Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review

Adherence to Mediterranean, Dietary Approaches to Stop Hypertension and Healthy Eating Indices are Associated with Lower Risk of Disability among Puerto Rican Adults from the Longitudinal Boston Puerto Rican Health Study

BACKGROUND

Emerging evidence suggests that poor dietary quality is an important risk factor for disability. However, few studies have compared adherence to dietary patterns and disability, and none among Puerto Rican adults.

OBJECTIVE

This study was designed to examine relationships between three dietary patterns, including DASH, Mediterranean (MeDS), and Healthy Eating Index (HEI-2010), and ∼6-y incidence of activities of daily living (ADL) and instrumental ADL (IADL) disability, and to assess potential mediation by handgrip strength.

METHODS

Data are from the Boston Puerto Rican Health Study (BPRHS), a longitudinal cohort of Puerto Rican adults aged 45-75 y (n=1502). Adherence to dietary pattern variables were derived from food frequency questionnaire (FFQ) data averaged at baseline and ∼2-y. Handgrip strength was assessed at baseline. Cox proportional hazards models were used to assess longitudinal associations between DASH, MeDS, HEI-2010, and incident ∼6-y ADL (and subscales) and IADL disability. Mediation by handgrip strength was also tested.

RESULTS

Participants with higher adherence DASH had lower risk of ADL, ADL mobility, and ADL manual dexterity disabilities (HR = 0.96, 95%CI: 0.91, 0.98; HR = 0.96, 95%CI: 0.92, 0.99; HR = 0.95, 95%CI: 0.92, 0.98, respectively).Higher adherence to MeDS was associated with lower risk of ADL and ADL mobility disabilities (HR = 0.89, 95%CI: 0.81, 0.98; HR = 0.90, 95%CI: 0.82, 1.00), and higher adherence to HEI with lower risk of ADL manual dexterity (HR = 0.98, 95%CI: 0.97, 0.99) in fully adjusted models. Only DASH tended to be associated with IADL (HR = 0.97, 95%CI: 0.94, 1.00). Baseline handgrip strength was a mediator between HEI and ADL manual dexterity (23.7% of the indirect effect was explained through handgrip strength).

CONCLUSIONS

Higher adherence to a healthy diet pattern may decrease risk of disability and may be an important prevention strategy for ADL and IADL disability associated with aging.

Association of the oxidative balance score with sarcopenia among young and middle-aged adults: findings from NHANES 2011-2018

Background

Sarcopenia is associated with oxidative stress. The Oxidative Balance Score (OBS) is commonly used to assess dietary and lifestyle exposure to oxidative stress. However, few studies in the literature have assessed the correlation between sarcopenia and OBS.

Aim

This study aimed to assess the association between OBS and sarcopenia among young and middle-aged adults in the United States using data from the National Health and Nutrition Examination Survey (NHANES).

Method

Weighted logistic regression analysis was used to investigate the association between OBS and sarcopenia based on data from NHANES 2011-2018. Subgroup analyses were performed to observe the consistency of the outcomes, and the stability of the results was tested using sensitivity analyses.

Result

The final sample included 5,525 young and middle-aged American adults. A higher OBS was associated with a lower risk of sarcopenia. In the fully adjusted model, the second (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.41, 0.94; p = 0.023), third (OR: 0.50; 95% CI: 0.34, 0.74; p < 0.001), and highest quartiles (OR: 0.18; 95% CI: 0.11, 0.28; p < 0.001) of the OBS were associated with higher risks of sarcopenia when compared to the lowest quartile. This association was consistent across both dietary and lifestyle OBS scores. Our subgroup analysis revealed no significant differences between the subgroups of variables included in the interaction analysis. Sensitivity analyses revealed similar results.

Conclusion

Our study showed that higher antioxidant and lower antioxidant exposure may decrease the risk of developing sarcopenia. Higher OBS scores may indicate greater protection against sarcopenia; however, further clinical studies are warranted to confirm these findings.

The Association between Dietary Nutrient Intake and Acceleration of Aging: Evidence from NHANES

The acceleration of aging is a risk factor for numerous diseases, and diet has been identified as an especially effective anti-aging method. Currently, research on the relationship between dietary nutrient intake and accelerated aging remains limited, with existing studies focusing on the intake of a small number of individual dietary nutrients. Comprehensive research on the single and mixed anti-aging effects of dietary nutrients has not been conducted. This study aimed to comprehensively explore the effects of numerous dietary nutrient intakes, both singly and in combination, on the acceleration of aging. Data for this study were extracted from the 2015-2018 National Health and Nutrition Examination Surveys (NHANES). The acceleration of aging was measured by phenotypic age acceleration. Linear regression (linear), restricted cubic spline (RCS) (nonlinear), and weighted quantile sum (WQS) (mixed effect) models were used to explore the association between dietary nutrient intake and accelerated aging. A total of 4692 participants aged ≥ 20 were included in this study. In fully adjusted models, intakes of 16 nutrients were negatively associated with accelerated aging (protein, vitamin E, vitamin A, beta-carotene, vitamin B1, vitamin B2, vitamin B6, vitamin K, phosphorus, magnesium, iron, zinc, copper, potassium, dietary fiber, and alcohol). Intakes of total sugars, vitamin C, vitamin K, caffeine, and alcohol showed significant nonlinear associations with accelerated aging. Additionally, mixed dietary nutrient intakes were negatively associated with accelerated aging. Single dietary nutrients as well as mixed nutrient intake may mitigate accelerated aging. Moderately increasing the intake of specific dietary nutrients and maintaining dietary balance may be key strategies to prevent accelerated aging.

Serum iron level is independently associated with sarcopenia: a retrospective study

Sarcopenia greatly reduces the quality of life of the elderly, and iron metabolism plays an important role in muscle loss. This study aimed to investigate the association between iron status and sarcopenia. A total of 286 adult patients hospitalized between 2019 and 2021 were included in this study, of which 117 were diagnosed with sarcopenia. Serum iron, total iron binding capacity (TIBC), transferrin, and transferrin saturation levels were compared between groups with and without sarcopenia and were included in the logistic analyses, with significant variables further included in the logistic regression model for the prediction of sarcopenia. Serum iron, TIBC, and transferrin levels decreased significantly in the sarcopenia group (p < 0.05), and were negatively associated with handgrip strength, relative skeletal muscle index, and multiple test performances (p < 0.05). Multivariate logistic analysis showed that sex, age, body mass index (BMI), and serum iron level were independent risk factors for sarcopenia. In the final logistic regression model, male sex (odds ratio [OR] 3.65, 95% confidence interval [CI] 1.67-7.98), age > 65 years (OR 5.40, 95% CI 2.25-12.95), BMI < 24 kg/m2 (OR 0.17, 95% CI 0.08-0.36), and serum iron < 10.95 μmol/L (OR 0.39, 95% CI 0.16-0.93) were included. Our study supported the impact of iron metabolism on muscle strength and performance.

Novel dietary strategies to manage sarcopenia

PURPOSE OF REVIEW

Sarcopenia is a wasting disease, mostly age-related in which muscle strength and mass decline, such as physical performance. With aging, both lower dietary protein intake and anabolic resistance lead to sarcopenia. Moreover, aging and sarcopenia display low-grade inflammation, which also worsen muscle condition. In this review, we focused on these two main targets to study dietary strategies.

RECENT FINDINGS

The better understanding in mechanisms involved in sarcopenia helps building combined dietary approaches including physical activity that would slow the disease progression. New approaches include better understanding in the choice of quality proteins, their amount and schedule and the association with antioxidative nutrients.

SUMMARY

First, anabolic resistance can be countered by increasing significantly protein intake. If increasing amount remains insufficient, the evenly delivery protein schedule provides interesting results on muscle strength. Quality of protein is also to consider for decreasing risk for sarcopenia, because varying sources of proteins appears relevant with increasing plant-based proteins ratio. Although new techniques have been developed, as plant-based proteins display a lower availability, we need to ensure an adapted overall amount of proteins. Finally, specific enrichment with leucine from whey protein remains the dietary combined approach most studied and studies on citrulline provide interesting results. As cofactor at the edge between anabolic and antioxidative properties, vitamin D supplementation is to recommend. Antioxidative dietary strategies include both fibers, vitamins, micronutrients and polyphenols from various sources for positive effects on physical performance. The ω 3 -polyunsaturated fatty acids also display positive modifications on body composition. Gut microbiota modifiers, such as prebiotics, are promising pathways to improve muscle mass and function and body composition in sarcopenic patients. Nutritional interventions could be enhanced by combination with physical activity on sarcopenia. In healthy older adults, promoting change in lifestyle to get near a Mediterranean diet could be one of the best options. In sarcopenia adults in which lifestyle changes appears unprobable, specific enrichement potentialized with physical activity will help in the struggle against sarcopenia. Longitudinal data are lacking, which makes it hard to draw strong conclusions. However, the effects of a physical activity combined with a set of nutrition interventions on sarcopenia seems promising.

