1
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Warner J, Stocker R, Brandt K, Crabtree DR, Ormond L, Stevenson E, Holliday A. Appetite, food intake, and gut hormone responses to glycomacropeptide protein ingestion in older adults: A feasibility, acceptability, and pilot study. Appetite 2024; 200:107509. [PMID: 38795943 DOI: 10.1016/j.appet.2024.107509] [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: 02/07/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024]
Abstract
Glycomacropeptide (GMP) has a unique amino acid profile which may make less satiating than other dietary proteins. This study assessed the feasibility and likely acceptability of a leucine-enriched GMP drink and determined appetite response in older adults (OA). Thirteen OA (11f; 70 ± 4 years) were recruited for sensory assessments of a leucine-enriched GMP drink when mixed with water and with fruit smoothie, compared with whey protein isolate (WHEY). Participants also partook in a single focus group exploring acceptability to protein and supplementation. Separately, a counterbalanced, double-blind study with twelve OA (8f; 69 ± 3 years) was conducted to determine appetite and gut hormone responses. Fasting subjective appetite was recorded using visual analogue scales and a fasted venous blood sample was collected (to measures acyl-ghrelin, PYY, GLP-1, and CCK) before participants consumed either: GMP protein (27g + 3g leucine, 350 mL water), WHEY (30g, 350 mL water), or water. Participants rested for 240 min, with appetite measures and blood sampling throughout. An ad libitum pasta-based meal was then consumed. Sensory testing revealed low pleasantness rating for GMP in water vs. WHEY (16 ± 14 vs 31 ± 24, p = 0.016). GMP addition to smoothie reduced pleasantness (26 ± 21 vs. 61 ± 29, p = 0.009) and worsened the aroma (46 ± 15 vs. 69 ± 28, p = 0.014). The focus group revealed uncertainty of protein needs and a scepticism of supplements, with preference for food. Gut hormone response did not differ between GMP and WHEY (nAUC for all gut hormones p > 0.05). There was no difference between conditions for lunch ad libitum intake (549 ± 171 kcal, 512 ± 238 kcal, 460 ± 199 kcal for GMP, WHEY, and water, p = 0.175), or for subjective appetite response. Leucine-enriched GMP was not less satiating than WHEY, and low palatability and scepticism of supplements question the likely acceptability of GMP supplementation. Providing trusted nutritional advice and food enrichment/fortification may be preferred strategies for increasing protein intake in OA.
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Affiliation(s)
- Jordan Warner
- School of Biomedical, Nutritional, and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Rachel Stocker
- School of Biomedical, Nutritional, and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Kirsten Brandt
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | | | | | - Emma Stevenson
- School of Biomedical, Nutritional, and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Adrian Holliday
- School of Biomedical, Nutritional, and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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2
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Hettiarachchi J, Reijnierse EM, Kew N, Fetterplace K, Tan SY, Maier AB. The effect of dose, frequency, and timing of protein supplementation on muscle mass in older adults: A systematic review and meta-analysis. Ageing Res Rev 2024; 99:102325. [PMID: 38830547 DOI: 10.1016/j.arr.2024.102325] [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: 01/23/2024] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 06/05/2024]
Abstract
Protein supplementation has shown to improve muscle mass in older adults. However, its effect may be influenced by supplementation dose, frequency and timing. This systematic review aimed to assess the effect of dose, frequency and timing of protein supplementation on muscle mass in older adults. Five databases were systematically searched from inception to 14 March 2023, for randomised controlled trials investigating the effect of protein supplementation on muscle mass in adults aged ≥65 years. Random effects meta-analyses were performed, stratified by population. Subgroups were created for dose (≥30 g, <30 g/day), frequency (once, twice, three times/day) and timing of supplementation (at breakfast, breakfast and lunch, breakfast and dinner, all meals, between meals). Heterogeneity within and between subgroups was assessed using I2 and Cochran Q statistics respectively. Thirty-eight articles were included describing community-dwelling (28 articles, n=3204, 74.6±3.4 years, 62.8 % female), hospitalised (8 articles, n=590, 77.0±3.7 years, 50.3 % female) and institutionalised populations (2 articles, n=156, 85.7±1.2 years, 71.2 % female). Protein supplementation showed a positive effect on muscle mass in community-dwelling older adults (standardised mean difference 0.116; 95 % confidence interval 0.032-0.200 kg, p=0.007, I2=15.3 %) but the effect did not differ between subgroups of dose, frequency and timing (Q=0.056, 0.569 and 3.084 respectively, p>0.05). Data including hospitalised and institutionalised populations were limited. Protein supplementation improves muscle mass in community-dwelling older adults, but its dose, frequency or timing does not significantly influence the effect.
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Affiliation(s)
- Jeewanadee Hettiarachchi
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia; Institute of Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Natalie Kew
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Kate Fetterplace
- Department of Allied Health (Clinical Nutrition), The Royal Melbourne Hospital, Melbourne, VIC, Australia; The University of Melbourne, Department of Critical Care, Melbourne Medical School, Melbourne, VIC, Australia
| | - Sze-Yen Tan
- Institute of Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, @AgeSingapore, National University Health System, Singapore.
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3
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Munoz N, Litchford M. Nutritional Aspects of Wound Care. Clin Geriatr Med 2024; 40:481-500. [PMID: 38960539 DOI: 10.1016/j.cger.2023.12.005] [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] [Indexed: 07/05/2024]
Abstract
Malnutrition is a collective term that includes both undernutrition and malnutrition. Malnutrition presents with and without inflammation, is reported in underweight, normal weight, and overweight individuals, and is associated with undesirable alterations in body composition, and diminished functional status. Older adults commonly experience dwindling nutritional status as evidenced by insidious weight loss, insufficient dietary intake, loss of muscle mass, quality, and strength, declining functional status, and other physical and emotional decline indicators. Sustained pressure, acute trauma, malnutrition, and inflammatory-driven chronic conditions increase the risk for skin integrity issues.
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Affiliation(s)
- Nancy Munoz
- Chief Nutrition and Food Service, VA Southern Nevada Healthcare System, Las Vegas, NV, USA.
| | - Mary Litchford
- Case Software, 5601 Forest Manor Drive, Greensboro, NC 27410, USA
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4
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Griffen C, Cullen T, Hattersley J, Weickert MO, Dallaway A, Duncan M, Renshaw D. Effects of resistance exercise and whey protein supplementation on cognitive function in older men: secondary analysis of a randomised, double-blind, placebo-controlled trial. Exp Gerontol 2024; 193:112477. [PMID: 38844183 DOI: 10.1016/j.exger.2024.112477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/22/2024] [Accepted: 06/02/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE Ageing is associated with cognitive decline. This study investigated the individual and combined effects of resistance exercise (RE) and whey protein supplementation (PRO) on cognitive function in older men. METHODS In a pooled-groups analysis, 36 older men (age: 67 ± 4 years) were randomised to either RE (2 x/week; n = 18) or no exercise (NE; n = 18), and either PRO (2 × 25 g/d whey protein isolate; n = 18) or control (CON, 2 × 23.75 g maltodextrin/d; n = 18). A sub-analysis was also conducted between RE + CON (n = 9) and RE + PRO (n = 9). At baseline and 12 weeks, participants completed a battery of neuropsychological tests (CANTAB; Cambridge Cognition, UK) and neurobiological, inflammatory, salivary cortisol and insulin sensitivity biomarkers were quantified. RESULTS PRO improved executive function z-score (+0.31 ± 0.08) greater than CON (+0.06 ± 0.08, P = 0.03) and there was a trend towards improved global cognitive function (P = 0.053). RE and RE + PRO did not improve any cognitive function domains (p ≥ 0.07). RE decreased tumor necrosis factor-alpha (P = 0.02) and interleukin-6 (P = 0.048) concentrations compared to NE, but changes in biomarkers did not correlate with changes in cognitive domains. Muscle strength (r = 0.34, P = 0.045) and physical function (ρ = 0.35-0.51, P < 0.05) outcomes positively correlated with cognitive function domains at baseline, but only Δskeletal muscle index correlated with Δepisodic memory (r = 0.34, P = 0.046) following the intervention. CONCLUSION In older men, PRO improved cognitive function, most notably executive functioning. RE did not improve any cognitive function domains but did decrease biomarkers of systemic inflammation. No synergistic effects were observed.
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Affiliation(s)
- Corbin Griffen
- Centre for Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom.
| | - Tom Cullen
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry CV1 2DS, United Kingdom
| | - John Hattersley
- Centre for Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom; School of Engineering, University of Warwick, Coventry CV4 7HL, United Kingdom
| | - Martin O Weickert
- Centre for Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom; Department of Endocrinology and Diabetes, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom
| | - Alexander Dallaway
- Centre for Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom
| | - Michael Duncan
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom
| | - Derek Renshaw
- Centre for Health and Life Sciences, Coventry University, Coventry CV1 2DS, United Kingdom
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5
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Uhlmann K, Reber E, Schonenberger KA, Stanga Z, Kurmann S. Should handgrip strength be considered when choosing the administration mode of oral nutritional supplements in geriatric patients? A secondary analysis of the MEDPass Trial. Nutrition 2024; 124:112429. [PMID: 38631270 DOI: 10.1016/j.nut.2024.112429] [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: 08/14/2023] [Revised: 11/09/2023] [Accepted: 03/17/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE It is important to individualize nutrition therapy and to identify whether certain patient groups benefit from a specific intervention such as oral nutritional supplements (ONS). This study investigated whether patients with weak handgrip strength (HGS) benefit better from ONS administration in the Medication Pass Nutritional Supplement Program (MEDPass) mode regarding the individual coverage of energy and protein requirements throughout their hospitalization. METHODS A secondary analysis of the intention-to-treat data set of the randomized controlled MEDPass trial was conducted. Weak HGS was defined as <27 kg for men and <16 kg for women. Linear mixed-effect models adjusted for the stratification factors energy density of ONS and nutritional risk screening 2002 score were used to address the aim of the study. RESULTS We included 188 participants. Energy and protein coverage did not differ between the patients with weak or normal HGS depending on ONS administration mode (P = 0.084, P = 0.108). Patients with weak HGS and MEDPass administration mode tended to have the lowest energy and protein coverage (estimated mean, 77.2%; 95% confidence interval [CI], 69.3%-85% and estimated mean, 95.1%; 95% CI, 85.3%-105%, respectively). Patients with weak HGS and conventional ONS administration had the highest energy and protein coverage (estimated mean, 90%; 95% CI, 82.8%-97.2% and estimated mean, 110.2%; 95% CI, 101.3%-119%, respectively). CONCLUSION No clear recommendations regarding the mode of ONS administration depending on HGS can be made. In clinical practice, appetite and satiety in patients with weak HGS should be monitored, and the ONS administration mode should be adjusted accordingly.
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Affiliation(s)
- Katja Uhlmann
- Health Division, Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland.
| | - Emilie Reber
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Katja A Schonenberger
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Zeno Stanga
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Silvia Kurmann
- Health Division, Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland
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6
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Volkert D, Delzenne N, Demirkan K, Schneider S, Abbasoglu O, Bahat G, Barazzoni R, Bauer J, Cuerda C, de van der Schueren M, Doganay M, Halil M, Lehtisalo J, Piccoli GB, Rolland Y, Sengul Aycicek G, Visser M, Wickramasinghe K, Wirth R, Wunderle C, Zanetti M, Cederholm T. Nutrition for the older adult - Current concepts. Report from an ESPEN symposium. Clin Nutr 2024; 43:1815-1824. [PMID: 38970937 DOI: 10.1016/j.clnu.2024.06.020] [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: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND & AIMS In view of the global demographic shift, a scientific symposium was organised by the European Society for Clinical Nutrition and Metabolism (ESPEN) to address nutrition-related challenges of the older population and provide an overview of the current state of knowledge. METHODS Eighteen nutrition-related issues of the ageing global society were presented by international experts during the symposium and summarised in this report. RESULTS Anorexia of ageing, dysphagia, malnutrition, frailty, sarcopenia, sarcopenic obesity, and the metabolic syndrome were highlighted as major nutrition-related geriatric syndromes. Great progress has been made in recent years through standardised definitions of some but not all syndromes. Regarding malnutrition, the GLIM approach has shown to be suitable also in older adults, justifying its continuous implementation. For anorexia of ageing, a consensus definition is still required. Intervention approaches should be integrated and person-centered with the aim of optimizing intrinsic capacity and maintaining functional capacity. Landmark studies like EFFORT and FINGER have impressively documented the potential of individualised and multifactorial interventions for functional and health benefits. Combining nutritional intervention with physical training seems particularly important whereas restrictive diets and drug treatment should generally be used with caution because of undesirable risks. Obesity management in older adults should take into account the risk of promoting sarcopenia. CONCLUSIONS In the future, even more individualised approaches like precision nutrition may enable better nutritional care. Meanwhile all stakeholders should focus on a better implementation of currently available strategies and work closely together to improve nutritional care for older adults.
