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Introduction Body composition is one of the main variables of interest in clinical practice in cancer patients. Specific markers from bioelectrical impedance analysis, such as phase angle (PhA), have been assuming increasing relevance in this population. The aim of the present systematic review was to study and systematise the effect of exercise on PhA in cancer survivors, as compared to control conditions, namely usual care, with no exercise. The effect of exercise on PhA in the population of cancer survivors is not yet established. EVIDENCE ACQUISITIONː This systematic review was conducted on October 13, 2021, through PubMed, Web of Science, Wiley Online Library, Directory of Open Access Journals, Science Direct and JSTOR, following PRISMA guidelines and PICOS model that include: cancer survivors with ≥18 years; intervention of any exercise program for the target group; comparison between intervention group and control group that followed control conditions, namely usual care, with no exercise; outcome related to PhA; and studies of randomized control trials. Evidence synthesis We founded a total of 1244 publications, using selected keywords. Eight studies were included in this systematic review, after inclusion/exclusion criteria considered. Compared with the control conditions, exercise training programs seem associated with a positive effect on PhA, both in solid tumours and haematologic cancer types, but only when using resistance exercise alone. According to the best evidence synthesis criteria, we could not conclude the superiority of any exercise program analysed in the value of the PhA. Conclusions There were several exercise details that may have potential to be beneficial for PhA in cancer patients, including an early start of the exercise intervention (during treatment and immediately after discharge from hospital), the use of resistance exercise or/and aerobic exercise, and mainly a long follow-up period (≥ 4 months) to verify the structural effects of exercise on the PhA. However, there were no effects on the PhA value immediately after the intervention, regardless of the type of protocol and the intervention time.

Accurate predictive tools are key factors for cancer care. Phase angle (PhA) has been proposed as a marker of cellular health, particularly of cell-membrane integrity. Cutoff values have been proposed, including for cancer survivors. This study aimed to assess the usefulness of the proposed PhA cutoff, as a marker of bioelectrical impedance analysis (BIA) assessed health-status, and functional capacity in breast cancer (BC) survivors. This cross-sectional study included 25 women (50.6 ± 8.6 yrs) survivors of BC, divided into two groups according to the PhA reference value of 5.6° (group 1 [G1]: PhA ≤ 5.6° [n=13]; group 2 [G2]: PhA > 5.6° [n=12]) (Gupta et al. 2008). BIA-assessed health status parameters included: extracellular water (ECW), intracellular water (ICW), total body water (TBW), PhA, body mass, fat-free mass, muscle mass, body cell mass (BCM). Four functional tests were performed: 30 s chair-stand test, timed up and go test, ball throw test and 6-minute walking test. Results showed G2 had lower ECW/ICW ratio (p=0.001; ES=1.2), ECW/BCM ratio (p=0.001; ES=3.2) and ECW/TBW ratio (p=0.001; ES=4.8). There was no difference in functional capacity between groups. The results of the present study show that patients with higher PhA values have a higher ICW values and preservation in the ECW/ICW ratio, suggesting it's a better cell membrane quality and integrity. Relation of both PhA and cell membrane integrity with functional capacity warrants further research.

This is the peer reviewed version of the following article: Pimenta N.M., Cortez-Pinto H., Melo X., Silva-Nunes J., Sardinha L.B. & Santa-Clara H. (2017) Waist-to-height ratio is independently related to whole and central body fat, regardless of the waist circumference measurement protocol, in non-alcoholic fatty liver disease patients. J Hum Nutr Diet. 30, 185–192, which has been published in final form atdoi: 10.1111/jhn.12410. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Background: Waist-to-height ratio (WHtR) has been reported as a prefer-able risk related body fat (BF) marker, although no standardised waistcircumference measurement protocol (WCmp) has been proposed. Thepresent study aimed to investigate whether the use of a different WCmpaffects the strength of relationship between WHtR and both whole andcentral BF in non-alcoholic fatty liver disease (NAFLD) patients.Methods: BF was assessed with dual energy X-ray absorptiometry (DXA) in28 NAFLD patients [19 males, mean (SD) 51 (13) years and nine females,47 (13) years]. All subjects also underwent anthropometric evaluationincluding height and waist circumference (WC) measurement using fourdifferent WCmp (WC1, minimal waist; WC2, iliac crest; WC3, mid-distancebetween iliac crest and lowest rib; WC4, at the umbilicus) and WHtR wascalculated using each WC measurements (WHtR1, WHtR2, WHtR3 andWHtR4, respectively). Partial correlations were conducted to assess the rela-tion of WHtR and DXA assessed BF.Results: All WHtR were particularly correlated with central BF, includingabdominal BF (r = 0.80, r = 0.84, r = 0.84 and r = 0.78, respectively, forWHtR1, WHtR2, WHtR3 and WHtR4) and central abdominal BF (r = 0.72,r = 0.77, r = 0.76 and r = 0.71, respectively, for WHtR1, WHtR2, WHtR3and WHtR4), after controlling for age, sex and body mass index. There wereno differences between the correlation coefficients obtained between allstudied WHtR and each whole and central BF variable.Conclusions: Waist-to-height ratio was found a suitable BF marker in thepresent sample of NAFLD patients and the strength of the relationshipbetween WHtR and both whole and central BF was not altered by usingdifferent WCmp in the present sample of NAFLD patients. FUNDING SOURCES The first author of this paper was supported by a research grant (PhD scholarship) from the Foundation for Science and Technology (FCT), Ministry of Education and Science of Portugal (grant: SFRH/ BD/ 70515/ 2010). The present study was funded by: the Centre for the Study of Human Performance, Portuguese Foundation for Science and Technology, Lisbon, Portugal. info:eu-repo/semantics/publishedVersion

