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Mirrafiei A, Radkhah P, Chambari M, Davarzani S, Babaee N, Djafarian K, Shab-Bidar S. Higher dietary methyl donor micronutrient consumption is associated with higher muscle strength in adults: a cross-sectional study. Br J Nutr 2024; 131:1926-1933. [PMID: 38443195 DOI: 10.1017/s0007114524000424] [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] [Indexed: 03/07/2024]
Abstract
Methyl donor micronutrients might affect muscle strength via DNA methylation. We aimed to evaluate the combined relationship of dietary methyl donor micronutrients containing betaine, choline, methionine, vitamin B12, vitamin B6 and folate on muscle strength. This cross-sectional study was conducted on 267 subjects including 113 men and 154 women. Dietary intake of micronutrients was assessed utilising a validated 168-item semi-quantitative FFQ, and methyl donor micronutrient score (MDMS) was calculated. The muscle strength of the participants was measured using a digital handgrip dynamometer. The association was determined using linear regression analysis. The mean age of participants was 36·8 ± 13·2 years. After taking into account potential confounding variables, there was no significant association between dietary methyl donor micronutrient score (MDMS) and the mean left-hand muscle strength (β: 0·07, se: 0·05, P = 0·07); however, the changes were significant in the mean right-hand muscle strength (β: 0·09, se: 0·04, P = 0·03). There was also a significant positive relationship between mean muscle strength and methyl donors' intake after fully adjusting for potential confounders (β: 0·08, se: 0·04, P = 0·04). In conclusion, our findings revealed that higher dietary methyl donor micronutrient consumption is associated with enhanced muscle strength. As a result, advice on a higher intake of methyl donor-rich foods including grains, nuts, dairy products and seafood might be recommended by dietitians as a general guideline to adhere to. Additional prospective studies are needed to confirm the findings.
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Affiliation(s)
- Amin Mirrafiei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Parisa Radkhah
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mahla Chambari
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Samira Davarzani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Nadia Babaee
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Kato N, Kimoto A, Zhang P, Bumrungkit C, Karunaratne S, Yanaka N, Kumrungsee T. Relationship of Low Vitamin B6 Status with Sarcopenia, Frailty, and Mortality: A Narrative Review. Nutrients 2024; 16:177. [PMID: 38202006 PMCID: PMC10780671 DOI: 10.3390/nu16010177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
Marginal vitamin B6 (B6) deficiency is a widespread global concern. Inadequate B6 levels have been linked to an increased risk of age-related chronic diseases such as cardiovascular diseases and cancers. In recent years, the growing concern over sarcopenia (the age-related loss of muscle mass and strength) and frailty (a decline in physiological resilience and increased vulnerability associated with aging) is particularly relevant due to the emergence of super-aged societies in developed countries. Notably, among the thirty-one studies included in this review, twenty-five showed a significant association of B6 status with sarcopenia, frailty, and all-cause mortality in adults (p < 0.05), while six showed no association. Emerging studies have suggested novel mechanisms underlying this association. These mechanisms involve P2X7 receptor-mediated NLRP3 inflammasome signaling, AMPK signaling, PD-L1 signaling, and satellite cell-mediated myogenesis. Furthermore, the modulation of PLP-dependent enzymes due to B6 deficiency is associated with impaired metabolic processes, affecting energy utilization, imidazole peptide production, and hydrogen sulfide production, as well as the kynurenine pathway, all of which play vital roles in skeletal muscle health and pathophysiology. This narrative review provides an up-to-date assessment of our current understanding of the potential role of nutritional B6 status in combating sarcopenia, frailty, and mortality.
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Affiliation(s)
- Norihisa Kato
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima 739-8528, Japan; (C.B.); (S.K.); (N.Y.)
| | - Akiko Kimoto
- Faculty of Health of Sciences, Hiroshima Shudo University, Hiroshima 731-3166, Japan;
| | - Peipei Zhang
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Xiamen University, Xiamen 361102, China;
- School of Medicine, Xiamen University, Xiamen 361102, China
| | - Chanikan Bumrungkit
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima 739-8528, Japan; (C.B.); (S.K.); (N.Y.)
| | - Sajith Karunaratne
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima 739-8528, Japan; (C.B.); (S.K.); (N.Y.)
| | - Noriyuki Yanaka
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima 739-8528, Japan; (C.B.); (S.K.); (N.Y.)
| | - Thanutchaporn Kumrungsee
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima 739-8528, Japan; (C.B.); (S.K.); (N.Y.)
