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Background: The prevalence of obesity is increasing worldwide and it is known to be associated with many postoperative complications, including infection. Patients' body fat distribution may vary and body mass index (BMI) does not provide sufficient information about adipose tissue thickness of the lower extremities. The aim of this study is to investigate the relationship between thigh diameters and early postoperative prosthesis-related joint infections (PJI) in patients who underwent arthroplasty. Methods: The study included 76 patients and 114 knees who were operated on by a single surgeon and underwent total knee arthroplasty (TKA) due to primary knee osteoarthritis between May 2022 and September 2023 in a tertiary reference hospital. Circumference of the thickest part of the operated thigh (cm), preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, height, weight, BMI and the presence of early postoperative prosthesis-related joint infections were evaluated. Results: The mean BMI was 32.6 ± 4.2 (kg/m2). Two (2.6%) were normal weight, 14 (18.5%) were overweight, 58 (76.3%) were obese and 2 (2.6%) were morbidly obese. The mean circumference of the thickest part of the thigh was 57.56 ± 6.38 (cm). 6 patients were diagnosed with PJI in the acute phase. The mean circumference of the thickest part of the thigh was statistically significantly greater in the group with acute PJI compared to the group without PJI (p = 0.048). Conclusion: The incidence of acute PJI was found to be significantly higher in patients with larger thigh diameters, whereas no such relationship was observed for BMI. The incorporation of preoperative soft tissue envelope measurements into routine clinical examination may prove beneficial in reducing the risk of PJI. [ABSTRACT FROM AUTHOR]

Background: Diminished muscle protein synthesis in cirrhosis leads to reduced strength and mass, impacting daily activities and overall quality of life. Aims: This study aimed to examine the effectiveness of exercise intervention in body composition, exercise capacity, fatigue, and quality of life in patients with liver cirrhosis. Methods: A systematic search of medical databases, including PubMed, Embase, Cochrane, and CINAHL, was executed from their inception to November 2022. The inclusion criteria were randomized controlled trials comparing exercise interventions with a control group that did not receive exercise interventions. Results: From the initially identified 2,565 articles, eight studies with a total of 220 patients were eligible for inclusion in this meta-analysis. According to the meta-analysis, exercise significantly improved the six-minute walk distance (6MWD) by 68.93 m (95% CI 14.29–123.57) compared to the control group. Furthermore, the subgroup analysis revealed that combing exercise with amino acid supplementation had a greater positive effect on the 6MWD (MD = 144.72, 95% CI 87.44–202.01). Exercise also significantly increased thigh circumference (MD = 1.26, 95% CI 0.12–2.39) and the thigh ultrasound average compression index (MD = 0.07, 95% CI 0.00–0.14). Moreover, exercise significantly decreased fatigue levels by 0.7 points in patients with liver cirrhosis (95% CI 0.38–1.03). However, no significant effects were observed on body mass index (BMI), fat mass, fat-free mass, and quality of life. Conclusions: Exercise can improve exercise capacity, thigh muscle thickness, and fatigue in patients with cirrhosis, but it does not have a significant impact on fat mass, BMI, or quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Measurements of diaphragm function by ultrasonography are affected by body position, but reference values in the seated position have not been established for an Asian population. This study aimed to determine reference values for diaphragm thickness, thickening fraction, and dome excursion by ultrasonography and to investigate the effects of sex, height, and body mass index. Methods: Diaphragm ultrasonography was performed on 109 seated Japanese volunteers with normal respiratory function who were enrolled between March 2022 and January 2023. Thickness, thickening fraction, and excursion were measured. Reference values and the measurement success rate were calculated. Multivariate analysis adjusted for sex, height, and body mass index was performed. Results: The measurement success rate was better for thickness than for excursion. The mean (lower limit of normal) values on the right/left sides were as follows. During quiet breathing, thickness at end expiration(mm) was 1.7 (0.9)/1.6 (0.80), thickening fraction(%) was 50 (0.0)/52 (0.0), and excursion(cm) was 1.7 (0.5)/1.9 (0.5). During deep breathing, the thickening fraction was 111 (24)/107 (22), and the excursion was 4.4 (1.7)/4.1 (2.0). In multivariate analysis, body mass index was positively associated with thickness but not with the thickening fraction. Conclusion: The reference values in this study were smaller than those in previous reports from Europe. Considering that thickness is influenced by body mass index, using Western reference values in Asia, where the average body mass index is lower, might not be appropriate. The thickening fraction in deep breathing is unaffected by other items and can be used more universally. [ABSTRACT FROM AUTHOR]

Introduction: The role of visceral fat in disease development, particularly in Crohn´s disease (CD), is significant. However, its preoperative prognostic value for postoperative complications and CD relapse after ileocecal resection (ICR) remains unknown. This study aims to assess the predictive potential of preoperatively measured visceral and subcutaneous fat in postoperative complications and CD recurrence using magnetic resonance imaging (MRI). The primary endpoint was postoperative anastomotic leakage of the ileocolonic anastomosis, with secondary endpoints evaluating postoperative complications according to the Clavien Dindo classification and CD recurrence at the anastomosis. Methods: We conducted a retrospective analysis of 347 CD patients who underwent ICR at our tertiary referral center between 2010 and 2020. We included 223 patients with high-quality preoperative MRI scans, recording demographics, postoperative outcomes, and CD recurrence rates at the anastomosis. To assess adipose tissue distribution, we measured total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), and abdominal circumference (AC) at the lumbar 3 (L3) level using MRI cross-sectional images. Ratios of these values were calculated. Results: None of the radiological variables showed an association with anastomotic leakage (TFA p = 0.932, VFA p = 0.982, SFA p = 0.951, SFA/TFA p = 0.422, VFA/TFA p = 0.422), postoperative complications, or CD recurrence (TFA p = 0.264, VFA p = 0.916, SFA p = 0.103, SFA/TFA p = 0.059, VFA/TFA p = 0.059). Conclusions: Radiological visceral obesity variables were associated with postoperative outcomes or clinical recurrence in CD patients undergoing ICR. Preoperative measurement of visceral fat measurement is not specific for predicting postoperative complications or CD relapse. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance (MR) imaging is the modality used for baseline assessment of locally advanced rectal cancer (LARC) and restaging after neoadjuvant treatment. The overall audited quality of MR imaging in large multicentre trials on rectal cancer is so far not routinely reported. Materials and methods: We collected MR images obtained within the Rectal Cancer And Pre-operative Induction Therapy Followed by Dedicated Operation (RAPIDO) trial and performed an audit of the technical features of image acquisition. The required MR sequences and slice thickness stated in the RAPIDO protocol were used as a reference. Results: Out of 920 participants of the RAPIDO study, MR investigations of 668 and 623 patients in the baseline and restaging setting, respectively, were collected. Of these, 304/668 (45.5%) and 328/623 (52.6%) MR images, respectively, fulfilled the technical quality criteria. The main reason for non-compliance was exceeding slice thickness 238/668, 35.6% in the baseline setting and 162/623, 26.0% in the restaging setting. In 166/668, 24.9% and 168/623, 27.0% MR images in the baseline and restaging setting, respectively, one or more of the required pulse sequences were missing. Conclusion: Altogether, 49.0% of the MR images obtained within the RAPIDO trial fulfilled the image acquisition criteria required in the study protocol. High-quality MR imaging should be expected for the appropriate initial treatment and response evaluation of patients with LARC, and efforts should be made to maximise the quality of imaging in clinical trials and in clinical practice. Critical relevance statement: This audit highlights the importance of adherence to MR image acquisition criteria for rectal cancer, both in multicentre trials and in daily clinical practice. High-resolution images allow correct staging, treatment stratification and evaluation of response to neoadjuvant treatment. Key points: - Complying to MR acquisition guidelines in multicentre trials is challenging. - Neglection on MR acquisition criteria leads to poor staging and treatment. - MR acquisition guidelines should be followed in trials and clinical practice. - Researchers should consider mandatory audits prior to study initiation. [ABSTRACT FROM AUTHOR]

Background: The use of inappropriately long needles for subcutaneous insulin injection increases the risk of inadvertent intramuscular injection. Aims: To estimate the inadvertent intramuscular injection risk at potential subcutaneous insulin injection sites and to identify the determinants of this risk in adults. Methods: A descriptive cross-sectional study was conducted on adult patients between the ages of 18 and 70 years who were admitted to the National Hospital of Sri Lanka. Skin-to-muscle distance and dermal thickness of potential insulin injection sites were measured using ultrasonography to estimate the intramuscular injection risk. Results: A total of 185 patients were included in the study. The estimated risk of inadvertent intramuscular injections with insulin needles of any length was considerably higher at the mid-arm and mid-thigh compared to the abdomen. The risk of inadvertent intramuscular injection was approximately 60% with 13-mm needles without a skin fold at the arm and thigh. The abovementioned risk was approximately halved when the needle length was 8 mm. We developed formulae to predict the skin-to-muscle distance with or without a raised skin fold based on assigned sex at birth and anthropometric parameters. Conclusions: There is a high inadvertent intramuscular injection risk with currently used needles (8 and 13 mm) with U-100 syringes in our population even with a raised skin fold. To minimize this risk, 13-mm needles should be avoided when injecting insulin subcutaneously especially to the limbs. Sex and anthropometric parameters can be used to predict the distance from skin to muscle surface; hence, the selection of needle length could be personalized based on the derived formulae. [ABSTRACT FROM AUTHOR]

Purpose: Minimally invasive lumbar decompression (MIS) in obese pzatients is technically challenging due to the use of longer tube retractors. The purpose of this study was to evaluate the impact of the thickness of the soft tissue and subcutaneous fat on complications, revisions, and patient-reported functional outcomes after MIS. Methods: This is a retrospective analysis of 148 consecutive patients who underwent minimally invasive lumbar decompression at our institute between 2013 and 2017 and had at least one year of follow-up. Analysis was performed five times, each time the study group was defined by another measure of adiposity: BMI > 30, skin to lamina distance at the site of surgery and at L4 > 6 cm, and subcutaneous fat thickness at the site of surgery and at L4 > 3 cm. Outcomes included intraoperative complications (durotomy or neurological deficit), possibly inadequate decompression (residual disc, reoperation), length of stay, return to the emergency room or readmission, postoperative medical complications, and functional outcomes: visual analog scores for back and leg pain, and Oswestry Disability Index (ODI). Results: Patients with a thicker layer soft tissue had a significantly higher burden of comorbidities than controls, including higher prevalence of cardiovascular disease (p = 0.002), diabetes (p < 0.001), hypertension (p < 0.001) and higher ASA scores (p = 0.002). Nevertheless, there was no significant difference between the patient groups in surgical and medical complications, functional outcomes, and other assessed outcomes. Conclusion: Our results indicate that minimally invasive lumbar decompression is safe and effective for patients with a thick layer of soft tissue and subcutaneous fat. [ABSTRACT FROM AUTHOR]

