INTRODUCTION: Obesity in older adults is linked to various chronic conditions and decreased quality of life. Traditional physical activity guidelines often overlook the specific postures and movements that older adults engage in daily. This study aims to explore the compositional associations between posture-specific behaviours and obesity risk in younger (M = 67.35 ± 2.03 years) and older (M = 75.73 ± 4.17 years) groups of older adults and investigate the differences in body mass index (BMI) associated with replacing time spent in lying, sitting and standing with moving or walking. METHODS: This cross-sectional study involved 309 older adults aged 65 and above from Czech Republic. Participants' movement behaviours, including lying, sitting, standing, moving, and walking, were measured using accelerometers. The data were analysed using compositional data analysis (CoDA) and isotemporal substitution models to assess the impact of reallocating time between different activities on self-reported (BMI). RESULTS: The younger group engaged in more overall movement (193.84 min/day vs. 172.41 min/day) and walking (92.15 min/day vs. 76.62 min/day) than the older group. Significant estimated increases in BMI were associated with reallocating 30 min from movement to lying, sitting, or standing (up to + 3.31 kg/m2), while reallocating the same amount of time from lying, sitting, or standing to movement was associated with estimated reductions in BMI (up to - 2.54 kg/m2). In the older group, reallocating time from slow walking to lying or sitting was associated with estimated increases in BMI (up to + 1.86 kg/m2), while increasing time spent slow walking at the expense of lying or sitting theoretically reduced BMI (up to - 0.95 kg/m2). CONCLUSIONS: The findings suggest that promoting movement and walking, including both slow and fast walking, may play a role in managing obesity risk in older adults. This study highlights the potential benefits of reducing sedentary time and encouraging low-intensity physical activity tailored to the capabilities of seniors, especially those aged 70+, as a possible strategy to mitigate obesity risk. However, further longitudinal studies are needed to confirm these associations and explore causal relationships.

• MeSH
• akcelerometrie metody   MeSH
• chůze * fyziologie   MeSH
• index tělesné hmotnosti MeSH
• lidé MeSH
• obezita * epidemiologie   patofyziologie   MeSH
• postura těla fyziologie   MeSH
• pozice sedu * MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stoj * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Ve spojení se stárnutím člověka se progresivně rozvíjí pokles svalových funkcí. S tím je spojená na věku závislá deplece svalové hmoty zvaná sarkopenie. Existuje obvyklá představa, že primární je pokles svalové hmoty, ale v drtivém počtu případů je tomu naopak. Nejprve vlivem zevních, ale také endogenních důvodů se snižuje svalová aktivita, rozvíjí se svalová slabost a ta je následována progresivním úbytkem svalové hmoty – sarkopenií. Výjimku tvoří některé typy primárního poškození svalové hmoty, sarkopenie vznikající v důsledku malnutrice a nedostatečného přívodu proteinu, vlivem toxických látek v zevním prostředí. Svalová dynamopenie a sarkopenie se stává globálním problémem, který kulminuje zejména v industriálně a ekonomicky rozvinutých státech. Prevence svalové dynamopenie a sarkopenie je zásadním trendem, který je nezbytný zejména v kontextu se stoupajícím věkem a počtem obyvatel. Podpořeno MZ ČR – RVO (FNHK, 00179906). Korespondenční adresa: prof. MUDr. Zdeněk Zadák, CSc. III. interní gerontometabolická klinika LF UK a FN Sokolská 581, 500 05 Hradec Králové e-mail: zadak@fnhk.cz

In connection with human aging, a decline in muscle function develops progressively. This is associated with an age-dependent depletion of muscle mass called sarcopenia. There is a common opinion that the decrease in muscle mass is primary, but in the overwhelming number of cases it is the opposite. First, due to external but also endogenous reasons, muscle activity decreases, muscle weakness develops and this is followed by a progressive loss of muscle mass – sarcopenia. The exception is some types of primary damage to muscle mass, sarcopenia arising as a result of malnutrition and insufficient protein intake, due to the influence of toxic substances in the external environment. Muscle dynamopenia and sarcopenia is becoming a global problem, which culminates especially in industrially and economically developed countries. Prevention of muscle dynamopenia and sarcopenia is a fundamental trend, which is necessary especially in the context of increasing age and increased population.

