Body fat distribution and bone mineral density in a multi-ethnic sample of postmenopausal women in The Malaysian Cohort.

In this study of postmenopausal women in Malaysia, total adiposity was inversely associated with total BMD, while regional associations varied. No differences were detected across Malay, Chinese, and Indian ethnicities. Low BMD contributes substantially to morbidity and mortality, and increasing adiposity levels globally may be contributing to this. PURPOSE: To investigate associations of total and regional adiposity with bone mineral density (BMD) among a multi-ethnic cohort of postmenopausal women. METHODS: Dual X-ray absorptiometry (DXA) imaging was undertaken for 1990 postmenopausal women without prior chronic diseases (30% Malay, 53% Chinese, and 17% Indian) from The Malaysian Cohort (TMC). The strength of the associations between standardized total and regional body fat percentages with total and regional BMD was examined using linear regression models adjusted for age, height, lean mass, ethnicity, education, and diabetes. Effect modification was assessed for ethnicity. RESULTS: Women with a higher total body fat percentage were more likely to be Indian or Malay. Mean (SD) BMD for the whole-body total, lumbar spine, leg, and arm were 1.08 (0.11), 0.96 (0.15), 2.21 (0.22), and 1.36 (0.12) g/cm2, respectively. Total body and visceral fat percentage were inversely associated with total BMD (- 0.02 [95% CI - 0.03, - 0.01] and - 0.01 [- 0.02, - 0.006] g/cm2 per 1 SD, respectively). In contrast, subcutaneous and gynoid fat percentages were positively associated with BMD (0.007 [0.002, 0.01] and 0.01 [0.006, 0.02] g/cm2, respectively). Total body fat percentage showed a weak positive association with lumbar BMD (0.01 [0.004, 0.02]) and inverse associations with leg (- 0.04 [- 0.06, - 0.03]) and arm (- 0.02 [- 0.03, - 0.02]) BMD in the highest four quintiles. There was no effect modification by ethnicity (phetero > 0.05). CONCLUSION: Total adiposity was inversely associated with total BMD, although regional associations varied. There was no heterogeneity across ethnic groups suggesting adiposity may be a risk factor for low BMD across diverse populations.

Sexual dimorphism of adiposity and fat distribution among children and adolescents (8-18 year olds) from Poland.

OBJECTIVES: The study aimed to analyze the sexual dimorphism of total body fat [BF%] and fat distribution among 8-18 year olds from Poland. METHODS: The study included 2175 participants, divided into sex and age groups. Waist and hip circumferences, the thickness of six skinfolds, waist-to-hips ratio [WHR], the ratio of abdominal-to-suprailiac skinfolds, and the limb-to-trunk adiposity index were analyzed. Fat percentage were measured with a body composition analyzer (Tanita) with accuracy 0.1%. The Mollison's Index [MI] was used for calculating sexual dimorphism. RESULTS: The value of MI for the WHR and its components (waist and hip circumferences) was negative (the boys were characterized by higher values of these parameters). The magnitude of the sex differences was lower in the younger age groups and the highest in the oldest groups. For adiposity [BF%], the average values were higher in females. In the younger age groups, girls had thicker skinfolds compared to boys, and this tendency was also observed in the older age groups, except for abdominal and suprailiac skinfolds. The values of the analyzed adiposity indicators also represented a tendency toward central allocation of fat tissue in boys. CONCLUSIONS: In conclusion, sexual dimorphism of fat distribution and adiposity could be detected as early as 7 years of age. These differences can be identified using simple anthropometric methods, which are relatively cheap and easy to use, particularly in the field setting and large populations. The observation of changes in these features in children should be a recommended procedure aimed at early detection of overweight, obesity, as well as normal weight obesity or other metabolic disorders.

Aging and changes in adiposity indices: the impact of menopause.

PURPOSE: Aging is associated with significant changes in fat distribution and menopause may alter this process. This study aimed to investigate the longitudinal effect of menopause on changes in adiposity indices (AI). METHODS: A total number of 3876 non-menopausal women, aged > 20 years, who participated in the Tehran Lipid and Glucose study, were selected for the present study. They were followed from 1998 to 2018 at a 3-year interval and their adiposity indices were measured. Throughout the study, participants were categorized into two groups according to their menopausal status as group 1): women who reached menopause and group 2): women who did not reach menopause. The generalized estimation equation (GEE) models were used to compare the trend of changes in AIs between these two groups. RESULTS: At the end of the study, a total number of 1479 (38.2%) participants reached menopause. The odds of general obesity decreased by 5% (OR: 0.95, 95% CI: 0.90-0.99), and the odds of central obesity increased by 6% in group1 compared to group2 (OR: 1.06, 95% CI: 1.01-1.12). CONCLUSIONS: Menopause alters the impact of aging on central fat distribution. Increasing awareness of the related risk in menopausal women and their healthcare professional may prevent adverse related outcomes.

Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty.

BACKGROUND: Bone mineral acquisition during adolescence is crucial for maximizing peak bone mass. Fat mass (FM) and bone mass are closely related. This study investigated the association of FM distribution with bone mass in Chinese male adolescents. METHOD: A total of 693 male adolescents aged 10-18 years were recruited from a secondary school in Jiangmen, China. Their bone mass and body composition were measured by quantitative ultrasound and bioelectrical impedance analysis, respectively. The associations of the measures of fat distribution with bone parameters, i.e., broadband ultrasound attenuation, speed of sound (SOS), and stiffness index (SI), were analyzed using multiple linear regression. Age, height, body mass index, stage of puberty, physical activity, sedentary behavior, dietary energy intake, and dietary calcium and vitamin D intake were adjusted in the model. Further subgroup analyses of prepubertal and pubertal participants were conducted. RESULTS: The measures of fat distribution showed negative associations with SOS and SI in total subjects (p < 0.010). In prepubertal boys, the measures of fat distribution were only associated with SOS (ß = -0.377 to -0.393, p < 0.050). In pubertal boys, the measures of fat distribution had associations with all bone parameters (ß = -0.205 to -0.584, p < 0.050). The strongest association was between trunk FM and SOS (ß = -0.584, p < 0.001). CONCLUSION: This study supported that the measures of fat distribution were negatively associated with bone parameters in Chinese male adolescents. Trunk FM had the strongest association with bone parameter. These associations appear to be stronger in pubertal boys than in prepubertal boys.

Association of sedentary patterns with body fat distribution among US children and adolescents: a population-based study.

BACKGROUND/OBJECTIVES: Children and adolescents spend a substantial amount of time being sedentary. The impact of prolonged sedentary patterns on fat distribution has not been elucidated especially in the context of physical activity level. Our objective is to examine the independent and joint associations of prolonged sedentary patterns and physical activity level with fat distribution among children and adolescents. SUBJECTS/METHODS: This included US children (8-11 years) and adolescents (12-19 years) from the National Health and Nutrition Examination Survey 2003-2006. Sedentary patterns comprise accelerometer-measured average sedentary bout duration and self-reported time of sitting watching TV/videos. Fat distribution (trunk and total fat percentage) was determined via dual X-ray absorptiometry. RESULTS: Among 810 children and 2062 adolescents, average sedentary bout duration was associated with greater total and trunk fat percentages only among male children, after adjusting for moderate-to-vigorous physical activity (MVPA) level by accelerometer. Prolonged sitting watching TV/videos was associated with higher total and trunk fat percentages in male children and all adolescents, independent of levels of MVPA (all P for trend <0.05). Compared with ≤1 h/day, male children who spent ≥4 h/day sitting watching TV/videos had 4.43% higher trunk fat (95% CI, 1.69-7.17%), with similar associations for female (3.53%; 95% CI, 1.03-6.03%) and male adolescents (4.78%; 95% CI, 2.97-6.60%). About 13-17% children and adolescents spent <1 h on MVPA and ≥4 h sitting watching TV/videos per day. Compared with the most active group (MVPA ≥ 1 h/day and sitting watching TV/videos ≤1 h/day), trunk fat in this least active group was 6.21% higher in female children, 9.90% higher in male children, 6.84% higher in female adolescents, and 5.36% higher in male adolescents. CONCLUSIONS: Prolonged time spent on sitting watching TV/videos was associated with fat accumulation among children and adolescents, independent of physical activity level.

Lifestyle weight-loss intervention may attenuate methylation aging: the CENTRAL MRI randomized controlled trial.

