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Background: The most important reason for treating children with Prader-Willi syndrome (PWS) with GH is to optimize their body composition.Objectives: The aim of this ongoing study was to determine whether long-term GH treatment can counteract the clinical course of increasing obesity in PWS by maintaining the improved body composition brought during early treatment.Setting: This was a multicenter prospective cohort study.Methods: We have been following 60 prepubertal children for 8 years of continuous GH treatment (1 mg/m(2)/d congruent to 0.035 mg/kg/d) and used the same dual-energy x-ray absorptiometry machine for annual measurements of lean body mass and percent fat.Results: After a significant increase during the first year of GH treatment (P Conclusion: This 8-year study demonstrates that GH treatment is a potent force for counteracting the clinical course of obesity in children with PWS.

BACKGROUND: Weight loss due to a negative energy balance is considered to be accompanied by a decrease in physical activity. OBJECTIVE: The aim of this study was to investigate whether a decrease in physical activity is sustained during weight maintenance. DESIGN: Subjects were 20 men and 31 women [mean (+/-SD) age: 42 +/- 8 y; BMI (in kg/m2): 31.4 +/- 2.8]. Weight loss was achieved by an 8-wk very-low-energy diet period, followed by 44 wk of weight maintenance. Physical activity measures were total energy expenditure expressed as a multiple of sleeping metabolic rate (PALSMR) and resting metabolic rate (PALRMR), activity-induced energy expenditure divided by body weight (AEE/kg), and activity counts measured by a triaxial accelerometer. Measurements took place at 0, 8, and 52 wk. RESULTS: Body mass decreased significantly during the diet period (10.5 +/- 3.8%, P < 0.001), and this reduction was sustained after 52 wk (6.0 +/- 5.1%, P < 0.001). PALSMR and PALRMR decreased from 1.81 +/- 0.23 and 1.70 +/- 0.22, respectively, before the diet to 1.69 +/- 0.20 and 1.55 +/- 0.19 after the diet (P < 0.001) and increased again after weight maintenance to 1.85 +/- 0.27 and 1.71 +/- 0.23, respectively, compared with 8-wk measurements (P < 0.001). AEE/kg decreased from 0.043 +/- 0.015 MJ/kg at baseline to 0.037 +/- 0.014 MJ/kg after the diet (P < 0.001) and was higher after 52 wk (0.044 +/- 0.17 MJ/kg) compared with after 8 wk (P < 0.001). Activity counts decreased from 1.64 +/- 0.37 megacounts/d at baseline to 1.54 +/- 0.35 megacounts/d after the diet (P < 0.05) and were higher after 52 wk (1.73 +/- 0.49 megacounts/d) compared with 8 wk (P < 0.01). CONCLUSION: A weight loss-induced reduction in physical activity returns to baseline values when weight loss is maintained. This trial was registered at clinicaltrials.gov as NCT01015508.

Obese individuals have more (hyperplastic) and larger (hypertrophic) adipocytes in their white adipose tissue (WAT) than normal-weight individuals. The difference in cell number emerges early in childhood, suggesting that this is a critical period for being susceptible to obesity. Breast-feeding has been shown to be protective against obesity, and we have previously shown in mice that the physical structure of lipids in human milk may contribute to this protective effect. In the present study, we investigated how differences in the physical structure of lipids in the early diet may modulate adipose tissue development. Male mice were fed a diet containing control infant milk formula (Control IMF; Danone Research) or Nuturis®(Concept IMF with large phospholipid-coated lipid droplets; Danone Research) from postnatal day (PN)16 to 42. Subsequently, mice were challenged with a moderate Western-style diet (WSD) until PN98, and body composition was monitored by dual-energy X-ray absorptiometry. Epididymal WAT was analysed for adipocyte size, number and gene expression of metabolic transcription factors. Early Concept IMF exposure reduced fat accumulation during the WSD challenge by 30 % compared with the Control IMF. It reduced adipocyte size without affecting adipocyte number in adult mice. The Concept IMF decreased the expression of PPARγ, CCAAT/enhancer-binding protein and retinoid X receptor α in WAT in adulthood, key regulators of metabolic activity. In conclusion, Concept IMF exposure in early life reduced susceptibility to obesity in adult life, by preventing adipocyte hypertrophia upon adult dietary challenge without affecting adipogenesis. These data emphasise the importance of the physical properties of dietary lipids in early life in obesity risk later in life.

Background The aging process results in a number of functional (e.g., deficits in balance and strength/power performance), neural (e.g., loss of sensory/motor neurons), muscular (e.g., atrophy of type-II muscle fibers in particular), and bone-related (e.g., osteoporosis) deteriorations. Traditionally, balance and/or lower extremity resistance training were used to mitigate these age-related deficits. However, the effects of resistance training are limited and poorly translate into improvements in balance, functional tasks, activities of daily living, and fall rates. Thus, it is necessary to develop and design new intervention programs that are specifically tailored to counteract age-related weaknesses. Recent studies indicate that measures of trunk muscle strength (TMS) are associated with variables of static/dynamic balance, functional performance, and falls (i.e., occurrence, fear, rate, and/or risk of falls). Further, there is preliminary evidence in the literature that core strength training (CST) and Pilates exercise training (PET) have a positive influence on measures of strength, balance, functional performance, and falls in older adults.Objective The objectives of this systematic literature review are: (a) to report potential associations between TMS/trunk muscle composition and balance, functional performance, and falls in old adults, and (b) to describe and discuss the effects of CST/PET on measures of TMS, balance, functional performance, and falls in seniors.Data Sources A systematic approach was employed to capture all articles related to TMS/trunk muscle composition, balance, functional performance, and falls in seniors that were identified using the electronic databases PubMed and Web of Science (1972 to February 2013).Study Selection A systematic approach was used to evaluate the 582 articles identified for initial review. Cross-sectional (i.e., relationship) or longitudinal (i.e., intervention) studies were included if they investigated TMS and an outcome-related measure of balance, functional performance, and/or falls. In total, 20 studies met the inclusionary criteria for review.Study Appraisal and Synthesis Methods Longitudinal studies were evaluated using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes (ES) were calculated whenever possible. For ease of discussion, the 20 articles were separated into three groups [i.e., cross-sectional (n = 6), CST (n = 9), PET (n = 5)].Results The cross-sectional studies reported small-to-medium correlations between TMS/trunk muscle composition and balance, functional performance, and falls in older adults. Further, CST and/or PET proved to be feasible exercise programs for seniors with high-adherence rates. Age-related deficits in measures of TMS, balance, functional performance, and falls can be mitigated by CST (mean strength gain = 30 %, mean effect size = 0.99; mean balance/functional performance gain = 23 %, mean ES = 0.88) and by PET (mean strength gain = 12 %, mean ES = 0.52; mean balance/functional performance gain = 18 %, mean ES = 0.71).Limitations Given that the mean PEDro quality score did not reach the predetermined cut-off of >= 6 for the intervention studies, there is a need for more high-quality studies to explicitly identify the relevance of CST and PET to the elderly population.Conclusions Core strength training and/or PET can be used as an adjunct or even alternative to traditional balance and/or resistance training programs for old adults. Further, CST and PET are easy to administer in a group setting or in individual fall preventive or rehabilitative intervention programs because little equipment and space is needed to perform such exercises.

