Habitual dietary fat intake and risk of muscle weakness and lower-extremity functional impairment in older adults: A prospective cohort study

Association of dietary patterns with sarcopenia in adults aged 50 years and older

PURPOSE

Although numerous studies have investigated the impact of dietary factors on the prevention of decreased muscle mass and function, limited research has examined the relationship between dietary patterns and sarcopenia. This study aimed to assess the associations between dietary patterns, and sarcopenia, muscle strength, and mass in adults following a Mediterranean diet residing in southern Italian cities.

METHODS

This cross-sectional study utilized data from an existing database, comprising 528 individuals aged 50 years or older who underwent health-screening tests at the Clinical Nutrition Unit of the "R.Dulbecco" University Hospital. Strength was assessed through handgrip strength, and appendicular skeletal muscle mass was estimated using bioelectrical impedance analysis. Dietary intake information was collected through a food frequency questionnaire linked to the MetaDieta 3.0.1 nutrient composition database. Principal Component Analysis, a statistical technique identifying underlying relationships among different nutrients, was employed to determine dietary patterns. Multinomial logistic regression analysis was conducted to estimate the odds ratio for sarcopenia or low handgrip strength in relation to the lowest tertile of dietary pattern adherence compared to the highest adherence.

RESULTS

The participants had a mean age of 61 ± 8 years. Four dietary patterns were identified, with only the Western and Mediterranean patterns showing correlations with handgrip strength and appendicular skeletal muscle mass. However, only the Mediterranean pattern exhibited a correlation with sarcopenia (r =  - 0.17, p = 0.02). The highest tertile of adherence to the Mediterranean dietary pattern demonstrated significantly higher handgrip strength compared to the lowest tertile (III Tertile: 28.3 ± 0.5 kg vs I Tertile: 26.3 ± 0.5 kg; p = 0.01). Furthermore, even after adjustment, the highest tertile of adherence to the Mediterranean pattern showed a significantly lower prevalence of sarcopenia than the lowest adherence tertile (4% vs 16%, p = 0.04). The lowest adherence to the Mediterranean dietary pattern was associated with increased odds of having low muscle strength (OR = 2.38; p = 0.03; 95%CI = 1.05-5.37) and sarcopenia (OR = 9.69; p = 0.0295; %CI = 1.41-66.29).

CONCLUSION

A high adherence to the Mediterranean dietary pattern, characterized by increased consumption of legumes, cereals, fruits, vegetables, and limited amounts of meat, fish, and eggs, is positively associated with handgrip strength and appendicular skeletal muscle mass. The highest adherence to this dietary model is associated with the lowest odds of low muscle strength and sarcopenia. Despite the changes brought about by urbanization in southern Italy compared to the past, our findings continue to affirm the superior benefits of the Mediterranean diet in postponing the onset of frailty among older adults when compared to other dietary patterns that are rich in animal foods.

Association between nut consumption and low muscle strength among Korean adults

Nuts are an important component of a healthy diet, but little has been known about their effects on muscle health. Therefore, this study examined the association between nut consumption and low muscle strength among Korean adults. This cross-sectional analysis was conducted using single 24-h recall and handgrip strength data from 3962 younger adults 19-39 years, 6921 middle-aged adults 40-64 years and 3961 older adults ≥65 years participated in the seventh cycle (2016-2018) of the Korea National Health and Nutrition Examination Survey. Low muscle strength was defined as handgrip strength <28 kg for men and <18 kg for women. Sex-specific OR were obtained for younger, middle-aged and older adults using multivariable logistic regression analyses. About one in four Korean adults were consuming nuts (using a culinary definition) with peanut being the most frequently consumed type. After adjustment for age, BMI, total energy intake, household income, alcohol consumption, smoking, resistance exercise, medical history and dietary protein intake, nut consumption was associated with the lower risk of low muscle strength among older adults ≥65 years (men: OR 0·55, 95 % CI (0·38, 0·79); women: OR 0·69, 95 % CI (0·51, 0·93)); however, this association was not observed among younger adults 19-39 years or middle-aged adults 40-64 years. Our results suggest that consuming nuts might be beneficial in lowering the risk of low muscle strength among Korean older adults.

Association of dietary fat intake with skeletal muscle mass and muscle strength in adults aged 20-59: NHANES 2011-2014

Background

Sarcopenia, a progressive loss of skeletal muscle mass and strength, needs to initially prevent in the twenties. Meanwhile, there is a lack of research on the effects of fat consumption on skeletal muscle mass and strength in adults aged 20-59. We aimed to assess associations between dietary fat intake and skeletal muscle mass, as measured by appendicular lean mass adjusted for body mass index (ALMBMI), and muscle strength, as represented by handgrip strength adjusted for body mass index (GSMAXBMI), among adults aged 20-59.

