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Baughman C, Gong Y, Wu Y, Hanlon E, Juraschek S. Nonpharmacologic Management of Hypertension in Older Adults. Clin Geriatr Med 2024; 40:615-628. [PMID: 39349035 PMCID: PMC11443068 DOI: 10.1016/j.cger.2024.04.013] [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] [Indexed: 10/02/2024]
Abstract
Hypertension is ubiquitous among older adults and leads to major adverse cardiovascular events. Nonpharmacologic lifestyle interventions represent important preventive and adjunct strategies in the treatment of hypertension and have benefits beyond cardiovascular disease in this population characterized by a high prevalence of frailty and comorbid conditions. In this review, the authors examine nonpharmacologic interventions with the strongest evidence to prevent cardiovascular disease with an emphasis on the older adults.
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Affiliation(s)
- Carter Baughman
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Yusi Gong
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Yingfei Wu
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emma Hanlon
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Stephen Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA.
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2
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Wang P, Liu M, Zhang S, Guo Y, Xiong Z, Huang Y, Cai X, He L, Chen Z, Zhou Y, Zhuang X, Liao X. Association of metabolically healthy obesity with risk of heart failure and left ventricular dysfunction among older adults. Int J Obes (Lond) 2024:10.1038/s41366-024-01587-3. [PMID: 39384862 DOI: 10.1038/s41366-024-01587-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 06/04/2024] [Accepted: 07/09/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND Obesity is major cause of heart failure (HF), but it is related with a better prognosis among the elderly. Therefore, we aimed to examine whether metabolically healthy obesity (MHO) in late life increases HF risk and is reflected in impaired left ventricular (LV) function. METHODS The participants were grouped into four metabolic phenotypes based on obesity and metabolic status: metabolically healthy non-obesity (MHN), MHO, metabolically unhealthy non-obesity (MUN), metabolically unhealthy obesity (MUO). Association of metabolic phenotypes with LV function was evaluated using multiple linear regression models. And association between metabolic phenotypes and risk of HF was assessed using multivariable logistic regression models. In addition, we validated the association of metabolic phenotypes and HF risk in a separate longitudinal cohort. RESULTS In the primary cohort of 6335 participant, there were 434 participants diagnosed with HF. Compared to MHN participants, the risk of HF was higher among older individuals with MUN (OR = 1.51 [95% CI: 1.14-1.99]) and MUO (OR = 2.01 [95% CI: 1.39-2.91]), but not older individuals with MHO (OR = 0.86 [95% CI: 0.30-2.43). Regarding to LV function, worse LV diastolic function was noted among MUN and MUO individuals rather than MHO individuals. Older adults with MHO were also not associated with risk of HF in the validation cohort. CONCLUSION Among older individuals, the metabolic health status might modify the association of obesity with risk of HF and LV diastolic dysfunction. Worse LV diastolic function and higher risk of HF were just noted in individuals with MUO, but not in those with MHO.
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Affiliation(s)
- Peng Wang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Menghui Liu
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Shaozhao Zhang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Yue Guo
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Zhenyu Xiong
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Yiquan Huang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Xiaojie Cai
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Lixiang He
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Zhuohui Chen
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Yi Zhou
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China
| | - Xiaodong Zhuang
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China.
| | - Xinxue Liao
- Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
- NHC Key Laboratory of Assisted Circulation and Vascular Diseases (Sun Yat-sen University), Guangzhou, China.
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Dubin RL, Heymsfield SB, Ravussin E, Greenway FL. Glucagon-like peptide-1 receptor agonist-based agents and weight loss composition: Filling the gaps. Diabetes Obes Metab 2024. [PMID: 39344838 DOI: 10.1111/dom.15913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 10/01/2024]
Abstract
Excess adiposity is at the root of type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as first-line treatments for T2D based on significant weight loss results. The composition of weight loss using most diets consists of <25% fat-free mass (FFM) loss, with the remainder from fat stores. Higher amounts of weight loss (achieved with metabolic bariatric surgery) result in greater reductions in FFM. Our aim was to assess the impact that GLP-1RA-based treatments have on FFM. We analysed studies that reported changes in FFM with the following agents: exenatide, liraglutide, semaglutide, and the dual incretin receptor agonist tirzepatide. We performed an analysis of various weight loss interventions to provide a reference for expected changes in FFM. We evaluated studies using dual-energy X-ray absorptiometry (DXA) for measuring FFM (a crude surrogate for skeletal muscle). In evaluating the composition of weight loss, the percentage lost as fat-free mass (%FFML) was equal to ΔFFM/total weight change. The %FFML using GLP-1RA-based agents was between 20% and 40%. In the 28 clinical trials evaluated, the proportion of FFM loss was highly variable, but the majority reported %FFML exceeding 25%. Our review was limited to small substudies and the use of DXA, which does not measure skeletal muscle mass directly. Since FFM contains a variable amount of muscle (approximately 55%), this indirect measure may explain the heterogeneity in the data. Assessing quantity and quality of skeletal muscle using advanced imaging (magnetic resonance imaging) with functional testing will help fill the gaps in our current understanding.
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Affiliation(s)
- Robert L Dubin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Frank L Greenway
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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Katalinic L, Juric I, Furic Cunko V, Premuzic V, Jelakovic B, Basic-Jukic N. A Comparative Analysis of the SARC-F Questionnaire and the Malnutrition-Inflammation Score for Sarcopenia Risk Assessment and Negative Outcome Probability in Chronic Hemodialysis Patients. J Clin Med 2024; 13:5554. [PMID: 39337040 PMCID: PMC11432496 DOI: 10.3390/jcm13185554] [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: 08/05/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: Protein-energy wasting (PEW) and sarcopenia are common in chronic hemodialysis (HD) patients, leading to numerous complications and increased mortality. This study aimed to compare the reliability of the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) and the Malnutrition-Inflammation Score (MIS) in assessing sarcopenia and predicting negative outcomes in HD patients. Methods: This cross-sectional study enrolled 109 HD patients. Nutritional assessments were performed, and blood samples were taken for routine blood laboratory investigations. The MIS was used as a scoring system to represent the severity of PEW, while the SARC-F was applied as an indicator of sarcopenia risk and general functional capacity. A multivariable logistic regression was conducted to analyze the association of several predictors with a negative cross-sectional outcome (death). Results: Patients with SARC-F scores ≥ 4 and MISs ≥ 6 were older, had significantly lower albumin and prealbumin levels, and more severe anemia. They were also more likely to report weight loss and poor appetite. A higher MIS was closely associated with unfavourable nutritional status according to the International Society of Renal Nutrition and Metabolism (ISRNM) criteria for PEW. However, in 71.25% of patients with satisfactory functional capacity (SARC-F scores 0-3), some form of PEW was still observed. After performing logistic regression modelling, only the MIS remained strongly associated with the probability of a negative outcome. Conclusions: The SARC-F alone often did not correspond to an increased sarcopenia risk or clear clinical and biochemical indicators of PEW in HD patients. When assessing nutritional risk in this group, it is recommended to use more detailed tools, such as the MIS, to ensure the accurate identification of those at the highest risk for negative outcomes.
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Affiliation(s)
- Lea Katalinic
- Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
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Cabo CA, Hernández-Beltrán V, Gamonales JM, Fernandes O, Espada MC, Parraca JA. Evolution of documents related to the influence of physical activity and functional capacity throughout the aging process: a bibliometric review. Front Physiol 2024; 15:1427038. [PMID: 39156828 PMCID: PMC11327041 DOI: 10.3389/fphys.2024.1427038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
Physical inactivity can lead to frailty and negative health outcomes in middle-aged to older adults. Sedentary individuals have double the risk of death compared to those who engage in high levels of physical activity (PA). The advantages of practicing PA in older age are significant, with regular, moderate-intensity activity (150 min per week)being consistently linked with a decreased risk of chronic disease, cognitive decline, and mortality. Therefore, the study aimed to carry out a bibliometric review related to the terms "Physical activity," "Functional capacity" and "Aging" including all the documents published in the Web of Science Core Collection until 31st December 2023. The sample was made up of 231 studies related to the topic. The results reported that the first document was published in 1994. However, there was no continuity in the publication of the documents till 1998, which was the first year with at least one document published. Considering 1998 as the first year, it is observed an exponential growth of 77.4%, between the oldest (1997-2008) and contemporaneous studies (2008-2023), in which "Geriatric Gerontology" was the Web of Science category with the highest number of documents (n = 59). The journal "Experimental Gerontology" was associated with the largest number of published documents (n = 7), being indexed in Quartil 2. The years 2009 had the highest number of citations (n = 1811), with a total of 7 documents published and 2018 with the higher number of documents (n = 25). These results reported the importance of PA in elderly people, and how it influences the risk of falls, improving the balance and the functional capacity. Thus, it is important to carry out programmes to promote physical activity to this population and reduce the risk of falls and the presence of diseases.
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Affiliation(s)
- Carolina A. Cabo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
- Instituto Politécnico de Setúbal, Escola Superior de Educação, Setúbal, Portugal
- Sport Physical Activity and Health Research and Innovation Center (SPRINT), Rio Maior, Portugal
| | - Víctor Hernández-Beltrán
- Training Optimization and Sports Performance Research Group (GOERD), Faculty of Sport Science, University of Extremadura, Cáceres, Spain
| | - José M. Gamonales
- Training Optimization and Sports Performance Research Group (GOERD), Faculty of Sport Science, University of Extremadura, Cáceres, Spain
- Faculty of Education and Psychology, University of Extremadura, Badajoz, Spain
- Programa de Doctorado en Educación y Tecnología, Universidad a Distancia de Madrid, Madrid, Spain
| | - Orlando Fernandes
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Mário C. Espada
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
- Instituto Politécnico de Setúbal, Escola Superior de Educação, Setúbal, Portugal
- Sport Physical Activity and Health Research and Innovation Center (SPRINT), Rio Maior, Portugal
- Life Quality Research Centre (CIEQV), Setúbal, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - José A. Parraca
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
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Stratton MT, Siedler MR, Rodriguez C, Harty PS, Boykin JR, Keith DS, Green JJ, White SJ, Tinoco E, DeHaven B, VanDusseldorp TA, Tinsley GM. No Effect of Breakfast Consumption Observed for Afternoon Resistance Training Performance in Habitual Breakfast Consumers and Nonconsumers: A Randomized Crossover Trial. J Acad Nutr Diet 2024; 124:995-1013. [PMID: 37742826 DOI: 10.1016/j.jand.2023.09.008] [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: 05/25/2023] [Revised: 08/23/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Pre-exercise meal frequency is commonly believed to impact exercise performance, but little is known about its impact on resistance training. OBJECTIVE This study investigated the impact of breakfast consumption on afternoon resistance training performance in habitual breakfast consumers and nonconsumers. DESIGN A randomized, crossover study was conducted in Lubbock, TX between November 2021 and May 2022. PARTICIPANTS Thirty-nine resistance-trained male (n = 20) and female (n = 19) adults (mean ± SD age 23.0 ± 4.7 years) who habitually consumed (≥5 d/wk; n = 19) or did not consume (≥5 d/wk; n = 20) breakfast completed the study. INTERVENTION After the establishment of 1-repetition maximums at the first visit, participants completed 2 additional visits, each of which included 4 sets of barbell back squat, bench press, and deadlift, using 80% of their 1-repetition maximum after either consuming breakfast and lunch or the same food at lunch only. MAIN OUTCOME MEASURES Repetitions, along with average and peak average concentric velocity and power, were measured for all repetitions throughout each exercise session. Visual analog scales were used to assess feelings of fatigue, energy, focus, hunger, desire to eat, and fullness throughout each exercise session. STATISTICAL ANALYSES PERFORMED Data were analyzed using linear mixed-effects models. RESULTS No interactions or main effects involving condition or habitual breakfast consumption were observed for resistance training outcomes, although sex differences were noted. Male participants performed significantly fewer repetitions on sets 2, 3, and 4 (P < .014) for total repetitions, on sets 2 and 4 for barbell back squat (P < .023), and set 4 for deadlift (P = .006), with no observed differences between sexes for bench press repetitions. Male participants displayed reductions in average power across all sets and exercises except deadlift. CONCLUSIONS These data suggest that alterations in pre-exercise meal frequency may not influence afternoon resistance training performance provided similar total nutritional intake is consumed.
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Affiliation(s)
- Matthew T Stratton
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas; Department of Health, Kinesiology and Sport, University of South Alabama, Mobile, Alabama
| | - Madelin R Siedler
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Christian Rodriguez
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Patrick S Harty
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas; Department of Kinesiology, College of Science, Technology, and Health; Lindenwood University, St Charles, Missouri
| | - Jake R Boykin
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas; Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida
| | - Dale S Keith
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Jacob J Green
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Sarah J White
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Ethan Tinoco
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Brielle DeHaven
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Trisha A VanDusseldorp
- Bonafide Health, LLC, JDS Therapeutics, Harrison, New York; Department of Health and Exercise Sciences, Jacksonville University, Jacksonville, Florida
| | - Grant M Tinsley
- Energy Balance and Body Composition Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas.
