A New Predictive Equation for Estimating Serum Ionized Calcium Levels in Patients on Chronic Hemodialysis.

BACKGROUND Circulating calcium mainly carries out its physiologic function in its ionized form (iCa). Clinically, iCa is usually estimated by multiplying the total calcium (TCa) level by 0.5 in the general population, but this method is not accurate when applied to patients on long-term hemodialysis (CHD). Accordingly, this study aimed to develop a predictive function for iCa in patients on CHD by incorporating TCa and other additional variables. MATERIAL AND METHODS This was a retrospective cross-sectional study consisting of 2 cross-sectional datasets: a derivation set including 469 CHD patients in June 2019, and a validation set including 446 CHD patients in September 2019. The derivation set's data were analyzed using the stepwise model selection of machine learning with 10-fold cross-validation to develop a predictive function for iCa. This predictive function was then applied to the validation set's data, and the predictive function's estimated iCa was compared with the actual laboratory iCa by using the paired-samples t test and intraclass correlation coefficient. RESULTS After analyzing the routine laboratory data parameters of patients in the derivation set, the following 5 variables were included in the predictive function of iCa: blood urea nitrogen, creatinine, phosphate, TCa, and albumin. This predictive function was applied to the validation set to yield an estimated iCa level that was not significantly different from the laboratory-measured iCa level of the validation dataset (P=0.676) with an excellent ICC of 0.905. CONCLUSIONS We developed a new predictive function that accurately measures the iCa in patients on CHD by using routine laboratory data.

Impact of Pre-Transplant Parathyroidectomy on Graft Survival: A Comparative Study of Renal Transplant Patients (2005-2015).

BACKGROUND Hyperparathyroidism poses significant risks for patients prior to kidney transplantation. However, the outcomes of patients who undergo parathyroidectomy before renal transplantation compared to those without such a procedure remain uncertain. This real-world data study aimed to examine the clinical outcomes of both patient groups. MATERIAL AND METHODS Using the Taiwan National Health Insurance Research Database, we conducted a retrospective cohort study on patients who underwent renal transplantation between January 2005 and December 2015. The patients were divided into two groups: a case group (n=294) with parathyroidectomy and a control group (n=588) without the need for parathyroidectomy before kidney transplantation. The groups were matched based on age, sex, dialysis vintage, and baseline characteristics at a 1:2 ratio. Hazard ratios (HR) were estimated using the Cox regression model. The main outcomes assessed were graft failure, mortality, and major adverse cardiovascular events (MACE) recorded until December 2019. RESULTS During a mean follow-up period of 6 years, a significant difference was observed in graft failure (HR 1.40; 95% confidence interval 1.10-1.79, p=0.007) between the two groups. After further adjustment, graft failure remained significant (HR 1.52; 95% CI 1.07-2.15, p=0.019). Additionally, machine learning-based feature selection identified the importance of parathyroidectomy (ranked 9 out of 11) before kidney transplantation in predicting subsequent graft failure. CONCLUSIONS Our study demonstrates that severe hyperparathyroidism requiring parathyroidectomy before kidney transplantation may contribute to poor post-transplant graft outcomes compared to patients who do not require parathyroidectomy.

Cardiometabolic Indices after Weight Loss with Calcium or Dairy Foods: Secondary Analyses from a Randomized Trial with Overweight/Obese Postmenopausal Women.