Background: This study critically appraises the measurement properties of tools to measure muscle mass, strength, and physical performance in community-dwelling older people. This can support the selection of a valid and reliable set of tools that is feasible for future screening and identification of sarcopenia.Methods: The databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane were systematically searched (January 11, 2012). Studies were included if they investigated the measurement properties or feasibility, or both, of tools to measure muscle mass, strength, and physical performance in community-dwelling older people aged >60 years. The consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist was used for quality appraisal of the studies.Results: Sixty-two publications were deemed eligible, including tools for muscle mass (n = 16), muscle strength (n = 15), and physical performance (n = 31). Magnetic resonance imaging, computed tomography, and a 4-compartment model were used as gold standards for muscle mass assessment. Other frequently used measures of muscle mass are dual-energy x-ray and the bioelectrical impedance (BIA); however, reliability data of the BIA are lacking. Handheld dynamometry and gait speed or a short physical performance battery provide a valid and reliable measurement of muscle strength and physical performance, respectively.Conclusions: It can be concluded that several tools are available for valid and reliable measurements of muscle mass, strength, and performance in clinical settings. For a home-setting BIA, handheld dynamometry and gait speed or a short physical performance battery are the most valid, reliable, and feasible. The combination of selected instruments and its use for the screening and identification of sarcopenia in community-dwelling older people need further evaluation. Published by Elsevier Inc. on behalf of the American Medical Directors Association, Inc.

Dietary intake changes during the course of aging. Normally an increase in food intake is observed around 55 years of age, which is followed by a reduction in food intake in individuals over 65 years of age. This reduction in dietary intake results in lowered levels of body fat and body weight, a phenomenon known as anorexia of aging. Anorexia of aging has a variety of consequences, including a decline in functional status, impaired muscle function, decreased bone mass, micronutrient deficiencies, reduced cognitive functions, increased hospital admission and even premature death. Several changes during lifetime have been implicated to play a role in the reduction in food intake and the development of anorexia of aging. These changes are both physiological, involving peripheral hormones, senses and central brain regulation and non-physiological, with differences in psychological and social factors. In the present review, we will focus on age-related changes in physiological and especially non-physiological factors, that play a role in the age-related changes in food intake and in the etiology of anorexia of aging. At the end we conclude with suggestions for future nutritional research to gain greater understanding of the development of anorexia of aging which could lead to earlier detection and better prevention. (c) 2012 Elsevier B.V. All rights reserved.

Aim: To compare body composition, resting metabolic rate, and maximal aerobic capacity parameters in obese adults and healthy controls, as well as to investigate the associations among these parameters. Materials and methods: A total of 120 participants, 60 obese participants (30 male, 30 female) with body mass indexes (BMIs) over 30 kg/m(2) and 60 healthy controls (30 male, 30 female) with BMIs of 18-25 kg/m(2), were included in the study. BMI was calculated as body weight divided by the square of the height (kg/m2). Body fat percentage, total body fat, and lean body mass were established with bioelectric impedance analysis. Resting metabolic rates (RMRs) were determined with indirect calorimeter. Maximal aerobic capacity was estimated with the Astrand exercise protocol. Results: RMRs (kcal/day) were significantly higher in male and female obese individuals than in the controls. VO2 max (L/min) levels were not significantly different between obese and control individuals of either sex. However, RMR per kilogram of body weight and VO2 max expressed in milliliters per kilogram of body weight were significantly lower in male and female obese adults compared to the controls. BMI, body fat percentage, and total body fat were positively correlated with RMR (kcal/day), but negatively correlated with RMR [(kcal/day)/kg] and VO2 max (mL/kg/min) in both sexes. Conclusion: We suggest that resting and maximal energy expenditure per kilogram of body weight are impaired in obese adults. Both low resting metabolic rate and weak maximal aerobic capacity are related to excess body fat in obese subjects.

Objective: The aim of this study was to identify the pre-treatment subject characteristics and weight loss changes as determinants of weight loss and attrition during a 10-week dietary intervention study. Methods: A total of 771 obese subjects (BMI 35.6 kg/m2) of both genders were included from 8 clinical centres in 7 European countries, who underwent a 10-week dietary intervention study comparing two hypo-energetic (–600 kcal/day) diets varying in fat content. Results: The multiple regression model showed that weight loss at week 10 was predicted by: 6.55 + 1.27 × early weight loss (kg) at week 1 + 1.35 × gender (R2 = 0.28, p < 0.001). When performing the corresponding model with half-way weight loss (week 5) as covariate, the regression equation was: weight loss (kg) at week 10 = 1.88 + 1.38 × half-way weight loss (kg) (week 5) + 0.42 × gender (R2 = 0.77, p < 0.001). A cut-off target of ≥ 4 kg weight loss at week 5 emerged as an optimal predictor for reaching at least 10% weight loss at week 10. Greater attrition likelihood was predicted by high-fat diet, decreased early and half-way weight losses. Conclusion: Early and half-way weight losses are associated with and could contribute to prediction of the final weight loss and attrition.

Background: Little is known about the consequences of the special energy enriched diet used to treat patients with phenylketonuria (PKU) in terms of obesity and metabolic syndrome (MetSyn) development. Objective: To investigate the prevalence of overweight and obesity, and its consequences in terms of body composition and MetSyn in early treated patients with PKU compared to controls. Design: A sample of 89 patients with PKU (3-30 y; 14.4 +/- 6.6 y) and 79 controls (3-47 y; 16.3 +/- 7.9 y) were studied. In the fasted state, anthropometric, body composition, blood pressure and analytical paratmeters [amino acids, glucose, insulin, total and HDL-cholesterol (HDL-c), triglycerides (TG), high sensitivity c-reactive protein and uric acid] were performed. Data on dietary intake was collected. BMI was classified using WHO criteria, while the definition from International Diabetes Federation (IDF) was used for MetSyn. Results: Prevalence of overweight and obesity (32.6% vs. 24.1%; p=0.293), body fat percentage (22% vs. 23.1%, p=0.581) and central obesity (36.9% vs. 36.4%, p=0.999) were comparable to controls. Patients revealed a higher TG/HDL-c (p

CONTEXT: Bariatric surgery is an effective method to reduce morbid obesity. Nutritional counseling is essential to achieve maximal treatment success and to avoid long-term complications. Increased dietary protein intake may improve various postoperative results. OBJECTIVE: The aim of this systematic review is to examine the relationship between intake of dietary protein or supplementation with amino acids and postoperative outcomes after gastric bypass surgery. DATA SOURCES: A systematic literature search was conducted in 4 electronic databases: Cochrane, Embase, PubMed, and Scopus. STUDY SELECTION: The initial search retrieved 7333 hits, which included 2390 duplicates. DATA EXTRACTION: Tweny-three studies with varying study designs, interventions, and outcomes were included. RESULTS: Studies did not provide convincing evidence of a beneficial effect on any postoperative outcome. CONCLUSIONS: The study of the influence of protein and its amino acid composition represents an important developing domain of knowledge and warrants further attention considering the popularity of bariatric surgery. Future studies should include a clear description of the quantity and composition of proteins and amino acids in the diet or supplement.

Sedentary behaviour (SB) is increasing in Western societies and some studies suggest a deleterious effect of SB on bone. The aim of this systematic review was to examine the association between SB and bone health in children, adolescents and young adults. Electronic databases (PubMed, MEDLINE, PsycINFO and Science Citation Index) were searched for relevant articles up to January 9, 2017. Studies were included when results on bone health (e.g. strength, mass and structure) and either subjectively (questionnaires) or objectively (accelerometry) measured SB were reported in healthy participants ≤24 years. Two reviewers independently screened titles and abstracts for eligibility, rated methodological quality and extracted data. Seventeen observational studies were included. Several studies that used DXA or quantitative ultrasound suggested that objectively measured SB was negatively associated with lower extremity bone outcomes, such as femoral neck bone mineral density. The magnitude of this negative association was small and independent of moderate-to-vigorous physical activity. In contrast to the lower extremities, there was insufficient evidence for an association of lumbar spine bone outcomes with objectively measured SB. In high-quality studies that used DXA, no association was observed between objectively measured SB and total body bone outcomes. In studies using questionnaires, none of these relationships were observed. Well-designed longitudinal studies, objectively measuring SB, are needed to further unravel the effect of SB, physical activity and their interaction on bone health. Electronic supplementary material The online version of this article (doi:10.1007/s00198-017-4076-2) contains supplementary material, which is available to authorized users.

