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Amasene M, Besga A, Echeverria I, Urquiza M, Ruiz JR, Rodriguez-Larrad A, Aldamiz M, Anaut P, Irazusta J, Labayen I. Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial. Nutrients 2019; 11:E2337. [PMID: 31581591 PMCID: PMC6835698 DOI: 10.3390/nu11102337] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/25/2019] [Indexed: 12/25/2022] Open
Abstract
Age-related strength and muscle mass loss is further increased after acute periods of inactivity. To avoid this, resistance training has been proposed as an effective countermeasure, but the additional effect of a protein supplement is not so clear. The aim of this study was to examine the effect of a whey protein supplement enriched with leucine after resistance training on muscle mass and strength gains in a post-hospitalized elderly population. A total of 28 participants were included and allocated to either protein supplementation or placebo supplementation following resistance training for 12 weeks (2 days/week). Physical function (lower and upper body strength, aerobic capacity and the Short Physical Performance Battery (SPPB) test), mini nutritional assessment (MNA) and body composition (Dual X-ray Absorptiometry) were assessed at baseline and after 12 weeks of resistance training. Both groups showed improvements in physical function after the intervention (p < 0.01), but there were no further effects for the protein group (p > 0.05). Muscle mass did not improve after resistance training in either group (p > 0.05). In conclusion, 12 weeks of resistance training are enough to improve physical function in a post-hospitalized elderly population with no further benefits for the protein-supplemented group.
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Affiliation(s)
- Maria Amasene
- Department of Pharmacy and Food Science, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain.
| | - Ariadna Besga
- Department of Medicine, Araba University Hospital, Bioaraba Research Institute, OSI Araba. CIBERSAM, University of the Basque Country (UPV/EHU), 01004 Vitoria-Gasteiz, Spain.
| | - Iñaki Echeverria
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Miriam Urquiza
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Mikel Aldamiz
- Department of Medicine, Araba University Hospital, Bioaraba Research Institute, OSI Araba. CIBERSAM, University of the Basque Country (UPV/EHU), 01004 Vitoria-Gasteiz, Spain.
| | - Pilar Anaut
- Department of Medicine, Araba University Hospital, Bioaraba Research Institute, OSI Araba. CIBERSAM, University of the Basque Country (UPV/EHU), 01004 Vitoria-Gasteiz, Spain.
| | - Jon Irazusta
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Idoia Labayen
- ELIKOS group, Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, 31006 Pamplona, Spain.
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Velez MP, Alvarado BE, Rosendaal N, da Câmara SM, Belanger E, Richardson H, Pirkle CM. Age at natural menopause and physical functioning in postmenopausal women: the Canadian Longitudinal Study on Aging. Menopause 2019; 26:958-965. [PMID: 31453956 PMCID: PMC6738924 DOI: 10.1097/gme.0000000000001362] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the association between categories of age at natural menopause (ANM) and gait speed (slowness) and grip strength (weakness), common measures of physical functioning in older women. METHODS We analyzed data from the Canadian Longitudinal Study on Aging, which included participants from seven cities across Canada collected in 2012. The sample was restricted to women who reported to have entered menopause (N = 9,920). Women who had a hysterectomy before menopause were excluded since the age at which this surgical procedure was performed was not available. ANM was categorized into five groups: less than 40 (premature), 40 to 44 (early), 45 to 49, 50 to 54, and more than 54. We conducted linear regressions to assess the association between ANM and gait speed (m/s) and grip strength (kg) adjusting for participant age, education, body mass index, smoking, use of hormone therapy, height, and province of residence. RESULTS Mean ANM was 49.8 (95% confidence interval [CI]: 49.7-50.0), with 3.8% of women having a premature menopause; the average gait speed was 0.98 m/s (standard deviation: 0.22), the average grip strength was 26.6 kg (standard deviation: 6.39). Compared to women with ANM of 50 to 54, women with premature menopause had 0.054 m/s (95% CI -0.083, -0.026) lower gait speed when adjusting for age and study site. In the fully adjusted model, the association was attenuated, 0.032 m/s (95% CI -0.060, -0.004). ANM was not associated with grip strength. CONCLUSION Our study suggests that premature menopause (<40 years) may be associated with lower gait speed (slowness) among Canadian women. No association was observed between ANM and grip strength. Future studies should include a life course approach to evaluate whether social and biological pathways modify the association between age at menopause and physical function in populations from different contexts.
