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Background and aims: We aimed to clarify the relationship between alanine aminotransferase (ALT) level and body composition in Japanese medical health checkups, especially in cases with ALT ≤ 30 IU/L (7569 men and 9497 women). Methods: We categorized our study cohort into four groups: type A (ALT value ≤ 10 IU/L), type B (11 ≤ ALT value ≤ 20 IU/L), type C (21 ≤ ALT value ≤ 30 IU/L) and type D (ALT value > 30 IU/L (ALT over 30)). We retrospectively compared body composition-related parameters (body mass index (BMI), waist circumference (WC), fat (F) index, fatty liver index (FLI), fat-free (FF) index and F-FF ratio) among the four types. Results: Type A/B/C/D in men and women was found in 262/3279/2107/1921 and 1549/5736/1495/717 (p < 0.0001). BMI, WC, F-index, FLI, FF index and F-FF ratio were all significantly stratified among the four types, regardless of whether they were male or female and over or under 50 years old. Conclusions: With a decrease in ALT level in medical health checkups, fat mass decreases, and F-FF ratio decreases, but a decrease in skeletal muscle mass cannot be overlooked.

To elucidate the relationship between metabolic syndrome (Mets) and somatic composition [fat mass, fat-free (FF) mass, and fat to fat-free (F-FF) ratio] among health checkup recipients (7,776 males and 10,121 females). We classified study subjects into four types considering Japanese criteria for Mets; Type A is for males with waist circumference (WC) <85 cm and females with WC <90 cm, Type B is for males with WC ≥85 cm and females with WC ≥90 cm, but without any metabolic abnormalities, Type C is for males with WC ≥85 cm and females with WC ≥90 cm and one metabolic disorder (pre-Mets), and Type D is Mets. We compared baseline characteristics among types of A, B, C, and D. F index, FF index, and F-FF ratio showed an increasing trend with increasing risk factors for Mets in both sexes. This study demonstrates a clear correlation between somatic composition and the severity of metabolic syndrome (Mets). As Mets risk factors increase, fat mass, fat-free mass, and the fat-to-fat-free ratio also rise, indicating that body composition shifts with disease progression. These findings emphasize the need for early intervention, such as exercise and diet, to manage somatic composition imbalances and reduce complications like insulin resistance.

Background Childhood overweight and obesity are increasing in low- and middle-income countries, including Tanzania, due to changing lifestyles and diets. This study evaluated the effect of a school-based physical activity (PA) programme and multi-micronutrient supplementation (MMNS) on body composition among primary schoolchildren in the Kilombero district, Tanzania. Methods In a cluster-randomized design, children aged 6–12 years were assigned to one of four groups: PA, MMNS, both interventions combined (PA + MMNS), or control. Body composition was assessed at baseline and after 14 months (T2) and 26 months (T3). Results Among 745 children (396 girls, 349 boys) from 16 clusters assessed at T3, no statistically significant differences in overall body composition (primary outcome) were observed across intervention groups compared to control. However, sex-stratified analyses revealed important differential responses: girls in the PA arm showed significant decreases in both fat mass (FM) and fat-free mass (FFM), while girls in the PA + MMNS arm exhibited significant decreases in FFM and truncal fat-free mass (TrFFM). In contrast, boys in the MMNS arm demonstrated significant increases in FFM and TrFFM, while boys in the PA + MMNS arm showed significant increases in FFM and TrFFM alongside a significant decrease in truncal fat mass (TrFM). Conclusion The interventions showed gender-specific effects on body composition. Further research is warranted to understand why boys and girls respond differently to similar interventions. Trial registration The study was registered on 9 August 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081 .

Background: Handgrip strength (HGS) is an important parameter to assess the upper extremity muscular strength. Aims and Objectives: Aim of the study is to record HGS in healthy young males and to compare with fat mass (FM), fat-free mass, fat-free mass index, and to find out which is better correlated. Materials and Methods: A total of one hundred and fourteen first year male medical students of age between 17 and 22 years were taken as sample. Results: The correlation between fat free mass, fat free mass index with HGS was found to be extremely significant whereas correlation between FAT%, FM with HGS was not significant. Conclusion: Increase in lean body mass increases muscular strength as fat-free mass and fat-free mass index positively and significantly correlated with HGS.

