Bioelectrical impedance analysis-derived phase angle (PhA) in lung cancer patients: a systematic review.

BACKGROUND: Lung cancer is the second most diagnosed cancer in the world. Up to 84% of diagnosed patients have malnutrition, which can negatively affect quality of life and survival and may worsen with neoadjuvant treatment. Bioelectrical Impedance Analysis-Derived Phase Angle (PhA) in these patients could be a valid tool to assess the nutritional status in order to improve their condition. METHODS: This review provides an update on PhA assessment in lung cancer patients over the past twenty years. We searched PubMed, Embase, Scopus, Web of Science, and Cochrane, for articles regarding the PhA obtained from Bioelectrical Impedance Analysis in lung cancer patients. The authors independently performed a literature search: sample size, patient population, study type, study dates, survival and interventions were evaluated. The final review included 11 studies from different countries. RESULTS: Eight studies only considered patients with lung cancer, while three studies considered patients with different kind of cancer, including lung. Correlation data between PhA and age are conflicting. In patients undergoing clinical treatment and patients undergoing surgical treatment lower PhA was observed. A lower PhA is associated with a shorter survival. In three studies emerged a relationship between Karnofski Performance Status and Handgrip Strenght with PhA. From one study, univariate logistic regression analysis showed that higher PhA values represent a protective factor for sarcopenia. CONCLUSION: Our research underlined interesting, but not conclusive, results on this topic; however more researches are needed to understand the clinical meaning of PhA.

Vitamin Nutritional Status in Patients with Pancreatic Cancer: A Narrative Review.

Due to the high mortality rate in Western countries, pancreatic cancer is considered one of the big killers, leaving patients and their families with little hope upon diagnosis. Although surgical and drug therapies are critical for cancer patients to improve life expectancy and alleviation of suffering, nutrition plays a key role in improving cancer treatment outcomes. This narrative review, conducted as part of the activities of the Italian Society of Human Nutrition (SINU) working group in oncology, focuses on the prevalence of vitamin malnutrition among pancreatic cancer patients. The results of the literature search show that pancreatic cancer patients are at a heightened risk of water-soluble vitamin deficiencies, particularly of vitamins B1, B3, and B6. Additionally, they also face an increased risk of deficiency of fat-soluble vitamins. Among these vitamins, the potential role of vitamin D in pancreatic cancer has garnered the most attention, with its plasma levels being identified as a significant factor in patient survival. Investigating vitamin nutritional status could provide valuable insights for incorporating nutritional approaches into the prevention and treatment of pancreatic cancer, thereby reducing the exacerbation of symptoms associated with the diagnosis.

Could BIA-derived phase angle predict health-related musculoskeletal fitness? A cross-sectional study in young adults.

OBJECTIVES: To our knowledge, little evidence exists on the relationships between body composition and health-related physical fitness; in particular, musculoskeletal fitness. Bioimpedance index phase angle (bioelectrical impedance analysis raw variables) is a candidate predictor of health-related fitness, a marker of fat-free and body cell mass, respectively. The aim of this study was to evaluate body composition, raw bioelectrical impedance analysis variables, and health-related fitness in young adults and investigate their mutual relationships to identify predictors of muscle strength. METHODS: The study included 229 young adults (115 men and 114 women; 24.2 ± 3 y; body mass index 19-30 kg/m²). Anthropometry was measured with standardized procedures. Whole-body BIA (50 kHz) was performed for impedance and phase angle. Predictive equations estimated fat-free mass and percentage body fat. The bioimpedance index was calculated as stature²/impedance. Musculoskeletal fitness was assessed by handgrip strength, standing broad jump, squat jump, and countermovement jump. RESULTS: In both sexes, health-related fitness had stronger associations with body composition than stature or weight. Handgrip strength was related to fat-free mass and bioimpedance index, while an inverse association with percent body fat emerged for standing broad jump, squat jump and countermovement jump. Phase angle is directly correlated with handgrip strength, standing broad jump, squat jump, and countermovement jump. In multiple regression analysis phase angle was an independent predictor of all health-related fitness tests, along with fat-free mass (or bioimpedance index) for handgrip strength, and with sex and percent body fat for the three jump tests. CONCLUSIONS: The present study provided consistent information on the relationships between body composition and health-related fitness in young adults. Phase angle emerged as a significant predictor of all health-related fitness measures and might be useful for a more consistent assessment of musculoskeletal fitness.

Association between health-related physical fitness indicators and working ability: a systematic review.

