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Fonseca ID, Fabbri LE, Moraes L, Coelho DB, Dos Santos FC, Rosse I. Pleiotropic effects on Sarcopenia subphenotypes point to potential molecular markers for the disease. Arch Gerontol Geriatr 2024; 127:105553. [PMID: 38970884 DOI: 10.1016/j.archger.2024.105553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/10/2024] [Accepted: 06/25/2024] [Indexed: 07/08/2024]
Abstract
Sarcopenia is a progressive age-related muscle disease characterized by low muscle strength, quantity and quality, and low physical performance. The clinical overlap between these subphenotypes (reduction in muscle strength, quantity and quality, and physical performance) was evidenced, but the genetic overlap is still poorly investigated. Herein, we investigated whether there is a genetic overlap amongst sarcopenia subphenotypes in the search for more effective molecular markers for this disease. For that, a Bioinformatics approach was used to identify and characterize pleiotropic effects at the genome, loci and gene levels using Genome-wide association study results. As a result, a high genetic correlation was identified between gait speed and muscle strength (rG=0.5358, p=3.39 × 10-8). Using a Pleiotropy-informed conditional and conjunctional false discovery rate method we identified two pleiotropic loci for muscle strength and gait speed, one of them was nearby the gene PHACTR1. Moreover, 11 pleiotropic loci and 25 genes were identified for muscle mass and muscle strength. Lastly, using a gene-based GWAS approach three candidate genes were identified in the overlap of the three Sarcopenia subphenotypes: FTO, RPS10 and CALCR. The current study provides evidence of genetic overlap and pleiotropy among sarcopenia subphenotypes and highlights novel candidate genes and molecular markers associated with the risk of sarcopenia.
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Affiliation(s)
- Isabela D Fonseca
- Programa de Pós-Graduação em Biotecnologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, MG Brazil; Laboratório de Biologia Celular e Molecular, Núcleo de Pesquisas em Ciências Biológicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro Ouro Preto, MG Brazil
| | - Luiz Eduardo Fabbri
- Faculdade de Ciências Farmacêuticas, Universidade Estadual de Campinas, Campinas, SP Brazil
| | - Lauro Moraes
- Laboratório Multiusuário de Bioinformática, Pós-Graduação em Biotecnologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, MG Brazil
| | - Daniel B Coelho
- Laboratório de Fisiologia do Exercício da Escola de Educação Física, Universidade Federal de Ouro Preto, Ouro Preto, MG Brazil
| | - Fernanda C Dos Santos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health Toronto, ON Canada
| | - Izinara Rosse
- Programa de Pós-Graduação em Biotecnologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, MG Brazil; Laboratório Multiusuário de Bioinformática, Pós-Graduação em Biotecnologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, MG Brazil; Laboratório de Biologia Celular e Molecular, Núcleo de Pesquisas em Ciências Biológicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro Ouro Preto, MG Brazil.
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Al-Rawhani AH, Adznam SN, Abu Zaid Z, Md Yusop NB, M Sallehuddin H, Alshawsh MA. Effectiveness of whey protein supplementation on muscle strength and physical performance of older adults: A systematic review and meta-analysis of randomized clinical trials. Clin Nutr 2024; 43:2412-2426. [PMID: 39303495 DOI: 10.1016/j.clnu.2024.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/03/2024] [Accepted: 08/29/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND The efficacy of whey protein supplement (WPS) in improving muscle strength, physical performance, and body composition in older adults has been widely promoted. However, the results of randomized clinical trials in this regard have been inconsistent. We aimed to determine the impact of WPS, compared to a placebo, during or without training on muscle strength, physical function, and body composition in older adults. METHODS Randomized controlled trials were thoroughly searched using PubMed, EMBASE, the Cochrane Library Database, and Scopus databases up to June 2024. The analysis focused on key parameters such as handgrip strength (HS), leg press, knee extension, gait speed (GS), 6-min walking test (6MWT), Timed-up and go test (TUG), lean body mass (LBM), fat mass (FM), and appendicular skeletal muscle mass (ASM). A pooled effect size was calculated using a random-effects model based on standardized mean differences (SMD). RESULTS Thirty studies involving 2105 participants aged 60 and older met the inclusion criteria. The meta-analysis of 26 RCTs showed no significant positive effect of WPS on HS (n = 11, SMD: 0.18; 95% CI: -0.13, 0.49; I2 = 69%), 6MWT (n = 5, SMD: -0.08; 95%CI: -0.31, 0.16; I2 = 0%), GS test (n = 4, SMD: -0.08; 95%CI: -0.43, 0.28; I2 = 36%), TUG test (n = 9, SMD: 0.0, 95% CI -0.15, 0.14; I2 = 0%), LBM (n = 11, SMD: 0.02; 95%CI: -0.13, 0.17; I2 = 0%), FM (n = 15, SMD: -0.04; 95%CI: -0.18, 0.10; I2 = 0%). However, ASM significantly improved after WPS consumption but with high heterogeneity (n = 2, SMD: 0.39; 95%CI: 0.28, 0.51; I2 = 69%). In interventions incorporating RE, statistically significant positive effects of WPS on lower body strength were observed (n = 11, SMD: 0.25; 95%CI: 0.05, 0.45; I2 = 0%). CONCLUSION The present meta-analysis indicates that WPS, when combined with resistance training (RT), can enhance lower body strength but does not seem to have a significant beneficial effect on handgrip strength, physical performance, or body composition. Further large-scale studies are necessary to confirm these findings and elucidate the potential benefits of WPS in this population.
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Affiliation(s)
- Alaa H Al-Rawhani
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Siti Nur'Asyura Adznam
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
| | - Zalina Abu Zaid
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
| | - Nor Baizura Md Yusop
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
| | - Hakimah M Sallehuddin
- Geriatric Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Malaysian Research Institute on Ageing, (MyAgeing) Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Mohammed A Alshawsh
- Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia; Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia.
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Lee NR, Hwang HK, Lee H, Kang CM. Oral Protein Supplements Might Improve Nutritional Status and Quality of Life in Elderly Patients after Standard Pancreatic Resection. Nutrients 2024; 16:2988. [PMID: 39275303 PMCID: PMC11397451 DOI: 10.3390/nu16172988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/16/2024] Open
Abstract
Elderly patients who undergo pancreaticoduodenectomy (PPPD) or distal pancreatectomy (DP) experience not only a reduction in protein intake but also a decrease in protease secretion, leading to impaired protein digestion and absorption. This increases the risk of malnutrition and creates a dual burden of sarcopenia. This randomized, double-blind, placebo-controlled trial examined the impact of protein supplements on the nutritional status and quality of life (QoL) of elderly patients after PPPD and DP surgeries. For six weeks, the case group (CG; n = 23) consumed protein supplements containing 18 g of protein daily, while the placebo group (PG; n = 18) consumed a placebo with the same amount of carbohydrate. In elderly patients where protein digestion and intake were compromised, the CG showed significantly higher protein intake (77.3 ± 5.3 g vs. 56.7 ± 6.0 g, p = 0.049), improved QoL, better nutritional status, and faster walking speed compared to the PG. Protein intake was positively correlated with muscle mass and phase angle. Protein supplementation may not only increase protein intake but also improve clinical outcomes such as walking speed, nutritional status, and QoL in elderly post-surgical patients at high risk of sarcopenia. Further studies are needed to determine the optimal dosage and long-term effects.
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Affiliation(s)
- Na Rae Lee
- Department of Nutrition Care, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Ho Kyoung Hwang
- Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hosun Lee
- Department of Nutrition Care, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Chang Moo Kang
- Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul 03722, Republic of Korea
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Zhou H, Tian L, Wu Y, Liu S. Computed tomography-measured body composition can predict long-term outcomes for stage I-III colorectal cancer patients. Front Oncol 2024; 14:1420917. [PMID: 39040454 PMCID: PMC11260682 DOI: 10.3389/fonc.2024.1420917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
Background There remains a pressing need to identify biomarkers capable of reliably predicting prognostic outcomes for colorectal cancer (CRC) patients. As several body composition parameters have recently been reported to exhibit varying levels of prognostic significance in particular cancers, the present study was devised to assess the ability of body composition to predict long-term outcomes for CRC patients with different stages of disease. Methods In total, this retrospective analysis enrolled 327 stage I-III CRC patients whose medical records were accessed for baseline demographic and clinical data. Primary outcomes for these patients included disease-free and overall survival (DFS and OS). The prognostic performance of different musculature, visceral, and subcutaneous fat measurements from preoperative computed tomography (CT) scans was assessed. Results Over the course of follow-up, 93 of the enrolled patients experienced recurrent disease and 39 died. Through multivariate Cox regression analyses, the visceral/subcutaneous fat area (V/S) ratio was found to be independently associated with patient DFS (HR=1.93, 95% CI: 1.24-3.01, P=0.004), and the skeletal muscle index (SMI) as an independent predictor for OS (HR=0.43, 95% CI: 0.21-0.89, P=0.023). Through subgroup analyses, higher V/S ratios were found to be correlated with reduced DFS among patients with stage T3/4 (P=0.011), lymph node metastasis-positive (P=0.002), and TNM stage III (P=0.002) disease, whereas a higher SMI was associated with better OS in all T stages (P=0.034, P=0.015), lymph node metastasis-positive cases (P=0.020), and in patients with TNM stage III disease (P=0.020). Conclusion Both the V/S ratio and SMI offer potential utility as clinical biomarkers associated with long-term CRC patient prognosis. A higher V/S ratio and a lower SMI are closely related to poorer outcomes in patients with more advanced disease.
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Affiliation(s)
| | | | | | - Sibin Liu
- Radiology Department, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
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Millward DJ. Post-prandial tracer studies of protein and amino acid utilisation: what can they tell us about human amino acid and protein requirements? Br J Nutr 2024; 131:2005-2030. [PMID: 38606599 PMCID: PMC11361918 DOI: 10.1017/s0007114524000734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/26/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
Nitrogen balance (NB), the principal methodology used to derive recommendations for human protein and amino acid requirements, has been widely criticised, and calls for increased protein and amino acid requirement recommendations have been made, often on the basis of post-prandial amino acid tracer kinetic studies of muscle protein synthesis, or of amino acid oxidation. This narrative review considers our knowledge of the homeostatic regulation of the FFM throughout the diurnal cycle of feeding and fasting and what can and has been learnt from post-prandial amino acid tracer studies, about amino acid and protein requirements. Within the FFM, muscle mass in well fed weight-stable adults with healthy lifestyles appears fixed at a phenotypic level within a wide range of habitual protein intakes. However homoeostatic regulation occurs in response to variation in habitual protein intake, with adaptive changes in amino acid oxidation which influence the magnitude of diurnal losses and gains of body protein. Post-prandial indicator amino acid oxidation (IAAO) studies have been introduced as an alternative to NB and to the logistically complex 24 h [13C-1] amino acid balance studies, for assessment of protein and amino acid requirements. However, a detailed examination of IAAO studies shows both a lack of concern for homeostatic regulation of amino acid oxidation and major flaws in their design and analytical interpretation, which seriously constrain their ability to provide reliable values. New ideas and a much more critical approach to existing work is needed if real progress is to be made in the area.
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Affiliation(s)
- D. Joe Millward
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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He W, Connolly ED, Cross HR, Wu G. Dietary protein and amino acid intakes for mitigating sarcopenia in humans. Crit Rev Food Sci Nutr 2024:1-24. [PMID: 38803274 DOI: 10.1080/10408398.2024.2348549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Adult humans generally experience a 0.5-1%/year loss in whole-body skeletal muscle mass and a reduction of muscle strength by 1.5-5%/year beginning at the age of 50 years. This results in sarcopenia (aging-related progressive losses of skeletal muscle mass and strength) that affects 10-16% of adults aged ≥ 60 years worldwide. Concentrations of some amino acids (AAs) such as branched-chain AAs, arginine, glutamine, glycine, and serine are reduced in the plasma of older than young adults likely due to insufficient protein intake, reduced protein digestibility, and increased AA catabolism by the portal-drained viscera. Acute, short-term, or long-term administration of some of these AAs or a mixture of proteinogenic AAs can enhance blood flow to skeletal muscle, activate the mechanistic target of rapamycin cell signaling pathway for the initiation of muscle protein synthesis, and modulate the metabolic activity of the muscle. In addition, some AA metabolites such as taurine, β-alanine, carnosine, and creatine have similar physiological effects on improving muscle mass and function in older adults. Long-term adequate intakes of protein and the AA metabolites can aid in mitigating sarcopenia in elderly adults. Appropriate combinations of animal- and plant-sourced foods are most desirable to maintain proper dietary AA balance.
