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Pedersen MM, Petersen J, Beyer N, Larsen HGJ, Jensen PS, Andersen O, Bandholm T. A randomized controlled trial of the effect of supervised progressive cross-continuum strength training and protein supplementation in older medical patients: the STAND-Cph trial. Trials 2019; 20:655. [PMID: 31779693 PMCID: PMC6883554 DOI: 10.1186/s13063-019-3720-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 09/13/2019] [Indexed: 01/03/2023] Open
Abstract
Background During hospitalization, older adults (+ 65 years) are inactive, which puts them at risk of functional decline and loss of independence. Systematic strength training can prevent loss of functional performance and combining strength training with protein supplementation may enhance the response in muscle mass and strength. However, we lack knowledge about the effect of strength training commenced during hospitalization and continued after discharge in older medical patients. This assessor-blinded, randomized study investigated the effect of a simple, supervised strength training program for the lower extremities, combined with post-training protein supplementation during hospitalization and in the home setting for 4 weeks after discharge, on the effect on change in mobility in older medical patients. Methods Older medical patients (≥ 65 years) admitted acutely from their home to the Emergency Department were randomized to either standard care or supervised progressive strength training and an oral protein supplement during hospitalization and at home 3 days/week for 4 weeks after discharge. The primary outcome was between-group difference in change in mobility from baseline to 4 weeks after discharge assessed by the De Morton Mobility Index, which assesses bed mobility, chair mobility, static and dynamic balance, and walking. Secondary outcomes were 24-h mobility, lower extremity strength, gait speed, grip strength and activities of daily living. Results Eighty-five patients were randomized to an intervention group (N = 43) or a control group (N = 42). In the intervention group, 43% were highly compliant with the intervention. Our intention-to-treat analysis revealed no between-group difference in mobility (mean difference in change from baseline to 4 weeks, − 4.17 (95% CI − 11.09; 2.74; p = 0.24) nor in any of the secondary outcomes. The per-protocol analysis showed that the daily number of steps taken increased significantly more in the intervention group compared to the control group (mean difference in change from baseline to 4 weeks, 1033.4 steps (95% CI 4.1; 2062.7), p = 0.049, adjusted for mobility at baseline and length of stay; 1032.8 steps (95% CI 3.6; 2061.9), p = 0.049, adjusted for mobility at baseline, length of stay, and steps at baseline). Conclusions Simple supervised strength training for the lower extremities, combined with protein supplementation initiated during hospitalization and continued at home for 4 weeks after discharge was not superior to usual care in the effect on change in mobility at 4 weeks in older medical patients. For the secondary outcome, daily number of steps, high compliance with the intervention resulted in a greater daily number of steps. Less than half of the patients were compliant with the intervention indicating that a simpler intervention might be needed. Trial registration ClinicalTrials.gov, NCT01964482. Registered on 14 October 2013. Trial protocol PubMed ID (PMID), 27039381.
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Affiliation(s)
- Mette Merete Pedersen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.
| | - Janne Petersen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5 Entrance B, 2nd floor, 1014, Copenhagen K, Denmark.,Center for Clinical Research and Prevention, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, Copenhagen N, Denmark
| | - Nina Beyer
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, Copenhagen N, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Helle Gybel-Juul Larsen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Pia Søe Jensen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Department of Orthopaedic Surgery, Copenhagen University Hospital, Kettegaard Alle 30, 2650, Hvidovre, Denmark
| | - Ove Andersen
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.,The Emergency Department, Copenhagen University Hospital, Kettegaard Alle 30, 2650, Hvidovre, Denmark
| | - Thomas Bandholm
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Department of Orthopaedic Surgery, Copenhagen University Hospital, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Department of Physical- and Occupational Therapy, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark
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152
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Takae R, Hatamoto Y, Yasukata J, Kose Y, Komiyama T, Ikenaga M, Yoshimura E, Yamada Y, Ebine N, Higaki Y, Tanaka H. Physical Activity and/or High Protein Intake Maintains Fat-Free Mass in Older People with Mild Disability; the Fukuoka Island City Study: A Cross-Sectional Study. Nutrients 2019; 11:nu11112595. [PMID: 31671741 PMCID: PMC6893506 DOI: 10.3390/nu11112595] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 12/21/2022] Open
Abstract
Body composition changes with age, with fat mass (FM) increasing and fat-free mass (FFM) decreasing. Higher physical activity and high or adequate protein intake are thought to be beneficial in preventing the loss of skeletal muscle mass in the elderly. We aimed to investigate the relationships between physical activity, protein intake, and FFM in older people with mild disability. Total energy expenditure (TEE) under free-living conditions was assessed using the doubly-labelled water (DLW) method, and physical activity was measured using a triaxial accelerometer. Dietary intake was assessed using a self-recorded food intake diary during the DLW period. Percent FFM was significantly positively correlated with protein intake and physical activity level (PAL) after adjustment for age and sex (protein intake r = 0.652, p < 0.001, PAL r = 0.345, p = 0.011). In multiple linear regression analysis, when PAL, moderate-to-vigorous physical activity (MVPA), or protein intake were included, 31%, 32%, and 55%, respectively, of the variation in %FFM was explained. Moreover, the addition of both PAL/MVPA and protein intake explained 61%/60%, respectively, of the variation in %FFM. Either protein intake above the currently recommended level or higher levels of physical activity would be beneficial for the maintenance of high %FFM.
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Affiliation(s)
- Rie Takae
- Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Yoichi Hatamoto
- Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Jun Yasukata
- Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, 8-19-1 Nanakuma Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan.
| | - Yujiro Kose
- Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, 8-19-1 Nanakuma Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan.
| | - Takaaki Komiyama
- Graduate School of Sports and Health Science, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
- Center for Education in Liberal Arts and Sciences, Osaka University, 1-17 Machikaneyamachou, Toyonaka, Osaka 560-0043, Japan.
| | - Masahiro Ikenaga
- Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
| | - Eiichi Yoshimura
- Department of Food and Health Sciences, Prefectural University of Kumamoto Faculty of Environmental and Symbiotic Sciences, 3-1-100 Tsukide, Higashi-ku, Kumamoto 862-8502, Japan.
| | - Yosuke Yamada
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha University, 1-3 Miyakodani Tatara, Kyotanabe-shi, Kyoto 610-0394, Japan.
| | - Yasuki Higaki
- Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, 8-19-1 Nanakuma Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan.
| | - Hiroaki Tanaka
- Institute for Physical Activity, Fukuoka University, 8-19-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka, 8-19-1 Nanakuma Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan.
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153
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Xu Y, Guo Z, Huang L, Gong J, Li Y, Gu L, Shen W, Zhu W. A nomogram for predicting the response to exclusive enteral nutrition in adult patients with isolated colonic Crohn's disease. Therap Adv Gastroenterol 2019; 12:1756284819881301. [PMID: 31656533 PMCID: PMC6791043 DOI: 10.1177/1756284819881301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/18/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Isolated colonic Crohn's disease (cCD) responds less well to induction therapy with exclusive enteral nutrition (EEN) compared with ileal or ileocolonic disease in adult patients; therefore, we aimed to identify the factors that influence the response to EEN and develop a predictive nomogram model to optimize the use of EEN in cCD patients. MATERIALS AND METHODS Eighty-five cCD patients treated with EEN as first-line therapy at our center between 1 June 2012 and 30 June 2018 were retrospectively analyzed as the primary cohort. The primary endpoint was clinical remission after EEN therapy. Potential predictive factors for the efficacy of EEN were assessed by univariate and multivariate analyses, and a nomogram to predict the response to EEN therapy in cCD patients was designed. Another 19 cCD patients were retrospectively included in the validation cohort to verify the accuracy of the nomogram model. RESULTS The clinical remission rates for the primary cohort and validation cohort were 52.9% and 47.4%, respectively. Pancolitis was the greatest contributor to the risk of failure to respond to EEN [odds ratio (OR) = 4.896; 95% confidence interval (CI) = 1.223-19.607; p = 0.025], lean body mass index (LBMI), colonic lesion features, simple endoscopic scores for Crohn's disease, C-reactive protein before treatment and ∆prealbumin were also related to the efficacy of EEN in cCD. The nomogram model showed robust discrimination, with an area under the receiving operating characteristic curve of 0.906. CONCLUSION Several predictive factors for response to EEN therapy in cCD adult patients were identified, and a promising nomogram that can predict the effect of EEN in cCD was developed.
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Affiliation(s)
- Yihan Xu
- Nanjing Medical University, Nanjing, China Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Zhen Guo
- Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Liangyu Huang
- Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Jianfeng Gong
- Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Yi Li
- Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Lili Gu
- Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Weisong Shen
- Research Institute of General Surgery, Jinling Hospital, Nanjing, China
| | - Weiming Zhu
- Research Institute of General Surgery, Nanjing Jinling Hospital, 305 Zhongshan East Road, Nanjing 210002, China
- Nanjing Medical University, 305 Zhongshan East Road, Nanjing, Jiangsu 210029, China
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154
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Schoufour JD, Overdevest E, Weijs PJM, Tieland M. Dietary Protein, Exercise, and Frailty Domains. Nutrients 2019; 11:E2399. [PMID: 31597289 PMCID: PMC6835617 DOI: 10.3390/nu11102399] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 01/08/2023] Open
Abstract
Increasing awareness of the impact of frailty on elderly people resulted in research focusing on factors that contribute to the development and persistence of frailty including nutrition and physical activity. Most effort so far has been spent on understanding the association between protein intake and the physical domain of frailty. Far less is known for other domains of frailty: cognition, mood, social health and comorbidity. Therefore, in the present narrative review, we elaborate on the evidence currently known on the association between protein and exercise as well as the broader concept of frailty. Most, but not all, identified studies concluded that low protein intake is associated with a higher prevalence and incidence of physical frailty. Far less is known on the broader concept of frailty. The few studies that do look into this association find a clear beneficial effect of physical activity but no conclusions regarding protein intake can be made yet. Similar, for other important aspects of frailty including mood, cognition, and comorbidity, the number of studies are limited and results are inconclusive. Future studies need to focus on the relation between dietary protein and the broader concept of frailty and should also consider the protein source, amount and timing.
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Affiliation(s)
- Josje D Schoufour
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1097 DZ Amsterdam, The Netherlands.
- Faculty Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1097 DZ Amsterdam, The Netherlands.
| | - Elvera Overdevest
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1097 DZ Amsterdam, The Netherlands.
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1097 DZ Amsterdam, The Netherlands.
- Amsterdam University Medical Centers, University of Amsterdam, 1012 WX Amsterdam, The Netherlands.
| | - Michael Tieland
- Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1097 DZ Amsterdam, The Netherlands.
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155
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Valenzuela PL, Castillo-García A, Morales JS, Izquierdo M, Serra-Rexach JA, Santos-Lozano A, Lucia A. Physical Exercise in the Oldest Old. Compr Physiol 2019; 9:1281-1304. [PMID: 31688965 DOI: 10.1002/cphy.c190002] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Societies are progressively aging, with the oldest old (i.e., those aged >80-85 years) being the most rapidly expanding population segment. However, advanced aging comes at a price, as it is associated with an increased incidence of the so-called age-related conditions, including a greater risk for loss of functional independence. How to combat sarcopenia, frailty, and overall intrinsic capacity decline in the elderly is a major challenge for modern medicine, and exercise appears to be a potential solution. In this article, we first summarize the physiological mechanisms underlying the age-related deterioration in intrinsic capacity, particularly regarding those phenotypes related to functional decline. The main methods available for the physical assessment of the oldest old are then described, and finally the multisystem benefits that exercise (or "exercise mimetics" in those situations in which volitional exercise is not feasible) can provide to this population segment are reviewed. In summary, lifetime physical exercise can help to attenuate the loss of many of the properties affected by aging, especially when the latter is accompanied by an inactive lifestyle and benefits can also be obtained in frail individuals who start exercising at an advanced age. Multicomponent programs combining mainly aerobic and resistance training should be included in the oldest old, particularly during disuse situations such as hospitalization. However, evidence is still needed to support the effectiveness of passive physical strategies including neuromuscular electrical stimulation or vibration for the prevention of disuse-induced negative adaptations in those oldest old people who are unable to do physical exercise. © 2019 American Physiological Society. Compr Physiol 9:1281-1304, 2019.