BACKGROUND: DNA methylation age (mAge), a methylation biomarker for the aging process, might serve as a more accurate predictor of morbidity and aging status than chronological age. We evaluated the role of multiple factors, including fat deposition, cardiometabolic risk factors and lifestyle weight-loss intervention, on the deviation of mAge from chronological age (mAge deviation) or 18-month change in mAge (∆mAge). In this sub-study of the CENTRAL magnetic resonance imaging weight-loss trial, we evaluated mAge by a validated 240-CpG-based prediction formula at baseline and after 18-month intervention of either low fat (LF) or mediterranean/low carbohydrate (MED/LC) diets. RESULTS: Among 120 CENTRAL participants with abdominal obesity or dyslipidemia, mAge (mean ± SD: 60.3 ± 7.5 years) was higher than the chronological age (48.6 ± 9.3 years) but strongly correlated (r = 0.93; p = 3.1 × 10-53). Participants in the lowest tertile of mAge deviation from their chronological age had significantly lower waist-circumference, visceral adipose tissue, intrahepatic fat (IHF) content, fasting-glucose and HOMA-IR, as compared with participants in the highest sex-specific residual tertile (p < 0.05 for all). IHF% remained associated with greater mAge deviation after further adjustments (ß = 0.23; p = 0.02). After 18-month weight-loss lifestyle intervention, mAge remained significantly correlated with chronological age (r = 0.94, p = 1.5 × 10-55). mAging occurred, with no difference between lifestyle intervention groups (∆ = 0.9 ± 1.9 years in MED/LC vs. ∆ = 1.3 ± 1.9 years in LF; p = 0.2); however, we observed a mAging attenuation in successful weight losers (> 5% weight loss) vs. weight-loss failures ( ∆ = 0.6 years vs. ∆ = 1.1 years; p = 0.04), and in participants who completed the trial with healthy liver fat content (< 5% IHF) vs. participants with fatty liver (∆ = 0.6 years vs. ∆ = 1.8 years; p = 0.003). Overall, 18 months of weight-loss lifestyle intervention attenuated the mAging of the men, mainly the older, by 7.1 months than the expected (p < 0.05). CONCLUSIONS: Lifestyle weight-loss intervention may attenuate mAging. Deviation of mAge from chronological age might be related to body fat distribution and glycemic control and could indicate biological age, health status and the risk for premature cardiometabolic diseases. TRIAL REGISTRATION: ClinicalTrials.gov NCT01530724. Registered 10 February 2012, https://clinicaltrials.gov/ct2/show/study/NCT01530724 .

Chinese Adults Are More Susceptible to Effects of Overall Obesity and Fat Distribution on Cardiometabolic Risk Factors.

CONTEXT: The body mass index (BMI) and waist circumference (WC) as diagnostic tools of obesity do not reflect the same level of fat mass and whether obesity leads to various effects on cardiometabolic risk factors among different racial/ethnic population is unknown. OBJECTIVE: The study aims to address the multicollinearity between BMI and WC by using the residual model approach and to assess and compare the effects of obesity metrics on cardiometabolic risk factors among different races/ethnicities. DESIGN, SETTING, AND PARTICIPANTS: Data from a nationally representative sample of mainland Chinese adults collected in 2010 and data from the National Health and Nutrition Evaluation Survey 2005-2016 were used. By conducting a regression analysis between WC and BMI, the variation of BMI was removed from WC measures and residual of WC was obtained. The associations between obesity metrics and cardiometabolic risk factors were compared among different races/ethnicities by sex. RESULTS: The residual WC was significantly associated with all the cardiometabolic risk factors in mainland Chinese, and most of the factors in non-Hispanic white and non-Hispanic black adults, but not in the other races/ethnicities. The standardized regression coefficients of the associations between obesity metrics and cardiometabolic factors showed that the obesity metrics had greater impact on systolic blood pressure, diastolic blood pressure, and triglyceride in Chinese adults than those of other racial/ethnic groups. CONCLUSIONS: Chinese adults are more susceptible to the effects of overall obesity and fat distribution on cardiometabolic risk factors than the other racial/ethnic population.

Longitudinal associations of total and trunk fat in childhood and adolescence and risk of hepatic steatosis at 24 years.

