HOBO: HOrmonal disbalances impacting BOdy composition in women living with obesity A preparatory scoping review and pilot validation study

Research Line: Living with Disease / Seed Call: i4PH April 2024

Body composition plays a crucial role in the health outcomes of individuals living with diseases, particularly obesity. However, accurately monitoring body composition, especially in patients with obesity, poses significant challenges.

Traditional methods such as DEXA, MRI, and CT imaging are accurate but impractical for routine clinical use due to cost and radiation exposure. Bio Impedance Analysis (BIA) offers a more accessible alternative but lacks accuracy, especially in individuals with disturbed water balance. The complexity is further compounded in women due to reproduction-related hormonal fluctuations. This project aims to address these challenges by developing more accurate measures of body composition at the individual level, incorporating hormonal fluctuations, and paving the way for home monitoring of body composition and hormonal imbalances.

Objectives and Route to Impact

The primary objective of this project is to enhance the long-term health outcomes of patients with obesity by improving the accuracy of body composition measurements and incorporating hormonal fluctuations. The project aims to achieve this by addressing the following research questions:

1. What is the validity of using raw BIA data, specifically the phase angle, compared to DEXA data and blood parameters?
2. How do hormonal fluctuations impact body composition measurements among women with obesity?
3. Can novel techniques such as Terahertz and/or photonics improve measures of body composition by providing a correction factor for fluid balance and hormonal fluctuations?

In the long term, spin-offs of this project are expected to contribute to a change in standard body composition practices, making researchers and clinicians more aware of hormonal factors influencing measurements. This will lead to personalised and timely lifestyle interventions to maintain adequate fat-free mass levels and achieve hormonal balance, thereby preventing recurrent weight gain and improving overall health.

Methods

To address the research questions, the project will employ three complementary approaches:

• Literature review: A comprehensive review of existing knowledge, challenges, and opportunities for measuring body composition and hormonal fluctuations in patients living with obesity.
• Interviews: Conducting interviews with patients to understand their needs and preferences regarding body composition measurements and hormone levels to motivate them toward healthier lifestyles.
• Validation study: A study involving women living with obesity to assess the added value of incorporating blood markers and hormonal levels.

Deliverables

The project outcomes, expected by the end of 2024, will provide preliminary evidence for more accurate measurements of body composition, considering hormonal fluctuations in women living with obesity.

Contribution to cross-EWUU collaboration

The project benefits from a collaborative effort between various partners, including patients, researchers, and clinicians. Partners bring expertise in fields such as obesity treatment, Terahertz, and photonics technology, body composition measurement, and lifestyle factors. Together, they form a robust network capable of addressing the complex challenges associated with obesity and contributing to the long-term health improvement of women living with obesity.

Team

• Dr. ir. Agnes Berendsen – WUR Human Nutrition & Health, Nutrition and Disease
• Min Wan, PhD – TU/e Biochemical engineering
• Janneke van Meel – UMCU Division of Internal Medicine and Dermatology
  Department of Dietetics
• Prof. Oscar Franco – UMCU MD Department of Global Public Health and Bioethics
• Dr. Marilyne Menassa – UMCU Department of Global Public Health and Bioethics

Clinical Partners

• Dr. Arianne van Bon – Rijnstate Hospital – Endocrinology
• Dr. Ineke Krabbendam – Hospital Gelderse Vallei Gynaecology