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Granic A, Mendonça N, Sayer AA, Hill TR, Davies K, Siervo M, Mathers JC, Jagger C. Effects of dietary patterns and low protein intake on sarcopenia risk in the very old: The Newcastle 85+ study. Clin Nutr 2019; 39:166-173. [PMID: 30709690 PMCID: PMC6961212 DOI: 10.1016/j.clnu.2019.01.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/10/2018] [Accepted: 01/10/2019] [Indexed: 02/06/2023]
Abstract
Background Sarcopenia, a progressive age-related loss of skeletal muscle mass and strength, leads to disability, falls, and hospitalisation. Individual variation in sarcopenia onset may be partly explained by lifestyle factors such as physical activity and diet. Healthy dietary patterns (DPs) have been linked to better physical functioning in older adults, but their role in sarcopenia in the very old (aged ≥85) is unknown. Aims To investigate the association between DPs and the risk of sarcopenia over 3 years, and to determine whether protein intake influences this relationship in community-dwelling older adults from the Newcastle 85 + Study. Methods The analytic sample consisted of 757 participants (61.2% women) who had dietary assessment at baseline. After two-step clustering with 30 food groups to derive DPs, we used logistic regression to determine the risk of prevalent and incident sarcopenia across DPs in all participants, and in those with low (<1 g/kg adjusted body weight/day [g/kg aBW/d]) and good protein intake (≥1 g/kg aBW/d). Results We identified three DPs (DP1: ‘Low Red Meat’, DP2: ‘Traditional British’ and DP3: ‘Low Butter’) that varied by unsaturated fat spreads/oils, butter, red meat, gravy and potato consumption. Compared with participants in DP3, those in DP2 had an increased risk of prevalent (OR = 2.42, 95% CI: 1.15–5.09, p = 0.02) but not 3-year incident sarcopenia (OR = 1.67, 0.59–4.67, p = 0.33) adjusted for socio-demographic, anthropometry, health and lifestyle factors. Furthermore, DP2 was associated with an increased risk of prevalent sarcopenia at baseline (OR = 2.14, 1.01–4.53, p = 0.05) and 3-year follow-up (OR = 5.45, 1.81–16.39, p = 0.003) after adjustment for key covariates in participants with good protein intake. Conclusion A DP high in foods characteristic of a traditional British diet (butter, red meat, gravy and potato) was associated with an increased risk of sarcopenia even when overall protein intake was good. The results need to be replicated in other cohorts of the very old to understand the role of DPs in sarcopenia onset and management.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Avan A Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, United Kingdom
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Ogawa M, Izawa KP, Satomi-Kobayashi S, Tsuboi Y, Komaki K, Gotake Y, Yoshida N, Wakida K, Uchida J, Sakai Y, Okita Y. Effects of postoperative dietary intake on functional recovery of patients undergoing cardiac surgery. Nutr Metab Cardiovasc Dis 2019; 29:90-96. [PMID: 30522928 DOI: 10.1016/j.numecd.2018.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/20/2018] [Accepted: 10/10/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Among elderly patients undergoing cardiac surgery, malnutrition is very common and related to muscle wasting known as sarcopenia. Cardiac surgery causes a further decline of nutritional status due to reduced dietary intake (DI); however, the impact of postoperative DI on functional recovery is unclear. METHODS AND RESULTS We enrolled 250 consecutive patients undergoing cardiac surgery. Daily DI was measured between postoperative days 3 and 7. Patients were categorized as having sufficient or insufficient DI based on whether their DI met or was less than estimated total energy requirements. Functional capacity was measured using the 6-minute walking distance (6MWD) preoperatively and at discharge. Mean postoperative DI was 22.4 ± 3.0 kcal/kg/day, and postoperative DI was insufficient in 92 patients (36.8%). The prevalence of sarcopenia was not different by postoperative DI. Although there was no significant difference in preoperative 6MWD results (P = 0.65), the sufficient DI group had longer 6MWD at discharge than the insufficient DI group (P = 0.04). In multivariate regression analysis, preoperative poor nutritional status (β = -0.29), duration of surgery (β = -0.18), and postoperative DI (β = 0.40) remained statistically significant predictors for improvement of 6MWD (P < 0.0001, adjusted R2 = 0.41). CONCLUSIONS Postoperative DI was independently associated with functional recovery, but preoperative sarcopenia was not. Regardless of preoperative nutritional status or the presence of sarcopenia, aggressive nutritional intervention in the early stage after surgery helps support functional recovery.
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Affiliation(s)
- M Ogawa
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - K P Izawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
| | - S Satomi-Kobayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Tsuboi
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - K Komaki
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Y Gotake
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Yoshida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Wakida
- Department of Nutrition, Kobe University Hospital, Kobe, Japan
| | - J Uchida
- Nutrition Management Department, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Y Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Okita
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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103
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Oktaviana J, Zanker J, Vogrin S, Duque G. The Effect of β-hydroxy-β-methylbutyrate (HMB) on Sarcopenia and Functional Frailty in Older Persons: A Systematic Review. J Nutr Health Aging 2019; 23:145-150. [PMID: 30697623 DOI: 10.1007/s12603-018-1153-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Beta-hydroxy-beta-methylbutyrate (HMB) has been shown to be effective and superior to other types of protein supplements to attenuate loss of muscle mass, strength and function, however, its benefits in sarcopenic and frail older people remain unclear. OBJECTIVE We seek to determine the effect of HMB on muscle mass, strength and function in older people with sarcopenia or frailty by reviewing results from available randomized controlled trials (RCTs). DESIGN This review was registered at PROSPERO (University of York) with registration number CRD42018088462 and conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Using a pre-determined e-search strategy, we searched PubMed, Medline, EMBASE, CINAHL, LILACS, Web of Science, Cochrane and Scopus databases. Our inclusion criteria were RCTs that assessed the effect of HMB on muscle mass, strength and function in older people with sarcopenia and frailty aged ≥60 years. The main outcomes were lean body mass, handgrip, leg press strength, and Short Physical Performance Battery (SPPB) score. RESULTS Three studies matched our eligibility criteria which enrolled 203 subjects through a variety of definitions of sarcopenia or frailty. Lean body mass increased and muscle strength and function were preserved following HMB supplementation. CONCLUSION HMB improves lean muscle mass and preserves muscle strength and function in older people with sarcopenia or frailty.
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Affiliation(s)
- J Oktaviana
- Prof. Gustavo Duque, MD, Ph.D., FRACP, FGSA, Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC, Australia 3021,Tel: +61 3 8395 8121,
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Landi F, Calvani R, Picca A, Marzetti E. Beta-hydroxy-beta-methylbutyrate and sarcopenia: from biological plausibility to clinical evidence. Curr Opin Clin Nutr Metab Care 2019; 22:37-43. [PMID: 30489401 DOI: 10.1097/mco.0000000000000524] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Given the role of leucine as a major regulator of muscle protein turnover, the consumption of protein sources enhanced with this essential amino acid, or its metabolite beta-hydroxy-beta-methylbutyrate (HMB), is assumed to give the greatest benefit in terms of maintenance of muscle mass and function during aging. The aim of this review is to discuss recent literature about HMB metabolism, its pharmacokinetics compared with the metabolite leucine, effectiveness of HMB to improve outcomes in older adults, and novel approaches for HMB use. RECENT FINDINGS Overall, this review article highlights the potential relationship between HMB dietary supplementation and parameters related to maintenance of muscle mass and strength in older people. However, there are limitations in the studies conducted so far, including low number of participants per study group, heterogeneity of study designs, methodologies, and outcomes. The combination of HMB with other amino acids or supplements limits the ability to determine the direct impact of HMB alone. SUMMARY It is proposed that HMB may be utilized to protect or rebuild muscle mass in older people with reduced lean body mass.
