Tri-ponderal mass index (TMI) and fat mass index (FMI) have been proposed as alternative approaches for assessing body fat since BMI does not ensure an accurate screening for obesity and overweight status in children and adolescents. This study proposes thresholds of the TMI and FMI for the prediction of metabolic syndrome (MetS) in children and young people. For this purpose, a cross-sectional study was conducted on 4673 participants (57.1% females), who were 9–25 years of age. As part of the study, measurements of the subjects’ weight, waist circumference, serum lipid indices, blood pressure and fasting plasma glucose were taken. Body composition was measured by bioelectrical impedance analysis (BIA). The TMI and FMI were calculated as weight (kg)/height (m³) and fat mass (kg)/height (m³), respectively. Following the International Diabetes Federation (IDF) definition, MetS is defined as including three or more metabolic abnormalities. Cohort-specific thresholds were established to identify Colombian children and young people at high risk of MetS. The thresholds were applied to the following groups: (i) a cohort of children where the girls’ TMI ≥ 12.13 kg/m³ and the boys’ TMI ≥ 12.10 kg/m³; (ii) a cohort of adolescents where the girls’ TMI ≥ 12.48 kg/m³ and the boys’ TMI ≥ 11.19 kg/m³; (iii) a cohort of young adults where the women’s TMI ≥ 13.21 kg/m³ and the men’s TMI ≥ 12.19 kg/m³. The FMI reference cut-off values used for the different groups were as follows: (i) a cohort of children where the girls’ FMI ≥ 2.59 fat mass/m³ and the boys’ FMI ≥ 1.98 fat mass/m³; (ii) a cohort of adolescents where the girls’ FMI ≥ 3.12 fat mass/m³ and the boys’ FMI ≥ 1.46 fat mass/m³; (iii) a cohort of adults where the women’s FMI ≥ 3.27 kg/m³ and the men’s FMI ≥ 1.65 kg/m³. Our results showed that the FMI and TMI had a moderate discriminatory power to detect MetS in Colombian children, adolescents, and young adults.

Fat-to-muscle ratio has been proposed as an alternative approach for assessing body fat. The objective of this study was to explore fat-to-muscle ratio thresholds in metabolic syndrome (MetS) diagnosis; it was hypothesised that the fat-to-muscle ratio is a good predictive indicator of MetS in a large population of young Colombian adults. For this purpose, a cross-sectional study was conducted on 1416 subjects (66.6% female), aged from 18.1 to 25.1. As part of the study, measurements of the subjects’ anthropometric indicators, serum lipid indices, blood pressure, and fasting plasma glucose were taken. Body composition was measured through bioelectrical impedance analysis (BIA). A new variable (ratio of fat mass to muscle mass, in kg) was calculated. Following the International Diabetes Federation (IDF) definition, MetS includes three or more metabolic abnormalities. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of the fat-to-muscle ratio to predict MetS. According to the IDF, the best fat-to-muscle ratio cut-off point for detecting MetS in men was 0.225 kg, with an area under the curve (AUC) of 0.83, sensitivity of 80%, and specificity of 70%. For women, the fat-to-muscle ratio cut-off point was 0.495 kg, the AUC was 0.88, and the sensitivity and specificity were 82% and 80%, respectively. In conclusion, our results showed that the fat-to-muscle ratio cut-off points from ROC analyses demonstrate good discriminatory power for detecting MetS in young Colombian adults.

Objective: since childhood and adolescence are critical periods for the acquisition of eating habits and lifestyles that will persist into adulthood, having a questionnaire that estimates adherence to the Mediterranean diet among the school-age population is necessary. The aim of this study was to assess the validity, reliability, and factor structure of the KIDMED questionnaire in a group of children and adolescents from Cali, Colombia. Methods: this was a cross-sectional study using a self-reported questionnaire in 167 schoolchildren (53.8% girls, mean age 13.3 ± 3.2 years). Cronbach's alpha and Cohen's kappa (κ) were calculated as reliability and reproducibility indicators. The extraction of main components by varimax rotation allowed to define the communalities of the proposed items as a measure of validity. Results: overall, one in every 3 schoolchildren showed an optimal Mediterranean diet pattern. The KIDMED questionnaire showed moderate reliability and reproducibility values (Cronbach's alpha = 0.79, 95% CI: 0.71-0.77, and κ = 0.66, 95% CI: 0.45-0.77). The factor structure showed six factors that accounted for 60.6% of the total variance with an adequate goodness-of-fit test (Kaiser-Meyer-Olkin = 0.730), and Bartlett's sphericity test (X2 = 414.8, p < 0.001, g/l = 120). Conclusions: the KIDMED questionnaire shown evidence adequate psychometric properties as an instrument for assessing adherence for assessing adherence to the Mediterranean diet in schoolchildren in Colombia. Future studies should focus on investigating the confirmatory structure and/or convergent validity of the questionnaire in different age groups for generating comparable data.