• Klíčová slova
• dynamopenie,
• MeSH
• antropometrie metody   MeSH
• lidé MeSH
• obezita etiologie   patofyziologie   MeSH
• sarkopenie * diagnóza   etiologie   farmakoterapie   terapie   MeSH
• senioři MeSH
• svalová atrofie * diagnóza   etiologie   farmakoterapie   terapie   MeSH
• svalová síla - dynamometr MeSH
• svalová síla fyziologie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Background: Intermittent fasting may be an effective tool for weight loss, but it is still unclear from previous studies to date whether it is as effective as a continuous energy restriction in terms of reducing adipose tissue and whether it leads to unwanted muscle loss. Objectives: The aim of this study was to compare the effect of intermittent fasting (IF) with continuous energy restriction (CER) on the body weight and body composition and to assess the effect of intermittent fasting also in isolation from the energy restriction. Methods: After completion of a three-week dietary intervention, differences in the weight loss and differences in the body composition were compared between three groups. The first group consumed 75% of their calculated energy intake requirements in a six-hour time window. The second group consumed 75% of their calculated energy intake requirements without a time window and the third group consumed 100% of their calculated energy intake requirements in a six-hour time window. The changes in the weight and body composition were assessed by BIA. Results: Of the 95 randomized participants, 75 completed the intervention phase of the study. The highest mean weight loss was achieved by the IF with ER (energy restriction) group (2.3 ± 1.4 kg), followed by the CER group (2.2 ± 1.1 kg); the difference between the groups did not reach statistical significance. The lowest mean weight loss was observed in the IF without ER group (1.1 ± 1.2 kg), the difference reaching statistical significance compared to the IF with ER (p=0.003) and CER (p=0.012) groups. The highest mean adipose tissue loss was observed in the CER group (1.5 ± 1.2 kg) followed by the IF with ER group (1.3 ± 1.1 kg), with no statistically significant differences between the groups. A mean adipose tissue loss was found in the IF without ER group (0.9 ± 1.1 kg) with no statistically significant differences compared to the IF with ER and CER groups. The highest mean fat-free mass loss was found in the IF with ER group (1.1 ± 1.0 kg), followed by the CER group (0.65 ± 0.91 kg) with no statistically significant differences. The IF without ER group showed the lowest mean fat-free mass loss (0.2 ± 1.3 kg), which reached statistical significance compared to the IF with ER group (p=0.027). Conclusion: The results showed a comparable effect in the weight loss and body fat reduction regardless of the timing of the food intake. The diet quality, together with the energy intake, appeared to be one of the most important factors influencing the body composition.

• MeSH
• antropometrie MeSH
• dospělí MeSH
• energetický příjem * fyziologie   MeSH
• hmotnostní úbytek * fyziologie   MeSH
• index tělesné hmotnosti MeSH
• kalorická restrikce * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• obezita dietoterapie   patofyziologie   MeSH
• omezení příjmu potravy * fyziologie   MeSH
• přerušované hladovění MeSH
• složení těla * fyziologie   MeSH
• tělesná hmotnost fyziologie   MeSH
• tuková tkáň MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