BRACKGROUND: The safety and tolerability of very low-calorie-ketogenic (VLCK) diets are a current concern in the treatment of obese type 2 diabetes mellitus (T2DM) patients. OBJECTIVE: Evaluating the short-term safety and tolerability of a VLCK diet (, We thank all of the investigators, coordinators and patients who took part in this study. Editorial assistance was provided by Montse Vidal, Punta Alta Communication and funded by PronoKal Group. The founding for the study as well as the DiaproKal Method products were provided by Pronokal Group., (Barcelona, Spain) free of charge to the patients. The funding source had no involvement in the study design, recruitment of patients, study interventions, the data collection or interpretation of the results. The investigators and representatives from Pronokal Group were responsible for the study design, protocol, statistical analysis plans, analysis and reporting of the results. Final responsibility for the decision to submit the manuscript for publication was made jointly by all author. Preliminary data at 2 months were presented in poster form at the 23th Annual Congress of Spanish Society of Diabetes, Vigo, Spain, 19-21 April 2012. Parts of this study were presented at the 34th National Congress of Spanish Society of Internal Medicine, Malaga, Spain, 21-23 November 2013.

BACKGROUND: Malnutrition, weight loss, and muscle wasting (sarcopenia) are common among women with advanced ovarian cancer and have been associated with adverse clinical outcomes and survival. Our objective is to investigate overall survival (OS) related to changes in skeletal muscle (SM) for patients with advanced ovarian cancer treated with neoadjuvant chemotherapy and interval debulking. METHODS: Ovarian cancer patients (n = 123) treated with neoadjuvant chemotherapy and interval debulking in the area of Maastricht (the Netherlands) between 2000 and 2014 were included retrospectively. Surface areas of SM and adipose tissue were defined on computed tomography at the level of the third lumbar vertebra. Low SM at baseline and SM changes during chemotherapy were compared with Kaplan Meier curves, and Cox-regression models were applied to test predictors of OS. RESULTS: Median OS for patients who lost SM (n = 83) was 916 ± 99 days, which was significantly different from median OS for patients who maintained or gained SM (n = 40), which was 1431 ± 470 days (P = 0.004). Loss of SM was also a significant predictor of OS in multivariable Cox-regression analysis (hazard ratio 1.773 (95%CI: 1.018-3.088), P = 0.043). Low baseline SM did not influence survival. CONCLUSIONS: Patients with ovarian cancer have a worse survival when they lose SM during neoadjuvant chemotherapy. Evaluation of low SM at a specific time point is not prognostic for OS. External and prospective validation of these findings is imperative. Nutritional, pharmacological, and/or physical intervention studies are necessary to establish whether SM impairment can be prevented to prolong ovarian cancer survival. ispartof: JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE vol:7 issue:4 pages:458-466 ispartof: location:Germany status: published

World journal of gastroenterology 22(45), 10064-10070 (2016). doi:10.3748/wjg.v22.i45.10064, Published by WJG Press, Beijing

Udgivelsesdato: 2010-Feb-1 Epidemiological studies consistently show that circulating sex hormone binding globulin (SHBG) levels are lower in type 2 diabetes patients than non-diabetic individuals, but the causal nature of this association is controversial. Genetic studies can help dissect causal directions of epidemiological associations because genotypes are much less likely to be confounded, biased or influenced by disease processes. Using this Mendelian randomization principle, we selected a common single nucleotide polymorphism (SNP) near the SHBG gene, rs1799941, that is strongly associated with SHBG levels. We used data from this SNP, or closely correlated SNPs, in 27 657 type 2 diabetes patients and 58 481 controls from 15 studies. We then used data from additional studies to estimate the difference in SHBG levels between type 2 diabetes patients and controls. The SHBG SNP rs1799941 was associated with type 2 diabetes [odds ratio (OR) 0.94, 95% CI: 0.91, 0.97; P = 2 x 10(-5)], with the SHBG raising allele associated with reduced risk of type 2 diabetes. This effect was very similar to that expected (OR 0.92, 95% CI: 0.88, 0.96), given the SHBG-SNP versus SHBG levels association (SHBG levels are 0.2 standard deviations higher per copy of the A allele) and the SHBG levels versus type 2 diabetes association (SHBG levels are 0.23 standard deviations lower in type 2 diabetic patients compared to controls). Results were very similar in men and women. There was no evidence that this variant is associated with diabetes-related intermediate traits, including several measures of insulin secretion and resistance. Our results, together with those from another recent genetic study, strengthen evidence that SHBG and sex hormones are involved in the aetiology of type 2 diabetes.

Muscle depletion is a poor prognostic indicator in colorectal cancer (CRC) patients, but there were no data assessing comparative temporal body composition changes following elective CRC surgery. We examined patient skeletal muscle index trajectories over time after surgery and determined factors that may contribute to those alterations.Patients diagnosed with CRC undergoing elective surgical resection between 2006 and 2013 were included in this study. Image analysis of serial computed tomography (CT) scans was used to calculate lumbar skeletal muscle index (LSMI). A multilevel mixed-effect linear regression model was applied using STATA (version 12.0) using the xtmixed command to fit growth curve models (GCM) for LSMI and time.In 856 patients, a total of 2136 CT images were analyzed; 856 (38.2 %) were preoperative. A quadratic GCM with random intercept and random slope for patients' LSMI was identified that demonstrated laparoscopy produces a positive change on the LSMI curve [estimate = 0.17 cm(2)/m(2), standard error (SE) 0.06 cm(2)/m(2); p = 0.03], whereas Union for International Cancer Control (UICC) stage III + IV disease contributed to a negative curve change (estimate = -0.19 cm(2)/m(2), SE 0.09 cm(2)/m(2); p = 0.03). Older age (p In patients undergoing CRC surgery, laparoscopy and the absence of a significantly elevated SIR favored preservation and restoration of skeletal muscle, postoperatively. These emerging data may permit the development of new treatment protocols whereby monitoring and modification of body composition has therapeutic potential.

Contains fulltext : 168011.PDF (Publisher’s version ) (Open Access) BACKGROUND: In this large observational study population of 105 myotonic dystrophy type 1 (DM1) patients, we investigate whether bodyweight is a contributor of total lung capacity (TLC) independent of the impaired inspiratory muscle strength. METHODS: Body composition was assessed using the combination of body mass index (BMI) and fat-free mass index. Pulmonary function tests and respiratory muscle strength measurements were performed on the same day. Patients were stratified into normal (BMI < 25 kg/m2) and overweight (BMI >/= 25 kg/m2) groups. Multiple linear regression was used to find significant contributors for TLC. RESULTS: Overweight was present in 59% of patients, and body composition was abnormal in almost all patients. In overweight patients, TLC was significantly (p = 2.40x10-3) decreased, compared with normal-weight patients, while inspiratory muscle strength was similar in both groups. The decrease in TLC in overweight patients was mainly due to a decrease in expiratory reserve volume (ERV) further illustrated by a highly significant (p = 1.33x10-10) correlation between BMI and ERV. Multiple linear regression showed that TLC can be predicted using only BMI and the forced inspiratory volume in 1 second, as these were the only significant contributors. CONCLUSIONS: This study shows that, in DM1 patients, overweight further reduces lung volumes, as does impaired inspiratory muscle strength. Additionally, body composition is abnormal in almost all DM1 patients.

