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Kim HK, Sagayama H, Yoshida T, Oishi K, Nakayama Y, Kimura M, Ono R, Yamada Y. Predictors of Water Turnover in Older Adults: A Doubly Labeled Water- and Triaxial Accelerometer-Based Study. J Nutr 2024; 154:1750-1757. [PMID: 38649093 DOI: 10.1016/j.tjnut.2024.04.023] [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: 12/22/2023] [Revised: 04/01/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Water is one of the most essential nutrients for life. The water turnover (WT), total body water (TBW), and total energy expenditure (TEE) can be measured using the doubly labeled water (DLW) method. WT and TBW are lower in older adults than in young adults, and the former are susceptible to dehydration, necessitating to identify predictors of the WT in older adults. OBJECTIVES The current study aimed to examine the association between WT and physical activity, physical function, and body composition in Japanese adults aged ≥65 y and identify predictors for WT in this population. METHODS This study enrolled 133 older adults (women, n = 61; men, n = 72) aged 65-88 y. WT, TBW, TEE, fat-free mass (FFM), and percent body fat (%Fat) were determined using the DLW method. The fitness age score (FAS) was obtained from 5 physical fitness tests. Physical activity and the step count were assessed using a previously validated triaxial accelerometer. Multiple regression analyses were performed with WT as the dependent variable. RESULTS WT was positively associated with weight, physical activity level (PAL), moderate-vigorous physical activity, and TEE, and negatively associated with sedentary behavior. We examined potential predictors for WT using age, sex, height, weight, FFM, %Fat, TEE, PAL, and FAS in older Japanese adults. CONCLUSIONS Our results confirmed that age, sex, weight, FFM, TEE, and PAL are the potential predictors of WT in older Japanese adults aged ≥65 y.
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Affiliation(s)
- Hyeon-Ki Kim
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Hiroyuki Sagayama
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tsukasa Yoshida
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Kan Oishi
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan; Graduate School of Health and Sports Science, Doshisha University, Kyoto, Japan; Japan Society for the Promotion of Sciences, Tokyo, Japan
| | - Yui Nakayama
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Rei Ono
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Yosuke Yamada
- National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan.
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Watanabe Y, Yamada Y, Yoshida T, Yokoyama K, Miyake M, Yamagata E, Yamada M, Yoshinaka Y, Kimura M. Comprehensive geriatric intervention in community-dwelling older adults: a cluster-randomized controlled trial. J Cachexia Sarcopenia Muscle 2020; 11:26-37. [PMID: 31997543 PMCID: PMC7015250 DOI: 10.1002/jcsm.12504] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/01/2019] [Accepted: 09/09/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND In longevity societies, one of the most serious social issues is sarcopenia and/or frailty. Preventing them is important for maintaining independence and quality of life in the older population. This study investigated the effect of a self-monitoring comprehensive geriatric intervention programme (CGIP) on physical function and muscle size in community-dwelling older adults. We compared the effects of a CGIP using weekly class-styled (CS) sessions and a home-based (HB) programme. METHODS The 526 participants were randomized into one of two groups (CS 251, HB 275) based on their residential districts. We conducted a 12 week CGIP, which consisted of low-load resistance exercise, physical activity increments, oral function improvements, and a nutritional guide. All participants were encouraged to attend two 90 min lectures that included instructions on the CGIP. They were provided with exercise materials (triaxial-accelerometers/pedometers, ankle weights, and elastic bands) and diary logs. The CS group attended 90 min weekly sessions and independently executed the programme on other days, whereas the HB group only received instructions on how to execute the programme. Physical functions, such as knee extension strength (KES), normal and maximum walking speed, the timed up-and-go test, and anterior thigh muscle thickness (MT), were measured and analysed using intention-to-treat analysis before and after the 12 week intervention. RESULTS Of the 526 participants identified, 517 (CS 243 age 74.0 ± 5.4 women 57.2%, HB 274 age 74.0 ± 5.6 women 58.8%) were enrolled. Nine (CS 8, HB 1) were excluded from the analysis because they did not participate in the pre-intervention measurements. Both interventions significantly improved KES (CS 18.5%, HB 10.6%), normal walking speed (CS 3.7%, HB 2.8%), and MT (CS 3.2%, HB 3.5%). Greater improvement of KES was observed in the CS group (P = 0.003). Maximum walking speed (CS 4.7%, HB 1.8%; P = 0.001) and timed up-and-go (CS -4.7%, HB -0.2%; P < 0.001) significantly improved in the CS group only. CONCLUSIONS The intervention was effective in preventing sarcopenia and/or frailty. Most physical functions and MT improved after both interventions. The HB intervention is cost-effective and may help prevent sarcopenia and/or frailty in the large older population.