No prior studies have examined the reliability properties of the 16-item Mediterranean Diet Quality Index (KIDMED) questionnaire among young adults from a non-Mediterranean country. The objective of this study was to determine the psychometric properties in terms of the reliability and validity of the KIDMED questionnaire in young adults from Colombia. A cross-sectional validation study was conducted among 604 Colombian college students (47.51% men and 52.48% women; mean age of 21.60 ± 2.02 years). Kappa statistics were used to assess the reliability of the KIDMED questionnaire. A categorical principal components analysis was used to determine validity. Based on the KIDMED score, 58.4% of students had a good adherence to the Mediterranean diet (MedDiet). Good agreement in the general score of the questionnaire was observed (κ = 0.727, 95% confidence interval = 0.676 to 0.778, p < 0.001). A five-factor model was identified which explained almost 51.38% of the variability, showing the multidimensionality of the questionnaire. In conclusion, this study provides reasonable evidence for the reliability and validity of the KIDMED questionnaire for assessing adherence to MedDiet in college students within a Latin American country. The evaluation of the psychometric properties of this tool in early adulthood and in a non-Mediterranean country will be useful in clinical practice and epidemiological research, since practitioners and health researchers now have a valid and reliable short scale.

The aim of the study was to investigate the combined association of adherence to a Mediterranean diet (MedDiet) and muscular fitness (MF) with cardiometabolic health in collegiate students. The present cross-sectional analysis consisted of 1248 (714 females) healthy collegiate students (20.1 ± 2.7 years old). Adherence to a MedDiet was assessed by a KIDMED (Mediterranean Diet Quality Index) questionnaire. Standing broad jump, standing vertical jump, and isometric handgrip dynamometry were used as indicators of MF. The cardiometabolic profile was assessed using the following components: triglycerides, blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, glucose, and waist circumference. Analysis of covariance shows a significant difference in the cardiometabolic profile of both genders between the high MF/low MedDiet and high MF/optimal MedDiet groups, and the low MF/low MedDiet and low MF/optimal MedDiet groups (p < 0.001). No difference was found on cardiometabolic profile between high MF/optimal MedDiet and high MF/low MedDiet, both in males and females. Additionally, logistic regression shows that both female (odds ratio (OR) = 2.01; 95% confidence interval (CI): (1.8–3.7); p = 0.02) and male (OR = 3.38; 95% CI: (1.9–5.8); p < 0.001) participants in the optimal MedDiet/high MF group had the highest odds of expressing a healthier cardiometabolic profile as compared to those in the low MF/low MedDiet group. In conclusion, a combination of high MF levels and optimal adherence to a MedDiet is associated with a healthier cardiometabolic profile; however, high MF levels seem to circumvent the deleterious effects of having a low adherence to a MedDiet.

This study investigated the associations of muscular fitness and various indicators of body fatness with cardio-metabolic risk factors and determined the muscular strength and body fatness thresholds for detecting a high risk of cardio-metabolic dysfunction in young adults. A cross-sectional study was conducted on 1798 collegiate students (61.5% females, mean age 20.5 years). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). Body mass index (BMI), waist circumference (WC), percentage of fat mass (BF%), fat-mass index (FMI), and waist-to-height ratio (WHR) were also included as body fatness measurements. A high cardio-metabolic risk cluster was derived by assessing triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, fasting glucose, and blood pressure. Logistic regression models showed that men and women with lower NGS had an increased cardio-metabolic risk odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.1 to 2.9, p = 0.006, and OR = 1.6, 95% CI 1.0 to 2.5, p = 0.036, respectively). In both sexes, higher levels of all fatness parameters were also associated with increased cardio-metabolic risk (p < 0.001). In both men and women, high FMI had the highest OR for clustered risk (OR = 4.7, 95% CI 2.6 to 8.4, and OR = 7.3, 95% CI 3.4 to 9.7, p < 0.001, respectively). Combined analysis showed that unfitness (lower NGS) and high fat had the highest OR for WC and FMI in men and women, respectively (OR = 5.5, 95% CI 2.6 to 11.4, OR = 7.7, 95% CI 2.3 to 15.8, p < 0.01). Muscular strength and body fatness are independently and jointly associated with increased cardiometabolic risk in young adults, which suggests that both are predictor variables for this.