Search Results (1,228)

Background: Body mass index (BMI) remains the standard tool for obesity screening; however, it does not account for body fat distribution or visceral adiposity, potentially leading to clinically relevant misclassification—particularly in young adults. Evidence on this issue in healthcare professionals is limited. Objective: To evaluate the extent of obesity misclassification when using BMI compared with alternative anthropometric and body composition indices, and to examine sex-specific associations between lifestyle factors and different adiposity phenotypes in young healthcare professionals. Methods: A large cross-sectional study was conducted in 12,874 medical residents, nursing residents, and age-matched controls (22–30 years). Obesity was defined using BMI (≥30 kg/m²), waist-to-height ratio (WtHR ≥ 0.5), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), body fat percentage, and bioimpedance-derived visceral fat. Multivariable logistic regression models adjusted for age, sex, professional group, smoking, physical activity, and Mediterranean diet adherence were fitted separately for each adiposity definition. Sex interaction terms were formally tested. Agreement between indices was assessed using Cohen’s kappa. Results: Obesity prevalence varied substantially according to the index applied and was consistently higher when central or visceral adiposity measures were used. Agreement between BMI and alternative indices was only fair to moderate, with the lowest concordance observed for visceral fat (κ = 0.29; 95% CI 0.26–0.32). Male sex was strongly associated with visceral fat-defined obesity (aOR 4.76; 95% CI 3.82–5.92), while effect sizes were attenuated for BMI-defined obesity (aOR 1.41; 95% CI 1.32–1.51). Significant sex interactions were detected for visceral adiposity, particularly for physical activity (p = 0.001) and smoking (p = 0.002), indicating differential lifestyle associations according to fat distribution phenotype. Conclusions: BMI substantially underestimates clinically relevant central and visceral adiposity in young healthcare professionals. Sex-specific differences were observed in the association between lifestyle behaviors and visceral fat. These findings highlight the limitations of relying exclusively on BMI for obesity screening. Incorporating waist-based or body composition-derived measures may improve early risk identification and support targeted preventive strategies. Full article

Background and Objective: Previous studies have shown that muscle mass and visceral fat are interrelated and affect metabolic health. However, there is limited research exploring machine learning (ML) models that can help us understand the relationship between muscle mass and the risk of adiposity in the adult population. The objective of this study was to identify predictors of obesity on the basis of data from 13,663 adults assessed via body composition analysis via optimal and interpretable ML algorithms. Methods: A cross-sectional design was used to analyze data from 13,663 adults, comprising men (n = 6877) and women (n = 6786). The variables were obtained via 8-point multifrequency BIA under standardized clinical protocols with an Inbody^® Model 770 device validated for the adult population. To illustrate the interaction between body composition components, a probability heatmap was generated on the basis of the values predicted from the logistic model. The decision boundary was defined via the metabolic risk probability gradient, allowing visualization of the two-dimensional transition between low- and high-risk states. Statistical processing and figure generation were performed via Python software v.3.10. Results: The evaluation of the 10 algorithms demonstrated exceptional predictive performance, with the multilayer perceptron (MLP) standing out as the superior model in both sexes. The AUC-ROC was 0.981 for men and 0.993 for women, with F1 scores of 0.912 and 0.969, respectively. Overall, systematically higher accuracy was observed in the female cohort, exceeding 95% accuracy in most models. Conclusions: Muscle mass has been shown to act as a metabolic mediator, modulating and reducing the risk associated with visceral adiposity. It also concludes that the use of ML algorithms, specifically neural networks, is a good model for analyzing the risk associated with excess visceral fat. Full article