Xavier Melo is supported by a research grant from the Foundation for Science and Technology (FCT), Ministry of Education and Science of Portugal (grant: SFRH/ BD/ 70515/ 2010). Nuno M. Pimenta is cofinanced by national funds through the Programa Operacional do Alentejo 2007-2013 (ALENT-07-0262- FEDER-001883) This study compared the effects of a bout of maximal running exercise on arterial stiffness in children and adults. Right carotid blood pressure and artery stiffness indices measured by pulse wave velocity (PWV), compliance and distensibility coefficients, stiffness index α and β (echo-tracking), contralateral carotid blood pressure, and upper and lower limb and central/aortic PWV (applanation tonometry) were taken at rest and 10 min after a bout of maximal treadmill running in 34 children (7.38 ± 0.38 years) and 45 young adults (25.22 ± 0.91 years) having similar aerobic potential. Two-by-two repeated measures analysis of variance and analysis of covariance were used to detect differences with exercise between groups. Carotid pulse pressure (PP; η(2) = 0.394) increased more in adults after exercise (p < 0.05). Compliance (η(2) = 0.385) decreased in particular in adults and in those with high changes in distending pressure, similarly to stiffness index α and β. Carotid PWV increased more in adults and was related to local changes in PP but not mean arterial pressure (MAP). Stiffness in the lower limbs decreased (η(2) = 0.115) but apparently only in those with small MAP changes (η(2) = 0.111). No significant exercise or group interaction effects were found when variables were adjusted to height. An acute bout of maximal exercise can alter arterial stiffness and hemodynamics in the carotid artery and within the active muscle beds. Arterial stiffness and hemodynamic response to metabolic demands during exercise in children simply reflect their smaller body size and may not indicate a particular physiological difference compared with adults. info:eu-repo/semantics/publishedVersion

Central accumulation and distribution of body fat (BF) is an important cardiometabolic risk factor. Waist-to-hip ratio (WHR), commonly elevated in nonalcoholic fatty liver disease (NAFLD) patients, has been endorsed as a risk related marker of central BF content and distribution, but no standardized waist circumference measurement protocol (WCmp) has been proposed. We aimed to investigate whether using different WCmp affects the strength of association between WHR and BF content and distribution in NAFLD patients. BF was assessed with dual energy X-ray absorptiometry (DXA) in 28 NAFLD patients (19 males, 51 ± 13 years, and 9 females, 47 ± 13 years). Waist circumference (WC) was measured using four different WCmp (WC1: minimal waist; WC2: iliac crest; WC3: mid-distance between iliac crest and lowest rib; WC4: at the umbilicus) and WHR was calculated accordingly (WHR1, WHR2, WHR3 and WHR4, respectively). High WHR was found in up to 84.6% of subjects, depending on the WHR considered. With the exception of WHR1, all WHR correlated well with abdominal BF (r = .47 for WHR1; r = .59 for WHR2 and WHR3; r = .58 for WHR4) and BF distribution (r = .45 for WHR1; r = .56 for WHR2 and WHR3; r = .51 for WHR4), controlling for age, sex and body mass index (BMI). WHR2 and WHR3 diagnosed exactly the same prevalence of high WHR (76.9%). The present study confirms the strong relation between WHR and central BF, regardless of WCmp used, in NAFLD patients. WHR2 and WHR3 seemed preferable for use in clinical practice, interchangeably, for the diagnosis of high WHR in NAFLD patients.

