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Gäbler, M, Prieske, O, Elferink-Gemser, MT, Hortobágyi, T, Warnke, T, and Granacher, U. Measures of physical fitness improve prediction of kayak and canoe sprint performance in young kayakers and canoeists. J Strength Cond Res XX(X): 000-000, 2021-Markers of talent selection and predictors of performance in canoe and kayak sprint are not yet well defined. We aimed to determine the combination of variables (i.e., demographic, anthropometric, and physical fitness) that most accurately predicts sprint performance (i.e., 500- and 2000-m race time) in semielite, young kayakers and canoeists (n = 39, age 13 year, 10F). The level of significance was set at p < 0.05. Linear regression analyses identified boat type (i.e., kayak or canoe), skeletal muscle mass, and average power during a 2-minute bench pull test, normalized to body mass, as predictors of 2000-m race time (R22000 m = 0.69, Akaike information criterion [AIC] = 425) and together with vertical jump height, as predictors of 500-m race time (R2500 m = 0.87, AIC = 255). This was an improvement over models containing solely demographic variables (R2500 m = 0.66, AIC = 293; R22000 m = 0.44, AIC = 446) and over models containing demographic and anthropometric variables (R2500m = 0.79, AIC = 277; R22000 m = 0.56, AIC = 437). Race time showed the strongest semipartial correlations with the 2-minute bench pull test (0.7 ≤ r ≤ 0.9). Adding physical fitness data (i.e., 2-minute bench pull test) to demographic and anthropometric data improves the prediction accuracy of race times in young kayak and canoe athletes. The characteristics of physical fitness tests should resemble as much as possible the biomechanical (e.g., prime movers) and metabolic (e.g., duration) demands of the sport.

Background: Creation of a hypertension risk stratification model and development of an algorithm to detect hypertension in teenagers. Methods: The study group consisted of 690 middle and high school students, aged 15–17 years, from the metropolitan area of Warsaw, Poland. Information concerning family history and presence of risk factors for cardiovascular disease was gathered. Three-time blood pressure measurements were taken during at least two separate visits, which were at least a week apart, using the auscultatory method, according to standard procedures. Anthropometric measurements included: body weight, height, arm, hip and abdominal circumference, skin-fold thickness measured on the rear surface of an arm, below the inferior angle of the scapula and at the belly. Following indexes were determined: body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR), hip to height ratio. Results: A logistic regression model, describing the risk of hypertension in adolescents aged 15–17 was invented. π (x)=e^(g (x))/(1+e^(g (x)) ) where: g (x) = –0.097 × height + 0.085 × weight + 7.764 × WHR + 1.312 × hypertens_1(=yes). Hypertens_1 means presence of hypertension among members of the closest family.The formula was created, allowing the pre-selection of adolescents at risk of hypertension during screening. Next an algorithm for the detection of hypertension for practical use was proposed. Conclusions: Body weight, WHR and incidence of hypertension in the family are the strongest predictors of hypertension in teenagers. Proposed screening algorithm can be a useful tool for selecting teenagers at risk of hypertension and in need of specialized diagnostics and care.

Purpose Continuous positive airway pressure (CPAP) is the most effective therapy for obstructive sleep apnoea syndrome (OSAS). Long-term adherence is necessary; however, it may be widely variable based on current literature, where the predicting factors are also not well defined. The aim of this study was to assess ten-year adherence to CPAP and to define factors influencing it. Methods In total, 107 patients (91 males) were enrolled in this study, with an average age of 53.5 years (SD 10.1), with CPAP therapy being indicated (Apnoea-Hypopnoea Index - AHI > 15). Anthropometric and social status data have been obtained as well as the average use of CPAP through device memory. Results Sufficient adherence (> 4 hours per night) was found in 57% of patients in the first year with no subsequent significant change during the next 9 years. Adherence correlated significantly with the severity of OSAS - AHI (r = 0.321 over 5 years) and Epworth Sleepiness Scale (r = 0.317 over ten years) but did not correlate with the pressure used or the age of the patient. No statistically significant differences have been found between the sexes, the different mask groups, or the social status groups. Conclusion Good adherence to CPAP therapy in OSAS patients is essential. According to our results, patients with more severe OSAS or more severe sleepiness seem to have better adherence.

OBJECTIVES Transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) are pain electrotherapies with questioned efficacy. Studies of their effects on tactile acuity of individuals with nonspecific chronic low back pain (NSCLBP) are limited, hence, this study. MATERIALS AND METHODS Thirty-three individuals with NSCLBP randomly allocated into three groups completed this study. Data collected from participants included age, gender, and anthropometric characteristics of height, weight, body mass index, and percentage body fat measured with standard instruments. Also, participants' tactile acuity, pain intensity, and disability were assessed before and after interventions with digital caliper, numerical pain rating scale, and Roland-Morris Disability Questionnaire, respectively. Interventions consisted of stretching, strengthening, and stabilization exercises to all three groups in addition of TENS to group 1 and IFC to group 2, respectively, for five weeks. Descriptive statistics of mean and standard deviation summarized the data. Inferential statistics of paired t-test, independent t-test, and analysis of variance tested the level of significance among variables at p ≤ 0.05. RESULTS Tactile acuity was significantly (p

Background and objectives Several anthropometric measurements have been suggested to identify a potentially difficult airway. We studied thyromental height (TMH) as a predictor of difficult laryngoscopy and difficult intubation. We also compared TMH, ratio of height to thyromental distance (RHTMD), and thyromental distance (TMD) as predictors of difficult airway. Methods This cross-sectional observational study was conducted in 300 adult surgical patients requiring tracheal intubation. Preoperatively airway characteristics were assessed. Standard anesthesia was administered. Degree of difficulty with mask ventilation, laryngoscopic view, duration of laryngoscopy, and difficulty in tracheal intubation (intubation difficulty scale score) were noted. Multivariate logistics regression analysis was performed to identify independent predictors for difficult laryngoscopy. Results Laryngoscopy was difficult in 46 of 300 (15.3%) patients; all 46 patients had Cormack-Lehane grade 3 view. Duration of laryngoscopy was 27 ± 11 s in patients with difficult laryngoscopy and 12.7 ± 3.9 s in easy laryngoscopy; p = 0.001. Multivariate analysis identified that TMH, presence of short neck, and history of snoring were independently associated with difficult laryngoscopy. Incidence of difficult intubation was 17.0%. A shorter TMH was associated with higher IDS scores; r = -0.16, p = 0.001. TMH and duration of laryngoscopy were found to be negatively correlated; a shorter TMH was associated with a longer duration of laryngoscopy; r = -0.13, p = 0.03. The cut-off threshold value for TMH in our study is 4.4 cm with a sensitivity of 66% and a specificity of 54%. Conclusion Thyromental height predicts difficult laryngoscopy and difficult intubation. TMD and RHTMD did not prove to be useful as predictors of difficult airway.

India faces an epidemic of cardiovascular disease (CVD). This study sought the effect of family history of CVD and/or its risk factors (CVD-risk) on the presence of risk factors for CVD, in a healthy young college population.Blood pressure (BP), heart rate (HR), anthropometric variables, fasting blood sugar and lipid fractions were measured in two hundred healthy individuals (163 men and 37 women), aged 17-22 years. Data were analysed to elicit effect of CVD-risk on measured parameters.All but one subject, had family history of a CVD-risk. Men with family history of coronary heart disease had higher diastolic BP (79.24 ± 7.7 vs 75.99 ± 7.49 mmHg, p = 0.007) and triglycerides (118.66 ± 57.98 vs 85.82 ± 50.89 mg/dL, p 0.0001) compared with those without similar family history. Men with family history of hypertension (HTN) had higher diastolic BP (78.75 ± 7.15 vs 75.84 ± 8.37 mmHg, p = 0.019) and low-density lipoprotein (86.24 ± 25.38 vs 78.21 ± 17.93 mg/dL, p = 0.019), as well as lower high-density lipoprotein (50.27 ± 8.4 vs 53.96 ± 10.38 mg/dL, p = 0.019). Women with family history of diabetes mellitus had lower high-density lipoproteins (49.89 ± 8.05 vs 59.53 ± 11.44, p = 0.006). Family history of dyslipidaemia was associated with significantly higher triglycerides (146.14 ± 46.19 vs 98.44 ± 56.19 mg/dL, p = 0.002) in men and in subjects across sex. HDL was contrarily higher, in women with family history of cerebrovascular accident/HTN and men with family history of coronary heart disease/HTN. The proportion of pre-HTN, overweight/obese, impaired fasting glucose and borderline high triglycerides was 88.3%, 36.8%, 11% and 38.7% in men and 64.9%, 37.8%, 18.9% and 48.7% in female subjects.Young adults with a family history of CVD-risk already have an incomplete/atypical CVD risk profile.