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Affiliation(s)
- Wenliang He
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Erin D Connolly
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - H Russell Cross
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Guoyao Wu
- Department of Animal Science, Texas A&M University, College Station, TX, USA
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Liu Y, Qian K, Shi X, Jing Y, He H, Li Y, Li D, Wang S. Synergistic Effects of Nutrients on Musculoskeletal Health in Gerontology: Understanding the Combined Impact of Macronutrients and Micronutrients. Nutrients 2024; 16:1640. [PMID: 38892573 PMCID: PMC11174030 DOI: 10.3390/nu16111640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
With the global aging population, addressing prevalent age-related conditions such as osteoporosis and sarcopenia is crucial. Traditional nutritional strategies focusing on single nutrients like calcium, vitamin D, or protein have limitations, prompting a nuanced exploration of the relationship between aging, nutrition, and musculoskeletal health. This cross-sectional study examines the complex interplay between dietary intake of macronutrients, common micronutrients, and water, as well as their association with musculoskeletal health in adults aged 50 to 80 years, using U.S. National Health and Nutrition Examination Survey data (NHANES). Employing multiple linear regression, restricted cubic splines, weighted quantile sum (WQS), and quantile-based g-computation (QGC) regression models, our initial analysis using the WQS model revealed that a one-quartile increase in mixed macronutrient intake was associated with a significant 0.009 unit increase in bone mineral density (BMD) and a 0.670 unit increase in grip strength, while a similar increase in mixed micronutrient intake showed a 0.007 unit increase in BMD and a 0.442 unit increase in grip strength. Our findings highlight the importance of a balanced dietary approach in promoting musculoskeletal health in the elderly, offering holistic strategies for overall well-being.
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Affiliation(s)
| | | | | | | | | | | | - Dapeng Li
- School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; (Y.L.); (K.Q.); (X.S.); (Y.J.); (H.H.)
| | - Shuran Wang
- School of Public Health, Wenzhou Medical University, Wenzhou 325035, China; (Y.L.); (K.Q.); (X.S.); (Y.J.); (H.H.)
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Wirth J, Segat A, Horner K, Crognale D, Smith T, O'Sullivan M, Brennan L. Impact of increased protein intake in older adults: a 12-week double-blind randomised controlled trial. Age Ageing 2024; 53:ii13-ii19. [PMID: 38745486 DOI: 10.1093/ageing/afae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Emerging evidence suggests health-promoting properties of increased protein intake. There is increased interest in plant protein but a dearth of information in relation to its impact on muscle function. The objective of the present work was to examine the impact of intake of different types of proteins on muscle functional parameters including handgrip strength, biomarkers of metabolic health, sleep quality and quality of life in a group of older adults. METHODS Healthy men and women aged 50 years and older entered a double-blinded, randomised, controlled nutritional intervention study with three parallel arms: high plant protein, high dairy protein and low protein. Participants consumed once daily a ready-to-mix shake (containing 20 g of protein in high protein groups) for 12 weeks. Changes in handgrip and leg strength, body composition, metabolic health, quality of life and sleep quality were analysed by linear mixed models in an intention-to-treat approach. RESULTS Eligible participants (n = 171) were randomly assigned to the groups (plant: n = 60, dairy: n = 56, low protein: n = 55) and 141 completed the study. Handgrip strength increased after the intervention (Ptime = 0.038), with no significant difference between the groups. There was no significant difference between groups for any other health outcomes. CONCLUSIONS In a population of older adults, increasing protein intake by 20 g daily for 12 weeks (whether plant-based or dairy-based) did not result in significant differences in muscle function, body composition, metabolic health, sleep quality or quality of life, compared with the low protein group.
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Affiliation(s)
- Janine Wirth
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Belfield, Dublin 4, Ireland
| | - Annalisa Segat
- Kerry Group, Global Technology and Innovation Center, Applied Health and Nutrition - Nutritional and Functional Proteins, Naas, Co. Kildare, Ireland
| | - Katy Horner
- Institute of Sport and Health, UCD, Belfield, Dublin 4, Ireland
| | | | - Thomas Smith
- Department of Clinical Chemistry, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Maurice O'Sullivan
- Kerry Group, Global Technology and Innovation Center, Applied Health and Nutrition - Nutritional and Functional Proteins, Naas, Co. Kildare, Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Belfield, Dublin 4, Ireland
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Koopmans L, Spoelder M, Bongers CCWG, Eijsvogels TMH, Hopman MTE. The effect of lesser mealworm protein on exercise-induced muscle damage in active older adults: a randomized controlled trial. J Nutr Health Aging 2024; 28:100204. [PMID: 38460318 DOI: 10.1016/j.jnha.2024.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES We compared the effect of 12 weeks lesser mealworm-based (Alphitobius diaperinus) protein supplementation to whey protein and placebo supplementation on Exercise-Induced Muscle Damage (EIMD) after long-distance walking in older adults. METHODS in this randomized controlled trial, 70 physically active older adults (>60 years) were randomly allocated to the following groups: I) lesser mealworm protein, II) whey protein or III) iso-caloric placebo. Participants received supplements 11 weeks before and 1 week during a 3-day long-distance walking challenge (30-50 km per day). Blood concentrations of creatinine kinase (CK) and lactate dehydrogenase (LDH), handgrip strength and muscle soreness were measured pre-exercise and directly after each walking bout. RESULTS Significant elevations of CK concentrations (103 [76-161] U/l to 758 [342-1104] U/l, p < 0.001) and LDH concentrations (202 [175-220] to 283 [252-339] U/l, p < 0.001) were observed following 7h45 min ± 11 min of walking exercise per day, but the magnitude of this effect did not differ among suppletion groups. Hand grip strength decreased significantly (p < 0.001) while muscle soreness increased (p = 0.002) after the first walking day compared to pre-exercise, with no group differences. CONCLUSION 12-weeks of lesser mealworm-based protein supplementation (30 g/day) does not attenuate exercise induced muscle damage in older adults following three days of prolonged walking exercise in comparison to placebo or whey protein.
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Affiliation(s)
- Lotte Koopmans
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcia Spoelder
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Radboud, The Netherlands
| | - Coen C W G Bongers
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands; School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands.
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Mast IH, Bongers CCWG, Gootjes EC, de Wilt JHW, Hopman MTE, Buffart LM. Potential mechanisms underlying the effect of walking exercise on cancer-related fatigue in cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01537-y. [PMID: 38296934 DOI: 10.1007/s11764-024-01537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/12/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a common and debilitating long-term side effect of cancer and its treatment. While exercise has been shown to effectively reduce CRF, the underlying mechanisms are not fully clear. Therefore, the aim of this study was to explore the effects of a 4-month walking exercise program on fatigue severity and to explore potential underlying physiological, behavioral, and psychological mechanisms of action. METHODS We included 27 cancer survivors (59 ± 15 years, 37% female) with variable cancer diagnoses who were at least moderately fatigued and finished treatment between 6 and 36 months ago. This study with a quasi-experimental interrupted time-series design compared a 4-month walking intervention period with a 4-month control period. Measurements of fatigue and physiological, behavioral, and psychological factors were performed, supplemented with participants' perceptions on how exercise influenced their fatigue. RESULTS A significant and clinically relevant decrease in fatigue severity was found over time (β = - 8.1, 95% CI = - 12.1; - 4.2), but could not be attributed directly to the walking exercise intervention. Increases in muscle strength (β = - 0.07, 95% CI = - 0.12; - 0.02), physical activity (β = - 0.1, 95% CI = - 0.2; - 0.04), and sleep quality (β = 1.1, 95% CI = 0.3; 1.9), as well as decreases in muscle relaxation times (β = 0.09, 95% CI = 0.02; 0.16) and psychological distress (β = 1.1, 95% CI = 0.8; 1.3) were associated with reductions in fatigue severity. Resilience and physical well-being were perceived as most important constructs explaining the walking exercise effects on fatigue. CONCLUSION Our findings reveal potential physiological, behavioral, and psychological mechanisms underlying the multidimensional effects of exercise on fatigue severity. IMPLICATIONS FOR CANCER SURVIVORS Incorporating resistance exercise and addressing resilience and physical well-being might improve the efficacy of exercise interventions for cancer survivors.
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Affiliation(s)
- Isa Hiske Mast
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Coen C W G Bongers
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Elske C Gootjes
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johannes H W de Wilt
- Department of Oncological Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maria T E Hopman
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
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Khaing IK, Tahara Y, Chimed-Ochir O, Shibata S, Kubo T. Effect of breakfast protein intake on muscle mass and strength in adults: a scoping review. Nutr Rev 2024:nuad167. [PMID: 38219154 DOI: 10.1093/nutrit/nuad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The distribution of protein intake throughout the day is frequently skewed, with breakfast having the lowest protein intake across all age groups. There is no review that addresses the association between breakfast protein intake and muscle mass and strength. OBJECTIVE This scoping review aims to summarize the literature on the relationship between protein intake during breakfast and muscle mass and strength in adults. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Two independent reviewers screened and appraised the articles identified from 3 electronic databases (Medline, Web of Science, and Scopus) that focused on protein intake per meal and its impact on muscle-related outcomes. RESULTS A total of 14 763 articles were retrieved from 3 databases, and after the screening process, 15 articles were included for analysis. Approximately 58.8% of findings from 11 studies examining the association between high protein intake during breakfast and muscle mass indicated an increase in muscle mass among participants. Half of 6 studies (50.0%) exploring the relationship between high protein intake at breakfast and muscle strength demonstrated an increase in muscle strength. Consuming high amounts of protein at breakfast or more protein in the morning than in the evening was associated with an increase in the skeletal muscle index and lean body mass. CONCLUSION Protein consumption at breakfast revealed potential benefits in increasing muscle mass across 5 studies involving an elderly population and 2 studies encompassing middle-aged women and young men in our review. However, the relationship between protein intake at breakfast and muscle strength remains unclear. Further high-quality randomized controlled trials are required to examine whether adults can preserve skeletal muscle health outcomes by consuming higher amounts of protein at breakfast.
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Affiliation(s)
- Inn-Kynn Khaing
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yu Tahara
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigenobu Shibata
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Zhang FM, Wu HF, Shi HP, Yu Z, Zhuang CL. Sarcopenia and malignancies: epidemiology, clinical classification and implications. Ageing Res Rev 2023; 91:102057. [PMID: 37666432 DOI: 10.1016/j.arr.2023.102057] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023]
Abstract
Sarcopenia is a progressive systemic skeletal muscle disorder characterized by a pathological decline in muscle strength, quantity, and quality, which frequently affects the elderly population. The majority of cancer patients are of advanced age. Patients may already have sarcopenia prior to cancer development, and those with cancer are prone to developing sarcopenia due to hypercatabolism, inflammation, reduced physical fitness, anorexia, adverse effects, and stress associated with anticancer therapy. Based on the timing, sarcopenia in patients with cancer can be categorized into three: pre-existing sarcopenia before the onset of cancer, sarcopenia related to cancer, and sarcopenia related to cancer treatment. Sarcopenia not only changes the body composition of patients with cancer but also increases the incidence of postoperative complications, reduces therapeutic efficacy, impairs quality of life, and results in shortened survival. Different therapeutic strategies are required to match the cancer status and physical condition of patients with different etiologies and stages of sarcopenia. Here, we present a comprehensive review of the epidemiology and diagnosis of sarcopenia in patients with cancer, elucidate the complex interactions between cancer and sarcopenia, and provide evidence-based strategies for sarcopenia management in these patients.
