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Stoodley IL, Berthon BS, Scott HA, Williams EJ, Baines PJ, Knox H, Wood S, Paradzayi B, Cameron-Smith D, Wood LG. Protein Intake and Physical Activity Levels as Determinants of Sarcopenia Risk in Community-Dwelling Older Adults. Nutrients 2024; 16:1380. [PMID: 38732628 PMCID: PMC11085115 DOI: 10.3390/nu16091380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Community screening for sarcopenia is complex, with barriers including access to specialized equipment and trained staff to conduct body composition, strength and function assessment. In the current study, self-reported dietary protein intake and physical activity (PA) in adults ≥65 years was assessed relative to sarcopenia risk, as determined by body composition, strength and physical function assessments, consistent with the European Working Group on Sarcopenia in Older People (EWGSOP) definition. Of those screened (n = 632), 92 participants (77% female) were assessed as being at high risk of developing sarcopenia on the basis of dietary protein intake ≤1 g∙kg-1∙day-1 [0.9 (0.7-0.9) g∙kg-1∙day-1] and moderate intensity physical activity <150 min.week-1. A further 31 participants (65% female) were defined as being at low risk, with both protein intake [1.2 (1.1-1.5) g∙kg-1∙day-1] and PA greater than the cut-off values. High-risk participants had reduced % lean mass [53.5 (7.8)% versus 54.8 (6.1)%, p < 0.001] and impaired strength and physical function. Notably, high-risk females exhibited greater deficits in lean mass and strength, with minimal differences between groups for males. In community-dwelling older adults, self-reported low protein intake and low weekly PA is associated with heightened risk for sarcopenia, particularly in older women. Future research should determine whether early intervention in older adults with low protein intake and PA attenuates functional decline.
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Affiliation(s)
- Isobel L. Stoodley
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Bronwyn S. Berthon
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hayley A. Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Evan J. Williams
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Penelope J. Baines
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Hannah Knox
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Sophie Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Beauty Paradzayi
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
| | - David Cameron-Smith
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A*STAR), 14 Medical Drive, #07-02 MD6, Singapore 117599, Singapore;
| | - Lisa G. Wood
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia; (I.L.S.); (B.S.B.); (H.A.S.); (E.J.W.); (P.J.B.); (H.K.); (S.W.); (B.P.)
- Immune Health Research Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
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Tong B, Chen H, Wang M, Liu P, Wang C, Zeng W, Li D, Shang S. Association of body composition and physical activity with pain and function in knee osteoarthritis patients: a cross-sectional study. BMJ Open 2024; 14:e076043. [PMID: 38233052 PMCID: PMC10806729 DOI: 10.1136/bmjopen-2023-076043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE The objective of this study is to delineate disparities between patients with knee osteoarthritis (KOA) based on obesity status, investigate the interplay among body composition, physical activity and knee pain/function in patients with KOA and conduct subgroup analyses focusing on those with KOA and obesity. DESIGN Cross-sectional study. SETTING Residents of eight communities in Shijiazhuang, Hebei Province, China, were surveyed from March 2021 to November 2021. PARTICIPANTS 178 patients with symptomatic KOA aged 40 years or older were included. MAIN OUTCOMES AND MEASURES The primary outcome measure was knee pain, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index-pain (WOMAC-P) scale. Secondary outcome measures included function, evaluated through the WOMAC-function (WOMAC-F) scale and the Five-Time-Sit-to-Stand Test (FTSST). Data analysis involved t-tests, Wilcoxon rank-sum tests, χ2 tests, linear and logistical regression analysis. RESULTS Participants (n=178) were 41-80 years of age (median: 65, P25-P75: 58-70), and 82% were female. Obese patients (n=103) had worse knee pain and self-reported function (p<0.05). In general patients with KOA, body fat mass was positively associated with bilateral knee pain (β=1.21 (95% CI 0.03 to 0.15)), WOMAC-P scores (β=0.25 (95% CI 0.23 to 1.22)), WOMAC-F scores (β=0.28 (95% CI 0.35 to 1.29)) and FTSST (β=0.19 (95% CI 0.03 to 0.42)), moderate-intensity to low-intensity physical activity was negatively associated with bilateral knee pain (β=-0.80 (95% CI -0.10 to -0.01)) and Skeletal Muscle Index (SMI) was negatively associated with WOMAC-F scores (β=-0.16 (95% CI -0.66 to -0.03)). In patients with KOA and obesity, SMI was negatively associated with FTSST (β=-0.30 (95% CI -3.94 to -0.00)). CONCLUSION Patients with KOA and obesity had worse knee pain and self-reported function compared with non-obese patients. Greater fat mass, lower muscle mass and lower moderate-intensity to low-intensity physical activity were associated with increased knee pain and poor self-reported function. More skeletal muscle mass was associated with the improvement of objective function.