Objective: To describe serum levels of calcium, copper, selenium, magnesium, iron and zinc and evaluate their relationship with maternal socio-demographic characteristics and dietary variables in women in the first trimester of pregnancy. Method: Cross-sectional study with 1279 participants from the INMA cohorts. Results: The concentrations of the elements analyzed were within the normal range. Associations with higher levels of these metals were found for calcium with white meat intake (p = 0.026), for cop-per with excess body weight (p < 0.01), low social class (p = 0.03) and being multipara (p < 0.01), for magnesium with being over 35 years old (p = 0.001), high social class (p = 0.044), primiparous status (p = 0.002) and low daily intake of bread (p = 0.009) and legumes (p = 0.020); for zinc with university edu-cation (p = 0.039) and residence in Gipuzkoa (p < 0.01), and for selenium with residence in Valencia (p < 0.01), university education (p = 0.001), vitamin B6 supplementation (p = 0.006), fish intake (> 71 g/day) (p = 0.014) and having been born in Spain (p = 0.001). Further, lower iron levels were associated with being overweight (p = 0.021) or obese (p < 0.001) and vitamin B12 supplementation (p = 0.006). Conclusions: Our results suggest that trace elements in the analyzed cohorts are adequate for this stage of pregnancy. The variability in these elements is mainly linked to socio-demographic and anthropometric variables. This study is part of the INMA (Infancia y Medio Ambiente) project. It was supported by grants from Instituto de Salud Carlos III (FIS-FEDER: 06/0867, 09/00090, 13/1944, 16/1288, 19/1338; Miguel Servet-FEDER: CP15/0025; Miguel Servet-FSE: MS15/0025) , by the Council of Gipuzkoa (DFG15/009) and by the Health Department of the Basque Government.

Background: Vaccination of children has played a significant role in reducing early childhood morbidity and mortality from vaccine-preventable diseases; however, some factors act as deterrents in achieving adequate coverage in this susceptible population. Aims & Objectives: The study, therefore, aimed to identify vaccine-related determinants of childhood vaccination as well as determine the relationship between childhood vaccination status and body weight, height, and a child’s body mass index (BMI). Methods: The study was conducted using a cross-sectional design in which 608 caregiver-child pair was recruited sequentially by using a two-stage sampling technique. Structured questionnaires based on the SAGE vaccine hesitancy model were used to interview the participants. Elicited data was analyzed and categorical variables were presented in tables and charts as frequencies, while a chi-square test was used to test the association between the independent and dependent variables. Pearson’s correlation analysis was also done to determine the correlation between vaccination status and weight, height, and BMI of children. Result: The study showed that vaccination coverage was suboptimal (70.56%) in children and was below the expected target of 80%. Although a few (183, 30.10%) of the respondents claimed they would prevent the vaccination of their children due to the fear of needles, the majority (87.50%) will be willing to accept more vaccine doses for their children if there were no pain. While factors such as the experience of adverse reaction (X2 = 13.22, df = 2, p Conclusion: Vaccination uptake and coverage can be significantly improved in children by designing and implementing interventional programs that target pharmaceutical and vaccine-specific factors acting as barriers in these rural communities.

Abstract. Background: The aim of this study was to assess the effects of supplementation with flaxseed on anthropometric measurements, lipid profile, insulin resistance, and inflammatory biomarkers in overweight and obese adults. Methods: Fifty overweight and obese adults with body mass index (BMI) of 30.72 ± 3.31 kg/m2 participated in this study. Participants were randomly assigned to take lifestyle advice or lifestyle advice plus 30 g/day milled flaxseed for 12 weeks. The primary outcome was body weight; secondary outcomes included other anthropometric parameters, lipid profile and inflammatory biomarkers. Results: At the end of the study, the following significant mean differences were seen in flaxseed and control groups, respectively: weight [−9.36 vs. −3.09 kg; P 2; P Conclusion: These results suggest that flaxseed supplementation in addition to lifestyle modification is significantly superior to lifestyle modification alone for weight loss. More studies with different dosages of flaxseed are needed to find the optimal dosage. This trial was registered at clinicaltrials.gov as NCT02410668.

Purpose: This work aims to determine the association between vitamin D deficiency and metabolic syndrome in overweight and obese adolescents from Ukraine.Methods: Anthropometric measurements were taken and general and biochemical examinations were performed on 136 obese and overweight adolescents and 60 adolescents with normal body weight. The vitamin D status was determined using 25-hydroxyvitamin D (25(OH)D) (calcidiol) levels in blood serum. To establish the factors influencing vitamin D status, the subjects were asked to answer a questionnaire and 2007 International Diabetes Federation diagnostic criteria were used to determine the incidence of metabolic syndrome. All research results were processed statistically.Results: A calcidiol sufficiency level was found in 3.9% of obese adolescents and 6.7% of overweight adolescents. Metabolic syndrome was found in 64.4% of obese adolescents with vitamin D deficiency, and in 26.2% of overweight adolescents. Factors associated with an increased risk of developing vitamin D deficiency in adolescents with metabolic syndrome included male sex (p=0.042), low income per family member (p=0.040), daily milk consumption of up to 1 cup per day (p=0.001), physical activity (p=0.001), duration of outdoor stays (p=0.001), and passive rest in front of a computer or television (p=0.001). Adolescents with metabolic syndrome were found predominance of body mass index (p

Context Accurate methods for predicting the percentage of body fat (%Fat) in female athletes are needed for those who lose weight before competition. Methods mandated by sport governing bodies for minimal weight determination in such athletes lack validation. Objective To (1) determine whether combining anthropometry using skinfold (SF) thicknesses and bioelectrical impedance analysis (BIA) in a 3-compartment (3C) model would improve the prediction of %Fat in female athletes and (2) evaluate the Slaughter SF equation. Design Cross-sectional study. Setting Laboratory-based study during the preseason for collegiate sports. Participants A total of 18 National Collegiate Athletic Association Division I female athletes were recruited from swim and gymnastics teams. Main Outcome Measure(s) We measured %Fat based on a 4-compartment (4C) criterion incorporating body density (air-displacement plethysmography), total body water (D2O dilution), and bone mineral mass (dual-energy x-ray absorptiometry) compared with predicted %Fat using SF alone (Slaughter equation), BIA (single frequency for total body water estimate), and combined SF and BIA (3C model). Results For the %Fat determined using the 4C criterion, the highest adjusted coefficient of determination and lowest prediction error (r2; ±standard error of estimate) were for the 3C model (r2 = 0.87; ±2.8%), followed by BIA (r2 = 0.80; ±3.5%) and SF (r2 = 0.76; ±3.8%; P values < .05 for all). Means differed for the %Fat determined using BIA (26.6% ± 7.5%) and the 3C (25.5% ± 7.2%) versus 4C model (23.5% ± 7.4%; analysis of variance and post hoc analyses: P values < .05). The SF estimate (24.0% ± 7.8%) did not differ from the 4C value. Conclusions Combining SF and BIA might improve the prediction and lower the prediction error for determining the %Fat in female athletes compared with using SF or BIA separately. Regardless, the Slaughter equation for SF appeared to be accurate for determining the mean %Fat in these female athletes.

Introduction. Somatotype is a form of manifestation the natural biological diversity, which is discrete and determines natural composition different variants of the constitution typology. Somatotype reflects main features in the dynamics of ontogenesis, metabolism, reactivity of the organism. These properties form individual features of the structure and, consequently, functions of the organism, determine its response to ever-changing environmental factors. Aim is to study relationship between somatotype in the children of 6-8 years and longitudinal dimensions of their bodies. Material and methods: analysis and generalization of scientific and methodological literature, anthropometric measurements included determining length and weight of the body, chest, shoulder, waist and thighs, measuring thickness of the skin and fat folds of the biceps, triceps, forearms, shoulder blades, abdomen, legs and thighs. Determination of somatotype was carried out by W.H. Sheldon: digestive, muscular, thoracic, asthenoid. Attention was focused on the development and ratio of such features as shape of the back, chest, abdomen, legs, state of development the bone, muscle and adipose tissue, statistical analysis. Results. There are measured and analyzed differences between the longitudinal body sizes in a practically healthy children and children of 6-8 years with hearing impairment depending on their somatotypes. Correlation analysis of a longitudinal body size allowed to determine common for all groups of children tendency to a direct dependence length of the body and torso on the somatotype in the examined children. At the same time, it is shown inverse relationship between somatotype of children with length of the upper and lower extremities, forearms, hands and legs. Conclusions. Cluster analysis confirmed that formation four subgroups of somatotypes in the children of 6-8 years determined by a longitudinal size of their body. Unlike practically healthy, at the children with disturbance of hearing with asthenoid and thoracic somatotypes, there are no differences between length of the body and length of the forearm, and in the children with thoracic and digestive somatotypes – between lengths of the hand. There is a different relationship between type of somatotype in the children of 6-8 years with a longitudinal size of their body, which did not depend on the gender and presence of hearing impairment. It is confirmed, that children with higher body and body characteristics belong to the muscular or digestive, and with higher extremities – to the asthenoid and thoracic somatotypes