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Affiliation(s)
- Pedro L Valenzuela
- Department of Systems Biology, University of Alcalá, Madrid, Spain
- Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | | | - Javier S Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Mikel Izquierdo
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Department of Health Sciences, Public University of Navarra, Navarrabiomed, Idisna, Pamplona, Spain
| | - José A Serra-Rexach
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain
- Department of Geriatric, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain and Research Institute Hospital 12 de Octubre (ì+12'), Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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156
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McGlory C, von Allmen MT, Stokes T, Morton RW, Hector AJ, Lago BA, Raphenya AR, Smith BK, McArthur AG, Steinberg GR, Baker SK, Phillips SM. Failed Recovery of Glycemic Control and Myofibrillar Protein Synthesis With 2 wk of Physical Inactivity in Overweight, Prediabetic Older Adults. J Gerontol A Biol Sci Med Sci 2019; 73:1070-1077. [PMID: 29095970 DOI: 10.1093/gerona/glx203] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 10/17/2017] [Indexed: 11/13/2022] Open
Abstract
Background Physical inactivity impairs insulin sensitivity, which is exacerbated with aging. We examined the impact of 2 wk of acute inactivity and recovery on glycemic control, and integrated rates of muscle protein synthesis in older men and women. Methods Twenty-two overweight, prediabetic older adults (12 men, 10 women, 69 ± 4 y) undertook 7 d of habitual activity (baseline; BL), step reduction (SR; <1,000 steps.d-1 for 14 d), followed by 14 d of recovery (RC). An oral glucose tolerance test was used to assess glycemic control and deuterated water ingestion to measure integrated rates of muscle protein synthesis. Results Daily step count was reduced (all p < .05) from BL at SR (7362 ± 3294 to 991 ± 97) and returned to BL levels at RC (7117 ± 3819). Homeostasis model assessment-insulin resistance increased from BL to SR and Matsuda insulin sensitivity index decreased and did not return to BL in RC. Glucose and insulin area under the curve were elevated from BL to SR and did not recover in RC. Integrated muscle protein synthesis was reduced during SR and did not return to BL in RC. Conclusions Our findings demonstrate that 2 wk of SR leads to lowered rates of muscle protein synthesis and a worsening of glycemic control that unlike younger adults is not recovered during return to normal activity in overweight, prediabetic elderly humans. Clinical Trials Registration ClinicalTrials.gov identifier: NCT03039556.
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Affiliation(s)
- Chris McGlory
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Mark T von Allmen
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Tanner Stokes
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Robert W Morton
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Amy J Hector
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Briony A Lago
- Michael G. DeGroote Institute for Infectious Disease Research and the Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Amogelang R Raphenya
- Michael G. DeGroote Institute for Infectious Disease Research and the Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Brennan K Smith
- Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada
| | - Andrew G McArthur
- Michael G. DeGroote Institute for Infectious Disease Research and the Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Gregory R Steinberg
- Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada.,Department of Biochemistry, McMaster University, Hamilton, Ontario, Canada
| | - Steven K Baker
- Division of Physical Medicine and Rehabilitation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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157
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Meex RCR, Blaak EE, van Loon LJC. Lipotoxicity plays a key role in the development of both insulin resistance and muscle atrophy in patients with type 2 diabetes. Obes Rev 2019; 20:1205-1217. [PMID: 31240819 PMCID: PMC6852205 DOI: 10.1111/obr.12862] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 12/12/2022]
Abstract
Insulin resistance and muscle mass loss often coincide in individuals with type 2 diabetes. Most patients with type 2 diabetes are overweight, and it is well established that obesity and derangements in lipid metabolism play an important role in the development of insulin resistance in these individuals. Specifically, increased adipose tissue mass and dysfunctional adipose tissue lead to systemic lipid overflow and to low-grade inflammation via altered secretion of adipokines and cytokines. Furthermore, an increased flux of fatty acids from the adipose tissue may contribute to increased fat storage in the liver and in skeletal muscle, resulting in an altered secretion of hepatokines, mitochondrial dysfunction, and impaired insulin signalling in skeletal muscle. Recent studies suggest that obesity and lipid derangements in adipose tissue can also lead to the development of muscle atrophy, which would make insulin resistance and muscle atrophy two sides of the same coin. Unfortunately, the exact relationship between lipid accumulation, type 2 diabetes, and muscle atrophy remains largely unexplored. The aim of this review is to discuss the relationship between type 2 diabetes and muscle loss and to discuss some of the joint pathways through which lipid accumulation in organs may affect peripheral insulin sensitivity and muscle mass.
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Affiliation(s)
- Ruth C R Meex
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Luc J C van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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158
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Kouw IWK, van Dijk JW, Horstman AMH, Kramer IF, Goessens JPB, van Dielen FMH, Verdijk LB, van Loon LJC. Basal and Postprandial Myofibrillar Protein Synthesis Rates Do Not Differ between Lean and Obese Middle-Aged Men. J Nutr 2019; 149:1533-1542. [PMID: 31174213 PMCID: PMC6736155 DOI: 10.1093/jn/nxz104] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/28/2019] [Accepted: 04/25/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Excess lipid availability has been associated with the development of anabolic resistance. As such, obesity may be accompanied by impairments in muscle protein metabolism. OBJECTIVE We hypothesized that basal and postprandial muscle protein synthesis rates are lower in obese than in lean men. METHODS Twelve obese men [mean ± SEM age: 48 ± 2 y; BMI (in kg/m2): 37.0 ± 1.5; body fat: 32 ± 2%] and 12 age-matched lean controls (age: 43 ± 3 y; BMI: 23.4 ± 0.4; body fat: 21 ± 1%) received primed continuous L-[ring-2H5]-phenylalanine and L-[ring-3,5-2H2]-tyrosine infusions and ingested 25 g intrinsically L-[1-13C]-phenylalanine labeled whey protein. Repeated blood and muscle samples were obtained to assess protein digestion and amino acid absorption kinetics, and basal and postprandial myofibrillar protein synthesis rates. RESULTS Exogenous phenylalanine appearance rates increased after protein ingestion in both groups (P < 0.001), with a total of 53 ± 1% and 53 ± 2% of dietary protein-derived phenylalanine appearing in the circulation over the 5-h postprandial period in lean and obese men, respectively (P = 0.82). After protein ingestion, whole-body protein synthesis and oxidation rates increased to a greater extent in lean men than in the obese (P-interaction < 0.05), resulting in a higher whole-body protein net balance in the lean than in the obese (7.1 ± 0.2 and 4.6 ± 0.4 µmol phenylalanine · h-1 · kg-1, respectively; P-interaction < 0.001). Myofibrillar protein synthesis rates increased from 0.030 ± 0.002 and 0.028 ± 0.003%/h in the postabsorptive period to 0.034 ± 0.002 and 0.035 ± 0.003%.h-1 in the 5-h postprandial period (P = 0.03) in lean and obese men, respectively, with no differences between groups (P-interaction = 0.58). CONCLUSIONS Basal, postabsorptive myofibrillar protein synthesis rates do not differ between lean and obese middle-aged men. Postprandial protein handling, including protein digestion and amino acid absorption, and the postprandial muscle protein synthetic response after the ingestion of 25 g whey protein are not impaired in obese men. This trial was registered at www.trialregister.nl as NTR4060.
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Affiliation(s)
- Imre W K Kouw
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands,Top Institute Food and Nutrition, Wageningen, Netherlands
| | - Jan Willem van Dijk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands,Top Institute Food and Nutrition, Wageningen, Netherlands
| | - Astrid M H Horstman
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands,Top Institute Food and Nutrition, Wageningen, Netherlands
| | - Irene Fleur Kramer
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands,Top Institute Food and Nutrition, Wageningen, Netherlands
| | - Joy P B Goessens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | | | - Lex B Verdijk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands,Top Institute Food and Nutrition, Wageningen, Netherlands
| | - Luc J C van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands,Top Institute Food and Nutrition, Wageningen, Netherlands,Address correspondence to LJCvL (e-mail: )
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159
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McKendry J, Shad BJ, Smeuninx B, Oikawa SY, Wallis G, Greig C, Phillips SM, Breen L. Comparable Rates of Integrated Myofibrillar Protein Synthesis Between Endurance-Trained Master Athletes and Untrained Older Individuals. Front Physiol 2019; 10:1084. [PMID: 31543824 PMCID: PMC6728413 DOI: 10.3389/fphys.2019.01084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/07/2019] [Indexed: 12/21/2022] Open
Abstract
Background An impaired muscle anabolic response to exercise and protein nutrition is thought to underpin age-related muscle loss, which may be exacerbated by aspects of biological aging that may not be present in older individuals who have undertaken long-term high-level exercise training, or master athletes (MA). The aim of this study was to compare rested-state and exercise-induced rates of integrated myofibrillar protein synthesis (iMyoPS) and intracellular signaling in endurance trained MA and healthy age-matched untrained individuals (Older Controls). Methods In a parallel study design, iMyoPS rates were determined over 48 h in the rested-state and following a bout of unaccustomed resistance exercise (RE) in OC (n = 8 males; 73.5 ± 3.3 years) and endurance-trained MA (n = 7 males; 68.9 ± 5.7 years). Intramuscular anabolic signaling was also determined. During the iMyoPS measurement period, physical activity was monitored via accelerometry and dietary intake was controlled. Results Anthropometrics, habitual activity, and dietary intake were similar between groups. There was no difference in rested-state rates of iMyoPS between OC (1.47 ± 0.06%⋅day–1) and MA (1.46 ± 0.08%⋅day–1). RE significantly increased iMyoPS above rest in both OC (1.60 ± 0.08%⋅day–1, P < 0.01) and MA (1.61 ± 0.08%⋅day–1, P < 0.01), with no difference between groups. AktThr308 phosphorylation increased at 1 h post-RE in OC (P < 0.05), but not MA. No other between-group differences in intramuscular signaling were apparent at any time-point. Conclusion While our sample size is limited, these data suggest that rested-state and RE-induced iMyoPS are indistinguishable between MA and OC. Importantly, the OC retain a capacity for RE-induced stimulation of skeletal muscle remodeling.
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Affiliation(s)
- James McKendry
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Brandon J Shad
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Gareth Wallis
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Carolyn Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, Birmingham, United Kingdom.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, Birmingham, United Kingdom.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
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160
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Muyskens JB, Foote DM, Bigot NJ, Strycker LA, Smolkowski K, Kirkpatrick TK, Lantz BA, Shah SN, Mohler CG, Jewett BA, Owen EC, Dreyer HC. Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty. J Appl Physiol (1985) 2019; 127:531-545. [PMID: 31343947 DOI: 10.1152/japplphysiol.00869.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Investigate the underlying cellular basis of muscle atrophy (Placebo) and atrophy reduction (essential amino acid supplementation, EAAs) in total knee arthroplasty (TKA) patients by examining satellite cells and other key histological markers of inflammation, recovery, and fibrosis. Forty-one subjects (53-76 yr) scheduled for TKA were randomized into two groups, ingesting 20 g of EAAs or placebo, twice-daily, for 7 days before TKA and for 6 wk after surgery. A first set of muscle biopsies was obtained from both legs before surgery in the operating room, and patients were randomly assigned and equally allocated to have two additional biopsies at either 1 or 2 wk after surgery. Biopsies were processed for gene expression and immunohistochemistry. Satellite cells were significantly higher in patients ingesting 20 g of essential amino acids twice daily for the 7 days leading up to surgery compared with Placebo (operative leg P = 0.03 for satellite cells/fiber and P = 0.05 for satellite cell proportions for Type I-associated cells and P = 0.05 for satellite cells/fiber for Type II-associated cells.) Myogenic regulatory factor gene expression was different between groups, with the Placebo Group having elevated MyoD expression at 1 wk and EAAs having elevated myogenin expression at 1 wk. M1 macrophages were more prevalent in Placebo than the EAAs Group. IL-6 and TNF-α transcripts were elevated postsurgery in both groups; however, TNF-α declined by 2 wk in the EAAs Group. EAAs starting 7 days before surgery increased satellite cells on the day of surgery and promoted a more favorable inflammatory environment postsurgery.NEW & NOTEWORTHY Clinical studies by our group indicate that the majority of muscle atrophy after total knee arthroplasty (TKA) in older adults occurs rapidly, within the first 2 wks. We have also shown that essential amino acid supplementation (EAAs) before and after TKA mitigates muscle atrophy; however, the mechanisms are unknown. These results suggest that satellite cell numbers are elevated with EAA ingestion before surgery, and after surgery, EAA ingestion positively influences markers of inflammation. Combined, these data may help inform further studies designed to address the accelerated sarcopenia that occurs in older adults after major surgery.
