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The objective of the present study was to examine the effect of dairy products enriched with calcium, vitamin D(3), and phylloquinone (vitamin K(1)) or menaquinone-7 (vitamin K(2)) on parameters of bone metabolism in postmenopausal women following a 12-month intervention. Postmenopausal women were divided into three intervention groups and a control group (CG). All three intervention groups attended biweekly sessions and received fortified dairy products providing daily 800 mg of calcium and 10 μg of vitamin D(3) (CaD). Furthermore, in two of the three intervention groups the dairy products were also enriched with vitamin K, providing daily 100 μg of either phylloquinone (CaDK1) or menaquinone-7 (CaDK2). The increase observed for serum 25(OH)D levels in all intervention groups and the increase observed for serum IGF-I levels in the CaDK2 group differed significantly compared to the changes observed in CG (P = 0.010 and P = 0.028, respectively). Furthermore, both the CaDK1 and CaDK2 groups had a significantly lower mean serum undercarboxylated osteocalcin to osteocalcin ratio and urine deoxypyridinoline levels at follow-up compared to the CaD and CG groups (P = 0.001 and P = 0.047, respectively). Significant increases in total-body BMD were observed in all intervention groups compared to CG (P < 0.05), while significant increases in lumbar spine BMD were observed only for CaDK1 and CaDK2 compared to CG (P < 0.05) after controlling for changes in serum 25(OH)D levels and dietary calcium intake. In conclusion, the present study revealed more favorable changes in bone metabolism and bone mass indices for the two vitamin K-supplemented groups, mainly reflected in the suppression of serum levels of bone remodeling indices and in the more positive changes in lumbar spine BMD for these two study groups. [ABSTRACT FROM AUTHOR]

Background: Common mental disorders often emerge during childhood and adolescence, and their prevalence is disproportionately elevated among those affected by obesity. Early life growth patterns may provide a useful target for primordial prevention; however, research is lacking. Therefore, this study aimed to identify distinct body mass index (BMI) trajectories during the first year of life and to assess their associations with psychosocial outcomes in preadolescence (9-13 years)., Methods: Data were obtained from n = 1778 Greek children (9-13 years). Infant anthropometric data were obtained from paediatric health records and BMI trajectories during the first year of life were estimated using group-based trajectory modelling. Preadolescent emotional functioning, self-esteem, body image dissatisfaction and dieting behaviours were self-reported via validated questionnaires. Associations were estimated using binary and ordinal logistic regression, adjusted for key confounders., Results: Four BMI trajectories were identified: low (26.7%), average (41.8%), high (25.2%), and very high (6.4%). Children belonging to the very high trajectory had greater odds of body image dissatisfaction (OR: 1.62, 95%CI: 1.11, 2.38), dieting behaviour (OR: 1.49, 95%CI: 1.01, 2.20) and restrained eating (OR: 1.69 95%CI: 1.14, 2.52) than children belonging to the average trajectory. Body image dissatisfaction was also greater in children belonging to the high trajectory (OR: 1.40, 95%CI: 1.11, 1.76). However, infant BMI trajectories did not significantly predict childhood emotional functioning or self-esteem status., Conclusion: Infants with BMI growth in the high reference ranges had poorer psychosocial outcomes in preadolescence. Whilst further research is needed to replicate these findings, monitoring early infant growth trajectories may allow for early stratification of infants at risk of poor psychosocial outcomes., (© 2024. The Author(s).)

Background/objectives: Data on the effect of dietary fat on dumping syndrome (DS) symptoms are limited. The aim of this study was to assess the effect of the addition of fat to a carbohydrate meal on the appearance of DS symptoms and glycemic response, in patients who had undergone gastric surgery., Subjects/methods: This was an interventional crossover study. Patients scheduled for gastric surgical procedures related to DS at two surgical units of two public hospitals (General University Hospital of Larissa and General Hospital of Larissa) were considered for study inclusion. Patients presenting symptoms suggestive of diagnosis (n = 12), after the ingestion of a carbohydrate meal, were used as both intervention and control groups. During the intervention process, a fat supplement was added to the carbohydrate meal that was previously used for diagnosis. Glycemic response and the amount and intensity of DS symptoms provoked by the two meals were assessed at both appointments., Results: Blood glucose levels were significantly lower in the group that consumed the added fat meal compared with the group that consumed the carbohydrate meal 60 minutes after ingestion (p = 0.028). Furthermore, a significant reduction was noted in the amount of late dumping symptoms (p = 0.021) and the intensity of both early and late dumping symptoms (p = 0.007 and p = 0.012 respectively), after fat addition.  Conclusions: Incorporating fat into a carbohydrate meal seems to attenuate postprandial blood glucose rises and reduce the amount and intensity of DS symptoms, in patients who had undergone gastric surgery., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Migdanis et al.)

