1
|
Beydoun HA, Beydoun MA, Kwon E, Alemu BT, Zonderman AB, Brunner R. Relationship of psychotropic medication use with physical function among postmenopausal women. GeroScience 2024:10.1007/s11357-024-01141-z. [PMID: 38517642 DOI: 10.1007/s11357-024-01141-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024] Open
Abstract
To examine cross-sectional and longitudinal relationships of psychotropic medications with physical function after menopause. Analyses involved 4557 Women's Health Initiative Long Life Study (WHI-LLS) participants (mean age at WHI enrollment (1993-1998): 62.8 years). Antidepressant, anxiolytic, and sedative/hypnotic medications were evaluated at WHI enrollment and 3-year follow-up visits. Performance-based physical function [Short Physical Performance Battery (SPPB)] was assessed at the 2012-2013 WHI-LLS visit. Self-reported physical function [RAND-36] was examined at WHI enrollment and the last available follow-up visit-an average of 22 [±2.8] (range: 12-27) years post-enrollment. Multivariable regression models controlled for socio-demographic, lifestyle, and health characteristics. Anxiolytics were not related to physical function. At WHI enrollment, antidepressant use was cross-sectionally related to worse self-reported physical function defined as a continuous (β = -6.27, 95% confidence interval [CI]: -8.48, -4.07) or as a categorical (< 78 vs. ≥ 78) (odds ratio [OR] = 2.10, 95% CI: 1.48, 2.98) outcome. Antidepressant use at WHI enrollment was also associated with worse performance-based physical function (SPPB) [< 10 vs. ≥ 10] (OR = 1.53, 95% CI: 1.05, 2.21) at the 2012-2013 WHI-LLS visit. Compared to non-users, those using sedative/hypnotics at WHI enrollment but not at the 3-year follow-up visit reported a faster decline in physical function between WHI enrollment and follow-up visits. Among postmenopausal women, antidepressant use was cross-sectionally related to worse self-reported physical function, and with worse performance-based physical function after > 20 years of follow-up. Complex relationships found for hypnotic/sedatives were unexpected and necessitate further investigation.
Collapse
Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, A.T. Augusta Military Medical Center, 9300 DeWitt Loop, Fort Belvoir, VA, 22060, USA.
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - Edward Kwon
- Department of Family Medicine, A.T. Augusta Military Medical Center, 9300 DeWitt Loop, Fort Belvoir, VA, 22060, USA
| | - Brook T Alemu
- Health Sciences Program, School of Health Sciences, Western Carolina University, Cullowhee, NC, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - Robert Brunner
- Department of Family and Community Medicine (Emeritus), School of Medicine, University of Nevada Reno, Reno, NV, USA
| |
Collapse
|
2
|
Willoughby DS, Florez C, Davis J, Keratsopoulos N, Bisher M, Parra M, Taylor L. Decreased Neuromuscular Function and Muscle Quality along with Increased Systemic Inflammation and Muscle Proteolysis Occurring in the Presence of Decreased Estradiol and Protein Intake in Early to Intermediate Post-Menopausal Women. Nutrients 2024; 16:197. [PMID: 38257090 PMCID: PMC10819584 DOI: 10.3390/nu16020197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Menopause causes a reduction in estradiol (E2) and may be associated with neuromuscular degeneration. Compared to pre-menopausal (PRE-M) women, this study sought to determine dietary protein intake and whether lower levels of circulating E2 in post-menopausal women (POST-M) were occurring alongside increased levels of biomarkers of axonal and neuromuscular junction degeneration (NMJ), inflammation, muscle protein degradation, and reduced indices of muscle quality and performance. Employing a cross-sectional design, PRE-M (n = 6) and POST-M (n = 6) dietary analysis data were collected and participants then donated a blood and urine sample followed by assessments for body composition, motor unit activation, and muscle performance. Independent group t-tests were performed to determine differences between groups (p ≤ 0.05). In POST-M women, E2, motor unit activity, muscle quality, and muscle performance were significantly less than those for PRE-M women; however, the levels of c-terminal fragment of agrin, tumor necrosis factor-α, and urinary titin were significantly greater (p < 0.05). POST-M women were also shown to be ingesting fewer total calories and less protein than PRE-M (p < 0.05). Reduced E2 and dietary protein intake in POST-M women occurs in conjunction with increased levels of biomarkers of NMJ degradation, inflammation, and muscle proteolysis, which may be associated with reduced motor unit activation and muscle quality.