OBJECTIVES: Work ability (WA) reflects a balance between work demands and an individual's ability to meet them. It is influenced by several occupational and health-related factors including the individual's physical fitness (PF). Therefore, the aim of the present study was to provide an overview of the possible relationship between PF measures and the individual's WA. METHODS: A systematic review of studies published up to December 1, 2022 and available in PubMed, Scopus, and ISI Web of Science databases, was performed. Results have been summarized according to the specific PF parameter explored. RESULTS: The 14 reviewed studies, enrolling 47 to 1005 workers, all showed a satisfactory methodological quality. Some positive evidence emerged for a possible association between changes in aerobic capacity, walking speed, balance, flexibility, muscle strength, and WA perception. However, the limited number of studies, their cross-sectional design, the different PF performance indicators, populations, and job tasks explored prevented definite conclusions. CONCLUSIONS: Future longitudinal studies should be planned to confirm such positive results and identify PF indicators better predictive for changes in the WA of employees engaged in specific job tasks, particularly in physically demanding activities. This may be helpful to include PF performance tests in occupational health practice as an integrated part of risk assessment and management strategies as well as in health and well-being promotion plans.

High Nutritional Risk Is Associated with Poor Functional Status and Prognostic Biomarkers in Stroke Patients at Admission to a Rehabilitation Unit.

Considering that malnutrition (undernutrition) is common in stroke patients and may negatively impact body function, the aim of this study was to determine the relationship between nutritional risk and functional status in stroke patients at admission to a rehabilitation unit. Nutritional risk was assessed using the Geriatric Nutritional Risk Index (GNRI), the Prognostic Nutritional Index (PNI) and the Controlling Nutritional Status (CONUT) score. Functional status was assessed using the Barthel Index, the modified Rankin Scale, the Trunk Control Test and the Sitting Balance Scale, and cognitive function was assessed using the Short Portable Mental Status Questionnaire. C-reactive protein, fibrinogen and D-dimer were also evaluated as established prognostic biomarkers. Stroke patients (n = 245; age 69.7 ± 12.8 years; 47%, women; 82% ischemic stroke) at admission to a rehabilitation unit were included in this study. A high prevalence of nutritional risk was detected with each tool and was found to be greater using the GNRI and in patients aged ≥75 years. Multiple logistic regression analysis showed that age and dysphagia were independent predictors of high nutritional risk. High risk groups performed worse on all functional tests compared to the low-risk groups (p < 0.05). Nutritional risk with each tool was associated with functional and cognitive statuses (with the highest correlation being with the Trunk Control Test). Significant associations were also found with C-reactive protein, fibrinogen and D-dimer. In conclusion, a high nutritional risk, as evaluated with the GNRI, the PNI and the CONUT score, was detected in stroke patients at admission to a rehabilitation unit. High nutritional risk was associated with functional status and with predictors of clinical outcomes (and specifically in older patients).

Relationship between Nutritional Risk, Clinical and Demographic Characteristics, and Pressure Ulcers in Patients with Severe Acquired Brain Injuries Attending a Rehabilitative Program.

Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.

Controlling Nutritional Status (CONUT) score and the risk of mortality or impaired physical function in stroke patients: A systematic review and meta-analysis.

AIMS: The Controlling Nutritional Status (CONUT) score is a tool for assessing the risk of malnutrition (undernutrition) that can be calculated from albumin concentration, total peripheral lymphocyte count, and total cholesterol concentration. CONUT score has been proposed as a promising prognostic marker in several clinical settings; however, a consensus on its prognostic value in patients with stroke is lacking. The aim of this systematic review and meta-analysis was to evaluate the relationship between CONUT score and clinical outcomes in patients with stroke based on all current available studies. DATA SYNTHESIS: Systematic research on PubMed, Scopus and Web of Science from inception to February 2023 was performed on the association between CONUT score and clinical outcomes in patients with stroke. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Methodological quality was evaluated using the Newcastle-Ottawa Scale quality assessment tool. Pooled effect estimation was calculated by a random-effect model. Through the initial literature search, 15 studies (all high-quality) including 16 929 patients were found to be eligible and analysed in the meta-analysis. A significant risk of malnutrition (in most studies defined by a CONUT score ≥5) was directly associated with mortality, higher risk of poor functional outcome according to the modified Rankin Scale and total infection development. Evidence was consistent for acute ischaemic stroke and preliminary for acute haemorrhagic stroke. CONCLUSION: CONUT score is an independent prognostic indicator, and it is associated with major disability and infection development during hospitalisation. PROSPERO ID: CRD42022306560.

