Search Results (63)

Background/Objectives: Multi-strain Limosilactobacillus fermentum supplementation has been reported to promote weight loss outcomes in free-living conditions, but limited evidence exists on these probiotic strains added to an energy-restricted diet and walking program in overweight adults. Methods: In a double-blind, placebo-controlled, parallel-arm randomized trial, overweight adults (35.2 ± 13.2 years old, 167.6 ± 8.6 cm, 79.9 ± 11.8 kg, 28.4 ± 2.7 kg/m² body mass index, 36.1 ± 6.6% body fat) completed a 12-week weight loss program that included a 500 kcal/day energy deficit and walking 10 k steps/d. Participants ingested one daily capsule containing a three-strain probiotic blend (L. fermentum K7-Lb1, L. fermentum K8-Lb1, L. fermentum K11-Lb3; 6 billion CFU/day) (PRO) or maltodextrin placebo (PLA). Assessments were performed at baseline, week 6, and week 12 and included body composition, resting energy expenditure, substrate utilization, peak oxygen uptake, dietary intake, step counts, blood biomarkers, quality of life, and side effects. Data were analyzed using multivariate and univariate repeated-measures general linear models (GLM), with mean changes from baseline presented alongside 95% confidence intervals. Results: All participants significantly reduced body weight, fat mass, body fat percentage, and waist circumference. At 12 weeks, PRO reduced fat mass more than PL (−2680.7 ± 1276.7 g; p = 0.039). In PRO, android and gynoid fat percentage decreased at 6 weeks (p < 0.001; p = 0.008) and 12 weeks (p = 0.004; p < 0.001), respectively. Visceral adipose tissue mass, volume, and area were lower at 6 weeks and trended lower at 12 weeks. In PRO, bone mineral content and bone mineral area decreased at 12 weeks, while bone mineral density paradoxically increased (0.007 ± 0.003 g/cm²; p = 0.024). Conclusions: During a 12-week weight loss program, supplementation of a multi-strain L. fermentum probiotic significantly reduced body fat and central adiposity. Full article

Background: Locomotive syndrome (LS) is a major cause of mobility impairment and loss of independence in older adults. Abdominal morphology and patterns of body fat distribution are thought to affect physical function; however, their relationships with the severity of LS in women with osteoporosis remain insufficiently characterized. Standing sacral–abdominal wall distance (SAD) is considered an indicator of compromised trunk support mechanisms, whereas the android/gynoid fat ratio (A/G ratio) primarily reflects body fat distribution patterns. Methods: This retrospective cross-sectional study included 221 women aged 65 years or older attending an osteoporosis outpatient clinic. LS was assessed using the stand-up test, the two-step test, and the Locomo 25 questionnaire according to official criteria. The most severe stage among the three tests was defined as the overall LS stage, and participants were classified into LS stage 0–1 and LS stage ≥ 2 groups. Associations of SAD and the A/G ratio with LS were examined using multivariable logistic regression analysis adjusted for age, skeletal muscle mass index (SMI), femoral neck T-score, and the Controlling Nutritional Status (CONUT) score. Results: Among the participants, 93 (42.1%) were classified as having LS stage ≥ 2. The LS stage ≥ 2 group had a significantly greater SAD than the LS stage 0–1 group (median, 167.3 mm vs. 154.6 mm; p < 0.001), whereas no significant difference was observed in the A/G ratio (p = 0.054). In multivariable analyses (n = 208), SAD was independently associated with LS stage ≥ 2 (odds ratio per 1 mm increase, 1.035; 95% confidence interval, 1.016–1.054; p < 0.001), corresponding to an odds ratio of 1.41 per 10 mm increase. The A/G ratio also showed an independent association, while no significant interaction between SAD and the A/G ratio was observed. Conclusions: In women with osteoporosis, SAD was independently associated with LS severity, reflecting mobility impairment from a perspective distinct from body fat distribution. SAD may serve as a simple and clinically useful indicator for assessing the risk of severe LS. Full article

