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This document is a clinical practice guideline on dietary recommendations for individuals with type 2 diabetes mellitus (T2DM). The guideline emphasizes the importance of individualized therapy, counseling, and self-management for T2DM patients. It discusses the different types of T2DM and the need for personalized diets based on individual preferences and protein requirements. The guideline recommends weight loss as a goal for individuals with excess weight and highlights the benefits of telehealth applications in supporting behavioral modifications and increasing adherence to weight loss programs. Additionally, it provides strategies for weight reduction and maintenance, emphasizing the need for close follow-up and coordination with patients. The text also discusses the impact of various dietary factors on blood glucose response, specifically focusing on the glycemic index (GI) and dietary fiber. It states that a low GI/GL diet is associated with a reduced risk of type 2 diabetes and improved glycemic control. The text emphasizes the importance of dietary fiber, particularly from whole grain products, in reducing the risk of type 2 diabetes, cardiovascular disease, and other diseases. It suggests a target of 30 grams of dietary fiber per day. The text also provides recommendations for specific populations, such as geriatric patients and migrants, and discusses the impact of beverages, particularly sugar-sweetened beverages, on blood glucose control and overall health. It concludes that routine micronutrient supplementation is not recommended for individuals with type 2 diabetes, but vitamin D supplementation may improve insulin resistance in those with established deficiency. The text also explores [Extracted from the article]

However, the intake of naturally-occurring sugars (within the normal range of the diet) was associated with improved parameters of glycemic control, and Nansel et al. conclude that foods containing this source of sugar do not have negative effects on blood glucose control in adolescents with T1Dm [59]. The increased consumption of high-fiber foods seems to have a positive effect on the trend of postprandial glycemia, but the recommendations for fiber intake are based on those for the general population (30 g per day). Meal frequency and meal timing Recommendation If people with T1Dm are overweight, they should avoid irregular eating times, eating late and a time window for daily food intake>12 h. With regard to the consumption of individual foods/meals (according to the "acute food/meal studies" and clinical experience), special consideration of foods containing carbohydrate with a very low GI (below approx. 30) or a very high GI (above approx. 90) seems advisable. However, this is not justified, since the study did not intend to compare a low-GI diet with a high-GI diet, but primarily compared a diet with a fixed carbohydrate distribution ("carbohydrate framework") vs. a diet with flexible carbohydrate intake. [Extracted from the article]

Nearly half of the overweight and obese patients with T2Dm who initially received only a formula diet of 825 to 853 kcal per day for 3-5 months achieved diabetes remission in contrast to only 4% of patients who received only standard therapy from their primary care physician [13]. They sometimes prefer different foods, often eat more carbohydrates, have different meal concepts, a different understanding of portions, and different food preparation methods and food combinations. For people with T2Dm, the recommendations are differentiated for the different treatment situations and forms: For overweight patients with T2Dm: a meta-analysis on fiber and whole grain consumption in diabetes management included 42 intervention studies. In patients with T2Dm, a high consumption of low GI foods such as legumes and oats can improve glycemic control, increase insulin sensitivity, and thus reduce insulin requirements [165]. Etiologic effects and optimal intakes of foods and nutrients for risk of cardiovascular diseases and diabetes: Systematic reviews and meta-analyses from the Nutrition and Chronic Diseases Expert Group (NutriCoDE). [Extracted from the article]

Summary: Traditional diagnosis and understanding of the pathophysiology of obesity are based on excessive fat storage due to a chronically positive energy balance characterized by body mass index (BMI). Quantitative and qualitative analysis of lean and adipose tissue compartments by body composition analysis reveals that characterization of obesity as "overfat" does not facilitate a comprehensive understanding of obesity‐associated health risk. Instead of being related to fat mass, body composition characteristics underlying BMI‐associated prognosis may depend (i) on accelerated growth by a gain in lean mass or fat‐free mass (FFM) in children with early BMI rebound or adolescents with early puberty; (ii) on a low muscle mass in aging, associated chronic disease, or severe illness; and (iii) on impaired adipose tissue expandability with respect to cardiometabolic risk. It is therefore time to call the adipocentric paradigm of obesity into question and to avoid the use of BMI and body fat percentage. By contrast, obesity should be seen in face of a limited FFM/muscle mass together with a limited capacity of fat storage. [ABSTRACT FROM AUTHOR]

The risk of potential malnutrition is present if the reduced food intake continues (approximately<50% of the requirement for more than 3 days) or if several risk factors are present at the same time, which either reduce the amount of food or significantly increase the energy and nutrient requirements. With regard to the consumption of individual foods/meals (according to the "acute food/meal studies" and clinical experience), special consideration of foods containing carbohydrate with a very low GI (below approx. 30) or a very high GI (above approx. 90) seems advisable. The increased consumption of high-fiber foods seems to have a positive effect on the trend of postprandial glycemia, but the recommendations for fiber intake are based on those for the general population (30 g per day). However, the intake of naturally-occurring sugars (within the normal range of the diet) was associated with improved parameters of glycemic control, and Nansel et al. conclude that foods containing this source of sugar do not have negative effects on blood glucose control in adolescents with T1Dm [59]. Meal Frequency and Meal Timing Recommendation If people with T1Dm are overweight, they should avoid irregular eating times, eating late and a time window for daily food intake>12 h. [Extracted from the article]

This document is a correction notice for an article titled "Total and regional appendicular skeletal muscle mass prediction from dual-energy X-ray absorptiometry body composition models" published in Scientific Reports. The original article contained errors in Figures 2 and 3, where the labels and text did not display correctly. The corrected figures and accompanying legends are provided in the document. The authors of the article are Cassidy McCarthy, Grant M. Tinsley, Anja Bosy-Westphal, Manfred J. Müller, John Shepherd, Dympna Gallagher, and Steven B. Heymsfield. [Extracted from the article]

• Fat-free mass, skeletal muscle mass, the combined mass of high-metabolic rate organs and resting metabolic rate were associated with fasting hunger. • High-metabolic rate organ mass was more strongly associated with hunger than fat-free mass. • Within high-metabolic rate organs, the strongest individual association was between liver mass and fasting hunger. • Higher allocation of energy to the brain was associated with a lower fasting hunger. • The association between liver and hunger may reflect its role in ensuring brain's basal energy needs. Fat-free mass (FFM) has been shown to be positively associated with hunger and energy intake, an association mediated by resting metabolic rate (RMR). However, FFM comprises a heterogeneous group of tissues with distinct metabolic rates, and it remains unknown how specific high-metabolic rate organs contribute to the degree of perceived hunger. To examine whether FFM and its anatomical components were associated with fasting hunger when assessed at the tissue-organ level. Body composition (quantitative magnetic resonance and magnetic resonance imaging), RMR and whole-body glucose oxidation (indirect calorimetry), HOMA-index as a marker of insulin sensitivity, nitrogen balance and fasting hunger (visual analogue scales) were assessed in 21 healthy males (age = 25 ± 3y; BMI = 23.4 ± 2.1 kg/m2) after 3 days of controlled energy balance. FFM (r s = 0.39; p = 0.09), RMR (r s = 0.52; p = 0.02) and skeletal muscle mass (r s = 0.57; p = 0.04), but not fat mass (r s = −0.01; p = 0.99), were positively associated with fasting hunger. The association between the combined mass of high-metabolic rate organs (i.e., brain, liver, kidneys and heart; r s = 0.58; p = 0.006) and fasting hunger was stronger than with FFM as a uniform body component. The strongest individual association was between liver mass and fasting hunger (r s = 0.51; p = 0.02). No associations were observed between glucose parameters, markers of insulin sensitivity and fasting hunger. The encephalic measure, an index of brain-to-body energy allocation, was negatively associated with fasting hunger (r s = −0.51; p = 0.02). Fasting hunger was more strongly associated with the combined mass of high-metabolic rate organs than with FFM as a uniform body component, highlighting the importance of integrating individual tissue-organ masses and their functional correlates into homeostatic models of human appetite. The association between liver mass and fasting hunger may reflect its role in ensuring the brain's basal energy needs are met. [ABSTRACT FROM AUTHOR]