Collapse
Affiliation(s)
- Darryn S. Willoughby
- School of Health Professions, University of Mary Hardin-Baylor, Belton, TX 76513, USA
| | - Christine Florez
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX 76513, USA; (C.F.)
| | - Jaci Davis
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX 76513, USA; (C.F.)
| | - Nikolas Keratsopoulos
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX 76513, USA; (C.F.)
| | - Morgan Bisher
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX 76513, USA; (C.F.)
| | - Mandy Parra
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX 76513, USA; (C.F.)
| | - Lemuel Taylor
- School of Health Professions, University of Mary Hardin-Baylor, Belton, TX 76513, USA
| |
Collapse
|
3
|
Mossavar-Rahmani Y. Commentary on the Women's Health Initiative: Over 30 Years of Contribution to Nutrition and Dietetics. J Acad Nutr Diet 2023:S2212-2672(23)01700-8. [PMID: 38048877 PMCID: PMC11144259 DOI: 10.1016/j.jand.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Yasmin Mossavar-Rahmani
- Division of Health Behavior Research and Implementation Science, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
| |
Collapse
|
4
|
Nutritional intake and malnutrition in institutionalised and non-institutionalised older adults. Br J Nutr 2022; 128:921-931. [PMID: 34583786 DOI: 10.1017/s0007114521003925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents (n 563) and community-dwellers (n 837) aged ≥ 65 years. Data included socio-demographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment®) and dietary intake (two non-consecutive 24-h recalls). A higher energy intake was associated with lower odds of malnutrition risk (being 'at risk of malnutrition' or 'malnourished') in both settings, but only significant among NH residents after adjusting for confounders (NH: OR = 0·66, 95 % CI 0·50, 0·86; community: OR = 0·64, 95 % CI 0·37, 1·10). The intake of carbohydrates, fat, fibre, vitamin C, Na, K and Mg was inversely associated with malnutrition risk in NH residents, and protein, fat, vitamin B6, folates, Na, K, Ca and Mg intake in community-dwellers. After additional adjustment for total energy, only Na and Mg intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.
Collapse
|
5
|
Jackson KL, Gropper SS, Hunt D, D’Avolio D, Newman D. Effectiveness of a Per-Meal Protein Prescription and Nutrition Education with versus without Diet Coaching on Dietary Protein Intake and Muscle Health in Middle-Aged Women. Nutrients 2022; 14:375. [PMID: 35057556 PMCID: PMC8781460 DOI: 10.3390/nu14020375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 01/25/2023] Open
Abstract
Sufficient dietary protein intake is vital to maintaining muscle health with aging. Yet protein intake among adults is often inadequate. This study's main objective was to examine the impact of nutrition education (NE) and a per-meal protein prescription (PRx) with versus without diet coaching on protein intake. A secondary objective examined its effects on muscle health. Participants included 53 women, age 45-64 years. All participants received NE and PRx; those randomized to coached-group received 10-weeks of diet coaching. Assessments included: protein intake at baseline, weeks 4 and 12 and muscle health (muscle mass, grip strength, five-chair rise test, 4 mgait speed test). The Chi-square test examined percentages of participants meeting PRx between groups. Repeated measures analysis of variance assessed within group and intervention effects on protein intake and muscle health parameters. Protein intake (g/kg body weight) increased (p < 0.001): not-coached (n = 28) 0.8 ± 0.2 to 1.2 ± 0.3 and coached (n = 25) 1.0 ± 0.2 to 1.4 ± 0.3 with no significant difference between groups. A greater percentage of coached-group participants met (p = 0.04) breakfast (72%) and met (p < 0.001) three-meal (76%) PRx versus not-coached participants (25% and 53%, respectively). Participants in both groups exhibited significantly (p < 0.001) improved times for the five-chair rise test and 4 mgait speed test. Diet coaching in conjunction with a PRx and NE should be considered to assist individuals in improving protein intake through self-selection of protein-rich foods.
