Effects of training and protein/carbohydrate supplementation by food on strength, body composition and bone metabolism in postmenopausal women

Background: Menopause is associated with impairments of health, e.g. cardiovascular disease, changes in body composition, decrease in bone density. Physical activity and nutrition strategies have been demonstrated to counteract some of these disabilities. Aim of the present study was to analyze the impact of 3 months of strength and endurance training combined with protein/carbohydrate supplementation on strength, body composition and bone metabolism in postmenopausal women. Method(s): 62 postmenopausal women were recruited. Measurements: Body composition by BIA. Strength of leg, chest and handgrip. delta44Ca/42Ca in blood and urine as proxies for bone metabolism, samples were analyzed by mass spectrometry. Participants completed 2/week endurance training (walking) for 60 minutes (60-75% km/h of 4mmol threshold) and a whole-body strength training 1/week for 60 minutes (online). In addition, the intervention group (IG) received 100g of sour milk cheese and 76g of white bread (35.3 g carbohydrate, 36.1 g protein, 3.5 g fat, 321 kcal) after each training. Result(s): Training results in an anabolic effect on bone metabolism, here protein/carbohydrate supplementation does not show additive effects. Training resulted in an increase of leg and hand grip strength. For hand grip strength an additive effect could be demonstrated after protein/carbohydrate supplementation. Both groups increased muscle mass and reduced fat mass, although the results were not significant. Discussion(s): Training was effective, showing an increase in strength. Additive effects of the nutritional intervention could be only observed for hand grip strength. This may be due to a weak compliance of the protein/carbohydrate supplementation by a meal while corona pandemic. Also, because of the endurance parts, the training was not specifically designed to increase strength. Nevertheless, even this mild training has a remarkably strong impact on bone metabolism. Conclusion(s): Even if the effects are faint, the data of this study provide evidence that protein/carbohydrate supplementation, also by food, supports the events of training on strength. Training has a strong impact on bone metabolism in postmenopausal women. The subjects respond very individually to training and nutrition interventions. Training consequentially is to be personalized.Copyright © 2023

Changes in weight and body composition in a school population post-restart of alternating academic activity after quarantine by COVID-19.

Objective: To determine the change in the anthropometric parameters of the child and adolescent population, which occurred during pandemic period in boys and girls between 8 and 17 years of age, after the resumption of alternating academic activity. Material(s) and Method(s): There were included 130 students from 8 to 17 years of age, through bioimpedatiometry using the InBody 170 scale, taking weight, lean mass, percentage of fat mass and total fat mass, height in cm with an InBody brand ultrasonic stadiometer. Result(s): It was found presence of excess weight in 36.1% of the population with predominance of overweight in females and obesity in males, lean mass 36.15% was below the range for age, being more frequent in the group of men than in women, total fat mass 40.76% was above the range for age and in percentage of total body fat 59.23% above the range for age, men showed greater body fat mass than women. Conclusion(s): Obesity and overweight in the school population in Colombia has grown notably in the pospandemic era, not only because of an increase in body weight that was greater than the ENSIN 2015 and a greater increase compared to that reported between 2010 and 2015 attributed to an abnormal body composition, with a high predominance of fat mass that exposes to an increased cardiometabolic risk related to the presence of lipotoxicity.Copyright © 2022 Sociedad Colombiana de Cardiologia y Cirugia Cardiovascular.

Body composition and physical activity of university students during COVID-19 lockdowns.

[Purpose] Behavioral restrictions during the corona virus disease 2019 (COVID-19) pandemic may have affected the physical activity levels of college students. We aimed to characterize the body composition and physical activity of college students during these behavioral restrictions. [Participants and Methods] The body composition (height, weight, body mass index, body fat mass, body fat percentage, total body muscle mass, free-fat muscle index [FFMI], and fat mass index [FMI]), physical activity, amount the of walking, amount of daily activity, and the number of steps were measured in 52 university students. [Results] For both male and females, the number of steps taken was lower than the average steps reported by the Ministry of Health, Labour and Welfare. In males, FFMI had a strong positive correlation with physical activity, amount of walking, and the number of steps taken. In females, FFMI had a strong positive correlation with physical activity and the amount of walking, as well as a moderate positive correlation with the amount of daily activity. [Conclusion] Since physical activity and walking of university students during COVID-19 affect FFMI, it is necessary to develop an exercise program that considers behavioral patterns.

