Phase angle as a potential tool to evaluate chronic inflammatory state and predict quality of life deterioration in women with breast cancer and obesity: A narrative review.

The interaction between lifestyle--defined more specifically in health care as the personal exposome--and its implications on obesity and breast cancer development highlights the critical role of body composition and inflammation in these patients. There is clear evidence that the personal and internal exposome triggers biochemical, inflammatory, and metabolic reprogramming, which might favor ectopic lipid accumulation within the body, such as muscles. Additionally, the presence of excessive adipose tissue exacerbates these alterations in the internal exposome, resulting in cell damage and modifying body composition. Understanding the nexus between these lifestyle-induced exposome modifications, such as inflammation, and the resultant changes in body composition is crucial to assess the association with breast cancer progression and treatment responses. Various techniques can be used to evaluate body composition; one of those most used currently is bioelectrical impedance analysis. This analysis provides parameters, including phase angle (PhA), by which cellular health and metabolic activity can be assessed. In addition, PhA is a potential indicator of nutritional status and disease prognosis, as it has been linked to survival and quality of life in patients with cancer. Therefore, PhA might be used in daily oncology practice to implement an accurate nutritional intervention, reducing side effects and complications of oncology management, and improving quality of life during treatment and survival, even in patients with breast cancer with obesity or overweight. The aim of this review is to analyze the existing information on the current application of PhA in patients with breast cancer and its potential use as a tool to assess inflammatory response, identify malnutrition, and predict the deterioration of quality of life so that it could be proposed as an early indicator for nutritional interventions in this group of patients.

Mental health from childhood to adolescence predicts excessive weight and body composition at 18 years.

OBJECTIVE: To investigate the association of mental health in childhood and adolescence with four outcomes at 18 years: ultra-processed food (UPF) consumption, body mass index (BMI), excessive weight (EW), and body composition, including fat mass (FM) and fat free mass (FFM) in kg, FM index (FMI) and FFM index (FFMI) in kg/m2. METHODS: Cohort study in which The Development and Well-Being Assessment (DAWBA) (6 and 11 years) and the MINI International Neuropsychiatric Interview (MINI) (18 years) provided information on internalizing (INT), externalizing (EXT) and any mental disorder (ANY). The exposure was classified in: "never", "at 6 and/or 11 years", "at 18 years only" and "at 6, 11, and 18 years". Linear and logistic regression were run. All analyses were stratified by sex. RESULTS: A total of 2722 participants were analyzed. At 18 years, female with EXT disorders at 6 and/or 11 years presented higher BMI (ß: 1.70; 0.18-3.23), FM (ß: 4.74; 1.42-8.06), and FMI (ß: 1.53; 0.28-2.79) than those who never had. The odds of EW at 18 years was also higher in females with EXT disorders at 6 and/or 11 years (OR: 3.39; 1.56-7.36) and at the three time points (OR: 7.08; 1.69-29.59). Males with EXT disorders at 6 and/or 11 years presented higher FM (ß: 4.45; 1.85-7.06) and FMI (ß: 1.47; 0.63-2.31). CONCLUSIONS: Among children and adolescents showing symptoms of EXT disorders, weight should be monitored carefully, thus ultimately contributing to reduce the burden of EW in adolescence.

The Association between Body Composition Phenotype and Insulin Resistance in Post-COVID-19 Syndrome Patients without Diabetes: A Cross-Sectional, Single-Center Study.

BACKGROUND: The most frequent body composition alterations in post-COVID-19 syndrome include low muscle mass, dynapenia, sarcopenia, and obesity. These conditions share interconnected pathophysiological mechanisms that exacerbate each other. The relationship between body composition phenotypes and metabolic abnormalities in post-COVID-19 syndrome remains unclear. OBJECTIVE: To evaluate the association between body composition phenotypes and insulin resistance (IR) and metabolic abnormalities in non-diabetic individuals with post-COVID-19 syndrome. METHODS: A cross-sectional, single-center study involving 483 subjects with post-COVID-19 syndrome following moderate to severe acute COVID-19 requiring hospitalization. Individuals with diabetes, those who declined to participate, or those who could not be contacted were excluded. Body composition phenotypes were classified as normal weight, dynapenia, sarcopenia, dynapenic obesity, and sarcopenic obesity (SO). RESULTS: The average age was 52.69 ± 14.75 years; of note, 67.08% were male. The prevalence of body composition phenotypes was as follows: 13.25% were of normal weight, 9.52% had dynapenia, 9.94% had sarcopenia, 43.69% had obesity, 18.84% had dynapenic obesity, and 4.76% had SO. Additionally, 58.18% had IR. Obesity (OR: 2.98, CI95%; 1.64-5.41) and dynapenic obesity (OR: 4.98, CI95%; 1.46-6.88) were associated with IR. CONCLUSION: The most common body composition phenotypes were obesity, dynapenic obesity, and dynapenia. Furthermore, obesity and dynapenic obesity were associated with IR in post-COVID-19 syndrome.