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Affiliation(s)
- Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital 'Fondazione Policlinico Agostino Gemelli' IRCCS at the Catholic University of the Sacred Heart, Rome, Italy
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105
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Watanabe K, Holobar A, Mita Y, Kouzaki M, Ogawa M, Akima H, Moritani T. Effect of Resistance Training and Fish Protein Intake on Motor Unit Firing Pattern and Motor Function of Elderly. Front Physiol 2018; 9:1733. [PMID: 30564141 PMCID: PMC6288440 DOI: 10.3389/fphys.2018.01733] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/16/2018] [Indexed: 12/18/2022] Open
Abstract
We investigated the effect of resistance training and fish protein intake on the motor unit firing pattern and motor function in elderly. Fifty healthy elderly males and females (69.2 ± 4.7 years) underwent 6 weeks of intervention. We applied the leg-press exercise as resistance training and fish protein including Alaska pollack protein (APP) as nutritional supplementation. Subjects were divided into four groups: fish protein intake without resistance training (APP-CN, n = 13), placebo intake without resistance training (PLA-CN, n = 12), fish protein intake with resistance training (APP-RT, n = 12), and placebo intake with resistance training (PLA-RT, n = 13). Motor unit firing rates were calculated from multi-channel surface electromyography by the Convolution Kernel. For the chair-stand test, while significant increases were observed at 6 weeks compared with 0 week in all groups (p < 0.05), significant increases from 0 to 3 weeks and 6 weeks were observed in APP-RT (18.2 ± 1.9 at 0 week to 19.8 ± 2.2 at 3 weeks and 21.2 ± 1.9 at 6 weeks) (p < 0.05). Increase and/or decrease in the motor unit firing rate were mainly noted within motor units with a low-recruitment threshold in APP-RT and PLA-RT at 3 and 6 weeks (12.3 pps at 0 week to 13.6 pps at 3 weeks and 12.1 pps at 6 weeks for APP-RT and 12.9 pps at 0 week to 13.9 pps at 3 weeks and 14.1 pps at 6 weeks for PLA-RT at 50% of MVC) (p < 0.05), but not in APP-CN or PLA-CN (p > 0.05). Time courses of changes in the results of the chair-stand test and motor unit firing rate were different between APP-RT and PLA-RT. These findings suggest that, in the elderly, the effect of resistance training on the motor unit firing rate is observed in motor units with a low-recruitment threshold, and additional fish protein intake modifies these adaptations in motor unit firing patterns and the motor function following resistance training.
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Affiliation(s)
- Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Aleš Holobar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | - Yukiko Mita
- Department of Human Nutrition, School of Life Studies, Sugiyama Jogakuen University, Nagoya, Japan
| | - Motoki Kouzaki
- Laboratory of Neurophysiology, Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan
| | - Madoka Ogawa
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Hiroshi Akima
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan.,Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
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Oliveira CL, Dionne IJ, Prado CM. Are Canadian protein and physical activity guidelines optimal for sarcopenia prevention in older adults? Appl Physiol Nutr Metab 2018; 43:1215-1223. [DOI: 10.1139/apnm-2018-0141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Aging is characterized by physiological and morphological changes that affect body composition, strength, and function, ultimately leading to sarcopenia. This condition results in physical disability, falls, fractures, poor quality of life, and increased health care costs. Evidence suggests that increased consumption of dietary protein and physical activity levels, especially resistance exercise, can counteract the trajectory of sarcopenia. Canadian guidelines for protein intake and physical activity were last updated in 2005 and 2011, respectively, and new evidence on sarcopenia diagnosis, prevention, and treatment is rapidly evolving. Protein recommendations are set as “one-size-fits-all” for both young and older adults. Recent evidence demonstrates that current recommendations are insufficient to meet the minimum protein requirement to counteract muscle loss and to stimulate hypertrophy in healthy older adults. Beyond quantity, protein quality is also essential to benefit muscle anabolism in older adults. In terms of physical activity, resistance exercise training is a potential strategy to counteract age-related effects, as it can elicit muscle hypertrophic response in addition to increases in muscle strength and function in older adults. Canadian physical activity guidelines lack details on how this modality of training should be performed. Current guidelines for protein intake and physical activity do not reflect recent knowledge on sarcopenia prevention. The gap between guidelines and the latest evidence on the maintenance and promotion of older adult’s health highlight the need for updated protein and physical activity recommendations.
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Affiliation(s)
- Camila L.P. Oliveira
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, 2-004 Li Ka Shing Center for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Isabelle J. Dionne
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Centre on Aging, CIUSS de l’Estrie-CHUS, 1036 rue Belvédère Sud, Sherbrooke, QC J1H 4C4, Canada
| | - Carla M. Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, 2-004 Li Ka Shing Center for Health Research Innovation, University of Alberta, Edmonton, AB T6G 2E1, Canada
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107
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Granic A, Mendonça N, Sayer AA, Hill TR, Davies K, Adamson A, Siervo M, Mathers JC, Jagger C. Low protein intake, muscle strength and physical performance in the very old: The Newcastle 85+ Study. Clin Nutr 2018; 37:2260-2270. [PMID: 29191494 PMCID: PMC6295979 DOI: 10.1016/j.clnu.2017.11.005] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/28/2017] [Accepted: 11/09/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Low protein intake has been linked to reduced muscle strength and physical performance in older adults but little is known about how it may affect muscle health and subsequent functional decline in the very old (aged 85+), who are at enhanced risk of malnutrition and loss of muscle mass and strength. AIMS To investigate the associations between low protein intake, defined as the intake of <1 g protein/kg adjusted body weight/day (<1 g/kg aBW/d) and decline in muscle strength and physical performance in the very old. METHODS The analytic sample consisted of 722 community-dwelling participants (60% women) from the Newcastle 85+ Study who had protein intake at baseline. Participants were followed-up for change in grip strength (GS) and Timed Up-and-Go (TUG) test over 5 years (baseline, 18, 36, and 60 months). We used mixed models to determine the effects of low protein intake on muscle strength and physical performance in all participants, and also stratified by sex. RESULTS At baseline, 390 (54%) participants (261 women, p < 0.001) reported low protein intake, and these differed from participants with good intake (≥1 g/kg aBW/d) on several measures of health and function. In the model adjusted for protein intake, consuming <1 g/kg aBW/d of protein was associated with a 1.62 kg lower GS (p = 0.008) in all participants, and especially in women (β (SE) = -0.83 (0.41), p = 0.05) after adjusting for key baseline covariates (anthropometry, multimorbidity, arthritis in hands, cognitive status and physical activity). The rate of decline in GS over 5 years was not associated with protein intake. Women, but not men, with low protein intake had worse baseline TUG (β (SE) = 0.04 (0.02), p = 0.03) compared with those with good protein intake in the fully adjusted model, but the rate of decline in TUG was not affected by daily protein status. CONCLUSIONS Intake of <1 g protein/kg aBW/d may negatively affect muscle strength and physical performance in late life, especially in older women, independently of important covariates. More research is needed in the very old to define the optimal protein intake for maintenance of muscle health and function.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Avan Aihie Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Karen Davies
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom
| | - Ashley Adamson
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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Calvani R, Picca A, Marini F, Biancolillo A, Gervasoni J, Persichilli S, Primiano A, Coelho-Junior HJ, Bossola M, Urbani A, Landi F, Bernabei R, Marzetti E. A Distinct Pattern of Circulating Amino Acids Characterizes Older Persons with Physical Frailty and Sarcopenia: Results from the BIOSPHERE Study. Nutrients 2018; 10:E1691. [PMID: 30404172 PMCID: PMC6265849 DOI: 10.3390/nu10111691] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/25/2022] Open
Abstract
Physical frailty and sarcopenia (PF&S) are hallmarks of aging that share a common pathogenic background. Perturbations in protein/amino acid metabolism may play a role in the development of PF&S. In this initial report, 68 community-dwellers aged 70 years and older, 38 with PF&S and 30 non-sarcopenic, non-frail controls (nonPF&S), were enrolled as part as the "BIOmarkers associated with Sarcopenia and Physical frailty in EldeRly pErsons" (BIOSPHERE) study. A panel of 37 serum amino acids and derivatives was assayed by UPLC-MS. Partial Least Squares⁻Discriminant Analysis (PLS-DA) was used to characterize the amino acid profile of PF&S. The optimal complexity of the PLS-DA model was found to be three latent variables. The proportion of correct classification was 76.6 ± 3.9% (75.1 ± 4.6% for enrollees with PF&S; 78.5 ± 6.0% for nonPF&S). Older adults with PF&S were characterized by higher levels of asparagine, aspartic acid, citrulline, ethanolamine, glutamic acid, sarcosine, and taurine. The profile of nonPF&S participants was defined by higher concentrations of α-aminobutyric acid and methionine. Distinct profiles of circulating amino acids and derivatives characterize older people with PF&S. The dissection of these patterns may provide novel insights into the role played by protein/amino acid perturbations in the disabling cascade and possible new targets for interventions.