Long-lasting brain fog is related with severity clusters of symptoms in COVID-19 patients. Background: COVID-19 patients may experience lon-lasting symptoms from weeks to even months. Aim: to evaluate long-term cognitive impairment based on the severity

Background: COVID-19 patients may experience lon-lasting symptoms from weeks to even months. Aim: To evaluate long-term cognitive impairment based on the severity of symptoms of COVID-19 infection in a primary health system setting. Material and methods: From a database of 363 patients, 83 cases aged 47 +or- 15 years, (58% females) were selected from June to August 2020. In patients who survived the virus, 24 infection-related symptoms were collected to create three severity clusters (mild, moderate, and severe). The follow-up time was at least seven months. Comparing the first two clusters with the severe cluster, the existence of brain fog and risk factors (obesity, hypertension, diabetes, chronic lung disease, and hypothyroidism) were analyzed. Results: Thirty-one patients (37%) had persistent symptoms lasting up to 240 days. Fifty-one patients (61%) experienced brain fog. Concentration was affected by symptom severity (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.26-10.46, p = 0.02). Short- or long-term memory loss was not affected. Moreover, symptom severity was related to brain fog (OR 3.16, 95% CI 1.05-9.51, p = 0.04). Patients with persistent symptoms had a concentration impairment associated with severity patterns (OR 24.3, 95% CI 1.73-340.11, p = 0.03). Conclusions: Brain fog is associated with symptom severity in COVID-19 survivors and lasts for more than eight months.

Metabolic risks and prognosis of COVID-19: are dietary patterns important?

PurposeThis study aims to identify the dietary patterns of two groups of subjects (with and without COVID-19), and to assess the relationship of findings with the prognosis of COVID-19 and metabolic risk parameters.Design/methodology/approachThis study included 100 individuals in the age range of 19–65 years. The medical history, and data on biochemical, hematological and inflammatory indicators were retrieved from the files. A questionnaire for the 24-h food record and the food intake frequency was administered in face-to-face interviews, and dietary patterns of subjects were assessed.FindingsIn individuals with COVID-19, the hip circumference, the waist-hip ratio and the body fat percentage were significantly higher (p < 0.05), and the muscle mass percentage was significantly lower (p < 0.05). Mediterranean diet adherence screener (MEDAS), dietary approaches to stop hypertension (DASH) and healthy eating ındex-2015 (HEI-2015) scores were low in the two groups. A linear correlation of DASH scores was found with the muscle mass percentage (p = 0.046) and a significant inverse correlation of with the body fat percentage (p = 0.006). HEI-2015 scores were significantly and negatively correlated with body weight, body mass index, waist circumference, hip circumference and neck circumference (p < 0.05). Every one-unit increase in MEDAS, DASH and HEI-2015 scores caused reductions in C-reactive protein levels at different magnitudes. Troponin-I was significantly and negatively correlated with fruit intake (p = 0.044), a component of a Mediterranean diet and with HEI-2015 total scores (p = 0.032).Research limitations/implicationsThe limitation of this study includes the small sample size and the lack of dietary interventions. Another limitation is the use of the food recall method for the assessment of dietary patterns. This way assessments were performed based on participants' memory and statements.Practical implicationsFollowing a healthy diet pattern can help reduce the metabolic risks of COVÍD-19 disease.Originality/valueDespite these limitations, this study is valuable because, to the best of the authors' knowledge, it is the first study demonstrating the association of dietary patterns with disease prognosis and metabolic risks concerning COVID-19. This study suggests that dietary patterns during the COVID-19 process may be associated with several metabolic risks and inflammatory biomarkers.

Clinical Nutrition in Covid-19 Patients-A Systematic Review

Introduction There is currently a lack of evidence on clinical nutrition in Covid-19. Aim of the work: Systematic overview of clinical nutrition in Covid-19. Material and methods A systematic literature search: 2 meta-analyses, 12 systematic reviews and meta-analyses, 9 prospective randomized controlled trials, 3 prospective observational studies, 7 retrospective studies, 25 narrative reviews. Results a) Obese patients have an increased risk of a severe course of the disease, b) there is a connection between obesity and an increased risk of death, c) Covid-19 mortality increases from a BMI>27 kg/m2, in all BMI classes 1,6% per 1 kg/m2 in the event of weight gain, in the case of severe obesity (> 40-45 BMI) by a factor of 1,5 to 2 and per 5 kg/m2, d) the risk of a severe course of Covid-19 increases also with increased visceral fat tissue percentage, total body fat mass and upper abdominal circumference, e) the mortality rate can be 10 times higher in malnourished Covid-19 patients, f) serum albumin provides evidence of a poor course of the disease, g) enteral omega-3 fatty acid intake could stabilize kidney function and improve the outcome, h) foods with a low glycemic index should be preferred, i) vitamin D deficiency should be avoided, daily vitamin D and zinc supplementation can be beneficial, j) one-time high dose vitamin D and enteral vitamin C provide no benefit, but the risk of thrombosis could be reduced and the antibody response enhanced with zinc, k) nutritional intervention reduces mortality. Conclusion Screening and assessment of nutritional status are important in Covid-19 patients. Overall, there are insufficient clinical results on specific nutritional therapy.Copyright © 2022 Georg Thieme Verlag. All rights reserved.