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Affiliation(s)
- Feng-Min Zhang
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hao-Fan Wu
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University/ Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Zhen Yu
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Cheng-Le Zhuang
- Colorectal Cancer Center/Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
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13
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Janssen TAH, Van Every DW, Phillips SM. The impact and utility of very low-calorie diets: the role of exercise and protein in preserving skeletal muscle mass. Curr Opin Clin Nutr Metab Care 2023; 26:521-527. [PMID: 37724991 PMCID: PMC10552824 DOI: 10.1097/mco.0000000000000980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
PURPOSE OF REVIEW Very low-calorie diets (VLCD) are used as a weight loss intervention, but concerns have been raised about their potential negative impact on lean mass. Here, we review the available evidence regarding the effects of VLCD on lean mass and explore their utility and strategies to mitigate reductions in skeletal muscle. RECENT FINDINGS We observed that VLCD, despite their effects on lean mass, may be suitable in certain populations but have a risk in reducing lean mass. The extent of the reduction in lean mass may depend on various factors, such as the duration and degree of energy deficit of the diet, as well as the individual's starting weight and overall health. SUMMARY VLCD may be a viable option in certain populations; however, priority needs to be given to resistance exercise training, and secondarily to adequate protein intake should be part of this dietary regime to mitigate losing muscle mass.
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Niskanen RT, Reinders I, Wijnhoven HAH, Hyvönen AA, Pols-Vrijmoeth M, Trommel-Bout M, Visser M, Pitkälä KH, Suominen MH, Öhman H, Jyväkorpi SK. The feasibility of a 6-month dietary intervention aiming to increase protein intake among community-dwelling older adults with low habitual protein intake: A secondary analysis of the PROMISS randomised controlled trial. J Hum Nutr Diet 2023; 36:1811-1820. [PMID: 37347495 DOI: 10.1111/jhn.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The PROMISS randomised controlled trial showed that personalised dietary advice increased protein intake and improved 400-m walk time and leg strength among community-dwelling older adults with a low habitual protein intake. This secondary analysis describes and further evaluates the methods and feasibility of the model used to carry out dietary intervention in the PROMISS randomised controlled trial. METHODS In total, 185 participants (≥65 years, 54% women) with a habitual low protein intake (<1.0 g/kg adjusted body weight/day) in Finland and the Netherlands received personalised dietary advice and complimentary protein-enriched food products for 6 months with two main objectives: (1) to increase protein intake to ≥1.2 g/kg adjusted body weight/day (energy-neutral) and (2) to include each day a 'high-protein meal' containing ≥ 30-35 g of protein. The feasibility of the model was evaluated by the adoption of the advice, feedback from the participants, and practical experiences by the nutritionists. RESULTS In all, 174 participants (93.5%) completed the intervention. At the 6-month follow-up, 41.8% reached both main objectives of the advice. The participants' general rating for the dietary advice was 8.6 (SD 1.0) (on a scale of 1-10; 10 indicating very good). Sticking to the advice was (very) easy for 79.2% of the participants. The nutritionists perceived the model feasible for the participants except for those with low food intake. CONCLUSIONS The methods used in this model are mainly feasible, well-received and effective in increasing protein intake among community-dwelling older adults with low habitual protein intake.
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Affiliation(s)
- Riikka T Niskanen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Ilse Reinders
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aliisa A Hyvönen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Merel Pols-Vrijmoeth
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mariska Trommel-Bout
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Hanna Öhman
- Geriatric Medicine, University of Helsinki (UH) and Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
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15
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Park JB. Effects of 12 weeks of low molecular collagen peptide supplementation on body composition in overweight Korean adults aged 50 years and older.. [DOI: 10.21203/rs.3.rs-3016558/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
After the age of 50, their muscle mass gradually declines each year, and the lost muscle is often replaced by fat mass. Insufficient protein intake after middle age further accelerates this process. Previous studies that have used collagen as a supplementation, which accounts for about 30% of the body's protein, have combined it with resistance exercise. This study investigated the effects of collagen supplementation on body composition in individuals over the age of 50 (23≤BMI≤32), while maintaining their daily activity levels constant. Participants were assigned to either the collagen group (n=42) or the placebo group(n=42). Collagen supplementation (15g of collagen) and placebo product (xanthan gum) were offered. Bioactive Collagen Peptides, which is a type of low molecular weight collagen extracted from porcine raw materials, was used. Body composition was measured by bioelectrical impedance analysis and dual-energy X-ray absorptiometry. Blood samples were taken for analysis. Physical activities and dietary intake were measured by international physical activity questionnaire and a 3-day food record, respectively. 74 participants in the collagen group (n=37) and placebo group (n=37) were used in the final analysis. Physical activity and dietary intake showed no significant difference between the two groups. The collagen group showed a significant reduction in total body fat mass compared to the placebo group, as evidenced by both BIA (P=0.021) and DEXA (P=0.041) measurements. There were no significant differences in blood measurements between the two groups. Therefore, the intake of collagen supplementation after middle age may be used for preventing age related fat mass accumulation.
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16
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Park JB. Effects of collagen supplementation on body composition and muscle strength in Korean adults aged 50 years and older.. [DOI: 10.21203/rs.3.rs-3016558/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
BACKGROUND: Insufficient protein intake can accelerate the loss of muscle mass as one ages. A decrease in muscle mass leads to an increase in fat mass, creating a vicious cycle that can result in sarcopenic obesity. Previous studies that have used collagen as a supplementation, which accounts for about 30% of the body's protein, have combined it with resistance exercise.
OBJECTIVE: This study investigated the effects of collagen supplementation on body composition in individuals over the age of 50, while maintaining their daily activity levels constant.
DESIGN: Double-blind randomized controlled trial
PARTICIPANTS: Participants were assigned to either the collagen group (n=42) or the placebo group(n=42).
MEASUREMENTS: Collagen supplementation (14g of collagen) and placebo product (xanthan gum) were offered to collagen group and placebo group respectively, once a day. Body composition was measured by bioelectrical impedance analysis and dual-energy X-ray absorptiometry. Participants were instructed to maintain their dietary intake and physical activity levels, which were evaluated through a 3-day food record analysis and an international physical activity questionnaire (IPAQ) analysis, respectively.
RESULTS: 74 participants in the collagen group (n=37) and placebo group (n=37) completed the follow-up, and there was no significant difference between the two groups in terms of physical activity levels. The collagen group showed a significant reduction in total body fat mass compared to the placebo group, as evidenced by both BIA (P=0.021) and DEXA (P=0.041) measurements. However, there was no significant difference between the two groups in terms of muscle mass.
Conclusion: From this study, the consumption of collagen supplementation is effective in reducing fat mass, which is significant in preventing sarcopenic obesity after middle age.
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17
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Nishimura Y, Højfeldt G, Breen L, Tetens I, Holm L. Dietary protein requirements and recommendations for healthy older adults: a critical narrative review of the scientific evidence. Nutr Res Rev 2023; 36:69-85. [PMID: 34666855 DOI: 10.1017/s0954422421000329] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Adequate protein intake is essential for the maintenance of whole-body protein mass. Different methodological approaches are used to substantiate the evidence for the current protein recommendations, and it is continuously debated whether older adults require more protein to counteract the age-dependent loss of muscle mass, sarcopenia. Thus, the purpose of this critical narrative review is to outline and discuss differences in the approaches and methodologies assessing the protein requirements and, hence, resulting in controversies in current protein recommendations for healthy older adults. Through a literature search, this narrative review first summarises the historical development of the Food and Agriculture Organization/World Health Organization/United Nations University setting of protein requirements and recommendations for healthy older adults. Hereafter, we describe the various types of studies (epidemiological studies and protein turnover kinetic measurements) and applied methodological approaches founding the basis and the different recommendations with focus on healthy older adults. Finally, we discuss important factors to be considered in future studies to obtain evidence for international agreement on protein requirements and recommendations for healthy older adults. We conclude by proposing future directions to determine 'true' protein requirements and recommendations for healthy older adults.
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Affiliation(s)
- Yusuke Nishimura
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Grith Højfeldt
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Inge Tetens
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Holm
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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18
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Allard NAE, Janssen L, Lagerwaard B, Nuijten MAH, Bongers CCWG, Rodenburg RJ, Thompson PD, Eijsvogels TMH, Assendelft WJJ, Schirris TJJ, Timmers S, Hopman MTE. Prolonged Moderate-Intensity Exercise Does Not Increase Muscle Injury Markers in Symptomatic or Asymptomatic Statin Users. J Am Coll Cardiol 2023; 81:1353-1364. [PMID: 37019582 DOI: 10.1016/j.jacc.2023.01.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Statin use may exacerbate exercise-induced skeletal muscle injury caused by reduced coenzyme Q10 (CoQ10) levels, which are postulated to produce mitochondrial dysfunction. OBJECTIVES We determined the effect of prolonged moderate-intensity exercise on markers of muscle injury in statin users with and without statin-associated muscle symptoms. We also examined the association between leukocyte CoQ10 levels and muscle markers, muscle performance, and reported muscle symptoms. METHODS Symptomatic (n = 35; age 62 ± 7 years) and asymptomatic statin users (n = 34; age 66 ± 7 years) and control subjects (n = 31; age 66 ± 5 years) walked 30, 40, or 50 km/d for 4 consecutive days. Muscle injury markers (lactate dehydrogenase, creatine kinase, myoglobin, cardiac troponin I, and N-terminal pro-brain natriuretic peptide), muscle performance, and reported muscle symptoms were assessed at baseline and after exercise. Leukocyte CoQ10 was measured at baseline. RESULTS All muscle injury markers were comparable at baseline (P > 0.05) and increased following exercise (P < 0.001), with no differences in the magnitude of exercise-induced elevations among groups (P > 0.05). Muscle pain scores were higher at baseline in symptomatic statin users (P < 0.001) and increased similarly in all groups following exercise (P < 0.001). Muscle relaxation time increased more in symptomatic statin users than in control subjects following exercise (P = 0.035). CoQ10 levels did not differ among symptomatic (2.3 nmol/U; IQR: 1.8-2.9 nmol/U), asymptomatic statin users (2.1 nmol/U; IQR: 1.8-2.5 nmol/U), and control subjects (2.1 nmol/U; IQR: 1.8-2.3 nmol/U; P = 0.20), and did not relate to muscle injury markers, fatigue resistance, or reported muscle symptoms. CONCLUSIONS Statin use and the presence of statin-associated muscle symptoms does not exacerbate exercise-induced muscle injury after moderate exercise. Muscle injury markers were not related to leukocyte CoQ10 levels. (Exercise-induced Muscle Damage in Statin Users; NCT05011643).
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Affiliation(s)
- Neeltje A E Allard
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Lando Janssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Health Sciences, Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bart Lagerwaard
- Human and Animal Physiology, Wageningen University, Wageningen, the Netherlands
| | - Malou A H Nuijten
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Coen C W G Bongers
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Richard J Rodenburg
- Radboud Center for Mitochondrial Medicine, Translational Metabolic Laboratory, Department of Pediatrics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Paul D Thompson
- Division of Cardiology, Hartford Hospital, Hartford, Connecticut, USA
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Willem J J Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tom J J Schirris
- Radboud Institute for Molecular Life Sciences, Department of Pharmacology and Toxicology, Radboud Centre for Mitochondrial Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Silvie Timmers
- Human and Animal Physiology, Wageningen University, Wageningen, the Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands.
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19
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Tan D, Sutanto CN, Lin JWX, Toh DWK, Lê KA, Kim JE. Measures of carbohydrate quality and their association with diet quality and cardiometabolic health outcomes in Singapore middle-aged and older adults. Nutr Metab Cardiovasc Dis 2023; 33:778-788. [PMID: 36842956 DOI: 10.1016/j.numecd.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIMS Carbohydrate quality may play a key role in cardiometabolic health and disease risk. This study aimed to assess the dietary carbohydrate quality of the free-living middle-aged and older adults in Singapore, and its association with overall diet quality and cardiometabolic health. METHODS AND RESULTS This cross-sectional study examined the diet and cardiometabolic disease risk indicators of middle-aged and older adults in Singapore (n = 104). Dietary carbohydrate quality was assessed as the pass and fail rate of the population to four measures of carbohydrate quality: (i) dietary fiber recommended daily allowance (RDA), (ii) whole-grain recommendation, (iii) free sugar recommendation, and (iv) carbohydrate metrics. The association between each carbohydrate quality measure and diet quality, as well as cardiometabolic health, was assessed. Except for free sugar recommendation, the carbohydrate quality of the population was found to be poor with a low adherence (20-36%) to three measures. Subjects meeting these measures had generally higher intakes of fiber, protein, and most micronutrients compared with subjects who failed. Meeting different variants of the carbohydrate metrics was associated with 60% lower odds of pre-hypertensive blood pressure (p = 0.037; p = 0.047), and meeting the dietary fiber RDA was associated with lower waist circumference (p = 0.021). CONCLUSION An improvement in carbohydrate quality is warranted among free-living middle-aged and older adults in Singapore. Not all measures of carbohydrate quality were equally effective in preserving overall diet quality; the carbohydrate metrics and dietary fiber RDA can be identified as effective measures in relation to cardiometabolic disease risk. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/ CLINICAL TRIAL REGISTRATION: NCT03554954, 13 Sept. 2018.