The role of dairy foods and calcium/vitamin D supplements in cardiometabolic diseases is unknown. The objective of this secondary analysis is to investigate cardiometabolic risk factors changes after a 6-month weight-loss intervention in overweight/obese postmenopausal women divided in three groups: Ca+vitamin D supplements (S); low-fat dairy foods (D; 4−5 servings/day); or control/placebo pills (C), as complements to hypocaloric diets. The original study focused on bone/body composition. This analysis included blood pressure (BP), and serum triglycerides, lipids (including apoproteins Apo1 and ApoB), adipokines, and C-reactive protein in n = 97 participants who finished with complete data points. Systolic BP decreased 5.1%, 4.8%, and 1.8% in S, D, and C groups, respectively (p < 0.05 for S and D vs. baseline and vs. C at 6 months). Reduction in triglycerides and ratio of total cholesterol (TC)/high-density lipoproteins cholesterol (HDL-C) was the highest in S, while the reduction in TC and LDL-C was the highest in D group (all p < 0.05). Leptin and ApoB significantly decreased and adiponectin and ApoA1 increased in all groups. In conclusion, although the C group's participants experienced an improvement in some of the cardiometabolic indices with weight loss, those in the S and D groups showed significantly better results in most of the outcomes, indicating the beneficial effects of low-fat dairy foods and/or Ca+vitamin D intake as complements to a hypocaloric diet.

Role of Calcium and Low-Fat Dairy Foods in Weight-Loss Outcomes Revisited: Results from the Randomized Trial of Effects on Bone and Body Composition in Overweight/Obese Postmenopausal Women.

Several studies have investigated the possibility of dairy foods and calcium (Ca) mediating weight and body composition, but a consensus has not been reached. We aimed to investigate weight-loss-related outcomes during intervention with low-fat dairy foods or Ca + vitamin D supplements, both as complements to hypocaloric diets. Overweight/obese Caucasian, early-postmenopausal women (n = 135) were recruited for a 6 month energy-restricted weight loss study complemented with either low-fat dairy foods (D; 4-5 servings/day), or Ca + vitamin D supplements (S); both to amount a total of ~1500 mg/day and 600 IU/day of Ca and vitamin D, respectively, or placebo pills (C). Bone mineral density (BMD) and lean and fat tissue were measured by Lunar iDXA. Serum and urinary markers of bone turnover were analyzed. Diet and physical activity were assessed with 3-day records. Participants on average lost ~4%, ~3%, and ~2% of body weight, fat, and lean tissue, respectively. The significantly better outcomes were noticed in participants in the D group regarding body composition (fat loss/lean tissue preservation) and in participants in the S group regarding the BMD outcomes, compared to those in the C group. Therefore, increasing low-fat dairy foods to 4-5 servings/day and/or increasing Ca & vitamin D intake by supplements (in those who are at the borderline dietary intake) may be beneficial for weight loss/maintenance and may lead to more favorable bone and body composition outcomes in postmenopausal women during moderate weight loss.

Female Distance Runners Training In Southeastern United States Have Adequate Vitamin D Status.

BACKGROUND: High rates of vitamin D deficiency have been reported in athletes. The purpose of this study was to evaluate the associations between vitamin D with bone health and parathyroid hormone (PTH) concentrations in female runners who trained at 30.4° degrees north. METHODS: Serum 25-hydroxyvitamin D (25(OH) D), PTH, body composition, and bone mineral density (BMD) were measured in 59 female runners, aged 18-40 years. Stress fracture history, training duration and frequency were evaluated by questionnaire. As per National Endocrine Society cut-offs, serum vitamin D ranges were: 25(OH)D < 50 nmol/L for deficient; 50-75 nmol/L for insufficient; and ≥ 75 nmol/L for sufficient status. RESULTS: Mean serum 25(OH)D concentrations were 122.6 ± 63.9 nmol/L, with 18.6% of subjects in the deficient (5.1%) or insufficient (13.5%) range. No significant differences were observed between sufficient and deficient/insufficient subjects for BMD, PTH, history of stress fractures, or demographic data. CONCLUSIONS: The majority of distance runners maintained sufficient vitamin D status, suggesting that training outdoors in latitude where vitamin D synthesis occurs year-round reduces the risk for vitamin D deficiency. Data do not support the indiscriminate supplementation of outdoor athletes in southern latitudes without prior screening.

The Effects of Resistance Training on Physical Function and Quality of Life in Breast Cancer Survivors.