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Affiliation(s)
| | - Douglas M Foote
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Nathan J Bigot
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | | | | | - Brick A Lantz
- Slocum Center for Orthopedics and Sports Medicine, Eugene, Oregon
| | - Steven N Shah
- Slocum Center for Orthopedics and Sports Medicine, Eugene, Oregon
| | - Craig G Mohler
- Slocum Center for Orthopedics and Sports Medicine, Eugene, Oregon
| | - Brian A Jewett
- Slocum Center for Orthopedics and Sports Medicine, Eugene, Oregon
| | - Erin C Owen
- Slocum Research and Education Foundation, Eugene, Oregon
| | - Hans C Dreyer
- Department of Human Physiology, University of Oregon, Eugene, Oregon
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161
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Long-chain n-3 fatty acids as an essential link between musculoskeletal and cardio-metabolic health in older adults. Proc Nutr Soc 2019; 79:47-55. [PMID: 31282319 DOI: 10.1017/s0029665119000922] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This narrative review aims to critically evaluate scientific evidence exploring the therapeutic role(s) of long-chain n-3 PUFA in the context of ageing, and specifically, sarcopenia. We highlight that beyond impairments in physical function and a lack of independence, the age-related decline in muscle mass has ramifications for cardio-metabolic health. Specifically, skeletal muscle is crucial in regulating blood glucose homeostasis (and by extension reducing type 2 diabetes mellitus risk) and providing gluconeogenic precursors that are critical for survival during muscle wasting conditions (i.e. AIDS). Recent interest in the potential anabolic action of n-3 PUFA is based on findings from experimental studies that measured acute changes in the stimulation of muscle protein synthesis (MPS) and/or chronic changes in muscle mass and strength in response to fish oil-derived n-3 PUFA supplementation. Key findings include a potentiated response of MPS to amino acid provision or resistance-based exercise with n-3 PUFA in healthy older adults that extrapolated to longer-term changes in muscle mass and strength. The key mechanism(s) underpinning this enhanced response of MPS remains to be fully elucidated, but is likely driven by the incorporation of exogenous n-3 PUFA into the muscle phospholipid membrane and subsequent up-regulation of cell signalling proteins known to control MPS. In conclusion, multiple lines of evidence suggest that dietary n-3 PUFA provide an essential link between musculoskeletal and cardio-metabolic health in older adults. Given that western diets are typically meagre in n-3 PUFA content, nutritional recommendations for maintaining muscle health with advancing age should place greater emphasis on dietary n-3 PUFA intake.
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162
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Reidy PT, Yonemura NM, Madsen JH, McKenzie AI, Mahmassani ZS, Rondina MT, Lin YK, Kaput K, Drummond MJ. An accumulation of muscle macrophages is accompanied by altered insulin sensitivity after reduced activity and recovery. Acta Physiol (Oxf) 2019; 226:e13251. [PMID: 30632274 DOI: 10.1111/apha.13251] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/05/2019] [Accepted: 01/07/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mechanisms underlying physical inactivity-induced insulin resistance are not well understood. In addition to a role in muscle repair, immune cell populations such as macrophages may regulate insulin sensitivity. AIM The aim of this study was to examine if the dynamic changes in insulin sensitivity during and after recovery from reduced physical activity corresponded to changes in skeletal muscle macrophages. METHODS In this prospective clinical study, we collected muscle biopsies from healthy older adults (70 ± 2 years, n = 12) before and during a hyperinsulinaemic-euglycaemic clamp and this occurred before (PRE) and after 2-week reduced physical activity (RA), and following 2-week of recovery (REC). Insulin sensitivity (hyperinsulinaemic-euglycaemic clamp), skeletal muscle mRNA expression of inflammatory markers, and immunofluorescent quantification of skeletal muscle macrophages, myofibre-specific satellite cell and capillary content were assessed. RESULTS Insulin sensitivity was decreased following reduced activity and rebounded following recovery above PRE levels. We observed an increase (P < 0.01) in muscle macrophages (CD68+ CD206+ : 190 [55, 324]; CD11b+ CD206+ : 117 [28, 205]% change from PRE) and CD68 (2.4 [1.4, 3.4]-fold) and CCL2 (1.9 [1.3, 2.5]-fold) mRNA following RA concurrent with increased (P < 0.03) satellite cells (55 [6, 104]%) in slow-twitch myofibres. Moreover, the distance of satellite cells to the nearest capillary was increased 7.7 (1.7, 13.7) µm in fast-twitch myofibres at RA (P = 0.007). Changes in macrophages were positively associated with increased insulin sensitivity following RA (R > 0.57, P < 0.05). CONCLUSION These findings suggested that a dynamic response of skeletal muscle macrophages following acute changes in physical activity in healthy older adults is related to insulin sensitivity.
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Affiliation(s)
- Paul T. Reidy
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | - Nikol M. Yonemura
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | | | - Alec I. McKenzie
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | - Ziad S. Mahmassani
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
| | - Matthew T. Rondina
- Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah
| | - Yu Kuei Lin
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah
| | - Katie Kaput
- Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine University of Utah School of Medicine Salt Lake City Utah
| | - Micah J. Drummond
- Departments of Physical Therapy and Athletic Training University of Utah Salt Lake City Utah
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Abstract
PURPOSE OF REVIEW Skeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care. RECENT FINDINGS Anabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states. Anabolic resistance describes the reduced stimulation of muscle protein synthesis to a given dose of protein/amino acids and contributes to declines in skeletal muscle mass. Physical inactivity induces: anabolic resistance (that is likely exacerbated with aging), insulin resistance, systemic inflammation, decreased satellite cell content, and decreased capillary density. Critical illness results in rapid skeletal muscle atrophy that is a result of both anabolic resistance and enhanced skeletal muscle breakdown. SUMMARY Insofar as atrophic loss of skeletal muscle mass is concerned, anabolic resistance is a principal determinant of age-induced losses and appears to be a contributor to critical illness-induced skeletal muscle atrophy. Older individuals should perform exercise using both heavy and light loads three times per week, ingest at least 1.2 g of protein/kg/day, evenly distribute their meals into protein boluses of 0.40 g/kg, and consume protein within 2 h of retiring for sleep. During critical care, early, frequent, and multimodal physical therapies in combination with early, enteral, hypocaloric energy (∼10-15 kcal/kg/day), and high-protein (>1.2 g/kg/day) provision is recommended.
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164
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Oikawa SY, Holloway TM, Phillips SM. The Impact of Step Reduction on Muscle Health in Aging: Protein and Exercise as Countermeasures. Front Nutr 2019; 6:75. [PMID: 31179284 PMCID: PMC6543894 DOI: 10.3389/fnut.2019.00075] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/03/2019] [Indexed: 12/17/2022] Open
Abstract
Declines in strength and muscle function with age—sarcopenia—contribute to a variety of negative outcomes including an increased risk of: falls, fractures, hospitalization, and reduced mobility in older persons. Population-based estimates of the loss of muscle after age 60 show a loss of ~1% per year while strength loss is more rapid at ~3% per year. These rates are not, however, linear as periodic bouts of reduced physical activity and muscle disuse transiently accelerate loss of muscle and declines in muscle strength and power. Episodic complete muscle disuse can be due to sickness-related bed rest or local muscle disuse as a result of limb immobilization/surgery. Alternatively, relative muscle disuse occurs during inactivity due to illness and the associated convalescence resulting in marked reductions in daily steps, often referred to as step reduction (SR). While it is a “milder” form of disuse, it can have a similar adverse impact on skeletal muscle health. The physiological consequences of even short-term inactivity, modeled by SR, show losses in muscle mass and strength, as well as impaired insulin sensitivity and an increase in systemic inflammation. Though seemingly benign in comparison to bed rest, periodic inactivity likely occurs, we posit, more frequently with advancing age due to illness, declining mental health and declining mobility. Given that recovery from inactivity in older adults is slow or possibly incomplete we hypothesize that accumulated periods of inactivity contribute to sarcopenia. Periodic activity, even in small quantities, and protein supplementation may serve as effective strategies to offset the loss of muscle mass with aging, specifically during periods of inactivity. The aim of this review is to examine the recent literature encompassing SR, as a model of inactivity, and to explore the capacity of nutrition and exercise interventions to mitigate adverse physiological changes as a result of SR.
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Affiliation(s)
- Sara Y Oikawa
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Tanya M Holloway
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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165
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Oikawa SY, Callahan DM, McGlory C, Toth MJ, Phillips SM. Maintenance of skeletal muscle function following reduced daily physical activity in healthy older adults: a pilot trial. Appl Physiol Nutr Metab 2019; 44:1052-1056. [PMID: 30794431 DOI: 10.1139/apnm-2018-0631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Older adults can experience periods of inactivity related to disease or illness, which can hasten the development of physical disability, in part, through reductions in skeletal muscle strength and power. To date no study has characterized adaptations in skeletal muscle physical function in response to reduced daily physical activity. Participants (15 men, aged 69 ± 2 years; 15 women, aged 68 ± 4 years) restricted their daily steps (<750 steps/day) while being energy restricted (-500 kcal/day) for 2 weeks before returning to normal activity levels during recovery (RC; 1 week). Before and after each phase, measures of knee extensor isometric maximum voluntary contraction (MVC), time-to-peak torque, and physical function were performed and muscle biopsies were taken from a subset of participants. Following the energy restriction and step-reduction phase (ER+SR), MVC was reduced by 9.1 and 6.1 Nm in men and women, respectively (p = 0.02), which returned to baseline after RC in men, but not women (p = 0.046). Maximum isometric tension in MHC IIA fibres (p < 0.01) and maximum power production in MHC I and IIA (p = 0.05) were increased by 14%, 25%, and 10%, respectively, following ER+SR. Reductions in muscle strength could not be explained by changes in single muscle fibre function in a subsample (n = 9 men) of volunteers. These data highlight the resilience of physical function in healthy older men in the face of an acute period of ER+SR and demonstrate sex-based differences in the ability to recover muscle strength upon resumption of physical activity.
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Affiliation(s)
- Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Damien M Callahan
- Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA
| | - Chris McGlory
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Michael J Toth
- Department of Medicine, University of Vermont, Burlington, VT 05401, USA
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4K1, Canada
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166
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2,000 Steps/Day Does Not Fully Protect Skeletal Muscle Health in Older Adults During Bed Rest. J Aging Phys Act 2019; 27:191-197. [PMID: 29989486 DOI: 10.1123/japa.2018-0093] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Physical activity in an inpatient setting is often limited to brief periods of walking. For healthy adults, public health agencies recommend a minimum of 150 min/week of moderate-intensity exercise. The authors sought to determine if meeting this activity threshold, in the absence of incidental activities of daily living, could protect skeletal muscle health during bed rest. Healthy older adults (68 ± 2 years) were randomized to 7-day bed rest with (STEP, n = 7) or without (CON, n = 10) a 2,000 steps/day intervention. Performing 2018 ± 4 steps/day did not prevent the loss of lean leg mass and had no beneficial effect on aerobic capacity, strength, or muscle fiber volume. However, the insulin response to an oral glucose challenge was preserved. Performing a block of 2,000 steps/day, in the absence of incidental activities of daily living, was insufficient to fully counter the catabolic effects of bed rest in healthy older adults.