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Affiliation(s)
- Denise Tan
- Department of Food Science & Technology, Faculty of Science, National University of Singapore, Singapore; Science and Technology Department, Nestlé R&D Center (Pte) Ltd., Singapore 618802, Singapore
| | - Clarinda Nataria Sutanto
- Department of Food Science & Technology, Faculty of Science, National University of Singapore, Singapore
| | - Jia Wen Xanthe Lin
- Department of Food Science & Technology, Faculty of Science, National University of Singapore, Singapore
| | - Darel Wee Kiat Toh
- Department of Food Science & Technology, Faculty of Science, National University of Singapore, Singapore
| | - Kim-Anne Lê
- Department of Nutrition Sciences, Nestlé Research, 1000 Lausanne 26, Switzerland
| | - Jung Eun Kim
- Department of Food Science & Technology, Faculty of Science, National University of Singapore, Singapore.
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20
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Increasing Muscle Mass in Elders through Diet and Exercise: A Literature Review of Recent RCTs. Foods 2023; 12:foods12061218. [PMID: 36981144 PMCID: PMC10048759 DOI: 10.3390/foods12061218] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/23/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
This study aimed to review the current evidence on the independent and combined effects of diet and exercise and their impact on skeletal muscle mass in the elderly population. Skeletal muscle makes up approximately 40% of total body weight and is essential for performing daily activities. The combination of exercise and diet is known to be a potent anabolic stimulus through stimulation of muscle protein synthesis from amino acids. Aging is strongly associated with a generalized deterioration of physiological function, including a progressive reduction in skeletal muscle mass and strength, which in turn leads to a gradual functional impairment and an increased rate of disability resulting in falls, frailty, or even death. The term sarcopenia, which is an age-related syndrome, is primarily used to describe the gradual and generalized loss of skeletal muscle mass (mainly in type II muscle fibers) and function. Multimodal training is emerging as a popular training method that combines a wide range of physical dimensions. On the other hand, nutrition and especially protein intake provide amino acids, which are essential for muscle protein synthesis. According to ESPEN, protein intake in older people should be at least 1 g/kgbw/day. Essential amino acids, such as leucine, arginine, cysteine, and glutamine, are of particular importance for the regulation of muscle protein synthesis. For instance, a leucine intake of 3 g administered alongside each main meal has been suggested to prevent muscle loss in the elderly. In addition, studies have shown that vitamin D and other micronutrients can have a protective role and may modulate muscle growth; nevertheless, further research is needed to validate these claims. Resistance-based exercise combined with a higher intake of dietary protein, amino acids, and/or vitamin D are currently recognized as the most effective interventions to promote skeletal muscle growth. However, the results are quite controversial and contradictory, which could be explained by the high heterogeneity among studies. It is therefore necessary to further assess the impact of each individual exercise and nutritional approach, particularly protein and amino acids, on human muscle turnover so that more efficient strategies can be implemented for the augmentation of muscle mass in the elderly.
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21
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Jang YJ. The Effects of Protein and Supplements on Sarcopenia in Human Clinical Studies: How Older Adults Should Consume Protein and Supplements. J Microbiol Biotechnol 2023; 33:143-150. [PMID: 36474318 PMCID: PMC9998208 DOI: 10.4014/jmb.2210.10014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022]
Abstract
Sarcopenia is a condition in which muscle mass, strength, and performance decrease with age. It is associated with chronic diseases such as diabetes, cardiovascular disease, and hypertension, and contributes to an increase in mortality. Because managing sarcopenia is critical for maintaining good health and quality of life for the elderly, the condition has sparked concern among many researchers. To counteract sarcopenia, intake of protein is an important factor, while a lack of either protein or vitamin D is a major cause of sarcopenia. In addition, essential amino acids, leucine, β-hydroxy β-methylbutyrate (HMB), creatine, and citrulline are used as supplements for muscle health and are suggested as alternatives for controlling sarcopenia. There are many studies on such proteins and supplements, but it is necessary to actually organize the types, amounts, and methods by which proteins and supplements should be consumed to inhibit sarcopenia. In this study, the efficacy of proteins and supplements for controlling sarcopenia according to human clinical studies is summarized to provide suggestions about how the elderly may consume proteins, amino acids, and other supplements.
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Affiliation(s)
- Young Jin Jang
- Major of Food Science and Technology, Seoul Women's University, Seoul 01797, Republic of Korea
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22
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Kanazashi M, Iida T, Nakanishi R, Tanaka M, Ikeda H, Takamiya N, Maeshige N, Kondo H, Nishigami T, Harada T, Fujino H. Brazilian Propolis Intake Decreases Body Fat Mass and Oxidative Stress in Community-Dwelling Elderly Females: A Randomized Placebo-Controlled Trial. Nutrients 2023; 15:nu15020364. [PMID: 36678234 PMCID: PMC9861743 DOI: 10.3390/nu15020364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/25/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
This study aimed to investigate the effects of Brazilian propolis on body fat mass and levels of adiponectin and reactive oxygen species among community-dwelling elderly females. This was a double-blind randomized placebo-controlled trial. Altogether, 78 females aged 66-84 years were randomly assigned to the propolis (PRO; n = 39) or placebo (PLA; n = 39) group. For 12 weeks, the PRO group were given three capsules containing 227 mg of propolis twice a day. Meanwhile, the PLA group were given daily placebo capsules. Of 78 participants, 53 (PLA group: n = 28, PRO group: n = 25) completed the study. Although no changes were observed in absolute or relative fat mass in the PLA group, they showed a significant decline in the PRO group. The level of serum adiponectin in the PLA group did not change, although that of the PRO group significantly increased. The level of d-ROMs in the PLA group significantly increased, whereas that of the PRO group significantly decreased. The serum SOD activity in the PLA group significantly decreased, whereas that of the PRO group tended to increase. These results suggest that propolis supplementation may decrease body fat mass and oxidative stress among community-dwelling elderly females.
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Affiliation(s)
- Miho Kanazashi
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara 723-0053, Japan
| | - Tadayuki Iida
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara 723-0053, Japan
| | - Ryosuke Nakanishi
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe 658-0032, Japan
| | - Masayuki Tanaka
- Department of Physical Therapy, Faculty of Health Sciences, Okayama Healthcare Professional University, Okayama 700-0913, Japan
| | - Hiromi Ikeda
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara 723-0053, Japan
| | - Naomi Takamiya
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara 723-0053, Japan
| | - Noriaki Maeshige
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
| | - Hiroyo Kondo
- Department of Food Science and Nutrition, Nagoya Women’s University, Nagoya 467-8611, Japan
| | - Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara 723-0053, Japan
| | - Toshihide Harada
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Mihara 723-0053, Japan
| | - Hidemi Fujino
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
- Correspondence: ; Tel.: +81-78-796-4542
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23
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van der Heijden I, Monteyne AJ, Stephens FB, Wall BT. Alternative dietary protein sources to support healthy and active skeletal muscle aging. Nutr Rev 2023; 81:206-230. [PMID: 35960188 DOI: 10.1093/nutrit/nuac049] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
To mitigate the age-related decline in skeletal muscle quantity and quality, and the associated negative health outcomes, it has been proposed that dietary protein recommendations for older adults should be increased alongside an active lifestyle and/or structured exercise training. Concomitantly, there are growing environmental concerns associated with the production of animal-based dietary protein sources. The question therefore arises as to where this dietary protein required for meeting the protein demands of the rapidly aging global population should (or could) be obtained. Various non-animal-derived protein sources possess favorable sustainability credentials, though much less is known (compared with animal-derived proteins) about their ability to influence muscle anabolism. It is also likely that the anabolic potential of various alternative protein sources varies markedly, with the majority of options remaining to be investigated. The purpose of this review was to thoroughly assess the current evidence base for the utility of alternative protein sources (plants, fungi, insects, algae, and lab-grown "meat") to support muscle anabolism in (active) older adults. The solid existing data portfolio requires considerable expansion to encompass the strategic evaluation of the various types of dietary protein sources. Such data will ultimately be necessary to support desirable alterations and refinements in nutritional guidelines to support healthy and active aging, while concomitantly securing a sustainable food future.
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Affiliation(s)
- Ino van der Heijden
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Alistair J Monteyne
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Francis B Stephens
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
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24
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Tuttiett ER, Ioannou E, Wijnhoven HA, Corfe BM, Williams EA. Adaptation and validation of a protein intake screening tool for a UK adult population. J Nutr Sci 2022; 11:e100. [PMID: 36405091 PMCID: PMC9672832 DOI: 10.1017/jns.2022.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 12/14/2022] Open
Abstract
Adequate dietary protein intake is important in human subjects for maintaining muscle turnover, determining the protein content of tissues and thus the preservation of muscle mass and function as we age. A screening tool to assess if an older individual is likely to have a lower dietary protein intake (predicted probability of protein intake ≤1⋅0 g/kg per d), has been developed for a Netherlands dietary profile, but this has not been validated in a UK population. This study aimed to adapt and then validate the protein screening tool for use in a UK population. Amendment of the tool was undertaken using data from UK BioBank and the UK National Diet and Nutrition Survey to reflect protein sources in the UK diet. Validation of the amended version of the protein screener screening tool was conducted using protein intake derived from a food frequency questionnaire (FFQ) in a sample of UK adults (n = 184) (age range 18-91 years) as the reference standard. Using the FFQ, 40 % of respondents (n = 74) reported a protein intake of ≤1⋅0 g per kg body mass. The discriminative accuracy of the amended screener was tested using receiver operating characteristic (ROC) curves. The area under the curve for the ROC was 0⋅731 (95 % CI 0⋅657, 0⋅805), indicating that the amended screener may be a valid tool to screen for individuals consuming ≤1⋅0 g/kg adjusted BM/d in an adult UK population. This protein screener tool is a potential method to screen individuals with a likelihood of habitually consuming protein intakes of ≤1⋅0 g/kg per d. Further validation is needed using a more robust dietary intake methodology and for specific groups, such as older adults. The screener may be applicable across healthcare, clinical and research applications.
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Affiliation(s)
- Esme R. Tuttiett
- Department of Oncology and Metabolism, The Medical School, The University of Sheffield, Sheffield S10 2RX, UK
| | - Elysa Ioannou
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Hanneke A.H. Wijnhoven
- Department of Health Sciences, Faculty of Science, and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Bernard M. Corfe
- Department of Oncology and Metabolism, The Medical School, The University of Sheffield, Sheffield S10 2RX, UK
- Human Nutrition Research Centre, Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4HH, UK
| | - Elizabeth A. Williams
- Department of Oncology and Metabolism, The Medical School, The University of Sheffield, Sheffield S10 2RX, UK
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25
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Compher C, Cederholm T, Correia MITD, Gonzalez MC, Higashiguch T, Shi HP, Bischoff SC, Boirie Y, Carrasco F, Cruz-Jentoft A, Fuchs-Tarlovsky V, Fukushima R, Heymsfield SB, Mourtzakis M, Muscaritoli M, Norman K, Nyulasi I, Pisprasert V, Prado CM, de van der Schuren M, Yoshida S, Yu J, Jensen G, Barazzoni R. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition. JPEN J Parenter Enteral Nutr 2022; 46:1232-1242. [PMID: 35437785 DOI: 10.1002/jpen.2366] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/21/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023]
Abstract
The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.
