{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T20:07:16Z","timestamp":1777579636994,"version":"3.51.4"},"reference-count":32,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T00:00:00Z","timestamp":1580169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Prior studies have investigated associations between body mass index (BMI) and foot structure; however, these studies are limited only to the evaluation of the longitudinal arch of the foot and do not evaluate associations with body composition. Therefore, this study examined associations between body fat percentage (BFP) and muscle mass percentage with foot structure in adolescents. This study was conducted with 158 healthy subjects aged from 11 to 13 years. Body fat percentage and muscle mass percentage were estimated using bioelectrical impedance analysis. A podoscope was used to calculate Clarke\u2019s angle (CL), the Wejsflog index (WI), hallux valgus angle (ALPHA), and the angle of the varus deformity of the fifth toe (BETA). Lower values of CL were found in participants with excessive BFP (p = 0.021). No differences were observed in the values of the Wejsflog, ALFA or BETA indices between normal and excessive BFP groups. Participants with the lowest muscle mass percentage were significantly more likely to have lower values of CL and WI (p = 0.014 and p &lt; 0.001, respectively). Excess BFP appeared to have a significant effect on the longitudinal arch and low muscle mass percentage on the longitudinal and transverse arches of the foot in adolescents. There was no association between fat and muscle content with positions of the big and fifth toes.<\/jats:p>","DOI":"10.3390\/ijerph17030811","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T09:37:09Z","timestamp":1580204229000},"page":"811","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Body Fat and Muscle Mass in Association with Foot Structure in Adolescents: A Cross-Sectional Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5786-6214","authenticated-orcid":false,"given":"Justyna","family":"Wyszy\u0144ska","sequence":"first","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8769-0048","authenticated-orcid":false,"given":"Justyna","family":"Leszczak","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justyna","family":"Podg\u00f3rska-Bednarz","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-5290","authenticated-orcid":false,"given":"Ewelina","family":"Czenczek-Lewandowska","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Rachwa\u0142","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0977-5844","authenticated-orcid":false,"given":"Katarzyna","family":"Dere\u0144","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8354-1651","authenticated-orcid":false,"given":"Joanna","family":"Baran","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justyna","family":"Drza\u0142-Grabiec","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Medical College, University of Rzesz\u00f3w, ul. Kopisto 2a, 35-959 Rzesz\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"9945","author":"Ng","year":"2014","journal-title":"Lancet."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s00431-008-0789-8","article-title":"Assessment of the medial longitudinal arch in children and adolescents with obesity: Footprints and radiographic study","volume":"168","author":"Villarroya","year":"2009","journal-title":"Eur. J. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/obr.12130","article-title":"The association between body composition and foot structure and function: A systematic review","volume":"15","author":"Butterworth","year":"2014","journal-title":"Obes. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s00431-013-1943-5","article-title":"Body weight and the medial longitudinal foot arch: High-arched foot, a hidden problem?","volume":"172","author":"Bac","year":"2013","journal-title":"Eur. J. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13047-017-0214-5","article-title":"Increase in body weight over a two-year period is associated with an increase in midfoot pressure and foot pain","volume":"10","author":"Walsh","year":"2017","journal-title":"J. Foot Ankle Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/j.1467-789X.2012.00996.x","article-title":"The association between body mass index and musculoskeletal foot disorders: A systematic review","volume":"13","author":"Butterworth","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1038\/oby.2006.227","article-title":"The feet of overweight and obese young children: Are they flat or fat?","volume":"14","author":"Mickle","year":"2006","journal-title":"Obesity"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s00431-009-1050-9","article-title":"Prevalence of flexible flatfoot in Taiwanese school-aged children in relation to obesity, gender, and age","volume":"169","author":"Chang","year":"2010","journal-title":"Eur. J. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13047-015-0101-x","article-title":"The relationship between paediatric foot posture and body mass index: Do heavier children really have flatter feet?","volume":"8","author":"Evans","year":"2015","journal-title":"J. Foot Ankle Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1757-1146-4-12","article-title":"The paediatric flat foot and general anthropometry in 140 Australian school children aged 7\u201310 years","volume":"4","author":"Evans","year":"2011","journal-title":"J. Foot Ankle Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13047-016-0183-0","article-title":"The influence of gender and body mass index on the FPI-6 evaluated foot posture of 10- to 14-year-old school children in S\u00e3o Paulo, Brazil: A cross-sectional study","volume":"10","author":"Carvalho","year":"2017","journal-title":"J. Foot Ankle Res."