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167
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The Muscle Protein Synthetic Response to Meal Ingestion Following Resistance-Type Exercise. Sports Med 2019; 49:185-197. [DOI: 10.1007/s40279-019-01053-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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168
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Abstract
Understanding how exercise and dietary protein alter the turnover and synthesis of body proteins in youth can provide guidelines for the optimal development of lean mass. This review hypothesizes that active youth obtain similar anabolic benefits from exercise and dietary protein as adults, but the requirement for amino acids to support growth renders them more sensitive to these nutrients.
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Affiliation(s)
- Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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170
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Kaur D, Rasane P, Singh J, Kaur S, Kumar V, Mahato DK, Dey A, Dhawan K, Kumar S. Nutritional Interventions for Elderly and Considerations for the Development of Geriatric Foods. Curr Aging Sci 2019; 12:15-27. [PMID: 31109282 PMCID: PMC6971894 DOI: 10.2174/1874609812666190521110548] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 12/22/2022]
Abstract
The process of aging is characterized by numerous changes in the body which has an overall negative effect on the health and lifestyle of elderly. Nutrition deserves special attention as an individual reaches old age. It plays a vital role in affecting the quality of life, including physical, mental and social health. The physiological decline in food intake is very common among older age and this result in nutritional deficiencies. These increased nutritional deficiencies are the major risk factors for certain chronic diseases and deteriorated age related health. Thus, the adoption of nutritional intervention can be a measure to tackle the current situation of nutritional deficiencies and promote a healthy lifestyle.
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Affiliation(s)
| | - Prasad Rasane
- Address correspondence to this author at the Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India; Tel: +919889532584; E-mail:
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171
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Ross M, Lithgow H, Hayes L, Florida-James G. Potential Cellular and Biochemical Mechanisms of Exercise and Physical Activity on the Ageing Process. Subcell Biochem 2019; 91:311-338. [PMID: 30888658 DOI: 10.1007/978-981-13-3681-2_12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Exercise in young adults has been consistently shown to improve various aspects of physiological and psychological health but we are now realising the potential benefits of exercise with advancing age. Specifically, exercise improves cardiovascular, musculoskeletal, and metabolic health through reductions in oxidative stress, chronic low-grade inflammation and modulating cellular processes within a variety of tissues. In this this chapter we will discuss the effects of acute and chronic exercise on these processes and conditions in an ageing population, and how physical activity affects our vasculature, skeletal muscle function, our immune system, and cardiometabolic risk in older adults.
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Affiliation(s)
- Mark Ross
- School of Applied Science, Edinburgh Napier University, Edinburgh, Scotland, UK.
| | - Hannah Lithgow
- School of Applied Science, Edinburgh Napier University, Edinburgh, Scotland, UK
| | - Lawrence Hayes
- Active Ageing Research Group, University of Cumbria, Lancaster, UK
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Bowden Davies KA, Pickles S, Sprung VS, Kemp GJ, Alam U, Moore DR, Tahrani AA, Cuthbertson DJ. Reduced physical activity in young and older adults: metabolic and musculoskeletal implications. Ther Adv Endocrinol Metab 2019; 10:2042018819888824. [PMID: 31803464 PMCID: PMC6878603 DOI: 10.1177/2042018819888824] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/22/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although the health benefits of regular physical activity and exercise are well established and have been incorporated into national public health recommendations, there is a relative lack of understanding pertaining to the harmful effects of physical inactivity. Experimental paradigms including complete immobilization and bed rest are not physiologically representative of sedentary living. A useful 'real-world' approach to contextualize the physiology of societal downward shifts in physical activity patterns is that of short-term daily step reduction. RESULTS Step-reduction studies have largely focused on musculoskeletal and metabolic health parameters, providing relevant disease models for metabolic syndrome, type 2 diabetes (T2D), nonalcoholic fatty liver disease (NAFLD), sarcopenia and osteopenia/osteoporosis. In untrained individuals, even a short-term reduction in physical activity has a significant impact on skeletal muscle protein and carbohydrate metabolism, causing anabolic resistance and peripheral insulin resistance, respectively. From a metabolic perspective, short-term inactivity-induced peripheral insulin resistance in skeletal muscle and adipose tissue, with consequent liver triglyceride accumulation, leads to hepatic insulin resistance and a characteristic dyslipidaemia. Concomitantly, various inactivity-related factors contribute to a decline in function; a reduction in cardiorespiratory fitness, muscle mass and muscle strength. CONCLUSIONS Physical inactivity maybe particularly deleterious in certain patient populations, such as those at high risk of T2D or in the elderly, considering concomitant sarcopenia or osteoporosis. The effects of short-term physical inactivity (with step reduction) are reversible on resumption of habitual physical activity in younger people, but less so in older adults. Nutritional interventions and resistance training offer potential strategies to prevent these deleterious metabolic and musculoskeletal effects. IMPACT Individuals at high risk of/with cardiometabolic disease and older adults may be more prone to these acute periods of inactivity due to acute illness or hospitalization. Understanding the risks is paramount to implementing countermeasures.
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Affiliation(s)
| | - Samuel Pickles
- Institute of Ageing and Chronic Disease,
University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group,
Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Victoria S. Sprung
- Research Institute for Sport and Exercise
Science, Liverpool John Moores University, Liverpool, UK
- Institute of Ageing and Chronic Disease,
University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group,
Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Graham J. Kemp
- Institute of Ageing and Chronic Disease,
University of Liverpool, Liverpool, UK
- Liverpool Magnetic Resonance Imaging Centre
(LiMRIC), University of Liverpool, Liverpool, UK
| | - Uazman Alam
- Institute of Ageing and Chronic Disease,
University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group,
Aintree University Hospital NHS Foundation Trust, Liverpool, UK
- Pain Research Institute, University of
Liverpool, Liverpool, UK
- Division of Endocrinology, Diabetes and
Gastroenterology, University of Manchester, Manchester, UK
- Department of Diabetes and Endocrinology, Royal
Liverpool and Broadgreen University NHS Hospitals Trust, Liverpool, UK
| | - Daniel R. Moore
- Faculty of Kinesiology and Physical Education,
University of Toronto, Toronto, ON, Canada
| | - Abd A. Tahrani
- Institute of Metabolism and Systems Research,
College of Medical and Dental Sciences, University of Birmingham,
Birmingham, UK
- Centre of Endocrinology, Diabetes and
Metabolism (CEDAM), Birmingham Health Partners, Birmingham UK
- Department of Diabetes and Endocrinology,
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Daniel J. Cuthbertson
- Institute of Ageing and Chronic Disease,
University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group,
Aintree University Hospital NHS Foundation Trust, Liverpool, UK
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173
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Kemp PR, Griffiths M, Polkey MI. Muscle wasting in the presence of disease, why is it so variable? Biol Rev Camb Philos Soc 2018; 94:1038-1055. [PMID: 30588725 DOI: 10.1111/brv.12489] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/22/2018] [Accepted: 11/27/2018] [Indexed: 12/16/2022]
Abstract
Skeletal muscle wasting is a common clinical feature of many chronic diseases and also occurs in response to single acute events. The accompanying loss of strength can lead to significant disability, increased care needs and have profound negative effects on quality of life. As muscle is the most abundant source of amino acids in the body, it appears to function as a buffer for fuel and substrates that can be used to repair damage elsewhere and to feed the immune system. In essence, the fundamentals of muscle wasting are simple: less muscle is made than is broken down. However, although well-described mechanisms modulate muscle protein turnover, significant individual differences in the amount of muscle lost in the presence of a given severity of disease complicate the understanding of underlying mechanisms and suggest that individuals have different sensitivities to signals for muscle loss. Furthermore, the rate at which muscle protein is turned over under normal conditions means that clinically significant muscle loss can occur with changes in the rate of protein synthesis and/or breakdown that are too small to be measurable. Consequently, the changes in expression of factors regulating muscle turnover required to cause a decline in muscle mass are small and, except in cases of rapid wasting, there is no consistent pattern of change in the expression of factors that regulate muscle mass. MicroRNAs are fine tuners of cell phenotype and are therefore ideally suited to cause the subtle changes in proteome required to tilt the balance between synthesis and degradation in a way that causes clinically significant wasting. Herein we present a model in which muscle loss as a consequence of disease in non-muscle tissue is modulated by a set of microRNAs, the muscle expression of which is associated with severity of disease in the non-muscle tissue. These microRNAs alter fundamental biological processes including the synthesis of ribosomes and mitochondria leading to reduced protein synthesis and increased protein breakdown, thereby freeing amino acids from the muscle. We argue that the variability in muscle loss observed in the human population arises from at least two sources. The first is from pre-existing or disease-induced variation in the expression of microRNAs controlling the sensitivity of muscle to the atrophic signal and the second is from the expression of microRNAs from imprinted loci (i.e. only expressed from the maternally or paternally inherited allele) and may control the rate of myonuclear recruitment. In the absence of disease, these factors do not correlate with muscle mass, since there is no challenge to the established balance. However, in the presence of such a challenge, these microRNAs determine the rate of decline for a given disease severity. Together these mechanisms provide novel insight into the loss of muscle mass and its variation in the human population. The involvement of imprinted loci also suggests that genes that regulate early development also contribute to the ability of individuals to resist muscle loss in response to disease.
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Affiliation(s)
- Paul R Kemp
- National Heart & Lung Institute, Imperial College London, South Kensington Campus, London, SW7 2AZ, U.K
| | - Mark Griffiths
- National Heart & Lung Institute, Imperial College London, South Kensington Campus, London, SW7 2AZ, U.K
| | - Michael I Polkey
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, Sydney Street, London SW3 6NP, U.K
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174
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Wilson D, Breen L, Lord JM, Sapey E. The challenges of muscle biopsy in a community based geriatric population. BMC Res Notes 2018; 11:830. [PMID: 30477571 PMCID: PMC6260758 DOI: 10.1186/s13104-018-3947-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/21/2018] [Indexed: 12/31/2022] Open
Abstract
Objectives To describe the difficulties of obtaining muscle samples using a Bergstrom needle technique in a frail older adult population. The data were obtained from a study primarily investigating immunosenescence in frailty. An intended research technique was skeletal muscle biopsy in a small subset of participants to investigate muscle morphology and local inflammatory factors. Results Forty healthy older adults and 37 frail older adults were considered for a Bergstrom needle muscle biopsy. Of these, 17.5% of healthy older adults and 94.6% of the frail older adults had single or multiple participant factors resulting in a contra-indication to muscle biopsy. 40.7% of healthy older female participants were at risk of a failed muscle biopsy due to low muscle mass. Considering only muscle mass muscle biopsy would have been successful in 18.7% of the frail older women and 21.4% of the frail older men. In this population, muscle biopsy was not feasible because of contra-indications in the majority of participants. This questions whether a biopsy sample obtained from frail older individuals, is actually representative of this population and supports the need to disclose biopsy failure rate in this population. Electronic supplementary material The online version of this article (10.1186/s13104-018-3947-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daisy Wilson
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2WD, UK.
| | - Leigh Breen
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2WD, UK
| | - Janet M Lord
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2WD, UK
| | - Elizabeth Sapey
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2WD, UK
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175
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Wilkinson D, Piasecki M, Atherton P. The age-related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans. Ageing Res Rev 2018; 47:123-132. [PMID: 30048806 PMCID: PMC6202460 DOI: 10.1016/j.arr.2018.07.005] [Citation(s) in RCA: 385] [Impact Index Per Article: 64.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 06/20/2018] [Accepted: 07/18/2018] [Indexed: 12/11/2022]
Abstract
Loss of muscle mass with age is due to atrophy and loss of individual muscle fibres. Anabolic resistance is fundamental in age-related fibre atrophy. Fibre loss is associated with denervation and remodelling of motor units. The plasticity of both factors should be considered in future research.