Objective We here studied how energy is allocated between brain and body both during the ontogenetic development from a child to an adult and during weight loss. Methods We investigated 180 normal weight female and male children and adolescents (aged 6.1-19.9 years) as well as 35 overweight adolescents undergoing weight reduction intervention. 52 normal weight and 42 obese adult women were used for comparison. We assessed brain mass by magnetic-resonance-imaging and body metabolism by indirect calorimetry. To study how energy is allocated between brain and body, we measured plasma insulin, since insulin fulfils the functions of a glucose allocating hormone, i.e., peripheral glucose uptake depends on insulin, central uptake does not. We used reference data obtained in the field of comparative biology. In a brain-body-plot, we calculated the distance between each subject and a reference mammal of comparable size and named the distance 'encephalic measure.' With higher encephalic measures, more energy is allocated to the brain. Results We found that ontogenetic development from a child to an adult was indicated by decreasing encephalic measures in females ( r = −0.729, P < 0.001) and increasing plasma insulin concentrations ( F = 6.6, P = 0.002 in females and F = 8.6, P < 0.001 in males). Weight loss of about 5 kg in females and about 9 kg in males resulted in reduced insulin concentrations and increased encephalic measures. Conclusion Our results indicate that the share of energy allocated to the brain increased with weight loss, but decreased during the ontogenetic development from childhood to adolescence. These developmental changes in brain-to-body energy allocation appear to be driven by increasing plasma insulin concentrations. Am. J. Hum. Biol. 25:725-732, 2013. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Sarcopenia, sarcopenic obesity, frailty, and cachexia have in common skeletal muscle (SM) as a main component of their pathophysiology. The reference method for SM mass measurement is whole-body magnetic resonance imaging (MRI), although dual-energy X-ray absorptiometry (DXA) appendicular lean mass (ALM) serves as an affordable and practical SM surrogate. Empirical equations, developed on relatively small and diverse samples, are now used to predict total body SM from ALM and other covariates; prediction models for extremity SM mass are lacking. The aim of the current study was to develop and validate total body, arm, and leg SM mass prediction equations based on a large sample (N = 475) of adults evaluated with whole-body MRI and DXA for SM and ALM, respectively. Initial models were fit using ordinary least squares stepwise selection procedures; covariates beyond extremity lean mass made only small contributions to the final models that were developed using Deming regression. All three developed final models (total, arm, and leg) had high R2s (0.88–0.93; all p < 0.001) and small root-mean square errors (1.74, 0.41, and 0.95 kg) with no bias in the validation sample (N = 95). The new total body SM prediction model (SM = 1.12 × ALM – 0.63) showed good performance, with some bias, against previously reported DXA-ALM prediction models. These new total body and extremity SM prediction models, developed and validated in a large sample, afford an important and practical opportunity to evaluate SM mass in research and clinical settings. [ABSTRACT FROM AUTHOR]

Following experts' consensus, waist circumference (WC) is the best anthropometric obesity index. However, different anatomic sites are used, and currently there is no universally accepted protocol for measurement of WC. In this study, we compare the associations between WC measured at different sites with total visceral adipose tissue (VAT) volume and cardiometabolic risk. Cross-sectional data were obtained from 294 adults and 234 children and adolescents. In addition, longitudinal data were provided in 75 overweight adults before and after dietary-induced weight loss. WC was measured below the lowest rib (WCrib), above the iliac crest (WCiliac crest), and midway between both sites (WCmiddle). Volumes of VAT and abdominal subcutaneous adipose tissue (SAT) were obtained using MRI. Cardiometabolic risk included blood pressure, plasma lipids, glucose, and homeostasis model (HOMA index). WC differed according to measurement site as WCrib < WCmiddle < WCiliac crest (P < 0.001) in children and women, and WCrib < WCmiddle, WCiliac crest (P < 0.001) in men. Elevated WC differed by 10-20% in females and 6-10% in males, dependent on measurement site. In men and children, all WC had similar relations with VAT, SAT, and cardiometabolic risk factors. In women, WCrib correlated with weight loss-induced decreases in VAT (r = 0.35; P < 0.05). By contrast, WCiliac crest had the lowest associations with VAT and cardiometabolic risk factors in women. Each WC had a stronger correlation with SAT than with VAT, suggesting that WC is predominantly an index of abdominal subcutaneous fat. There is need for a unified measurement protocol. [ABSTRACT FROM AUTHOR]

Abstract: The BIOPAC indirect calorimeter for measuring resting energy expenditure (REE) is less cumbersome than many other calorimeters. We tested the hypothesis that the BIOPAC calorimeter is as well suited for determining REE in older people as traditional calorimeters. In 50 healthy persons (24 men and 26 women; age range, 61-83 years), REE by BIOPAC was validated against Vmax Spectra indirect calorimeter as a criterion method. Resting energy expenditure by BIOPAC was recorded at 2 different time intervals to find optimal conditions for older persons. Also, REE by 7 published equations was validated. The Bland-Altman procedure was used to test agreement between methods. Multiple regression analysis was applied to develop a new equation for predicting REE from BIOPAC. The BIOPAC calorimeter and most empirical equations significantly overpredicted mean REE in both sexes. Mifflin''s equation best-predicted mean REE. Limits of agreement were wide for BIOPAC and narrow for most empirical equations. The Lührmann and Müller equations had smallest limits of agreement in men (±950 kJ/24 h) and the Harris-Benedict and Müller equations in women (±672 kJ/24 h). A new equation was developed for the BIOPAC device improving both predictions of mean and individual REE (R 2 = 0.671, standard error of the estimate = 136 kJ/24 h). Using this equation, 72.9% of subjects were lying within 10% of measured REE, compared with only 12.5% when using the manufacturer''s algorithm. In conclusion, the BIOPAC calorimeter is suitable for measuring REE in healthy older adults when the new prediction equation is applied. This calorimeter is not applicable to frail older persons. [Copyright &y& Elsevier]

Aim: To investigate the effect of a 4-week vitamin C and E supplementation on oxidative stress induced by hyperbaric oxygen (HBO). Methods: 19 healthy men were exposed to 3 sequential protocols, i.e. HBO (100% O2, 2.4 bar, 131 min) before (T1) and after 4 weeks of daily supplementation with 500 mg slow-release vitamin C and 272 IU vitamin E (T2). A normoatmospheric protocol (21% O2, 1.0 bar, 131 min) served as control treatment (nonexposed). Blood samples were taken before (B) and immediately after (A) treatment. Plasma levels of vitamin A, C, E, β-carotene, reduced glutathione and malondialdehyde were measured by HPLC. Antioxidative capacity and lipid peroxides in plasma were analyzed by ELISA. Results: HBO decreased vitamin C and antioxidative capacity (T1). At T1, Δ A – B of vitamin C and lipid peroxides was different from nonexposed. Vitamin supplementation increased plasma levels of vitamin C and E by 28 and 37%, respectively. Vitamin supplementation led to decreased concentrations of lipid peroxides and reduced glutathione. After supplementation, HBO decreased vitamin C and reduced glutathione. At T2, Δ A – B of vitamin C and lipid peroxides was significantly different from nonexposed. Conclusion: In humans, oxidative stress decreased plasma levels of vitamin C and antioxidative capacity and increased plasma lipid peroxides. Supplementation with vitamin C and E did not prevent these effects. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective To examine the determinants of adiponectin levels (i) in 23 women with anorexia nervosa (mean BMI 15.0± 1.2) and 43 healthy normal weight females (mean BMI 22.3± 2.3; cross-sectional design) as well as (ii) after six and twelve weeks of weight gain in subgroups of 18 and 11 anorectic patients (mean weight gain 5.8kg; longitudinal design). Plasma adiponectin and leptin concentrations were measured and their relationships to body composition (fat mass by bioelectrical impedance analysis and anthropometrics), different hormones and metabolic parameters (insulin,ACTH, cortisol, glucose, FFA, lipid profile) were investigated. Results In anorectic patients, adiponectin levels were higher (+29 %) and leptin levels were lower (-75 %) than in control subjects. There was a high variance in adiponectin levels in patients ranging from 2.6 to 18nM. Combining patients and controls, an inverse linear correlation was observed between adiponectin levels and fat mass (r=-0.36, p<0.05), while a positive exponential relation was found between leptin levels and fat mass (r=0.82, p<0.001). In anorectic patients, there were no significant correlations between adiponectin and hormonal or metabolic parameters. Weight gain resulted in increasing leptin (+0.17± 0.12nM; p<0.001) and a nonsignificant decrease in adiponectin concentrations (-1.12± 2.51nM). Changes in leptin levels were mainly explained by a gain in fat mass (r=0.85, p<0.001). In contrast, changes in adiponectin levels were closely linked to initial adiponectin levels (r=-0.84, p<0.001) but not to changes in fat mass or BMI. Conclusion Cross-sectionally serum adiponectin concentration followed a linear inverse function with fat mass when patients and controls were combined. Longitudinally gain in fat mass was not associated with changes in adiponectin levels suggesting other yet unidentified influences on adiponectin secretion in anorexia nervosa. [ABSTRACT FROM AUTHOR]