- Graduate School of Innovation and Practice for Smart Society, Hiroshima University, Higashi-Hiroshima 739-8528, Japan
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Alsaeedi A, Welham S, Rose P. Impact of lifestyle factors on dietary vitamin B 6 intake and plasma pyridoxal 5'-phosphate level in UK adults: National Diet and Nutrition Survey Rolling Programme (NDNS) (2008-2017). Br J Nutr 2023; 130:1403-1415. [PMID: 36789783 PMCID: PMC10511679 DOI: 10.1017/s0007114523000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Reduction in dietary vitamin B6 intake is associated with an increased relative risk of diseases such as cancer, atherosclerosis and cognitive dysfunction. The current research has assessed vitamin B6 intakes and PLP concentrations as a marker of vitamin B6 status among the UK adult (≥ 19 years) population. This study was carried out using a cross-sectional analysis of the National Diet and Nutrition Survey Rolling Programme (NDNS) (2008-2017). The impacts of lifestyle factors, including type of diet, smoking, alcohol consumption, and commonly used medications grouped by therapeutic usage, were determined, and data were analysed using IBM SPSS®. Results are expressed as medians (25th-75th percentiles), with P values ≤ 0·05 considered statistically significant. Among UK adults, the median intakes of total population of dietary vitamin B6 met the reference nutrient intake and median plasma PLP concentrations were above the cut-off of vitamin B6 deficiency; however, we found an association between reduction in vitamin B6 intake and plasma PLP concentration and age group (P < 0·001). Smokers had significantly lower plasma PLP concentrations than non-smokers (P < 0·001). Moreover, regression analysis showed some commonly used medications were associated with plasma PLP levels reduction (P < 0·05). Taken together, we report on a tendency for dietary vitamin B6 intake and plasma PLP concentrations to decrease with age and lifestyle factors such as smoking and medication usage. This information could have important implications for smokers and in the elderly population using multiple medications (polypharmacy).
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Affiliation(s)
- Asrar Alsaeedi
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LeicestershireLE12 5RD, UK
| | - Simon Welham
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LeicestershireLE12 5RD, UK
| | - Peter Rose
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LeicestershireLE12 5RD, UK
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Magalhães NV, Waitzberg DL, Lopes NC, Vicedomini ACC, Prudêncio APA, Jacob-Filho W, Busse AL, Ferdinando D, Alves TP, Pereira RMR, Torrinhas RS, Belarmino G. High Prevalence of Energy and Nutrients Inadequacy among Brazilian Older Adults. Nutrients 2023; 15:3246. [PMID: 37513664 PMCID: PMC10384757 DOI: 10.3390/nu15143246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Poor nutrition increases the risk of diseases and adverse health outcomes in older adults. We evaluated the potential inadequacy of nutrient intake among older adults in Brazil and its association with body anthropometry and composition outcomes. Dietary intake was obtained from 295 community-living older adults (>60 years old), of both genders, using a seven-day food record. Nutrient inadequacy was further identified based on the Dietary Reference Intakes and European Guidelines. Skeletal muscle mass (SM), strength and performance, and the diagnosis of sarcopenia were assessed using reference methods. Nutritional inadequacy was high, with energy, dietary fiber, and six micronutrients exhibiting the greatest inadequacy levels (>80%). Energy intake was correlated with SM strength (p = 0.000) and performance (p = 0.001). Inadequate energy, fiber, and protein intakes influenced BMI, while inadequate intake of vitamin B6 directly affected the diagnosis of sarcopenia (p ≤ 0.005). Further research is required to investigate whether these inadequacies can be associated with other clinical health outcomes.
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Affiliation(s)
- Natalia Vieira Magalhães
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Dan Linetzky Waitzberg
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Natalia Correia Lopes
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Ana Carolina Costa Vicedomini
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Ana Paula Aguiar Prudêncio
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Wilson Jacob-Filho
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Alexandre Leopold Busse
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Douglas Ferdinando
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Tatiana Pereira Alves
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Rosa Maria Rodrigues Pereira
- Research Laboratory in Rheumatology, LIM-17, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Raquel Susana Torrinhas
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Giliane Belarmino
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
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Fushimi T, Fujihira K, Takase H, Miyashita M. Relationships among Physical Activity, Physical Function, and Food Intake in Older Japanese Adults Living in Urban Areas: A Cross-Sectional Study. Geriatrics (Basel) 2023; 8:41. [PMID: 37102967 PMCID: PMC10137593 DOI: 10.3390/geriatrics8020041] [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: 12/30/2022] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/28/2023] Open
Abstract
Japan is experiencing a super-ageing society faster than anywhere else in the world. Consequently, extending healthy life expectancy is an urgent social issue. To realize a diet that can support the extension of healthy life expectancy, we studied the quantitative relationships among physical activities (number of steps and activity calculated using an accelerometer), physical functions (muscle strength, movement function, agility, static balance, dynamic balance, and walking function), and dietary intake among 469 older adults living in the Tokyo metropolitan area (65-75 years old; 303 women and 166 men) from 23 February 2017 to 31 March 2018. Physical activities and functions were instrumentally measured, and the dietary survey adopted the photographic record method. There was a significant positive association (p < 0.05) between physical activities (steps, medium-intensity activity, and high-intensity activity) and physical functions (movement function, static balance, and walking function), but no association with muscle strength. These three physical functions were significantly positively correlated with intake of vegetables, seeds, fruits, and milk; with magnesium, potassium, and vitamin B6; and with the dietary fibre/carbohydrate composition ratio (p < 0.05). Future intervention trials must verify if balancing diet and nutrition can improve physical activities in older adults through increased physical functions.
