Study on the Anthropometric and Body Composition Indices for Prediction of Cold and Heat Patter

Objectives: Many symptoms of cold and heat patterns are related to the thermoregulation of the body. Thus, we aimed to study the association of cold and heat patterns with anthropometry/body composition.Methods: The cold and heat patterns of 2000 individuals aged 30–55 years were evaluated using a self-administered questionnaire.Results: Among the anthropometric and body composition variables, body mass index (-0.37, 0.39) and fat mass index (-0.35, 0.38) had the highest correlation coefficients with the cold and heat pattern scores after adjustment for age and sex in the cold-heat group, while the correlation coefficients were relatively lower in the non-cold-heat group. In the cold-heat group, the most parsimonious model for the cold pattern with the variables selected by the best subset method and Lasso included sex, body mass index, waist-hip ratio, and extracellular water/total body water (adjusted R2 = 0.324), and the model for heat pattern additionally included age (adjusted R2 = 0.292).Conclusions: The variables related to obesity and water balance were the most useful for predicting cold and heat patterns. Further studies are required to improve the performance of prediction models.

Influence of Ketogenic Diet and Nutraceutical Correction in the Complex Treatment of Lower Limbs Lipedema

Currently, the ketogenic diet (KD) is used to treat obesity. A prospective study on the use of KD and nutraceutical correction of the nutritional status of patients with lipedema was carried out. Aim. To study the effect of the ketogenic diet, accompanied by correction of changes in the intestinal microbiome and hepatoprotection,on the reduction of fatty deposits in lipedema and the dynamics of changes in lipid and carbohydrate metabolism hormones. Material and methods. 60 patients with lower limb lipedema of stages I-III were randomized into 2 groups: Group 1 received a lowcalorie diet (LCD), physical exercises in the gym (PE), and physical activity (FA) in the form of daily walking up to 3-5 km/ day. Group 2 received a modified version of the Atkins ketogenic diet, physical exercises in the gym and FA, as well as nutraceutical correction of increased appetite, probiotic intestinal composition, hepatoprotection. The duration of the treatment course was 4 weeks. Anthropometric methods and bioimpedansometry were used to control limb circumferences, waist and thigh. Results and discussion. After treatment, patients in 1st group showed a decrease in body weight, lean and active cell mass, a decrease in musculoskeletal mass, and a decrease in total water due to extracellular water. A decrease in total cholesterol and high density lipoproteins (HDL) fraction, an increase in blood triglyceride fraction was noted. Leptin decreased by 12.73%. Patients of the 2nd group showed a decrease in body weight, fat mass, lean mass, total water and extracellular water. There was a decrease in total cholesterol, triglycerides, transaminases. Leptin decreased by 32.02%, insulin decreased by 9.87%. To prevent the development of fatty hepatosis against the background of the use of KD, patients of the 2nd group received nutraceutical correction: hepatoprotector Gepamin, metaprebiotic Stimbifid-plus, modulating the formation of resident intestinal microbiota. To reduce appetite, the patients of the 2nd group were also prescribed anorexic - an algal product Nativ containing the polysaccharide fucoidan, having a prebiotic effect. Improvement of reparative processes in the liver, suppression of oxidative processes also contributed to the restoration of the sensitivity of insulin receptors, which was confirmed by the normalization of the lipid-carbohydrate spectrum of blood in patients of the 2nd group after the course of the treatment. The insulin decrease in patients of Group 2 indicated not only insulin resistance decrease , but also the lipogenesis decrease and stimulation of lipolysis. Adipose tissue reduction due to lipolysis stimulation was also indicated by a decrease in leptin expression. Conclusion. Thus, a ketogenic diet, accompanied by nutraceutical correction of the intestinal microbiome and hepatoprotection can be effectively used in combination with physical activity in order to reduce body weight, fat mass and edema, as evidenced by a decrease in the expression level of leptin and insulin, correlating with the levels of fat loss and free water.

Effects of Electrolyte Supplements on Body Water Homeostasis and Exercise Performance during Exhaustive Exercise

This study aimed to compare the physiologic effects of regular water consumption to those of electrolyte drink consumption in exercise capacity and recovery after exhaustive exercise. The participants were 10 healthy young men who exercised on a treadmill before and after receiving regular water and an electrolyte drink (3RINK) four weeks later. A 250-mL fluid volume was ingested 30 min before exercise and immediately after. Body composition, water metabolizing hormones, and body electrolytes were analyzed at rest (R), immediately after exercise (P0), and 1 h after exercise (P1). Moreover, serum lactic acid levels were measured to determine recovery. Total body water, intracellular, and extracellular water levels were higher after consuming 3RINK at P0 than at R. There was no interaction effect between the types of fluids and antidiuretic hormone, aldosterone, and renin levels. Hematocrit levels showed an interaction effect between the type of fluid and period. Sodium levels were significantly different between the different types of fluids at P0 and P1. Finally, an interaction effect was noted between each type of fluid and serum lactate levels. Thus, 3RINK intake before and after exhaustive exercise increased body capacity to retain water, improved exercise ability, and reduced exercise-related fatigue.