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Affiliation(s)
- D Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.
| | - N Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Brussels, Belgium.
| | - K Demirkan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkiye.
| | - S Schneider
- Gastroenterology and Nutrition, CHU de Nice, Université Côte d'Azur, Nice, France.
| | - O Abbasoglu
- Department of Clinical Nutrition, Hacettepe University, Ankara, Turkiye.
| | - G Bahat
- Department of Internal Medicine, Division of Geriatrics, Medical Faculty, Istanbul University, Istanbul, Turkiye.
| | - R Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.
| | - J Bauer
- Center for Geriatric Medicine, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Germany.
| | - C Cuerda
- Department of Medicine, Universidad Complutense, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - M de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands; Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands.
| | - M Doganay
- Department of Surgery and Surgical Oncology, University of Health Sciences, Gulhane Medical Faculty, Ankara, Turkiye.
| | - M Halil
- Department of Internal Medicine, Division of Geriatrics, Medical Faculty, Hacettepe University, Ankara, Turkiye.
| | - J Lehtisalo
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - G B Piccoli
- Nephrologie, Centre Hospitalier Le Mans, Le Mans, France.
| | - Y Rolland
- IHU HealthAge, Centre Hospitalo-Universitaire de Toulouse, France; Centre for Epidemiology and Research in POPulation Health, CERPOP UMR 1295, Toulouse, France.
| | | | - M Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - K Wickramasinghe
- Special Initiative on Noncommunicable Diseases and Innovation, WHO Regional Office for Europe, Copenhagen, Denmark.
| | - R Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany.
| | - C Wunderle
- Medical University Department, Division of General Internal and Emergency Medicine, Cantonal Hospital Aarau, Aarau, Switzerland.
| | - M Zanetti
- Geriatric Clinic, Department of Medical Sciences, University of Trieste, Italy.
| | - T Cederholm
- Department of Clinical Nutrition & Metabolism, Uppsala University and Theme Inflammation & Aging, Karolinska University Hospital, Stockholm, Sweden.
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Fine H, Bonthu A, Kogan M. Integrative Geriatric Oncology: A Review of Current Practices. Curr Oncol Rep 2024:10.1007/s11912-024-01575-w. [PMID: 39042197 DOI: 10.1007/s11912-024-01575-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE OF REVIEW This article aims to offer a comprehensive review of optimal integrative medicine practices for geriatric oncology patients. Given the aging population and the global rise in cancer incidence, it is crucial to identify evidence-based modalities and employ an integrated approach to enhance cancer outcomes and quality of life in older adults. RECENT FINDINGS It has been predicted that 20.5% (6.9 million) of new cancer cases in 2050 will occur in adults over 80 years old.1 The increasing focus on lifestyle factors in healthy aging has shed light on various overlooked areas of significance. Notably, anti-inflammatory diets and the promotion of a healthy gut microbiome have demonstrated significant impacts on overall health outcomes, bolstering the body's innate capacity to combat disease. This review delves into further evidence and extrapolation concerning integrative approaches and their influence on cancer outcomes and older adults quality of life. The complexity and unique nature of cancer in older adults requires a wide range of support from medical providers. Incorporating various integrative techniques as part of cancer treatment and side effect support can improve health outcomes and patient's quality of life. Familiarity with the lifestyle interventions and other topics explored in this review equips healthcare providers to offer tailored and holistic care to geriatric patients navigating cancer.
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Affiliation(s)
- Hannah Fine
- GW Center for Integrative Medicine, GW University, Washington, D.C, USA
| | - Amrita Bonthu
- Georgetown University Masters in Integrative Medicine and Health Sciences, Washington, D.C, USA
| | - Mikhail Kogan
- GW Center for Integrative Medicine, GW University, Washington, D.C, USA.
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8
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Cederholm T, Bosaeus I. Malnutrition in Adults. N Engl J Med 2024; 391:155-165. [PMID: 38986059 DOI: 10.1056/nejmra2212159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Affiliation(s)
- Tommy Cederholm
- From Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala (T.C.), Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (T.C.), Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Stockholm (T.C.), and the Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, and the Clinical Nutrition Unit, Sahlgrenska University Hospital, Gothenburg (I.B.) - all in Sweden
| | - Ingvar Bosaeus
- From Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala (T.C.), Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm (T.C.), Theme Inflammation and Aging, Medical Unit Aging, Karolinska University Hospital, Stockholm (T.C.), and the Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, and the Clinical Nutrition Unit, Sahlgrenska University Hospital, Gothenburg (I.B.) - all in Sweden
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9
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Le AK, Lee JW, Nguyen TT, Nguyen TN, Kim Y. Dietary Intake, Menopausal Symptoms, and Body Composition Associated with Possible Sarcopenia Among Vietnamese Middle-Aged Women: A Cross-Sectional Study. Metab Syndr Relat Disord 2024. [PMID: 38985661 DOI: 10.1089/met.2024.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
Background: This study aims to investigate the prevalence of possible sarcopenia and its associated factors among middle-aged Vietnamese women. Methods: A cross-sectional study was conducted on 205 women aged 40-55 years who were admitted to the Can Tho Obstetrics and Gynecology Hospital between February and December 2023. The presence of possible sarcopenia was determined according to the AWGS 2019 criteria. Associated factors were dietary intake (total energy, protein, lipid, and carbohydrate intake), the severity of menopausal symptoms by using the Kupperman index, and body composition by using the bioelectrical impedance analysis device, Inbody S10. Logistic regressions were built to analyze the association between possible sarcopenia and its associated factors. Results: The prevalence of possible sarcopenia was 29.8%, with a mean age of 47.2. Possible sarcopenia was detected in 23% of the participants based on the criterion of low handgrip strength, whereas 83.6% of the participants when considered low performance in the chair stand test. Adjusted logistic regression analysis showed that living in a rural area (adjusted odds ratio [AOR]: 2.16, 95% confidence interval [95% CI]: 1.22-4.72), energy intake <25 kcal/body weight, (AOR: 1.94, 95% CI: 1.75-5.06), protein intake <0.91 g/body weight (AOR: 2.42, 95% CI: 1.51-5.76), skipping breakfast (AOR: 2.03, 95% CI: 0.91-4.54), mild menopausal symptoms (AOR: 2.68, 95% CI: 1.61-5.36), and obesity (AOR: 1.59, 95%CI: 1.29-3.67) were significantly associated with higher risk of possible sarcopenia. Conversely, higher muscle mass and higher upper limb mass were associated with a decreased risk of possible sarcopenia (total muscle mass AOR: 0.20, 95% CI: 0.07-0.59). Conclusions: These findings would provide a basis for enhancing management and prevention strategies to reduce the risk of sarcopenia in Vietnam. In particular, attention to nutrient intake and the management of menopausal symptoms may reduce the risk of sarcopenia.
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Affiliation(s)
- An Khanh Le
- Department of Human Ecology, Graduate School, Korea University, Seoul, Korea
- Department of Nutrition and Dietetics, Can Tho Obstetrics and Gynecology Hospital, Can Tho city, Viet Nam
| | - Jung Woo Lee
- Department of Human Ecology, Graduate School, Korea University, Seoul, Korea
| | - Tam Thanh Nguyen
- Department of Nutrition and Dietetics, Can Tho Obstetrics and Gynecology Hospital, Can Tho city, Viet Nam
| | - Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Ha Noi city, Viet Nam
| | - Yookyung Kim
- Department of Human Ecology, Graduate School, Korea University, Seoul, Korea
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10
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Kishi S, Kadoya H, Kashihara N. Treatment of chronic kidney disease in older populations. Nat Rev Nephrol 2024:10.1038/s41581-024-00854-w. [PMID: 38977884 DOI: 10.1038/s41581-024-00854-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 07/10/2024]
Abstract
As the world population ages, an expected increase in the prevalence of chronic kidney disease (CKD) among older individuals will pose a considerable challenge for health care systems in terms of resource allocation for disease management. Treatment strategies for older patients with CKD should ideally align with those applied to the general population, focusing on minimizing cardiovascular events and reducing the risk of progression to kidney failure. Emerging therapies, such as SGLT-2 inhibitors and GLP-1 receptor agonists, hold promise for the effective management of CKD in older individuals. In addition, non-pharmacological interventions such as nutritional and exercise therapies have a crucial role. These interventions enhance the effects of pharmacotherapy and, importantly, contribute to the maintenance of cognitive function and overall quality of life. Various factors beyond age and cognitive function must be taken into account when considering kidney replacement therapy for patients with kidney failure. Importantly, all treatment options, including dialysis, transplantation and conservative management approaches, should be tailored to the individual through patient-centred decision-making. The dynamic integration of digital technologies into medical practice has the potential to transform the management of CKD in the aging population.
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Affiliation(s)
- Seiji Kishi
- Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan
| | - Hiroyuki Kadoya
- Department of General Geriatric Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Naoki Kashihara
- Department of Medical Science, Kawasaki Medical School, Kurashiki, Japan.
- Kawasaki Geriatric Medical Center, Kawasaki Medical School, Okayama, Japan.
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11
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Wang K, Zhao X, Yang S, Qi X, Li A, Yu W. New insights into dairy management and the prevention and treatment of osteoporosis: The shift from single nutrient to dairy matrix effects-A review. Compr Rev Food Sci Food Saf 2024; 23:e13374. [PMID: 38847750 DOI: 10.1111/1541-4337.13374] [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: 02/18/2024] [Revised: 04/23/2024] [Accepted: 05/12/2024] [Indexed: 06/13/2024]
Abstract
Dairy is recognized as a good source of calcium, which is important for preventing osteoporosis. However, the relationship between milk and bone health is more complex than just calcium supplementation. It is unwise to focus solely on observing the effects of a single nutrient. Lactose, proteins, and vitamins in milk, as well as fatty acids, oligosaccharides, and exosomes, all work together with calcium to enhance its bioavailability and utilization efficiency through various mechanisms. We evaluate the roles of dairy nutrients and active ingredients in maintaining bone homeostasis from the perspective of the dairy matrix effects. Special attention is given to threshold effects, synergistic effects, and associations with the gut-bone axis. We also summarize the associations between probiotic/prebiotic milk, low-fat/high-fat milk, lactose-free milk, and fortified milk with a reduced risk of osteoporosis and discuss the potential benefits and controversies of these dairy products. Moreover, we examine the role of dairy products in increasing peak bone mass during adolescence and reducing bone loss in old age. It provides a theoretical reference for the use of dairy products in the accurate prevention and management of osteoporosis and related chronic diseases and offers personalized dietary recommendations for bone health in different populations.
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Affiliation(s)
- Kaili Wang
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Xu Zhao
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Sijia Yang
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Xiaoxi Qi
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Aili Li
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
- Dairy Processing Technology Research Centre, Heilongjiang Green Food Science Research Institute, Harbin, China
| | - Wei Yu
- Key Laboratory of Dairy Science, College of Food Science, Ministry of Education, Northeast Agricultural University, Harbin, China
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12
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Dowling L, Lynch DH, Batchek D, Sun C, Mark-Wagstaff C, Jones E, Prochaska M, Huisingh-Sheetz M, Batsis JA. Nutrition interventions for body composition, physical function, cognition in hospitalized older adults: A systematic review of individuals 75 years and older. J Am Geriatr Soc 2024; 72:2206-2218. [PMID: 38376064 PMCID: PMC11226365 DOI: 10.1111/jgs.18799] [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: 09/11/2023] [Revised: 12/01/2023] [Accepted: 01/21/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Globally, the oldest old population is expected to triple by 2050. Hospitalization and malnutrition can result in progressive functional decline in older adults. Minimizing the impact of hospitalization on functional status in older adults has the potential to maintain independence, reduce health and social care costs, and maximize years in a healthy state. This study aimed to systematically review the literature to identify nutritional interventions that target physical function, body composition, and cognition in the older population (≥ 75 years). METHODS A systematic review was conducted to evaluate the efficacy of nutritional interventions on physical function, body composition, and cognition in adults aged ≥ 75 years or mean age ≥80 years. Searches of PubMed (National Institutes of Health, National Library of Medicine), Scopus (Elsevier), EMBASE (Elsevier), Cumulative Index to Nursing and Allied Health Literature (CINAHL) with Full Text (EBSCOhost), and PsycInfo (EBSCOhost) were conducted. Screening, data extraction, and quality assessment were performed in duplicate and independently (CRD42022355984; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=355984). RESULTS Of 8311 citations identified, 2939 duplicates were excluded. From 5372 citations, 189 articles underwent full-text review leaving a total of 12 studies for inclusion. Interventions were food-based, protein-based, carbohydrate-based, personalized, or used parenteral nutrition. Ten studies monitored anthropometric or body composition changes with three showing maintenance or improvements in lean mass, body mass index, triceps skinfold, and mid-upper arm circumference compared with the control group. Six studies monitored physical function but only the largest study found a beneficial effect on activities of daily living. Two of three studies showed the beneficial effects of nutritional intervention on cognition. CONCLUSION There are few, high-quality, nutrition-based interventions in older adults ≥75 years. Despite heterogeneity, our findings suggest that large, longer-term (>2 weeks) nutritional interventions have the potential to maintain body composition, physical function, and cognition in adults aged 75 years and older during hospitalization.