Effect of telehealth-based versus in-person nutritional and exercise intervention on type II diabetes mellitus improvement and efficiency of human resources utilization in patients with obesity

Aims: Telehealth became a patient necessity during the COVID pandemic and evolved into a patient preference in the post-COVID era. This study compared the % total body weight loss (%TBWL), HbA1c reduction, and resource utilization among patients with obesity and diabetes who participated in lifestyle interventions with or without telehealth. Method(s): A total of 150 patients with obesity and diabetes who were followed every 4-6 weeks either in-person (n = 83) or via telehealth (n = 67), were included. All patients were provided with an individualized nutritional plan that included a weight-based daily protein intake from protein supplements and food, an activity/sleep schedule-based meal times, and an aerobic exercise goal of a 2000-calorie burn/week, customized to patient's preferences, physical abilities, and comorbidities. The goal was to lose 10%TBWL. Telehealth-based follow-up required transmission via texting of weekly body composition measurements and any blood glucose levels below 100 mg/dl for medication adjustments. Weight, BMI, %TBWL, HbA1c (%), and medication effect score (MES) were compared. Patient no-show rates, number of visits, program duration, and drop-out rate were used to assess resource utilization based on cumulative staff and provider time spent (CSPTS), provider lost time (PLT) and patient spent time (PST). Result(s): Mean age was 47.2 +/- 10.6 years and 74.6% were women. Mean Body Mass Index (BMI) decreased from 44.1 +/- 7.7-39.7 +/- 6.7 kg/m2 (p < 0.0001). Mean program duration was 189.4 +/- 169.3 days. An HbA1c% unit decline of 1.3 +/- 1.5 was achieved with a 10.1 +/- 5.1%TBWL. Diabetes was cured in 16% (24/150) of patients. %TBWL was similar in regards to telehealth or in-person appointments (10.6% +/- 5.1 vs. 9.6% +/- 4.9, p = 0.14). Age, initial BMI, MES, %TBWL, and baseline HbA1c had a significant independent effect on HbA1c reduction (p < 0.0001). Program duration was longer for in-person follow-up (213.8 +/- 194 vs. 159.3 +/- 127, p = 0.019). The mean annual telehealth and in-person no-show rates were 2.7% and 11.2%, respectively (p < 0.0001). Mean number of visits (5.7 +/- 3.0 vs. 8.6 +/- 5.1) and drop-out rates (16.49% vs. 25.83%) were lower in telehealth group (p < 0.0001). The CSPTS (440.4 +/- 267.5 min vs. 200.6 +/- 110.8 min), PLT (28.9 +/- 17.5 min vs. 3.1 +/- 1.6 min), and PST (1033 +/- 628 min vs. 113.7 +/- 61.4 min) were significantly longer (p < 0.0001) for the in-person group. Conclusion(s): Telehealth offered comparable %TBWL and HbA1c decline as in-person follow-up, but with a shorter follow-up, fewer appointments, and no-shows. If improved resource utilization is validated by other studies, telehealth should become the standard of care for the management of obesity and diabetes.Copyright © 2023 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.

How to scientifically return to physical activity after the COVID-19 infection?

The COVID-19 pandemic has had a profound impact on the physical health and personal well-being of people around the world, and a significant portion of patients experience persistent symptoms for several weeks or even months after their initial recovery from the infection, which the academic community refers to as "long COVID" or post-acute sequelae of SARS-CoV-2 infection (PASC). PASC is increasingly recognized as a serious global public health issue, and there is an urgent need for more effective strategies to control and prevent this risk. Appropriate exercise is considered a good way to improve the physical fitness of COVID-19 patients, strengthen muscle strength, and improve neurological function, which can help alleviate PASC symptoms. However, if patients have underlying pathological risks (such as myocarditis) or engage in inappropriate exercise, exercise may instead be harmful to health and even lead to sudden death. Therefore, safely and scientifically return to physical activity after the COVID-19 infection has become a common demand of patients. To achieve this goal, this article focuses on the scientific return to exercise after a COVID-19 virus infection. It first introduces the specific manifestations, pathological mechanisms, and current research status of PASC, and discusses the benefits and risks of exercise after infection. And then, based on different recovery exercise guidelines, the main principles and precautions for rehabilitation of exercise after the COVID-19 infection are analyzed. Finally, this article summarizes the exercise recommendations of some authoritative organizations, aiming to provide insights for safely returning to exercise after recovering from the COVID-19 infection.