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Boyle LD, Akbas F, Yazıcı D, McGowan BM, Yumuk V. Pharmacotherapy for older people with obesity. Eur J Intern Med 2024:S0953-6205(24)00192-4. [PMID: 38897877 DOI: 10.1016/j.ejim.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 06/21/2024]
Abstract
Rates of obesity continue to rise, including in older adults. Use of medication for obesity in the elderly has been considered controversial, due to concerns around potential progression of age-related sarcopenia and a general lack of evidence for its use in this age group. Within this review, we describe the general considerations when prescribing obesity pharmacotherapy for older adults living with obesity. We evaluate in detail the anti-obesity medications currently licenced in Europe, with emphasis on the available efficacy, safety and cardiovascular outcome data gathered from study of older people. Finally, we discuss future directions and avenues of research.
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Affiliation(s)
- Luke D Boyle
- Centre for Obesity, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
| | - Feray Akbas
- Department of Internal Medicine Clinic, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Dilek Yazıcı
- Koç University Medical School Section of Endocrinology and Metabolism, Istanbul, Turkey
| | - Barbara M McGowan
- Centre for Obesity, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Volkan Yumuk
- Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Division of Endocrinology, Metabolism, and Diabetes, Istanbul, Turkey
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Won H, Yoon DY, Lee S, Cho J, Oh J, Jang I, Yoo S, Yu K. Effects of meal type on the bioavailability of vutiglabridin, a novel anti-obesity agent, in healthy subjects. Clin Transl Sci 2024; 17:e13744. [PMID: 38436494 PMCID: PMC10910614 DOI: 10.1111/cts.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Vutiglabridin, which affects the pharmacokinetics (PKs) of food, is currently under clinical development for the treatment of obesity. This study aimed to evaluate the effects of low- and high-fat meals on PKs of vutiglabridin in healthy male subjects. A randomized, open-label, single-dose, three-period, six-sequence crossover study was conducted. The subjects received a single oral dose of vutiglabridin 480 mg in a fasted state, 30 min after the intake of a low-fat meal (total 500-600 kcal, fat content 100-125 kcal) and high-fat meal (total 800-1000 kcal, fat content 500-600 kcal), with a 21-day washout period. Geometric mean ratios (GMRs) and 90% confidence intervals (CIs) for maximum plasma concentration (Cmax ) and area under the plasma concentration-time curve to the last measurable timepoint (AUClast ) were calculated. After intake of low- and high-fat meals, systemic exposure to vutiglabridin was increased, and the time to reach Cmax (Tmax ) was delayed compared to that in the fasted state. The GMRs (90% CIs) of low-fat meal to fasted state for Cmax and AUClast were 2.14 (1.76-2.60) and 2.15 (1.92-2.42), respectively, and those of high-fat meal to fasted state were 3.07 (2.53-3.72) and 3.00 (2.67-3.37), respectively. The median Tmax was delayed by 1.5 h in both fed states compared with that in the fasted state. The study drug was well-tolerated after administration in both the fed and fasted states. Food ingestion substantially increased the extent of oral vutiglabridin absorption in healthy subjects, and this enhancement increased with the fat content of the meal.
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Affiliation(s)
- Heejae Won
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
| | - Deok Yong Yoon
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Sangmi Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Integrated Major in Innovative Medical ScienceSeoul National University Graduate SchoolSeoulKorea
| | - Joo‐Youn Cho
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of PharmacologyJeju National University College of MedicineJejuRepublic of Korea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | | | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
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9
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Huang J, Zeng X, Ning H, Peng R, Guo Y, Hu M, Feng H. Development and validation of prediction model for older adults with cognitive frailty. Aging Clin Exp Res 2024; 36:8. [PMID: 38281238 PMCID: PMC10822804 DOI: 10.1007/s40520-023-02647-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/01/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE This study sought to develop and validate a 6-year risk prediction model in older adults with cognitive frailty (CF). METHODS In the secondary analysis of Chinese Longitudinal Healthy Longevity Survey (CLHLS), participants from the 2011-2018 cohort were included to develop the prediction model. The CF was assessed by the Chinese version of Mini-Mental State Exam (CMMSE) and the modified Fried criteria. The stepwise regression was used to select predictors, and the logistic regression analysis was conducted to construct the model. The model was externally validated using the temporal validation method via the 2005-2011 cohort. The discrimination was measured by the area under the curve (AUC), and the calibration was measured by the calibration plot. A nomogram was conducted to vividly present the prediction model. RESULTS The development dataset included 2420 participants aged 60 years or above, and 243 participants suffered from CF during a median follow-up period of 6.91 years (interquartile range 5.47-7.10 years). Six predictors, namely, age, sex, residence, body mass index (BMI), exercise, and physical disability, were finally used to develop the model. The model performed well with the AUC of 0.830 and 0.840 in the development and external validation datasets, respectively. CONCLUSION The study could provide a practical tool to identify older adults with a high risk of CF early. Furthermore, targeting modifiable factors could prevent about half of the new-onset CF during a 6-year follow-up.
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Affiliation(s)
- Jundan Huang
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Xianmei Zeng
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Ruotong Peng
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Yongzhen Guo
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, 410013, Hunan, China.
- Oceanwide Health Management Institute, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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Heymsfield SB, Yang S, McCarthy C, Brown JB, Martin CK, Redman LM, Ravussin E, Shen W, Müller MJ, Bosy-Westphal A. Proportion of caloric restriction-induced weight loss as skeletal muscle. Obesity (Silver Spring) 2024; 32:32-40. [PMID: 37807154 PMCID: PMC10872987 DOI: 10.1002/oby.23910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE This study's objective was to develop models predicting the relative reduction in skeletal muscle (SM) mass during periods of voluntary calorie restriction (CR) and to validate model predictions in longitudinally monitored samples. METHODS The model development group included healthy nonexercising adults (n = 897) who had whole-body SM mass measured with magnetic resonance imaging. Model predictions of relative SM changes with CR were evaluated in two longitudinal studies, one 12 to 14 weeks in duration (n = 74) and the other 12 months in duration (n = 26). RESULTS A series of SM prediction models were developed in a sample of 415 males and 482 females. Model-predicted changes in SM mass relative to changes in body weight (i.e., ΔSM/Δbody weight) with a representative model were (mean ± SE) 0.26 ± 0.013 in males and 0.14 ± 0.007 in females (sex difference, p < 0.001). The actual mean proportions of weight loss as SM in the longitudinal studies were 0.23 ± 0.02/0.20 ± 0.06 in males and 0.10 ± 0.02/0.17 ± 0.03 in females, similar to model-predicted values. CONCLUSIONS Nonelderly males and females with overweight and obesity experience respective reductions in SM mass with voluntary CR in the absence of a structured exercise program of about 2 to 2.5 kg and 1 to 1.5 kg per 10-kg weight loss, respectively. These estimates are predicted to be influenced by interactions between age and body mass index in males, a hypothesis that needs future testing.
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Affiliation(s)
- Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Jasmin B. Brown
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, and Institute of Human Nutrition, Columbia University Irving Medical Center; Columbia Magnetic Resonance Research Center, Columbia University, New York, NY, USA
| | - Manfred J. Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
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11
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Tsubota-Utsugi M, Tanno K, Takahashi N, Onoda T, Yonekura Y, Ohsawa M, Takahashi S, Kuribayashi T, Itabashi R, Tanaka F, Asahi K, Omama S, Ogasawara K, Ishigaki Y, Takahashi F, Soma A, Takanashi N, Sakata K, Ohkubo T, Okayama A. Rapid weight change as a predictor of disability among community-dwelling Japanese older adults. Geriatr Gerontol Int 2023; 23:809-816. [PMID: 37770036 DOI: 10.1111/ggi.14687] [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: 06/22/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
AIM To fill the knowledge gap regarding weight change and the onset of disability in community-dwelling Japanese older adults, we investigated the potential effects of rapid weight change on disability risk as defined by Japan's long-term care insurance (LTCI) system. METHODS We analyzed data from a longitudinal study of 10 375 community-dwelling older Japanese adults (≥65 years) who were not LTCI needs certified at baseline and joined the study from 2002 to 2005. Weight change (percentage) was calculated by subtracting participants' weight in the previous year from that measured during a physical examination at study commencement. The five weight-change categories ranged from sizable weight loss (≤ -8.0%) to sizable weight gain (≥ +8.0%). Disability was defined according to LTCI certifications at follow-up. Hazard ratios (HRs) and 95% confidence intervals were calculated for new-onset disability using a Cox proportional hazards model that fitted the proportional subdistribution hazards regression model with weights for competing risks of death. RESULTS During the mean 10.5-year follow-up, 2994 participants developed a disability. Sizable weight loss (HR [95% confidence intervals], 1.41 [1.17-1.71]) and weight loss (1.20 [1.05-1.36]) were significant predictors of disability onset. Sizable weight gain (1.45 [1.07-1.97]) corresponded to severe disability. Stratified analyses by lifestyle and initial body mass index categories revealed more pronounced associations between weight change and disability risk in the unhealthy lifestyle and below initial normal body mass index groups. CONCLUSIONS Rapid and sizable weight gain could be additional criteria for disability risk in older adults. Geriatr Gerontol Int 2023; 23: 809-816.
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Grants
- JP17K09126 a grant-in-aid for Scientific Research (C) from the Japan Society for the Promotion of Science
- JP21K10477 a grant-in-aid for Scientific Research (C) from the Japan Society for the Promotion of Science
- 20FA1002 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- H23-Junkankitou [Seishuu]-Ippan-005 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- H26-Junkankitou [Seisaku]-Ippan-001 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- H29-Junkankitou-Ippan-003 a grant-in-aid from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan
- Eli Lilly Japan K.K.
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Affiliation(s)
- Megumi Tsubota-Utsugi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Naomi Takahashi
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | | | - Yuki Yonekura
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Masaki Ohsawa
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Shuko Takahashi
- Division of Medical Education, Iwate Medical University, Morioka, Japan
| | - Toru Kuribayashi
- Faculty of Humanities and Social Sciences, Iwate University, Morioka, Japan
| | - Ryo Itabashi
- Stroke Center, Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Fumitaka Tanaka
- Division of Nephrology and Hypertension, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Koichi Asahi
- Department of General Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shinichi Omama
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kuniaki Ogasawara
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
| | - Yasushi Ishigaki
- Department of Neurosurgery, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Morioka, Japan
| | - Akemi Soma
- Iwate Health Service Association, Morioka, Japan
| | - Nobuyuki Takanashi
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University, Morioka, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
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12
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Tan J, Krasilshchikov O, Kuan G, Hashim HA, Aldhahi MI, Al-Mhanna SB, Badicu G. The Effects of Combining Aerobic and Heavy Resistance Training on Body Composition, Muscle Hypertrophy, and Exercise Satisfaction in Physically Active Adults. Healthcare (Basel) 2023; 11:2443. [PMID: 37685476 PMCID: PMC10487730 DOI: 10.3390/healthcare11172443] [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] [Received: 07/27/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
This study investigated the effects of combined aerobic and heavy resistance training on the variables of body composition, muscle hypertrophy, and exercise satisfaction in physically active adults in comparison with heavy resistance training only (predominantly designed for hypertrophy). Twenty-two healthy male adults between the ages of 18 and 35, who had limited previous experience with muscle resistance training, participated in the intervention program while maintaining their physical activity level. The participants were randomly allocated into two groups: the resistance training group (control group) and the combined training group (experimental group), which involved both resistance training and aerobic training. Aerobic training consisted of 30 min aerobic interval training sessions three times a week with a total of 8 min work bouts in each at 60-70% of heart rate reserve (HRR). The intervention training program lasted for eight weeks. Resistance training consisted of a 3-day muscle group split (2-3 exercises per muscle group, 8 sets per muscle group, 6-12 repetition maximum (RM). Upon completion, body composition, muscle hypertrophy, and exercise satisfaction were analyzed using the mixed-design ANOVA. Variables selected for this study as markers of body composition responded differently to the different interventions and time; however, some trends were not statistically significant. Overall, it is not possible to state unequivocally that one training modality was superior to another in the body composition cluster, for significant improvements were observed within the groups from pre- to post-interventions, but no significant differences were observed between the resistance training and combined training groups, while, both interventions showed improvement with time in some variables of muscle hypertrophy. Compared to baseline, the exercise satisfaction post-intervention improved within the groups. From pre- to post-testing, both resistance and combined training groups improved exercise satisfaction (p < 0.05 in both groups). However, there was no significant difference in exercise satisfaction observed between the resistance training and combined training groups after the training intervention (p > 0.05).