Methods

Dietary fat intake per kilogram of actual body weight was assessed using two 24h recalls, while ALM and GSMAX were measured using DXA and a handgrip dynamometer, respectively. A weighted multiple linear regression model was employed to analyze the association between dietary fat intake and skeletal muscle mass, utilizing data from the National Health and Nutrition Examination Survey spanning from 2011 to 2014. To assess the non-linear relationship and saturation value between dietary fat intake and skeletal muscle mass, a smooth curve fitting approach and a saturation effect analysis model were utilized.

Results

The study comprised a total of 5356 subjects. After adjusting for confounding factors, there was a positive association observed between dietary fat intake and ALMBMI as well as GSMAXBMI. The relationship between dietary fat intake and ALMBMI showed an inverted U-shaped curve, as did the association with GSMAXBMI. Turning points were observed at 1.88 g/kg/d for total fat intake and ALMBMI, as well as at 1.64 g/kg/d for total fat intake and GSMAXBMI. Furthermore, turning points were still evident when stratifying by gender, age, protein intake, and physical activity. The turning points were lower in individuals with low protein intake(<0.8 g/kg/d) and high levels of physical activity.

Conclusion

The moderate dietary fat intake can be beneficial for muscle mass and strength in adults aged 20-59 under specific conditions. Special attention should be directed toward the consumption of fats in individuals with low protein intake and those engaged in high levels of physical activity.

Cross-sectional and longitudinal associations between empirically derived dietary patterns and frailty among older men: The Concord Health and Ageing in Men Project

BACKGROUND

Diet may be associated with frailty.

OBJECTIVE

We aimed to evaluate the associations between empirically derived dietary patterns and frailty in older men.

DESIGN

Prospective cohort study.

SETTING

The Concord Health and Ageing in Men Project, Sydney, Australia.

PARTICIPANTS

785 community-dwelling older Australian men aged 75 years and older.

METHODS

Men underwent dietary assessment using a validated dietitian-administered diet history questionnaire. Factor analysis identified three dietary patterns. Multinomial logistic regression was conducted between frailty and dietary patterns for cross-sectional analyses and longitudinal analyses over a 3-year follow-up. Frailty was defined by the Fried frailty phenotype.

RESULTS

Of the 785 men, pre-frailty was prevalent in 47.1% (n = 370), and frailty in 8.3% (n = 65). In fully adjusted cross-sectional analyses, the top tertile and a higher 'vegetables-legumes-seafood' dietary pattern score were associated with reduced prevalence of frailty (OR 0.34 [95% CI: 0.12, 0.93, P = .036]) and OR 0.50 [95% CI: 0.30, 0.83, P = .007] respectively). The top tertile of the 'discretionary-starchy vegetables-processed meats' dietary pattern was also associated cross-sectionally with increased prevalence of pre-frailty (OR 1.75 [95% CI: 1.08, 2.83, P = .022]). Of the 296 robust men in fully adjusted longitudinal analyses, the incidence of pre-frailty was 52.4% (n = 155), and frailty was 5.4% (n = 16) over a 3-year follow-up. The middle tertile of the 'vegetables-legumes-seafood' dietary pattern had a non-significant trend towards reduced incident pre-frailty (OR 0.52 [95% CI: 0.27, 1.00, P = .050]).

CONCLUSION

Consumption of a 'vegetables-legumes-seafood' dietary pattern appears to be less favoured by frail older men.

Lipids and the hallmarks of ageing: From pathology to interventions

Lipids are critical structural and functional architects of cellular homeostasis. Change in systemic lipid profile is a clinical indicator of underlying metabolic pathologies, and emerging evidence is now defining novel roles of lipids in modulating organismal ageing. Characteristic alterations in lipid metabolism correlate with age, and impaired systemic lipid profile can also accelerate the development of ageing phenotype. The present work provides a comprehensive review of the extent of lipids as regulators of the modern hallmarks of ageing viz., cellular senescence, chronic inflammation, gut dysbiosis, telomere attrition, genome instability, proteostasis and autophagy, epigenetic alterations, and stem cells dysfunctions. Current evidence on the modulation of each of these hallmarks has been discussed with emphasis on inherent age-dependent deficiencies in lipid metabolism as well as exogenous lipid changes. There appears to be sufficient evidence to consider impaired lipid metabolism as key driver of the ageing process although much of knowledge is yet fragmented. Considering dietary lipids, the type and quantity of lipids in the diet is a significant, but often overlooked determinant that governs the effects of lipids on ageing. Further research using integrative approaches amidst the known aging hallmarks is highly desirable for understanding the therapeutics of lipids associated with ageing.