Nutritional Strategies for Muscle Atrophy: Current Evidence and Underlying Mechanisms

Skeletal muscle can undergo detrimental changes in various diseases, leading to muscle dysfunction and atrophy, thus severely affecting people's lives. Along with exercise, there is a growing interest in the potential of nutritional support against muscle atrophy. This review provides a brief overview of the molecular mechanisms driving skeletal muscle atrophy and summarizes recent advances in nutritional interventions for preventing and treating muscle atrophy. The nutritional supplements include amino acids and their derivatives (such as leucine, β-hydroxy, β-methylbutyrate, and creatine), various antioxidant supplements (like Coenzyme Q10 and mitoquinone, resveratrol, curcumin, quercetin, Omega 3 fatty acids), minerals (such as magnesium and selenium), and vitamins (such as vitamin B, vitamin C, vitamin D, and vitamin E), as well as probiotics and prebiotics (like Lactobacillus, Bifidobacterium, and 1-kestose). Furthermore, the study discusses the impact of a combined approach involving nutritional support and physical therapy to prevent muscle atrophy, suggests appropriate multi-nutritional and multi-modal interventions based on individual conditions to optimize treatment outcomes, and enhances the recovery of muscle function for patients. By understanding the molecular mechanisms behind skeletal muscle atrophy and implementing appropriate interventions, it is possible to enhance the recovery of muscle function and improve patients' quality of life.

A Patented Dietary Supplement (Hydroxy-Methyl-Butyrate, Carnosine, Magnesium, Butyrate, Lactoferrin) Is a Promising Therapeutic Target for Age-Related Sarcopenia through the Regulation of Gut Permeability: A Randomized Controlled Trial

Adequate diet, physical activity, and dietary supplementation with muscle-targeted food for special medical purposes (FSMP) or dietary supplement (DS) are currently considered fundamental pillars in sarcopenia treatment. The aim of this study is to evaluate the effectiveness of a DS (containing hydroxy-methyl-butyrate, carnosine, and magnesium, for its action on muscle function and protein synthesis and butyrate and lactoferrin for their contribution to the regulation of gut permeability and antioxidant/anti-inflammation activity) on muscle mass (assessed by dual X-ray absorptiometry (DXA)), muscle function (by handgrip test, chair test, short physical performance battery (SPPB) test, and walking speed test), inflammation (tumor necrosis factor-alpha (TNF-a), C-reactive protein (CRP), and visceral adipose tissue (VAT)) and gut axis (by zonulin). A total of 59 participants (age 79.7 ± 4.8 years, body mass index 20.99 ± 2.12 kg/m2) were enrolled and randomly assigned to intervention (n = 30) or placebo (n = 28). The skeletal muscle index (SMI) significantly improved in the supplemented group compared to the placebo one, +1.02 (CI 95%: -0.77; 1.26), p = 0.001; a significant reduction in VAT was observed in the intervention group, -70.91 g (-13.13; -4.70), p = 0.036. Regarding muscle function, all the tests significantly improved (p = 0.001) in the supplemented group compared to the placebo one. CRP, zonulin, and TNF-alpha significantly decreased (p = 0.001) in intervention, compared to placebo, -0.74 mg/dL (CI 95%: -1.30; -0.18), -0.30 ng/mL (CI 95%: -0.37; -0.23), -6.45 pg/mL (CI 95%: -8.71; -4.18), respectively. This DS improves muscle mass and function, and the gut muscle has emerged as a new intervention target for sarcopenia.

Iron status and sarcopenia-related traits: a bi-directional Mendelian randomization study

Although serum iron status and sarcopenia are closely linked, the presence of comprehensive evidence to establish a causal relationship between them remains insufficient. The objective of this study is to employ Mendelian randomization techniques to clarify the association between serum iron status and sarcopenia. We conducted a bi-directional Mendelian randomization (MR) analysis to investigate the potential causal relationship between iron status and sarcopenia. MR analyses were performed using inverse variance weighted (IVW), MR-Egger, and weighted median methods. Additionally, sensitivity analyses were conducted to verify the reliability of the causal association results. Then, we harvested a combination of SNPs as an integrated proxy for iron status to perform a MVMR analysis based on IVW MVMR model. UVMR analyses based on IVW method identified causal effect of ferritin on appendicular lean mass (ALM, β = - 0.051, 95% CI - 0.072, - 0.031, p = 7.325 × 10-07). Sensitivity analyses did not detect pleiotropic effects or result fluctuation by outlying SNPs in the effect estimates of four iron status on sarcopenia-related traits. After adjusting for PA, the analysis still revealed that each standard deviation higher genetically predicted ferritin was associated with lower ALM (β = - 0.054, 95% CI - 0.092, - 0.015, p = 0.006). Further, MVMR analyses determined a predominant role of ferritin (β = - 0.068, 95% CI - 0.12, - 0.017, p = 9.658 × 10-03) in the associations of iron status with ALM. Our study revealed a causal association between serum iron status and sarcopenia, with ferritin playing a key role in this relationship. These findings contribute to our understanding of the complex interplay between iron metabolism and muscle health.

A review of dairy food intake for improving health among black geriatrics in the US

The transition to older adulthood is generally marked by progressive declines in body composition, metabolism, cognitive function, and immunity. For socially disadvantaged geriatric populations such as Black Americans, this life stage may also include additional stressors, including dealing with discrimination, poor access to healthcare, and food insecurity. These types of chronic stressors are linked to a higher allostatic load, which is associated with accelerated biological aging, higher rates of adverse health outcomes, and an overall lower quality of life. Of the numerous factors involved in healthy aging, a growing body of research indicates that consuming a higher quality diet that is rich in fruits, vegetables, whole grains, protein foods, and dairy foods, is one of the most potent factors for helping to protect against age-related disease progression. Among the food groups listed above that are recommended by the 2020-2025 Dietary Guidelines for Americans dairy foods are unique in their ability to provide several of the essential nutrients (e.g., high-quality protein, calcium, potassium, vitamin B12, and vitamin D in fortified products) that are most often inadequately consumed by older Black Americans. However, dairy is the most inadequately consumed food group in the US, with older Black adults consuming fewer than half of the 3 daily recommended servings. Therefore, this review examines the current body of evidence exploring the links between dairy intake and age-related disease risk, with a special focus on health and disparities among older Black Americans. Overall, the evidence from most systematic reviews and/or meta-analyses focused on dairy intake and musculoskeletal health suggest that higher dairy intake across the life span, and especially from fermented and fortified products, is associated with better bone and muscle health outcomes in older adults. The evidence on dairy intake and neurocognitive and immune outcomes among older adults holds significant promise for potential benefits, but most of these results are sourced from individual studies or narrative reviews and are not currently corroborated in systematic reviews or meta-analyses. Additionally, most of the research on dairy intake and age-related disease risk has been performed in White populations and can only be extrapolated to Black populations. Nonetheless, older Black populations who do not meet the DGA recommended 3 servings of dairy per day due to lactose intolerance, restrictive dietary patterns, or for other reasons, are likely falling short of several of the nutritional requirements necessary to support healthy aging.

Association between dietary magnesium intake and muscle mass among hypertensive population: evidence from the National Health and Nutrition Examination Survey

BACKGROUND

Magnesium is critical for musculoskeletal health. Hypertensive patients are at high risk for magnesium deficiency and muscle loss. This study aimed to explore the association between magnesium intake and muscle mass in patients with hypertension.

METHODS

In this population-based cross-sectional study, 10,279 U.S. hypertensive adults aged 20 years or older were derived from the National Health and Nutrition Examination Survey in 1999-2006 and 2011-2018. Magnesium (Mg) intake from diet and supplements was assessed using 24-hour diet recalls. Muscle mass was evaluated by appendicular skeletal muscle mass index (ASMI, total ASM in kilograms [kg] divided by square of height in meters [m2]). The association of Mg intake with ASMI was estimated using weighted multivariable-adjusted linear regression models and restricted cubic splines.

RESULTS

Dose-response analyses showed a positive linear correlation between dietary Mg intake and ASMI. Every additional 100 mg/day in dietary Mg was associated with 0.04 kg/m2 (95% confidence interval [CI] 0.02-0.06 kg/m2) higher ASMI. The ASMI in participants who met the recommended dietary allowance (RDA) for dietary Mg was 0.10 kg/m2 (95% CI 0.04-0.16 kg/m2) higher than those whose dietary Mg was below estimated average requirement (EAR). However, the relationship of Mg intake from supplements with ASMI was not identified.

CONCLUSION

Higher level of dietary Mg intake rather than Mg supplements was associated with more muscle mass in U.S. adults with hypertension, which highlights the importance of meeting the recommended levels for dietary Mg intake.

Specific dairy foods and risk of frailty in older women: a prospective cohort study

BACKGROUND

Dairy contains a complex mixture of lipids, proteins, and micronutrients. Whether habitual dairy consumption is associated with health benefits is not well established. Since dairy is high in nutrients that are potentially protective against frailty, the association between dairy products and the risk of frailty is of interest.

METHODS

We analyzed data from 85,280 women aged ≥ 60 years participating in the Nurses' Health Study. Consumption of milk, yogurt, and cheese was obtained from repeated food frequency questionnaires administered between 1980 and 2010. Frailty was defined as having at least three of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥ 5 chronic illnesses, and a weight loss of ≥ 5%. The occurrence of frailty was assessed every four years from 1992 to 2018. Cox proportional hazard models were used to examine the association between the intake of dairy foods and frailty.

RESULTS

During follow-up we identified 15,912 incident cases of frailty. Consumption of milk or yogurt was not associated with the risk of frailty after adjustment for lifestyle factors, medication use, and overall diet quality. Cheese consumption was positively associated with risk of frailty [relative risk (95% confidence interval) for one serving/day increment in consumption: 1.10 (1.05, 1.16)]. Replacing one serving/day of milk, yogurt, or cheese with one serving/day of whole grains, nuts, or legumes was associated with a significant lower risk of frailty, while replacing milk, yogurt, or cheese with red meat or eggs was associated with an increased risk. When milk was replaced with a sugar-sweetened or artificially sweetened beverage, a greater risk of frailty was observed, while replacing milk with orange juice was associated with a lower risk of frailty.