Background/Objectives: Cancer cachexia (CC) is a metabolic syndrome characterized by the progressive loss of skeletal muscle and adipose tissue during tumor progression. Despite its clinical prevalence, effective therapeutic options are currently lacking. Phloretin, a natural flavonoid with potent anti-inflammatory and antioxidant properties, has unclear efficacy against CC. This study investigates the therapeutic potential of phloretin in ameliorating cancer cachexia. Methods: Mouse models of CC were established using BALB/c mice implanted with C26 colon carcinoma cells and C57BL/6 mice implanted with Lewis lung carcinoma (LLC) cells. Upon the detection of palpable tumors, phloretin (10 mg/kg) was administered daily via intraperitoneal injection. At the endpoint, hind limb skeletal muscle, inguinal white adipose tissue (iWAT), and hearts were harvested and weighed. Lean body mass was assessed by analyzing the weight of the carcass following the excision of skin, subcutaneous fat, and visceral organs. Gene expression and protein levels in muscle tissues were subsequently quantified. Results: Phloretin administration significantly alleviated tumor-induced loss of tumor-free body weight. It effectively preserved skeletal muscle mass in both C26 and LLC cachexia models, while significantly attenuating adipose tissue depletion in the C26 model. In vitro, phloretin treatment mitigated myotube atrophy induced by C26 conditioned medium. Mechanistically, phloretin inhibited STAT3 activation in skeletal muscle. This inhibition suppressed the expression of the E3 ubiquitin ligases MuRF-1 and Atrogin-1. Furthermore, phloretin concurrently modulated the autophagy pathway. Conclusions: Phloretin effectively ameliorates cancer cachexia-induced muscle wasting by targeting STAT3-mediated protein degradation and autophagy pathways. These findings suggest that phloretin represents a promising therapeutic agent for the clinical management of cancer-associated cachexia. Full article

Background: Obesity represents a major public health challenge worldwide and contributes substantially to the burden of type 2 diabetes and hypertension. While body mass index (BMI) is widely used in clinical practice, indices reflecting central adiposity may provide additional prognostic value. This study aimed to assess the prevalence of general and central obesity in an adult population across different age groups from Stara Zagora, Bulgaria, and to examine their associations with cardiometabolic outcomes and lifestyle factors. Methods: A quasi-representative cross-sectional study was conducted among 3512 adults (mean age 53.7 ± 14.9 years). Anthropometric indices, including BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio were measured. Cardiometabolic outcomes included diabetes, hypertension, and their combined presence. Multicollinearity was assessed using the Variance Inflation Factor (VIF), and the discriminatory ability of indices was evaluated using Receiver Operating Characteristic (ROC) analysis and DeLong’s test. Results: The prevalence of overweight/obesity (BMI ≥25) was 68.4%, while central obesity (WHtR ≥0.5) affected 66.9% of participants. BMI demonstrated the highest discriminatory ability in this dataset for hypertension (AUC = 0.852) and diabetes (AUC = 0.796), significantly outperforming WC and WHR (p < 0.05). However, 24.4% of individuals with normal BMI exhibited high-risk central adiposity. Significant sex-specific differences were observed: short sleep duration (<6 h) was a strong predictor of obesity in women (aOR = 2.98), whereas smoking showed stronger associations in men. Age-stratified analyses revealed that while BMI stabilizes in the oldest age group (75–89 years), WHtR continues to increase, reflecting age-related redistribution of visceral fat. A strong protective effect of physical activity was observed, supported by quasi-complete separation in active subgroups. Conclusions: General and central obesity represent a substantial health burden in this urban population. While BMI remains a robust screening tool, the integration of WHtR enhances the identification of “hidden” cardiometabolic risk particularly in older adults and individuals with normal BMI. Given the quasi-representative nature of the sample, these findings are primarily generalizable to similar urban populations and may inform targeted regional public health strategies. Full article

Obesity represents a major public health crisis in Mexico, affecting over 70% of adults, and although strength training is effective for improving body composition, direct maximal strength testing (1RM) poses risks in this population. Mobile applications have emerged as popular tools for exercise prescription, yet their effectiveness compared to supervised, scientifically-based protocols remains unknown. To compare the effects of a supervised strength training program based on indirect 1RM estimation (S1RM group) versus a mobile application-generated program (App group) on body composition, anthropometric measures, and strength gains in male adults with obesity. Twenty male participants (BMI ≥ 30 kg/m²) were randomly assigned to either the S1RM group or the App group. Both groups trained three times per week for 12 weeks. Body composition (bioelectrical impedance), anthropometric measures (waist and hip circumference), and estimated 1RM were assessed pre- and post-intervention. A mixed repeated-measures ANOVA (Group × Time) was conducted, with effect sizes (${\eta }^2$p) and 95% confidence intervals calculated. Both groups showed significant improvements in most outcomes (p < 0.05). However, significant group × time interactions favored the S1RM group for waist circumference (F(1,18) = 14.50, p = 0.001, ${\eta }^2$p = 0.45) and hip circumference (F(1,18) = 217.90, p < 0.001, ${\eta }^2$p = 0.92). A significant between-group difference was also observed for visceral fat (F(1,18) = 4.91, p = 0.040, ${\eta }^2$p = 0.21). For muscle and fat mass, interactions showed large effect sizes (${\eta }^2$p = 0.18–0.19) with trends toward significance (p = 0.057–0.096). Strength increased significantly in all exercises for the S1RM group (14.9–22.0%, p < 0.01). These findings support the implementation of indirect 1RM estimation methods in obesity populations and highlight the added value of professional supervision in strength training programs. Full article

