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Li ZL, Sun Y. Role of obesity in pathogenesis of acute pancreatitis. Shijie Huaren Xiaohua Zazhi 2023; 31:953-959. [DOI: 10.11569/wcjd.v31.i23.953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023] Open
Abstract
Acute pancreatitis (AP) is one of the most common digestive disorders that cause hospitalization. While most of patients with AP have a mild to moderate disease and recover rapidly, about 20% of patients with AP have a severe disease and experience substantial morbidity and mortality from local and/or systemic compli-cations. The incidence of obesity has increased worldwide, and its epidemiological characteristics and rising trend are consistent with those of AP. Therefore, obesity has probably contributed to the increase in the incidence and severity of AP. However, previous studies have generated conflicting results, and some studies demonstrated that obesity is a protective factor in patients with AP. Here we discuss the role of obesity in the pathogenesis of AP and the underlying mechanisms based on clinically relevant studies.
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Affiliation(s)
- Zhuang-Li Li
- Department of Critical Care Medicine, The 901 Hospital of The Joint Logistic Support Force of the Chinese People`s Liberation Army, Clinic College, Anhui Medical University, Hefei 230031, Anhui Province, China
| | - Yun Sun
- The First Department of Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
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Wu X, Zhao Y, Zhou Q, Han M, Qie R, Qin P, Zhang Y, Huang Z, Liu J, Hu F, Luo X, Zhang M, Liu Y, Sun X, Hu D. All-cause mortality risk with different metabolic abdominal obesity phenotypes: the Rural Chinese Cohort Study. Br J Nutr 2023; 130:1637-1644. [PMID: 36924137 DOI: 10.1017/s0007114523000673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15 704 Chinese adults (38·86 % men) with a median age of 51·00 (interquartile range: 41·00-60·00) at baseline (2007-2008) and followed up during 2013-2014. Obesity was defined by waist circumference (WC: ≥ 90 cm for men and ≥ 80 cm for women) or waist-to-height ratio (WHtR: ≥ 0·5). The hazard ratio (HR) and 95 % CI for the risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6·01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) at baseline was 12·12 %, 2·80 %, 41·93 % and 43·15 %, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity and education, the risk of all-cause mortality was higher with both MUNO (HR = 1·20, 95 % CI 1·14, 1·26) and MUO (HR = 1·20, 95 % CI 1·13, 1·27) v. MHNO, but the risk was not statistically significant with MHO (HR = 0·99, 95 % CI 0·89, 1·10). This result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small.
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Affiliation(s)
- Xiaoyan Wu
- Department of Cardio-Cerebrovascular Disease and Diabetes Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, People's Republic of China
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Qionggui Zhou
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Minghui Han
- Department of Epidemiology and Health Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ranran Qie
- Department of Epidemiology and Health Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Pei Qin
- Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Yanyan Zhang
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Zelin Huang
- Department of Biostatistics and Epidemiology, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Jiong Liu
- Department of Biostatistics and Epidemiology, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xinping Luo
- Department of Biostatistics and Epidemiology, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Medical School, Shenzhen, Guangdong, People's Republic of China
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Millimono TM, Camara A, Mabiama G, Daffé M, Boumédiène F, Preux PM, Desport JC, Fayemendy P, Jésus P. Nutritional status and associated factors among the elderly in Guinea: a first national cross-sectional study. Sci Rep 2023; 13:15307. [PMID: 37723221 PMCID: PMC10507041 DOI: 10.1038/s41598-023-42494-3] [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: 12/22/2022] [Accepted: 09/11/2023] [Indexed: 09/20/2023] Open
Abstract
Aging of the Guinean population is a public health concern for the coming years, and the nutritional status of older people is virtually unknown. We also know that this population is growing and that undernutrition and obesity can affect the health of older adults. This study aimed to assess the nutritional status of older people in the general population of Guinea and its associated factors. A representative cross-sectional survey was conducted using sociodemographic, clinical, and anthropometric data (weight and height). Oral status was assessed by using the University of Nebraska Oral Status Scale. Visual acuity was assessed using the Monoyer scale. The standardized prevalence ratio (SPR) of the nutritional status was calculated for each region. The sample included 1698 subjects with a mean BMI of 22.6 ± 4.3 kg/m2. A total of 50.3% had impaired oral status and 20.3% had moderately to severely impaired visual acuity. The prevalence of undernutrition was 14.4% and of obesity 5.7%. Differences in the prevalence of nutritional status were found between regions, with an SPR > 1 for undernutrition in the Labé region (SPR 1.9, 95% CI = 1.5-2.5) and for obesity in the Conakry and Kindia regions (SPR of 2.90, 95% CI = 2.0-4.05 and 2.32, 95% CI = 1.5-3.3, respectively). In Guinea, The prevalence of nutritional disorders was approximately 20%. Screening and management of the health and nutritional status of older adults should be a national priority, and management should be adapted to each region of the country.
