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Yang J, Yu J, Kim J, Park E. Association between Physical Activity and Phase Angle Obtained via Bioelectrical Impedance Analysis in South Korean Adults Stratified by Sex. Nutrients 2024; 16:2136. [PMID: 38999883 PMCID: PMC11242964 DOI: 10.3390/nu16132136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
This cross-sectional study aimed to examine the association of various aspects of physical activity, including intensity, duration, type, and purpose, with the phase angle (PhA), an objective indicator of health, in Korean adults after stratification by sex. Data from the 2022 Korean National Health and Nutrition Examination Survey, a nationwide, representative, population-based survey, were used. In total, 3996 participants were included in the study. Participants self-reported their weekly intensity, frequency, duration of engagement in physical activity. PhA was categorized into two groups on the basis of sex-specific averages. Multiple logistic regression analysis was used to investigate the relationship between physical activity and PhA, and proportional odds logistic regression analysis was performed to determine the association between physical activity and different subclasses of PhA. A positive association was found between sufficiently active aerobic physical activity and PhA compared with inactive physical activity (sufficiently active, male: odds ratio = 1.952, 95% confidence interval = 1.373-2.776; female: odds ratio = 1.333, 95% confidence interval = 1.019-1.745). This association was further strengthened when aerobic physical activity was accompanied by muscle-strengthening activity (sufficiently active with muscle-strengthening activity, male: aOR = 2.318, 95% CI = 1.512-3.554; female: aOR = 1.762, 95% CI = 1.215-2.556) and vigorous-intensity activities (sufficiently active with sufficient vigorous-intensity activity, male: aOR = 2.785, 95% CI = 1.647-4.709; female: aOR = 2.505, 95% CI = 1.441-4.356) and when there was more leisure-time physical activity than occupational physical activity (sufficiently active with more leisure-time physical activity, male: aOR = 2.158, 95% CI = 1.483-3.140; female: aOR = 1.457, 95% CI = 1.078-1.969). Furthermore, the inclusion of muscle-strengthening activity made a significant difference in the values of PhA for males with insufficiently active physical activity (aOR = 2.679, 95% CI = 1.560-4.602). For females with highly active physical activity (aOR = 1.521, 95% CI = 1.068-2.166), the inclusion of muscle-strengthening and vigorous-intensity activities were significantly associated with higher values for PhA. This study can be utilized to provide specific suggestions for better health programs and can change perception that only occupational physical activity is enough. This study also indicated that PhA can be used for personalized health assessments.
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Affiliation(s)
- Jiwon Yang
- Medical Courses, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jiho Yu
- Medical Courses, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Euncheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
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Shibata K, Kameshima M, Adachi T, Kito H, Tanaka C, Sano T, Tanaka M, Suzuki Y, Tamaki M, Kitamura H. Association between preoperative phase angle and all-cause mortality after cardiovascular surgery: A retrospective cohort study. J Cachexia Sarcopenia Muscle 2024. [PMID: 38859616 DOI: 10.1002/jcsm.13514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 04/20/2024] [Accepted: 05/15/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND The importance of preoperative physical function assessment for post-operative intervention has been reported in older patients undergoing cardiovascular surgery. Phase angle (PhA), measured using bioelectrical impedance analysis, is an indicator of cellular health and integrity and is reported as a prognostic factor in several chronic diseases; however, its association with the long-term prognosis of cardiovascular surgery remains unclear. This study aimed to investigate the prognostic value of PhA for long-term mortality in patients undergoing cardiovascular surgery. METHODS This retrospective cohort study included consecutive patients who underwent elective cardiovascular surgery between October 2016 and March 2021 at Nagoya Heart Center, Japan. PhA was assessed using bioelectrical impedance analysis before surgery, and physical function measures (gait speed, grip strength and short physical performance battery [SPPB]) were measured synchronously. The association between PhA and all-cause mortality after discharge was assessed using Kaplan-Meier and multivariate Cox regression analyses. The incremental prognostic value of PhA was compared with other physical function measures using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). RESULTS A total of 858 patients were included in the present analysis (mean age = 68.4 ± 11.9 years, 67.6% male). PhA positively correlated with body mass index (ρ = 0.38, P < 0.001), skeletal muscle mass index (ρ = 0.58, P < 0.001), usual gait speed (ρ = 0.44, P < 0.001), grip strength (ρ = 0.73, P < 0.001) and SPPB (ρ = 0.51, P < 0.001). The mean follow-up period, within which 44 (4.7%) died, was 908.9 ± 499.9 days for the entire cohort. Kaplan-Meier survival curves based on the PhA tertiles showed that higher PhA was associated with better survival (log-rank test, P < 0.001). The Cox regression analysis showed the independent association of PhA with mortality risk (hazard ratio: 0.91 per 0.1° increment; 95% confidence interval [CI]: 0.87-0.95; P < 0.001). The NRI and IDI showed significant improvements in predicting mortality after adding PhA to the clinical model consisting of age, sex and cardiac and renal function (NRI: 0.426, 95% CI: 0.124-0.729, P = 0.006; IDI: 0.037, 95% CI: 0.012-0.062, P = 0.003). The predictive model consisting of the clinical model and PhA was superior to the model consisting of the clinical model and each of the other physical function indicators (P < 0.05). CONCLUSIONS PhA correlated with physical function and independently predicted long-term mortality after cardiovascular surgery. The additive prognostic value of PhA compared with the other physical function measures suggests the clinical usefulness of preoperative PhA for risk stratification in planning post-operative treatment and rehabilitation.