Air-displacement plethysmography (ADP) is now widely used for body composition measurement in pediatric populations. However, the manufacturer's software developed for adults leaves a potential bias for application in children and adolescents, and recent publications do not consistently use child-specific corrections. Therefore we analyzed child-specific ADP corrections with respect to quantity and etiology of bias compared with adult formulas. An optimal correction protocol is provided giving step-by-step instructions for calculations. In this study, 258 children and adolescents (143 girls and 115 boys ranging from 5 to 18 y) with a high prevalence of overweight or obesity (28.0% in girls and 22.6% in boys) were examined by ADP applying the manufacturer's software as well as published equations for child-specific corrections for surface area artifact (SM), thoracic gas volume (TGV), and density of fat-free mass (FFM). Compared with child-specific equations for SM, TGV, and density of FFM, the mean overestimation of the percentage of fat mass using the manufacturer's software was 10% in children and adolescents. Half of the bias derived from the use of Sin's equation not corrected for age- dependent differences in FFM density. An additional 3 and 2% of bias resulted from the application of adult equations for prediction of SAA and TGV, respectively. Different child-specific equations used to predict TGV did not differ in the percentage of fat mass. We conclude that there is a need for child-specific equations in ADP raw data analysis considering SAA, TGV, and density of FFM. [ABSTRACT FROM AUTHOR]

Graph: Figure 3Total skeletal muscle (SM) mass predicted by Kim's equation 8 versus SM measured with MRI at Kiel (A) and corresponding Bland-Altman plot (B) (n = 475). Total body skeletal muscle (SM) mass predicted by the newly developed Kiel equation versus SM measured with MRI by Kim et al. 8 (C) and corresponding Bland-Altman plot (D) (n = 270). [Extracted from the article]

There is conflicting evidence as to whether the age-related decline in resting energy expenditure (REE) can be attributed to i) absolute changes in fat-free mass (FFM), ii) alterations in the composition of FFM or iii) decreasing organ metabolic rates. This study directly addressed the first and second hypotheses by quantification of metabolically active components of FFM assuming constant tissue respiration rates to calculate REE (REEc). REE was measured (REEm) in 26 young (13 females, 13 males, age 22-31 y) and 26 elderly subjects (15 females, 11 males, age 60-82 y) by indirect calorimetry and detailed body composition analysis was obtained using bioelectrical impedance analysis (BIA), dual energy X-ray absorptiometry (DXA), and MRI. Specific organ metabolic rates were taken from the literature. REEm adjusted for differences in FFM was lower in older subjects than in younger control subjects (5.43 +/- 0.61 MJ/d compared with 6.37 +/- 0.48 MJ/d; P < 0.001). Skeletal muscle mass plus liver mass accounted for 86% and 48% of the variance in REE in young and elderly subjects, respectively. The difference between REEm and REEc was 0.03 +/- 0.40 MJ/d and -0.36 +/- 0.70 MJ/d in young and elderly subjects, respectively. In the elderly 58% of the difference in variance was attributed to heart mass. REEm - REEc was -1.40 +/- 0.44 MJ/d in subjects with hypertensive cardiac hypertrophy, i.e., heart mass > 500 g, suggesting a decrease in heart metabolic rate with increasing heart mass. Excluding five elderly subjects with cardiac hypertrophy resulted in agreement between REEm and REEc in the elderly (-0.10 +/- 0.48 MJ/d). We concluded that the age-related decline in REE is attributed to a reduction in FFM as well as in proportional changes in its metabolically active components. There is no evidence for a decreasing organ metabolic rate in healthy aging. [ABSTRACT FROM AUTHOR]

Adverse effects of high vitamin B[sub 6] intake include peripheral neuropathy. Recent studies focussing on the reduction of plasma homocysteine as a risk factor for vascular disease showed that vitamin B[sub 6] reduces plasma folate levels. The significance of this finding is unclear. We therefore analyzed plasma folate and basal homocysteine levels as well as the response to an oral methionine loading test in 8 healthy individuals before and after a controlled supplementation with oral doses of 25 mg pyridoxine for 10 days. Plasma pyridoxal phosphate increased from 40.6 ± 13.6 to 426.8 ± 200.3 nmol/l (p < 0.001), whereas plasma folate decreased from 6.3 ± 1.6 to 4.6 ±1.5 ng/ml (p < 0.01), respectively. Plasma vitamin B[sub 12] and basal homocysteine levels remained unchanged (234.0 ± 27.8 vs. 217.1 ± 50.4 pg/ml and 10.9 ± 4.8 vs. 10.1 ± 3.6 μmol/l). There was no significant effect of vitamin B[sub 6] supplementation on the area under methionine and homocysteine concentration versus time curve. Significant correlations were found between pre- and post-supplement levels of folate as well as PLP levels (r = 0.73, p < 0.05; r = 0.75, p < 0.05). These data suggest that a dose of 25 mg vitamin B[sub 6] supplemented for 10 days reduces plasma folate but did not affect basal and postprandial homocysteine levels suggesting (1) a normal cellular availability of folate or (2) a compensation of impaired homocysteine remethylation by increased transsulfuration.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This study examined the effect of exogenous ketone bodies (KB) on oxygen consumption (V̇ o 2), carbon dioxide production (V̇ co 2), and glucose metabolism. The data were compared with the effects of endogenous ketonemia during both, a ketogenic diet or fasting. Eight healthy individuals [24.1 ± 2.5 yr, body mass index (BMI) 24.3 ± 3.1 kg/m2] participated in a crossover intervention study and were studied in a whole-room indirect calorimeter (WRIC) to assess macronutrient oxidation following four 24-h interventions: isocaloric controlled mixed diet (ISO), ISO supplemented with ketone salts (38.7 g of β-hydroxybutyrate/day, EXO), isocaloric ketogenic diet (KETO), and total fasting (FAST). A physical activity level of 1.65 was obtained. In addition to plasma KB, 24-h C-peptide and KB excretion rates in the urine and postprandial glucose and insulin levels were measured. Although 24-h KB excretion increased in response to KETO and FAST, there was a modest increase in response to EXO only (P < 0.05). When compared with ISO, V̇ o 2 significantly increased in KETO (P < 0.01) and EXO (P < 0.001), whereas there was no difference in FAST. V̇ co 2 increased in EXO but decreased in KETO (both P < 0.01) and FAST (P < 0.001), resulting in 24-h respiratory exchange ratios (RER) of 0.828 ± 0.024 (ISO) and 0.811 ± 0.024 (EXO) (P < 0.05). In response to EXO there were no differences in basal and postprandial glucose and insulin levels, as well as in insulin sensitivity. When compared with ISO, EXO, and KETO, FAST increased homeostatic model assessment β-cell function (HOMA-B) (all P < 0.05). In conclusion, at energy balance exogenous ketone salts decreased respiratory exchange ratio without affecting glucose tolerance. NEW & NOTEWORTHY: Our findings revealed that during isocaloric nutrition, additional exogenous ketone salts increased V̇ o 2 and V̇ co 2 while lowering the respiratory exchange ratio (RER). Ketone salts had no effect on postprandial glucose metabolism. [ABSTRACT FROM AUTHOR]