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Affiliation(s)
- Thierno Mamadou Millimono
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France.
- Gamal Abdel Nasser University of Conakry, Conakry, Guinea.
| | - Alioune Camara
- Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Gustave Mabiama
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Department of Family and Home Economics, Advanced Teachers Training College for Technical Education (ATTCTE), University of Douala, Douala, Cameroon
| | - Mamady Daffé
- Gamal Abdel Nasser University of Conakry, Conakry, Guinea
- Ministry of Health and Public Hygiene, Food and Nutrition Division, Conakry, Guinea
| | - Farid Boumédiène
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
| | - Jean-Claude Desport
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Resource Centre for Nutrition Nouvelle Aquitaine Region (CERENUT), Isle, France
| | - Philippe Fayemendy
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Resource Centre for Nutrition Nouvelle Aquitaine Region (CERENUT), Isle, France
- Nutrition Unit, University Hospital, Limoges, France
| | - Pierre Jésus
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Resource Centre for Nutrition Nouvelle Aquitaine Region (CERENUT), Isle, France
- Nutrition Unit, University Hospital, Limoges, France
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Optimal body composition indices cutoff values based on all-cause mortality in the elderly. Exp Gerontol 2023; 171:112026. [PMID: 36400117 DOI: 10.1016/j.exger.2022.112026] [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: 09/24/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
The cutoffs of body composition indices are inconclusive in older populations. This study is designed toward determining the optimal cutoffs of the body composition indices based on the association with all-cause mortality. During 2009 and 2010, a cohort population of 1200 was enrolled in central western Taiwan. Of the 1200 subjects, 428 older subjects (mean age: 72.5 ± 5.4 yrs.; 47.7 % were women) were censored in this study. The waist circumference (WC) and body mass index (BMI) were measured using standard anthropometric methods. A multi-frequency bioelectrical impedance analysis device was utilized to estimate each participant's body composition indices, including percent body fat (PBF) and skeletal muscle mass index (SMMI). All claims records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. A receiver operating characteristic curve method and the highest Youden index were used to identify the optimal cutoffs. A Cox proportional hazards regression analysis was used to model associations between each of the recommended cutoff values with all-cause mortality. The all-cause mortality rate was 20.09 % after a follow-up period of 5.86 ± 2.39 person-years. The significant indices cutoff value was identified to be WC (86.7 cm) for older women and BMI (23.8 kg/m2) and as WC (77.6 cm), and SMMI (8.7 kg/m2) for older men. The recommended optimal cutoffs of the body composition indices were gender-specific and can be utilized to predict the risk of all-cause mortality.
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Putra ICS, Kamarullah W, Prameswari HS, Pramudyo M, Iqbal M, Achmad C, Akbar MR, Tiksnadi BB. Metabolically unhealthy phenotype in normal weight population and risk of mortality and major adverse cardiac events: A meta-analysis of 41 prospective cohort studies. Diabetes Metab Syndr 2022; 16:102635. [PMID: 36240685 DOI: 10.1016/j.dsx.2022.102635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/14/2022] [Accepted: 09/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS It is still debatable whether metabolic status in normal weight population increases the risk of mortality (all-cause mortality (ACM), cardiovascular mortality (CVM)) and major adverse cardiac events (MACE) as compared to the obese population. Therefore, this meta-analysis aims to evaluate the association of the metabolically unhealthy normal weight (MUH-NW) phenotype with all-cause mortality, cardiovascular mortality, and MACE in comparison to metabolically healthy obesity (MH-O), along with the association of metabolically unhealthy obesity (MUH-O) phenotype regarding the same outcomes compared to MUH-NW. METHODS A systematic literature search was conducted using online databases from inception to June 20, 2022, to comprehensively search all prospective cohort studies comprising three variables including adults aged ≥18 years, obesity and four metabolic phenotypes, and interest outcomes (ACM, CVM, and MACE). RESULTS Forty-one prospective cohort studies with a total of 4,028,750 participants was included in this study. Compared to MH-O, MUH-NW had a substantially higher risk of ACM (RR = 1.47 (95%CI = 1.32-1.64); P < 0.001; I2 = 89.8%,P-heterogeneity<0.001), CVM (RR = 2.37 (95%CI = 1.97-2.86); P < 0.001; I2 = 83.7%,P-heterogeneity<0.001), and MACE (RR = 1.73 (95%CI = 1.49-2.00); P < 0.001; I2 = 74.3%,P-heterogeneity<0.001). Moreover, MUH-O did not have a significantly elevated risk of ACM (RR = 0.97 (95%CI = 0.82-1.15); P = 0.736; I2 = 98.3%,P-heterogeneity<0.001), CVM (RR = 0.96 (95%CI = 0.88-1.05); P = 0.394; I2 = 77.0%,P-heterogeneity<0.001), and MACE (RR = 0.95 (95%CI = 0.80-1.13); P = 0.570; I2 = 92.2%,P-heterogeneity<0.001) compared to MUH-NW. CONCLUSION In conclusion, MUH-NW was superior but not inferior to MH-O and MUH-O in terms of increased risk of interest outcomes, refuting the notion that normal weight population is a benign condition. Hence, in normal weight population, metabolic screening is highly suggested to measure the baseline of obesity and metabolic phenotypes, thus preventing the risk of CVD and mortality in the future.