Breast cancer survivors (BCS) exhibit decreased physical function and quality of life (QOL) following cancer treatments. Resistance training (RT) may elicit positive changes in physical and mental well-being. This study assessed 27 BCS, pre-and post-intervention (six months) on the following variables: muscular strength (via one repetition maximum (1RM) of chest press and leg extension), physical function (via the Continuous Scale-Physical Functional Performance test) and QOL (via the Short Form-36 survey). RT consisted of two days/week of ten exercises including two sets of 8-12 repetitions at 52%-69% of their 1RM. A repeated measures analysis of variance revealed BCS significantly (p < 0.05) increased upper (71 ± 22 to 89 ± 22 kg) and lower body (74 ± 18 to 93 ± 24 kg) strength, total physical function (65.5 ± 12.1 to 73.6 ± 12.2 units) and the subcomponents of physical function: upper body strength (63.5 ± 16.3 to 71.2 ± 16.8 units), lower body strength (58.5 ± 14.9 to 68.6 ± 16.3 units), balance and coordination (66.5 ± 12.2 to 74.6 ± 11.6 units), and endurance (67.2 ± 12.0 to 75.0 ± 11.6 units). No changes were observed over time for subjective measures of physical function and QOL. Results showed RT could be an effective means to improve objective physical function in BCS. Further research is needed to clarify the effects of RT on subjective physical function and QOL.

New insight into fat, muscle and bone relationship in women: determining the threshold at which body fat assumes negative relationship with bone mineral density.

BACKGROUND: The aim was to investigate the relationships among lean mass (LM), fat mass (FM), and bone mineral density (BMD) in women stratified by body mass index (BMI) (BMI - normal-weight, overweight, obese) and to determine threshold at which body fat assumes negative relationship with BMD. METHODS: This was a cross-sectional study in 471 healthy Caucasian women, aged 18-67 years. BMD, LM, and FM were measured using dual-energy X-ray absorptiometry. Analysis of variance with Bonferroni corrections was used to test the BMI group differences. Linear regression was used to examine independent contributions of LM and FM on BMD of various skeletal sites (controlling for age and height). In overweight/obese women PROC LOESS plots were used to determine the inflection points at which either LM or FM relationship with BMD changes direction. Separate analyses in pre- and post-menopausal women were conducted as well. RESULTS: Spine and femoral neck BMD were not different among three BMI groups while total body, femur and radius BMD were statistically different (the highest in the obese group). Linear regression revealed that LM had significant positive association with BMD of various skeletal sites in all groups. FM showed a negative association with BMD of femoral neck and femur in normal-weight and spine in overweight women, but a positive association with radius in obese women. Inflection points showed that body fat between 33% and 38% assumed negative relationship with BMD for most skeletal sites in overweight and obese women. CONCLUSIONS: Although LM has strong positive relationship with BMD, FM above 33% in overweight/obese women is negatively related to BMD of most skeletal sites. Therefore, overweight/obesity after certain amount of FM, may not be a protective factor against osteoporosis in females. For clinical practice in women, it is important to maintain LM and keep FM accrual below ~30% body fat to maintain good skeletal health.

Body composition and muscular strength as predictors of bone mineral density in African American women with metabolic syndrome.

Our cross-sectional study investigated the relationships between regional bone mineral density (BMD) and body composition variables, including total body lean mass (LM) and fat mass (FM), as well as muscular strength in overweight and obese African-American (AA) women with metabolic syndrome (MetS). Forty-four women ranging in age from 39 to 61 years participated. Upper and lower body strength measurements were assessed using chest press and leg extension exercises, respectively. Body composition and BMD of the total body, spine (L2-L4), hip, and radius were measured by dual-energy X-ray absorptiometry. LM was positively correlated with total body, spine, hip, and radius BMD (r = .338-.603, all P < .05), and FM was positively correlated with total body BMD (r = .343, P < .05). In multiple linear regression analyses after controlling for age, height, total energy, and calcium intake, LM was a significant positive determinant of BMD at various skeletal sites (P < .05), while FM was negatively related to BMD of total hip (P < .05). Our results indicate that LM is an independent predictor of total body, spine, hip, and total radius BMD. In contrast, FM is a negative predictor of total body and hip BMD in overweight or obese AA women with MetS (P < .05). Upper and lower body muscular strength measures were not associated with BMD at any skeletal sites. These results suggest an important role for LM in preventing the development of osteopenia and osteoporosis.