BACKGROUND: The importance of body fat distribution in the development of nonalcoholic fatty liver disease (NAFLD) is unclear. OBJECTIVE: To examine whether total and truncal fat deposition patterns in childhood/adolescence are associated with NAFLD risk at 24 years. METHODS: Data were from 1657 participants in the Avon Longitudinal Study of Parents and Children. Transient elastography was used to assess hepatic steatosis (low/moderate/severe) at 24 years and dual-energy X-ray absorptiometry was used to assess total body fat percent (TBF%) and trunk fat percent (TrF%) at 9, 13, 15, 17, and/or 24 years. Linear mixed models were constructed with quadratic age to examine trajectories of TBF% and TrF% by steatosis at 24 years, adjusting for confounders. RESULTS: In both sexes, TBF% trajectories from 9 to 24 years followed a similar pattern based on steatosis group (P = .83 for boys and P = .14 for girls for age2 *steatosis fixed effect). However, at all ages TBF% was higher for moderate/severe vs low steatosis at 24 years (P < .05). In contrast, TrF% trajectories diverged based on steatosis group (P = .001 for boys and P = .0002 for girls for age2 *steatosis fixed effect), such that, in both sexes, participants with moderate/severe steatosis at 24 yrs exhibited less decline in TrF% from adolescence to adulthood compared to participants with low steatosis at 24 yrs. Similar to TBF%, TrF% was higher at nearly all ages for moderate/severe vs low steatosis. Results were similar after adjusting for BMI category at each age, except in boys some differences for TrF% were attenuated. CONCLUSIONS: These findings suggest that sex-specific body fat distribution patterns in childhood/adolescence may help to identify those at risk of developing NAFLD in adulthood.

Evaluation of the body adiposity index against dual-energy X-ray absorptiometry for assessing body composition in children and adolescents.

BACKGROUND: It is important to clarify the association of lean and fat mass between children and adolescents considering the rising prevalence of overweight and obesity in this age group. The aim of this study was to verify the association between the body adiposity index (BAI) and dual-energy X-ray absorptiometry (DXA) methods for analyzing body composition, as well as analyzing the validity of BAI to verify the percentage of fat in children and adolescents. METHODS: The sample was composed of 106 children and adolescents, 44 females (age: 11.5 ± 1.8 years) and 62 evils (13.6 ± 2.6 years). The body fat (%F) was measured using DXA and the doubly indirect BAI body fat estimation technique. RESULTS: The BAI and DXA estimates of %F were strongly correlated (boys: r = .71, P < .0001; girls: r = .72, P < .0001). The linear regression analyses showed that BAI is significant to estimate the %F in total sample (P < .0001). For boys, the %F analyzes performed by BAI and DXA did not show any differences when compared (P = .2). In addition, BAI pointed out a significant proportion bias for both sexes (P < .0001), which suggests its inefficiency in the analysis of %F. CONCLUSIONS: BAI and DXA correlate; however, there is low reliability and a high proportion bias for the analysis of %F by BAI.

Relationship Among Adherence to the Mediterranean Diet and Anthropometric and Metabolic Parameters in Subjects with Obesity.

BACKGROUND: There is moderate-to-high evidence that the Mediterranean diet prevents increases in body weight and waist circumference in non-obese individuals, but less is known about its effects in overweight and obese subjects. The present study was focused on exploring the cross-sectional association among the adherence to a Mediterranean diet and the most commonly used variables of metabolic and cardiovascular risk factors in a cohort of overweight subjects from a typical Mediterranean region, Apulia, in Southern Italy. METHODS: The study was performed in a cohort of 1214 individuals, all overweight or obese but with no other clinical condition. We investigated the association with adherence to a Mediterranean diet, assessed using the PREDIMED score, and anthropometric parameters [namely body mass index (BMI), WC, waist to height ratio (WHtR) and neck circumference (NC)], fasting serum levels of glucose, insulin, uric acid and lipids (triglycerides, total cholesterol, HDL cholesterol, and LDL cholesterol), and blood pressure and insulin resistance, measured by HOMA-IR. RESULTS: The waist to height ratio was negatively associated with a PREDIMED score ≥7 (p<0.04), whereas HDL cholesterol was positively associated with a PREDIMED score ≥7 (p<0.04). CONCLUSION: This study suggests that body fat distribution and HDL-cholesterol are the parameters most strongly influenced by MedDiet in Apulian subjects.

The associations of the gut microbiome composition and short-chain fatty acid concentrations with body fat distribution in children.