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Affiliation(s)
- Takashi Fushimi
- Biological Science Research, Kao Corporation, 2-1-3 Bunka, Sumida-ku, Tokyo 131-8501, Japan
| | - Kyoko Fujihira
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa 359-1192, Saitama, Japan
| | - Hideto Takase
- Biological Science Research, Kao Corporation, 2-1-3 Bunka, Sumida-ku, Tokyo 131-8501, Japan
| | - Masashi Miyashita
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa 359-1192, Saitama, Japan
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, Leicestershire, UK
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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Associations between Serum Folate Concentrations and Functional Disability in Older Adults. Antioxidants (Basel) 2023; 12:antiox12030619. [PMID: 36978867 PMCID: PMC10045063 DOI: 10.3390/antiox12030619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Folate may have beneficial effects on physical function through its antioxidant effect. Thus, we investigated the associations between serum folate and functional disability in older adults. Data from the National Health and Nutrition Examination Survey 2011–2018 were used. Serum folate included 5-methyltetrahydrofolate and total folate. Five domains of functional disability, including lower extremity mobility (LEM), instrumental activities of daily living (IADL), activities of daily living (ADL), leisure and social activities (LSA), and general physical activities (GPA), were self-reported. Multivariable-adjusted logistic regression models and restricted cubic splines were employed. 5-Methyltetrahydrofolate was inversely associated with IADL and GPA disability, and the multivariate-adjusted ORs (95% CIs) in the highest versus lowest quartiles were 0.65 (0.46–0.91) and 0.70 (0.50–0.96), respectively. The total folate was also inversely associated with IADL (OR quartile 4vs1 = 0.65, 95% CI: 0.46–0.90) and GPA (OR quartile 3vs1 = 0.66, 95% CI: 0.44–0.99) disability. The dose–response relationships showed a gradual decrease in the risk of IADL and GPA disability as serum folate increased. In the sex, age, BMI, and alcohol consumption subgroup analyses, we saw that the associations were primarily found in females, under 80 years old, normal weight, and non-drinkers. Sensitivity analyses further confirmed the robustness of our results. Our results indicated that serum folate concentrations were negatively associated with IADL and GPA disability, especially in females. In other subgroup analyses, we discovered that these negative associations were primarily prevalent in participants under 80 years old, normal weight, and non-drinkers.
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Gold SL, Manning L, Kohler D, Ungaro R, Sands B, Raman M. Micronutrients and Their Role in Inflammatory Bowel Disease: Function, Assessment, Supplementation, and Impact on Clinical Outcomes Including Muscle Health. Inflamm Bowel Dis 2023; 29:487-501. [PMID: 36287025 DOI: 10.1093/ibd/izac223] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Stephanie L Gold
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura Manning
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Kohler
- Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Ryan Ungaro
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bruce Sands
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, AB, Canada
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Abstract
Sarcopenia, a skeletal muscle disorder that is characterised by loss of muscle strength and mass, is common in older populations and associated with poorer health outcomes. Although the individual and economic costs of sarcopenia are widely recognised, current understanding of its pathophysiology is incomplete, limiting efforts to translate research evidence into effective preventive and treatment strategies. While nutrition is a key field of sarcopenia research, the role of differences in habitual diets, and the effectiveness of dietary change as a prevention or treatment strategy, is uncertain. There is a growing evidence base that links low micronutrient intakes to sarcopenia risk and/or its components (low muscle strength and mass, impaired physical performance), although there remain many gaps in understanding. There is some consistency in findings across studies highlighting potential roles for antioxidant nutrients, B vitamins and magnesium; however, the evidence is largely observational and from cross-sectional studies, often describing associations with different muscle outcomes. As low intakes of some micronutrients are common in older populations, there is a need for new research, particularly from well-characterised prospective cohorts, to improve the understanding of their role and importance in the aetiology of sarcopenia and to generate the evidence needed to inform dietary guidelines to promote muscle health.