The effects of a 6-month resistance training and dried plum consumption intervention on strength, body composition, blood markers of bone turnover, and inflammation in breast cancer survivors.

The purpose of this study was to examine the effects of resistance training (RT) and dried plum (DP) consumption on strength, body composition, blood markers of bone, and inflammation in breast cancer survivors (BCS). Twenty-three BCS (RT, n = 12; RT+DP, n = 11), aged 64 ± 7 years, were evaluated at baseline and after 6 months of intervention on the following: muscular strength (chest press and leg extension) via 1-repetition maximums (1RMs); body composition, specifically bone mineral density (BMD) by dual energy X-ray absorptiometry; biochemical markers of bone turnover (bone-specific alkaline phosphatase (BAP), tartrate resistant acid phosphatase (TRAP-5b)); and inflammation (C-reactive protein (CRP)). Target RT prescription was 2 days/week of 10 exercises, including 2 sets of 8-12 repetitions at ∼60%-80% of 1RM. RT+DP also consumed 90 g of DP daily. There were no baseline differences between groups or any group-by-time interactions for any of the variables. BCS increased upper (p < 0.05) (RT: 64 ± 14 to 80 ± 17 kg; RT+DP: 72 ± 23 to 91 ± 20 kg) and lower (p < 0.05) (RT: 69 ± 20 to 87 ± 28 kg; RT+DP: 78 ± 19 to 100 ± 21 kg) body strength. Body composition and BMD improvements were not observed. TRAP-5b decreased in the RT group (p < 0.05) (4.55 ± 1.57 to 4.04 ± 1.63 U/L) and the RT+DP group (p = 0.07) (5.10 ± 2.75 to 4.27 ± 2.03 U/L). Changes in BAP and CRP were not observed. RT was effective for improving biochemical markers of bone turnover and muscular strength in BCS. A longer and higher intensity intervention may be needed to reveal the true effects of RT and DP on body composition and biochemical markers of inflammation.

Use of CHAID decision trees to formulate pathways for the early detection of metabolic syndrome in young adults.

Metabolic syndrome (MetS) in young adults (age 20-39) is often undiagnosed. A simple screening tool using a surrogate measure might be invaluable in the early detection of MetS. Methods. A chi-squared automatic interaction detection (CHAID) decision tree analysis with waist circumference user-specified as the first level was used to detect MetS in young adults using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 Cohort as a representative sample of the United States population (n = 745). Results. Twenty percent of the sample met the National Cholesterol Education Program Adult Treatment Panel III (NCEP) classification criteria for MetS. The user-specified CHAID model was compared to both CHAID model with no user-specified first level and logistic regression based model. This analysis identified waist circumference as a strong predictor in the MetS diagnosis. The accuracy of the final model with waist circumference user-specified as the first level was 92.3% with its ability to detect MetS at 71.8% which outperformed comparison models. Conclusions. Preliminary findings suggest that young adults at risk for MetS could be identified for further followup based on their waist circumference. Decision tree methods show promise for the development of a preliminary detection algorithm for MetS.

Physical performance in relation to body composition and bone mineral density in healthy, overweight, and obese postmenopausal women.

