Determination of Fat-Free Mass Density and its Components in Older Hispanic Adults by In Vivo Methods.

The densitometry method estimates body composition based on cadaver reference values, mainly the fat-free mass density value of 1.100 g/cm3. However, several changes in fat-free mass components by aging, ethnicity, and excess adiposity could influence their density and affect body composition estimations. The present study aimed to compare the mean fat-free mass component values in older Hispanic adults to cadaver reference values. This cross-sectional study included a sample of 420 subjects aged ≥60 yr from northern Mexico. Fat-free mass was determined by the four-compartment model using air displacement plethysmography, the deuterium dilution technique, and dual-energy X-ray absorptiometry for body density, aqueous and mineral fractions of body weight, respectively. A 1-sample t test was used to compare the fat-free mass density and aqueous, mineral, and residue fractions of fat-free mass from subjects in the study to the assumed cadaver reference values. The mean fat-free mass density value for the total sample of older Hispanic adults (1.096 ± 0.011 g/cm3) was significantly (p < 0.001) lower than the assumed value of 1.100 g/cm3, except in obese older men. The mean aqueous fraction of fat-free mass (74.8 ± 3.3%) was higher than the assumed value of 73.8%, and the mean residue fraction of fat-free mass value was lower (18.3 ± 3.4%) than the reference value of 19.4%. Indeed, only the mean mineral fraction of fat-free mass value (6.8 ± 0.8%) was similar to the reference value. In the total sample, all characteristic mean fat-free mass values in these older Hispanic adults differed from cadaver reference values, except the mineral fraction of fat-free mass value.

Analysis of type 2 diabetes and obesity genetic variants in Mexican Pima Indians: Marked allelic differentiation among Amerindians at HLA.

Prevalence of diabetes and obesity in Mexican Pima Indians is low, while prevalence in US Pima Indians is high. Although lifestyle likely accounts for much of the difference, the role of genetic factors is not well explored. To examine this, we genotyped 359 single nucleotide polymorphisms, including established type 2 diabetes and obesity variants from genome-wide association studies (GWAS) and 96 random markers, in 342 Mexican Pimas. A multimarker risk score of obesity variants was associated with body mass index (BMI; ß = 0.81 kg/m2 per SD, P = 0.0066). The mean value of the score was lower in Mexican Pimas than in US Pimas (P = 4.3 × 10-11 ), and differences in allele frequencies at established loci could account for approximately 7% of the population difference in BMI; however, the difference in risk scores was consistent with evolutionary neutrality given genetic distance. To identify loci potentially under recent natural selection, allele frequencies at 283 variants were compared between US and Mexican Pimas, accounting for genetic distance. The largest differences were seen at HLA markers (e.g., rs9271720, difference = 0.75, P = 8.7 × 10-9 ); genetic distances at HLA were greater than at random markers (P = 1.6 × 10-46 ). Analyses of GWAS data in 937 US Pimas also showed sharing of alleles identical by descent at HLA that exceeds its genomic expectation (P = 7.0 × 10-10 ). These results suggest that, in addition to the widely recognized balancing selection at HLA, recent directional selection may also occur, resulting in marked allelic differentiation between closely related populations.

Prevalence of prediabetes and modifiable factors in an ethnic group of Mexico: the Comcáac Project.

OBJECTIVE: To determine the prevalence of and modifiable factors associated with prediabetes in the Comcáac Indians. DESIGN: Cross-sectional study where prediabetes was defined using fasting plasma glucose, 2 h plasma glucose and glycated Hb (HbA1c). Physical, anthropometric and biochemical measurements, medical record, socio-economic, dietary and physical activity information were collected. The modifiable factors associated with prediabetes were assessed using multiple logistic regression. Settings Comcáac Indian communities of Punta Chueca and El Desemboque, Sonora, Mexico. SUBJECTS: Adults (n 227) aged 20 years or older. RESULTS: The sex- and age-adjusted prevalence (95 % CI) of prediabetes was 47·1 (40·8, 53·5) % in the overall population; age-adjusted prevalence was 47·3 (35·6, 59·0) % in men and 46·7 (39·1, 54·3) % in women. The modifiable factors associated with a risk of prediabetes (OR; 95 % CI) were light-intensity physical activity (per 1 h/week increase: 1·04; 1·01, 1·07) and insulin resistance (homeostasis model assessment of insulin resistance score >6·1 v. <4·1: 4·62; 1·37, 15·51). Increased consumption of a traditional dietary pattern based on fish and seafood, low-fat cereals, fruits and vegetables was a protective factor (0·49; 0·31, 0·79). All variables were modelled together and adjusted for age and sex. CONCLUSIONS: The high prediabetes prevalence found in the Comcáac community is alarming because it represents a large number of people who are at risk for type 2 diabetes. The identification of modifiable factors associated with prediabetes that are specific to this population may be useful for designing effective strategies to prevent prediabetes.

Cardiometabolic risk in young adults from northern Mexico: Revisiting body mass index and waist-circumference as predictors.

BACKGROUND: A body mass index (BMI) ≥30 kg/m(2) and a waist circumference (WC) ≥80 cm in women (WCF) or ≥90 cm in men (WCM) are reference cardiometabolic risk markers (CMM) for Mexicans adults. However, their reliability to predict other CMM (index tests) in young Mexicans has not been studied in depth. METHODS: A cross-sectional descriptive study evaluating several anthropometric, physiological and biochemical CMM from 295 young Mexicans was performed. Sensitivity (Se), specificity (Sp) and Youden's index (J) of reference BMI/WC cutoffs toward other CMM (n = 14) were obtained and their most reliable cutoffs were further calculated at Jmax. RESULTS: Prevalence, incidence and magnitude of most CMM increased along the BMI range (p < 0.01). BMI explained 81 % of WC's variance [Se (97 %), Sp (71 %), J (68 %), Jmax (86 %), BMI = 30 kg/m(2)] and 4-50 % of other CMM. The five most prevalent (≥71 %) CMM in obese subjects were high WC, low HDL-C, and three insulin-related CMM [Fasting insulin, HOMA-IR, and QUICKI]. For a BMI = 30 kg/m(2), J ranged from 16 % (HDL-C/LDL-C) to 68 % (WC), being moderately reliable (Jmax = 61-67) to predict high uric acid (UA), metabolic syndrome (MetS) and the hypertriglyceridemic-waist phenotype (HTGW). Corrected WCM/WCF were moderate-highly reliable (Jmax = 66-90) to predict HTGW, MetS, fasting glucose and UA. Most CMM were moderate-highly predicted at 27 ± 3 kg/m(2) (CI 95 %, 25-28), 85 ± 5 cm (CI 95 %, 82-88) and 81 ± 6cm (CI 95 %, 75-87), for BMI, WCM and WCF, respectively. CONCLUSION: BMI and WC are good predictors of several CMM in the studied population, although at different cutoffs than current reference values.

Changes in energy expenditure and physical activity over 15 years of environmental changes: The Maycoba project.

OBJECTIVE: This work aimed to parse out the role of changing environments on body composition, total energy expenditure, and physical activity in the Mexican Pima, a population experiencing rapid industrialization. METHODS: Using doubly labeled water, we compared energy expenditure and physical activity in a longitudinal cohort of Mexican Pima (n = 26; female: 12) in 1995 and 2010. Body mass and composition were assessed by bioimpedance analysis. To determine the effects of environmental factors on body weight independent of age, we compared the 1995 longitudinal cohort with an age- and sex-matched cross-sectional cohort (n = 26) in 2010. RESULTS: Body mass, fat mass, and fat-free mass all significantly increased between 1995 and 2010. Despite a 13% average increase in body weight, weight-adjusted total daily energy expenditure decreased significantly. Measured physical activity levels also decreased between 1995 and 2010, after we adjusted for weight. CONCLUSIONS: Our results suggest that the recent industrialization of the Maycoba region in Sonora, Mexico, has contributed to a decrease in physical activity, in turn contributing to weight gain and metabolic disease among the Mexican Pima.

Predictive equations for fat mass in older Hispanic adults with excess adiposity using the 4-compartment model as a reference method.

BACKGROUND: Predictive equations are the best option for assessing fat mass in clinical practice due to their low cost and practicality. However, several factors, such as age, excess adiposity, and ethnicity can compromise the accuracy of the equations reported to date in the literature. OBJECTIVE: To develop and validate two predictive equations for estimating fat mass: one based exclusively on anthropometric variables, the other combining anthropometric and bioelectrical impedance variables using the 4C model as the reference method. SUBJECTS/METHODS: This is a cross-sectional study that included 386 Hispanic subjects aged ≥60 with excess adiposity. Fat mass and fat-free mass were measured by the 4C model as predictive variables. Age, sex, and certain anthropometric and bioelectrical impedance data were considered as potential predictor variables. To develop and to validate the equations, the multiple linear regression analysis, and cross-validation protocol were applied. RESULTS: Equation 1 included weight, sex, and BMI as predictor variables, while equation 2 considered sex, weight, height squared/resistance, and resistance as predictor variables. R2 and RMSE values were ≥0.79 and ≤3.45, respectively, in both equations. The differences in estimates of fat mass by equations 1 and 2 were 0.34 kg and -0.25 kg, respectively, compared to the 4C model. This bias was not significant (p < 0.05). CONCLUSIONS: The new predictive equations are reliable for estimating body composition and are interchangeable with the 4C model. Thus, they can be used in epidemiological and clinical studies, as well as in clinical practice, to estimate body composition in older Hispanic adults with excess adiposity.

Effectiveness of a Lifestyle Change Program on Insulin Resistance in Yaquis Indigenous Populations in Sonora, Mexico: PREVISY.

To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆ = -0.91 and ∆ = -1.29, p ≤ 0.05) and the TyG index (∆ = -0.24 y ∆ = -0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆ = -3.32 and ∆ = -4.89, p ≤ 0.05) and the TyG index (∆ = -0.80 and ∆ = -0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes.

External validation of BIA equations to estimate appendicular skeletal muscle mass in older adults: Importance of the bias analysis and derivation of correction factors to achieve agreement.

There are several equations based on bioelectrical impedance analysis (BIA) to estimate with high precision appendicular skeletal muscle mass (ASM). However, most of the external validation studies have reported that these equations are inaccurate or biased when applied to different populations. Furthermore, none of the published studies has derived correction factors (CFs) in samples of community-dwelling older adults, and none of the published studies have assessed the influence of the dual-energy X-ray absorptiometry (DXA) model on the validation process. This study assessed the agreement between six BIA equations and DXA to estimate ASM in non-Caucasian older adults considering the DXA model and proposed a CF for three of them. This analysis included 547 non-institutionalized subjects over 60 years old from the northwest of Mexico who were physically independent and without cognitive impairment: 192 subjects were measured using DXA Hologic, while 355 were measured by DXA Lunar. The agreement between each of the equations and DXA was tested considering the DXA model used as a reference method for the design of each equation, using the Bland and Altman procedure, a paired t test, and simple linear regression as objective tests. This process was supported by the differences reported in the literature and confirmed in a subsample of 70 subjects measured with both models. Only six published BIA equations were included. The results showed that four equations overestimated ASMDXA, and two underestimated it (p < 0.001, 95% CI for Kim's equation:-5.86--5.45, Toselli's:-0.51--0.15, Kyle's: 1.43-1.84, Rangel-Peniche's: 0.32-0.74, Sergi's: 0.83-1.23, and Yoshida's: 4.16-4.63 kg). However, Toselli's, Kyle's and Rangel-Peniche's equations were the only ones that complied with having a homogeneous bias. This finding allowed the derivation of CFs, which consisted of subtracting or adding the mean of the differences from the original equation. After estimating ASM applying the respective CF, the new ASM estimations showed no significant bias and its distribution remained homogeneously distributed. Therefore, agreement with DXA in the sample of non-Caucasian was achieved. Adding valid CFs to some BIA equations allowed to reduce the bias of some equations, making them valid to estimate the mean values of ASM at group level.