This study examined the correlates of dietary energy under-reporting (UR) and over-reporting (OV) in European adolescents. Two self-administered computerised 24-h dietary recalls and physical activity data using accelerometry were collected from 1512 adolescents aged 12·5–17·5 years from eight European countries. Objective measurements of height and weight were obtained. BMI was categorised according to Cole/International Obesity Task Force (IOTF) cut-off points. Diet-related attitudes were assessed via self-administered questionnaires. Reported energy intake (EI) was compared with predicted total energy expenditure to identify UR and OV using individual physical activity objective measures. Associations between misreporting and covariates were examined by multilevel logistic regression analyses. Among all, 33·3 % of the adolescents were UR and 15·6 % were OV when considering mean EI. Overweight (OR 3·25; 95 % CI 2·01, 5·27) and obese (OR 4·31; 95 % CI 1·92, 9·65) adolescents had higher odds for UR, whereas underweight individuals were more likely to over-report (OR 1·67; 95 % CI 1·01, 2·76). Being content with their own figures (OR 0·61; 95 % CI 0·41, 0·89) decreased the odds for UR, whereas frequently skipping breakfast (OR 2·14; 95 % CI 1·53, 2·99) was linked with higher odds for UR. Those being worried about gaining weight (OR 0·55; 95 % CI 0·33, 0·92) were less likely to OV. Weight status and psychosocial weight-related factors were found to be the major correlates of misreporting. Misreporting may reflect socially desirable answers and low ability to report own dietary intakes, but also may reflect real under-eating in an attempt to lose weight or real over-eating to reflect higher intakes due to growth spurts. Factors influencing misreporting should be identified in youths to clarify or better understand diet–disease associations.

OBJECTIVE: To investigate the effect of rate of weight loss, with similar total weight loss, on weight regain in individuals with overweight and obesity. METHODS: Fifty-seven participants (BMI: 28-35 kg/m(2) ) underwent a dietary intervention (DI). They were randomized to a low-calorie diet (LCD; 1250 kcal/day) for 12 weeks (slow weight loss) or a very-low-calorie diet (VLCD; 500 kcal/day) for 5 weeks (rapid weight loss) (weight loss (WL) period) followed by a 4-week weight-stable (WS) period and 9 months follow-up. Body weight and body composition (BodPod) were determined at study start and after each period. RESULTS: Weight change was similar in both groups after WL (LCD: -8.2 kg and VLCD: -9.0 kg, P = 0.24). Weight regain after follow-up was not significantly different between groups (LCD: 4.2 kg and VLCD: 4.5 kg, P = 0.73). Percentage fat-free mass loss (%FFML) was higher in the VLCD-group compared to the LCD-group after DI (8.8% and 1.3%, respectively, P = 0.034) and was associated with weight regain during follow-up in the whole group (r = 0.325, P = 0.018). CONCLUSIONS: The present study showed that, with similar total weight loss, rate of weight loss did not affect weight regain. However, %FFML after DI was associated with weight regain.

RationaleThe doubly labelled water (DLW) method is a stable isotopic technique for measuring total energy expenditure (TEE). Saliva is the easiest sampling fluid for assessing isotopic enrichments, but blood is considered superior because of its rapid exchange with body water. Therefore, we compared a large range of isotopic enrichments in saliva and blood, and related TEE in subjects with their ad libitum total energy intake (TEI). The relevance of these parameters to body weight and fat change over an 8-day interval was also assessed. MethodsThirty subjects underwent DLW analysis over either 8 or 14days, during which time initial and final blood and saliva enrichments were compared. TEI was assessed by dieticians over the 8-day period only. Isotope ratio mass spectrometry was used for the measurement of H-2 and O-18 values. ResultsNo discrepancies were observed between sampling fluids over a wide range of enrichments. During the 8-day period, average TEI exceeded TEE by similar to 5% or less. Using saliva as sampling fluid, TEI and TEI-TEE, but not TEE, were positively correlated to body weight change. TEI-TEE and physical activity EE (AEE), but not TEI, correlated, respectively, positively and negatively to changes in fat mass. ConclusionsThe DLW method in humans can be reliably applied using saliva as sampling fluid. TEI-TEE as well as AEE contributes significantly to changes in fat mass over an 8-day period. Copyright (c) 2015 John Wiley & Sons, Ltd.

A unique example of phenotypic flexibility of the oral apparatus is present in newts (Salamandridae) that seasonally change between an aquatic and a terrestrial habitat. Newts grow flaps of skin between their upper and lower jaws, the labial lobes, to partly close the corners of the mouth when they adopt an aquatic lifestyle during their breeding season. Using hydrodynamic simulations based on μCT-scans and cranial kinematics during prey-capture in the smooth newt (Lissotriton vulgaris), we showed that this phenotypic flexibility is an adaptive solution to improve aquatic feeding performance: both suction distance and suction force increase by approximately 15% due to the labial lobes. As the subsequent freeing of the corners of the mouth by resorption of the labial lobes is assumed beneficial for the terrestrial capture of prey by the tongue, this flexibility of the mouth fine-tunes the process of capturing prey throughout the seasonal switching between water and land.

DOI: 10.1093/nutrit/nuw004 Context: The use of social marketing to modify lifestyle choices could be helpful in reducing youth obesity. Some or all of the 8 domains of the National Social Marketing Centre's social marketing benchmark criteria (SMBC) are often used but not always defined in intervention studies. Objective: The aim of this review is to assess the effectiveness of European school-based interventions to prevent obesity relative to the inclusion of SMBC domains in the intervention. Data Sources: The PubMed, Cochrane, and ERIC databases were used. Study Selection: Nonrandomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5 to 17 years were included. Data Extraction: After the study selection, the 8 domains of the SMBC were assessed in each included study. Results: Thirty-eight publications were included in the systematic review. For the meta-analysis, randomized controlled trials (RCTs) reporting body mass index or prevalence of overweight and obesity were considered. Eighteen RCTs with a total of 8681 participants included at least 5 SMBC. The meta-analysis showed a small standardized mean difference in body mass index of 0.25 (95%CI, 0.45 to 0.04) and a prevalence of overweight and obesity odds ratio of 0.72 (95%CI, 0.5-0.97). Conclusion: Current evidence indicates that the inclusion of at least 5 SMBC domains in schoolbased interventions could benefit efforts to prevent obesity in young people. PROSPERO registration number: CRD42014007297.

Background: Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus an integral strategy to improve Quality of Life in breast cancer survivors. Methods: This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema. Discussion: This study has been designed to seek to address the new needs for support and treatment of breast cancer survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of health professionals in this type of patients. Trial registration: ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016)., The study was funded by the Spanish Ministry of Economy and Competitiveness (Plan Estatal de I + D + I 2013-2016), Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI14/01627), Fondos Estructurales de la Unión Europea (FEDER) and by the Spanish Ministry of Education (FPU14/01069). This is part of a Ph.D. Thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of the University of Granada, Spain.