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Affiliation(s)
- Iwan Cahyo Santosa Putra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
| | - William Kamarullah
- R. Syamsudin SH Regional Public Hospital, Sukabumi, West Java, Indonesia.
| | - Hawani Sasmaya Prameswari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
| | - Miftah Pramudyo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
| | - Mohammad Iqbal
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
| | - Chaerul Achmad
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
| | - Badai Bhatara Tiksnadi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
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Yannakoulia M, Mamalaki E, Poulimenas D. Intentional weight loss and mortality in middle-aged and older adults: A narrative review. Maturitas 2022; 165:100-103. [DOI: 10.1016/j.maturitas.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022]
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Effects of age and gender on body composition indices as predictors of mortality in middle-aged and old people. Sci Rep 2022; 12:7912. [PMID: 35551227 PMCID: PMC9098413 DOI: 10.1038/s41598-022-12048-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/26/2022] [Indexed: 11/08/2022] Open
Abstract
To determine whether body composition indices interact with age and gender as a predictor of all-cause mortality, 1200 participants at least 40 years of age were recruited in 2009 and 2010. A multi-frequency bioelectrical impedance analysis device was used to measure each participant's body composition indices, including the fat mass index (FMI), fat free mass index (FFMI), skeletal muscle mass index (SMMI), and visceral fat area index (VFAI). A baseline questionnaire was used to collect demographic information about lifestyle habits, socioeconomic status, and medical conditions. All claimed records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. The all-cause mortality rate was 8.67% after a mean follow-up period of 5.86 ± 2.39 person-years. The Cox proportional hazard model analysis showed significantly negative associations between FFMI or SMMI with all-cause mortality in the total group and those aged ≥ 65 y/o. The FFMI and SMMI were negative predictors of mortality in both genders. The FMI and VFAI were positive predictors of mortality exclusively in females. In conclusion, the SMMI is a better predictor of mortality than the BMI, FMI, and FFMI, especially in older adults. A higher fat mass or visceral fat distribution may predict higher mortality in females.
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Ler P, Li X, Hassing LB, Reynolds CA, Finkel D, Karlsson IK, Dahl Aslan AK. Independent and joint effects of body mass index and metabolic health in mid- and late-life on all-cause mortality: a cohort study from the Swedish Twin Registry with a mean follow-up of 13 Years. BMC Public Health 2022; 22:718. [PMID: 35410261 PMCID: PMC9004188 DOI: 10.1186/s12889-022-13082-3] [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: 10/11/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is robust evidence that in midlife, higher body mass index (BMI) and metabolic syndrome (MetS), which often co-exist, are associated with increased mortality risk. However, late-life findings are inconclusive, and few studies have examined how metabolic health status (MHS) affects the BMI-mortality association in different age categories. We, therefore, aimed to investigate how mid- and late-life BMI and MHS interact to affect the risk of mortality. METHODS This cohort study included 12,467 participants from the Swedish Twin Registry, with height, weight, and MHS measures from 1958-2008 and mortality data linked through 2020. We applied Cox proportional hazard regression with age as a timescale to examine how BMI categories (normal weight, overweight, obesity) and MHS (identification of MetS determined by presence/absence of hypertension, hyperglycemia, low HDL, hypertriglyceridemia), independently and in interaction, are associated with the risk of all-cause mortality. Models were adjusted for sex, education, smoking, and cardiovascular disease. RESULTS The midlife group included 6,252 participants with a mean age of 59.6 years (range = 44.9-65.0) and 44.1% women. The late-life group included 6,215 participants with mean age 73.1 years (65.1-95.3) and 46.6% women. In independent effect models, metabolically unhealthy status in midlife increased mortality risks by 31% [hazard ratio 1.31; 95% confidence interval 1.12-1.53] and in late-life, by 18% (1.18;1.10-1.26) relative to metabolically healthy individuals. Midlife obesity increased the mortality risks by 30% (1.30;1.06-1.60) and late-life obesity by 15% (1.15; 1.04-1.27) relative to normal weight. In joint models, the BMI estimates were attenuated while those of MHS were less affected. Models including BMI-MHS categories revealed that, compared to metabolically healthy normal weight, the metabolically unhealthy obesity group had increased mortality risks by 53% (1.53;1.19-1.96) in midlife, and across all BMI categories in late-life (normal weight 1.12; 1.01-1.25, overweight 1.10;1.01-1.21, obesity 1.31;1.15-1.49). Mortality risk was decreased by 9% (0.91; 0.83-0.99) among those with metabolically healthy overweight in late-life. CONCLUSIONS MHS strongly influenced the BMI-mortality association, such that individuals who were metabolically healthy with overweight or obesity in mid- or late-life did not carry excess risks of mortality. Being metabolically unhealthy had a higher risk of mortality independent of their BMI.