Leucine Intake and Risk of Impaired Physical Function and Frailty in Older Adults

BACKGROUND

Leucine is suggested to play a central role in age-related physical decline, but the effect of dietary leucine intake on physical functioning is uncertain. We examined the prospective association between dietary leucine intake and impaired lower-extremity function (ILEF) and frailty in older adults.

METHODS

We used data from 2 956 adults aged ≥60 and older from the Seniors-ENRICA cohort. At baseline (2008-2010) and in 2012, dietary information was obtained with a validated computerized face-to-face diet history, from which energy-adjusted cumulative leucine intake per body weight was calculated. Participants were followed up through 2017 to assess incident ILEF, ascertained with the Short Physical Performance Battery, and incident frailty, according to the Fried phenotype criteria. Statistical analysis was performed with Cox models adjusted for the main potential confounders.

RESULTS

During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared with participants in the lowest tertile of leucine intake (35.5-89.0 mg/kg/d), those in the highest tertile (107.4-372.5 mg/kg/d) had a lower risk of ILEF (fully adjusted hazard ratio [95% confidence interval]: 0.70 [0.53-0.93], p trend: .01) and of frailty (0.63 [0.41-0.96], p trend: .03]. A higher consumption of important sources of leucine in this population, including unprocessed beef, oily and white fish, and bread, were also associated with a lower risk of incident ILEF and frailty.

CONCLUSIONS

Higher leucine intake was associated with reduced risk of ILEF and frailty. Dietary leucine, obtained from foods rich in high-quality protein, could be a key nutrient to prevent age-related physical function decline in older adults.

Effects of fish oil-derived n-3 polyunsaturated fatty acid on body composition, muscle strength and physical performance in older people: a secondary analysis of a randomised, double-blind, placebo-controlled trial

BACKGROUND

the effects regarding n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on sarcopenia have been explored by several clinical trials. Nonetheless, the use of n-3 PUFA for improving body composition, muscle strength and physical performance in older people is conflicting.

OBJECTIVES

our aim was to perform a randomised, double-blind, controlled trial to evaluate the effects of 6-month n-3 PUFA supplementation on body composition, muscle strength and physical performance in older Chinese people.

METHODS

in this double-blind, placebo-controlled trial, 200 eligible subjects were randomly assigned to receive 4 g/day fish oil capsules (1.34 g eicosapentaenoic [EPA] + 1.07 docosahexaenoic [DHA]) or 4 g/day corn oil capsules (EPA + DHA <0.05 g) for 6 months. The primary outcomes were the changes of body composition, muscle strength (hand grip strength) and physical performance (Timed Up and Go time). Secondary outcomes were the changes in serum lipid profiles.

RESULTS

compared with control group, fish oil-derived n-3 PUFA supplementation resulted in significant increases in thigh circumference (interaction time × group effect P < 0.001), total skeletal muscle mass (interaction time × group effect P < 0.001) and appendicular skeletal muscle mass (interaction time × group effect P < 0.001); the differences were still significant even after height correction. Muscle strength and physical performance including hand grip strength (interaction time × group effect P < 0.001) and Timed Up and Go time (interaction time × group effect P < 0.001) were also improved after a 6-month fish oil-derived n-3 PUFA intervention. In terms of serum lipid profiles, fish oil-derived n-3 PUFA supplementation could significantly reduce serum level of triglyceride (interaction time × group effect P = 0.012) and increase high density lipoprotein cholesterol (interaction time × group effect P < 0.001); while no significant improvement was found in serum concentrations of total cholesterol (interaction time × group effect P = 0.413) and low density lipoprotein cholesterol (interaction time × group effect P = 0.089).

CONCLUSIONS

our present trial demonstrated that a 6-month fish oil-derived n-3 PUFA supplementation could beneficially affect the body composition, muscle strength, physical performance and serum lipid profiles in older people, which could be into considerations when making strategies aiming to the primary prevention of sarcopenia.

Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study

Purpose

To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study.

Methods

This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up.

Results

Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women.

Conclusions

PUFA intake was associated with decreased risk of disabling hearing function in women, but not in men.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-021-02644-7.

Plasma Ceramides and Risk of Impaired Lower-Extremity Function in Older Adults: A Nested Case-Control Study

BACKGROUND

Higher levels of ceramides have been linked to several chronic diseases; also there is emerging cross-sectional evidence that ceramides are associated with lower physical functioning. This research assessed for the first time the prospective relationship between ceramide species and impaired lower-extremity function (ILEF) in older adults.