Objective: Inflammation and ulcers at the anastomotic site are frequently observed after intestinal resection surgery for Crohn's disease (CD), which often signify postoperative recurrence. Crohn's disease causes abnormalities in whole-body fat metabolism, and alterations in subcutaneous and visceral fat are potential indicators of disease development. This study aimed to quantify the areas of subcutaneous (SFA) and visceral fat (VFA) and investigate the relationship between fat tissue and endoscopic recurrence and anastomotic ulceration after Crohn's disease surgery. Methods: We conducted a retrospective analysis of clinical data from 279 patients diagnosed with Crohn's disease. Using abdominal CT (Computed Tomography) scans at the level of the umbilicus, we measured the area of subcutaneous and visceral fat, and calculated the Mesenteric Fat Index (MFI), which is defined as the ratio of the area of visceral fat to subcutaneous fat. We compared the changes in fat tissue between surgical Crohn's disease patients and non-surgical patients in remission, as well as changes in fat tissue before and after surgery, and between patients with and without endoscopic recurrence after surgery. Results: The MFI value of the surgical group was higher than that of the non-surgical group(0.88(1.27 ± 1.26) VS 0.39(0.44 ± 0.21), P < 0.001), while the SFA value was lower(70.16(92.97 ± 78.23) VS 157.64(175.96 ± 101.58), P < 0.001). Of the 134 surgical patients who underwent abdominal CT examination after surgery, the SFA value was significantly higher after surgery(143.61 ± 81.86 VS 90.87 ± 71.93, P < 0.001), and the MFI value decreased accordingly(0.57 ± 0.36 VS 1.30 ± 1.35, P < 0.001). Multivariate Cox analysis indicated that high VFA and MFI values, smoking history, and preoperative biologic therapy were all risk factors for postoperative endoscopic recurrence(p < 0.05), while high MFI values and preoperative biologic therapy were also risk factors for anastomotic ulcers(p < 0.05). The Kaplan-Meier analysis showed that these factors increased the risk of reaching the endpoint with time(p < 0.05). The ROC curve results showed that MFI value had high diagnostic value for postoperative endoscopic recurrence [AUC:0.831, 95% CI: 0.75–0.91, p < 0.001] and anastomotic ulcers [AUC:0.801, 95% CI: 0.71–0.89, p < 0.001]. Conclusions: Surgical CD patients have significantly higher MFI values but the values decline after surgery. When the preoperative MFI value is > 0.82, the risk of postoperative endoscopic recurrence increases significantly, and when the MFI value is ≥ 1.10, the risk of anastomotic ulceration after surgery increases significantly. Meanwhile, biologic therapy preoperatively also is a high-risk factor for early postoperative endoscopic recurrence or anastomotic ulcers after intestinal resection surgery. [ABSTRACT FROM AUTHOR]

Purpose: Sulfur amino acids (SAAs) have been associated with obesity and obesity-related metabolic diseases. We investigated whether plasma SAAs (methionine, total cysteine (tCys), total homocysteine, cystathionine and total glutathione) are related to specific fat depots. Methods: We examined cross-sectional subsets from the CODAM cohort (n = 470, 61.3% men, median [IQR]: 67 [61, 71] years) and The Maastricht Study (DMS; n = 371, 53.4% men, 63 [55, 68] years), enriched with (pre)diabetic individuals. SAAs were measured in fasting EDTA plasma with LC–MS/MS. Outcomes comprised BMI, skinfolds, waist circumference (WC), dual-energy X-ray absorptiometry (DXA, DMS), body composition, abdominal subcutaneous and visceral adipose tissues (CODAM: ultrasound, DMS: MRI) and liver fat (estimated, in CODAM, or MRI-derived, in DMS, liver fat percentage and fatty liver disease). Associations were examined with linear or logistic regressions adjusted for relevant confounders with z-standardized primary exposures and outcomes. Results: Methionine was associated with all measures of liver fat, e.g., fatty liver disease [CODAM: OR = 1.49 (95% CI 1.19, 1.88); DMS: OR = 1.51 (1.09, 2.14)], but not with other fat depots. tCys was associated with overall obesity, e.g., BMI [CODAM: β = 0.19 (0.09, 0.28); DMS: β = 0.24 (0.14, 0.34)]; peripheral adiposity, e.g., biceps and triceps skinfolds [CODAM: β = 0.15 (0.08, 0.23); DMS: β = 0.20 (0.12, 0.29)]; and central adiposity, e.g., WC [CODAM: β = 0.16 (0.08, 0.25); DMS: β = 0.17 (0.08, 0.27)]. Associations of tCys with VAT and liver fat were inconsistent. Other SAAs were not associated with body fat. Conclusion: Plasma concentrations of methionine and tCys showed distinct associations with different fat depots, with similar strengths in the two cohorts. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study were (1) to assess the test–retest reliability of the primary near infrared spectroscopy (NIRS) variables (i.e., StO2, T[Hb], [HbO2] and [HHb]) during cycling and (2) to investigate potential influences of exercise intensity and adipose tissue thickness (ATT) on this reliability.21 men and 20 women completed twelve constant work rate tests (6 min) at six different exercise intensities with each intensity performed twice. NIRS variables were measured at the vastus lateralis. The coefficient of variance (CV%), the intraclass correlation coefficient (ICC), mean bias and limits of agreement (LoA) were determined for reliability purposes.The reliability of baseline values were acceptable to very good (CV% range: 5.83 – 21.96%). The reliability of end-values (CV% range: 0.02 – 25.02%, ICC range: 0.0 – 0.935) and amplitudes (CV% range: 0.46 – 5099%, ICC range: 0.0 – 0.887) were more variable. In general, the mean biases of end-values and amplitudes showed wide limits of agreement. A homogeneous influence of exercise intensity on reliability could not be established but reliability measures appeared to be lower in people with a lower skinfold thickness. Moreover, the NIRS signals decreased with increasing ATT but stabilized upon reaching a cut-off of 8 mm ATT. In addition, ATT did have a significant influence on [HHb] amplitude. In participants with ATT < 8 mm, higher amplitudes were observed with increasing intensity whereas in participants with ATT > 8 mm, there were no differences between the intensities.The study reveals variable results with regards to reliability and there was no consistent influence of exercise intensity on reliability. Participants with a lower skinfold thickness showed stronger reliability. Moreover, NIRS signals decrease when ATT exceeds 8 mm. Careful consideration is necessary when interpreting NIRS signals in such cases.Methods: The aims of this study were (1) to assess the test–retest reliability of the primary near infrared spectroscopy (NIRS) variables (i.e., StO2, T[Hb], [HbO2] and [HHb]) during cycling and (2) to investigate potential influences of exercise intensity and adipose tissue thickness (ATT) on this reliability.21 men and 20 women completed twelve constant work rate tests (6 min) at six different exercise intensities with each intensity performed twice. NIRS variables were measured at the vastus lateralis. The coefficient of variance (CV%), the intraclass correlation coefficient (ICC), mean bias and limits of agreement (LoA) were determined for reliability purposes.The reliability of baseline values were acceptable to very good (CV% range: 5.83 – 21.96%). The reliability of end-values (CV% range: 0.02 – 25.02%, ICC range: 0.0 – 0.935) and amplitudes (CV% range: 0.46 – 5099%, ICC range: 0.0 – 0.887) were more variable. In general, the mean biases of end-values and amplitudes showed wide limits of agreement. A homogeneous influence of exercise intensity on reliability could not be established but reliability measures appeared to be lower in people with a lower skinfold thickness. Moreover, the NIRS signals decreased with increasing ATT but stabilized upon reaching a cut-off of 8 mm ATT. In addition, ATT did have a significant influence on [HHb] amplitude. In participants with ATT < 8 mm, higher amplitudes were observed with increasing intensity whereas in participants with ATT > 8 mm, there were no differences between the intensities.The study reveals variable results with regards to reliability and there was no consistent influence of exercise intensity on reliability. Participants with a lower skinfold thickness showed stronger reliability. Moreover, NIRS signals decrease when ATT exceeds 8 mm. Careful consideration is necessary when interpreting NIRS signals in such cases.Results: The aims of this study were (1) to assess the test–retest reliability of the primary near infrared spectroscopy (NIRS) variables (i.e., StO2, T[Hb], [HbO2] and [HHb]) during cycling and (2) to investigate potential influences of exercise intensity and adipose tissue thickness (ATT) on this reliability.21 men and 20 women completed twelve constant work rate tests (6 min) at six different exercise intensities with each intensity performed twice. NIRS variables were measured at the vastus lateralis. The coefficient of variance (CV%), the intraclass correlation coefficient (ICC), mean bias and limits of agreement (LoA) were determined for reliability purposes.The reliability of baseline values were acceptable to very good (CV% range: 5.83 – 21.96%). The reliability of end-values (CV% range: 0.02 – 25.02%, ICC range: 0.0 – 0.935) and amplitudes (CV% range: 0.46 – 5099%, ICC range: 0.0 – 0.887) were more variable. In general, the mean biases of end-values and amplitudes showed wide limits of agreement. A homogeneous influence of exercise intensity on reliability could not be established but reliability measures appeared to be lower in people with a lower skinfold thickness. Moreover, the NIRS signals decreased with increasing ATT but stabilized upon reaching a cut-off of 8 mm ATT. In addition, ATT did have a significant influence on [HHb] amplitude. In participants with ATT < 8 mm, higher amplitudes were observed with increasing intensity whereas in participants with ATT > 8 mm, there were no differences between the intensities.The study reveals variable results with regards to reliability and there was no consistent influence of exercise intensity on reliability. Participants with a lower skinfold thickness showed stronger reliability. Moreover, NIRS signals decrease when ATT exceeds 8 mm. Careful consideration is necessary when interpreting NIRS signals in such cases.Conclusion: The aims of this study were (1) to assess the test–retest reliability of the primary near infrared spectroscopy (NIRS) variables (i.e., StO2, T[Hb], [HbO2] and [HHb]) during cycling and (2) to investigate potential influences of exercise intensity and adipose tissue thickness (ATT) on this reliability.21 men and 20 women completed twelve constant work rate tests (6 min) at six different exercise intensities with each intensity performed twice. NIRS variables were measured at the vastus lateralis. The coefficient of variance (CV%), the intraclass correlation coefficient (ICC), mean bias and limits of agreement (LoA) were determined for reliability purposes.The reliability of baseline values were acceptable to very good (CV% range: 5.83 – 21.96%). The reliability of end-values (CV% range: 0.02 – 25.02%, ICC range: 0.0 – 0.935) and amplitudes (CV% range: 0.46 – 5099%, ICC range: 0.0 – 0.887) were more variable. In general, the mean biases of end-values and amplitudes showed wide limits of agreement. A homogeneous influence of exercise intensity on reliability could not be established but reliability measures appeared to be lower in people with a lower skinfold thickness. Moreover, the NIRS signals decreased with increasing ATT but stabilized upon reaching a cut-off of 8 mm ATT. In addition, ATT did have a significant influence on [HHb] amplitude. In participants with ATT < 8 mm, higher amplitudes were observed with increasing intensity whereas in participants with ATT > 8 mm, there were no differences between the intensities.The study reveals variable results with regards to reliability and there was no consistent influence of exercise intensity on reliability. Participants with a lower skinfold thickness showed stronger reliability. Moreover, NIRS signals decrease when ATT exceeds 8 mm. Careful consideration is necessary when interpreting NIRS signals in such cases. [ABSTRACT FROM AUTHOR]