BACKGROUND AND AIMS: Prolonged fasting, which leads to the mobilization of fat from adipose tissue, can result in the development of hepatosteatosis. However, it is not yet known whether the accumulation of fat in the liver after fasting can be affected by concurrent obesity. Therefore, this study aimed to assess how excessive adiposity influences changes in liver fat content induced by fasting and subsequent refeeding. METHODS AND RESULTS: Ten lean women and eleven women with obesity (age: 36.4 ± 7.9 and 34.5 ± 7.9 years, BMI: 21.4 ± 1.7 and 34.5 ± 4.8 kg/m2) underwent a 60-h fasting period followed by 2 days of isocaloric high-carbohydrate refeeding. Magnetic resonance spectroscopy (MRS) examinations of liver were conducted at baseline, after 48 h of fasting, and at the end of refeeding period. Hepatic fat content (HFC) increased in lean women after fasting, whereas no statistically significant change in HFC was observed in women with obesity. Additionally, fasting led to significant reductions in liver volume in both groups, likely attributable to glycogen depletion, with subsequent restoration upon refeeding. Notably, changes in hepatic fat volume (HFV) rather than HFC inversely correlated with baseline liver fat content and HOMA-IR. CONCLUSION: We demonstrated that prolonged fasting results in accumulation of fat in the liver in lean subjects only and that this accumulation is inversely related to baseline fat content and insulin resistance. Moreover, the study underscored the importance of evaluating hepatic fat volume rather than hepatic fat content in studies that involve considerable changes in hepatic lean volume.

• MeSH
• adipozita * MeSH
• časové faktory MeSH
• dietní sacharidy aplikace a dávkování   MeSH
• dospělí MeSH
• játra * metabolismus   diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita * patofyziologie   terapie   metabolismus   MeSH
• omezení příjmu potravy * MeSH
• sacharidová dieta škodlivé účinky   MeSH
• studie případů a kontrol MeSH
• ztučnělá játra diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

• MeSH
• inzulinová rezistence fyziologie   MeSH
• kanabinoidy metabolismus   MeSH
• lidé MeSH
• mastné kyseliny * dějiny   fyziologie   klasifikace   metabolismus   MeSH
• nenasycené mastné kyseliny fyziologie   metabolismus   MeSH
• obezita * patofyziologie   MeSH
• přijímání potravy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Inflammation is thought to be an important mechanism for the development and progression of obesity-related heart failure with preserved ejection fraction (HFpEF). In the STEP-HFpEF Program, once-weekly 2.4 mg semaglutide improved heart failure-related symptoms, physical limitations, and exercise function, reduced the levels of C-reactive protein (CRP), a biomarker of inflammation, and reduced body weight in participants with obesity-related HFpEF. However, neither the prevalence nor the clinical characteristics of patients who have various magnitudes of inflammation in the context of obesity-related HFpEF have been well described. Furthermore, whether the beneficial effects of semaglutide on the various HF efficacy endpoints in the STEP-HFpEF Program are modified by the baseline levels of inflammation has not been fully established. Finally, the relationship between weight reduction and changes in CRP across the STEP-HFpEF Program have not been fully defined. OBJECTIVES: This study sought to: 1) evaluate baseline characteristics and clinical features of patients with obesity-related HFpEF that have various levels of inflammation in the STEP-HFpEF Program; 2) determine if the effects of weekly semaglutide 2.4 mg vs placebo across all key outcomes are influenced by baseline levels of inflammation assessed by CRP levels; and 3) determine the relationship between change in CRP and weight loss in the STEP-HFpEF Program. METHODS: This was a secondary analysis of pooled data from 2 international, double-blind, placebo-controlled, randomized trials (STEP-HFpEF and STEP-HFpEF DM). The outcomes were change in the dual primary endpoints (health status [measured by the Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS)] and body weight) from baseline to 52 weeks according to baseline CRP levels. Additional efficacy endpoints included change in 6-minute walk distance (6MWD), a hierarchical composite endpoint that included death, heart failure events, and differences in the change in the KCCQ-CSS and 6MWD, and levels of CRP in semaglutide- vs placebo-treated patients. Patients were stratified into 3 categories based on baseline CRP levels (<2, ≥2 to <10, and ≥10 mg/L). RESULTS: In total, 1,145 patients were randomized, of which 71% of patients had evidence of inflammation (CRP ≥2 mg/L). At baseline, those with higher levels of inflammation were younger, were more likely to be female, and had higher body mass index, worse health status (KCCQ-CSS), and shorter 6MWD. Semaglutide vs placebo led to reductions in HF-related symptoms and physical limitations as well as body weight, and to improvements in 6MWD and the hierarchical composite endpoint that were consistent across baseline CRP categories (all P interaction nonsignificant). Semaglutide also reduced CRP to a greater extent than placebo regardless of baseline CRP levels (P interaction = 0.32). Change in CRP from baseline to 52 weeks was similar regardless of the magnitude of weight loss (P interaction = 0.91). CONCLUSIONS: Inflammation is highly prevalent in obesity-related HFpEF. Semaglutide consistently improved HF-related symptoms, physical limitations, and exercise function, and reduced body weight across the categories of baseline CRP. Semaglutide also reduced inflammation, regardless of either baseline CRP or magnitude of weight loss during the trials. (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity [STEP-HFpEF; NCT04788511]; Research Study to Look at How Well Semaglutide Works in People Living With Heart Failure, Obesity and Type 2 Diabetes [STEP HFpEF DM; NCT04916470]).