Agreement between laboratory methods and the 4-compartment model in assessing fat mass in obese older Hispanic-American adults.

BACKGROUND/OBJECTIVES: Densitometry (Siri's and Brozek's equations), hydrometry (by the deuterium dilution technique), and dual-energy X-ray absorptiometry (DXA) are three methods for estimating body composition. However, because they are all based on certain assumptions, they may not be applicable to aged and obese subjects due to changes in their body composition. Hence, the validity of these "laboratory methods" could be affected in obese older people. The main aim was to assess the agreement between densitometry, hydrometry, and DXA with the 4-compartment (4C) model to estimate fat mass (FM) in obese older Hispanic-American adults. As secondary goals, we explored whether the bias in densitometry and hydrometry results could be improved by modifying the assumptions regarding fat-free mass (FFM) density and hydration factor (HF) values, respectively. In the case of DXA, we explored the factors that contribute to bias. SUBJECTS/METHODS: This is a cross-sectional study based on a sample of 171 obese subjects aged ≥60 years from 3 regions of northern Mexico. Body composition was assessed by the 4C model as the reference method and by all three laboratory methods. Agreement of the latter with the 4C model was probed by Bland and Altman analysis, a paired sample t-test, and simple linear regression analyses. In addition, the mean FFM density estimated in this sample, and HF values (published previously) of 0.737 and 0.753 for obese older Hispanic-American men and women, respectively, were considered as ethnic- and gender-specific values. These values were used to modify the densitometric and hydrometric equations in order to improve their bias. Finally, we tested whether the hydration status and indirect markers of adiposity are contributing factors to the bias of DXA using multiple linear regression analysis. RESULTS: Siri's equation overestimated FM by 0.57 kg (p < 0.01), while Brozek's equation, hydrometry, and DXA underestimated it by 1.24 kg, 0.89 kg, and 0.79 kg (p < 0.01), respectively, compared to the 4C model. The bias in the densitometry and hydrometry results was eliminated by substituting the ethnic- and gender-specific values into the equations. Finally, we found that hip circumference contributes to the bias in DXA. CONCLUSION: The densitometry, hydrometry, and DXA methods are not interchangeable with the 4C model for assessing fat mass in obese, older Hispanic-American adults. The lack of agreement could indicate that the assumptions of each method do not apply to this population.

Sarcopenia: Influence of Regional Skeletal Muscle Cutoff Points and Fat-Free Mass in Older Mexican People-A Pilot Study.

BACKGROUND: Variation in the prevalence of sarcopenia is related to the skeletal muscle index cutoff points applied. The objective of this pilot study was to examine the recruitment process for testing different sarcopenia definitions (ASMI cutoffs) in older Mexican adults. It explored whether the prevalence of sarcopenia decreased by applying ethnic- and gender-specific, DXA-derived appendicular skeletal muscle index (ASMI)-cutoff points in the definitions, as well as some associated factors in a sample of community-dwelling older Mexican people. METHODS: This is a pilot feasibility study that included a convenience sample of 217 community-dwelling older adults. Volunteers underwent DXA measurements and an assessment of functional status based on hand grip strength and physical performance. Six definitions were formed based on the 2010 EWGSOP criteria, but using different cutoff points for each of the three components, including regional cutoff points for ASMI derived from young Mexican adults. Several risk factors for sarcopenia were also assessed. RESULTS: The prevalence of sarcopenia varied according to the different definitions applied. The lowest level was found with the definition that applied regional ASMI-cutoff points (p < 0.01). The sarcopenic older adults had significant lower body weight, fat mass, and fat-free mass (FFM) than the nonsarcopenic subjects. The risk of sarcopenia increased with age and low FFM (p < 0.001). CONCLUSION: The present study demonstrates the feasibility of the main study, and our data support the notion that using regional ASMI cutoff points resulted in a low prevalence of sarcopenia. Therefore, it is preferable to estimate the prevalence of this condition using ethnic- and gender-specific cutoff points and to explore associated factors such as low FFM.