The Assessment of the Risk of Malnutrition (Undernutrition) in Stroke Patients.

Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients' clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols.

Comparison of bioelectrical impedance analysis-derived phase angle in individuals with different weight status.

OBJECTIVE: Obesity is characterized not only by an increase of fat mass but also by alterations in skeletal muscle. Bioimpedance analysis (BIA)-derived phase angle (PhA) may provide specific information on the inherent characteristics of fat-free mass, and is widely used as an index of poor nutritional status. The aim of this study was to describe whether and to what extent PhA varies depending on age, sex, and body mass index (BMI) in individuals with different weight status. METHODS: We selected 1877 participants for this retrospective study (two weight status groups): 983 individuals with obesity (age 40 ± 13.9 y; BMI 39.5 ± 7.2 kg/m²) and 894 controls (age 40 ± 13.3 y; BMI 24.6 ± 2.7 kg/m²). Anthropometry and PhA at 50 kHz for the whole body were performed in all participants. RESULTS: PhA was greater in men than in women, although a decline of PhA was observed with age, which was linear in women and occurred in men after 40 y of age. On the other hand, no significant differences were observed with increasing BMI in either sex; lower values might be observed when BMI >50 kg/m². CONCLUSIONS: A more detailed appraisal of BIA-derived PhA in obesity is reported in the present study, providing basic data that might be taken into consideration in prevention and clinical nutrition. Further studies are needed to explore differences of PhA in individuals with different weight status.

Bioelectrical Impedance Analysis-Derived Phase Angle and Body Composition Are Predictors of Health-Related Fitness in Children and Adolescents with Obesity.

There is little evidence in children and adolescents with obesity of the relationships between muscle strength/cardiorespiratory fitness (both components of health-related fitness = HRF) and body composition. Body composition and HRF were studied in 281 children and adolescents with obesity to explore their mutual relationship and to identify the predictors of HRF. By performing a bioelectrical impedance analysis (BIA), the fat-free mass (FFM) and percentage of body fat (%BF) were calculated, and the phase angle (PhA) was recorded. Handgrip strength (HGS), the standard broad jump (SBJ), and five broad jumps (FIVEBJ) were considered for the assessment of muscle strength, and the six-minute walking distance (SIXMWD) for cardiorespiratory fitness. The BMI Z-score was slightly higher in boys, and the %BF was higher in girls, with no difference in the FFM. HGS, the SBJ, and FIVEBJ were greater in the male sex. After controlling for sex, HGS was associated with the FFM, and with height, weight, and absolute BMI. On the contrary, the SBJ and FIVEBJ were negatively associated with adiposity, with a weak relationship with the FFM. The SIXMWD was only poorly related to height, the BMI Z-score, and the waist-to-height ratio. These results were confirmed with a multiple regression analysis. HGS, the SBJ, and FIVEBJ were higher in the first compared to the third tertile of the PhA in both sexes. The PhA also remained a consistent predictor of HGS, the SBJ, and FIVEBJ in a multiple regression analysis. In conclusion, the following predictors have been identified for HRF: the FFM for the isometric strength of the upper limbs and adiposity indicators for the SBJ and FIVEBJ. The PhA emerged as a proxy index of muscle strength.

Perceived Difficulties in Physical Tasks and Physical Fitness in Treatment- and Non-Treatment-Seeking Youths with Obesity.

Youths with obesity are more likely to experience physical and psychosocial distress which strongly limits physical activity, with consequences on the quality of life. Most evidence of lower physical fitness and physical activity levels has been reported in treatment-seeking samples, while few data are available in community samples. Our aim was to assess whether perceived difficulties in physical tasks and physical fitness performance differed between treatment- and non-treatment-seeking youths with obesity, enrolled from a hospital (H) and a school (S). Three hundred fifty-one youths (269 from H and 82 from S) were enrolled. Sports participation, sedentary habits and perceived difficulties in physical tasks were assessed by interview. Six-minute walk test (SMWD) and long jump (LJ) were performed. BMI Z-score, sedentary time and perceived difficulties were higher in H vs. S. In addition, youths from H scored worse in SMWD and LJ. For the same BMI Z-score, the perceived difficulties and physical fitness were poorer in the H compared to the S group. The setting (H) was the stronger predictor of perceived difficulties and lower performance. Our findings underline that physical aspects imposed by obesity are more evident in treatment-seeking youths. Counseling related to perceived difficulties in physical tasks and performance is useful to treat youth with obesity with appropriate and personalized modalities.

Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19.

Poor nutritional status is common (estimated prevalence 5-69%) in acute coronavirus disease-2019 (COVID-19), and has been associated with hospitalization, the need for intensive care, and mortality. Body composition (BC) and muscle function have also been related in such patients to poor disease outcomes. As the evidence in the literature is limited, a cross-sectional study was carried out to determine the frequency of malnutrition in a cohort of post-acute COVID-19 patients referred to a rehabilitation center after hospital discharge. BC and muscle strength were assessed and the differences between bedridden and not bedridden patients were specifically evaluated. The study sample was composed of 144 post-acute COVID-19 patients (mean age 64.8 years; males = 95), 37% of whom were bedridden (males = 60%). Nutritional status was evaluated with Mini-Nutritional Assessment (MNA) and Controlling Nutritional status (CONUT). Fat-free mass (FFM) and skeletal muscle mass (SM) were estimated using bioelectrical impedance analysis (BIA). Raw BIA variables (phase angle = PhA and impedance ratios = IRs) were also determined and handgrip strength (HGS) was measured. Dynapenia was identified according to the 2019 EWGSOP criteria. According to MNA, 18% (n. 26) of patients were malnourished and 62% (n. 89) were at risk of malnutrition. As for CONUT, 21% (n. 31) of cases had moderate-severe malnutrition and 58% (n. 83) had light malnutrition. Abnormalities of raw BIA variables (low PhA and high IRs) and low HGS were more common in bedridden patients, in those who were malnourished, or had low FFM or SM. Dynapenic patients were 65% men and 47% women. In conclusion, malnutrition, BC alterations, and low HGS occur in post-acute COVID-19 patients and are more common in bedridden patients. Further studies are needed to identify reliable algorithms for assessing nutritional status in post-acute COVID-19 patients undergoing rehabilitation.

Bioelectrical Impedance Analysis (BIA)- Derived Phase Angle in Children and Adolescents: A Systematic Review.

Phase angle (PhA), a directly-measured bioelectrical impedance analysis variable, is suggested to be a proxy of body cell mass as well as extracellular/intracellular water ratio, and is related to cellular integrity and functions. The aim of this systematic review was to evaluate PhA in healthy youths in relation to sex, age, weight status, physical fitness, and sports activities. A systematic literature search (preferred reporting items for systematic reviews and meta-analyses criteria) until January 2022 was performed using PubMed, Embase, Scopus, and Web of Science regarding studies on PhA in healthy children and adolescents 4-18 years of age. Quality was assessed according to the National Institute of Health. After removing duplicates and studies not fulfilling the inclusion criteria, 22 cross-sectional and 1 longitudinal were considered appropriate. As for quality, 14 articles were rated fair and 9 good. Ten studies found that PhA increases with age: the increase was more marked after puberty, whereas changes in younger subjects are by far less defined. A clear sex difference was found in adolescents, likely due to pubertal development. Limited evidence suggests that PhA increases in participants with very high BMI. Limited data were reported on physically active youths without convincing findings. Positive associations of PhA with physical fitness and fat-free mass were found in few studies. In conclusion, partial and limited evidence suggests that changes in PhA over the first 2 decades of life reflect modification in body composition and fat-free mass composition. Further studies are needed for confirming PhA as a relevant marker of nutritional status in youths.

Bioelectrical Phase Angle in Patients with Breast Cancer: A Systematic Review.

Breast cancer (BC) is the most common cancer diagnosed among women worldwide. Phase angle (PhA), a proxy measure of membrane integrity and function, has gained relevance in clinical practice and it has been suggested to be a prognostic and nutritional indicator. This systematic review aimed to explore PhA and its relationship with nutritional status and survival in BC patients. Four databases (PubMed, EMBASE, Web of Science, and CINAHL) were systematically searched until September 2021 for studies evaluating PhA in BC patients. A total of 16 studies met the inclusion criteria, where 11 were observational studies and 5 were interventional studies. Baseline PhA-value varied from 4.9 to 6.30 degrees, showing a great variability and heterogeneity across the selected studies. Available data suggested that PhA decreased by 5-15% after completing chemotherapy, and those effects might persist in the long term. However, the use of tailored nutritional and/or exercise programs during and after therapy could prevent PhA reduction and body derangement. High PhA values were found in women displaying a better nutritional status, while inconsistent data were found on survival. Therefore, further studies are needed to focus on the clinical relevance of PhA in BC patients, evaluating its association with disease outcomes and survival.