Objectives: The general perception is that menstrual cycle is a factor related to body weight and body composition fluctuations in women. The lack of a standardized methodology of the so far conducted studies has led to controversial results. The aim of the current study is to identify if there are any changes in body weight and body composition during the menstrual cycle., Methods: In the current study measurements of body weight, circumferences, skinfolds and body composition with bioelectrical impedance analysis were conducted twice per week in 42 women during their menstrual cycle., Results: Body weight was found to be statistically significantly higher during menstruation compared to the first week of the menstrual cycle by 0.450 kg, which could be attributed to a statistically significant increase of 0.474 kg observed in extracellular water. No other statistically significant changes were observed regarding body composition., Conclusions: An increase of approximately 0.5 kg was observed during women's menstrual cycle, mostly due to extracellular fluid retention at menstruation days. These findings could be taken into account to interpret body weight and composition periodic fluctuations in women of reproductive age., (© 2023 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.)

Introduction: The low-density lipoprotein receptor-related protein 5 (LRP5) and its inhibitor sclerostin, are key components of bone metabolism and potential contributors to type 2 diabetes mellitus susceptibility. This study aims at evaluating the expression of placental LRP5 and sclerostin in pregnancies with gestational diabetes mellitus (GDM) and investigate possible associations with umbilical sclerostin concentrations and clinical outcomes in mothers and their neonates., Methods: Twenty-six GDM-mothers and 34 non-GDM mothers of Caucasian origin and their neonates admitted in a gynecology and obstetrics department of a university hospital were included in this study. Demographic data and maternal fasting glucose concentrations (24-28 weeks of gestation) were retrieved from the patients' medical records. Placental LRP5 was determined by immunohistochemistry (IHC) and Western blotting analysis; placental sclerostin was determined by IHC. Umbilical serum sclerostin concentrations were measured by ELISA., Results: Placental sclerostin IHC intensity values were positively correlated with LRP5 values as detected either by IHC (r = 0.529; P < .001) or Western blotting (r = 0.398; P = .008), with pregestational maternal body mass index values (r = 0.299; P = .043) and with maternal fasting glucose concentrations (r = 0.475; P = .009). Placental sclerostin and LRP5 were significantly greater in GDM compared with non-GDM placentas (histo-score: 65.08 ± 17.09 vs 11.45 ± 2.33, P < .001; 145.53 ± 43.74 vs 202.88 ± 58.65, P < .001; respectively)., Discussion: Sclerostin and LRP5 were detected in human placentas. The overexpression of placental sclerostin and LRP5 values in GDM compared with non-GDM pregnancies, as well as the positive association of placental sclerostin values with pregestational maternal body mass index and maternal fasting glucose concentrations may indicate the development of an adaptive mechanism in face of maternal hyperglycemia., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Undeniably, biological age can significantly differ between individuals of similar chronological age. Longitudinal, deep multi-omic profiling has recently enabled the identification of individuals with distinct aging phenotypes, termed 'ageotypes'. This effort has provided a plethora of data and new insights into the diverse molecular mechanisms presumed to drive aging. Translational opportunities stemming from this knowledge continue to evolve, providing an opportunity for the provision of nutritional interventions aiming to decelerate the aging process. In this framework, the contemporary ageotypes classification was revisited via in silico analyses, with the brain and nervous system being identified as the primary targets of age-related biomolecules, acting through inflammatory and metabolic pathways. Nutritional and lifestyle factors affecting these pathways in the brain and central nervous system that could help guide personalized recommendations for the attainment of healthy aging are discussed., Competing Interests: Declaration of competing interest The authors declare that they have no competing interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Earlier age at menarche is one of the well-documented antecedents of a range of adverse health effects in adulthood including obesity and psychopathological effects. Yet, few researchers have examined the potential association of menarcheal age with body fat distribution, self-perception, and body image. We retrospectively tested a sample (N = 392) of adult women (18-80 years) to examine the associations of age at menarche with body composition and body image indices. Analyses of covariance and multivariable logistic and linear regression were fitted adjusting for age, physical activity level, smoking, and alcohol consumption. Further adjustment was made for body mass index (BMI) and percentage of fat mass. Earlier age at menarche was associated with slightly increased odds of higher BMI and abdominal fat percentage; of note is the positive correlation with lower body composition indices including hip and calf circumferences/skinfolds. Additionally, earlier age at menarche was associated with higher scores in the negative body image scales, namely overweight preoccupation and self-classified weight, whereas lower risks were found for higher scores in the positive body image scales, namely appearance evaluation and body area satisfaction scales. These findings remained significant after correcting for body fat percentage. The present results showed positive associations for earlier age at menarche with gross indices of obesity with the associations mainly confined to distribution of body fat in the lower part of the body, whereas an increased risk of negative body image was also found. Future research could refine our understanding of the biological and psychological mechanisms underlying these associations.