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Affiliation(s)
- Jerrican Tan
- Fitness Innovations Malaysia Sendirian Berhad, Petaling Jaya 47820, Selangor, Malaysia
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Oleksandr Krasilshchikov
- Faculty of Sports Science and Recreation, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia
| | - Garry Kuan
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Hairul Anuar Hashim
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Sameer Badri Al-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Faculty of Physical Education and Mountain Sports, Transilvania University of Braşov, 500068 Braşov, Romania
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13
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Naruse M, Vincenty CS, Konopka AR, Trappe SW, Harber MP, Trappe TA. Cycle exercise training and muscle mass: A preliminary investigation of 17 lower limb muscles in older men. Physiol Rep 2023; 11:e15781. [PMID: 37606179 PMCID: PMC10442866 DOI: 10.14814/phy2.15781] [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: 06/19/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/23/2023] Open
Abstract
Cycling exercise in older individuals is beneficial for the cardiovascular system and quadriceps muscles, including partially reversing the age-related loss of quadriceps muscle mass. However, the effect of cycling exercise on the numerous other lower limb muscles is unknown. Six older men (74 ± 8 years) underwent MRI before and after 12-weeks of progressive aerobic cycle exercise training (3-4 days/week, 60-180 min/week, 60%-80% heart rate reserve, VO2 max: +13%) for upper (rectus femoris, vastii, adductor longus, adductor magnus, gracilis, sartorius, biceps femoris long head, biceps femoris short head, semimembranosus, semitendinosus) and lower (anterior tibial, posterior tibialis, peroneals, flexor digitorum longus, lateral gastrocnemius, medial gastrocnemius, soleus) leg muscle volumes. In the upper leg, cycle exercise training induced hypertrophy (p ≤ 0.05) in the vastii (+7%) and sartorius (+6%), with a trend to increase biceps femoris short head (+5%, p = 0.1). Additionally, there was a trend to decrease muscle volume in the adductor longus (-6%, p = 0.1) and biceps femoris long head (-5%, p = 0.09). In the lower leg, all 7 muscle volumes assessed were unaltered pre- to post-training (-2% to -3%, p > 0.05). This new evidence related to cycle exercise training in older individuals clarifies the specific upper leg muscles that are highly impacted, while revealing all the lower leg muscles do not appear responsive, in the context of muscle mass and sarcopenia. This study provides information for exercise program development in older individuals, suggesting other specific exercises are needed for the rectus femoris and adductors, certain hamstrings, and the anterior and posterior lower leg muscles to augment the beneficial effects of cycling exercise for older adults.
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Affiliation(s)
- Masatoshi Naruse
- Human Performance LaboratoryBall State UniversityMuncieIndianaUSA
| | | | - Adam R. Konopka
- Human Performance LaboratoryBall State UniversityMuncieIndianaUSA
| | - Scott W. Trappe
- Human Performance LaboratoryBall State UniversityMuncieIndianaUSA
| | | | - Todd A. Trappe
- Human Performance LaboratoryBall State UniversityMuncieIndianaUSA
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14
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Salis Z, Sainsbury A. Association of Change in Body Mass Index With Incidence and Progression of the Structural Defects of Hip Osteoarthritis: Data From the Osteoarthritis Initiative and the Cohort Hip and Cohort Knee study. Arthritis Care Res (Hoboken) 2023; 75:1527-1537. [PMID: 36354244 PMCID: PMC10952232 DOI: 10.1002/acr.25057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 10/14/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To define the association between change in body mass index (BMI) and the incidence and progression of structural defects of hip osteoarthritis as assessed by radiography. METHODS We used data from 2 independent cohort studies: the Osteoarthritis Initiative (OAI) and the Cohort Hip and Cohort Knee (CHECK) study. Our exposure was change in BMI from baseline to 4-5 years' follow-up. Our outcomes were the incidence and progression of structural defects of hip osteoarthritis as assessed using a modified Croft grade in OAI and the Kellgren/Lawrence grade in the CHECK study. To study incidence, we created incidence cohorts of hips without definite overall structural defects at baseline (i.e., grade <2) and then investigated the odds of hips having definite overall structural defects at follow-up (i.e., grade ≥2). To study progression, we created progression cohorts of hips with definite overall structural defects at baseline (i.e., grade ≥2) and then investigated the odds of having a grade increase of ≥1 from baseline to follow-up. RESULTS There was a total of 5,896 and 1,377 hips in the incidence cohorts, and 303 and 129 hips in the progression cohorts for the OAI and CHECK study, respectively. Change in BMI (decrease or increase) was not associated with any change in odds of the incidence or progression of definite structural defects of hip osteoarthritis in either the OAI or CHECK cohorts. CONCLUSION Weight loss may not be an effective strategy for preventing, slowing, or delaying the structural defects of hip osteoarthritis over 4-5 years.
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Affiliation(s)
- Zubeyir Salis
- University of New South WalesKensingtonNew South WalesAustralia
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15
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Cobb-Clark DA, Dahmann SC, Kamhöfer DA, Schildberg-Hörisch H. Self-control and unhealthy body weight: The role of impulsivity and restraint. ECONOMICS AND HUMAN BIOLOGY 2023; 50:101263. [PMID: 37453372 DOI: 10.1016/j.ehb.2023.101263] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
We examine the relationship between trait self-control and body weight. Data from a population representative household survey reveal that limited self-control is strongly associated with both unhealthy body weight and poorer subjective weight-related well-being. Those with limited self-control are characterized by reduced exercising, repeated dieting, unhealthier eating habits, and poorer nutrition. We propose an empirical method to isolate two facets of self-control limitations-high impulsivity and low restraint. Each has differential predictive power. Physical activity, dieting, and overall body weight are more strongly associated with restraint; impulsivity is relatively more predictive of when, where, and what people eat.
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Affiliation(s)
- Deborah A Cobb-Clark
- The University of Sydney, School of Economics, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Australia; IZA Institute of Labor Economics, Germany
| | - Sarah C Dahmann
- The University of Melbourne, Melbourne Institute: Applied Economic & Social Research, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Australia; IZA Institute of Labor Economics, Germany.
| | - Daniel A Kamhöfer
- Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics, Germany; IZA Institute of Labor Economics, Germany
| | - Hannah Schildberg-Hörisch
- Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics, Germany; ARC Centre of Excellence for Children and Families over the Life Course, Australia; IZA Institute of Labor Economics, Germany
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16
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Kwon SY, Kim G, Lee J, Park J, Lee YB, Jin SM, Hur KY, Kim JH. Association of body weight change with all-cause and cause-specific mortality: A nationwide population-based study. Diabetes Res Clin Pract 2023; 199:110666. [PMID: 37031890 DOI: 10.1016/j.diabres.2023.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/09/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
AIMS Weight gain and loss increase the risk of all-cause mortality. This study explored the association of short-term weight change with all-cause and cause-specific mortality in middle-aged to older people. METHODS This was a 8.4-year retrospective cohort study of 645,260 adults aged 40 to 80 who underwent health checkups twice within a 2-year interval between January 2009 and December 2012. Cox analyses were used to analyze the association between short-term weight change and all-cause and cause-specific mortality. RESULTS Weight gain and loss were associated with an increased risk of all-cause mortality: the hazard ratios were 2.05 (95% confidence interval [CI], 1.93-2.16), 1.21 (95% CI, 1.16-1.25), 1.12 (95% CI 1.08-1.17), and 1.60 (95% CI, 1.49-1.70) for the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups, respectively. This U-shaped association was also seen between weight change and cause-specific mortality. Within the weight loss group, those who regained weight after two years had a reduced mortality risk. CONCLUSIONS In a middle-aged and elderly population, weight gain or loss of more than 3% during a 2-year interval was related to an elevated risk of all-cause and cause-specific mortality.
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Affiliation(s)
- So Yoon Kwon
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Jiyun Park
- Division of Endocrine and Metabolism, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Bundang-gu, Seongnam, Gyeonggi-do, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
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17
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David MCB, Kolanko M, Del Giovane M, Lai H, True J, Beal E, Li LM, Nilforooshan R, Barnaghi P, Malhotra PA, Rostill H, Wingfield D, Wilson D, Daniels S, Sharp DJ, Scott G. Remote Monitoring of Physiology in People Living With Dementia: An Observational Cohort Study. JMIR Aging 2023; 6:e43777. [PMID: 36892931 PMCID: PMC10037178 DOI: 10.2196/43777] [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] [Received: 10/24/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Internet of Things (IoT) technology enables physiological measurements to be recorded at home from people living with dementia and monitored remotely. However, measurements from people with dementia in this context have not been previously studied. We report on the distribution of physiological measurements from 82 people with dementia over approximately 2 years. OBJECTIVE Our objective was to characterize the physiology of people with dementia when measured in the context of their own homes. We also wanted to explore the possible use of an alerts-based system for detecting health deterioration and discuss the potential applications and limitations of this kind of system. METHODS We performed a longitudinal community-based cohort study of people with dementia using "Minder," our IoT remote monitoring platform. All people with dementia received a blood pressure machine for systolic and diastolic blood pressure, a pulse oximeter measuring oxygen saturation and heart rate, body weight scales, and a thermometer, and were asked to use each device once a day at any time. Timings, distributions, and abnormalities in measurements were examined, including the rate of significant abnormalities ("alerts") defined by various standardized criteria. We used our own study criteria for alerts and compared them with the National Early Warning Score 2 criteria. RESULTS A total of 82 people with dementia, with a mean age of 80.4 (SD 7.8) years, recorded 147,203 measurements over 958,000 participant-hours. The median percentage of days when any participant took any measurements (ie, any device) was 56.2% (IQR 33.2%-83.7%, range 2.3%-100%). Reassuringly, engagement of people with dementia with the system did not wane with time, reflected in there being no change in the weekly number of measurements with respect to time (1-sample t-test on slopes of linear fit, P=.45). A total of 45% of people with dementia met criteria for hypertension. People with dementia with α-synuclein-related dementia had lower systolic blood pressure; 30% had clinically significant weight loss. Depending on the criteria used, 3.03%-9.46% of measurements generated alerts, at 0.066-0.233 per day per person with dementia. We also report 4 case studies, highlighting the potential benefits and challenges of remote physiological monitoring in people with dementia. These include case studies of people with dementia developing acute infections and one of a person with dementia developing symptomatic bradycardia while taking donepezil. CONCLUSIONS We present findings from a study of the physiology of people with dementia recorded remotely on a large scale. People with dementia and their carers showed acceptable compliance throughout, supporting the feasibility of the system. Our findings inform the development of technologies, care pathways, and policies for IoT-based remote monitoring. We show how IoT-based monitoring could improve the management of acute and chronic comorbidities in this clinically vulnerable group. Future randomized trials are required to establish if a system like this has measurable long-term benefits on health and quality of life outcomes.
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Affiliation(s)
- Michael C B David
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Magdalena Kolanko
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Martina Del Giovane
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Helen Lai
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Jessica True
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Emily Beal
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Lucia M Li
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Ramin Nilforooshan
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Payam Barnaghi
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Paresh A Malhotra
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
- Imperial College London, Brain Sciences, South Kensington, London, United Kingdom
| | - Helen Rostill
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, Surrey, United Kingdom
| | - David Wingfield
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Danielle Wilson
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Sarah Daniels
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - David J Sharp
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
| | - Gregory Scott
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London, London, United Kingdom
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18
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Moon S, Yang YS, Kimm H, Jung KJ, Lee JY, Jee SH, Lee S, Kim SY, Nam CM. Do Weight Changes Affect the Association between Smoking Cessation and the Risk of Stroke Subtypes in Korean Males? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4712. [PMID: 36981627 PMCID: PMC10048944 DOI: 10.3390/ijerph20064712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: We investigated whether weight changes affect the association between smoking cessation and stroke risk; (2) Methods: Overall, 719,040 males were categorized into eight groups according to smoking status (sustained smokers, non-smokers, long-term quitters (quit > 4 years), and recent quitters (quit < 4 years)) and post-cessation weight change (-5 kg, -5.0 to 0.1 kg, maintainers, 0.1-5.0 kg, and >5.0 kg). The hazard ratios (HR) and 95% confidence intervals (CI) for incident total, ischemic, and hemorrhagic strokes, including subarachnoid and intracerebral hemorrhage, were calculated using Cox proportional hazard models; (3) Results: We detected 38,730 strokes (median follow-up, 25.7 years), including 30,609 ischemic and 9055 hemorrhagic strokes. For recent quitters with a >5.0 kg or 0.1-5.0 kg weight increase, maintainers, or those who lost 0.1-5 kg, the multivariable HR for total stroke was 0.73 (95% CI, 0.67-0.79), 0.78 (95% CI, 0.74-0.82), 0.77 (95% CI, 0.69-0.85), 0.84 (95% CI, 0.77-0.90), and 1.06 (95% CI, 0.92-1.23), respectively, compared with that of sustained smokers; (4) Conclusions: Comparable patterns were obtained for stroke subtypes. Thus, we strongly recommend quitting smoking, as weight gain after quitting smoking does not alter the stroke-related benefits.