Whole‐room indirect calorimeters (WRICs) provide accurate instruments for the measurement of respiratory exchange, energy expenditure, and macronutrient oxidation. Here, we aimed to determine the validity and reproducibility of a 7500 L WRIC for the measurement of ventilation rates and resting metabolic rate (RMR). Technical validation was performed with propane combustion tests (n = 10) whereas biological reproducibility was tested in healthy subjects (13 women, 6 men, mean ± SD age 39.6 ± 15.3) in two 60 min measurements separated by 24 h. Subjects followed a run‐in protocol prior to measurements. The coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for ventilation rates of O2 (VO2), CO2 (VCO2), the respiratory quotient (RQ; VCO2/VO2), and RMR. Technical validation showed good validity with CVs ranging from 0.67% for VO2 to 1.00% for energy expenditure. For biological reproducibility, CVs were 2.89% for VO2; 2.67% for VCO2; 1.95% for RQ; and 2.68% for RMR. With the exception of RQ (74%), ICCs were excellent for VO2 (94%), VCO2 (96%) and RMR (95%). Excluding participants that deviated from the run‐in protocol did not alter results. In conclusion, the 7500 L WRIC is technically valid and reproducible for ventilation rates and RMR. [ABSTRACT FROM AUTHOR]

Background: This study examined sex-specific differences in physical health-related quality of life (HRQoL) across subgroups of metabolic health and obesity. We specifically asked whether (1) obesity is related to lower HRQoL independent of metabolic health status and potential confounders, and (2) whether associations are similar in men and women.Methods: We used cross-sectional data from the German Health Interview and Examination Survey 2008-11. Physical HRQoL was measured using the Short Form-36 version 2 physical component summary (PCS) score. Based on harmonized ATPIII criteria for the definition of the metabolic health and a body mass index ≥ 30 kg/m2 to define obesity, individuals were classified as metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Sex-specific analyses including multivariable linear regression analyses were based on PCS as the dependent variable, metabolic health and obesity category as the independent variable with three categories and MHNO as the reference, and age, education, lifestyle and comorbidities as confounders.Results: This study included 6860 participants (3298 men, 3562 women). Compared to MHNO, all other metabolic health and obesity categories had significantly lower PCS in both sexes. As reflected by the beta coefficients [95% confidence interval] from bivariable linear regression models, a significant inverse association with PCS was strongest for MUO (men: -7.0 [-8.2; -5.8]; women: -9.0 [-10.2; -7.9]), intermediate for MUNO (men: -4.2 [-5.3; -3.1]; women: -5.6 [-6.8; -4.4]) and least pronounced for MHO (men: -2.2 [-3.6; -0.8]; women -3.9 [-5.4; -2.5]). Differences in relation to MHNO remained statistically significant for all groups after adjusting for confounders, but decreased in particular for MUNO (men:-1.3 [-2.3; -0.3]; women: -1.5 [-2.7; -0.3].Conclusions: Obesity was significantly related to lower physical HRQoL, independent of metabolic health status. Potential confounders including age, educational status, health-related behaviors, and comorbidities explained parts of the inverse relationship. Associations were evident in both sexes and consistently more pronounced among women than men. [ABSTRACT FROM AUTHOR]

Although different genotypes of mamey sapote with distinct pulp colors are consumed in countries from Central to South America, in-depth knowledge on genotype-related differences of their carotenoid profile is lacking. Since the fruit was found to contain the potentially vitamin A-active keto-carotenoids sapotexanthin and cryptocapsin, we sought to qualitatively and quantitatively describe the carotenoid profile of different genotypes by HPLC-DAD-MS n . Sapotexanthin and cryptocapsin were present in all genotypes. Keto-carotenoids such as cryptocapsin, capsoneoxanthin, and their esters were most abundant in orange-fleshed fruit, whereas several carotenoid epoxides prevailed in yellow-fleshed fruit. Differing carotenoid profiles were associated with different color hues of the fruit pulp, while the widely variable carotenoid content (3.7–8.0 mg/100 g FW) was mainly reflected by differences in color intensity (chroma C ∗ ). Furthermore, the post-prandial absorption of sapotexanthin to human plasma was proven for the first time. Besides sapotexanthin, cryptocapsin was found to be resorbed. [ABSTRACT FROM AUTHOR]

Objective: The study examined potential changes in the proportion of metabolic health according to body size categories over time and across strata of sex and age, varying definitions of metabolic health. Methods: We analysed data from national health interview and examination surveys 1997–99 and 2008–11 for adults aged 18–79 years (GNHIES98: N = 6,565; DEGS1: 6,860). Metabolic health as defined by ATPIII criteria was examined across body mass index categories. The Plourde and Karelis criteria were applied in relation to abdominal obesity. Results: Proportions of adults with metabolic health by body size categories were largely stable over time, except for an increasing proportion of metabolically healthy persons with pre-obesity and metabolically healthy women without abdominal obesity. In both surveys proportions of adults meeting ATPIII criteria ranged from approximately 30% among men and women with obesity, to about two thirds of those with pre-obesity to about 93% among those with normal weight. According to Plourde and Karelis criteria proportions ranged from almost 30% among men and women without abdominal obesity to less than 10% among those with abdominal obesity. Proportions were consistently higher among younger than older age groups and less consistently higher among women than men. Conclusions: Proportions of adults with metabolic health by body size categories were largely stable over time, except for an increasing proportion of metabolically healthy women without abdominal obesity. There is no evidence that metabolic health among adults with obesity increased in Germany over a period of ten years. [ABSTRACT FROM AUTHOR]

The objective of the four-way cross-over pilot study was the investigation of quercetin bioavailability after ingestion of apple quercetin incorporated in different matrices and quercetin dihydrate capsule. Six healthy volunteers were given a standard diet supplemented with 71 μmol quercetin equivalents from vacuum impregnated apple chips, apple peel extract capsules and apple peel. Quercetin dihydrate capsules were used as control. The vacuum impregnated apple chips were enriched with a quercetin rich apple peel extract. The ingestion of vacuum impregnated apple chips, apple peel extract capsules and apple peel resulted in similar plasma quercetin and plasma total flavonol concentrations compared to the quercetin dihydrate capsule. With regard to the bioavailabilities of all quercetin treatments, a reduced release from vacuum impregnated apple chips can be excluded. The apple peel matrix which is rich in indigestible dietary fibers impacted the profile of the plasma flavonol time curve similar to poor soluble quercetin dihydrate. Finally, the quercetin bioavailability of vacuum impregnated apple chips (AUC 0–1440 min : 104 ± 24 μmol·min ∙ L − 1 ) as functional food was similar to the supplementation with apple peel extract capsules (AUC 0–1440 min : 87 ± 27 μmol ∙ min ∙ L − 1 ). [ABSTRACT FROM AUTHOR]