The association between dairy product consumption and biomarkers of inflammation, adipocytokines, and oxidative stress is poorly studied in children. Therefore, these associations were examined in a representative subsample of 1338 schoolchildren with a mean age of 11.5 (±0.7) years in the Healthy Growth Study. Information on dairy product consumption was collected by dietary recalls. Total dairy consumption was calculated by summing the intake of milk, yogurt, and cheese. Inflammatory markers, i.e., high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and adipocytokines, i.e., leptin, adiponectin, and the antioxidant enzyme glutathione peroxidase (GPx) were analysed. Due to the skewed distribution hs-CRP, IL-6, and leptin were log transformed. Multivariable regression analyses adjusted for age, sex, energy intake, physical activity, parental education, Tanner stage, and fat mass were used to assess the associations between consumption of total dairy, milk, yogurt, cheese, and markers of inflammation, adipocytokines, oxidative stress, and adiponectin-leptin ratio. Our results showed that milk consumption was inversely associated with leptin (β: -0.101; 95% CI: -0.177, -0.025, p = 0.009) and positively associated with the adiponectin-leptin ratio (β: 0.116; 95% CI: 0.020, 0.211; p = 0.018), while total dairy, cheese, and yogurt consumption were not associated with inflammatory, adipocytokine, or antioxidant markers. Further prospective studies are needed to confirm these results.

Background and Aims: Excessive body fat accumulation is associated with adverse health effects; therefore its accurate and reliable assessment is of great significance. The aim of the study was to develop and validate an easy and applicable equation, based on bioelectrical impedance analysis, estimating fat free mass in Greek general population and compare it with those of the literature., Methods: Anthropometric and bioelectrical impedance parameters were obtained from 694 Greek adults (429 women and 265 men) so as to develop and validate the equation, using DXA as reference method. The validation and the reliability of the equation were examined with Bland-Altman analysis and Intraclass Correlation Coefficient (ICC)., Results: The developed prediction equation was FFM (kg) = 12.299 + (0.164 * Weight (kg)) + (7.287 * Gender (0:female, 1:male)) - (0.116 * Resistance (ohm)/Height (m) 2 ) + (0.365 * Reactance (ohm)/Height (m) 2 ) + (21.570 * Height (m)) (R 2  = 0.944, p < 0.0001). Regarding the current population, the current equation presented the lowest bias (-0.069 kg, p = 0.707) and the highest ICC (0.985) compared to those of the literature., Conclusion: The current prediction equation was found to be valid and reliable in a representative sample of the Caucasian Greek general population and its utilization for body composition assessment could be an alternative of using labor-intensive, expensive and time-consuming reference methods., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Early identification of type 2 diabetes mellitus (T2DM) and hypertension (HTN) risk may improve prevention and promote public health. Implementation of self-reported scores for risk assessment provides an alternative cost-effective tool. The study aimed to develop and validate two easy-to-apply screening tools identifying high-risk individuals for insulin resistance (IR) and HTN in a European cohort. Sociodemographic, lifestyle, anthropometric and clinical data obtained from 1581 and 1350 adults (baseline data from the Feel4Diabetes-study) were used for the European IR and the European HTN risk assessment index respectively. Body mass index, waist circumference, sex, age, breakfast consumption, alcohol, legumes and sugary drinks intake, physical activity and sedentary behavior were significantly correlated with Homeostatic Model Assessment of IR (HOMA-IR) and/or HTN and incorporated in the two models. For the IR index, the Area Under the Curve (AUC), sensitivity and specificity for identifying individuals above the 75th and 95th of HOMA-IR percentiles were 0.768 (95%CI: 0.721-0.815), 0.720 and 0.691 and 0.828 (95%CI: 0.766-0.890), 0.696 and 0.778 respectively. For the HTN index, the AUC, sensitivity and specificity were 0.778 (95%CI: 0.680-0.876), 0.667 and 0.797. The developed risk assessment tools are easy-to-apply, valid, and low-cost, identifying European adults at high risk for developing T2DM or having HTN.