BACKGROUND Ultrasonography (US) is the simplest method of evaluating thyroid volume (TV). The current normal TV in Liguria is not known. The aim of this study was to obtain normative data on TV in Liguria. MATERIALS AND METHODS From 3552 files of endocrine evaluations registered in a primary outpatient setting, we selected 483 files on euthyroid subjects (383 females and 100 males) with a normal echoic pattern on US. The inclusion criterion was the absence of thyroperoxidase autoantibodies and drugs known to interfere with thyroid hormone secretion or metabolism. TV was calculated by means of US. Anthropometric characteristics, smoking habits and the district where subjects lived were registered. RESULTS Less than 50% of patients were not taking any drug. The percentage of obesity was similar in both sexes. TSH levels were similar in males and females. Median TV was 8.0 ml (IQR 6.7 - 9.8 ml) in females and 11.8 ml (9.3 - 15.6 ml) in males (P

The initial assessment of physical fitness (PF) is associated with daily duty tasks/performance, and health-indicators (risk of injury/illnesses) of police officers. This research aimed to characterize the demographic, sports practice, PF, and metabolic profile of Elite Portuguese Public Security Police recruits. This cross-sectional study included 32 participants (age 30.1 +/- 2.7 years old). The following data were collected: demographic, sports practice, PF (e.g. muscular resistance [pull/sit/push-ups], cardiorespiratory fitness [Cooper Test]), and metabolic measures (e.g. blood pressure [systolic/diastolic]). A robust PF and metabolic profile was observed: sit-ups 79.6 +/- 11.6 rep.; push-ups 65.4 +/- 17.3 rep.; VO2max prediction 49.6 +/- 4.7 ml/kg/min; Body Mass Index 23.5 +/- 2.1 kg/m2; fat mass 10.7 +/- 2.3%; systolic blood pressure 134.0 +/- 12.0 mm Hg, and diastolic blood pressure 74.6 +/- 12.5 mm Hg. Deeper knowledge on initial PF and its impact on health may be relevant for policing policy, allowing one to define assessment guidelines and implement regular training to optimize PF throughout police officers ' lives and careers, with potentially general health benefits.

BACKGROUND/AIM: Hormonal changes and hepatic osteodystrophy are less often studied complications of cirrhosis. This study describes the variance in hormones and osteodystrophy between Frail and Not frail patients with cirrhosis. METHODS: 116 outpatients with cirrhosis were prospectively enrolled in this study. Frailty assessment was done using Liver Frailty Index (LFI). Sociodemographic assessment, anthropometry, nutritional assessment, hormone profile, and dual-energy X-ray absorptiometry scan were done in all patients. RESULTS: 116 patients, predominantly males (100 (86.2%) with mean age of 50.16 years (95% CI, 48.43–51.89) were included. Malnutrition was more common in Frail group as compared to Not frail group. Subjective global assessment (SGA) class-B patients were significantly more in Frail group (37 (74%) vs 3 (4.5%), P = 0.001). The prevalence of lower parathyroid hormone (PTH) (14 (28%) vs 2 (3%)), testosterone (33 (66%) vs 15 (22.7%)), vitamin D3 (44 (88%) vs 39 (59.1%)), and cortisol (37 (74%) vs 37 (56.1) levels was higher in Frail group (P < 0.05). The number of patients diagnosed with osteodystrophy (34 (68%) vs 21 (31.8%), P = 0.001) was significantly higher in Frail group. The marker of osteoclastic activity, β-cross laps, was significantly elevated in the Frail group both in males (736 (655–818) vs 380 (329–432), P = 0.001) and (females 619 (479–758) vs 313 (83–543), P = 0.02). Bone mineral density (BMD) at lumbar spine (LS) and neck of femur (NF) had significant correlation with LFI (ρ = 0.60, P = 0.001 for LS and ρ = 0.59, P = 0.001 for NF), serum testosterone (ρ = 0.58, P = 0.001 for LS and ρ = 0.53, P = 0.001 for NF), β-cross laps (ρ = 0.38, P = 0.001for LS and ρ = 0.35, P = 0.000 for NF), vitamin D3 (ρ = 0.23, P = 0.04 for LS and ρ = 0.25, P = 0.01 for NF), PTH (ρ = 0.52, P = 0.001 for LS and ρ = 0.48. P = 0.001 for NF), and cortisol (ρ = 0.50, P = 0.001 for LS and ρ = 0.45, P = 0.001 for NF) levels. CONCLUSION: This is the first study that highlights the high prevalence of hormonal changes and hepatic osteodystrophy in frail patients with cirrhosis and opens a new dimension for research and target of therapy in this field.

BACKGROUND There is concern that the polyunsaturated fatty acid (PUFA) composition of ready-to-use therapeutic food (RUTF) for treatment of severe acute malnutrition (SAM) is suboptimal for neurocognitive recovery. OBJECTIVE We tested the hypothesis that RUTF made with reduced amounts of linoleic acid, achieved using high oleic (HO) peanuts without added DHA (HO-RUTF) or with added DHA (DHA-HO-RUTF), improves cognition when compared to standard RUTF (S-RUTF). METHODS A triple-blind, randomized, controlled clinical feeding trial was conducted among children with uncomplicated SAM in Malawi with 3 types of RUTF: DHA-HO-RUTF, HO-RUTF and S-RUTF. The primary outcomes, measured in a subset of subjects, were the Malawi Developmental Assessment Tool (MDAT) global z-score and a modified Willatts problem solving assessment (PSA) intention score for 3 standardized problems, measured 6 months and immediately after completing RUTF therapy, respectively. MDAT domain z-scores, plasma fatty acid content, anthropometry and eye tracking were secondary outcomes. Comparisons were made between the novel PUFA RUTFs and S-RUTF. RESULTS Among the 2565 SAM children enrolled, mean global MDAT z-scores were -0.69 ± 1.19 and -0.88 ± 1.27 for children receiving DHA-HO-RUTF and S-RUTF, respectively (difference 0.19, 95% CI 0.01, 0.38). Children receiving DHA-HO-RUTF had higher gross motor and social domain z-scores than those receiving S-RUTF. The PSA problem 3 scores did not differ by dietary group (Odds Ratios 0.92, 95% CI 0.67, 1.26 for DHA-HO-RUTF). After 4 weeks of treatment, plasma phospholipid EPA and α-linolenic acid were greater in children consuming DHA-HO-RUTF or HO-RUTF when compared to S-RUTF (for all 4 comparisons P values

STUDY DESIGN A cross-sectional study. OBJECTIVE The present study aimed to investigate the prevalence of neuropathic pain (NeP) in subjects suffering from neck and shoulder pain (NSP) to reveal the impact of NeP on the health-related quality of life (HRQOL) in middle-aged and elderly people with NSP in a health checkup. SUMMARY OF BACKGROUND DATA No previous studies have established the relationship between NSP and NeP as potential risk factors contributing to a decreased quality of life (QOL) in the general population. METHODS The present study involved 203 participants (men: 84, women: 119; mean age: 63.3 years). For each subject, anthropometric measurements, physical function examinations, and blood testing were performed. A cut-off score of ≥0 on the short-form Spine painDETECT questionnaire (SF-SPDQ) defined the presence of NeP. Subsequently, the NSP (+) subjects were divided into two sub-groups: the NeP (+) and NeP (-) groups. For the assessment of QOL, the Medical Outcomes Study 36-item short-form health survey (SF-36) and the EuroQol 5 dimension 5 level version (EQ-5D-5L) tool were used. RESULTS The study included 100 NSP (+) and 103 NSP (-) subjects. Among the NSP (+) subjects, 46 and 54 subjects were found to be NeP (+) and NeP (-), respectively. For SF-36, the multivariate regression analysis revealed that the prevalence of NeP was associated with a lower physical QOL (odds ratio [OR] 3.56) and lower mental QOL (OR 4.04). Similarly, the NeP prevalence was found to be the predictor for low QOL scores in EQ-5D-5L (EQ-5D-5L index value

Background: Metabolic syndrome is closely related to cardiovascular disease, and the prevalence of metabolic syndrome in postmenopausal women is increasing rapidly. Objective: The purpose of this study is to investigate the association between the number of breastfed children and the risk factors for metabolic syndrome in postmenopausal women and to evaluate the association between metabolic syndrome and bone mineral density and body composition variables in postmenopausal women depending on the number of breastfed children. Methods: Data from KNHANES V-1 and 2 (2010-2011) were used, and a total of 939 PM women with 1 to 6 breastfed children aged 65-80 years participated in this study. We divided these women into three groups (group1 with 1-2, group2 with 3-4, group3 with 5-6) depending on the number of breastfed children. Result: In analysis of the associations between metabolic syndrome and its risk factors, high-density lipoprotein cholesterol was the most negatively strongly associated with group1 (OR=0.103 [0.047-0.225]), triglyceride showed the highest association with group2 (OR=7.760 [3.770-15.97]) and group3 (OR=7.668 [4.102-14.33]). The risk factors of metabolic syndrome except for high-density lipoprotein cholesterol and triglyceride was not associated with group1, while all risk factors of metabolic syndrome displayed a high association with group2 and group3. Conclusion: The findings of the present study suggest that the number of breastfed children is significantly associated with a greater number of risk factors of metabolic syndrome in postmenopausal women, and the association between metabolic syndrome and body composition variables may differ depending on the number of breastfed children.