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Davis B, Liu YH, Stampley J, Wood GC, Mitchell DC, Jensen GL, Gao X, Glynn NW, Still CD, Irving BA. The Association between Poor Diet Quality, Physical Fatigability and Physical Function in the Oldest-Old from the Geisinger Rural Aging Study. Geriatrics (Basel) 2021; 6:geriatrics6020041. [PMID: 33920900 PMCID: PMC8167721 DOI: 10.3390/geriatrics6020041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 01/09/2023] Open
Abstract
More perceived physical fatigability and poor diet quality are associated with impairments in physical function in older adults. However, the degree to which more perceived fatigability explains the association between poor diet quality and low physical function is unknown. We examined this relationship in 122 (66F, 56M) of the oldest-old participants from the Geisinger Rural Aging Study (GRAS). We used 24-h dietary recalls to assess the Healthy Eating Index (HEI), the Pittsburgh Fatigability Scale (PFS, 0–50) to assess perceived physical fatigability, and the PROMIS Physical Function 20a* to assess physical function. We grouped participants into three age categories: 80–84 (n = 51), 85–89 (n = 51), and 90+ (n = 20) years. Multiple linear regression revealed that a lower HEI was associated with higher PFS Physical score after adjusting for age group, sex, body mass index, and the number of medical conditions (p = 0.001). Several macro- and micro-nutrient intakes were also lower in those reporting more (≥15) compared to less (<15) perceived physical fatigability. Mediation analysis revealed that PFS Physical scores explained ~65% (p = 0.001) of the association between HEI total score and PROMIS19 Physical Function score. Poor diet quality may contribute to more perceived physical fatigability, which could exacerbate impairments in the oldest-old’s physical function.
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Affiliation(s)
- Brett Davis
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA; (B.D.); (J.S.)
| | - Yi-Hsuan Liu
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA; (Y.-H.L.); (D.C.M.); (X.G.)
| | - James Stampley
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA; (B.D.); (J.S.)
| | - G. Craig Wood
- Geisinger Obesity Institute, Geisinger Health System, Danville, PA 17822, USA; (G.C.W.); (C.D.S.)
| | - Diane C. Mitchell
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA; (Y.-H.L.); (D.C.M.); (X.G.)
| | - Gordon L. Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT 05401, USA;
| | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA; (Y.-H.L.); (D.C.M.); (X.G.)
| | - Nancy W. Glynn
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA;
| | - Christopher D. Still
- Geisinger Obesity Institute, Geisinger Health System, Danville, PA 17822, USA; (G.C.W.); (C.D.S.)
| | - Brian A. Irving
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USA; (B.D.); (J.S.)
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
- Correspondence: ; Tel.: +1-225-578-7179
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Grootswagers P, Mensink M, Berendsen AAM, Deen CPJ, Kema IP, Bakker SJL, Santoro A, Franceschi C, Meunier N, Malpuech-Brugère C, Bialecka-Debek A, Rolf K, Fairweather-Tait S, Jennings A, Feskens EJM, de Groot LCPGM. Vitamin B-6 intake is related to physical performance in European older adults: results of the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) study. Am J Clin Nutr 2021; 113:781-789. [PMID: 33515034 PMCID: PMC8024000 DOI: 10.1093/ajcn/nqaa368] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Maintenance of high physical performance during aging might be supported by an adequate dietary intake of niacin, vitamins B-6 and B-12, and folate because these B vitamins are involved in multiple processes related to muscle functioning. However, not much is known about the association between dietary intake of these B vitamins and physical performance. OBJECTIVES The objectives of this study were to investigate the association between dietary intake of niacin, vitamins B-6 and B-12, and folate and physical performance in older adults and to explore mediation by niacin status and homocysteine concentrations. METHODS We used baseline data from the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) trial, which included n = 1249 healthy older adults (aged 65-79 y) with complete data on dietary intake measured with 7-d food records and questionnaires on vitamin supplement use and physical performance measured with the short physical performance battery and handgrip dynamometry. Associations were assessed by adjusted linear mixed models. RESULTS Intake of vitamin B-6 was related to lower chair rise test time [β: -0.033 ± 0.016 s (log); P = 0.043]. Vitamin B-6 intake was also significantly associated with handgrip strength, but for this association, a significant interaction effect between vitamin B-6 intake and physical activity level was found. In participants with the lowest level of physical activity, higher intake of vitamin B-6 tended to be associated with greater handgrip strength (β: 1.5 ± 0.8 kg; P = 0.051), whereas in participants in the highest quartile of physical activity, higher intake was associated with lower handgrip strength (β: -1.4 ± 0.7 kg; P = 0.041). No evidence was found for an association between intake of niacin, vitamin B-12, or folate and physical performance or for mediation by niacin status or homocysteine concentrations. CONCLUSIONS Vitamin B-6 intake was associated with better chair rise test time in a population of European healthy older adults and also with greater handgrip strength in participants with low physical activity only. Homocysteine concentrations did not mediate these associations. The NU-AGE trial was registered at clinicaltrials.gov as NCT01754012.