BACKGROUND AND PURPOSE: Diminished physical performance can be detrimental among the older adults, causing falls and subsequent fractures, loss of independence, and increased morbidity and mortality rates. Therefore, it is important to maintain functional ability from the early onset of aging. The purpose of this study was to investigate the relationship between physical performance measures and body composition (bone, fat, and lean mass) in healthy, overweight and obese, early postmenopausal white women. METHODS: A total of 97 participants aged 56.0 (4.4) years (mean (SD)) with body mass index of 31.0 (4.6) kg/m(2) were included. Weight and height were recorded and 3 days of dietary records and physical activity were collected. Dual-energy x-ray absorptiometry measurements for body composition and bone mineral density were performed. Fasting blood samples were used for serum 25-hydroxy vitamin D (25OHD) analysis. Measures of physical performance included handgrip strength, 8-meter walking speed, one-leg-stance time, 8-foot Timed Get-Up-and-Go Test, and chair sit-to-stand test. RESULTS: Results showed that higher lean mass was related to better physical performance on items assessing body strength, including handgrip (r ranged from 0.22 to 0.25, P < .05) while higher body fat was related to the poorer physical performance in each of the assessed measures. Bone mineral density of the forearm was positively related to the handgrip strength (r = 0.207, P < .05). In regression analyses (controlled for age, weight, height, serum 25OHD status, calcium intake, physical activity, and smoking), fat mass of the lower extremities was inversely related to walking speed, one-leg-stance time, and Get-Up-and-Go measures, all crucial for mobility (r(2) = 0.13-0.23, P < .05). CONCLUSIONS: Overall, higher fat and lower lean mass was related to poorer physical performance, while forearm bone mineral density was related to the handgrip strength only. Further investigation may be beneficial for a better understanding of how body composition may prevent decline in physical performance among overweight/obese, mid-age, and older women.

Dietary and training predictors of stress fractures in female runners.

PURPOSE: To compare female runners with and without a history of stress fractures to determine possible predictors of such fractures. METHODS: 27 female runners (age 18-40 yr) who had had at least 1 stress fracture were matched to a control sample of 32 female runners without a history of stress fractures. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (iDXA). Subjects answered questionnaires on stress-fracture history, training, menstrual status, and diet. RESULTS: No significant differences were found in menstrual characteristics, diet and dairy intake, or bone measurements. Weekly servings of milk during middle school significantly predicted BMD at the femur (p = .010), femoral neck (p = .002), Ward's triangle (p = .014), and femoral shaft (p = .005). Number of menstrual cycles in the previous year predicted femoral-neck BMD (p = .004). Caffeine intake was negatively associated with BMD of the femur (p = .010), femoral neck (p = .003), trochanter (p = .038), and femoral shaft (p = .035). Weekly hours of training were negatively associated with total-body BMD (p = .021), total-body bone mineral content (p = .028), and lumbar-spine BMD (p = .011). Predictors for stress fractures included the number of years running, predominantly running on hard ground, irregular menstrual history, low total-body BMD, and low current dietary calcium intake when controlling for body-mass index (Nagelkerke R2 = .364). CONCLUSIONS: Servings of milk during middle-school years were positively correlated with hip BMD, although current calcium intake, low BMD, irregular menstrual history, hard training surface, and long history of training duration were the most important predictors of stress fractures.

Evidence for the association between abdominal fat and cardiovascular risk factors in overweight and obese African American women.