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Affiliation(s)
- Charlene Compher
- Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Theme Inflammation & Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Isabel T D Correia
- Department of Surgery, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Han Ping Shi
- Key Laboratory of Cancer FSMP for State Market Regulation, Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Stephan C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Yves Boirie
- Unité de Nutrition Humaine, Clinical Nutrition Department, INRAE, CHU Clermont-Ferrand, CRNH Auvergne, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, Nutrition and Bariatric Surgery Center, University of Chile, and Clínica Las Condes, Santiago, Chile
| | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | - Ryoji Fukushima
- Department of Surgery, Teikyo University School of Medicine/Health and Dietetics Teikyo Heisei University, Tokyo, Japan
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Ibolya Nyulasi
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia
- Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria, Australia
- Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Veeradej Pisprasert
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Marian de van der Schuren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Wageningen University & Research, Human Nutrition and Health, Wageningen, The Netherlands
| | - Sadao Yoshida
- Department of Rehabilitation, Chuzan Hospital, Okinawa-city, Okinawa Prefecture, Japan
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Gordon Jensen
- Dean's Office, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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26
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Griffen C, Renshaw D, Duncan M, Weickert MO, Hattersley J. Changes in 24-h energy expenditure, substrate oxidation, and body composition following resistance exercise and a high protein diet via whey protein supplementation in healthy older men. Physiol Rep 2022; 10:e15268. [PMID: 37815091 PMCID: PMC9332127 DOI: 10.14814/phy2.15268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/01/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate changes in 24-h energy expenditure (EE), substrate oxidation, and body composition following resistance exercise (RE) and a high protein diet via whey protein supplementation (alone and combined) in healthy older men. METHODS In a pooled groups analysis, 33 healthy older men [(mean ± SE) age: 67 ± 1 years; BMI: 25.4 ± 0.4 kg/m2] were randomized to either RE (2×/week; n = 17) or non-exercise (n = 16) and either a high protein diet via whey protein supplementation (PRO, 2 × 25 g whey protein isolate/d; n = 17) or control (CON, 2 × 23.75 g maltodextrin/d; n = 16). An exploratory sub-analysis was also conducted between RE+CON (n = 8) and RE+PRO (n = 9). At baseline and 12 weeks, participants resided in respiration chambers for measurement of 24-h EE and substrate oxidation and wore an accelerometer for 7 days for estimation of free-living EE. RESULTS Resistance exercise resulted in greater increases in fat-free mass (1.0 ± 0.3 kg), resting metabolic rate [(RMR) 36 ± 14 kcal/d], sedentary EE (60 ± 33 kcal/d), and sleeping metabolic rate [(SMR) 45 ± 7 kcal/d] compared to non-exercise (p < 0.05); however, RE decreased activity energy expenditure in free-living (-90 ± 25 kcal/d; p = 0.049) and non-exercise activity inside the respiration chamber (-1.9 ± 1.1%; p = 0.049). PRO decreased fat mass [(FM) -0.5 ± 0.3 kg], increased overnight protein oxidation (30 ± 6 g/d), and decreased 24-h protein balance (-20 ± 4 g/d) greater than CON (p < 0.05). RE+PRO decreased FM (-1.0 ± 0.5 kg) greater than RE+CON (p = 0.04). CONCLUSION Resistance exercise significantly increased RMR, SMR, and sedentary EE in healthy older men, but not total EE. PRO alone and combined with RE decreased FM and aided body weight maintenance. This study was registered at clinicaltrials.gov as NCT03299972.
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Affiliation(s)
- Corbin Griffen
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- Human Metabolism Research UnitUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Derek Renshaw
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
| | - Michael Duncan
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- School of Life SciencesFaculty of Health and Life SciencesCoventry UniversityCoventryUK
| | - Martin O. Weickert
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of Endocrinology and DiabetesUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - John Hattersley
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- Human Metabolism Research UnitUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
- School of EngineeringUniversity of WarwickCoventryUK
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27
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Barazzoni R, Jensen GL, Correia MITD, Gonzalez MC, Higashiguchi T, Shi HP, Bischoff SC, Boirie Y, Carrasco F, Cruz-Jentoft A, Fuchs-Tarlovsky V, Fukushima R, Heymsfield S, Mourtzakis M, Muscaritoli M, Norman K, Nyulasi I, Pisprasert V, Prado C, de van der Schuren M, Yoshida S, Yu Y, Cederholm T, Compher C. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr 2022; 41:1425-1433. [PMID: 35450768 DOI: 10.1016/j.clnu.2022.02.001] [Citation(s) in RCA: 134] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 01/02/2023]
Abstract
The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.
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Affiliation(s)
- Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Gordon L Jensen
- Dean's Office, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Maria Isabel T D Correia
- Department of Surgery, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Han Ping Shi
- Key Laboratory of Cancer FSMP for State Market Regulation, Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Stephan C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Yves Boirie
- Unité de Nutrition Humaine, Clinical Nutrition Department, INRAE, CHU Clermont-Ferrand, CRNH Auvergne, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, Nutrition and Bariatric Surgery Center, University of Chile, Clínica Las Condes, Santiago, Chile
| | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | - Ryoji Fukushima
- Department of Surgery Teikyo University School of Medicine/Health and Dietetics Teikyo Heisei University, Tokyo, Japan
| | - Steve Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Ibolya Nyulasi
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Veeradej Pisprasert
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Carla Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Marian de van der Schuren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands; Wageningen University & Research, Human Nutrition and Health, Wageningen, the Netherlands
| | - Sadao Yoshida
- Department of Rehabilitation, Chuzan Hospital, Okinawa-city, Okinawa Prefecture, Japan
| | - Yanchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Theme Inflammation & Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Charlene Compher
- Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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28
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Koponen S, Nykänen I, Savela RM, Välimäki T, Suominen AL, Schwab U. Individually tailored nutritional guidance improved dietary intake of older family caregivers: a randomized controlled trial. Eur J Nutr 2022; 61:3585-3596. [PMID: 35622137 PMCID: PMC9136734 DOI: 10.1007/s00394-022-02908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Older family caregivers (FCs) are vulnerable to insufficient dietary intake and risk of malnutrition. The aim of this study was to assess the impact of individually tailored nutritional guidance on the dietary intake and nutritional status of older FCs and their care recipients' (CRs') nutritional status. METHODS This study was a randomized controlled 6-month nutrition intervention in Eastern Finland. The inclusion criteria for FCs were having a home-living CR aged 65 or above and a valid care allowance. The exclusion criterion was CR receiving end-of-life care at baseline. Participants were randomly assigned to an intervention (FCs n = 63, CRs n = 59) and a control (FCs n = 50, CRs n = 48) group. Individually tailored nutritional guidance targeted to FCs was given to an intervention group by a clinical nutritionist. The main outcomes were dietary intake (3-day food record). RESULTS After the 6-month intervention, 63 FCs and 59 CRs in the intervention group and 50 FCs and 48 CRs in the control group were analyzed. In the intervention group of FCs, the intakes of protein, riboflavin, calcium, potassium, phosphorus, and iodine differed significantly (p < 0.05) compared to the control group. In addition, the intake of vitamin D supplementation improved in the intervention group of the FCs and CRs (p < 0.001). CONCLUSION Individually tailored nutrition guidance improves the intake levels of crucial nutrients, such as the intake levels of protein, vitamin D, and calcium of the FCs. Further studies are warranted to optimize the methods to improve the nutrition of FCs. Registration number of Clinical Trials: ClinicalTrials.gov NCT04003493 (1 July 2019).
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Affiliation(s)
- Sohvi Koponen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland ,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland ,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
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29
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Ning H, Shi D, Tian Z, Liu Z, Wang X, Yan X, Sun C, Niu Y. Metabolomics analysis of urine from rats given long-term high-protein diet using ultra-high-performance liquid chromatography-mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1190:123082. [PMID: 35032889 DOI: 10.1016/j.jchromb.2021.123082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/20/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022]
Abstract
Previous studies have indicated high-protein diet (HPD) promotes weight loss and improves metabolic parameters, but most of these studies have focused on the impact of short-term, long-term effects remain unclear. In this study, male Wistar rats were fed two diets for 88 weeks: normal control diet (NCD, 20.5% of energy as protein) or HPD (30.5% of energy as protein). At 88 weeks intervention, compared to NCD rats, HPD rats had lower fat tissue and higher skeletal muscle to body weight ratio, but there were no significantly differences in body weight and food intake. To explore the mechanism underlying metabolism and diet, we further collected rat urine samples at 16, 40, 64 and 88 weeks diet treatment and analyzed metabolomics profiles using ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). Partial least squares-discriminant analysis (PLS-DA) scores plots from ESI- or ESI+ model revealed a perfect separation between two diets at four time points. We identified 11 dramatically different metabolites (with VIP cut-off value > 1) in HPD, including 3 up-regulated and 8 down-regulated. And these 11 metabolites were identified as effective biomarkers, which were significantly related to HPD-induced metabolism related outcomes (fat tissue and skeletal muscle to body weight ratio). Our results provided vital information regarding metabolism in long-term HPD and more importantly, a few potentially promising metabolites were firstly identified which may related to metabolic responses.
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Affiliation(s)
- Hua Ning
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Dan Shi
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, PR China
| | - Zhen Tian
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Zhipeng Liu
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Xinyue Wang
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Xuemin Yan
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China
| | - Changhao Sun
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China.
| | - Yucun Niu
- National Key Discipline Laboratory, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, PR China.
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30
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Strategies to Prevent Sarcopenia in the Aging Process: Role of Protein Intake and Exercise. Nutrients 2021; 14:nu14010052. [PMID: 35010928 PMCID: PMC8746908 DOI: 10.3390/nu14010052] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022] Open
Abstract
Sarcopenia is one of the main issues associated with the process of aging. Characterized by muscle mass loss, it is triggered by several conditions, including sedentary habits and negative net protein balance. According to World Health Organization, it is expected a 38% increase in older individuals by 2025. Therefore, it is noteworthy to establish recommendations to prevent sarcopenia and several events and comorbidities associated with this health issue condition. In this review, we discuss the role of these factors, prevention strategies, and recommendations, with a focus on protein intake and exercise.
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Griffen C, Duncan M, Hattersley J, Weickert MO, Dallaway A, Renshaw D. Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial. Exp Gerontol 2021; 158:111651. [PMID: 34896568 DOI: 10.1016/j.exger.2021.111651] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To determine the individual and combined effects of 12 weeks of resistance exercise (RE) and whey protein supplementation on skeletal muscle strength (primary outcome), mass and physical function, and hormonal and inflammatory biomarkers in older adults. METHODS Thirty-six healthy older men [(mean±SE) age: 67±1 y; BMI: 25.5±0.4 kg/m2] were randomised to either control (CON; n=9), whey protein (PRO; n=9), RE+control (EX+CON; n=9), or RE+whey protein (EX+PRO; n=9) in a double-blinded fashion. Whole-body RE (2 sets of 8 repetitions and 1 set to volitional failure at 80% 1RM) was performed twice weekly. Supplements (PRO, 25 g whey protein isolate; CON, 23.75 g maltodextrin) were consumed twice daily. RESULTS EX+CON and EX+PRO increased leg extension (+19±3 kg and +20±3 kg, respectively) and leg press 1RM (+27±3 kg and +39±2 kg, respectively) greater than the CON and PRO groups (P<0.001, Cohen's d=1.50-1.90). RE (EX+CON and EX+PRO groups pooled) also increased fat-free mass (FFM) (+0.9±0.3 kg) and 6-min walk test distance (+21±5 m) and decreased fat mass (-0.4±0.4 kg), and interleukin-6 (-1.0±0.4 pg/mL) and tumor necrosis factor-alpha concentration (-0.7±0.3 pg/mL) greater than non-exercise (CON and PRO groups pooled; P<0.05, Cohen's f=0.37-0.45). Whey protein supplementation (PRO and EX+PRO groups pooled) increased 4-m gait speed greater than control (CON and EX+CON groups pooled) (+0.08±0.03 m/s; P=0.007, f=0.51). CONCLUSION RE increased muscle strength, FFM and physical function, and decreased markers of systemic inflammation in healthy active older men. Whey protein supplementation alone increased gait speed. No synergistic effects were observed. This study was registered at clinicaltrials.gov as NCT03299972.