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Affiliation(s)
| | - Marco Mensink
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Agnes A M Berendsen
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Carolien P J Deen
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Aurelia Santoro
- Department of Experimental, Diagnostic, and Specialty Medicine and CIG Interdepartmental Center “L. Galvani,” Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic, and Specialty Medicine and CIG Interdepartmental Center “L. Galvani,” Alma Mater Studiorum, University of Bologna, Bologna, Italy,Department of Experimental, Diagnostic, and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy,Department of Applied Mathematics, Institute of Information Technology, Mathematics, and Mechanics, Lobachevsky State University of Nizhny Novgorod–National Research University, Nizhny Novgorod, Russia
| | | | - Corinne Malpuech-Brugère
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000 Clermont-Ferrand, France
| | - Agata Bialecka-Debek
- Department of Human Nutrition, Warsaw University of Life Sciences–SGGW, Warsaw, Poland
| | - Katarzyna Rolf
- Department of Human Nutrition, Warsaw University of Life Sciences–SGGW, Warsaw, Poland
| | - Susan Fairweather-Tait
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Amy Jennings
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
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11
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García-Esquinas E, Carrasco-Rios M, Ortolá R, Sotos Prieto M, Pérez-Gómez B, Gutiérrez-González E, Banegas JR, Queipo R, Olmedo P, Gil F, Tellez-Plaza M, Navas-Acien A, Pastor-Barriuso R, Rodríguez-Artalejo F. Selenium and impaired physical function in US and Spanish older adults. Redox Biol 2020; 38:101819. [PMID: 33316745 PMCID: PMC7744768 DOI: 10.1016/j.redox.2020.101819] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023] Open
Abstract
Background Selenium (Se) is a trace element with a narrow safety margin. Objectives To evaluate the cross-sectional and longitudinal dose-response association between Se exposure and measures of impaired physical function and disability in older adults. Design NHANES 2011–2014 cross-sectional (US, n = 1733, age ≥60 years) and Seniors-ENRICA-2 2017–2019 cross-sectional and longitudinal (Spain, n = 2548 and 1741, respectively, age ≥65 years) data were analyzed. Whole blood and serum Se levels were measured using inductively coupled plasma-mass spectrometry. Lower-extremity performance was assessed with the Short Physical Performance Battery, and muscle weakness with a dynamometer. Incident mobility and agility limitations, and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including physical activity. Results across studies were pooled using random-effects meta-analysis. Results Meta-analyzed odds ratios (95% confidence interval) per log2 increase in whole blood Se were 0.54 (0.32; 0.76) for weakness, 0.59 (0.34; 0.83) for impaired lower-extremity performance, 0.48 (0.31; 0.68) for mobility limitations, 0.71 (0.45; 0.97) for agility limitations, and 0.34 (0.12; 0.56) for disability in at least one IADL. Analyses for serum Se in NHANES showed similar results. Findings suggest the inverse association with grip strength is progressive below 140 μg/L (p-value for non-linear trend in the Seniors-ENRICA-2 study = 0.13), and above 140 μg/L (p-value for non-linear trend in NHANES = 0.11). In the Seniors-ENRICA-2 cohort, with a 2.2 year follow-up period, a doubling in baseline Se levels were associated with a lower incidence of weakness [odds ratio (95% confidence interval): 0.45 (0.22; 0.91)], impaired lower-extremity performance [0.63 (0.32; 1.23)], mobility [0.43 (0.21; 0.91)] and agility [0.38 (0.18; 0.78)] limitations. Discussion In US and Spanish older adults, Se concentrations were inversely associated with physical function limitations. Further studies are needed to elucidate underlying mechanisms.
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Affiliation(s)
- E García-Esquinas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - M Carrasco-Rios
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain
| | - R Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health. Boston, MA, USA
| | - M Sotos Prieto
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - B Pérez-Gómez
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; National Center of Epidemiology. Carlos III Health Institute, Madrid, Spain
| | | | - J R Banegas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - R Queipo
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; Department of Medicine. School of Biomedical Sciences. Universidad Europea. Madrid, Spain
| | - P Olmedo
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - F Gil
- Department of Legal Medicine, Toxicology, and Physical Anthropology, School of Medicine, University of Granada, Granada, Spain
| | - M Tellez-Plaza
- National Center of Epidemiology. Carlos III Health Institute, Madrid, Spain; Biomedical Research Institute Hospital Clinic de Valencia (INCLIVA), Valencia, Spain
| | - A Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - R Pastor-Barriuso
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; National Center of Epidemiology. Carlos III Health Institute, Madrid, Spain
| | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid, Madrid. Spain; IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA Research Institute on Food and Health Sciences. Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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12
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Are legume-based recipes an appropriate source of nutrients for healthy ageing? A prospective cohort study. Br J Nutr 2020; 124:943-951. [PMID: 32475362 DOI: 10.1017/s0007114520001907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although legumes are rich in protein and fibre, and low in saturated fat and Na, traditional legume-based recipes include substantial amounts of processed meat, salt and potatoes, which could counteract the potential benefits of legumes. This prospective study aimed to assess the longitudinal association of consumption of different types of legumes, and traditional legume-based recipes, with unhealthy ageing in older adults. Data were taken from 2505 individuals aged ≥60 years from the Seniors-ENRICA cohort. Habitual legume consumption was assessed in 2008-2010 with a validated diet history. Unhealthy ageing was measured in the 2013, 2015 and 2017 follow-up waves, with a fifty-two-item multidimensional health deficit accumulation index (DAI) which ranges from 0 (best) to 100 (worst health). The mean age was 68·7 years, with 53·1 % of women. Among study participants, 78·4 % reported consumption of legumes, with a mean intake of 57·9 g/d. Multivariable-adjusted linear regression models did not show an association between total legume consumption and the DAI over a 7-year follow-up (non-standardised coefficient for the second and highest v. the lowest tertile of consumption: 0·94 (95 % CI -0·30, 2·17) and 0·18 (95 % CI -1·07, 1·43), respectively; Ptrend = 0·35). Similar results were observed for the 3-year and 5-year follow-ups and, separately, for lentils, beans, chickpeas and traditional legume-based recipes. According to the results obtained, consumption of legumes and traditional legume-based recipes is not associated with unhealthy ageing and can be part of a healthy diet in old age.