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Affiliation(s)
- Lisa Dowling
- The Medical School, University of Sheffield, Sheffield, UK
| | - David H Lynch
- Division of Geriatric Medicine, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dakota Batchek
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Chang Sun
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Emily Jones
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Micah Prochaska
- Section of Hospital Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Megan Huisingh-Sheetz
- Section of Geriatrics and Palliative Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - John A Batsis
- Division of Geriatric Medicine, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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McKendry J, Lowisz CV, Nanthakumar A, MacDonald M, Lim C, Currier BS, Phillips SM. The effects of whey, pea, and collagen protein supplementation beyond the recommended dietary allowance on integrated myofibrillar protein synthetic rates in older males: a randomized controlled trial. Am J Clin Nutr 2024; 120:34-46. [PMID: 38762187 DOI: 10.1016/j.ajcnut.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Skeletal muscle mass is determined predominantly by feeding-induced and activity-induced fluctuations in muscle protein synthesis (MPS). Older individuals display a diminished MPS response to protein ingestion, referred to as age-related anabolic resistance, which contributes to the progression of age-related muscle loss known as sarcopenia. OBJECTIVES We aimed to determine the impact of consuming higher-quality compared with lower-quality protein supplements above the recommended dietary allowance (RDA) on integrated MPS rates. We hypothesized that increasing total protein intake above the RDA, regardless of the source, would support higher integrated rates of myofibrillar protein synthesis. METHODS Thirty-one healthy older males (72 ± 4 y) consumed a controlled diet with protein intake set at the RDA: control phase (days 1-7). In a double-blind, randomized controlled fashion, participants were assigned to consume an additional 50 g (2 × 25g) of whey (n = 10), pea (n = 11), or collagen (n = 10) protein each day (25 g at breakfast and lunch) during the supplemental phase (days 8-15). Deuterated water ingestion and muscle biopsies assessed integrated MPS and acute anabolic signaling. Postprandial blood samples were collected to determine feeding-induced aminoacidemia. RESULTS Integrated MPS was increased during supplemental with whey (1.59 ± 0.11 %/d; P < 0.001) and pea (1.59 ± 0.14 %/d; P < 0.001) when compared with RDA (1.46 ± 0.09 %/d for the whey group; 1.46 ± 0.10 %/d for the pea group); however, it remained unchanged with collagen. Supplemental protein was sufficient to overcome anabolic signaling deficits (mTORC1 and rpS6), corroborating the greater postprandial aminoacidemia. CONCLUSIONS Our findings demonstrate that supplemental protein provided at breakfast and lunch over the current RDA enhanced anabolic signaling and integrated MPS in older males; however, the source of additional protein may be an important consideration in overcoming age-related anabolic resistance. This trial was registered clinicaltrials.gov as NCT04026607.
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Affiliation(s)
- James McKendry
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Caroline V Lowisz
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Arraksana Nanthakumar
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Meaghan MacDonald
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Changhyun Lim
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Brad S Currier
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada.
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Riddle E, Munoz N, Clark K, Collins N, Coltman A, Nasrallah L, Nishioka S, Scollard T, Simon JR, Moloney L. Prevention and Treatment of Malnutrition in Older Adults Living in Long-Term Care or the Community: An Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2024; 124:896-916.e24. [PMID: 38583584 DOI: 10.1016/j.jand.2024.03.013] [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: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
Malnutrition in older adults can decrease quality of life and increase risk of morbidities and mortality. Accurate and timely identification of malnutrition, as well as subsequent implementation of effective interventions, are essential to decrease poor outcomes associated with malnutrition in older adults. The Academy of Nutrition and Dietetics Evidence Analysis Center conducted a systematic review of the literature to develop an evidence-based nutrition practice guideline for the prevention and treatment of malnutrition in older adults. The objective of this guideline was to provide evidence-based recommendations to identify, prevent, or treat protein-energy malnutrition in older adults (mean age ≥65 years) living in long-term care and community settings. This guideline provides 11 nutrition recommendations to inform shared decision making among dietitians, members of the health care team, family members or caregivers, and older adults living in long-term care or the community to prevent or treat malnutrition. Topics include dietitian effectiveness, nutrition assessment tools, oral nutrition supplements, food fortification, and home-delivered and congregate meals. Guideline implementation should include consideration of the importance of comprehensive individualized nutrition care for older adults. Future research is needed to address gaps that were identified related to the validity, reliability, and feasibility of nutrition assessment tools, as well as the effectiveness of dietitian interventions on outcomes of interest in older adults living in long-term care and the community.
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Affiliation(s)
- Emily Riddle
- State University of New York at Oneonta, Oneonta, New York
| | - Nancy Munoz
- Veterans Affairs Southern Nevada Healthcare System, Las Vegas, Nevada
| | | | | | - Anne Coltman
- Commission on Dietetic Registration, Chicago, Illinois
| | - Lamia Nasrallah
- Outpatient Nutrition Services, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | | | - Judy R Simon
- Nutrition and Health Promotion Consultant, Easton, Maryland
| | - Lisa Moloney
- Academy of Nutrition and Dietetics, Chicago, Illinois.
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15
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McGrath R, McGrath BM, Jurivich D, Knutson P, Mastrud M, Singh B, Tomkinson GR. Collective Weakness Is Associated With Time to Mortality in Americans. J Strength Cond Res 2024; 38:e398-e404. [PMID: 38595265 PMCID: PMC11189751 DOI: 10.1519/jsc.0000000000004780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
ABSTRACT McGrath, R, McGrath, BM, Jurivich, D, Knutson, P, Mastrud, M, Singh, B, and Tomkinson, GR. Collective weakness is associated with time to mortality in Americans. J Strength Cond Res 38(7): e398-e404, 2024-Using new weakness cutpoints individually may help estimate time to mortality, but their collective use could improve value. We sought to determine the associations of (a) each absolute and body size normalized cut point and (b) collective weakness on time to mortality in Americans. The analytic sample included 14,178 subjects aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. Date of death was confirmed from the National Death Index. Handgrip dynamometry measured handgrip strength (HGS). Men were categorized as weak if their HGS was <35.5 kg (absolute), <0.45 kg·kg -1 (body mass normalized), or <1.05 kg·kg -1 ·m -2 (body mass index [BMI] normalized). Women were classified as weak if their HGS was <20.0 kg, <0.337 kg·kg -1 , or <0.79 kg·kg -1 ·m -2 . Collective weakness categorized persons as below 1, 2, or all 3 cutpoints. Cox proportional hazard regression models were used for analyses. Subject values below each absolute and normalized cutpoint for the 3 weakness parameters had a higher hazard ratio for early all-cause mortality: 1.45 (95% confidence interval [CI]: 1.36-1.55) for absolute weakness, 1.39 (CI: 1.30-1.49) for BMI normalized weakness, and 1.33 (CI: 1.24-1.43) for body mass normalized weakness. Those below 1, 2, or all 3 weakness cut points had a 1.37 (CI: 1.26-1.50), 1.47 (CI: 1.35-1.61), and 1.69 (CI: 1.55-1.84) higher hazard for mortality, respectively. Weakness determined by a composite measure of absolute and body size adjusted strength capacity provides robust prediction of time to mortality, thus potentially informing sports medicine and health practitioner discussions about the importance of muscle strength during aging.
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Affiliation(s)
- Ryan McGrath
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
- Fargo VA Healthcare System, Fargo, ND, USA
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | | | - Donald Jurivich
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
| | - Peter Knutson
- Department of Geriatrics, University of North Dakota, Grand Forks, ND, USA
| | - Michaela Mastrud
- Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND, USA
| | - Ben Singh
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Grant R. Tomkinson
- Alliance for Research in Exercise, Nutrition, and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Millward DJ. Post-prandial tracer studies of protein and amino acid utilisation: what can they tell us about human amino acid and protein requirements? Br J Nutr 2024; 131:2005-2030. [PMID: 38606599 DOI: 10.1017/s0007114524000734] [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: 04/13/2024]
Abstract
Nitrogen balance (NB), the principal methodology used to derive recommendations for human protein and amino acid requirements, has been widely criticised, and calls for increased protein and amino acid requirement recommendations have been made, often on the basis of post-prandial amino acid tracer kinetic studies of muscle protein synthesis, or of amino acid oxidation. This narrative review considers our knowledge of the homeostatic regulation of the FFM throughout the diurnal cycle of feeding and fasting and what can and has been learnt from post-prandial amino acid tracer studies, about amino acid and protein requirements. Within the FFM, muscle mass in well fed weight-stable adults with healthy lifestyles appears fixed at a phenotypic level within a wide range of habitual protein intakes. However homoeostatic regulation occurs in response to variation in habitual protein intake, with adaptive changes in amino acid oxidation which influence the magnitude of diurnal losses and gains of body protein. Post-prandial indicator amino acid oxidation (IAAO) studies have been introduced as an alternative to NB and to the logistically complex 24 h [13C-1] amino acid balance studies, for assessment of protein and amino acid requirements. However, a detailed examination of IAAO studies shows both a lack of concern for homeostatic regulation of amino acid oxidation and major flaws in their design and analytical interpretation, which seriously constrain their ability to provide reliable values. New ideas and a much more critical approach to existing work is needed if real progress is to be made in the area.
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Affiliation(s)
- D Joe Millward
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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17
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Irigoyen-Camacho ME, Velazquez-Alva MC, Zepeda-Zepeda MA, Lazarevich I, Castano-Seiquer A, Flores-Fraile J. Physical Performance, Body Composition, and Oral Health in Community-Residing Older Adults: A Cross-Sectional Study. Geriatrics (Basel) 2024; 9:89. [PMID: 39051253 DOI: 10.3390/geriatrics9040089] [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: 05/22/2024] [Revised: 06/23/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
Physical activity is essential for healthy aging. This study aimed to identify an association between physical performance, body fat percentage (%BF), and the perception of oral health-related quality of life (OHRQoL) in independent older adults. METHOD A group of active older adults was selected from a government-sponsored reunion center in Mexico City. OHRQoL was assessed using the General Oral Health Index (GOHAI), and nutritional status was assessed using the Mini Nutritional Assessment (MNA) tool. A short physical performance battery (SPPB) was applied, and, for body composition, DXA (dual X-ray absorptiometry) was conducted. Data were analyzed using logistic regression models, and marginal probabilities were obtained. RESULTS This study involved 366 participants; their mean age was 73.9 (±6.2) years, and 24.9% had type 2 diabetes mellitus (T2DM). OHRQoL information revealed that pain or discomfort in the oral cavity was perceived by 63.9% of the older adults during the previous three months. The SPPB score was low in 159 (43.44%) participants. The logistic regression model revealed that age (OR = 1.13, p < 0.001), T2DM (OR = 2.10, p = 0.009), the risk of malnutrition/malnutrition (OR = 1.76, p = 0.047), high %BF (OR = 1.09, <0.001), and poor OHRQoL (OR = 1.96, p = 0.009) were associated with deteriorated physical performance. CONCLUSION OHRQoL self-perception, excess body fat, and nutritional status impacted physical performance. Aging well requires a comprehensive approach.
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Affiliation(s)
- Maria Esther Irigoyen-Camacho
- Health Care Department, Metropolitan Autonomous University, Calzada del Hueso 1100, Col. Villa Quietud, Mexico City 04960, Mexico
| | - Maria Consuelo Velazquez-Alva
- Health Care Department, Metropolitan Autonomous University, Calzada del Hueso 1100, Col. Villa Quietud, Mexico City 04960, Mexico
| | - Marco Antonio Zepeda-Zepeda
- Health Care Department, Metropolitan Autonomous University, Calzada del Hueso 1100, Col. Villa Quietud, Mexico City 04960, Mexico
| | - Irina Lazarevich
- Health Care Department, Metropolitan Autonomous University, Calzada del Hueso 1100, Col. Villa Quietud, Mexico City 04960, Mexico
| | | | - Javier Flores-Fraile
- Department of Surgery, Faculty of Medicine, University of Salamanca, C. Alfonso X el Sabio, s.n., 37008 Salamanca, Spain
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18
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Kokura Y, Ueshima J, Saino Y, Keisuke M. Enhanced protein intake on maintaining muscle mass, strength, and physical function in adults with overweight/obesity: A systematic review and meta-analysis. Clin Nutr ESPEN 2024; 63:417-426. [PMID: 39002131 DOI: 10.1016/j.clnesp.2024.06.030] [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: 06/07/2024] [Accepted: 06/18/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND & AIMS Weight loss in individuals with obesity and overweight leads to metabolic and health benefits but also poses the risk of muscle mass reduction. This systematic review and meta-analysis of randomized controlled trials aims to determine the initial protein amount necessary for achieving weight loss while maintaining muscle mass, strength, and physical function in adults with overweight and obesity. METHODS Relevant literature databases, including Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica (Embase), the Cumulative Index to Nursing and Allied Health Literature (CINHAL), and Web of Science, were electronically searched up to 15 March 2023. We examined the effect of additional protein intake on muscle mass, strength, and physical function in adults with overweight or obesity targeting weight loss. The risk of bias was assessed using the Cochrane RoB 2.0 tool. Results were synthesized using standardized mean differences (SMD) and 95% confidence intervals (CI) via a random-effects model. RESULTS Forty-seven studies (n = 3218) were included. In the muscle mass analysis, twenty-eight trials with 1989 participants were encompassed. Results indicated that increased protein intake significantly prevents muscle mass decline in adults with overweight or obesity aiming for weight loss (SMD 0.75; 95% CI 0.41 to 1.10; p < 0.001). Enhanced protein intake did not significantly prevent decreases in muscle strength and physical function. An intake exceeding 1.3 g/kg/day is anticipated to increase muscle mass, while an intake below 1.0 g/kg/day is associated with a higher risk of muscle mass decline. The risk of bias in studies regarding muscle mass ranged from low to high. CONCLUSIONS Adults with overweight or obesity and aim for weight loss can more effectively retain muscle mass through higher protein intake, as opposed to no protein intake enhancement.
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Affiliation(s)
- Yoji Kokura
- Department of Nutritional Management, Keiju Hatogaoka Integrated Facility for Medical and Long-Term Care, Ishikawa, Japan.
| | - Junko Ueshima
- Department of Nutritional Service, NTT Medical Center Tokyo, Japan, Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.
| | - Yoko Saino
- Department of Clinical Nutrition, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan, Department of Nutrition and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
| | - Maeda Keisuke
- Nutrition Therapy Support Center, Aichi Medical University Hospital, Aichi, Japan, Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Aichi, Japan.