Background Previous studies suggested that obesity and fat mass are associated with QT interval prolongation, but the role of different body parts' fat mass is unclear. The associations between total and regional fat mass (FM) and corrected QT interval (QTc) were investigated for the first time in this study. Methods In this sub-analysis of Fasa PERSIAN cohort Study data, 3217 subjects aged 35–70 entered our study. Body fat mass was assessed by bioelectrical impedance analysis and QTc interval calculated by the QT interval measured by Cardiax ® software from ECGs and Bazett’s formula. Uni- and multi-variable linear and logistic regression was performed in IBM SPSS Statistics v23. Results In males, the fat mass to fat-free mass (FM/FFM) ratio in the trunk, arms, total body, and legs were significantly higher in the prolonged QTc group (QTc > 450 ms). Trunk (B = 0.148), total (B = 0.137), arms (B = 0.124), legs (B = 0.107) fat mass index (FMI) showed significant positive relationship with continuous QTc (P-value < 0.001). Also, just the fat-free mass index of legs had significant positive associations with QTc interval (P-value < 0.05). Surprisingly, in females, the mean of FM/FFM ratio in trunk and legs in the normal QTc group had higher values than the prolonged QTc group (QTc > 470 ms). Also, none of the body composition variables had a significant correlation with continuous QTc. Conclusion Our study suggested that FMI ratios in the trunk, total body, arms, and legs were positively associated with QTc interval in males, respectively, from a higher to a lower beta-coefficient. Such associations were not seen in females. Our study implies that body fat mass may be an independent risk factor for higher QTc interval and, consequently, more cardiovascular events that should be investigated.

BackgroundIn recent years, the prevalence of overweight and obesity has increased, leading to the development of various dietary interventions as potential treatments. Two popular diets are time-restricted feeding and low-carbohydrate diets, but there is limited research on the effects of combining them. This study assessed the effects of pairing an eight-hour time-restricted feeding window with a moderate-carbohydrate diet and compared to a paired eight-hour time-restricted feeding window with a regular diet.ResultsThe study involved 52 obese women divided into three groups: the first group followed an 8 h time-restricted feeding with a moderate low-carbohydrate diet (8-hTRF+mLCD), the second group followed an 8 h time-restricted feeding with a regular diet (8-hTRF), and the third group was the control group. Both 8 h TRF+mLCD and 8 h TRF groups had a decrease in TG levels compared to the control group. The HDL levels in both TRF groups were significantly higher than the control group, while LDL levels remained statistically insignificant in both TRF groups.ConclusionsThis suggests that an 8 h TRF with or without mLCD can effectively treat obesity without a change in physical activity, and combining it with a low-carbohydrate diet gives better and more rapid results.

•Appendicular fat-free mass was calculated from 4062 dual-energy x-ray absorptiometries, and four possible cutoff points for sarcopenia were obtained.•The appendicular fat-free mass of young Chileans is lower than that from Western countries but similar to Latin American data; therefore, establishing sarcopenia as 2 standard deviation below average would not be appropriate and –1 standard deviation could be more suitable but gives cutoffs even higher than Baumgartner's.•Only by calculating the percentage of muscle mass in relation to total mass, the expected age-related increase in frequency of sarcopenia was observed, and correlated with handgrip strength in elderly women. International cutoff points for the diagnosis of sarcopenia are not applicable to the Chilean population due to previous evidence of a lower lean mass and strength in this population. Dual-energy x-ray absorptiometry is used to establish fat-free mass cutoff points to define sarcopenia in the Chilean population and analyze its association with handgrip strength in older adults. Appendicular fat-free mass (AFFM) was calculated from 4062 dual-energy x-ray absorptiometries of healthy Chileans, ages 18 to 99 y. Possible cutoff points for sarcopenia were obtained using four methods: A) Normative, –2 standard deviation (SD) below mean AFFM/height2 (AFFMI) of adults age <40 y; B) normative –1 SD, –1 SD under the average AFFMI of adults age <40 y; C) stratification, 25th percentile of the residual distribution obtained with the regression equation to predict AFFM in the entire sample; and D) percentage, –2 SD under the average skeletal muscle mass/total body mass of individuals age <40 y. Additionally, in a subsample of elderly subjects, the correlation between handgrip strength and the four calculated cutoff points was analyzed. Using the normative method, sarcopenia was defined as an AFFMI <6.4 kg/m2 in men and <4.8 kg/m2 in women and at –1 SD, the cutoff points were <7.5 kg/m2 and <5.6 kg/m2, respectively. With the stratification method, sarcopenia was defined as –1.33 kg and –1.05 kg of AFFM with respect to the expected value according to the regression equation in men and women, respectively. According to the percentage method, the cutoff points for sarcopenia were <30% and <22.9% in men and women, respectively. The concordance of the four methods was slight to moderate. Only the percentage method showed a progressive increase in the proportion of subjects with sarcopenia as age increased. The latter and the normative –1 DS predicted lower handgrip strength in elderly women, unlike the other diagnostic methods. For elderly men, only the normative –1 DS method predicted weaker handgrip strength. The AFFM of young Chileans is lower than that reported in Western countries but similar to Latin American data; therefore, the use of the traditional normative method would not be appropriate with –2 SD to establish cutoff points, and using –1 DS resulted in values that are higher than Baumgartner's. Stratification is advantageous because this method throws expected values of AFFM for each population; however, overdiagnosis of sarcopenia is a possibility and thus the method requires a representative sample. The percentage method is simple and showed the expected decrease of muscle mass with age, and also correlated well with handgrip strength in elderly women. Thus, this method represented our method of choice to detect sarcopenia.