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Affiliation(s)
- Peggy Ler
- Aging Research Network-Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Xia Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Linda B Hassing
- Department of Psychology and Centre for Ageing and Health, University of Gothenburg, Gothenburg, Sweden
| | - Chandra A Reynolds
- Department of Psychology, University of California - Riverside, Riverside, CA, USA
| | - Deborah Finkel
- Aging Research Network-Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Psychology, Indiana University Southeast, New Albany, Indiana, USA
| | - Ida K Karlsson
- Aging Research Network-Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna K Dahl Aslan
- Aging Research Network-Jönköping (ARN-J), School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,School of Health Sciences, University of Skövde, Skövde, Sweden
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Bahat G, Kilic C, Ozkok S, Ozturk S, Karan MA. Associations of sarcopenic obesity versus sarcopenia alone with functionality. Clin Nutr 2021; 40:2851-2859. [PMID: 33940398 DOI: 10.1016/j.clnu.2021.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/18/2021] [Accepted: 04/07/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND & AIMS There have been several attempts to come up with a global operational definition of sarcopenia (S), and consequently, a definition of S has been established, to some extent. That said, the definition of sarcopenic obesity (SO), which is defined as the presence of obesity + sarcopenia, remains obscure, hindering evaluations of the prevalence and relevance of SO. It has yet to be elucidated whether SO is associated with worse functionality when compared to S alone (S without obesity). In the present study, we compare SO and S alone in terms of their associations with functional measures through the application of alternative definitions of SO. As a secondary output, we document the prevalence of SO based on alternative definitions. METHODS This retrospective cross-sectional study included community-dwelling adults over 60 years of age who presented as outpatients to a university hospital between 2012 and 2020. All were evaluated for body composition (bioimpedance analysis), handgrip strength (Jamar hand dynamometer) and functional health status [activities of daily living (ADL), instrumental activities of daily living (IADL)]. The fat percentile method was used to define the obesity component of SO. Low muscle mass (LMM) was defined using two different adjustment methods of skeletal muscle mass (LMM adjusted by height2 or LMM adjusted by BMI). S was defined based on the EWGSOP2 definition, as probable S (low muscle strength) or confirmed S (low muscle strength + LMM). Accordingly, three alternative definitions of SO were applied based on three alternative definitions of S, i.e., "obesity + sarcopenia (probable)", "obesity + sarcopenia (confirmed, LMM adjusted by height2)" and "obesity + sarcopenia (confirmed, LMM adjusted by BMI)". The associations of SO and S alone with functional measures were examined with univariate analyses and adjusted multivariate analyses. RESULTS Included in the study were 1468 older adults (median age 75; 68.8% female). The prevalence of SO was very low (0.2%) based on the SO definition "obesity + sarcopenia (confirmed, LMM adjusted by height2), but it was present at a considerable and comparable rate based on SO definition "obesity + sarcopenia (probable)" and SO definition "obesity + sarcopenia (confirmed, LMM adjusted by BMI)" (4.1%, 4.0%; respectively). As SO by "obesity + sarcopenia (confirmed, LMM adjusted by height2)" had an ignorable prevalence, this definition of SO was excluded from further analyses. Multivariate analyses revealed that, when compared to the Non-S Non-Obese group, S alone definitions had odds ratio (OR) of 5.4 and 3.4 while SO definitions had an OR of 3.2 and 2.7 for impaired ADL, and an OR of 7.9 and 6.4, while SO definitions had an OR of 3.0 and 2.7 for impaired IADL. SO was thus found to be associated with a lower prevalence of impaired functional measures than that of S alone. CONCLUSIONS Our results suggest that the SO definition confirmed, LMM adjusted by height2 has an ignorable prevalence in populations in which underweight or malnutrition is uncommon. Among sarcopenic older individuals, obesity may have a protective effect against the limitations of some functional measures, providing evidence of the possible protective effect of obesity in sarcopenic individuals.