Assessing the role of prognostic nutritional index in predicting outcomes for rectal cancer surgery.

BACKGROUND & AIMS: The association of Prognostic Nutritional Index (PNI) with prognosis has been established for various cancer types, including rectal cancer. However, the precise relationship between PNI and body composition characteristics in patients with non-metastatic rectal cancer remain unclear. This study aimed to investigate the impact of PNI on overall survival and disease-free survival in non-metastatic rectal cancer patients undergoing total surgical resection. Additionally, it sought to assess the inflammatory status and body composition in patients across different PNI levels. METHODS: Patients with non-metastatic rectal cancer who underwent total surgical resection, were consecutively enrolled. PNI was calculated using the formula: PNI = (10 × serum albumin [g/dl]) + (0.005 × lymphocytes/µL). Body composition was assessed using CT-derived measurements and laboratory tests performed at diagnosis were used to calculate inflammatory indices. Univariate and multivariate logistic regression analyses as well as Kaplan-Meier curves were used to determine prognostic values. RESULTS: A total of 298 patients were included. Patients with low PNI demonstrated significantly reduced overall survival and disease-free survival compared to those with high PNI (Hazard ratio [HR] 1.85; Confidence interval [CI] 1.30-2 0.62; p = 0.001). Moreover, patients with low PNI exhibited heightened systemic inflammatory status and reduced skeletal muscle index, increased muscle radiodensity, as well as a decrease in subcutaneous adipose tissue area, subcutaneous fat index, and low attenuation of both subcutaneous and visceral adipose tissue. CONCLUSION: The PNI, assessed prior to treatment initiation, serves as a prognostic biomarker for non-metastatic rectal cancer patients undergoing total surgical resection and is linked with both inflammation and alterations in body composition.

Effectiveness of Resistance Training Program on Body Composition in Adults Following Vegan Diet versus Omnivorous Diet; Developed in Mobile Health Modality.

BACKGROUND: The vegan diet (VEGD) has gained popularity in recent years for ecological and ethical reasons, as well as for its health benefits. In addition to the type of diet, the resistance training program (RTP) plays a fundamental role as one of the main natural anabolic stimuli to increase musculoskeletal mass and reduce fat mass. METHODS: The study was a 16-week non-randomized controlled clinical trial consisting of three RTP sessions per week. The sample included 70 Chilean individuals, aged between 18 and 59 years, who had been following a VEGD or omnivorous diet (OMND) for the past 6 months. Four groups were established: Vegan Diet Resistance Training Program (VEGD-RTP), Vegan Diet Control (VEGD-C), Omnivorous Diet Resistance Training Program (OMND-RTP), and Omnivorous Diet Control (OMND-C). RESULTS: The sample consisted of 47 women and 23 men, with a mean age of 30.1 (±8.6) years. A reduction of 1.20% in the percentage of fat mass (%FM) was observed in the VEGD-RTP group (r = 0.554, p = 0.016), as well as a reduction of 0.70 kg in kilograms of fat mass (KFM) (r = 0.480, p = 0.036). The OMND-RTP group decreased %FM by 0.90% (r = 0.210, p = 0.432) and KFM by 0.50 kg (r = 0.109, p = 0.683). CONCLUSIONS: RTP combined with VEGD or OMND significantly reduced the percentage of fat mass, although its effect was more significant in the VEGD-RTP participants.