Relationship between sarcopenia and cachexia with prognostic markers of middle-aged and older inpatients with COVID-19: a case-control study.

PURPOSE: SARS-CoV-2 infection can lead to various manifestations beyond an inflammatory response, such as anorexia, hyposmia, and other symptoms that may increase the risk of nutritional disorders. Sarcopenia and cachexia are conditions that appear to influence COVID-19 evolution. Thus, this study aimed to evaluate sarcopenia and cachexia in hospitalized patients with COVID-19, verifying their clinical impacts and relationship with prognostic markers. METHODS: This is a case-control study involving inpatients with and without a COVID-19 diagnosis. The occurrence of sarcopenia was evaluated according to European Working Group on Sarcopenia 2 criteria. Cachexia was evaluated according to (Evans et al. in Clin Nutr 27:793-799, 2008) criteria. Inflammatory markers and the 4C Mortality Score were evaluated. RESULTS: Our study included 96 individuals, divided into two groups: COVID-19 (n = 32) and control (n = 64). The mean age of the COVID-19 group was 63.3 ± 11.8 years, and the control group had a mean age of 64.3 ± 5.5 years. No significant differences in mean age were found between the groups. The prevalence of sarcopenia and cachexia in patients with COVID-19 was 21.9% and 28.1%, respectively, while in the control group, it was 29.7% and 26.6%, respectively. Sarcopenic patients with COVID-19 had a higher risk of death (4C Mortality Score) (p = 0.038). The occurrence of sarcopenia or cachexia within the COVID-19 group was not associated with inflammatory biomarkers or a higher number of COVID-19 symptoms (p > 0.05). CONCLUSION: The presence of sarcopenia among COVID-19 patients increased the risk of mortality.

Impact of Prolonged Cessation of Organized Team Training Due to the COVID-19 Pandemic on the Body Composition of Japanese Elite Female Wheelchair Basketball Athletes.

Studies on the effects of training confinement on athletes with physical impairments are limited. Hence, in this retrospective cohort study, we aimed to investigate the impact of prolonged cessation of organized team training due to the coronavirus disease 2019 pandemic on the body composition of elite female Japanese basketball athletes. Fourteen female wheelchair basketball athletes (aged ≥20 years) were enrolled. The primary outcomes were lean and adipose indices measured using whole-body dual-energy X-ray absorptiometry. The impact of prolonged organized team training cessation on body composition was investigated by comparing the body composition at baseline and post-training confinement. A reduced whole-body lean mass (p = 0.038) and percent lean mass (p = 0.022), as well as an increased percent body fat (p = 0.035), were observed after the confinement period. The regional analysis revealed reduced percent lean and increased percent fat masses in the trunk (p = 0.015 and p = 0.026, respectively) and upper limbs (p = 0.036 and p = 0.048, respectively). In conclusion, prolonged organized team training cessation reduced lean mass and increased body fat percentage, primarily in the trunk and upper limbs. Individualized training programs targeting these body regions should be implemented to improve body composition and physical conditions in athletes during and after prolonged cessation of organized team training.

Abstracts from the 6th International Symposium of Advanced Topics in Exercise Physiology: Interval Training as an Efficient Strategy to Overcome the 21st Century Diseases with Emphasis in the Mental Brain Diseases

The proceedings contain 14 papers. The topics discussed include: lifestyles and their relationship with the psychological status of postgraduate students in the area of physical activity;impact of a remote supervised moderate interval training on cognitive functions in Mexican older adults. a preliminary study;bone diameters and their association with causes of health risk in college athletes;an online home exercise program changes lower body strength, nutritional status but not depression scores during the COVID-19 in Mexican elderly;anxiety symptoms in older adults during the COVID-19 pandemic. Intervention of physical exercise through social networks;leger test as a specific protocol to estimate the maximum oxygen consumption in the urban search and rescue division of the fire department of Tijuana, Mexico;effect of physical exercise on natural killer cells;effects of a 16-session high intensity interval training program on body composition in sedentary subjects;and resistance training using time under tension improves the muscle quality and muscle mass in healthy-young women. a preliminary study.