Background: We previously demonstrated recapitulation of the relative hypogonadotropic hypogonadism of obesity, the Reprometabolic Syndrome (RMS), in women of normal BMI with a one-month high-fat, eucaloric diet (HFD). Objective: Assess effects of HFD on sleep, body composition and lifestyle and metabolic secondary outcomes and correlate insulin sensitivity changes with the RMS. Methods: A total of 18 normally cycling women aged 18–38 with BMI 18–24 kg/m² were enrolled for a four-month study including a eucaloric HFD (48% calories from fat) for one menstrual cycle. Activity, sleep, body composition, and the lipidome were measured in all participants. Fecal microbiome was analyzed in the last nine participants, and insulin sensitivity by two-stage hyperinsulinemic euglycemic clamp was measured before and after HFD in 15 participants. Results: Relative to the pre-diet period, BMI, activity and sleep measures did not change, except for waking after sleep onset (WASO), which appeared to decrease during and post HFD. DXA revealed statistically significant decreases in total percent fat, total fat mass, visceral fat volume, and trunk fat volume. Whole-body insulin sensitivity decreased with the HFD while adipocyte insulin sensitivity was unaffected. Insulin sensitivity changes did not correlate with change in gonadotropins or response to gonadotropin releasing hormone (GnRH). Multiple significant changes in plasma lipids were observed, including increased ceramides and glucosylceramides. Microbiome analysis revealed increased microbial diversity. Conclusions: A one-month eucaloric HFD that induced RMS in normal-weight, reproductive-aged women also induced whole-body insulin resistance (IR) and multiple lipidomics changes potentially associated with IR. These changes in IR occurred despite overall stable activity, BMI and sleep, but did not correlate with the HPO axis defects. The unexpected decrease in body fat and increase in microbial diversity may be related to specific dietary elements of the HFD. Full article

Background: Ectopic fat deposition has been demonstrated to play a critical role in the onset and progression of renal dysfunction. However, research on renal parenchymal fat deposition and its association with renal dysfunction in type 2 diabetes mellitus (T2DM) remains limited, particularly regarding its association with early kidney injury. The present study aimed to further investigate the relationship between renal fat fraction (FF) and biomarkers of kidney injury, thereby providing new evidence for the potential link between intrarenal fat accumulation and early renal impairment in T2DM. Methods: This cross-sectional study enrolled 60 patients with T2DM. Renal FF was quantitatively assessed using magnetic resonance imaging (MRI). Clinical characteristics, body composition parameters, and biochemical indices were collected. Levels of kidney injury biomarkers, including tumor necrosis factor receptors 1 (TNF-R1), tumor necrosis factor receptors 2 (TNF-R2), chitinase-3-like protein 1 (YKL-40), and kidney injury molecule-1 (KIM-1), were measured using enzyme-linked immunosorbent assay (ELISA). To evaluate the correlations between fat distribution and inflammatory biomarkers, Pearson correlation analysis was performed. Furthermore, linear regression analysis was conducted to explore the associations between renal FF and kidney injury biomarkers with adjustments for potential confounders such as smoking status, diabetes duration, and visceral fat. Lasso regression was used to screen variables. Results: The results demonstrated that renal FF was significantly positively correlated with serum YKL-40 (r = 0.3, p = 0.021), TNF-R1 (r = 0.246, p = 0.042), and urinary KIM-1 (r = 0.396, p = 0.004), indicating a close association between renal fat accumulation and early kidney injury biomarkers. In regression analyses adjusted for age, sex, and duration of diabetes, the associations between renal FF and these biomarkers remained significant. After further adjustment for potential confounders, including smoking history, alcohol consumption, hypertension, renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-dependent glucose transporters 2 (SGLT2) inhibitors, glucagon-Like Peptide-1 (GLP-1) receptor agonists, and lipid-lowering drugs, renal FF remained significantly associated with TNF-R1 (β = 0.327, p = 0.015), KIM-1 (β = 0.352, p = 0.021), and YKL-40 (β = 0.275, p = 0.025). Moreover, even after additional adjustment for visceral fat, the associations of renal FF with TNF-R1 and KIM-1 persisted. After using the Benjamini–Hochberg procedure for false discovery rate, the relationship between renal FF and KIM-1 had a significant difference. Variables of age and gender were excluded to build the parsimonious modeling using Lasso regression. It suggested that renal fat accumulation may contribute to kidney injury independently of visceral adiposity. Conclusions: The study systematically demonstrates a significant association between renal FF and early biomarkers of kidney injury in T2DM, which may suggest the potential role of renal fat accumulation in the pathogenesis of diabetic nephropathy. These findings provide clinical data support for the development of a fat-targeted intervention study. Future research should further elucidate the long-term mechanistic role of renal FF in diabetic nephropathy, as well as its potential value in early diagnosis and therapeutic applications. Full article