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Rios-Escalante V, Perez-Barba JC, Espinel-Bermudez MC, Zavalza-Gomez AB, Arias-Merino ED, Zavala-Cerna MG, Sanchez-Garcia S, Trujillo X, Nava-Zavala AH. Effects of a Multicomponent Preventive Intervention in Women at Risk of Sarcopenia: A Pilot Study. Healthcare (Basel) 2024; 12:1191. [PMID: 38921304 PMCID: PMC11203817 DOI: 10.3390/healthcare12121191] [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: 02/02/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
Sarcopenia is defined by the presence of decreased skeletal muscle mass, strength, and functionality in older people. Multicomponent interventions represent an alternative to non-pharmacological treatment for preventing disease progression. This study aimed to evaluate the effects of a multicomponent intervention approach in women at risk of sarcopenia. METHODS A quasi-experimental pilot study of 12 weeks was conducted, with 24 sessions of dancing and resistance exercises and 12 sessions of nutritional education. The outcomes were changes in muscle mass, grip strength, gait speed, and body composition. The project was registered on Clinical Trials: NCT06038500 (14 September 2023). RESULTS Twelve women aged 55-75 years participated in this study; after the intervention, changes were found in the following variables: grip strength, from 18.70 (17.98-19.23) at baseline to 21.57 (20.67-23.16) kg (p = 0.002); gait speed, from 0.95 (0.81-1.18) at baseline to 1.34 (1.20-1.47) m/s (p = 0.003); and hip circumference, from 99.75 (94.75-110.37) at baseline to 97.65 (93.92-109.50) cm (p = 0.023). Other measurements that appeared without changes were appendicular skeletal muscle mass, from 21.17 (18.58-22.33) at baseline to 20.77 (18.31-22.39) kg (p = 0.875), and the appendicular skeletal muscle mass index, from 8.64 (8.08-9.35) at baseline to 8.81 (7.91-9.38) kg/m2 (p = 0.875) after the intervention. CONCLUSIONS The three-month multicomponent intervention in women at risk of sarcopenia improved their grip strength and gait speed.
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Affiliation(s)
- Violeta Rios-Escalante
- Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (V.R.-E.); (E.D.A.-M.)
- Facultad de Medicina, Universidad de Colima, Colima 28040, Colima, Mexico
| | - Juan Carlos Perez-Barba
- Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico; (J.C.P.-B.); (A.B.Z.-G.)
| | - Maria Claudia Espinel-Bermudez
- Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (V.R.-E.); (E.D.A.-M.)
- Facultad de Medicina, Universidad de Colima, Colima 28040, Colima, Mexico
- Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico; (J.C.P.-B.); (A.B.Z.-G.)
- Unidad de Investigacion Biomedica 02, Hospital de Especialidades, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico
| | - Ana Bertha Zavalza-Gomez
- Hospital de Ginecologia y Obstetricia, Centro Medico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico; (J.C.P.-B.); (A.B.Z.-G.)
| | - Elva Dolores Arias-Merino
- Departamento de Salud Publica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (V.R.-E.); (E.D.A.-M.)
| | - Maria G. Zavala-Cerna
- Unidad Academica Ciencias de la Salud, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico;
| | - Sergio Sanchez-Garcia
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Area Envejecimiento, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico 06720, Mexico;
| | - Xochitl Trujillo
- Centro Universitario de Investigaciones Biomedicas, Universidad de Colima, Colima 28040, Colima, Mexico;
| | - Arnulfo Hernan Nava-Zavala
- Unidad de Investigacion Epidemiologica y en Servicios de Salud, Centro Medico Nacional de Occidente Organo de Operación Administrativa Desconcentrada Jalisco, Instituto Mexicano del Seguro Social, Guadalajara 44329, Jalisco, Mexico
- Programa Internacional de Medicina, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico
- Departamento de Inmunologia y Reumatologia del Hospital General de Occidente, Secretaria de Salud Jalisco, Guadalajara 45170, Jalisco, Mexico
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Yuan W, Chen M, Chen Y, Xu D, Li Z, Bai H, Xu Q, Jiang Y, Gu J, Li S, Su C, Gu L, Fang J, Zhu X, Sun J, Chen J. Effects of soy protein-rich meals on muscle health of older adults in long-term care: A randomized clinical trial. Nutrition 2024; 126:112507. [PMID: 39003895 DOI: 10.1016/j.nut.2024.112507] [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: 02/02/2024] [Revised: 05/09/2024] [Accepted: 05/30/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE This study investigated the effects of a soy protein-rich meal intervention on the muscle health of older adults in long-term care facilities. METHODS A 12-week single-center randomized controlled trial with a control-group and open-label design was conducted. Eighty-four older adults from a long-term care facility participated in the study. The chefs at the facility cooked three meals using soy protein-rich recipes designed by dieticians. For 12 weeks, the intervention group participants consumed three meals with 30 g of soy protein (10 g/meal) per day, and the control group participants maintained their habitual diets. RESULTS The 84 participants (mean age, 84.9 ± 7.0 years; 61.9% female) were randomly assigned to an intervention group (43 participants) and a control group (41 participants). The intervention group exhibited significant increases in several lean mass indicators, namely soft lean mass (mean, 1.43 kg; 95% confidence interval [CI]: 0.20-1.65 kg), skeletal muscle mass (mean, 1.20 kg; 95% CI: 0.43-1.96 kg), appendicular skeletal muscle mass (mean, 0.79 kg; 95% CI: 0.07-1.52 kg), and skeletal muscle index (mean, 0.37 kg/m2; 95% CI: 0.05-0.68 kg/m2) (all P < 0.05). These changes were not observed in the control group (all P > 0.05). Notably, calf circumference decreased significantly in the control group (mean, -0.98 cm; 95% CI: -1.61 to -0.36 cm) but was maintained in the intervention group. The differences in the calf circumference and 6-m walk performance of the two groups were significant (P < 0.05). CONCLUSIONS The 12-week soy protein-rich meal intervention improved the muscle mass and 6-m walk performance of older adults in a long-term care facility.
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Affiliation(s)
- Wuke Yuan
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China; School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China; School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Chen
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Yanqiu Chen
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Danfeng Xu
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Zhen Li
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Huijing Bai
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Qi Xu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanrong Jiang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Jie Gu
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Shengqi Li
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Chenxi Su
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Lili Gu
- Shanghai XiJiao Union Retirement Center, Shanghai, China
| | - Jiaxin Fang
- Shanghai XiJiao Union Retirement Center, Shanghai, China
| | - Xinyao Zhu
- Shanghai XiJiao Union Retirement Center, Shanghai, China
| | - Jianqin Sun
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China; Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China.
| | - Jie Chen
- Shanghai Elderly Nutrition and Health Quality Control Center, Shanghai, China; Department of Geriatrics, Fudan University Affiliated to HuaDong Hospital, Shanghai, China
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21
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O'Brien L, Wilkinson TJ, Frampton C, Gearry RB, Wall C. A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities. Am J Clin Nutr 2024:S0002-9165(24)00520-3. [PMID: 38851635 DOI: 10.1016/j.ajcnut.2024.05.026] [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: 12/03/2023] [Revised: 05/12/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Older adults living in residential care facilities are commonly given laxatives to treat constipation; however, these may not always provide full relief, and side effects include diarrhea. Dietary fiber effectively prevents constipation, and international guidelines recommend 25 g/d for optimal laxation. Older adults in residential care rely on the facility menu to provide their nutritional requirements, including adequate dietary fiber. Little is known about how much dietary fiber is provided and consumed. OBJECTIVES We aimed to determine the provision and consumption of dietary fiber for older adults living in residential care facilities. METHODS We systematically searched available literature for studies reporting the analysis of residential care menus and meals consumed by residents aged over 65 y. A meta-analysis was performed on the studies that provided the mean amount of dietary fiber provided and consumed by residents. A random effect model was applied due to the heterogeneity of study methodologies. RESULTS The literature search yielded 4406 publications, but only 28 studies were eligible for our meta-analysis. The study sample comprised 4817 residents. The mean amount of fiber provided to residents was 21.4 g/d [standard error (SE): 1.2; 95% confidence interval: 18.8, 24.2 g/d], the mean amount of fiber consumed by residents was 15.8 g/d (SE: 0.6; 95% confidence interval: 14.7, 16.9 g/d). CONCLUSIONS Older adults living in care facilities are provided with dietary fiber below the recommended guidelines. Compounding this is that residents consume much less than what is provided and do not meet the recommendations for dietary fiber consumption. There is scope to improve dietary fiber provision, promote consumption to residents to aid laxation, and potentially reduce laxative use and the unwanted side effects of diarrhea. This trial was registered at PROSPERO as CRD42023427265.
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Affiliation(s)
- Leigh O'Brien
- Department of Medicine, University of Otago, Christchurch, New Zealand.
| | - Tim J Wilkinson
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Catherine Wall
- Department of Medicine, University of Otago, Christchurch, New Zealand
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Shaban M, Amer FGM, Shaban MM. The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatr Nurs 2024; 58:215-224. [PMID: 38838403 DOI: 10.1016/j.gerinurse.2024.05.021] [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: 01/10/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This study assesses a geriatric nursing-led sustainable heat prevention program for elderly agricultural workers. It targets those aged 60 and above, addressing the heightened risk of heat strain in the era of climate change. METHODS A community-based quasi-experimental design involved 120 elderly agricultural workers, divided into intervention and control groups. The program, spanning three months, included education on hydration, rest, protective clothing, and recognition of heat-related illnesses. RESULTS The intervention led by geriatric nursing professionals showed significant improvements in heat strain metrics. The Heat Strain Score Index (HSSI) and the Observational-Perceptual Heat Strain Risk Assessment (OPHSRA) Index indicated increased safety levels and reduced risk categories among participants. CONCLUSIONS The study demonstrates the effectiveness of a geriatric nursing-led, tailored prevention program in reducing heat strain among elderly agricultural workers. It highlights the crucial role of nursing in adapting healthcare practices to the challenges posed by climate change. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06192069 retrospectively registered.
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Hetherington MM, Thomas JM, McLeod CJ. "I see it very much as an end-of-life food" - Barriers to oral nutritional supplement adherence, views from healthy older adults. Appetite 2024; 197:107327. [PMID: 38555018 DOI: 10.1016/j.appet.2024.107327] [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: 01/15/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Malnutrition affects approximately one quarter of UK adults aged 65 years and over. As the global demographic shift continues, malnutrition is expected to increase. Oral nutritional supplements (ONS) are used both to prevent and to treat malnutrition. However, their effectiveness is compromised by poor adherence, and it is not well understood what contributes to this. Therefore, the current research was designed to explore ONS adherence from the parallel perspectives of ONS as a prescribed "medication" and as a food supplement/substitute. Eighteen older adults (13F, 5M; mean age = 73.4 yr; range: 70-80 yr) participated in focus groups (three in-person and one online), to investigate experiences of taking prescribed medications, including dietary supplements, and what should be factors to consider in supporting regular intake of ONS for trial development, as well as any potential improvements to products. Focus group sessions were recorded and then transcribed. Thematic Analysis was applied to the transcripts by the first author, and themes were discussed in depth, using exemplar quotes from participants. Five dominant themes were identified from the data: Disgust, Palatability and Acceptance; End-of-Life Care; Resistance to Medicines; Rituals and Reminders; and Real Food Displacement. Nutritional supplements were characterised as "disgusting", "manufactured", and associated with serious, chronic illness, as well as end-of-life care, in contrast to probiotics which were linked with health and wellness. The sweet taste of ONS was identified as a barrier to intake, given that it is generally associated with a signal to stop eating, and low hunger. As a group, participants tried to "avoid taking medicines", and viewed the need to have them negatively, yet most regularly took prescribed medication and/or vitamin supplements. Participants identified several, rituals and reminders to take medicines, including meal-based, or time-of-day-based prompts (e.g., before, with or after meals). To improve adherence, savoury products were suggested, as well as a more person-centred approach to individual nutritional needs and preferences. Overall, the group discussion mainly identified barriers to intake, but that improving taste, adding to "real food" (not replacing meals), and offering variety of flavour and form (e.g., savoury soups as well as sweet drinks) could be included in future trials to improve appeal and therefore intake. Future work should continue to explore how best to formulate, market and/or prescribe ONS, and how this might vary for malnutrition prevention vs treatment strategies.
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Affiliation(s)
| | - Jason M Thomas
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK
| | - Chris J McLeod
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
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24
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Reyes-Torres CA, Castillo-Martínez L, Ramos-Vázquez AG, Cassis-Nosthas L, Zavala-Solares M, García-de-la-Torre G, Serralde-Zúñiga AE. Effect of a texture-modified and controlled bolus volume diet on all-cause mortality in older persons with oropharyngeal dysphagia: Secondary analysis of a randomized controlled trial. Nutr Clin Pract 2024; 39:665-672. [PMID: 37537941 DOI: 10.1002/ncp.11052] [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: 01/12/2023] [Revised: 07/02/2023] [Accepted: 07/09/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Oropharyngeal dysphagia (OD) is common among older adults. Some studies have evaluated the efficacy of a texture-modified diet on mortality but with short-term follow-up. We aimed to evaluate the effect of a texture-modified diet and controlled bolus volume on all-cause mortality after 12 months in older persons with OD. METHODS This secondary analysis of a randomized clinical trial included patients aged ≥60 years with a diagnosis of OD. They were concurrently and randomly assigned to receive either a texture-modified food diet and controlled bolus volume (intervention group) or standard treatment (control group) with 12 months of follow-up. Secondary outcomes were oral intake, weight, handgrip strength, phase angle, and aspiration pneumonia. Kaplan-Meier analysis and the Cox proportional hazards model were used for mortality analysis. RESULTS A total of 127 participants (intervention group: 64 and control group: 63) were recruited, with a mean age of 76 years. The probability of all-cause mortality was significantly lower in the intervention group (n = 8, 12%) than in the control group (n = 18, 29%) (hazard ratio = 0.36 [95% CI = 0.16-0.86]; P = 0.01). There were 5 (7.9%) and 10 (16.1%) aspiration pneumonia events in the intervention and control groups, respectively (not significant) in 12 months of follow-up. Changes were observed in protein consumption (P = 0.01), body weight (P = 0.04), body mass index (P = 0.004), handgrip strength (P = 0.02), and phase angle (P = 0.04) between the treatment groups. CONCLUSION Compared with the standard treatment, the dietary intervention improved efficacy by limiting nutrition complications, aspiration pneumonia, and all-cause mortality.