Copyright © 2021 EDIZIONI MINERVA MEDICA, Background: Combined training (CT) simultaneously associates aerobic and strength exercises. Worldwide, studies on CT´s on Police officers' physical fitness are scarce. This study aims to measure a 4-month CT program's impact in the Close Protection Unit of the Portuguese Elite Police. Methods: A pre-and post-test study included 32 participants (mean age 30.1±2.7 years old). Anthropometry, body composition, physical fitness, and blood pressure assessments were collected. Statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS, 26.0) with a significance level at p≤0.05. Results: The main results showed an improvement in anthropometrics; aerobic capacity, strength, muscular endurance, and systolic blood pressure. However, a lean mass decrease, a fat mass increase, and worse results in other bioimpedance measures were observed. Conclusions: In this study, the poor body composition results may imply a closer look for health concerns, although physical fitness has improved. Thus, it might be suggested that a CT program is helpful to increase physical fitness in elite police officers. Yet, improvements for its future application can be suggested, namely to include and address hydration level, nutrition, and rest/sleep moments. Moreover, because a high physical fitness level is needed in these population throughout their lifespan, ministerial policies should develop specific training programs, that can reduce morbidity and premature mortality, and have a major cos-teffectiveness impact on public health.

BACKGROUND Fermentable Oligosaccharides, Disaccharides and Monosaccharides And Polyols (FODMAPs) have been shown to be involved in gastrointestinal disorders. In view of their pro-inflammatory potential and their interactions with the gut microbiota, their contribution to the etiology of other chronic diseases such as cancer has been postulated. However, no epidemiological study has investigated this hypothesis so far. OBJECTIVE Our objective was to investigate the associations between FODMAP intake (total and by type) and cancer risk (overall, breast, prostate and colorectal) in a large prospective cohort. DESIGN The study was based on the NutriNet-Sante cohort (2009-2020); 104,909 adult participants without cancer at baseline were included in our analyses (median follow-up time = 7.7y, 78.7% women, mean age at baseline 42.1y (SD = 14.5)). Baseline dietary intakes were obtained from repeated 24h-dietary records linked to a detailed food composition table. Associations between FODMAP intake (expressed in quintiles, Q) and cancer risks were assessed by Cox proportional hazard models adjusted for a large range of lifestyle, sociodemographic and anthropometric variables. RESULTS Total FODMAP intake was associated with increased overall cancer risk (n = 3374 incident cases, HR for sex-specific Quintile 5 versus Quintile 1: 1.21; 95%CI: 1.02, 1.44; P-trend = 0.04). In particular, oligosaccharides were associated with cancer risk: a trend was observed for overall cancer (HR Q5 vs. Q1: 1.10; 95%CI: 0.97, 1.25; P-trend = 0.04) and colorectal cancer (n = 272, HR Q5 vs. Q1: 1.78; 95%CI: 1.13-2.79; P-trend = 0.02). CONCLUSION Results from this large population-based study on French adults from the NutriNet-Sante cohort show a significant association between FODMAP intake and the risk of cancer development. Further epidemiological and experimental studies are needed to confirm these results and provide data on the potential underlying mechanisms.

Background: One of the common disorders that can negatively affect the health status of old adults is hypertension. Self-management education is an effective method to control various disorders. This study was designed to assess the effectiveness of self-management education program on blood pressure, management of anthropometric measures, and some metabolic factors among elderly in Tabriz, Iran. Methods: 227 eligible hypertensive elderly patients from three primary health care centers of Tabriz were participated in 12 sessions of self-management education intervention conducted in 6 months from April to October 2019. Systolic (SBP) and diastolic blood pressure (DBP), serum levels of fasting blood sugar (FBS), total cholesterol (TC), and triglyceride, as well as anthropometric indices were assessed both before and at the end of the intervention. Results: The participated elderly had the mean± SD age of 64.52±5.76 years. After 6-month presence of subjects in the educational sessions, the SBP (p=0.038), body weight (p=0.012), BMI (p=0.021), FBS (0.011), and TC ( < 0.0001) were significantly decreased compared to baseline. Conclusion: Self-management educations can improve compliance of elderly to controlling factors of blood pressure such as diet and exercise. Consequently, following a healthy lifestyle can be effective in reducing a number of the hypertension risk factors.

Background: Central obesity is the important risk factor in metabolic syndrome which is in turn cardiovascular risk factor which will increase the morbidity and mortality. The study was conducted to assess the anthropometric indices in predicting metabolic syndrome among obese adults. Methods: Cross sectional study was done among 264 adults having BMI more than 35 and visiting our hospital for a period of three months were included. A predesigned and pretested proforma was used to collect data. Anthropometric measurements, Blood pressure and diabetic profile was measured. Data was analysed using SPSS. Results: Among 264 adults, 118 (44.69%) had metabolic syndrome; Majority belonged to 30- 39 years (40.15%); educated up to PUC (32.58%) and belonged to class II socio-economic status (38.64%). There was significant mean difference between waist circumference, diastolic blood pressure, HDL levels and FBS levels among the study participants who had and who didn’t have metabolic syndrome. Area under curve (AUC) for waist: height ratio was 0.969, whereas for waist circumference and BMI it was 0.956 and 0.689 respectively. Conclusion: Waist: height ratio can predict metabolic syndrome better than waist circumference and BMI. Central obesity should be identified at the earliest than general obesity. So that lifestyle modifications can be advised in early life to avoid further morbidity leading to further permanent disabilities and life threatening events in future.

OBJECTIVE: The aim of this study was to determine the haemodynamics of the intrarenal arteries from the relationship between resistivity index (RI) and kidney function, and to identify the predictors of high RI among patients with diabetic nephropathy (DN) and those with diabetes mellitus (DM) without DN. METHODS: This was a cross-sectional survey of 133 participants, comprising 40 subjects with DM without DN, 53 with DM with DN and 40 healthy controls. Information obtained was demographics, lifestyle, medical and medication histories, while anthropometric and blood pressure measurements were taken. Albuminuria and estimated glomerular filtration rate were determined and RI was measured using a Doppler ultrasound scan. RESULTS: The mean intrarenal artery RIs were higher among the patients with DM without DN (0.60 ± 0.04) and the group with DM with DN (0.61 ± 0.04) than in the controls (0.56 ± 0.04) (p = 0.02). Glycated haemoglobin (HbA(1c)) predicted high RI in the DM without DN group (OR 2.81; CI: 1.73–9.03) while hypertension (OR 3.60; CI: 1.06–12.22) predicted high RI in the DM with DN group. CONCLUSION: Elevated intrarenal artery RI was prevalent among patients with DM without DN and those with DM with DN, while elevated HbA(1c) level and hypertension predicted elevated RI in subjects with DM without DN and those with DM with DN.

No study on the relationship between hepatic steatosis and sex hormone levels in male patients with chronic hepatitis B (CHB) infection has been conducted.We aimed to investigate the association between serum sex hormones and hepatic steatosis among a cohort of males with CHB.In this cross-sectional study, 268 male patients with CHB were enrolled. All participants underwent anthropometric measurement, blood testing, and FibroScan test. Multiple logistic regression analysis was used to investigate the association of serum sex hormones with hepatic steatosis.We included 137 males with and 131 without hepatic steatosis in this study. Subjects with serum testosterone (T) levels in the highest tertile had an odds ratio (OR) (95% confidence interval [CI]) of 0.35 (0.18-0.70) (P for trend=0.003); those with serum prolactin (PRL) levels in the highest tertile had an OR (95%CI) of 0.21 (0.10-0.45) (P for trend0.001); and those with serum estradiol/testosterone (E2/T) in the highest tertile had an OR (95%CI) of 4.02 (1.97-8.20) (P for trend0.001) for hepatic steatosis.Lower serum total T and PRL levels and higher total E2/T are independently associated with presence of hepatic steatosis in male patients with CHB.

Introduction Metabolic control in type 1 diabetes (T1D) depends on many factors such as eating habits, exercise and lifestyle. The objective of this study was to investigate how these factors were affected during the coronavirus disease 2019 (COVID-19) lockdown and impacted metabolic control in children with T1D. Materials and method One hundred children with T1D were enrolled in the study. Anthropometric measurements, snack and meal frequency, carbohydrate consumption, HbA1c levels, and exercise patterns were recorded and compared before and after the lockdown. Subjects were divided into two subgroups—patients with decreased and patients with increased HbA1c levels after the lockdown—and comparisons of the same parameters were also made between these two subgroups. Results In the overall group, the mean HbA1c level was significantly higher after the lockdown compared to before (p = 0.035). Meal schedules changed due to delayed sleep and waking times, and total daily carbohydrate consumption increased in the subgroup with increased HbA1c while it decreased in the subgroup with decreased HbA1c (p Conclusion Our study supports the notion that blood sugar management in children with T1D worsened during the COVID-19 pandemic. Although it is not possible to explain this with any one factor, some behavioral changes observed in our study, such as inactivity, irregular meal frequency and timing, and irregular sleep and waking patterns appeared to be associated with blood sugar management.