Background/Objectives: While sarcopenia has been implicated, we hypothesize that a distinct body composition phenotype, characterized by elevated visceral adiposity and reduced abdominal muscle mass, plays a more critical role in T2DM-related fracture pathogenesis. Methods: In a cross-sectional study of 99 female patients aged ≥65 years who underwent surgery for hip fracture, we compared body composition parameters derived from DXA scans between those with (n = 40) and without (n = 59) T2DM. Key measures included appendicular lean mass index (ALMI), visceral adipose tissue (VAT) mass, android-to-gynoid (A/G) fat ratio, and a derived measure of relative core lean mass (RCLM). Results: There were no significant differences in ALMI between T2DM and non-DM groups. In contrast, T2DM showed significantly higher central adiposity—A/G ratio (1.13 ± 0.15 vs. 1.05 ± 0.17; p = 0.0298) and TL fat ratio (1.31 ± 0.22 vs. 1.19 ± 0.23; p = 0.0071)—with VAT estimate numerically higher. Conclusions: In older hip-fracture patients, T2DM was characterized not by appendicular sarcopenia but by central adiposity without significant differences in LMI or RCLM—a phenotype that may contribute to fracture risk through bone-quality and fall-related pathways independent of ALMI. Full article

Background: Excess body fat during growth has been associated with impaired bone development; however, evidence on the influence of total and regional body fat on bone mineral content (BMC) in physically active youth remains limited. Objective: This study aimed to analyze the association between total and regional body fat and BMC in children and adolescent athletes. Methods: This cross-sectional study included 109 children and adolescents aged 9 to 18 years participating in different sports (indoor volleyball, beach volleyball, swimming, track and field, and basketball). Bone mineral content assessed by DXA and normalized by height (BMC/Height) for the total body less head (TBLH), lumbar spine (L1–L4), and femoral neck was considered the dependent variable. Total and regional (android and gynoid) body fat percentages obtained by dual-energy X-ray absorptiometry (DXA) were treated as independent variables. Associations were examined using multivariable linear regression adjusted for biological and training-related covariates. Results: Total body fat (β = −0.014; p < 0.05), android fat (β = −0.011; p < 0.05), and gynoid fat (β = −0.014; p < 0.05) were significantly and inversely associated with lumbar spine BMC/Height. No associations were observed between total, android, or gynoid fat percentage and TBLH or femoral neck BMC/Height (p > 0.05). Conclusions: The inverse and site-specific association of total, android, and gynoid fat with lumbar spine BMC/Height highlights the greater susceptibility of this skeletal site to adiposity-related detriments, underscoring the importance of site-specific monitoring of bone mineral content, even among physically active youth. Full article

Background/Objectives: Midlife is associated with changes in body weight and fat distribution in women; however, it remains unclear whether these changes can be attributed to chronological aging, menopause, or associated lifestyle changes. The objective of this study was to compare the possible differences in body fat distribution parameters measured by regional Lunar osteodensitometry scans (DXA) between clinically healthy, BMI-matched pre- and postmenopausal women. Methods: A cross-sectional analysis of body composition parameters, such as total body, android, and gynoid fat percentage, was performed using DXA hip and lumbar scans in 171 women aged 45–55 years. Comparisons were made across 50 premenopausal (median age 47.9 (4.5) years) and 121 postmenopausal women (median age 51.7 (3.7) years), matched for median BMI (25.8 (6.7) vs. 25.6 (7.8) kg/m²). Associations between body fat outcomes and predictors were examined using multivariable linear regression. Results: No significant differences were observed between study groups in body composition parameters, including android fat percentage (%), gynoid fat%, total body fat%, or android/gynoid ratio. Unlike age, menopausal status, or years since menopause, BMI was the only significant predictor of body fat distribution. In the entire cohort, total body fat percentage showed a modest but significant positive correlation with age (ρ = 0.200, 95%CI [0.043, 0.345], p = 0.009), while the menopause onset age was positively correlated with BMI (ρ = 0.195, 95%CI [0.002, 0.369], p = 0.032). Among postmenopausal women within the first two years of menopause, the android/gynoid ratio showed a positive correlation with years of estrogen deprivation (ρ = 0.451, 95%CI [0.144, 0.707], p = 0.007). Conclusions: Age was correlated with higher total body fat %; neither age nor menopausal status was correlated with BMI. In early postmenopause, the android/gynoid ratio increased with years since menopause. The median age at menopause observed in our study was 48 years, which is lower than in other Caucasian studies. Full article