CONCLUSIONS

The results suggest that the association between milk, yogurt, and cheese and frailty partly depends on the replacement product. Habitual consumption of milk or yogurt was not associated with risk of frailty, whereas cheese consumption may be associated with an increased risk.

Nutrient Intake and Its Association with Appendicular Total Lean Mass and Muscle Function and Strength in Older Adults: A Population-Based Study

Treatment options for sarcopenia are currently limited, and primarily rely on two main therapeutic approaches: resistance-based physical activity and dietary interventions. However, details about specific nutrients in the diet or supplementation are unclear. We aim to investigate the relationship between nutrient intake and lean mass, function, and strength. Data were derived from the Gothenburg H70 birth cohort study in Sweden, including 719,70-year-olds born in 1944 (54.1% females). For independent variables, the diet history method (face-to-face interviews) was used to estimate habitual food intake during the preceding three months. Dependent variables were gait speed (muscle performance), hand grip strength (muscle strength), and the appendicular lean soft tissue index (ALSTI). Linear regression analyses were performed to analyze the relationship between the dependent variables and each of the covariates. Several nutrients were positively associated with ALSTI, such as polyunsaturated fatty acids (DHA, EPA), selenium, zinc, riboflavin, niacin equivalent, vitamin B12, vitamin D, iron, and protein. After correction for multiple comparisons, there were no remaining correlations with handgrip and gait speed. Findings of positive correlations for some nutrients with lean mass suggest a role for these nutrients in maintaining muscle volume. These results can be used to inform clinical trials to expand the preventive strategies and treatment options for individuals at risk of muscle loss and sarcopenia.

Associations of micronutrient dietary patterns with sarcopenia among US adults: a population-based study

Background

Current epidemiological evidence points to an association between micronutrient (MN) intake and sarcopenia, but studies have focused on single MN, and no combined effects on MNs have been reported. The aim of this study was to investigate the relationship between different MN intake patterns and sarcopenia and skeletal muscle mass.

Methods

We performed a population-based cross-sectional study, with a total of 5,256 U.S. adults aged 20-59 years, and we collected total daily MN intake and appendicular skeletal muscle mass measured by Dual-Energy X-ray Absorptiometry (DXA). Principal component analysis (PCA) was used to obtain nutrient patterns and principal component scores based on the intake of 14 MNs, and logistic regression analysis was used to assess the effects of single MN and MN intake patterns on sarcopenia and muscle mass.

Results

We defined three MN intake patterns by PCA: (1) adherence to VitB-mineral, high intake of vitamin B and minerals; (2) adherence to VitAD-Ca-VB12, high intake of vitamin A, vitamin D, calcium and vitamin B12; and (3) adherence to Antioxidant Vit, high intake of antioxidant vitamins A, C, E, and K. These three nutrient patterns explained 73.26% of the variance of the population. A negative association was observed between most single MN intakes and sarcopenia, and after adjusting for confounders, adherence to the highest tertile of the three nutrient patterns was associated with a lower risk of sarcopenia and relatively higher skeletal muscle mass compared to the lowest adherence. In subgroup analysis, MN intake patterns were significantly correlated with sarcopenia in middle-aged females.

Conclusion

Nutritional patterns based on MN intake were significantly related to sarcopenia, indicating that MNs interact with each other while exerting their individual functions, and that MN dietary patterns may provide promising strategies for preventing the loss of muscle mass, with further prospective studies warranted in the future.

Magnesium and the Hallmarks of Aging

Magnesium is an essential ion in the human body that regulates numerous physiological and pathological processes. Magnesium deficiency is very common in old age. Age-related chronic diseases and the aging process itself are frequently associated with low-grade chronic inflammation, called 'inflammaging'. Because chronic magnesium insufficiency has been linked to excessive generation of inflammatory markers and free radicals, inducing a chronic inflammatory state, we formerly hypothesized that magnesium inadequacy may be considered among the intermediaries helping us explain the link between inflammaging and aging-associated diseases. We show in this review evidence of the relationship of magnesium with all the hallmarks of aging (genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, disabled autophagy, dysbiosis, and chronic inflammation), which may positively affect the human healthspan. It is feasible to hypothesize that maintaining an optimal balance of magnesium during one's life course may turn out to be a safe and economical strategy contributing to the promotion of healthy aging. Future well-designed studies are necessary to further explore this hypothesis.

Imaging of Sarcopenia in Type 2 Diabetes Mellitus

Sarcopenia is an age-related condition characterized by the loss of skeletal muscle mass, muscular strength, and muscle function. In older adults, type 2 diabetes mellitus (T2DM) constitutes a significant health burden. Skeletal muscle damage and deterioration have emerged as novel chronic complications in patients with diabetes, often linked to their increased longevity. Diabetic sarcopenia has been associated with increased rates of hospitalization, cardiovascular events, and mortality. Nevertheless, effectively managing metabolic disorders in patients with T2DM through appropriate therapeutic interventions could potentially mitigate the risk of sarcopenia. Utilizing imaging technologies holds substantial clinical significance in the early detection of skeletal muscle mass alterations associated with sarcopenia. Such detection is pivotal for arresting disease progression and preserving patients' quality of life. These imaging modalities offer reproducible and consistent patterns over time, as they all provide varying degrees of quantitative data. This review primarily delves into the application of dual-energy X-ray absorptiometry, computed tomography, magnetic resonance imaging, and ultrasound for both qualitative and quantitative assessments of muscle mass in patients with T2DM. It also juxtaposes the merits and limitations of these four techniques. By understanding the nuances of each method, clinicians can discern how best to apply them in diverse clinical scenarios.

Sweat Rate, Sweat Sodium Losses, and Body Composition in Professional Male Soccer Players in Southwest Colombia

Background and Objective: Dehydration and hyperhydration impact athletes' performance. Exploring the fluid balance concerning body composition might help estimate individual hydration requirements. This area of research, particularly regarding sodium losses, has been relatively understudied. We evaluated the sweat rate (SR), sweat sodium losses, and their relationship with body composition in professional soccer players in Cali, Colombia. Materials and Methods: Thirty-two male players, aged 24.3 (±5.2) years, from the Colombian main soccer league, underwent high-intensity training at 32 °C (with a relative humidity of 79%). The outcome variables included SR, calculated using weight loss and fluid intake; forearm sweat sodium concentration (FSCC), measured through the direct ion-selective electrode method; and estimated the predicted whole sweat sodium loss (PWSSL) in mmol. Predictor variables (body mass, fat, and muscle masses) were estimated using the Deborah Kerr anthropometry method. The association between predictors and outcomes was assessed using linear regression. Results: The mean FSCC, PWSSL, and SR were 26.7 ± 11.3 mmol/L, 43 ± 15.9 mmol/L, and 1.7 ± 0.5 L/h, respectively. Body mass positively predicted FSCC in unadjusted and age/fat-mass-adjusted models [Beta 1.28, 95% confidence interval (CI) 0.39-2.18, p = 0.006], and continued related to FSCC after adjustment for muscle mass with marginal significance [Beta 0.85, 95% CI -0.02 to 1.73, p = 0.056]. Muscle mass was associated with the PWSSL in unadjusted and age/fat-mass-adjusted models [Beta 2.42, 95% CI 0.58-4.26, p = 0.012] and sustained an association with marginal statistical significance after adjustment for body mass [Beta 1.86, 95% CI -0.35 to 4.09, p = 0.097]. Conclusions: Under hot tropical weather conditions, FSCC was relatively low among the players. Body mass was better associated with the FSSC, and muscle mass better related to the PWSSL. Body and muscle masses could be regarded as potential factors to be explored in the estimation of individual sodium needs. However, further studies are required to validate and contrast our findings.

Association between serum copper levels and muscle mass: results from NHANES 2011-2016

Copper is essential for various biological processes. However, excess copper has several adverse health effects. The effects of serum copper on muscle mass are poorly understood. This study aimed to investigate the association between serum copper levels and muscle mass in the US population. We utilized National Health and Nutrition Examination Survey (NHANES) data between 2011 and 2016 for analysis. Data on serum copper, muscle mass (measured using the appendicular skeletal muscle mass index (ASMI)), and covariates were extracted and analyzed. Weighted multivariate linear regression analyses and smooth curve fittings were performed to investigate the association between serum copper levels and ASMI. Subgroup analyses stratified according to age and sex were performed. In the presence of nonlinearity, threshold effect analysis was performed using a two-piecewise linear regression model. A total of 3860 participants were included in the final analysis. Serum copper levels were negatively associated with ASMI in the fully adjusted model. Furthermore, by comparing participants in the highest and lowest tertiles of serum copper levels, we found that the ASMI decreased by 0.292 kg/m2. In the sex-stratified subgroup analysis, we observed an inverse association between serum copper levels and the ASMI in both men and women. When stratified by age, the association remained significant among participants < 40 years of age, but not among those ≥ 40 years old. Smooth curve fitting revealed a nonlinear relationship between serum copper and ASMI, with an inflection point identified at 150.6 μg/dL. Our study revealed an inverse relationship between serum copper levels and muscle mass. This finding improves the current knowledge on the impact of serum copper on muscle loss and highlights the importance of serum copper homeostasis in muscle health.