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Affiliation(s)
- Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Cihan Kilic
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Serdar Ozkok
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Savas Ozturk
- Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Mehmet Akif Karan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
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Metabolically healthy obesity is associated with longitudinal changes in high-density lipoprotein cholesterol in Chinese adults. Eat Weight Disord 2021; 26:263-272. [PMID: 32002828 DOI: 10.1007/s40519-020-00847-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/30/2019] [Accepted: 01/08/2020] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Whether metabolically healthy obesity (MHO) is associated with longitudinal changes in high-density lipoprotein cholesterol (HDL-C) remains unclear. METHODS MHO was defined as participants with overweight and obesity (BMI ≥ 24.0 kg/m2, n = 2921), free of history of metabolic diseases, and without abnormalities of blood pressure, fasting blood glucose, hemoglobin A1c, lipid profile, carotid artery and liver ultrasonographic findings at baseline. Metabolically healthy normal weight (MHN) was defined as participants with normal weight (BMI < 24.0 kg/m2, n = 9578) and without above-mentioned abnormalities. HDL-C, fasting blood glucose, hemoglobin A1c, and blood pressure were assessed annually. Glucose abnormality was considered if either FBG ≥ 5.6 mmol/L or HbA1c ≥ 5.7%; while, high blood pressure (HBP) was considered if either systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg during 5 years of follow-up. RESULTS Compared with the MHN group, the adjusted mean difference in HDL-C change rate was - 0.005 mmol/L per year [95% confidence interval (CI) - 0.007, - 0.003] for MHO after adjustment for a series of potential confounders. Furthermore, transiting to abnormality of blood glucose, but not high blood pressure, was associated with lower cumulative average of HDL-C in MHN group, compared with those remained in metabolically healthy status. CONCLUSIONS MHO and transiting from metabolically healthy to abnormality of blood glucose were associated with HDL-C in Chinese adults. LEVEL OF EVIDENCE III, cohort study.
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11
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Mazza E, Ferro Y, Pujia R, Mare R, Maurotti S, Montalcini T, Pujia A. Mediterranean Diet In Healthy Aging. J Nutr Health Aging 2021; 25:1076-1083. [PMID: 34725664 PMCID: PMC8442641 DOI: 10.1007/s12603-021-1675-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/22/2021] [Indexed: 12/28/2022]
Abstract
The World elderly population is expected to double before 2050. Unhealthy habits and unhealthy lifestyles are commonly associated with age-related diseases or their worsening. Modification in daily lifestyle and diet may help preventing age-related diseases onset and efficiently affecting their evolution, thus promoting the Healthy Aging process, concept recently coined to describe the disease-free aging process. This review highlights the role of nutrition science in promoting healthy aging. Since the Mediterranean Model demonstrated to be a useful style in supporting healthy aging, promotion of this correct lifestyle by health policies seems to be the best approach to achieve this target.
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Affiliation(s)
- E Mazza
- Elisa Mazza, Department of Medical and Surgical Science, University Magna Grecia, Viale Europa, 88100 Catanzaro, Italy. E-mail: , telephone numbers: +3909613697231
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12
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Lincoln KD. Race, Obesity, and Mental Health Among Older Adults in the United States: A Literature Review. Innov Aging 2020; 4:igaa031. [PMID: 32923693 PMCID: PMC7477914 DOI: 10.1093/geroni/igaa031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Indexed: 12/24/2022] Open
Abstract
Rising rates of obesity among older adults in the United States are a serious public health concern. While the physical health consequences of obesity are well documented, the mental health consequences are less understood. This is especially the case among older adults in general and among racial and ethnic minority older adults in particular. Available studies document a link between obesity and a variety of mental health disorders. However, findings from this body of evidence are inconsistent, especially when race and ethnicity are considered. This article examines research on obesity and mental health among older adults and identifies risk factors, causal mechanisms, and methodological approaches that help clarify the equivocal nature of the literature. Promising research and future directions include studies that consider a wide array of contextual factors and population heterogeneity.