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Affiliation(s)
- Kenichi Shibata
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Masataka Kameshima
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Takuji Adachi
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hisako Kito
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Chikako Tanaka
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Taisei Sano
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Mizuki Tanaka
- Department of Cardiac Rehabilitation, Nagoya Heart Center, Nagoya, Japan
| | - Yoriyasu Suzuki
- Department of Cardiology, Nagoya Heart Canter, Nagoya, Japan
| | - Mototsugu Tamaki
- Department of Cardiovascular Surgery, Nagoya Heart Canter, Nagoya, Japan
| | - Hideki Kitamura
- Department of Cardiovascular Surgery, Nagoya Heart Canter, Nagoya, Japan
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Musijowska M, Kwilosz E. Association between Physical Activity Level, Body Composition, and Phase Angle in University Students from Bioelectrical Impedance Analysis (BIA). J Clin Med 2024; 13:2743. [PMID: 38792285 PMCID: PMC11121990 DOI: 10.3390/jcm13102743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/23/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The aim of this study is to determine the relationship between selected components of body composition and the phase angle specified by bioelectrical impedance analysis, depending on the level of physical activity among students. Materials and Methods: The study group consisted of 484 university students from Krosno. The diagnostic survey method (IPAQ-SF), measurements of highs, and analysis of body composition components (BIA) were used. The relationship between variables was determined using the χ2 test, the V-Kramer coefficient, and Spearman's rho coefficient. Results: University students in physical education demonstrated the highest level of physical activity and the lowest incidence of excessive body mass. Among the participants, 28.1% did not engage in any physical activity, or their level was insufficient. The PhA level was correlated with lean body mass and muscle mass. The correlation between higher levels of PA and PhA values was statistically significant, as was the relationship between self-assessment of physical fitness and the level of PA determined by IPAQ-SF. Conclusions: Preventive actions and educational programs, especially about spending leisure time in active ways, should be particularly targeted at students of disciplines with a significant amount of sedentary classes.
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Affiliation(s)
- Monika Musijowska
- Department of Physical Education, State University of Applied Sciences in Krosno, Rynek 1, 38-400 Krosno, Poland
| | - Edyta Kwilosz
- Department of Nursing, State University of Applied Sciences in Krosno, St. Kazimierza Wielkiego 6, 38-400 Krosno, Poland
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Kobayashi T, Murakami T, Ono H, Takahashi T. Phase angle as an indicator of physical activity in patients with stable chronic obstructive pulmonary disease. Nutrition 2024; 120:112330. [PMID: 38262195 DOI: 10.1016/j.nut.2023.112330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES Phase angle (PhA) reflects cell membrane integrity and vitality and is an indicator of sarcopenia. PhA is associated with physical function in patients with stable chronic obstructive pulmonary disease (COPD). To our knowledge, the association between PhA and physical activity (PA) has not been investigated. Therefore, the aim of this study was to investigate whether PhA reflects PA in patients with COPD. METHODS This single-center, cross-sectional, observational study included 103 patients with stable COPD (87 men; mean age, 74.7 ± 8.1 y; mean forced expiratory volume in 1s %predicted value, 58.9 ± 20.4%). PhA was measured by bioelectrical impedance analysis. Patients were stratified into low (n = 54) and high (n = 49) PhA groups based on median values (4.3° ± 0.6° and 5.4° ± 0.5°, respectively). PA was calculated as the average daily duration of high-intensity light PA (HLPA; 2.0-2.9 metabolic equivalents [METs] of PA) and moderate- to vigorous-intensity PA (MVPA; >3 METs). Correlation and multivariate analyses using multiple regression analysis were performed to confirm the association between PhA and PA. RESULTS The high-PhA group demonstrated greater HLPA (104.4 [16.5-332.5] versus 131.3 [61.1-328.7] min, P = 0.005) and MVPA (19.5 [4.7-96.0] versus 46.6 [8.9-139.3] min, P < 0.001) than the low-PhA group. PhA was positively correlated with HLPA (r = 0.32, P < 0.001) and MVPA (r = 0.49, P < 0.001). MVPA (β = 0.178, P = 0.029) and HLPA (β = 0.158, P = 0.026) were associated with PhA independent of age, sex, body mass index, respiratory function, muscle strength, skeletal muscle mass index, and 6-min walking distance. CONCLUSION In patients with COPD, PhA may reflect PA as well as muscle function.