Background and Aims: Abdominal obesity is associated with adverse health implications. However, the assessment of abdominal adiposity is either indirect, like in the case of waist circumference measurement, or difficult in daily clinical practice, like in the case of using reference methods such as computerized tomography, magnetic resonance imaging, etc. The aim of the current study was to develop and validate, using DXA as reference method, two easy and simple to use protocols, that estimate abdominal fat mass percentage (%AFM) in Greek females and males respectively, based on simple anthropometric measurements., Methods: Circumferences and skinfolds were obtained from 709 Caucasian adults (437 women and 272 men) in order to develop and validate the two equations. The validation and the reliability of the equations were examined with Bland-Altman analysis and Intraclass Correlation Coefficient (ICC)., Results: The equations were: for females, %AFM = -121,368 - (17,322 × Height(m)) + (76,452 × log Abdominal Circumference(cm)) + (18,341 × log Suprailiac Skinfold(mm)) + (8802 × log Abdominal Skinfold(mm)), for males, %AFM = -174,117 - (15,247 × Height(m))+ (104,503 × log Abdominal Circumference(cm)) + (9907 × log Suprailiac Skinfold(mm)) + (7971 × log Abdominal Skinfold(mm)). The equations had no significant bias (0,203% and 0,406%, respectively), acceptable limits of agreement (±9.358% and ±8.780%, respectively) and high reliability (0,940 and 0,957, respectively)., Conclusion: Both equations were found to be valid and reliable for Greek population. Therefore, the utilization of these equations for abdominal fat assessment could be an alternative of labor-intensive, expensive and time-consuming reference methods., (Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: Niemann-Pick type C disease (NPC) is an autosomal recessive, neurovisceral, lysosomal storage disorder with protean and progressive clinical manifestations, resulting from mutations in either of the two genes, NPC1 (~95% of families) and NPC2. Contrary to other populations, published evidence regarding NPC disease in Greece is sparse., Methods: The study population consisted of two Greek NPC patients and their extended pedigree. Patients' clinical, biochemical, molecular profiles and the possible correlations are presented. Genotyping was performed by direct sequencing. Mutations' origin was investigated through selected exonic NPC1 polymorphisms encountered more frequently in a group of 37 Greek patients with clinical suspicion of NPC disease and in a group of 90 healthy Greek individuals, by the use of Haplore software., Results: Two novel NPC1 mutations, [IVS23 + 3insT (c.3591 + 3insT) and p. K1057R (c.3170A > C)] were identified and each mutation was associated with a specific haplotype. One of the patients was entered to early treatment with miglustat and has presented no overt neurological impairment after 11.5 years., Conclusions: The splicing mutation IVS23 + 3insT was associated in homozygocity with a severe biochemical and clinical phenotype. A possible founder effect for this mutation was demonstrated in the Greek Island, as well as a different origin for each novel mutation. Longitudinal follow-up may contribute to clarify the possible effect of early miglustat therapy on the patient compound heterozygous for the two novel mutations.