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Affiliation(s)
- Riccardo Calvani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Anna Picca
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Federico Marini
- Department of Chemistry, Sapienza University of Rome, Rome 00168, Italy.
| | | | - Jacopo Gervasoni
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Silvia Persichilli
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | | | - Hélio José Coelho-Junior
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
- Applied Kinesiology Laboratory⁻LCA, School of Physical Education, University of Campinas, Campinas-SP 13.083-851, Brazil.
| | - Maurizio Bossola
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Andrea Urbani
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Francesco Landi
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Roberto Bernabei
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
- Università Cattolica del Sacro Cuore, Rome 00168, Italy.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.
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Ohashi K, Ishikawa T, Hoshi A, Suzuki M, Mitobe Y, Yamada E, Abeywickrama HM, Seki N, Koyama C, Aoki H, Koyama Y. Relationship Between Sarcopenia and Both Physical Activity and Lifestyle in Patients With Chronic Liver Disease. J Clin Med Res 2018; 10:920-927. [PMID: 30425765 PMCID: PMC6225858 DOI: 10.14740/jocmr3640] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/12/2018] [Indexed: 12/26/2022] Open
Abstract
Background Sarcopenia can affect the prognosis of patients with cirrhosis or hepatocellular carcinoma. Exercise therapy and nutritional therapy are carried out to prevent processing sarcopenia. In addition, changing lifestyle is also important. However, there are only few reports on the physical activities (PAs) and lifestyle of chronic liver disease patients and their association with sarcopenia. The aim of this study is to examine the relationship between sarcopenia in patients with chronic liver disease and both PA and lifestyle. Methods A total of 214 out-patients with chronic liver disease were enrolled into the present study. All patients were evaluated for with or without sarcopenia based on the sarcopenia diagnostic criteria of the Japan Society of Hepatology. Then, patient’s characteristics and laboratory parameters were divided into two groups with or without sarcopenia and compared. In continuous variable with significant difference in univariate analysis, cut-off value was calculated by receiver operating characteristic curve. We determined which factors were associated with sarcopenia in univariate analyses, and variables significant in the univariate analyses were entered in a multivariable logistic regression model. Results Patients with chronic liver disease had a prevalence of sarcopenia of 12.6% in this study. Sarcopenia patients were older (76.48 ± 6.69 versus 66.97 ± 11.19 years old; P < 0.01), had lower body mass index (BMI) (20.84 ± 2.44 versus 23.76 ± 3.72 kg/m2; P < 0.01), lower PA (6.6 (2.34 - 19.90) versus 16.5 (6.60 - 41.23) metabolic equivalents (METs)-h/week; P < 0.01) and longer total time sitting and lying on the day (7.43 ± 4.09 versus 5.68 ± 3.17 h/day; P = 0.01); retirement status (81.5% versus 48.1%; P < 0.01) and low frequency of driving (40% versus 20%; P = 0.01) were higher in sarcopenia patients than in non-sarcopenia patients. The independent predictive factors of sarcopenia, analyzed with logistic regression, were age (odds ratio (OR): 5.89, 95% confidence interval (CI): 2.15 - 16.20; P < 0.01), BMI (OR: 4.77, 95% CI: 1.87 - 12.10; P < 0.01) and PA (OR: 3.65, 95% CI: 2.15 - 16.20; P < 0.01). Conclusion Sarcopenia patients’ lifestyle characteristics were longer sedentary time and low frequency of driving, high retirement. Independent predictive factors of sarcopenia were elderly, low BMI and low PA. For these patients, intervention in the lifestyle for prevention of sarcopenia may be effective for patients with chronic liver disease.
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Affiliation(s)
- Kazuki Ohashi
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan.,Department of Nursing, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - Toru Ishikawa
- Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - Asami Hoshi
- Department of Medical Radiology, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - Mitsuyuki Suzuki
- Department of Pharmacology, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - Yuta Mitobe
- Department of Nursing, Teikyo University, Faculty of Medical Technology, Tokyo, Japan
| | - Etsuko Yamada
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | | | - Nao Seki
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Chikayo Koyama
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
| | - Hagiko Aoki
- Department of Nursing, Chukyo Gakuin University, Gifu, Japan
| | - Yu Koyama
- Department of Nursing, Niigata University Graduate School of Health Sciences, Niigata, Japan
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110
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Alexandrov NV, Eelderink C, Singh-Povel CM, Navis GJ, Bakker SJL, Corpeleijn E. Dietary Protein Sources and Muscle Mass over the Life Course: The Lifelines Cohort Study. Nutrients 2018; 10:nu10101471. [PMID: 30308987 PMCID: PMC6212815 DOI: 10.3390/nu10101471] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 09/30/2018] [Accepted: 10/02/2018] [Indexed: 12/28/2022] Open
Abstract
The influence of dietary protein intake on muscle mass in adults remains unclear. Our objective was to investigate the association between protein intake and muscle mass in 31,278 men and 45,355 women from the Lifelines Cohort. Protein intake was estimated by food frequency questionnaire and muscle mass was estimated from 24 h urinary creatinine excretion. The age range was 18⁻91 years and mean total protein intake was 1.0 ± 0.3 g/kg/day. Across increasing quartiles of total protein intake, animal protein intake, and fish/meat/egg protein intake, creatinine excretion significantly increased in both men (+4% for total and +6% for fish/meat/egg protein intake, p < 0.001) and women (+3% for total and +6% for fish/meat/egg protein intake, p < 0.001). The associations were not systematically stronger or weaker with increasing age, but associations were strongest for young men (26⁻45 years) and older women (>75 years). The association between total protein intake and muscle mass was dependent on physical activity in women (p interaction < 0.001). This study suggests that total protein intake, animal protein intake, and in particular fish/meat/egg protein intake may be important for building and preserving muscle mass. Dietary protein sources should be further studied for their potential to build and preserve muscle mass.