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Affiliation(s)
- Takeshi Kobayashi
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan.
| | - Tomoyuki Murakami
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
| | - Hiroto Ono
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
| | - Tsuneyuki Takahashi
- Department of Internal Medicine, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, Yamatomachi, Wakabayashi-ku, Sendai, Japan
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Kawase F, Masaki Y, Ozawa H, Imanaka M, Sugiyama A, Wada H, Kobayashi S, Tsukahara T. Association of resting energy expenditure with phase angle in hospitalized older patients: a cross-sectional analysis. Eur J Clin Nutr 2024; 78:187-192. [PMID: 37990127 DOI: 10.1038/s41430-023-01370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND/OBJECTIVES Resting energy expenditure (REE) constitutes the largest component of total energy expenditure and undergoes an age-related decline that is unexplained by decreased fat-free mass. Phase angle (PhA) is a cellular health indicator that is possibly associated with REE. We investigated the association of REE and PhA in hospitalized older adults. SUBJECTS/METHODS This single-center, cross-sectional analysis utilized the baseline data from a prospective longitudinal study and included 131 eligible patients aged ≥70 years. The REE was measured using indirect calorimetry, and PhA and body composition were assessed using bioelectrical impedance. The association between REE, PhA, and body composition was examined, and REE was compared using previously reported PhA cutoff values. RESULTS In this cohort with a mean (±standard deviation) age of 87.4 (±7.0) years, 34.4% of the participants were men. REE and PhA correlated strongly (r: 0.562, p < 0.001) and significantly after adjusting for age and sex (r: 0.433, p < 0.001). Multivariate analysis showed a significant independent association between REE and PhA and skeletal muscle mass (standardized β [95% CI]; 28.072 [2.188-53.956], p = 0.035) without any significant interaction between PhA and age on REE. The low PhA group had a significantly lower REE (kcal/day; 890 [856-925] vs. 1077 [1033-1122], p < 0.001), and this remained significant after adjusting for age, sex, and skeletal muscle mass index. CONCLUSIONS PhA is associated with REE in older adults. Adjusting REE calculation algorithms based on PhA values and correcting predicted REE according to PhA may aid in determining more accurate energy requirements.
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Affiliation(s)
- Fumiya Kawase
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan.
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan.
| | - Yoshiyuki Masaki
- Department of Internal Medicine, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
- Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroko Ozawa
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Manami Imanaka
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Aoi Sugiyama
- Department of Nursing, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Hironari Wada
- Department of Rehabilitation Therapy, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Shinya Kobayashi
- Department of Internal Medicine, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota, Aichi, Japan
| | - Takayoshi Tsukahara
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Nisshin, Aichi, Japan
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Nam JS, Kim HA, Kwak T, Cho KH, Jung IY, Moon CW. Feasibility of Mobile Health App-Based Home Aerobic Exercise for Physical Performance in Healthy Young Adults. Ann Rehabil Med 2024; 48:75-85. [PMID: 38433008 PMCID: PMC10915298 DOI: 10.5535/arm.230023] [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: 11/26/2023] [Revised: 01/16/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE To investigate the feasibility and effects of a mobile app-based home cycling exercise program compared to home cycling exercise without additional monitoring system. Compared with fitness facilities or outdoor exercise, home-based exercise programs effectively improve physical performance in an indwelling community. However, a flexible, informal environment may decrease motivation and impair adherence to physical exercise. Mobile devices for aerobic exercise and mobile applications provide real-time monitoring, immediate feedback, and encouragement to increase motivation and promote physical performance. We investigated the feasibility and effects of a mobile app-based home exercise program on body composition, muscular strength, and cardiopulmonary function. METHODS Between February and May 2023, 20 participants were randomly allocated to the intervention (mobile application with a tablet) and control groups, and they performed aerobic exercise using a stationary bicycle for ≥150 minutes per week for 6 weeks (≤30-minute exercise session, with 3-minute warm-up and 3-minute cool-down). Karvonen formula-based heartrate defined the weekly increase in exercise intensity. Outcome measures included body-composition parameters, isokinetic knee flexor and extensor strength tests, cardiopulmonary exercise test results, and rate of target heart rate (HR) achievement. Participants were assessed at baseline and after the intervention. RESULTS Unrelated personal events led two participants to drop out. The intervention and control groups had similar baseline characteristics. Compared with the control group, in the post-intervention isokinetic strength test, bilateral knee flexor and extensor power, and time to target HR achievement significantly increased each week in the intervention group. CONCLUSION Home-based exercise to achieve long-term cardiovascular fitness with portable electronic/mobile devices facilitates individualized exercise using real-time feedback to improve motivation and adherence.