To date, neutrophil-derived myeloperoxidase (MPO), a key mediator of inflammation and oxidative stress, has predominantly been assessed in peripheral fluids by protein concentration rather than enzymatic activity, mainly due to methodological limitations. However, MPO activity directly reflects the enzyme’s cytotoxic potential and pathogenic role in inflammatory diseases. To address this gap, we employed an optimized immunocapture assay to evaluate MPO activity, specific activity, and protein concentration in females with type 2 diabetes mellitus (T2DM), a condition tightly linked to chronic low-grade inflammation and obesity. Our findings revealed that females with T2DM exhibited nearly three-fold higher serum MPO activity and more than two-fold greater specific activity compared to controls with no differences in MPO protein concentration. Notably, MPO-specific activity remained significantly associated with T2DM (p < 0.01 to p < 0.001 across multivariate models), even after adjusting for age and dual-energy X-ray absorptiometry-derived measures of total and regional fat mass. Only android/gynoid fat distribution retained marginal significance in these models. This study is the first demonstration that MPO enzymatic activity, rather than protein concentration, is independently linked to T2DM in females. These findings underscore the importance of assessing functional MPO activity in the context of metabolic disease and support its potential role as a pathophysiological marker. Full article

Objectives: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder with diverse pathogenetic mechanisms and clinical manifestations. Phenotype D PCOS is characterized by oligomenorrhoea and polycystic ovaries without hyperandrogenism. Altered adipokine profiles may contribute to reproductive and metabolic disturbances. Chemerin is an adipokine involved in inflammatory and metabolic processes. It remains unclear whether altered chemerin levels in PCOS reflect metabolic dysfunction alone or are directly associated with hyperandrogenism. The aim of this study was to compare serum chemerin levels in women with normoandrogenic PCOS and a control group. Methods: This cross-sectional preliminary study included 49 women with phenotype D PCOS and 40 healthy, age- and body mass index (BMI)-matched controls. Anthropometric, biochemical, hormonal parameters, and serum chemerin concentrations were assessed. Results: Serum chemerin concentrations did not differ significantly between the groups. In the PCOS group, the 95% confidence interval ranged from 198.61 to 234.37, while in the controls, it ranged from 187.13 to 216.21. In women with PCOS, chemerin showed significant positive correlations with weight, BMI, waist and hip circumference, total adipose tissue, and both gynoid and android fat content. Positive correlations were also observed with highly sensitive C-reactive protein (hs-CRP), insulin, glucose, triglycerides, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and a negative correlation was found with high-density lipoprotein (HDL) cholesterol. Chemerin was weakly negatively correlated with sex hormone binding globulin (SHBG) and positively correlated with the free androgen index (FAI). In the control group, chemerin correlated positively with CRP, insulin, triglycerides, total and gynoid adipose tissue, and negatively correlated with HDL cholesterol and SHBG. Conclusions Although chemerin levels did not differ from controls, chemerin was associated with metabolic and inflammatory markers in both groups. These findings should be considered preliminary due to the limited sample size. Chemerin may reflect metabolic and inflammatory status rather than hyperandrogenism in normoandrogenic PCOS. Full article

Background/Objectives: Lipedema is a chronic disorder that affects almost exclusively women and is characterized by bilateral, symmetrical accumulation of subcutaneous fat, typically in the buttocks, hips, and lower limbs, and in some cases the arms. The primary objective of this study was to describe the clinical and anatomical manifestations of lipedema, together with the associated physical and psychological comorbidities, in a large Spanish cohort. Methods: Descriptive study of 1803 patients aged ≥ 17 years who attended two clinics in Spain between January 2022 and November 2024. Results: The mean age was 42.9 years (SD: 11.3), and 60.6% of patients were diagnosed during their reproductive years. The mean body mass index was 28.6 (SD: 6.2), and 87.6% presented a gynoid fat distribution. A total of 46.6% were classified as Schingale stage IV or V. The most frequent comorbidities were chronic low-grade inflammatory alterations and connective tissue damage. Particularly suspected high intestinal permeability (99%), bilateral trochanteric pain region (97.4%), iliotibial band involvement, and ligamentous hyperlaxity (95.8%). Thyroid disorders, inflammatory ovarian dysfunction, and psychological impairment were also common. Conclusions: Lipedema is a complex condition that extends beyond lower-limb adipose tissue and is associated with multiple comorbidities. This study also presents a novel approach to clinical assessment that may help physicians gain a deeper understanding of this pathology and formulate etiological hypotheses that will need to be tested. Full article