Energy and nutrient intake by people with and without sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People: a systematic review and meta-analysis

CONTEXT

There is growing evidence that insufficient dietary intake is associated with sarcopenia.

OBJECTIVE

In this systematic review and meta-analysis, the energy and nutrient intakes by people with and without sarcopenia were compared using only the European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) consensus diagnostic criteria.

DATA SOURCES

Only observational studies that compared energy and nutrient intake from food alone by individuals with and without sarcopenia were included. Studies were searched in the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus. The review followed the PRISMA checklist and submitted the protocol to PROSPERO.

DATA EXTRACTION

Data were extracted by 2 authors independently. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale.

DATA ANALYSIS

A total of 8648 articles were identified and 12 were selected. Among individuals with sarcopenia, lower intakes of energy and some nutrients, mainly with antioxidant properties, were observed compared with those without sarcopenia. Meta-analyses showed that individuals with sarcopenia consume fewer calories/day than individuals without sarcopenia (n = 10 studies; standardized mean difference (SMD) -0.15; 95% confidence interval: -0.29, -0.01) diagnosed by EWGSOP1 and EWGSOP2. Individuals with sarcopenia consume less omega-3, folate, magnesium, phosphorus, selenium, zinc, and vitamins C, D, and E when compared with those without sarcopenia.

CONCLUSION

The results of the present study suggest that insufficient intake of energy and nutrients with antioxidant potential may be associated with sarcopenia.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD 42020195698.

Nutritional and Technological Properties of Albino Peach Palm (Bactris gasipaes) from the Amazon: Influence of Cooking and Drying

This study aimed to subject the albino peach palm to cooking and drying processes and characterize the raw pulp (RP), cooked pulp (CP), raw pulp flour (RPF), and cooked pulp flour (CPF). The product's chemical composition, bioactive compounds, and physicochemical, color, thermal, morphological, and functional-technological properties were evaluated. The proximate composition showed that carbohydrates were the main constituents of all the products (69.59-72.08 g/100 g). The cooking process decreased the lipids (10.21 to 8.63 g/100 g), dietary fiber (13.64 to 12.81 g/100 g), and total sugar content (59.18 to 49.10 g/100 g) of the CP. The colorimetric parameters indicated a significant browning of the CP and CPF, which can be attributed to the Maillard reaction and lipid oxidation. After cooking, the total phenolic compound and ascorbic acid content decreased in the pulp. The RPF and CPF displayed different thermogravimetric behaviors. The spectral patterns in the infrared region showed the characteristic bands of organic compounds that are present in the structure of starches. The scanning electron microscopy showed amyloplast and fiber bundles with starches in the RP and gelatinized starch granules in the CP and CPF. The RPF presented small and heterogeneous starch granules with isolated amyloplast. The RPF and CPF showed different granulometric patterns and technological indices. The results suggest that the pulp and flour from the pulp of albino peach palms can be exploited by the food, pharmaceutical, and biotechnological industries.

Impact of Restricted Phosphorus, Calcium-adjusted Diet on Musculoskeletal and Mental Health in Hypophosphatasia

Context

Impairments in musculoskeletal and mental health are common in adults with Hypophosphatasia (HPP). Restricted phosphorus intake has been suggested to positively affect symptoms in HPP, but there is a lack of interventional evidence.

Objective

This work aimed to evaluate the effect of a phosphorus-restricted, calcium-adjusted diet on musculoskeletal and mental health in HPP.

Methods

A prospective, noncontrolled, single-center interventional study (NuSTEPS II) was conducted among outpatients at the Osteology Department, University of Wuerzburg, Germany. A total of 26 adults with an established HPP diagnosis received a standardized diet with a defined daily intake of phosphorus (1160-1240 mg/d) and calcium (870-930 mg/d) over 8 weeks. Main outcome measures were functional testing and patient-reported outcome measures.

Results

At 8 weeks, significant improvements were observed in usual gait speed (P = .028) and the chair-rise test (P = .019), while no significant changes were seen in the 6-minute walk test (P = .468) and the timed up-and-go test (P = .230). Pain was not significantly reduced according to the visual analog scale (VAS) (P = .061), pain subscale of the 36-Item Short-Form Health Survey (SF-36) (P = .346), and Pain Disability Index (P = .686). Further, there was a significant improvement in the SF-36 vitality subscale (P = .022) while all other subscales as well as the Lower Extremity Functional Scale (P = .670) and the Fatigue Assessment Scale (P = .392) did not change significantly. Adjustments of mineral intake were not associated with relevant alterations regarding the intake of energy and energy-supplying nutrients or body composition.

Conclusion

Adjusting phosphorus and calcium intake may positively affect individual symptoms in adults with HPP, but overall clinical effectiveness regarding major issues like pain and endurance appears limited.

Dietary Supplementation with Lauric Acid Improves Aerobic Endurance in Sedentary Mice via Enhancing Fat Mobilization and Glyconeogenesis

BACKGROUND

Lauric acid (LA), a major, natural, medium-chain fatty acid, is considered an efficient energy substrate for intense exercise and in patients with long-chain fatty acid β-oxidation disorders. However, few studies have focused on the role of LA in exercise performance and related glucolipid metabolism in vivo.

OBJECTIVES

We aimed to investigate the effect of dietary supplementation with LA on exercise performance and related metabolic mechanisms.

METHODS

Male C57BL/6N mice (14 wk old) were fed a basal diet or a diet containing 1% LA, and a series of exercise tests, including a high-speed treadmill test, aerobic endurance exercises, a 4-limb hanging test, and acute aerobic exercises, were performed.

RESULTS

Dietary supplementation with 1.0% LA accelerated the recovery from fatigue after explosive exercise (P < 0.05) and improved aerobic endurance and muscle strength in sedentary mice (P = 0.039). Lauric acid intake not only changed muscle fatty acid profiles, including increases in C12:0 and n-6/n-3 PUFAs (P < 0.001) and reductions in C18:0, C20:4n-6, C22:6n-3, and n-3 PUFAs (P < 0.05) but also enhanced fat mobilization from adipose tissue and fatty acid oxidation in the liver, at least partly via the AMP-activated protein kinase-acetyl CoA carboxylase pathway (P < 0.05). Likewise, LA supplementation promoted liver glyconeogenesis and conserved muscular glycogen during acute aerobic exercise (P < 0.05), which was accompanied by an increase in the mitochondrial DNA copy number and Krebs cycle activity in skeletal muscle (P < 0.05).

CONCLUSIONS

Dietary supplemental LA serves as an efficient energy substrate for sedentary mice to improve aerobic exercise endurance and muscle strength through regulation of glucolipid metabolism. These findings imply that LA supplementation might be a promising nutritional strategy to improve aerobic exercise performance in sedentary people.

The role of nutrition in the prevention of sarcopenia

Sarcopenia is a common skeletal muscle disorder characterized by a loss of muscle mass and impaired muscle function that is associated with poor health outcomes. Although nutrition is considered an important factor in the etiology of sarcopenia, the preventive potential of diet, specifically the extent to which differences in habitual patterns of diet and/or nutrient intakes impact risk of its development, is poorly understood. This narrative review considered research evidence on dietary patterns and nutrient intakes in mid- (<60 y) and young-older (60-70 y) adulthood to evaluate how they relate to age-related changes in muscle mass and function. A key finding was that current evidence on adult diet and sarcopenia risk in older age is limited and fragmented, with different outcomes reported across studies (for example, lean mass, strength) and few reporting links to incident diagnosed sarcopenia. As these outcomes are not interchangeable, it challenges collation of the evidence, leaving many gaps in understanding. There is also limited information about adult (<70 y) diet and few longitudinal studies with repeated dietary assessments to enable definition of cumulative exposures across adulthood. However, despite these limitations, findings from studies of dietary patterns already provide reasonably consistent messages about the benefits of diets of higher quality in earlier adulthood for later physical performance, although whole-diet intervention trials are urgently needed to understand their potential. In comparison, there is little evidence of benefits of higher intakes of individual nutrients in earlier adulthood for later muscle mass and function. Although these gaps need to be addressed in future research, there may already be sufficient data to promote messages about diet quality more widely - that healthier diets of higher quality across adulthood, with known benefits for a range of health outcomes, are also linked to the effective preservation of muscle mass and function.

Benefits and side effects of protein supplementation and exercise in sarcopenic obesity: A scoping review

BACKGROUND

Protein supplements have been widely used among those who are struggling with sarcopenic obesity among older adults. However, despite their popularity, there is still a lack of concrete evidence on both the potential benefits and side effects of protein supplementation and exercise on sarcopenic obesity (SO).

OBJECTIVE

Thus, we aimed to determine the impacts of protein supplementation and exercise in older adults with sarcopenic obesity.

METHOD

A systematic database search was conducted for randomised controlled trials, quasi experimental study and pre-post study design addressing the effects of protein supplementation in improving sarcopenic obesity among older adults. This scoping review was conducted based on PRISMA-Scr guidelines across PubMed, Embase, Web of Science and Cochrane Library databases. To assess record eligibility, two independent reviewers performed a rigorous systematic screening process.

RESULTS

Of the 1,811 citations identified, 7 papers met the inclusion criteria. Six studies were randomised controlled trials and one study was a pre-post test study design. The majority of studies discussed the use of both protein supplements and exercise training. The included studies prescribed protein intake ranging from 1.0 to 1.8 g/kg/BW/day for the intervention group, while the duration of exercise performed ranged from 2 to 3 times per week, with each session lasting for 1 hour. Whey protein supplementation has been shown to be effective in improving sarcopenic conditions and weight status in SO individuals. The combination of exercise training especially resistance training and the used of protein supplement provided additional benefits in terms of lean muscle mass as well as biomarkers. The study also revealed a lack of consistency in exercise design among interventions for sarcopenic obesity.