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Affiliation(s)
- Je Shik Nam
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Hyun-Ah Kim
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | | | - Kang Hee Cho
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Il-Young Jung
- Department of Rehabilitation Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Chang-Won Moon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
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Lakenman PLM, van Marwijk I, van der Hoven B, van Bommel J, Joosten KFM, Olieman JF. Association between fat-free mass and survival in critically ill patients with COVID-19: A prospective cohort study. JPEN J Parenter Enteral Nutr 2024; 48:192-198. [PMID: 38035857 DOI: 10.1002/jpen.2585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 11/17/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Most critically ill patients with COVID-19 experience malnutrition and weight loss associated with negative clinical outcomes. Our primary aim was to assess body composition during acute and late phase of illness in these patients in relation to clinical outcome and secondary to tailored nutrition support. METHODS This prospective cohort study included adult critically ill patients with COVID-19. Body composition (fat-free mass [FFM] [exposure of interest], fat mass [FM], skeletal muscle mass [SMM], and phase angle [PA]) was determined with multifrequency bioelectrical impedance analyses in the acute and late phase. Nutrition support data were collected simultaneously. Clinical outcome was defined as intensive care unit (ICU) survival (primary outcome) and 30-90 days thereafter, duration of mechanical ventilation, and length of ICU stay and length of hospital stay (LOS). Nonparametric tests and regression analyses were performed. RESULTS We included 70 patients (73% male, median age 60 years). Upon admission, median BMI was 30 kg/m2 , 54% had obesity (BMI > 30 kg/m2 ). Median weight change during ICU stay was -3 kg: +3 kg FM and -6 kg FFM (-4 kg SMM). Body composition changed significantly (P < 0.001). Regarding clinical outcome, only low PA was associated with prolonged LOS (odds ratio = 0.83, 95% CI = 0.72-0.96; P = 0.015). Patients with optimal protein intake (>80%) during acute phase maintained significantly more FFM (2.7 kg, P = 0.047) in the late phase compared with patients who received <80%. CONCLUSION FFM decreased significantly during acute and late phase of illness, but we observed no association with ICU survival. Only low PA was associated with prolonged LOS. FFM wasting likely occurred because of disease severity and immobility.
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Affiliation(s)
- Patty L M Lakenman
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Iris van Marwijk
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Ben van der Hoven
- Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Jasper van Bommel
- Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Koen F M Joosten
- Intensive Care Unit, Department of Paediatrics and Paediatric Surgery, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Joanne F Olieman
- Department of Internal Medicine, Division of Dietetics, Erasmus Medical Centre, Rotterdam, the Netherlands
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Nakashima D, Fujii K, Tsubouchi Y, Kubo Y, Yorozuya K, Noritake K, Tomiyama N, Tsujishita S, Iitsuka T. Relationship between Phase Angle and Physical Activity Intensity among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:167. [PMID: 38255056 PMCID: PMC10815904 DOI: 10.3390/healthcare12020167] [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: 11/28/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
This cross-sectional study aimed to determine the association between phase angle (PhA) and physical activity intensity in community-dwelling older Japanese adults. The intensity and time of physical activity for predicting high PhA were also examined. This study involved 67 community-dwelling older adults (mean age: 78.3 ± 5.5; female: 83.6%). We measured the physical activity and body composition of the participants. Physical activity was measured using a triaxial accelerometer, and light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) hours per day were calculated from the results. Body composition was measured using Inbody S10, and the PhA was calculated from the measurements of the right side of the body. Bayesian statistical modeling revealed an association between PhA and MVPA (β = 0.256; p = 0.022; 95% Bayesian confidence interval [CI] = 0.001, 0.012), but not LPA (β = -0.113; p = 0.341; 95% Bayesian CI = -0.002, 0.001), even after adjustment for confounders. The cutoff value of MVPA predicting high PhA, calculated by the receiver operator characteristic curve, was 19.7 min/d (sensitivity = 0.906; specificity = 0.429). These results can be used to develop strategies to increase PhA in older adults and suggest that MVPA is important in this population.
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Affiliation(s)
- Daiki Nakashima
- Department of Rehabilitation, Faculty of Health Science, Naragakuen University, 3-15-1, Nakatomigaoka, Nara 631-8524, Nara, Japan (T.I.)
| | - Keisuke Fujii
- Department of Rehabilitation Occupational Therapy Course, Faculty of Health Science, Suzuka University of Medical Science, 1001-1, Kishioka, Suzuka 510-0293, Mie, Japan;
| | - Yoshihito Tsubouchi
- Department of Rehabilitation, Faculty of Health Science, Naragakuen University, 3-15-1, Nakatomigaoka, Nara 631-8524, Nara, Japan (T.I.)
| | - Yuta Kubo
- Division of Occupational Therapy, Faculty of Rehabilitation and Care, Seijoh University, 2-172 Fukinodai, Tokai 476-8588, Aichi, Japan; (Y.K.); (K.Y.); (N.T.)
| | - Kyosuke Yorozuya
- Division of Occupational Therapy, Faculty of Rehabilitation and Care, Seijoh University, 2-172 Fukinodai, Tokai 476-8588, Aichi, Japan; (Y.K.); (K.Y.); (N.T.)
| | - Kento Noritake
- Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Higashihaemi, Handa 475-0012, Aichi, Japan;
| | - Naoki Tomiyama
- Division of Occupational Therapy, Faculty of Rehabilitation and Care, Seijoh University, 2-172 Fukinodai, Tokai 476-8588, Aichi, Japan; (Y.K.); (K.Y.); (N.T.)
| | - Soma Tsujishita
- Division of Physical Therapy, Faculty of Rehabilitation and Care, Kobe International University, 9-1-6 Kouyou, Higashinada, Kobe 658-0032, Hyogo, Japan;
| | - Terufumi Iitsuka
- Department of Rehabilitation, Faculty of Health Science, Naragakuen University, 3-15-1, Nakatomigaoka, Nara 631-8524, Nara, Japan (T.I.)
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Iwasaka C, Nanri H, Nakagata T, Ohno H, Tanisawa K, Konishi K, Murakami H, Hosomi K, Park J, Yamada Y, Ono R, Mizuguchi K, Kunisawa J, Miyachi M. Association of skeletal muscle function, quantity, and quality with gut microbiota in Japanese adults: A cross-sectional study. Geriatr Gerontol Int 2024; 24:53-60. [PMID: 38098315 DOI: 10.1111/ggi.14751] [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: 08/14/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024]
Abstract
AIM The gut microbiota has emerged as a new intervention target for sarcopenia. Prior studies in humans have focused on the association between gut microbiota and skeletal muscle quantity, while the evidence on muscle function and quality is lacking. This study aimed to identify gut microbiota genera associated with skeletal muscle function, quantity, and quality in a general population of Japanese adults. METHODS This cross-sectional study included 164 participants aged 35-80 years, women and men recruited from urban areas of Japan. Fecal samples were collected and analyzed using 16S rRNA gene amplicon sequencing. Skeletal muscle function was measured using handgrip strength and leg extension power (LEP), while skeletal muscle mass was estimated using bioelectrical impedance analysis. Phase angle was used as a measure of skeletal muscle quality. Multivariate linear regression analysis stratified by age group was used to examine the association between the dominant genera of the gut microbiota and skeletal muscle variables. RESULTS A significant association was found between Bacteroides and Prevotella 9 with LEP only in the ≥60 years group. When both Bacteroides and Prevotella 9 were included in the same regression model, only Bacteroides remained consistently and significantly associated with LEP. No significant associations were observed between skeletal muscle mass, handgrip strength, and phase angle and major gut microbiota genera. CONCLUSIONS In this study, we observed a significant positive association between Bacteroides and leg muscle function in older adults. Further studies are required to elucidate the underlying mechanisms linking Bacteroides to lower-extremity muscle function. Geriatr Gerontol Int 2024; 24: 53-60.
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Affiliation(s)
- Chiharu Iwasaka
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Hinako Nanri
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Laboratory of Gut Microbiome for Health, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Takashi Nakagata
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Laboratory of Gut Microbiome for Health, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Harumi Ohno
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Department of Nutrition, Kiryu University, Kiryu, Japan
| | - Kumpei Tanisawa
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Kana Konishi
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Faculty of Food and Nutritional Sciences, Toyo University, Tokyo, Japan
| | - Haruka Murakami
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Koji Hosomi
- Laboratory of Vaccine Materials and Laboratory of Gut Environmental System, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Jonguk Park
- Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Yosuke Yamada
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Laboratory of Gut Microbiome for Health, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Rei Ono
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Laboratory of Gut Microbiome for Health, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Kenji Mizuguchi
- Artificial Intelligence Center for Health and Biomedical Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Jun Kunisawa
- Laboratory of Vaccine Materials and Laboratory of Gut Environmental System, Microbial Research Center for Health and Medicine, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Graduate School of Medicine, Osaka University, Osaka, Japan
- Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
- Graduate School of Dentistry, Osaka University, Osaka, Japan
- Graduate School of Science, Osaka University, Osaka, Japan
- International Vaccine Design Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Microbiology and Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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10
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Lin LY, Chen J, Lai TF, Chung YY, Park JH, Hu YJ, Liao Y. Sedentary Behavior and Phase Angle: An Objective Assessment in Physically Active and Inactive Older Adults. Nutrients 2023; 16:101. [PMID: 38201931 PMCID: PMC10780613 DOI: 10.3390/nu16010101] [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: 11/27/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The purpose of the present study was to investigate the associations of the objectively assessed total sedentary behavior (SB) amount and SB patterns with phase angle (PhA) in older populations and to conduct a comparison analysis for those who are physically active (meet 150 min/week) and inactive (less than 150 min/week). During May to August 2023, a convenience sampling was used to recruit older adults (aged ≥ 65 years) living in a community in Taiwan. The total SB amount (minutes/day), SB patterns (including SB bouts and breaks), and physical activity were assessed by a triaxial accelerometer. A multifrequency bioelectrical impedance analyzer (BIA) was used to measure PhA. Multiple linear regression analysis was employed to examine the associations between SB and PhA in the total number of participants and stratified in the physically active and inactive groups. For the whole sample (n = 166; mean age: 72.1 ± 5.5 years), the total SB amount and patterns of SB were not associated with PhA. For those physically active, the total SB amount and SB patterns were not associated with PhA. Among those physically inactive, the total SB amount was negatively related to PhA (B: -0.059, 95% CI: -0.118, 0.000). This study underscores the importance of minimizing the total SB amount in physically inactive older adults, providing evidence for future interventions targeting SB and PhA in this population.
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Affiliation(s)
- Liu-Yin Lin
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 10610, Taiwan;
- Zhongshan District Health Center, Taipei 10402, Taiwan
- Department of Health, Long-Term Care Division, Taipei City Government, Taipei 11008, Taiwan
| | - Jiaren Chen
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei 106, Taiwan; (J.C.); (T.-F.L.); (Y.-Y.C.)
| | - Ting-Fu Lai
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei 106, Taiwan; (J.C.); (T.-F.L.); (Y.-Y.C.)
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea;
| | - Yen-Yu Chung
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei 106, Taiwan; (J.C.); (T.-F.L.); (Y.-Y.C.)
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea;
| | - Yih-Jin Hu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 10610, Taiwan;
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei 106, Taiwan; (J.C.); (T.-F.L.); (Y.-Y.C.)
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11
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Otsubo R, Hashida R, Murotani K, Iwanaga S, Hirota K, Koya S, Tsukada Y, Ogata Y, Yokosuka K, Yoshida T, Nakae I, Fudo T, Morito S, Shimazaki T, Yamada K, Sato K, Matsuse H, Shiba N, Hiraoka K. Phase angle is related to physical function and quality of life in preoperative patients with lumbar spinal stenosis. Sci Rep 2023; 13:13909. [PMID: 37626144 PMCID: PMC10457364 DOI: 10.1038/s41598-023-40629-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Lumbar spinal stenosis (LSS) can interfere with daily life and quality of life (QOL). Evaluating physical function and QOL and helping patients to improve is the focus of rehabilitation. Phase angle (PhA) assessment is widely used to measure body composition and is considered an indicator of physical function and QOL. This study investigated the relationship between PhA and physical function, physical activity, and QOL in patients with LSS. PhA, handgrip strength, walking speed, Timed Up and Go test (TUG), Life Space Assessment (LSA), Prognostic Nutritional Index (PNI), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and EQ-5D were assessed and statistically analyzed. The study included 133 patients with LSS. Multiple regression analysis of PhA adjusted for age, sex, and body mass index (Model 1) and for Model 1 + PNI (Model 2) showed significant correlations (P < 0.05) with handgrip strength, walking speed, TUG, and LSA. Regarding QOL, PhA was significantly correlated (P < 0.05) with lumbar function in JOABPEQ. PhA was associated with physical function and QOL in patients with LSS and might be a new clinical indicator in this population.
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Affiliation(s)
- Ryota Otsubo
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
| | - Ryuki Hashida
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011.
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.
| | - Kenta Murotani
- Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Sohei Iwanaga
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Keisuke Hirota
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
| | - Shunji Koya
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
| | - Yuya Tsukada
- Institute of Health and Sports Sciences, Kurume University, Kurume, Japan
| | - Yuta Ogata
- Division of Rehabilitation, Kurume University Medical Center, Kurume, Japan
| | - Kimiaki Yokosuka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Tatsuhiro Yoshida
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Ichiro Nakae
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Takuma Fudo
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Shinji Morito
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Takahiro Shimazaki
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Kei Yamada
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Kimiaki Sato
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Naoto Shiba
- Division of Rehabilitation, Kurume University Hospital, 67 Asahi-machi, Kurume, Fukuoka, Japan, 830-0011
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - Koji Hiraoka
- Department of Orthopaedics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
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12
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Asano Y, Nagata K, Shibuya K, Fujii Y, Kitano N, Okura T. Association of 24-h movement behaviors with phase angle in community-dwelling older adults: a compositional data analysis. Aging Clin Exp Res 2023:10.1007/s40520-023-02425-8. [PMID: 37247128 DOI: 10.1007/s40520-023-02425-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/24/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Phase angle (PhA) is an indicator of cellular conditions. Recent studies have suggested that PhA supports healthy aging. Identifying modifiable lifestyle factors for PhA is important. The associations of PhA in 24-h movement behaviors, including physical activity (PA), sedentary behavior (SB), and sleep, have not been studied in older adults. OBJECTIVES We investigated the cross-sectional associations between 24-h movement behaviors and PhA in community-dwelling older adults while appropriately considering the co-dependent nature of daily time use using compositional data analysis. METHODS The participants were 113 healthy older adults. PhA was measured using a bioelectrical impedance device. Time spent in light-intensity PA (LPA), moderate- to vigorous-intensity PA (MVPA), and SB was measured using a tri-axial accelerometer. Sleep duration information was self-reported in a questionnaire. Compositional multiple linear regression and compositional isotemporal substitution were performed to examine the associations of 24-h movement behaviors with PhA and hypothetical time reallocation in movement behaviors with PhA, respectively. RESULTS Even after adjusting for potential confounders, relative to other behaviors more time spent in MVPA was significantly associated with higher PhA (p < 0.001). The 30 min/day of time reallocation from the other behaviors (SB, LPA, and sleep) to MVPA was predicted to be 0.12 higher PhA (corresponding to 2.3% increase; 95% CI 0.01, 0.24). CONCLUSIONS Our results suggest that increasing or maintaining the daily time spent in MVPA is important for managing PhA in older adults, regardless of the other behaviors time consumed instead.
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Affiliation(s)
- Yujiro Asano
- Doctoral Program in Physical Education, Health and Sport Science, Graduate School of Comprehensive Human Sciences, Degree Programs in Comprehensive Human SciencesUniversity of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Koki Nagata
- Doctoral Program in Public Health, Graduate School of Comprehensive Human Sciences, Degree Programs in Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Kyohei Shibuya
- R&D Center for Tailor-Made QOL, University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
| | - Yuya Fujii
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, 192-0001, Japan
| | - Naruki Kitano
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, 192-0001, Japan.
| | - Tomohiro Okura
- R&D Center for Tailor-Made QOL, University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
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13
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Fazliana M, Nor Hanipah Z, Mohd Yusof BN, Zainal Abidin NA, Tan YZ, Mohkiar FH, Liyana AZ, Mohd Naeem MN, Mohmad Misnan N, Ahmad H, Draman MS, Tsen PY, Lim SY, Gee T. Molecular, Metabolic, and Nutritional Changes after Metabolic Surgery in Obese Diabetic Patients (MoMen): A Protocol for a Multicenter Prospective Cohort Study. Metabolites 2023; 13:metabo13030413. [PMID: 36984853 PMCID: PMC10059761 DOI: 10.3390/metabo13030413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/26/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023] Open
Abstract
Metabolic surgery is an essential option in the treatment of obese patients with type 2 diabetes (T2D). Despite its known advantages, this surgery still needs to be introduced in Malaysia. In this prospective study, the pathophysiological mechanisms at the molecular level will be studied and the metabolomics pathways of diabetes remission will be explored. The present study aims to evaluate the changes in the anthropometric measurements, body composition, phase angle, diet intake, biochemistry parameters, adipokines, microRNA, and metabolomics, both pre- and post-surgery, among obese diabetic patients in Malaysia. This is a multicenter prospective cohort study that will involve obese patients (n = 102) with a body mass index (BMI) of ≥25 kg/m2 (Asian BMI categories: WHO/IASO/IOTF, 2000) who will undergo metabolic surgery. They will be categorized into three groups: non-diabetes, prediabetes, and diabetes. Their body composition will be measured using a bioimpedance analyzer (BIA). The phase angle (PhA) data will be analyzed. Venous blood will be collected from each patient for glycated hemoglobin (HbA1c), lipids, liver, renal profile, hormones, adipokines, and molecular and metabolomics analyses. The serum microRNA will be measured. A gene expression study of the adipose tissue of different groups will be conducted to compare the groups. The relationship between the 1HNMR-metabolic fingerprint and the patients’ lifestyles and dietary practices will be determined. The factors responsible for the excellent remission of T2D will be explored in this study.