Lower bone mass in older adults may be mediated by the endocrine crosstalk between muscle, adipose tissue and bone. In 150 community-dwelling adults (59–86 years, BMI 17–37 kg/m2; 58.7% female), skeletal muscle mass index, adipose tissue and fat mass index (FMI) were determined. Levels of myokines, adipokines, osteokines, inflammation markers and insulin were measured as potential determinants of bone mineral content (BMC) and density (BMD). FMI was negatively associated with BMC and BMD after adjustment for mechanical loading effects of body weight (r-values between −0.37 and −0.71, all p < 0.05). Higher FMI was associated with higher leptin levels in both sexes, with higher hsCRP in women and with lower adiponectin levels in men. In addition to weight and FMI, sclerostin, osteocalcin, leptin × sex and adiponectin were independent predictors of BMC in a stepwise multiple regression analysis. Muscle mass, but not myokines, showed positive correlations with bone parameters that were weakened after adjusting for body weight (r-values between 0.27 and 0.58, all p < 0.01). Whereas the anabolic effect of muscle mass on bone in older adults may be partly explained by mechanical loading, the adverse effect of obesity on bone is possibly mediated by low-grade inflammation, higher leptin and lower adiponectin levels. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was (1) to assess AT through 13 different mathematical approaches and to compare their results; and (2) to understand if AT occurs after moderate WL. Methods: Ninety-four participants [mean (SD); BMI, 31.1 (4.3) kg/m2; age, 43.0 (9.4) years; 34% females] underwent a 1-year lifestyle intervention (clinicaltrials.gov ID: NCT03031951) and were randomized to intervention (IG, n = 49) or control groups (CG, n = 45), and all measurements were made at baseline and after 4 months. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry and REE by indirect calorimetry. AT was assessed through 13 different approaches, varying in how REE was predicted and/or how AT was assessed. Results: IG underwent a mean negative energy balance (EB) of 270 (289) kcal/day, p < 0.001), resulting in a WL of − 4.8 (4.9)% and an FM loss of − 11.3 (10.8)%. Regardless of approach, AT occurred in the IG, ranging from ~ − 65 to ~ − 230 kcal/day and three approaches showed significant AT in the CG. Conclusions: Regardless of approach, AT occurred after moderate WL in the IG. AT assessment should be standardized and comparisons among studies with different methodologies to assess AT must be avoided. [ABSTRACT FROM AUTHOR]

Objectives: A classic association is the link between brain mass and body mass across mammals that has now been shown to derive from fat-free mass (FFM) and not fat mass (FM). This study aimed to establish for the first time the associations between human brain mass and body composition and to compare these relations with those established for liver as a reference organ. Methods: Subjects were 112 men and 148 women who had brain and liver mass measured by magnetic resonance imaging with FM and FFM measured by dual-energy X-ray absorptiometry. Results: Brain mass scaled to height (H) with powers of ≤0.6 in men and women; liver mass and FFM both scaled similarly as H∼2. The fraction of FFM as brain thus scaled inversely to height ( P < 0.001) while liver mass/FFM was independent of height. After controlling for age, brain, and liver mass were associated with FFM while liver was additionally associated with FM (all models P ≤ 0.01). After controlling for age and sex, FFM accounted for ∼5% of the variance in brain mass while levels were substantially higher for liver mass (∼60%). Brain mass was significantly larger ( P < 0.001) in men than in women, even after controlling for age and FFM. Conclusions: As across mammals, human brain mass associates significantly, although weakly, with FFM and not FM; the fraction of FFM as brain relates inversely to height; brain differs in these relations from liver, another small high metabolic rate organ; and the sexual dimorphism in brain mass persists even after adjusting for age and FFM. Am. J. Hum. Biol., 2012. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The article presents the results of a research aimed at comparing men's and women's specific resting metabolic rates (Ki) of major organs and tissues in non-obese subjects aged 20- 49 years. It cites the previous Ki values submitted by Elia in 1992 who measured and evaluated whole body resting energy expenditure (REE) rates, noting that gender influences on such Ki values were not established. The study noted that men exhibited higher values than women, thus validating Elia's earlier data.

Our aim was to investigate the effects of an oral supplementation of quercetin at 3 different doses on plasma concentrations of quercetin, parameters of oxidant/antioxidant status, inflammation, and metabolism. To this end, 35 healthy volunteers were randomly assigned to take 50, 100, or 150 mg/d (group 050-01501 quercetin for 2 wk. Fasting blood samples were collected at the beginning and end of the supplementation period. Compared with baseline, quercetin supplementation significantly increased plasma concentrations of quercetin by 178% (0501,359% (01001, and 570% (0150; P< 0.01 for all). High interindividual variation was found for plasma quercetin concentrations (36-57%). Quercetin did not affect concentrations of serum uric acid or plasma α-and γ-tocopherols, oxidized LDL, and tumor necrosis factor-α, or plasma antioxidative capacity as assessed by the ferric-reducing antioxidant potential and oxygen radical absorbance capacity assays. In addition, serum lipids and lipoproteins, body composition, and resting energy expenditure did not significantly change during quercetin supplementation. Pharmacokinetics of quercetin were investigated in a subgroup of 15 volunteers. The areas under the plasma concentration-time curves ranged from 76.1 µmol·min·L-1 to 305.8 µmol·min·L-1 150- and 150-mg dosages, respectively). Median maximum plasma concentrations of quercetin (431 nmol/L) were observed 360 min after intake of 150 mg quercetin. In conclusion, daily supplementation of healthy humans with graded concentrations of quercetmn for 2 wk dose-dependently increased plasma quercetin concentrations but did not affect antioxidant status, oxidized LDL, inflammation, or metabolism. [ABSTRACT FROM AUTHOR]

Summary Objective To study the effect of regional lean body mass (LBM) on resting energy expenditure (REE). Design Cross-sectional study in a homogenous group of 26 young healthy non-obese subjects. Methods Regional body composition was assessed by dual-energy X-ray absorptiometry (DEXA). REE was measured by indirect calorimetry. Results REE showed positive relationships with whole body LBM (LBM[sub b] ; r=0.89) as well as with regional LBM (LBM[sub trunk] = LBM[sub t] , r = 0.88, and LBM[sub arms+legs] = LBM[sub e] for LBM[sub extremities] , r = 0.89) with non-zero intercepts (between 1.86 and 2.83 MJ/d). REE per kg LBM[sub b] falls as LBM[sub b] increases (r = 0.77). By contrast, REE adjusted for regional distribution of LBM (i. e. the ratio of LBM[sub t] to LBM[sub e] ) increases as LBM[sub b] increases (r = 0.91) showing a near-zero intercept (i. e. 0.048 MJ/d). Adjusting REE for LBM[sub b] as well as for the ratio of LBM[sub t] to LBM[sub e] can be used for comparison between subjects. Conclusions Our data suggest that regional distribution of LBM is a determinant of REE. Assessment of LBM[sub t] and LBM[sub e] by DEXA provides a possibility to adjust for the non-linearity of REE on LBM[sub b] . [ABSTRACT FROM AUTHOR]

Behavioral compensations may occur as a response to a negative energy balance. The aim of this study was to explore the associations between changes in energy intake (EI) and changes in physical activity (PA, min/day; kcal/d) as a response to a weight loss (WL) intervention and to understand if interindividual differences occur in EI and energy expenditure (EE). Eighty-one participants [mean (SD): age = 42.8 (9.4)y, BMI = 31.2 (4.4)kg/m2, 37% females] divided in intervention (IG, n = 43) and control group (CG, n = 38) were included. The IG underwent a moderate energy restriction (300–500 kcal/d). EI was measured through the intake-balance method. Non-exercise PA (NEPA) and exercise (through logbook) were assessed by accelerometery. The EE in NEPA (NEAT) and in exercise (EiEE) was calculated by applying the Freedson Combination'98 algorithm over the time spent in these activities. Pearson correlations were performed in IG to examine associations between EE components, EI and body composition. To understand if interindividual differences were observed, the SD of individual response (SD IR) and the smallest worthwhile change (SWC, S D b a s e l i n e C G × 0.2) were calculated. Changes in EI [ Δ EI, (kcal/d)] was negatively associated with Δ exercise (min/d:r = −0.413, p = 0.045; %:r = −0.846, p = 0.008) and with Δ EiEE (kcal/d:r = −0.488, p = 0.016; %:r = −0.859, p = 0.006). A negative correlation was found between Δ sedentary time and Δ NEPA (min/d:r = −0.622, p = 0.002; %:r = −0.487, p = 0.018). An interindividual variability was found for EI(SD IR = 151.6, SWC = 72.3) and EE (SD IR = 165, SWC = 134). Decreases in EI were not associated to compensatory responses such as decreases in PA and/or increases in sedentary time. Interindividual variability was found for EI and EE. Nevertheless, behavioral compensations and the interindividual variability should be considered when implementing WL interventions, to increase the likelihood of achieving sustainable results. (clinicaltrials.gov ID: NCT03031951) [ABSTRACT FROM AUTHOR]