Background: Pancreatic consistency is one of the most widely accepted risk factors of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatectoduodenectomy (PD). The present study aims to identify preoperative characteristics from the preoperative computed tomography (CT) associated with an increased risk. Methods: Retrospective observational cohort study of patients who underwent PD surgery (January 2010–2019) were enrolled. All patients with available preoperative imaging were included; 103 met the inclusion criteria. Several parameters were measured on preoperative abdominal CT: retrorenal adipose tissue; abdominal perimeter; total adipose tissue, visceral and subcutaneous; skeletal muscle mass; main pancreatic duct (MPD) diameter; pancreatic thickness; remnant pancreatic volume; pancreatic attenuation (pancreas-to-spleen ratio). Primary endpoints were the association of radiological variables with soft pancreatic consistency and POPF development. All variables possibly associated with POPF and soft pancreas were subsequently included into a multivariable logistic regression model. Results: Soft pancreas consistency was found in 43 patients (41.7%) and CR-POPF was higher (51.2% vs. 18%, p < 0.001). Multivariable analysis identified MPD ≤ 3 mm (OR = 7.2, 95%CI 2.3–23, p = 0.001), a remnant pancreatic volume ≥ 20 cm3 (OR = 6.4, 95%CI 2–21, p = 0.041), pancreas-to-spleen < 0.8 (OR = 3.2, 95%CI 1.2–8.4, p = 0.039), and retrorenal adipose tissue ≥ 12 cm3 (OR = 5.3, 95%CI 1.8–15.7, p = 0.013). Multivariable analysis showed MPD ≤ 3 mm (OR = 8.25, 95%CI 2.2–30.8, p = 0.002) and total adipose tissue ≥ 190 cm3 (OR = 3.2, 95%CI 1.1–9.1, p = 0.0027) were independent predictors of CR-POPF. Conclusion: The preoperative assessment of MPD, remnant pancreatic volume, pancreas-to-spleen ratio, total adipose tissue, and retrorenal adipose tissue are associated with soft pancreas texture and the risk of CR-POPF. [ABSTRACT FROM AUTHOR]

Purpose: Risks for postoperative small bowel obstruction have been demonstrated in several reports, most of which indicated male sex was a risk factor, but with the reason remaining unknown. We tested the hypothesis that it could be because males have more visceral fat than females. This prospective observational study aims to examine risks of early postoperative small bowel obstruction (EPSBO) after colorectal cancer surgery and the association between visceral to subcutaneous fat area ratio (V/S ratio) and EPSBO. Methods: Four hundred and seventy-four patients who underwent colectomy for colorectal cancer in our hospital were enrolled in this study. The influence of several factors including V/S ratio on the development of EPSBO was analyzed. Results: Thirty-one of the 474 patients (6.5%) developed EPSBO. EPSBO occurred more frequently in males (p = 0.03) and cases who developed postoperative anastomotic leakage (p < 0.001) or wound infection (p = 0.02). Higher V/S ratio was strongly related to male sex (p < 0.001). Multivariate analysis revealed higher V/S ratio (OR 2.25; p = 0.049) and anastomotic leakage (OR 5.86; p < 0.001) were independent risk factors for EPSBO. Conclusion: Higher V/S ratio was significantly related to EPSBO, suggesting that one of the reasons EPSBO was more likely to occur in males because they have more visceral fat than females. Preoperative identification of this risk factor could help us watch out for this potential complication. [ABSTRACT FROM AUTHOR]

Background: Pectus excavatum is the most common congenital deformity of the chest, with a frequency of one in 300 to 500 births. Twenty-five percent of pectus excavatum patients are female. Different surgical methods are used to treat female patients, depending on the degree of their thorax's deformity. For patients with mild deformity, fat transfer alone is often used to augment their breasts and improve appearance. This study aims to evaluate the thickness of the subdermal fat of adult female patients with pectus excavatum. Methods: The thickness of subdermal fat of the central regions of the chest was measured by referring to computer tomographic data of 62 adult Japanese female patients with pectus excavatum and 64 intact Japanese adult females. The pectus excavatum patients have no other comorbidities. These two groups were defined as pectus group and intact group, respectively. The two groups showed no statistically significant differences in ages, BMI, and thoracic cage width. Fat thickness was measured for each person at the levels of the clavicle, middle-height of the sternum, nipples, and inframammary fold. The data for each level were compared between the two groups. Results: Fat thickness presented statistically significant differences at the levels of nipples and inframammary fold between pectus group (17.8 ± 5.2 SD mm at the nipple level; 19.2 ± 4.9 SD mm at the inframammary fold level) and intact group (8.0 ± 2.6 SD mm at the nipple level; 10.2 ± 4.3SD mm at the inframammary fold level). Fat thickness presented no statistically significant differences between the two groups at the levels of clavicle and middle-height of the sternum. Conclusions: The intramammary fat of female pectus excavatum patients is thicker than that of intact adult women. Because of the thick fat, the intramammary groove can appear shallow after the depressed sternum is elevated in the correction surgery for pectus excavatum. Accordingly, the breasts can look smaller. Removal or positional transfer of intramammary fat can remedy this esthetic complication. Level of evidence: Level III, diagnostic study. [ABSTRACT FROM AUTHOR]

Introduction: The cystatin C (CysC) serum level is a marker of glomerular filtration rate and depends on age, gender, and pubertal stage. We hypothesize that CysC might overall reflect energy homeostasis and be regulated by components of the endocrine system and metabolites in pubertal adolescents. Methods: Serum CysC levels and further possible effector parameters in 5355 fasting, morning venous blood samples from 2035 healthy participants of the LIFE Child cohort study (age 8 to 18 years) were analyzed. Recruitment started in 2011, with probands followed up once a year. Linear univariate and stepwise multivariate regression analyses were performed. Results: Annual growth rate, serum levels of thyroid hormones, parathyroid hormone, insulin-like growth factor 1, hemoglobin A1c (HbA1c), uric acid, and alkaline phosphatase show relevant and significant associations with CysC serum concentrations (p <0.001). Furthermore, male probands' CysC correlated with the body mass index and testosterone among other sexual hormones. Multivariate analyses revealed that uric acid and HbA1c are associated variables of CysC independent from gender (p <0.001). In males, alkaline phosphatase (p <0.001) is additionally significantly associated with CysC. Thyroid hormones show significant correlations only in multivariate analyses in females (p <0.001). Conclusions: The described associations strongly suggest an impact of children's metabolism on CysC serum levels. These alterations need to be considered in kidney diagnostics using CysC in adolescents. Additionally, further studies are needed on CysC in children. [ABSTRACT FROM AUTHOR]

Purpose: Injury to the radial nerve is not an uncommon phenomenon in fracture displacement of distal humerus and its operative management as the nerve is immobile and superficial at its point of entry into the anterior compartment and in close proximity to humerus. Such injuries can be reduced by defining a 'safe area' for the radial nerve in relation to the triceps aponeurosis in the distal humerus. Methods: Radial nerve was dissected in 40 arms and distance of the nerve from triceps aponeurosis was measured at five sites; first one at the level of proximal or medial apex of aponeurosis, followed by four sites along its lateral border. These distances were analyzed to identify its location and to define a 'safe area' in relation to the triceps aponeurosis in the distal humerus. Results: In majority of cases (67.50%), the point of entry of radial nerve into anterior compartment was at the level of proximal or medial apex at a mean distance of 2.11 ± 0.31 cm. The mean distance of radial nerve from the lateral border of triceps aponeurosis was 1.98 ± 0.60 cm with a range of 1.00–2.50 cm. The closest distance between the nerve and the aponeurosis was found to be 1.00 cm at the level of distal or lateral apex. Conclusion: The relationship between radial nerve and triceps aponeurosis is constant and easily reproducible. It is suggested that the rectangular zone immediately adjoining the lateral border of aponeurosis (< 1.00 cm) can be considered "safe" for soft tissue dissection while surgically approaching distal humeral fractures. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare whole body composition, generated by air displacement plethysmography (ADP) and dual-energy X-ray absorptiometry (DXA), and to evaluate the potential predictive value of the sum of skinfolds (∑SFT) for whole body composition, in preterm infants at term equivalent age. A convenience sample of sixty-five preterm infants with a mean (SD) gestational age of 29 (1.6) weeks was studied at term equivalent age. Fat mass measured by DXA and ADP were compared and the ability of the ∑SFT to predict whole body fat mass was investigated. There was poor agreement between fat mass percentage measured with ADP compared with DXA (limits of agreement: − 4.8% and 13.7%). A previously modeled predictive equation with the ∑SFT as a predictor for absolute fat mass could not be validated. Corrected for confounders, the ∑SFT explained 42% (ADP, p = 0.001) and 75% (DXA, p = 0.001) of the variance in fat mass percentage. Conclusions: The ∑SFT was not able to accurately predict fat mass and ADP and DXA did not show comparable results. It remains to be elucidated whether or not DXA provides more accurate assessment of whole body fat mass than ADP in preterm infants. Trial registration: NTR5311 What is Known: • Diverse methods are used to assess fat mass in preterm infants. What is New: • This study showed that there is poor agreement between dual-energy X-ray absorptiometry, air displacement plethysmography, and skinfold thickness measurements. • Our results affirm the need for consensus guidelines on how to measure fat mass in preterm infants, to improve the assimilation of data from different studies and the implementation of the findings from those studies. [ABSTRACT FROM AUTHOR]