The Effect of Physical Activities on Somatic Parameters of the Selected Czech University Students – Some Selected Results

Purpose: The current trend is an increasing sedentary lifestyle in all age categories. Among university students, there is an alarming decline in physical activity while increasing the percentage of total body fat compared to high school students. The main goal of the study is to describe the current state of body composition of university students and to assess the impact of physical activity / inactivity in this specific age group, which has changed very dynamically in recent years due to the coronavirus pandemic. Methods: A total of 358 probands with a mean age of 20.87 ± 1.43 years were involved in the research, of which 234 women (65.4 %) had a height of 167.9 ± 6.3 cm and a body weight of 61.3 ± 10.0 kg, BMI 21.7 ± 3.2, body fat 25.9 ± 6.4 %, skeletal muscle mass 24.7 ± 3.3 % and 124 men (34.6 %) with body height 180.9 ± 7.7 cm, body weight 77.6 ± 12.4 kg, BMI 23.6 ± 2.8, body fat 15.8 ± 5.4 %, skeletal muscle mass 37.0 ± 5.6 %. For the purposes of valid categorization into high active, minimally active, and inactive probands, the International Standardized Physical Activity Questionnaire (IPAQ) was used, which monitors physical activity in the last 7 days. The questionnaire includes questions regarding the frequency and time spent in each intensity of physical activity, as well as the time spent sitting. The non-invasive method of bioelectric tetrapolar impedance using the InBody 230 device was used for the analysis of somatic parameters. The Takei hand dynamometer was used for the diagnosis of muscle strength. Some selected results: According to IPAQ, probands were classified as inactive (16 %), minimally active (58 %) and high active (25 %), the analysis of selected aspects of physical activity shows that men are more active than women, but both sexes spend more than 5.5 hours a day sitting on average. A total of 39 % of probands have higher level of total body fat than the recommended norms. Conclusion: The study showed that lower levels of physical activity are associated with higher values of total body fat in university students. At the same time, within our sample both sexes out of 84 % comply with general recommendations regarding the volume and intensity of physical activity. Copyright 2023 by the author(s).

Prevalence of metabolic syndrome criteria among adults post COVID pandemic situation and steps towards prevention

Metabolic Syndrome (MetS) is one among the Non-Communicable Diseases (NCDs) which might occur due to genetic, environmental, physiological and behavioural factors. MetS is increasing alarmingly in the population. Addressing the modifiable factors to reduce the risk is of prime importance. The current study is intended to observe the prevalence of Metabolic Syndrome criteria with respect to its relation to lifestyle factors among subjects post pandemic situation and the MetS incidence to understand how the disease can be prevented and the means to improve the public health. Random sampling method was used to enrol 20-50 year old (male and female) urban adults of Bengaluru into the study. Type-I-diabetics, lactating and pregnant women, post-cardiac surgery/ pre-post-transplant/ covid-19 recovered patients were excluded. Height, weight, Waist-Circumference (WC) and hip-circumference were measured. BMI and Waist-Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBS), Triglycerides (TG), HDL, Blood Pressure (BP) values were analysed and recorded. Diet recall was captured and calories consumed per day was estimated. The habits of exercise routine, smoking, tobacco chewing and alcohol were observed. IDF (International Diabetes Federation, 2006) criteria was used to categorise MetS. The data was analysed using relevant statistical tools. A total of 1211 adults (females 486 and males 725) were assessed. High WC indicating central obesity was observed in 55%. High FBS was observed in 29%. Hyper-triglyceridemia was more in males (36%) than females (19%). Low HDL was observed in 65% females against 43% males. High BP was observed among 10% in males and 8% in females. Lack of exercise was observed among 81% of the adults. Due to pandemic situation 10.7% stopped doing exercise. Moderate activity in 5.6% and vigorous activity in 2.8% was recorded;68% of the subjects were consuming >2000 calories/day on an average;18.6% were alcoholic. MetS was observed in 10.6% and MetS-2 criteria in 33.4% and MetS-1criteria in 24.5% before pandemic situation and post pandemic there was an increase. MetS was observed in 12.2% and MetS-2criteria in 49.7% and MetS-1criteria in 27.9% post pandemic. The lack of exercise and high-calorie consumption had a significant correlation with altered lipid values and central obesity. High WC had significant relation to High BMI. WHR had very significant correlation with high FBS and TG. Women had significantly high WC compared to men. The alcohol habit had a significant correlation with hypertriglyceridemia in males. Increased calorie consumption had a moderate correlation with raised FBS and WHR. MetS was significantly observed in those who had lack of exercise, high calorie consumption and alcohol habit. Findings suggest that MetS is in rise in 31-50 year age group. Central obesity, dyslipidemia and high FBS were predominant in 31-40 year group. High BP was observed in 45-50 years age group. Identifying and educating the young adults to correct their life style is the need of the hour to reduce increase of MetS in community.

