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McLeod KJ. Reversal of Soleus Muscle Atrophy in Older Adults: A Non-Volitional Exercise Intervention for a Changing Climate. Clin Interv Aging 2024; 19:795-806. [PMID: 38745745 PMCID: PMC11093118 DOI: 10.2147/cia.s447665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/27/2024] [Indexed: 05/16/2024] Open
Abstract
The World Health Organization recommends that older adults undertake at least 150 minutes of moderate intensity physical activity over the course of each week in order to maintain physical, mental, and social health. This goal turns out to be very difficult for most community dwelling older adults to achieve, due to both actual and perceived barriers. These barriers include personal health limitations, confinement issues, and self-imposed restrictions such as fear of injury. Climate change exacerbates the confinement issues and injury fears among the elderly. To assist older adults in obtaining the benefits of increased physical activity under increasingly challenging climate conditions, we propose a targeted non-volitional intervention which could serve as a complement to volitional physical activity. Exogenous neuro-muscular stimulation of the soleus muscles is a non-invasive intervention capable of significantly increasing cardiac output in sedentary individuals. Long-term daily use has been shown to improve sleep, reduce bone loss, and reverse age-related cognitive decline, all of which are significant health concerns for older adults. These outcomes support the potential benefit of exogenous neuro-muscular stimulation as a complementary form of physical activity which older adults may find convenient to incorporate into their daily life when traditional forms of exercise are difficult to achieve due to barriers to completing traditional physical activities as a result of in-home or in-bed confinement, perceptual risks, or real environmental risks such as those arising from climate change.
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Porter J, Ward LC, Nguo K, Ward A, Davidson Z, Gibson S, Prentice R, Neuhouser ML, Truby H. Development and validation of age-specific predictive equations for total energy expenditure and physical activity levels for older adults. Am J Clin Nutr 2024; 119:1111-1121. [PMID: 38503654 DOI: 10.1016/j.ajcnut.2024.02.005] [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: 08/21/2023] [Revised: 12/12/2023] [Accepted: 02/06/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Predicting energy requirements for older adults is compromised by the underpinning data being extrapolated from younger adults. OBJECTIVES To generate and validate new total energy expenditure (TEE) predictive equations specifically for older adults using readily available measures (age, weight, height) and to generate and test new physical activity level (PAL) values derived from 1) reference method of indirect calorimetry and 2) predictive equations in adults aged ≥65 y. METHODS TEE derived from "gold standard" methods from n = 1657 (n = 1019 females, age range 65-90 y), was used to generate PAL values. PAL ranged 1.28-2.05 for males and 1.26-2.06 for females. Physical activity (PA) coefficients were also estimated and categorized (inactive to very active) from population means. Nonlinear regression was used to develop prediction equations for estimating TEE. Double cross-validation in a randomized, sex-stratified, age-matched 50:50 split, and leave one out cross-validation were performed. Comparisons were made with existing equations. RESULTS Equations predicting TEE using the Institute of Medicine method are as follows: For males, TEE = -5680.17 - 17.50 × age (years) + PA coefficient × (6.96 × weight [kilograms] + 44.21 × height [centimeters]) + 1.13 × resting metabolic rate (RMR) (kilojoule/day). For females, TEE = -5290.72 - 8.38 × age (years) + PA coefficient × (9.77 × weight [kilograms] + 41.51 × height [centimeters]) + 1.05 × RMR (kilojoule/day), where PA coefficient values range from 1 (inactive) to 1.51 (highly active) in males and 1 to 1.44 in females respectively. Predictive performance for TEE from anthropometric variables and population mean PA was moderate with limits of agreement approximately ±30%. This improved to ±20% if PA was adjusted for activity category (inactive, low active, active, and very active). Where RMR was included as a predictor variable, the performance improved further to ±10% with a median absolute prediction error of approximately 4%. CONCLUSIONS These new TEE prediction equations require only simple anthropometric data and are accurate and reproducible at a group level while performing better than existing equations. Substantial individual variability in PAL in older adults is the major source of variation when applied at an individual level.