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Affiliation(s)
- Yuya Watanabe
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yosuke Yamada
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Tsukasa Yoshida
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kameoka, Japan
| | - Keiichi Yokoyama
- Non-profit Organization Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Motoko Miyake
- Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yasuko Yoshinaka
- Non-profit Organization Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kameoka, Japan
| | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
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Watanabe D, Nanri H, Sagayama H, Yoshida T, Itoi A, Yamaguchi M, Yokoyama K, Watanabe Y, Goto C, Ebine N, Higaki Y, Ishikawa-Takata K, Kimura M, Yamada Y. Estimation of Energy Intake by a Food Frequency Questionnaire: Calibration and Validation with the Doubly Labeled Water Method in Japanese Older People. Nutrients 2019; 11:nu11071546. [PMID: 31323937 PMCID: PMC6683088 DOI: 10.3390/nu11071546] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 12/03/2022] Open
Abstract
Accurate assessments of a target population’s energy intake (EI) are essential to prevent poor nutritional status. However, self-reported dietary records (DRs) or food frequency questionnaires (FFQs) are not always accurate, thereby requiring validation and calibration studies. This study aimed to validate the EI estimated by a FFQ using the doubly labeled water (DLW) method. Participants were 109 Japanese older adults (50 women and 59 men) aged 65–88 years. The EI was obtained by a DR and 47-item FFQ over 1 year. The total energy expenditure (TEE) was measured by DLW for ~2 weeks. EI was significantly lower than TEE (p < 0.01); ratios of EI assessed by DR and FFQ against TEE were 0.91 ± 0.17 and 0.82 ± 0.22, respectively. TEE was significantly and moderately correlated with the EI estimated by the DR (r = 0.45, p < 0.01) and FFQ (r = 0.37, p < 0.01). Furthermore, the EI correlation coefficients estimated by DR and the FFQ in this study were not significantly different (p = 0.46). The EI/TEE ratio was significantly and negatively correlated with the body mass index (BMI). In conclusion, EI estimated with a DR or FFQ modestly correlated with TEE, and calibrating EI with a developed equation in this study can attenuate the underestimation of EI.
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Affiliation(s)
- Daiki Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
- Department of Pharmacology, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan
| | - Hinako Nanri
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Senior Citizen's Welfare Section, Kameoka City Government, Kyoto 621-8501, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan
| | - Aya Itoi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo 650-0046, Japan
| | - Miwa Yamaguchi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
| | - Keiichi Yokoyama
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan
| | - Yuya Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Faculty of Health and Sports Science, Doshisha University, Kyoto 610-0394, Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University, Aichi 492-8520, Japan
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha University, Kyoto 610-0394, Japan
| | - Yasuki Higaki
- Faculty of Sports and Health Science, Fukuoka University, Fukuoka 814-0180, Japan
| | - Kazuko Ishikawa-Takata
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,
| | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan,.
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto 621-8555, Japan.
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Validity of a triaxial accelerometer and simplified physical activity record in older adults aged 64-96 years: a doubly labeled water study. Eur J Appl Physiol 2018; 118:2133-2146. [PMID: 30019086 DOI: 10.1007/s00421-018-3944-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/12/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND The aim was to examine the validity of a triaxial accelerometer (ACCTRI) and a simplified physical activity record (sPAR) in estimating total energy expenditure (TEE) and physical activity level (PAL) in older adults with the doubly labeled water (DLW) method. METHODS A total of 44 Japanese elderly individuals (64-96 years), of which 28 were community-dwelling healthy adults with or without sporting habits (S or NS group) and 16 were care home residents with frailty (F group), were included in the study. Basal metabolic rate (BMR) was measured by indirect calorimetry, TEE was obtained by the DLW method, and PAL was calculated as TEE/BMR. Daily step count was monitored by a pedometer (Lifecorder). The 24-h average metabolic equivalent was assessed by ACCTRI and sPAR. RESULTS The TEEDLW in men was 2704 ± 353, 2308 ± 442, and 1795 ± 338 kcal d-1, and that in women was 2260 ± 208, 1922 ± 285, and 1421 ± 274 kcal d-1 for the S, NS, and F groups, respectively. ACCTRI and sPAR systematically underestimated actual TEE (- 14.2 ± 11.6 and - 15.3 ± 12.3% for ACCTRI and sPAR, respectively). After diet-induced thermogenesis was taken into account for ACCTRI and sPAR, TEEDLW was significantly correlated with TEEACCTRI (R2 = 0.714) and TEEsPAR (R2 = 0.668). PALDLW was also significantly correlated with PALACCTRI (R2 = 0.438) and PALsPAR (R2 = 0.402). CONCLUSIONS Age, living conditions, frailty, and sporting habits contribute to TEE and PAL in the elderly population. ACCTRI and sPAR underestimated TEE and PAL, and adequate corrections are required. The corrected ACCTRI and sPAR are both useful tools to estimate TEE and PAL.