Background: Head and neck cancer patients have the second highest malnutrition prevalence, when compared with other oncological patients. They experience significant weight loss before diagnosis, during and after treatment, and even during the first year of follow-up. However, the prognostic value of weight loss depends on body mass index, and this may be associated with low skeletal muscle mass, masking its loss. Thus, weight loss itself poorly predicts outcome in head and neck cancer patients when compared with depleted skeletal muscle mass, illustrating the inadequacy of body mass index as an accurate method to reflect nutritional status. A synthesis is needed of the body composition changes occurring in head and neck cancer patients during treatment, as well as of the methods to assess it. Objective: The aim of this scoping review is to examine and map the body composition changes in head and neck cancer patients under oncological treatment with curative intent. A further objective is to determine which methods are used to assess body composition in these patients. Inclusion criteria: Types of participants: The current review considered head and neck cancer patients, aged 18 years or older. Concept: This scoping review considered all studies that focused on the body composition changes. Context: This scoping review considered the studies that evaluated the body composition changes in the context of treatment with curative intent. Surgical treatment approach was excluded to avoid excess heterogeneity in the data. Types of sources: This scoping review considered only published studies, with abstract available. Search strategy: A three-step search strategy was undertaken. This review was limited to studies published in English, Spanish, and Portuguese during 2000–2019. Data extraction: The data extracted included author(s)/year of publication, aims and purpose of the study, sample size, study design, type of treatment, measurement points and component(s) of body composition evaluated, body composition assessment methods, and main results/findings. Presentation of results: Head and neck cancer patients suffer from serious loss of lean body mass, skeletal muscle, or free fat mass, after treatment compared with baseline. Further, nutritional deterioration is evident and occurs up to 8–12 months after treatment. Bioelectrical impedance analysis is one of the body composition assessment tools that has the great advantage for being available on a regular basis for assessment of body composition in head and neck cancer patients. However, it cannot be recommended for clinical decision making until further validation. Conclusion: Head and neck cancer patients experience a significant depletion of lean body mass, fat-free mass, and skeletal muscle, accompanied by body fat mass, while undergoing (chemo)radiotherapy. This can be demonstrated either by triceps skinfold thickness, bioelectrical impedance analysis, dual-energy x-ray absorptiometry, or computed tomography. This loss has a remarkable impact on their survival, on their quality of life, and on the risk for post-operative complications and may result in a reduced response to cancer treatment. Thus, body composition assessment should become an integral component of the care of head and neck cancer patients, beyond weight and body mass index, and should be carried out at different times throughout treatment. [ABSTRACT FROM AUTHOR]

Objective: To reveal the best-suited method for fat quantification of lumbar multifidus to demonstrate its relationship to herniated nucleus pulposus (HNP) using T2-weighted Dixon.Materials and Methods: One hundred eight patients who underwent MRI for low back pain were enrolled. Two readers independently analyzed the fat fraction (Ff) using axial two-dimensional (D), coronal 2-D, and coronal 3-D measurement. Pearson's correlation coefficient was calculated between age, body mass index (BMI), and the Ff, and age, sex, BMI, and Ff were compared between 'HNP group' and 'no HNP group'. Multivariate logistic regression analysis was performed to identify factors associated with HNP.Results: Coronal 2-D Ff showed the highest correlation with age (r = 0.536, P < 0.001). Coronal 2-D Ff, and coronal 3-D Ff were significantly higher in those with HNP (coronal 2-D: 18.9 ± 2.9, coronal 3-D: 19.7 ± 2.6, respectively) than those without HNP (coronal 2-D: 17.2 ± 3.2, coronal 3-D: 17.4 ± 3.2, respectively). Ff of all three measurements were significantly higher in those with HNP ≥ 3 levels (axial 2-D: 20.7 ± 3.0, coronal 2-D: 21.1 ± 2.7, coronal 3-D: 21.6 ± 2.5, respectively) than those with HNP <3 levels (axial 2-D: 17.5 ± 4.3, coronal 2-D: 18.5 ± 2.7, coronal 3-D: 19.3 ± 2.5). The BMI was an independent predisposing factor to HNP (P = 0.011). Age and coronal 2-D Ff were significant predictors for multilevel HNP (P = 0.028 and 0.040, respectively).Conclusions: The Ff of the multifidus muscle on T2-weighted Dixon was associated with age, sex, and HNP. The coronal 2-D measurement was the best suited for fat quantification in multifidus muscle among three measurement methods. [ABSTRACT FROM AUTHOR]

Background: During the past few decades, overweight and obesity have become a global health hazard. The estimation and documentation of obesity are important in countries like India that have a broad diversity of populations. However, there is discrepancy in the various adiposity indicators used to estimate obesity. The present study examines population-specific associations between percent body fat (%BF) and adiposity variables among females in three population groups. Materials and methods: A cross-sectional study was conducted among Jat, Mizo, and Liangmai communities of India. Data were collected using interview schedules and somatometric measurements based on ISAK protocols. Body density was calculated from skinfold measurements and the Siri equation was used to determine %BF. WHO cut-offs were used for waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI), whereas Ashwell and Gibson and American Council for Exercise cut-offs were used for waist-to-height ratio (WHtR) and %BF, respectively. Results: Obesity variables are differentially distributed across the three populations. The mean values of %BF and WHtR were the highest among the Liangmai, whereas BMI, WC, and WHR were the highest among the Mizo. Conclusion: All of the selected adiposity indicators (WC, WHR, WHtR, and BMI) in all three populations were significantly positively correlated with %BF. Thus, %BF should be incorporated with other adiposity indicators as well, for a better understanding and categorisation of obesity among different populations. [ABSTRACT FROM AUTHOR]

Objective: Exercise training is recently considered as a trend in adjuvant therapies for cancer patients, but its mechanisms need to be scrutinized further. This study is aimed to test the hypothesis that the patients who perform the high-intensity interval exercise training (HIIT) during hormone therapy would show improvements in low-grade inflammation and HSP70 compared to the controls receiving standard care. Methods: Fifty two non-metastatic and hormone-responsive breast cancer patients were randomly assigned to high-intensity interval exercise (HIIT) (n = 26) and usual care (n = 26) groups. The HIIT groups participated in a high-intensity interval training protocol on a treadmill 3 days/week for 12 weeks. The training intensity was determined according to the predicted maximal heart rate. Demographic characteristics and medical history were collected via an interviewer-administered questionnaire at the baseline visit. Body fat was estimated based on skinfold thickness measured with calipers on the participant's nonsurgery side at the triceps, suprailiac crest. V O 2 max was estimated by 1-Mile Rockport Walk Test. Blood samples were collected 48 h before starting the exercise protocol and 48 h after the last exercise session. TNF-α, IL-6, IL-1β, IL-10, and HSP70 levels in serum were measured using the enzyme-linked immunosorbent assay (ELISA) method according to the manufacture's instruction. Supernatant cytokine concentrations were determined by ELISA for IL-4 and IFN-γ. The data were analyzed by ANCOVA test that the pretest values were considered as covariate at P ≤ 0.05. Results: HIIT improved V O 2 max in the HIIT group compared to the usual care group (P = 0.002). The serum levels of TNF-α (P = 0.001), IL-6 (P = 0.007), and IL-10 (P = 0.001) were lower in the HIIT group. The level of IL-4 (P = 0.050) in the stimulated peripheral blood mononuclear cells significantly increased in the HIIT group compared to the usual care group. Furthermore, the serum level of the HSP70 was significantly higher in the HIIT group in comparison to the usual care group (P = 0.050). The TNF-α/IL-10 (P = 0.050) and IL-6/IL-10 (P = 0.042) ratios were lower in the HIIT group. Conclusion: The results of this study indicated that HIIT has positive impacts on the cardiorespiratory fitness and inflammatory cytokines in the breast cancer patients undergoing hormone therapy. [ABSTRACT FROM AUTHOR]

Aim: Our aim is to demonstrate that a healthy diet might reduce the relation between adiposity and inflammation, whereas an unhealthy diet may increase the effect of adiposity on inflammatory biomarkers. Methods: In 618 adolescents (13–17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake determined by a self-administered computerized 24-h recall. A 9-point Mediterranean diet score and an antioxidant-rich diet score were used as dietary parameters and tested as moderator. Total body fat was represented by the sum of six skinfold thicknesses and central adiposity by waist circumference. A set of inflammation-related biomarkers was used as outcome: a pro/anti-inflammatory interleukins ratio, TGFβ-1, C-reactive protein, TNF-α, 3 cell adhesion molecules, and 3 types of immune cells; gamma-glutamyltransferase (GGT) and homocysteine were used as cardiovascular disease risk biomarkers, and alanine transaminase (ALT) as liver dysfunction biomarker. Multiple linear regression analyses tested moderation by diet in the adiposity-inflammation association and were adjusted for age, sex, country, puberty, socioeconomic status. Results: Both the Mediterranean and antioxidant-rich diet, and overall and central adiposity, were important in the moderation. Diet was a significant protective moderator in the effect of adiposity on the pro/anti-inflammatory interleukins ratio, TGFβ-1, GGT, and ALT. Conclusion: In conclusion, in some cases, a diet rich in antioxidants and essential nutrients may attenuate the concentration of inflammatory biomarkers caused by adiposity, whereas a poor diet appears to contribute to the onset of early oxidative stress signs. [ABSTRACT FROM AUTHOR]

