Search Results (425)

Background/Objectives: Colorectal cancer (CRC) is among the most common cancers in Korea, and visceral adiposity is an established modifiable risk factor. The body roundness index (BRI), derived from waist circumference and height, estimates visceral adipose tissue more accurately than the body mass index (BMI) alone. We investigated the longitudinal association between the BRI and incident CRC in a large Korean national cohort. Methods: A nationwide cohort of 4,492,697 adults aged ≥20 years who participated in the 2012 Korean National Health Insurance Service health check-up was followed through December 2023 (mean 10.32 years). BRI values were categorized into quartiles (Q1–Q4). After applying a 1-year lag period, Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for age, sex, smoking, alcohol consumption, exercise, income, diabetes, hypertension, hypercholesterolemia, and chronic kidney disease. Subgroup and site-specific analyses were also performed. Results: During 46,382,686 person-years of follow-up, 57,644 incident CRCs were diagnosed. A higher BRI was independently and dose-dependently associated with CRC risk (Q4 vs. Q1: aHR 1.104, 95% CI 1.075–1.135; p for trend < 0.001). The association was significantly stronger in men (Q4 aHR 1.352, 95% CI 1.302–1.404) than in women (Q4 aHR 0.891, 95% CI 0.858–0.925; p for interaction < 0.001) and most pronounced in middle-aged adults (40–64 years). Site-specific analyses revealed a proximal-to-distal gradient: proximal colon (Q4 aHR 1.363), distal colon (Q4 aHR 1.244), and rectum (Q4 aHR 1.070). Conclusions: A higher BRI is independently and dose-dependently associated with increased CRC incidence in Korean adults, particularly in men and those with general obesity. The BRI may serve as a practical complement to the BMI for CRC risk stratification in populations with a high prevalence of metabolic obesity. Full article

Background/Objectives: Vitamin D deficiency has been associated with obesity and adverse metabolic outcomes. This study aimed to evaluate the associations between serum vitamin D levels and body composition parameters, including visceral fat level, body fat percentage, body mass index, muscle mass, and metabolic age, and to determine whether these relationships were independent of age and sex. Methods: This retrospective cross-sectional study included 164 individuals aged 18–64 years who had serum vitamin D measurements and concurrent body composition analyses between February 2023 and May 2025. Body composition was assessed using bioelectrical impedance analysis (Tanita BC-418), and serum vitamin D levels were measured by electrochemiluminescence immunoassay. Correlations were assessed using Spearman’s rank correlation analysis, and multivariate linear regression analyses were performed after adjusting for age and sex. Results: Serum vitamin D levels showed significant negative correlations with visceral fat level (r = −0.272; p < 0.001), body fat percentage (r = −0.225; p = 0.004), body mass index (r = −0.282; p < 0.001), and metabolic age (r = −0.254; p = 0.001). No significant association was found between serum vitamin D levels and muscle mass (p = 0.409). In multivariate regression analysis, serum vitamin D levels remained independently associated with visceral fat level (p = 0.017), body fat percentage (p = 0.015), and metabolic age (p = 0.026), whereas the association with body mass index was no longer significant (p = 0.114). Conclusions: Low vitamin D levels were independently associated with increased visceral adiposity, higher body fat percentage, and advanced metabolic age. Across all multivariable regression models, age consistently emerged as the strongest predictor, while vitamin D levels remained independently associated with visceral fat, body fat percentage, and metabolic age. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) is clinically heterogeneous. Patients with similar body mass index, waist circumference, or noninvasive fibrosis stratum may differ markedly in histologic activity, fibrosis trajectory, and progression risk. Adipose tissue dysfunction helps explain this variation. Adipose dysfunction has been characterized by direct depot quantification, measurement of subcutaneous adipose tissue fibrogenesis, adipose tissue insulin resistance, and circulating adipokine profiles. These measures capture different features of adipose biology and have each been linked to liver injury or fibrosis severity. Clinically recognizable body-composition phenotypes—lean MASLD, sarcopenic visceral obesity, myosteatosis, and the hypertriglyceridemic waist—differ in accessibility, mechanistic specificity, and prognostic value. Recent therapeutic developments in metabolic dysfunction-associated steatohepatitis (MASH), including resmetirom, semaglutide, tirzepatide, fibroblast growth factor 21 (FGF21) analogs, and older adipose-directed agents such as pioglitazone, illustrate the importance of distinguishing adipose-mediated, weight-mediated, and liver-directed mechanisms. This review summarizes the literature on adipose tissue dysfunction in MASLD, the body-composition phenotypes associated with it, and recent therapeutic data in the context of adipose–liver–muscle biology. Full article