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Affiliation(s)
- Seulji Moon
- Department of Medicine, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Yeun Soo Yang
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
- Department of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Heejin Kimm
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Keum Ji Jung
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Ji Young Lee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Republic of Korea
| | - Sunmi Lee
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju 26464, Republic of Korea
| | - So Young Kim
- Health Insurance Policy Research Institute, National Health Insurance Service, Wonju 26464, Republic of Korea
| | - Chung Mo Nam
- Department of Medicine, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea
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The association of moderate-to-vigorous and light-intensity physical activity on static balance in middle-aged and older-aged adults. Aging Clin Exp Res 2023; 35:541-550. [PMID: 36696017 DOI: 10.1007/s40520-023-02344-8] [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: 09/19/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Falls are the leading cause of injury among adults ≥ 65 years of age. Participation in physical activity (PA) is associated with improved balance, though it is impact in the middle-age population is not well understood. AIM The purpose of the current study was to examine the influence of PA intensity on static balance in middle-aged and older aged individuals. METHODS Included were middle-aged adults (40-64 years) and older adults (≥ 65 years) from the 2003-2004 years of the National Health and Nutrition Evaluation Survey. Light physical activity (LPA) and moderate-vigorous physical activity (MVPA) were collected via accelerometer and static balance via the Romberg Test of Standing Balance. RESULTS No significant odds ratio relationship was found between MVPA or LPA and having good static balance in the middle-aged population; 1.04 (95% CI 0.95, 1.13) p = 0.427 and 1.05 (95% CI 0.97, 1.14) p = 0.182, respectively. Whereas, in older adults, every 60-min increase in LPA was significantly associated with 28% higher odds of good balance (95% CI 1.15, 1.41; p < 0.001), and every 10-min increase in MVPA with 25% higher odds of good balance (95% CI 1.08, 1.45; p = 0.006). DISCUSSION LPA and MVPA were not associated with good static balance in middle-aged adults, but in older adults LPA was significantly associated with good static balance. CONCLUSION A significant relationship is found between age and fall risk, which is a major concern in the aging population.
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20
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Evaluation of bone density and skeletal muscle mass after sleeve gastrectomy using computed tomography method. Bone Rep 2023; 18:101661. [PMID: 36846622 PMCID: PMC9946851 DOI: 10.1016/j.bonr.2023.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 01/20/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023] Open
Abstract
Introduction Sleeve gastrectomy is the most common surgical procedure to reduce weight and treat metabolic complications in patients with moderate-to-severe obesity; however, it affects the musculoskeletal system. Dual-energy X-ray absorptiometry (DXA), which is commonly used to measure bone mineral density (BMD), may be affected by excess fat tissue around the bones, interrupting BMD measurement. Due to the strong correlation between DXA and the Hounsfield units (HU) obtained from computed tomography (CT) scans, BMD assessment using clinical abdominal CT scans has been useful. To date, there has been no report of detailed CT evaluation in patients with severe obesity after sleeve gastrectomy. Objective This study investigated the effect of sleeve gastrectomy in severely obese patients on bone and psoas muscle density, and cross-sectional area using retrospective clinical CT scans. Methods This was a retrospective observational study that included 86 patients (35 males and 51 females) who underwent sleeve gastrectomy between March 2012 and May 2019. Patients' clinical data (age at the time of surgery, sex, body weight, body mass index (BMI), comorbidities, and preoperative and postoperative blood test results, HU of the lumbar spine and psoas muscle and psoas muscle mass index (PMI)) were evaluated. Results The mean age at the time of surgery was 43 years, and the body weight and BMI significantly reduced (p < 0.01) after surgery. The mean hemoglobin A1c level showed significant improvement in males and females. Serum calcium and phosphorus levels remained unchanged before and after surgery. In CT analysis, HU of the lumbar spine and psoas muscle showed no significant decrease, but PMI showed a significant decrease (p < 0.01). Conclusions Sleeve gastrectomy could dramatically improve anthropometric measures without causing changes in serum calcium and phosphorus levels. Preoperative and postoperative abdominal CT revealed no significant difference in the bone and psoas muscle density, and the psoas muscle mass was significantly decreased after sleeve gastrectomy.
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21
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Paez HG, Pitzer CR, Alway SE. Age-Related Dysfunction in Proteostasis and Cellular Quality Control in the Development of Sarcopenia. Cells 2023; 12:cells12020249. [PMID: 36672183 PMCID: PMC9856405 DOI: 10.3390/cells12020249] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Sarcopenia is a debilitating skeletal muscle disease that accelerates in the last decades of life and is characterized by marked deficits in muscle strength, mass, quality, and metabolic health. The multifactorial causes of sarcopenia have proven difficult to treat and involve a complex interplay between environmental factors and intrinsic age-associated changes. It is generally accepted that sarcopenia results in a progressive loss of skeletal muscle function that exceeds the loss of mass, indicating that while loss of muscle mass is important, loss of muscle quality is the primary defect with advanced age. Furthermore, preclinical models have suggested that aged skeletal muscle exhibits defects in cellular quality control such as the degradation of damaged mitochondria. Recent evidence suggests that a dysregulation of proteostasis, an important regulator of cellular quality control, is a significant contributor to the aging-associated declines in muscle quality, function, and mass. Although skeletal muscle mammalian target of rapamycin complex 1 (mTORC1) plays a critical role in cellular control, including skeletal muscle hypertrophy, paradoxically, sustained activation of mTORC1 recapitulates several characteristics of sarcopenia. Pharmaceutical inhibition of mTORC1 as well as caloric restriction significantly improves muscle quality in aged animals, however, the mechanisms controlling cellular proteostasis are not fully known. This information is important for developing effective therapeutic strategies that mitigate or prevent sarcopenia and associated disability. This review identifies recent and historical understanding of the molecular mechanisms of proteostasis driving age-associated muscle loss and suggests potential therapeutic interventions to slow or prevent sarcopenia.
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Affiliation(s)
- Hector G. Paez
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Integrated Biomedical Sciences Graduate Program, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Laboratory of Muscle Biology and Sarcopenia, Department of Physical Therapy, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Muscle, Metabolism and Neuropathology, Division of Regenerative and Rehabilitation Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Christopher R. Pitzer
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Integrated Biomedical Sciences Graduate Program, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Laboratory of Muscle Biology and Sarcopenia, Department of Physical Therapy, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Muscle, Metabolism and Neuropathology, Division of Regenerative and Rehabilitation Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Stephen E. Alway
- Department of Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Integrated Biomedical Sciences Graduate Program, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Laboratory of Muscle Biology and Sarcopenia, Department of Physical Therapy, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Center for Muscle, Metabolism and Neuropathology, Division of Regenerative and Rehabilitation Sciences, College of Health Professions, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- The Tennessee Institute of Regenerative Medicine, Memphis, TN 38163, USA
- Correspondence:
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22
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Tian Y, Huan Y, Chen L, Peng S, He Z, Wang Q. Effects of protein intake from an energy-restricted diet on the skeletal muscle composition of overweight and obese rats. Sci Rep 2022; 12:20396. [PMID: 36437293 PMCID: PMC9701787 DOI: 10.1038/s41598-022-24961-5] [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: 02/08/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022] Open
Abstract
Excess weight and obesity are often associated with ectopic adipose tissue accumulation in skeletal muscles. Intermuscular adipose tissue (IMAT) impairs muscle quality and reduces insulin-stimulated skeletal muscle glucose uptake. Although energy restriction and high protein intake can decrease IMAT, the effects and mechanisms of protein intake from an energy-restricted diet on protein and fat masses in skeletal muscle have received little attention. After establishing a diet-induced overweight and obese Sprague-Dawley rat model (half male and half female), rats were divided into five groups: normal control (NC; normal weight, general maintenance diet), model control (MC; overweight and obesity, high-fat diet), energy-restricted low protein (LP; overweight and obesity, 60% energy intake of NC, general maintenance diet), energy-restricted normal protein (NP; overweight and obesity, 60% energy intake of NC, high-protein diet 1), and energy-restricted high protein (HP; overweight and obesity, 60% energy intake of NC, high-protein diet 2). After 8 weeks, plasma and skeletal muscle (quadriceps femoris and gastrocnemius) samples were collected. Plasma levels of glucose, triglycerides, and hormones were analyzed, while contents of protein, fat, and factors associated with their synthesis and degradation were evaluated in skeletal muscles. Plasma concentrations of hormones contrasted protein and fat contents in skeletal muscles. Fat weights and contents of quadriceps femoris and gastrocnemius muscles in the NP group were significantly lower compared with LP and HP groups (P < 0.05). Moreover, concentrations of factors associated with the degradation of muscle fat were significantly higher in the NP group compared with LP and HP groups (P < 0.05). During energy restriction, protein intake equal to that of a normal protein diet increased lipolysis of quadriceps femoris and gastrocnemius muscles in rats of both sexes.
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Affiliation(s)
- Ying Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Yangzhou University, Yangzhou, China.
| | - Yuping Huan
- Department of Cuisine and Nutrition, School of Tourism and Cuisine, Yangzhou University, Yangzhou, China
| | - Lihong Chen
- Qingdao Eighth People's Hospital, Qingdao, China
| | - Suwen Peng
- Department of Cuisine and Nutrition, School of Tourism and Cuisine, Yangzhou University, Yangzhou, China
| | - Zhiyan He
- Department of Cuisine and Nutrition, School of Tourism and Cuisine, Yangzhou University, Yangzhou, China
| | - Qian Wang
- Department of Cuisine and Nutrition, School of Tourism and Cuisine, Yangzhou University, Yangzhou, China
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23
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Na JY, Yoon DY, Yoo H, Lee S, Yu K, Jang I, Yoo S, Kim Y, Oh J. Safety, tolerability, pharmacokinetic, and pharmacodynamic characteristics of vutiglabridin: A first-in-class, first-in-human study. Clin Transl Sci 2022; 15:2744-2757. [PMID: 36176051 PMCID: PMC9652434 DOI: 10.1111/cts.13401] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/17/2022] [Accepted: 08/26/2022] [Indexed: 01/26/2023] Open
Abstract
This study aimed to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of vutiglabridin, a potential anti-obesity treatment under development, for the first time in humans. A randomized, placebo-controlled, single- and multiple-ascending dose study (SAD and MAD, respectively) was performed in healthy Koreans and Whites. Subjects randomly received a single oral dose of 30-720 mg vutiglabridin or placebo at a ratio of 8:2 in the SAD study or 240-480 mg vutiglabridin or placebo once daily for 14 days in the MAD study. Food effect was also evaluated in 240 mg single dose group. Pharmacokinetics were evaluated through plasma concentrations, and pharmacodynamic biomarkers related to obesity or inflammation were analyzed. Safety and tolerability were assessed throughout the study. Single and multiple doses of vutiglabridin were generally well-tolerated. The pharmacokinetic parameters show less than dose-proportionality increase, and plasma concentrations increased more than two-fold after multiple administrations. The mean half-life of Koreans and Whites in the MAD study was 110 and 73 h, respectively. The systemic exposure of vutiglabridin was significantly increased when taken with a high-fat meal, and the systemic exposure was lower in Whites than in Koreans. Vutiglabridin was well-tolerated in healthy Koreans and Whites. The plasma concentration increased less than the dose-proportionality manner. These results justify further investigation of vutiglabridin in patients with obesity.
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Affiliation(s)
- Joo Young Na
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Deok Yong Yoon
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Hyounggyoon Yoo
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical CenterSeongnamKorea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | | | | | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
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24
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Espinosa-Moreno MF, Torres-Restrepo JM, Sanjuan-Marín JF, Medina-Rojas R. Medidas antropométricas versus grosor de masa muscular como predictores de mortalidad en la unidad de cuidado intensivo. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.1215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. En Colombia, la tasa de mortalidad en la Unidad de Cuidados Intensivos es cercana al 32 %, por lo anterior, se han estudiado múltiples predictores de mortalidad que identifiquen de manera precoz una evolución inadecuada. La masa muscular corresponde a cerca del 50 % del peso corporal y cumple importantes funciones metabólicas, como la generación de energía y la homeostasis de la glucosa. Se ha informado la disminución de hasta el 1,6 % de la masa muscular por día en pacientes críticos, factor relacionado con la mortalidad.
Métodos. Se realizó un estudio de cohorte prospectiva entre enero de 2020 y diciembre de 2021, con una muestra no probabilística a conveniencia, incluyendo a los pacientes que ingresaron a las diferentes Unidad de Cuidados Intensivos del Hospital Universitario Hernando Moncaleano Perdomo, en quienes se realizó un registro periódico de las medidas antropométricas y del grosor del musculo cuádriceps.
Resultados. Se incluyeron 82 pacientes, encontrando como variables asociadas a la mortalidad la edad, el número de días de hospitalización, el índice de masa corporal y el delta del musculo cuádriceps. Una medida del grosor del musculo cuádriceps al ingreso menor de 2,5 cm, se asoció con alto riesgo de muerte y una disminución de más de 1,72 cm durante el control ecográfico se relacionó con mal pronóstico.