• Phase angle by bioelectrical impedance analyses depends on measurement configuration. • Phase angle is higher in supine than in standing measurements. • Electrode placement and body side (right vs. left) also affect phase angle. • The BIA devices seca mBCA 515 and mBCA 525 were used for comparison. Phase angle (PhA) obtained by bioelectrical impedance analysis is a well-established predictor of malnutrition that reflects the amount and quality of soft tissue. However, PhA results may depend on configurations of the measurement that differ between devices. The aim was to analyze differences between devices for supine and standing measurements. In a cross-sectional study, differences in PhA were analyzed comparing supine vs. standing positions, metal vs. adhesive electrodes and the right vs. left side of the body in 302 multi-ethnic adults (18–65y) and 1298 Mexican children and adolescents (4–20y). PhA was higher in supine than in standing position (from 0.71°±0.22° in children to 0.97°±0.25° in adults; all p < 0.001) with approximately fifty percent of observed differences explained by electrode placement. PhA differences increased with increasing PhA (r = 0.419) and decreased with age (r = −0.346) in adults, but increased with PhA (r = 0.677), age (r = 0.752) and height (r = 0.737) in children (all p < 0.001). In adults, PhA was higher on the right side of the body (standing 0.18°±0.17°; supine 0.36°±0.33°; p < 0.001). Phase angle results are influenced by posture and electrode placement. Measurement configuration must be considered when phase angle values are compared between different devices or with literature values. [ABSTRACT FROM AUTHOR]

Purpose: In this study, we investigated the absorption and excretion kinetics of antioxidant dietary phytochemicals (vitamin E, γ-oryzanol, and ferulic acid) in healthy humans after the ingestion of an oatmeal porridge supplemented with rice bran extract (RBE) prepared with water or with whole milk, and we compared it with the intake of an equivalent dose of the rice bran content, in the form of RBE oil. Methods: Twelve healthy volunteers (6 men and 6 women) orally ingested RBE oil (2 g) or RBE-enriched porridge (35 g, including 2-g RBE) with water or with milk, in a three-armed, crossover trial. Blood and urine samples were collected at baseline and up to 24 h after intake. Vitamin E (α-, β-, γ-, and δ-tocopherols and tocotrienols), ferulic acid (FA), and γ-oryzanol (ORY) were quantified by HPLC. Results: The ingestion of RBE-fortified oatmeal porridge and RBE oil significantly increased FA concentrations in plasma, showing faster absorption and higher maximum plasma concentrations after the intake of the porridges, irrespective of the addition of water or milk. At least part of the FA could have been hydrolyzed from ORY. However, plasma vitamin E concentrations did not increase from baseline, and no intact FA esters (cycloartenyl ferulate, 24-methylenecycloartanyl ferulate, campesteryl ferulate, and β-sitosteryl ferulate) were detected in plasma or urine with any of the meal treatments. Conclusions: Rice bran extract-enriched porridge and, to a lesser extent, RBE oil, provide relevant sources of bioaccessible and bioavailable ferulic acid, and could be further developed into functional foods with health potential. [ABSTRACT FROM AUTHOR]

According to the World Health Organization Expert Consultation, current body mass index (BMI) cut-offs should be retained as an international classification. However, there are ethnic differences in BMI-associated health risks that may be caused by differences in body fat or skeletal muscle mass and these may affect the interpretation of phase angle and bioelectrical impedance vector analysis (BIVA). Therefore, the aim of this study was to compare body composition measured by bioelectrical impedance analysis among 1048 German, 1026 Mexican, and 995 Japanese adults encompassing a wide range of ages and BMIs (18–78 years; BMI, 13.9–44.3 kg/m2). Regression analyses between body composition parameters and BMI were used to predict ethnic-specific reference values at the standard BMI cut-offs of 18.5, 25, and 30 kg/m2. German men and women had a higher fat-free mass per fat mass compared with Mexicans. Normal-weight Japanese were similar to Mexicans but approached the German phenotype with increasing BMI. The skeletal muscle index (SMI, kg/m2) was highest in Germans, whereas in BIVA, the Mexican group had the longest vector, and the Japanese group had the lowest phase angle and the highest extracellular/total body water ratio. Ethnic differences in regional partitioning of fat and muscle mass at the trunk and the extremities contribute to differences in BIVA and phase angle. In conclusion, not only the relationship between BMI and adiposity is ethnic specific; in addition, fat distribution, SMI, and muscle mass distribution vary at the same BMI. These results emphasize the need for ethnic-specific normal values in the diagnosis of obesity and sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Bioimpedance spectroscopy (BIS) with a whole-body model to distinguish excess fluid from major body tissue hydration can provide objective assessment of fluid status. BIS is integrated into the Body Composition Monitor (BCM) and is validated in adults, but not children. This study aimed to (1) assess agreement between BCM-measured total body water (TBW) and a gold standard technique in healthy children, (2) compare TBW_BCM with TBW from Urea Kinetic Modelling (UKM) in haemodialysis children and (3) investigate systematic deviation from zero in measured excess fluid in healthy children across paediatric age range.Methods: TBW_BCM and excess fluid was determined from standard wrist-to-ankle BCM measurement. TBW_D2O was determined from deuterium concentration decline in serial urine samples over 5 days in healthy children. UKM was used to measure body water in children receiving haemodialysis. Agreement between methods was analysed using paired t test and Bland-Altman method comparison.Results: In 61 healthy children (6-14 years, 32 male), mean TBW_BCM and TBW_D2O were 21.1 ± 5.6 and 20.5 ± 5.8 L respectively. There was good agreement between TBW_BCM and TBW_D2O (R2 = 0.97). In six haemodialysis children (4-13 years, 4 male), 45 concomitant measurements over 8 months showed good TBW_BCM and TBW_UKM agreement (mean difference − 0.4 L, 2SD = ± 3.0 L). In 634 healthy children (2-17 years, 300 male), BCM-measured overhydration was − 0.1 ± 0.7 L (10-90th percentile − 0.8 to + 0.6 L). There was no correlation between age and OH (p = 0.28).Conclusions: These results suggest BCM can be used in children as young as 2 years to measure normally hydrated weight and assess fluid status. [ABSTRACT FROM AUTHOR]

Introduction: Magnitude and variation in energy balance (EB) components over an athletic season are largely unknown. Purpose: We investigated the longitudinal changes in EB over one season and explored the association between EB variation and change in the main fat-free mass (FFM) components in highly trained athletes. Methods: Eighty athletes (54 males; handball, volleyball, basketball, triathlete, and swimming) were evaluated from the beginning of the season to the main competition stage. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively. Physical activity energy expenditure was calculated as TEE - 0.1 TEE - REE. Fat mass (FM), FFM, and bone mineral were evaluated with dual-energy x- ray absorptiometry; changedbodyenergy storeswere calculatedas 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). Total-body water (TBW) and its compartments were assessed through dilution techniques, and total-body protein was calculated from a four-compartment model, with body volume assessed by air displacement plethysmography. Results: Although a negative EB of -17.4 ± 72.7 kcal⋅d-1 was observed (P < 0.05), EB varied widely among sports and across sex groups resulting in a net weight increase (0.7 ± 2.3 kg) that is attributable to significant changes in FFM (1.2 ± 1.6 kg) and FM (-0.7 ± 1.5 kg) (P < 0.05). EB was related with TBW and intracellular water (r = 0.354, r = 0.257, P < 0.05, respectively), regardless of sex, sports, and age. Conclusions: The mean negative EB observed over the season resulted from the rate of FM use and FFM accretion, but with a large variation by sex and sports. TBW, but not total-body protein or mineral balance, explained the magnitude of EB, which means that athletes under a positive or a negative EB showed a TBW expansion or shrinkage, respectively, specifically within the cells, over one athletic season. [ABSTRACT FROM AUTHOR]

Purpose: Mechanisms in energy balance (EB) regulation may include compensatory changes in energy intake (EI) and metabolic adaption (MA), but information is unavailable in athletes who often change EB components. We aim to investigate EB regulation compensatory mechanisms over one athletic season. Methods: Fifty-seven athletes (39 males/18 females; handball, volleyball, basketball, triathlon, and swimming) were evaluated from the beginning to the competitive phase of the season. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively, and physical activity energy expenditure was determined as TEE - 0.1(TEE) - REE. Fat mass (FM) and fat-free mass (FFM) were evaluated by dual-energy x-ray absorptiometry and changed body energy stores was determined by 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). EI was derived as TEE + EB. REE was predicted from baseline FFM, FM, sex, and sports. %MA was calculated as 100(measured REE/predicted REE-1) and MA (kcal) as %MA/100 multiplied by baseline measured REE. Average EI minus average physical activity energy expenditure was computed as a proxy of average energy availability, assuming that a constant nonexercise EE occurred over the season. Results: Body mass increased by 0.8 ± 2.5 kg (P < 0.05), but a large individual variability was found ranging from -6.1 to 5.2 kg. The TEE raise (16.8% ± 11.7%) was compensated by an increase EI change (16.3% ± 12.0%) for the whole group (P < 0.05). MA was found in triathletes, sparing 128 ± 168 kcal⋅d-1, and basketball players, dissipating 168 ± 205 kcal⋅d-1 (P < 0.05). MA was associated (P < 0.05) with EB and energy availability (r = 0.356 and r = 0.0644, respectively). Conclusion: TEE increased over the season without relevant mean changes in weight, suggesting that EI compensation likely occurred. The thrifty or spendthrift phenotypes observed among sports and the demanding workloads these athletes are exposed to highlight the need for sport-specific energy requirements. [ABSTRACT FROM AUTHOR]

Background: Assessing skeletal muscle (SM) and visceral adipose tissue (VAT) by a single MRI slice at lumbar vertebra (L) 3 can replace whole-body MRI in young and middle-aged adults. However, this technique has not been proven in older adults.Objective: The aim of this analysis was to reinvestigate the best estimate for SM and VAT in an independent population of healthy elderly people.Methods: SM and VAT were assessed by whole-body MRI in 84 subjects ≥60 y [45 men; mean ± SD age: 68.4 ± 5.4 y, mean ± SD body mass index (in kg/m2): 25.5 ± 3.5]. SM and VAT areas of 9 slices at the lumbar spine were analyzed. The best estimate was investigated by Pearson correlations. Total volumes (in liters) were predicted by the area at lumbar vertebra 3 (AL3). Besides Bland-Altman analysis, linear regressions were performed to explain the variance of the bias by age, height, and percentage of fat mass (%FM). In a mixed population (healthy elderly plus reference population), linear regression with total SM and VAT volume as dependent variables and AL3, age, and height as independent variables was applied.Results: When comparing the correlation coefficients between the tissue areas and total volumes, L3 was identified as the best estimate (r range: 0.71-0.94; all P < 0.05). However, Bland-Altman analysis showed a positive SM bias in men (mean ± SD: -1.0% ± 9.0%; P < 0.05) and a negative SM bias in women (mean ± SD: 3.7% ± 9.6%; P < 0.05). Contrary to SM, no significant bias was observed for VAT. In the elderly, stepwise linear regression showed height as a predictor for SM bias (R2 = 0.21, SEE = 2.07 L; P < 0.05) and %FM and age as predictors of the nonsignificant VAT bias (R2 = 0.26, SEE = 0.22L, P < 0.05), in men only. In the mixed population, AL3 and height were predictors for total SM, and AL3 for total VAT, independent of sex.Conclusions: AL3 was confirmed as the best estimate for SM and VAT volumes in healthy elderly adults. Contrary to VAT, there is a bias for SM, and height has to be added to the algorithm. [ABSTRACT FROM AUTHOR]

Background: The effect of gender as well as gender-specific changes of fat free mass (FFM) and its metabolic active components (muscle mass and organ masses [OMs]) and fat mass (FM) on age-related changes in resting energy expenditure (REE) are not well defined. We hypothesized that there are gender differences in (1) the age-specific onset of changes in detailed body composition (2); the onset of changes in body composition-REE associations with age.Methods: Using a cross-sectional magnetic resonance imaging database of 448 Caucasian participants (females and males) with comprehensive data on skeletal muscle (SM) mass, adipose tissue (AT), OMs, and REE.Results: We observed gender-specific differences in the onset of age-related changes in metabolic active components and REE. Declines in body composition and REE started earlier in females than in males for SM (29.4 vs 39.6 years), AT (38.2 vs 49.9 years), OM (34.7 vs 45.7 years), and REE (31.9 vs 36.8 years). The age-related decrease of AT was significantly higher in females than in males (-5.69kg/decade vs -0.59kg/decade). In females adjusted REEmFFM&FM (resting energy expenditure measured adjusted for FFM and FM) and REEmSM/OM/AT (resting energy expenditure measured adjusted for skeletal muscle and organ mass and adipose tissue) decreased by -145 kJ/d/decade and -604.8 kJ/d/ decade after the age of 35.2 respectively 34.3 years. SM was main determinant of REEm in females (R (2) = .67) and males (R (2) = .66) with remaining variance mainly explained by kidney mass (R (2) = .07) in females and liver mass (R (2) = .09) in males.Conclusion: We concluded that gender affects the age-related changes in body composition as well as changes in body composition-REE relationship. This trial was registered at linicaltrials.gov as NCT01737034. [ABSTRACT FROM AUTHOR]

Background: Monitoring of serum lipid concentrations at the population level is an important public health tool to describe progress in cardiovascular disease risk control and prevention. Using data from two nationally representative health surveys of adults 18-79 years, this study identified changes in mean serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in relation to changes in potential determinants of serum lipids between 1997-99 and 2008-11 in Germany.Methods: Sex-specific multivariable linear regression analyses were performed with serum lipids as dependent variables and survey wave as independent variable and adjusted for the following covariables: age, fasting duration, educational status, lifestyle, and use of medication.Results: Mean TC declined between the two survey periods by 13 % (5.97 mmol/l vs. 5.19 mmol/l) among men and by 12 % (6.03 mmol/l vs. 5.30 mmol/l) among women. Geometric mean TG decreased by 14 % (1.66 mmol/l vs. 1.42 mmol/l) among men and by 8 % (1.20 mmol/l vs. 1.10 mmol/l) among women. Mean HDL-C remained unchanged among men (1.29 mmol/l vs. 1.27 mmol/l), but decreased by 5 % among women (1.66 mmol/l vs. 1.58 mmol/l). Sports activity and coffee consumption increased, while smoking and high alcohol consumption decreased only in men. Processed food consumption increased and wholegrain bread consumption decreased in both sexes, and obesity increased among men. The use of lipid-lowering medication, in particular statins nearly doubled over time in both sexes. Among women, hormonal contraceptive use increased and postmenopausal hormone therapy halved over time. The changes in lipid levels between surveys remained significant after adjusting for covariables.Conclusion: Serum TC and TG considerably declined over one decade in Germany, which can be partly explained by increased use of lipid-lowering medication and improved lifestyle among men. The decline in serum lipids among women, however, remains unexplained. [ABSTRACT FROM AUTHOR]