Background: Visceral obesity is increasingly recognised not as a simple excess of adipose tissue, but as a systemic pathological condition characterised by profound metabolic, endocrine, and immune dysregulation. Visceral adipose tissue (VAT) operates as an autonomous neuro-immune-endocrine organ whose dysfunctional expansion drives insulin resistance, atherogenesis, and accelerated cellular ageing through mechanisms converging on chronic low-grade sterile inflammation, referred to as inflammaging. Objectives: This narrative review integrates evidence across four domains: (1) the multi-system clinical complications of visceral obesity and the methodological controversies surrounding its measurement; (2) the cellular heterogeneity, immunometabolic reprogramming, and molecular mechanisms through which excess VAT accelerates biological ageing, with a focus on genomic instability, mitochondrial dysfunction, the NAD⁺/sirtuin regulatory axis, cellular senescence, and inter-organ communication; (3) the role of bioelectrical impedance analysis (BIA)—particularly phase angle—as a non-invasive functional biomarker of biological age and longevity, positioned critically against alternative assessment methods; and (4) current knowledge gaps and priorities for future research. Methods: A narrative review of PubMed/MEDLINE, Google Scholar, and the Cochrane Library was conducted using MeSH terms and free-text keywords including visceral obesity, bioelectrical impedance analysis, phase angle, sarcopenia, inflammaging, mitochondrial dysfunction, cellular senescence, epigenetic clocks, NAD⁺, sirtuin, and longevity, supplemented by citation-tracking of retrieved reviews. English-language articles published up to April 2025 were considered, prioritising systematic reviews, meta-analyses, and prospective cohort studies; formal risk-of-bias tools and quantitative synthesis were not applied, consistent with a narrative review design. Results and Discussion: BIA-derived phase angle constitutes a macroscopic electrobiological correlate of inflammaging: low phase angle values in visceral obese subjects overlap with those of frail elderly individuals, reflecting impaired membrane integrity, loss of active cell mass, and altered ICW/ECW balance. However, this evidence base remains largely cross-sectional and correlative; the directionality and population-specific calibration of BIA-derived indices constitute the principal unresolved methodological questions. Integration with epigenetic clocks, circulating NAD⁺ levels, and gut microbiome indices offers a framework for dynamic biological age assessment, though prospective interventional validation is still lacking. Sarcopenic obesity, evaluated through EWGSOP2 combined with BIA-derived skeletal muscle mass index and handgrip dynamometry, represents a critical comorbidity demanding integrated therapeutic targeting. Conclusions: BIA provides a quantitative, accessible correlate for translating cellular metabolic health into clinically actionable parameters, complementary to rather than a replacement for anthropometric and imaging-based methods. Optimising phase angle and reducing VAT through anti-inflammatory nutrition, exercise, and nutraceutical strategies targeting the NAD⁺/sirtuin and mTOR/AMPK axes constitutes a measurable objective for the promotion of healthy longevity, contingent on the longitudinal, mechanistic studies identified as priorities in this review. Full article

Background and Objectives: Chronotype and sleep quality are related but non-identical dimensions of sleep health. We examined whether later chronotype is associated with subclinical visceral adiposity and atherogenic dyslipidaemia independently of perceived sleep quality, and whether this association differs by sex, in adults without previously diagnosed chronic disease. Materials and Methods: This single-centre cross-sectional study included 282 adults without previously diagnosed chronic disease or regular medication use. Chronotype was assessed with the Morningness–Eveningness Questionnaire (MEQ) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Composite cardiometabolic indices were calculated from routine anthropometric and biochemical data. Primary dependent variables were log-transformed Visceral Adiposity Index (log[VAI]) and Atherogenic Index of Plasma (AIP). Multivariable linear models used heteroscedasticity-consistent type 3 (HC3) robust standard errors and adjusted for age, sex, education, physical activity, and PSQI; body mass index (BMI) was additionally included in the AIP model. Sex × MEQ interactions, false-discovery-rate (FDR) correction, and glycaemic sensitivity analyses were performed. Results: Median age was 28.0 years; 50.4% were women, 25.9% were evening type, and 51.8% had poor sleep quality. Higher MEQ score (greater morningness) was independently associated with lower log(VAI) (B = −0.0096; 95% confidence interval (CI), −0.0159 to −0.0033; β = −0.190; p = 0.003) and AIP (B = −0.0035; 95% CI, −0.0063 to −0.0008; β = −0.160; p = 0.011), whereas PSQI was not independently associated with either outcome. Sex × MEQ interactions were nominally significant and estimates were stronger in women, but interaction terms did not survive FDR correction. Associations persisted after excluding diabetes-range glycaemia but attenuated in strictly normoglycaemic participants. Conclusions: Later chronotype was associated with a less favourable subclinical adiposity–atherogenic profile independently of perceived sleep quality. Findings are cross-sectional, and the sex-specific pattern is hypothesis-generating. Prospective studies with objective circadian, sleep, dietary-timing, behavioural, and hormonal measures are required. Full article