Age-related loss of skeletal muscle mass and function, sarcopenia, is associated with physical frailty and increased risk of morbidity (chronic diseases), in addition to all-cause mortality. The loss of muscle mass occurs incipiently from middle-age (∼1%/year), and in severe instances can lead to a loss of ∼50% by the 8–9th decade of life. This review will focus on muscle deterioration with ageing and highlight the two underpinning mechanisms regulating declines in muscle mass and function: muscle fibre atrophy and muscle fibre loss (hypoplasia) – and their measurement. The mechanisms of muscle fibre atrophy in humans relate to imbalances in muscle protein synthesis (MPS) and breakdown (MPB); however, since there is limited evidence for basal alterations in muscle protein turnover, it would appear that “anabolic resistance” to fundamental environmental cues regulating diurnal muscle homeostasis (namely physical activity and nutrition), underlie age-related catabolic perturbations in muscle proteostasis. While the ‘upstream’ drivers of the desensitization of aged muscle to anabolic stimuli are poorly defined, they most likely relate to impaired efficiency of the conversion of nutritional/exercise stimuli into signalling impacting mRNA translation and proteolysis. Additionally, loss of muscle fibres has been shown in cadaveric studies using anatomical fibre counts, and from iEMG studies demonstrating motor unit loss, albeit with few molecular investigations of this in humans. We suggest that defining countermeasures against sarcopenia requires improved understandings of the co-ordinated regulation of muscle fibre atrophy and fibre loss, which are likely to be inextricably linked.
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176
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Reidy PT, McKenzie AI, Mahmassani Z, Morrow VR, Yonemura NM, Hopkins PN, Marcus RL, Rondina MT, Lin YK, Drummond MJ. Skeletal muscle ceramides and relationship with insulin sensitivity after 2 weeks of simulated sedentary behaviour and recovery in healthy older adults. J Physiol 2018; 596:5217-5236. [PMID: 30194727 PMCID: PMC6209761 DOI: 10.1113/jp276798] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 08/31/2018] [Indexed: 01/01/2023] Open
Abstract
KEY POINTS Insulin sensitivity (as determined by a hyperinsulinaemic-euglyceamic clamp) decreased 15% after reduced activity. Despite not fully returning to baseline physical activity levels, insulin sensitivity unexpectedly, rebounded above that recorded before 2 weeks of reduced physical activity by 14% after the recovery period. Changes in insulin sensitivity in response to reduced activity were primarily driven by men but, not women. There were modest changes in ceramides (nuclear/myofibrillar fraction and serum) following reduced activity and recovery but, in the absence of major changes to body composition (i.e. fat mass), ceramides were not related to changes in inactivity-induced insulin sensitivity in healthy older adults. ABSTRACT Older adults are at risk of physical inactivity as they encounter debilitating life events. It is not known how insulin sensitivity is affected by modest short-term physical inactivity and recovery in healthy older adults, nor how insulin sensitivity is related to changes in serum and muscle ceramide content. Healthy older adults (aged 64-82 years, five females, seven males) were assessed before (PRE), after 2 weeks of reduced physical activity (RA) and following 2 weeks of recovery (REC). Insulin sensitivity (hyperinsulinaemic-euglyceamic clamp), lean mass, muscle function, skeletal muscle subfraction, fibre-specific, and serum ceramide content and indices of skeletal muscle inflammation were assessed. Insulin sensitivity decreased by 15 ± 6% at RA (driven by men) but rebounded above PRE by 14 ± 5% at REC. Mid-plantar flexor muscle area and leg strength decreased with RA, although only muscle size returned to baseline levels following REC. Body fat did not change and only minimal changes in muscle inflammation were noted across the intervention. Serum and intramuscular ceramides (nuclear/myofibrillar fraction) were modestly increased at RA and REC. However, ceramides were not related to changes in inactivity-induced insulin sensitivity in healthy older adults. Short-term inactivity induced insulin resistance in older adults in the absence of significant changes in body composition (i.e. fat mass) are not related to changes in ceramides.
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Affiliation(s)
- Paul T. Reidy
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
| | - Alec I. McKenzie
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
| | - Ziad Mahmassani
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
| | - Vincent R. Morrow
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
| | - Nikol M. Yonemura
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
| | - Paul N. Hopkins
- Cardiovascular GeneticsDepartment of Internal MedicineUniversity of Utah School of MedicineSalt Lake CityUTUSA
| | - Robin L. Marcus
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
| | - Matthew T. Rondina
- Department of Internal Medicine & Molecular Medicine ProgramUniversity of Utah School of MedicineSalt Lake CityUTUSA
| | - Yu Kuei Lin
- Department of Internal Medicine, Division of EndocrinologyMetabolism and DiabetesUniversity of Utah School of MedicineSalt Lake CityUTUSA
| | - Micah J. Drummond
- Department of Physical Therapy and Athletic TrainingUniversity of UtahSalt Lake CityUTUSA
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177
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Oikawa SY, McGlory C, D'Souza LK, Morgan AK, Saddler NI, Baker SK, Parise G, Phillips SM. A randomized controlled trial of the impact of protein supplementation on leg lean mass and integrated muscle protein synthesis during inactivity and energy restriction in older persons. Am J Clin Nutr 2018; 108:1060-1068. [PMID: 30289425 DOI: 10.1093/ajcn/nqy193] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 07/16/2018] [Indexed: 12/24/2022] Open
Abstract
Background In older persons, muscle loss is accelerated during physical inactivity and hypoenergetic states, both of which are features of hospitalization. Protein supplementation may represent a strategy to offset the loss of muscle during inactivity, and enhance recovery on resumption of activity. Objective We aimed to determine if protein supplementation, with proteins of substantially different quality, would alleviate the loss of lean mass by augmenting muscle protein synthesis (MPS) while inactive during a hypoenergetic state. Design Participants (16 men, mean ± SD age: 69 ± 3 y; 15 women, mean ± SD age: 68 ± 4 y) consumed a diet containing 1.6 g protein · kg-1 · d-1, with 55% ± 9% of protein from foods and 45% ± 9% from supplements, namely, whey protein (WP) or collagen peptides (CP): 30 g each, consumed 2 times/d. Participants were in energy balance (EB) for 1 wk, then began a period of energy restriction (ER; -500 kcal/d) for 1 wk, followed by ER with step reduction (ER + SR; <750 steps/d) for 2 wk, before a return to habitual activity in recovery (RC) for 1 wk. Results There were significant reductions in leg lean mass (LLM) from EB to ER, and from ER to ER + SR in both groups (P < 0.001) with no differences between WP and CP or when comparing the change from phase to phase. During RC, LLM increased from ER + SR, but in the WP group only. Rates of integrated muscle protein synthesis decreased during ER and ER + SR in both groups (P < 0.01), but increased during RC only in the WP group (P = 0.05). Conclusions Protein supplementation did not confer a benefit in protecting LLM, but only supplemental WP augmented LLM and muscle protein synthesis during recovery from inactivity and a hypoenergetic state. This trial was registered at http://www.clinicaltrials.gov as NCT03285737.
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Affiliation(s)
- Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Chris McGlory
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Lisa K D'Souza
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adrienne K Morgan
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Nelson I Saddler
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Steven K Baker
- Department of Neurology, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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178
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Murphy CH, Roche HM. Nutrition and physical activity countermeasures for sarcopenia: Time to get personal? NUTR BULL 2018. [DOI: 10.1111/nbu.12351] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- C. H. Murphy
- University College Dublin; Belfield Dublin 4 Ireland
| | - H. M. Roche
- Institute of Global Food Security; Queens University Belfast; Belfast UK
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179
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McCormick R, Vasilaki A. Age-related changes in skeletal muscle: changes to life-style as a therapy. Biogerontology 2018; 19:519-536. [PMID: 30259289 PMCID: PMC6223729 DOI: 10.1007/s10522-018-9775-3] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022]
Abstract
As we age, there is an age-related loss in skeletal muscle mass and strength, known as sarcopenia. Sarcopenia results in a decrease in mobility and independence, as well as an increase in the risk of other morbidities and mortality. Sarcopenia is therefore a major socio-economical problem. The mechanisms behind sarcopenia are unclear and it is likely that it is a multifactorial condition with changes in numerous important mechanisms all contributing to the structural and functional deterioration. Here, we review the major proposed changes which occur in skeletal muscle during ageing and highlight evidence for changes in physical activity and nutrition as therapeutic approaches to combat age-related skeletal muscle wasting.
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Affiliation(s)
- Rachel McCormick
- Musculoskeletal Biology II, Institute of Ageing and Chronic Disease, Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.
| | - Aphrodite Vasilaki
- Musculoskeletal Biology II, Institute of Ageing and Chronic Disease, Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
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180
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Jackman SR, Brook MS, Pulsford RM, Cockcroft EJ, Campbell MI, Rankin D, Atherton P, Smith K, Bowtell JL. Tart cherry concentrate does not enhance muscle protein synthesis response to exercise and protein in healthy older men. Exp Gerontol 2018; 110:202-208. [PMID: 29890270 DOI: 10.1016/j.exger.2018.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/30/2018] [Accepted: 06/07/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Oxidative stress and inflammation may contribute to anabolic resistance in response to protein and exercise in older adults. We investigated whether consumption of montmorency cherry concentrate (MCC) increased anabolic sensitivity to protein ingestion and resistance exercise in healthy older men. METHODS Sixteen healthy older men were randomized to receive MCC (60 mL·d-1) or placebo (PLA) for two weeks, after baseline measures in week 1. During week 3, participants consumed 10 g whey protein·d-1 and completed three bouts of unilateral leg resistance exercise (4 × 8-10 repetitions at 80% 1RM). Participants consumed a bolus (150 mL) and weekly (50 mL) doses of deuterated water. Body water 2H enrichment was measured in saliva and vastus lateralis biopsies were taken from the non-exercised leg after weeks 1, 2 and 3, and the exercised leg after week 3, to measure tracer incorporation at rest, in response to protein and protein + exercise. RESULTS Myofibrillar protein synthesis increased in response to exercise + protein compared to rest (p < 0.05) in both groups, but there was no added effect of supplement (MCC: 1.79 ± 0.75 EX vs 1.15 ± 0.40 rest; PLA: 2.22 ± 0.54 vs 1.21 ± 0.18; all %·d-1). Muscle total NFĸB protein was decreased with exercise and protein in MCC (NFĸB: -20.7 ± 17.5%) but increased in PLA (NFĸB: 17.8 ± 31.3%, p = 0.073). CONCLUSION Short-term MCC ingestion does not affect the anabolic response to protein and exercise in healthy, relatively active, older men, despite MCC ingestion attenuating expression of proteins involved in the muscle inflammatory response to exercise, which may influence the chronic training response.
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Affiliation(s)
- Sarah R Jackman
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Matthew S Brook
- Medical Research Council-Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, United Kingdom
| | - Richard M Pulsford
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Emma J Cockcroft
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Matthew I Campbell
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Debbie Rankin
- Medical Research Council-Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, United Kingdom
| | - Philip Atherton
- Medical Research Council-Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, United Kingdom
| | - Kenneth Smith
- Medical Research Council-Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Nottingham, United Kingdom
| | - Joanna L Bowtell
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.
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181
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Larsen MS, Couppé C, Møller AB, Schjerling P, Andersen JL, Nygaard RH, Langberg H, Kjaer M, Hansen M. Response to resistance training following immobilization-Influence of delaying post-exercise meal. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Mads Sørensen Larsen
- Department of Public Health; Section for Sport Science; Aarhus University; Aarhus Denmark
| | - Christian Couppé
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - Andreas Buch Møller
- Research Laboratory for Biochemical Pathology; Department of Clinical Medicine; Aarhus University; Aarhus Denmark
| | - Peter Schjerling
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - Jesper Løvind Andersen
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - Rie Harboe Nygaard
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - Henning Langberg
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - Michael Kjaer
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
| | - Mette Hansen
- Department of Orthopaedic Surgery M; Faculty of Health and Medical Sciences; Institute of Sports Medicine; Bispebjerg Hospital & Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Physical Therapy; Musculoskeletal Rehabilitation Research Unit; Bispebjerg Hospital; Copenhagen Denmark
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182
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Tessier AJ, Chevalier S. An Update on Protein, Leucine, Omega-3 Fatty Acids, and Vitamin D in the Prevention and Treatment of Sarcopenia and Functional Decline. Nutrients 2018; 10:E1099. [PMID: 30115829 PMCID: PMC6116139 DOI: 10.3390/nu10081099] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 12/16/2022] Open
Abstract
Aging is associated with sarcopenia and functional decline, leading to frailty and disability. As a modifiable risk factor, nutrition may represent a target for preventing or postponing the onset of these geriatric conditions. Among nutrients, high-quality protein, leucine, vitamin D, and omega-3 polyunsaturated fatty acids (n-3 PUFA) are of particular interest for their demonstrated effects on skeletal muscle health. This narrative review aims to examine the recent observational and interventional evidence on the associations and the role of these nutrients in the muscle mass, strength, mobility, and physical function of free-living older adults, who are either healthy or at risk of frailty. Recent evidence supports a higher protein intake recommendation of 1.0⁻1.2 g/kg/day in healthy older adults; an evenly distributed mealtime protein intake or minimal protein per meal may be beneficial. In addition, vitamin D supplementation of 800⁻1000 IU, particularly when vitamin D status is low, and doses of ~3 g/day of n-3 PUFA may be favorable for physical function, muscle mass, and strength. Reviewed studies are highly heterogenous, yet the quantity, quality, and timing of intakes should be considered when designing intervention studies. Combined protein, leucine, vitamin D, and n-3 PUFA supplements may convey added benefits and may represent an intervention strategy in the prevention of sarcopenia and functional decline.