International audience; Background: Individual sensory liking appears to be an important determinant of dietary intake and may consequently influence weight status. Cross-sectional studies have shown positive association between fat liking and weight status and equivocal results regarding salt and sweet liking. Moreover, the contribution of dietary intake to explain this relationship has not been studied yet. We investigated the prospective association between sensory liking for fat, sweet or salt and the onset of obesity over 5 years in adults, and the mediating effect of dietary intake.Methods: We prospectively examine the risk of obesity among 24,776 French adults participating in the NutriNet-Sante cohort study. Liking scores and dietary data were assessed at baseline using a validated web-based questionnaire and 24 h records, respectively. Self-reported anthropometric data were collected using web-based questionnaire, each year during 5 years. Associations between quartiles of liking for fat, sweet or salt and obesity risk, and the mediating effect of diet were assessed by multivariate Cox proportional hazards models stratified by gender, adjusted for sociodemographic and lifestyle factors.Results: In both genders, sensory liking for fat was associated with an increased risk of obesity (hazard ratios for quartile 4 compared to quartile 1, men: HRQ4vs.(Q1) = 2.39 (95 % Cl 1.39,4.11) P-trend = 0.0005, women: HRQ4vs.Q1 = 2.02 (1.51,2.71) P-trend = < 0.0001). Dietary intake explained 32 % in men and 52 % in women of the overall variation of liking for fat in obesity. Sensory liking for sweet was associated with a decreased risk of obesity (men: HRQ4vs.Q1 = 0.51 (0.31,0.83) P-trend = 0.01, women: HRQ4vs.Q1 = 0.72 (0.54,0.96) P-trend = 0.035). No significant association between salt liking and the risk of obesity was found.Conclusions: Unlike sweet and salt liking, higher liking for fat appears to be a major risk factor of obesity, largely explained by dietary intake. Our findings emphasize the need to centrally position sensory liking in obesity prevention.

Objectives: Cognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning. The objective of this study was to investigate the association between physical frailty and cognitive functioning in depressed older persons.Design: Baseline data of a depressed cohort, participating in the Netherlands Study of Depression in Older persons (NESDO).Setting: Primary care and specialized mental health care.Participants: A total of 378 patients (>= 60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher.Measurements: The physical frailty phenotype as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity). Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.Results: Of the 378 depressed patients (range 60-90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (>= 3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory (beta = -0.13, P = .039), slower processing speed (beta = -0.20, P = .001), and decreased working memory (beta = -0.18, P = .004), but not with changes in interference control (beta = 0.04, P = .54).Conclusion: In late-life depression, physical frailty is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

WOS: 000374719000025, A preliminary study was conducted to evaluate the effect of the Bay laurel (Latina nobilis) extract on growth performance and body composition of the African catfish (Clarias gariepinus, Burchell, 1822). Fish with an average body weight of 10.52 +/- 0.89 g were fed with different concentrations (0, 0.5, 1 and 1.5%) of bay laurel extract for 60 days. At the end of experiment, the highest weight gain, specific growth rate and food conversion rate were 13.19 +/- 0.18 g, 1.65 +/- 0.04 and 1.89 +/- 0.03, respectively at 1.5% bay laurel group. Also, the highest survival rates and PER were 100% and 1.10 +/- 0.02, respectively at 1.5% bay laurel dosage group. The best protein content (21.49%) was observed at 1.5% bay laurel dosage group. These results indicate that bay laurel extract, a feed additive of natural origin, may be considered as a potential growth promoter in catfish culture.

Objective Seamless transition of endocrine patients from the paediatric to adult setting is still suboptimal, especially in patients with complex disorders, i.e., small for gestational age, Turner or Prader–Willi syndromes; Childhood Cancer Survivors, and those with childhood-onset growth hormone deficiency. Methods An expert panel meeting comprised of European paediatric and adult endocrinologists was convened to explore the current gaps in managing the healthcare of patients with endocrine diseases during transition from paediatric to adult care settings. Results While a consensus was reached that a team approach is best, discussions revealed that a ‘one size fits all’ model for transition is largely unsuccessful in these patients. They need more tailored care during adolescence to prevent complications like failure to achieve target adult height, reduced bone mineral density, morbid obesity, metabolic perturbations (obesity and body composition), inappropriate/inadequate puberty, compromised fertility, diminished quality of life and failure to adapt to the demands of adult life. Sometimes it is difficult for young people to detach emotionally from their paediatric endocrinologist and/or the abrupt change from an environment of parental responsibility to one of autonomy. Discussions about impending transition and healthcare autonomy should begin in early adolescence and continue throughout young adulthood to ensure seamless continuum of care and optimal treatment outcomes. Conclusions Even amongst a group of healthcare professionals with a great interest in improving transition services for patients with endocrine diseases, there is still much work to be done to improve the quality of healthcare for transition patients.

Objectives Protein supplementation has been proposed as an effective dietary strategy to augment the skeletal muscle adaptive response to prolonged resistance-type exercise training in elderly people. Our objective was to assess the impact of protein supplementation on muscle mass, strength, and physical performance during prolonged resistance-type exercise training in frail elderly men and women. Design/setting/participants A randomized, double-blind, placebo-controlled trial with 2 arms in parallel among 62 frail elderly subjects (78 ± 1 year). These elderly subjects participated in a progressive resistance-type exercise training program (2 sessions per week for 24 weeks) during which they were supplemented twice daily with either protein (2 ∗ 15 g) or a placebo. Measurements Lean body mass (DXA), strength (1-RM), and physical performance (SPPB) were assessed at baseline, and after 12 and 24 weeks of intervention. Results Lean body mass increased from 47.2 kg (95% CI, 43.5–50.9) to 48.5 kg (95% CI, 44.8–52.1) in the protein group and did not change in the placebo group (from 45.7 kg, 95% CI, 42.1–49.2 to 45.4 kg, 95% CI, 41.8–48.9) following the intervention ( P value for treatment × time interaction = .006). Strength and physical performance improved significantly in both groups ( P = .000) with no interaction effect of dietary protein supplementation. Conclusions Prolonged resistance-type exercise training represents an effective strategy to improve strength and physical performance in frail elderly people. Dietary protein supplementation is required to allow muscle mass gain during exercise training in frail elderly people. Trial Registration: clinicaltrials.gov identifier: NCT01110369 .

Weight loss resulting from an exercise intervention tends to be lower than predicted. Modest weight loss can arise from an increase in energy intake, physiological reductions in resting energy expenditure, an increase in lean tissue or a decrease in non-exercise activity. Lower than expected, weight loss could also arise from weak and invalidated assumptions within predictive models. To investigate these causes, we systematically reviewed studies that monitored compliance to exercise prescriptions and measured exercise-induced change in body composition. Changed body energy stores were calculated to determine the deficit between total daily energy intake and energy expenditures. This information combined with available measurements was used to critically evaluate explanations for low exercise-induced weight loss. We conclude that the small magnitude of weight loss observed from the majority of evaluated exercise interventions is primarily due to low doses of prescribed exercise energy expenditures compounded by a concomitant increase in caloric intake.

Background & aims: Weight loss is a frequently observed problem in patients with head and neck cancer (HNC) during radiotherapy. It is still to be assessed whether hypermetabolism is contributing to this problem. The aim of this study was to investigate hypermetabolism before radiotherapy, and changes in resting energy expenditure (REE) in HNC patients during radiotherapy.Methods: REE was measured by indirect calorimetry in 71 patients with HNC before radiotherapy, after 3 and 6 weeks of radiotherapy, and 3 months after radiotherapy. The association between REE and tumour stage, CRP, and prior tumour surgery was analyzed by linear regression analyses. Forty healthy control subjects were one-to-one matched to 40 patients by gender, age and fat free mass (FFM) index to compare REE.Results: Before radiotherapy, REE was not significantly different between patients and controls, neither in absolute values (1568 +/- 247 vs. 1619 +/- 244 kcal/d; p = 0.29), nor after weight-adjustment (22.1 +/- 3.5 vs. 21.5 +/- 3.3 kcal/kg, p = 0.42) or FFM-adjustment (31.5 +/- 4.9 vs. 30.7 +/- 4.5 kcal/kg, p = 0.38). REE was independent of tumour stage, CRP, and prior tumour surgery. REE (kcal/d) decreased during radiotherapy and thereafter by 9% from pre-radiotherapy (p Conclusions: Head and neck cancer patients had normal REE before radiotherapy. During radiotherapy. REE decreased continuously with ongoing weight loss. However, weight loss is not the only explaining factor, since REE expressed per kg FFM showed a much more divergent course which is currently unexplained. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