Background/Objectives: Obesity induced by high-fat high-fructose (HFHF) diets is associated with adipose tissue expansion, dysregulated adipogenesis, chronic low-grade inflammation, and oxidative stress. Bioactive compounds have emerged as promising nutritional strategies to mitigate these alterations, although their stability and bioavailability remain limiting factors. This study investigated the effects of different forms of jabuticaba (Plinia sp.) consumption—whole fruit, freeze-dried peel, and phenolic microencapsulated peel extract—on adipose tissue remodeling, oxidative stress, and metabolic parameters in HFHF-fed mice. Methods: Male C57BL/6 mice were fed an HFHF diet for six weeks, followed by six weeks of intervention with the jabuticaba formulations. Results: HFHF feeding induced significant metabolic alterations, evidenced by increased body weight gain, abdominal perimeter, Lee index, and fasting glucose levels. Jabuticaba intake, regardless of formulation, reduced abdominal perimeter, final body weight, and Lee index (p < 0.05) without affecting food intake. Treatment also improved metabolic biomarkers, reducing serum glucose, LDL cholesterol, and triglycerides, while increasing HDL cholesterol (p < 0.05). In addition, jabuticaba decreased visceral and total adipose tissue mass, attenuated adipocyte hypertrophy, and enhanced antioxidant defenses, leading to reduced oxidative damage in adipose tissue. Conclusions: All the jabuticaba formulations exerted protective metabolic effects; the whole fruit showed more consistent systemic metabolic improvements, whereas the microencapsulated peel extract demonstrated greater efficacy in modulating adipose tissue. Full article

Background/Objectives: Body mass index (BMI) is widely used to classify weight status, but it does not reflect fat distribution, muscle mass, or bone mass. Bioelectrical impedance analysis (BIA)-derived visceral fat rating (VFR) is a device-generated estimate of visceral adiposity. This study assessed age- and gender-related differences in anthropometric and BIA-derived body composition parameters, with particular attention to the relationship between BMI classification and VFR. Methods: This cross-sectional study included consecutive adults admitted to a single plastic surgery clinic over three months. Waist and hip circumferences were measured, waist-to-hip ratio was calculated, and body composition was assessed using a Tanita BC-420 MA analyzer. Associations between age, BMI, and BIA-derived parameters were assessed using Spearman’s rank correlation. BMI categories were cross-tabulated with VFR categories, and multivariable linear regression was used to assess VFR in relation to age, BMI, and gender. Results: The study included 326 patients. Mean BMI was higher in men than in women (27.6 ± 4.33 vs. 26.4 ± 5.07; p = 0.006), and men also had higher VFR (12.8 ± 6.15 vs. 7.75 ± 3.74; p < 0.001). Older age groups had higher VFR values, ranging from 2.16 ± 1.82 in participants aged 18–29 years to 14.3 ± 5.0 in patients aged ≥ 80 years. BMI and VFR were strongly correlated, but BMI categories did not fully correspond to VFR categories. Manufacturer-defined elevated VFR was observed in 5 patients with normal BMI and 24 patients with overweight, whereas 26 patients classified as obese had a manufacturer-defined normal VFR category. Conclusions: In this surgical cohort, older age groups had markedly higher VFR values than younger groups despite relatively modest differences in BMI. Because VFR is a device-generated estimate rather than a direct measure of visceral adiposity, these cross-sectional findings should be interpreted cautiously. Validation against established reference methods is needed before drawing broader clinical conclusions. Full article