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Affiliation(s)
- Karen D Lincoln
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
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13
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BMI, high-sensitivity C-reactive protein and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults: a cohort study. Public Health Nutr 2020; 24:4124-4131. [PMID: 32840191 DOI: 10.1017/s136898002000289x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We performed the cohort study to evaluate the association between BMI, high-sensitivity C-reactive protein (hs-CRP) and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults. DESIGN Metabolically healthy was defined as participants without history of metabolic diseases and with normal fasting blood glucose level, glycated Hb A1c level, blood pressure, lipid profile, serum uric acid level and liver ultrasonographic findings at baseline. Participants were either classified into normal weight (18·5 ≤ BMI < 24·0 kg/m2) and overweight (BMI ≥ 24·0 kg/m2) based on baseline BMI, or low (<1 mg/l) and high (≥1 mg/l) groups based on baseline hs-CRP. The conversion from metabolically healthy to unhealthy phenotype was deemed if any of the metabolic abnormalities had been confirmed twice or more during 5 years of follow-up. RESULTS Included were 4855 (1942 men and 2913 women, aged 36·0 ± 8·9 years) metabolically healthy Chinese adults. We identified 1692 participants who converted to metabolically unhealthy phenotype during the follow-up. Compared with their counterparts, the adjusted hazards ratio of the conversion was 1·19 (95 % CI 1·07, 1·33) for participants with overweight, while it was 1·15 (95 % CI 1·03, 1·29) for those with high hs-CRP level (≥1 mg/l). Further adjustment of hs-CRP did not materially change the association between BMI and the conversion. However, the association between hs-CRP and the conversion was not significant after further adjustment of BMI. The sensitivity analysis generated similar results to main analysis. CONCLUSION BMI was associated with the risk of the conversion from metabolically healthy to unhealthy status in Chinese adults.
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14
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Javed AA, Aljied R, Allison DJ, Anderson LN, Ma J, Raina P. Body mass index and all-cause mortality in older adults: A scoping review of observational studies. Obes Rev 2020; 21:e13035. [PMID: 32319198 DOI: 10.1111/obr.13035] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 03/14/2020] [Accepted: 03/24/2020] [Indexed: 12/17/2022]
Abstract
In older age, body composition changes as fat mass increases and redistributes. Therefore, the current body mass index (BMI) classification may not accurately reflect risk in older adults (65+). This study aimed to review the evidence on the association between BMI and all-cause mortality in older adults and specifically, the findings regarding overweight and obese BMI. A systematic search of the OVID MEDLINE and Embase databases was conducted between 2013 and September 2018. Observational studies examining the association between BMI and all-cause mortality within a community-dwelling population aged 65+ were included. Seventy-one articles were included. Studies operationalized BMI categorically (n = 60), continuously (n = 8) or as a numerical change/group transition (n = 7). Reduced risk of mortality was observed for the overweight BMI class compared with the normal BMI class (hazard ratios [HR] ranged 0.41-0.96) and for class 1 or 2 obesity in some studies. Among studies examining BMI change, increases in BMI demonstrated lower mortality risks compared with decreases in BMI (HR: 0.83-0.95). Overweight BMI classification or a higher BMI value may be protective with regard to all-cause mortality, relative to normal BMI, in older adults. These findings demonstrate the potential need for age-specific BMI cut-points in older adults.
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Affiliation(s)
- Ayesha A Javed
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,McMaster Institute for Research on Aging, Hamilton, Canada
| | - Rumaisa Aljied
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - David J Allison
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,McMaster Institute for Research on Aging, Hamilton, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,McMaster Institute for Research on Aging, Hamilton, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,McMaster Institute for Research on Aging, Hamilton, Canada.,Labarge Centre for Mobility in Aging, Hamilton, Canada
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15
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Amann VR, Santos LPD, Gigante DP. [Association of excess weight and obesity and mortality in Brazilian state capitals and Argentine provinces]. CAD SAUDE PUBLICA 2019; 35:e00192518. [PMID: 31800787 DOI: 10.1590/0102-311x00192518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 06/03/2019] [Indexed: 01/04/2023] Open
Abstract
This study aimed to assess the association between prevalence of excess weight and obesity and overall and disease-specific mortality rates in Brazilian state capitals and Argentine provinces. This was an ecological study with secondary data, where the principal exposures were prevalence rates for excess weight and obesity, estimated with data from Brazil's Vigitel survey (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interveiew) in 2014 and Argentina's National Risk Factor Survey in 2013. Overall and specific mortality rates for the year 2015 were obtained from the Brazilian Mortality Information System in the Brazilian Health Informatics Department and the Division of Health Statistics and Information of the Argentine Ministry of Health. Brazilian mortality rates were standardized with the age structure of the Argentine population as the standard. Crude and adjusted linear regressions were used to assess the association between the prevalence rates for excess weight and obesity and the overall and specific mortality rates. After adjusting for potential confounding factors, prevalence of obesity was positively associated with the overall mortality rate both in Brazil (β = 0.18; 95%CI: 0.01; 0.35) and in Argentina (β = 0.06; 95%CI: 0.01; 0.13). There was no association with the specific cardiovascular and cancer mortality rates. We conclude that the Brazilian state capitals and Argentine provinces with the highest prevalence of obesity present higher overall mortality rates, while this association was inconsistent for the specific rates.