Rationale: Rivastigmine patches are used for patients with Alzheimer's disease (AD), but little is known about the serum concentration of rivastigmine and its metabolite or clinical adherence in relation to skinfold thickness after rivastigmine patch application. Objectives: The aim of this study was to examine the association between rivastigmine and NAP 226-90 serum concentration and skinfold thickness and to determine the appropriate skinfold thickness for the use of rivastigmine patch in patients with AD. Methods: Patients with AD who continuously used rivastigmine patches (4.6 mg/24 h, 5 cm2) for more than 6 months were recruited. The serum concentrations of rivastigmine and NAP 226-90 were measured. Skinfold thickness was measured using a Lange Skinfold Caliper. Results: In total, 91 patients with AD (40 men and 51 women) participated in this study on skinfold thickness measurement. Among them, 27 patients were examined for rivastigmine and NAP 226-90 serum concentrations, with mean concentrations of 1.0 ± 0.6 ng/mL and 3.6 ± 3.6 ng/mL, respectively. The skinfold thickness in the subscapular area was significantly negatively correlated with the NAP 226-90 serum concentration (Spearman's rank correlation coefficient = − 0.47, P =.01). In addition, patients with AD and a subscapular skinfold thickness of ≥25 mm exhibited a significantly high risk of decreased Mini-Mental Status Examination score and nonadherence to a rivastigmine patch (odds ratio 3.00; 95% confidence interval = 1.076–8.366, P =.03). Conclusions: Subscapular skinfold thickness was significantly negatively correlated with the NAP 226-90 serum concentration and may be considered an appropriate predictor of response and adherence to clinical application of a rivastigmine patch. [ABSTRACT FROM AUTHOR]

Background: Bovine colostrum (COL) has been advocated as a nutritional countermeasure to exercise-induced immune dysfunction, but there is a lack of research with clinically relevant in vivo measures.Aim: To investigate the effects of COL supplementation on in vivo immunity following prolonged exercise using experimental contact hypersensitivity (CHS) with the novel antigen diphenylcyclopropenone (DPCP).Methods: In a double-blind design, 31 men were randomly assigned to COL (20 g/day) or placebo (PLA) for 58 days. Participants ran for 2 h at 60% maximal aerobic capacity on day 28 and received a primary DPCP exposure (sensitisation) 20 min after. On day 56, participants received a low-dose-series DPCP challenge to elicit recall of in vivo immune-specific memory (quantified by skinfold thickness 24 and 48 h later). Analysis of the dose-response curves allowed determination of the minimum dose required to elicit a positive response (i.e., sensitivity).Results: There was no difference in summed skinfold thickness responses between COL and PLA at 24 h (p = 0.124) and 48 h (p = 0.405). However, sensitivity of in vivo immune responsiveness was greater with COL at 24 h (p < 0.001) and 48 h (p = 0.023) with doses ~ twofold greater required to elicit a positive response in PLA.Conclusions: COL blunts the prolonged exercise-induced decrease in clinically relevant in vivo immune responsiveness to a novel antigen, which may be a mechanism for reduced illness reports observed in the previous studies. These findings also suggest that CHS sensitivity is highly relevant to host defence. [ABSTRACT FROM AUTHOR]

Tumor necrosis factor alpha (TNFα) has an important role in the body composition of patients with rheumatoid arthritis (RA), Crohn's disease (CD), and spondyloarthritis (SpA). We aimed to assess the nutritional profile of patients with RA, CD, and SpA undergoing remission with multiple therapies comparing to controls and to analyze the effect of anti-TNFα medications in the nutritional parameters of these patients. One hundred thirty-one patients were included: 44 with RA, 43 with CD, and 44 with SpA. Patients receiving anti-TNFα were compared with those receiving non-biological treatment as well as to controls. Nutritional profile included body mass index (BMI), waist circumference (WC), mid-upper arm circumference, and triceps skinfold measurement. Overweight and obesity were highly prevalent on three assessed groups. In patients with RA, BMI was > 25 kg/m2 in 74.9% patients and 49.2% controls (p < 0.0005); in CD, in 55.7% patients and 41.2% controls (p < 0.0001); and in SpA, in 68.1% patients and 43.5% controls (p < 0.0001). Central obesity was higher in all three disease groups when compared to healthy controls. There was no significant difference on nutritional parameters in patients using or not using anti-TNFα medications, except in patients with SpA, in which biologic therapy was significantly associated with lower BMI and WC, when compared to other therapies. Overweight, obesity, and elevated WC were more prevalent in patients with RA, CD, and SpA undergoing remission when compared to controls despite of used therapy. The use of biologic drugs in patients with SpA was associated with a lower BMI and lower WC. [ABSTRACT FROM AUTHOR]

Purpose: Arterial occlusion pressure (AOP) measured in a supine position is often used to set cuff pressures for blood flow restricted exercise (BFRE). However, supine AOP may not reflect seated or standing AOP, thus potentially influencing the degree of occlusion. The primary aim of the study was to investigate the effect of body position on AOP. A secondary aim was to investigate predictors of AOP using wide and narrow cuffs. Methods: Twenty-four subjects underwent measurements of thigh circumference, skinfold and blood pressure, followed by assessments of thigh AOP in supine and seated positions with a wide and a narrow cuff, respectively, using Doppler ultrasound. Results: In the supine position, AOP was 148 ± 19 and 348 ± 94 mmHg with the wide and narrow cuff, respectively. This increased to 177 ± 20 and 409 ± 101 mmHg in the seated position, with correlations between supine and seated AOP of R = 0.81 and R = 0.50 for the wide and narrow cuff, respectively. For both cuff widths, thigh circumference constituted the strongest predictor of AOP, with diastolic blood pressure explaining additional variance with the wide cuff. The predictive strength of these variables did not differ between body positions. Conclusion: Our results indicate that body position strongly influences lower limb AOP, especially with narrow cuffs, yielding very high AOP (≥ 500-600 mmHg) in some subjects. This should be taken into account in the standardization of cuff pressures used during BFRE to better control the physiological effects of BFRE. [ABSTRACT FROM AUTHOR]

Rugby league is a collision team sport played at junior and senior levels worldwide, whereby players require highly developed anthropometric and physical qualities (i.e. speed, change-of-direction speed, aerobic capacity, muscular strength and power). Within junior levels, professional clubs and national governing bodies implement talent identification and development programmes to support the development of youth (i.e. 13-20 years) rugby league players into professional athletes. This review presents and critically appraises the anthropometric and physical qualities of elite male youth rugby league players aged between 13 and 20 years, by age category, playing standard and playing position. Height, body mass, body composition, linear speed, change-of-direction speed, aerobic capacity, muscular strength and power characteristics are presented and demonstrate that qualities develop with age and differentiate between playing standard and playing position. This highlights the importance of anthropometric and physical qualities for the identification and development of youth rugby league players. However, factors such as maturity status, variability in development, longitudinal monitoring and career attainment should be considered to help understand, identify and develop the physical qualities of youth players. Further extensive research is required into the anthropometric and physical qualities of youth rugby league players, specifically considering national standardised testing batteries, links between physical qualities and match performance, together with intervention studies, to inform the physical development of youth rugby league players for talent identification and development purposes. [ABSTRACT FROM AUTHOR]

Objective To investigate the association between maternal caffeine intake during pregnancy and infant anthropometric measurements at age 3 and 6 months. Methods Longitudinal observational study of mother-child pairs stratified into five groups: diabetic women (DM), hypertensive women (HYP), smoking mothers (SMO), mothers of infants small for gestational age (SGA), and controls (CTL). Pairs were recruited from three public hospitals in Porto Alegre, Brazil, from 2011 to 2015, using a convenience sampling strategy. The Food Frequency Questionnaire (FFQ) was administered on postpartum day 7 to evaluate maternal caffeine intake during pregnancy. The anthropometric measurements of interest (weight, length, and skinfold thickness) were assessed at birth and at age 3 and 6 months. Linear regression was used to analyze the interaction between caffeine intake and skinfold thickness. Results Overall, 272 mother-child pairs were investigated (41 DM, 26 HYP, 68 SMO, 25 SGA, and 112 CTL). There were no differences in anthropometric measurements between infants born to mothers who had and had not consumed caffeine during pregnancy (P > 0.05). Children of mothers in the DM group had the highest adjusted average skinfold thicknesses at 3 months. An interaction between maternal caffeine intake during pregnancy and the sum of skinfolds at age 3 months was found in the DM and CTL groups (P < 0.05). However, significant differences were not observed at 6 months. Conclusions Maternal caffeine intake influenced infants skinfold thickness measurements at 3 months of age. This parameter was reduced in infants born to mothers with DM and increased in those born to healthy control mothers. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to assess the influence of different skinfold thicknesses (ST) and their relation to the attenuation of the mechanomyographic (MMG) signal at different force levels (maximal voluntary contraction – MVC, 40% of MVC and 70% of MVC) of the rectus femoris muscle. Methods: Fifteen volunteers were divided in two groups: ST lower than 10mm (G35) (7 participants). Student t tests were employed to investigate differences between G35 regarding MMG analysis parameters (acceleration root mean square – aRMS, zero crossing – ZC, and median frequency – MDF), for the X, Y and Z axes, as well as for the modulus of these three axes. Results: We found that thicker layers of body fat act as attenuator filters for the MMG signal [MDFMVC: X (p = 0.005), Z (p = 0.003); MDF70%MVC: X (p = 0.034); ZCMVC: Z (p = 0.037), modulus (p = 0.005); ZC70%MVC: Z (p = 0.047)]. We found significant correlation between ST values and aRMS in three levels, in the Yaxis (p = 0.591), for the group G35 in 40%MVC (R2 = 0.610), and 70%MVC (R2 = 0.592). The MDF parameter showed correlation with ST values only in the Yaxis in 70%MVC (R2 = 0.700) for G>35. Conclusions: We observed MMG signal attenuation in at least one of the parameters analyzed for each level of the rectus femoris muscle force, indicating that MMG signals are significantly attenuated with increasing thickness of the subcutaneous fat layer. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to develop a specific mathematical model to estimate the body fat percentage (BF%) of children with cerebral palsy, based on a Brazilian population of patients with this condition. Method: This is a descriptive cross-sectional study. The study included 63 Caucasian children with cerebral palsy, both males and females, aged between three and ten-years-old. Participants were assessed for functional motor impairment using the Gross Motor Function Classification System (GMFCS), dual energy x-ray absorptiometry (DXA) and skinfold thickness. Total body mass (TBM) and skinfolds thickness from: triceps (Tr), biceps (Bi), Suprailiac (Si), medium thigh (Th), abdominal (Ab), medial calf (Ca) and subscapular (Se) were collected. Fat mass (FM) was estimated by dual energy x-ray absorptiometry (gold standard). Results: The model was built from multivariate linear regression; FM was set as a dependent variable and other anthropometric variables, age and sex, were set as independent variables. The final model was established as F%=((0.433xTBM + 0.063xTh + 0.167xSi - 6.768) ÷ TBM) × 100, the R2 value was 0.950, R2 adjusted=0.948 and the standard error of estimate was 1.039 kg. Conclusion: This method was shown to be valid to estimate body fat percentage of children with cerebral palsy. Also, the measurement of skinfolds on both sides of the body showed good results in this modelling. [ABSTRACT FROM AUTHOR]