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Affiliation(s)
- Beibei Tong
- Peking University School of Nursing, Peking University, Beijing, China
| | - Hongbo Chen
- Nursing Department of Peking University Third Hospital, Peking University Third Hospital, Beijing, China
| | - Mengqi Wang
- Peking University School of Nursing, Peking University, Beijing, China
| | - Peiyuan Liu
- Peking University School of Nursing, Peking University, Beijing, China
| | - Cui Wang
- Peking University School of Nursing, Peking University, Beijing, China
| | - Wen Zeng
- Peking University School of Nursing, Peking University, Beijing, China
| | - Dan Li
- Peking University School of Nursing, Peking University, Beijing, China
| | - Shaomei Shang
- Peking University School of Nursing, Peking University, Beijing, China
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Mizukami Y, Onishi H, Mifuku Y, Kubota M, Ikeda R, Hayashi H, Yamamura O. The role of fat indices as factors leading to sarcopenia in older adults residing in underpopulated areas. J Clin Biochem Nutr 2024; 74:70-73. [PMID: 38292122 PMCID: PMC10822752 DOI: 10.3164/jcbn.23-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/22/2023] [Indexed: 02/01/2024] Open
Abstract
Simplifying the diagnostic criteria for sarcopenia is key to establishing effective interventions. Herein, we aimed to clarify novel diagnostic factors. We calculated novel fat indices [total fat index (TFI) and limb fat index (LFI)] and clarified factors leading to pre-sarcopenia and sarcopenia in 594 enrolled older adults. Physical measurements [height, weight, body mass index (BMI), gait speed, grip strength, and skeletal muscle mass] were performed. Sarcopenia was determined using established diagnostic criteria (pre-sarcopenia, n = 102; sarcopenia, n = 42). Age was associated with sarcopenia status. BMI, TFI, and LFI were lower in patients with pre-sarcopenia and sarcopenia. Logistic regression analysis showed the following odds ratios (ORs) for pre-sarcopenia: BMI [OR: 0.787, 95% confidence interval (CI): 0.7-0.885], LFI (OR: 0.589, 95% CI: 0.402-0.863), and age (OR: 1.06, 95% CI: 1.02-1.1). ORs for sarcopenia (vs pre-sarcopenia) were as follows: LFI (OR: 50.6, 95% CI: 10.2-250.0), age (OR: 1.1, 95% CI: 1.0-1.2), and BMI (OR: 0.418, 95% CI: 0.28-0.608). Our findings contribute to informing medical guidelines.
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Affiliation(s)
- Yasutaka Mizukami
- Department of Family Medicine, University of Fukui Hospital, Yoshida-gun, Fukui 910-1104, Japan
- Fukui Kosei Hospital, Fukui, Fukui 918-8135, Japan
| | - Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Yoshida-gun, Fukui 910-1193, Japan
| | - Yuta Mifuku
- Department of Rehabilitation, University of Fukui Hospital, Yoshida-gun, Fukui 910-1104, Japan
| | - Masafumi Kubota
- Department of Rehabilitation Science, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-0942, Japan
| | - Ryouko Ikeda
- Department of Health and Nutrition, Faculty of Human Life Studies, Jin-ai University, Echizen, Fukui 915-0015, Japan
| | - Hiroyuki Hayashi
- Department of Family Medicine, University of Fukui Hospital, Yoshida-gun, Fukui 910-1104, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Yoshida-gun, Fukui 910-1193, Japan
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Cabrera D, Moncayo-Rizzo J, Cevallos K, Alvarado-Villa G. Waist Circumference as a Risk Factor for Non-Alcoholic Fatty Liver Disease in Older Adults in Guayaquil, Ecuador. Geriatrics (Basel) 2023; 8:geriatrics8020042. [PMID: 37102968 PMCID: PMC10137339 DOI: 10.3390/geriatrics8020042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/21/2023] [Accepted: 04/07/2023] [Indexed: 04/28/2023] Open
Abstract
Non-alcoholic liver steatosis is currently considered an epidemic. It involves a broad spectrum of liver diseases, in which older adults constitute a susceptible group. The aim of this study is to identify the role of waist circumference as a risk factor for non-alcoholic fatty liver disease. METHODS A cross-sectional study was carried out in 99 older adults who regularly attended five gerontological centers in the city of Guayaquil, Ecuador. The variables studied were age, gender, independent life, access to complete meals, waist circumference, and NAFLD diagnosed by ultrasound. RESULTS A significant relationship exists between waist circumference, body mass index, and fat mass percentage. However, only age and waist circumference were significant in the multivariate logistic regression model. Our results suggest that in the presence of waist circumference, body mass index loses its significance and age may be a protective factor due to adipose tissue loss and redistribution. CONCLUSION Anthropometric measurements such as waist circumference can be used as complement indicators of NAFLD.