Background/Objectives: this study evaluated the effects of a 12-week multicomponent training (MCT) program combined with multiprofessional interventions (nutritional and psychoeducational) on body composition, lipid profiles, fasting glucose levels, and arterial stiffness in Brazilian older women stratified by nutritional status. Methods: thirty-six older women, who were classified as normal weight (n = 8; mean age: 69.2 ± 7.2 years), overweight (n = 13; mean age: 72.1 ± 5.3 years), or obese (n = 15; mean age: 70.3 ± 4.6 years), were included in the study. The outcomes included body fat percentage (BFP), visceral fat level, fat-free mass (FFM), fasting glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and arterial stiffness, as determined by pulse wave velocity (PWV). Results: BFP was reduced in all groups (p < 0.001), but in the overweight and obese groups, these decreases were greater. Visceral fat level decreased significantly in all groups (p < 0.001), with greater decreases in the obese group compared with the normal weight and overweight groups (p < 0.001), and greater reductions in the normal weight group compared to the overweight group (p < 0.05). A significant reduction in PWV was observed only in the overweight group (p < 0.05), while greater improvements were observed in the overweight group compared to the normal weight group (p < 0.05) in FFM, lipid profiles, and fasting glucose. Conclusions: an MCT combined with multiprofessional intervention effectively reduced BFP and arterial stiffness in Brazilian older women with excess adiposity. Full article

Background: Overweight and obesity are major health problems of the 21st century. As a significant risk factor for numerous noncommunicable diseases, obesity is also strongly associated with the development of abdominal hernias, which significantly impair patients’ quality of life. The review focuses on the pathophysiological mechanisms linking obesity to hernias and the impact of key prehabilitation components. Available research indicates a complex interrelationship between obesity and the development of ventral hernias, driven by pathophysiological mechanisms such as increased intra-abdominal pressure and chronic inflammation, which weakens the collagen matrix of the abdominal wall. Furthermore, both smoking and alcohol consumption significantly increase the risk of abdominal obesity and surgical complications; in turn, physical activity is crucial for reducing visceral fat. Psychological support may reduce pre-operative stress and contribute to improved outcomes. Nutritional intervention and weight loss are other essential components of preoperative management for ventral hernia repair. This review aims to highlight the role of prehabilitation in ventral hernia surgery in obese patients and to propose a structured, evidence-based algorithm (DEPP) for this high-risk population. The algorithm includes: Dietary intervention (D), Elimination of smoking and alcohol consumption (E), Physical activity (P), and Psychological support (P). The algorithm was developed to systematize the clinical approach and determine the steps to be taken in the treatment of patients with obesity and abdominal hernia. Methodology: A literature search was conducted across PubMed, Scopus, and Google Scholar databases for articles published between 2002 and 2026. We included randomized controlled trials, prospective/retrospective cohort studies, systematic reviews, and meta-analyses. Conclusions: Prehabilitation is a multifaceted strategy for optimizing the health of patients with obesity prior to abdominal hernia repair. The proposed prehabilitation algorithm, known as DEPP, is a preliminary approach for managing this group of patients. Full article