OBJECTIVE: To determine the association between total body fat and abdominal region fat derived from dual-energy x-ray absorptiometry (DXA) scans and cardiovascular disease (CVD) risk factors in middle- to older-aged African American (AA) women. We also compared tape-measured waist and hip circumference and their ratio (WHR) with DXA measurements in the context of CVD risk factor predictability. METHODS: Participants included 59 overweight or obese African American women (age, 48.7 ± 5.6 years). Anthropometries, including waist and hip circumferences, were measured, and DXA scans were used to derive fat mass from the total body and abdominal region. Blood analyses included glucose, total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol/HDL and LDL/HDL ratios, C-reactive protein (CRP), and fibrinogen. Multiple linear regression models were used to investigate the association among DXA-derived fat mass measures, waist circumference, WHR, and cardiovascular risk factors. RESULTS: Among DXA-derived fat mass measures, DXA-derived abdominal fat mass showed the best prediction for glucose and triglycerides, although waist circumference and DXA-derived abdominal fat mass had equivalent capacity for predicting the total cholesterol/HDL ratio. Furthermore, waist circumference showed the best prediction for LDL/HDL ratio and CRP. CONCLUSIONS: Both DXA-derived abdominal fat mass and waist circumference had comparable capacity for predicting blood lipid profiles and CRP. Therefore, if waist circumference is measured correctly, it could be used as the simplest means of predicting CVD risk factors in overweight/obese AA women when DXA is not available.

Weight and body-composition change during the college freshman year in male general-population students and Army Reserve Officer Training Corps (ROTC) cadets.

PURPOSE: To examine relationships between changes in body weight, body composition, and fitness level in male students of the general population and those in the Army Reserve Officer Training Corps (ROTC) program during the freshman year of college. METHODS: Thirty-seven (18.4 ± 0.7 yr) healthy, nonsmoking, first-semester-resident male students were divided into 3 groups: low active (LA), high active (HA), and ROTC. Baseline (beginning of freshman year) and 6-month follow-up measurements included anthropometry, body composition (by DXA), 3-day food records, and physical activity (PA) assessment. RESULTS: Weight and body-mass index did not change significantly within or among groups. HA participants compared with LA and ROTC had a significant decrease in body fat (-1.6% ± 2.5% vs. 1.9% ± 1.2% and 0.8% ± 2.2%, respectively). They also had a significant increase in lean mass compared with LA and ROTC (1.8 ± 1.1 kg vs. -0.2 ± 2.0 kg and 0.2 ± 1.7 kg, respectively). All p values were <.05. ROTC and LA participants were similar in all measures of body composition and PA and had significantly lower PA levels than the HA group. No significant relationships were observed between dietary variables and body-composition changes. CONCLUSIONS: These results suggest that higher PA was the most powerful determinant in achieving favorable body-composition outcomes. In addition, current physical training conducted by ROTC at Florida State University (which seems to be a practice nationwide) might not be sufficient to offset gains in body fat.

Validation of body adiposity index as a measure of obesity in overweight and obese postmenopausal white women and its comparison with body mass index.

OBJECTIVE: The purpose of this study was to evaluate whether the recently developed body adiposity index (BAI) in Mexican American and African American women could be validated in postmenopausal American white women and to determine if it is a better obesity classification measure than body mass index (BMI) is in the latter population. METHODS: Total body percentage adiposity (%adiposity) measured by dual-energy x-ray absorptiometry (DXA) was compared with total body %adiposity predicted by BAI in 187 overweight/obese postmenopausal white women (mean ± SD %adiposity, 45.9 ± 4.9% and 38.3 ± 6.2% for DXA and BAI, respectively). SPSS 19.0 and Medcalc 11.6.1.0 were used to conduct Pearson's correlations (r), paired t test, receiver operating curve, and Lin's concordance coefficient (ρc) and to create Bland and Altman's limit-of-agreement plot. RESULTS: Pearson's correlation analysis revealed a strong association between DXA %adiposity and BAI (r = 0.78, P < 0.001), DXA %adiposity and BMI (r = 0.75, P < 0.001), and BMI and BAI (r = 0.90, P < 0.001). Bias correction factor was 0.51 between DXA %adiposity and BAI. Paired t test showed a significant mean difference between measurements (P < 0.0001), and the plot showed that BAI underestimated DXA %adiposity by 7.56%. Concordance coefficient (ρc = 0.39; 95% CI, 0.33-0.46) revealed a poor agreement strength. There was no difference between the area under the curve statistic for BAI and BMI. CONCLUSION: Based on our results, BAI has limitations for use in a clinical setting in overweight/obese postmenopausal white women but may be practical for research applications and eventually developed into an easy method to estimate overweight/obesity in other settings.

