and 18 years old (n=489, 300 boys and 189 girls). Electric bioimpedance (BIA; Quantum_II, RJL system, Rome, Italy) provided resistance and reactance parameters to calculate phase angle (PA), fat-free mass (FFM) and body fat (%BF). The confidence ellipses were compared, and the construction of the tolerance ellipses allowed individual and qualitative evaluation of the vectors and classification in dehydrated, normohydrated and hyperhydrated. RESULTS 78 obese and 411 eutrophic adolescents participated. Resistance (p<0.001) and reactance (p<0.001) and their normalization by stature (p<0.001) were reduced in the obese, whereas the PA was higher (p=0.003). %BF was 11.3% higher in obese adolescents. The main vector of the obese, both male (D=1.38; p<0.001) and female (D=1.49; p<0.001), indicated greater hydration. The ellipse of tolerance of the total sample showed that 25 (32.1%) were hyperhydrated and 02 (2.6%) vectors positioned in the sense of dehydration. A total of 17 (53.2%) girls and 16 (34.8%) boys were hyperhydrated. Logistic regression showed an inverse relation of BMI with resistance (p<0.001), reactance (p<0.001) and both normalized by stature. Adolescents with increased PA (p<0.001) were twice as likely to present obesity. CONCLUSIONS Obese adolescents were hyperhydrated and there was an inverse relationship of BMI with resistance and direct with PA.
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Association of Low Energy Availability and Suppressed Metabolic Status in Korean Male Collegiate Soccer Players: A Pilot Study.
Lee, S, Kuniko, M, Han, S, Oh, T, Taguchi, M
American journal of men's health. 2020;(6):1557988320982186
Abstract
Low energy availability (EA) can impair physiological function in athletes. The purpose of this study was to investigate EA status, metabolic status, and bone metabolism with biochemical analysis in Korean male soccer players. Twelve male athletes (18-20 years) completed the study. Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA), while VO2 max was determined by an incremental exercise test. Blood samples were taken for bone marker and hormone analyses. Resting energy expenditure (REE) was measured using the Douglas bag method and predicted using the DXA method. Food diaries and heart rates (HR) during training were recorded, and the Profile of Mood States 2 and Eating Attitude Test 26 were completed. Group differences between low EA (LEA <30 kcal/kg FFM/d, n = 5) and high EA (HEA ≥30 kcal/kg FFM/d, n = 7) were evaluated. The mean EA of the all participants was 31.9 ± 9.8 kcal/kg FFM/d with only two participants having an EA above 45 kcal/kg FFM/d. LEA showed suppressed REE (LEA: 26.0 ± 1.7 kcal/kg/d, HEA: 28.8 ± 1.4 kcal/kg/d, p = .011) with a lower REEratio (LEA: 0.91 ± 0.06, HEA: 1.01 ± 0.05, p = .008) as well as a lower insulin-like growth factor 1 (IGF-1) level (LEA: 248.6 ± 51.2 ng/mL, HEA: 318.9 ± 43.4 ng/mL, p = .028) compared to HEA. There were no group differences in bone markers or other hormone levels. Korean male athletes exhibited low EA status with suppressed metabolism, but there was limited evidence on the effect of EA on bone metabolism, endocrine system, and psychological parameters.
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B-vitamins and body composition: integrating observational and experimental evidence from the B-PROOF study.