1. Seasonal carry-over effects may be important structuring components of avian life-history cycles. However, little is known on physiological transitions between stages and on phenotypic compromises that may be made at such time to improve fitness.2. We studied postmigratory body remodelling in red knots (Calidris canutus islandica) arriving on the Arctic breeding grounds. Our objectives were to determine the effects of body reconstruction and preparation for breeding on maintenance energy costs and to determine whether weather conditions can force compromises between functions required for postmigration recovery of body composition, thermoregulation and breeding.3. During two consecutive springs at the northernmost land on Earth (Alert, Ellesmere Island, Canada, 82 degrees 30' N), we monitored changes in knots post- arrival body stores. Using ultrasonography, we also tracked changes in gizzard size, an indicator of gut size, and pectoral muscle thickness, not only an endogenous protein source but also a thermogenic organ. We measured basal metabolic rate (BMR) throughout reconstruction and compared it with BMR of nonbreeding red knots wintering in the Dutch Wadden Sea.4. Arriving knots faced temperatures up to 13 degrees C lower than during midwinter. Birds arrived with large body stores and pectoral muscles, which declined in size while they grew their gizzard and prepared for breeding. BMR at arrival was indistinguishable from winter BMR and increased linearly throughout reconstruction. BMR increased up to 69% faster in females than males, likely due to the development of their reproductive organs.5. Birds had lower body stores but larger muscles in the colder year, and muscle loss was correlated with the warming of spring temperatures. Therefore, muscles would not only serve as a nutrient source, but their thermogenic function could also provide the flexibility to cope with high thermostatic costs in the spring. However, retaining muscles for shivering may limit protein recirculation and delay the onset of breeding.6. Postmigratory recovery therefore involves significant energy costs and arriving birds likely have to make physiological compromises, depending on spring conditions, which may impact on fitness. Although this period is clearly critical in the life cycle of red knots, it is one of the least understood life- history stages in Arctic- breeding shorebirds.

Background Problematic activities of daily life (ADLs) can be the main reason to refer patients with chronic obstructive pulmonary disease (COPD) for pulmonary rehabilitation. To date, information on problematic ADLs and their clinical correlates in COPD remain scarce. This retrospective chart review aimed to identify the most prevalent self-reported problematic ADLs in COPD patients, determine performance and satisfaction scores of these problematic ADLs, and explore the association between 13 clinical determinants and 4 problematic ADL domains. Methods A total of 820 COPD patients entering pulmonary rehabilitation assessment were included in this retrospective study. Self-reported problematic ADLs were assessed using the Canadian Occupational Performance Measure, administered by occupational therapists in the form of a semistructured interview. Results COPD patients (59% male, age 63.6 ± 9.3 years, FEV 1 (%pred): 46.4 ± 18.4) reported 2999 problematic ADLs. The most prevalent problematic ADLs were walking (68%), stair climbing (35%), and cycling (30%). Moreover, 30% of the patients reported "not able to do any of the scored problematic ADL" and 44% were "not satisfied at all with the performance of any of the scored problematic ADL." Significant but weak associations were found between clinical determinants (eg, physical and psychosocial) and problematic ADLs. Conclusions The lack of a strong association between problematic ADLs and clinical determinants emphasizes the need for individualized assessment of these ADLs to allow tailored intervention.

Patients with phenylketonuria (PKU) must follow a strict low-phenylalanine (Phe) diet in order to minimise the potentially disabling neuropsychological sequelae of the disorder. Research in this area has unsurprisingly focussed largely on managing blood Phe concentrations to protect the brain. Protein requirements in dietary management of PKU are met mostly from Phe-free protein substitutes with the intake of natural protein restricted to patient tolerance. Several reports have suggested that growth in early childhood in PKU is sub-optimal, relative to non-PKU control groups or reference populations. We reviewed the literature searching for evidence regarding PKU and growth as well as possible links between dietary management of PKU and growth. The search retrieved only limited evidence on the effect of PKU and its dietary management on growth. Physical development in PKU remains an understudied aspect of this disorder. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Patients with phenylketonuria (PKU) must follow a strict low-phenylalanine (Phe) diet in order to minimise the potentially disabling neuropsychological sequelae of the disorder. Research in this area has unsurprisingly focussed largely on managing blood Phe concentrations to protect the brain. Protein requirements in dietary management of PKU are met mostly from Phe-free protein substitutes with the intake of natural protein restricted to patient tolerance. Several reports have suggested that growth in early childhood in PKU is sub-optimal, relative to non-PKU control groups or reference populations. We reviewed the literature searching for evidence regarding PKU and growth as well as possible links between dietary management of PKU and growth. The search retrieved only limited evidence on the effect of PKU and its dietary management on growth. Physical development in PKU remains an understudied aspect of this disorder. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Background: Children with cystic fibrosis (CF) tend to suffer from chronic systemic inflammation and may have impaired growth associated with muscle catabolism. Therefore, investigating which type of exercise can elicit an anabolic response with minimal inflammation is of clinical value.Methods: Twelve children with CF (mean +/- SD; age: 14.7 +/- 2.3 years, predicted FEV1: 90.0 +/- 21.6%) and biological age-matched controls (age: 13.9 +/- 2.1 years) completed moderate-intensity, continuous exercise (MICE) and high-intensity, intermittent exercise (HIIE) on separate days. During each exercise, blood was drawn at various time points and analyzed for immune cells, inflammatory cytokines, and growth mediators.Results: At rest, children with CF had higher concentrations of neutrophils and IL-6 compared with controls. In children with CF, HUE did not affect immune cell subsets or cytokines: TNF-alpha, IL-6, and tumor necrosis factor-like weak inducer of apoptosis (TWEAK). All immune cell subsets and IL-6 increased significantly with MICE in both groups. Growth hormone (GH) increased with both types of exercise, with a greater change from rest during MICE.Conclusions: HIIE was a sufficient stimulus to increase OH in children with CF, without affecting systemic inflammation. (C) 2011 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Cis-9, trans-11 conjugated linoleic acid (CLA) is a natural trans fatty acid that is largely restricted to ruminant fats and consumed in foods and supplements. Its role in blood pressure (BP) regulation is still unclear. We examined the effect of cis-9, trans-11 CLA on BP compared with oleic acid. A total of 61 healthy volunteers were sequentially fed each of 3 diets for 3 weeks, in random order, for a total of 9 weeks. The diets were identical except for 7% of energy (18.9 g in a diet of 10 MJ day(-1)) that was provided either by oleic acid, by industrial trans fatty acids or by cis-9, trans-11 CLA. We measured BP on two separate days at the end of each intervention period. At baseline, mean BP was 113.8±14.4 mm Hg systolic and 66.3±9.6 mm Hg diastolic. The effect of the CLA diet compared with the oleic acid diet was 0.11 mm Hg (95% confidence interval: -1.27, 1.49) systolic and -0.45 mm Hg (-1.63, 0.73) diastolic. After the industrial trans fatty acid diet, the effect was 1.13 mm Hg (-0.25, 2.51) systolic and -0.44 mm Hg (-1.62, 0.73) diastolic compared with the oleic acid diet. Our study suggests that short-term high intakes of cis-9,trans-11 CLA do not affect BP in healthy volunteers.