Effects of resistance training and walking on cardiovascular disease risk in African-American women.

PURPOSE: The study's purpose was to evaluate the effects of walking (W) and walking plus resistance training (WRT) on cardiovascular disease risk factors in inactive middle-aged (49.0 ± 5.5 yr) African-American women (body mass index = 34.7 ± 6.4 kg·m(-2)). METHODS: Body composition, blood pressure, HDL cholesterol, triglycerides, glycosylated hemoglobin (HbA1c), C-reactive protein, and fibrinogen were measured before and after a 12-wk exercise intervention. Subjects were randomly assigned to one of two training groups. The W group (n = 25) was instructed to increase daily pedometer-measured walking to ≥10,000 steps per day, whereas the WRT group (n = 19) was given the same walking prescription plus supervised resistance training 2 d·wk(-1). A two-way repeated-measures ANOVA with an intention-to-treat analysis was performed to examine changes between groups. Significance was accepted at P ≤ 0.05. RESULTS: Both groups significantly (P < 0.001) increased walking (W = 5453 ± 2119 to 6845 ± 2279 steps per day, WRT = 4823 ± 1758 to 6859 ± 2012 steps per day). WRT significantly (P < 0.001) increased both upper (100 ± 15 to 113 ± 18 kg) and lower (102 ± 20 to 116 ± 25 kg) body strength compared with W. WRT significantly decreased waist circumference (94.8 ± 12.3 to 92.9 ± 12.0 cm, P = 0.021) and total fat mass (42.6 ± 11.1 to 41.8 ± 10.8 kg, P = 0.036) compared with W. WRT also significantly decreased pre- to postintervention body fat (45.8% ± 6.2% to 45.3% ± 6.2%, P = 0.018), HbA1c (5.9% ± 1.2% to 5.6% ± 1.0%, P = 0.028), and mean glucose calculated from HbA1c (122 ± 39 to 114 ± 32 mg·dL(-1), P = 0.028), whereas W showed no changes. Blood pressure, HDL cholesterol, triglycerides, and C-reactive protein were not affected by either intervention. CONCLUSIONS: Although both interventions increased steps per day, WRT was more effective in improving several body composition measures and glucose control in 12 wk. WRT may be an important addition to a lifestyle intervention aiming to facilitate reductions in cardiovascular disease risk factors in overweight and obese African-American women.

Self-efficacy improves weight loss in overweight/obese postmenopausal women during a 6-month weight loss intervention.

The objective was to examine the relationship between self-efficacy and subsequent weight loss during a 6-month weight loss intervention in 90 white early postmenopausal healthy women. We hypothesized that participants with higher self-efficacy scores, either at baseline or follow-up, would lose more weight than those with lower scores. Each participant received a balanced meal plan with reduced energy intake. Nutritional and behavioral sessions were provided every 2 weeks during the first 3 months. Weight and height were measured at baseline, every 2 weeks in the first 3 months, and at month 6. Three-day dietary and physical activity records and Weight Efficacy Lifestyle Questionnaire were completed at the same intervals. At month 6, participants lost 3.6 ± 4.1 kg or 4.4% (mean ± SD) and decreased in weight from 82.2 ± 11.1 kg to 77.6 ± 11.4 kg (P < .001). When participants were divided into groups based on weight loss success (<5% or ≥5% of initial weight), logistic regression (controlling for age, energy intake, physical activity, attendance at group sessions, and previous weight loss attempts) demonstrated that higher self-efficacy for the Availability of Food subscale of Weight Efficacy Lifestyle Questionnaire (95% confidence interval, 1.03-1.17) and total self-efficacy (95% confidence interval, 1.00-1.04) were associated with a greater likelihood of losing 5% or more of initial weight. Overall, participants who had higher total self-efficacy and self-efficacy to resist eating when food was available were able to lose more weight. Therefore, cognitive-behavioral efforts promoting self-efficacy may be useful for bolstering individual's confidence to resist eating under various conditions and thereby improve weight loss outcomes.