Background/Objectives: A subset of individuals develops persistent symptoms following SARS-CoV-2 infection, including musculoskeletal (MSK) manifestations, a condition known as long COVID (LC). Emerging hypotheses suggest that chronic low-grade inflammation in LC may impair bone metabolism and compromise joint health. However, empirical evidence is limited, and the impact of LC on MSK health, particularly bone and joint integrity, is poorly understood. To determine the influence of LC on MSK function, including bone health, body composition, and joint integrity. Methods: A 12-month longitudinal prospective cohort feasibility study was conducted involving 45 adults with LC and 40 well-recovered (WR) post-COVID-19 controls. Baseline and follow-up assessments included dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD) and total body composition (TBC), alongside ultrasound of the hand and knee joints to evaluate intra-articular changes. Results: The LC group had more fat in the gynoid, android, and leg regions at each assessment point compared to the controls (p < 0.01). LC showed a significantly lower knee synovial hypertrophy at the baseline, 13.3% compared to WR 45% (p = 0.001), and a marginal improvement in hand synovial hypertrophy, over 12 months, from a median of 2 (IQR 1;5) to 1 (IQR 0;3) (p = 0.012), as observed via MSK ultrasound. No notable differences were found between groups regarding BMD, either in the LC group compared to the control group or overtime. Conclusions: This cohort study of LC adults and controls found no evidence of rapid bone loss; however, adiposity and joint symptoms suggest the need for ongoing monitoring. Future research should focus on MSK markers, muscle function, advanced imaging, and improving MSK health. Full article

Background/Objectives: The location and distribution of excess fat, rather than overall adiposity, are stronger predictors of cardiometabolic risk and are commonly assessed using the waist-to-hip ratio (WHR). Fat distribution in women has a heritable component, yet the genetic factors that influence it remain poorly understood. We aim to assess the association between obesity-related polymorphisms with WHR and cardiometabolic risk in overweight and obese women. Methods: A cohort study was conducted in 512 women (56.1 ± 6.4 years; body mass index (BMI) ≥ 25 kg/m²). WHR was calculated, and participants were classified into android (WHR > 0.85) or gynoid (WHR ≤ 0.85) obesity groups. We genotyped 15 SNPs previously associated with obesity using TaqMan real-time PCR. Different genetic models (dominant, recessive, and allelic) were analysed, and bivariate and multivariate analyses were performed to compare the fat distribution groups. Results: Of the 15 SNPs studied, only 3 presented a significant association with WHR > 0.85. PSRC1 rs599839 in a dominant model (AA + GA vs. GG) with OR = 3.18 (p = 0.041), SLC30A8 rs1326634 in a recessive model (CC vs. TC + TT) (OR = 2.38; p = 0.004), both showing increased susceptibility to central obesity. KIF6 rs20455 offers protection in a recessive model (CC vs. TC + TT) with an OR of 0.47 (p = 0.043). After adjusted multivariate analysis, only SLC30A8 and diabetes remained independently associated with an increased risk of android obesity (OR = 2.50; p = 0.003 and OR = 3.63; p = 0.004, respectively). Conclusions: The SLC30A8 variant was significantly associated with android fat distribution and high cardiometabolic risk in overweight/obese women. Identifying genetic factors that influence fat distribution may help specify targeted lifestyle changes or pharmacological interventions to reduce risk. Full article