• MeSH
• C-reaktivní protein metabolismus   MeSH
• dvojitá slepá metoda MeSH
• glukagonu podobné peptidy * terapeutické užití   MeSH
• hmotnostní úbytek MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita * komplikace   patofyziologie   MeSH
• senioři MeSH
• srdeční selhání * farmakoterapie   patofyziologie   MeSH
• tepový objem * fyziologie   účinky léků   MeSH
• výsledek terapie MeSH
• zánět * farmakoterapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

Autophagy is an evolutionarily conserved process that plays a pivotal role in the maintenance of cellular homeostasis and its impairment has been implicated in the pathogenesis of various metabolic diseases including obesity, type 2 diabetes (T2D), and metabolic dysfunction-associated steatotic liver disease (MASLD). This review synthesizes the current evidence from human studies on autophagy alterations under these metabolic conditions. In obesity, most data point to autophagy upregulation during the initiation phase of autophagosome formation, potentially in response to proinflammatory conditions in the adipose tissue. Autophagosome formation appears to be enhanced under hyperglycemic or insulin-resistant conditions in patients with T2D, possibly acting as a compensatory mechanism to eliminate damaged organelles and proteins. Other studies have proposed that prolonged hyperglycemia and disrupted insulin signaling hinder autophagic flux, resulting in the accumulation of dysfunctional cellular components that can contribute to β-cell dysfunction. Evidence from patients with MASLD supports autophagy inhibition in disease progression. Nevertheless, given the available data, it is difficult to ascertain whether autophagy is enhanced or suppressed in these conditions because the levels of autophagy markers depend on the overall metabolism of specific organs, tissues, experimental conditions, or disease duration. Owing to these constraints, determining whether the observed shifts in autophagic activity precede or result from metabolic diseases remains challenging. Additionally, autophagy-modulating strategies are shortly discussed. To conclude, more studies investigating autophagy impairment are required to gain a more comprehensive understanding of its role in the pathogenesis of obesity, T2D, and MASLD and to unveil novel therapeutic strategies for these conditions.

• MeSH
• autofagie * fyziologie   MeSH
• diabetes mellitus 2. typu * komplikace   patofyziologie   metabolismus   MeSH
• lidé MeSH
• obezita * komplikace   patofyziologie   metabolismus   MeSH
• ztučnělá játra patofyziologie   komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function.

• MeSH
• cvičení * fyziologie   MeSH
• index tělesné hmotnosti * MeSH
• kognice * fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita * psychologie   patofyziologie   MeSH
• obvod pasu MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• C-reaktivní protein * fyziologie   ultrastruktura   MeSH
• dospělí MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• obezita * komplikace   patofyziologie   prevence a kontrola   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• Klíčová slova
• semaglutid,
• MeSH
• bariatrická chirurgie metody   MeSH
• diabetes mellitus * farmakoterapie   patofyziologie   MeSH
• glifloziny terapeutické užití   MeSH
• glukagonu podobné peptidy terapeutické užití   MeSH
• klinická studie jako téma MeSH
• krevní glukóza analýza   MeSH
• lidé MeSH
• metformin terapeutické užití   MeSH
• obezita * komplikace   patofyziologie   MeSH
• srdeční selhání * komplikace   MeSH
• žaludeční inhibiční polypeptid terapeutické užití   MeSH
• životní styl MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH