Harmful effects of malnutrition and possible sustainable solution

Malnutrition is a condition that results from eating a diet that does not supply a healthy amount of one or more nutrients. It is a condition characterized by lack of one or more essential nutrients from the diet or a surplus of some nutrients which affect the body negatively. Malnutrition consists of two types: undernutrition and overnutrition. Undernutrition involves the deficiency of macronutrients like protein or calories and micronutrients like iron, iodine and many more. Protein energy malnutrition is caused by the inadequate intake of protein and calories. It is further classified in three types, kwashiorkor, marasmus and marasmic kwashiorkor. Malnutrition mainly affects an individual’s immune system, lean body mass, cardio-respiratory functions, muscle functions. Malnutrition can be caused due to many factors including unavailability of food, poverty, higher food prices and many more. Strategies like biofortification and supplementation are used for the treatment of malnutrition.

Lean body mass and total body weight versus body surface area as determinant of docetaxel pharmacokinetics and toxicity

Aim: In our study we examined whether anthropometric and body composition parameters, i.e. body surface area (BSA), lean body mass (LBM) and total body weight (TBW), are correlated with docetaxel clearance and exposure. In addition, LBM, TBW and a fixed dose were compared to BSA as dosing parameters for dose individualisation of docetaxel. Methods: Thirty-six patients affected by breast or castration-resistant prostate carcinoma receiving docetaxel chemotherapy entered the study. LBM was measured by a Dual Energy Xray Absorptiometry (DEXA) scanner before treatment. Blood samples were collected up to 180 minutes after dosing to analyse docetaxel concentrations and to determine individual pharmacokinetic (PK) parameters. Results: No significant correlations were found between the docetaxel pharmacokinetic parameters clearance and volume of distribution and the anthropometric and body composition variables BSA, LBM and TBW. AUC was significantly but poorly correlated with BSA (r=0.452 [p=0.016]) and with TBW (r=0.476 (p=0.011]). The Mean Absolute Percentage Error and Mean Error of simulated dosing based on LBM and fixed dosing ME were not significant different compared to BSA. For TBW, only the MAPE of dosing was significant higher compared to BSA (24.1 vs. 17.1, P=0.001). Conclusion: There is no correlations between docetaxel pharmacokinetics and the anthropometric and body composition variables BSA, LBM and TBW. Dose individualisation of docetaxel based on LBM or TBW or fixed dosing cannot be recommended over BSA based dosing.

Arterial health during early childhood following abnormal fetal growth

Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed. Conclusions Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood.

Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

Background: Data on postoperative follow-ups and bariatric surgery (BS) outcomes performed in the United Arab Emirates (UAE) are crucial for registry. This study assessed the one-year postoperative changes in body composition and metabolic profiles in BS patients. Methods: The medical and dietetics records of 51 adult patients who underwent BS in the largest public hospital in Sharjah, UAE were reviewed. Data on body weight and composition, as well as metabolic profile (blood glucose and lipid levels) from the initial until the last hospital visit were recorded. Results: The median (interquartile range) follow-up period was 6.0 (8.0) months. The patients had significant total weight loss [19.3 (12.6)%] and reduction in body mass index (BMI) [18.0 (13.6)%] of approximately 7 BMI points. Moreover, the patients’ body composition improved significantly; loss was the highest in fat mass [–30.9 (22.1)%] and the least in lean body mass [–8.6 (8.4)%]. There was a steady decline in all body composition variables with a longer duration of follow-up visits from 1–3 months to 10–12 months. The fat mass (–40.3%):lean body mass (–10.7%) loss ratio was 3.8:1 at 10–12 months. The patients’ metabolic status was normal during the last postoperative visit. Conclusions: Incremental improvements in body composition of patients were evident with longer follow-up visits up to one year after BS. Hence, patients should attend regular follow-up visits after BS. Moreover, accurate and complete documentations of medical and dietetics visits are mandated.

Relative Lean Body Mass and Waist Circumference for the Identification of Metabolic Syndrome in the Korean General Population

Lean body mass (LBM) comprises organs and muscle, which are the primary determinants of energy expenditure and regulation of glucose and lipid metabolism. Excessive abdominal fat is associated with metabolic abnormality. Little is known about the relationship between metabolic abnormality and LBM and waist circumference (WC), especially in the Asian general population. The aim of this study was to clarify this relationship. We performed a cross-sectional study with 499,648 subjects who received health check-ups at 16 health promotion centers in 13 Korean cities between January 2018 and October 2019. The subjects were categorized into four groups: (a) High (H)-RLBM (relative lean body mass)/Normal (N)-WC, (b) High-RLBM/Abnormal (A)-WC, (c) Low (L)-RLBM/Normal-WC, and (d) Low-RLBM/Abnormal-WC. RLBM was calculated using fat mass data that were estimated via bioelectrical impedance analysis. L-RLBM/A-WC was significantly associated with metabolically unhealthy status (OR: 4.40, 95% CI: 4.326–4.475) compared to H-RLBM/N-WC. L-RLBM/N-WC (OR: 2.170, 95% CI: 2.122–2.218) and H-RLBM/A-WC (OR: 2.713, 95% CI: 2.659–2.769) were also significantly related to metabolic unhealthy status. The cut-offs of RLBM for predicting metabolic syndrome (MetS) were 74.9 in males and 66.4 in females (p < 0.001). L-RLBM and A-WC are associated with metabolic abnormality in the Korean general population. RLBM is an anthropometric index that can be used to predict MetS in primary health care.

O-B05 Does rapid or gradual weight loss following bariatric surgery affect lean body mass depreciation?

Background Controversy exists regarding the influence of the rate of weight loss on long-term body composition. The objective of this study was to compare body composition changes in patients with successful and unsuccessful weight loss 12 months after bariatric surgery. Methods A prospective analysis was completed on patients undergoing bariatric surgery at St Vincent’s Hospital Melbourne between 2017 and 2021. Body composition was measured with dual-energy X-ray absorptiometry immediately before surgery, and at 12 months post-operatively. Fat mass (FM), lean body mass (LBM) and skeletal muscle index (SMI) trajectories were analysed between patients, with either successful weight loss (SWL) or unsuccessful weight loss (USWL) stratified based on an excess weight loss (EWL) threshold of ≥ 50%. Results Thirty-seven patients were included in this series (SWL n = 25, USWL n = 12). Compared to those with USWL, SWL demonstrated a greater mean loss in BMI (12.3 vs 7.3 kg/m2; p &lt; 0.001) and weight (34.4 vs 20.3 kg; p &lt; 0.001). SWL demonstrated a significantly greater reduction in tissue fat% than USWL, with patients losing 7.3% more tissue fat on average. SWL was associated with an improved mean SMI% when compared with USWL (5.5 vs. 2.42%; p &lt; 0.0009). However, the difference in FM:LBM loss ratio between the two groups did not demonstrate statistical significance (7.07 vs 4.62, p = 0.2519). Conclusions This data suggests that SWL is associated with a more optimal body composition outcome than USWL, which is at least partly due to a relative skeletal muscle-sparing effect in this group. Further research is warranted in understanding the implications of these changes on resting energy expenditure and the risk of weight regain.

Biathlon Performance: Heart Rate, Hit Rate, Speed and Physiological Variables

Aim: Biathlon is a sport that combines cross-country skiing and rifle shooting. The athlete is fast in the cross-country skiing section, in the gun shooting section, the heart rate should be low. This study aims to determine the hitting rate of the shots made with different training loads on low altitude in elite biathletes in terms of maximum speed and physiological variables. Methods: To evaluate shooting performances first with the resting pulse and then after 2.5 km skiing respectively with 50%, 70% and 100% pulse rate which is separately calculated for each athlete according to karvonen formula. Results: Our findings show that while there was negative relation between maximum speed and body fat there was a positive relation with lean body mass. It has been determined that low body fat percentage and high lean body mass are effective at the athletes’ maximum speed and the pulse level with the highest target shooting accuracy rate was at rest and 70% in the second level. Conclusion: Since the pulse of the athlete who comes to the shooting area cannot be reduced to a resting level in a short time, focusing the 70% pulse zone may be beneficial in terms of shooting accuracy and acceleration after the shot. The lowest results in target shooting accuracy were seen at 50% and 100% loads. Keywords: Athletes, performance, heart, rate, lean body mass.

Association of Predicted Lean Body Mass and Fat Mass With Incident Diabetic Nephropathy in Participants With Type 2 Diabetes Mellitus: A Post Hoc Analysis of ACCORD Trial

BackgroundLean body mass (LBM) and fat mass (FM) have been shown to have different associations with several chronic diseases but little is known about the sex-specific association of LBM and FM with diabetic nephropathy (DN) risk among participants with diabetes.MethodsParticipants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used in a post hoc analysis to examine the association of predicted LBM index (LBMI) and FM index (FMI) with incident DN risk (defined as a composite outcome of three types of predefined DN). Because of sex differences in body composition, analyses were conducted separately using sex-specific quartiles of predicted LBMI and FMI.ResultsOf the 9,022 participants with type 2 diabetes (5,575 men and 3,447 women) included in this study, 5,374 individuals developed DN (3,396 in men and 1,978 in women). Higher quartiles of LBMI were associated with a reduced risk of DN while higher quartiles of FMI were associated with an increased higher risk of DN among men but not women. Compared with the lowest quartile, the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs)for the highest quartile of predicted LBMI and FMI were respectively 0.83 (95% CI 1.71 – 0.96) and 1.23 (95% CI 1.06-1.43) among men; and 0.92 (95% CI 0.63 – 1.33) and 1.14 (95% CI 0.79 – 1.63) among women.ConclusionsAmong participants with diabetes, predicted LBMI was inversely associated with risk of DN while predicted FMI was positively associated with an increased risk of incident DN among men but not women. Trial registration: ClinicalTrials.gov., no. NCT00000620.

Plasma levels of bile acids are related to cardiometabolic risk factors in young adults

Context Bile acids (BA) are known for their role in intestinal lipid absorption, and can also play a role as signaling molecules to control energy metabolism. Prior evidence suggests that alterations in circulating BA levels and in the pool of circulating BA are linked to an increased risk of obesity and a higher incidence of T2D in middle-aged adults. Objective To investigate the association between plasma levels of BA with cardiometabolic risk factors in a cohort of well-phenotyped relatively healthy young adults. Methods Body composition, brown adipose tissue, serum classical cardiometabolic risk factors, and a set of 8 plasma BA (including glyco-conjugated forms) in 136 young adults (age 22.1±2.2 years, 67% women) were measured. Results Plasma levels of CDCA and GUDCA were higher in men than in women, although these differences disappeared after adjusting for body fat percentage. Furthermore, CA, CDCA, DCA, and GDCA levels were positively, yet weakly associated, with lean body mass levels, while GDCA and GLCA levels were negatively associated with 18F-fluorodeoxyglucose uptake by brown adipose tissue. Interestingly, GCA, GCDCA, and GUDCA were positively associated with glucose and insulin serum levels, HOMA index, LDL-C, TNFa, IL-2 and IL-8 levels, but negatively associated with HDL-C, ApoA1, and adiponectin levels, yet these significant correlations partially disappeared after the inclusion of lean body mass as a confounder. Conclusion Our findings indicate that plasma levels of BA might be sex-dependent and that are associated with cardiometabolic and inflammatory risk factors in young and relatively healthy adults.