Efficacy of vitamin D alone or in combination with weight-reduction programs in weight loss among adults with above-normal BMI: a systematic review and meta-analysis

Introduction The impact of Vitamin D supplementation on weight loss has been demonstrated in several randomized controlled trials (RCT), but there is still lack of consensus regarding its efficacy. This study aims to assess the efficacy and safety of Vitamin D in weight reduction in terms of changes in weight loss, BMI, neck circumference, mid-upper arm circumference, waist circumference, waist-thigh ratio, waist-to-hip ratio, and percent body fat, as well as reported adverse effects. Methodology MEDLINE (PubMed), Google Scholar, WHO database, Herdin, Cochrane Database and EMBASE were searched for literature published from 2005–2020. A systematic search was conducted for RCTs on the efficacy of Vitamin D (alone or in combination with Calcium, or with a weight-loss program, or with both) in weight loss among participants 18–75 years old with above-normal BMI, and with a study duration of 4–12 weeks. Sixteen RCTs were included in this systematic review and meta-analysis. Screening and selection were based on the eligibility criteria, while appraisal included checking for the risk of bias, assessing the validity of the results of the study, and its methodological quality. Outcomes of eligible studies were obtained directly from the studies, if available, or summarized and calculated from the available data. For continuous data, mean differences were compared. Results When compared with placebo, Vitamin D supplementation showed a significant reduction in weight loss (mean difference [MD] = −0.92; 95% confidence interval [95% CI], −1.52 to −0.31; P=0.003), BMI (MD = −0.52; 95% CI: −0.73 to −0.31; P=0.02), waist circumference (MD = −1.35; 95% CI: −2.21 to −0.33 P=0.0006) and percent body fat (MD = −0.82; 95% CI; −1.40 to −0.25; P=0.005) but no significant effect on reduction of waist-to-hip ratio (MD = −0.01, 95% CI; −0.01 to 0.00; P=0.17). None of the studies reported outcomes for neck circumference, mid-upper arm circumference, and waist-thigh ratio. Heterogeneity was addressed using random effects model in analysis. Out of the 16 studies included, only two reported adverse events, which include constipation after intake of Vitamin D and calcium supplements and other multiple non-serious adverse events. Conclusion and recommendations Vitamin D as an adjunct showed a significant effect on weight loss, BMI reduction, decrease in waist circumference and percent body fat among adults after a short-term intake of oral Vitamin D, thus Vitamin D supplementation may be recommended as an adjunct treatment for weight loss among adults, but the study results should be used with caution as significant heterogeneity was observed. Further conduction of local RCTs and meta-analysis is recommended for further elucidation of data in order to determine its efficacy among Filipinos. FUNDunding Acknowledgement Type of funding sources: None. Effect of Vit D on waist circumference

Association of Adherence to a Mediterranean Diet with Excess Body Mass, Muscle Strength and Physical Performance in Overweight or Obese Adults with or without Type 2 Diabetes: Two Cross-Sectional Studies

Overweight and obesity in older adults is associated with disability and is exacerbated by the presence of type 2 diabetes (T2DM). There is emerging evidence that adherence to a Mediterranean diet (MedDiet) reduces adiposity and attenuates physical disability. These cross-sectional studies explored the associations of adherence to a MedDiet with body mass index (BMI), adiposity, muscle strength, and physical performance in older adults without diabetes and in middle-aged or older adults with T2DM. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener. Fat mass and percent body fat were assessed by dual energy X-ray absorptiometry. Muscle strength was assessed using hand-grip strength, while physical performance was assessed using the Short Physical Performance Battery and gait speed. A total of n = 87 participants with T2DM (T2DM sample: 71.2 ± 8.2 years, BMI: 29.5 ± 5.9) and n = 65 participants without diabetes (non-T2DM sample: 68.7 ± 5.6 years, BMI: 33.7 ± 4.9) were included in these analyses. In the T2DM sample, when controlled for age, gender, and appendicular lean mass index, adherence to a MedDiet was inversely associated with BMI, fat mass, and percent body fat. However, this was no longer maintained in the fully adjusted models. Although, adherence to a MedDiet was positively associated with gait speed (β = 0.155; p = 0.050) independent of all covariates used. Adherence to a MedDiet may be a suitable dietary strategy for preserving lower body physical function in middle-aged and older adults with T2DM. However, these findings should be further investigated using well-designed randomised controlled trials and prospective cohort studies with a wider range of adherence scores to investigate temporal associations.