The objectives of this study were to determine nitrogen loss at different stages of growth and during the entire growing period and to investigate the associations between nitrogen excretion and production traits in growing pigs. Data from 315 pigs of an F-2 population which originated from crossing Pietrain sires with a commercial dam line were used. Nitrogen retention was derived from protein retention as measured using the deuterium dilution technique during different stages of growth (60 to 90 kg, 90 to 120 kg, and 120 to 140 kg). Pigs were fed ad libitum with 2 pelleted diets containing 17% (60 to 90 kg) and 16.5% (90 to 120 and 120 to 140 kg) CP. Average daily nitrogen excretion (ADNE) within each stage of growth was calculated on the basis of the accumulated difference between average daily nitrogen intake (ADNI) and average daily nitrogen retention (ADNR). Least ADNE, nitrogen excretion per BW gain (NEWG) and total nitrogen excretion (TNE) were observed during growth from 60 to 90 kg. In contrast, the greatest ADNE, NEWG, and TNE were found during growth from 120 to 140 kg. Statistical analyses indicated that gender, housing type, the ryanodine receptor 1 (RYR1) gene, and batch influenced nitrogen excretion (P

Aging coincides with a decline in LLMS. Preserving LLMS may be considered a very important determinant of functional independence in the elderly. To maintain LLMS the question arises whether habitual physical activities (HPA) can prevent a decline in LLMS. This review aims to determine the relationship between HPA throughout life and LLMS above age 50. Using relevant databases and keywords, 70 studies that met the inclusion criteria were reviewed and where possible, a meta-analysis was performed. The main findings are: (1) the present level of HPA is positively related to LLMS; (2) HPA in the past has little effect on present LLMS; (3) HPA involving endurance have less influence on LLMS compared to HPA involving strength; (4) people with a stable habitually physically active life are able to delay a decline in LLMS. In conclusion, to obtain a high amount of LLMS during aging, it is important to achieve and maintain a high level of HPA with mainly muscle-strengthening activities. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

BACKGROUND: It is not clear why some anovulatory women with polycystic ovary syndrome (PCOS) and obesity resume ovulation and others remain anovulatory after weight loss. The objective of this study was to compare the changes in body fat distribution and specifically intra-abdominal fat (IAF) and subcutaneous abdominal fat (SAF) between a group of anovulatory women with PCOS and obesity who resume ovulation (RO+) to those who remain anovulatory (RO-) during a lifestyle program.METHODS: In a prospective pilot cohort study, anovulatory women with PCOS underwent a 6 month lifestyle program in a tertiary fertility clinic. Body fat distribution was assessed by anthropometrics, dual-energy X-ray absorptiometry (DEXA) and single slice abdominal CT scan at intake, after 3 months and after 6 months. Baseline-corrected changes over time were analysed using generalized estimating equations longitudinal regression analysis.RESULTS: In 32 anovulatory women with PCOS (age, 28 +/- 4 years; BMI, 37.5 +/- 5.0 kg/m(2)), there were no significant baseline differences in anthropometrics and biochemical assessment between 14 RO+ participants and 18 RO- participants. RO+ women lost more weight (6.3 versus 3.0%) and abdominal fat on DEXA (15.0 versus 4.3%) compared with RO- women. Resumption of ovulation was associated with early and consistent loss of IAF (12.4 versus 5.0% at 3 months and 18.5 versus 8.6% at 6 months). Loss of SAF between the RO+ women and the RO- women was similar at 3 months (6.2 versus 6.1%) but did not change any further in RO- women (6.1%) as it did in RO+ women (11.4%) at 6 months.CONCLUSIONS: In anovulatory women with PCOS and obesity undergoing a lifestyle program, RO+ women lose more body weight and abdominal fat on DEXA than RO- women. In addition, this study shows that early and consistent loss of IAF is associated with resumption of ovulation. Future studies should address the mechanisms behind these changes and should assess interventions aimed at loss of IAF to facilitate resumption of ovulation.

Background. The purpose of this study was to test whether nutritional status of patients with head and neck cancer changes during and after treatment.Methods. Nutritional status (including body weight, lean mass, and fat mass) and dietary intake were assessed in 29 patients with head and neck cancer. Patients were assessed 1 week before, and 1 and 4 months after treatment (radiotherapy, either alone or combined with chemotherapy or surgery).Results. During treatment, body weight (-3.6 +/- 5.3 kg; p = .019) and lean mass (-2.43 +/- 2.81 kg; p = .001) significantly declined. Patients with sufficient intake (>= 35 kcal and >= 1.5 grams protein/kg body weight) lost less body weight and lean mass than patients with insufficient intake (mean difference, -4.0 +/- 1.9 kg; p = 0.048 and -2.1 +/- 1.0 kg; p = .054, respectively). After treatment, only patients with sufficient intake gained body weight (2.3 +/- 2.3 kg) and lean mass (1.2 +/- 1.3 kg).Conclusion. Patients with head and neck cancer fail to maintain or improve nutritional status during treatment, despite sufficient intake. (C) 2010 Wiley Periodicals, Inc. Head Neck 33: 863-870, 2011

International audience; Purpose of review Cancer and HIV infection/AIDS are associated with an increased risk of undernutrition and cachexia. During the past decade, patients became older, frequently overweight or obese and sedentary, conditions which are likely to result in fat-free mass (FFM) loss. This review sustains the hypothesis that FFM measurement should be implemented in routine clinical practice, to optimize the management of cancer and AIDS, as well as disease-related undernutrition. Recent findings Undernutrition and FFM loss are associated with worse clinical outcome and increased therapy toxicity in cancer and AIDS patients. The emergence of the concept of sarcopenic obesity in cancer patients, a condition associated with decreased survival, demonstrates the necessity to assess their body composition with easily available methods, such as dual energy X-ray absorptiometry, computerized tomography and bioelectrical impedance analysis. FFM measurement could be helpful for guiding the choice of both disease-specific and nutritional therapies and for evaluating their efficacy and putative toxicity. Summary FFM measurement at different steps of disease course could allow improving the guidance and efficacy of both cancer and HIV/AIDS-specific and nutritional therapies. The repeated measurement of FFM could allow reducing undernutrition-related morbidity, mortality and global healthcare costs, and could improve response and tolerance towards therapy, and quality of

Endurance-type exercise training represents a cornerstone in type 2 diabetes treatment. However, the effects of prolonged continuous, endurance-type exercise on muscle fiber characteristics remain equivocal. Fifteen obese male type 2 diabetes patients (61 +/- 6 years) participated in a 6-month continuous, endurance-type exercise program. Muscle biopsies were collected before, and after 2 and 6 months of intervention. Muscle fiber type-specific composition, size, and satellite cell (SC) and myonuclear content were determined by immunohistochemistry. Although continuous endurance-type exercise training lowered total body weight and reduced fat mass, no changes were observed in leg lean mass. At baseline, SC content was significantly lower in type II compared with type I muscle fibers. No change in SC content was observed after exercise training. Continuous endurance-type exercise training lowers fat mass, but it does not increase leg lean mass and/or modulate muscle fiber characteristics in type 2 diabetes patients. Muscle Nerve, 2010.

Meta-analysis of results from multiple studies could lead to more precise quantitative trait loci (QTL) position estimates compared to the individual experiments. As the raw data from many different studies are not readily available, the use of results from published articles may be helpful. In this study, we performed a meta-analysis of QTL on chromosome 4 in pig, using data from 25 separate experiments. First, a meta-analysis was performed for individual traits: average daily gain and backfat thickness. Second, a meta-analysis was performed for the QTL of three traits affecting loin yield: loin eye area, carcass length and loin meat weight. Third, 78 QTL were selected from 20 traits that could be assigned to one of three broad categories: carcass, fatness or growth traits. For each analysis, the number of identified meta-QTL was smaller than the number of initial QTL. The reduction in the number of QTL ranged from 71% to 86% compared to the total number before the meta-analysis. In addition, the meta-analysis reduced the QTL confidence intervals by as much as 85% compared to individual QTL estimates. The reduction in the confidence interval was greater when a large number of independent QTL was included in the meta-analysis. Meta-QTL related to growth and fatness were found in the same region as the FAT1 region. Results indicate that the meta-analysis is an efficient strategy to estimate the number and refine the positions of QTL when QTL estimates are available from multiple populations and experiments. This strategy can be used to better target further studies such as the selection of candidate genes related to trait variation.