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Affiliation(s)
- Judi Porter
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, the University of Queensland, Brisbane, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | | | - Zoe Davidson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Ross Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center and School of Public Health and Community Medicine, University of Washington, Seattle, WA, United States
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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Jeziorek M, Wronowicz J, Janek Ł, Kujawa K, Szuba A. Development of New Predictive Equations for the Resting Metabolic Rate (RMR) of Women with Lipedema. Metabolites 2024; 14:235. [PMID: 38668363 PMCID: PMC11052101 DOI: 10.3390/metabo14040235] [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: 03/27/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to develop a novel predictive equation for calculating resting metabolic rate (RMR) in women with lipedema. We recruited 119 women diagnosed with lipedema from the Angiology Outpatient Clinic at Wroclaw Medical University, Poland. RMR was assessed using indirect calorimetry, while body composition and anthropometric measurements were conducted using standardized protocols. Due to multicollinearity among predictors, classical multiple regression was deemed inadequate for developing the new equation. Therefore, we employed machine learning techniques, utilizing principal component analysis (PCA) for dimensionality reduction and predictor selection. Regression models, including support vector regression (SVR), random forest regression (RFR), and k-nearest neighbor (kNN) were evaluated in Python's scikit-learn framework, with hyperparameter tuning via GridSearchCV. Model performance was assessed through mean absolute percentage error (MAPE) and cross-validation, complemented by Bland-Altman plots for method comparison. A novel equation incorporating body composition parameters was developed, addressing a gap in accurate RMR prediction methods. By incorporating measurements of body circumference and body composition parameters alongside traditional predictors, the model's accuracy was improved. The segmented regression model outperformed others, achieving an MAPE of 10.78%. The proposed predictive equation for RMR offers a practical tool for personalized treatment planning in patients with lipedema.
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Affiliation(s)
- Małgorzata Jeziorek
- Department of Dietetics and Bromatology, Faculty of Pharmacy, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Jakub Wronowicz
- Statistical Analysis Center, Wroclaw Medical University, 50-372 Wroclaw, Poland; (J.W.); (Ł.J.); (K.K.)
| | - Łucja Janek
- Statistical Analysis Center, Wroclaw Medical University, 50-372 Wroclaw, Poland; (J.W.); (Ł.J.); (K.K.)
| | - Krzysztof Kujawa
- Statistical Analysis Center, Wroclaw Medical University, 50-372 Wroclaw, Poland; (J.W.); (Ł.J.); (K.K.)
| | - Andrzej Szuba
- Department of Angiology and Internal Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland;
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Willis EA, Herrmann SD, Hastert M, Kracht CL, Barreira TV, Schuna JM, Cai Z, Quan M, Conger SA, Brown WJ, Ainsworth BE. Older Adult Compendium of Physical Activities: Energy costs of human activities in adults aged 60 and older. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:13-17. [PMID: 38242593 PMCID: PMC10818108 DOI: 10.1016/j.jshs.2023.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE To describe the development of a Compendium for estimating the energy costs of activities in adults ≥60 years (OA Compendium). METHODS Physical activities (PAs) and their metabolic equivalent of task (MET) values were obtained from a systematic search of studies published in 4 sport and exercise databases (PubMed, Embase, SPORTDiscus (EBSCOhost), and Scopus) and a review of articles included in the 2011 Adult Compendium that measured PA in older adults. MET values were computed as the oxygen cost (VO2, mL/kg/min) during PA divided by 2.7 mL/kg/min (MET60+) to account for the lower resting metabolic rate in older adults. RESULTS We identified 68 articles and extracted energy expenditure data on 427 PAs. From these, we derived 99 unique Specific Activity codes with corresponding MET60+ values for older adults. We developed a website to present the OA Compendium MET60+ values: https://pacompendium.com. CONCLUSION The OA Compendium uses data collected from adults ≥60 years for more accurate estimation of the energy cost of PAs in older adults. It is an accessible resource that will allow researchers, educators, and practitioners to find MET60+ values for older adults for use in PA research and practice.