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Affiliation(s)
- Carlos A Reyes-Torres
- Posgrado en Ciencias de la Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Lilia Castillo-Martínez
- Servicio de Nutriología Clínica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aniela G Ramos-Vázquez
- Posgrado en Ciencias de la Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Lorena Cassis-Nosthas
- Departamento de Ciencia y Tecnología de los Alimentos, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Guadalupe García-de-la-Torre
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City, Mexico
| | - Aurora E Serralde-Zúñiga
- Servicio de Nutriología Clínica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Smith R, Methven L, Clegg ME, Geny A, Ueland Ø, Synnøve Grini I, Helgesdotter Rognså G, Maitre I, Brasse C, Van Wymelbeke-Delannoy V, Sulmont-Rossé C. Older adults' acceptability of and preferences for food-based protein fortification in the UK, France and Norway. Appetite 2024; 197:107319. [PMID: 38514019 DOI: 10.1016/j.appet.2024.107319] [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: 01/29/2024] [Revised: 02/16/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
Research suggests that as we age, protein intake, recognised as vital for combating negative health outcomes, consistently falls below recommendations in older adults. Decreased food intake, combined with age-related eating complications is a major determinant of this protein undernutrition. If nutritional interventions are to be effective and sustainable, they must enable eating pleasure, cater for personal preferences and be adaptable to different eating patterns. As such, we aimed to identify successful strategies for at-home protein-fortification to empower older adults to take a personalised approach to their nutrition, without requiring a large behavioural change. To explore healthy older adults' (age 70+) acceptability and preferences for at-home protein fortification, European project Fortiphy led discussions with older adults (n = 37) and caregivers of older adults (n = 15) to develop high-protein recipes, which were then utilised in a home-use trial with healthy older adults (n = 158). Each fortified recipe was paired with a questionnaire to rate the ease of preparation and liking, and an end-of-study questionnaire was provided to capture overall opinions and preferences. The uniqueness of this study is that the protein fortified recipes were prepared and tested by older adults themselves, in their own homes. Findings showed that older adults were unaware of the importance of protein in ageing and did not have a desire to fortify their foods at present. Yet, they were positive regarding the concept and highlighted the importance of taste, familiar ingredients, and preferred preparation methods. Cultural preferences across countries were identified as having the most influence on the liking of fortified meals. This study also indicated a need for increased awareness of protein requirements to influence the motivation to use fortification.
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Affiliation(s)
- Rachel Smith
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6AP, UK.
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6AP, UK.
| | - Miriam E Clegg
- School of Food and Nutritional Sciences, University College Cork, Ireland
| | - Alexia Geny
- Centre des Sciences Du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, F-21000, Dijon, France
| | | | | | | | - Isabelle Maitre
- GRAPPE, Ecole Supérieure des Agricultures, USC 1422, INRAE, 49007, Angers, France
| | - Céline Brasse
- GRAPPE, Ecole Supérieure des Agricultures, USC 1422, INRAE, 49007, Angers, France
| | - Virginie Van Wymelbeke-Delannoy
- Centre des Sciences Du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, F-21000, Dijon, France; CHU Dijon Bourgogne, Unité de Recherche Pôle Personnes Âgées, Dijon, France
| | - Claire Sulmont-Rossé
- Centre des Sciences Du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, F-21000, Dijon, France
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Liu D, Wang S, Liu S, Wang Q, Che X, Wu G. Frontiers in sarcopenia: Advancements in diagnostics, molecular mechanisms, and therapeutic strategies. Mol Aspects Med 2024; 97:101270. [PMID: 38583268 DOI: 10.1016/j.mam.2024.101270] [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: 10/28/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/09/2024]
Abstract
The onset of sarcopenia is intimately linked with aging, posing significant implications not only for individual patient quality of life but also for the broader societal healthcare framework. Early and accurate identification of sarcopenia and a comprehensive understanding of its mechanistic underpinnings and therapeutic targets paramount to addressing this condition effectively. This review endeavors to present a cohesive overview of recent advancements in sarcopenia research and diagnosis. We initially delve into the contemporary diagnostic criteria, specifically referencing the European Working Group on Sarcopenia in Older People (EWGSOP) 2 and Asian Working Group on Sarcopenia (AWGS) 2019 benchmarks. Additionally, we elucidate comprehensive assessment techniques for muscle strength, quantity, and physical performance, highlighting tools such as grip strength, chair stand test, dual-energy X-ray Absorptiometry (DEXA), bioelectrical impedance analysis (BIA), gait speed, and short physical performance battery (SPPB), while also discussing their inherent advantages and limitations. Such diagnostic advancements pave the way for early identification and unequivocal diagnosis of sarcopenia. Proceeding further, we provide a deep-dive into sarcopenia's pathogenesis, offering a thorough examination of associated signaling pathways like the Myostatin, AMP-activated protein kinase (AMPK), insulin/IGF-1 Signaling (IIS), and the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways. Each pathway's role in sarcopenia mediation is detailed, underscoring potential therapeutic target avenues. From a mechanistic perspective, the review also underscores the pivotal role of mitochondrial dysfunction in sarcopenia, emphasizing elements such as mitochondrial oxidative overload, mitochondrial biogenesis, and mitophagy, and highlighting their therapeutic significance. At last, we capture recent strides made in sarcopenia treatment, ranging from nutritional and exercise interventions to potential pharmacological and supplementation strategies. In sum, this review meticulously synthesizes the latest scientific developments in sarcopenia, aiming to enhance diagnostic precision in clinical practice and provide comprehensive insights into refined mechanistic targets and innovative therapeutic interventions, ultimately contributing to optimized patient care and advancements in the field.
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Affiliation(s)
- Dequan Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Shijin Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Shuang Liu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China
| | - Qifei Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Xiangyu Che
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
| | - Guangzhen Wu
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning, China.
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Ishikawa-Takata K, Matsumoto M, Takimoto H. Are higher protein intake and distribution of protein intake related to higher appendicular muscle mass among an older Japanese population?: A cross-sectional analysis of the National Health and Nutrition Survey 2017. Geriatr Gerontol Int 2024; 24:634-640. [PMID: 38679586 DOI: 10.1111/ggi.14875] [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: 12/12/2023] [Revised: 02/27/2024] [Accepted: 03/27/2024] [Indexed: 05/01/2024]
Abstract
AIM Protein intake is an important component in retaining muscle mass, especially among older people. This study examined the relationship between total protein intake and/or the distribution of protein intake in each meal and appendicular muscle mass, using data from the National Health and Nutrition Survey (NHNS) in Japan. METHODS Data from the NHNS were re-analyzed in this study. We used data from a one-day dietary record, physical examination, and lifestyle questionnaire completed by 1766 participants aged over 60 years. Appendicular muscle mass was assessed by multiple-frequency bioimpedance measurement. Leucine intake was calculated by the weighted average amino acid content from all 98 food subcategories used in the NHNS, based on amino acid composition data in the 2020 Standard Tables of Food Composition. RESULTS Participants with higher protein intake showed significantly higher appendicular muscle mass. This relationship was independent of physical activity, including steps taken per day, exercise habit, and physical labor. Frequent intake of ≥0.4 g protein/kg/meal was not related to appendicular muscle mass. The combination of higher total protein intake and higher physical activity seemed to have the largest association with appendicular muscle mass. CONCLUSIONS Higher protein intake may be related to higher appendicular muscle mass, independent of higher physical activity, among older Japanese people. Geriatr Gerontol Int 2024; 24: 634-640.
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Affiliation(s)
- Kazuko Ishikawa-Takata
- Tokyo University of Agriculture, Tokyo, Japan
- National Institutes of Biomedical Innovation, Health, and Nutrition, Osaka, Japan
| | - Mai Matsumoto
- National Institutes of Biomedical Innovation, Health, and Nutrition, Osaka, Japan
| | - Hidemi Takimoto
- National Institutes of Biomedical Innovation, Health, and Nutrition, Osaka, Japan
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He W, Connolly ED, Cross HR, Wu G. Dietary protein and amino acid intakes for mitigating sarcopenia in humans. Crit Rev Food Sci Nutr 2024:1-24. [PMID: 38803274 DOI: 10.1080/10408398.2024.2348549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Adult humans generally experience a 0.5-1%/year loss in whole-body skeletal muscle mass and a reduction of muscle strength by 1.5-5%/year beginning at the age of 50 years. This results in sarcopenia (aging-related progressive losses of skeletal muscle mass and strength) that affects 10-16% of adults aged ≥ 60 years worldwide. Concentrations of some amino acids (AAs) such as branched-chain AAs, arginine, glutamine, glycine, and serine are reduced in the plasma of older than young adults likely due to insufficient protein intake, reduced protein digestibility, and increased AA catabolism by the portal-drained viscera. Acute, short-term, or long-term administration of some of these AAs or a mixture of proteinogenic AAs can enhance blood flow to skeletal muscle, activate the mechanistic target of rapamycin cell signaling pathway for the initiation of muscle protein synthesis, and modulate the metabolic activity of the muscle. In addition, some AA metabolites such as taurine, β-alanine, carnosine, and creatine have similar physiological effects on improving muscle mass and function in older adults. Long-term adequate intakes of protein and the AA metabolites can aid in mitigating sarcopenia in elderly adults. Appropriate combinations of animal- and plant-sourced foods are most desirable to maintain proper dietary AA balance.
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Affiliation(s)
- Wenliang He
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Erin D Connolly
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - H Russell Cross
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Guoyao Wu
- Department of Animal Science, Texas A&M University, College Station, TX, USA
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29
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Sobotka O, Mezera V, Blaha V, Skorepa P, Fortunato J, Sobotka L. Optimizing Recovery in Elderly Patients: Anabolic Benefits of Glucose Supplementation during the Rehydration Period. Nutrients 2024; 16:1607. [PMID: 38892539 PMCID: PMC11173922 DOI: 10.3390/nu16111607] [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: 04/25/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Since many acutely admitted older adults display signs of dehydration, treatment using balanced crystalloids is an important part of medical care. Additionally, many of these patients suffer from chronic malnutrition. We speculated that the early addition of glucose might ameliorate the hospital-related drop of caloric intake and modify their catabolic status. METHODS We included patients 78 years and older, admitted acutely for non-traumatic illnesses. The patients were randomized into either receiving balanced crystalloid (PlasmaLyte; group P) or balanced crystalloid enriched with 100 g of glucose per liter (group G). The information about fluid balance and levels of minerals were collected longitudinally. RESULTS In the G group, a significantly higher proportion of patients developed signs of refeeding syndrome, i.e., drops in phosphates, potassium and/or magnesium when compared to group P (83.3 vs. 16.7%, p < 0.01). The drop in phosphate levels was the most pronounced. The urinalysis showed no differences in the levels of these minerals in the urine, suggesting their uptake into the cells. There were no differences in the in-hospital mortality or in the 1-year mortality. CONCLUSION The short-term administration of balanced crystalloids with glucose induced an anabolic shift of electrolytes in acutely admitted older adults.
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Affiliation(s)
- Ondrej Sobotka
- 3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic; (O.S.); (L.S.)
- Oroboros Instruments, 6020 Innsbruck, Austria
| | - Vojtech Mezera
- 3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic; (O.S.); (L.S.)
- Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
- Geriatric Center, Pardubice Hospital, 532 03 Pardubice, Czech Republic
| | - Vladimir Blaha
- 3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic; (O.S.); (L.S.)
- Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
| | - Pavel Skorepa
- 3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic; (O.S.); (L.S.)
- Department of Military Internal Medicine and Military Hygiene, Military Faculty of Medicine, University of Defence, 500 01 Hradec Kralove, Czech Republic
| | - Joao Fortunato
- 3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic; (O.S.); (L.S.)
| | - Lubos Sobotka
- 3rd Department of Internal Medicine-Metabolism and Gerontology, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic; (O.S.); (L.S.)
- Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
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Groenendijk I, de Groot LCPGM, Tetens I, Grootswagers P. Discussion on protein recommendations for supporting muscle and bone health in older adults: a mini review. Front Nutr 2024; 11:1394916. [PMID: 38840697 PMCID: PMC11150820 DOI: 10.3389/fnut.2024.1394916] [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: 03/02/2024] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
Muscle and bone tissues are interconnected, and both rely on an adequate protein intake. Recommendations for protein intake for older adults specifically vary across countries. The purpose of this narrative review is to discuss the existing evidence for protein recommendations for supporting muscle and bone health in older adults and to evaluate if a protein intake above the current population reference intake (PRI) for older adults would be scientifically justified. First, this review summarizes the protein recommendations from bodies setting dietary reference values, expert groups, and national health organizations. Next, relevant studies investigating the impact of protein on muscle and bone health in older adults are discussed. In addition, the importance of protein quality for muscle and bone health is addressed. Lastly, a number of research gaps are identified to further explore the added value of a protein intake above the PRI for older adults.