Factors of persistent limited exercise tolerance in patients after COVID-19 with normal left ventricular ejection fraction

Background: Exercise intolerance de novo is one of the most common reported symptoms in patients (pts) recovering from COVID-19. Purpose(s): The present study determines etiological and pathophysiological factors influencing the mechanism of exercise intolerance in the COVID-19 survivors. Therefore, the factors affecting percent predicted oxygen uptake at peak exercise VO2 (%VO2pred) in pts after COVID-19 with normal left ventricular ejection fraction were assessed. Methods and Results: The 120 consecutive patients from the Department of Cardiology recovering from COVID-19 at three to six months after confirmed diagnosis were included. The clinical examinations, laboratory test results, echocardiography using Vivid E95 - GE Healthcare, non-invasive body mass analysis using Body Composition Analyzer (Tanita Pro), and spiroergometry using The MetaSoft Studio application were analysed. The subjects were divided into the two following groups: Study i.e. pts with worse oxygen uptake (%VO2pred <80%;N=47) and control including these cases with %VO2pred >=80% (N=73) - Table 1. Pts with %VO2pred <80% presented significantly lower global peak systolic strain (GLPS) [p=0.03], tricuspid annular plane systolic excursion (TAPSE) [p=0.002] and late diastolic filling velocity (A) [p=0.004] compared to controls - Figure 1. The male gender (p=0.007) and the percent of total body water content (TBW %) (p=0.02) were significantly higher in study in comparison to the control group. The results of multiple logistic regression model independently associated with %VO2pred were as follows: A (OR 0.4, 95% CI: 0.17-0.95;p=0.03) and gender (OR 2.52, 95% CI: 1.07-5.91;p=0.03). Conclusion(s): Males have over twice risk of persistent limited exercise tolerance after COVID-19 infection than females. The lower late diastolic filling velocity, tricuspid annular plane systolic excursion, worse global peak systolic strain, and hydration status are connected with limited exercise tolerance after COVID-19 in patients with normal left ventricular ejection fraction.

Prevalence and clinical implications of abnormal body composition phenotypes in patients with COVID-19: a systematic review.

BACKGROUND: The impact of body composition (BC) abnormalities on COVID-19 outcomes remains to be determined. OBJECTIVES: We summarized the evidence on BC abnormalities and their relationship with adverse clinical outcomes in patients with COVID-19. METHODS: A systematic search was conducted up until 26 September, 2022 for observational studies using BC techniques to quantify skeletal muscle mass (or related compartments), muscle radiodensity or echo intensity, adipose tissue (AT; or related compartments), and phase angle (PhA) in adults with COVID-19. Methodological quality of studies was assessed using the Newcastle-Ottawa Scale. A synthesis without meta-analysis was conducted to summarize the prevalence of BC abnormalities and their significant associations with clinical outcomes. RESULTS: We included 62 studies (69.4% low risk of bias) with 12-1138 participants, except 3 studies with ≤490,301 participants. Using CT and different cutoff values, prevalence ranged approximately from 22% to 90% for low muscle mass, 12% to 85% for low muscle radiodensity, and 16% to 70% for high visceral AT. Using BIA, prevalence of high FM was 51%, and low PhA was 22% to 88%. Mortality was inversely related to PhA (3/4 studies) and positively related to intra- and intermuscular AT (4/5 studies), muscle echo intensity (2/2 studies), and BIA-estimated FM (2/2 studies). Intensive care unit (ICU) admission was positively related to visceral AT (6/7 studies) and total AT (2/3 studies). Disease severity and hospitalization outcomes were positively related to intra- and intermuscular AT (2/2 studies). Inconsistent associations were found for the rest of the BC measures and hospitalization outcomes. CONCLUSIONS: Abnormalities in BC were prevalent in patients with COVID-19. Although conflicting associations were observed among certain BC abnormalities and clinical outcomes, higher muscle echo intensity (reflective of myosteatosis) and lower PhA were more consistently associated with greater mortality risk. Likewise, high intra- and intermuscular AT and visceral AT were associated with mortality and ICU admission, respectively. This trial was registered at PROSPERO as CRD42021283031.

Body composition and chemotherapy toxicity among women treated for breast cancer: a systematic review.