CONCLUSION

Overall, it appears to be a promising option for SO individuals to improve their sarcopenic condition and weight status through the combination of resistance exercise and whey protein supplementation. However, it also highlights the need for caution when it comes to high amounts of protein intake prescription. Future research is warranted to investigate the optimal exercise design for this population, given the limited research conducted in this specific area.

The Crucial Role of Diet Therapy and Selenium on the Evolution of Clinical and Paraclinical Parameters in Patients with Metabolic Syndrome

Oxidative stress (OS) is associated with metabolic syndrome (MS) and represents a complex disease association that has become a major challenge in the field of public health. The aim of this study was to investigate the effectiveness of introducing selenium in the management of OS, while considering a balanced diet based on a healthy lifestyle and dietary therapy. A total of 206 individuals participated voluntarily in the study, divided into three groups: the control group with 35 individuals (17.0%) designated as control lot (LC), the group undergoing diet therapy with 119 individuals (57.8%) designated as diet therapy lot (LD), and the group undergoing diet therapy supplemented with selenium consisting of 52 individuals (25.2%) designated as diet therapy with selenium lot (LD + Se). The study assessed various clinical parameters (such as body mass index (BMI), body weight status, fat mass, visceral fat, and sarcopenic index), paraclinical parameters (including HOMA index, cholesterol, triglycerides, C-reactive protein, and glycosylated haemoglobin (HGS)), as well as OS parameters (measured using the FORD test, FORT test, and MIXED test). The LD + Se group demonstrated the most favourable results in terms of BMI reduction, decreased fat and visceral mass, reduced levels of C-reactive protein, and improved glycosylated haemoglobin levels. By implementing a balanced diet therapy and supplementing the diet with selenium, it was possible to achieve a reduction in adipose tissue and glycosylated haemoglobin levels, ultimately contributing to the reduction of OS in the body.

Zinc and aging: a narrative review of the effects on hematopoiesis and its link with diseases

There has been a global increase in the older population in recent decades and, as age advances, complex metabolic and epigenetic changes occur in the organism, and these may trigger some health complications commonly found among this population. Additionally, several changes occur in older people that can reduce the dietary intake or the process of nutrient absorption. In this way, tissues with high nutrient requirements are more affected. Hematopoiesis is the process of formation, development, and maturation of blood cells and is a process with a high turnover. This high demand makes the integrity of the hematopoietic process susceptible to various factors that impair physiological function, such as aging and micronutrient bioavailability. Among these micronutrients, Zinc is considered an important micronutrient, playing diverse roles across various tissues and cell types. Some of the alterations in hematopoiesis that appear as a consequence of aging and due to insufficient micronutrient intake are well described in the literature; however, not much is known about how zinc deficiency contributes towards the development of diseases seen in aging. Considering the importance of zinc to act on several biological processes, this narrative review discusses several studies related to the physiological requirements, deficiency, or excess of zinc, including studies in experimental models and humans, and aimed to shed light on the relationship between zinc and the regulation of hematopoietic tissue, exploring possible links between this mineral with common disorders that appear during aging.

Recent Advances in Nutraceuticals for the Treatment of Sarcopenic Obesity

Sarcopenic obesity, low muscle mass, and high body fat are growing health concerns in the aging population. This review highlights the need for standardized criteria and explores nutraceuticals as potential therapeutic agents. Sarcopenic obesity is associated with insulin resistance, inflammation, hormonal changes, and reduced physical activity. These factors lead to impaired muscle activity, intramuscular fat accumulation, and reduced protein synthesis, resulting in muscle catabolism and increased fat mass. Myostatin and irisin are myokines that regulate muscle synthesis and energy expenditure, respectively. Nutritional supplementation with vitamin D and calcium is recommended for increasing muscle mass and reducing body fat content. Testosterone therapy decreases fat mass and improves muscle strength. Vitamin K, specifically menaquinone-4 (MK-4), improves mitochondrial function and reduces muscle damage. Irisin is a hormone secreted during exercise that enhances oxidative metabolism, prevents insulin resistance and obesity, and improves bone quality. Low-glycemic-index diets and green cardamom are potential methods for managing sarcopenic obesity. In conclusion, along with exercise and dietary support, nutraceuticals, such as vitamin D, calcium, vitamin K, and natural agonists of irisin or testosterone, can serve as promising future therapeutic alternatives.

Non-pharmacological interventions for community-dwelling older adults with possible sarcopenia or sarcopenia: a scoping review

BACKGROUND

Sarcopenia is a progressive, age-related muscle disease that, if left untreated, imposes significant personal, social, and economic burdens.

OBJECTIVE

To compile and document the nature and extent of existing studies exploring non-pharmacological interventions as a strategy to prevent or treat possible sarcopenia or sarcopenia in community-dwelling older adults.

METHOD

Thirteen databases were searched up from January 2010 to March 2023 and filters were limited to English and Chinese language. Studies with older adults (≥60 y) in the community were included. The review was conducted and reported according to the PRISMA-ScR guidance and seven stages of methodology framework. A descriptive synthesis of trial characteristics and effectiveness was conducted.

RESULTS

A total of 59 studies were included in the analysis. Most studies were RCTs. Few studies enrolled older adults with possible sarcopenia. The 70-79 age group has been studied more than any other age group. Six intervention types were identified, including exercise-only, nutrition-only, health education-only, traditional Chinese medicine-only, multicomponent intervention and control type. Majority of exercise-only interventions received resistance-based exercise. In nutrition-only category, overall food intervention or nutrients intervention was more than dietary pattern. Moreover, exercise plus nutrition was the main sub-type in multicomponent interventions. Health education-only and traditional Chinese medicine-only interventions were less frequently identified. Most studies had high and moderate compliance.

CONCLUSION

There is evidence for the effectiveness of exercise and exercise plus nutrition interventions in improving muscle strength and physical performance, whereas the effectiveness of other intervention types or their combinations requires additional research.

SCOPING REVIEW REGISTRATION

Open Science Framework (OSF) Registration DOI 10.17605/OSF.IO/RK3TE.

Association Between Autoimmune Diseases and Sarcopenia: A Two-Sample Mendelian Randomization Study

Purpose

Observational studies have reported that autoimmune diseases are closely related to sarcopenia, but the causalities of autoimmune diseases with sarcopenia have not been established. We conducted this Mendelian randomization (MR) study to reveal the causal associations of overall autoimmune disease and five common autoimmune diseases with sarcopenia-related traits.

Methods

The publicly available summary-level data of autoimmune diseases and three sarcopenia-related traits were used for analysis. The causal effects of autoimmune diseases on sarcopenia-related traits were first identified in discovery samples using the inverse-variance-weighted method as the primary method, and the robustness of results was examined by additional sensitivity analyses. Replication MR analyses were then conducted using replication samples of five autoimmune diseases. Finally, the possibility of reverse causation was assessed by reverse MR analyses.

Results

In both the discovery and replication samples, we identified potential causal effects of rheumatoid arthritis (RA) on appendicular lean mass (ALM) and low grip strength (OR = 0.979, 95% CI: 0.964-0.995 for ALM; OR = 1.042, 95% CI: 1.013-1.072 for low grip strength), but not on walking pace. We also found that inflammatory bowel disease (IBD) and type 1 diabetes (T1D) were only causally negatively associated with ALM in the discovery stage (OR = 0.986, 95% CI: 0.974-0.999 for IBD; OR = 0.987, 95% CI: 0.975-0.999 for T1D), whereas systemic lupus erythematosus, multiple sclerosis, and overall autoimmune disease were not associated with any of the three sarcopenia-related traits. Additionally, reverse MR analysis only found an association between walking pace and overall autoimmune disease, but this association did not remain in the weighted-median method.

Conclusion

This study demonstrates that RA is causally associated with low grip strength and reduced ALM, and that IBD and T1D may be causally negatively related to ALM.

Sarcopenia in Type 2 Diabetes Mellitus: Study of the Modifiable Risk Factors Involved

(1) Background: Sarcopenia has gained much interest in recent years due to an increase in morbidity. Sarcopenia is associated with type 2 diabetes mellitus (T2DM) and vice versa. There is a paucity of information regarding the prevalence and predictors of sarcopenia among T2DM individuals. The aim of the present study was to determine the prevalence and predictors of sarcopenia among T2DM individuals. (2) Methods: This study included 159 diabetics (cases) and 79 non-diabetics (controls) aged >50 years. The subjects were assessed for demographic and anthropometric parameters. Sarcopenia (according to the Asian Working Group for Sarcopenia 2019 criteria) was assessed using Jammer's hydraulic dynamometer for handgrip strength, dual-energy X-ray absorptiometry for muscle mass, and 6m gait speed. The biochemical investigations included glycated hemoglobin; fasting and prandial glucose; fasting insulin; lipid, renal, liver, and thyroid profiles; serum calcium; phosphorous; vitamin D; and parathyroid hormone (PTH). Appropriate statistical methods were used to determine the significance of each parameter, and a multivariate regression analysis was applied to determine the predictors. (3) Results: The prevalence of sarcopenia was significantly higher among the cases than the controls (22.5% vs. 8.86%, p-0.012). Body mass index (BMI) (OR-0.019, CI-0.001-0.248), physical activity (OR-0.45, CI-0.004-0.475), serum calcium levels (OR-0.155, CI-0.035-0.687), hypertension (OR-8.739, CI-1.913-39.922), and neuropathy (OR-5.57, CI-1.258-24.661) were significantly associated with sarcopenia following multivariate regression analysis. (4) Conclusions: T2DM individuals are prone to sarcopenia, especially those with a low BMI, low physical activity, hypertension, neuropathy, and low serum calcium levels. Hence, by modifying these risk factors among the elderly T2DM, sarcopenia can be prevented.

