The “Fat but Fit” Paradigm and Bone Health in Young Adults: A Cluster Analysis

Torres‐Costoso, Ana; Garrido‐Miguel, Miriam; Gracia‐Marco, Luis; López-Muñoz, Purificación; Reina‐Gutiérrez, Sara; Arenas‐Arroyo, Sergio Núñez de; Martínez‐Vizcaíno, Vicente

doi:10.3390/nu13020518

Cited by 11 publications

(8 citation statements)

References 38 publications

(42 reference statements)

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“…Additionally, the mediation analysis showed that the CRF/P1NP relationship was totally mediated by hsCRP levels, which reinforces the abovementioned protective role of CRF on the adverse effects of adiposity (Oktay et al, 2017). In this sense, Torres-Costoso et al (2021) have recently shown that fat individuals with high levels of CRF had a good bone health, probably due to its relationship on the decrease in fat mass and the ensuing inflammatory status (Torres-Costoso et al, 2015). Thus, this provides preliminary evidence for the hypothesis that hsCRP levels play an important role in the relationship between CRF and P1NP levels.…”

Section: Discussionsupporting

confidence: 72%

Cardiorespiratory Fitness and Bone Turnover Markers in Adults With Metabolic Syndrome: The Mediator Role of Inflammation

Gil-Cosano

Gracia‐Marco

Courteix

et al. 2023

International Journal of Sport Nutrition and Exercise Metabolism

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The relationship between inflammatory markers and bone turnover in adults is well known, and a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5 ± 5.0 years, 62.7% women) were included in the analysis. CRF was measured by the 6-min walking test. Serum interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP), and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy X-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers, and bone turnover markers, controlling for sex, lean mass, and fat mass. Boot-strapped mediation procedures were performed, and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r = .228, p = .044) and osteocalcin levels (r = .296, p = .009). Furthermore, CRF was positively correlated with IL-1β levels (r = .340, p = .002) and negatively correlated with hsCRP levels (r = −.335, p = .003), whereas IL-1β levels were positively correlated with P1NP levels (r = .245, p = .030), and hsCRP levels were negatively correlated with P1NP levels (r = −.319, p = .004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (percentage of mediation = 39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population.

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Section: Discussionsupporting

confidence: 72%

Cardiorespiratory Fitness and Bone Turnover Markers in Adults With Metabolic Syndrome: The Mediator Role of Inflammation

Gil-Cosano

Gracia‐Marco

Courteix

et al. 2023

International Journal of Sport Nutrition and Exercise Metabolism

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“…It was discovered that BMD did not present unlimited reduction with non-trunk BFM increasing compared with a condition where trunk far increasing. Trunk fat presented a linear negative relationship with BMD in our study and this finding is persistent with a study of primarily small cohorts in which the majority 41–44 but not all 45 showed a negative relationship between central fat mass and BMD. These results reflected that limb fat might not be boundless proliferation, and limb fat sustained a protective effect on BMD to some extent.…”

Section: Discussionsupporting

confidence: 86%

Novel Insight into the Relationship Between Muscle-Fat and Bone in Type 2 Diabetes Ranging from Normal Weight to Obesity

Wang¹,

Peng²,

Zhang³

et al. 2022

DMSO

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Objective Decreased bone mineral density (BMD) is a common complication in individuals with type 2 diabetes mellitus (T2DM). Body weight, mainly consisting of muscle and fat, is the main determinant of BMD and fracture risks but does not accurately describe nutritional status. Most studies suggest that skeletal muscle mass (SMM) promotes BMD, while body fat mass (BFM) decreases BMD. However, the combined effect of SMM and BFM on BMD is elusive. Thus, the study aims to explore the combined effect of fat and muscle by the ratio index SMM/BFM on BMD in T2DM. Methods BFM and SMM were measured by the bioelectrical impedance analysis (BIA) method among 593 T2DM individuals ranging from normal weight and obesity. BMD was analyzed by DXA. Novel non-linear generalized additive models (GAMs) were used as the statistical analysis method. Results The results demonstrated that BMD T score/Z score of both femur and lumbar vertebrae were significantly higher and waist–hip ratio (WHR) was significantly lower in the high SMM/BFM group of both normal weight and overweight groups in T2DM individuals. Hence, SMM/BFM might be a good factor indicating BMD in different weight ranges. Additionally, the relationship between muscle fat and BMD was not linear. Notably, this correlation was not influenced by hyperglycemia in T2DM since different analytic models adjusted with the age, gender, BMI and HbA1c were adopted in this study. Furthermore, the impact of trunk fat (central, visceral fat most) and non-trunk fat (peripheral, the sum of subcutaneous limb fat most) on BMD was inconsistent. BMD presented unlimited reduction with trunk BFM increasing, while sustaining minimal diminishment with non-trunk BFM accumulation. Conclusion Our study provided a novel viewpoint relationship between muscle-fat and bone, and SMM/BFM might be a potential biomarker for bone health and clinical treatments of diabetes and related metabolic syndromes.