Background: Although obesity is a recognized cardiometabolic risk determinant, debate persists over the most appropriate anthropometric technique. This study evaluated different anthropometric techniques for predicting cardiometabolic risk in Turkish adolescents and aimed to develop and temporally validate a machine learning–based prediction model, reported in accordance with the TRIPOD statement. Methods: Adolescents from the Türkiye Nutrition and Health Survey in 2010 (n = 1357) and 2017 (n = 561) were included. Anthropometric and biochemical parameters were assessed. BMI z-scores, waist-to-hip and waist-to-height ratios, triponderal mass index (TMI), visceral adiposity index (VAI), and lipid accumulation product (LAP) were calculated. Results: In ROC analysis, VAI showed the highest discrimination (AUC = 0.747, p < 0.001), followed by LAP (AUC = 0.670). In machine learning, XGBoost achieved the highest training discrimination (ROC–AUC = 0.879), whereas logistic regression was the most stable, with minimal overfitting (ΔAUC = 0.008). The logistic regression model was well calibrated (Brier score = 0.107; calibration slope 1.00 development, 1.03 external). External temporal validation showed comparable discrimination across models (AUC = 0.742–0.757), with logistic regression showing the greatest consistency. The model showed a high negative predictive value (NPV = 91.7%) and was therefore better suited to ruling out than ruling in cardiometabolic risk; positive findings warrant confirmatory testing (PPV = 35.4%). A simple logistic-based formula was derived. Conclusions: Machine learning approaches, together with the developed model and simplified formula, may be useful tools for estimating cardiometabolic risk in adolescents and could support a stepwise screening strategy, pending recalibration and prospective validation. Full article

Background and Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease and frequently improves after bariatric surgery. Conventional postoperative follow-up is mainly based on weight-loss outcomes, such as Body Mass Index (BMI), excess weight loss (EWL), total weight loss (TWL), and routine biochemical parameters, which may not fully characterize hepatic fat response. Ultrasound-derived fat fraction (UDFF) provides a quantitative non-invasive assessment of hepatic steatosis, while DXA-derived visceral adipose tissue (VAT) reflects central adiposity and metabolic risk. This study aimed to evaluate whether combined UDFF and DXA-VAT assessment provides complementary information to conventional bariatric follow-up parameters after bariatric surgery. Methods: We conducted a prospective longitudinal cohort study on 41 patients with severe obesity who underwent bariatric surgery between July 2025 and May 2026. Anthropometric, body composition, metabolic, hepatic, and biochemical parameters were assessed at baseline (T0) and 6 months postoperatively (T1). UDFF, utilizing a DAX ultrasound transducer, was used for hepatic steatosis assessment, while DXA was performed for VAT, android fat mass, total body fat percentage, and lean mass quantification. Correlation analyses, multivariable linear regression, and an exploratory clinical discordance analysis were performed. Results: At 6 months after surgery, patients showed significant improvements in body weight, visceral adiposity, insulin resistance, biochemical parameters, and hepatic steatosis. VAT reduction showed the strongest association with UDFF reduction, whereas conventional weight-loss outcomes, anthropometric, and metabolic parameters did not fully identify patients with residual steatosis. These findings suggest that hepatic fat improvement after bariatric surgery is more closely related to changes in visceral adiposity than to weight loss alone. Conclusions: Combined UDFF and DXA-derived VAT assessment may provide a practical dual-compartment imaging framework for postoperative MASLD monitoring. This approach captures both hepatic fat response and visceral adiposity remodeling, offering information that complements conventional bariatric follow-up based on weight-loss outcomes. Full article