High Prevalence of Energy and Nutrients Inadequacy among Brazilian Older Adults

Poor nutrition increases the risk of diseases and adverse health outcomes in older adults. We evaluated the potential inadequacy of nutrient intake among older adults in Brazil and its association with body anthropometry and composition outcomes. Dietary intake was obtained from 295 community-living older adults (>60 years old), of both genders, using a seven-day food record. Nutrient inadequacy was further identified based on the Dietary Reference Intakes and European Guidelines. Skeletal muscle mass (SM), strength and performance, and the diagnosis of sarcopenia were assessed using reference methods. Nutritional inadequacy was high, with energy, dietary fiber, and six micronutrients exhibiting the greatest inadequacy levels (>80%). Energy intake was correlated with SM strength (p = 0.000) and performance (p = 0.001). Inadequate energy, fiber, and protein intakes influenced BMI, while inadequate intake of vitamin B6 directly affected the diagnosis of sarcopenia (p ≤ 0.005). Further research is required to investigate whether these inadequacies can be associated with other clinical health outcomes.

Advances in nutritional supplementation for sarcopenia management

Sarcopenia is a syndrome characterized by a decline in muscular mass, strength, and function with advancing age. The risk of falls, fragility, hospitalization, and death is considerably increased in the senior population due to sarcopenia. Although there is no conclusive evidence for drug treatment, resistance training has been unanimously recognized as a first-line treatment for managing sarcopenia, and numerous studies have also pointed to the combination of nutritional supplementation and resistance training as a more effective intervention to improve quality of life for people with sarcopenia. People with both malnutrition and sarcopenia have a higher mortality rate, so identifying people at risk of malnutrition and intervening early is extremely important to avoid sarcopenia and its associated problems. This article provides important information for dietary interventions in sarcopenia by summarizing the discoveries and developments of nutritional supplements such as protein, leucine, β-hydroxy-β-methylbutyric acid, vitamin D, vitamin C, vitamin E, omega-3 fatty acids, creatine, inorganic nitrate, probiotics, minerals, collagen peptides, and polyphenols in the management of sarcopenia.

INFLAMMATORY BOWEL DISEASE AND SARCOPENIA: A FOCUS ON MUSCLE STRENGTH - NARRATIVE REVIEW

•Muscle strength decline is a crucial factor for the course of sarcopenia in inflammatory bowel disease (IBD) patients. •There is a need to discuss the association between IBD and sarcopenia focusing not only on changes of muscle mass, but also on muscle strength. •A narrative review was conducted in order to present the set of factors with impact in both muscle strength and IBD. •Inflammation, reduced nutrient intake and malabsorption, changes in body composition and gut microbiota dysbiosis are most likely the main factors with impact on muscle strength in IBD patients. Inflammation, changes in nutrient absorption and gut dysbiosis are common conditions in patients with inflammatory bowel disease. These factors may lead to variations in macro- and micronutrients and, particularly, to an imbalance of protein metabolism, loss of muscle mass and development of sarcopenia. This narrative review aims to present the set of factors with impact in muscle strength and physical performance that may potentially mediate the relation between inflammatory bowel disease and sarcopenia. Studies that associated changes in muscle strength, sarcopenia and inflammatory bowel disease were selected through a literature search in databases Medline, Pubmed and Scielo using relevant keywords: muscle strength, physical performance, sarcopenia and inflammatory bowel disease. Chronic inflammation is currently reported as a determinant factor in the development of muscle atrophy in inflammatory bowel disease. In addition, strength decline in inflammatory bowel disease patients may be also influenced by changes in body composition and by gut dysbiosis. Measures of muscle strength and physical performance should be considered in the initial identification of sarcopenia, particularly in patients with inflammatory bowel disease, for a timely intervention can be provided. Presence of proinflammatory cytokines, high adiposity, malabsorption and consequent deficits of macro and micronutrients, loss of muscle mass, and gut dysbiosis may be the main factors with impact in muscle strength, that probably mediate the relation between inflammatory bowel disease and sarcopenia.

A Narrative Review of Non-Pharmacological Strategies for Managing Sarcopenia in Older Adults with Cardiovascular and Metabolic Diseases

This narrative review examines the mechanisms underlying the development of cardiovascular disease (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being and quality of life in older adults with sarcopenia and coexisting cardiovascular and metabolic diseases.

Minerals and Sarcopenia in Older Adults: An Updated Systematic Review

OBJECTIVE

This systematic review aims to reevaluate the role of minerals on muscle mass, muscle strength, physical performance, and the prevalence of sarcopenia in community-dwelling and institutionalized older adults.

DESIGN

Systematic review.

SETTING AND PARTICIPANTS

In March 2022, a systematic search was performed in PubMed, Scopus, and Web of Sciences using predefined search terms. Original studies on dietary mineral intake or mineral serum blood concentrations on muscle mass, muscle strength, and physical performance or the prevalence of sarcopenia in older adults (average age ≥65 years) were included.

METHODS

Eligibility screening and data extraction was performed by 2 independent reviewers. Quality assessment was performed with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Risk of bias was evaluated using the Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) tool.

RESULTS

From the 15,622 identified articles, a total of 45 studies were included in the review, mainly being cross-sectional and observational studies. Moderate quality of evidence showed that selenium (n = 8) and magnesium (n = 7) were significantly associated with muscle mass, strength, and physical performance as well as the prevalence of sarcopenia. For calcium and zinc, no association could be found. For potassium, iron, sodium, and phosphorus, the association with sarcopenic outcomes remains unclear as not enough studies could be included or were nonconclusive (low quality of evidence).

CONCLUSIONS AND IMPLICATIONS

This systematic review shows a potential role for selenium and magnesium on the prevention and treatment of sarcopenia in older adults. More randomized controlled trials are warranted to determine the impact of minerals on sarcopenia in older adults.

Relationship between dietary patterns and physical performance in the very old population: a cross-sectional study from the Kawasaki Aging and Wellbeing Project

OBJECTIVES

As the world's population is ageing, improving the physical performance (PP) of the older population is becoming important. Although diets are fundamental to maintaining and improving PP, few studies have addressed the role of these factors in adults aged ≥ 85 years, and none have been conducted in Asia. This study aimed to determine the dietary patterns (DP) and examine their relationship with PP in this population.

DESIGN

This cross-sectional study (Kawasaki Aging and Wellbeing Project) estimated food consumption using a brief-type self-administered diet history questionnaire. The results were adjusted for energy after aggregating into thirty-three groups, excluding possible over- or underestimation. Principal component analysis was used to identify DP, and outcomes included hand grip strength (HGS), timed up-and-go test, and usual walking speed.

SETTING

This study was set throughout several hospitals in Kawasaki city.

PARTICIPANTS

In total, 1026 community-dwelling older adults (85-89 years) were enrolled.

RESULTS

Data of 1000 participants (median age: 86·9 years, men: 49·9 %) were included in the analysis. Three major DP (DP1: various foods, DP2: red meats and coffee, DP3: bread and processed meats) were identified. The results of multiple regression analysis showed that the trend of DP2 was negatively associated with HGS (B, 95 % CI -0·35, -0·64, -0·06).

CONCLUSIONS

This study suggests a negative association between HGS and DP characterised by red meats and coffee in older adults aged ≥ 85 years in Japan.

Application of the metal ions as potential population biomarkers for wastewater-based epidemiology: estimating tobacco consumption in Southern China

Wastewater-based epidemiology (WBE) is an objective approach for the estimation of population-level exposure to a wide range of substances, in which the use of a population biomarker (PB) could significantly reduce back-calculation errors. Although some endogenous or exogenous compounds such as cotinine and other hormones have been developed as PBs, more PBs still need to be identified and evaluated. This study aimed to propose a novel method to estimate population parameters from the mass load of metal ion biomarkers in wastewater, and estimate the consumption of tobacco in 24 cities in Southern China using the developed method. Daily wastewater samples were collected from 234 wastewater treatment plants (WWTPs) in 24 cities in Southern China. Atomic absorption spectroscopy (AAS) was applied to determine the concentrations of common health-related metal ions in wastewater, including sodium (Na), potassium (K), magnesium (Mg), calcium (Ca), iron (Fe), and zinc (Zn), and compared them with the daily mass load of cotinine corresponding to catchment populations. The concentrations of cotinine in wastewater samples were measured using liquid chromatography-tandem mass spectrometry. There were clear and strong correlations between the target metal ion equivalent population and census data. The correlation coefficients (R) were R_K = 0.78, R_Na = 0.66, R_Ca = 0.81, R_Mg = 0.77, and R_Fe = 0.69, at p < 0.01 and R² > 0.6. Subsequently, the combination of WBE and metal ion PBs was used to estimate tobacco consumption. Daily consumption of nicotine was estimated to be approximately 1.76 ± 1.19 mg/d/capita, equivalent to an average of 13.0 ± 8.75 cigarettes/d being consumed by smokers. The data on tobacco consumption in this study were consistent with those in traditional surveys in Southern China. The metal ion potassium is an appropriate PB for reflecting the real-time population and could be used to evaluate the tobacco consumption in WBE study.