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Affiliation(s)
- Mansor Fazliana
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
- Correspondence:
| | - Zubaidah Nor Hanipah
- Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Barakatun Nisak Mohd Yusof
- Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Nur Azlin Zainal Abidin
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
| | - You Zhuan Tan
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
| | - Farah Huda Mohkiar
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
| | - Ahmad Zamri Liyana
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
| | - Mohd Nawi Mohd Naeem
- Nutrition, Metabolism and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
| | - Norazlan Mohmad Misnan
- Herbal Medicine Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia
| | - Haron Ahmad
- KPJ Damansara Specialist Hospital, 119, Jalan SS 20/10, Petaling Jaya 47400, Selangor, Malaysia
| | - Mohd Shazli Draman
- KPJ Damansara Specialist Hospital, 119, Jalan SS 20/10, Petaling Jaya 47400, Selangor, Malaysia
| | - Poh Yue Tsen
- Sunway Medical Centre, No. 5 Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
- iHeal Medical Centre, Menara IGB, Mid Valley City, Lingkaran Syed Putra, Kuala Lumpur 59200, Malaysia
- Sunway Velocity Medical Centre, Lingkaran SV2, Sunway Velocity, Kuala Lumpur 55100, Malaysia
| | - Shu Yu Lim
- Sunway Medical Centre, No. 5 Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
- iHeal Medical Centre, Menara IGB, Mid Valley City, Lingkaran Syed Putra, Kuala Lumpur 59200, Malaysia
- Sunway Velocity Medical Centre, Lingkaran SV2, Sunway Velocity, Kuala Lumpur 55100, Malaysia
| | - Tikfu Gee
- Sunway Medical Centre, No. 5 Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
- iHeal Medical Centre, Menara IGB, Mid Valley City, Lingkaran Syed Putra, Kuala Lumpur 59200, Malaysia
- Sunway Velocity Medical Centre, Lingkaran SV2, Sunway Velocity, Kuala Lumpur 55100, Malaysia
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14
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Abstract
The biophysical response of the human body to electric current is widely appreciated as a barometer of fluid distribution and cell function. From distinct raw bioelectrical impedance (BIA) variables assessed in the field of body composition, phase angle (PhA) has been repeatedly indicated as a functional marker of the cell's health and mass. Although resistance training (RT) programs have demonstrated to be effective to improve PhA, with varying degrees of change depending on other raw BIA variables, there is still limited research explaining the biological mechanisms behind these changes. Here, we aim to provide the rationale for the responsiveness of PhA determinants to RT, as well as to summarize all available evidence addressing the effect of varied RT programs on PhA of different age groups. Available data led us to conclude that RT modulates the cell volume by increasing the levels of intracellular glycogen and water, thus triggering structural and functional changes in different cell organelles. These alterations lead, respectively, to shifts in the resistive path of the electric current (resistance, R) and capacitive properties of the human body (reactance, Xc), which ultimately impact PhA, considering that it is the angular transformation of the ratio between Xc and R. Evidence drawn from experimental research suggests that RT is highly effective for enhancing PhA, especially when adopting high-intensity, volume, and duration RT programs combining other types of exercise. Still, additional research exploring the effects of RT on whole-body and regional BIA variables of alternative population groups is recommended for further knowledge development.
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Affiliation(s)
- Luís B Sardinha
- Exercise and Health Laboratory, Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, , Cruz Quebrada, Portugal.
| | - Gil B Rosa
- Exercise and Health Laboratory, Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, , Cruz Quebrada, Portugal
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15
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Tan LF, Chan YH, Seetharaman S, Denishkrshna A, Au L, Kwek SC, Chen MZ, Ng SE, Hui RJY, Merchant RA. Impact of Exercise and Cognitive Stimulation Therapy on Physical Function, Cognition and Muscle Mass in Pre-Frail Older Adults in the Primary Care Setting: A Cluster Randomized Controlled Trial. J Nutr Health Aging 2023; 27:438-447. [PMID: 37357328 PMCID: PMC10230140 DOI: 10.1007/s12603-023-1928-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/13/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Multicomponent exercise program have shown to improve function and cognition in older adults but studies on pre-frail older adults in the primary care setting are limited. This study aimed i) to evaluate impact of 6 months exercise (Ex) versus complementary effect of 3 months of cognitive stimulation therapy (CST) to 6 months of Ex (Ex+CST) on physical function, muscle mass and cognition versus control group at 3, 6 and 12 months ii) inflammatory biomarkers such as Interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNF-α). DESIGN Cluster randomised control trial. SETTING AND INTERVENTION Pre-frail older adults ≥ 65 years attending primary care clinic. Two intervention groups i) Ex 6 months ii) CST 3 months with Ex 6 months. MEASUREMENTS At 0, 3, 6 and 12 months, questionnaires (on demographics, physical function, cognition, and depression) were administered and physical function assessment (gait speed, short physical performance battery (SPPB) test, handgrip strength, five times sit-to-stand (5x-STS)) was conducted. Muscle mass and its surrogates such as phase angle and body cell mass were measured using bioelectrical impedance analysis machine. Inflammatory biomarkers were measured at 0 and 3 months. RESULTS Data from 190 participants was analysed at 3 months (111 control, 37 Ex and 41 Ex+CST). At 3 months, significant improvement in cognition was seen only in the Ex+CST group whereas improvements in depression, gait speed, SPPB and 5x-STS were seen in both the Ex and Ex+CST groups. At 6 months, the Ex+CST group improved in cognition and depression whereas improvement in frailty and muscle mass indices were seen in both the interventions groups. At 12 months, both the interventions groups had better perceived health, gait speed and less decline in muscle mass compared with control groups. Both the Ex and Ex+CST had significant association with TNF-α at 3 months (β -2.71 (95% CI -4.80 - -0.62); p = 0.012 and β -1.74 (95% CI -3.43 - -0.06); p = 0.043 respectively). CONCLUSION Combined Ex+CST had significant improvement in cognition whereas the intervention groups improved in depression, physical function, muscle mass, frailty, perceived health and TNF-α levels. With growing evidence of the benefits of multicomponent interventions at primary care level, incorporating it into mainstream care with action plans on long-term sustainability and scalability should be a priority for every country.
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Affiliation(s)
- L F Tan
- Associate Professor Reshma A Merchant, Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228,
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