Background/Objectives: Chronic kidney disease (CKD) and diabetic kidney disease (DKD) are growing public health challenges. While diet and body composition influence metabolic and renal health, their combined role remains underexplored. This study investigates the association between the Planetary Health Diet Index (PHDI), body mass distribution, and the prevalence of CKD and DKD in U.S. adults. Methods: We analyzed data from 8093 adults aged ≥40 years from NHANES 2003–2018. PHDI was computed using two 24 h dietary recalls. Body composition was assessed using dual-energy X-ray absorptiometry (DXA), focusing on the android-to-gynoid fat ratio (AGFR) and lean mass ratio (AGLR). Survey-weighted linear and logistic regressions evaluated cross-sectional associations between PHDI score, body composition indices, and prevalence of CKD and DKD. Mediation analyses explored AGLR, AGFR, and body mass index (BMI) as potential mediators of the association between PHDI score and either CKD or DKD. Results: Higher PHDI scores were mildly associated with lower odds of CKD (OR per 10-point increase: 0.91; 95% CI: 0.83–0.99) and DKD (OR: 0.86; 95% CI: 0.76–0.97). Greater PHDI scores correlated with lower BMI, AGFR, and AGLR. Among participants with diabetes, AGLR mediated 17% of the relationship between a 10-point increase in PHDI score and decreased DKD prevalence, suggesting central lean mass distribution as a relevant pathway. No significant mediation was observed for AGFR, BMI, or for CKD. Conclusions: Adherence to PHD is associated with healthier body composition and lower prevalence of CKD and DKD. These findings support the promotion of dietary strategies that enhance metabolic and renal health in middle-aged and older individuals. Full article

Background and Objectives: Body composition changes with aging and menopause, often leading to increased adiposity and a shift in fat distribution. While BMI is commonly used in clinical practice, it does not accurately reflect fat mass or distribution. This study aims to evaluate age-related changes in both total and regional adiposity using DXA-derived indices in Korean women aged ≥ 40 years and to assess the limitations of BMI-based obesity classification. Materials and Methods: This retrospective multicenter study analyzed the DXA scans and clinical records of 914 Korean women aged 40–80 years who attended menopause clinics across multiple institutions between 2018 and 2021. We analyzed five adiposity indices: body mass index (BMI), total body fat percentage (TB%F), fat mass index (FMI), visceral adipose tissue (VAT) area, and android-to-gynoid (A/G) fat ratio. Excess adiposity was defined as BMI ≥ 23 kg/m², TB%F ≥ 40%, FMI ≥ 9 kg/m², VAT > 100 cm², or A/G ratio > 1.0. Age group comparisons were made using ANOVA, and misclassification was assessed by comparing BMI with other indices. Results: Mean BMI increased with age, peaking in the 60s before declining in the 70s. TB%F and FMI peaked in the 50s, while VAT and A/G ratio increased continuously with age. Excess adiposity was found in 41.9% of women by TB%F, 40.5% by FMI, and 59.4% by VAT in the 70s. Notably, 22% of women with normal BMI (<23 kg/m²) had VAT > 100 cm², and 35.7% had A/G > 1.0, indicating central obesity. Conclusions: DXA-based indices provide a more accurate assessment of adiposity and associated cardiometabolic risks in aging women than BMI alone. Clinical screening strategies should consider incorporating regional fat distribution markers, particularly in midlife and postmenopausal populations, to better identify individuals at risk. Full article