Speed of Movement, Fatness, and the Change in Cardiometabolic Risk Factors in Children

We aimed to examine speed of movement and its interactive association with fatness to changes in cardiometabolic risk factors over one year in children. The analysis included 8345 children aged 6–13 years. Cardiometabolic risk score was computed by summing Z-scores of waist circumference, the average of systolic and diastolic blood pressure, fasting glucose, high-density lipoprotein cholesterol (multiplied by −1), and triglycerides. Both high baseline and improvement in speed of movement were associated with favourable changes in percent body fat, lipids, and cardiometabolic risk score. Percentages of the association between baseline speed of movement and changes in cardiometabolic risk score, triglycerides, and high-density lipoprotein cholesterol explained by baseline BMI were 24.6% (19.6–29.1%), 26.2% (19.7–31.1%), and 12.5% (9.6–15.4%), respectively. The corresponding number for percent body fat was 47.0% (40.4–54.1%), 43.3% (36.7–51.7%), and 29.8% (25.0–34.6%), respectively. Speed of movement mediated the association between fatness and cardiometabolic risk factors. Improved speed of movement was associated with a lower increase in blood pressure in obese children only. Speed of movement is a strong predictor of changes in cardiometabolic risk factors. Fatness and speed of movement are interactively associated with cardiometabolic risk factors. Speed of movement may attenuate the positive association between fatness and blood pressure.

Association among Neck Circumference and Percent Body Fat with Fasting Blood Glucose in Obese Female College Students

Background: Neck circumference could describe upper-body subcutaneous fat, correlated with obesity and diabetes mellitus.Objective: The purpose of this study was to determine the correlation between percent body fat and neck circumference with fasting blood glucose in obese female college students.Methods: The study was cross-sectional, conducted at Diponegoro University in June-August 2019. 119 participants were female, aged 17-21 years selected using the purposive sampling method. Measurement of waist circumference was used as an indicator of obesity. Percent body fat was measured using Bioelectrical Impedance Analysis (BIA), and neck circumference was measured using a met line. Fasting blood glucose was examined after the subject fasted for 8-12 hours, the amount of blood taken was 5 cc. Data were analyzed with the Rank-Spearman correlation test.Results: As many as 84% of subjects had excess percent body fat. The median neck circumference was 32.5 cm. The median fasting blood glucose was 87 mg / dL. There was a significant correlation between percent body fat with fasting blood glucose (r = 0.231) (p = 0.012). There was no correlation between neck circumference with fasting blood glucose (r = 0.137) (p = 0.137).Conclusion: Percent of body fat had a significant relationship with fasting blood glucose, and the greater the circumference of the neck, the greater fasting blood glucoseKeywords: Obesity, Neck Circumference, Percent Body Fat, Fasting Blood Glucose

Hubungan Indeks Masa Tubuh (IMT) dengan Persen Lemak Tubuh, dan Lemak Viscelar di Kota Semarang

Indonesia is predicted to experience a demographic bonus period, namely the number of productive age population (aged 15-64 years) of 64%. The prevalence of obesity at productive age from 2007 to 2018 has increased from 8.6% to 13.6%. Obesity will result in high percent body fat andvisellar fat, and will result in various non-communicable diseases such as type 2 diabetes, cardiovascular disease, stroke, cancer and other non-metabolic complications such as arthritis. The onset of this disease in obese people is preceded by a group of symptoms such as hypertension, insulinresistance, dyslipidemia. Objectives: To determine the relationship between Body Mass Index and Percent body fat and to determine the relationship between Body Mass Index and Viscelar Fat. Methods: This study used a cross sectional design with purposive sampling method, namely thosevisiting the Aisyiyah Regional Leadership Stand in Semarang City at the Expo of Community Organizations in Semarang City. The sample is 115 people. Results: This study found that 35 (30.4%) men and 80 (69.6%) women, Average Age: (45.14 ± 14.55) years, Body Mass Index (25.39 ± 3.96), mean percent body fat (32.63 ± 6.68) mean viscelar fat (7.93 ± 5.13). There is a relationship between BMI and percent body fat (p = 0.000) and there is a relationship between BMI and Viscelar fat (p = 0.000).Keywords: Body Mass Index, percent body fat, Viscelar fat

Visceral fat area is the measure of obesity best associated with mobility disability in community dwelling oldest-old Chinese adults

Background Although obesity can be clinically defined by body mass index (BMI), waist circumference, percent body fat, or visceral fat area, it is unclear which specific measure is best associated with mobility disability in oldest-old adults. Methods Among 589 Chinese participants aged 85 years and older in a population-based cohort in Singapore, we measured waist circumference, computed BMI, estimated appendicular skeletal muscle mass, percent body fat, and visceral fat area using bioelectrical impedance analysis, and evaluated mobility disability using the Loco-Check questionnaire. We computed areas under the receiver operating characteristic curves (AUCROC) to compare how well these measures discriminated between those with and without mobility disability. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between obesity defined by these measures and mobility disability. Results Compared to BMI, which had an AUCROC (95% CI) of 0.68 (0.64–0.72) for the discrimination of mobility disability, only visceral fat area had a significantly higher discriminative performance [AUCROC (95% CI) of 0.71 (0.67–0.75) (Padjusted = 0.002)]. The optimal cut-offs of visceral fat area for the discrimination of mobility disability were ≥ 104 cm2 in men and ≥ 137 cm2 in women. In fully adjusted models, only obesity defined by visceral fat area was significantly associated with mobility disability [OR (95% CI) of 2.04 (1.10–3.77)]; obesity defined by the other measures were not associated with mobility disability after adjusting for visceral fat. Conclusion In oldest-old adults, visceral fat area was the best discriminator for obesity associated with mobility disability.