Conclusiones. Aunque estas variables se eligieron en función de su asociación con mortalidad, nuestros resultados emplean importantes características, como la medición del grosor muscular y su delta durante la estancia en la unidad de cuidados intensivos, lo que indica un mayor consumo de las reservas fisiológicas, asociándose a mayor riesgo de complicaciones y mortalidad.
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25
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Kim YJ, Moon S, Yu JM, Chung HS. Implication of diet and exercise on the management of age‐related sarcopenic obesity in Asians. Geriatr Gerontol Int 2022; 22:695-704. [PMID: 35871525 PMCID: PMC9544230 DOI: 10.1111/ggi.14442] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
The incidence of sarcopenic obesity among adults aged ≥65 years is rising worldwide. Sarcopenic obesity is a high‐risk geriatric syndrome defined as a gain in the amount of adipose tissue along with the age‐related loss of muscle mass and strength or physical performance. Sarcopenic obesity is associated with increased risks of falls, physical limitations, cardiovascular diseases, metabolic diseases, and/or mortality. Thus, the identification of preventive and treatment strategies against sarcopenic obesity is important for healthy aging. Diet and exercise are the reasons for the development of sarcopenic obesity and are key targets in its prevention and treatment. Regarding weight reduction alone, it is most effective to maintain a negative energy balance with dietary calorie restriction and aerobic exercise. However, it is important to preserve skeletal muscle mass while reducing fat mass. Resistance exercise and appropriate protein supply are the main ways of preserving skeletal muscle mass, as well as muscle function. Therefore, in order to improve sarcopenic obesity, a complex treatment strategy is needed to limit energy ingestion with proper nutrition and to increase multimodal exercises. In this review, we focus on recently updated interventions for diet and exercise and potential future management strategies for Asian individuals with aging‐related sarcopenic obesity. Geriatr Gerontol Int 2022; 22: 695–704.
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Affiliation(s)
- Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
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26
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Hirase T, Ling JF, Haghshenas V, Fuld R, Dong D, Hanson DS, Meyer BC, Marco RAW. Obesity and perioperative adverse events in patients undergoing complex revision surgery for the thoracolumbar spine. BMC Musculoskelet Disord 2022; 23:534. [PMID: 35659650 PMCID: PMC9166525 DOI: 10.1186/s12891-022-05505-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 06/01/2022] [Indexed: 12/03/2022] Open
Abstract
Background There are no previous studies that evaluate the effect of obesity on patients undergoing complex revision thoracolumbar spine surgery. The primary objective was to determine the relationship between obesity and perioperative adverse events (AEs) with patients undergoing complex revision thoracolumbar spine surgery while controlling for psoas muscle index (PMI) as a confounding variable. The secondary objective was to determine the relationship between obesity and 30-day readmission rates, 30-day re-operation rates, rate of discharge to a facility, and post-operative length of stay (LOS). Methods Between May 2016 and February 2020, a retrospective analysis of individuals undergoing complex revision surgery of the thoracolumbar spine was performed at a single institution. Obesity was defined as BMI ≥ 30.0 kg/m2. PMI < 500 mm2/m2 for males and < 412 mm2/m2 for females were used to define low muscle mass. A Spine Surgical Invasiveness Index (SSII) > 10 was used to define complex revision surgery. A multivariable logistic regression model was used to ascertain the effects of low muscle mass, obesity, age, and gender on the likelihood of the occurrence of any AE. Results A total of 114 consecutive patients were included in the study. Fifty-four patients were in the obese cohort and 60 patients in the non-obese cohort. There was not a significant difference in perioperative outcomes of both the obese and non-obese patients. There were 22 obese patients (40.7%) and 33 non-obese patients (55.0%) that experienced any AE (p = 0.130). Multivariable analysis demonstrated that individuals with low muscle mass had a significantly higher likelihood for an AE than individuals with normal or high muscle mass (OR: 7.53, 95% CI: 3.05-18.60). Obesity did not have a significant effect in predicting AEs. Conclusions Obesity is not associated with perioperative AEs, 30-day readmission rates, 30-day re-operation rates, rate of discharge to a facility, or post-operative length of stay (LOS) among patients undergoing complex revision thoracolumbar spine surgery. Level of evidence III
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Affiliation(s)
- Takashi Hirase
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA. .,Texas A&M University Health Science Center College of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA.
| | - Jeremiah F Ling
- Texas A&M University Health Science Center College of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA
| | - Varan Haghshenas
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - Richard Fuld
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - David Dong
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - Darrell S Hanson
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - B Christoph Meyer
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - Rex A W Marco
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
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27
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Fasting and Fasting Mimicking Diets in Obesity and Cardiometabolic Disease Prevention and Treatment. Phys Med Rehabil Clin N Am 2022; 33:699-717. [DOI: 10.1016/j.pmr.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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28
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Abstract
Overweight and obesity adversely impact cardiac structure and function, affecting systolic and diastolic ventricular function. Epidemiologic studies have documented an obesity paradox in large heart failure cohorts, where overweight and obese individuals with established heart failure have a better short- and medium-term prognosis compared with leaner patients; this relationship is strongly impacted by level of cardiorespiratory fitness. There are implications for therapies aimed at increasing lean mass as well as weight loss and improvements in quality of diet for the prevention and treatment of heart failure and concomitant obesity to improve cardiorespiratory fitness.
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Jaroch A, Kozakiewicz M, Jaroch K, Główczewska-Siedlecka E, Bojko B, Kędziora-Kornatowska K. Untargeted Metabolomic Assay of Prefrail Older Adults after Nutritional Intervention. Metabolites 2022; 12:metabo12050378. [PMID: 35629882 PMCID: PMC9145750 DOI: 10.3390/metabo12050378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 03/30/2022] [Accepted: 04/19/2022] [Indexed: 01/25/2023] Open
Abstract
Frailty is a geriatric syndrome causing a reduction in the body’s functional reserves. Proper nutrition may be helpful in delaying transitioning older adults from pre-frail to frailty syndrome. The present study evaluates the nutritional status of pre-frail patients who underwent nutritional intervention and metabolomic changes resulting from this intervention. Sixteen pre-frail patients (68.4 ± 5.5 years old; 81.3% women) were enrolled for nutritional intervention, and twenty-nine robust elderly people (69.3 ± 5.3 years old; 82.8% women) were the control group. Pre-frail patients consumed 1.0 g protein/kg BW/day for eight weeks through diet modification and an additional daily intake of a protein powder formula. Taken measurements included: Nutritional anthropometry, assessment of food intake, and blood serum analysis with an untargeted metabolomic assessment. Protein consumption increased by 25.8%; moreover, significant increases in body weight (+1.2 kg; p = 0.023) and muscle mass index (+0.1 kg/m2; p = 0.042) were also observed. The untargeted metabolomic assay showed a significant increase in arachidonic acid (p = 0.038), and valine (p = 0.008) among pre-frail patients. Increased protein consumption is reflected in improved anthropometric and biochemical parameters of pre-frail patients. Moreover, metabolomic assay can be a useful tool in determining compliance with dietary recommendations.
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Affiliation(s)
- Alina Jaroch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-626 Bydgoszcz, Poland;
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (E.G.-S.); (K.K.-K.)
| | - Mariusz Kozakiewicz
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (E.G.-S.); (K.K.-K.)
| | - Karol Jaroch
- Department of Pharmacodynamics and Molecular Pharmacology, Faculty of Pharmacy, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-089 Bydgoszcz, Poland;
| | - Emilia Główczewska-Siedlecka
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (E.G.-S.); (K.K.-K.)
| | - Barbara Bojko
- Department of Pharmacodynamics and Molecular Pharmacology, Faculty of Pharmacy, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-089 Bydgoszcz, Poland;
- Correspondence:
| | - Kornelia Kędziora-Kornatowska
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland; (M.K.); (E.G.-S.); (K.K.-K.)
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Soares RN, Ramirez-Perez FI, Cabral-Amador FJ, Morales-Quinones M, Foote CA, Ghiarone T, Sharma N, Power G, Smith JA, Rector RS, Martinez-Lemus LA, Padilla J, Manrique-Acevedo C. SGLT2 inhibition attenuates arterial dysfunction and decreases vascular F-actin content and expression of proteins associated with oxidative stress in aged mice. GeroScience 2022; 44:1657-1675. [PMID: 35426600 PMCID: PMC9213629 DOI: 10.1007/s11357-022-00563-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/02/2022] [Indexed: 02/07/2023] Open
Abstract
Aging of the vasculature is characterized by endothelial dysfunction and arterial stiffening, two key events in the pathogenesis of cardiovascular disease (CVD). Treatment with sodium glucose transporter 2 (SGLT2) inhibitors is now known to decrease cardiovascular morbidity and mortality in type 2 diabetes. However, whether SGLT2 inhibition attenuates vascular aging is unknown. We first confirmed in a cohort of adult subjects that aging is associated with impaired endothelial function and increased arterial stiffness and that these two variables are inversely correlated. Next, we investigated whether SGLT2 inhibition with empagliflozin (Empa) ameliorates endothelial dysfunction and reduces arterial stiffness in aged mice with confirmed vascular dysfunction. Specifically, we assessed mesenteric artery endothelial function and stiffness (via flow-mediated dilation and pressure myography mechanical responses, respectively) and aortic stiffness (in vivo via pulse wave velocity and ex vivo via atomic force microscopy) in Empa-treated (14 mg/kg/day for 6 weeks) and control 80-week-old C57BL/6 J male mice. We report that Empa-treated mice exhibited improved mesenteric endothelial function compared with control, in parallel with reduced mesenteric artery and aortic stiffness. Additionally, Empa-treated mice had greater vascular endothelial nitric oxide synthase activation, lower phosphorylated cofilin, and filamentous actin content, with downregulation of pathways involved in production of reactive oxygen species. Our findings demonstrate that Empa improves endothelial function and reduces arterial stiffness in a preclinical model of aging, making SGLT2 inhibition a potential therapeutic alternative to reduce the progression of CVD in older individuals.
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Affiliation(s)
| | | | | | | | - Christopher A. Foote
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO USA
| | - Thaysa Ghiarone
- Department of Medicine, University of Missouri, Columbia, MO USA
| | - Neekun Sharma
- Department of Medicine, University of Missouri, Columbia, MO USA
| | - Gavin Power
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO USA
| | - James A. Smith
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO USA
| | - R. Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO USA ,Research Service, Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO USA ,Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, MO USA
| | - Luis A. Martinez-Lemus
- Department of Medicine, University of Missouri, Columbia, MO USA ,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO USA ,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO USA ,Department of Biomedical, Biological and Chemical Engineering, University of Missouri, Columbia, MO USA
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO USA ,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO USA
| | - Camila Manrique-Acevedo
- Research Service, Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO USA ,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO USA ,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Missouri, Columbia, MO USA
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31
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Tamiya H, Imura Y, Wakamatsu T, Takenaka S. Comorbidity, body mass index, and performance status as prognostic factors in older patients with soft-tissue sarcoma. J Geriatr Oncol 2022; 13:673-681. [DOI: 10.1016/j.jgo.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
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32
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Bae EH, Oh TR, Suh SH, Yang EM, Choi HS, Kim CS, Ma SK, Kim B, Han KD, Kim SW. Underweight and Weight Change Increases End-Stage Renal Disease Risk in Patients with Diabetes: A Nationwide Population-Based Cohort Study. Nutrients 2021; 14:nu14010154. [PMID: 35011029 PMCID: PMC8747041 DOI: 10.3390/nu14010154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 12/23/2022] Open
Abstract
Weight variability has known as a risk factor for cardiovascular events and mortality. However, its effect on end-stage renal disease (ESRD) development remains controversial. We investigated the relationship between weight change and ESRD risk. Overall, 97,029 patients with DM aged >20 years were selected from the Korean National Health Screening Program 2009–2012. Weight change was defined as differences in body weight from the index year to 2 years later. Newly diagnosed ESRD was observed until 2017 end. Over a 5.1-year median follow-up period, ESRD was newly diagnosed in 7932 (4.81%) DM patients. BMI < 18.5 kg/m2 and waist circumferences <85/80 and >100/95 cm were ESRD risk factors. ESRD risk increased with increasing weight change; ≥10% weight loss (hazard ratio [HR], 1.247) followed by ≥10% weight gain (1.247) was associated with a higher HR than ≤5% weight change after adjusting for several confounding factors. The association between weight change and ESRD risk in a subgroup analysis was significantly stronger in patients aged <65 years, without proteinuria, with BMI ≥ 25, with DM duration <5 years, and prescribed less than 3 classes of DM medication. Underweight patients showed higher ESRD risks than overweight patients. Weight loss >10% was associated with the fastest decline in renal function.
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Affiliation(s)
- Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Eun Mi Yang
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 06978, Korea;
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 06978, Korea;
- Correspondence: (K.-D.H.); (S.W.K.); Tel.: +82-2-820-7025 (K.-D.H.); +82-62-220-6271 (S.W.K.); Fax: +82-2-823-1746 (K.-D.H.); +82-62-225-8578 (S.W.K.)