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Watanabe Y, Yamada Y, Yokoyama K, Yoshida T, Yoshinaka Y, Yoshimoto M, Tanaka Y, Itoi A, Yamagata E, Ebine N, Ishikawa-Takata K, Kimura M. Comprehensive geriatric intervention program with and without weekly class-style exercise: research protocol of a cluster randomized controlled trial in Kyoto-Kameoka Study. Clin Interv Aging 2018; 13:1019-1033. [PMID: 29872280 PMCID: PMC5973472 DOI: 10.2147/cia.s151427] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The number of long-term care (LTC) users and the associated expenditures in Japan are increasing dramatically. The national government recommends LTC prevention through activation of communities. However, there is no clear evidence of the effect of population-based comprehensive geriatric intervention program (CGIP) for restraints of LTC users and the associated expenditures in the future. The aims of the current paper are to describe the study protocol and progress of a cluster randomized controlled trial (RCT) with a CGIP in Kameoka City. Methods The cluster RCT involved random allocation of regions as intervention (n=4,859) and nonintervention (n=7,195). Participants were elderly persons aged ≥65 years without LTC certification who had responded to a mailing survey. The residents living in intervention regions were invited to a physical check-up, and 1,463 people participated (30.3%). These individuals were invited to the CGIP, and 526 accepted. The CGIP comprised instructions on: 1) low-load resistance training using bodyweight, ankle weights, and elastic bands; 2) increasing daily physical activity; 3) oral motor exercise and care; and 4) a well-balanced diet based on a program from Ministry of Health, Labour and Welfare. We allocated the intervention regions randomly into home-based self-care program alone (HB group, 5 regions, n=275) and home-based program+weekly class-style session (CS group, 5 regions, n=251). We evaluated the effects of the CGIP at 12 weeks and at 12 or 15 months on physical function, and are conducting follow-up data collection for an indefinite period regarding LTC certification, medical costs, and mortality. Results and discussion The study was launched with good response rates in each phase. Participants of both groups significantly increased their step counts by ~1,000 per day from the baseline during the CGIP. This RCT will provide valuable information and evidence about effectiveness of a community-based CGIP.
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Affiliation(s)
- Yuya Watanabe
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan.,Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Yosuke Yamada
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Keiichi Yokoyama
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Specified Non-profit Corporation Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kyoto, Japan
| | - Tsukasa Yoshida
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Senior Citizen's Welfare Section, Kameoka City Government, Kameoka, Japan
| | - Yasuko Yoshinaka
- Specified Non-profit Corporation Genki-up AGE Project, Kameoka, Japan.,Department of Business Administration, Kyoto Gakuen University, Kyoto, Japan
| | - Mie Yoshimoto
- Corporation of Japan Dental Hygienists' Association, Kyoto, Japan
| | | | - Aya Itoi
- Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Kobe, Japan
| | - Emi Yamagata
- Faculty of Nursing, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Japan
| | - Kazuko Ishikawa-Takata
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Misaka Kimura
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Department of Health and Sports Sciences, Kyoto Gakuen University, Kameoka, Japan
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Itoi A, Yamada Y, Yokoyama K, Adachi T, Kimura M. Validity of predictive equations for resting metabolic rate in healthy older adults. Clin Nutr ESPEN 2017; 22:64-70. [DOI: 10.1016/j.clnesp.2017.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 08/17/2017] [Indexed: 12/18/2022]
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