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Affiliation(s)
- Maria P Velez
- Department of Obstetrics and Gynaecology, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Beatriz E Alvarado
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Nicole Rosendaal
- Department of Obstetrics and Gynaecology, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada
| | - Saionara M da Câmara
- Faculty of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Emmanuelle Belanger
- Department of Health Services, Policy and Practice, Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI
| | - Harriet Richardson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawaii at Mānoa, Honolulu, HI
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Liao CD, Chen HC, Huang SW, Liou TH. The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials. Nutrients 2019; 11:E1713. [PMID: 31349606 PMCID: PMC6723070 DOI: 10.3390/nu11081713] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/20/2022] Open
Abstract
Aging and frailty are associated with a high risk of lean mass (LM) loss, which leads to physical disability and can be effectively alleviated by protein supplementation (PS) and muscle strengthening exercise (MSE). In this study, the associations between LM gain and PS + MSE efficacy (measured using physical outcomes) in elderly patients with a high risk of sarcopenia or frailty were identified. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) reporting the efficacy of PS + MSE in elderly patients with sarcopenia or frailty. The included RCTs were analyzed using meta-analysis and risk of bias assessment. We finally included 19 RCTs in this meta-analysis with a median (range/total) Physiotherapy Evidence Database score of 7/10 (5-9/10). The PS + MSE group exhibited significant improvements in the whole-body LM (standard mean difference (SMD) = 0.66; p < 0.00001), appendicular LM (SMD = 0.35; p < 0.00001), leg strength (SMD = 0.65; p < 0.00001), and walking capability (SMD = 0.33; p = 0.0006). Meta-regression analyses showed that changes in appendicular LM were significantly associated with the effect sizes of leg strength (β = 0.08; p = 0.003) and walking capability (β = 0.17; p = 0.04), respectively. Our findings suggest that LM gain after PS + MSE significantly contributes to the efficacy of the intervention in terms of muscle strength and physical mobility in elderly patients with a high risk of sarcopenia or frailty.
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Affiliation(s)
- Chun-De Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 10055, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
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Rigamonti AE, De Col A, Tamini S, Cicolini S, Caroli D, De Micheli R, Tringali G, Abbruzzese L, Marazzi N, Cella SG, Sartorio A. Multidisciplinary Integrated Metabolic Rehabilitation in Elderly Obese Patients: Effects on Cardiovascular Risk Factors, Fatigue and Muscle Performance. Nutrients 2019; 11:nu11061240. [PMID: 31159183 PMCID: PMC6627369 DOI: 10.3390/nu11061240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Obesity is a widespread problem in the elderly, being associated with severe comorbidities negatively influencing life expectancy. Integrated multidisciplinary metabolic rehabilitation aimed to reduce body weight (BW) and fatigue, increase physical autonomy and introduce healthy life style changes has been proposed as a useful intervention to improve the general health status and quality of life of the obese geriatric population. Methods: Six hundred-eighty four severely obese subjects (F/M = 592/92; age range: 61–83 years; mean body mass index, BMI ± SD: 42.6 ± 5.6 kg/m2) were admitted to take part in a three-week in-hospital BW reduction program (BWRP), entailing energy restricted diet, psychological counselling, physical rehabilitation and nutritional education. Biochemical parameters, cardiovascular risk factors (throughout the Coronary Heart Disease Risk, CHD-R), fatigue (throughout the Fatigue Severity Scale, FSS) and lower limb muscle performance (throughout the Stair Climbing Test, SCT) were evaluated before and at the end of the BWRP. Results: A 4% BW reduction was achieved at the end of the BWRP. This finding was associated with a significant improvement of the metabolic homeostasis (i.e., decrease in total cholesterol and glucose) and a reduction of systolic blood pressure in both females and males, thus resulting in a reduction of CHD-R in the male group. Total FSS score and SCT time decreased in female and male obese patients. The effects of BWPR were comparable among all age-related subgroups (>60, 60–69 and >70 years), apart from ΔCHD-R, which was higher in male subgroups. Finally, age was negatively correlated with ΔBMI and ΔFSS. Conclusions: Though only a relatively limited number of outcomes were investigated, the present study shows that a 4% BW reduction in severely elderly obese patients is associated with positive multisystemic effects, particularly, muscle-skeletal and cardiometabolic benefits, which can favorably influence their general well-being and improve the autonomy level in performing more common daily activities. The maintenance of a healthy life style, including controlled food intake and regular physical activity, after a BWRP is obviously recommended in all elderly obese patients to further improve their clinical condition.
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Affiliation(s)
- Antonello E Rigamonti
- Department of Clinical Sciences and Community Health, University of Milan, via Vanvitelli 32, 20129 Milan, Italy.
| | - Alessandra De Col
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Sofia Tamini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Sabrina Cicolini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Diana Caroli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Roberta De Micheli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Gabriella Tringali
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Laura Abbruzzese
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
- Istituto Auxologico Italiano, IRCCS, Division of Metabolic Diseases, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Nicoletta Marazzi
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
| | - Silvano G Cella
- Department of Clinical Sciences and Community Health, University of Milan, via Vanvitelli 32, 20129 Milan, Italy.
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
- Istituto Auxologico Italiano, IRCCS, Division of Metabolic Diseases, strada L. Cadorna 90, 28824 Piancavallo (VB), Italy.
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