Background: The Mediterranean diet is considered one of the healthiest and safest diets for preventing chronic diseases. The primary objective of this study was to assess the association between adherence to the Mediterranean diet and the occurrence of prediabetes in a representative population of Bialystok, Poland. Prediabetes is a condition characterized by elevated blood glucose levels that are higher than normal but not yet in the diabetic range, indicating an increased risk of developing type 2 diabetes. Methods: The study participants were selected into healthy control (HC) and prediabetic (PreD) groups based on age and gender. Biochemical measurements included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting glucose (FG), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6). Additionally, blood pressure, handgrip strength, anthropometric parameters, and body composition were measured. Information on patients’ social data, medical history, and lifestyle history was collected using questionnaires developed for this study. A standardized questionnaire, the Satisfaction with Life Scale (SWLS), was used to assess life satisfaction. Dietary total antioxidant capacity (DTAC) and dietary total polyphenol intake (DTPI) were determined using a 3-day nutritional interview and appropriate databases containing information on polyphenols and the antioxidant potential of food products. To assess adherence to the Mediterranean diet recommendations, a 9-item Mediterranean Diet Index (MDI) was used. Results: It was found that the mean MDI for the entire group was low (3.98 ± 1.74), and the HC was characterized by a significantly higher MDI compared to the PreD. A statistically significant positive correlation was found between MDI and HDL-C, whereas a negative correlation was found between MDI and FG, homeostatic model assessment for insulin resistance (HOMA-IR), diastolic blood pressure (DBP), IL-6, body mass index (BMI), waist-hip ratio (WHR), waist circumference, visceral fat mass, android/gynoid fat ratio. Conclusions: Abdominal obesity was shown to significantly reduce life satisfaction. In model 3, after adjusting for age, sex, dietary energy intake, alcohol consumption, and smoking, each additional MDI point indicated a 10% lower risk of prediabetes. Full article

Background: There are different types of obesity, and the metabolic conditions associated with these phenotypes are also heterogeneous. Overweight and obesity are not only associated with pain but are also identified as risk factors for the development of pain. Objective: This study aimed to compare the levels of inflammatory biomarkers, counting of immune cells, and chronic pain between android and gynoid female patients with obesity. Method: Thirty (n = 30) women took part in this study (18 androids, age: 50.61 ± 9.41 and 12 gynoids, age: 50.67 ± 9.45). The participants underwent anamnesis, Visual Numeric Scale (VNS), dual-energy X-ray absorptiometry, and blood sampling for the analysis of leukocytes, C-reactive protein (CRP), and interleukin (IL)-6. Results: The number of total leukocytes in the blood was not different when comparing the android group (6045 µL) with the gynoid group (5230 µL). No differences were observed for neutrophils (3440 µL in android and 3017 µL in gynoid), lymphocytes (2208 µL in android and 2115 µL in gynoid), for monocytes (429.7 µL in android and 392.8 µL in gynoid), and basophils (17.27 µL in android and 15.41 µL in gynoid). However, there was a significant difference between the number of eosinophils when comparing the android group (137.6 µL) with the gynoid group (204.9 µL), p = 0.04. Although both groups presented CRP values above 0.3 mg/dL—indicative of low-grade inflammation—no statistically significant difference was observed. Similarly, no difference was found in pain intensity between groups, as measured by the Visual Numeric Scale (VNS). Conclusions: Although most inflammatory and pain markers did not differ between groups, the higher eosinophil count in the gynoid phenotype suggests immunological distinctions between obesity types. These findings underline the importance of considering body fat distribution in clinical assessments of inflammation and chronic pain in women with obesity. Full article

Background/Objectives: Aging is a natural, gradual, and irreversible process associated with disruptions in homeostasis, causing several unfavorable changes, including changes in body composition. Some studies show that higher water intake can be related to a healthier body composition, but studies in older adults are rare. The aim of this study is to assess the relationship between water intake, dietary acid load, and body composition, and also to assess the interrelationship of these two factors with body composition in older women. Methods: This cross-sectional study involved 195 independently living women aged 65–84. Body composition was assessed using fan-beamed dual-energy X-ray absorptiometry (DXA). Potential renal acid load (PRAL) and water intake were evaluated using the 3-day food record method. Results: Higher water intake was associated with significantly lower android (p = 0.004), gynoid (p < 0.001), and total body fat mass (p = 0.005), as well as higher lean body mass (p = 0.021). Among the assessed anthropometric indicators, only for the appendicular lean mass (ALM) was there a significant difference between the “low-PRAL diet” compared to the “high-PRAL diet” (6.2 ± 0.8 vs. 6.0 ± 0.9 kg/m²; p = 0.045). A “low-PRAL diet” was characterized by a significantly lower energy value, lower protein intake, and a higher plant-to-animal protein ratio than a “high-PRAL diet”. Conclusions: A more acidifying diet pattern appeared to have an adverse effect on lean body mass in older women. The ratio of plant to animal protein may be crucial in this relationship. Full article