Central fat accumulation is important in nonalcoholic fatty liver disease (NAFLD) etiology. It is unknown whether any commonly used waist circumference measurement protocol (WCmp), as a whole and central fat accumulation marker, is preferable for patients with NAFLD. The present study sought to find a preferable WCmp to be used in patients with NAFLD, based on 3-fold criteria.Body fat (BF) was assessed through dual-energy x-ray absorptiometry in 28 patients with NAFLD (19 men, 51 ± 13 years; 9 women, 47 ± 13 years). WC was measured with 4 types of WCmp: WC1, narrowest torso; WC2, just above iliac crest; WC3, middistance between iliac crest and last rib; WC4, at the umbilicus.All WC measurements were highly correlated with central BF depots, including trunk BF (r = 0.78, r = 0.82, r = 0.82, r = 0.84 for WC1, WC2, WC3, and WC4, respectively), abdominal BF (r = 0.78, r = 0.78, r = 0.80, r = 0.72 for WC1, WC2, WC3, and WC4, respectively), and central abdominal BF (r = 0.76, r = 0.77, r = 0.78, r = 0.68 for WC1, WC2, WC3, and WC4, respectively), controlling for age, sex, and body mass index. There were no differences between the correlation coefficients obtained between all studied waist circumference measurements and each whole and central analyzed BF variable.All studied WCmps seem suitable for use in patients with NAFLD, particularly as a central BF clinical assessment tool, though not interchangeably. Hence, biological and precision criteria alone did not sanction the superiority of any WCmp. Practical criteria may endorse WC measured at the iliac crest.

Summary Background Central fatness might be a more sensitive predictor of atherosclerotic changes in children than are total body fat measures. However, it is unclear whether a total body fat measure coupled with an estimate of a more central pattern of fat accumulation predicts increased carotid intima-media-thickness (cIMT) better than either measure alone. Objective The objective of the study is to identify the ability of a combination of simple anthropometric screening tools or a combination of objective measures of body composition to predict cIMT. Methods cIMT was assessed on the common carotid artery in 349 children aged 11–12 years old (183 girls). Body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) were dichotomized according to established criteria and indices of total body (TBFI) and abdominal (ABFMI) fat were assessed by dual-energy X-ray absorptiometry and categorized (increased risk ≥85%). Single and combined associations among anthropometric and laboratorial measures with the risk of having increased cIMT (≥85%) and discriminatory performance were tested with logistic regression analysis and Receiver Operator Curve analysis. Results Children with higher total fatness (BMI and TBFI) or higher central pattern of fat accumulation (WC, WHtR and BFMI) were in higher risk for increased cIMT [odds ratio (OR): 2.08–3.24). The risk for increased cIMT was not higher among children who coupled high total and high central fatness (OR: 2.27–3.10). Conclusions Combination of total and central measures of fat does not improve the prediction of increased cIMT in children. Simple surrogate measures of fatness can be used to predict increased cIMT urging special attention to those children who exhibit increased abdominal fat.

Background:It is unclear how sedentary behavior (SED), physical activity (PA), and cardiorespiratory fitness (CRF) influence vascular structure in children of varying body size. This study examined whether associations between SED, PA, and CRF with intima-media thickness (IMT) added to that of abdominal fatness and IMT. Differences in physiological measures among waist circumference (WC) percentiles were tested.Methods:We assessed IMT of the carotid artery in 265 children aged 11 to 13 years (135 girls). Measures included IMT assessed with high-resolution ultrasonography, WC, body fat mass (BFM) from DXA, and CRF determined using a maximal cycle test. SED and PA were assessed by accelerometry. Association between IMT and CRF adjusted for PA variables, and body composition phenotypes were tested with multiple linear regression analysis.Results:CRF was related to IMT independently of moderate to vigorous PA (MVPA) and SED (P < .05). When WC was added to the model CRF was no longer associated with IMT (P > .05). Children in the higher WC group had increased mean values of BMI, BFM, WC, and IMT and lower MVPA and CRF (P < .05).Conclusion:Full modeling of SED, MVPA, CRF, and WC revealed that regional adiposity appears to have the biggest role in arterial structure of children.

Early detection of impairment in vascular structure is an important clinical pursuit. However, it is unknown which measure of body composition best predicts vascular wall changes. We assess the differences in body composition among intima-media thickness (IMT) tertiles and determined which measures of body composition are associated with IMT in 385 children aged 11–13 years (196 girls). In this cross-sectional study, body mass index (BMI), waist circumference (WC), body fat mass (BFM), and trunk fat mass (TFM) from dual-energy radiographic absorptiometry and IMT through high-resolution ultrasonography were collected. Differences in body composition measures among IMT tertiles [low IMT (LIMT), ≤0.46 mm; middle IMT, 0.46–0.53 mm; higher IMT (HIMT), ≥0.53 mm] were assessed with ANOVA/ANCOVA after categorization. Regression analysis was used to assess the relationships between body composition and IMT. The groups were similar for sex, age, and maturity (p > 0.05). As compared with LIMT group, subjects with HIMT had higher mean values of BMI, BFM, TFM, and WC (p