Objective: To validate anthropometric equations in the current literature predicting body fat percentage (%BF) in the Greek population, to develop and validate two anthropometric equations estimating %BF, and to compare them with the retrieved equations., Methods: Anthropometric data from 642 Greek adults were incorporated. Dual-energy X-ray absorptiometry was used as reference method. The comparison with other equations was made using Bland-Altman analysis, intraclass correlation coefficient, and Lin's concordance correlation coefficient., Results: Nine of the thirty-one retrieved equations had no statistically significant bias. However, all of them had wide limits of agreement (±8.3 to ±16%BF). The equations accrued were: BF% = -0.615-10.948 × sex + 0.321 × waist circumference + 0.502 × hips circumference-0.39 × forearm circumference - 19.768 × height (m) and BF% = -27.787-5.515 × sex-8.419 × height + 0.145 × waist circumference + 0.270 × hips circumference + 7.509 × log of thigh skinfold + 20.090 × log of sum of skinfolds (bicep + tricep + suprailiac + subscapular)-0.445 × forearm circumference. Bland-Altman's reliability analysis showed no significant bias of -0.058 and -0.148%BF and limits of agreement ±8.100 and ±6.056%BF; the intraclass correlation coefficient was 0.955 and 0.976; and Lin's concordance correlation coefficient was 0.914 and 0.951, respectively., Conclusions: Literature equations performed moderately on this study's population. Therefore, two equations were designed and validated. The first one was simple and easily applicable, with measures obtained from a measuring tape, and the second one more complicated yet more accurate and reliable. Both were found to be reliable for the assessment of body composition in the Greek population., (© 2017 The Obesity Society.)

The aim of the current study was to investigate if the supplementation of vitamin A via a phytosterol enriched low-fat milk could prevent the reduction of plasma beta-carotene concentrations than often occurs after plant sterols' or stanols' intake. A sample of 108 hypercholesterolaemic adults (40-60 years old) was randomized to an enriched milk group that contained among other nutrients phytosterols (0.5 g/100 ml) and vitamin A (111 μg/100 ml) (EMG: n = 40), a placebo plain milk group (PMG: n = 37), and a control group (CG: n = 31) following their usual diet; the EMG and the PMG consumed 500 ml milk per day and in order to ensure compliance with the intervention scheme, attended health and nutrition counselling sessions biweekly over a 3-month period. Dietary intake of vitamin A significantly increased in the EMG compared to the PMG and the CG (P < 0.001) and all groups significantly increased their vegetable consumption. However, no significant differences were found among groups regarding changes in dietary intake of beta-carotene and consumption of fruits. Regarding biochemical indices, total cholesterol, LDL-cholesterol and apolipoprotein-B decreased significantly within all study groups, with the decreases being significantly higher in the EMG compared to the CG (-25.4 vs. -9.9; -21.7 vs. -8.2 and -13.2 vs. -3.4 mg/dl, respectively; P < 0.05). Plasma concentrations of beta-carotene did not change in any of the three groups. Extra fortification of a phytosterol enriched milk with vitamin A seems to be useful in maintaining plasma beta-carotene levels of hypercholesterolemic adults after consumption of 2.5 g/d of phytosterols over a 3-month intervention period.

Objective: Since abdominal adiposity has been associated with increased risk for chronic diseases, valid and low cost methods to estimate it are needed for clinical and research purposes. The aim of the current study was to develop and validate, using dual-energy x-ray absorptiometry (DXA) as reference method, a model that estimates abdominal fat mass percentage (AFM%) in white postmenopausal women based on simple and easy-to-apply anthropometric measurements. An additional aim was to validate an abdominal bioelectrical impedance analyzer (ViScan) for estimating waist circumference (WC) and AFM% in this group., Methods: Ninety-one postmenopausal women (mean age, 61.5 y) with body mass index ranging from 20.9 to 42 kg/m2 were randomly divided into one training set (n = 60) and one testing set (n = 31) to develop and validate a model based on anthropometric measurements estimating abdominal fat mass. Furthermore, in all 91 participants, ViScan estimations of WC and AFM% were validated against tape measurement and DXA results., Results: The model developed was AFM% = 4.496 + (0.318 × WC) + 0.342 × suprailiac skinfold (r = 0.834, P < 0.0001). The model had no significant bias (0.25%) and ± 7.5% limits of agreement. ViScan significantly overestimated WC by 7.04 cm and estimated AFM% with no significant bias (-0.13%) and ± 7.6% limits of agreement., Conclusions: Both the model and ViScan are equally valid against DXA in estimating AFM%. However, ViScan is not valid in estimating WC in white postmenopausal women.

