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Body composition, energy expenditure and physical activity

Abdominal fat distribution differently affects muscle strength of the upper and lower extremities in women

European Journal of Clinical Nutrition volume 71, pages 372–376 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

In obese subjects, reduced muscle mass and strength are associated with impaired functional and metabolic capacity. We therefore investigated the association between abdominal fat distribution, fat mass index and maximum muscle strength of upper and lower extremities in obese patients.

Subjects/Methods:

One hundred and fifty five outpatients with a body mass index (BMI)⩾30 kg/m2 (105 women; 45.1±14.6 years; BMI 43.5±8.2 kg/m2) were included in the study. Grip and knee extension strength were measured with dynamometers. Using bioelectric impedance analysis, fat-free mass and fat mass indices (FFMI, FMI) were calculated. The influence of age, weight, FFMI, FMI and waist-to-hip ratio (WHR) on grip and knee extension strength was investigated in a risk factor-adjusted regression analysis.

Results:

BMI did not correlate with hand grip or knee extension strength. The regression model confirmed a positive effect of higher weight on strength parameters; however, increased FMI was shown to have a negative effect on strength in both sexes (women, knee: β: −1.495, confidence interval (CI): −2.075 to −0.0914, P<0.0001; women, hand: β: −0.714, CI: −1.156 to −0.273, P=0.002; men, hand: β:−1.448, CI: −2.618 to −0.278, P=0.016). Although increased WHR positively influenced knee extension strength (β: 24.286, CI: 0.728–47.844, P<0.043), it did not affect grip strength in women. This association was not seen in men.

Conclusions:

Body fat distribution rather than BMI alone needs to be considered when evaluating strength parameters in obesity. As the relationship between obesity and strength of the upper versus lower extremities differs, grip strength cannot be considered an indicator of whole body strength in obese individuals.

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References

  1. Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M . Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr 2011; 30: 135–142.

    Article  Google Scholar 

  2. Norman K, Stobaus N, Reiss J, Schulzke J, Valentini L, Pirlich M . Effect of sexual dimorphism on muscle strength in cachexia. J Cachexia Sarcopenia Muscle 2012; 3: 111–116.

    Article  Google Scholar 

  3. Fogelholm M, Malmberg J, Suni J, Santtila M, Kyrolainen H, Mantysaari M . Waist circumference and BMI are independently associated with the variation of cardio-respiratory and neuromuscular fitness in young adult men. Int J Obes 2006; 30: 962–969.

    Article  CAS  Google Scholar 

  4. Keevil VL, Luben R, Dalzell N, Hayat S, Sayer AA, Wareham NJ et al. Cross-sectional associations between different measures of obesity and muscle strength in men and women in a British cohort study. J Nutr Health Aging 2015; 19: 3–11.

    Article  CAS  Google Scholar 

  5. Schautz B, Later W, Heller M, Muller MJ, Bosy-Westphal A . Total and regional relationship between lean and fat mass with increasing adiposity—impact for the diagnosis of sarcopenic obesity. Eur J Clin Nutr 2012; 66: 1356–1361.

    Article  CAS  Google Scholar 

  6. Goodpaster BH, Park SW, Harris TB, Kritchevsky SB, Nevitt M, Schwartz AV et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 2006; 61: 1059–1064.

    Article  Google Scholar 

  7. Newman AB, Haggerty CL, Goodpaster B, Harris T, Kritchevsky S, Nevitt M et al. Strength and muscle quality in a well-functioning cohort of older adults: the Health, Aging and Body Composition Study. J Am Geriatr Soc 2003; 51: 323–330.

    Article  Google Scholar 

  8. Marcus RL, Addison O, Dibble LE, Foreman KB, Morrell G, Lastayo P . Intramuscular adipose tissue, sarcopenia, and mobility function in older individuals. J Aging Res 2012; 2012: 629637.

    Article  Google Scholar 

  9. Hsieh CJ, Wang PW, Chen TY . The relationship between regional abdominal fat distribution and both insulin resistance and subclinical chronic inflammation in non-diabetic adults. Diabetol Metab Syndr 2014; 6: 49.

    Article  Google Scholar 

  10. Gallagher D, Kuznia P, Heshka S, Albu J, Heymsfield SB, Goodpaster B et al. Adipose tissue in muscle: a novel depot similar in size to visceral adipose tissue. Am J Clin Nutr 2005; 81: 903–910.

    Article  CAS  Google Scholar 

  11. Norman K, Stobaus N, Kulka K, Schulzke J . Effect of inflammation on handgrip strength in the non-critically ill is independent from age, gender and body composition. Eur J Clin Nutr 2014; 68: 155–158.

    Article  CAS  Google Scholar 

  12. Janssen I, Katzmarzyk PT, Ross R . Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004; 79: 379–384.

    Article  CAS  Google Scholar 

  13. Barbat-Artigas S, Rolland Y, Cesari M, Abellan van Kan G, Vellas B, Aubertin-Leheudre M . Clinical relevance of different muscle strength indexes and functional impairment in women aged 75 years and older. J Gerontol A Biol Sci Med Sci 2013; 68: 811–819.