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13
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Estrada-DeLeón DB, Struijk EA, Caballero F, Rodríguez-Artalejo F, Lopez-Garcia E. Distribution of daily protein intake across meals and lower extremity functioning in community-dwelling Spanish older adults: a prospective cohort study. Eur J Nutr 2020; 60:665-675. [PMID: 32417947 DOI: 10.1007/s00394-020-02273-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/04/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Total dietary protein intake has been associated with better physical function in older adults. However, it is unclear whether an even mealtime distribution of protein intake also has an impact on physical functioning. The aim of this study was to examine the prospective association between distribution of daily protein intake across meals and the risk of impaired lower extremity function (ILEF). METHODS We used information of 2975 individuals ≥ 60 years from the Seniors-ENRICA cohort. Habitual dietary protein intake was assessed in 2008-2010 with a validated diet history. For each participant, dietary protein intake across meals was determined using the coefficient of variation (CV) of the distribution. Study participants were followed up until 2017 to identify incident ILEF, assessed with the short physical performance battery (SPPB). RESULTS Over a median follow-up of 6.3 years, we identified 521 participants with ILEF (SPPB ≤ 6). After adjusting for potential confounders including total protein intake/kg/day, a higher CV (less even distribution) of protein intake did not show an association with the risk of ILEF [hazard ratios (HR) and 95% confidence intervals (CI) for second and third vs. the first tertile: 1.08 (0.87-1.34), and 1.06 (0.85-1.32), respectively; p trend = 0.60]. When assessing each component of the SPPB, a higher CV of protein intake was associated with higher risk of impaired standing balance (HR for tertile 3 vs. tertile 1: 1.26 (1.03-1.54); p trend = 0.02). CONCLUSION The mealtime distribution of protein intake was not associated with ILEF. The possibility of a detrimental effect of uneven distribution of protein on standing balance needs to be further investigated.
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Affiliation(s)
- Daniela B Estrada-DeLeón
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. .,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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14
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Behrouzi P, Grootswagers P, Keizer PLC, Smeets ETHC, Feskens EJM, de Groot LCPGM, van Eeuwijk FA. Dietary Intakes of Vegetable Protein, Folate, and Vitamins B-6 and B-12 Are Partially Correlated with Physical Functioning of Dutch Older Adults Using Copula Graphical Models. J Nutr 2020; 150:634-643. [PMID: 31858107 PMCID: PMC7056616 DOI: 10.1093/jn/nxz269] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/14/2019] [Accepted: 10/09/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND In nutritional epidemiology, dealing with confounding and complex internutrient relations are major challenges. An often-used approach is dietary pattern analyses, such as principal component analysis, to deal with internutrient correlations, and to more closely resemble the true way nutrients are consumed. However, despite these improvements, these approaches still require subjective decisions in the preselection of food groups. Moreover, they do not make efficient use of multivariate dietary data, because they detect only marginal associations. We propose the use of copula graphical models (CGMs) to model and make statistical inferences regarding complex associations among variables in multivariate data, where associations between all variables can be learned simultaneously. OBJECTIVE We aimed to reconstruct nutritional intake and physical functioning networks in Dutch older adults by applying a CGM. METHODS We addressed this issue by uncovering the pairwise associations between variables while correcting for the effect of remaining variables. More specifically, we used a CGM to infer the precision matrix, which contains all the conditional independence relations between nodes in the graph. The nonzero elements of the precision matrix indicate the presence of a direct association. We applied this method to reconstruct nutrient-physical functioning networks from the combined data of 4 studies (Nu-Age, ProMuscle, ProMO, and V-Fit, total n = 662, mean ± SD age = 75 ± 7 y). The method was implemented in the R package nutriNetwork which is freely available at https://cran.r-project.org/web/packages/nutriNetwork. RESULTS Greater intakes of vegetable protein and vitamin B-6 were partially correlated with higher scores on the total Short Physical Performance Battery (SPPB) and the chair rise test. Greater intakes of vitamin B-12 and folate were partially correlated with higher scores on the chair rise test and the total SPPB, respectively. CONCLUSIONS We determined that vegetable protein, vitamin B-6, folate, and vitamin B-12 intakes are partially correlated with improved functional outcome measurements in Dutch older adults.