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Affiliation(s)
- Anne-Julie Tessier
- School of Human Nutrition, McGill University, 21111 Lakeshore Rd, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada.
- Research Institute of the McGill University Health Centre, 1001 Décarie Blvd, Montreal, QC H4A 3J1, Canada.
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, 21111 Lakeshore Rd, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada.
- Research Institute of the McGill University Health Centre, 1001 Décarie Blvd, Montreal, QC H4A 3J1, Canada.
- Department of Medicine, McGill University, 845 Sherbrooke St. W, Montreal, QC H3A 0G4, Canada.
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183
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Moore DR, Kelly RP, Devries MC, Churchward-Venne TA, Phillips SM, Parise G, Johnston AP. Low-load resistance exercise during inactivity is associated with greater fibre area and satellite cell expression in older skeletal muscle. J Cachexia Sarcopenia Muscle 2018; 9:747-754. [PMID: 29761654 PMCID: PMC6104111 DOI: 10.1002/jcsm.12306] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/07/2018] [Accepted: 03/21/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Age-related sarcopenia is accelerated by physical inactivity. Low-load resistance exercise (LLRE) counters inactivity-induced muscle atrophy in older adults, but changes in muscle fibre morphology are unstudied. We aimed to determine the impact of LLRE during short-term inactivity (step-reduction) on muscle fibre size and capillarity as well as satellite cell (SC) content in older skeletal muscle. METHODS Fourteen older (~71 years) male adults underwent 14 days of step reduction (<1500 steps/day) while performing six sessions of LLRE (~30% maximal strength) with one leg (SR + EX) while the contralateral leg served as an untrained control (SR). Seven healthy ambulatory age-matched male adults (~69 years) served as a comparator group (COM). Muscle biopsies were taken from the vastus lateralis after 14 days, and immunohistochemical analysis was performed to determine muscle fibre cross-sectional area (CSA), myonuclear content, SC content (PAX7+ cells), and total (C:F) and fibre type-specific (C:Fi) capillary-to-fibre ratios. RESULTS Type I and II fibre CSA was greater in SR + EX compared with SR. Whereas there were no differences across fibre types between SR + EX and CON, type II fibre CSA was significantly lower in SR compared with COM. Type II myonuclear domain was greater in SR + EX compared with COM and SR. Pax7+ cells associated with type I and II fibres were lower in SR compared with SR + EX. Type II PAX7+ cells were also lower in SR compared with COM with a similar trend for type I fibres. There were trends for a lower C:Fi in SR compared with SR + EX for both fibre types with no differences for each compared with COM. CONCLUSIONS Minimal LLRE during a period of decreased physical activity is associated with greater muscle fibre CSA, SC content, and capillarization. These results support the use of LLRE as an effective countermeasure to inactivity-induced alterations in muscle morphology with age.
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Affiliation(s)
- Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Ryan P Kelly
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
| | | | | | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adam P Johnston
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
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184
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Mundi MS, Patel J, McClave SA, Hurt RT. Current perspective for tube feeding in the elderly: from identifying malnutrition to providing of enteral nutrition. Clin Interv Aging 2018; 13:1353-1364. [PMID: 30122907 PMCID: PMC6080667 DOI: 10.2147/cia.s134919] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With the number of individuals older than 65 years expected to rise significantly over the next few decades, dramatic changes to our society and health care system will need to take place to meet their needs. Age-related changes in muscle mass and body composition along with medical comorbidities including stroke, dementia, and depression place elderly adults at high risk for developing malnutrition and frailty. This loss of function and decline in muscle mass (ie, sarcopenia) can be associated with reduced mobility and ability to perform the task of daily living, placing the elderly at an increased risk for falls, fractures, and subsequent institutionalization, leading to a decline in the quality of life and increased mortality. There are a number of modifiable factors that can mitigate some of the muscle loss elderly experience especially when hospitalized. Due to this, it is paramount for providers to understand the pathophysiology behind malnutrition and sarcopenia, be able to assess risk factors for malnutrition, and provide appropriate nutrition support. The present review describes the pathophysiology of malnutrition, identifies contributing factors to this condition, discusses tools to assess nutritional status, and proposes key strategies for optimizing enteral nutrition therapy for the elderly.
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Affiliation(s)
- Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA,
| | - Jayshil Patel
- Division of Pulmonary, Critical Care & Sleep Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Stephen A McClave
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA
| | - Ryan T Hurt
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
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185
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Bruun IH, Maribo T, Norgaard B, Schiottz-Christensen B, Jessen MGB, Mogensen CB. The effect of systematic functional assessment and immediate rehabilitation on physical performance in acutely admitted older adults with reduced functional performance: a randomised clinical trial. Disabil Rehabil 2018; 42:53-62. [PMID: 30053788 DOI: 10.1080/09638288.2018.1492034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Aims: We hypothesised that a systematic functional assessment in a short stay unit at an emergency department (ED) and/or immediate rehabilitation after discharge will result in sustained or improved physical performance in comparison to a regimen in which neither of these interventions is offered.Methods: A two-way factorial randomised clinical trial was completed in an ED and the primary sector. We enrolled 336 nonsurgical patients of 65 years or older, scoring eight or less in the 30-s chair stand test. The interventions were: 1) Usual assessment; 2) Usual rehabilitation; 3) A systematic functional assessment performed within 48 h of admission, in order to identify those with loss of functional mobility, or at risk thereof; and 4) Immediate rehabilitation initiated within five days after discharge. The primary outcome was the 30-s chair stand test three weeks after admission. Secondary outcome measures were Barthel, EQ-5D-3L, and length of stay (LOS).Results: An intention-to-treat analysis showed no significant difference in the 30-s chair stand test score nor when analysed by groups or by intervention. The changes were approximately 1% when compared to the reference. No significant differences were found in the secondary outcomes. A per-protocol analysis showed that 99% had received assessment as assigned; however, the extent of mobilisation during hospitalisation was not disclosed. Of the patients, 48% were received the post-discharge rehabilitation they were assigned to.Conclusions: Systematic functional assessment and immediate rehabilitation led to no significant differences in physical performance. The study was weakened by the incomplete implementation of mobilisation during hospitalisation and low adherence to protocol on immediate rehabilitation.Implications for rehabilitationA systematic functional assessment within the first 48 h of hospital admission is suitable for the identification of older adults in need of post-discharge rehabilitation when compared to usual assessment.To sustain physical performance in older adults during acute hospitalisation, further research focusing on mobilisation or physical activation is needed in older adults with a loss of functional mobility, or at risk thereof.Further research focusing on physical activation during transition is needed to ameliorate tiredness and inactivity in older adults after acute hospitalisation.
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Affiliation(s)
- Inge H Bruun
- Department of Physiotherapy and Occupational Therapy, Lillebaelt Hospital, Kolding, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Birgitte Norgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Berit Schiottz-Christensen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Spine Centre of Southern Denmark, Lillebaelt Hospital, Middelfart, Denmark
| | - Morten G B Jessen
- Department of Physiotherapy and Occupational Therapy, Lillebaelt Hospital, Kolding, Denmark
| | - Christian B Mogensen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Emergency Department, Hospital of Southern Jutland, Aabenraa, Denmark
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186
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Franzke B, Neubauer O, Cameron-Smith D, Wagner KH. Dietary Protein, Muscle and Physical Function in the Very Old. Nutrients 2018; 10:E935. [PMID: 30037048 PMCID: PMC6073115 DOI: 10.3390/nu10070935] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
There is an ongoing debate as to the optimal protein intake in older adults. An increasing body of experimental studies on skeletal muscle protein metabolism as well as epidemiological data suggest that protein requirements with ageing might be greater than many current dietary recommendations. Importantly, none of the intervention studies in this context specifically investigated very old individuals. Data on the fastest growing age group of the oldest old (aged 85 years and older) is very limited. In this review, we examine the current evidence on protein intake for preserving muscle mass, strength and function in older individuals, with emphasis on data in the very old. Available observational data suggest beneficial effects of a higher protein intake with physical function in the oldest old. Whilst, studies estimating protein requirements in old and very old individuals based on whole-body measurements, show no differences between these sub-populations of elderly. However, small sample sizes preclude drawing firm conclusions. Experimental studies that compared muscle protein synthetic (MPS) responses to protein ingestion in young and old adults suggest that a higher relative protein intake is required to maximally stimulate skeletal muscle MPS in the aged. Although, data on MPS responses to protein ingestion in the oldest old are currently lacking. Collectively, the data reviewed for this article support the concept that there is a close interaction of physical activity, diet, function and ageing. An attractive hypothesis is that regular physical activity may preserve and even enhance the responsiveness of ageing skeletal muscle to protein intake, until very advanced age. More research involving study participants particularly aged ≥85 years is warranted to better investigate and determine protein requirements in this specific growing population group.
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Affiliation(s)
- Bernhard Franzke
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
| | - Oliver Neubauer
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
- School of Biomedical Sciences, Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD 4059, Australia.
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Karl-Heinz Wagner
- Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria.
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187
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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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188
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Perkin OJ, McGuigan PM, Thompson D, Stokes KA. Habitual physical activity levels do not predict leg strength and power in healthy, active older adults. PLoS One 2018; 13:e0200089. [PMID: 29965998 PMCID: PMC6028110 DOI: 10.1371/journal.pone.0200089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/19/2018] [Indexed: 01/25/2023] Open
Abstract
Physical activity is considered crucial in attenuating losses in strength and power associated with ageing. However, in well-functioning, active older adults the relationship between habitual physical activity and muscle function is surprisingly unclear. Leg press velocity, force, and power, were compared between 50 older and 30 younger healthy individuals, and associations with habitual physical activity explored. An incremental power test was performed on a pneumatic leg press, with theoretical maximum velocity, force, and power calculated. Vastus lateralis muscle thickness was measured by ultrasound, and participants wore a combined accelerometer and heart rate monitor for 6-days of free-living. Older individuals produced lower absolute maximum velocity, force, and power, than younger individuals. When accounting for smaller muscle size, older individual's maximum force and power remained markedly lower. Both groups were active, however using age specific thresholds for classifying physical activity, the older individuals engaged in twice the amount of moderate-to-vigorous physical activity in comparison to the younger individuals. There were no associations between any characteristics of muscle function and physical activity. These data support that the ability to generate force and power deteriorates with age, however habitual physical activity levels do not explain inter-individual differences in muscle function in active older individuals.