Background: Global takeaway fast-food consumption (TFC) has surged. This study aimed to investigate the association between TFC frequency and diastolic blood pressure (DBP) and to explore the potential mediating roles of metabolic and inflammatory markers. Methods and Results: In this cross-sectional study of 13,062 adults from the National Health and Nutrition Examination Survey (NHANES), we utilized weighted regression and restricted cubic splines (RCS) to evaluate the association between TFC frequency and DBP. We performed exploratory mediation analyses to explore the roles of body mass index (BMI), visceral adiposity index (VAI), cardiometabolic index (CMI), dietary inflammatory index (DII), and insulin resistance (HOMA-IR). In the overall cohort, the main association between TFC frequency and DBP did not reach statistical significance in fully adjusted models. However, restricted cubic spline analysis revealed a linear dose–response trajectory without an evident threshold effect. In exploratory subgroup analyses, a potentially pronounced positive association was noted among females, although the formal interaction test was not statistically significant. Mediation models indicated that the examined metabolic and inflammatory markers did not significantly mediate this relationship, suggesting that the association with diastolic blood pressure may not operate through these specific pathways. Conclusions: While the overall main categorical association did not reach statistical significance, TFC demonstrated a potential continuous trend with DBP, with potential associations observed among females. Notably, this relationship was not mediated by established metabolic or inflammatory indices, suggesting that the association between TFC and blood pressure elevation may exist independent of overt structural obesity. These findings highlight the potential value of incorporating takeaway fast-food consumption into routine dietary screening for early cardiovascular risk assessment in young adults. Full article

Background/Objectives: The global rise in obesity represents a major public health issue, extending its detrimental impact beyond metabolic complications to encompass renal dysfunction. A key element in this relationship lies in the interaction between visceral obesity and glomerular hyperfiltration—an early, often silent indicator of kidney injury that may precede the onset of chronic kidney disease (CKD). Methods: In this monocentric, retrospective study, we evaluated 43 adults with obesity attending the Outpatient Clinic for Diet Therapy in Transplantation, Renal Failure and Chronic Pathology at the University of Naples Federico II between March 2022 and March 2024. Clinical, anthropometric, biochemical, and 24 h urinary parameters were recorded, along with several validated visceral adiposity indices. Glomerular hyperfiltration was assessed through measured creatinine clearance (mClCr) tertiles, while associations with adiposity indices, proteinuria, and urinary sodium excretion were explored. Results: Higher creatinine clearance values were significantly associated with increased levels of adiposity indices—particularly Lipid Accumulation Product (LAP), New Visceral Adiposity Index (NVAI), and Metabolic Score for Visceral Fat (METS-VF)—as well as greater proteinuria, urinary sodium excretion, and daily salt intake. Subjects with proteinuria ≥ 150 mg/day exhibited higher NVAI values and elevated sodium and potassium urinary excretion compared with those without proteinuria. Significant correlations emerged between LAP and mClCr, sodium excretion, and proteinuria, even after adjustment for age and BMI. Conclusions: Higher visceral adiposity indices were associated with increased creatinine clearance, proteinuria, and urinary sodium excretion in adults with obesity. These findings suggest that visceral adiposity may represent a useful marker of early obesity-related renal alterations. Prospective studies are warranted to determine the causal relationships and mechanisms underlying these associations. Full article

Melanoma remains a major global health burden, though immunotherapy and targeted therapy have markedly improved survival. Obesity has paradoxically been associated with favorable outcomes in melanoma, yet body mass index (BMI) alone fails to capture its influence on treatment response. To address this gap, we conducted a multi-site cohort study within the Canadian Melanoma Research Network, including patients with advanced melanoma treated with immunotherapy or targeted therapy. Body composition was quantified using computerized tomography (CT) imaging to assess visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), skeletal muscle (SM) mass and intermuscular adipose tissue (IMAT), and associations with progression-free survival (PFS) and overall survival (OS) were evaluated. No overall association was seen for BMI, SAT, VAT, IMAT or SM with PFS or OS. In the targeted therapy subset, higher BMI, SAT, VAT and SM were associated with better OS (hazard ratios 0.56 to 0.65), while no effect was seen in the immunotherapy group. IMAT emerged as a novel prognostic marker, with elevated levels associated with lower OS in males and better OS in females. Our findings show that CT-based body composition is not associated with survival outcomes in patients with advanced melanoma receiving immunotherapy. Full article