Background: Carbohydrate (CHO) supplementation during prolonged exercise is widely acknowledged to blunt in vitro immunoendocrine responses, but no study has investigated in vivo immunity. Purpose: To determine the effect of CHO supplementation during prolonged exercise on in vivo immune induction using experimental contact hypersensitivity with the novel antigen diphenylcyclopropenone (DPCP). Methods: In a double-blind design, 32 subjects were randomly assigned to 120 min of treadmill exercise at 60 % $$\dot{V}{\text{O}}_{2} { \hbox{max} }$$ with CHO (Ex-CHO) or placebo (Ex-PLA) supplementation. Responses were also compared to 16 resting control (CON) subjects from a previous study (for additional comparison with a resting non-exercise condition). Standardised diets (24 h pre-trial) and breakfasts (3.5 h pre-trial) were provided. Subjects received a primary DPCP exposure (sensitisation) 20 min after trial completion, and exactly 28 days later the strength of immune reactivity was quantified by magnitude of the cutaneous response (skin-fold thickness and erythema) to a low dose-series DPCP challenge. Stress hormones and leucocyte trafficking were also monitored. Results: CHO supplementation blunted the cortisol and leucocyte trafficking responses, but there was no difference ( P > 0.05) between Ex-CHO and Ex-PLA in the in vivo immune responses (e.g. both ~46 % lower than CON for skin-fold response). Conclusions: CHO supplementation does not influence the decrease in in vivo immunity seen after prolonged exercise. The effects with more stressful (or fasted) exercise remain to be determined. However, there appears to be no benefit under the conditions of the present study, which have practical relevance to what many athletes do in training or competition. [ABSTRACT FROM AUTHOR]

Purpose: Consuming 375-500 ml of water 30 min before a meal has been shown to reduce energy intake in older, but not younger adults. This study investigated the effects of ingesting a water preload immediately pre-meal (<1 min before eating) on within-meal ad libitum energy intake in non-obese young males. Methods: Fourteen healthy males [mean (SD) age 27 (3) years, height 1.83 (0.05) m, body weight 80.47 (9.89) kg, body fat 17.5 (4.0) %, body mass index 24.0 (2.5) kg/m] completed a familiarisation trial and two experimental trials in randomised counterbalanced order. Subjects arrived at the laboratory overnight fasted and consumed an ad libitum porridge breakfast. Immediately prior to the meal, subjects consumed either a 568 ml (1 pint) water preload (preload trial) or no preload (control trial). Visual analogue scale questionnaires to assess hunger, fullness and satisfaction were completed before and after the meal in both trials, as well as after the water preload. Results: Ad libitum energy intake was greater ( P < 0.001) during control [2551 (562) kJ] than preload [1967 (454) kJ]. Ad libitum water intake was also greater ( P < 0.001) during control [318 (226-975) ml] than preload [116 (0-581) ml]. The water preload increased fullness and satisfaction and decreased hunger compared to pre-trial ( P < 0.001) and the control trial ( P < 0.001). Conclusion: This study demonstrates that consumption of a 568 ml water preload immediately before a meal reduces energy intake in non-obese young males. This might therefore be an effective strategy to suppress energy intake in this population and possibly assist with weight management. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to establish the role of angiotensin-converting enzyme gene insertion/deletion (ACE I/D) polymorphism in determining obesity or undernutrition in a child population in Romania. Methods: We assessed 293 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided, according to body mass index (BMI), into three groups: group I, the control group consisting of 126 children, group II patients with undernutrition (85 patients) and group III patients with obesity (82 patients). ACE I/D polymorphisms were performed in all three patient groups, as well as the measuring of anthropometric parameters [middle upper arm circumference (MUAC), tricipital skinfold thickness (TST)]. All patients also underwent paraclinical evaluations (protein and albumin). The cutoffs criteria for moderate undernutrition were: BMI between −2.0 SD and −3.0 SD, severe undernutrition: BMI <−3.0 SD, moderate obesity: BMI between +2.0 SD and +3.0 SD and severe obesity: BMI >+3.0 SD. Results: We observed that DD genotype (64.7 %) was prevalent in the moderate undernutrition group, while ID (35.3 %) and II genotypes were higher in the subgroup of severe undernutrition, with significant correlations in DD and ID genotype groups between BMI and MUAC, protein and albumin ( p < 0.0001). In the obese group, we observed significant correlations in DD genotype, between BMI and MUAC ( p = 0.0014) and TST, and for II genotype, between BMI and TST ( p = 0.0071). II genotype was associated with severe obesity, while D allele carriers were associated with moderate undernutrition and moderate obesity. Conclusion: BMI, MUAC, TST and serum protein levels are correlated with D allele carriers of ACE genes in children with moderate undernutrition and moderate obesity, whereas II genotype is an unfavorable prognostic factor corresponding to severe obesity and severe undernutrition. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate total, energy-adjusted dietary fiber (DF), water-soluble fiber (WSF), and water-insoluble fiber (WIF) intakes in European adolescents and to investigate their association with indicators of adiposity and serum biomarkers. Methods: This study, conducted from 2006 to 2007, included 1804 adolescents aged 12.5-17.5 years (47 % males) from eight European cities completing two non-consecutive computerized 24-h dietary recalls. GLM multivariate analysis was used to investigate associations. Results: Mean DF intake (20 g/day) of the sample met the European Food Safety Authority recommendation, but was below those of the World Health Organization and of the Institute of Medicine. Total DF, WSF and WIF intakes were higher in males ( P < 0.001), but following energy-adjustments significantly higher intakes were observed among females ( P < 0.001). Bread and cereals contributed most to total DF, WSF and WIF intakes, followed by potatoes and grains, energy-dense but low-nutritious foods, fruits and vegetables. Moreover, energy-adjusted WSF and WIF were positively associated with body fat percentage (BF%), waist to height ratio and low-density lipoprotein cholesterol, while energy-adjusted WSF was inversely associated with serum fasting glucose ( β = −0. 010, P = 0.020). Conclusion: Total DF intakes are rather low in European adolescents. An inverse association with serum fasting glucose might indicate a possible beneficial role of DF in preventing insulin resistance and its concomitant diseases, even though DF intakes were positively associated with adolescents' BF%. Therefore, further longitudinal studies should elaborate on these potential beneficial effects of DF intake in the prevention of obesity and related chronic diseases. [ABSTRACT FROM AUTHOR]

Analysis of 786 NF1 mutation-positive subjects with clinical diagnosis of neurofibromatosis type 1 (NF1) allowed to identify the heterozygous c.5425C>T missense variant (p.Arg1809Cys) in six (0.7%) unrelated probands (three familial and three sporadic cases), all exhibiting a mild form of disease. Detailed clinical characterization of these subjects and other eight affected relatives showed that all individuals had multiple cafè-au-lait spots, frequently associated with skinfold freckling, but absence of discrete cutaneous or plexiform neurofibromas, Lisch nodules, typical NF1 osseous lesions or symptomatic optic gliomas. Facial features in half of the individuals were suggestive of Noonan syndrome. Our finding and revision of the literature consistently indicate that the c.5425C>T change is associated with a distinctive, mild form of NF1, providing new data with direct impact on genetic counseling and patient management. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the surface mechanomyographic mean power frequency (MMG MPF)-force relationships with linear regression models applied to the absolute and log-transformed values for the first dorsal interosseous (FDI), vastus lateralis (VL) and rectus femoris (RF) muscles. Thirteen healthy males performed isometric ramp contractions of the leg extensors and index finger from 10 to 80 % of their maximal voluntary contraction with MMG sensors positioned on the VL, RF, and FDI. Simple linear regression models were fit to the absolute and log-transformed MMG MPF-force relationships. Skinfold thickness measurements were taken at each sensor site. There were significant differences for the slopes from the log-transformed MMG MPF-force relationships between the FDI and the leg extensors ( P < 0.001) but not the absolute model ( P = 0.168). The Y-intercepts were greater for the FDI than the leg extensors for the absolute ( P < 0.001) and log-transformed models ( P < 0.001), which reflected similar muscle-related differences ( P < 0.001) for skinfold thickness. However, there were no significant correlations between Y-intercepts and skinfold thicknesses. Differences in the patterns of response between the FDI and leg extensors were only quantified with the log-transformed model. [ABSTRACT FROM AUTHOR]