Body Composition Results of Caucasian Young Normal Body Mass Women in the Follicular Proliferative Phase, Measured for the Different Positions of Limbs

The bioelectrical impedance analysis (BIA) became a standardized technique for assessing body composition, but many factors affect the reproducibility of measurement, including body and limbs position. In spite of the fact that it is recommended for patient to be in a supine position, with arms abducted at least 30° and legs abducted at approximately 45°, a lot of authors conduct their measurements with arms and legs of patients separated to not touch the body but not strictly following the recommendations. Taking this into account, the aim of the study was to analyze the body composition results of Caucasian young normal body mass women in the follicular proliferative phase, measured for the different positions of limbs in order to compare the results obtained in the recommended position (with arms abducted at least 30° and legs abducted at approximately 45°) and in the commonly used position (not following strictly the recommendations). The study was conducted in a homogenous group of 100 adult females under the age of 30 years using BIA 101/ASE with the Bodygram Pro software and its equations by Akern Srl, Firenze, Italy, based on the measurement recommendations. The measurements were conducted (1) in a recommended position of arms abducted at least 30° and legs abducted at approximately 45° and (2) with arms spread and legs separated to not touch the body to compare the body composition assessment (fat mass, fat-free mass, body cell mass, muscle mass, water content, extracellular water content, and intracellular water content). It was stated that the results obtained for various positions of limbs were positively correlated (p < 0.0001; R > 0.5). At the same time, the statistically significant differences dependent on the position were observed for the calculated results of body cell mass (lower results for the recommended position for the results observed in kg and % of body mass; p = 0.0165 and p = 0.0075, respectively) and muscle mass (lower results for the recommended position for the results observed in kg and % of body mass; p = 0.0025 and p = 0.0011, respectively), as well as extracellular and intracellular water (higher % of total body water for the extracellular water and lower for intracellular water; p = 0.0049 and p = 0.0115, respectively), resulting from the measured resistance and reactance values. For all listed comparisons of significantly differing variables, weighted κ statistics indicated moderate agreement (values of 0.41–0.60), and the Bland–Altman plot analysis indicated no agreement (Bland–Altman index of >5%). While compared with the reference values, the major differences were observed for extracellular/intracellular water content, as, while applying a method with arms and legs separated to not touch the body (not recommended position), the extracellular water content was underestimated for 31% and intracellular water content was overestimated for 28% of participants. It may be concluded that the recommended body position of arms abducted at least 30° and legs abducted at approximately 45° should be chosen to ensure the reliability of the BIA measurements, as, while the recommendations of a body position are not followed, the results obtained may be misleading and may not reflect the actual body composition.

Effect of bioimpedance-defined overhydration parameters on mortality and cardiovascular events in patients undergoing dialysis: a systematic review and meta-analysis

Objective To evaluate the role of bioimpedance-defined overhydration (BI-OH) parameters in predicting the risk of mortality and cardiovascular (CV) events in patients undergoing dialysis. Methods We searched multiple electronic databases for studies investigating BI-OH indicators in the prediction of mortality and CV events through 23 May 2020. We assessed the effect of BI-OH indexes using unadjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Sensitivity analysis was used for each outcome. Results We included 55 studies with 104,758 patients in the meta-analysis. Extracellular water/total body water (ECW/TBW) >0.4 (HR 5.912, 95% CI: 2.016–17.342), ECW/intracellular water (ICW) for every 0.01 increase (HR 1.041, 95% CI: 1.031–1.051), and OH/ECW >15% (HR 2.722, 95% CI: 2.005–3.439) increased the risk of mortality in patients receiving dialysis. ECW/TBW >0.4 (HR 2.679, 95% CI: 1.345–5.339) and ECW/ICW per increment of 10% (HR 1.032, 95% CI: 1.017–1.047) were associated with an increased risk of CV events in patients undergoing dialysis. A 1-degree increase in phase angle was a protective factor for both mortality (HR 0.676, 95% CI: 0.474–0.879) and CV events (HR 0.736, 95% CI: 0.589–0.920). Conclusions BI-OH parameters might be independent predictors for mortality and CV events in patients undergoing dialysis.