Oliai Araghi, S, Braun, KVE, van der Velde, N, van Dijk, SC, van Schoor, NM, Zillikens, MC, de Groot, LCPGM, Uitterlinden, AG, Stricker, BH, Voortman, T, et al
European journal of nutrition. 2020;(3):1253-1262
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Abstract
PURPOSE Higher folate and vitamin-B12 have been linked to lower risk of overweight. However, whether this is a causal effect of these B-vitamins on obesity risk remains unclear and evidence in older individuals is scarce. This study aimed to assess the role of B-vitamin supplementation and levels on body composition in older individuals. METHODS A double-blind, randomized controlled trial in 2919 participants aged ≥ 65 years with elevated homocysteine levels. The intervention comprised a 2-year supplementation with a combination of folic acid (400 µg) and vitamin B12 (500 µg), or with placebo. Serum folate, vitamin-B12, active vitamin-B12 (HoloTC), methylmalonic acid (MMA), and anthropometrics were measured at baseline and after 2 years of follow-up. Dietary intake of folate and vitamin-B12 was measured at baseline in a subsample (n = 603) using a validated food-frequency questionnaire. Fat mass index (FMI) and fat-free mass index (FFMI) were assessed with Dual Energy X-ray absorptiometry (DXA). RESULTS Cross-sectional analyses showed that a 1 nmol/L higher serum folate was associated with a 0.021 kg/m2 lower BMI (95% CI - 0.039; - 0.004). Higher HoloTC (per pmol/L log-transformed) was associated with a 0.955 kg/m2 higher FMI (95% CI 0.262; 1.647), and higher MMA (per μgmol/L) was associated with a 1.108 kg/m2 lower FMI (95% CI - 1.899; - 0.316). However, random allocation of B-vitamins did not have a significant effect on changes in BMI, FMI or FFMI during 2 years of intervention. CONCLUSIONS Although observational data suggested that folate and vitamin B12 status are associated with body composition, random allocation of a supplement with both B-vitamins combined versus placebo did not confirm an effect on BMI or body composition.
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Energy Expenditure and Changes in Body Composition during Submarine Deployment-An Observational Study "DasBoost 2-2017".
Rietjens, G, Most, J, Joris, PJ, Helmhout, P, Plasqui, G
Nutrients. 2020;(1)
Abstract
The present study was designed to objectively assess the effects of 3-months submarine deployment on behavioural and metabolic determinants of metabolic health. In 13 healthy, non-obese volunteers, we using stable isotope dilution, and plasma and urinary biochemistry to characterize metabolic health before and after a 3-month submarine deployment. Volunteers worked in 6-h shifts. After deployment, we observed reduced fat-free mass (mean ± SD, -4.1 ± 3.3 kg, p = 0.003) and increased adiposity (21.9 ± 3.2% fat mass to 24.4 ± 4.7%, p = 0.01). Changes in fat-free mass were positively associated with physical activity (+0.8 kg per 0.1 increase in PAL, p = 0.03). The average physical activity level was 1.64 ± 0.26 and total energy expenditure during deployment was 2937 ± 498 kcal/d, while energy intake was 3158 ± 786 kcal/d. Fasting glucose (p = 0.03), and triglycerides (p = 0.01) declined, whereas fasting free fatty acids increased (p = 0.04). Plasma vitamin D and B12 concentrations decreased (-14%, p = 0.04, and -44%, p = 0.001, respectively), and plasma calcium, and magnesium increased (+51%, p = 0.01, and +5%, p = 0.02). Haemoglobin was unchanged, but haematocrit decreased (-2.2 ± 2.1%, p = 0.005). In conclusion, submarine deployment impairs fat-free mass maintenance and promotes adiposity. High physical activity may prevent the decline in fat-free mass. Our study confirms the need to counteract Vitamin D and B12 deficiencies, and suggests impairments in erythrocyte metabolism.
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Changes in resting metabolic rate and body composition due to intragastric balloon therapy.
