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. 2023 Sep;12(5):630-638.
doi: 10.1016/j.jshs.2021.06.003. Epub 2021 Jun 18.

Exploring overweight and obesity beyond body mass index: A body composition analysis in people with and without patellofemoral pain

Amanda Schenatto Ferreira  1 , Benjamin F Mentiplay  2 , Bianca Taborda  3 , Marcella Ferraz Pazzinatto  2 , Fábio Mícolis de Azevedo  3 , Danilo De Oliveira Silva  2
Affiliations

Exploring overweight and obesity beyond body mass index: A body composition analysis in people with and without patellofemoral pain

Amanda Schenatto Ferreira et al. J Sport Health Sci. 2023 Sep.

Abstract

Background: We compared body mass index (BMI), body fat, and skeletal muscle mass between (1) a mixed-sex nonathletic cohort of people with patellofemoral pain (PFP) and pain-free people, and (2) a nonathletic cohort of people with PFP and pain-free people subgrouped by sex (i.e., men and women with PFP vs. pain-free men and women).

Methods: This cross-sectional study included 114 people with PFP (71 women, 43 men) and 54 pain-free controls (32 women, 22 men). All participants attended a single testing session to assess body composition measures, which included BMI, percentage of body fat (%BFBioimpedance), and skeletal muscle mass (both assessed by bioelectrical impedance analysis), and percentage of body fat (%BFSkinfold) (assessed by skinfold caliper analysis). A one-way univariate analysis of covariance (age and physical activity levels as covariates) was used to compare body composition measures between groups (i.e., PFP vs. pain-free group; women with PFP vs. pain-free women; men with PFP vs. pain-free men).

Results: Women with PFP presented significantly higher BMI, %BFBioimpedance, and %BFSkinfold, and lower skeletal muscle mass compared to pain-free women (p ≤ 0.04; effect size : ‒0.47 to 0.85). Men with PFP and men and women combined had no differences in BMI, %BFBioimpedance, %BFSkinfold, and skeletal muscle mass compared to their respective pain-free groups (p > 0.05).

Conclusion: Our findings indicate that BMI and body composition measures should be considered as part of the evaluation and management of people with PFP, especially in women, who have demonstrated higher BMI and body fat and lower skeletal muscle mass compared to pain-free controls. Future studies should not assess body composition measures in a mixed-sex population without distinguishing men participants from women participants.

Keywords: Body composition; Body mass index; Patellofemoral pain syndrome; Skinfold thickness.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Image, graphical abstract
Graphical abstract
Fig 1
Fig. 1
Effect sizes for all participants (PFP vs. pain-free), women (women with PFP vs. pain-free women), and men (men with PFP vs. pain-free men) for body composition measures. Non-normally distributed variables were log-transformed. (All participants: log BMI, log skeletal muscle mass measured by bioimpedance analysis, log %BFSkinfold. Women: log BMI. Men: log BMI, log %BFBioimpedance). %BFBioimpedance = percentage of body fat measured by bioimpedance analysis; %BFSkinfold = percentage of body fat measured by skinfold caliper; BMI = body mass index; PFP = patellofemoral pain.
Fig 2
Fig. 2
Proposed hypothetical vicious cycle of pain leading to reduced physical activity levels, leading to worsening of psychological factors, leading to obesity in nonathletic people with patellofemoral pain.
See this image and copyright information in PMC

References

    1. NCD Risk Factor Collaboration (NCD-RisC) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet. 2017;390:2627–2642. - PMC - PubMed
    1. World Health Organization (WHO). Fact sheets: Obesity and overweight. 2020. https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight. [accessed 24.02.2021].
    1. Abdullah A, Stoelwinder J, Shortreed S, et al. The duration of obesity and the risk of type 2 diabetes. Public Health Nutr. 2011;14:119–126. - PubMed
    1. Wilson PW, D'Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: The Framingham experience. Arch Intern Med. 2002;162:1867–1872. - PubMed
    1. Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis: The Framingham Study. Ann Intern Med. 1988;109:18–24. - PubMed

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