270 body composition analyzer

Weight, BMI, and body fat percentage were measured using an Inbody-270 Body Composition Analyzer (Inbody, Seoul, Republic of Korea) before and after the program. A stadiometer was used to measure height. All participants’ waist and hip circumferences were measured, and the waist-to-hip ratio (WHR) was calculated. Blood pressure was measured using a HEM-7121 (Omron, Kyoto, Japan) blood pressure monitor before and after the program.
We also measured the exercise stress scores of the participants before and after the program. The exercise stress score was calculated using exercise intensity in the Karvonen scale. The chair test was used to measure exercise stress. The participants repeatedly sat and stood up from the chair 100 times for 5 min, and the maximum heart rate (HR) during the test was recorded. According to the equation below, the lower the score, the better the physical ability.
$$\mathrm{Exercise}\mathrm{stress}\mathrm{score}=\frac{\left(\mathrm{Maximum}\mathrm{heart}\mathrm{rate}\left[\mathrm{bpm}\right]-\mathrm{Resting}\mathrm{heart}\mathrm{rate}\left[\mathrm{bpm}\right]\right)}{\left(\left[220-\mathrm{Age}\right]-\mathrm{Resting}\mathrm{heart}\mathrm{rate}\right)\times 100}$$

Body composition was analyzed using the portable and precise InBody 270 body composition analyzer after the end of HD session. It provides accurate analysis for professionals on the go. It also delivers standard measurements like percent body fat, skeletal muscle mass, basal metabolic rate, and more. It quickly measures fat mass, muscle mass, and body water. It is also auto-calibrated, user-friendly, and non-invasive. The patient just stands on the device and hold the hand electrodes. Direct Segmental Multi-Frequency BIA technology measures body segments separately for an accurate analysis based on patient’s body. The following parameters were yielded from the InBody: Body mass index (BMI), total body water (%), body fat mass (kg), percent body fat (%), fat-free mass (kg), skeletal muscle mass (kg), and skeletal muscle index.

Before the COVID-19 pandemic, the secondary outcomes included changes in body composition and AT. Body composition, which includes fat mass, percentage of body fat, and fat-free mass, was assessed using bioelectrical impedance analysis (InBody 270 body composition analyzer; InBody, Inc). Resting energy expenditure was measured using open-circuit indirect calorimetry using a metabolic cart with a flow-dilution canopy hood (Quark RMR; COSMED). Details regarding these study procedures were previously published.^{15 (link)} Adaptive thermogenesis was calculated from the difference between measured REE and estimated REE. Estimated REE at 3 and 6 months was determined using a linear regression model, including the independent variables of age, sex, fat mass, and fat-free mass at 3 and 6 months.^{17 (link)} The estimated REE equation is detailed in the eMethods in Supplement 2 (section 1.4). After the pandemic, these outcome measures were dropped from the study; thus, these data were available on only a subset of participants.