Purpose: The metabolic syndrome (MetS) in adolescents is a growing problem. The objectives were to verify the association among early predictors such as birth weight, breastfeeding, maternal weight status, smoking during pregnancy, and the development of MetS. Methods: A cross-sectional study was performed of 976 children and adolescents, 10-15 years of age, at schools in the provinces of Granada and Almeria (Spain). For this purpose, we analyzed the physical characteristics as well as the biochemical markers of the participants with a view to ascertaining the prevalence of the MetS. Relevant data were also extracted from the clinical histories of their mothers. Results: It was found that 3.85 % of the female subjects and 5.38 % of the male subjects in the sample population suffered from MetS. In both sexes, there was an association between birth weight and positive MetS diagnosis (OR 1.27). For both males and females, there was an inverse association between the length of time that they had been breastfed and positive MetS diagnosis (OR 3.16; OR 1.70; OR 0.13). There was also a significant association between maternal weight (OR 30.79; OR 49.36) and cigarette consumption during pregnancy (OR 1.47) and the subsequent development of MetS in the children of these mothers. Conclusions: Those subjects born with a higher than average birth weight had a greater risk of developing MetS in childhood and adolescence. Breastfeeding children for longer than 6 months protected them from MetS in their early years as well as in their teens. Other risk factors for MetS were maternal smoking during pregnancy as well as maternal overweight and obesity. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyse the association of European adolescents' ready-to-eat-cereal (RTEC) consumption frequency with their dietary intake by applying the concept of diet quality index and nutritional status. Methods: From the multi-centre European HELENA study, relevant data were available in 1,215 adolescents (12.5-17.5 years). RTEC consumption was identified from a food frequency questionnaire. A diet quality index, daily nutrient intakes and daily milk/yoghurt and fruit intake were calculated from two 24-h dietary recalls. BMI, waist and hip circumference and body fat were measured for body composition. Cross-sectional regression analyses were adjusted for sex, age, socio-economic status, city and breakfast skipping. Differences in sub-regions within Europe were explored. Results: RTEC consumers showed a more favourable daily micronutrient intake (vitamin B2, B5, B7, D, calcium, phosphorus and potassium), a better diet quality index, more frequent fruit (57 vs. 51 %) and milk/yoghurt consumption (81.2 vs. 56 %) and less breakfast skipping (25.1 vs. 36.7 %). No differences in energy and macronutrient intake were observed. Daily RTEC consumers were 57 % less likely to be overweight than RTEC non-consumers but did not differ in glucose and lipid status ( N = 387). Conclusion: This is the first comprehensive pan-European survey elucidating socio-demographic determinants of European adolescents' RTEC consumption and indicating better dietary habits in RTEC consumers. The improved dietary profile was reflected in a more beneficial body composition. Our results have also shown the advantage of using an all-integrating diet quality index by capturing the diet complexity. [ABSTRACT FROM AUTHOR]

Purpose: Childhood obesity is an increasing problem and is accompanied by metabolic disturbances. Recently, we have identified 14 serum metabolites by a metabolomics approach (FIA-MS/MS), which showed altered concentrations in obese children as compared to normal-weight children. Obese children demonstrated higher concentrations of two acylcarnitines and lower levels of three amino acids, six acyl-alkyl phosphatidylcholines, and three lysophosphatidylcholines. The aim of this study was to analyze whether these alterations normalize in weight loss. Methods: We analyzed the changes of these 14 metabolites by the same metabolic kit as in our previous study in serum samples of 80 obese children with substantial weight loss (BMI-SDS reduction >0.5) and in 80 obese children with stable weight status all participating in a 1-year lifestyle intervention. Results: In the children without weight change, no significant changes of metabolite concentrations could be observed. In children with substantial weight loss, glutamine, methionine, the lysophosphatidylcholines LPCaC18:1, LPCaC18:2, and LPCa20:4, as well as the acyl-alkyl phosphatidylcholine PCaeC36:2 increased significantly, while the acylcarnitines C12:1 and C16:1, proline, PCaeC34:1, PCaeC34:2, PCaeC34:3, PCaeC36:3, and PCaeC38:2 did not change significantly. Conclusions: The changes of glutamine, methionine, LPCaC18:1, LPCaC18:2, LPCa20:4, and PCaeC36:2 seem to be related to the changes of dieting or exercise habits in lifestyle intervention or to be a consequence of overweight since they normalized in weight loss. Further studies should substantiate our findings. [ABSTRACT FROM AUTHOR]

Background/objective: The aim of this study was to assess the validity of body fatness estimations based on skinfolds and bioelectrical iImpedance analyses (BIA) measurements compared to a three-component model (3C model) in prepubertal Chilean children, considering potential differences by sex and nutritional status.Subjects/methods: Four hundred and twenty four Chilean children (198 females and 226 males) were assessed for body composition. Body fat percentage (BF%) was evaluated by Skinfold equations (Slaughter, Ramirez and Huang) and Bioelectrical impedance (BIA: Tanita BC-418MA) using both the equipment and the Ramirez equation. Measurements based on a 3C model constructed from total body water estimates by isotope dilution and from body volume estimates by air displacement plethysmography were used as gold standard.Results: Coefficient of determination (R2) values were higher in overweight and in the whole group of both gender. All slopes were differed significantly from 1, and most intercepts were significantly different from 0. Skinfold Equations: an underestimation of BF% was found for all equations, being higher with the Slaughter equation. BIA: Tanita underestimated BF% in all groups, whereas Ramirez equation shows an overestimation.Conclusions: Skinfolds and bio-impedance equations serve well to rank children according to their BF%. However, these methods are not accurate for describing body composition in prepubertal Chilean children. [ABSTRACT FROM AUTHOR]

Rugby league is a team sport in which players engage in repeated high-intensity exercise involving frequent collisions. Recent research, much of which has involved global positioning system (GPS) technology, has provided coaches and sport scientists with a deeper understanding of match demands, particularly at the elite level. This has allowed for the development of training programmes that prepare players for the most intense contact and running demands likely to be experienced in competition. At the elite level, rugby league players have well-developed aerobic and anaerobic endurance, muscular strength and power, reactive agility, and speed. Upper- and lower-body strength and aerobic power are associated with a broad range of technical and sport-specific skills, in addition to a lower risk of injury. Significant muscle damage (as estimated from creatine kinase concentrations) and fatigue occurs as a result of match-play; while muscle function and perceptual fatigue generally return to baseline 48 h following competition, increases in plasma concentrations of creatine kinase can last for up to 5 days post-match. Well-developed physical qualities may minimise post-match fatigue and facilitate recovery. Ultimately, the literature highlights that players require a broad range of physical and technical skills developed through specific training. This review evaluates the demands of the modern game, drawing on research that has used GPS technology. These findings highlight that preparing players based on the average demands of competition is likely to leave them underprepared for the most demanding passages of play. As such, coaches should incorporate drills that replicate the most intense repeated high-intensity demands of competition in order to prepare players for the worst-case scenarios expected during match-play. [ABSTRACT FROM AUTHOR]

To estimate the effects of gestational weight gain (GWG), central adiposity and subcutaneous fat on maternal post-load glucose concentration, pregnant women [n = 413, 62 % black, 57 % with pregravid body mass index (BMI) ≥25] enrolled in a cohort study at ≤13 weeks gestation. GWG was abstracted from medical records. In a sub-sample of women (n = 214), waist circumference (WC), and biceps and triceps skinfold thicknesses were measured at enrollment. At 24-28 weeks gestation, post-load glucose concentration was measured using a 50-g 1-h oral glucose tolerance test. After adjustment for pre-pregnancy BMI, age, parity, race/ethnicity, smoking, marital status, annual family income, education, family history of diabetes, and gestational age of GDM screening, each 0.3-kg/week increase in weight in the first trimester was associated with a 2.2 (95 % CI 0.1, 4.3)-mg/dl increase in glucose concentration. Each 8.6-mm increase in biceps skinfold thickness and each 11.7-mm increase in triceps skinfold thickness was associated with 4.3 (95 % CI 0.2, 8.5)-mg/dl increase in maternal glucose, independent of BMI and other confounders. Neither GWG in the second trimester nor WC at ≤13 weeks was significantly associated with glucose concentration after confounder adjustment. Independent of pre-pregnancy BMI, high early pregnancy GWG and maternal subcutaneous body fat may be positively associated with maternal glucose concentrations at 24-28 weeks. [ABSTRACT FROM AUTHOR]

Purpose: Several countries have recently reported stabilization and/or a decrease in the prevalence of pediatric obesity. However, systematic, repeated national monitoring studies are scarce, and it is unclear whether this trend would be sustained. The objective was to present the latest overweight and obesity prevalence in Swiss children and to investigate trends in prevalence from 1999 to 2012. Methods: Using probability-proportionate-to-size cluster sampling, nationally representative samples of children aged 6-12 years were recruited in 1999 ( n = 594), 2002 ( n = 2,493), 2004 ( n = 328), 2007 ( n = 2,218), 2009 ( n = 907), and 2012 ( n = 2,963). Height and weight were measured to calculate BMI (kg/m). BMI cutoffs proposed by the Centers for Disease Control and Prevention (CDC) and by the International Obesity Task Force were used to determine the prevalence of overweight (excluding obesity) and obesity. Waist circumference was measured in 2007 and 2012, and multiple skinfold thicknesses assessed in 2002 and 2012. Results: Using the CDC criteria, prevalences of overweight and obesity in 2012 were 11.9 % (95 % CI 10.7-13.1) and 7.1 % (95 % CI 6.2-8.0), respectively, and did not change between 1999 and 2012 ( β = −0.144, p = 0.293 and β = −0.063, p = 0.552, respectively). Boys had significantly higher obesity prevalence than girls in 2007 (5.6 vs. 3.4 %) and 2012 (8.1 vs. 5.9 %). Percentage of children with excess waist circumference and body fat percentage did not differ between 2007 and 2012, and 2002 and 2012, respectively. Conclusion: Our data indicate the prevalence of childhood adiposity in Switzerland stabilized between 1999 and 2012, but ≈1 in 5 children remain overweight or obese and further efforts are needed to control the epidemic. [ABSTRACT FROM AUTHOR]

Background: Foods with low glycaemic index (LGI) are reported to suppress appetite mainly in overweight population but have not been investigated in athletic adults. Objective: The aim of this study was to compare the short-term effects of LGI and high GI (HGI) meals over a day on subsequent subjective appetite sensation, energy intake, energy expenditure, energy balance and resting metabolic rate in physically active males. Methods: This cross-sectional randomized crossover study included 14 active males (mean ± SD; age 34.5 ± 8.9 years, body mass index 22.8 ± 2.1 kg m) to consume LGI and HGI meals on two separate days. On each trial day, participants consumed a breakfast in the laboratory and then left with a packed lunch, dinner and snacks. Appetite scores, energy intake and expenditure were assessed. Results: The area under the curve for appetite scores of the HGI trial was significantly smaller than that of the LGI trial during the laboratory period ( p = 0.027) and throughout the day ( p = 0.009). No significant differences in energy intake, energy expenditure, energy balance and resting metabolic rate were found between groups, between the trial days and between the corresponding post-trial days. Conclusions: These results show that frequent ingestion of the HGI meals, contrary to the previous reports, suppresses appetite more than that of LGI meals, but did not affect energy balance in physically active normal-weight males. [ABSTRACT FROM AUTHOR]