Context Body composition may explain partially why non-obese individuals still at the risk of developing non-alcoholic fatty liver disease (NAFLD). The ratio of fat mass to fat-free mass (FM/FFM) has been proposed to assess the combined effect of different body compositions. Objective We aimed to investigate the associations of FM/FFM ratio with the risk of developing NAFLD and fibrosis and to identify the potential mediators according to obesity status. Methods This cohort study comprised 3419 adults age ≥ 40 years and free of NAFLD at baseline. Body composition was measured by bioelectrical impedance analysis. NAFLD was ascertained by ultrasonography and fibrosis was assessed by non-invasive score systems. Results For each 1 standard deviation increment in FM/FFM ratio, the odds ratio for the risk of NAFLD was 1.55 (95% confidence interval [CI] 1.23–1.95) in non-obese men, 1.33 (95% CI 1.08–1.65) in obese men, 1.42 (95% CI 1.44–1.67) in non-obese women, and 1.29 (95% CI 1.12–1.50) in obese women. Similar associations were also found between FM/FFM ratio and NAFLD with fibrosis. Mediation analysis showed that insulin resistance, triglycerides, high-density lipoprotein cholesterol, white blood cells, and total cholesterol mediated the association of FM/FFM ratio with NAFLD risk in specific sex and obesity subgroups. Conclusions The FM/FFM ratio significantly associated with the NAFLD and fibrosis risk in both non-obese and obese individuals. Different factors may mediate the association between body composition and NAFLD risk according to different obesity status.

Obesity remains a serious relevant public health concern throughout the world despite related countermeasures being well understood (i.e. mainly physical activity and an adjusted diet). Among different nutritional approaches, there is a growing interest in ketogenic diets (KD) to manipulate body mass (BM) and to enhance fat mass loss. KD reduce the daily amount of carbohydrate intake drastically. This results in increased fatty acid utilisation, leading to an increase in blood ketone bodies (acetoacetate, 3-β-hydroxybutyrate and acetone) and therefore metabolic ketosis. For many years, nutritional intervention studies have focused on reducing dietary fat with little or conflicting positive results over the long term. Moreover, current nutritional guidelines for athletes propose carbohydrate-based diets to augment muscular adaptations. This review discusses the physiological basis of KD and their effects on BM reduction and body composition improvements in sedentary individuals combined with different types of exercise (resistance training or endurance training) in individuals with obesity and athletes. Ultimately, we discuss the strengths and the weaknesses of these nutritional interventions together with precautionary measures that should be observed in both individuals with obesity and athletic populations. A literature search from 1921 to April 2021 using Medline, Google Scholar, PubMed, Web of Science, Scopus and Sportdiscus Databases was used to identify relevant studies. In summary, based on the current evidence, KD are an efficient method to reduce BM and body fat in both individuals with obesity and athletes. However, these positive impacts are mainly because of the appetite suppressive effects of KD, which can decrease daily energy intake. Therefore, KD do not have any superior benefits to non-KD in BM and body fat loss in individuals with obesity and athletic populations in an isoenergetic situation. In sedentary individuals with obesity, it seems that fat-free mass (FFM) changes appear to be as great, if not greater, than decreases following a low-fat diet. In terms of lean mass, it seems that following a KD can cause FFM loss in resistance-trained individuals. In contrast, the FFM-preserving effects of KD are more efficient in endurance-trained compared with resistance-trained individuals.

The composition of weight change has a large impact on energy balance calculations. Composition of long‐term weight change interventions is well‐documented, but information on short‐term weight change under unrestricted free‐living conditions is limited. The composition and energy density of the changes in body weight during 2‐week free‐living conditions were analyzed in adults from two cohorts: cohort 1 (n = 24) included participants from the reproducibility subset of the Observing Protein and Energy Nutrition study; cohort 2 (n = 22) included participants who were studied under free‐living conditions in an ongoing study in the Chicago area. Change in body weight, total body water (TBW) by stable isotope dilution (cohort 1), and fat mass (FM) and fat‐free mass (FFM) by serial DXA (cohort 2) were measured. To determine the fractional composition of the change in body weight we analyzed the linear associations between changes in body weight and changes in body composition. In the combined dataset, the average change in body weight (0.26 ± 1.2 kg) was consistent with being in energy balance. Average change in body weight was associated with the change in TBW (P < 0.0001) in cohort 1 and the change in FFM (P = 0.0002) in cohort 2. A unit change in body weight was composed of 84% change in FFM in the combined dataset indicating that 2‐week fluctuation in body weight is largely composed of FFM. The energy density of 1–3 kg short‐term changes in body weight averaged 2380 kcal/kg. Little data is available on the tissue composition and hence energy density of short‐term fluctuations in body energy stores weight. Here we report a relatively larger contribution of fat‐free mass (84%; mainly body water), as compared to fat mass (16%), to the body weight fluctuations after 2‐weeks of unrestricted free‐living conditions. We also show that the energy density of short‐term changes in body energy stores is small. Our findings are useful for short‐term, near energy balance studies where body composition cannot be easily measured.