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Affiliation(s)
- Corbin Griffen
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom.
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 2DS, United Kingdom
| | - John Hattersley
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; School of Engineering, University of Warwick, Coventry, CV4 7HL, United Kingdom
| | - Martin O Weickert
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Department of Endocrinology and Diabetes, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Alexander Dallaway
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom
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Hengeveld LM, de Goede J, Afman LA, Bakker SJL, Beulens JWJ, Blaak EE, Boersma E, Geleijnse JM, van Goudoever J(HB, Hopman MTE, Iestra JA, Kremers SPJ, Mensink RP, de Roos NM, Stehouwer CDA, Verkaik-Kloosterman J, de Vet E, Visser M. Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands. Adv Nutr 2021; 13:1083-1117. [PMID: 35016214 PMCID: PMC9340973 DOI: 10.1093/advances/nmab140] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/07/2021] [Accepted: 11/17/2021] [Indexed: 01/06/2023] Open
Abstract
Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or "some concerns" (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0-29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.
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Affiliation(s)
| | | | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Eric Boersma
- Erasmus MC, University Medical Center, Department of Cardiology, Rotterdam, The Netherlands
| | - Johanna M Geleijnse
- Health Council of the Netherlands, The Hague, The Netherlands,Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Johannes (Hans) B van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Department of Pediatrics, Amsterdam, The Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jolein A Iestra
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicole M de Roos
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands,Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Emely de Vet
- Department of Social Sciences, Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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The cost effectiveness of personalized dietary advice to increase protein intake in older adults with lower habitual protein intake: a randomized controlled trial. Eur J Nutr 2021; 61:505-520. [PMID: 34609621 PMCID: PMC8490609 DOI: 10.1007/s00394-021-02675-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/02/2021] [Indexed: 11/05/2022]
Abstract
Purpose To examine the cost effectiveness of dietary advice to increase protein intake on 6-month change in physical functioning among older adults. Methods In this multicenter randomized controlled trial, 276 community-dwelling older adults with a habitual protein intake < 1.0 g/kg adjusted body weight (aBW)/d were randomly assigned to either Intervention 1; advice to increase protein intake to ≥ 1.2 g/kg aBW/d (PROT, n = 96), Intervention 2; similar advice and in addition advice to consume protein (en)rich(ed) foods within half an hour after usual physical activity (PROT + TIMING, n = 89), or continue the habitual diet with no advice (CON, n = 91). Primary outcome was 6-month change in 400-m walk time. Secondary outcomes were 6-month change in physical performance, leg extension strength, grip strength, body composition, self-reported mobility limitations and quality of life. We evaluated cost effectiveness from a societal perspective. Results Compared to CON, a positive effect on walk time was observed for PROT; – 12.4 s (95%CI, – 21.8 to – 2.9), and for PROT + TIMING; – 4.9 s (95%CI, – 14.5 to 4.7). Leg extension strength significantly increased in PROT (+ 32.6 N (95%CI, 10.6–54.5)) and PROT + TIMING (+ 24.3 N (95%CI, 0.2–48.5)) compared to CON. No significant intervention effects were observed for the other secondary outcomes. From a societal perspective, PROT was cost effective compared to CON. Conclusion Dietary advice to increase protein intake to ≥ 1.2 g/kg aBW/d improved 400-m walk time and leg strength among older adults with a lower habitual protein intake. From a societal perspective, PROT was considered cost-effective compared to CON. These findings support the need for re-evaluating the protein RDA of 0.8 g/kg BW/d for older adults. Trial registration The trial has been registered at ClinicalTrials.gov (NCT03712306). Date of registration: October 2018. Registry name: The (Cost) Effectiveness of Increasing Protein Intake on Physical Functioning in Older Adults. Trial Identifier: NCT03712306. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02675-0.
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Osuka Y, Kojima N, Sasai H, Wakaba K, Miyauchi D, Tanaka K, Kim H. Effects of exercise and/or β-hydroxy-β-methylbutyrate supplementation on muscle mass, muscle strength, and physical performance in older women with low muscle mass: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2021; 114:1371-1385. [PMID: 34081113 DOI: 10.1093/ajcn/nqab176] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/05/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The interaction between exercise and nutritional supplementation is unclear among older adults at risk of sarcopenia. OBJECTIVES We aimed to examine if β-hydroxy-β-methylbutyrate (HMB) supplementation enhances the effects of exercise on muscle mass, strength, and physical performance and observe potential residual effects in older women with low muscle mass. METHODS This 12-wk, randomized, double-blind, placebo-controlled, 2 × 2 factorial design (exercise-only, HMB-only, both, and none) trial included 156 women aged 65-79 y with skeletal muscle index <5.7 kg/m2, and was followed by a 12-wk observational period. Resistance training twice weekly or education programs every 2 wk and calcium-HMB (1500 mg) or placebo supplements daily were provided. The primary outcome was the change in muscle mass from baseline to postintervention. Secondary outcomes included changes in muscle strength and physical performance. RESULTS In total, 149 and 144 participants completed the assessment at weeks 12 and 24, respectively. ANOVAs based on the intention-to-treat principle showed no significant interactions between exercise and HMB on any primary outcomes. The main-effect analyses revealed that exercise improved the usual and maximal gait speed by 0.16 m/s (95% CI: 0.10, 0.21 m/s) and 0.15 m/s (95% CI: 0.09, 0.22 m/s), respectively; the knee extensor and hip adductor strength by 22.0 N (95% CI: 10.1, 33.9 N) and 21.8 N (95% CI: 12.9, 30.7 N), respectively; and timed up-and-go and sit-to-stand time by -0.5 s (95% CI: -0.7, -0.3 s) and -1.7 s (95% CI: -2.1, -1.3 s), respectively, relative to education. HMB improved usual gait speed by 0.06 m/s (95% CI: 0.01, 0.11 m/s) relative to placebo. Most improvements disappeared during the subsequent 12-wk observation period. CONCLUSIONS HMB additively improved gait performance with negligible benefit and provided no enhancements in the effects of exercise on other outcomes. Exercise appeared to be the only effective intervention to improve outcomes in older women with low muscle mass.This trial was registered at www.umin.ac.jp/ctr/as UMIN000028560.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kyohsuke Wakaba
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Kiyoji Tanaka
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Kim HN, Song SW. Association between dietary protein intake and skeletal muscle mass in older Korean adults. Eur Geriatr Med 2021; 12:1221-1228. [PMID: 34156655 DOI: 10.1007/s41999-021-00530-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/08/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE We investigated the association of low and high daily protein intakes on skeletal muscle mass status in Korean adults aged 60 years and older. METHODS This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey conducted between 2008 and 2011. The participants' dietary protein intake was assessed using the 24-h dietary recall method and was classified as low (< 0.8 g/kg body weight/day), moderate (0.8-1.2 g/kg/day), and high (> 1.2 g/kg/day). Amount of skeletal muscle mass was measured using whole-body dual-energy X-ray absorptiometry. Low skeletal muscle mass was defined as appendicular skeletal muscle mass index < 7.0 kg/m2 in men and < 5.4 kg/m2 in women. RESULTS The study included data from 4585 participants (2022 men and 2563 women). All skeletal muscle parameters in women and total lean mass in men decreased as the amount of protein consumed daily increased. However, there was no association between high or low protein intake and low skeletal muscle mass in men or women. CONCLUSIONS No association was found between the amount of daily protein intake and skeletal muscle mass status in older Korean adults. Gender-specific further studies focussing on the interactions of dietary protein intake under specific conditions including physical activity status and the daily distribution of protein intake and the quality and source of the protein are needed to evaluate the impact of protein intake status on muscle health in older Koreans.
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Affiliation(s)
- Ha-Na Kim
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyeonggi, 16247, Republic of Korea
| | - Sang-Wook Song
- Department of Family Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon, Gyeonggi, 16247, Republic of Korea.
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Buscemi C, Ferro Y, Pujia R, Mazza E, Boragina G, Sciacqua A, Piro S, Pujia A, Sesti G, Buscemi S, Montalcini T. Sarcopenia and Appendicular Muscle Mass as Predictors of Impaired Fasting Glucose/Type 2 Diabetes in Elderly Women. Nutrients 2021; 13:nu13061909. [PMID: 34199375 PMCID: PMC8227668 DOI: 10.3390/nu13061909] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 12/18/2022] Open
Abstract
Elderly women exhibit a high risk of type 2 diabetes (T2D), but no definitive data exist about the possible role of postmenopausal increases in visceral adiposity, the loss of lean body mass, or decreases in the sum of the lean mass of arms and legs (appendicular skeletal muscle mass (ASMM)). This retrospective, longitudinal study investigated whether body composition (bioelectrical impedance analysis) predicted the development of impaired fasting glucose (IFG) or T2D in a cohort of 159 elderly women (age: 71 ± 5 years, follow-up: 94 months) from southern Italy (Clinical Nutrition and Geriatric Units of the “Mater Domini” University Hospital in Catanzaro, Calabria region, and the “P. Giaccone ”University Hospital in Palermo, Sicily region). Sarcopenia was defined in a subgroup of 128 women according to the EWGSOP criteria as the presence of low muscle strength (handgrip strength <16 kg) plus low muscle mass (reported as appendicular skeletal muscle mass <15 kg). Participants with a low ASMM had a higher IFG/T2D incidence than those with a normal ASMM (17% vs. 6%, p-adjusted = 0.044); this finding was independent of BMI, fat mass, waist circumference, and habitual fat intake (OR = 3.81, p = 0.034). A higher incidence of IFG/T2D was observed in the subgroup with sarcopenia than those without sarcopenia (33% vs. 7%, p-adjusted = 0.005) independent of BMI and fat mass (OR = 6.75, p = 0.007). In conclusion, this study demonstrates that elderly women with low ASMM had a higher probability of developing IFG/T2D. Further studies are needed to confirm these results in men and in other age groups.
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Affiliation(s)
- Carola Buscemi
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Yvelise Ferro
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Roberta Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giada Boragina
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Angela Sciacqua
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Salvatore Piro
- Department of Clinical and Molecular Medicine, Postgraduate Specialization School in Geriatrics, University of Catania, 95100 Catania, Italy; (C.B.); (S.P.)
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Graecia, 88100 Catanzaro, Italy; (Y.F.); (R.P.); (E.M.); (G.B.); (A.S.); (A.P.)
| | - Giorgio Sesti
- Dipartimento di Medicina clinica e molecolare, Università la Sapienza, 00185 Roma, Italy;
| | - Silvio Buscemi
- Unit of Clinical Nutrition, Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), University of Palermo, AOU Policlinico “P. Giaccone”, 90127 Palermo, Italy;
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, 88100 Catanzaro, Italy
- Correspondence:
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Tu DY, Kao FM, Tsai ST, Tung TH. Sarcopenia among the Elderly Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Healthcare (Basel) 2021; 9:healthcare9060650. [PMID: 34072617 PMCID: PMC8228648 DOI: 10.3390/healthcare9060650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
Purpose. This systematic review and meta-analysis was conducted to explore the effect of protein intake on the prevention and improvement of sarcopenia. Methods. We searched the Cochrane Library, PubMed, and EMBASE from inception to 20 May 2021. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Results. There were 12 studies that met the selection criteria among 53 eligible publications. The results of the study show that the protein intake has no significant effect on the physical performance—4 m gait speed, chair rise test, short physical performance battery, muscle mass—skeletal muscle mass index, and muscle strength—hand grip strength. Conclusion. Protein supplementation had no significant effect on 4 m gait speed and on improving skeletal muscle mass index, hand grip strength, chair rise test, and short physical performance battery. Additional randomized controlled trials are warranted to adequately assess the effect of protein supplementation on elderly sarcopenia.
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Affiliation(s)
- Di-Ya Tu
- Department of Nutrition Therapy, Cheng-Hsin General Hospital, Taipei 112, Taiwan; (D.-Y.T.); (F.-M.K.); (S.-T.T.)
| | - Fa-Min Kao
- Department of Nutrition Therapy, Cheng-Hsin General Hospital, Taipei 112, Taiwan; (D.-Y.T.); (F.-M.K.); (S.-T.T.)
| | - Shih-Tzer Tsai
- Department of Nutrition Therapy, Cheng-Hsin General Hospital, Taipei 112, Taiwan; (D.-Y.T.); (F.-M.K.); (S.-T.T.)