PURPOSE: Toxicity is a significant problem among women receiving systemic chemotherapy for breast cancer, with up to 60% experiencing hematologic and 14% experiencing non-hematologic toxicity. Chemotherapy is dosed using body surface area, which does not account for heterogeneity in lean body mass (LBM) and adipose tissue (AT). This systematic review, registered with the PROSPERO International Prospective Register of Systematic Reviews (#CRD42021279874), evaluates associations between body composition and chemotherapy-related toxicity during breast cancer treatment. METHODS: Scientific literature databases (PubMed, Scopus, CINAHL, and CENTRAL) were systematically searched in November 2021 for studies evaluating associations between body composition (assessed using computed tomography or dual x-ray absorptiometry) and chemotherapy-related toxicity among women receiving breast cancer treatment. Eligibility was not limited by year or country of publication. Article screening and data abstraction was conducted using the Covidence Systematic Review Management System. Predetermined criteria were used to evaluate rigor of participant recruitment, representativeness of the population, and use of validated measures of body composition and toxicity. RESULTS: An inverse association between LBM and toxicity was reported in seven of the eight included studies, although definitions of low LBM differed across studies. Three studies evaluated the association between AT and chemotherapy toxicity with inconsistent findings. Heterogeneity in body composition measures/definitions and treatment regimens precluded the ability to perform meta-analyses. CONCLUSION: Low LBM appears to be a risk factor for chemotherapy toxicity, but the role of AT is unclear. IMPLICATIONS FOR CANCER SURVIVORS: Further research that accounts for guideline concordance in chemotherapy prescriptions and the use of supportive care medications is needed.

Future lines of research on phase angle: Strengths and limitations.

Bioelectrical impedance analysis (BIA) is the most widely used technique in body composition analysis. When we focus the use of phase sensitive BIA on its raw parameters Resistance (R), Reactance (Xc) and Phase Angle (PhA), we eliminate the bias of using predictive equations based on reference models. In particular PhA, have demonstrated their prognostic utility in multiple aspects of health and disease. In recent years, as a strong association between prognostic and diagnostic factors has been observed, scientific interest in the utility of PhA has increased. In the different fields of knowledge in biomedical research, there are different ways of assessing the impact of a scientific-technical aspect such as PhA. Single frequency with phase detection bioimpedance analysis (SF-BIA) using a 50 kHz single frequency device and tetrapolar wrist-ankle electrode placement is the most widely used bioimpedance approach for characterization of whole-body composition. However, the incorporation of vector representation of raw bioelectrical parameters and direct mathematical calculations without the need for regression equations for the analysis of body compartments has been one of the most important aspects for the development of research in this area. These results provide new evidence for the validity of phase-sensitive bioelectrical measurements as biomarkers of fluid and nutritional status. To enable the development of clinical research that provides consistent results, it is essential to establish appropriate standardization of PhA measurement techniques. Standardization of test protocols will facilitate the diagnosis and assessment of the risk associated with reduced PhA and the evaluation of changes in response to therapeutic interventions. In this paper, we describe and overview the value of PhA in biomedical research, technical and instrumental aspects of PhA research, analysis of Areas of clinical research (cancer patients, digestive and liver diseases, critical and surgical patients, Respiratory, infectious, and COVID-19, obesity and metabolic diseases, Heart and kidney failure, Malnutrition and sarcopenia), characterisation of the different research outcomes, Morphofunctional assessment in disease-related malnutrition and other metabolic disorders: validation of PhA with reference clinical practice techniques, strengths and limitations. Based on the detailed study of the measurement technique, some of the key issues to be considered in future PhA research. On the other hand, it is important to assess the clinical conditions and the phenotype of the patients, as well as to establish a disease-specific clinical profile. The appropriate selection of the most critical outcomes is another fundamental aspect of research.

Predictors for Failure Reduction of Hemodialysis Frequency during the Pandemic

Introduction: A dialysis unit is compatible with a long-range airborne transmission environment resulting in a higher risk of Coronavirus disease 2019 (COVID-19) infection in hemodialysis patients. Reduction of hemodialysis frequency is a common practice to prevent COVID-19 from spreading in the dialysis unit. However, the predictors to determine which patient is likely to fail from reducing frequency of dialysis is still lacking. This study determined the predictors for a failure reduction in hemodialysis frequency at 4 weeks. Method(s): This retrospective observational study enrolled adult patients receiving long-term thrice-weekly hemodialysis at Thammasat University Hospital in 2021 who decreased dialysis frequency to twice-weekly during COVID-19 outbreak in Thailand. The outcomes were prevalence of failure reduction in dialysis frequency at 4 and 8 weeks and predictors of failure reduction at 4 weeks. Multivariable logistic regression analysis was performed to determine the predictors and create a predicting model for failure reduction of dialysis frequency. Result(s): Of 161 patients receiving hemodialysis in 2021, 83 patients with dialysis frequency reduction had a median age of 69.6 years and a median dialysis vintage of 4.5 years. 27 (33%) and 68 (82%) patients failed to reduce dialysis frequency at 4 and 8 weeks. At 4 weeks, 22 (81.5%) patients failed to reduce dialysis frequency from hypervolemia-related causes. From multivariate logistic regression analysis showed that the predictors for failure reduction at 4 weeks were pre-existing diabetes, congestive heart failure, pre-dialysis weight gain, dry weight from body composition measurement, mean pre- and post-dialysis weight gain during one week before dialysis reduction (Table 1). The model including these predictors (Table 2) demonstrated an Area Under the Receiver Operating Characteristic (AUROC) of 0.78 (95% CI 0.69-0.88) for predicting a failure reduction. At 4 weeks, 0 (0%), 7 (28.0%), and 20 (54.1%) of patients with low risk (score of <0 point), intermediate risk (score of 0-1 point) and high risk (score of >1 point) failed to reduce dialysis frequency, respectively. Conclusion(s): During the COVID-19 pandemic, 33% and 88% of hemodialysis patients failed to reduce their dialysis frequency at 4 and 8 weeks. The predicting model for a failure dialysis reduction demonstrated a good performance. Conflict of interest Potential conflict of interest: - Speaker fee from Fresenius Medical Care and Boehringer Ingelheim (Thai) - Registration fee from Novo Nordisk and Sanofi Aventis ThailandCopyright © 2023