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Affiliation(s)
- Nikita V Alexandrov
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | - Coby Eelderink
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | | | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
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111
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112
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Coelho-Júnior HJ, Milano-Teixeira L, Rodrigues B, Bacurau R, Marzetti E, Uchida M. Relative Protein Intake and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2018; 10:nu10091330. [PMID: 30235845 PMCID: PMC6163569 DOI: 10.3390/nu10091330] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/03/2018] [Accepted: 09/13/2018] [Indexed: 12/25/2022] Open
Abstract
(1) Background: The present work aims to conduct a systematic review and meta-analysis of observational studies, in order to investigate the association of relative protein intake and physical function in older adults; (2) Methods: Observational studies, that investigated the association between protein intake and physical function in older adults, were retrieved from MEDLINE, SCOPUS, CINAHL, AgeLine, EMBASE, and Cochrane-CENTRAL. Two independent researchers conducted study selection and data extraction; (3) Results: Very high protein intake (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) groups showed better lower limb physical functioning and walking speed (WS) performance, respectively, in comparison to individuals who present relative low protein (<0.80 g/kg/day) intake. On the other hand, relative high protein intake does not seem to propitiate a better performance on isometric handgrip (IHG) and chair rise in comparison to relative low protein intake. In addition, there were no significant differences in the physical functioning of high and middle protein intake groups; (4) Conclusions: In conclusion, findings of the present study indicate that a very high (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) are associated with better lower-limb physical performance, when compared to low protein (<0.80 g/kg/day) intake, in community-dwelling older adults. These findings act as additional evidence regarding the potential need to increase protein guidelines to above the current recommendations. However, large randomized clinical trials are needed to confirm the addictive effects of high-protein diets (≥1.0 g/kg/day) in comparison to the current recommendations on physical functioning. All data are available in the Open ScienceFramework.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
- Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital "Agostino Gemelli", Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Luiz Milano-Teixeira
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
| | - Bruno Rodrigues
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
| | - Reury Bacurau
- School of Arts, Sciences and Humanities, University of São Paulo, Rua Arlindo Béttio, 1000-Ermelino Matarazzo, São Paulo-SP 03828-000, Brazil.
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital "Agostino Gemelli", Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Marco Uchida
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
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113
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Ni Lochlainn M, Bowyer RCE, Steves CJ. Dietary Protein and Muscle in Aging People: The Potential Role of the Gut Microbiome. Nutrients 2018; 10:E929. [PMID: 30036990 PMCID: PMC6073774 DOI: 10.3390/nu10070929] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/13/2018] [Accepted: 07/18/2018] [Indexed: 12/22/2022] Open
Abstract
Muscle mass, strength, and physical function are known to decline with age. This is associated with the development of geriatric syndromes including sarcopenia and frailty. Dietary protein is essential for skeletal muscle function. Resistance exercise appears to be the most beneficial form of physical activity for preserving skeletal muscle and a synergistic effect has been noted when this is combined with dietary protein. However, older adults have shown evidence of anabolic resistance, where greater amounts of protein are required to stimulate muscle protein synthesis, and response is variable. Thus, the recommended daily amount of protein is greater for older people. The aetiologies and mechanisms responsible for anabolic resistance are not fully understood. The gut microbiota is implicated in many of the postulated mechanisms for anabolic resistance, either directly or indirectly. The gut microbiota change with age, and are influenced by dietary protein. Research also implies a role for the gut microbiome in skeletal muscle function. This leads to the hypothesis that the gut microbiome might modulate individual response to protein in the diet. We summarise the existing evidence for the role of the gut microbiota in anabolic resistance and skeletal muscle in aging people, and introduce the metabolome as a tool to probe this relationship in the future.
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Affiliation(s)
- Mary Ni Lochlainn
- The Department of Twin Research, Kings College London, 3-4th Floor South Wing Block D, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
- Clinical Age Research Unit, Kings College Hospital Foundation Trust, London SE5 9RS, UK.
| | - Ruth C E Bowyer
- The Department of Twin Research, Kings College London, 3-4th Floor South Wing Block D, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
| | - Claire J Steves
- The Department of Twin Research, Kings College London, 3-4th Floor South Wing Block D, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
- Clinical Age Research Unit, Kings College Hospital Foundation Trust, London SE5 9RS, UK.
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114
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de Sire R, Rizzatti G, Ingravalle F, Pizzoferrato M, Petito V, Lopetuso L, Graziani C, de Sire A, Mentella MC, Mele MC, Gasbarrini A, Scaldaferri F. Skeletal muscle-gut axis: emerging mechanisms of sarcopenia for intestinal and extra intestinal diseases. MINERVA GASTROENTERO 2018; 64:351-362. [PMID: 30016852 DOI: 10.23736/s1121-421x.18.02511-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In recent years, there has been an increasing interest on muscle wasting, considering the reduction of quality of life and the increase of morbidity and mortality associated. Sarcopenia and cachexia represent two conditions of reduction of muscle mass, sharing several elements involved in their pathogenesis, such as systemic inflammation, impaired muscle protein synthesis, increased muscle apoptosis, mitochondrial dysfunction in skeletal muscle tissue and insulin resistance. These features often characterize cancer, inactivity or denervation, but also inflammatory diseases, such as chronic obstructive pulmonary disease, renal failure, cardiac failure, rheumatoid arthritis, inflammatory bowel disease and aging in general. The gastrointestinal tract and gut microbiota are thought to be deeply associated with muscle function and metabolism, although the exact mechanisms that link gut with skeletal muscle are still not well known. This review summarized the potential pathways linking gut with muscle, in particular in conditions as sarcopenia and cachexia. The main emerging pathways implicated in the skeletal muscle-gut axis are: the myostatin/activin signaling pathway, the IGF1/PI3K/AKT/mTOR signaling pathway, which results suppressed, the NF-kB signaling pathway and the FOXO signaling pathway. Further researches in this field are necessary to better explain the linkage between gut microbiota and muscle wasting and the possible emerging therapies associated.
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Affiliation(s)
- Roberto de Sire
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy
| | - Gianenrico Rizzatti
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy
| | - Fabio Ingravalle
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy
| | - Marco Pizzoferrato
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy.,UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valentina Petito
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy.,UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Loris Lopetuso
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy.,UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina Graziani
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy.,UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Chiara Mentella
- Clinical Nutrition, A. Gemelli Polyclinic Foundation and Institute for Research and Care, Rome, Italy
| | - Maria Cristina Mele
- Clinical Nutrition, A. Gemelli Polyclinic Foundation and Institute for Research and Care, Rome, Italy
| | - Antonio Gasbarrini
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy.,UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Franco Scaldaferri
- Istituto di Patologia Speciale Medica, Sacred Heart Catholic University, Rome, Italy - .,UOC Medicina Interna e Gastroenterologia, Area Gastroenterologia e Oncologia Medica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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115
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Smith GI, Commean PK, Reeds DN, Klein S, Mittendorfer B. Effect of Protein Supplementation During Diet-Induced Weight Loss on Muscle Mass and Strength: A Randomized Controlled Study. Obesity (Silver Spring) 2018; 26:854-861. [PMID: 29687650 PMCID: PMC5918424 DOI: 10.1002/oby.22169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/12/2018] [Accepted: 02/19/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE High protein (particularly leucine-rich whey protein) intake is recommended to mitigate the adverse effect of weight loss on muscle mass. The effectiveness of this approach is unknown. METHODS Seventy middle-aged (50-65 years old) postmenopausal women with obesity were randomized to (1) weight maintenance (WM), (2) weight loss and the recommended daily allowance for protein (0.8 g/kg/d) (WL group), or (3) weight loss plus whey protein supplementation (total protein: 1.2 g/kg/d) (WL-PS group). Thigh muscle volume and strength were assessed at baseline and after 5% and 10% weight loss in the weight-loss groups and after matched time periods (∼3 and 6 months, respectively) in the WM group. RESULTS A 5% weight loss caused a greater decrease in thigh muscle volume in the WL group than the WL-PS group (4.7% ± 0.7% vs. 2.8% ± 0.8%, respectively; P < 0.05). After 10% weight loss, there was no statistically significant difference in muscle mass loss in the two groups, and the total loss was small in both groups (5.5% ± 0.8% and 4.5% ± 0.7%, respectively). The dietary interventions did not affect muscle strength. CONCLUSIONS Whey protein supplementation during diet-induced weight loss does not have clinically important therapeutic effects on muscle mass or strength in middle-aged postmenopausal women with obesity.