Exposure of newborns to persistent organic pollutants (POPs) is a public health concern. The objective of this study was to assess the prevalence of POPs in human milk collected from lactating mothers in Lebanon and to investigate the sociodemographic, nutritional, and other lifestyle determinants. Fifty-four breast milk samples were collected as per World Health Organization guidelines. A survey was used to assess the anthropometric and demographic characteristics of participants. Dietary habits were evaluated based on a semiquantitative food frequency questionnaire. Organochlorine pesticides and polychlorinated biphenyls were measured in milk samples with liquid-liquid extraction and gas chromatography. Among the screened POPs, dichlorodiphenyldichloroethylene (DDE) was the only POP detected in breast milk samples and was found in only 17.9% of the samples, with a mean (SD) of 11.6 (5.0) μg/L and a range of 5.7 to 21.4 μg/L. Prepregnancy body mass index and age were positively associated with DDE contamination in breast milk. Women who consumed cereals at least two times per week had detectable DDE contamination in their breast milk. Consumption of potatoes and beans at least once per week was also associated with DDE contamination. Our study is the first to assess the presence of POPs in breast milk in Lebanon. The benefits of breastfeeding compensate for the low prevalence of DDE in the breast milk. Our findings highlight the high need to implement monitoring policies, good agricultural practices, and education programs for breastfeeding mothers.

Protein-energy wasting (PEW) and poor health-related quality of life (HRQoL) are independently associated with morbi-mortality in continuous ambulatory peritoneal dialysis (CAPD). PEW may reduce HRQoL; however, we hypothesized HRQoL is affected differentially by PEW degrees or by individual criteria of nutritional status. AIM: To evaluate HRQoL according to PEW severity and nutritional status indicators in CAPD. This is a cross-sectional study in 151 patients. Subjective global assessment (SGA) was employed, and nutritional status classified as normal, mild-moderate PEW, and severe PEW. HRQoL was evaluated using Kidney Disease Quality of Life Short Form™, including physical (PCS), mental (MCS) and kidney disease (KDCS) components, and their subscales. Dietary intake, anthropometric and biochemical variables were measured. Forty-six percent of patients were well-nourished, 44% had mild-moderate PEW, and 10% severe PEW. Compared with well-nourished patients, those with mild-moderate (p=0.06) and severe (p=0.005) PEW had lower HRQoL score [68 (52-75), 55 (45-72), 46 (43-58), respectively]. PCS, MCS, and KDCS and their subscales had lower values as PEW was more severe. Patients with obesity and hypoalbuminemia had significantly lower HRQoL overall and component scores than their counterparts. Dietary intake was not associated with quality of life. In multivariate analysis obesity, PEW (by SGA), hypoalbuminemia, and low educational level predicted poor HRQoL (χ2 58.2, p

Background Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in morbid obesity (MO). A considerable proportion of patients with MO have non-alcoholic steatohepatitis (NASH). Liver biopsy (LB) is the only procedure that reliably differentiates NASH from other stages of NAFLD, but its invasive nature prevents it from being generalisable. Hence, non-invasive assessment is critical in this group of patients. Objectives To report NAFLD/NASH prevalence in a cohort of patients with MO and to identify predictors of NASH. Methods Fifty-two consecutive patients subjected to bariatric surgery in a University hospital in Spain underwent LB. Anthropometric, clinical and biochemical variables were registered. According of the results of the LB, individuals were classified by whether they had NASH or not. Multiple logistic regression analysis was performed to identify independent factors associated with NASH. Results NAFLD was reported in 94.2% of the patients, simple steatosis was present in 51.92% and NASH in 42.31%. Meanwhile, 17.3% of patients exhibited significant fibrosis (≥F2). HIGHT score for NASH risk was established using five independent predictors: systemic Hypertension, Insulin resistance, Gamma-glutamyl transferase, High density lipoprotein cholesterol and alanine Transaminase. This score ranges from 0 to 7 and was used to predict NASH in our cohort (area under the receiver operator characteristic curve 0.846). A score of 4 or greater implied high risk (sensitivity 77.3%, specificity 73.3%, positive predictive value 68%, negative predictive value 81.5%, accuracy 75%). Conclusions NAFLD is practically a constant in MO with a considerable proportion of patients presenting NASH. The combination of five independent predictors in a scoring system may help the clinician optimise the selection of patients with MO for LB.

Background : Sarcopenia is defined as low muscle mass, with low muscle strength or low physical performance. The skeletal muscle mass (or density) and strength are inversely associated with cardiovascular risk factors. We aim to determine the relationship between skeletal muscle characteristics (strength, mass, area), and cardiovascular risk factors in a population with lower extremity artery disease (LEAD) Methods : An observational, prospective study including patients with LEAD was conducted from January 2018 to December 2020. The cardiovascular risk factors and anthropometric measurements were prospectively registered. The skeletal muscle characteristics (area, density/mass and strength) were analysed. The skeletal muscle area and density were quantified with a CT scan. The strength was determined with a Jamar® hydraulic hand dynamometer. Results : 96 patients with LEAD with 67.70± 10.11 years-old were enrolled in the study. The most prevalent cardiovascular risk factor was hypertension, followed by dyslipidemia and diabetes. Patients with diabetes had a lower handgrip strength and skeletal muscle density, when compared with patients without diabetes (strength: 19.67± 9.98 kgf versus 26.79 ± 11.80 kgf, p=0.002 and skeletal muscle density: 10.58 ± 17.61 HU versus 18.17 ± 15.33 HU, p=0.032). There was a trend for the association between the presence of cardiovascular risk factors (hypertension and dyslipidemia) and a decrease in skeletal muscle density and strength (density: hypertension: 13.46 ± 16.74 HU versus 20.38 ± 11.63 HU p=0.055; dyslipidemia: 13.57 ± 17.16 HU versus 17.74 ± 13.00 HU p=0.315; strength- hypertension: 22.55 ± 10.08 kgf versus 27.58 ± 15.11 p= 0.073; dyslipidemia: 22.80 ± 10.52 kgf versus 25.28 ± 13.14 kgf p=0.315). Interestingly, we found that smokers had a favorable skeletal muscle characteristic, which could be explained by the higher prevalence of diabetes in non-smokers. Conclusions : The indicators of skeletal muscle dysfunction (strength and density) are associated to the presence of diabetes in patients with LEAD. Therapeutic strategies to improve the skeletal muscle characteristics could have a role in improving LEAD risk factors, particularly diabetes.

Background. Poor physical function is associated with disability and mortality in old people. Objectives. The aim was to find determinants of physical function in old people. Design. Secondary, cross-sectional analysis.Setting. Community in the Reykjavik, Iceland.Participants. 236 old people (73.7 ± 5.7 years, 58.2% female).Measurements. Timed-up-and-go (TUG), six-minute-walk-for-distance (6MWD), anthropometrics, quadriceps strength, dietary intake, mini-mental-state-examination (MMSE), leisure-time physical activity (LTPA) and blood variables were assessed. Descriptive, bivariate and multivariate statistical analyses were used.Results. There were differences between men and women in energy intake, body composition and muscular strength, but physical function did not differ between men and women. In bivariate analysis, most of the assessed variables correlated with 6MWD and TUG. Stepwise linear models showed that age, body composition, strength, medication, LTPA and MMSE were predictors of physical function but not hematological variables. The association between MMSE and function disappeared when corrected for strength/body weight. Results were similar for both 6MWD and TUG and the strongest predictors in the final models were age and quadriceps strength/body weight. Conclusions. In community dwelling old people, physical function decreases with age. However, it is of clinical relevance that there are modifiable determinants of physical function, in particular strength for a given body weight, LTPA and number of medications, which represent potential targets to maintain physical function in this age group. Our results also indicate that neither cognitive function, nor dietary intake nor blood chemical variables were independently associated with physical function.

Background Coronary Artery Disease (CAD) is one of the most common causes of death in Palestine. This study aimed to assess the nontraditional risk factors among CAD patients underwent invasive coronary angiography in Gaza-Palestine. Methods Unmatched one-to-one case-control study was conducted among 200 participants. Cases were recruited from newly discovered CAD patients after a confirmed diagnosis of CAD by interventional cardiologist post catheterization "coronary angiography" in Al-Shifa Cardiovascular Catheterization Center. Controls were enrolled from individuals with no history of CAD. An interview-based questionnaire was used to assess patient's characteristic data and medical history; anthropometric, and the Ankle Brachial Index(ABI) was measured and calculated. Furthermore, biochemical analysis of high sensitivity C-reactive protein (hs-CRP) level and Random blood glucose level (RBG) and Leukocyte count (WBCs)were investigated. All required ethical approvals were obtained. Data were managed and analyzed by STATA version 14. Correlation analysis by multivariate logistic regression was done. Results hs-CRP, RBG, and WBCs remained significant predictors for CAD adjusted for age, education level, employment status, and monthly income. As, the odds of CAD increased by 3% for each unit increased in hs-CRP (Odd Ratio (OR)=1.03; 95% confidence interval (CI):1.01, 1.06; P = 0.020); and the odds of CAD was augmented by 30% for each unit increased in WBCs (OR= 1.30; 95% CI: 1.07, 1.67; P = 0.010); While the odds of CAD was 5 times more for each unit increased in RBG (OR=5.04; 95% CI: 1.17, 14.88; P = 0.003). Still, age remained a significant risk factor as the odds of CAD was 19% more for each increased year in age (OR=1.19; 95%CI: 1.13, 1.26; P Conclusion Nontraditional factors (hs-CRP, RBG, and WBCs) are significant predictors of CAD, and should be considered in adult patients coming with attacks of angina pain.