Relationships among Physical Activity, Physical Function, and Food Intake in Older Japanese Adults Living in Urban Areas: A Cross-Sectional Study

Japan is experiencing a super-ageing society faster than anywhere else in the world. Consequently, extending healthy life expectancy is an urgent social issue. To realize a diet that can support the extension of healthy life expectancy, we studied the quantitative relationships among physical activities (number of steps and activity calculated using an accelerometer), physical functions (muscle strength, movement function, agility, static balance, dynamic balance, and walking function), and dietary intake among 469 older adults living in the Tokyo metropolitan area (65-75 years old; 303 women and 166 men) from 23 February 2017 to 31 March 2018. Physical activities and functions were instrumentally measured, and the dietary survey adopted the photographic record method. There was a significant positive association (p < 0.05) between physical activities (steps, medium-intensity activity, and high-intensity activity) and physical functions (movement function, static balance, and walking function), but no association with muscle strength. These three physical functions were significantly positively correlated with intake of vegetables, seeds, fruits, and milk; with magnesium, potassium, and vitamin B6; and with the dietary fibre/carbohydrate composition ratio (p < 0.05). Future intervention trials must verify if balancing diet and nutrition can improve physical activities in older adults through increased physical functions.

Dietary profiling of physical frailty in older age phenotypes using a machine learning approach: the Salus in Apulia Study

PURPOSE

Growing awareness of the biological and clinical value of nutrition in frailty settings calls for further efforts to investigate dietary gaps to act sooner to achieve focused management of aging populations. We cross-sectionally examined the eating habits of an older Mediterranean population to profile dietary features most associated with physical frailty.

METHODS

Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1502 older adults (65 +). CHS criteria were applied to classify physical frailty, and a validated Food Frequency Questionnaire to assess diet. The population was subdivided by physical frailty status (frail or non-frail). Raw and adjusted logistic regression models were applied to three clusters of dietary variables (food groups, macronutrients, and micronutrients), previously selected by a LASSO approach to better predict diet-related frailty determinants.

RESULTS

A lower consumption of wine (OR 0.998, 95% CI 0.997-0.999) and coffee (OR 0.994, 95% CI 0.989-0.999), as well as a cluster of macro and micronutrients led by PUFAs (OR 0.939, 95% CI 0.896-0.991), zinc (OR 0.977, 95% CI 0.952-0.998), and coumarins (OR 0.631, 95% CI 0.431-0.971), was predictive of non-frailty, but higher legumes intake (OR 1.005, 95%CI 1.000-1.009) of physical frailty, regardless of age, gender, and education level.

CONCLUSIONS

Higher consumption of coffee and wine, as well as PUFAs, zinc, and coumarins, as opposed to legumes, may work well in protecting against a physical frailty profile of aging in a Mediterranean setting. Longitudinal investigations are needed to better understand the causal potential of diet as a modifiable contributor to frailty during aging.

Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

Background

The Composite Dietary Antioxidant Index (CDAI), a composite score of multiple dietary antioxidants (including vitamin A, C, and E, selenium, zinc, and carotenoids), represents an individual’s comprehensive dietary antioxidant intake profile. CDAI was developed based on its combined effect on pro-inflammatory markers Tumor Necrosis Factor-α (TNF-α) and anti-inflammatory effects of Interleukin-1β (IL-1β), which are associated with many health outcomes, including depression, all-cause mortality, colorectal cancer, etc. Handgrip strength is used as a simple measure of muscle strength, not only is it highly correlated with overall muscle strength, but also serves as a diagnostic tool for many adverse health outcomes, including sarcopenia and frailty syndromes.

Purpose

The association between CDAI and Handgrip strength (HGS) is currently unclear. This study investigated the association between CDAI (including its components) and HGS in 6,019 American adults.

Method

The research data were selected from the 2011–2014 National Health and Nutrition Survey (NHANES), and a total of 6,019 American adults were screened and included. A weighted generalized linear regression model was used to evaluate CDAI (including its components) and HGS.

Results

(1) CDAI was significantly positively correlated with HGS (β = 0.009, 0.005∼0.013, P &lt; 0.001), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.084, 0.042∼0.126, P = 0.002) and significant in trend test (P for trend &lt; 0.0100). Gender subgroup analysis showed that male CDAI was significantly positively correlated with HGS (β = 0.015, 0.007∼0.023, P = 0.002), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.131, 0.049∼0.213, P = 0.006) and the trend test was significant (P for trend &lt; 0.0100). There was no correlation between female CDAI and HGS, and the trend test was not statistically significant (P &gt; 0.05). (2) The intake of dietary vitamin E, Zinc and Selenium showed a significant positive correlation with HGS (β = 0.004, 0.002∼0.007, P = 0.006; β = 0.007, 0.004∼0.009, P &lt; 0.001; β = 0.001, 0.001∼0.001, P &lt; 0.001), vitamin A, vitamin C and carotenoid were significantly associated with HGS in the Crude Model, but this significant association disappeared in the complete model with the increase of control variables. Gender subgroup analysis showed that in model 3, male dietary intake levels of vitamin E, Zinc, and Selenium were significantly positively correlated with HGS (β = 0.005, 0.002∼0.009, P = 0.011; β = 0.007, 0.004∼0.011, P = 0.001; β = 0.001, 0.001∼0.001, P = 0.004), the rest of the indicators had no significant correlation with HGS. Among the female subjects, dietary zinc intake was significantly positively correlated with HGS (β = 0.005, 0.001∼0.008, P = 0.008), and there was no significant correlation between other indicators and HGS (P &gt; 0.05).

Conclusion

There was an association between the CDAI and HGS, but there was a gender difference, and there was an association between the CDAI and HGS in male, but the association was not significant in female. Intake of the dietary antioxidants vitamin E, selenium, and zinc was associated with HGS in male, but only zinc was associated with HGS among dietary antioxidants in female.

Effects of Microfiltered Seawater Intake and Variable Resistance Training on Strength, Bone Health, Body Composition, and Quality of Life in Older Women: A 32-Week Randomized, Double-Blinded, Placebo-Controlled Trial

The aim was to explore the effects of a 32-week resistance training (RT) intervention with elastic bands with or without microfiltered seawater (SW) supplementation on isokinetic strength, bone mineral density (BMD), body composition, and subjective quality of life in postmenopausal women. Ninety-three untrained women (age: 70.00 ± 6.26 years; body mass index: 22.05 ± 3.20 kg/m²; body fat: 37.77 ± 6.38%; 6.66 ± 1.01 s up-and-go test) voluntarily participated in this randomized, double-blinded, controlled trial. Participants were allocated into four groups (RT+SW, RT+PLA, CON+SW, and CON+PLA). The RT intervention (twice weekly) consisted of different exercises for the whole body performed at submaximal intensities with elastic bands. Both control groups were not involved in any exercise program. A two-way mixed analysis of variance of repeated measures revealed significant improvements in almost all the variables in both intervention groups (p < 0.05). However, significant differences with controls were encountered in isokinetic strength, body fat percentage, and bodily pain. Although the group with SW supplementation obtained greater effect sizes, non-significant differences between both RT groups were observed. In conclusion, the determinant factor of the adaptations seems to be RT rather than SW.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Insights into Pathogenesis, Nutritional and Drug Approach in Sarcopenia: A Systematic Review

Sarcopenia is a multifactorial condition related to the loss of muscle mass and strength due to aging, eating habits, physical inactivity, or even caused by another disease. Affected individuals have a higher risk of falls and may be associated with heart disease, respiratory diseases, cognitive impairment, and consequently an increased risk of hospitalization, in addition to causing an economic impact due to the high cost of care during the stay in hospitals. The standardization of appropriate treatment for patients with sarcopenia that could help reduce pathology-related morbidity is necessary. For these reasons, this study aimed to perform a systematic review of the role of nutrition and drugs that could ameliorate the health and quality of life of sarcopenic patients and PRISMA guidelines were followed. Lifestyle interventions have shown a profound impact on sarcopenia treatment but using supplements and different drugs can also impact skeletal muscle maintenance. Creatine, leucine, branched-chain amino acids, omega 3, and vitamin D can show benefits. Although with controversial results, medications such as Metformin, GLP-1, losartan, statin, growth hormone, and dipeptidyl peptidase 4 inhibitors have also been considered and can alter the sarcopenic's metabolic parameters, protect against cardiovascular diseases and outcomes, while protecting muscles.

Higher dietary magnesium and potassium intake are associated with lower body fat in people with impaired glucose tolerance

Introduction

Obesity and diabetes are public health concerns worldwide, but few studies have examined the habitual intake of minerals on body composition in people with prediabetes.

Methods

In this prospective cross-sectional study, 155 Chinese subjects with IGT [median age: 59 (53-62) years, 58% female] had an assessment of body composition including body fat percentage, oral glucose tolerance tests (OGTT), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and 3-day food records from nutritional programme analysis.