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Affiliation(s)
- Erik A Willis
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Stephen D Herrmann
- Kansas Center for Metabolism and Obesity Research, The University of Kansas Medical Center, Kansas City, KS 66160, USA; Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Mary Hastert
- Kansas Center for Metabolism and Obesity Research, The University of Kansas Medical Center, Kansas City, KS 66160, USA; Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Chelsea L Kracht
- Clinical Science Division, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Tiago V Barreira
- Exercise Science Department, Syracuse University, Syracuse, NY 13244, USA
| | - John M Schuna
- School of Exercise & Sport Science, Oregon State University, Corvallis, OR 97331, USA
| | - Zhenghua Cai
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Minghui Quan
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Scott A Conger
- Department of Kinesiology, Boise State University, Boise, ID 83725, USA
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4229, Australia
| | - Barbara E Ainsworth
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; College of Health Solutions, Arizona State University, Phoenix, AZ 85003, USA
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Danielewicz AL, Lazzer S, Marra A, Abbruzzese L, D’Alleva M, Martino MD, Isola M, Avelar NCP, Mendonça VA, Lacerda ACR, Sartorio A. Prediction of resting energy expenditure in Italian older adults with severe obesity. Front Endocrinol (Lausanne) 2023; 14:1283155. [PMID: 38027183 PMCID: PMC10663312 DOI: 10.3389/fendo.2023.1283155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background In the last decade a large number of studies proposed and/or validated equations to estimate the Resting Energy Expenditure (REE) in adults and/or older adults, however, no equation currently available showed good accuracy for older adults with severe obesity. Thus, this study aimed to develop and validate new predictive equations for REE, based on data from the indirect calorimetry, in Italian older adults with severe obesity. Methods A retrospective study was as conducted with 764 Caucasian older adults with severe obesity (age range: 60-74 years and BMI ≥ 35 kg/m/²). Four models were used to test the accuracy of anthropometry and body composition variables in multivariable prediction of REE. All models were derived by stepwise multiple regression analysis using a calibration group of 382 subjects [295 females and 87 males] and the equations were cross-validated in the remaining 382 subjects [295 females and 87 males] as validation group. The new prediction equations and the other published equations were tested using the Bland-Altman method. Prediction accuracy was defined as the percentage of subjects whose REE was predicted within ± 10% of measured REE. Results All the equations analyzed predicted higher energy requirements for males than females, and most of them underestimated the energy requirement values of our sample. The highest accuracy values were observed in the new equations, with 62% in the anthropometric model and 63% in the body composition model. Conclusion Although the accuracy of our equations was slightly higher in comparison with the other taken into consideration, they cannot be considered completely satisfactory for predicting REE in Italians older adults with severe obesity. When predicting equations cannot guarantee precise or acceptable values of REE, the use of indirect calorimetry (if available) should be always recommended, especially in clinical practice.
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Affiliation(s)
- Ana Lúcia Danielewicz
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
- Department of Health Sciences, Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | - Alice Marra
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
| | - Laura Abbruzzese
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Division of Eating and Nutrition Disorders, Piancavallo-Verbania, Italy
| | - Mattia D’Alleva
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | | | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | - Núbia Carelli Pereira Avelar
- Department of Health Sciences, Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Vanessa Amaral Mendonça
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-endocrinological Research, Piancavallo-Verbania, Italy
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Kawase F, Masaki Y, Ozawa H, Imanaka M, Sugiyama A, Wada H, Kobayashi S, Tsukahara T. New prediction equations for resting energy expenditure in older hospitalized patients: Development and validation. Nutrition 2023; 115:112188. [PMID: 37729675 DOI: 10.1016/j.nut.2023.112188] [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: 06/21/2023] [Revised: 07/26/2023] [Accepted: 08/05/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES Accurate resting energy expenditure (REE) prediction is needed to prevent over- or underfeeding in older hospitalized patients. However, few validated REE prediction Equations are known for such patients. Therefore, this study aimed to develop new REE prediction Equations and evaluate their validity. METHODS This single-center, cross-sectional study enrolled 134 patients ages ≥70 y. For holdout validation, patients were randomized in a 3:1 ratio; for the development data set, a new Equation was developed according to the measured REE using indirect calorimetry. The new and existing Equations were compared using the validation data set. RESULTS Mean patient age was 87.4 ± 6.9 y, and 34.3% were male. Two Equations were developed in multivariable regression models: Equation 1: REE (kcal/day) = 313.582 + Height (cm) × 3.973 + Body weight (kg) × 5.332 - Age (y) × 5.474 - (0 if male; 1 if female) × 20.012 + Calf circumference (cm) × 12.174; and Equation 2: REE (kcal/day) = 594.819 + Height (cm) × 3.760 + Body weight (kg) × 8.888 - Age (y) × 6.298 - (0 if male; 1 if female) × 16.396. The mean relative bias (95% CI) with measured REE as a reference had a small bias for Equations 1 and 2 (-0.1 [-4.1 to 3.9]% and -0.2 [-4.4 to 4.1]%, respectively); however, the Harris-Benedict, Food and Agriculture Organization of the United Nations/World Health Organization/United Nations University, Ganpule, and body weight × 20 Equations had larger biases (-6.2 [-10.3 to -2.0]%; 5.3 [1.3 to 9.3]%; -13.9 [-18.6 to -9.3]%; and -11.6 [-16.1 to -7.1]%, respectively). CONCLUSIONS New prediction Equations using height, body weight, age, sex, and calf circumference improve REE prediction accuracy in older hospitalized patients.
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Affiliation(s)
- Fumiya Kawase
- Department of Nutrition, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan; Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan.
| | - Yoshiyuki Masaki
- Department of Internal Medicine, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan; Department of Community-based Medical Education, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan
| | - Hiroko Ozawa
- Department of Nursing, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Manami Imanaka
- Department of Nursing, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Aoi Sugiyama
- Department of Nursing, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Hironari Wada
- Department of Rehabilitation Therapy, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Shinya Kobayashi
- Department of Internal Medicine, Asuke Hospital, Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Takayoshi Tsukahara
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
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