ABSTRACT
BACKGROUND: Traditional metrics such as body mass index (BMI) and waist circumference (WC) fail to accurately assess the health outcomes associated with abdominal adiposity, because they neglect the intricacies of adipose tissue distribution. Notably, the variability in body composition scaled to height remains underexplored in Chinese demographics. This study introduces height-normalised indices of abdominal adiposity using computed tomography (CT) scans and further assesses their associations with various health outcomes. METHODS: In a large, diverse Chinese population (n = 1054 healthy individuals; n = 1159 with dyslipidemia; n = 803 with diabetes; n = 1289 with cardio-cerebrovascular diseases; n = 1108 with cancers; and n = 509 with abnormal bone mas), abdominal CT scans were performed and allometric growth model analyses were used to derive height-normalised indices (body composition/heightß). Logistic regression models assessed the associations between these indices and health outcomes. RESULTS: Distinct scaling powers were observed for visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and total abdominal adipose tissue (TAT), as well as for sagittal diameter (SAD), with marked sex differences. Powers for VAT were 1.786 ± 1.270 for males and 1.274 ± 0.692 for females. Powers for SAT were 2.266 ± 0.856 for males and 1.656 ± 0.497 for females. Powers for TAT were 2.141 ± 0.967 for males and 1.438 ± 0.489 for females. Powers for SAD were 0.646 ± 0.217 for males and 0.678 ± 0.141 for females. After controlling for age, BMI and WC, VAT/heightß, TAT/heightß and SAD/heightß retained their significantly positive associations with the odds of health outcomes, whereas SAT/heightß did not. CONCLUSIONS: Our findings endorse the clinical utility of height-normalised indices, particularly VAT/heightß, TAT/heightß and SAD/heightß, in health outcomes assessment. These indices, grounded in robust empirical data, underscore the necessity of a nuanced approach in obesity-related health evaluations, advocating for a departure from conventional methods like BMI.
ABSTRACT
With the global aging population, addressing prevalent age-related conditions such as osteoporosis and sarcopenia is crucial. Traditional nutritional strategies focusing on single nutrients like calcium, vitamin D, or protein have limitations, prompting a nuanced exploration of the relationship between aging, nutrition, and musculoskeletal health. This cross-sectional study examines the complex interplay between dietary intake of macronutrients, common micronutrients, and water, as well as their association with musculoskeletal health in adults aged 50 to 80 years, using U.S. National Health and Nutrition Examination Survey data (NHANES). Employing multiple linear regression, restricted cubic splines, weighted quantile sum (WQS), and quantile-based g-computation (QGC) regression models, our initial analysis using the WQS model revealed that a one-quartile increase in mixed macronutrient intake was associated with a significant 0.009 unit increase in bone mineral density (BMD) and a 0.670 unit increase in grip strength, while a similar increase in mixed micronutrient intake showed a 0.007 unit increase in BMD and a 0.442 unit increase in grip strength. Our findings highlight the importance of a balanced dietary approach in promoting musculoskeletal health in the elderly, offering holistic strategies for overall well-being.