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Affiliation(s)
- Gordon I Smith
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Paul K Commean
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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116
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Rahimi MH, Mohammadi H, Eshaghi H, Askari G, Miraghajani M. The Effects of Beta-Hydroxy-Beta-Methylbutyrate Supplementation on Recovery Following Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis. J Am Coll Nutr 2018; 37:640-649. [DOI: 10.1080/07315724.2018.1451789] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Mohammad Hossein Rahimi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hesam Eshaghi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Askari
- Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Miraghajani
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK
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117
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Park HA. Adequacy of Protein Intake among Korean Elderly: An Analysis of the 2013-2014 Korea National Health and Nutrition Examination Survey Data. Korean J Fam Med 2018; 39:130-134. [PMID: 29629047 PMCID: PMC5876049 DOI: 10.4082/kjfm.2018.39.2.130] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/16/2017] [Accepted: 02/25/2017] [Indexed: 11/05/2022] Open
Abstract
Background Protein intake in South Korea is generally considered to be adequate; however, there is concern that it may be inadequate among the elderly. This study evaluated the adequacy of protein intake, the source of protein, and the distribution of protein intake in daily meals in the Korean elderly population. Methods Data were obtained from 1,484 men and 2,028 women aged 60 years or older who had participated in the nutrition survey of the 2013–2014 Korea National Health and Nutrition Examination Survey. One-day (24-hour) recall data were used to estimate the daily protein intake. Results The mean protein intake was 65.3±1.0 g/d (13.1%±0.1% of energy) and 49.7±0.7 g/d (12.6%±0.1% of energy) for men and women, respectively. The protein intake was less than the estimated average requirement in 30.8%±1.4% of men and 42.6%±1.3% of women, and 47.9%±1.6% and 60.1%±1.4%, respectively, consumed less than the recommended daily allowance. The protein intake was relatively evenly distributed among meals; however, the absolute amount of protein consumption per meal was very low. Only one-third of the protein intake came from animal sources. Conclusion The quantity and quality of protein intake were inadequate in the elderly Korean population.
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Affiliation(s)
- Hyun Ah Park
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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118
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Granic A, Mendonça N, Hill TR, Jagger C, Stevenson EJ, Mathers JC, Sayer AA. Nutrition in the Very Old. Nutrients 2018; 10:E269. [PMID: 29495468 PMCID: PMC5872687 DOI: 10.3390/nu10030269] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/21/2018] [Accepted: 02/26/2018] [Indexed: 12/15/2022] Open
Abstract
The population of older adults aged 85 years and over (the very old) is growing rapidly in many societies because of increases in life expectancy and reduced mortality at older ages. In 2016, 27.3 million very old adults were living in the European Union, and in the UK, 2.4% of the population (1.6 million) were aged 85 and over. Very old age is associated with increased risks of malnutrition, multimorbidity, and disability. Diet (nutrition) is a modifiable risk factor for multiple age-related conditions, including sarcopenia and functional decline. Dietary characteristics and nutrient intakes of the very old have been investigated in several European studies of ageing to better understand their nutritional requirements, which may differ from those in the young-old. However, there is a major gap in regard to evidence for the role of dietary patterns, protein, vitamin D and other nutrients for the maintenance of physical and cognitive functioning in later life. The Newcastle 85+ Study, UK and the Life and Living in Advanced Age, New Zealand are unique studies involving single birth cohorts which aim to assess health trajectories in very old adults and their biological, social and environmental influences, including nutrition. In this review, we have updated the latest findings in nutritional epidemiology with results from these studies, concentrating on the diet-physical functioning relationship.
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Affiliation(s)
- Antoneta Granic
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
| | - Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Institute for Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Institute for Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
| | - Emma J Stevenson
- Human Nutrition Research Centre, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
- Institute of Cellular Medicine, Newcastle University, William Leech Building, Newcastle upon Tyne NE2 4HH, UK.
| | - Avan A Sayer
- Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Newcastle University Institute for Ageing, Newcastle upon Tyne NE2 4AX, UK.
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK.
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119
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Strasser B, Volaklis K, Fuchs D, Burtscher M. Role of Dietary Protein and Muscular Fitness on Longevity and Aging. Aging Dis 2018; 9:119-132. [PMID: 29392087 PMCID: PMC5772850 DOI: 10.14336/ad.2017.0202] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/02/2017] [Indexed: 12/21/2022] Open
Abstract
Muscle atrophy is an unfortunate effect of aging and many diseases and can compromise physical function and impair vital metabolic processes. Low levels of muscular fitness together with insufficient dietary intake are major risk factors for illness and mortality from all causes. Ultimately, muscle wasting contributes significantly to weakness, disability, increased hospitalization, immobility, and loss of independence. However, the extent of muscle wasting differs greatly between individuals due to differences in the aging process per se as well as physical activity levels. Interventions for sarcopenia include exercise and nutrition because both have a positive impact on protein anabolism but also enhance other aspects that contribute to well-being in sarcopenic older adults, such as physical function, quality of life, and anti-inflammatory state. The process of aging is accompanied by chronic immune activation, and sarcopenia may represent a consequence of a counter-regulatory strategy of the immune system. Thereby, the kynurenine pathway is induced, and elevation in the ratio of kynurenine to tryptophan concentrations, which estimates the tryptophan breakdown rate, is often linked with inflammatory conditions and neuropsychiatric symptoms. A combined exercise program consisting of both resistance-type and endurance-type exercise may best help to ameliorate the loss of skeletal muscle mass and function, to prevent muscle aging comorbidities, and to improve physical performance and quality of life. In addition, the use of dietary protein supplementation can further augment protein anabolism but can also contribute to a more active lifestyle, thereby supporting well-being and active aging in the older population.
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Affiliation(s)
- Barbara Strasser
- Division of Medical Biochemistry, Biocenter, Medical University Innsbruck, Austria
| | | | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Medical University Innsbruck, Austria
| | - Martin Burtscher
- Department of Sport Science, Medical Section, University Innsbruck, Austria
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120
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Abstract
PURPOSE OF REVIEW The speed of dietary protein digestion influences postprandial amino acid availability which is crucial for improving altered anabolic response of skeletal muscle one feature of sarcopenia during aging. RECENT FINDINGS By analogy with carbohydrate and in reference to their absorption rate, dietary proteins can be classified as 'fast' or 'slow' proteins depending on matrix food structure and technological processes, which can influence amino acids availability and their subsequent metabolic actions. 'Fast' digestive proteins have been shown to stimulate muscle protein synthesis and to improve muscle function in several recent studies involving older patients. These new aspects may be applied for improving health through preservation or restoration of muscle protein mass and function in clinical situations (obesity, rheumatoid arthritis and cancer cachexia). SUMMARY Using fast digestive proteins is of major interest to overcome 'anabolic resistance' of aging for limiting sarcopenia. Fast proteins' action on muscle anabolism may be stimulated by other nutrients like vitamin D or omega 3 fatty acids or by combination with exercise. The beneficial impact of the 'fast' protein concept beyond the amount of dietary protein on muscle preservation is a promising therapeutic perspective to improve mobility and quality of life of older patients affected with chronic disease.