Results

Dietary intake of minerals was negatively correlated with body fat. People with obesity had the lowest daily consumption of iron median (IQR) 10.3 (6.9-13.3) mg, magnesium 224 (181-282) mg, and potassium 1973 (1563-2,357) mg when compared to overweight [10.5 (8.0-14.5) mg, 273 (221-335) mg, and 2,204 (1720-2,650) mg] and normal weight individuals [13.2 (10.0-18.6) mg, 313 (243-368) mg, and 2,295 (1833-3,037) mg] (p = 0.008, <0.0001, and 0.013 respectively). Amongst targeted minerals, higher dietary magnesium and potassium intake remained significantly associated with lower body fat after the adjustment of age, gender, macronutrients, fibre, and physical activity.

Conclusion

Dietary magnesium and potassium intake may be associated with lower body fat in people with impaired glucose tolerance. Inadequate dietary mineral intake may play contribute to obesity and metabolic disorders independent of macronutrients and fibre consumption.

Evaluation of Trace Element and Heavy Metal Levels of Some Ethnobotanically Important Medicinal Plants Used as Remedies in Southern Turkey in Terms of Human Health Risk

Heavy metal accumulation in medicinal plants has increased dramatically in recent years due to agricultural and industrial activities leading to pollution of natural sources. This study is focused on the concentration of trace elements and heavy metals in aboveground parts of 33 medicinal plants from the Eastern Mediterranean of Turkey. Results showed that the Al concentrations varied between 4.368 and 1104.627, the B level varied between 47.850 and 271.479, Ca values ranged between 1971.213 and 22,642.895, Cd concentrations ranged between 0.011 and 0.651, Cr contents varied between 1.371 and 41.692, Cu values varied between 13.278 and 42.586, Fe concentrations varied between 20.705 and 1276.783, K levels ranged between 652.143 and 14,440.946, Mg concentrations varied from 336.871 to 1869.486, Mn contents varied between 46.383 and 849.492, Na concentrations varied between 167.144 and 3401.252, Ni values varied between 0.065 and 9.968, Pb levels ranged between 1.311 and 16.238, and Zn concentrations ranged between 67.250 and 281.954 mg kg^-1, respectively. Furthermore, Recommended Dietary Allowance (RDA) values for trace elements and estimated daily intake (EDI), target hazard quotient (THQ), and hazard index (HI) for heavy metals were calculated. The concentrations of heavy metals in some studied plants distributed in industrial and mining regions were found as slightly higher than the acceptable limits determined by WHO. Consequently, in order to prevent this heavy metal accumulation, when collecting medicinal aromatic plants, rural areas, close to clean rivers, or mountainous areas should be preferred, away from highway, mining, and industrial areas.

Differential Allele-Specific Expression Revealed Functional Variants and Candidate Genes Related to Meat Quality Traits in B. indicus Muscle

Traditional transcriptomics approaches have been used to identify candidate genes affecting economically important livestock traits. Regulatory variants affecting these traits, however, remain under covered. Genomic regions showing allele-specific expression (ASE) are under the effect of cis-regulatory variants, being useful for improving the accuracy of genomic selection models. Taking advantage of the better of these two methods, we investigated single nucleotide polymorphisms (SNPs) in regions showing differential ASE (DASE SNPs) between contrasting groups for beef quality traits. For these analyses, we used RNA sequencing data, imputed genotypes and genomic estimated breeding values of muscle-related traits from 190 Nelore (Bos indicus) steers. We selected 40 contrasting unrelated samples for the analysis (N = 20 animals per contrasting group) and used a beta-binomial model to identify ASE SNPs in only one group (i.e., DASE SNPs). We found 1479 DASE SNPs (FDR ≤ 0.05) associated with 55 beef-quality traits. Most DASE genes were involved with tenderness and muscle homeostasis, presenting a co-expression module enriched for the protein ubiquitination process. The results overlapped with epigenetics and phenotype-associated data, suggesting that DASE SNPs are potentially linked to cis-regulatory variants affecting simultaneously the transcription and phenotype through chromatin state modulation.

Nutrition in the prevention and management of sarcopenia - A special focus on Asian Indians

Sarcopenia, characterized by loss of muscle mass and strength, is common in advanced old age but can be accelerated by chronic disease, malnutrition and physical inactivity. Early initiation of intervention to achieve and maintain a higher peak muscle mass and strength may allow for prevention or delay of sarcopenia and facilitate independent living even in old age. In this context, malnutrition, a significant contributor to sarcopenia, is often overlooked among the Indian population. Maintenance of an optimal energy and protein balance with adequate physical activity level is essential to preserve physical function in the aging population. However, research on the role of micronutrients in muscle maintenance, is still in its infancy. This narrative review, therefore, aims to explore the current status of International and Indian research on the role of nutrition in sarcopenia mitigation and the way forward.

Systematic review and meta-analysis of intravenous iron therapy for adults with non-anaemic iron deficiency: An abridged Cochrane review

Iron is an essential nutrient for oxygen supply and aerobic metabolism. Iron deficiency impacts cellular respiration and mitochondrial energy metabolism, which can lead to reduced skeletal muscle function and muscle mass, causing sarcopenia. Intravenous iron offers the ability to rapidly correct iron deficiency, but the functional impact on patient mental and physical health is unclear. We assessed the effects of intravenous iron therapy on physical function and quality of life in the treatment of adults with non-anaemic iron deficiency. An update and reanalysis of a previously published Cochrane systematic review was performed to assess randomized controlled trials that compared any intravenous iron preparation with placebo in adults. The primary functional outcome measure was physical performance as defined by the trial authors. Secondary outcome measures included fatigue and quality-of-life scores, and adverse effects at the end of follow-up. Biochemical efficacy was assessed by change in serum ferritin and haemoglobin concentration levels. Twenty-one randomized controlled trials, comprising 3514 participants, were included. Intravenous iron compared with placebo resulted in significantly increased physical function measured by mean peak oxygen consumption (mean difference [MD] 1.77 mL/kg/min, 95% confidence interval [CI] 0.57 to 2.97). An overall improvement in fatigue was seen (standardized MD 0.30, 95% CI -0.52 to -0.09) but no overall difference in quality of life (MD 0.15, 95% CI -0.01 to 0.31). Biochemically, intravenous iron resulted in improved serum ferritin (MD 245.52 μg/L, 95% CI 152.1 to 338.9) and haemoglobin levels (MD 4.65 g/L, 95% CI 2.53 to 6.78). There was a higher risk of developing mild adverse events in the intravenous iron group compared with the placebo group (risk ratio 1.77, 95% CI 1.10 to 2.83); however, no differences were seen in serious adverse events (risk difference 0, 95% CI -0.01 to 0.01). The quality of evidence was rated 'low' and 'very low' for all outcome variables, except for fatigue, mainly due to most studies being judged as having a high risk of bias. In non-anaemic iron-deficient adults, the use of intravenous iron compared with placebo improved physical function and reduced fatigue scores. However, we remain uncertain about the efficacy in this population due to low-quality evidence, and there is a need for further studies to address potential impact on overall quality of life.

Nutrition and sarcopenia: Current knowledge domain and emerging trends

Objective

Non-pharmacological management like nutrient supplements has shown positive impacts on muscle mass and strength, which has burgeoned clinical and research interest internationally. The aim of this study was to analyze the current knowledge domain and emerging trends of nutrition-related research in sarcopenia and provide implications for future research and strategies to prevent or manage sarcopenia in the context of aging societies.

Materials and methods

Nutrition- and sarcopenia-related research were obtained from the Web of Science Core Collection (WoSCC) database from its inception to April 1, 2022. Performance analysis, science mapping, and thematic clustering were performed by using the software VOSviewer and R package “bibliometrix.” Bibliometric analysis (BA) guideline was applied in this study.

Results

A total of 8,110 publications were extracted and only 7,510 (92.60%) were selected for final analysis. The production trend in nutrition and sarcopenia research was promising, and 1,357 journals, 107 countries, 6,668 institutions, and 31,289 authors were identified in this field till 2021. Stable cooperation networks have formed in the field, but they are mostly divided by region and research topics. Health and sarcopenia, metabolism and nutrition, nutrition and exercise, body compositions, and physical performance were the main search themes.

Conclusions

This study provides health providers and scholars mapped out a comprehensive basic knowledge structure in the research in the field of nutrition and sarcopenia over the past 30 years. This study could help them quickly grasp research hotspots and choose future research projects.

Association of Micronutrients and Handgrip Strength in Korean Older Population: A Cross-Sectional Study

Sarcopenia is characterized by the loss of skeletal muscle mass, strength, and physical performance. Dynapenia and kratopenia are described as the loss of muscle strength and power. Nutritional intake status is one of the factors affecting the prevention of an age-related muscle decline such as sarcopenia, dynapenia, or kratopenia in older populations. This study aimed to investigate the association between the intake of micronutrients and handgrip strength in 1254 individuals (546 men and 708 women) of the Korean older population from the most recent dataset. They were analyzed and divided into two groups: a LHS group with low handgrip strength (<28 kg for men and <18 kg for women) and a normal group with normal handgrip strength. Logistic regression analysis was performed to estimate the odds ratios (ORs) and 95% confidence intervals (Cis) of the associations between micronutrient intakes and low handgrip strength in Korean older population by gender. Among micronutrients, insufficient potassium intake showed a significant association with low handgrip strength for men (OR: 3.159, 95% CI: 1.164−8.578) and women (OR: 2.793, 95% CI: 1.380−5.654) aged ≥65 years, respectively (p = 0.005 for men, p = 0.024 for women), as a result of adjusting for all confounding factors that could affect low handgrip strength. In conclusion, potassium intake among micronutrients in Korean older populations with low handgrip strength might need continuous monitoring for the intervention or prevention of dynapenia or sarcopenia.