},{"key":"ref_12","first-page":"226","article-title":"Diagnostic criteria for metabolic obesity in normal weight subjects","volume":"5","author":"Bucyk","year":"2009","journal-title":"Endokr. Oty\u0142o\u015b\u0107 i Zab. Przem. Ma."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1080\/08035320510035221","article-title":"Body composition measurements: From the past to the future","volume":"448","author":"Pietrobelli","year":"2005","journal-title":"Acta Paediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1139\/h06-092","article-title":"Characteristics of metabolically obese normal-weight (MONW) subjects","volume":"32","author":"Conus","year":"2007","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1177\/107110070402500811","article-title":"The arch index: A measure of flat or fat feet?","volume":"25","author":"Wearing","year":"2004","journal-title":"Foot Ankle Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1038\/sj.ijo.0801192","article-title":"Does obesity influence foot structure in prepubescent children?","volume":"24","author":"Steele","year":"2000","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1038\/sj.ijo.0802729","article-title":"What are the effects of obesity in children on plantar pressure distributions?","volume":"28","author":"Dowling","year":"2004","journal-title":"Int. J. Obes."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1038\/sj.ijo.0801531","article-title":"Foot-to-foot bioelectrical impedance analysis: A valuable tool for the measurement of body composition in children","volume":"25","author":"Tyrrell","year":"2001","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"423S","DOI":"10.1093\/ajcn\/64.3.423S","article-title":"Clinical characteristics influencing bioelectrical impedance analysis measurements","volume":"64","author":"Kushner","year":"1996","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis--part I: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.clnu.2004.09.012","article-title":"Bioelectrical impedance analysis-part II: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1038\/sj.ijo.0803232","article-title":"Body fat reference curves for children","volume":"30","author":"McCarthy","year":"2006","journal-title":"Int. J. Obes. (Lond.)"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"148","DOI":"10.2188\/jea.JE20140082","article-title":"Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older","volume":"25","year":"2015","journal-title":"J. Epidemiol."},{"key":"ref_24","first-page":"435","article-title":"Inter and intra-examiner reliability of photopodometry and intra-examiner reliability of photopodoscopy","volume":"10","author":"Ribeiro","year":"2006","journal-title":"BJPT"},{"key":"ref_25","first-page":"99","article-title":"An objective method of measuring the height of the longitudinal arch in foot examinations","volume":"4","author":"Clarke","year":"1933","journal-title":"Res. Q."},{"key":"ref_26","first-page":"113","article-title":"Postawa\u2014jej badania i dokumentacja kliniczna [Posture\u2014its research and clinical documentation]","volume":"21","author":"Wejsflog","year":"1956","journal-title":"Pol. Orthop. Traumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1046\/j.1467-789X.2002.00054.x","article-title":"The biomechanics of adiposity\u2014structural and functional limitations of obesity and implications for movement","volume":"3","author":"Hills","year":"2002","journal-title":"Obes. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/ijo.2010.119","article-title":"Are the feet of obese children fat or flat? Revisiting the debate","volume":"35","author":"Steele","year":"2011","journal-title":"Int. J. Obes."},{"key":"ref_29","first-page":"13","article-title":"Flat foot and associated factors among primary school children: A cross-sectional study","volume":"32","author":"Ezema","year":"2014","journal-title":"HKPJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1093\/gerona\/glv136","article-title":"Leg Muscle Mass and Foot Symptoms, Structure, and Function: The Johnston County Osteoarthritis Project","volume":"71","author":"Golightly","year":"2016","journal-title":"J. Gerontol. A. Biol. Sci. Med. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13047-014-0046-5","article-title":"The associations of leg lean mass with foot pain, posture and function in the Framingham foot study","volume":"7","author":"McLean","year":"2014","journal-title":"J. Foot Ankle Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"69","DOI":"10.5507\/ag.2015.010","article-title":"The impact of obesity on foot morphology in women aged 48 years or older","volume":"45","year":"2015","journal-title":"Acta Gymn."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/3\/811\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:30:36Z","timestamp":1760362236000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/3\/811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,28]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["ijerph17030811"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17030811","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,28]]}}}