Background: Normal-weight obesity (NWO) is a nutritional status in which individuals have a normal body mass index (BMI) with a high percentage of body fat (%BF). However, the impact of elevated %BF on cardiometabolic risk remains unclear. This study aimed to evaluate whether NWO is associated with worse cardiometabolic risk markers and scores. Methods: We conducted a cross-sectional study using a convenience sample of employees from a public hospital. Participants aged ≥18 years with a BMI between 18.5–24.9 kg/m² were included in the study. %BF was categorized according to sex and age (InBody720). Normal weight and normal %BF (NWNB) and NWO were defined using cutoff points. Body composition, serum biochemical and inflammatory markers, hemodynamics, and autonomic function were considered cardiometabolic risk markers. The visceral fat area (VFA), atherogenic coefficient (AC), atherogenic index of plasma (AIP), body shape index (ABSI), and Framingham Risk (FR) score were considered cardiometabolic risk scores. Statistical significance was set at p < 0.05. Results: Of the 228 eligible participants, 52 met the inclusion criteria (NWNB, N = 29 and NWO, N = 23). Participants with NWO presented worse values of lipid profiles, anthropometric measurements, hemodynamic parameters, and autonomic function indices. After adjustment for age and sex, NWO remained associated with selected cardiometabolic markers, particularly LDL-c, triglycerides, and autonomic indices, whereas body composition findings should be interpreted as confirmatory of the phenotype. Conclusions: In this cross-sectional secondary analysis, NWO was associated with worse cardiometabolic markers and selected risk scores compared with NWNB. These findings support an unfavorable cardiometabolic profile in individuals with NWO, but do not allow inferences about future cardiometabolic events or causal relationships. Longitudinal studies are needed to clarify its prognostic significance. Full article

Objective: Village Health Volunteers (VHVs) are vital to Thailand’s primary healthcare, yet many face high risks for non-communicable diseases (NCDs). This preliminary study aimed to implement health empowerment theory-based personalized health promotion for individuals in the NCD-risk group. Methods: The preliminary mixed-methods study implemented a 6-month empowerment-based health promotion program for 21 VHV leaders (mean age 62.43 ± 7.28 years) at risk for NCDs. The intervention integrated laboratory data, behavioral and qualitative focus-group insights, and quantitative anthropometric data obtained via bioelectrical impedance analysis (BIA). Results: Participants’ exercise adequacy significantly improved after the intervention, increasing from 8.3% to 61.9% (p = 0.03). BIA revealed a physiological shift toward improved energy homeostasis, including decreased body weight, reduced visceral fat area, and increased muscle hydration. While biochemical markers did not reach statistical significance, clinically favorable downward trends were observed in median HbA1c (8.0% to 7.3%) and LDL cholesterol (141.8 to 119.0 mg/dL), alongside stable renal and liver function. Qualitative thematic analysis identified four primary domains of impact: sustainability and systemic advocacy, personal transformation, broad competence acquisition, and enhanced social capital. Participants reported a marked increase in self-efficacy, transitioning from inactive beneficiaries to active health advocates. This change was largely driven by mastery experiences, such as visible improvements in body composition and functional health literacy. Conclusions: The empowerment program significantly improved physical activity and body composition while fostering the social capital and health literacy necessary for community leadership, suggesting that personal health mastery is a critical precursor to effective systemic advocacy and long-term sustainability in community-led health programs. Full article

Background/Objectives: Metabolic syndrome (MS) is associated with an increased cardiovascular risk. The aim of this study was to reveal the effects of Chaenomeles japonica fruit juice (CJFJ) on energy balance and biochemical and histological parameters in rats with diet-induced MS. Methods: Fifty Wistar rats were allocated into five groups. For ten weeks, the Control group received a standard laboratory diet and tap water, while the other groups were given a high-fat high-fructose (HFHF) diet. The Control and MS groups were treated with distilled water, while the other three groups were treated with CJFJ at increasing doses. Results: Rats on an HFHF diet consumed less food and more liquids and had a higher caloric intake than the Control group. Among the CJFJ-treated animals, an increased food consumption, as well as an increased total caloric intake, and no difference in body weight gain were observed in comparison with the MS group. CJFJ did not affect glucose tolerance or the triglyceride and total cholesterol levels. CJFJ prevented an HFHF-induced decrease in superoxide dismutase and caused a decrease in thiobarbituric acid-reactive substances in serum. The medium CJFJ dose prevented an HFHF-induced increase in adipose tissue indices. Liver and adipose tissue histology revealed a protective effect of CJFJ. Conclusions: CJFJ may exert beneficial effects on visceral adiposity, oxidative status, and histopathological changes in the liver and adipose tissue in rats with diet-induced MS. Full article