- Department of Internal Medicine, Cheng-Hsin General Hospital, Taipei 112, Taiwan
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
- Correspondence: ; Tel.: +86-576-8512-0120
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Huschtscha Z, Parr A, Porter J, Costa RJS. Sarcopenic Characteristics of Active Older Adults: a Cross-Sectional Exploration. SPORTS MEDICINE-OPEN 2021; 7:32. [PMID: 33999277 PMCID: PMC8128944 DOI: 10.1186/s40798-021-00323-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 04/29/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Ageing is associated with a decline in skeletal muscle mass and function (strength and power), known as sarcopenia. Inadequate dietary protein and inactivity have been shown to accelerate sarcopenia outcomes, occurring at different rates in males and females. Regardless, active older adults who often exceed the exercise guidelines still show signs of sarcopenia. This study aimed to explore the link between age, physical activity, protein intake, and biological sex with skeletal muscle mass, strength, power, and physical capacity/performance in active older adults. Fifty-four active older adults were recruited from this trial and grouped according to age (middle aged: 50-59 years, and older age: ≥ 60 years), exercise volume (low: ≥ 90-149 min/week, moderate: ≥ 150-299 min/week, and high: ≥ 300 min/week), protein intake (low: < 0.8 g/kg body mass (BM), moderate: ≥ 0.8-1.19g /kg BM, and high: ≥ 1.2 g/kg BM), and biological sex (males and females). Skeletal muscle and fat mass (dual X-ray absorptiometry), strength (1-repetition maximum using leg press, chest press, lateral pull down, and hand grip), power (counter movement jump), and general fitness (cardiorespiratory capacity and gait speed) were assessed. Data were grouped based on variables, and a general linear model (ANCOVA) or an independent t test was used to determine between group differences. RESULTS Fifty three of the total participants' data were analysed. The middle-aged group had 18%, 11%, and 10% higher leg press, chest press, and lateral pull down, respectively, compared to the older-aged group (p < .05). There were no significant differences between different levels of training volume and any of the outcomes. Higher protein intakes were associated with significantly less body fat mass (p = .005) and a trend towards a higher leg press (p = .053) and higher relative power (W/kg) (p = .056) compared with the moderate and low protein intake groups. Significant differences based on biological sex were observed for all outcomes except for gait speed (p = .611) and cardiorespiratory fitness (p = .147). CONCLUSIONS Contributions of age, physical activity, daily protein intake, and biological sex can explain the individual variation in outcomes related to changes in body composition, strength, power, and/or cardiorespiratory fitness in a cohort of active older adults. The preprint version of this work is available on Research Square: https://www.researchsquare.com/article/rs-51873/v1 . TRIAL REGISTRATION This trial is registered in the ANZCTR.org.au, no. ACTRN12618001088235 ( https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375286 ).
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Affiliation(s)
- Zoya Huschtscha
- Department of Nutrition Dietetics & Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
| | - Alexandra Parr
- Department of Nutrition Dietetics & Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
| | - Judi Porter
- Department of Nutrition Dietetics & Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia.,School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Ricardo J S Costa
- Department of Nutrition Dietetics & Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia.
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Roberts SB, Silver RE, Das SK, Fielding RA, Gilhooly CH, Jacques PF, Kelly JM, Mason JB, McKeown NM, Reardon MA, Rowan S, Saltzman E, Shukitt-Hale B, Smith CE, Taylor AA, Wu D, Zhang FF, Panetta K, Booth S. Healthy Aging-Nutrition Matters: Start Early and Screen Often. Adv Nutr 2021; 12:1438-1448. [PMID: 33838032 PMCID: PMC8994693 DOI: 10.1093/advances/nmab032] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/11/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging including: noncommunicable diseases, sarcopenia, cognitive decline and dementia, osteoporosis, age-related macular degeneration, diabetic retinopathy, hearing loss, obstructive sleep apnea, urinary incontinence, and constipation. In addition, randomized clinical trials show that disease-specific nutrition interventions can attenuate progression-and in some cases effectively treat-many established aging-associated conditions. However, middle-aged and older adults are vulnerable to unhealthy dietary patterns, and typically consume diets with inadequate servings of healthy food groups and essential nutrients, along with an abundance of energy-dense but nutrient-weak foods that contribute to obesity. However, based on menu examples, diets that are nutrient-dense, plant-based, and with a moderately low glycemic load are better equipped to meet the nutritional needs of many older adults than current recommendations in US Dietary Guidelines. These summary findings indicate that healthy nutrition is more important for healthy aging than generally recognized. Improved public health messaging about nutrition and aging, combined with routine screening and medical referrals for age-related conditions that can be treated with a nutrition prescription, should form core components of a national nutrition roadmap to reduce the epidemic of unhealthy aging.
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Affiliation(s)
| | - Rachel E Silver
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Cheryl H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Jennifer M Kelly
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Joel B Mason
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Meaghan A Reardon
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sheldon Rowan
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Barbara Shukitt-Hale
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Caren E Smith
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Allen A Taylor
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Dayong Wu
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Karen Panetta
- School of Engineering, Tufts University, Medford, MA, USA
| | - Sarah Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
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40
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Impact of dietary protein intake on the incidence of low muscle strength in middle-aged and older adults. Clin Nutr 2021; 40:1467-1474. [PMID: 33740517 DOI: 10.1016/j.clnu.2021.02.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/17/2020] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND A reduction in skeletal muscle strength is a prognostic indicator of negative consequences, such as physical disability, frailty, and mortality in older adults. Studies investigating associations between the risk of reduction in skeletal muscle strength and the amount of dietary protein which is a factor influenced muscle health are scarce, particularly in Asian populations. Therefore, we investigated the association between the amount and change in daily protein intake and the prospective risk of developing low skeletal muscle strength in middle-aged and older adults. METHODS This study used data from the Korean Genome and Epidemiology Study as an ongoing population-based cohort study of adults aged 40 years and over. The amount of daily protein consumed was assessed using a semi-quantitative food frequency questionnaire. Low skeletal muscle strength was measured with a handgrip strength dynamometer. RESULTS In total, 32,458 adults (11,358 males and 21,100 females) were evaluated. The amount of daily dietary protein consumed was not associated with the risk of low muscle strength over the 4-year follow-up period after adjusting for covariates. No associations between low muscle strength events according to the change in the amount of protein consumed from the baseline to the follow-up surveys were identified. CONCLUSIONS The amount of and change in dietary protein consumed were not associated with developing low muscle strength in middle-aged and older adults. Further studies with a focus on physical activity-protein intake interactions and specific conditions, such as mobility-limited adults or hospitalized patients, are warranted to clarify the relationship between protein intake status and the incidence of low skeletal muscle strength.
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41
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Prado CM, Anker SD, Coats AJ, Laviano A, von Haehling S. Nutrition in the spotlight in cachexia, sarcopenia and muscle: avoiding the wildfire. J Cachexia Sarcopenia Muscle 2021; 12:3-8. [PMID: 33382196 PMCID: PMC7890147 DOI: 10.1002/jcsm.12673] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Carla M. Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional ScienceUniversity of AlbertaEdmontonABCanada
| | - Stefan D. Anker
- BIH Centre for Regenerative TherapiesCharité Uinversitätsmedizin BerlinBerlinGermany
- Department of Cardiology (Campus Virchow‐Klinikum)Charité Universitätsmedizin BerlinBerlinGermany
- German Centre for Cardiovascular Research (DZHK), partner site BerlinBerlinGermany
| | - Andrew J.S. Coats
- Monash UniversityMelbourneAustralia
- University of Warwick (UK)WarwickUK
| | - Alessandro Laviano
- Department of Translational and Precision MedicineSapienza UniversityRomeItaly
| | - Stephan von Haehling
- Department of Cardiology and PneumologyUniversity Medicine GoettingenGoettingenGermany
- German Centre for Cardiovascular Research (DZHK), partner site GöttingenGöttingenGermany
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42
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Iwase T, Wang X, Shrimanker TV, Kolonin MG, Ueno NT. Body composition and breast cancer risk and treatment: mechanisms and impact. Breast Cancer Res Treat 2021; 186:273-283. [PMID: 33475878 DOI: 10.1007/s10549-020-06092-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/31/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this review is to clarify the association of body composition with breast cancer risk and treatment, including physiological mechanisms, and to elucidate strategies for overcoming unfavorable body composition changes that relate to breast cancer progression. METHODS We have summarized updated knowledge regarding the mechanism of the negative association of altered body composition with breast cancer risk and treatment. We also review strategies for reversing unfavorable body composition based on the latest clinical trial results. RESULTS Body composition changes in patients with breast cancer typically occur during menopause or as a result of chemotherapy or endocrine therapy. Dysfunction of visceral adipose tissue (VAT) in the setting of obesity underlies insulin resistance and chronic inflammation, which can lead to breast cancer development and progression. Insulin resistance and chronic inflammation are also observed in patients with breast cancer who have sarcopenia or sarcopenic obesity. Nutritional support and a personalized exercise program are the fundamental interventions for reversing unfavorable body composition. Other interventions that have been explored in specific situations include metformin, testosterone, emerging agents that directly target the adipocyte microenvironment, and bariatric surgery. CONCLUSIONS A better understanding of the biology of body composition phenotypes is key to determining the best intervention program for patients with breast cancer.
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Affiliation(s)
- Toshiaki Iwase
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Xiaoping Wang
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Tushaar Vishal Shrimanker
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Mikhail G Kolonin
- Center for Metabolic and Degenerative Diseases, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX, 77030, USA
| | - Naoto T Ueno
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA. .,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
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43
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Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience 2020; 42:1547-1578. [PMID: 33001410 PMCID: PMC7528158 DOI: 10.1007/s11357-020-00272-3] [Citation(s) in RCA: 178] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
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Affiliation(s)
- Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Deaglan McCullough
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK.
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Claire Stewart
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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44
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Anker MS, Springer J, Coats AJ, von Haehling S. The 10th year of the Journal of Cachexia, Sarcopenia and Muscle. J Cachexia Sarcopenia Muscle 2020; 11:1390-1395. [PMID: 33340288 PMCID: PMC7749579 DOI: 10.1002/jcsm.12657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Markus S Anker
- Division of Cardiology and Metabolism, Department of Cardiology (CVK), Charité University Medicine Berlin, Berlin, Germany.,Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany.,Department of Cardiology, Campus Benjamin Franklin (CBF), Charité University Medicine Berlin, Berlin, Germany
| | - Jochen Springer
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Andrew Js Coats
- Department of Cardiology, IRCCS San Raffaele Pisana, Rome, Italy
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
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45
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Reinders I, Wijnhoven HAH, Jyväkorpi SK, Suominen MH, Niskanen R, Bosmans JE, Brouwer IA, Fluitman KS, Klein MCA, Kuijper LD, van der Lubbe LM, Olthof MR, Pitkälä KH, Vijlbrief R, Visser M. Effectiveness and cost-effectiveness of personalised dietary advice aiming at increasing protein intake on physical functioning in community-dwelling older adults with lower habitual protein intake: rationale and design of the PROMISS randomised controlled trial. BMJ Open 2020; 10:e040637. [PMID: 33444206 PMCID: PMC7682452 DOI: 10.1136/bmjopen-2020-040637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/18/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Short-term metabolic and observational studies suggest that protein intake above the recommended dietary allowance of 0.83 g/kg body weight (BW)/day may support preservation of lean body mass and physical function in old age, but evidence from randomised controlled trials is inconclusive. METHODS AND ANALYSIS The PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) trial examines the effect of personalised dietary advice aiming at increasing protein intake with or without advice regarding timing of protein intake to close proximity of usual physical activity, on change in physical functioning after 6 months among community-dwelling older adults (≥65 years) with a habitual protein intake of <1.0 g/kg adjusted (a)BW/day. Participants (n=264) will be recruited in Finland and the Netherlands, and will be randomised into three groups; two intervention groups and one control group. Intervention group 1 (n=88) receives personalised dietary advice and protein-enriched food products in order to increase their protein intake to at least 1.2 g/kg aBW/day. Intervention group 2 (n=88) receives the same advice as described for intervention group 1, and in addition advice to consume 7.5-10 g protein through protein-(en)rich(ed) foods within half an hour after performing usual physical activity. The control group (n=88) receives no intervention. All participants will be invited to attend lectures not related to health. The primary outcome is a 6-month change in physical functioning measured by change in walk time using a 400 m walk test. Secondary outcomes are: 6-month change in the Short Physical Performance Battery score, muscle strength, body composition, self-reported mobility limitations, quality of life, incidence of frailty, incidence of sarcopenia risk and incidence of malnutrition. We also investigate cost-effectiveness by change in healthcare costs. DISCUSSION The PROMISS trial will provide evidence whether increasing protein intake, and additionally optimising the timing of protein intake, has a positive effect on the course of physical functioning after 6 months among community-dwelling older adults with a habitual protein intake of <1.0 g/kg aBW/day. ETHICS AND DISSEMINATION The study has been approved by the Ethics Committee of the Helsinki University Central Hospital, Finland (ID of the approval: HUS/1530/2018) and The Medical Ethical Committee of the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (ID of the approval: 2018.399). All participants provided written informed consent prior to being enrolled onto the study. Results will be submitted for publication in peer-reviewed journals and will be made available to stakeholders (ie, older adults, healthcare professionals and industry). TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03712306).