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Affiliation(s)
- Yves Boirie
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CHU Clermont-Ferrand, Service de Nutrition Clinique
| | - Christelle Guillet
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
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121
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Sanz-Paris A, Camprubi-Robles M, Lopez-Pedrosa JM, Pereira SL, Rueda R, Ballesteros-Pomar MD, Garcia Almeida JM, Cruz-Jentoft AJ. Role of Oral Nutritional Supplements Enriched with β-Hydroxy-β-Methylbutyrate in Maintaining Muscle Function and Improving Clinical Outcomes in Various Clinical Settings. J Nutr Health Aging 2018; 22:664-675. [PMID: 29806855 PMCID: PMC5984960 DOI: 10.1007/s12603-018-0995-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/09/2017] [Indexed: 02/07/2023]
Abstract
Aging and disease-related malnutrition are well associated with loss of muscle mass and function. Muscle mass loss may lead to increased health complications and associated increase in health care costs, especially in hospitalized individuals. High protein oral nutritional supplements enriched with β-hydroxy-β-methylbutyrate (HP-ONS+HMB) have been suggested to provide benefits such as improving body composition, maintaining muscle mass and function and even decreasing mortality rates. The present review aimed to examine current evidence on the effect of HP-ONS+HMB on muscle-related clinical outcomes both in community and peri-hospitalization patients. Overall, current evidence suggests that therapeutic nutrition such as HP-ONS+HMB seems to be a promising tool to mitigate the decline in muscle mass and preserve muscle function, especially during hospital rehabilitation and recovery.
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Affiliation(s)
- A Sanz-Paris
- Alejandro Sanz-Paris, Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, Zaragoza 50009, Spain.
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Rusu ME, Gheldiu AM, Mocan A, Vlase L, Popa DS. Anti-aging potential of tree nuts with a focus on the phytochemical composition, molecular mechanisms and thermal stability of major bioactive compounds. Food Funct 2018; 9:2554-2575. [DOI: 10.1039/c7fo01967j] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Tree nuts, complete functional foods, contain macro- and micronutrients of high biological value.
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Affiliation(s)
- Marius Emil Rusu
- Department of Pharmaceutical Technology and Biopharmaceutics
- Faculty of Pharmacy
- “Iuliu Hatieganu” University of Medicine and Pharmacy
- Cluj-Napoca 400012
- Romania
| | - Ana-Maria Gheldiu
- Department of Pharmaceutical Botany
- Faculty of Pharmacy
- “Iuliu Hatieganu” University of Medicine and Pharmacy
- Cluj-Napoca 400012
- Romania
| | - Andrei Mocan
- Department of Pharmaceutical Botany
- Faculty of Pharmacy
- “Iuliu Hatieganu” University of Medicine and Pharmacy
- Cluj-Napoca 400012
- Romania
| | - Laurian Vlase
- Department of Pharmaceutical Technology and Biopharmaceutics
- Faculty of Pharmacy
- “Iuliu Hatieganu” University of Medicine and Pharmacy
- Cluj-Napoca 400012
- Romania
| | - Daniela-Saveta Popa
- Department of Toxicology
- Faculty of Pharmacy
- “Iuliu Hatieganu” University of Medicine and Pharmacy
- Cluj-Napoca 400012
- Romania
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123
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Faure AM, Fischer K, Dawson-Hughes B, Egli A, Bischoff-Ferrari HA. Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors. Osteoporos Int 2017; 28:3451-3462. [PMID: 28971236 DOI: 10.1007/s00198-017-4220-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/06/2017] [Indexed: 01/08/2023]
Abstract
UNLABELLED Diet-related mild metabolic acidosis may play a role in the development of sarcopenia. We investigated the relationship between dietary acid load and total lean body mass in male and female seniors age ≥ 60 years. We found that a more alkaline diet was associated with a higher %TLM only among senior women. INTRODUCTION The aim of this study was to determine if dietary acid load is associated with total lean body mass in male and female seniors age ≥ 60 years. METHODS We investigated 243 seniors (mean age 70.3 ± 6.3; 53% women) age ≥ 60 years who participated in the baseline assessment of a clinical trial on vitamin D treatment and rehabilitation after unilateral knee replacement due to severe knee osteoarthritis. The potential renal acid load (PRAL) was assessed based on individual nutrient intakes derived from a food frequency questionnaire. Body composition including percentage of total lean body mass (%TLM) was determined using dual-energy X-ray absorptiometry. Cross-sectional analyses were performed for men and women separately using multivariable regression models controlling for age, physical activity, smoking status, protein intake (g/kg BW per day), energy intake (kcal), and serum 25-hydroxyvitamin D concentration. We included a pre-defined subgroup analysis by protein intake (< 1 g/kg BW day, > 1 g/kg BW day) and by age group (< 70 years, ≥ 70 years). RESULTS Adjusted %TLM decreased significantly across PRAL quartiles only among women (P trend = 0.004). Moreover, in subgroup analysis, the negative association between the PRAL and %TLM was most pronounced among women with low protein intake (< 1 g/kg BW per day) and age below 70 years (P = 0.002). Among men, there was no association between the PRAL and %TLM. CONCLUSION The association between dietary acid load and %TLM seems to be gender-specific, with a negative impact on total lean mass only among senior women. Therefore, an alkaline diet may be beneficial for preserving total lean mass in senior women, especially in those with low protein intake.
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Affiliation(s)
- A M Faure
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - K Fischer
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - A Egli
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - H A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Raemistrasse 101, 8091, Zurich, Switzerland.
- University Clinic for Acute Geriatric Care, Waid City Hospital, Zurich, Switzerland.
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Martone AM, Bianchi L, Abete P, Bellelli G, Bo M, Cherubini A, Corica F, Di Bari M, Maggio M, Manca GM, Marzetti E, Rizzo MR, Rossi A, Volpato S, Landi F. The incidence of sarcopenia among hospitalized older patients: results from the Glisten study. J Cachexia Sarcopenia Muscle 2017; 8:907-914. [PMID: 28913934 PMCID: PMC5700449 DOI: 10.1002/jcsm.12224] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/29/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND New evidence is emerging on the importance of lean body mass during periods of illness and recovery. The preservation of lean body mass during such periods of intense stress impacts both patient and treatment outcomes. However, data concerning the incidence of sarcopenia among older people during hospitalization are scarce. The objective of this study was to evaluate the development of sarcopenia in a sample of hospitalized older subjects. METHODS We used data of 394 participants from the multicentre Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia-Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards (Internal Medicine and Geriatrics) of University Hospitals across Italy. This study was designed to determine the prevalence of sarcopenia at hospital admission and the change in muscle mass and strength during hospitalization. Sarcopenia was defined as low skeletal mass index (kg/m2 ) along with either low handgrip strength or slow walking speed [European Working Groups on Sarcopenia in Older People (EWGSOP) criteria]. Estimation of skeletal muscle mass was performed by bioelectrical impedance analysis (BIA). RESULTS The mean age of the 394 enrolled patients (including 211 females who accounted for 53% of the sample) was 79.6 ± 6.4 years. Among those without sarcopenia at hospital admission, 14.7% of the study sample met the EWGSOP sarcopenia diagnostic criteria at discharge. The incidence of sarcopenia during hospitalization was significantly associated with the number of days spent in bed but was not correlated with the total length of hospital stay. In particular, patients who developed sarcopenia spent an average of 5.1 days in bed compared with 3.2 days for those with no sarcopenia at discharge (P = 0.02). Patients with sarcopenia showed a significantly lower body mass index compared with non-sarcopenic peers (25.0 ± 3.8 kg/m2 vs. 27.6 ± 4.9 kg/m2 , respectively; P < 0.001). Similarly, the skeletal mass index at admission was significantly lower among patients who developed sarcopenia during hospital stay. CONCLUSIONS Incident sarcopenia during hospital stay is relatively common and is associated with nutritional status and the number of days of bed rest.