METHODS

Case-control study with 43 cases of ILEF and 86 age- and sex-matched controls, which was nested in the Seniors-ENRICA cohort of community-dwelling older adults. Incident ILEF from 2015 to 2017 was ascertained with the Short Physical Performance Battery. In 2015, 27 ceramide species were measured in plasma by liquid chromatography-tandem mass spectrometry. Conditional logistic regression models were used to assess the longitudinal relationship between ceramides concentration and incidence of ILEF.

RESULTS

After adjusting for education level, body mass index, alcohol and total energy intake, physical activity, and presence of chronic conditions, some ceramide species were related to 2-year incidence of ILEF. Specifically, the odds ratios of ILEF per 1-SD increase in ceramide concentration were: 1.66 [95% CI = (1.03, 2.68)] for ceramide C14:0, 1.61 (1.00, 2.59) for ceramide C16:0, and 1.64 (1.03, 2.60) for ceramide C16:1 (n-7). In the case of ceramides C16:0 and C16:1 (n-7), a stronger relationship was found in those with a higher body mass index; systolic blood pressure could also mediate the relationship between ceramide C16:1 (n-7) and ILEF (p for interaction = .03).

CONCLUSIONS

Higher plasma levels of ceramides C14:0, C16:0, and C16:1 (n-7) are associated with higher risk of ILEF, and might serve as risk markers for functional decline in older adults.

Beneficial Role of Replacing Dietary Saturated Fatty Acids with Polyunsaturated Fatty Acids in the Prevention of Sarcopenia: Findings from the NU-AGE Cohort

Dietary fat subtypes may play an important role in the regulation of muscle mass and function during ageing. The aim of the present study was to determine the impact of isocaloric macronutrient substitutions, including different fat subtypes, on sarcopenia risk in older men and women, while accounting for physical activity (PA) and metabolic risk. A total of 986 participants, aged 65–79 years, completed a 7-day food record and wore an accelerometer for a week. A continuous sex-specific sarcopenia risk score (SRS), including skeletal muscle mass assessed by dual-energy X-ray absorptiometry (DXA) and handgrip strength, was derived. The impact of the isocaloric replacement of saturated fatty acids (SFAs) by either mono- (MUFAs) or poly-unsaturated (PUFAs) fatty acids on SRS was determined using regression analysis based on the whole sample and stratified by adherence to a recommended protein intake (1.1 g/BW). Isocaloric reduction of SFAs for the benefit of PUFAs was associated with a lower SRS in the whole population, and in those with a protein intake below 1.1 g/BW, after accounting for age, smoking habits, metabolic disturbances, and adherence to PA guidelines. The present study highlighted the potential of promoting healthy diets with optimised fat subtype distribution in the prevention of sarcopenia in older adults.

Relationships Between Eating Behaviors and Hand Grip Strength Among Chinese Adults: A Population-Based Cross-Sectional Study

Purpose

Poor eating behaviors are associated with imbalances in energy and food intake, which may directly or indirectly contribute to muscle strength loss. This study aimed to investigate the association between eating behaviors and hand grip strength in Chinese adults.

Materials and Methods

We designed and conducted a cross-sectional study of 2009 Chinese individuals aged 25–65 years in 2017. Eating behaviors, including breakfast consumption, snacking after dinner, and eating rate, were assessed using a self-administered questionnaire. Hand grip strength was assessed using a digital grip dynamometer. Age, sex, BMI, physical activity, educational level, occupation, living status, sleep duration, smoking and drinking status, hypertension, diabetes, and depressive symptoms were used as confounding factors.

Results

After final adjustments for confounding factors, grip strength was measured as 35.2 (95% confidence interval [CI]: 34.7–35.8), 36.0 (95% CI: 35.6–36.4), and 36.9 (95% CI: 36.6–37.3) for those who skipped, occasionally ate, and regularly ate breakfast, respectively (p for trend <0.001). Those who always, sometimes, and seldom snacked after dinner (p for trend <0.001) reported the following grip strength: 34.7 (95% CI: 34.0–35.3), 36.2 (95% CI: 35.8–36.6), and 36.9 (95% CI: 36.6–37.2), respectively. Significant associations were not found between eating rate and grip strength.

Conclusion

This study showed that higher frequency of breakfast consumption and lower frequency of snacking after dinner were associated with higher grip strength in Chinese adults. Therefore, eating behaviors may be involved in muscle function.