BACKGROUND & AIMS: Previous studies linking the gut microbiome with childhood obesity largely used the body mass index to measure obesity and reached inconsistent findings. Little evidence has linked the gut microbiome to regional body fat deposition. We investigated whether the abundance of specific taxa in the gut microbiota and the concentrations of short-chain fatty acids (SCFAs) were associated with the content and regional deposition of body fat in children. METHODS: This cross-sectional study involved 236 children aged 6-9 years. The fat mass contents/percentages in the total body and the android, gynoid, and limb regions were determined by dual-energy X-ray absorptiometry, and the android-to-gynoid fat mass ratio and fat-to-lean mass ratios were calculated. Fecal samples were subjected to16S rRNA amplicon sequencing, and the fecal SCFA concentrations were quantified via high-performance liquid chromatography. RESULTS: A weighted gene co-expression network analysis identified seven modules of co-expressed operational taxonomic units (OTUs). A total of 57 OTUs from 4 key modules were selected for further analysis. After adjustment of covariates and controlling for the false discovery rate (FDR), a multiple linear regression analysis revealed significant correlations of the abundances of some OTUs with obesity and body fat measures. For instance, the OTUs classified to the species Ruminococcus gnavus and Flavonifractor plautii showed significant negative correlations with the total and regional body fat (ß: -0.250 to -0.180, PFDR: 0.041-0.049), whereas OTUs belonging to the genera Blautia and Romboutsia exhibited positive correlations with body fat measures (ß: 0.184-0.222, PFDR: 0.041-0.049). The fecal concentrations of acetic, propionic, and butyric acids and total SCFAs were significantly positively correlated with various parameters of body fat distribution (ß: 0.160-0.275, PFDR: <0.001-0.042). CONCLUSION: The gut microbiome and SCFAs are significantly associated with obesity and body fat distribution in pediatric population.

Fatores associados ao elevado percentual de gordura corporal em indivíduos fisicamente ativos / Factors associated with the high body fat percentage in physically active individuals

Introdução: O exercício físico é praticado com diversos objetivos, destacando-se a promoção na mudança da composição corporal, com a redução de gordura e aumento de massa magra. Assim, compreender os fatores que podem estar associados nesta modificação se torna relevante. Objetivo: Analisar os fatores demográficos, estilo de vida, bioquímico, alimentares e de treinamento associados ao percentual de gordura corporal em praticantes de exercício físico em academias. Materiais e Métodos: Estudo transversal com 143 praticantes de exercícios físicos saudáveis, de ambos os sexos. Características sociodemográficas e estilo de vida foram obtidas através da aplicação de questionário. O consumo alimentar foi obtido através de registros alimentares de 24h, considerando as médias de três dias. A composição corporal foi avaliada por meio de avaliação antropométrica e pelo teste de bioimpedância elétrica. A análise estatística contemplou o teste de Shapiro Wilk para verificação da normalidade; o qui-quadrado e exato de Fisher foram usados para avaliar a associação entre as variáveis categóricas e a variável resposta e os testes de Mann-Whitney e t de Student para as contínuas. A regressão de Poisson com variância robusta foi usada para determinar as associações entre variáveis estudadas. O software Stata versão 14.0 foi usado para análise estatística, tendo sido adotado o valor de p <0,05. Resultados: A prevalência de gordura corporal elevada foi de 49,3% nos homens e 79,2% nas mulheres. Os fatores associados foram o maior consumo de proteína e fibras nas mulheres e a concentração de monócitos nos homens. Conclusão: Apesar de se tratar de público fisicamente ativo, observou-se elevado percentual de gordura entre os participantes do estudo e os fatores associados reforçam o caráter multietiológico deste indicador. (AU)

Introduction: Physical exercise is practiced with several objectives, especially the promotion of changes in body composition, with fat reduction and increase in lean mass. Thus, understanding the factors that may be associated with this modification becomes relevant. Objective: To analyze demographic, lifestyle, biochemical, dietary, and training factors associated with the percentage of body fat in practitioners of physical exercise in gyms. Materials and Methods: Cross-sectional study with 143 healthy physical exercise practitioners, of both sexes. Sociodemographic characteristics and lifestyle were obtained through the application of a questionnaire. Food consumption was obtained through 24-hour food records, considering the averages of three days. Body composition was assessed using anthropometric assessment and the electrical bioimpedance test. The statistical analysis included the Shapiro Wilk test to verify normality, the chi-square and Fisher's exact test were used to assess the association between categorical variables and the response variable and the Mann-Whitney and Student t tests for the continuous variables. Poisson regression with robust variance was used to determine the associations between studied variables. Stata software version 14.0 was used for statistical analysis and a value of p <0.05 was adopted. Results: The prevalence of high body fat was 49.3% in men and 79.2% in women. The associated factors were the higher consumption of protein and fibers in women and the concentration of monocytes in men. Conclusion: Despite being a physically active public, a high percentage of fat was observed among the study participants and the associated factors reinforce the multi-etiological character of this indicator. (AU)

Visceral fat in different locations assessed by ultrasound: Correlation with computed tomography and cut-off values in patients with metabolic syndrome.

The aim of this study was to evaluate the correlation between ultrasound measurements of visceral adipose tissue (VAT) in different locations and visceral fat area parameters estimated by computed tomography (CT), as well as to determine the cut-off values of ultrasound measurements in patients with metabolic syndrome and in normal controls. Altogether, 304 patients aged 18 to 65 years were enrolled in the study. Ultrasound measurements of visceral fat volume were performed using a number of already described techniques. The correlations of ultrasound indices of VAT and СТ (104 patients) ranged from 0.420 to 0.726. For the most effective diagnostic VAT ultrasound indices, the cut-off values in metabolic syndrome were (200 patients): 21.12 cm2 for the inferior part of perirenal fat (AUC = 0.983); and 47.00, 61.3 and 72.7 mm for the distance between the internal surface of the rectus abdominis muscle and the anterior wall of the aorta, the posterior wall of the aorta and the lumbar vertebra (AUC = 0.960, 0.966, 0.968, respectively). Ultrasound VAT measurements highly correlated with CT results. Cut-off VAT values, determined by ultrasound for the patients with metabolic syndrome, yielded good diagnostic operational characteristics.

The non-linear relationship between sum of 7 skinfolds and fat and lean mass in elite swimmers.

Body composition can substantially impact elite swimming performance. In practice, changes in fat and lean mass of elite swimmers are estimated using body mass, sum of seven skinfolds (∑7) and lean mass index (LMI). However, LMI may be insufficiently accurate to detect small changes in body composition which could meaningfully impact swimming performance. This study developed equations which estimate dual-energy x-ray absorptiometry (DXA)-derived lean and fat mass using body mass and ∑7 data. Elite Australian swimmers (n = 44; 18 male, 26 female) completed a DXA scan and standardised body mass and ∑7 measurements. Equations to estimate DXA-derived lean and fat mass based on body mass, ∑7 and sex were developed. The relationships between ∑7, body mass and DXA-derived lean and fat mass were non-linear. Fat mass (Adjusted R2 = 0.91; standard error = 1.0 kg) and lean mass (Adjusted R2 = 0.99; standard error = 1.0 kg) equations were considered sufficiently accurate. Lean mass estimates outperformed the LMI in identifying the correct direction of change in lean mass (82% correct; LMI 71%). Using the accurate estimations produced by these equations will enhance the prescription and evaluation of programmes to optimise the body composition and subsequent performance in swimmers.

Association of Trunk/Leg Fat Mass Ratio with Low-Density Lipoproteins-Cholesterol and Triglycerides Concentration in Children and Adolescents: A Cross-Sectional, Retrospective Study.

Background: Increased central (or abdominal) fat mass has been associated with cardiometabolic risk factors such as high low-density lipoproteins (LDL)-cholesterol or triglycerides (TG) concentration in children. Objectives: To generate pediatric reference centiles for trunk/leg fat mass ratio (T2L) (assessed by dual-energy X-ray absorptiometry [DXA]) and to evaluate the association of LDL-cholesterol and TG concentrations with T2L in children and adolescents. Methods: Data of the National Health and Nutrition Examination Survey (1999-2004) were used to determine total and regional fat mass by DXA of the participants (aged 8-19 years) who had also an examination of LDL-cholesterol and TG concentrations. Fat mass was assessed by DXA-determined fat mass index (FMI). Central fat mass was quantified by T2L. Results: The DXA results of 6538 children and adolescents (2629 females) were used to generate reference centiles for T2L. In girls, T2L was significantly associated with high LDL-cholesterol and TG concentration (odds ratio [OR] adjusted to FMI 1.69), (95% confidence interval [CI] 1.20-2.40), and 1.45 (95% CI 1.11-1.91, p = 0.003 and p = 0.008). In boys, T2L was significantly associated only with high TG concentration (OR adjusted to FMI 1.81 [95% CI 1.52-2.19, p < 0.001]). Conclusions: A central fat distribution seemed to be an independent risk factor for high TG concentrations in children and for high LDL-cholesterol only in girls. The first ethnicity-specific, pediatric reference centiles for T2L were presented.

Shift in body fat distribution from lower body to upper body among urban Colombian women, 1988-1989 to 2007-2008.

OBJECTIVE: Body fat distribution may be a stronger predictor of metabolic risk than BMI. Yet, few studies have investigated secular changes in body fat distribution in middle-income countries or how those changes vary by socioeconomic status (SES). This study evaluated changes in body fat distribution by SES in Colombia, a middle-income country where BMI is increasing rapidly. DESIGN: We applied factor analysis to previously published data to assess secular changes in adiposity and body fat distribution in cross-sectional samples of urban Colombian women. Anthropometry was used to assess weight, height and skinfolds (biceps, triceps, subscapular, suprailiac, thigh, calf). SETTING: Cali, Colombia. PARTICIPANTS: Women (18-44 years) in 1988-1989 (n 1533) and 2007-2009 (n 577) from three SES groups. RESULTS: We identified an overall adiposity factor, which increased between 1988-1989 and 2007-2008 in all SES groups, particularly in the middle SES group. We also identified arm, leg and trunk adiposity factors. In all SES groups, leg adiposity decreased, while trunk and arm adiposity increased. CONCLUSIONS: Factor analysis highlighted three trends that were not readily visible in BMI data and variable-by-variable analysis of skinfolds: (i) overall adiposity increased between time periods in all SES groups; (ii) the adiposity increase was driven by a shift from lower body to upper body; (iii) the adiposity increase was greatest in the middle SES group. Factor analysis provided novel insights into secular changes and socioeconomic variation in body fat distribution during a period of rapid economic development in a middle-income country.

Higher erythrocyte n-3 polyunsaturated fatty acid were associated with a better profile of DXA-derived body fat and fat distribution in adults.

BACKGROUND: Previous studies have reported that high-dose supplementation of n-3 polyunsaturated fatty acids (PUFAs) may reduce the risk of metabolic diseases, but there is limited evidence of an effect on body fat. We examined the associations of erythrocyte n-3 PUFAs with body fat and fat distribution in a general population consuming a normal diet. METHODS: This community-based cross-sectional study included 3075 Chinese (68% women, 40-75 years) recruited between 2008 and 2013. We collected general information and measured anthropometric indices; erythrocyte n-3 PUFAs (including α-C18:3, C20:5, C22:5 and C22:6) by gas-chromatography, and fat mass (FM) and %FM at the total body (TB), android (A) and gynoid (G) regions by dual-energy X-ray absorptiometry (DXA). RESULTS: Both minimally and maximally adjusted models showed dose-dependent inverse associations of total and individual levels of erythrocyte n-3 PUFAs (except C20:5 n-3[EPA]) with adiposity indices. In the full model, the mean differences between quartiles 4 and 1 of total n-3 PUFAs were -1.60% (BMI), -4.06% (TB FM), -5.38% (A FM), -2.05% (G FM), -2.05% (TB %FM), -3.39% (A %FM) and -2.50% (% A/G); the ORs (95% CI) of %FM-derived obesity (≥25% for men, ≥35% for women) for the highest (vs. lowest) quartile were 0.70 (0.57, 0.86) for total n-3 PUFAs and 0.71 (0.58, 0.87), 0.96(0.78, 1.18), 0.82(0.67, 1.00), 0.66 (0.54, 0.81) for α-C18:3/C20:5/C22:5/C22:6 n-3, respectively. The favourable associations were more pronounced for the DXA-derived FM indices, measurements at the android region and for C22:6 n-3. No significant associations between C20:5 n-3 and the adiposity indices were observed. CONCLUSIONS: Higher levels of circulating n-3 PUFAs were dose-dependently associated with better profiles of body fat and fat distribution, particularly in the abdominal regions in this population.

Prospective observational investigation of body habitus measurements and relationship to epidural depth in term pregnant women.

BACKGROUND: High body mass index (BMI) can predict difficult neuraxial block; however, fat distribution may also be important. The primary study aim was to identify body habitus and fat distribution measurements that correlated with ultrasound measured epidural depth. We hypothesized that measurements such as midarm and subscapular fatpad thicknesses and length of cervical spine may correlate better with ultrasound measured epidural depth than a global measure of BMI. METHODS: Prospective IRB approved study of term pregnant women requiring neuraxial block. We measured height, weight (BMI, kg/m2 ), subscapular, midarm fatpad thickness (digital caliper, mm), vertebral column length (C7 to sacral hiatus, cm) and epidural depth (ultrasound, mm). Four experts assessed photographs to assign anticipated difficult neuraxial block in sitting and lateral positions (5-point Likert scale, 1 = very easy, 5 = very difficult). RESULTS: In all, 131 women completed body habitus measurements. Measured mean (standard deviation) BMI was 30.3 (5.4) kg/m2 . Measured BMI, subscapular fatpad and midarm fatpad thickness were significantly correlated with ultrasound depth to epidural space (R2 0.733, 0.626 and 0.633, respectively, P < .0001) but vertebral column length was not. The experts had a high level of agreement (Cronbach's alpha >0.7) for assessment of anticipated difficult block in the sitting and lateral positions; however, anticipated difficult block was not correlated with epidural depth measured by ultrasound for sitting position, R2  = -0.015, P = .87; and lateral position, R2  = -0.087, P = .33. CONCLUSIONS: Measurements of body habitus and fat distribution were no better than measured BMI to anticipate greater ultrasound measured depth to epidural space. Clinical trial number: Non-interventional observational study, not registered.

Body Fat Is Related to Sedentary Behavior and Light Physical Activity but Not to Moderate-Vigorous Physical Activity in Type 2 Diabetes Mellitus.

BACKGROUND: Sedentary behavior (SB) has emerged as a new risk factor for cardiovascular accidents. We investigated whether physical activity levels or SB were related to percent body fat (%BF) in type 2 diabetes mellitus (T2DM). METHODS: In this cross sectional study, we measured the duration of SB, light physical activity (LPA), moderate to vigorous physical activity (MVPA), total energy expenditure, and step counts using a wireless activity tracker (Fitbit HR; FB) for 7 days in free-living conditions, along with %BF using a bio impedance analyzer (Inbody; Biospace) in 120 smartphone users with T2DM. Subjects were divided into exercise (Exe, n=68) and non-exercise (nonExe, n=52) groups based on self-reports of whether the recommended exercises (30 min/day, 3 days/week for 3 months) were performed. SBt, LPAt, MVPAt were transformed from SB, LPA, MVPA for normally distributed variables. RESULTS: Participants were: female, 59.2%; age, 59.3±8.4 years; body mass index, 25.5±3.4 kg/m²; glycosylated hemoglobin (HbA1c), 7.6%±1.2%; %BF, 30.4%±7.1%. They performed SB for 15.7±3.7 hr/day, LPA for 4.4±1.7 hr/day, and MVPA for 0.9±0.8 hr/day. The %BF was related to SBt and LPAt, but not to MVPA after adjustments for age, gender, and HbA1c. VPA was significantly higher in the Exe group than in the nonExe group, but SB, LPA, and moderate physical activity were not different. Predicted %BF was 89.494 to 0.105 (age), -13.047 (gender), -0.507 (HbA1c), -7.655 (LPAt) (F[4, 64]=62.929, P<0.001), with an R² of 0.785 in multiple linear regression analysis. CONCLUSION: Reduced body fat in elderly diabetic patients might be associated with reduced inactivity and increased LPA.

The comparison of percent body fat estimated by different anthropometrics to predict the incidence of hypertension.

Percent body fat (%BF) is associated with the development of hypertension. However, the power of %BF estimated by different anthropometrics to predict incident hypertension was unknown. This study was from the China Health and Nutrition Survey (CHNS). %BF was calculated using the equations with BMI, WC, and skinfold thickness and divided into low and high %BF according to ROC. Cox regression was employed to evaluate the power of different %BFs to predict the development of hypertension. When not adjusting for covariates, %BFs defined by BMI, WC, and ST were the significant predictors of the development of hypertension (all P < 0.0001; crude HR: 2.238, 3.243, and 1.574; and HR 95% CI: 2.098-2.387, 2.905-3.619, and 1.464-1.692). When three %BFs entered into model simultaneously, the significance in %BF estimated by ST disappeared (P = 0.0765; adjusted HR: 1.124; and HR 95% CI: 0.988-1.280). For males, %BFs by BMI, WC, and ST significantly affected the incidence of hypertension as they were separately analyzed (all P < 0.0001; crude HR: 2.445, 2.335, and 1.828; and HR 95% CI: 2.220-2.693, 2.011-2.712, and 1.636-2.042, respectively). For females, %BFs estimated by BMI, WC, and ST were the determinants of the development of hypertension whether covariates were adjusted or not (all P < 0.0001). In conclusion, there was a poor and ineffective association of %BF estimated by triceps skinfold thickness with the development of hypertension, especially when three %BFs were analyzed together. High %BFs estimated by BMI and WC were the true and effective predictors of the incidence of hypertension.