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, 42 Jebongro, Gwangju 61469, Korea; (E.H.B.); (T.R.O.); (S.H.S.); (E.M.Y.); (H.S.C.); (C.S.K.); (S.K.M.)
- Department of Internal Medicine, Chonnam National University Hospital, 42 Jebongro, Gwangju 61469, Korea
- Correspondence: (K.-D.H.); (S.W.K.); Tel.: +82-2-820-7025 (K.-D.H.); +82-62-220-6271 (S.W.K.); Fax: +82-2-823-1746 (K.-D.H.); +82-62-225-8578 (S.W.K.)
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33
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Wang J, Xu L, Huang S, Hui Q, Shi X, Zhang Q. Low muscle mass and Charlson comorbidity index are risk factors for short-term postoperative prognosis of elderly patients with gastrointestinal tumor: a cross-sectional study. BMC Geriatr 2021; 21:730. [PMID: 34949161 PMCID: PMC8705191 DOI: 10.1186/s12877-021-02683-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/26/2021] [Indexed: 01/06/2023] Open
Abstract
Background Sarcopenia is one of the most frequent syndromes in older adults and one of its main characteristics is low muscle mass. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of low muscle mass in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between low muscle mass and short-term postoperative prognosis. Method A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate low muscle mass. Short-term postoperative complications and length of stay were considered as short-term outcomes of this study. Results Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of low muscle mass, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of low muscle mass. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Low muscle mass and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in older adults with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay. Conclusions Low muscle mass and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.
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Affiliation(s)
- Jiaqiu Wang
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Liqian Xu
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Shunmei Huang
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Quan Hui
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Xuexue Shi
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China
| | - Qin Zhang
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China. .,Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Raod, Hangzhou, Zhejiang, 310003, People's Republic of China.
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Nwanaji-Enwerem JC, Chung FFL, Van der Laan L, Novoloaca A, Cuenin C, Johansson H, Bonanni B, Hubbard AE, Smith MT, Hartman SJ, Cardenas A, Sears DD, Herceg Z. An epigenetic aging analysis of randomized metformin and weight loss interventions in overweight postmenopausal breast cancer survivors. Clin Epigenetics 2021; 13:224. [PMID: 34920739 PMCID: PMC8684118 DOI: 10.1186/s13148-021-01218-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
Metformin and weight loss relationships with epigenetic age measures-biological aging biomarkers-remain understudied. We performed a post-hoc analysis of a randomized controlled trial among overweight/obese breast cancer survivors (N = 192) assigned to metformin, placebo, weight loss with metformin, or weight loss with placebo interventions for 6 months. Epigenetic age was correlated with chronological age (r = 0.20-0.86; P < 0.005). However, no significant epigenetic aging associations were observed by intervention arms. Consistent with published reports in non-cancer patients, 6 months of metformin therapy may be inadequate to observe expected epigenetic age deceleration. Longer duration studies are needed to better characterize these relationships.Trial Registration: Registry Name: ClincialTrials.Gov.Registration Number: NCT01302379.Date of Registration: February 2011.URL: https://clinicaltrials.gov/ct2/show/NCT01302379.
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Affiliation(s)
- Jamaji C Nwanaji-Enwerem
- Department of Emergency Medicine, Gangarosa Department of Environmental Health, Emory University School of Medicine, Emory Rollins School of Public Health, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA.
- Division of Environmental Health Sciences, School of Public Health and Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA.
| | - Felicia Fei-Lei Chung
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Lars Van der Laan
- Division of Environmental Health Sciences, School of Public Health and Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Alexei Novoloaca
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Cyrille Cuenin
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Harriet Johansson
- Division of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, Via Ripamonti, 435 - 20141, Milan, Italy
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, Via Ripamonti, 435 - 20141, Milan, Italy
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Alan E Hubbard
- Division of Environmental Health Sciences, School of Public Health and Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Martyn T Smith
- Division of Environmental Health Sciences, School of Public Health and Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health, University of California, San Diego, CA, USA
- Moores Cancer Center, University of California, San Diego, CA, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health and Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Dorothy D Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Moores Cancer Center, University of California, San Diego, CA, USA
- Department Medicine, University of California, San Diego, CA, USA
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
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Lee M, Damhorst ML. Women's body image throughout the adult life span: a living history approach. J Women Aging 2021; 34:810-827. [PMID: 34890533 DOI: 10.1080/08952841.2021.2015197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Based on the life course perspective, this study used a mixed method approach to (1) arrive at a deeper understanding of body image in each of three adult life stages among older white women living in a Midwest state of the United States of America, (2) investigate how these women's body images have changed during aging, and (3) identify major life transitions affecting women's body image throughout the adult life span. This study used retrospective, self-reported data. Both open-ended and scale ratings questions were incorporated into the paper-based survey questionnaire. Older white women (n = 102) aged 65 to 94 years completed a survey questionnaire. Written responses to seven open-ended questions assessing the older women's past and current body images were analyzed, and 14 themes emerged. A quantitative scale of body satisfaction with five body attributes was included to provide a validity check with written responses. The women's body images significantly changed across the adult life span, reflecting different body concerns and evaluations at each life stage. This study revealed contrasting results to previous cross-generational comparisons which concluded that women's perceived level of body satisfaction remains stable through life. Many of the women expressed some degree of positive body image at all stages but became less satisfied with several aspects of their bodies as they aged, including aging appearance, decline in physical function, and several health problems. The study provided a general picture of white women's body image development throughout the adult life span.
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Affiliation(s)
- Minsun Lee
- Department of Fashion Design, Konkuk University, Seoul, South Korea
| | - Mary Lynn Damhorst
- Department of Apparel, Events, and Hospitality Management, Iowa State University, Ames, Iowa, USA
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36
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Gwin JA, Carbone JW, Rodriguez NR, Pasiakos SM. Physiological Limitations of Protein Foods Ounce Equivalents and the Underappreciated Role of Essential Amino Acid Density in Healthy Dietary Patterns. J Nutr 2021; 151:3276-3283. [PMID: 34386826 DOI: 10.1093/jn/nxab262] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/03/2021] [Accepted: 07/15/2021] [Indexed: 11/14/2022] Open
Abstract
Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein quality should be emphasized as a key characteristic during protein food selection within the larger context of healthy dietary patterns, especially when considering the wide variance of protein quality across animal- and plant-based foods. However, the USDA Dietary Guidelines for Americans (DGA) do not address specific protein quality recommendations within their protein foods ounce equivalents guidance or as a component of Healthy U.S. Style, Healthy Vegetarian, and Healthy Mediterranean Style dietary patterns. In addition, the protein foods ounce equivalents within the DGA are not established on any obvious metabolic equivalency characteristic [i.e., energy, protein, or essential amino acid (EAA) content], which creates misleading messaging of equivalent functional and metabolic benefit across protein foods. EAA content is a key characteristic of protein quality and can be a practical focal point for protein intake recommendations and achieving healthy dietary patterns. This review discusses the importance of protein quality, the state of messaging within DGA recommendations, and proposes EAA density (i.e., EAA content relative to total energy) as one practical approach to improve current dietary recommendations. Two recent publications that evaluated the DGA protein foods ounce equivalents based on metabolic effect and their application within DGA recommended dietary patterns are discussed.
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Affiliation(s)
- Jess A Gwin
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - John W Carbone
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI, USA
| | - Nancy R Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA
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Jiang LL, Xu XH, Luo MH, Wang HY, Ding B, Yan RN, Hu Y, Ma JH. Association of Acarbose with Decreased Muscle Mass and Function in Patients with Type 2 Diabetes: A Retrospective, Cross-Sectional Study. Diabetes Ther 2021; 12:2955-2969. [PMID: 34542866 PMCID: PMC8521566 DOI: 10.1007/s13300-021-01151-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/02/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Prevalence of sarcopenia has increased in patients with type 2 diabetes. The influence of glucose-lowering drugs on muscles in these patients remains unclear. We aimed to investigate the association between muscle mass/function and glucose-lowering drugs. METHODS Data of 1042 hospitalized patients with type 2 diabetes were included in this retrospective, cross-sectional study. All the patients had stable hypoglycemic therapy in the last 3 months, and performed bioelectrical impedance analysis, grip strength, and gait speed tests on admission. RESULTS Skeletal muscle index [6.81 (95% CI 6.67, 6.94) vs. 7.17 (7.09, 7.24) kg/m2], handgrip strength [23.41 (22.24, 24.58) vs. 26.93 (26.33, 27.54) kg], and gait speed [1.19 (1.15, 1.22) vs. 1.27 (1.25, 1.28) m/s] decreased in patients using acarbose compared with the others (all p < 0.001). Gait speed and skeletal muscle index remained lower in patients using acarbose compared to their matched patients in propensity score matching (p = 0.036 and 0.010, respectively). Among drug-naïve patients and patients using insulin, metformin, sulfonylureas, or acarbose monotherapy, the acarbose group had lowest skeletal muscle index and handgrip strength [6.81 (6.52, 7.11) kg/m2 and 22.54 (19.28, 25.79) kg, p = 0.028 and 0.001, respectively]. CONCLUSION Acarbose treatment was associated with decreased muscle mass and strength. Assessment and exercise of muscles in patients with long-term acarbose treatment should be considered.
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Affiliation(s)
- Lan-lan Jiang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Xiao-hua Xu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Meng-hui Luo
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Hui-ying Wang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Bo Ding
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Reng-na Yan
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Yun Hu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
| | - Jian-hua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqingtuan Road, Nanjing, 210012 Jiangsu China
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Gandhi GY, Mooradian AD. Clinical Considerations for Insulin Therapy in Older Adults with Type 1 Diabetes. Drugs Aging 2021; 39:23-37. [PMID: 34664212 DOI: 10.1007/s40266-021-00900-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 02/07/2023]
Abstract
Type 1 diabetes represents an autoimmune condition with a strong inherited background, and its incidence is increasing worldwide. About 25% of such cases are diagnosed in adulthood, some even as late as the ninth decade of life. The number of older adults with type 1 diabetes is increasing due to improvements in care and decreased mortality rate. However, there is a lack of clinical trials in people older than 70 years of age with type 1 diabetes complicated with comorbidities, frailty, and dependency. The management of type 1 diabetes and the goals of therapy should be individualized based on the patient's health status and life expectancy. In healthier older adults, insulin treatment regimens (multiple daily insulin injections or insulin pump therapy) that approximate the normal physiology of insulin secretion should be used to achieve lower glycemic goals, while reducing the risk of hypoglycemia with frequent glucose monitoring (preferably using continuous glucose monitoring systems). For frail individuals with poor health, simpler insulin regimens and less stringent glycemic targets would be more appropriate. Poor cognition, vision and hearing, impaired mobility, depression, and chronic pain can interfere with complex insulin regimens. In these individuals, the principal goals of therapy are to reduce the acute effects of hyperglycemia, minimize hypoglycemia risk, and optimize quality of life. The newer insulin preparations and technological advances in insulin delivery and blood glucose monitoring have enhanced the management of type 1 diabetes in all age groups.
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Affiliation(s)
- Gunjan Y Gandhi
- Division of Endocrinology, Department of Medicine, University of Florida College of Medicine-Jacksonville, 653-1 West 8th Street, 4th Floor-LRC, Jacksonville, FL, 32209, USA
| | - Arshag D Mooradian
- Division of Endocrinology, Department of Medicine, University of Florida College of Medicine-Jacksonville, 653-1 West 8th Street, 4th Floor-LRC, Jacksonville, FL, 32209, USA.
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Wu KC, Ewing SK, Li X, Sigurðsson S, Guðnason V, Kado DM, Hue TF, Woods GN, Veldhuis-Vlug AG, Vittinghoff E, Zaidi M, Rosen CJ, Lang T, Kim TY, Schwartz AV, Schafer AL. FSH Level and Changes in Bone Mass and Body Composition in Older Women and Men. J Clin Endocrinol Metab 2021; 106:2876-2889. [PMID: 34212197 PMCID: PMC8475206 DOI: 10.1210/clinem/dgab481] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Indexed: 01/02/2023]
Abstract
CONTEXT FSH may have independent actions on bone remodeling and body fat regulation. Cross-sectionally, we have shown that serum FSH is associated with bone mineral density (BMD) and body fat in older postmenopausal women, but it remains unknown whether FSH predicts bone and fat changes. OBJECTIVE We examined whether baseline FSH level is associated with subsequent bone loss or body composition changes in older adults. SETTING, DESIGN, PARTICIPANTS We studied 162 women and 158 men (mean age 82 ± 4 years) from the Age, Gene/Environment Susceptibility (AGES)-Bone Marrow Adiposity cohort, a substudy of the AGES-Reykjavik Study of community-dwelling older adults. Skeletal health and body composition were characterized at baseline and 3 years later. MAIN OUTCOMES Annualized change in BMD and body composition by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). Models were adjusted for serum estradiol and testosterone levels. RESULTS There was no evidence for an association between baseline FSH level and change in BMD or body composition by DXA or QCT. For femoral neck areal BMD, adjusted mean difference (95% CI) per SD increase in FSH was 1.3 (-0.7 to 3.3) mg/cm2/y in women, and -0.2 (-2.6 to 2.2) mg/cm2/y in men. For visceral fat, adjusted mean difference (95% CI) per SD increase in FSH was 1.80 (-0.03 to 3.62) cm2/y in women, and -0.33 (-3.73 to 3.06) cm2/y in men. CONCLUSIONS Although cross-sectional studies and studies in perimenopausal women have demonstrated associations between FSH and BMD and body composition, in older adults, FSH level is not associated with bone mass or body composition changes.