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“…Physical fitness acquires special relevance in this regard because scores obtained in physical fitness tests during adolescence can predict health-related fitness in adulthood [ 20 ], with cardiorespiratory capacity, upper limb strength, speed, and flexibility being the physical capacities most valued in previous research conducted with adolescents due to their relationship with health [ 21 ]. So much so that research conducted in recent years has given rise to a phenomenon known as “fat but fit”, in which overweight or obese individuals, but with a high level of cardiorespiratory fitness or a good fitness level, have a lower risk of metabolic and cardiovascular diseases, regardless of their weight status [ 22 , 23 ], giving even more relevance to the practice of physical activity.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding the “fat but fit” paradox, few studies have been carried out in adolescents, and these are observational studies that have used cardiorespiratory fitness or handgrip strength as variables to determine physical fitness [ 22 , 23 ]. However, part of the variability in fitness is explained by genetics and hormonal changes, so that adolescents who are not very active can present moderate levels of these variables, which is a factor to be taken into account when considering subjects as fit [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Physical, Psychological, and Body Composition Differences between Active and Sedentary Adolescents According to the “Fat but Fit” Paradigm

Mateo-Orcajada

Vaquero-Cristóbal

Esparza-Ros

et al. 2022

IJERPH

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The practice of physical activity during adolescence is essential for the proper development of the population. In recent decades, the relevance of physical activity has been increasing, due to the development of the “fat but fit” paradigm. This paradigm shows that adolescents with a high level of physical fitness are healthier than adolescents with poorer physical fitness, regardless of their weight, giving importance to sports practice over other aspects. However, few previous studies have analyzed the differences in physical and body composition between active and sedentary adolescents in this paradigm. For this reason, the objectives of the present study were to establish the differences in body composition, physical performance, and adherence to the Mediterranean diet between active and sedentary adolescents; and to analyze the differences between active and sedentary adolescents according to the “fat but fit” paradigm. The sample consisted of 791 adolescent whose body composition, level of physical activity, adherence to the Mediterranean diet, and physical fitness were measured. It was found significant between active and sedentary adolescents in most of the anthropometric, AMD, and physical fitness variables, with a significant effect of the covariates gender, age, BMI, and biological maturation on the model. The binary logistic regression analysis performed shows that anthropometric variables, AMD, and VO2 max can be considered as primary outcomes to distinguish between active and sedentary groups of adolescents. Furthermore, the results showed that the active adolescents, regardless of their weight status, had lower fat mass and greater muscle mass, as well as a higher performance in the physical fitness tests, and greater adherence to the Mediterranean diet than the sedentary adolescents. To conclude, the practice of physical activity is a determinant for the improvement of body composition, physical performance, and adherence to the Mediterranean diet of the adolescent population, regardless of their gender, age, weight, or maturity status.

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The “Fat but Fit” Paradigm and Bone Health in Young Adults: A Cluster Analysis

Cited by 11 publications

References 38 publications

Cardiorespiratory Fitness and Bone Turnover Markers in Adults With Metabolic Syndrome: The Mediator Role of Inflammation

Cardiorespiratory Fitness and Bone Turnover Markers in Adults With Metabolic Syndrome: The Mediator Role of Inflammation

Novel Insight into the Relationship Between Muscle-Fat and Bone in Type 2 Diabetes Ranging from Normal Weight to Obesity

Physical, Psychological, and Body Composition Differences between Active and Sedentary Adolescents According to the “Fat but Fit” Paradigm

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