Gaździńska, AP, Mojkowska, A, Zieliński, P, Gazdzinski, SP
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2020;(1):34-39
Abstract
BACKGROUND Intragastric balloon (IGB) insertion leads to dietary restriction; however, its neurohormonal actions were also described. Resting metabolic rate (RMR) adjusted for body mass (RMR/mass) seems to increase after bariatric interventions, whereas it generally decreases after caloric restriction-based therapies. However, no studies have evaluated the changes in body composition and RMR over IGB treatment. OBJECTIVE To evaluate the relationships between changes in body composition, RMR, RMR/mass, and RMR adjusted for fat-free mass (FFM) (RMR/FFM) over IGB treatment lasting 6 months. SETTING Single-center observational study. METHODS Twenty-one morbidly obese patients treated with IGB (143 ± 20 kg, body mass index [BMI] = 49.5 ± 7.3, 98% ± 29% percent excess weight, 43.6 ± 12.6 yr) were enrolled. Changes in body composition, RMR, RMR/mass, and RMR/FFM were evaluated between 1 month before IGB insertion (time point 1 [TP1]) and 3 months thereafter (TP2). Fourteen patients were also assessed 1 month after IGB removal (TP3). RESULTS There was a 9.5% reduction in weight, a 9.4% reduction in BMI, and 19.1% decrease in percent excess weight at TP2 (n = 21; P < .001); a further 6.5% reduction in weight and BMI and a 13.1% drop in percent excess weight (n = 14, P < .001) at TP3. They were accompanied by a 5.4% reduction in FFM between TP1 and TP2 (n = 21, P < .001). Compared with pretreatment values, at TP2 RMR was 12.5% lower (P < .001) but did not change thereafter. RMR/mass increased 12.4% between TP2 and TP3 (n = 14, P = .02) but on average did not change between TP1 and TP3. The results in the smaller cohort (n = 14) between TP1 and TP2 were consistent with results obtained for the entire cohort. Similar findings were obtained for RMR/FFM. The larger increases in RMR/mass between TP1 and TP3 were associated with more weight loss, larger drop in BMI, and more loss of excess weight (r < -.55, P < .03). CONCLUSION This is the first study to evaluate the relationship between changes in body composition and RMR over IGB treatment. IGB therapy leads to both fat and fat-free mass reductions and RMR decreases. More weight reduction is associated with larger increases in RMR/mass.
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Early Season Hormonal and Biochemical Changes in Division I Field Hockey Players: Is Fitness Protective?
Walker, AJ, McFadden, BA, Sanders, DJ, Bozzini, BN, Conway, SP, Arent, SM
Journal of strength and conditioning research. 2020;(4):975-981
Abstract
Walker, AJ, McFadden, BA, Sanders, DJ, Bozzini, BN, Conway, SP, and Arent, SM. Early season hormonal and biochemical changes in Division I field hockey players: is fitness protective? J Strength Cond Res 34(4): 975-981, 2020-The purpose was to evaluate changes in hormonal and biochemical markers as a result of the accumulated stress of the initial 4-week training block in field hockey players. Women's Division I field hockey players (N = 22; Mage = 19.7 ± 1.1 years) performed testing before the start of preseason (A1) that included body composition (%BF), vertical jump, and V[Combining Dot Above]O2max. Blood draws were conducted at A1 to assess creatine kinase (CK), iron (Fe), hemoglobin (HGB), hematocrit (HCT), percent saturation (%sat), total cortisol (TCORT), free cortisol (FCORT), interleukin-6 (IL-6), sex hormone-binding globulin (SHBG), prolactin (PRL), vitamin D (vitD), and thyroxine (T3). Blood draws were repeated 4 weeks later (A2). Athletes were monitored during this training block, which included 2 weeks of preseason and the first 2 weeks of the season, using heart rate monitors to determine energy expenditure (Kcal) and training load. There were significant disruptions in TCORT, FCORT, T3, CK, Fe, and SHBG (p < 0.05) from A1 to A2. V[Combining Dot Above]O2max accounted for 31% (p < 0.05) of the variance in TCORT and %BF accounting for an additional 20.1% (p < 0.05). V[Combining Dot Above]O2max accounted for 32.7% (p < 0.05) of the variance in FCORT. %BF accounted for 48.9% (p < 0.05) of the variance in T3. Kcal was positively correlated with V[Combining Dot Above]O2max (p < 0.05) and negatively correlated with %BF (p < 0.05). Athletes with higher V[Combining Dot Above]O2max and lower %BF may be capable of a higher work output and therefore more likely to experience increased physiological disruptions during intense training. The high-volume nature of preseason and differences in athlete fitness capabilities require coaches to manage players at an individual level to maintain athlete readiness.