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Affiliation(s)
- Anna Maria Martone
- Department of Geriatrics, Neurosciences, and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Lara Bianchi
- Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, Geriatric Unit, S. Gerardo Hospital, Monza, Italy
| | - Mario Bo
- Struttura Complessa Dipartimento Universitario Geriatria e Malattie Metaboliche dell'Osso, Città della Salute e della Scienza-Molinette, Turin, Italy
| | - Antonio Cherubini
- Geriatrics and Geriatrics Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy
| | - Francesco Corica
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Mauro Di Bari
- Research Unit of Medicine of Aging, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marcello Maggio
- Department of Medicine and Surgery, Geriatric Rehabilitation Department, University and University-Hospital of Parma, Parma, Italy
| | | | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences, and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Rosaria Rizzo
- Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, Second University of Naples, Caserta, Italy
| | - Andrea Rossi
- Department of Medicine, Geriatrics Division, University of Verona, Verona, Italy
| | - Stefano Volpato
- Department of Medical Science, University of Ferrara, Ferrara, Italy.,Center for Clinical Epidemiology, School of Medicine, University of Ferrara, Ferrara, Italy
| | - Francesco Landi
- Department of Geriatrics, Neurosciences, and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
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125
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Ziaaldini MM, Marzetti E, Picca A, Murlasits Z. Biochemical Pathways of Sarcopenia and Their Modulation by Physical Exercise: A Narrative Review. Front Med (Lausanne) 2017; 4:167. [PMID: 29046874 PMCID: PMC5632757 DOI: 10.3389/fmed.2017.00167] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/21/2017] [Indexed: 12/15/2022] Open
Abstract
Aging is a complex process characterized by progressive multisystem derangement predisposing individuals to increased risk of developing negative health outcomes. Sarcopenia is the age-related decline of muscle mass and function/strength and represents a highly prevalent correlate of aging. Several factors have been indicated to play a role in the onset and progression of sarcopenia; however, its pathophysiology is still unclear. Physical exercise is to date one of the few strategies able to improve muscle health in old age through multiple metabolic and transcriptional adaptations. Although the benefits of different exercise modalities on the function and structure of aged myocytes is acknowledged, the cellular and molecular mechanisms underlying such effects are not yet fully identified. Here, we briefly overview the current knowledge on the biochemical pathways associated with the onset and progression of sarcopenia. We subsequently describe the effects of exercise on relevant signaling pathways involved in sarcopenia pathophysiology.
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Affiliation(s)
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Picca
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Zsolt Murlasits
- Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar
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126
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Shao A, Campbell WW, Chen CYO, Mittendorfer B, Rivas DA, Griffiths JC. The emerging global phenomenon of sarcopenic obesity: Role of functional foods; a conference report. J Funct Foods 2017. [DOI: 10.1016/j.jff.2017.03.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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127
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Landi F, Calvani R, Ortolani E, Salini S, Martone AM, Santoro L, Santoliquido A, Sisto A, Picca A, Marzetti E. The association between sarcopenia and functional outcomes among older patients with hip fracture undergoing in-hospital rehabilitation. Osteoporos Int 2017; 28:1569-1576. [PMID: 28154941 DOI: 10.1007/s00198-017-3929-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
UNLABELLED This study evaluates the prevalence of sarcopenia among older people admitted to a rehabilitation unit after hip fracture and the association between sarcopenia and functional outcomes. The results show that sarcopenia had a negative impact on functional recovery. The assessment of sarcopenia among older adults receiving rehabilitation programs is crucial. INTRODUCTION Sarcopenia is a highly prevalent geriatric syndrome associated with adverse outcomes, including falls, disability, institutionalization, and mortality. Few studies assessed sarcopenia among older adults receiving rehabilitation programs. METHODS Patients aged 70 years or more consecutively admitted to in-hospital rehabilitation programs that had suffered from hip fracture entered the study. Sarcopenia was defined according to the Foundation for National Institutes of Health (FNIH) criteria. Multivariable linear regression models were used to analyze the association between the sarcopenia and functional recovery. RESULTS The recruited population was composed of 127 patients, with a mean age of 81.3 ± 4.8 years, predominantly females (64.6%). Using the criteria proposed by the FNIH, patients with a diagnosis of sarcopenia were 43 (33.9%). After adjustment for potential confounders, participants with sarcopenia had a significant increased risk of incomplete functional recovery compared with non-sarcopenic patients (OR 3.07, 95% CI 1.07-8.75). Compared with participants without sarcopenia, those with sarcopenia showed lower Barthel index scores at the time of discharge from the rehabilitation unit (69.2 versus 58.9, respectively; p < 0.001) and after 3 months of follow-up (90.9 versus 80.5, respectively; p = 0.02). CONCLUSIONS These findings support the systematic assessment of sarcopenia among older adults receiving rehabilitation programs to assist in the development of personalized treatment plans aimed at improving functional outcomes.
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Affiliation(s)
- F Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
- Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, 00168, Rome, Italy.
| | - R Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - E Ortolani
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - S Salini
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - A M Martone
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - L Santoro
- Department of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - A Santoliquido
- Department of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - A Sisto
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - A Picca
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - E Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
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128
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Zukeran MS, Ribeiro SML. The Importance of Nutrition in a Conceptual Framework of Frailty Syndrome. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0195-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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129
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Exercise and Protein Intake: A Synergistic Approach against Sarcopenia. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2672435. [PMID: 28421192 PMCID: PMC5379082 DOI: 10.1155/2017/2672435] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/22/2016] [Accepted: 01/30/2017] [Indexed: 01/06/2023]
Abstract
Sarcopenia, the age-dependent loss of muscle mass and function/strength, is increasingly recognized as a major risk factor for adverse outcomes in frail older people. As such, the skeletal muscle is a relevant target for interventions aimed at preventing or postponing the occurrence of negative health-related events in late life. The association among physical inactivity, insufficient intake of energy and protein, and poor muscle health in older adults suggests that physical exercise and targeted nutritional supplementation may offer substantial therapeutic gain against sarcopenia and its negative correlates. This view is supported by observational studies as well as by small-scale clinical trials. In this review, we summarize the available evidence on the beneficial effects of behavioral interventions on sarcopenia. We also briefly describe how the knowledge gathered so far has been used to design the “Sarcopenia and Physical fRailty IN older people: multicomponenT Treatment strategies” (SPRINTT) project. The randomized clinical trial conducted within SPRINTT will provide robust evidence on the effectiveness of exercise and nutrition at preventing negative outcomes associated with sarcopenia and physical frailty.
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130
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Ethgen O, Beaudart C, Buckinx F, Bruyère O, Reginster JY. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action. Calcif Tissue Int 2017; 100:229-234. [PMID: 28012107 PMCID: PMC5313588 DOI: 10.1007/s00223-016-0220-9] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/10/2016] [Indexed: 11/25/2022]
Abstract
Sarcopenia is a major public health issue. To convince health policy makers of the emergency to invest in the sarcopenia field, it is of critical importance to produce reliable figures of the expected burden of sarcopenia in the coming years. Age- and gender-specific population projections were retrieved until 2045 from the Eurostat online database (28 European countries). Age- and gender-specific prevalences of sarcopenia were interpolated from a study that compared prevalence estimates according to the different diagnostic cutoffs of the EWGSOP proposed definition. The reported prevalence estimates were interpolated between 65 and 100 years. Interpolated age- and gender-specific estimates of sarcopenia prevalence were then applied to population projections until 2045. Using the definition providing the lowest prevalence estimates, the number of individuals with sarcopenia would rise in Europe from 10,869,527 in 2016 to 18,735,173 in 2045 (a 72.4% increase). This corresponds to an overall prevalence of sarcopenia in the elderly rising from 11.1% in 2016 to 12.9% in 2045. With the definition providing the highest prevalence estimates, the number of individuals with sarcopenia would rise from 19,740,527 in 2016 to 32,338,990 in 2045 (a 63.8% increase), corresponding to overall prevalence rates in the elderly of 20.2% and 22.3% for 2016 and 2045, respectively. We showed that the number of sarcopenic patients will dramatically increase in the next 30 years, making consequences of muscle wasting a major public health issue.