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Affiliation(s)
- Pariya Behrouzi
- Biometris, Mathematical and Statistical Methods, Wageningen University and Research, Wageningen, Netherlands
| | - Pol Grootswagers
- Department of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands
| | - Paul L C Keizer
- Biometris, Mathematical and Statistical Methods, Wageningen University and Research, Wageningen, Netherlands
| | - Ellen T H C Smeets
- Department of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands
| | - Edith J M Feskens
- Department of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands
| | | | - Fred A van Eeuwijk
- Biometris, Mathematical and Statistical Methods, Wageningen University and Research, Wageningen, Netherlands
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15
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Kelleher JL, Rodriguez AD, McGregor KM, Serra MC. Differences in dietary recall and subjective physical functioning status in stroke survivors with self-reported cognitive impairment. Top Stroke Rehabil 2019; 26:307-311. [PMID: 30907282 DOI: 10.1080/10749357.2019.1593611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Little is known about the dietary intake of these nutrients in stroke survivors, who often experience greater difficulties with physical functioning due to cognitive impairment. OBJECTIVES To explore whether dietary intake and physical function differ between those with and without self-report cognitive impairment. METHODS The present study analyzes data from the 2011-2012 and 2013-2014 National Health and Nutrition Examination Survey. Individuals were included if they self-reported a stroke and had data regarding cognitive impairment (self-reported "periods of confusion or memory problems") and dietary intake from 24-hr recalls (N = 360). A subset had handgrip strength (N = 330) and questionnaire data regarding the presence of 19 different functional limitations (N = 187). RESULTS Of the 360 stroke survivor participants (66 ± 1 years, 53% female, mean±SEM), 48% reported cognitive impairment. Dietary intake of polyunsaturated fatty acids was 19% lower (p = 0.01), with a trend for 13% lower vitamin B6 intake (p = 0.07) in those with cognitive impairment compared to those who did not. Those with cognitive impairment had lower handgrip strength and reported twice as many functional limitations (p's<0.01). CONCLUSION A lower intake of polyunsaturated fat and vitamin B6 may be associated with cognitive function, ultimately affecting physical functioning, post-stroke. It is possible that differing stroke severity and difficulty recalling dietary habits could have affected the present findings. Therefore, further research is needed to determine if interventions designed to modify polyunsaturated fat and vitamin B6 intakes are able to influence cognitive and physical function in stroke survivors with varying degrees of functional and cognitive deficits.
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Affiliation(s)
- Jessica L Kelleher
- a VARRD Center for Visual and Neurocognitive Rehabilitation , Atlanta VA Medical Center , Decatur , GA , USA
| | - Amy D Rodriguez
- a VARRD Center for Visual and Neurocognitive Rehabilitation , Atlanta VA Medical Center , Decatur , GA , USA.,b School of Medicine , Emory University , Atlanta , GA , USA
| | - Keith M McGregor
- a VARRD Center for Visual and Neurocognitive Rehabilitation , Atlanta VA Medical Center , Decatur , GA , USA.,b School of Medicine , Emory University , Atlanta , GA , USA
| | - Monica C Serra
- a VARRD Center for Visual and Neurocognitive Rehabilitation , Atlanta VA Medical Center , Decatur , GA , USA.,b School of Medicine , Emory University , Atlanta , GA , USA
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16
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Soysal P, Smith L, Capar E, Kalan U, Arik F, Isik AT. Vitamin B12 and folate deficiencies are not associated with nutritional or weight status in older adults. Exp Gerontol 2018; 116:1-6. [PMID: 30550763 DOI: 10.1016/j.exger.2018.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/25/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022]
Abstract
It is not known whether undernutrition causes vitamin B12 and folate deficiencies. The present study aimed to determine whether nutritional status, measured using the Mini Nutritional Assessment (MNA) scale, and body mass index (BMI) are indicators of lower level serum vitamin B12 and folate in older adults. 1007 outpatients aged 65 years or over were included the study. MNA scores >23.5, 17-23.5, <17, were categorized as normal nutritional status, risk of malnutrition, and malnutrition, respectively. Weight status was assessed using BMI and categorized as under or normal weight (<25 kg/m2), overweight (25-30 kg/m2), class I obese (30.0-35 kg/m2), class II obese (35-40 kg/m2), and class III obese (≥40 kg/m2). Vitamin B12 and folate deficiencies were defined as <200 pg/ml and <3 ng/ml, respectively. Among 1007 patients with an average age of 74.3 ± 8.2 years, 6.9% were categorized as having malnutrition and 31.2% were categorized as at risk of malnutrition. While 45.7% of patients were categorized as having vitamin B12 deficiency and 0.9% folate deficiency. There were no differences between patients with malnutrition, at risk of malnutrition, and good nutrition in serum vitamin B12 or folate levels, or the presence of vitamin B12 or folate deficiency after adjustment for age, gender, and education (p > 0.05). The results were the same across BMI classifications (p > 0.05). Vitamin B12 and folate levels are not associated with nutritional or weight status and these should be evaluated independently of BMI and MNA values.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Emre Capar
- Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey
| | - Ugur Kalan
- Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey
| | - Ferhat Arik
- Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Balboa-Castillo T, Struijk EA, Lopez-Garcia E, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillon P. Low vitamin intake is associated with risk of frailty in older adults. Age Ageing 2018; 47:872-879. [PMID: 30052701 DOI: 10.1093/ageing/afy105] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/03/2018] [Indexed: 01/07/2023] Open
Abstract
Background the association between vitamin intake and frailty has hardly been studied. The objective was to assess the association of dietary vitamin intake with incident frailty in older adults from Spain. Methods data came from a cohort of 1,643 community-dwelling individuals aged ≥65, recruited in 2008-10 and followed up prospectively throughout 2012. At baseline, 10 vitamins were assessed (vitamin A, thiamine, riboflavin, niacin, vitamins B6, B12, C, D, E and folates) using a validated face-to-face diet history. Incident frailty was identified using Fried's definition as having ≥3 of the following five criteria: unintentional weight loss of ≥4.5 kg, exhaustion, weakness, slow walking speed and low physical activity. Nonadherence to the recommended dietary allowances (RDA) was considered when the intake of a vitamin was below the recommendation. Analyses were performed with logistic regression and adjusted for main confounders. Results during a 3.5-year follow-up, 89 (5.4%) participants developed frailty. The odds ratios (95% confidence interval) of frailty for those in the lowest versus the highest tertile of vitamin intake were 2.80 (1.38-5.67), P-trend: 0.004, for vitamin B6; 1.65 (0.93-2.95), P-trend: 0.007, for vitamin C; 1.93 (0.99-3.83), P-trend: 0.06, for vitamin E and 2.34 (1.21-4.52), P-trend: 0.01, for folates. Nonadherence to the RDAs of vitamins was related to frailty for thiamine odds ratio (OR): 2.09 (1.03-4.23); niacin OR: 2.80 (1.46-5.38) and vitamin B6; 2.23 (1.30-3.83). When considering tertiles of RDAs for the 10 vitamins those who met <5 RDAs had a higher risk of frailty, OR: 2.84 (1.34-6.03); P-trend: <0.001, compared to those who met >7. Conclusion a lower intake of vitamins B6, C, E and folates was associated with a higher risk of frailty. Not meeting RDAs for vitamins was also strongly associated.
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Affiliation(s)
- Teresa Balboa-Castillo
- Department of Public Health—EPICYN Research Center, School of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Pilar Guallar-Castillon
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
- Johns Hopkins Bloomerg School of Public Health, Baltimore, USA
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18
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Struijk EA, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Consumption of meat in relation to physical functioning in the Seniors-ENRICA cohort. BMC Med 2018; 16:50. [PMID: 29622014 PMCID: PMC5887175 DOI: 10.1186/s12916-018-1036-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/13/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Meat is an important source of high-quality protein and vitamin B but also has a relatively high content of saturated and trans fatty acids. Although protein and vitamin B intake seems to protect people from functional limitations, little is known about the effect of habitual meat consumption on physical function. The objective of this study was to examine the prospective association between the intake of meat (processed meat, red meat, and poultry) and physical function impairment in older adults. METHODS Data were collected for 2982 participants in the Seniors-ENRICA cohort, who were aged ≥60 years and free of physical function impairment. In 2008-2010, their habitual diet was assessed through a validated computer-assisted face-to-face diet history. Study participants were followed up through 2015 to assess self-reported incident impairment in agility, mobility, and performance-based lower-extremity function. RESULTS Over a median follow-up of 5.2 years, we identified 625 participants with impaired agility, 455 with impaired mobility, and 446 with impaired lower-extremity function. After adjustment for potential confounders, processed meat intake was associated with a higher risk of impaired agility (hazard ratio [HR] for highest vs. lowest tertile: 1.33; 95% confidence interval [CI]: 1.08-1.64; p trend = 0.01) and of impaired lower-extremity function (HR for highest vs. lowest tertile: 1.31; 95% CI: 1.02-1.68; p trend = 0.04). No significant associations were found for red meat and poultry. Replacing one serving per day of processed meat with one serving per day of red meat, poultry, or with other important protein sources (fish, legumes, dairy, and nuts) was associated with lower risk of impaired agility and lower-extremity function. CONCLUSIONS A higher consumption of processed meat was associated with a higher risk of impairment in agility and lower-extremity function. Replacing processed meat by other protein sources may slow the decline in physical functioning in older adults.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain. .,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avda. Arzobispo Morcillo, 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
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