Introduction: Weight loss interventions have been studied extensively, but methodological limitations negatively affecting applicability in everyday clinical practice are a very common problem in these studies. Despite the fact that obesity is treated mostly in a primary care setting, studies that investigate weight loss interventions in a primary care setting are scarce. Our objective was to assess the effectiveness of a tailor-made weight loss intervention in achieving a clinically significant weight loss in overweight (BMI ≥ 27 kg/m²) women aged 50-60 years in a primary care setting. Methods: As part of a randomized controlled trial on the effects of a tailor-made weight loss intervention and oral glucosamine sulphate on the incidence of osteoarthritis of the knee in 407 overweight women aged 50-60 years, we analysed the effectiveness of the weight loss intervention in achieving clinically relevant weight loss. Results: At baseline, the mean body weight for all participants was 88.7 ± 13.2 kg, and the mean BMI was 32.4 ± 4.3 kg/m². The percentage of participants that lost ≥5 kg or 5 % of their baseline body weight was 14.8 versus 6.3 % ( p = 0.012) at 6 months for the intervention group and the control group, respectively. At 12 months, this was 18.7 versus 14.9 % ( p = 0.027). Mean weight gain at 6 months was −0.9 versus 0.9 kg ( p < 0.001) for the intervention group and the control group, respectively. At 12 months, this was −0.6 versus 0.6 kg ( p = 0.01). At 30 months of follow-up, no significant differences were found between both groups. Conclusions: This weight loss intervention, which, at short notice, is easily applicable in everyday clinical practice, is effective in achieving clinically significant weight loss in overweight women aged 50-60 over a 12-month period. Long-term weight loss maintenance, however, occurred only marginally. Magnitude of the effect is comparable to that achieved in many other more intensive weight loss interventions. [ABSTRACT FROM AUTHOR]

Objective:To examine changes in skinfolds in late gestation in healthy women.Study Design:Skinfold measures were performed in 39 women at 30.8 (mean) and 37.7 weeks gestation. Fat mass (kg) and sum of three skinfolds were calculated.Results:A decrease in skinfold thickness was observed in 21 women (−3.1±2.1 mm) in late gestation, whereas 18 women had an increase (4.3±3.2 mm), P<0.001. The group of women who lost body fat (decrease in skinfold thickness) had a trend toward greater pregravid body mass index (BMI, 25 vs 22 kg/m2, P=0.06), and gained less weight in late gestation (3.0 vs 4.3 kg, P=0.042). On multiple regression, maternal age and gestational weight gain were positively correlated with fat mass accrual, whereas pregravid BMI and dietary fiber were negative determinants of late gestational fat mass.Conclusion:Increases in maternal fat mass in late gestation were related to maternal age and gestational weight gain, whereas decreases were related to increased pregravid BMI and dietary fiber. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have examined responsiveness of bioimpedance (BIA) to detect changes over time in body composition using a longitudinal design. Accuracy of BIA and skinfold thickness in estimating body composition among 39-64 year-old women was investigated using dual-energy X-ray absorptiometry (DXA) as a criterion method both cross-sectionally and during a training intervention. Methods: 97 women had percentage of fat assessed using DXA, skinfolds and eight-polar BIA using multi-frequency current. Fat mass and lean mass were estimated by DXA and BIA. Measurements were performed before and after the 21-week training intervention. Results: At baseline relative to DXA, BIA under predicted percentage of fat (−6.50 %) and fat mass (−3.42 kg) and overestimated lean mass (3.18 kg) considerably. Also skinfold measurement under predicted percentage of fat compared to DXA, but the difference was smaller (−1.69 % units). Skinfold measurement overestimated percentage of fat at low values and underestimated at high values ( r = 0.535). A significant bias was detected between DXA and BIA's estimate of change in percentage of fat, fat mass and lean mass. Compared to DXA, BIA and skinfolds underestimated the training-induced positive changes in body composition. Conclusions: BIA and skinfold methods compared to DXA are not interchangeable to quantify the percentage of fat, fat mass and lean mass at the cross-sectional design in middle-aged women. Moreover, exercise training-induced small changes in body composition cannot be detected with BIA or skinfold method, even though DXA was able to measure statistically significant within-group changes in body composition after training. [ABSTRACT FROM AUTHOR]

Background/objectives:To establish new reference values for triceps (TSF) and subscapular (SSF) skinfolds of Norwegian children 4-16 years of age, and to define cutoff values for overweight and obesity using the criteria of the International Obesity Task Force (IOTF).Subjects/methods:A cross-sectional sample of 4606 children 4-16 years of age, part of a larger growth study, was used to estimate reference curves with the LMS method; suggested cutoffs were selected using receiver operating characteristic analyses.Results:Reference values for TSF and SSF are presented as percentiles. Mean skinfold size increased with age. Girls had higher values than boys over the entire age range. There was a strong positive correlation between both skinfolds and body mass index (BMI). For all ages together, a cutoff of 1.0 standard deviation score (SDS) gave a sensitivity of 76% for SSF, and 70% for TSF to detect overweight, with a corresponding specificity of 92% for both. To detect obesity, a cutoff value of 1.3 SDS gave a sensitivity of 91% and specificity of 90% for SSF. Corresponding values for TSF were 86% for the sensitivity, and 91% for the specificity.Conclusions:This study presents new reference values for TSF and SSF skinfolds in Norwegian children 4-16 years of age. Both skinfolds had a high-discriminating power to detect overweight and obesity as defined by the IOTF BMI criteria. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The mini-nutritional assessment (MNA) has been used most frequently for the determination of malnutrition in older adults; however it is not suitable for some hospitalized patients. The aim of this study was to identify the nutritional status of the elderly hospitalized patients by MNA and by other assessment methods including anthropometric measurements, bioelectrical impedance analysis (BIA) and laboratory parameters and to demonstrate the correlation of them with MNA. Patients: A total of 100 patients were included in the study. Linear regression analysis was performed to compare the effects of parameters on MNA scores. Results: By MNA; 69% of the patients were found to have nutritional risk, 12% were malnourished and 19% were well nourished. Skinfold thicknesses, calf circumference, prealbumin, albumin, C-reactive protein (CRP), glomerular filtration rate (GFR) and some of the BIA parameters including body fat, free fat mass index, extracellular, intracellular and total body water were significantly correlated with MNA score in univariate analysis. On the other hand; only suprailiac skinfold thickness (OR: 0.106, 95%CI: 0.031–0.181, P: 0.006), prealbumin (OR: 0.256, 95%CI: 0.158–0.354, P <0.001) and GFR (OR: 0.036, 95%CI: 0.014–0.057, P: 0.01) were significantly correlated with MNA in multivariate analysis. Conclusions: These parameters or their combinations can be used for the evaluation of nutritional status in hospitalized older adults when the MNA cannot be used. [Copyright &y& Elsevier]

Objective:To compare different field methods for estimating body fat mass with a reference value derived by a three-component (3C) model in pre-school and school children across Europe.Design:Multicentre validation study.Subjects:Seventy-eight preschool/school children aged 4-10 years from four different European countries.Methods:A standard measurement protocol was carried out in all children by trained field workers. A 3C model was used as the reference method. The field methods included height and weight measurement, circumferences measured at four sites, skinfold measured at two-six sites and foot-to-foot bioelectrical resistance (BIA) via TANITA scales.Results:With the exception of height and neck circumference, all single measurements were able to explain at least 74% of the fat-mass variance in the sample. In combination, circumference models were superior to skinfold models and height-weight models. The best predictions were given by trunk models (combining skinfold and circumference measurements) that explained 91% of the observed fat-mass variance. The optimal data-driven model for our sample includes hip circumference, triceps skinfold and total body mass minus resistance index, and explains 94% of the fat-mass variance with 2.44 kg fat mass limits of agreement. In all investigated models, prediction errors were associated with fat mass, although to a lesser degree in the investigated skinfold models, arm models and the data-driven models.Conclusion:When studying total body fat in childhood populations, anthropometric measurements will give biased estimations as compared to gold standard measurements. Nevertheless, our study shows that when combining circumference and skinfold measurements, estimations of fat mass can be obtained with a limit of agreement of 1.91 kg in normal weight children and of 2.94 kg in overweight or obese children. [ABSTRACT FROM AUTHOR]

Purpose: Body mass index (BMI) and waist circumference (WC) are widely used to predict % body fat (BF) and classify degrees of pediatric adiposity. However, both measures have limitations. The aim of this study was to evaluate whether a combination of WC and BMI would more accurately predict %BF than either alone. Methods: In a nationally representative sample of 2,303 6- to 13-year-old Swiss children, weight, height, and WC were measured, and %BF was determined from multiple skinfold thicknesses. Regression and receiver operating characteristic (ROC) curves were used to evaluate the combination of WC and BMI in predicting %BF against WC or BMI alone. An optimized composite score (CS) was generated. Results: A quadratic polynomial combination of WC and BMI led to a better prediction of %BF ( r = 0.68) compared with the two measures alone ( r = 0.58-0.62). The areas under the ROC curve for the CS [0.6 * WC-SDS + 0.4 * BMI-SDS] ranged from 0.962 ± 0.0053 (overweight girls) to 0.982 ± 0.0046 (obese boys) and were somewhat greater than the AUCs for either BMI or WC alone. At a given specificity, the sensitivity of the prediction of overweight and obesity based on the CS was higher than that based on either WC or BMI alone, although the improvement was small. Conclusion: Both BMI and WC are good predictors of %BF in primary school children. However, a composite score incorporating both measures increased sensitivity at a constant specificity as compared to the individual measures. It may therefore be a useful tool for clinical and epidemiological studies of pediatric adiposity. [ABSTRACT FROM AUTHOR]