Type 2 Diabetes Mellitus (T2DM) is one of major life style disorder with multiple systemic complications. Lifestyle modification and management of chronic mental stress plays a major role in treating and preventing T2DM. Naturopathy uses lifestyle modification and natural therapies to cure the diseases. Effectiveness of Yoga practice in stress management is proven through various studies. In this study we evaluate the effect of Naturopathy and Yogic lifestyle intervention on the anthropometric, biochemical, electrophysiological parameters and development of cardiovascular risk among T2DM patients. Methods The study is a prospective randomized parallel group trial. The study is divided into two phases, intensive phase and continuation phase. 252 T2DM patients will be randomized into intervention group and control group after screening. The intervention group will receive intense NY CTRI/2018/12/016550

Background There are worrying indications that diphtheria-tetanus-pertussis (DTP) vaccine has negative non-specific effects for females. We previously found, in a trial of early-Bacillus Calmette-Guerin (BCG) to low weight (LW) neonates, that receiving early-DTP (before 2 months of age), was associated with increased female mortality compared with no-DTP/delayed-DTP. Within a subsequent LW trial, we aimed to retest this observation. Methods Between 2010 and 2014, in Guinea-Bissau, 2,398 infants were randomised 1:1 to early-BCG (intervention) or delayed-BCG (standard practice for LW neonates) and visited at 2, 6 and 12 months of age to assess nutritional and vaccination status. DTP is recommended at 6 weeks of age. We examined the effect of having “early-DTP” versus “no-DTP” at the time of the 2-month visit on all-cause mortality between the 2- and 6-month visits in Cox models stratified by sex and adjusted for BCG-group and 2-month-weight-for-age (z-scores) providing adjusted mortality rate ratios (aMRRs). We analysed to which extent conditions varied between the present and the previous LW trials and how that might have affected the overall result of comparing the early-DTP and the no-DTP groups. Results At the time of the 2-month visit, 75% (1,795/2,398) had received DTP. Those vaccinated had better anthropometric indices than no-DTP infants at birth and by 2 months of age. Between the 2- and 6-month visits, 29 deaths occurred. The early-DTP/no-DTP aMRR was 1.09 (95% CI: 0.44–2.69); 1.19 (0.45–3.15) for females and 0.77 (0.14–4.19) for males. Compared to the previous study, the present study cohort had 56% (30–72%) lower overall mortality, fewer no-DTP infants, higher BCG vaccination coverage and several more oral polio vaccine campaigns. Conclusion We did not find that early-DTP was associated with increased female mortality as found in a previous study; differences in results may partly be due to a decline in overall mortality and changes in vaccination practices.

Objective: This study investigates correlations between different methods for diagnosis of protein energy malnutrition (PEM) in peritoneal dialysis patients. Methods: Twenty four patients were included. Patients with amputations, infections, peritonitis, malignancies and PD duration less than three months were excluded. Physical examination findings, laboratory results and anthropometric measurements were recorded. Body composition analysis was performed with multi-frequency bioimpedance analyzer. Dialysis malnutrition score (DMS) was calculated. The correlations of different parameters were searched. Results: Eleven patients were female and 13 patients were male. Mean age was 58.9±12.6 years. Median dialysis duration was 25 (interquartile range: 14) months. Protein percentage was negatively correlated with fat percentage (r=-0.785; p

As trials and treatments for Spinal Muscular Atrophy (SMA) rapidly evolve, understanding the natural history and potential utility of the 10-meter walk/run test (10MWRT) in ambulant individuals is critical. Study aims were to: 1) establish change over time and across age for 10MWRT time in an untreated natural history cohort of young, ambulatory participants with SMA and 2) identify relations between 10MWRT time and age, SMA type, SMN2 copy number and anthropometrics. Untreated individuals (n=56) age 2 to 21 years who were enrolled in a long-term natural history study between 2005 and 2014 and met inclusion criteria were included. Linear mixed effects models were used to assess changes in 10MWRT time with age and associations with SMA type, SMN2 copy number, and body mass. SMA type 3b (versus 3a), SMN2 copy number 4 (versus 3) and lower body mass were associated with faster 10MWRT. 10MWRT performance improved between 3 and 8 years of age, was stable between 9 and 10, and gradually declined from 11 to 18. Findings provide the first longitudinal natural history report of 10MWRT time in young individuals with SMA and offer a critical foundation for interpreting childhood change in short distance walking speed with pharmacologic treatment.

Objectives (1) Compare changes in body composition estimates over the menstrual cycle in active females using Dual-energy X-ray absorptiometry, standardised brightness-mode ultrasound and skinfolds (2) Compare the predictability of Dual-energy X-ray absorptiometry fat mass estimate via standardised brightness-mode ultrasound versus skinfolds measurements. Design Thirty active females (27 ± 5 y) with regularly occurring menstrual cycles participated in a cross sectional study. Methods Participants completed four assessment sessions scheduled according to each individual's menstrual cycle. These sessions took place during their (1) early follicular, (2) mid-to-late follicular, (3) mid-luteal and (4) second early follicular phases. Body composition estimates were acquired using Dual-energy X-ray absorptiometry, subcutaneous adipose tissue thickness was measured at eight sites using standardised brightness-mode ultrasound and skinfolds. Results The sum of eight subcutaneous adipose tissue thickness measured using standardised brightness-mode ultrasound and skinfolds were not different between the cycle phases (p > 0.05). Body mass and Dual-energy X-ray absorptiometry total mass estimate as well as Dual-energy X-ray absorptiometry estimates of total and regional lean and fat mass were also not different between cycle phases (p > 0.05) and any changes were within the 95% confidence intervals of their respective least significant change values. Conclusions There were no true and meaningful changes in the sum of eight subcutaneous adipose tissue thickness measured via standardised brightness-mode ultrasound and skinfolds or Dual-energy X-ray absorptiometry total and regional tissue mass estimates across the menstrual cycle in active eumenorrheic females. Body composition may thus be assessed via these methods in this population at any cycle phase with standardised participant presentation.

Background: Parenting interventions during the first years of life on what and/or how to feed infants during complementary feeding can promote healthy eating habits. Objectives: An intervention promoting repeated exposure to a variety of vegetables [repeated vegetable exposure (RVE); what] and an intervention promoting responding sensitively to child signals during mealtime [video-feedback intervention to promote positive parenting-feeding infants (VIPP-FI); how] were compared, separately and combined (COMBI), with an attention control condition (AC). Primary outcomes were vegetable consumption and self-regulation of energy intake; secondary outcomes were child anthropometrics and maternal feeding practices (sensitive feeding, pressure to eat). Methods: Our 4-arm randomized controlled trial included 246 first-time Dutch mothers and their infants. Interventions started when infants were 4-6 mo old and ended at age 16 mo. The present study evaluated effects at 18 (t18) and 24 (t24) mo of age. Vegetable acceptance was assessed using three 24-h dietary recalls, self-regulation of energy intake by an eating-in-the-absence-of-hunger experiment and mother-report, and maternal feeding behavior by observation and mother-report. Results: Linear mixed model and ANOVA analyses revealed no follow-up group differences regarding child vegetable intake or self-regulatory behavior. The proportion of children with overweight was significantly lower in the COMBI group, compared with the VIPP-FI group at t18 (2% compared with 16%), and with the AC group at t24 (7% compared with 20%), although this finding needs to be interpreted cautiously due to the small number of infants with overweight and nonsignificant effects on the continuous BMI z-score measure (P values: 0.29-0.82). Finally, more sensitive feeding behavior and less pressure to eat was found in the VIPP-FI and COMBI groups, compared with the RVE and AC groups, mostly at t18 (significant effect sizes: D = 0.23-0.64). Conclusions: Interventions were not effective in increasing vegetable intake or self-regulation of energy intake. Future research might usefully focus on risk groups such as families who already experience problems around feeding. This trial is registered at clinicaltrials.gov as NCT03348176.

Summary Objective We undertook to examine growth patterns and the development of leg muscle power by socioeconomic classes among healthy Tunisian adolescents aged 13 to 19 years. Methods Five hundred and sixty Tunisian healthy adolescents (259 males and 301 females) were randomly selected. Anthropometric variables were measured and socioeconomic status was assessed according to a standard questionnaire. Jump heights and leg power were provided by an Optojump device using countermovement jump and squat jump. Results Tunisian adolescents from high socioeconomic status had significant differences (P Conclusion The socioeconomic status act on growth patterns and the development of leg muscle power in healthy Tunisian adolescents aged between 13–19 years. Tunisian adolescents from high socioeconomic status had higher mean values of leg muscle volume than those from low socioeconomic status.