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Affiliation(s)
- Karin C Wu
- Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
- Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
- Correspondence: Karin C. Wu, MD, 1700 Owens St., RM 349, San Francisco, CA 94158, USA.
| | - Susan K Ewing
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Xiaojuan Li
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH 44195, USA
| | | | - Vilmundur Guðnason
- Icelandic Heart Association Research Institute, 201 Kópavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Deborah M Kado
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
- Geriatric Research Education and Clinical Center, Veterans Affairs Health Care System, Palo Alto, CA 94304, USA
| | - Trisha F Hue
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Gina N Woods
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Annegreet G Veldhuis-Vlug
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, ME 04074, USA
- Center for Bone Quality, Department of Endocrinology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Mone Zaidi
- The Mount Sinai Bone Program and Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Clifford J Rosen
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, ME 04074, USA
| | - Thomas Lang
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
| | - Tiffany Y Kim
- Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
- Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Anne L Schafer
- Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
- Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94143, USA
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Delaire L, Courtay A, Fauvernier M, Humblot J, Bonnefoy M. Integrating a Prevention Care Path into the Daily Life of Older Adults with Mobility Disability Risk: Introducing a Predictive Response Model to Exercise. Clin Interv Aging 2021; 16:1617-1629. [PMID: 34531652 PMCID: PMC8439386 DOI: 10.2147/cia.s315112] [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: 04/16/2021] [Accepted: 07/15/2021] [Indexed: 01/16/2023] Open
Abstract
Introduction Exercise and nutrition are the best targets to tackle mobility issues in community-dwelling older adults. As exercise response relies on multiple factors, improving the understanding of their interactions is a necessity to tailor effective preventive strategies. Based on a prevention care path designed for community-dwelling older adults with mobility disability risk, our main goal was to determine the predictive factors of the response to a multimodal intervention, combining structured exercise training and nutritional counselling. Thus, this study aimed to tailor prevention programs for non-responder participants. Methods We analyzed the response of participants to a prevention program and built a multivariate predictive model to highlight the profile of the best responders. The model was based on the likelihood of at least 1 point of short physical performance battery (SPPB) score gain. Inclusion criteria were being aged ≥70 years and having completed a multicomponent group-based supervised training consisting of 20 sessions (10 weeks). Results A total of 103 participants were included, their mean ± SD age was 81.9 ± 5.7 years. The model demonstrated interactions between baseline SPPB score (OR=0.42; p < 0.001), body mass index (BMI; OR=0.82; p=0.003), and grip strength value (OR=1.15; p=0.008). The highest probability of response was found for participants with low SPPB, normal BMI (21 kg/m2), and high grip strength (27 kg). Conclusion This study demonstrated that the response to a multimodal intervention in community-dwelling older adults with mobility disability risk was influenced by the baseline SPPB score, BMI, and grip strength value. To increase the proportion of responders, strategies that could be more effective include constituting more homogenous group, and implementing a specific approach for obese sarcopenic older adults and those with low grip strength by increasing the dose of physical activity and monitoring endurance and mobility activities between sessions. Our results provide important consideration for the development of targeted-interventions.
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Affiliation(s)
- Leo Delaire
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de médecine du vieillissement, Pierre-Bénite, cedex F-69495, France
| | - Aymeric Courtay
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de médecine du vieillissement, Pierre-Bénite, cedex F-69495, France
| | - Mathieu Fauvernier
- UMR CNRS 5558, Université Claude Bernard Lyon 1, Villeurbanne, 69100, France.,Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Biostatistique - Bioinformatique, Pierre-Bénite, cedex F-69495, France
| | - Joannès Humblot
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de médecine du vieillissement, Pierre-Bénite, cedex F-69495, France
| | - Marc Bonnefoy
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de médecine du vieillissement, Pierre-Bénite, cedex F-69495, France.,Inserm 1060-CarMeN, Université Claude Bernard Lyon 1, Villeurbanne, 69100, France.,Université Claude Bernard Lyon 1, Villeurbanne, 69100, France
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Golubnitschaja O, Liskova A, Koklesova L, Samec M, Biringer K, Büsselberg D, Podbielska H, Kunin AA, Evsevyeva ME, Shapira N, Paul F, Erb C, Dietrich DE, Felbel D, Karabatsiakis A, Bubnov R, Polivka J, Polivka J, Birkenbihl C, Fröhlich H, Hofmann-Apitius M, Kubatka P. Caution, "normal" BMI: health risks associated with potentially masked individual underweight-EPMA Position Paper 2021. EPMA J 2021; 12:243-264. [PMID: 34422142 PMCID: PMC8368050 DOI: 10.1007/s13167-021-00251-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 02/06/2023]
Abstract
An increasing interest in a healthy lifestyle raises questions about optimal body weight. Evidently, it should be clearly discriminated between the standardised "normal" body weight and individually optimal weight. To this end, the basic principle of personalised medicine "one size does not fit all" has to be applied. Contextually, "normal" but e.g. borderline body mass index might be optimal for one person but apparently suboptimal for another one strongly depending on the individual genetic predisposition, geographic origin, cultural and nutritional habits and relevant lifestyle parameters-all included into comprehensive individual patient profile. Even if only slightly deviant, both overweight and underweight are acknowledged risk factors for a shifted metabolism which, if being not optimised, may strongly contribute to the development and progression of severe pathologies. Development of innovative screening programmes is essential to promote population health by application of health risks assessment, individualised patient profiling and multi-parametric analysis, further used for cost-effective targeted prevention and treatments tailored to the person. The following healthcare areas are considered to be potentially strongly benefiting from the above proposed measures: suboptimal health conditions, sports medicine, stress overload and associated complications, planned pregnancies, periodontal health and dentistry, sleep medicine, eye health and disorders, inflammatory disorders, healing and pain management, metabolic disorders, cardiovascular disease, cancers, psychiatric and neurologic disorders, stroke of known and unknown aetiology, improved individual and population outcomes under pandemic conditions such as COVID-19. In a long-term way, a significantly improved healthcare economy is one of benefits of the proposed paradigm shift from reactive to Predictive, Preventive and Personalised Medicine (PPPM/3PM). A tight collaboration between all stakeholders including scientific community, healthcare givers, patient organisations, policy-makers and educators is essential for the smooth implementation of 3PM concepts in daily practice.
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Affiliation(s)
- Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
| | - Alena Liskova
- Clinic of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Comenius University, in Bratislava, 03601 Martin, Slovakia
| | - Lenka Koklesova
- Clinic of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Comenius University, in Bratislava, 03601 Martin, Slovakia
| | - Marek Samec
- Clinic of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Comenius University, in Bratislava, 03601 Martin, Slovakia
| | - Kamil Biringer
- Clinic of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Comenius University, in Bratislava, 03601 Martin, Slovakia
| | - Dietrich Büsselberg
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, 24144 Doha, Qatar
| | - Halina Podbielska
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wrocław University of Science and Technology, 50-370 Wrocław, Poland
| | - Anatolij A. Kunin
- Departments of Maxillofacial Surgery and Hospital Dentistry, Voronezh N.N. Burdenko State Medical University, Voronezh, Russian Federation
| | | | - Niva Shapira
- Nutrition Department, Ashkelon Academic College, Ashkelon, Tel Aviv, Israel
| | - Friedemann Paul
- NeuroCure Clinical Research Centre, Experimental and Clinical Research Centre, Max Delbrueck Centre for Molecular Medicine and Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - Carl Erb
- Private Institute of Applied Ophthalmology, Berlin, Germany
| | - Detlef E. Dietrich
- European Depression Association, Brussels, Belgium
- AMEOS Clinical Centre for Psychiatry and Psychotherapy, 31135 Hildesheim, Germany
| | - Dieter Felbel
- Fachklinik Kinder und Jugendliche Psychiatrie, AMEOS Klinikum Hildesheim, Akademisches Lehrkrankenhaus für Pflege der FOM Hochschule Essen, Hildesheim, Germany
| | - Alexander Karabatsiakis
- Institute of Psychology, Department of Clinical Psychology II, University of Innsbruck, Innsbruck, Austria
| | - Rostyslav Bubnov
- Ultrasound Department, Clinical Hospital “Pheophania”, Kyiv, Ukraine
- Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Jiri Polivka
- Department of Neurology, Faculty of Medicine in Pilsen, Charles University and University Hospital Pilsen, Pilsen, Czech Republic
| | - Jiri Polivka
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Staré Město, Czech Republic
| | - Colin Birkenbihl
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Schloss Birlinghoven, 53757 Sankt Augustin, Germany
- Bonn-Aachen International Centre for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, 53115 Bonn, Germany
| | - Holger Fröhlich
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Schloss Birlinghoven, 53757 Sankt Augustin, Germany
- Bonn-Aachen International Centre for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, 53115 Bonn, Germany
- UCB Biosciences GmbH, Alfred-Nobel Str. 10, 40789 Monheim am Rhein, Germany
| | - Martin Hofmann-Apitius
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Schloss Birlinghoven, 53757 Sankt Augustin, Germany
- Bonn-Aachen International Centre for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, 53115 Bonn, Germany
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
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Suh J, Cho YJ, Kim HJ, Choi SS. Age-Related Difference in Weight Change and All-Cause Mortality in Middle-Aged and Older Korean Populations: Korean Longitudinal Study of Aging. Korean J Fam Med 2021; 42:297-302. [PMID: 34320797 PMCID: PMC8321903 DOI: 10.4082/kjfm.20.0170] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background Obesity is associated with increased mortality as a significant risk factor for chronic diseases, including cardiovascular diseases and cancer. Several people believe that weight gain is harmful, and weight loss helps maintain health. However, some studies have shown that weight loss, particularly among older adults, is more likely to increase the risk of mortality than weight gain. Methods We used data for the cohort of the Korean Longitudinal Study of Aging, which is a nationwide stratified multi-stage sample of adults aged 45 years. The all-cause mortality risk was assessed using the survival status and the number of months of survival calculated from 2006 (baseline year) to 2016. Cox proportional hazard regression were used to study the causal link between weight change and all-cause mortality risk. Results The results showed interactive associations between weight loss and mortality among middle-aged and older adults. The hazard ratio was 1.62 (95% confidence interval [CI], 1.10–2.40) for the participants aged 45–65 years with weight losses greater than 5 kg and 1.56 (95% CI, 1.29–1.89) for those older than 65 years with weight losses greater than 5 kg. The results for the group with weight gain above 5 kg were not significant. Middle-aged and older men showed an increase in all-cause mortality associated with weight loss of more than 5 kg, but only the older women showed significant results. Conclusion This large-scale cohort study in Korea showed a relationship between weight loss and all-cause mortality in middle-aged and older individuals.
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Affiliation(s)
- Jungki Suh
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Hyun Ji Kim
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Seong Soo Choi
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
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Karim KMR, Tasnim T, Shams SD, Zaher MA, Mamun S. Mini Nutritional Assessment and physical function of older people in residential aged care facility, Bangladesh. Nutr Health 2021; 28:443-452. [PMID: 34250851 DOI: 10.1177/02601060211030119] [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: 11/16/2022]
Abstract
BACKGROUND Malnutrition may decrease physical function and exacerbate health conditions and thus have a negative effect on health-related quality of life of older people. AIM The study was aimed at evaluating the extent of malnutrition, physical function and other associated risk factors for the older persons (>65 years) living in the residential aged care facilities in Bangladesh. METHODS A cross-sectional study was performed with a sample of 200 older people in various residential aged care facilities in Dhaka, Bangladesh. Nutritional status was evaluated using the Mini Nutritional Assessment. A structured questionnaire was used to assess the socioeconomic condition, dietary diversity, functional ability and other related risk factors for malnutrition. RESULTS According to the Mini Nutritional Assessment, 33.5% of participants living in residential aged care facilities were malnourished and 52.5% were at risk of malnutrition. Dietary diversity score differs significantly (p<0.001) among malnourished (3.78 ± 0.45), at risk of malnutrition (4.46 ± 0.98) and well-nourished (4.75 ± 1.11) groups. Twenty-five percent of the study participants reported limitations in mobility and 26.5% reported limitations in activities of daily living. Females were more vulnerable in terms of malnutrition and physical function than males. Mini Nutritional Assessment score is significantly correlated (p<0.05) with several risk factors for malnutrition such as body mass index, education level, meal, protein consumption, dietary diversity score, weight loss, reduced food intake, mobility and activities of daily living of the older people. CONCLUSIONS The study reaffirms that a high rate of malnutrition and risk of malnutrition is prevalent among aged care residents, who need special attention and may benefit from individualized nutrition interventions.