Vitamin D status and Framingham risk score in overweight postmenopausal women.

BACKGROUND: Epidemiologic studies have suggested associations between vitamin D status and coronary heart disease (CHD) risk. The purpose of this work was to determine if vitamin D status was predictive of CHD risk assessed by Framingham risk score (FRS) in overweight, Caucasian, postmenopausal women, using the baseline data collected in a clinical trial. METHODS: The study comprised 178 women aged 42-67 years (mean±standard deviation [SD] 55.7±4.3). Fasting serum was used to analyze blood lipids and vitamin D. The status of the latter was determined based on serum 25-hydroxyvitamin D [25(OH)D], with inadequacy defined as serum 25(OH)D <75 nmol/L (or <50.0 nmol/L, per new Institute of Medicine recommendations). Usual dietary intake and activity were assessed using 3-day food and 2-day activity records, respectively. Education, medical history, blood pressure, and anthropometric measures were obtained as well. Season was determined based on date of blood draw. RESULTS: Mean serum 25(OH)D concentration was 65.3±27.5 nmol/L (range 7.0-147.6 nmol/L); 66% (n=118) and 32% (n=57) of subjects were vitamin D insufficient [25(OH)D <75 nmol/L or <50 nmol/L, respectively] of which 14% (n=25) were vitamin D deficient [25(OH)D <37.5 nmol/L]. Body mass index (BMI) was a significant negative and dietary vitamin D positive predictor of 25(OH)D. In hierarchical regression, FRS was predicted by education level only. No association was observed between 25(OH)D and FRS (p=0.981). CONCLUSIONS: Serum 25(OH)D concentrations were inversely associated with BMI, but no relationship with FRS was found. Given the physiologic importance of vitamin D, further investigations aimed at determining the effects of obesity and heart disease on vitamin D requirements are warranted.

Females have a greater incidence of stress fractures than males in both military and athletic populations: a systemic review.

OBJECTIVE: The purpose of this study was to review incidence of stress fractures in military and athlete populations and identify factors explaining causes and differences in the incidence among genders. METHODS: Searches were conducted using several major databases. The studies were included if they were original studies including both male and female subjects and their aim was to identify incidence rates and risk factors contributing to the development of stress fractures. Of several thousand studies, 11 focusing on military populations and 10 on athletes are discussed. RESULTS: In both populations, females had higher incidence of stress fractures, with incidence of approximately 3% and approximately 9.2% for males and females, respectively, in military populations and approximately 6.5% and approximately 9.7%, respectively, in athletes. CONCLUSIONS: Factors possibly explaining why females are more susceptible to stress fractures include bone anatomy, lower aerobic capacity, smaller muscle, and poor diet. However, both female recruits and athletes with normal weight and bone health are less likely to develop stress fractures, showing that gender is less important than the overall physical shape/condition.

Aerobic exercise and whole-body vibration in offsetting bone loss in older adults.

Osteoporosis and its associated fractures are common complications of aging and most strategies to prevent and/or treat bone loss focused on antiresorptive medications. However, aerobic exercise (AEX) and/or whole-body vibration (WBV) might have beneficial effect on bone mass and provide an alternative approach to increase or maintain bone mineral density (BMD) and reduce the risk of fractures. The purpose of this paper was to investigate the potential benefits of AEX and WBV on BMD in older population and discuss the possible mechanisms of action. Several online databases were utilized and based on the available literature the consensus is that both AEX and WBV may increase spine and femoral BMD in older adults. Therefore, AEX and WBV could serve as nonpharmacological and complementary approaches to increasing/maintaining BMD. However, it is uncertain if noted effects could be permanent and further studies are needed to investigate sustainability of either type of the exercise.