Collapse
Affiliation(s)
- Kelley L. Jackson
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| | - Sareen S. Gropper
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| | - Dennis Hunt
- Department of Rehabilitation Sciences, Florida Gulf Coast University, 10501 FGCU Blvd S, Fort Myers, FL 33965, USA;
| | - Deborah D’Avolio
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| |
Collapse
|
6
|
Su Y, Cochrane BB, Reding K, Herting JR, Tinker LF, Zaslavsky O. Mediterranean Diet and Fatigue among Community-Dwelling Postmenopausal Women. J Nutr Gerontol Geriatr 2022; 41:22-45. [PMID: 35038968 PMCID: PMC9835016 DOI: 10.1080/21551197.2022.2025972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We investigated cross-sectional relationships between the Mediterranean diet and overall fatigue, energy, and weariness scores among 4,563 women aged 65+ from the Women's Health Initiative study. We also used the Isocaloric Substitution approach to explore whether the substitution of fish for red and processed meat, whole for non-whole grains, and whole fruit for fruit juice relate to RAND-36 measured overall fatigue and its subdomains. The alternate Mediterranean Diet (aMED) Index quintiles (Q1-Q5) and selected Mediterranean foods available on a Food Frequency Questionnaire were exposure measures. Results showed aMED Q5 was associated with 2.99 (95% CI: 0.88, 5.11), 4.01 (95% CI: 1.51, 6.53), and 2.47 (95% CI: 0.24, 4.70) point improvements in fatigue, energy, and weariness scores, respectively, compared with aMED Q1. Substituting fish for red and processed meat and whole for non-whole grains was associated with more favorable fatigue scores, whereas substituting whole fruit for juice was not.
Collapse
Affiliation(s)
- Yan Su
- School of Nursing, University of Washington, Seattle, WA
| | - Barbara B. Cochrane
- School of Nursing, University of Washington, Seattle, WA
- Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, WA
| | - Kerryn Reding
- School of Nursing, University of Washington, Seattle, WA
| | | | - Lesley F. Tinker
- Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, WA
| | - Oleg Zaslavsky
- School of Nursing, University of Washington, Seattle, WA
| |
Collapse
|
7
|
Barcın Güzeldere HK, Aksoy M. Anthropometric measurements and food consumption analysis of older people according to place of residence and gender: A cross-sectional study. Clin Nutr ESPEN 2021; 45:236-244. [PMID: 34620323 DOI: 10.1016/j.clnesp.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/20/2021] [Accepted: 08/17/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND & AIMS The older population across the world is rapidly increasing, raising the importance of a healthy and independent aging process and the factors affecting it. This study aimed to examine the food consumption habits and anthropometric measurements of older people according to their gender and the place of residence. METHODS A total of 121 healthy participants aged over 80 years who lived in rural (n:70) and urban (n:51) areas in the Aegean Region of Turkey were included in the study. A questionnaire was administered to determine the demographic data and nutritional status of the participants. Three-day food consumption was recorded and then analyzed using BeBiS 8.1. The participants' adherence to the Mediterranean diet and their Healthy Eating Index-2015 values were calculated based on their food consumption. The circumferences of the waist, hip, upper-mid arm and calf of the participants were measured by the researcher using an inelastic measuring tape. Weight, fat, muscle, water and basal metabolic rate were measured using the TANITA BC730 body impedance analyzer. RESULTS The mean weight, body mass index, circumferences of waist, hip and upper-mid arm,fat-free mass and basal metabolic rate were higher in the rural men than the urban ones (p < 0.05). The urban women had a higher waist-to-hip ratio than the rural ones (p < 0.05). There were no significant differences in the participants' adherence to the Mediterranean diet and their Healthy Eating Index values according to gender or the region they lived in. Nutrient intake was compared with the daily recommendations in the Turkish Nutrition Guide. It was found that the urban men consumed more carbohydrates, fats, vitamins A and C, and sodium. In contrast, energy, protein, fiber, vitamins E, D, B1, B2, B6 and B12, folic acid, magnesium, calcium, iron and zinc were consumed at lower amounts than recommendations. On the other hand, the rural men consumed more carbohydrates, fats, vitamins A, C and B2, folic acid, sodium and zinc. Similarly, the urban and rural women were found to have a higher intake of carbohydrates, fats, vitamins A and B2 and sodium and lower intake of other nutrients than recommendations. CONCLUSION Old age is one of the most sensitive periods in a person's life cycle. Place of residence during this period may physiologically affect food intake, physical activity, and therefore, anthropometric measurements. Healthcare providers should take into account that place of residence may alter older individuals' nutritional status and anthropometric measurements.