The aim of this study was to validate noninvasive models, retrieved from the literature, estimating body fat in white women. The cohort used for the validation consisted of 277 postmenopausal women, and the reference method was dual-energy X-ray absorptiometry (DXA). Five models were retrieved containing anthropometric measurements such as bicep and tricep skinfolds, waist circumference (WC), height, and body weight. Models including only BMI were found to be less biased and more valid than others including skinfolds and circumferences. The model by Visser et al., estimating body density (BD = 0.0226 × sex - 0.0022 × BMI + 1.0605) with the subsequent use of Brozek's (and not Siri's) equation to estimate body fat percentage (%BF), was found to be more valid than the other models for this cohort. In conclusion, it seems that Visser's et al. model, including only BMI, with Brozek's equation, is a fast, noninvasive, and valid method to assess body composition in white postmenopausal women in clinical practice and research.

The aim of the present study was to examine whether a holistic approach combining nutrition and lifestyle counselling with the consumption of milk and yoghurt enriched with calcium, vitamin D(3) and phylloquinone (vitamin K(1)) or menaquinone (vitamin K(2)) would have any additional benefit on bone mineral density (BMD) indices measured at various skeletal sites using two different techniques, dual energy X-ray absorptiometry and quantitative ultrasonography (QUS). A sample of 115 postmenopausal women were randomized to three intervention groups, receiving daily via fortified milk and yoghurt and for 12 months, 800 mg calcium and 10 μg vitamin D(3) (CaD group, n = 26); 800 mg calcium, 10 μg vitamin D(3) and 100 μg vitamin K(1) (CaDK1 group, n = 26); 800 mg calcium, 10 μg vitamin D(3) and 100 μg vitamin K(2) (CaDK2 group, n = 24); and a control group (CO group, n = 39) following their usual diet. All three intervention groups attended biweekly nutrition and lifestyle counselling sessions. Total BMD significantly increased in all three intervention groups and these changes were significantly higher compared to the CO (P < 0.001). Furthermore, the significant increases observed for L2-L4 BMD in the CaDK1 and CaDK2 groups were found to be significantly higher compared to the decrease observed in the CO (P = 0.001). No significant differences were observed for QUS parameters. The combined approach used in the current study led to favourable changes for all three intervention groups in total body BMD, while an additional benefit was observed for L2-L4 BMD in CaDK1 and CaDK2 groups. No significant differences were observed among groups in any of the QUS parameters.

Objective: The aim of this study was to develop and validate two equations that best predict body composition of overweight and obese postmenopausal women., Methods: Bioelectrical impedance analyses (BIAs) and anthropometric data such as circumferences and skinfolds were incorporated in the development of these two equations, respectively, while dual energy X-ray absorptiometry (DXA) was used as the reference method. A total number of 196 overweight and obese Greek postmenopausal women were used (131 subjects to develop the equations, and 65 to validate them)., Results: The BIA equation was: (FFM)=38.475+0.207xWt-0.092xRz/Ht(2)+0.291xXc/Ht(2) (R(2)=0.800, p<0.0001) and the anthropometry equation was FM=-31.913+0.333xGC+0.840xbody mass index (BMI)+0.064x(biceps+triceps skinfold) (R(2)=0.835, p<0.0001). Both equations were found to result in unbiased estimates. Regarding reliability, BIA equation was found to be more reliable compared to existing ones when applied to this population. Additionally, BIA equation was more reliable compared to the anthropometric equation (+/-3.12642kg vs. +/-5.2342kg limits of agreement, respectively)., Conclusion: These conclude that the equations developed in the current study are more reliable than the existing ones in the literature, and could be applied for assessing body composition in clinical practice and research.