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Affiliation(s)
- Inge Groenendijk
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | | | - Inge Tetens
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Pol Grootswagers
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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Lavriša Ž, Pravst I. Nutritional Challenges in Nursing Homes: Pilot Study on Macronutrient Intake and Status of Vitamins D and B12. Nutrients 2024; 16:1495. [PMID: 38794733 PMCID: PMC11124101 DOI: 10.3390/nu16101495] [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: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Older adults living in nursing homes (NH) are considered a population group that could be at risk in terms of nutrition, even more so than their community-dwelling peers. Evidence on the nutritional status of NH residents is scarce, as they are commonly excluded from population-based dietary studies. This is also the case in Slovenia. In the presented pilot study, we assessed the intake of macronutrients as well as the intake and status of vitamin D and vitamin B12 on a sample of NH and NH daycare center users to explore the need for a larger representative study. The pilot study included 37 participants from three Slovenian NH (20 participants) and their daycare centers (17 participants). Daycare centers offer daytime care services for older adults, where users are also provided with major meals during their stay. Intakes of energy and nutrients were estimated by three 24 h dietary records. Fasting blood samples were collected for the assessment of vitamin D and vitamin B12 status. Over 90% of the participants had daily energy and protein intakes below recommendations (reference values: energy intake: males 2100 kcal and females 1700 kcal; protein intake > 1 g/kg body mass). The males' median daily intakes of vitamin D were 1.7 µg (1.5 µg females), and 2.3 µg for vitamin B12 (2.0 µg females). None of the participants had adequate vitamin D intake (>20 µg), and 92.3% males and 87.5% females had inadequate vitamin B12 intake (<4 µg). The prevalence of vitamin D deficiency (serum 25-OH-D conc. < 30 nmol/L) was 100% among NH residents and 53% among NH daycare center users. The prevalence of vitamin B12 deficiency was found in 20% of NH residents. The study results highlighted that certain nutrients might be critical in this population, especially among NH residents; however, a more thorough investigation with the inclusion of other important markers of nutritional status should be performed on a larger, representative sample to support the development and implementation of appropriate public health interventions.
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Affiliation(s)
- Živa Lavriša
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia;
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition and Public Health Research Group, Nutrition Institute, Koprska ulica 98, SI-1000 Ljubljana, Slovenia;
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
- VIST–Faculty of Applied Sciences, Gerbičeva cesta 51A, SI-1000 Ljubljana, Slovenia
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Wirth J, Segat A, Horner K, Crognale D, Smith T, O'Sullivan M, Brennan L. Impact of increased protein intake in older adults: a 12-week double-blind randomised controlled trial. Age Ageing 2024; 53:ii13-ii19. [PMID: 38745486 DOI: 10.1093/ageing/afae031] [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: 12/09/2023] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Emerging evidence suggests health-promoting properties of increased protein intake. There is increased interest in plant protein but a dearth of information in relation to its impact on muscle function. The objective of the present work was to examine the impact of intake of different types of proteins on muscle functional parameters including handgrip strength, biomarkers of metabolic health, sleep quality and quality of life in a group of older adults. METHODS Healthy men and women aged 50 years and older entered a double-blinded, randomised, controlled nutritional intervention study with three parallel arms: high plant protein, high dairy protein and low protein. Participants consumed once daily a ready-to-mix shake (containing 20 g of protein in high protein groups) for 12 weeks. Changes in handgrip and leg strength, body composition, metabolic health, quality of life and sleep quality were analysed by linear mixed models in an intention-to-treat approach. RESULTS Eligible participants (n = 171) were randomly assigned to the groups (plant: n = 60, dairy: n = 56, low protein: n = 55) and 141 completed the study. Handgrip strength increased after the intervention (Ptime = 0.038), with no significant difference between the groups. There was no significant difference between groups for any other health outcomes. CONCLUSIONS In a population of older adults, increasing protein intake by 20 g daily for 12 weeks (whether plant-based or dairy-based) did not result in significant differences in muscle function, body composition, metabolic health, sleep quality or quality of life, compared with the low protein group.
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Affiliation(s)
- Janine Wirth
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Belfield, Dublin 4, Ireland
| | - Annalisa Segat
- Kerry Group, Global Technology and Innovation Center, Applied Health and Nutrition - Nutritional and Functional Proteins, Naas, Co. Kildare, Ireland
| | - Katy Horner
- Institute of Sport and Health, UCD, Belfield, Dublin 4, Ireland
| | | | - Thomas Smith
- Department of Clinical Chemistry, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland
| | - Maurice O'Sullivan
- Kerry Group, Global Technology and Innovation Center, Applied Health and Nutrition - Nutritional and Functional Proteins, Naas, Co. Kildare, Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, UCD, Belfield, Dublin 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD, Belfield, Dublin 4, Ireland
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McEvoy CT, McClure CD. Nutrition resilience for healthy ageing. Age Ageing 2024; 53:ii1-ii3. [PMID: 38745487 DOI: 10.1093/ageing/afae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Indexed: 05/16/2024] Open
Affiliation(s)
- Claire T McEvoy
- Queen's University Belfast, School of Medicine Dentistry and Biomedical Sciences, Institute for Global Food Security, Centre for Public Health, Belfast BT12 6BJ, UK
| | - Colin D McClure
- Queen's University Belfast, School of Biological Sciences, Institute for Global Food Security, Belfast BT9 5DL, UK
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Giacosa A, Barrile GC, Mansueto F, Rondanelli M. The nutritional support to prevent sarcopenia in the elderly. Front Nutr 2024; 11:1379814. [PMID: 38798767 PMCID: PMC11119320 DOI: 10.3389/fnut.2024.1379814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Sarcopenia has been described as a muscle disease, with multiple adverse consequences on human health. Recommendations aimed at supporting awareness, prevention, early detection and treatment of this disease are needed. This review focuses on the epidemiology, pathophysiology and early detection of elderly sarcopenia. As far as treatment is concerned, physical activity and nutritional support are specifically evaluated. An individually tailored resistance exercise training program appears to be crucial for a positive outcome of the sarcopenia prevention and treatment. The nutritional intervention is mostly based on the supplementation with high-quality proteins (i.e., whey protein) in order to increase the intake of essential amino acids and in particular of leucine. In addition, of relevant importance appears to be the supplementation with vitamin D, with omega-3 fatty acids and probiotics. This review evaluates the results of the most qualified studies on the nutritional supplementation of sarcopenic elderly subjects and shows that promising results have been achieved in community elderly subjects, or subjects followed in rehabilitation centers and in nursing homes, with additional resistance exercise programs.
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Affiliation(s)
| | - Gaetan Claude Barrile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Francesca Mansueto
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
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Jones D, Celis-Morales C, Gray SR, Morrison DJ, Ozanne SE, Jain M, Mattin LR, Burden S. Effect of Sustainably Sourced Protein Consumption on Nutrient Intake and Gut Health in Older Adults: A Systematic Review. Nutrients 2024; 16:1398. [PMID: 38732644 PMCID: PMC11085519 DOI: 10.3390/nu16091398] [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: 04/09/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
Diet is integral to the healthy ageing process and certain diets can mitigate prolonged and deleterious inflammation. This review aims to assess the impact of diets high in sustainably sourced proteins on nutrient intake, gut, and age-related health in older adults. A systematic search of the literature was conducted on 5 September 2023 across multiple databases and sources. Studies assessing sustainably sourced protein consumption in community dwelling older adults (≥65 years) were included. Risk of bias (RoB) was assessed using 'RoB 2.0' and 'ROBINS-E'. Narrative synthesis was performed due to heterogeneity of studies. Twelve studies involving 12,166 older adults were included. Nine studies (n = 10,391) assessed habitual dietary intake and had some RoB concerns, whilst three studies (n = 1812), two with low and one with high RoB, conducted plant-based dietary interventions. Increased adherence to sustainably sourced diets was associated with improved gut microbial factors (n = 4640), healthier food group intake (n = 2142), and increased fibre and vegetable protein intake (n = 1078). Sustainably sourced diets positively impacted on gut microbiota and healthier intake of food groups, although effects on inflammatory outcomes and health status were inconclusive. Future research should focus on dietary interventions combining sustainable proteins and fibre to evaluate gut barrier function and consider inflammatory and body composition outcomes in older adults.
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Affiliation(s)
- Debra Jones
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK;
| | - Carlos Celis-Morales
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK; (C.C.-M.); (S.R.G.); (M.J.)
| | - Stuart R. Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK; (C.C.-M.); (S.R.G.); (M.J.)
| | - Douglas J. Morrison
- Scottish Universities Environmental Research Centre (SUERC), University of Glasgow, Glasgow G75 0QF, UK;
| | - Susan E. Ozanne
- Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Institute of Metabolic Science, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 0QQ, UK;
| | - Mahek Jain
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK; (C.C.-M.); (S.R.G.); (M.J.)
- Scottish Universities Environmental Research Centre (SUERC), University of Glasgow, Glasgow G75 0QF, UK;
| | - Lewis R. Mattin
- School of Life Sciences, University of Westminster, London W1W 6UW, UK;
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK;
- Salford Care Organisation, Northern Care Alliance NHS Trust, Stott Lane, Salford M6 8HD, UK
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Layman DK. Impacts of protein quantity and distribution on body composition. Front Nutr 2024; 11:1388986. [PMID: 38765819 PMCID: PMC11099237 DOI: 10.3389/fnut.2024.1388986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/02/2024] [Indexed: 05/22/2024] Open
Abstract
The importance of meal distribution of dietary protein to optimize muscle mass and body remains unclear, and the findings are intertwined with age, physical activity, and the total quantity and quality of protein consumed. The concept of meal distribution evolved from multiple discoveries about regulating protein synthesis in skeletal muscle. The most significant was the discovery of the role of the branched-chain amino acid leucine as a metabolic signal to initiate a post-meal anabolic period of muscle protein synthesis (MPS) in older adults. Aging is often characterized by loss of muscle mass and function associated with a decline in protein synthesis. The age-related changes in protein synthesis and subsequent muscle atrophy were generally considered inevitable until the discovery of the unique role of leucine for the activation of the mTOR signal complex for the initiation of MPS. Clinical studies demonstrated that older adults (>60 years) require meals with at least 2.8 g of leucine (~30 g of protein) to stimulate MPS. This meal requirement for leucine is not observed in younger adults (<30 years), who produce a nearly linear response of MPS in proportion to the protein content of a meal. These findings suggest that while the efficiency of dietary protein to stimulate MPS declines with aging, the capacity for MPS to respond is maintained if a meal provides adequate protein. While the meal response of MPS to total protein and leucine is established, the long-term impact on muscle mass and body composition remains less clear, at least in part, because the rate of change in muscle mass with aging is small. Because direct diet studies for meal distribution during aging are impractical, research groups have applied meal distribution and the leucine threshold to protein-sparing concepts during acute catabolic conditions such as weight loss. These studies demonstrate enhanced MPS at the first meal after an overnight fast and net sparing of lean body mass during weight loss. While the anabolic benefits of increased protein at the first meal to stimulate MPS are clear, the benefits to long-term changes in muscle mass and body composition in aging adults remain speculative.
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Affiliation(s)
- Donald K. Layman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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Stoodley IL, Berthon BS, Scott HA, Williams EJ, Baines PJ, Knox H, Wood S, Paradzayi B, Cameron-Smith D, Wood LG. Protein Intake and Physical Activity Levels as Determinants of Sarcopenia Risk in Community-Dwelling Older Adults. Nutrients 2024; 16:1380. [PMID: 38732628 PMCID: PMC11085115 DOI: 10.3390/nu16091380] [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: 03/17/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg-1∙day-1 [0.9 (0.7-0.9) g∙kg-1∙day-1] and moderate intensity physical activity <150 min.week-1. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1-1.5) g∙kg-1∙day-1] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.
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Affiliation(s)
- Isobel L. Stoodley
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Bronwyn S. Berthon
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hayley A. Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Evan J. Williams
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Penelope J. Baines
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hannah Knox
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Sophie Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Beauty Paradzayi
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
| | - David Cameron-Smith
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 14 Medical Drive, #07-02 MD6, Singapore 117599, Singapore;
| | - Lisa G. Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
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Koopmans L, Spoelder M, Bongers CCWG, Eijsvogels TMH, Hopman MTE. The effect of lesser mealworm protein on exercise-induced muscle damage in active older adults: a randomized controlled trial. J Nutr Health Aging 2024; 28:100204. [PMID: 38460318 DOI: 10.1016/j.jnha.2024.100204] [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: 01/18/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES We compared the effect of 12 weeks lesser mealworm-based (Alphitobius diaperinus) protein supplementation to whey protein and placebo supplementation on Exercise-Induced Muscle Damage (EIMD) after long-distance walking in older adults. METHODS in this randomized controlled trial, 70 physically active older adults (>60 years) were randomly allocated to the following groups: I) lesser mealworm protein, II) whey protein or III) iso-caloric placebo. Participants received supplements 11 weeks before and 1 week during a 3-day long-distance walking challenge (30-50 km per day). Blood concentrations of creatinine kinase (CK) and lactate dehydrogenase (LDH), handgrip strength and muscle soreness were measured pre-exercise and directly after each walking bout. RESULTS Significant elevations of CK concentrations (103 [76-161] U/l to 758 [342-1104] U/l, p < 0.001) and LDH concentrations (202 [175-220] to 283 [252-339] U/l, p < 0.001) were observed following 7h45 min ± 11 min of walking exercise per day, but the magnitude of this effect did not differ among suppletion groups. Hand grip strength decreased significantly (p < 0.001) while muscle soreness increased (p = 0.002) after the first walking day compared to pre-exercise, with no group differences. CONCLUSION 12-weeks of lesser mealworm-based protein supplementation (30 g/day) does not attenuate exercise induced muscle damage in older adults following three days of prolonged walking exercise in comparison to placebo or whey protein.