Body Composition Classification with Electrical Bioimpedance in Chilean Military by Sex / Clasificación de la Composición Corporal con Bioimpedancia Eléctrica en Militares Chilenos por Sexo

SUMMARY: Military readiness relies heavily on the physical fitness and operational capability of its personnel. This study aims to enhance the effectiveness of body composition assessment and classification protocols within the military context. A comprehensive evaluation of 4370 active-duty Chilean military personnel was conducted, focusing on anthropometric characteristics, including adipose tissue, muscle tissue, and anthropometric indices. The study observed significant differences in body composition between genders, with men exhibiting lower levels of body fat percentage (men: 26.28 %; women: 34.62 %) but higher levels of muscle mass (men: 42.0 %; women: 36.0 %;), skeletal muscle index (men:11.81; women: 9.31), and fat-free mass index (men: 19.92; women: 18.45) compared to women. High levels of muscle tissue were observed in both groups. By integrating these findings into a standardized assessment protocol, a more accurate classification of military personnel was achieved, surpassing traditional methods used in sedentary obese populations. The study advocates the future adoption of an assessment model based on artificial intelligence (AI) algorithms, which consider the multifaceted nature of body composition and its impact on operational capability. Such a model would enable military forces to optimize their personnel's physical fitness and readiness, thus enhancing their effectiveness in deployment operations.

La preparación militar depende en gran medida de la aptitud física y la capacidad operativa de su personal. Este estudio tiene como objetivo mejorar la eficacia de los protocolos de evaluación y clasificación de la composición corporal dentro del contexto militar. Se realizó una evaluación integral de 4.370 militares chilenos en servicio activo, centrándose en las características antropométricas, incluido el tejido adiposo, el tejido muscular y los índices antropométricos. El estudio observó diferencias significativas en la composición corporal entre sexos, con los hombres exhibiendo niveles más bajos de porcentaje de grasa corporal (hombres: 26,28 %; mujeres: 34,62 %) pero niveles más altos de masa muscular (hombres: 42,0 %; mujeres: 36,0 %;), índice de músculo esquelético (hombres: 11,81; mujeres: 9,31) e índice de masa magra (hombres: 19,92; mujeres: 18,45) en comparación con las mujeres. Se observaron altos niveles de tejido muscular en ambos grupos. Al integrar estos hallazgos en un protocolo de evaluación estandarizado, se logró una clasificación más precisa del personal militar, superando los métodos tradicionales utilizados en poblaciones obesas sedentarias. El estudio aboga por la adopción futura de un modelo de evaluación basado en algoritmos de inteligencia artificial (IA), que consideren la naturaleza multifacética de la composición corporal y su impacto en la capacidad operativa. Un modelo de este tipo permitiría a las fuerzas militares optimizar la aptitud física y la preparación de su personal, mejorando así su eficacia en las operaciones de despliegue.

Age-dependent Model for Dynamics of Change in Body Composition Indicators in Professional Firefighters: Serbian Cross-Sectional Study / Modelo Dependiente de la Edad para la Dinámica de Cambio en los Indicadores de Composición Corporal en Bomberos Profesionales: Estudio Transversal Serbio

SUMMARY: The aim of this study was to establish an age-related dynamic of change model for predicting changes in body composition indicators in professional firefighters. The study included a total sample of 145 subjects, comprising professional firefighters from Serbia (Age: 36.6 ± 7.6 yrs., Min - Max: 21.0 - 52.0 yrs.). Four basic variables were analysed: Body Mass - BM, Body Fat Mass - BFM, Skeletal Muscle Mass - SMM, and Visceral Fat Area - VFA, as well as five derived, or index, variables: Body Mass Index - BMI, Percentage of Body Fat - PBF, Percentage of Skeletal Muscle Mass - PSMM, Protein-Fat Index - PFI, and Index of Body - IBC Composition. The results showed a statistically significant dynamic of change as a function of age for eight of the examined variables, while only one (Skeletal Muscle Mass - SMM) was not statistically significant. The highest statistical significance in terms of dynamics of change as a function of age was found for the variable VFA (F = 35.241, p = 000) and the variable PSMM (F = 31.398, p = 0.000). Professional firefighters in Serbia fall into the category of people with normal nutritional indicators. However, due to a dominant increase in visceral fat (VFA) combined with a dominant decrease in the proportion of skeletal muscles in the body (PSMM), it can be concluded that they are exposed to a risk of developing various chronic diseases, while their working conditions, which promote certain negative lifestyle habits, also contribute to the observed increase in body fat components.