Collapse
Affiliation(s)
- Hatice Kübra Barcın Güzeldere
- Istanbul Medeniyet University, Department of Nutrition and Dietetic, Kartal, Istanbul, Turkey; Istanbul Medipol University, Institute of Health Science, Nutrition and Dietetic, Kavacık, Istanbul, Turkey.
| | | |
Collapse
|
8
|
Fanelli SM, Kelly OJ, Krok-Schoen JL, Taylor CA. Low Protein Intakes and Poor Diet Quality Associate with Functional Limitations in US Adults with Diabetes: A 2005-2016 NHANES Analysis. Nutrients 2021; 13:nu13082582. [PMID: 34444742 PMCID: PMC8400247 DOI: 10.3390/nu13082582] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 02/07/2023] Open
Abstract
Type 2 diabetes is associated with an increased risk for sarcopenia. Moreover, sarcopenia correlates with increased risk for falls, fractures, and mortality. This study aimed to explore relationships among nutrient intakes, diet quality, and functional limitations in a sample of adults across levels of glycemic control. Data were examined from 23,487 non-institutionalized adults, 31 years and older, from the 2005–2016 National Health and Nutrition Examination Survey. Hemoglobin A1c (%) was used to classify level of glycemic control: non-diabetes (<5.7%); pre-diabetes (5.7–6.4%); diabetes (≥6.5%). Dietary data were collected from a single 24-h dietary recall. Participants were categorized as meeting or below the protein recommendation of 0.8 g/kg of body weight. Physical functioning was assessed across 19-discrete physical tasks. Adults below the protein recommendation consumed significantly more carbohydrate and had lower diet quality across all glycemic groups compared to those who met the protein recommendation (p < 0.001). Adults with diabetes who did not meet protein recommendations had significantly poorer diet quality and significantly higher mean number of functional limitations. A greater percent of adults with diabetes who did not meet the protein recommendation reported being physically limited for most activities, with more than half (52%) reporting limitations for stooping, crouching, and kneeling. This study underscores the potential for physical limitations associated with low protein intakes, especially in adults with diabetes. In the longer term, low protein intakes may result in increased risk of muscle loss, as protein intake is a critical nutritional factor for prevention of sarcopenia, functional limitations, and falls.
Collapse
Affiliation(s)
| | - Owen J. Kelly
- Department of Molecular and Cellular Biology, Sam Houston State University, Conroe, TX 77304, USA;
| | - Jessica L. Krok-Schoen
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Christopher A. Taylor
- Medical Dietetics, The Ohio State University, Columbus, OH 43210, USA;
- Correspondence: ; Tel.: +1-614-688-7972
| |
Collapse
|
9
|
Dietary Assessment Methodology in Response to September 2020 Issue. J Acad Nutr Diet 2020; 121:213. [PMID: 33246849 DOI: 10.1016/j.jand.2020.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/16/2020] [Indexed: 11/20/2022]
|
10
|
Malik N. Estimated Average Requirements for Assessing Group Dietary Intake Data. J Acad Nutr Diet 2020; 121:210. [PMID: 33191159 DOI: 10.1016/j.jand.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/14/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, CA
| |
Collapse
|