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Affiliation(s)
- Lotte Koopmans
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcia Spoelder
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Radboud, The Netherlands
| | - Coen C W G Bongers
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands; School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands.
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Takayama H, Yoshimura T, Suzuki H, Hirano Y, Tezuka M, Ishida T, Ishihata K, Amitani M, Amitani H, Nakamura Y, Imamura Y, Inui A, Nakamura N. Comparison between single-muscle evaluation and cross-sectional area muscle evaluation for predicting the prognosis in patients with oral squamous cell carcinoma: a retrospective cohort study. Front Oncol 2024; 14:1336284. [PMID: 38751815 PMCID: PMC11094248 DOI: 10.3389/fonc.2024.1336284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction The most effective method of assessing sarcopenia has yet to be determined, whether by single muscle or by whole muscle segmentation. The purpose of this study was to compare the prognostic value of these two methods using computed tomography (CT) images in patients with oral squamous cell carcinoma (OSCC). Materials and methods Sex- and age-adjusted Cox proportional hazards models were employed for each parameter of sarcopenia related to overall survival, disease-free survival, and disease-specific survival. Harrell's concordance index was calculated for each model to assess discriminatory power. Results In this study including 165 patients, a significant correlation was found between the CT-based assessment of individual muscles and their cross-sectional area. Single muscle assessments showed slightly higher discriminatory power in survival outcomes compared to whole muscle assessments, but the difference was not statistically significant, as indicated by overlapping confidence intervals for the C-index between assessments. To further validate our measurements, we classified patients into two groups based on intramuscular adipose tissue content (P-IMAC) of the spinous process muscle. Analysis showed that the higher the P-IMAC value, the poorer the survival outcome. Conclusion Our findings indicate a slight advantage of single-muscle over whole-muscle assessment in prognostic evaluation, but the difference between the two methods is not conclusive. Both assessment methods provide valuable prognostic information for patients with OSCC, and further studies involving larger, independent cohorts are needed to clarify the potential advantage of one method over the other in the prognostic assessment of sarcopenia in OSCC.
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Affiliation(s)
- Hirotaka Takayama
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takuya Yoshimura
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hajime Suzuki
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuka Hirano
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masahiro Tezuka
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takayuki Ishida
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kiyohide Ishihata
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Marie Amitani
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Haruka Amitani
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yasunori Nakamura
- Department of Oral Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima, Japan
| | - Yasushi Imamura
- Department of Internal Medicine, Kagoshima Kouseiren Hospital, Kagoshima, Japan
| | - Akio Inui
- Pharmacological Department of Herbal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Norifumi Nakamura
- Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Mou K, Chan SMH, Vlahos R. Musculoskeletal crosstalk in chronic obstructive pulmonary disease and comorbidities: Emerging roles and therapeutic potentials. Pharmacol Ther 2024; 257:108635. [PMID: 38508342 DOI: 10.1016/j.pharmthera.2024.108635] [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: 11/06/2023] [Revised: 02/13/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a multifaceted respiratory disorder characterized by progressive airflow limitation and systemic implications. It has become increasingly apparent that COPD exerts its influence far beyond the respiratory system, extending its impact to various organ systems. Among these, the musculoskeletal system emerges as a central player in both the pathogenesis and management of COPD and its associated comorbidities. Muscle dysfunction and osteoporosis are prevalent musculoskeletal disorders in COPD patients, leading to a substantial decline in exercise capacity and overall health. These manifestations are influenced by systemic inflammation, oxidative stress, and hormonal imbalances, all hallmarks of COPD. Recent research has uncovered an intricate interplay between COPD and musculoskeletal comorbidities, suggesting that muscle and bone tissues may cross-communicate through the release of signalling molecules, known as "myokines" and "osteokines". We explored this dynamic relationship, with a particular focus on the role of the immune system in mediating the cross-communication between muscle and bone in COPD. Moreover, we delved into existing and emerging therapeutic strategies for managing musculoskeletal disorders in COPD. It underscores the development of personalized treatment approaches that target both the respiratory and musculoskeletal aspects of COPD, offering the promise of improved well-being and quality of life for individuals grappling with this complex condition. This comprehensive review underscores the significance of recognizing the profound impact of COPD on the musculoskeletal system and its comorbidities. By unravelling the intricate connections between these systems and exploring innovative treatment avenues, we can aspire to enhance the overall care and outcomes for COPD patients, ultimately offering hope for improved health and well-being.
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Affiliation(s)
- Kevin Mou
- Centre for Respiratory Science and Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Stanley M H Chan
- Centre for Respiratory Science and Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Ross Vlahos
- Centre for Respiratory Science and Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, VIC, Australia.
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Pagan JI, Bradshaw BA, Bejte B, Hart JN, Perez V, Knowles KS, Beausejour JP, Luzadder M, Menger R, Osorio C, Harmon KK, Hanney WJ, Wilson AT, Stout JR, Stock MS. Task-specific resistance training adaptations in older adults: comparing traditional and functional exercise interventions. FRONTIERS IN AGING 2024; 5:1335534. [PMID: 38746477 PMCID: PMC11091347 DOI: 10.3389/fragi.2024.1335534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024]
Abstract
Muscle strength declines ∼3% per year after the age of 70. Resistance training guidelines for older adults are often based on free-weight and machine exercises, which may be inaccessible and lack carryover to activities of daily living. We tested the hypothesis that resistance training adaptations in older adults are task-specific. Thirty adults (8 males, 22 females; mean age = 71 years) were randomly assigned to participate in 6 weeks of supervised, high-intensity resistance training (twice per week) utilizing free-weight and machine exercises (traditional) versus functional activities that were overloaded with a weighted vest (functional). Participants were thoroughly familiarized with the exercises and testing prior to beginning the study. Major outcome measures included assessments of functional performance, five-repetition maximum strength, isometric knee extensor force, and quadriceps muscle size. Physical activity and nutrition were monitored. The study results demonstrate that the magnitude of improvement within a given outcome was largely dependent on group assignment, with greater improvements in gait speed and the timed-up-and-go in the functional group, but 2-3× greater five repetition maximum strength improvements for the trap bar deadlift, leg press, and leg extension following traditional resistance training. Both groups showed improvements in isometric knee extensor force and muscle size, suggesting that some aspects of the observed adaptations were generic, rather than specific. Overall, these novel findings suggest that, among older adults, 1) resistance training adaptations exhibit a high degree of task specificity and 2) significant improvements in functional outcomes can be achieved with the use of a weighted vest.
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Affiliation(s)
- Jason I. Pagan
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Bethany A. Bradshaw
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Brisilda Bejte
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jordan N. Hart
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Vanjeliz Perez
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Kevan S. Knowles
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jonathan P. Beausejour
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Marc Luzadder
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Reed Menger
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Carlos Osorio
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Kylie K. Harmon
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - William J. Hanney
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Abigail T. Wilson
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R. Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Matt S. Stock
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
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Zhang K, Wu J. Meat-Egg-Dairy Consumption and Frailty among Chinese Older Adults: Exploring Rural/Urban and Gender Differences. Nutrients 2024; 16:1334. [PMID: 38732580 PMCID: PMC11085892 DOI: 10.3390/nu16091334] [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: 04/05/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
The dietary patterns of older adults, particularly in relation to meat, egg, and dairy (MED) consumption, significantly impact frailty, a state of heightened vulnerability to adverse health outcomes. This paper investigates the association between MED consumption and frailty among older Chinese adults, considering rural/urban disparities and gender differences. Analyzing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning from 2008 to 2018, this study explores how MED consumption influences frailty levels over time. The results show that moderate MED consumption is associated with slower frailty progression, suggesting a protective effect against frailty among older adults. However, excessive MED consumption, particularly among rural residents and females, is linked to accelerated frailty progression. Urban residents and males report higher MED consumption levels, possibly due to their greater access to diverse food options and traditional dietary preferences. The findings underscore the complex interplay between dietary habits, demographic factors, and frailty outcomes. Understanding these dynamics is crucial for developing targeted interventions to mitigate frailty risk factors and promote healthy aging among Chinese older adults.
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Affiliation(s)
- Keqing Zhang
- School of English and International Studies, Beijing Foreign Studies University, Beijing 10089, China;
| | - Jiangcheng Wu
- School of Japanese and International Studies, Beijing Foreign Studies University, Beijing 10089, China
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Peng LN, Lin MH, Tseng SH, Yen KH, Lee HF, Hsiao FY, Chen LK. Protein-enriched soup and weekly exercise improve muscle health: A randomized trial in mid-to-old age with inadequate protein intake. J Cachexia Sarcopenia Muscle 2024. [PMID: 38641937 DOI: 10.1002/jcsm.13481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/27/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Prior research has highlighted the synergistic impact of protein supplementation on muscle function post-exercise in adults; however, evidence supporting the combined effects were less robust and inconsistent on those with protein insufficiency. This investigation aims to explore efficacy of protein-enriched soup coupled with exercise on muscle health and metabolism in middle-aged and older adults with suboptimal protein intake. METHODS An open-label, 12-week, randomized controlled trial involving participants with insufficient protein intake (<1.0 g/kg/day) was done. The intervention group consumed protein-enriched soup (24-30 g protein daily) and 1-h weekly exercise, while controls received health education. Assessments included laboratory tests, functional assessments, and body composition. RESULTS In this trial, 97 out of 100 randomized participants (mean age: 64.65 ± 4.84 years, 81.8% female) completed the study (47 in intervention group and 50 in control group). Compared results of baselines, at 1 and 3 months of intervention, significant improvements in waist circumference (83.48 ± 10.22 vs. 82.5 ± 9.88 vs. 82.37 ± 9.42 cm, P for trend = 0.046), 6-min walking distance (525.65 ± 58.46 vs. 534.47 ± 51.87 vs. 552.02 ± 57.66 m, P for trend = 0.001), five-time sit-to-stand time (7.63 ± 1.63 vs. 6.81 ± 1.8 vs. 6.4 ± 1.42 s, P for trend <0.001), grip strength (26.74 ± 6.54 vs. 27.53 ± 6.99 vs. 28.52 ± 7.09 kg, P for trend <0.001), and MNA score (26.8 ± 2.14 vs. 27.73 ± 1.74 vs. 27.55 ± 1.72, P for trend <0.001) were discerned within the intervention group. The intervention demonstrated a significant reduction in serum triglyceride (105.32 ± 49.84 vs. 101.36 ± 42.58 vs. 93.43 ± 41.49 mg/dL, P for trend = 0.023), increased HDL-C (60.04 ± 16.21 vs. 60 ± 17.37 vs. 62.55 ± 18.27 mg/dL, P for trend = 0.02), and DHEA-S levels (97.11 ± 54.39 vs. 103.39 ± 56.75 vs. 106.83 ± 60.56 μg/dL, P for trend = 0.002). Serum myostatin did not differ in both groups, but serum leptin levels significantly increased (9118.88 ± 5811.68 vs. 11508.97 ± 7151.08 vs. 11220.80 ± 7190.71 pg/mL, P for trend = 0.016) in controls. The intervention group showed greater improvements in 6 min walking distance (β = 0.71, 95% CI: 6.88 to 40.79, P = 0.006), five-time sit-to-stand test (β = -0.87, 95% CI: -1.59 to -0.15, P = 0.017), MNA score (β = 0.96, 95% CI: 0.20 to 1.71, P = 0.013), serum triglycerides (β = -15.01, 95% CI: -27.83 to -2.20, P = 0.022), LDL-C (β = -9.23, 95% CI: -16.98 to -1.47, P = 0.020), and DHEA-S levels (β = 9.98, 95% CI: 0.45 to 19.51, P = 0.04) than controls. CONCLUSIONS Protein-enriched soup with weekly exercise over 12 weeks significantly improved physical performance, lipid profile, and DHEA-S levels among middle-aged and older adults with inadequate protein intake, while studies assessing long-term benefits of the intervention are needed.
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Affiliation(s)
- Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Sung-Hua Tseng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ko-Han Yen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Huei-Fang Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
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da Silva Lockmann A, Scariot EL, Buss C. The healthy eating index for older adults: adaptation of the 2015 healthy eating index considering dietary guidelines for healthy aging. Eur J Nutr 2024:10.1007/s00394-024-03387-x. [PMID: 38635027 DOI: 10.1007/s00394-024-03387-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION The Healthy Eating Index (HEI) is a comprehensive measure to assess diet quality. Because of the various factors that influence the nutritional status of older adults, there is a need to adapt an index that assesses the quality of the diet considering the dietary requirements of aging and health promotion. This study aimed to adapt the HEI for older adults, considering their needs for healthy eating. METHODS Food consumption data was collected by means of three non-consecutive 24-hour food recalls (R24h). For the adaptation of the Healthy Eating Index for Older Adults (HEI-OA), the components and scoring methodology of HEI-2015 were maintained and Brazilian food intake recommendations for the older population were used, which are in line with international recommendations. The validity of the HEI-OA was assessed by four ideal diets, Mann-Whitney's test, Spearman's correlation analysis and Cronbach's coefficient. RESULTS Content validity of the HEI-OA was confirmed by the maximum score for diets recommended to older adults and by the score between groups with known differences in diet quality. The HEI-OA total score did not correlate with total energy intake (TEI - total energy value: r = -0.141, p > 0.05). The total HEI-OA score showed a statistically significant correlation with several nutrients. These correlations allowed identifying that these nutrients are closely related to the components of the HEI-OA. The internal consistency value for the HEI-OA total score was 0.327, similar to the 2005 and 2010 versions of the HEI. CONCLUSION The HEI was successfully adapted for use with older adults, presenting validity and reliability. The HEI-OA can be used to assess diet quality in line with international dietary guidelines for healthy aging.