    Article  Google Scholar 

  14. Horie LM, Barbosa-Silva MC, Torrinhas RS, de Mello MT, Cecconello I, Waitzberg DL . New body fat prediction equations for severely obese patients. Clin Nutr 2008; 27: 350–356.

    Article  Google Scholar 

  15. Hardy R, Cooper R, Aihie Sayer A, Ben-Shlomo Y, Cooper C, Deary IJ et al. Body mass index, muscle strength and physical performance in older adults from eight cohort studies: the HALCyon programme. PloS One 2013; 8: e56483.

    Article  CAS  Google Scholar 

  16. Forbes GB . Longitudinal changes in adult fat-free mass: influence of body weight. Am J Clin Nutr 1999; 70: 1025–1031.

    Article  CAS  Google Scholar 

  17. Marette A, Liu Y, Sweeney G . Skeletal muscle glucose metabolism and inflammation in the development of the metabolic syndrome. Rev Endocr Metab Disord 2014; 15: 299–305.

    Article  CAS  Google Scholar 

  18. Delmonico MJ, Harris TB, Visser M, Park SW, Conroy MB, Velasquez-Mieyer P et al. Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr 2009; 90: 1579–1585.

    Article  CAS  Google Scholar 

  19. Brady AO, Straight CR, Schmidt MD, Evans EM . Impact of body mass index on the relationship between muscle quality and physical function in older women. J Nutr Health Aging 2014; 18: 378–382.

    Article  CAS  Google Scholar 

  20. Barbat-Artigas S, Pion CH, Leduc-Gaudet JP, Rolland Y, Aubertin-Leheudre M . Exploring the role of muscle mass, obesity, and age in the relationship between muscle quality and physical function. J Am Med Dir Assoc 2014; 15: 303 e13–303 e20.

    Article  Google Scholar 

  21. Yang S, Nguyen ND, Center JR, Eisman JA, Nguyen TV . Association between abdominal obesity and fracture risk: a prospective study. J Clin Endocrinol Metab 2013; 98: 2478–2483.

    Article  CAS  Google Scholar 

  22. Kelly DM, Jones TH . Testosterone and obesity. Obes Rev 2015.

  23. Sowers MF, Beebe JL, McConnell D, Randolph J, Jannausch M . Testosterone concentrations in women aged 25-50 years: associations with lifestyle, body composition, and ovarian status. Am J Epidemiol 2001; 153: 256–264.

    Article  CAS  Google Scholar 

  24. Soderberg S, Olsson T, Eliasson M, Johnson O, Brismar K, Carlstrom K et al. A strong association between biologically active testosterone and leptin in non-obese men and women is lost with increasing (central) adiposity. Int J Obes Relat Metab Disord 2001; 25: 98–105.

    Article  CAS  Google Scholar 

  25. Evans DJ, Hoffmann RG, Kalkhoff RK, Kissebah AH . Relationship of androgenic activity to body fat topography, fat cell morphology, and metabolic aberrations in premenopausal women. J Clin Endocrinol Metab 1983; 57: 304–310.

    Article  CAS  Google Scholar 

  26. van Anders SM, Hampson E . Waist-to-hip ratio is positively associated with bioavailable testosterone but negatively associated with sexual desire in healthy premenopausal women. Psychosom Med 2005; 67: 246–250.

    Article  Google Scholar 

  27. Mondragon-Ceballos R, Garcia Granados MD, Cerda-Molina AL, Chavira-Ramirez R, Hernandez-Lopez LE . Waist-to-hip ratio, but not body mass index, is associated with testosterone and estradiol concentrations in young women. Int J Endocrinol 2015; 2015: 654046.

    Article  Google Scholar 

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Author notes

  1. U Elbelt and K Norman: Shared last authorship.

Authors and Affiliations

  1. Charité—Universitätsmedizin Berlin, Campus Virchow-Klinikum, Forschungsgruppe Geriatrie, Berlin, Germany

    L Otten & K Norman

  2. Universität Hohenheim, Fg. Angewandte Ernährungswissenschaft/Diätetik, Hohenheim, Germany

    A Bosy-Westphal

  3. Charité—Universitätsmedizin Berlin, Campus Mitte, Zentrum für Adipositas und Metabolische Chirurgie, Berlin, Germany

    J Ordemann

  4. Charité—Universitätsmedizin Berlin, Campus Mitte, Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Berlin, Germany

    E Rothkegel & N Stobäus

  5. Charité—Universitätsmedizin Berlin, Campus Mitte, Medizinische Klinik mit Schwerpunkt Endokrinologie, Diabetes und Ernährungsmedizin, Berlin, Germany

    U Elbelt

  6. Charité—Universitätsmedizin Berlin, Interdisziplinäres Stoffwechselcentrum, Berlin, Germany

    K Norman

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  1. L Otten
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Correspondence to K Norman.

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Otten, L., Bosy-Westphal, A., Ordemann, J. et al. Abdominal fat distribution differently affects muscle strength of the upper and lower extremities in women. Eur J Clin Nutr 71, 372–376 (2017). https://doi.org/10.1038/ejcn.2016.226

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  • DOI: https://doi.org/10.1038/ejcn.2016.226

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