The aim of this investigation was to analyze differences in body composition and body fat distribution between subjects following a structured cardiac rehabilitation program (CRP) and subjects not involved in any CRP.Body composition and body fat distribution were assessed by dual-energy X-ray absorptiometry (DXA) in 62 male subjects, white, who had been diagnosed with coronary artery disease (CAD). The sample came from two groups: a CRP group (n=31) who had been engaged in phase IV of a CRP for more than a year (age: 58 +/- 10 years), and a non-CRP group (n=31) who were not involved in any CRP (age: 59 +/- 12 years).The non-CRP group showed higher values than the CRP group in the following variables: body weight (84.924 +/- 11.250 kg vs. 79.077 +/- 10.050 kg, p0.05), BMI (29.0 +/- 3.2 kg/m2 vs. 27.3 +/- 2.6 kg/m2, p0.05), body fat (BF) (24.584 +/- 6.696 kg vs. 20.010 +/- 7.340 kg, p0.05), % BF (28.6 +/- 4.9% vs. 24.7 +/- 6.7%, p0.05), trunk BF (14.563 +/- 4.408 kg vs. 11.430 +/- 4.743 kg, p0.01), % trunk BF (32.8 +/- 6.0% vs. 27.4 +/- 8.5%, p0.01), abdominal BF (2.934 +/- 1.068 kg vs. 2.083 +/- 1.058 kg, p0.01), % abdominal BF (37.2 +/- 6.1% vs. 31.3 +/- 9.4%, p0.01), visceral BF (2.401 +/- 0.693 kg vs. 1.731 +/- 0.826 kg, p0.01), % visceral BF (35.5 +/- 5.7% vs. 29.6 +/- 9.1%, p0.01), abdominal subcutaneous BF (0.533 +/- 0.421 kg vs. 0.353 +/- 0.257 kg, p = 0.05) and abdominal BF/BF ratio (0.12 +/- 0.03 vs. 0.10 +/- 0.02, p0.05). There were no significant differences in the other variables studied, including total and regional fat-free mass.These results show that the subjects who did not participate in any CRP had a more adverse profile of body composition and body fat distribution. The higher values found for specific fat depots, as well as for the total abdominal BF/BF ratio, confirm the more adverse body fat distribution in non-CRP subjects. These data are in agreement with results from intervention studies in CAD patients.

O objectivo desta investigação foi analisar a composição corporal e a distribuição de gordura corporal de sujeitos com doença das artérias coronárias (DAC) envolvidos num programa estruturado de reabilitação cardíaca (PRC) e sujeitos com DAC que não participam em qualquer PRC. População e métodos: A amostra foi constituída por 62 sujeitos do sexo masculino, caucasianos, com DAC diagnosticada, oriundos de cada um de dois grupos estudados: grupo C/PRC (n=31) foi constituído por sujeitos que participavam na fase IV de um PRC há mais de um ano (idade: 58 + 10 anos); grupo S/PRC (n=31) foi constituído por sujeitos que não participavam em qualquer PRC (idade: 59 + 12 anos). Foi observada a composição corporal e distribuição de gordura corporal dos sujeitos da amostra, através da análise por Densitometria por Raio-X de Dupla Energia (DXA). Foram recolhidas medidas antropometricas. Resultados principais: sujeitos que não participaram em qualquer PRC apresentaram valores superiores, aos sujeitos do grupo C/PRC, nas variáveis massa corporal total (p 30 kg/m2) no grupo S/PRC (p

O objectivo desta investigação foi analisar a composição corporal e a distribuição de gordura corporal de sujeitos com doença das artérias coronárias (DAC) envolvidos num programa estruturado de reabilitação cardíaca (PRC) e sujeitos com DAC que não participam em qualquer PRC. População e métodos: A amostra foi constituída por 62 sujeitos do sexo masculino, caucasianos, com DAC diagnosticada, oriundos de cada um de dois grupos estudados: grupo C/PRC (n=31) foi constituído por sujeitos que participavam na fase IV de um PRC há mais de um ano (idade: 58 + 10 anos); grupo S/PRC (n=31) foi constituído por sujeitos que não participavam em qualquer PRC (idade: 59 + 12 anos). Foi observada a composição corporal e distribuição de gordura corporal dos sujeitos da amostra, através da análise por Densitometria por Raio-X de Dupla Energia (DXA). Foram recolhidas medidas antropométricas. The aim of this investigation was to analyze differences in body composition and body fat distribution between subjects following a structured cardiac rehabilitation program (CRP) and subjects not involved in any CRP. Methods: Body composition and body fat distribution were assessed by dual-energy X-ray absorptiometry (DXA) in 62 male subjects, white, who had been diagnosed with coronary artery disease (CAD). The sample came from two groups: a CRP group (n=31) who had been engaged in phase IV of a CRP for more than a year (age: 58±10 years), and a nonCRP group (n=31) who were not involved in any CRP (age: 59±12 years. info:eu-repo/semantics/publishedVersion