Cardiovascular and Neuronal Consequences of Thyroid Hormones Alterations in the Ischemic Stroke.

Ischemic stroke is one of the leading global causes of neurological morbidity and decease. Its etiology depends on multiple events such as cardiac embolism, brain capillaries occlusion and atherosclerosis, which ultimately culminate in blood flow interruption, incurring hypoxia and nutrient deprivation. Thyroid hormones (THs) are pleiotropic modulators of several metabolic pathways, and critically influence different aspects of tissues development. The brain is a key TH target tissue and both hypo- and hyperthyroidism, during embryonic and adult life, are associated with deranged neuronal formation and cognitive functions. Accordingly, increasing pieces of evidence are drawing attention on the consistent relationship between the THs status and the acute cerebral and cardiac diseases. However, the concrete contribution of THs systemic or local alteration to the pathology outcome still needs to be fully addressed. In this review, we aim to summarize the multiple influences that THs exert on the brain and heart patho-physiology, to deepen the reasons for the harmful effects of hypo- and hyperthyroidism on these organs and to provide insights on the intricate relationship between the THs variations and the pathological alterations that take place after the ischemic injury.

Body Composition and Bioelectrical-Impedance-Analysis-Derived Raw Variables in Pole Dancers.

Few data are available on the body composition of pole dancers. Bioelectrical impedance analysis (BIA) is a method that is used to estimate fat-free mass (FFM) and fat mass (FM), while raw BIA variables, such as the impedance ratio (IR) and phase angle (PhA), are markers of body cell mass and the ratio between extracellular and total body water. The aim of this study was to evaluate the body composition of pole dancers compared to controls, in particular, those raw BIA variables that are considered as markers of muscle composition. Forty female pole dancers and 59 controls participated in the study. BIA was performed on the whole body and upper and lower limbs, separately, at 5, 50, 100 and 250 kHz. The FFM, FFM index, FM and body fat percentage (BF%) were predicted. The bioelectrical impedance indexes IR and PhA were also considered. Pole dancers exhibited higher FFMI and BI indexes and lower BF%. PhA was greater and IRs were smaller in pole dancers than in controls for the whole body and upper limbs. Considering the training level, FFM, whole-body IR and PhA were higher in the professionals than non-professionals. Raw BIA variables significantly differed between the pole dancers and controls, suggesting a higher BCM; furthermore, practicing pole dancing was associated with a greater FFM and lower FM.

Raw bioelectrical impedance analysis variables (phase angle and impedance ratio) are significant predictors of hand grip strength in adolescents and young adults.

OBJECTIVES: Musculoskeletal fitness and body composition are major components of health-related physical fitness that are expected to be linked to each other. The aim of this study was to explore the association of musculoskeletal fitness (expressed as hand grip strength [HGS]) and raw bioelectrical impedance analysis (BIA) variables and other predictors in the second and third decades of life. METHODS: Four groups of healthy normal-weight and overweight participants were studied: 130 male adolescents (age 16.0 ± 1.1 y), 143 female adolescents (16.0 ± 0.9 y), 141 young men (25.5 ± 2.0 y), and 141 young women (25.2 ± 1.9 y). Raw BIA variables (impedance [Z] and phase angle [PhA]) for the whole body were measured at four frequencies (5, 50, 100, and 250 kHz), and HGS was measured in both upper limbs. RESULTS: HGS was higher in males than females and higher in young men than male adolescents. A fairly strong correlation emerged in both genders between HGS and raw BIA variables-that is, bioimpedance index (height2/Z), PhA, and impedance ratios (Z at high frequency/Z at low frequency). In multiple regression analysis, bioimpedance index, PhA, and impedance ratio were more effective predictors of HGS than BIA-derived estimates of body composition or anthropometric variables such as height, weight, and body mass index. In both genders, HGS was significantly higher in young adults than in adolescents for the same PhA or impedance ratio. CONCLUSIONS: This study provides some insight into the use of raw BIA variables and HGS in the first decades of life, suggesting a new approach for a reliable assessment of muscle quality in terms of both muscle structure and strength.

Resting energy expenditure in elite athletes: development of new predictive equations based on anthropometric variables and bioelectrical impedance analysis derived phase angle.

