***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Muscle mass decreases with age , leading to " sarcopenia , " or low relative muscle mass , in elderly people . Sarcopenia is believed to be associated with metabolic , physiologic , and functional impairments and disability . Methods of estimating the prevalence of sarcopenia and its associated risks in elderly population s are lacking . Data from a  population -based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico ( the New Mexico Elder Health Survey , 1993 - 1995 ) were analyzed to develop a method for estimating the prevalence of sarcopenia . An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a r and om sub sample ( n = 199 ) of participants and was extended to the total sample . Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 ( m2 ) being less than two st and ard deviations below the mean of a young reference group . Prevalences increased from 13 - 24 % in persons under 70 years of age to > 50 % in persons over 80 years of age , and were slightly greater in Hispanics than in non-Hispanic whites . Sarcopenia was significantly associated with self-reported physical disability in both men and women , independent of ethnicity , age , morbidity , obesity , income , and health behaviors . This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia BACKGROUND Cancer cachexia-associated weight loss is poorly understood ; energetically dem and ing tissues ( eg , organ and tumor mass ) and resting energy expenditure ( REE ) are reported to increase with advanced cancer . OBJECTIVE The objective was to quantify the potential contribution of increasing masses of energetically dem and ing tissues to REE with colorectal cancer cachexia progression . DESIGN A longitudinal computed tomography ( CT ) image review was performed to quantify organ size ( liver , including metastases , and spleen ) and peripheral tissues ( skeletal muscle and adipose tissue ) during colorectal cancer cachexia progression ( n = 34 ) . Body composition was prospect ively evaluated by CT and dual-energy X-ray absorptiometry , and REE was determined by indirect calorimetry in advanced colorectal cancer patients ( n = 18 ) . RESULTS Eleven months from death , the liver ( 2.3 + /- 0.7 kg ) and spleen ( 0.32 + /- 0.2 kg ) were larger than reference values . One month from death , liver weight increased to 3.0 + /- 1.5 kg ( P = 0.010 ) , spleen showed a trend to increase ( P = 0.077 ) , and concurrent losses of muscle ( 4.2 kg ) and fat ( 3.5 kg ) ( P < 0.05 ) were observed . The estimated percentage of fat-free mass ( FFM ) occupied by the liver increased from 4.5 % to 7.0 % ( P < 0.001 ) . The most rapid loss of peripheral tissues and liver and metastases gain occurred within 3 mo of death . A positive linear relation existed between liver mass and measured whole-body REE ( r(2 ) = 0.35 , P = 0.010 ) ; because liver accounted for a larger percentage of FFM , measured REE . kg FFM(-1 ) . d(-1 ) increased ( r(2 ) = 0.35 , P = 0.010 ) . CONCLUSIONS Increases in mass and in the proportion of high metabolic rate tissues , including liver and tumor , represented a cumulative incremental REE of approximately 17,700 kcal during the last 3 mo of life and may contribute substantially to cachexia-associated weight loss BACKGROUND The association between body mass index as a measure of obesity and rectal cancer outcomes has been inconsistent . Radiologic measures of visceral adiposity using CT scans have not been well characterized among rectal cancer patients . The objective of this study was to examine quantitative radiologic measures of visceral obesity compared with body mass index in predicting patient outcomes among patients undergoing neoadjuvant chemoradiation and resection for locally advanced rectal cancers . STUDY DESIGN We identified 99 rectal adenocarcinoma patients treated with neoadjuvant chemoradiation and surgical resection .  Visceral and subcutaneous fat areas , as well as perinephric fat thickness ( PNF ) , were recorded and categorized as obese ( body mass index ≥30 , visceral fat area to subcutaneous fat area ratio [ V/S ] ≥0.4 , or median PNF ) . The Kaplan-Meier method , log-rank test , and Cox proportional hazards models evaluated overall and disease-free survival differences by adiposity . RESULTS Viscerally obese rectal cancer patients ( V/S > 0.4 or PNF ) were more likely to be older , male , and have pre-existing obesity-related conditions ( eg , diabetes , hypertension , and /or hypercholesterolemia ) . Elevated V/S or PNF was associated with shorter disease-free survival ( p = 0.02 ) or overall survival time ( p = 0.047 ) , respectively . Among patients with well to moderately differentiated tumors , visceral obesity was associated with poorer disease-free survival ( V/S > 0.4 : adjusted hazard ratio = 5.0 ; 95 % CI , 1.2 - 22.0 ) . CONCLUSIONS Visceral fat area to subcutaneous fat area ratio and PNF were strongly associated with key preoperative metabolic comorbidities , and body mass index was not . Findings suggests that elevated visceral adiposity was associated with an