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Affiliation(s)
| | - Tasmia Tasnim
- Department of Nutrition and Food Engineering, 130058Daffodil International University, Bangladesh
| | - Sabrin Deeba Shams
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
| | | | - Sumaiya Mamun
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
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Shen W, Chen J, Zhou J, Martin CK, Ravussin E, Redman LM. Effect of 2-year caloric restriction on organ and tissue size in nonobese 21- to 50-year-old adults in a randomized clinical trial: the CALERIE study. Am J Clin Nutr 2021; 114:1295-1303. [PMID: 34159359 PMCID: PMC8645192 DOI: 10.1093/ajcn/nqab205] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sustained calorie restriction (CR) promises to extend the lifespan. The effect of CR on changes in body mass across tissues and organs is unclear. OBJECTIVES We used whole-body MRI to evaluate the effect of 2 y of CR on changes in body composition. METHODS In an ancillary study of the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial, 43 healthy adults [25-50 y; BMI (kg/m2): 22-28] randomly assigned to 25% CR (n = 28) or ad libitum (AL) eating (n = 15) underwent whole-body MRI at baseline and month 24 to measure adipose tissue in subcutaneous, visceral, and intermuscular depots (SAT, VAT, and IMAT, respectively); skeletal muscle; and organs including brain, liver, spleen, and kidneys but not heart. RESULTS The CR group lost more adipose tissue and lean tissue than controls (P < 0.05). In the CR group, at baseline, total tissue volume comprised 32.1%, 1.9%, and 1.0% of SAT, VAT, and IMAT, respectively. The loss of total tissue volume over 24 mo comprised 68.4%, 7.4%, and 2.2% of SAT, VAT, and IMAT, respectively, demonstrating preferential loss of fat vs. lean tissue. Although there is more muscle loss in CR than AL (P < 0.05), the loss of muscle over 24 mo in the CR group comprised only 17.2% of the loss of total tissue volume. Changes in organ volumes were not different between CR and AL. The degree of CR (% decrease in energy intake vs. baseline) significantly (P < 0.05) affected changes in VAT, IMAT, muscle, and liver volume (standardized regression coefficient ± standard error of estimates: 0.43 ± 0.15 L, 0.40 ± 0.19 L, 0.55 ± 0.17 L, and 0.45 ± 0.18 L, respectively). CONCLUSIONS Twenty-four months of CR (intended, 25%; actual, 13.7%) in young individuals without obesity had effects on body composition, including a preferential loss of adipose tissue, especially VAT, over the loss of muscle and organ tissue. This trial was registered at www.clinicaltrials.gov as NCT02695511.
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Affiliation(s)
- Wei Shen
- Address correspondence to WS (e-mail: )
| | - Jun Chen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Irving Medical Center, New York, NY, USA
| | - Jane Zhou
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Irving Medical Center, New York, NY, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Arigo D, Ainsworth MC, Pasko K, Brown MM, Travers L. Predictors of change in BMI over 10 years among midlife and older adults: Associations with gender, CVD risk status, depressive symptoms, and social support. Soc Sci Med 2021; 279:113995. [PMID: 33993009 PMCID: PMC8393364 DOI: 10.1016/j.socscimed.2021.113995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/10/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Change in BMI is recognized as a key health indicator among midlife and older adults, though predictors of BMI change in this group have received little attention. OBJECTIVE The aim of this study was to examine relations between hypothesized predictors (i.e., gender, cardiovascular disease [CVD] risk status, depressive symptoms, social support) and BMI change over 10 years, among midlife and older adults. METHODS Participants were adults ages 50-74 at baseline (N = 5,688, 64% women) who completed four assessments over 10 years. Gender, CVD risk status (i.e., diagnosis of hypertension, type 2 diabetes, or both), depressive symptoms, and perceived social support were assessed at baseline, and BMI was calculated from height and weight reports at all assessments. Multilevel models tested for concurrent and prospective relations between predictors and BMI change (effect size estimates as semipartial correlation coefficients, sr), as well as whether observed relations were further moderated by baseline BMI category (underweight, healthy weight, overweight, or obese). RESULTS Baseline BMI was higher among those with (vs. without) CVD risk, higher (vs. lower) depressive symptoms, and lower (vs. higher) social support; all of these relations were moderated by gender (ps < 0.05, srs 0.03-0.32). Moreover, BMI showed significant change over 10 years, and BMI variability during this time was higher among women (vs. men) and those with (vs. without) CVD risk (ps < 0.0001). BMI change also differed by CVD risk status, and this relation was moderated by gender, baseline depressive symptoms, and baseline BMI category (ps < 0.05, srs 0.03-0.08). CONCLUSIONS Although the predictors of interest were not associated with steady BMI decreases (which are associated with long term health risks for older adults), findings reveal unique patterns of change in BMI among subgroups of midlife and older adults, and may allow for early identification of those with noteworthy BMI changes after age 50.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA; Department of Family Medicine, Rowan School of Osteopathic Medicine, One Medical Center Drive, Stratford, NJ, 08084, USA.
| | - M Cole Ainsworth
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
| | - Kristen Pasko
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
| | - Megan M Brown
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
| | - Laura Travers
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA.
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Diet quality in middle-aged and older women with and without body weight dissatisfaction: results from a population-based national nutrition survey in Switzerland. J Nutr Sci 2021; 10:e38. [PMID: 34367623 PMCID: PMC8342191 DOI: 10.1017/jns.2021.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 01/13/2023] Open
Abstract
Body weight dissatisfaction is associated with unhealthy dietary behaviours in young adults, but data are scarce regarding how this relationship evolves with age. The objectives of the present study were to assess the prevalence of body weight dissatisfaction and the association between body weight dissatisfaction, nutrient intake and diet quality in middle-aged and older women. We used data of a population-based sample of 468 middle-aged (50–64 y/o) and older (65–75 y/o) women, extracted from the cross-sectional 2014–15 Swiss National Nutrition Survey. Body weight dissatisfaction was assessed by questionnaire. Dietitians assessed dietary intakes using two non-consecutive computer-assisted multi-pass 24-h dietary recalls and performed anthropometric measurements. Nutrient intakes were calculated and compared with national dietary guidelines, and diet quality scored with the 2010 Alternate Healthy Eating Index (2010-AHEI). 41⋅1 % of women reported body weight dissatisfaction, and 49⋅8 % wanted to lose weight. Body weight dissatisfaction was associated with weight loss desire and a higher body mass index (BMI; P < 0⋅001). Women with body weight dissatisfaction consumed significantly less carbohydrates and dietary fibres, even when BMI was controlled for (P < 0⋅05). They also fell short of national dietary guidelines for magnesium and iron. Body weight dissatisfied women obtained lower 2010-AHEI scores than satisfied women (β −4⋅36, 95 % CI −6⋅78, −1⋅93). However, this association disappeared when the BMI was introduced in the equation. This highlights the importance of targeting both body dissatisfaction and unhealthy eating in obesity prevention and treatment at all ages.
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Cornejo-Pareja I, Molina-Vega M, Gómez-Pérez AM, Damas-Fuentes M, Tinahones FJ. Factors Related to Weight Loss Maintenance in the Medium-Long Term after Bariatric Surgery: A Review. J Clin Med 2021; 10:jcm10081739. [PMID: 33923789 PMCID: PMC8073104 DOI: 10.3390/jcm10081739] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022] Open
Abstract
Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.
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Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Ana María Gómez-Pérez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
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Welzel FD, Bär J, Stein J, Löbner M, Pabst A, Luppa M, Grochtdreis T, Kersting A, Blüher M, Luck-Sikorski C, König HH, Riedel-Heller SG. Using a brief web-based 5A intervention to improve weight management in primary care: results of a cluster-randomized controlled trial. BMC FAMILY PRACTICE 2021; 22:61. [PMID: 33794781 PMCID: PMC8017625 DOI: 10.1186/s12875-021-01404-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/25/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The primary health care setting is considered a major starting point in successful obesity management. However, research indicates insufficient quality of weight counseling in primary care. Aim of the present study was to implement and evaluate a 5A online tutorial aimed at improving weight management and provider-patient-interaction in primary health care. The online tutorial is a stand-alone low-threshold minimal e-health intervention for general practitioners based on the 5As guidance for obesity management by the Canadian Obesity Network. METHODS In a cluster-randomized controlled trial, 50 primary care practices included 160 patients aged 18 to 60 years with obesity (BMI ≥ 30). The intervention practices had continuous access to the 5A online tutorial for the general practitioner. Patients of control practices were treated as usual. Primary outcome was the patients' perspective of the doctor-patient-interaction regarding obesity management, assessed with the Patient Assessment of Chronic Illness Care before and after (6/12 months) the training. Treatment effects over time (intention-to-treat) were evaluated using mixed-effects linear regression models. RESULTS More than half of the physicians (57%) wished for more training offers on obesity counseling. The 5A online tutorial was completed by 76% of the physicians in the intervention practices. Results of the mixed-effects regression analysis showed no treatment effect at 6 months and 12 months' follow-up for the PACIC 5A sum score. Patients with obesity in the intervention group scored lower on self-stigma and readiness for weight management compared to participants in the control group at 6 months' follow-up. However, there were no significant group differences for weight, quality of life, readiness to engage in weight management, self-stigma and depression at 12 months' follow-up. CONCLUSION To our knowledge, the present study provides the first long-term results for a 5A-based intervention in the context of the German primary care setting. The results suggest that a stand-alone low-threshold minimal e-health intervention for general practitioners does not improve weight management in the long term. To improve weight management in primary care, more comprehensive strategies are needed. However, due to recruitment difficulties the final sample was smaller than intended. This may have contributed to the null results. TRIAL REGISTRATION The study has been registered at the German Clinical Trials Register (Identifier: DRKS00009241 , Registered 3 February 2016).
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Affiliation(s)
- Franziska D Welzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
| | - Jonathan Bär
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Thomas Grochtdreis
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anette Kersting
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
- Department of Endocrinology, Nephrology, Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Claudia Luck-Sikorski
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
- SRH University of Applied Sciences Gera, Gera, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
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Miller MG, Starr KNP, Rincker J, Orenduff MC, McDonald SR, Pieper CF, Fruik AR, Lyles KW, Bales CW. Rationale and Design for a Higher (Dairy) Protein Weight Loss Intervention That Promotes Muscle Quality and Bone Health in Older Adults with Obesity: A Randomized, Controlled Pilot Study. J Nutr Gerontol Geriatr 2021; 40:150-170. [PMID: 33719918 PMCID: PMC9351499 DOI: 10.1080/21551197.2021.1896615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In contrast to recommendations for young and middle-aged adults, intentional weight loss among older adults remains controversial and is inconsistently advised. Recent research suggests that a higher protein diet can mitigate loss of lean mass during periods of intentional weight loss among older adults with obesity; however, the effects of intentional weight loss on skeletal muscle and bone are not fully understood. The Dairy in the Diet Yields New Approaches for Muscle Optimization (DDYNAMO) trial is a 6-month, randomized, controlled pilot study assessing the effects of combining regular, generous intakes of high quality protein (30 g/meal; primarily from dairy) with caloric restriction (-500kcal/d) and low-intensity resistance exercise (30 min/3 times per week) on muscle quality, muscle composition, bone mineral density in men and women aged ≥60 years with obesity and mild to moderate functional impairment (Short Physical Performance Battery [SPPB] score ≥4 to ≤10). Participants will be re-assessed at 18 months to evaluate weight maintenance, bone mineral density, physical function, and other secondary measures. ClinicalTrials.gov Identifier: NCT02437643.
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Affiliation(s)
- Marshall G. Miller
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Kathryn N. Porter Starr
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Jamie Rincker
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Melissa C. Orenduff
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Shelley R. McDonald
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Carl F. Pieper
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Angela R. Fruik
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Kenneth W. Lyles
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Connie W. Bales
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
- Durham VA Medical Center, Durham, NC, USA
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50
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Guest PC. New Therapeutic Approaches and Biomarkers for Increased Healthspan. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1286:1-13. [PMID: 33725342 DOI: 10.1007/978-3-030-55035-6_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Healthcare costs have increased in developing countries over the last few decades, mostly due to the escalation in average life expectancy and the concomitant increase in age-related disorders. To address this issue, widespread research is now being undertaken across the globe with the aim of finding a way of increasing healthy aging. A number of potential interventions have already shown promise, including lifestyle changes and the use of natural products or pharmaceuticals that may delay the onset of diseases associated with the aging process. In parallel, a number of potential biomarkers have already been identified that can be used for assessing risk of developing age-associated disorders and for monitoring response to therapeutic interventions. This review describes the most recent advances towards the goal of achieving healthier aging with fewer disabilities that may lead to enhanced quality of life and reduced healthcare costs around the world.
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Affiliation(s)
- Paul C Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil.
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