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Affiliation(s)
- O Ethgen
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - C Beaudart
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - F Buckinx
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - O Bruyère
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, Liège State University, Quartier Hôpital, CHU B23, Avenue Hippocrate, 13, 4000, Liège, Belgium.
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Abstract
Sarcopenia, the age-dependent loss of muscle mass and function, is a common condition among older adults, and is associated with several adverse health outcomes. Owing to the impact of sarcopenia on quality of life, disability and mortality, a greater awareness is necessary in order to correctly identify the condition both in community and geriatric settings. Research on sarcopenia prevention and treatment is developing quickly, but many questions are still unanswered. The core of the sarcopenia condition involves quantitative and qualitative losses of skeletal muscle. These two dimensions should therefore be considered when designing and testing preventive and therapeutic interventions. The recently released operationalization of sarcopenia by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project allows for the framing of an objective, standardized, and clinically relevant condition, which should facilitate its translation into the clinical arena as well as its adoption by public health and regulatory agencies. Such a conceptualization might eventually encourage key stakeholders to combine their efforts in approaching the sarcopenia condition. Bearing these considerations in mind, the "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" project has operationalized a specific condition, named physical frailty and sarcopenia (PF&S), characterized by the combination of low physical performance (based on the Short Physical Performance Battery) and low muscle mass (according to the FNIH cut-points). A randomized controlled trial will be conducted to evaluate the efficacy of a multi-component intervention for preventing mobility disability and other adverse health outcomes in older adults with PF&S.
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The "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT) randomized controlled trial: design and methods. Aging Clin Exp Res 2017; 29:89-100. [PMID: 28144914 DOI: 10.1007/s40520-016-0715-2] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/11/2016] [Indexed: 02/01/2023]
Abstract
The sustainability of health and social care systems is threatened by a growing population of older persons with heterogeneous needs related to multimorbidity, frailty, and increased risk of functional impairment. Since disability is difficult to reverse in old age and is extremely burdensome for individuals and society, novel strategies should be devised to preserve adequate levels of function and independence in late life. The development of mobility disability, an early event in the disablement process, precedes and predicts more severe forms of inability. Its prevention is, therefore, critical to impede the transition to overt disability. For this reason, the Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT) project is conducting a randomized controlled trial (RCT) to test a multicomponent intervention (MCI) specifically designed to prevent mobility disability in high-risk older persons. SPRINTT is a phase III, multicenter RCT aimed at comparing the efficacy of a MCI, based on long-term structured physical activity, nutritional counseling/dietary intervention, and an information and communication technology intervention, versus a healthy aging lifestyle education program designed to prevent mobility disability in 1500 older persons with physical frailty and sarcopenia who will be followed for up to 36 months. The primary outcome of the SPRINTT trial is mobility disability, operationalized as the inability to walk for 400 m within 15 min, without sitting, help of another person, or the use of a walker. Secondary outcomes include changes in muscle mass and strength, persistent mobility disability, falls and injurious falls, disability in activities of daily living, nutritional status, cognition, mood, the use of healthcare resources, cost-effectiveness analysis, quality of life, and mortality rate. SPRINTT results are expected to promote significant advancements in the management of frail older persons at high risk of disability from both clinical and regulatory perspectives. The findings are also projected to pave the way for major investments in the field of disability prevention in old age.
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133
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Landi F, Calvani R, Tosato M, Martone AM, Picca A, Ortolani E, Savera G, Salini S, Ramaschi M, Bernabei R, Marzetti E. Animal-Derived Protein Consumption Is Associated with Muscle Mass and Strength in Community-Dwellers: Results from the Milan EXPO Survey. J Nutr Health Aging 2017; 21:1050-1056. [PMID: 29083447 DOI: 10.1007/s12603-017-0974-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Behavioral factors, including protein intake, influence the quantity and quality of skeletal muscle. The aim of this study was to explore the relationship between animal-derived protein intake and muscle mass and function in a large sample of unselected community-dwellers. MATERIAL AND METHODS The VIP (Very Important Protein) study, conducted during Expo 2015 in Milan, was a population survey aimed at assessing major health metrics in a population outside of the research setting, with a special focus on the relation between animal-derived protein intake and muscle mass and function. A brief questionnaire exploring lifestyle habits, dietary preferences and the consumption of selected foods was administered. Muscle mass was estimated by calf circumference (CC) and mid-arm muscle circumference (MAMC) of the dominant side. Muscle strength of upper and lower extremities was assessed through handgrip strength testing and repeated chair stand test, respectively. RESULTS The mean age of the 1,853 participants was 50.3 years (standard deviation: 15.7; range: 18-98 years), of whom 959 (51.7%) were women. Participants in the highest tertile of protein consumption showed better performance at both the handgrip strength (p <0.001) and chair stand tests than those in the lowest tertile (p <0.01). The same results were found for CC (p <0.001) and MAMC (p <0.001). Participants with high protein intake and engaged in regular physical activity showed the higher scores in all the assessed domains. CONCLUSIONS The results of the VIP survey suggest an association between animal-derived protein intake and muscle mass and strength across ages. Our findings also indicate a synergistic effect of animal-derived protein intake and physical activity on muscle-related parameters.
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Affiliation(s)
- F Landi
- Francesco Landi, MD, PhD - Center for Geriatric Medicine [CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy. Phone: +39 (06) 3388546, Fax: +39 (06) 3051-911, e-mail:
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Miki A, Hashimoto Y, Matsumoto S, Ushigome E, Fukuda T, Sennmaru T, Tanaka M, Yamazaki M, Fukui M. Protein Intake, Especially Vegetable Protein Intake, Is Associated with Higher Skeletal Muscle Mass in Elderly Patients with Type 2 Diabetes. J Diabetes Res 2017; 2017:7985728. [PMID: 29209633 PMCID: PMC5676451 DOI: 10.1155/2017/7985728] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/20/2017] [Accepted: 10/04/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/AIMS Protein intake is important for maintaining muscle mass in general population. However, it remains to be elucidated the association between dietary protein intake and skeletal muscle mass in elderly patients with type 2 diabetes. METHODS In this cross-sectional study of 168 elderly patients with type 2 diabetes, we investigated the relationship between skeletal muscle index (SMI) and protein intake. Bioimpedance analysis was used for measurement for skeletal muscle mass (kg) and SMI (%), which was defined as skeletal muscle mass (kg)/total body weight (kg) × 100. Habitual food and nutrient intake were estimated by a questionnaire. RESULTS Protein intake was independently correlated with SMI after adjusting for age, hemoglobin A1c, C-peptide index, exercise, smoking, insulin treatment, total energy intake, and C-reactive protein (standardized regression coefficient = 0.664, P < 0.001 in men and standardized regression coefficient = 0.516, P = 0.005 in women). Additionally, the animal protein to vegetable protein ratio was negatively correlated with SMI after adjusting for covariates in men (standardized regression coefficient = -0.339, P = 0.005). CONCLUSIONS We found that total protein intake, especially vegetable protein intake, was positively associated with skeletal muscle mass in elderly patients with type 2 diabetes.
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Affiliation(s)
- Akane Miki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Shinobu Matsumoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Takuya Fukuda
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Takafumi Sennmaru
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
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Landi F, Calvani R, Tosato M, Martone AM, Fusco D, Sisto A, Ortolani E, Savera G, Salini S, Marzetti E. Age-Related Variations of Muscle Mass, Strength, and Physical Performance in Community-Dwellers: Results From the Milan EXPO Survey. J Am Med Dir Assoc 2017; 18:88.e17-88.e24. [DOI: 10.1016/j.jamda.2016.10.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 12/25/2022]
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