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Affiliation(s)
| | - Jorge Moncayo-Rizzo
- Department of Health Sciences, Universidad de Especialidades Espiritu Santo, Guayaquil 092301, Ecuador
| | - Karen Cevallos
- Department of Health Sciences, Universidad de Especialidades Espiritu Santo, Guayaquil 092301, Ecuador
| | - Geovanny Alvarado-Villa
- Department of Health Sciences, Universidad de Especialidades Espiritu Santo, Guayaquil 092301, Ecuador
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Liu C, Wong PY, Chung YL, Chow SKH, Cheung WH, Law SW, Chan JCN, Wong RMY. Deciphering the "obesity paradox" in the elderly: A systematic review and meta-analysis of sarcopenic obesity. Obes Rev 2023; 24:e13534. [PMID: 36443946 DOI: 10.1111/obr.13534] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/20/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022]
Abstract
Aging and obesity are two global concerns in public health. Sarcopenic obesity (SO), defined as the combination of age-related sarcopenia and obesity, has become a pressing issue. This systematic review and meta-analysis summarize the current clinical evidence relevant to SO. PubMed, Embase, and Web of Science were searched, and 106 clinical studies with 167,151 elderlies were included. The estimated prevalence of SO was 9% in both men and women. Obesity was associated with 34% reduced risk of sarcopenia (odds ratio [OR] 0.66, 95% CI 0.48-0.91; p < 0.001). The pooled hazard ratio (HR) of all-cause mortality was 1.51 (95% CI 1.14-2.02; p < 0.001) for people with SO compared with healthy individuals. SO was associated with increased risk of cardiovascular disease and related mortality, metabolic disorders, cognitive impairment, arthritis, functional limitation, and lung diseases (all ORs > 1.0, p < 0.05). The attenuated risk of sarcopenia in elderlies with obesity ("obesity paradox") was dependent on higher muscle mass and strength. Apart from unifying the diagnosis of SO, more research is needed to subphenotype people with obesity and sarcopenia for individualized treatment. Meanwhile, the maintenance of proper body composition of muscle and fat may delay or attenuate the adverse outcomes of aging.
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Affiliation(s)
- Chaoran Liu
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Pui Yan Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yik Lok Chung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wing Hoi Cheung
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sheung Wai Law
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Juliana Chung Ngor Chan
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ronald Man Yeung Wong
- Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chao YP, Fang WH, Chen WL, Peng TC, Yang WS, Kao TW. Exploring Muscle Health Deterioration and Its Determinants Among Community-Dwelling Older Adults. Front Nutr 2022; 9:817044. [PMID: 35571885 PMCID: PMC9101463 DOI: 10.3389/fnut.2022.817044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Age-related muscle mass and function decline are critical issues that have gained attention in clinical practice and research. Nevertheless, little is known regarding the time course of muscle health progression, and its determinants during this transition should be estimated. Methods We enrolled community-dwelling adults aged ≥65 years during their regular health checkup. The participants’ body composition and muscle function were measured annually from 2015 to 2021. Presarcopenia was characterized by the loss of muscle mass only; dynapenia was defined as low muscle function without changes in muscle mass; and sarcopenia was indicated as a decline in both muscle mass and muscle function. We observed the natural course of muscle health progression during aging. The relationship between muscle health decline and different determinants among old adults was examined. Results Among 568 participants, there was 18.49%, 3.52%, and 1.06% of healthy individuals transited to dynapenia, presarcopenia, and sarcopenia, respectively. Significant positive correlations between age, fat-to-muscle ratio (FMR) and the dynapenia transition were existed [hazard ratio (HR) = 1.08 and HR = 1.73, all p < 0.05]. Serum albumin level had negative correlation with the dynapenia transition risk (HR = 0.30, p = 0.004). Participants with these three risk factors had the highest HR of dynapenia transition compared to those without (HR = 8.67, p = 0.001). A dose-response effect existed between risk factors numbers and the risk of dynapenia transition (p for trend < 0.001). This positive association and dose-response relationship remains after multiple covariates adjustment (HR = 7.74, p = 0.002, p for trend < 0.001). Participants with two or more than two risk factors had a higher risk of dynapenia transition than those with low risk factors (p = 0.0027), and the HR was 1.96 after multiple covariate adjustment (p = 0.029). Conclusion Healthy community-dwelling old adults tended to transit to dynapenia during muscle health deterioration. Individuals with older age, higher FMR, lower albumin level had a higher risk of dynapenia transition; and a positive dose-response effect existed among this population as well.
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Affiliation(s)
- Yuan-Ping Chao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Shiung Yang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center for Obesity, Life Style and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- *Correspondence: Tung-Wei Kao,
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