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Affiliation(s)
- Ilse Reinders
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Riikka Niskanen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kristien S Fluitman
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, The Netherlands
- Wallenburg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michel C A Klein
- Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lothar D Kuijper
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura M van der Lubbe
- Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Rachel Vijlbrief
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Xia L, Zhao R, Wan Q, Wu Y, Zhou Y, Wang Y, Cui Y, Shen X, Wu X. Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies. Cancer Med 2020; 9:7964-7978. [PMID: 32924316 PMCID: PMC7643685 DOI: 10.1002/cam4.3428] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/08/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health-related outcomes. DESIGN An umbrella review of meta-analyses of observational studies. SETTING AND PARTICIPANTS Patients with sarcopenia and controls without sarcopenia were included. MEASURES The PubMed, Web of Science and Embase were searched for relevant systematic review and meta-analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively. RESULTS Totally 54 outcomes extracted from 30 meta-analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age-related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all-cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases. CONCLUSIONS AND IMPLICATIONS Sarcopenia significantly affected a wide range of adverse health-related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as "low" and "very low," more prospective cohort studies are required in the future.
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Affiliation(s)
- Lin Xia
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Rui Zhao
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Qianyi Wan
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Yutao Wu
- Department of Oral and Maxillofacial SurgeryWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Yong Zhou
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Yong Wang
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Yaping Cui
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Xiaoding Shen
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Xiaoting Wu
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
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47
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Ben-Harchache S, Roche HM, Corish CA, Horner KM. The Impact of Protein Supplementation on Appetite and Energy Intake in Healthy Older Adults: A Systematic Review with Meta-Analysis. Adv Nutr 2020; 12:490-502. [PMID: 33037427 PMCID: PMC8009738 DOI: 10.1093/advances/nmaa115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/10/2020] [Accepted: 08/25/2020] [Indexed: 01/04/2023] Open
Abstract
Protein supplementation is an attractive strategy to prevent loss of muscle mass in older adults. However, it could be counterproductive due to adverse effects on appetite. This systematic review and meta-analysis aimed to determine the effects of protein supplementation on appetite and/or energy intake (EI) in healthy older adults. MEDLINE, The Cochrane Library, CINAHL, and Web of Science were searched up to June 2020. Acute and longitudinal studies in healthy adults ≥60 y of age that reported effects of protein supplementation (through supplements or whole foods) compared with control and/or preintervention (for longitudinal studies) on appetite ratings, appetite-related peptides, and/or EI were included. Random-effects model meta-analysis was performed on EI, with other outcomes qualitatively reviewed. Twenty-two studies (9 acute, 13 longitudinal) were included, involving 857 participants (331 males, 526 females). In acute studies (n = 8), appetite ratings were suppressed in 7 out of 24 protein arms. For acute studies reporting EI (n = 7, n = 22 protein arms), test meal EI was reduced following protein preload compared with control [mean difference (MD): -164 kJ; 95% CI: -299, -29 kJ; P = 0.02]. However, when energy content of the supplement was accounted for, total EI was greater with protein compared with control (MD: 649 kJ; 95% CI: 438, 861 kJ; P < 0.00001). Longitudinal studies (n = 12 protein arms) showed a higher protein intake (MD: 0.29 g ⋅ kg-1 ⋅ d-1; 95% CI: 0.14, 0.45 g ⋅ kg-1 ⋅ d-1; P < 0.001) and no difference in daily EI between protein and control groups at the end of trials (MD: -54 kJ/d; 95% CI: -300, 193 kJ/d; P = 0.67). While appetite ratings may be suppressed with acute protein supplementation, there is either a positive effect or no effect on total EI in acute and longitudinal studies, respectively. Therefore, protein supplementation may represent an effective solution to increase protein intakes in healthy older adults without compromising EI through appetite suppression. This trial was registered at PROSPERO as https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019125771 (CRD42019125771).
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Affiliation(s)
- Sana Ben-Harchache
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Dublin, Ireland,Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Helen M Roche
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Dublin, Ireland,Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland,Nutrigenomics Research Group, UCD Conway Institute, University College Dublin, Belfield, Dublin, Ireland,Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Dublin, Ireland,Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
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48
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Liao CD, Wu YT, Tsauo JY, Chen PR, Tu YK, Chen HC, Liou TH. Effects of Protein Supplementation Combined with Exercise Training on Muscle Mass and Function in Older Adults with Lower-Extremity Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients 2020; 12:nu12082422. [PMID: 32806718 PMCID: PMC7468926 DOI: 10.3390/nu12082422] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Aging and osteoarthritis (OA) are associated with a high risk of muscle mass loss, which can lead to physical disability. This study investigated the effectiveness of protein supplementation combined with exercise training (PS + ET) in improving muscle mass and functional outcomes in older adults with lower-limb OA. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) on the effectiveness of PS + ET in older adults with hip or knee OA. Meta-analysis and risk of bias assessment of the included RCTs were conducted. Six RCTs were included in this systemic review; they had a median (range/total) Physiotherapy Evidence Database (PEDro) score of 7 (6-9) out of 10, respectively. Five RCTs that enrolled patients who underwent total joint replacement were included in this meta-analysis. The PS + ET group exhibited significant improvements in muscle mass (standard mean difference [SMD] = 1.13, p < 0.00001), pain (SMD = 1.36, p < 0.00001), and muscle strength (SMD = 0.44, p = 0.04). Our findings suggest that PS + ET improves muscle mass, muscle strength, and functional outcomes and reduces pain in older adults with lower-limb OA, particularly in those who have undergone total joint replacement.
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Affiliation(s)
- Chun-De Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; (C.-D.L.); (Y.-T.W.); (J.-Y.T.)
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan;
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; (C.-D.L.); (Y.-T.W.); (J.-Y.T.)
- Physical Therapy Center, National Taiwan University Hospital, Taipei 100229, Taiwan
| | - Jau-Yih Tsauo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; (C.-D.L.); (Y.-T.W.); (J.-Y.T.)
| | - Pey-Rong Chen
- Department of Dietetics, National Taiwan University Hospital, Taipei 100225, Taiwan;
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110301, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100025, Taiwan;
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan;
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan;
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Correspondence: ; Tel.: +886-2-2249-0088 (ext. 1600); Fax: +886-2-2248-0577
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Kim IY, Park S, Jang J, Wolfe RR. Understanding Muscle Protein Dynamics: Technical Considerations for Advancing Sarcopenia Research. Ann Geriatr Med Res 2020; 24:157-165. [PMID: 32752586 PMCID: PMC7533194 DOI: 10.4235/agmr.20.0041] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia, which is the loss of muscle mass and strength that occurs with aging, involves imbalanced muscle protein turnover (i.e., protein breakdown exceeding synthesis), which in turn exacerbates other clinical conditions such as type 2 diabetes mellitus, obesity, osteoporosis, and cancer, thereby worsening the quality of life in older adults. This imbalance is attributed in part to the resistance of aged muscle to anabolic stimuli such as dietary protein/amino acids and resistance exercise known as anabolic resistance. Despite research efforts, no practical therapeutics have been successfully discovered possibly because of a lack of understanding of the dynamic nature of muscle protein, and the use of indirect assessments of muscle mass. Herein, we briefly discuss the regulation of protein turnover in response to the abovementioned anabolic stimuli with respect to anabolic resistance and optimal protein intake, followed by methodological considerations for advancing sarcopenia research, including assessments of muscle mass and dynamics.
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Affiliation(s)
- Il-Young Kim
- Department of Molecular Medicine, College of Medicine, Gachon University, Incheon, Korea.,Korea Mouse Metabolic Phenotyping Center, Lee Gil Ya Cancer and Diabetes Institute, College of Medicine, Gachon University, Incheon, Korea
| | - Sanghee Park
- Korea Mouse Metabolic Phenotyping Center, Lee Gil Ya Cancer and Diabetes Institute, College of Medicine, Gachon University, Incheon, Korea
| | - Jiwoong Jang
- Korea Mouse Metabolic Phenotyping Center, Lee Gil Ya Cancer and Diabetes Institute, College of Medicine, Gachon University, Incheon, Korea
| | - Robert R Wolfe
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Elstgeest LEM, Schaap LA, Heymans MW, Hengeveld LM, Naumann E, Houston DK, Kritchevsky SB, Simonsick EM, Newman AB, Farsijani S, Visser M, Wijnhoven HAH. Sex-and race-specific associations of protein intake with change in muscle mass and physical function in older adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2020; 112:84-95. [PMID: 32520344 PMCID: PMC7326591 DOI: 10.1093/ajcn/nqaa099] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/16/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Protein intake recommendations advise ≥0.8 g/kg body weight (BW)/d, whereas experts propose a higher intake for older adults (1.0-1.2 g/kg BW/d). It is unknown whether optimal protein intake differs by sex or race. OBJECTIVES We examined the shape of sex- and race-specific associations of dietary protein intake with 3- and 6-y changes in appendicular lean mass (aLM) and gait speed and also 6-y incidence of mobility limitation in community-dwelling older men and women. METHODS We used data on men (n = 1163) and women (n = 1237) aged 70-81 y of the Health, Aging, and Body Composition Study. Protein intake was assessed using an FFQ (1998-1999). aLM and gait speed were measured at baseline and at 3 and 6 y. Difficulty walking one-quarter mile or climbing stairs was measured every 6 mo over 6 y. Prospective associations were evaluated with linear and Cox regression models, comparing fit of models with and without spline functions. All analyses were stratified by sex and additionally by race. RESULTS Mean ± SD protein intake was 0.94 ± 0.36 g/kg adjusted body weight (aBW)/d in men and 0.95 ± 0.36 g/kg aBW/d in women. There were no strong indications of nonlinear associations. In women, higher protein intake was associated with less aLM loss over 3 y (adjusted B per 0.1 g/kg aBW/d: 39.4; 95% CI: 11.6, 67.2), specifically in black women, but not over 6 y or with gait speed decline. In men, protein intake was not associated with changes in aLM and gait speed. Higher protein intake was associated with a lower risk of mobility limitation in men (adjusted HR per 1.0 g/kg aBW/d: 0.55; 95% CI: 0.34, 0.91) and women (adjusted HR: 0.56; 95% CI: 0.33, 0.94), specifically white women. CONCLUSIONS Associations between protein intake and physical outcomes may vary by sex and race. Therefore, it is important to consider sex and race in future studies regarding protein needs in older adults.
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Affiliation(s)
- Liset E M Elstgeest
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC – Location VU University Medical Center, Amsterdam, the Netherlands
| | - Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Elke Naumann
- Department of Nutrition and Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- European Federation of the Associations of Dietitians (EFAD), The Hague, the Netherlands
| | - Denise K Houston
- Sticht Center for Healthy Aging and Alzheimer's Prevention and Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention and Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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