Background/Objectives: Nutritional therapy has emerged as a promising therapeutic strategy for the management of chronic metabolic diseases. This study aims to evaluate the efficacy of a low-purine, energy-restricted, and balanced diet (LPEB diet) in ameliorating gout conditions and improving related metabolic risk factors. Methods: A total of 90 patients with gout were randomly allocated to either the intervention group or the control group, with 45 cases in each group. Patients in the control group received routine basic nutritional health education. Based on the conventional education, the intervention group underwent a 42-day structured dietary intervention characterized by low purine intake, energy restriction, and balanced nutritional composition. Results: Compared with the control group, the intervention group showed a significant reduction in serum uric acid (sUA) level by 112.4 μmol/L (p = 0.007). Meanwhile, the fractional excretion of uric acid (FEUA) showed a significantly greater increase of 0.87% in the intervention group compared with the control group (p = 0.003), while daily purine intake was significantly reduced by 262 mg (p = 0.001) in the intervention group. Moreover, notable improvements in body composition were observed in the intervention group. Specifically, body mass index (BMI) decreased by 0.50 kg/m² (p < 0.001) and visceral fat area (VFA) was reduced by 12.1 cm² (p < 0.001), with significant intergroup differences confirmed for both indicators. Conclusions: This study demonstrates that an LPEB diet not only effectively reduces sUA levels by enhancing FEUA but also significantly ameliorates central adiposity and related metabolic risk factors in patients with gout. Full article

In hemodialysis patients, Body Mass Index is insufficient in assessing their nutritional status due to the ‘obesity paradox’ and the association between body composition and inflammation. This study assessed the relationship between body composition, traditional inflammatory markers, the new NETosis indicators (neutrophil extracellular traps), and their association with 12-month mortality. The study included 99 maintenance hemodialysis (HD) patients. Their body composition was assessed using bioelectrical impedance analysis. Blood serum was tested for inflammatory markers (hs-CRP-high sensitive c-reactive protein, IL-6 interleukin-6, TNF-α tumor necrosis factor alfa, IL-1β interleukin-1 beta), NETosis markers (citrullinated histone CH3, myeloperoxidase -MPO, elastase), and nutritional status parameters (albumin, transferrin). No correlation between BMI -body mas index and inflammation was demonstrated. Higher adipose tissue, particularly visceral, was significantly positively correlated with IL-6 and hs-CRP levels, while muscle mass was negatively correlated with inflammation. Dialysis catheter use was associated with higher CH3 levels (NETosis indicator) and lower albumin concentrations. Low albumin levels and high TNF-α levels were independent predictors of death. Body composition, rather than BMI, is associated with the severity of inflammation. Visceral obesity is positively correlated with increased inflammation, while muscle mass shows an inverse association. Dialysis catheters are linked to higher NETosis markers and lower albumin levels, which are associated with a poorer prognosis. Full article

Objectives: Explore and compare the effects of 8-week time-restricted eating (TRE), walking exercise, and their combination on fat and lean muscle distribution in female college students with hidden obesity. Methods: A total of 68 participants were randomly assigned to four groups: Control (CON), TRE, Exercise (EXE), and TRE + EXE. An 8-week intervention was begun according to a predetermined experimental plan, comparing changes in body fat and lean tissue indices before and after the intervention. Results: Before and after the intervention, the TRE group showed a significant decrease in body mass, body mass index (BMI), and total lean mass (p < 0.05). The EXE group saw a significant reduction in visceral fat area, visceral fat mass, and visceral fat volume (p < 0.01). The TRE + EXE group experienced a significant decrease in android lean mass (p < 0.05); Comparing before and after the intervention, there were no statistically significant differences in the body fat percentage, total fat mass, fat and lean in the android and gynoid areas, and %fat in trunk/%fat in legs among the CON, TRE, EXE, and TRE + EXE groups (p > 0.05). After the intervention, there were no significant differences in the body fat percentage, total fat mass, total lean mass, fat and lean in the android and gynoid areas, %fat in trunk/%fat in legs, visceral fat area, visceral fat mass, visceral fat volume, subcutaneous fat area, subcutaneous fat mass, and subcutaneous fat volume among the four groups (p > 0.05). Conclusions: An 8-week TRE intervention in young women with hidden obesity reduced body mass and BMI but also decreased total lean mass, potentially compromising metabolic health, with no statistically significant changes in total body fat or regional fat distribution. Walking exercise showed significant reductions in visceral adiposity indicators (VFA, VFM, VFV), whereas the combined TRE + EXE group did not achieve comparable reductions. These findings suggest that while isolated TRE facilitates body mass loss, it carries a distinct risk of muscle tissue loss and may not confer comparable benefits on visceral fat reduction as walking exercise. However, the generalizability of these preliminary observations is constrained by methodological limitations including retrospective registration, participant attrition, and restricted statistical power. Consequently, these exploratory outcomes must be interpreted with caution, warranting future robust, large-scale trials with enhanced compliance monitoring to optimize prescriptive guidelines for this specific cohort. Full article