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Affiliation(s)
- Valeria Romina Amann
- Programa de Pós-graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas, Brasil
| | | | - Denise Petrucci Gigante
- Programa de Pós-graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Pelotas, Brasil.,Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
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Lopina EA, Dushina AG, Libis RA. The effect of the metabolically unhealthy obese phenotype on the vascular wall of the carotid arteries in patients with arterial hypertension who had acute cerebrovascular accident. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2019. [DOI: 10.15829/1728-8800-2019-5-5-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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17
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Xu R, Gao X, Wan Y, Fan Z. Association of Metabolically Healthy Overweight Phenotype With Abnormalities of Glucose Levels and Blood Pressure Among Chinese Adults. JAMA Netw Open 2019; 2:e1914025. [PMID: 31651967 PMCID: PMC6822082 DOI: 10.1001/jamanetworkopen.2019.14025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
IMPORTANCE Whether the metabolically healthy overweight (MHO) phenotype is resistant to metabolic abnormalities remains unknown. OBJECTIVE To evaluate the association of MHO with glucose level abnormalities and high blood pressure (BP) in Chinese adults. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from January 1, 2013, to October 31, 2018, in the Health Management Center at Ren Ji Hospital, Shanghai, China, using data from 55 155 recruited Chinese adults. Body weight, fasting blood glucose (FBG) level, hemoglobin A1c (HbA1c) level, and BP were measured annually. EXPOSURES Metabolically healthy overweight was defined as a body mass index (calculated as weight in kilograms divided by height in meters squared) of 24.0 in 2013 (baseline) and 2014, no history of metabolic diseases, and normal FBG level, HbA1c level, BP, lipid profile, serum uric acid level, and liver ultrasonographic findings at baseline; the remaining participants were defined as being metabolically healthy normal. MAIN OUTCOMES AND MEASURES Glucose level abnormality was confirmed if the FBG level was 101 mg/dL or greater or the HbA1c level was 5.7%, and high BP was confirmed if the systolic BP was 130 mm Hg or higher or the diastolic BP was 80 mm Hg or higher at least twice during the subsequent 4 years of follow-up. RESULTS A total of 3204 metabolically healthy Chinese adults (mean [SD] age, 39.8 [10.9] years; 1940 women [60.5%]) were included in the study. The prevalence of MHO was 7.0%. A total of 146 incident cases of glucose level abnormality and 220 cases of high BP during 4 years of follow-up were identified. Compared with the metabolically healthy normal group, the MHO group had a higher risk of glucose level abnormality (adjusted hazard ratio, 2.36; 95% CI, 1.52-3.64) and high BP (adjusted hazard ratio, 1.73; 95% CI, 1.18-2.53) after adjusting for several potential confounders. CONCLUSIONS AND RELEVANCE Metabolically healthy overweight may be associated with a high future risk of glucose abnormality and high BP in Chinese adults. If the individuals are confirmed with MHO, early interventions, including diet and exercise, should be recommended to decrease the risk of developing abnormalities of glucose and BP.