Chronic Effect of Fatmax Training on Body Weight, Fat Mass, and Cardiorespiratory Fitness in Obese Subjects: A Meta-Analysis of Randomized Clinical Trials.

Exercise training performed at the maximal fat oxidation intensity (FMT) stands out as a potential treatment of overweight and obesity. This work is a meta-analysis of randomized clinical trials of studies about the effect of FMT on fat mass and maximal oxygen consumption using PubMed, SCOPUS, EBSCOhost, and ScienceDirect as databases. Two independent reviewers selected 11 trials from 356 publications identified by the following keywords: fatmax, lipoxmax, maximal fat oxidation, peak of fat oxidation, physical training, physical exercise, body fat (BF), fat mass, overweight, and obesity. The risk of bias was assessed following the Cochrane Guidelines. The pooled mean difference was computed for each outcome with the random-effects model and the inverse-variance method. The meta-analysis was performed with the RevMan software v 5.3, and the heterogeneity across studies by the I2. The statistical significance was accepted at p < 0.05. Results showed that the FMT reduced body weight (MD = -4.30 kg, p < 0.01, I2 = 0%), fat mass (MD = -4.03 kg, p < 0.01, I2 = 0%), and waist circumference (MD = -3.34 cm, p < 0.01). Fat-free mass remains unchanged (MD = 0.08 kg, p = 0.85), but maximal oxygen consumption increased (MD = 2.96 mL∙kg-1∙min-1, p < 0.01, I2 = 0%). We conclude that FMT at short and medium-term (eight to twenty weeks) reduces body weight and BF, increasing cardiovascular fitness in low physical fitness people with obesity.

Effectiveness of the Healthy Lifestyle Promotion Program for Yaquis with Obesity and Risk of Diabetes in the Short and Medium Term: A Translational Study.

Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.

High Hydration Factor in Older Hispanic-American Adults: Possible Implications for Accurate Body Composition Estimates.

Age- and obesity-related body composition changes could influence the hydration factor (HF) and, as a result, body composition estimates derived from hydrometry. The aim of the present study was to compare the HF in older Hispanic-American adults to some published values. This cross-sectional study included a sample of 412 subjects, men and women, aged ≥60 years from northern Mexico. HF values were calculated based on the ratio of total body water-using the deuterium dilution technique-to fat-free mass, derived from the four-compartment model. The mean HF value for the total sample (0.748 ± 0.034) was statistically (p ≤ 0.01) higher than the traditionally assumed value of 0.732 derived from chemical analysis, the "grand mean'' value of 0.725 derived from in vivo methods, and the 0.734 value calculated for older French adults via the three-compartment model. The HF of the older women did not differ across the fat mass index categories, but in men the obese group was lower than the normal and excess fat groups. The hydration factor calculated for the total sample of older Hispanic-American people is higher than the HF values reported in the literature. Therefore, the indiscriminate use of these assumed values could produce inaccurate body composition estimates in older Hispanic-American people.

Prevalence of metabolic syndrome and its determinants in older Mexican non-diabetic adults.