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Affiliation(s)
- Oliver J. Perkin
- Department for Health, University of Bath, Claverton Down, Bath, United Kingdom
- Arthritis Research UK, Centre for Sport, Exercise and Osteoarthritis, Bath, United Kingdom
| | - Polly M. McGuigan
- Department for Health, University of Bath, Claverton Down, Bath, United Kingdom
| | - Dylan Thompson
- Department for Health, University of Bath, Claverton Down, Bath, United Kingdom
| | - Keith A. Stokes
- Department for Health, University of Bath, Claverton Down, Bath, United Kingdom
- Arthritis Research UK, Centre for Sport, Exercise and Osteoarthritis, Bath, United Kingdom
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189
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Hulston CJ, Woods RM, Dewhurst‐Trigg R, Parry SA, Gagnon S, Baker L, James LJ, Markey O, Martin NRW, Ferguson RA, van Hall G. Resistance exercise stimulates mixed muscle protein synthesis in lean and obese young adults. Physiol Rep 2018; 6:e13799. [PMID: 30009507 PMCID: PMC6046643 DOI: 10.14814/phy2.13799] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 12/16/2022] Open
Abstract
Obese individuals exhibit a diminished muscle protein synthesis response to nutrient stimulation when compared with their lean counterparts. However, the effect of obesity on exercise-stimulated muscle protein synthesis remains unknown. Nine lean (23.5 ± 0.6 kg/m2 ) and 8 obese (33.6 ± 1.2 kg/m2 ) physically active young adults participated in a study that determined muscle protein synthesis and intracellular signaling at rest and following an acute bout of resistance exercise. Mixed muscle protein synthesis was determined by combining stable isotope tracer ([13 C6 ]phenylalanine) infusion with serial biopsies of the vastus lateralis. A unilateral leg resistance exercise model was adopted so that resting and postexercise measurements of muscle protein synthesis could be obtained simultaneously. Obesity was associated with higher basal levels of serum insulin (P < 0.05), plasma triacylglycerol (P < 0.01), plasma cholesterol (P < 0.01), and plasma CRP (P < 0.01), as well as increased insulin resistance determined by HOMA-IR (P < 0.05). However, resting and postexercise rates of muscle protein synthesis were not significantly different between lean and obese participants (P = 0.644). Furthermore, resistance exercise stimulated muscle protein synthesis (~50% increase) in both groups (P < 0.001), with no difference between lean and obese (P = 0.809). Temporal increases in the phosphorylation of intracellular signaling proteins (AKT/4EBP1/p70S6K) were observed within the exercised leg (P < 0.05), with no differences between lean and obese. These findings suggest a normal anabolic response to muscle loading in obese young adults.
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Affiliation(s)
- Carl J. Hulston
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Rachel M. Woods
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Rebecca Dewhurst‐Trigg
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Sion A. Parry
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
- Present address:
Sion A. Parry Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordChurchill HospitalOxfordUnited Kingdom
| | - Stephanie Gagnon
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Luke Baker
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Lewis J. James
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Oonagh Markey
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Neil R. W. Martin
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Richard A. Ferguson
- School of Sport, Exercise & Health SciencesLoughborough UniversityLoughboroughLeicestershireUnited Kingdom
| | - Gerrit van Hall
- Clinical Metabolomics Core FacilityDepartment of Clinical BiochemistryRigshospitaletDepartment of Biomedical SciencesUniversity of CopenhagenCopenhagenDenmark
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190
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Khan J, Bath K, Hafeez F, Kim G, Pesola GR. Creatinine Excretion as a Determinant of Accelerated Skeletal Muscle Loss with Critical Illness. Turk J Anaesthesiol Reanim 2018; 46:311-315. [PMID: 30140539 DOI: 10.5152/tjar.2018.60437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/09/2018] [Indexed: 12/25/2022] Open
Abstract
Objective The 24-h urinary creatinine excretion rate has been used as an approximation of the skeletal muscle (SM) mass in non-intensive care unit (ICU) settings. The study goal or aim was to determine reductions in SM mass in patients with recurrent critical illness who are admitted to a medical ICU. Methods Retrospective ICU patient records between 2013 and 2015 were reviewed. Inclusion of ICU patients with repeat 24-h urinary creatinine excretion levels at two different ICU admissions done routinely as part of care. The study design is a case series with patients as their own control. Results Three patients were found to have data on two separate ICU admissions. The reduction in creatinine excretion among ICU patients was correlated with estimated SM mass. All patients had >50% reduction in creatinine excretion and ≥47% reduction in estimated SM mass over 4 months. All patients were bed-bound after the first ICU admission and met the definition of sarcopenia by the second ICU admission; all patients died during the second ICU admission. The final SM mass in all patients was <4 kg m-2. Conclusion Patients with chronic critical illness admitted to the medical ICU, who become bed bound, can experience up to 50% reduction in SM mass as gleaned from creatinine excretion within 4 months. Low SM mass may predispose patients to increased mortality. Measurement of 24-h urinary creatinine excretion may be a useful ICU biomarker to determine SM mass for diagnostic and prognostic purposes.
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Affiliation(s)
- Jehanzeb Khan
- Department of Medicine, Section of Critical Care/Pulmonary Medicine, Harlem Hospital/Columbia University, New York, USA
| | - Khushbir Bath
- Department of Medicine, Section of Critical Care/Pulmonary Medicine, Harlem Hospital/Columbia University, New York, USA
| | - Fareeha Hafeez
- Department of Medicine, Section of Critical Care/Pulmonary Medicine, Harlem Hospital/Columbia University, New York, USA
| | - Gayoung Kim
- Department of Nursing, Harlem Hospital/Columbia University, New York, USA
| | - Gene R Pesola
- Department of Medicine, Section of Critical Care/Pulmonary Medicine, Harlem Hospital/Columbia University, New York, USA
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191
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Bowden Davies KA, Sprung VS, Norman JA, Thompson A, Mitchell KL, Halford JCG, Harrold JA, Wilding JPH, Kemp GJ, Cuthbertson DJ. Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes. Diabetologia 2018; 61:1282-1294. [PMID: 29671031 DOI: 10.1007/s00125-018-4603-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/02/2018] [Indexed: 12/17/2022]
Abstract
AIMS/HYPOTHESIS Low physical activity levels and sedentary behaviour are associated with obesity, insulin resistance and type 2 diabetes. We investigated the effects of a short-term reduction in physical activity with increased sedentary behaviour on metabolic profiles and body composition, comparing the effects in individuals with first-degree relatives with type 2 diabetes (FDR+ve) vs those without (FDR-ve). METHODS Forty-five habitually active participants (16 FDR+ve [10 female, 6 male] and 29 FDR-ve [18 female, 11 male]; age 36 ± 14 years) were assessed at baseline, after 14 days of step reduction and 14 days after resuming normal activity. We determined physical activity (using a SenseWear armband), cardiorespiratory fitness ([Formula: see text]), body composition (dual-energy x-ray absorptiometry/magnetic resonance spectroscopy) and multi-organ insulin sensitivity (OGTT) at each time point. Statistical analysis was performed using a two-factor between-groups ANCOVA, with data presented as mean ± SD or (95% CI). RESULTS There were no significant between-group differences in physical activity either at baseline or following step reduction. During the step-reduction phase, average daily step count decreased by 10,285 steps (95% CI 9389, 11,182; p < 0.001), a reduction of 81 ± 8%, increasing sedentary time by 223 min/day (151, 295; p < 0.001). Pooling data from both groups, following step reduction there was a significant decrease in whole-body insulin sensitivity (Matsuda index) (p < 0.001), muscle insulin sensitivity index (p < 0.001), cardiorespiratory fitness (p = 0.002) and lower limb lean mass (p = 0.004). Further, there was a significant increase in total body fat (p < 0.001), liver fat (p = 0.001) and LDL-cholesterol (p = 0.013), with a borderline significant increase in NEFA AUC during the OGTT (p = 0.050). Four significant between-group differences were apparent: following step reduction, FDR+ve participants accumulated 1.5% more android fat (0.4, 2.6; p = 0.008) and increased triacylglycerol by 0.3 mmol/l (0.1, 0.6; p = 0.044). After resuming normal activity, FDR+ve participants engaged in lower amounts of vigorous activity (p = 0.006) and had lower muscle insulin sensitivity (p = 0.023). All other changes were reversed with no significant between-group differences. CONCLUSIONS/INTERPRETATION A short-term reduction in physical activity with increased sedentary behaviour leads to a reversible reduction in multi-organ insulin sensitivity and cardiorespiratory fitness, with concomitant increases in central and liver fat and dyslipidaemia. The effects are broadly similar in FDR+ve and FDR-ve individuals. Public health recommendations promoting physical activity should incorporate advice to avoid periods of sedentary behaviour.
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Affiliation(s)
- Kelly A Bowden Davies
- Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.
- Obesity and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool, L9 7AL, UK.
| | - Victoria S Sprung
- Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool, L9 7AL, UK
| | - Juliette A Norman
- Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool, L9 7AL, UK
| | - Andrew Thompson
- Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Katie L Mitchell
- Department of Psychological Sciences, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Jason C G Halford
- Department of Psychological Sciences, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Jo A Harrold
- Department of Psychological Sciences, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - John P H Wilding
- Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
- Eye and Vision Science, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
| | - Graham J Kemp
- Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC), University of Liverpool, Liverpool, UK
| | - Daniel J Cuthbertson
- Musculoskeletal Biology II, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
- Obesity and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool, L9 7AL, UK
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192
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Murphy CH, Shankaran M, Churchward-Venne TA, Mitchell CJ, Kolar NM, Burke LM, Hawley JA, Kassis A, Karagounis LG, Li K, King C, Hellerstein M, Phillips SM. Effect of resistance training and protein intake pattern on myofibrillar protein synthesis and proteome kinetics in older men in energy restriction. J Physiol 2018. [PMID: 29532476 DOI: 10.1113/jp275246] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Strategies to enhance the loss of fat while preserving muscle mass during energy restriction are of great importance to prevent sarcopenia in overweight older adults. We show for the first time that the integrated rate of synthesis of numerous individual contractile, cytosolic and mitochondrial skeletal muscle proteins was increased by resistance training (RT) and unaffected by dietary protein intake pattern during energy restriction in free-living, obese older men. We observed a correlation between the synthetic rates of skeletal muscle-derived proteins obtained in serum (creatine kinase M-type, carbonic anhydrase 3) and the synthetic rates of proteins obtained via muscle sampling; and that the synthesis rates of these proteins in serum revealed the stimulatory effects of RT. These results have ramifications for understanding the influence of RT on skeletal muscle and are consistent with the role of RT in maintaining muscle protein synthesis and potentially supporting muscle mass preservation during weight loss. ABSTRACT We determined how the pattern of protein intake and resistance training (RT) influenced longer-term (2 weeks) integrated myofibrillar protein synthesis (MyoPS) during energy restriction (ER). MyoPS and proteome kinetics were measured during 2 weeks of ER alone and 2 weeks of ER plus RT (ER + RT) in overweight/obese older men. Participants were randomized to consume dietary protein in a balanced (BAL: 25% daily protein per meal × 4 meals) or skewed (SKEW: 7:17:72:4% daily protein per meal) pattern (n = 10 per group). Participants ingested deuterated water during the consecutive 2-week periods, and skeletal muscle biopsies and serum were obtained at the beginning and conclusion of ER and ER + RT. Bulk MyoPS (i.e. synthesis of the myofibrillar protein sub-fraction) and the synthetic rates of numerous individual skeletal muscle proteins were quantified. Bulk MyoPS was not affected by protein distribution during ER or ER + RT (ER: BAL = 1.24 ± 0.31%/day, SKEW = 1.26 ± 0.37%/day; ER + RT: BAL = 1.64 ± 0.48%/day, SKEW = 1.52 ± 0.66%/day) but was ∼26% higher during ER + RT than during ER (P = 0.023). The synthetic rates of 175 of 190 contractile, cytosolic and mitochondrial skeletal muscle proteins, as well as synthesis of muscle-derived proteins measured in serum, creatine kinase M-type (CK-M) and carbonic anhydrase 3 (CA-3), were higher during ER + RT than during ER (P < 0.05). In addition, the synthetic rates of CK-M and CA-3 measured in serum correlated with the synthetic rates of proteins obtained via muscle sampling (P < 0.05). This study provides novel data on the skeletal muscle adaptations to RT and dietary protein distribution.