Respiratory function in subjects recovered from covid-19 with sarcopenia

Introduction: Coronavirus disease 2019 causes severe complications in subjects with risk factors: advanced age, diabetes, hypertension, obesity, among others. Patients with COVID-19 with severe disease have prolonged hospital stays, which causes dynapenia, muscle depletion, and sarcopenia, this induce a worse disease evolution and poor prognosis. Objective(s): Evaluate lung function in recovered COVID-19 with sarcopenia patients. Method(s): Cross-sectional study. 102 patients recovered from COVID-19 who required hospitalization wereincluded. Lung function was assessed using PIMAX, PEMAX, DLCO2 spirometry. Body composition was evaluated by electrical bioimpedance. Sarcopenia was diagnosed by appendicular muscle mass index (men: <7 kg / m, women <5.5 kg) and hand strength (men <27 kg, women <16 kg). Result(s): The population's average age was 44 years +/- 11.66, 58.88% were men, the subjects with sarcopenia had a higher prevalence of diabetes (26.32% vs 7.81%, p=0.039) hypertension (28.95% vs 12.5%, p = 0.039) compared with those without sarcopenia. Subjects with sarcopenia had worse respiratory parameters of FEV1(2.73lt vs 3.19lt, p=0.003), FEV1 post (2.70lt vs 3.24 lt, p=0.0005), FVC (3.19lt vs 3.9lt, p<0.001), FVCpost (3.22lt vs 3.90lt, p<0.001), FEV1/FVC (81.83 vs 84.17, p=0.040), DLCO (25.21 vs 31.83, p<0.001), and exercise tolerance (464.16 m vs 535.84 m, p<0.001) compared to the subjects withoout sarcopenia. Conclusion(s): COVID-19 recovered patients with a higher amount and sarcopenia developed a worse pulmonary and probably poor prognosis.

Metabolomic spittle analysis of post COVID-19 patients

Post COVID-19 patients have been suffering from persistent symptoms even after long periods. The physiopathology of these clinical manifestations still has a lack of knowledge. The objective was to evaluate the total expression of metabolites and spittle biological pathways in patients with 60 days post COVID-19. We included 30 post-hospital discharge patients and we compared seven non COVID-19 patients control. All COVID-19 patients were assessed by demographic characteristics, pulmonary function, exercise capacity, quality of life and body composition. The metabolomic analysis was performed in the patient's splits. From the total of post COVID-19 patients, 66% were male, 60+/-14 years. The lean body mass was 30+/-7kg and fat mass 34+/-13kg. Spirometry mean severity showed FVC of 4+/-1L, FEV1 3+/-1L. Pimax and Pemax values were 90+/-31(cmH2O) and 97+/-31(cmH2O), respectively. The quality of life evaluated by the SGRQ questionnaire showed a mean percentage of magnitude of symptoms 32+/-15, activities 41+/-25, impact 13+/-11 and total of 24+/-15. Physical capacity was measured by the distance in the 6MWT, and presented an average of 413+/-131. The metabolomic analysis showed 19 metabolites statistically significant difference between groups. We observed 3 metabolites overexpressed and 16 with lower expression in post COVID19 patients. From those metabolites, we can have attention to Sphinganine(p=0.03), Piperenol A triacetate(p=0.02) and 1-Monopalmitin(p=0.03) were lower expressed in control group. The creatin was one of the non-expressed metabolites in post hospital discharge COVID-19 patients compared to the control group. Thus, metabolomic analysis can demonstrate different metabolites in post COVID-19 patients to answer persistent symptoms.