Summary Background & aims Evidence suggests that multiple-behavior interventions (with a specialist) have a greater impact on public health than single-behavior interventions, particularly in a chronic patient. However, there is little understanding of some very basic principles concerning multiple health behavior change, especially in situations such as kidney transplantation, which requires a great willingness to change negative lifestyle behaviors to achieve intermediate and long-term success. We compared healthy lifestyles and nutritional status according to the willingness to change dietary and exercise behavior in dialysis patients from a living donor kidney transplant program. Methods 400 dialysis patients had a dietetic, anthropometric, protein-energy wasting [subjective global assessment (SGA)] and biochemical evaluation. Lifestyle was evaluated with an adapted instrument to measure lifestyle in chronic disease. Willingness to change behaviors was evaluated by the trans-theoretical model; 2 groups were formed: willingness to change dietary and exercise behaviors and unwillingness to change. Results Willingness to change dietary behavior was 50% and exercise 25%. Patients with willingness to change dietary and exercise behaviors had better healthy lifestyle scores, and higher frequency of healthy food consumption. Healthy lifestyle score (R2=0.37, p Conclusions Willingness to change dietary and exercise behaviors was associated with healthy lifestyle, as well as with higher frequency of healthy food consumption and with lower frequency of unhealthy food consumption.

Summary: Background and Aims: Oesophagectomy is the primary curative treatment for oesophageal cancer but is associated with considerable postoperative morbidity and mortality. To better understand the aetiology of impaired health-related quality of life (HRQL) in oesophageal cancer survivors (OCS), this study sought to determine the longitudinal changes in nutritional status, nutrition-impact symptoms (NIS), and HRQL in this cohort, and to determine which variables have the greatest impact on postoperative HRQL decline. Methods: Data, derived from St. James' Hospital, Dublin, included patients who underwent oesophagectomy from October 2017 to May 2019 and attended clinic preoperatively and 6 months postoperatively. A subset attended a further 12-month appointment. HRQL and symptom data were collected using validated questionnaires and anthropometric measures were completed by clinicians. Data were analysed using SPSS. Results: A total of 66 patients were studied preoperatively and 6 months postoperatively, of whom 37 were studied at 12 months postoperatively. Malnutrition remained prevalent at each time-point, although rates did not significantly change longitudinally. Conversely, the prevalence of malabsorption (7.6%–14.3%, P

Актуальність. Проведено оцінку залежності ступеня неврологічного дефіциту в пацієнтів із гострим ішемічним інсультом від біохімічних та метаболічних показників метаболічного синдрому. Мета дослідження — визначення біохіміко-метаболічних показників у хворих на первинний гострий ішемічний інсульт із метаболічним синдромом та без такого. Матеріали та методи. Матеріал: 160 пацієнтів із гострим первинним ішемічним інсультом (чоловіків — 103, жінок — 57) віком від 39 до 91 року. Методи: артеріальна тонометрія, пульсометрія, електрокардіографія, антропометрія, глюкометрія, ліпідометрія, транскраніальна допплерографія, магнітно-резонансна томографія, неврологічні. Результати. Установлено, що біохіміко-метаболічні порушення, які лежать в основі виникнення метаболічного синдрому в рамках гострої церебральної катастрофи, впливають на формування вогнища ішемії, збільшуючи його, що викликає поглиблення неврологічного дефіциту. Класифікацію патогенетичних підтипів інсульту здійснювали за Adams (1993). Виявлено вплив атерогенної дисліпідемії на виникнення атеротромботичного та лакунарного підтипів інсульту як основи патобіохімічної ланки формування цих підтипів. До того ж атеротромботичний потенціал у пацієнтів із метаболічним синдромом був високим. Вірогідне превалювання обсягу неврологічного дефіциту та середнього розміру вогнища ішемії при атеротромботичному та кардіоемболічному підтипах інсульту свідчить про негативний вплив метаболічних і біохімічних порушень на перебіг ішемічного інсульту. Висновок. Доведено, що гіперглікемія як основа біохімічних та метаболічних процесів в організмі не тільки є незалежним предиктором виникнення ішемічного інсульту, але й у поєднанні з іншими факторами метаболічного синдрому впливає на формування розмірів вогнища ішемії, вираженість неврологічного дефіциту та його еволюцію.

Актуальність. Дотримання традиційних дієтичних рекомендацій при лікуванні хворих із хронічними захворюваннями біліарної системи на тлі ожиріння має ряд небажаних наслідків, зокрема призводить до зменшення м’язової маси тіла, що негативно впливає на перебіг захворювання. Метою дослідження є вивчення впливу високобілкової ізокалорійної дієти на антропометричні показники хворих на хронічні захворювання біліарної системи на тлі ожиріння. Матеріали та методи. Досліджено 124 хворих на хронічні захворювання біліарної системи на тлі ожиріння, які були розподілені в основну (62 пацієнти) та контрольну групу (62 хворі). Хворі основної та контрольної групи отримували харчування з помірним зниженням енергетичної цінності (ізокалорійна дієта) на 300–400 ккал. Відмінність харчування хворих основної групи полягала в значному збільшенні квоти білка (до 1,6–1,8 г на 1 кг маси тіла) за рахунок нежирного м’яса, птиці й риби, зменшення в раціоні простих та складних вуглеводів (не більше від 3 г на 1 кг маси тіла) та нижньої норми жиру (1,0–1,2 г на 1 кг маси тіла). Результати. При антропометричному дослідженні виявлено, що зниження маси тіла у хворих основної групи відбувається в основному за рахунок жирової тканини, що сприяє підвищенню коефіцієнта м’язи/жир з 0,98 ± 0,05 до 1,21 ± 0,07 (р < 0,05). Висновки. Високобілкова ізокалорійна дієта має позитивний вплив на атропометричні показники у хворих на хронічні захворювання біліарної системи на тлі ожиріння.

BACKGROUND We aimed to assess safety, tolerability, and improvement in weight gain with an energy- and protein-enriched formula (EPEF) in infants with poor growth. METHODS Infants aged 1-8 months with poor growth were enrolled to receive EPEF for 16 weeks. PRIMARY OBJECTIVE improvement in weight as measured by change in weight-for-age z-score (WAZ) and weight gain velocity (g/day) ≥ median weight gain velocity for age based on WHO growth standards. Secondary objectives: improvements in other anthropometric z-scores, formula tolerance, and safety. RESULTS 26 subjects with poor growth due to congenital heart disease (15/26), other organic causes (9/26), and non-organic causes (2/26) completed the study per protocol. Mean calorie intake was 123 ± 32 kcals/kg body weight per day with >90% of calories coming from EPEF. Weight gain velocity exceeded the WHO median for 83% (20/24) and 67% (16/24) of infants at ≥1 time point and for the overall study period, respectively. Mean ± SD WAZ improved from -2.92 ± 1.04 at baseline to -2.01 ± 1.12 at 16 weeks (p = 0.0001). Z-scores for weight-for-length and head circumference (p = 0.0001) and for length-for-age (p = 0.003) were significantly improved at 16 weeks. There were no significant differences from baseline in vomiting, fussiness, or number of stools per day. Compared to baseline, stool consistency was different at 2,4, and 16 weeks (p < 0.05). There was a decrease or no change in spit-up, flatulence, crying or gassiness. CONCLUSION EPEF is safe, well tolerated, and improves weight gain in infants with poor growth. This article is protected by copyright. All rights reserved.

Objectives To determine the physiological effects of multiple stressors including energy deficit during a 62-day Ranger course in a hot-humid environment. Design Prospective cohort design. Methods Food intake data were collected daily and energy expenditure at each of the three phases of the course was estimated by the doubly-labeled water method. Anthropometry, hydration status, stress and metabolic hormones, handgrip strength and lower explosive power were measured at the start and at the end of each phase. Results Seventeen male participants (age: 24.5 ± 3.2 years, height: 173.9 ± 5.1 cm, body mass: 69.3 ± 3.2 kg, BMI: 22.9 ± 0.9 kg/m2, percent body fat: 14 ± 5%) completed the study. Mean total daily energy expenditure was 4756 kcal/day and mean daily energy intake was 3882 kcal/day. An 18% energy deficit resulted in an average body mass loss of 4.6 kg, comprising mostly fat mass. Participants with higher baseline adiposity (>15% body fat) lost more fat mass and gained (rather than lost) muscle mass compared to those with lower baseline adiposity. Handgrip strength declined only at the end of Phase I, while lower body explosive power declined progressively throughout the course. Lean mass in arms and legs was correlated with initial grip strength and lower body explosive power, but only at the start of the course. Conclusions Physiologically demanding Ranger training in an equatorial environment is at least as metabolically demanding and stressful as other similar high-risk training courses, as demonstrated by the stress and metabolic endocrine responses, changes in body composition, and reduction in explosive power. Moreover, the smaller body size of Asian soldiers may confer an energetic advantage over larger sized Western counterparts.