BACKGROUND: An accurate estimation of athletes' energy needs is crucial in diet planning to improve sport performance and to maintain an appropriate body composition. This study aimed to develop and validate in elite athletes new equations for estimating resting energy expenditure (REE) based on anthropometric parameters as well as bioimpedance analysis (BIA)-derived raw variables and to validate the accuracy of selected predictive equations. METHODS: Adult elite athletes aged 18-40 yrs were studied. Anthropometry, indirect calorimetry and BIA were performed in all subjects. The new predictive equations were generated using different regression models. The accuracy of the new equations was assessed at the group level (bias) and at the individual level (precision accuracy), and then compared with the one of five equations used in the general population or three athletes-specific formulas. RESULTS: One-hundred and twenty-six male athletes (age 26.9 ± 9.1 yrs; weight 71.3 ± 10.9 kg; BMI 22.8 ± 2.7 kg/m2) from different sport specialties were randomly assigned to the calibration (n = 75) or validation group (n = 51). REE was directly correlated with individual characteristics, except for age, and raw BIA variables. Most of the equations from the literature were reasonably accurate at the population level (bias within ±5%). The new equations showed a mean bias -0.3% (Eq. A based on anthropometric parameters) and -0.6% (Eq. B based on BIA-derived raw variables). Precision accuracy (individual predicted-measured differences within ±5%) was ~75% in six out of eight of the selected equations and even higher for Eq. A (82.4%) and Eq. B (92.2%). CONCLUSION: In elite athletes, BIA-derived phase angle is a significant predictor of REE. The new equations have a very good prediction accuracy at both group and individual levels. The use of phase angle as predictor of REE requires further research with respect to different sport specialties, training programs and training level.

Dynapenia is highly prevalent in older patients with advanced idiopathic pulmonary fibrosis.

Body composition and muscle strength are emerging aspects in idiopathic pulmonary fibrosis (IPF) clinical assessment. We aimed to study the relationships of handgrip strength (HGS) with anthropometric variables, body composition, and disease staging, and to evaluate the prevalence of dynapenia in 102 clinically stable IPF patients (70 M; mean age: 69.4 years). Fat-free mass (FFM), skeletal muscle (SM) were estimated with bioimpedance analysis. HGS was measured with a digital handle dynamometer for both dominant and non-dominant body sides. Dynapenia was identified according to six recognized criteria sets. Mean body mass index (BMI) was 28.2 ± 4.7 kg/m2, with a prevalence of overweight (BMI > 25 and < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2) of 35% and 37%, respectively. FFM and SM were greater in males, whereas percentage body fat was higher in women. HGS was higher and declined with age slightly more rapidly in men, showing a stronger correlation with FFM and SM. Dynapenia prevalence ranged from 20.6 to 56.9%, depending on the criteria used, and was more frequent in older patients and advanced disease. Dynapenia is highly prevalent in IPF. HGS is a promising proxy marker of muscle function to be used in clinical evaluation and follow-up programs.

Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review.

BACKGROUND & AIMS: Bioimpedance analysis-derived phase angle (PhA), as marker of body cell mass and cell integrity, might be altered in obesity, a condition which is characterized by alterations in muscle structure and function. The aim of this systematic review was to evaluate whether and to which extent PhA varies in individuals/patients with excess body weight focusing on: a) changes in PhA due to obesity; b) changes in PhA after bariatric interventions or training programs. METHODS: According to PRISMA criteria, a systematic literature search until February 2021 using PubMed, Embase, Scopus, and Web of Science was performed. Selection criteria included studies on patients with obesity without comorbidities other than metabolic diseases. RESULTS: A total of 278 articles were first identified. After removing duplicates and excluding studies that did not fulfil the inclusion criteria, the full text of the remaining 80 potentially relevant studies was examined to finally retrieve 11 cross-sectional and 10 longitudinal studies. Few studies have shown that PhA is lower in individuals/patients with obesity than in controls. The only study on the matter showed a decrease with age after the fourth decade of life. Four out of five studies reported consistently greater mean values in men than in women. In two studies PhA was lower in patients with severe obesity; in addition, Patients with low PhA had higher BMI and PhA was inversely correlated with fat mass. Longitudinal studies showed that PhA markedly decreased after bariatric surgery and slightly increased after training programs. CONCLUSIONS: Thus, a relatively low number of studies have evaluated PhA in individuals/patients with obesity with sometimes contradictory and preliminary results. PhA might be useful to evaluate muscle quality in individuals/patients with obesity but further studies are needed to more accurately associate this variable with changes in muscle structure and strength, as well as in metabolic functions.