Background/Objectives: Non-alcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder for which there are limited pharmacotherapies. Sodium rutin (NaR), a soluble flavonoid derivative, has shown beneficial metabolic effects, but its role in NAFLD remains unclear. This study investigates whether NaR ameliorates high-fat diet (HFD)-induced NAFLD and insulin resistance through promoting hepatic lipophagy. Methods: Male mice aged 8 weeks old were fed a HFD for 12 weeks with/without NaR supplementation. Body weight was measured every week. After 12 weeks of treatment, GTT and ITT were performed to assess insulin resistance. Then, the tissues were collected and hepatic histology, serum biochemistry, and markers of autophagy and senescence were assessed. Results: NaR treatment significantly attenuated HFD-induced weight gain, reduced visceral fat and liver weights, and ameliorated hepatic steatosis and vacuolization. NaR improved serum lipid profiles; lowered alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels; and reduced hepatic cellular senescence. NaR enhanced hepatic autophagy, evidenced by decreased p62 levels, increased LC3-II/LC3-I ratio, and enhanced colocalization of lipid droplets with LC3 and LAMP1 in vivo and in vitro. These changes were accompanied by improved glucose tolerance and insulin sensitivity. Conclusions: NaR effectively alleviates HFD-induced NAFLD and insulin resistance by activating hepatic lipophagy. These findings support NaR as a promising multi-targeted therapeutic candidate for NAFLD. Full article

Background: Recent research has highlighted the potential of postbiotics for addressing obesity and associated metabolic disorders. In this randomized, double-blind clinical trial, the efficacy of a postbiotic product in managing overweight and associated parameters was assessed. Methods: Sixty individuals were randomized into two groups: one group (n = 30) received the Postbiotic (heat-killed L. fermentum strain K8-Lb1) and the other (n = 30) a Placebo control. Body weight, waist circumference, body composition, vital signs, blood biomarkers and questionnaires for quality of life, eating behavior, eating control and gastrointestinal symptoms were assessed. Results: After a 12-week intervention, body fat mass (primary parameter) was significantly (p = 0.016) reduced in the Postbiotic group (98.15 ± 3.32% of baseline) compared to the Placebo group (100.41 ± 3.39%). In line with this, body weight (p = 0.047) and waist circumference (p = 0.034) were significantly reduced and visceral fat tended to be reduced (p = 0.053). Accordingly, the Postbiotic group tended (p = 0.066) to feel more in control of their body weight. Despite weight loss, muscle mass tended (p = 0.062) to increase. ALT, AST and GGT tended to be reduced, which may indicate an improvement in liver steatosis. Estimated average glucose (eAG) differed significantly between the groups in individuals with normal fasting glucose levels. The ability to concentrate significantly (p = 0.014) improved. Conclusions: Under an ad libitum diet, the postbiotic L. fermentum strain K8-Lb1 reduced body fat mass, body weight, and waist circumference, improved the ability to concentrate, and showed a trend towards an increase in muscle mass. The results of this pilot trial need confirmation by a pivotal trial. Full article

Background/Objectives: Young women with breast cancer (aged ≤ 40 years) have distinct prognostic characteristics, yet little is known about how modifiable body composition factors influence outcomes in this age group. This study examined whether CT-derived body composition measures could identify thresholds that predict overall survival (OS). Methods: This was a single-center, 10-year, matched case–control study nested within a cohort, utilizing retrospectively collected data. Using an institutional database (2009–2018) and the initial cohort of 112 patients, we performed a subset analysis of patients with stage I–III breast cancer at diagnosis who had available pretreatment CT scans to estimate associations with body composition metrics and OS. The final analytic dataset included 89 individuals (49 survivors and 40 deceased). CT scans at the L3 level were analyzed using Slice-O-Matic software to quantify visceral (VAT), subcutaneous (SAT), intermuscular (IMAT), total adipose tissue (TAT), skeletal muscle density (SMD), skeletal muscle gauge (SMG), and skeletal muscle index (SMI). Cox proportional hazard models determined optimal cutpoints for OS. Multivariable models included adjustments for disease stage and hormone receptor status. Results: The median age was 35 (IQR, 32–38); 47% were White and 37% were Black. The majority (78%) were not Hispanic or Latina. Most (67%) were overweight/obese. Specific thresholds for IMAT index (>2.57), VAT (>31.38), and SMG (<2419.89) were associated with worse survival (all p < 0.05), while no cutpoints were identified for other variables. Conclusions: These findings show that muscle fat infiltration and reduced muscle quality have important prognostic value in young women with breast cancer. Exploratory cutpoints derived from routine staging CT scans may help inform risk stratification and generate hypotheses for targeted nutritional or exercise interventions, but require validation in larger, independent cohorts before clinical application. Full article