El objetivo de este estudio fue establecer un modelo de dinámica de cambio relacionada con la edad para predecir cambios en los indicadores de composición corporal en bomberos profesionales. El estudio incluyó una muestra total de 145 sujetos, incluidos bomberos profesionales de Serbia (Edad: 36,6 ± 7,6 años, mín. - máx.: 21,0 - 52,0 años). Se analizaron cuatro variables básicas: Masa Corporal - MC, Masa Grasa Corporal - MGC, - Masa Muscular Esquelética - MME y Área Grasa Visceral - AGV, así como cinco variables derivadas o indexadas: Índice de Masa Corporal - IMC, Porcentaje de grasa corporal - PGC, porcentaje de masa muscular esquelética - PMME, índice proteína-grasa - IPG e índice de composición corporal - ICC. Los resultados mostraron una dinámica de cambio estadísticamente significativa en función de la edad para ocho de las variables examinadas, mientras que sólo una, MME no fue estadísticamente significativa. La mayor significancia estadística en términos de dinámica de cambio en función de la edad se encontró para la variable AGV (F = 35,241, p = 000) y la variable PMME (F = 31,398, p = 0,000). Los bomberos profesionales de Serbia pertenecen a la categoría de personas con indicadores nutricionales normales. Sin embargo, debido a un aumento dominante de la grasa visceral combinado con una disminución dominante de la PMME, se puede concluir que están expuestos a un riesgo de desarrollar diversas enfermedades crónicas, mientras que las condiciones de trabajo, que promueven ciertos hábitos de vida negativos, también contribuyen al aumento observado de los componentes de la grasa corporal.

Correlación del Ángulo de Fase con las Masas Muscular y Grasa en una Población Caucásica Sana de Amplio Rango de Edad / Correlation of Phase Angle with Muscle and Fat Mass in a Healthy Caucasian Population of a Wide Age Range

El análisis de impedancia bioeléctrica (BIA) es un método relativamente económico, rápido y no invasivo para la determinación de la composición corporal. El ángulo de fase (PhA) es un indicador de la salud celular y de la integridad de la membrana y parece estar relacionado con la capacidad física y el rendimiento deportivo. El objetivo de este estudio fue el de analizar las posibles relaciones entre PhA y el porcentaje de masa muscular esquelética (SMM%) y entre PhA y el porcentaje de masa grasa (FM%) en una población caucásica sana, con un amplio rango de edad. Se analizaron 210 sujetos caucásicos sanos (99 mujeres y 111 hombres), de edades comprendidas entre 20 y 70 años. Se utilizó un dispositivo BIA mano-pie (BIA-101, AKERN-Srl, Firenze, Italy) para la determinación de los parámetros bioeléctricos y un escáner DXA de cuerpo entero QDR, serie Horizon (Hologic Inc., Bedford, MA, USA) para la determinación de SMM% y FM%. Se observaron correlaciones significativas positivas fuertes entre PhA y SMM%, independientemente de la franja de edad, (0,520-0,687; p < 0,01) y correlaciones significativas negativas fuertes (o moderadas/fuertes) entre PhA y FM% (0,492-0,657; p < 0,01), también independientemente de la franja de edad. Estas correlaciones indican que PhA podría utilizarse como marcador para ver la evolución de un sujeto activo, sea deportista o no. Se recomienda, por tanto, el desarrollo y la validación de nuevas ecuaciones para determinar la masa muscular y la masa grasa, que incluyan PhA como parámetro bioeléctrico.

SUMMARY: Bioelectrical impedance analysis (BIA) is a non-invasive, economic and fast method for body composition assessment. Phase angle (PhA) is considered an indicator of cellular health and cell membrane integrity, and it seems to be related to physical capacity and performance. The aim of this study was to analyze the possible relationships between PhA and skeletal muscle mass percentage (SMM%) and between PhA and fat mass percentage (FM%) in a healthy Caucasian population with a wide age range. 210 healthy Caucasian participants (99 women and 111 men), aged 20-70 years were analyzed. A BIA foot-to-hand body composition analyzer (BIA-101, AKERN-Srl, Firenze, Italy) was used to determine bioelectrical parameters, and a whole body DXA scanner QDR, serie Horizon (Hologic Inc., Bedford, MA, USA) was used for SMM% and FM% assessment. Irrespective of age range, strong positive significant correlations were observed between PhA and SMM% (0.520-0.687; p < 0.01) and strong (or moderate/strong) negative significant correlations were observed between PhA and FM% (0.492-0.657; p < 0.01). These correlations indicate that PhA could be used as a marker to monitor the evolution of an active subject, whether an athlete or not. It would be useful to develop and validate new equations for skeletal muscle mass and fat mass assessment, which include PhA as a bioelectrical parameter.

Effect of Detraining on Muscle Strength, Functional Capacity, Mental Health, and Body Composition in Individuals with Spinal Cord Injury.

Spinal cord injury (SCI) is a condition that significantly affects the quality of life (QoL) of individuals, causing motor, physiological, social, and psychological impairments. Physical exercise plays a crucial role in maintaining the health and functional capacity of these individuals, helping to minimize the negative impacts of SCI. The aim of this study was to evaluate the effect of detraining (DT) (reduction or cessation of physical exercise) during the pandemic on five individuals with thoracic SCI. We assessed muscle strength using strength tests, functional capacity using a functional agility test, mental health using anxiety and depression inventories, and body composition using dual-energy X-ray absorptiometry (DEXA). The results after 33 months of DT showed significant losses in functional agility and MS, as well as a worsening in symptoms of anxiety and depression. It was observed that total body mass and fat mass (FM) exhibited varied behaviors among the individuals. Similarly, the results for lean body mass were heterogeneous, with one participant showing significant deterioration. It is concluded that DT caused by the pandemic worsened the physical and mental condition of individuals with SCI, highlighting the importance of continuous exercise for this population and underscoring the need for individual assessments to fully understand the impacts of DT.

Comparison of bone mineral density between female amateur triathletes and nonathletes: A cross-sectional study.

PURPOSE: Physical inactivity is considered an important risk factor for osteoporosis, however, some athletes performing extremely high training volumes can also develop bone mass loss. Moreover, the effect of total body mass or body surface area on bone mineral density remains controversial. Therefore, the aim of this study was to compare the absolute bone mineral density and bone mineral density adjusted to body surface area between amateur triathletes and nonactive women. METHODS: Forty-two healthy women (23 amateur triathletes and 19 nonactive individuals) were evaluated for body composition using a dual-energy X-ray absorptiometry system. RESULTS: Compared to nonactive women, amateur triathletes exhibited lower body mass index (p < 0.001), lower bone mineral density (p < 0.001), and body surface area (p < 0.001). However, bone mineral density adjusted by body surface area in the triathletes was higher than in the nonactive women (p = 0.03). CONCLUSION: These findings showed that amateur triathles presented lower absolute bone mineral density, but higher bone mineral density adjusted to body surface area. Future studies are recommended to identify if the higher bone mineral density adjusted to body surface area are associated with a lower bone fragility.

Kinanthropometry and dietary habits of non-professional rugby players.

Introduction: Evaluating the body composition and dietary habits of non-professional athletes can help identify areas for improvement to enhance sports performance. The present study aimed to describe the anthropometric and body composition features, as well as the dietary habits, of non-professional rugby players in Argentina. Methods: Fifty-seven rugby players from a Group III Club of the Unión de Rugby de Buenos Aires (URBA) were assessed using extensive anthropometric measurements according to the International Society for the Advancement of Kinanthropometry (ISAK) protocol. Reference data from professional rugby players in Group I clubs were used as a control for body composition comparisons. Dietary intake was evaluated using the 24-h recall method, and nutrient analysis was performed with SARA software. Results: Non-professional rugby players were shorter (Forwards: 175.9 vs. 181.5 cm; Backs: 172.5 vs. 175.7 cm), had higher body fat percentages (Forwards: 16.4 vs. 12.3%; Backs: 11.0 vs. 9.3%), and were less muscular (Forwards: 46.0 vs. 48.8%; Backs: 48.4 vs. 50.2%) compared to professional rugby players. The average dietary intake was 3,363 Kcal, with protein and carbohydrate intakes of 1.4 g kg-1 day-1 and 4.1 g kg-1 day-1, respectively, and 35% of energy intake from fat. Backs reported a higher caloric intake than forwards (3,682 vs. 2,827 Kcal). There was a high prevalence of insufficient intake of calcium (58%), vitamin A (49%), and vitamin C (65%), the latter two corresponding with a low intake of fruits and vegetables (6% of total energy intake). Meal pattern analysis showed that 46% of total energy was ingested at dinner. Conclusions: The body composition of non-professional rugby players from low-income clubs could be improved to enhance rugby performance, as compared to players in more competitive tiers. Economic constraints might contribute to a sub-optimal nutritional profile, potentially affecting body composition and on-field performance negatively. Recommendations to improve dietary intake should be made considering the budget constraints of these players.

Load carriage does not reduce absolute mechanical power output but reduces agility in elite military police officers.

Objectives. The main objective of this study was to evaluate mean propulsive velocity (MPV), mean propulsive force (MPF) and mean propulsive power (MPP) in elite police officers under LOADED and UNLOADED conditions. The study also investigated the association of body composition and strength levels under the same load conditions. Methods. Twenty-one men from an elite unit in Brazil participated in the study, performing Smith machine half squats and an agility test. Dual energy X-ray absorptiometry measured body composition; a linear encoder measured MPV, MPF and MPP during the half squats; and a manual chronometer registered agility test performance. Results. The results showed that wearing and carrying occupational loads did not alter the squat exercise's MPP, MPV and MPF but reduced the performance of relative MPP and agility (p < 0.05). The results also showed that MPP had a higher association with force (i.e., MPF and one-repetition maximum [1RM]) than velocity (i.e., MPV and agility) under the LOADED condition (p < 0.05). Among the body composition variables, only lean body mass was associated with MPP under the LOADED condition (p < 0.05). Conclusion. These findings suggest that load carriage does not reduce absolute mechanical power output, but reduces the relative MPP and agility in military police officers.

Effect of Early Time-Restricted Eating on Metabolic Markers and Body Composition in Individuals with Overweight or Obesity.

This study aimed to evaluate the effect of early time-restricted eating (eTRE) on metabolic markers and body composition in individuals with overweight or obesity. Seventeen subjects completed a randomized, crossover, and controlled clinical trial. Twelve women and five men participated, with a mean age of 25.8 ± 10.0 years and a BMI of 32.0 ± 6.3 kg/m2. The eTRE intervention included 16 h of fasting (3:00 pm to 7:00 am) and 8 h of ad libitum eating (7:00 am to 03:00 pm) (16:8). The trial included four weeks of interventions followed by a four-week washout period. Body weight, waist and hip circumferences, and body composition measurements were taken. Additionally, a venous blood sample was collected for biochemical determinations. In a before-after analysis, eTRE induced a reduction in BW and BMI in women but this was not significant when compared to the control group. eTRE did not modify any other anthropometric measurements, fasting biochemical parameters, glycemic and insulinemic responses, blood pressure, or subjective appetite. In conclusion, eTRE did not induce beneficial effects on the glycemic and lipid metabolisms, body composition, subjective appetite, or blood pressure. These findings may be attributed to the special characteristics of the population and the short intervention period.

Dietary Profile of Patients with Inflammatory Bowel Disease in Clinical Remission-A Preliminary Study.

Imbalanced dietary intake is associated with the development of inflammatory bowel diseases (IBDs) and is often observed during the active phases of Crohn's disease (CD) and ulcerative colitis (UC). Cumulative data also suggest the potential for dietary manipulation in avoiding IBD relapse. However, there is a paucity of dietary data from patients in clinical remission to guide such an approach. Our study aimed to characterize the dietary pattern and adequacy of patients with IBD in clinical remission. Data on dietary intake (three alternate 24 h food records) were collected from 40 patients with IBD (20 CD and 20 UC) and 45 gender-matched healthy controls (HC). Statistical comparisons between patients and controls employed Student's t-test, Mann-Whitney U, chi-squared, and Fisher's exact tests. The adequacy of dietary intake of IBD patients was further studied by assessing the nutrient inadequacy prevalence, estimated using the Dietary Reference Intakes (DRI) framework and the Estimated Average Requirement (EAR) parameter. We observed significant dietary imbalances among patients with IBD compared to the HC group, marked by disparities in both macronutrient and micronutrient intakes. Inadequacies with frequencies >80% were observed for the ingestion of total fiber and 13 micronutrients in IBD patients. Our preliminary findings suggest that imbalanced dietary intake is also characteristic among individuals with IBD during clinical remission, corroborating the need for dietary interventions in this population.

Comparative Effects of Gymnema sylvestre and Berberine on Adipokines, Body Composition, and Metabolic Parameters in Obese Patients: A Randomized Study.

Gymnema sylvestre (GS) and berberine (BBR) are natural products that have demonstrated therapeutic potential for the management of obesity and its comorbidities, as effective and safe alternatives to synthetic drugs. Although their anti-obesogenic and antidiabetic properties have been widely studied, comparative research on their impact on the gene expression of adipokines, such as resistin (Res), omentin (Ome), visfatin (Vis) and apelin (Ap), has not been reported. METHODOLOGY: We performed a comparative study in 50 adult Mexican patients with obesity treated with GS or BBR for 3 months. The baseline and final biochemical parameters, body composition, blood pressure, gene expression of Res, Ome, Vis, and Ap, and safety parameters were evaluated. RESULTS: BBR significantly decreased (p < 0.05) body weight, blood pressure and Vis and Ap gene expression and increased Ome, while GS decreased fasting glucose and Res gene expression (p < 0.05). A comparative analysis of the final measurements revealed a lower gene expression of Ap and Vis (p < 0.05) in patients treated with BBR than in those treated with GS. The most frequent adverse effects in both groups were gastrointestinal symptoms, which attenuated during the first month of treatment. CONCLUSION: In patients with obesity, BBR has a better effect on body composition, blood pressure, and the gene expression of adipokines related to metabolic risk, while GS has a better effect on fasting glucose and adipokines related to insulin resistance, with minimal side effects.

Thigh muscle by CT images as a predictor of mortality in patients with newly diagnosed colorectal cancer.

This study aimed to evaluate the prognostic value of thigh muscle assessed by CT images to predict overall mortality in patients with colorectal cancer (CRC). This was a multicenter cohort study including adults (≥ 18 years old) newly diagnosed with CRC, who performed a diagnostic computed tomography (CT) exam including thigh regions. CT images were analyzed to evaluate skeletal muscle (SM in cm2), skeletal muscle index (SMI in cm2/m2), and skeletal muscle density (SMD in HU). Muscle abnormalities (low SM, SMI, and SMD) were defined as the values below the median by sex. Kaplan-Meyer curves and hazard ratios (HRs) for low SM, SMI and SMD were evaluated for overall mortality, stratified by sex. A total of 257 patients were included in the final analysis. Patients' mean age was 62.6 ± 12.1 years, and 50.2% (n = 129) were females. In males, low thigh SMI was associated with shorter survival (log-rank P = .02). Furthermore, this low thigh SMI (cm2/m2) was independently associated with higher mortality rates (HR adjusted 2.08, 95% CI 1.03-4.18). Our additional findings demonstrated that low SMD was independently associated with overall mortality among early-stage patients (I-III) (HR adjusted 2.78, 95% CI 1.26-6.15).

Body mass index-adjusted calf circumference is associated with mortality in hospitalized older patients with excess weight.

OBJECTIVES: Given the innovative nature of the method, our study aimed to assess the prognostic significance of body mass index (BMI)-adjusted calf circumference (CC) in older patients who are hospitalized. METHODS: This was a unique analysis as part of other cohorts comprising general hospitalized patients aged 60 years or older of both sexes. Only patients with excess weight (BMI ≥ 25 kg/m2) were included. CC was adjusted by reducing 3, 7, or 12 cm for BMI (in kg/m2) within 25-29.9, 30-39.9, and ≥40 kg/m2, respectively. CC was considered low if ≤ 34 cm for males and ≤ 33 cm for females. Clinical outcomes included prolonged length of hospital stay (LOS) and mortality. RESULTS: A total of 222 patients were included. After BMI adjustments, 72.1% of the patients were reclassified from a normal CC category to a low CC category. The frequency of low CC increased from 33.8% to 81.9% following BMI adjustments. Among those reclassified to the low CC, 11 died, compared to only 2 patients in the group that maintained a normal CC classification. BMI-adjusted CC was inversely associated with mortality (HR adjusted 0.84, 95% CI 0.73 to 0.95), but not with prolonged LOS. CONCLUSIONS: Our novel study highlights the prognostic value of BMI-adjusted CC. As an anthropometric marker of muscle mass, it proved to be a predictor of mortality in older patients with high BMI. This adjustment is further important because it may help to better detect low muscle mass in these patients where such conditions might be masked.

Age-adjusted Charlson comorbidity index and its association with body composition and overall survival in patients with colorectal cancer.

OBJECTIVE: To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC). RESEARCH METHODS AND PROCEDURES: In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established. RESULTS: A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard (adjusted HR 5.12, 95% CI 2.73-9.57; adjusted HR 4.58, 95% CI 2.37-8.85; and adjusted HR 2.36, 95% CI 1.07-5.22, respectively). CONCLUSION: The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.

Frailty and sarcopenia in patients with acute-on-chronic liver failure: Assessment and risk in the liver transplant setting.

Frailty and sarcopenia are well-recognized factors related to worse outcomes in patients with cirrhosis, including liver transplant (LT) candidates. Implications of pre-LT functional and muscle deterioration also affect post-LT outcomes. Patients with cirrhosis and acute-on-chronic liver failure (ACLF) have a lower survival rate, both before and after LT. There is a need to better identify those patients with ACLF who would benefit from LT. This review aims to present the available data about frailty and sarcopenia in patients with ACLF in the LT setting. An exhaustive review of the published literature was conducted. Data regarding frailty and sarcopenia in LT candidates with ACLF are scarce and heterogeneous. Studies evaluating frailty and sarcopenia in critically ill patients outside the liver literature are also presented in this review to enrich the knowledge of this field in expansion. Frailty and sarcopenia seem to contribute to worse outcomes in LT candidates with ACLF, both before and after LT. Sarcopenia evaluation may be the most prudent approach for those very sick patients. Skeletal muscle index assessed by computed tomography is recommended to evaluate sarcopenia. The role of muscle ultrasound and bioelectrical impedance analysis is to be determined. Frailty and sarcopenia are crucial factors to consider on a case-by-case basis in LT candidates with ACLF to improve patient outcomes.

Full-body resistance training promotes greater fat mass loss than a split-body routine in well-trained males: A randomized trial.

While significant progress has been made in understanding the resistance training (RT) strategy for muscle hypertrophy increase, there remains limited knowledge about its impact on fat mass loss. This study aimed to investigate whether full-body is superior to split-body routine in promoting fat mass loss among well-trained males. Twenty-three participants were randomly assigned to 1 of 2 groups: full-body (n = 11, training muscle groups 5 days per week) and split-body (n = 12, training muscle groups 1 day per week). Both groups performed a weekly set volume-matched condition (75 sets/week, 8-12 repetition maximum at 70%-80 % of 1RM) for 8 weeks, 5 days per week with differences only in the routine. Whole-body and regional fat were assessed using DXA at the beginning and at the end of the study. Full-body RT elicited greater losses compared to split-body in whole-body fat mass (-0.775 ± 1.120 kg vs. +0.317 ± 1.260 kg; p = 0.040), upper-limb fat mass (-0.085 ± 0.118 kg vs. +0.066 ± 0.162 kg; p = 0.019), gynoid fat mass (-0.142 ± 0.230 kg vs. +0.123 ± 0.230 kg; p = 0.012), lower-limb fat mass (-0.197 ± 0.204 kg vs. +0.055 ± 0.328 kg; p = 0.040), and a trend in interaction in android fat mass (-0.116 ± 0.153 kg vs. +0.026 ± 0.174 kg; p = 0.051), with large effects sizes (η2 p ≥ 0.17). This study provides evidence that full-body is more effective in reducing whole-body and regional fat mass compared to split-body routine in well-trained males.