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[ENG]Importance Strategies targeting body composition may help prevent chronic diseases in persons with excess weight, but randomized clinical trials evaluating lifestyle interventions have rarely reported effects on directly quantified body composition. OBJECTIVE To evaluate the effects of a lifestyle weight-loss intervention on changes in overall and regional body composition. DESIGN, SETTING, AND PARTICIPANTS The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of the intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. The trial reported herein is an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, and data analysis was conducted from February 1 to November 30, 2022. Of 6874 total PREDIMED-Plus participants, a subsample of 1521 individuals, coming from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. INTERVENTION Participants were randomly allocated to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. MAIN OUTCOMES AND MEASURES The outcomes (continuous) were 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models. Clinical relevance of changes in body components (dichotomous) was assessed based on 5% or more improvements in baseline values, using logistic regression. Main analyses were performed in the evaluable population (completers only) and in sensitivity analyses, multiple imput

[EN] The COVID-19 pandemic has forced the health public authorities to impose a lockdown as an epidemiological containment strategy. This study aimed to provide information regarding the impact of the mandatory confinement on the physical activity, eating disorders risk, sleep quality and well-being on a Spanish sample. An online survey that included the Minnesota Leisure Time Physical Activity Questionnaire, the Eating Attitude Test-26, and Pittsburgh Sleep Quality Index was administered two days after the state of alarm was stablished in Spain and five days after such measures began to be eased. Out of the 693 people who answered the first questionnaire, 161 completed the second one. These participants spent a total of 48 days locked at home, a period during which a significant worsening in all the variables assessed except for the risk of developing eating disorders, was observed: weight (kg), 67.3 ± 14.8 vs 67.7 ± 15.1, p = 0.012; physical activity (MET minutes per week), 8515.7 ± 10260.0 vs 5053.5 ± 5502.0, p < 0.001; sleep problems (total score), 6.2 ± 3.5 vs 7.2 ± 3.9, p < 0.001; self-perceived well-being (score), 4 (3–4) vs 3 (3–4), p < 0.001. The confinement had a significant differential effect on physically active participants, who experienced a significant decline (p < 0.05) on their physical activity levels, quality of sleep and well-being; whereas physically inactive participants did not experience significant changes. Findings from this longitudinal study indicate that a lockdown period due to COVID-19 had a negative impact on the physical activity levels, sleep quality and well-being in a group of physically active Spanish adults. Public health authorities should be aware that people who usually lead an active lifestyle, might be particularly susceptible to such disruptions