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Affiliation(s)
- Adriana da Silva Lockmann
- Food Bank of Rio Grande do Sul State, Porto Alegre, Brazil.
- Graduate Study Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.
| | - Estela Lopes Scariot
- Graduate Study Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Caroline Buss
- Graduate Study Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
- Nutrition Department, UFCSPA, Porto Alegre, Brazil
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Zhao X, Meng L, Wang D, Shi J, Wu W, Fan G, Shi H, Dong J, Yu P, Yang R. Targeted metabolomic profiles of serum amino acids are independently correlated with malnutrition in older adults. BMC Geriatr 2024; 24:341. [PMID: 38622502 PMCID: PMC11020810 DOI: 10.1186/s12877-024-04937-y] [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: 12/18/2023] [Accepted: 03/31/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Malnutrition is a common geriatric syndrome that is closely associated with adverse clinical outcomes and poses significant harm to older adults. Early assessment of nutritional status plays a crucial role in preventing and intervening in cases of malnutrition. However, there is currently a lack of measurable methods and biomarkers to evaluate malnutrition in older adults accurately. The aim of this study is to investigate the independent correlation between serum levels of amino acids and malnutrition in older adults, and to identify effective metabolomics biomarkers that can aid in the early detection of geriatric malnutrition. METHODS A total of 254 geriatric medical examination participants from Beijing Hospital were included in the study, consisting of 182 individuals with normal nutritional status (Normal group) and 72 patients at risk of malnutrition or already malnourished (MN group). Malnutrition was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). Demographic data were collected, and muscle-related and lipid indexes were determined. Serum amino acid concentrations were measured using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation between serum amino acid levels and malnutrition was analyzed using non-parametric tests, partial correlation analysis, linear regression, and logistic regression. RESULTS The geriatric MN group exhibited significantly lower serum aromatic amino acid levels (P < 0.05) compared to the normal group. A positive correlation was observed between serum aromatic amino acid levels and the MNA-SF score (P = 0.002), as well as with known biomarkers of malnutrition such as body mass index (BMI) (P < 0.001) and hemoglobin (HGB) (P = 0.005). Multivariable logistic or linear regression analyses showed that aromatic amino acid levels were negatively correlated with MN and positively correlated with the MNA-SF score, after adjusting for some confounding factors, such as age, gender, BMI, smoking status, history of dyslipidemia, diabetes mellitus and frailty. Stratified analyses revealed that these trends were more pronounced in individuals without a history of frailty compared to those with a history of frailty, and there was an interaction between aromatic amino acid levels and frailty history (P = 0.004). CONCLUSION Our study suggests that serum aromatic amino acids are independently associated with malnutrition in older adults. These results have important implications for identifying potential biomarkers to predict geriatric malnutrition or monitor its progression and severity, as malnutrition can result in poor clinical outcomes.
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Affiliation(s)
- Xianghui Zhao
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Li Meng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Daguang Wang
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jing Shi
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Wenbin Wu
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Guoqing Fan
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jun Dong
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Pulin Yu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China.
| | - Ruiyue Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China.
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Yébenes JC, Bordeje-Laguna ML, Lopez-Delgado JC, Lorencio-Cardenas C, Martinez De Lagran Zurbano I, Navas-Moya E, Servia-Goixart L. Smartfeeding: A Dynamic Strategy to Increase Nutritional Efficiency in Critically Ill Patients-Positioning Document of the Metabolism and Nutrition Working Group and the Early Mobilization Working Group of the Catalan Society of Intensive and Critical Care Medicine (SOCMiC). Nutrients 2024; 16:1157. [PMID: 38674847 PMCID: PMC11054493 DOI: 10.3390/nu16081157] [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: 03/01/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Adequate medical nutrition therapy for critically ill patients has an impact on their prognoses. However, it requires an individualized approach that takes into account the activity (phases of metabolic stress) and particularity of these patients. We propose a comprehensive strategy considering the patients' nutritional status and the set of modifiable circumstances in these patients, in order to optimize/support nutritional efficiency: (1) A detailed anamnesis and an adequate initial nutritional assessment must be performed in order to implement medical nutrition therapy that is in line with the needs and characteristics of each patient. Furthermore, risks associated with refeeding syndrome, nutritrauma or gastrointestinal dysfunction must be considered and prevented. (2) A safe transition between nutrition therapy routes and between health care units will greatly contribute to recovery. The main objective is to preserve lean mass in critically ill patients, considering metabolic factors, adequate protein intake and muscle stimulation. (3) Continuous monitoring is required for the successful implementation of any health strategy. We lack precise tools for calculating nutritional efficiency in critically ill patients, therefore thorough monitoring of the process is essential. (4) The medical nutrition approach in critically ill patients is multidisciplinary and requires the participation of the entire team involved. A comprehensive strategy such as this can make a significant difference in the functional recovery of critically ill patients, but leaders must be identified to promote training, evaluation, analysis and feedback as essential components of its implementation, and to coordinate this process with the recognition of hospital management.
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Affiliation(s)
- Juan Carlos Yébenes
- Institut d’Assistència Sanitària (IAS)—Hospital Santa Caterina, 17007 Girona, Spain
| | | | - Juan Carlos Lopez-Delgado
- Hospital Clinic, Medical ICU, Clinical Institute of Internal Medicine & Dermatology (ICMiD), 08036 Barcelona, Spain;
| | | | | | | | - Lluis Servia-Goixart
- Intensive Care Department, Hospital Universitari Arnau de Vilanova, LLeida, 25198 Lleida, Spain;
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Hahm JH, Nirmala FS, Ha TY, Ahn J. Nutritional approaches targeting mitochondria for the prevention of sarcopenia. Nutr Rev 2024; 82:676-694. [PMID: 37475189 DOI: 10.1093/nutrit/nuad084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
A decline in function and loss of mass, a condition known as sarcopenia, is observed in the skeletal muscles with aging. Sarcopenia has a negative effect on the quality of life of elderly. Individuals with sarcopenia are at particular risk for adverse outcomes, such as reduced mobility, fall-related injuries, and type 2 diabetes mellitus. Although the pathogenesis of sarcopenia is multifaceted, mitochondrial dysfunction is regarded as a major contributor for muscle aging. Hence, the development of preventive and therapeutic strategies to improve mitochondrial function during aging is imperative for sarcopenia treatment. However, effective and specific drugs that can be used for the treatment are not yet approved. Instead studies on the relationship between food intake and muscle aging have suggested that nutritional intake or dietary control could be an alternative approach for the amelioration of muscle aging. This narrative review approaches various nutritional components and diets as a treatment for sarcopenia by modulating mitochondrial homeostasis and improving mitochondria. Age-related changes in mitochondrial function and the molecular mechanisms that help improve mitochondrial homeostasis are discussed, and the nutritional components and diet that modulate these molecular mechanisms are addressed.
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Affiliation(s)
- Jeong-Hoon Hahm
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
| | - Farida S Nirmala
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| | - Tae Youl Ha
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
| | - Jiyun Ahn
- Research Group of Aging and Metabolism, Korea Food Research Institute, Wanju-gun, South Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon-si, South Korea
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Argyropoulou D, Nomikos T, Terzis G, Karakosta M, Aphamis G, Geladas ND, Paschalis V. The Effect of Chronic Dietary Protein Manipulation on Amino Acids' Profile and Position Sense in the Elderly Suffering from Type 2 Diabetes Mellitus. J Funct Morphol Kinesiol 2024; 9:62. [PMID: 38651420 PMCID: PMC11036287 DOI: 10.3390/jfmk9020062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Dietary protein with adequate essential amino acids effectively stimulates protein synthesis and improves muscle mass. Musculoskeletal disorders in lower or upper limbs are not uncommon among patients with type II diabetes mellitus (T2DM). Therefore, this study primarily examines the effects of chronic dietary protein manipulation on amino acids' profile and position sense in the elderly suffering from T2DM. A total of 26 individuals suffering from non-insulin-dependent T2DM (age > 55 years old) participated in a 12 week nutritional intervention. The subjects were randomly assigned and the control group received 0.8-1.0 g protein/kg/day, while the intervention group received 1.2-1.5 g protein/kg/day. Lean body mass, muscle strength, and position sense were assessed at baseline, as well as at the 6th and 12th week of the intervention. Only in the intervention group, the essential amino acids intake met the current nutritional recommendations (p < 0.05), while, by the 12th week, only the intervention group showed significant improvement in the muscle strength of knee (p < 0.05) and shoulder (p < 0.05) extension. On the contrary, in the control group, a significant decline in appendicular lean mass (p < 0.05) was observed by the 12th week. Position sense at the knee joint revealed a tendency for improvement in the intervention group by the 12th week (main effect of time p = 0.072). In the present investigation, it was revealed that the higher protein intake in the intervention group seemed to have positive effects on muscle strength and nearly positive effects on position sense.
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Affiliation(s)
- Dionysia Argyropoulou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (G.T.); (N.D.G.)
| | - Tzortzis Nomikos
- Department of Nutrition and Dietetics, Harokopio University, 17676 Athens, Greece; (T.N.); (M.K.)
| | - Gerasimos Terzis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (G.T.); (N.D.G.)
| | - Myrto Karakosta
- Department of Nutrition and Dietetics, Harokopio University, 17676 Athens, Greece; (T.N.); (M.K.)
| | - George Aphamis
- Department of Life Sciences, University of Nicosia, Nicosia 1700, Cyprus;
| | - Nickos D. Geladas
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (G.T.); (N.D.G.)
| | - Vassilis Paschalis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (D.A.); (G.T.); (N.D.G.)
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Meza-Valderrama D, Sánchez-Rodríguez D, Messaggi-Sartor M, Muñoz-Redondo E, Morgado-Pérez A, Tejero-Sánchez M, De Jaime-Gil E, Leiva-Banuelos N, Marco E. Supplementation with β-hydroxy-β-methylbutyrate after resistance training in post-acute care patients with sarcopenia: A randomized, double-blind placebo-controlled trial. Arch Gerontol Geriatr 2024; 119:105323. [PMID: 38171034 DOI: 10.1016/j.archger.2023.105323] [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: 09/14/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES This study aimed to evaluate the efficacy of adding β-hydroxy-β- methylbutyrate (HMB) supplementation to a 12-week exercise-based rehabilitation program in older adults with sarcopenia after discharge from a post-acute geriatric rehabilitation unit. STUDY DESIGN A randomized, double-blind, placebo-controlled trial with two parallel groups. The intervention group received 3 g/day of Ca-HMB and participated in a 12- week resistance training program (3 sessions/week). The control group received a placebo and followed the same training program. MAIN OUTCOME MEASURES The primary outcomes were the improvements of handgrip strength and physical performance assessed through the Short Physical Performance Battery (SPPB) and 4-meter gait speed; and handgrip strength. All variables were assessed at baseline, post-intervention, and 1-year follow-up. RESULTS After completing the 12-week exercise program, the intervention group showed significant improvements in SPPB-Balance (1.3, 95 %CI 0.3 to 2.4) and total SPPB score (2.2, 95 %CI 0.4 to 4.0). Intra-group analysis demonstrated gains in the SPPB-Chair Stand (0.7 points, 95 %CI 0.0 to 1.4) and total SPPB score (2.1 points, 95 %CI 0.3 to 3.9) in the intervention group. Improvements in handgrip strength were observed in women (3.7 kg, 95 %CI: 0.2 to 7.3) at the end of the intervention, and persisted at the 1-year follow-up. CONCLUSIONS Our findings suggest that the supplementation of 3 g/day of Ca-HMB with resistance exercise may significantly enhance muscle strength and physical performance among older women with sarcopenia after recent hospitalization. Given this study's limitations, the intervention's effectiveness cannot be drawn, and further studies are needed.
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Affiliation(s)
- Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation, Vía Centenario, 0819 Panamá City, Panamá; Sistema Nacional de Investigación- Secretaria Nacional de Ciencia e Investigación, Clayton Ciudad del Saber Edificio 205, 0819 Panamá City, Panamá.
| | - Dolores Sánchez-Rodríguez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A.Van Gehuchten 4, 1020 Brussels, Belgium; WHO Collaborating Center for Public Health aspects of musculoskeletal health and ageing. Division of Public Health, Epidemiology and Health Economics, University of Liège, Pl. du Vingt Août 7, 4000, Liège, Belgium
| | - Monique Messaggi-Sartor
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elena Muñoz-Redondo
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Andrea Morgado-Pérez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Marta Tejero-Sánchez
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain
| | - Elisabet De Jaime-Gil
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019, Barcelona, Catalonia, Spain
| | - Nuria Leiva-Banuelos
- Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019, Barcelona, Catalonia, Spain
| | - Ester Marco
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain; Physical Medicine and Rehabilitation Department. Hospital del Mar - Centre Esperança. Sant Josep de la Muntanya 12, 08024 Barcelona, Catalonia, Spain; Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Dr Aiguader Building (Mar Campus), Dr. Aiguader 80, 08003 Barcelona, Catalonia, Spain
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Dericioglu D, Methven L, Clegg ME. Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population. Proc Nutr Soc 2024:1-13. [PMID: 38557431 DOI: 10.1017/s0029665124002192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.
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Affiliation(s)
- Dilara Dericioglu
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
| | - Lisa Methven
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- Food Research Group, Department of Food and Nutritional Sciences, University of Reading,Whiteknights, Reading RG6 6DZ, UK
| | - Miriam E Clegg
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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