Background In prior studies, lifestyle indices were associated with numerous disease end points, but the association with fatty liver disease (FLD), a key correlate of cardiometabolic risk, is unknown. The aim was to investigate associations between a lifestyle index with liver fat content. Methods Liver fat was quantified by MRI as liver signal intensity (LSI) in 354 individuals selected from a population-based cohort from Germany. Exposure to favourable lifestyle factors was quantified using an additive score with each factor modelled as a dichotomous trait. Favourable lifestyle factors were defined as waist circumference below 102 (men) or 88 cm (women), physical activity ≥3.5 h/week, never-smoking and a favourable dietary pattern, which was derived to explain liver fat variation. In a cross-sectional study, multivariable adjusted linear and logistic regression was applied to investigate the association between the lifestyle index (range 0-4, exposure) and LSI (modelled as a continuous trait or dichotomised as a FLD indicator variable, respectively). Results Individuals with four favourable lifestyle factors (n=9%) had lower LSI values (β -0.40; 95% CI -0.61 to -0.19) and a lower OR (0.09; 95% CI 0.03 to 0.30) for FLD compared with individuals with zero favourable lifestyle factors (n=10%). Conclusions A healthy lifestyle pattern was associated with less liver fat. Prospective studies are warranted. [ABSTRACT FROM AUTHOR]

Objective We investigated the impact of detailed body composition on aerobic fitness to determine whether regional components of fat mass have independent effects on VO2submax, and whether VO2submax and detailed body composition independently explain variation in REE. Methods 71 healthy adults (80% female, 20% male, BMI 28.2-43.8 kg/m2) were investigated. Body composition was measured by the four-compartment model together with whole body magnetic resonance imaging (MRI) to assess high and low metabolic rate organs and regional fat depots. VO2submax was estimated at 75% of predicted maximum heart rate. Results There was a strong association between VO2submax and FFM and all organ masses except for heart. Skeletal muscle mass accounted for 34.8% of the variance in VO2submax. In addition, subcutaneous adipose tissue (SAT) of extremities explained additional 14.4%. FFM and FM explained 71.3% of the variance in REE. Including the components of FFM and FM, the explained variance in REE increased by about 5.8%; skeletal muscle mass explained 70.0% of the variance in REE and kidney and liver masses explained additional 7.1%. VO2submax correlated with REE. Taking into account body composition, VO2submax did not add to the variance in REE. Conclusion FFM is a determinant of both VO2submax and REE. Modeling either REE or VO2submax from individual components of FFM, about 77.1% of variance in REE (by muscle, liver and kidneys mass) and 34.8% of variance in VO2submax (by skeletal muscle mass) could be explained. FM explained additional variance in REE, whereas SAT of extremities added to the variance in VO2submax only. Am. J. Hum. Biol. 27:397-406, 2015. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective: Changes in insulin sensitivity (IS) and insulin secretion occur with perturbations in energy balance and glycemic load (GL) of the diet that may precede the development of insulin resistance and hyperinsulinemia. Determinants of changes in IS and insulin secretion with weight cycling in non-obese healthy subjects remain unclear. Methods: In a 6wk controlled 2-stage randomized dietary intervention 32 healthy men (26±4y, BMI: 24±2kg/m2) followed 1wk of overfeeding (OF), 3wks of caloric restriction (CR) containing either 50% or 65% carbohydrate (CHO) and 2wks of refeeding (RF) with the same amount of CHO but either low or high glycaemic index at ±50% energy requirement. Measures of IS (basal: HOMA-index, postprandial: Matsuda-ISI), insulin secretion (early: Stumvoll-index, total: tAUC-insulin/tAUC-glucose) and potential endocrine determinants (ghrelin, leptin, adiponectin, thyroid hormone levels, 24h-urinary catecholamine excretion) were assessed. Results: IS improved and insulin secretion decreased due to CR and normalized upon RF. Weight loss-induced improvements in basal and postprandial IS were associated with decreases in leptin and increases in ghrelin levels, respectively (r = 0.36 and r = 0.62, p<0.05). Weight regain-induced decrease in postprandial IS correlated with increases in adiponectin, fT3, TSH, GL of the diet and a decrease in ghrelin levels (r-values between -0.40 and 0.83, p<0.05) whereas increases in early and total insulin secretion were associated with a decrease in leptin/adiponectin-ratio (r = -0.52 and r = -0.46, p<0.05) and a decrease in fT4 (r = -0.38, p<0.05 for total insulin secretion only). After controlling for GL associations between RF-induced decrease in postprandial IS and increases in fT3 and TSH levels were no longer significant. Conclusion: Weight cycling induced changes in IS and insulin secretion were associated with changes in all measured hormones, except for catecholamine excretion. While leptin, adiponectin and ghrelin seem to be the major endocrine determinants of IS, leptin/adiponectin-ratio and fT4 levels may impact changes in insulin secretion with weight cycling. Trial Registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

In this controlled, parallel-group feeding trial, we examined the impact of carbohydrate (CHO) intake and glycemic index (GI) on glucose and lipid metabolism during refeeding after weight loss. Healthy men (n = 32 total, age: 25.5 ± 3.9 y, BMI: 23.5 ± 2.0 kg/m² overconsumed diets containing either 50% or 65% CHO for 1 wk (+50% of energy requirements) and then underwent 3 wk of calorie restriction (CR; -50%) followed by 2 wk of overconsuming (refeeding, +50%) the same diet but with either a low or high GI (40 vs.70 during CR, 41 vs.74 during refeeding) so that glycemic load (GL; dietary CHO content x GI) differed between groups during all phases. Glucose profiles were assessed by continuous interstitial glucose monitoring, insulin sensitivity (IS) by fasting blood sampling, oral glucose tolerance test (OGTT) and hyperinsulinemic-euglycemic clamp, and liver fat by MRI. Daytime area under the curve-glucose during refeeding was higher with high compared with low GI (P = 0.01) and 65% compared with 50% CHO intake (P = 0.05) and correlated with dietary GL (r = 0.71; P < 0.001). IS increased with CR and decreased again with refeeding in all groups. The decrease in OGTT-derived IS was greater with high-than with Iow-GI diets (-41 vs. -15%; P-interaction = 0.01) and correlated with dietary GL during refeeding (r = -0.51; P < 0.01). Serum triglycerides (TGs) and liver fat also improved with CR (-17 ± 38 mg/dL and -1.1 ± 1.3%; P < 0.05 and <0.001 ) and increased again with refeeding (+48 ± 48 mg/dL and +2.2 ± 1.6%; P < 0.001 ). After refeeding, serum TGs and liver fat were elevated above baseline values with 65% CHO intake only (+59.9 ± 37.5 mg/dL and +1.1 ± 1.7%, P-interaction <0.001 and <0.05). In conclusion, a diet low in GI and moderate in CHO content (i.e., low GL) may have health benefits by positively affecting daylong glycemia, IS, and liver fat. [ABSTRACT FROM AUTHOR]

Vineatrol ® 30 grapevine-shoot extract contains the stilbenes trans-resveratrol as well as considerable amounts of the resveratrol dimer trans-ε-viniferin. Resveratrol is a potent antioxidant, anti-inflammatory, and chemopreventive agent in vitro and in vivo, and is thought to be cardio- and neuroprotective. The bioavailability of these stilbene compounds in humans is low (ca. 1-2%). The aim of our project was therefore to enhance the oral bioavailability and thus potentially the biological activity of trans-resveratrol and trans-ε-viniferin from Vineatrol ® 30, and to assess its safety in humans. We performed a single-blind crossover trial with twelve healthy volunteers, with the two study arms separated by ≥1-week washout periods. All participants orally ingested in random order capsules with a single dose of 500 mg Vineatrol ® 30 as native powder or liquid micelles. Blood samples were collected before (0 h) and after (0.5, 1, 2, 4, 6, 8 and 24 h) Vineatrol ® 30 intake. Urine samples were collected before (0 h) and 1-6, 6-12 and 12-24 h after intervention. Liver and kidney function parameters were quantified in serum samples before as well as 4 and 24 h after intake of Vineatrol ® 30. Blood and urine samples are currently being analysed for total trans-resveratrol and trans-ε-viniferin by HPLC and serum samples for the activity of liver enzymes and further safety parameters. The pharmacokinetics of native and micellar stilbenes as well as the tolerability and safety of the native and micellar formulations will be presented. [ABSTRACT FROM AUTHOR]