INTRODUCTION: the prevalence of metabolic syndrome (MetS) is high in older people, and several factors have been explored as main determinants. However, few data exist for older people from low- and middle-income countries. Therefore, our objective was to estimate the prevalence of MetS. Secondly, to explore which of the cardio-metabolic, body composition, inflammatory and demographic risk factors were associated with the prevalence of MetS in a population of older Mexican adults. METHODS: data for this analysis were collected in subjects over 60 years of age from northwest Mexico. Fasting and two-hour glucose, fasting insulin, homeostasis model assessment of insulin resistance, lipid profiles, markers of adiposity and inflammation, and blood pressure were assessed. In addition, anthropometry and body composition data, levels of physical activity and demographic variables were also considered. MetS was diagnosed by three different criteria. RESULTS: total sample size was 369 subjects. The prevalence of MetS varied widely, from 36% to 52% depending on the criteria applied, but regardless of the criteria, all subjects with MetS were heavier and more overweight, and had higher triglyceride values and lower values of total HDL-cholesterol compared to those without MetS (p < 0.0001). Final models adjusted for age showed that, regardless of the diagnostic criteria applied, fat mass, the homeostasis model assessment and some demographic variables were main determinants of MetS in this sample of older people without diabetes. CONCLUSIONS: the prevalence of MetS is relatively high in non-diabetic older adults and it was associated with some biological and demographic factors as the main determinats.

Food neophobia, Mediterranean diet adherence and acceptance of healthy foods prepared in gastronomic workshops by Spanish students.

INTRODUCTION: food neophobia can affect dietary variety and hedonic acceptance due to rejection of healthy foods. OBJECTIVE: to evaluate the impact of dietary neophobia on adherence to the Mediterranean diet and on the hedonic acceptance of healthy foods made in gastronomic workshops by schoolchildren. METHODOLOGY: descriptive cross-sectional study of Primary (8-11) and Secondary (12-18) schoolchildren from Murcia, Spain, participating in gastronomic workshops, where two recipes were prepared and tasted (vegetables + blue fish and fruits). Food neophobia (FN) and adherence to the Mediterranean diet (KIDMED) were identified and each participant assessed the acceptance of each recipe using a hedonic scale (seven points). RESULTS: a total of 1,491 students (49.5% girls) participated in the study; 13.5% were neophobic and 61.1% presented optimal diet quality. A linear inverse relationship between the degree of neophobia and the quality of the diet (ρ[rho] = -0.31, p = 0.001) was found. High adherence to the Mediterranean diet was associated with lower neophobia and better hedonic scores, compared to intermediate or low adhesions (p < 0.0001). Neophobic schoolchildren presented significantly worse results in vegetable consumption, especially at the Secondary level, and in the acceptance of healthy preparations (p < 0.05). A good acceptance of the prepared preparations was associated with the usual adequate consumption of fruits, vegetables, fish and legumes. CONCLUSION: food neophobia affects the adherence to the Mediterranean diet and the acceptance of healthy foods elaborated in gastronomic workshops by Spanish schoolchildren.

Differences in Body Composition in Older People from Two Regions of Mexico: Implications for Diagnoses of Sarcopenia and Sarcopenic Obesity.

BACKGROUND: Mexico is a country that is rich in ethnicity and cultural diversity, divided into three well-defined socioeconomic, ecological, and epidemiological areas. However, we do not know the influence that these factors may have on body composition. Therefore, this study was designed to assess body composition and compare appendicular skeletal muscle mass (ASM) in older people from two areas of the country. METHODS: This is a cross-sectional study that included 430 subjects ≥60 years of age from northwestern and central Mexico. Body composition, including ASM, was measured by dual-energy X-ray absorptiometry, while anthropometry, handgrip strength, demographic variables, health status/chronic conditions, and energy expenditure data were all included. RESULTS: Men and women from the northwestern region had 5.9 kg and 3.8 kg more body fat, respectively, and 3.9 kg more as a group than their counterparts from central Mexico (p ≤ 0.0001). While there were no significant differences across gender or region in terms of ASM, the older subjects from central Mexico had a significantly higher ASM index (ASMI) than the sample from the northwest. When ASM was adjusted for age, body weight, height, health status/chronic conditions, estimated energy expenditure, and demographic variables, the subjects from central Mexico had significantly higher adjusted mean values of ASM and ASMI than their counterparts from the northwest. CONCLUSION: Older people from two regions of Mexico had significantly different estimates of body composition. Our findings highlight the importance of regionalizing estimates of ASM and ASMI if they are to be used for diagnostic purposes. It is also important to emphasize that appendicular skeletal muscle mass, or the ASM index, should be adjusted for other associated biological variables.