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Affiliation(s)
| | - Mahalakshmi Shankaran
- KineMed, Inc., Emeryville, CA, USA.,Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | | | | | | | - Louise M Burke
- Department of Sports Nutrition, Australian Institute of Sport, Canberra, Australia
| | - John A Hawley
- Exercise and Nutrition Research Group, Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - Amira Kassis
- Nestlé Research Center, Nestec Ltd, Lausanne, Switzerland
| | | | - Kelvin Li
- KineMed, Inc., Emeryville, CA, USA.,Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | | | - Marc Hellerstein
- KineMed, Inc., Emeryville, CA, USA.,Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
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193
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Gao Y, Arfat Y, Wang H, Goswami N. Muscle Atrophy Induced by Mechanical Unloading: Mechanisms and Potential Countermeasures. Front Physiol 2018; 9:235. [PMID: 29615929 PMCID: PMC5869217 DOI: 10.3389/fphys.2018.00235] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/02/2018] [Indexed: 12/23/2022] Open
Abstract
Prolonged periods of skeletal muscle inactivity or mechanical unloading (bed rest, hindlimb unloading, immobilization, spaceflight and reduced step) can result in a significant loss of musculoskeletal mass, size and strength which ultimately lead to muscle atrophy. With advancement in understanding of the molecular and cellular mechanisms involved in disuse skeletal muscle atrophy, several different signaling pathways have been studied to understand their regulatory role in this process. However, substantial gaps exist in our understanding of the regulatory mechanisms involved, as well as their functional significance. This review aims to update the current state of knowledge and the underlying cellular mechanisms related to skeletal muscle loss during a variety of unloading conditions, both in humans and animals. Recent advancements in understanding of cellular and molecular mechanisms, including IGF1-Akt-mTOR, MuRF1/MAFbx, FOXO, and potential triggers of disuse atrophy, such as calcium overload and ROS overproduction, as well as their role in skeletal muscle protein adaptation to disuse is emphasized. We have also elaborated potential therapeutic countermeasures that have shown promising results in preventing and restoring disuse-induced muscle loss. Finally, identified are the key challenges in this field as well as some future prospectives.
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Affiliation(s)
- Yunfang Gao
- Key Laboratory of Resource Biology and Biotechnology in Western China, College of Life Sciences, Ministry of Education, Northwest University, Xi'an, China
| | - Yasir Arfat
- Key Laboratory of Resource Biology and Biotechnology in Western China, College of Life Sciences, Ministry of Education, Northwest University, Xi'an, China
| | - Huiping Wang
- Key Laboratory of Resource Biology and Biotechnology in Western China, College of Life Sciences, Ministry of Education, Northwest University, Xi'an, China
| | - Nandu Goswami
- Physiology Unit, Otto Loewi Center of Research for Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
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194
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Truba TN, Doan J, Currie CL, Copeland JL. Short-term changes in daily movement behaviour influence salivary C-reactive protein in healthy women. Appl Physiol Nutr Metab 2018; 43:854-856. [PMID: 29499122 DOI: 10.1139/apnm-2017-0758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This study assessed the effect of changing daily movement behaviour on C-reactive protein (CRP) measured in saliva. Two groups of women either reduced daily movement or increased physical activity for 10 days. Salivary CRP increased by 31% in the sedentary group (0.378 ± 0.596 to 0.487 ± 0.793 μg·L-1) and decreased by 22% in the active group (0.414 ± 0.640 to 0.259 ± 0.284 μg·L-1). These results suggest short-term changes in daily movement behaviour can affect salivary CRP, a marker of systemic inflammation.
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Affiliation(s)
- Taura N Truba
- a Department of Kinesiology & Physical Education, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Jon Doan
- a Department of Kinesiology & Physical Education, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Cheryl L Currie
- b Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
| | - Jennifer L Copeland
- a Department of Kinesiology & Physical Education, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
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195
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Gray SR, Mittendorfer B. Fish oil-derived n-3 polyunsaturated fatty acids for the prevention and treatment of sarcopenia. Curr Opin Clin Nutr Metab Care 2018; 21:104-109. [PMID: 29232264 DOI: 10.1097/mco.0000000000000441] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Muscle mass and function decline progressively starting in middle age, which can result in sarcopenia and affect people's mobility and independence later in life. Exercise training and increased protein intake are typically recommended to counteract the age-associated decline in muscle mass and function. However, few people comply with exercise recommendations and the effectiveness of high-protein intake to halt the decline in muscle mass and function has not been proven. This review aims to explore recent developments in the potential for fish-oil derived n-3 polyunsaturated fatty acids (n-3 PUFA) to improve muscle mass and function in older people. RECENT FINDINGS The results from several recent studies demonstrate that dietary supplementation with fish oil-derived n-3 PUFA stimulates muscle protein synthesis and improves muscle mass and function in sedentary older adults and augments the resistance exercise training-induced increase in muscle strength in older adults. The exact mechanisms by which fish oil-derived n-3 PUFAs exert their beneficial effects on muscle mass and function remain to be elucidated. SUMMARY Fish-oil supplementation has antisarcopenic effects and should be considered in the clinical care of older adults.
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Affiliation(s)
- Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Center, University of Glasgow, Glasgow, Scotland, UK
| | - Bettina Mittendorfer
- Division of Geriatrics & Nutritional Sciences, Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA
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196
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Kuczmarski JM, Hord JM, Lee Y, Guzzoni V, Rodriguez D, Lawler MS, Garcia-Villatoro EL, Holly D, Ryan P, Falcon K, Garcia M, Janini Gomes M, Fluckey JD, Lawler JM. Effect of Eukarion-134 on Akt-mTOR signalling in the rat soleus during 7 days of mechanical unloading. Exp Physiol 2018; 103:545-558. [PMID: 29315934 DOI: 10.1113/ep086649] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 01/02/2018] [Indexed: 12/21/2022]
Abstract
NEW FINDINGS What is the central question of this study? Translocation of nNOSμ initiates catabolic signalling via FoxO3a and skeletal muscle atrophy during mechanical unloading. Recent evidence suggests that unloading-induced muscle atrophy and FoxO3a activation are redox sensitive. Will a mimetic of superoxide dismutase and catalase (i.e. Eukarion-134) also mitigate suppression of the Akt-mTOR pathway? What is the main finding and its importance? Eukarion-134 rescued Akt-mTOR signalling and sarcolemmal nNOSμ, which were linked to protection against the unloading phenotype, muscle fibre atrophy and partial fibre-type shift from slow to fast twitch. The loss of nNOSμ from the sarcolemma appears crucial to Akt phosphorylation and is redox sensitive, although the mechanisms remain unresolved. ABSTRACT Mechanical unloading stimulates rapid changes in skeletal muscle morphology, characterized by atrophy of muscle fibre cross-sectional area and a partial fibre-type shift from slow to fast twitch. Recent studies revealed that oxidative stress contributes to activation of forkhead box O3a (FoxO3a), proteolytic signalling and unloading-induced muscle atrophy via translocation of the μ-splice variant of neuronal nitric oxide synthase (nNOSμ) and activation of FoxO3a. There is limited understanding of the role of reactive oxygen species in the Akt-mammalian target of rapamycin (mTOR) pathway signalling during unloading. We hypothesized that Eukarion-134 (EUK-134), a mimetic of the antioxidant enzymes superoxide dismutase and catalase, would protect Akt-mTOR signalling in the unloaded rat soleus. Male Fischer 344 rats were separated into the following three study groups: ambulatory control (n = 11); 7 days of hindlimb unloading + saline injections (HU, n = 11); or 7 days of HU + EUK-134; (HU + EUK-134, n = 9). EUK-134 mitigated unloading-induced dephosphorylation of Akt, as well as FoxO3a, in the soleus. Phosphorylation of mTOR in the EUK-treated HU rats was not different from that in control animals. However, EUK-134 did not significantly rescue p70S6K phosphorylation. EUK-134 attenuated translocation of nNOSμ from the membrane to the cytosol, reduced nitration of tyrosine residues and suppressed upregulation of caveolin-3 and dysferlin. EUK-134 ameliorated HU-induced remodelling, atrophy of muscle fibres and the 12% increase in type II myosin heavy chain-positive fibres. Attenuation of the unloaded muscle phenotype was associated with decreased reactive oxygen species, as assessed by ethidium-positive nuclei. We conclude that oxidative stress affects Akt-mTOR signalling in unloaded skeletal muscle. Direct linkage of abrogation of nNOSμ translocation with Akt-mTOR signalling during unloading is the subject of future investigation.
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Affiliation(s)
- J Matthew Kuczmarski
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Heart and Vascular Institute, Penn State College of Medicine, Hershey, PA, USA
| | - Jeff M Hord
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Yang Lee
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Vinicius Guzzoni
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Laboratory of Biochemistry and Molecular Biology, Department of Physiological Science, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Dinah Rodriguez
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Matthew S Lawler
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Department of Biomedical Engineering, Georgia Tech University, Atlanta, GA, USA
| | - Erika L Garcia-Villatoro
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Department of Nutrition and Food Science, Texas A&M University, College Station, TX, USA
| | - Dylan Holly
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Patrick Ryan
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Kristian Falcon
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Marcela Garcia
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Mariana Janini Gomes
- Physiopathology Program in Internal Medicine, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - James D Fluckey
- Muscle Biology Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - John M Lawler
- Redox Biology & Cell Signaling Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.,Department of Nutrition and Food Science, Texas A&M University, College Station, TX, USA
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197
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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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Oestergaard AS, Mathiesen MH, Karlsen A, Turtumoeygaard IF, Vahlgren J, Kjaer M, Beyer N. In acutely admitted geriatric patients, offering increased physical activity during hospitalization decreases length of stay and can improve mobility. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- A. S. Oestergaard
- Institute of Sports Medicine Copenhagen; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - M. H. Mathiesen
- Institute of Sports Medicine Copenhagen; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - A. Karlsen
- Institute of Sports Medicine Copenhagen; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
- Department of Geriatrics; Bispebjerg Hospital; Copenhagen Denmark
- Center for Healthy Aging; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - I. F. Turtumoeygaard
- Institute of Sports Medicine Copenhagen; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - J. Vahlgren
- Institute of Sports Medicine Copenhagen; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - M. Kjaer
- Institute of Sports Medicine Copenhagen; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
- Center for Healthy Aging; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Institute for Clinical Medicine; University of Copenhagen; Copenhagen Denmark
| | - N. Beyer
- Institute for Clinical Medicine; University of Copenhagen; Copenhagen Denmark
- Department of Physical & Occupational Therapy; Bispebjerg & Frederiksberg Hospital; University of Copenhagen; Copenhagen Denmark
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199
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Norheim KL. Changes in muscle mass during acute short-term hospitalization of elderly patients: A mini-review. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- K. L. Norheim
- Department of Health Science and Technology; Physical Activity and Human Performance Group; SMI; Aalborg University; Aalborg Denmark
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200
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Welch C, K Hassan-Smith Z, A Greig C, M Lord J, A Jackson T. Acute Sarcopenia Secondary to Hospitalisation - An Emerging Condition Affecting Older Adults. Aging Dis 2018; 9:151-164. [PMID: 29392090 PMCID: PMC5772853 DOI: 10.14336/ad.2017.0315] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/15/2017] [Indexed: 12/12/2022] Open
Abstract
There has been increasing interest and research into sarcopenia in community-dwelling older adults since the European Working Group on Sarcopenia in Older People (EWGSOP) agreed a consensus definition in 2010. Sarcopenia has been defined as loss of muscle mass with loss of muscle function (strength or physical performance), with measurements two Standard Deviations (SDs) below the mean of a young reference population. This definition does not necessitate longitudinal measurements, or the absence of acute illness and diagnosis can be made from single measurements. We hypothesise that hospitalisation, due to a combination of acute inflammatory burden and muscle disuse, leads to an acute decline in muscle mass and function and may lead to some individuals meeting criteria for sarcopenia, acutely, based on the EWGSOP definition. This may be partially recoverable or may lead to increased risk of developing sarcopenia long-term. We have denoted the term “acute sarcopenia” to refer to acute loss of muscle mass and function associated with hospitalisation. This review discusses some of the current available research in this context and also identifies some of the knowledge gaps and potential areas for future research.
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Affiliation(s)
- Carly Welch
- 1Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,2Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham: B15 2WB, UK
| | - Zaki K Hassan-Smith
- 2Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham: B15 2WB, UK.,3Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,4Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Carolyn A Greig
- 5School of Sport, Exercise & Rehabilitation Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,6MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Janet M Lord
- 1Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,6MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Thomas A Jackson
- 1Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,2Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham: B15 2WB, UK
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