Testosterone is an important hormone for both bone gain and maintenance in men. Hypogonadal men have accelerated bone turnover and increased fracture risk. In these men, administration of testosterone inhibits bone resorption and maintains bone mass. Testosterone, however, is converted into estradiol via aromatization in many tissues including male bone. The importance of estrogen receptor alpha activation as well of aromatization of androgens into estrogens was highlighted by a number of cases of men suffering from an inactivating mutation in the estrogen receptor alpha or in the aromatase enzyme. All these men typically had low bone mass, high bone turnover and open epiphyses. In line with these findings, cohort studies have confirmed that estradiol contributes to the maintenance of bone mass after reaching peak bone mass, with an association between estradiol and fractures in elderly men. Recent studies in knock-out mice have increased our understanding of the role of androgens and estrogens in different bone compartments. Estrogen receptor activation, but not androgen receptor activation, is involved in the regulation of male longitudinal appendicular skeletal growth in mice. Both the androgen and the estrogen receptor can independently mediate the cancellous bone-sparing effects of sex steroids in male mice. Selective KO studies of the androgen receptor in osteoblasts in male mice suggest that the osteoblast in the target cell for androgen receptor mediated maintenance of trabecular bone volume and coordination of bone matrix synthesis and mineralization. Taken together, both human and animal studies suggest that testosterone has a dual mode of action on different bone surfaces with involvement of both the androgen and estrogen receptor. ispartof: Journal of Osteoporosis vol:2011 pages:240328- ispartof: location:United States status: published

BACKGROUND: Central fatness is associated with higher arterial stiffness, a mechanism that may explain adiposity-related increases in cardiovascular disease risk. In contrast, peripheral fat and lean masses may counteract such adverse effects, but evidence of this contention, as derived from longitudinal studies at the general population level, is lacking. OBJECTIVE: The objective was to investigate the associations between changes in central (ie, trunk) fat mass, peripheral (ie, limbs) fat mass, and lean masses with changes in arterial stiffness. DESIGN: A longitudinal study in 277 (145 women) healthy adults was conducted. Body composition (dual-energy X-ray absorptiometry) and arterial stiffness estimates (ultrasound imaging) were measured repeatedly at the ages of 36 and 42 y. RESULTS: Changes (per 10 kg) in trunk fat mass were positively associated and changes in peripheral fat mass were inversely associated with carotid Young's elastic modulus (in 10(3) . kPa) [beta = 0.14 (95% CI: 0.02, 0.25) and -0.16 (-0.30, -0.01), respectively] and carotid-femoral pulse wave velocity (in m/s) [beta = 1.54 (0.02, 3.07) and -1.46 (-3.48, 0.56), respectively]. Individuals in whom trunk fat increased and peripheral fat decreased over the 6-y follow-up (33% of the study population) had the steepest increases in these stiffness estimates. Notably, these changes were accompanied by minor increases in body weight, which remained within the limits of the normal range throughout. CONCLUSIONS: Increases in trunk mass and decreases in peripheral fat mass are associated with accelerated arterial stiffening. These findings emphasize the importance of assessing regional changes in body composition, because it may enable identification of individuals with an unrecognized increased cardiovascular disease risk.

Objective: The goal of this study was to investigate the effect of Pilates exercises on the social physical concern (SPC) of patients with fibromyalgia syndrome (FMS). We also aimed to determine the effect of Pilates exercises on strength, body mass index (BMI), pain, and depression. Materials and Methods: Twenty-five female patients with an age range of 33 to 63 years (mean: 49.16 +/- 7.51) were evaluated. All patients had been diagnosed with FMS according to the American College of Rheumatology (ACR) criteria. Patients underwent a Pilates exercise program consisting of one hour of exercise performed three times per week for 12 weeks. Prior to exercise and at the end of the 12(th) week, the patient's weight, grip strength of the hands, back strength, body fat ratio, and BMI were measured. Before-and after-exercise measurements were compared. The patient pain level was determined using the visual analog scale (VAS). Beck Depression Inventory (BDI) was used to define the depression level of patients. SPC level of patients was obtained by Social Physique Anxiety Scale (SPAS). The correlations between SPC scores and anthropometric values and pain and depression levels were evaluated. Results: Pilates exercises significantly improved the weight, BMI, body fat ratio and SPC and pain level of the patients. No statistically significant change was found for grip strength of either hand or back strength. A statistically significant correlation was found between SPC scores and the body fat ratio, weight, BMI, and pain and depression scores of patients before and after the exercise program. Conclusion: A 12-week Pilates program had positive effects on anthropometric parameters, SPC, and pain and depression levels of FMS patients. Patients with FMS can safely perform Pilates exercises to control weight, improve physical appearance, and reduce SPC and pain and depression levels, and no adverse side effects were observed. To obtain further evidence regarding the effectiveness of Pilates exercises, additional studies involving different patient groups are required.(Turk J Rheumatol 2010; 25: 201-7) Fibromiyalji sendromu (FMS) olan hastalarda Pilates egzersizlerinin sosyal fiziksel kaygı (SPC) seviyesine olan etkisini araştırmak. Aynı zamanda Pilates egzersizlerinin mukavemet, vücut kütle indeksi (BMI), ağrı ve depresyon düzeylerine olan katkısını belirlemek. Yöntem ve Gereçler: Yaşları 33 ile 63 arasında olan 25 hasta çalışmaya dahil edildi. Tüm hastaların FMS tanısı Amerikan Romatizma Koleji (ACR) kriterlerine göre konmuştur. 1 saatlik bir Pilates egzersiz programı hastalara haftada 3 kez olmak üzere 12 hafta boyunca uygulandı. Egzersiz öncesi ve 12. haftanın sonunda, hastaların ağırlıkları, ellerin kavrama kuvveti, bel kuvveti, vücut yağ oranları ve BMI ölçüldü. Hastaların ağrı düzeyleri görsel analog skala (VAS) kullanılarak belirlendi. Depresyon seviyeleri Beck Depression anketi (BDI) ile belirlendi. SPC düzeyleri sosyal fiziksel anksiyete anketi (SPAS) uygulanarak ölçüldü. Katılımcıların SPC değerleri ile anropometrik ölçümleri, ağrı, depresyon düzeyleri arasında korelasyon araştırıldı. Bulgular: Pilates egzersizleri hastaların ağırlığı, BMI, yağ oranı ve SPC değerlerini iyileştirmiştir. El kavrama gücü ve sırt gücü için istatistiksel olarak anlamlı bir etkisi bulunamadı. Egzersiz programı öncesi ve sonrası, ölçülmüş vücut yağ oranı, ağırlık, BMI ve SPC düzeyi arasında önemli bir korelasyon bulundu. Sonuç: Oniki haftalık Pilates programının FMS hastalarındada antropometrik ölçüler, SPC, ağrı ve depresyon üzerinde olumlu etkileri vardı. FMS hastalar kilo kontrolü, fiziksel görünümünü iyileştirmek ve SPC seviyelerini azaltmak için Pilates egzersizlerini hiçbir yan etkisi olmadan güvenli bir şekilde uygulayabilirler. Pilates egzersizlerinin etkinliği hakkında daha fazla kanıt elde etmek için, farklı hasta gruplarını içeren ek çalışmalar gerekmektedir.