increased risk of recurrence , which was most evident among patients with well to moderately differentiated tumors and those with incomplete response to neoadjuvant chemoradiation treatment . Quantitative measures of visceral adiposity warrant large-scale prospect i ve evaluation BACKGROUND Bioelectrical impedance analysis would be a more practical tool to measure body composition in clinical setting s , dietetic practice and epidemiological studies if patients /subjects did not have to fast before measurements . The present study assessed whether the ingestion of food or drink had any biologically significant effect on bioimpedance measurements and body composition by the foot-to-foot method . METHODS Fifty-five healthy adults [ 30 males and 25 females ; mean ( SD ) age 27.7 ( 7.1 ) years ; mean (SD)body mass index 24 ( 3.8 ) kg m(-2 ) ] were r and omly assigned to a 2-day food trial ( high-fat meal or high-carbohydrate meal ) or a 2-day drink trial ( water or high electrolyte drink ) .  Body composition measurements were carried out in the fasting state , immediately after meal consumption and every 30 min for 2 h by the foot-to-foot single frequency bioimpedance technique . RESULTS Bioimpedance increased significantly after the ingestion of food and fluid , although the changes were small . The electrolyte drink , high-fat and high-carbohydrate meals significantly increased the percentage body fat and fat mass . In all cases , the median percentage changes from baseline were approximately 1 % in body fat percentage units . CONCLUSIONS Although there were statistically significant changes in body composition estimates after food or drink consumption , these were small and within the imprecision of the impedance technique , and so are unlikely to be of clinical significance . The present study suggests that impedance measures of body fatness in clinical setting s do not require strict adherence to fasting , and this should increase the opportunities for clinical application BACKGROUND & AIMS Extensive loss of adipose tissue is a key feature of cancer cachexia . Advanced cancer patients also exhibit low plasma phospholipids . It is not known whether these processes coincide across the cancer trajectory nor has their relationship with survival been defined . Changes in adipose tissue mass and plasma phospholipids were characterized within 500days prior to death and prognostic significance assessed . METHODS Adipose tissue rate of change was determined in a retrospective cohort of patients who died of colorectal and lung cancers ( n=108 ) and who underwent > 2 computed tomography scans in the last 500days of life .  Plasma phospholipid fatty acids  were measured prospect ively in a similar cohort of patients with metastatic cancer ( n=72 ) . RESULTS Accelerated loss of adipose tissue begins at 7months from death reaching an average loss of 29 % of total AT 2months from death . Plasma phospholipid fatty acids were 35 % lower in patients closest to death versus those surviving > 8months . Losses of phospholipid fatty acids and adipose tissue occur in t and em and are predictive of survival . CONCLUSIONS Depletion of plasma phospholipids likely indicates a deficit of essential fatty acids in the periphery which may contribute to loss of adipose tissue BACKGROUND AND AIM Obesity as a risk factor for colorectal neoplasm ( CRN ) is controversial . In the present study , we evaluated visceral obesity as a risk factor for CRN . METHODS We prospect ively enrolled 200 consecutive , asymptomatic adults ( male : female = 133:67 , mean age , 50.9 + /- 8.5 years ) undergoing both colonoscopy and abdominopelvic computed tomography ( CT ) scan for routine health evaluations . The presence or absence and the characteristics of CRN were determined during colonoscopy . The amount of  visceral adipose tissue ( VAT ) and subcutaneous adipose tissue was measured by an abdominopelvic CT scan .  Body mass index , waist circumference , and percentage of body fat were measured . Blood pressure and other blood markers for assessing the metabolic syndrome were also investigated . RESULTS Of the 200 patients , 53 ( 26.5 % ) had CRN . Old age , smoking , metabolic syndrome , and a high fasting plasma glucose level were associated with an increased risk of CRN . VAT ( P < 0.01 ) and waist circumference ( P = 0.01 ) were significantly higher in those with CRN . A multivariate analysis of the risks of CRN showed an odds ratio of 4.07 ( 95 % confidence interval : 1.01 - 16.43 , P = 0.03 ) for those with VAT over 136.61 cm(2 ) relative to those with VAT under 67.23 cm(2 ) . Waist circumference , metabolic syndrome , and fasting plasma glucose levels were not independent risk factors for CRN in the multivariate analysis . CONCLUSION Increased VAT is an independent risk factor for CRN . Further large scale studies are needed to clarify the causal relationship between VAT and CRN 
    Output:
    
CT scans can identify reduced muscle mass and predict negative cancer outcomes in people with abdominal malignancies , where traditional methods of assessment are less effective