Body Image Satisfaction as a Physical Activity Indicator in University Students.

OBJECTIVE: We examined the association of body image satisfaction (BIS) with physical activity (PA) in university athletes and non-athletes from northern Mexico. METHODS: In a non-probability cross-sectional study, 294 participants (51% male, 41% athletes; 18-35 years old) completed 2 self-administered questionnaires to evaluate BIS and PA. We categorized somatotypes (endomorphy-mesomorphy-ectomorphy) by international standardized anthropometry. Data analysis included the Mann-Whitney U test, χ2test, Kendall's Tau-b correlation, binary logistic regression analysis, and receiver operating characteristic (ROC) curves. RESULTS: Self-perceived sports abilities and desirable body shape predicted 30% of sports participation in students, whereas an endomorphic shape (<5.4 units) and being male predicted 15.4% of sports participation. CONCLUSIONS: BIS was a reliable indicator of sports participation among these university students.

Double-blind randomised controlled trial of the independent and synergistic effect of Spirulina maxima with exercise (ISESE) on general fitness, lipid profile and redox status in overweight and obese subjects: study protocol.

INTRODUCTION: In order to reduce cardiovascular disease risk factors, a healthy diet must include dietary antioxidants from different sources (eg, Spirulina maxima) and regular practice of exercise should be promoted. There is some evidence from animal studies that S. maxima and exercise decrease cardiovascular disease risks factors. However, very few studies have proved the independent or synergistic effect of S. maxima plus exercise in humans. This study attempts to address the independent and synergistic effects in overweight and obese subjects participating in a systematic physical exercise programme at moderate intensity on general fitness, plasma lipid profile and antioxidant capacity. METHODS AND ANALYSIS: Using a randomised, double-blind, placebo-controlled, counterbalanced crossover study design, 80 healthy overweight and obese subjects will be evaluated during a 12-week isoenergetic diet accompanied by 4.5 g/day S. maxima intake and/or a physical systematic exercise programme at moderate intensity. Body composition, oxygen uptake, heart rate, capillary blood lactate, plasma concentrations of triacylglycerols, total, low-density and high-density lipoprotein cholesterol, antioxidant status, lipid oxidation, protein carbonyls, superoxide dismutase, catalase, glutathione, glutathione peroxidase, glutathione reductase and paraoxonase will be assessed. ETHICS AND DISSEMINATION: This study and all the procedures have been approved by the Universidad Autonoma de Ciudad Juarez Bioethics Committee. Findings will be disseminated through peer-reviewed journals, national and international conferences. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov: NCT02837666.

Body shape as body image determinant in university students.

INTRODUCTION AND OBJECTIVES: Body shape (BSP) and body image (BI) are part of the external physical structure, then modifications in body shape necessarily affect body image; however, both combined have not been studied. The purpose of the study was to evaluate the statistical relationship between BSP and BI in university students. METHOD: Two hundred and ninety-six participants (17-35 years) were included in this study. Different anthropometric measurements were used to define their somatotype (BSP), body mass index (BMI), waist to hip ratio (WHR) and waist circumference (WC). In addition, a questionnaire on body image perception was applied (McElhone et al.), regarding "how do I look?", "how do I think others see me?", "how do others see me?", and "how do I want to look like?". RESULTS: On average, men perceived themselves in normal weight; in contrast, women perceived themselves as overweight. Men were meso-endomorphic, while women were endo-mesomorphic as an average. CONCLUSION: Body shape measured as somatotype as well as WC and WHR were excellent determinants of body image. Participants who presented a higher endomorphy, WC and WHR and a lower ectomorphy had a higher appreciation of being overweight or obese and wish to become thinner.