Summary Background & Aims Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and one of the leading indications for liver transplantation in adults. However, current screening methods are inadequate and are accompanied by several disadvantages. This meta-analysis aims to identify the anthropometrical and biochemical characteristics most commonly appearing in pediatric NAFLD that could contribute to the diagnosis of the disease in the every-day clinical setting. Methods A systematic search was conducted in major electronic databases (MEDLINE, Scopus and Embase) up to 15th of August 2021. Primary outcome was the comparison of the anthropometric characteristics, whereas secondary outcomes were the comparisons of biochemical profile, lipid profile, and metabolic parameters in children with NAFLD compared with age-matched healthy controls. Quality assessment was performed with Newcastle-Ottawa Scale (NOS) and results were expressed as mean differences with 95% confidence intervals. Results Sixty-four studies were included. Two different comparisons were designed regarding the body mass status. Statistically significant differences were demonstrated by comparing children with NAFLD vs lean/normal weighted controls in body weight (23.0 kg, 95% CI: 14.0-31.8, P Conclusions Anthropometrical and biochemical characteristics of children and adolescents with NAFLD are statistically significantly different compared to age-matched controls; these characteristics could be used to identify individuals at risk of developing NAFLD and related comorbidities.

Background: It is well known that the family environment is associated with child health behavior and outcomes. However, there is a lack of available instruments to measure family health behaviors, even more so in languages other than English. The aim of the present study was to adapt and validate the Family Health Behavior Scale (FHBS) for Brazilian families.Methods: The FHBS was translated and culturally adapted for the Brazilian families. Psychometric properties (content validity, construct validity, and concurrent validity) and reliability (internal consistency, ceiling-floor effect, and test-retest) were evaluated in a sample of healthy community-dwelling children who were between 5 to 12 years old, of both sexes. Caregivers responded to the FHBS. Concurrent validity was assessed by comparing the FHBS scale with Body Mass Index (BMI) percentile, percent body fat, and physical activity level.Results: 272 children (54% girls) with a mean age of 7.9 years (SD = 2.0) and their caregivers were tested. Confirmatory analysis of the initial 4-factor structure (as proposed in the original English version of the questionnaire) suggested its performance was below acceptable. Exploratory factor analysis showed however an acceptable fit (Kaiser-Meyer-Olkin index = 0.79), and the factor loadings suggested a 7-factor model. Children who were considered obese (BMI percentile ≥ 97) had lower mean total FHBS scores than children who had a healthy weight or were overweight. Children who were classified as having a healthy fat percentage had higher FHBS scores than children classified as having an excessively high fat percentage. Children who were physically active had significantly higher total FHBS scores than children who were physically inactive. Cronbach's alpha was 0.81 and we noted acceptable values of the ceiling-floor effect. Test-retest analyses showed lower agreement and intraclass correlation coefficients ​​than expected 0.63 (95% CI 0.41 to 0.78).Conclusion: The adapted Family Health Behavior Scale for the Brazilian population showed adequate psychometric properties.

Objective Investigate the impact of urinary incontinence (UI) on quality of life (QoL) in female CrossFit practitioners and to verify the strategies used by them to minimize the occurrence of urine leakage. In addition, to verify whether anthropometric and clinical characteristics increase the UI impact on QoL of female CrossFit practitioners. Study Design This was an online cross-sectional survey. The impact of UI on QoL was investigated by International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Associations between the impact of UI on QoL and the clinical (age, BMI, gestations, mode of delivery, practice of other physical activities) and the others pelvic floor dysfunctions (PFD) related independent variables were tested using logistic regression analysis. Results A total of 828 female CrossFit practitioners answered the questionnaire and 36% reported UI symptoms. The women who obtained the highest score on the ICIQ-SF have high UI interference in QoL. Previous history of two or more gestations and sexual dysfunctions (dyspareunia or vaginismus) or pelvic organ prolapse increase 2.65 and 1.82 times the risk of female CrossFit practitioners with UI having a high impact of UI on their QoL, respectively (OR = 2.65 95% CI 1.30–5.40, p = 0.01; and OR = 1.82 95% CI 1.04–3.21, p = 0.04, respectively). The most strategies used by them to minimize the occurrence of urine leakage were emptying the bladder before training (77.5%) and use absorbent (17.8%). Conclusions Women who had higher scores on the ICIQ-SF reported greater impact on QoL, and the previous history of two or more gestations and sexual dysfunction/pelvic organ prolapse increase the risk of women with UI who practice CrossFit to have a greater impact on QoL. Multigravida and women with sexual dysfunction/pelvic organ prolapse who practice CrossFit could have more attention on the UI symptoms due to the high impact on their QoL.

Obesity and its associated comorbidities are a major public health concern worldwide. Reduced energy intake and increased physical activity interventions have limited success in the long term. Nutraceuticals might be an alternative means to help lose weight and reduce obesity-associated cardiometabolic risk factors without changes in the habitual diet. The objective of the present study was to comparatively evaluate the efficiency of nutraceuticals based on the combination of a decaffeinated green coffee bean extract (GCBE) and two types of oat beta-glucans (BG) with different physiochemical properties on obesity related biomarkers in overweight/obese subjects. A randomized, dose–response, parallel, blind study was carried out in four groups of subjects (n = 15 each) who consumed for 6 weeks, twice a day, a nutraceutical containing 3 g d−1 or 5 g d−1 doses of 35% or 70% BG and a fixed amount of GCBE providing 600 mg d−1 of phenols. 35% BG showed a 10 and 100 times higher molecular weight and viscosity, respectively, compared to 70% BG. Food intake, anthropometry and different cardiometabolic markers were assessed at the beginning and end of the intervention. According to the general model of variance with repeated measure analysis, the intervention caused positive changes in the levels of total cholesterol, LDL cholesterol, VLDL cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, haemoglobin A1c, insulin, systolic blood pressure (SBP), total body fat percentage (TBF%), visceral fat percentage, and waist and hip circumferences without differences among the treatments, except for SBP and TBF%. Looking into the rates of change [(end value − beginning value)/beginning value] of these parameters, 5 g – 70% BG was the treatment that lowered TBF% the most. In conclusion, 5 g – 70% BG may be more effective in helping to lose weight and additionally, it produced the least bloating according to participants’ subjective perception., This research was funded by project AGL2015-69986-R from the Ministerio de Economía y Competitividad. JGC had a predoctoral grant funded by Comunidad de Madrid (PEJD-2018-PRE/SAL-9104).

IntroductionTo train and prepare cadets for a career as firefighters in Rio de Janeiro, the second-year students of the Officers Training Course are submitted to a Search, Rescue, and Survival Training (SRST) course, which is characterized by long periods of high physical exertion and sleep restriction during a 9-day instruction module, and food restriction during a 7-day survival module. The present study investigated changes in the body composition of 39 male cadets submitted to SRST during training and 4 weeks of recovery with no restrictions in food consumption.Materials and MethodsEach cadet was evaluated by anthropometric measurements at six time points: pre-SRST; after the first module; after the second module; and after 1, 2, and 4 weeks of recovery. Measurements included body girths and skinfolds, to estimate trunk (chest and waist) and limbs (arm and thigh) dimensions, as well as body composition. Repeated measures ANOVA and Friedman test were applied (depending on each data distribution).ResultsStatistically significant decreases in body weight (76.2; 69.8-87.2 to 63.9; 58.9-73.5 kg) and fat free mass (FFM, 69.2; 63.7-77.2 to 60.1; 56.2-68.0 kg) were observed following the second module of SRST. Following a single week of recovery, the FFM returned to pre-SRST values. Body weight returned to pre-training levels in 2 weeks. Body fat percentage and mass also significantly decreased during SRST (9.0; 7.7-12.3 to 6.5; 5.1-9.3% and 6.9; 5.6-10.0 to 6.9; 5.6-10.0 kg, respectively), which showed a slower and more gradual recovery that reached pre-SRST values after 4 weeks. The girths of arm, thigh, chest and waist significantly decreased due to SRST. The girths of the limbs (arm and thigh) returned to pre-training values after one month of recovery, while the girths of the trunk (chest and waist) did not return to pre-SRST values during the study period.ConclusionsThe findings suggest that men who experience periods of high energy demands and sleep restriction followed by a period of food restriction will endure unavoidable physical consequences that can be mostly reversed by a 1-month recovery.

Summary Background and aims Lean muscle and fat mass in the human body are important indicators of the risk of cardiovascular and metabolic diseases. Techniques such as dual-energy X-ray absorptiometry (DXA) accurately measure body composition, but they are costly and not easily accessible. Multiple linear regression (MLR) models have been developed to estimate body composition using simple demographic and anthropometric measures instead of expensive techniques, but MLR models do not explore nonlinear interactions between inputs. In this study, we developed simple demographic and anthropometric measure-driven artificial neural network (ANN) models that can estimate lean muscle and fat mass more effectively than MLR models. Methods We extracted the demographic, anthropometric, and body composition measures of 20,137 participants from the National Health and Nutrition Examination Survey conducted between 1999 and 2006. We included 13 demographic and anthropometric measures as inputs for the ANN models and divided the dataset into training and validation sets (70:30 ratio) to build and cross-validate the models that estimate lean muscle and fat mass, which were originally measured using DXA. This process was repeated 100 times by randomly dividing the training and validation sets to eliminate any effect of data division on model performance. We built additional models separately for each sex and ethnicity, older individuals, and people with underlying diseases. The coefficient of determination (R2) and standard error of estimate (SEE) were used to quantify the goodness of fit. Results The ANN models yielded high R2 values between 0.923 and 0.981. These values were significantly higher than those of the MLR models (p Conclusions We developed and validated an inexpensive but effective method for estimating body composition using easily obtainable demographic and anthropometric data.