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Affiliation(s)
- Renying Xu
- Ren Ji Hospital, School of Medicine, Department of Clinical Nutrition, Shanghai Jiao Tong University, Shanghai, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park
| | - Yanping Wan
- Ren Ji Hospital, School of Medicine, Department of Clinical Nutrition, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuping Fan
- Ren Ji Hospital, School of Medicine, Department of Digestion, Shanghai Jiao Tong University, Shanghai, China
- Ren Ji Hospital, School of Medicine, Department of Health Management, Shanghai Jiao Tong University, Shanghai, China
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Puzianowska-Kuznicka M, Kuryłowicz A, Walkiewicz D, Borkowska J, Owczarz M, Olszanecka-Glinianowicz M, Wieczorowska-Tobis K, Skalska A, Szybalska A, Mossakowska M. Obesity Paradox in Caucasian Seniors: Results of the PolSenior Study. J Nutr Health Aging 2019; 23:796-804. [PMID: 31641728 PMCID: PMC6800404 DOI: 10.1007/s12603-019-1257-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/19/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To investigate the influence of overweight and obesity on general performance and mortality in seniors. DESIGN Cross-sectional multidisciplinary study on ageing of the Polish population. SETTING Community-dwelling individuals aged 65 years or older, selected using three-stage stratified, proportional draw. PARTICIPANTS 4944 Polish Caucasian seniors, aged 65 years or older recruited between October 2007 and October 2010. MEASUREMENTS All study subjects underwent measurement of body mass index (BMI), waist circumference (WC), and arm circumference (AC). The physical and cognitive performance was evaluated using the Katz Activities of Daily Living (ADL) score and Mini-Mental State Examination (MMSE), respectively. Morbidity data were obtained from a medical questionnaire. Mortality data were obtained from the Population Register of Poland between October 2015 and October 2018. RESULTS Increasing age was associated with a decreased prevalence of obesity (all p<0.001). Higher BMI, WC and AC values were associated with higher ADL and MMSE scores (all p<0.001). On multivariate analysis, all three body measurements in women remained independent predictors of the ADL score (BMI p=0.002, WC p=0.005, AC p<0.001) and MMSE score (p<0.001, p=0.003, p<0.001). In men, physical functioning was associated with AC (p=0.003), and cognitive status was associated with AC (p<0.001) and BMI (p=0.013). There was no association between general obesity, abdominal obesity, or AC with several aging-related adverse conditions. Kaplan-Meier survival curves showed that overweight and obesity were associated with the lowest mortality. On multivariate analysis, BMI and AC values remained independent predictors of mortality. In successfully aging individuals, neither BMI, WC, nor AC remained such predictors. CONCLUSIONS Overweight and obesity in Caucasian seniors are not associated with deterioration of physical and cognitive function or with increased mortality.
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Affiliation(s)
- M Puzianowska-Kuznicka
- Monika Puzianowska-Kuznicka, MD, PhD, Department of Human Epigenetics, Mossakowski Medical Research Centre, PAS, Pawinskiego 5, 02-106 Warsaw, Poland; phone/fax: +48 22 6086591;
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Tsabar N, Press Y, Rotman J, Klein B, Grossman Y, Vainshtein-Tal M, Eilat-Tsanani S. The low indexes of metabolism intervention trial (LIMIT): design and baseline data of a randomized controlled clinical trial to evaluate how alerting primary care teams to low metabolic values, could affect the health of patients aged 75 or older. BMC Health Serv Res 2018; 18:4. [PMID: 29301522 PMCID: PMC5755463 DOI: 10.1186/s12913-017-2812-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 12/18/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Too-low body mass index (BMI), HbA1c% or cholesterol levels predicts poor survival. This study investigates whether e-mails about these low values, improve health of people older than 75 years. METHODS LIMIT - an open label randomized trial - compares usual care to the addition of an e-mail which alerts the family physicians and nurses to low metabolic indexes of a specific patient and advises on nutritional and medical changes. PARTICIPANTS Clalit Health Services (CHS) patients in the Northern and Southern Districts, aged ≥75 years with any of the following inclusion criteria: a. Significant weight loss: BMI < 23 kg/m2 with BMI drop of ≥2 kg/m2 during previous two years and without dietitian counseling during previous year. b. Tight diabetic control: HbA1c% ≤ 6.5% and received anti-diabetic medicines during previous 2 months. c. Drug associated hypocholesterolemia: total cholesterol <160 mg/dL and received cholesterol-lowering medicines during previous 2 months. Excluded from criterion c, were patients diagnosed with either ischemic heart disease, transient ischemic attack or stroke. The primary outcome was death from any cause, within one year. In a population of 48,623 people over the age of 75 years, 8584 (17.7%) patients were identified with low metabolic indices and were randomized to intervention or control groups. E-mails were sent on November 2015 to physicians and nurses at 383 clinics. DISCUSSION Low metabolic reserve is common in people in Israel's peripheral districts aged ≥75 years. LIMIT may show whether alerting primary care staff is beneficial. TRIAL REGISTRATION ClinicalTrials.gov NCT02476578 . Registered on June 11, 2015.
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Affiliation(s)
- Nir Tsabar
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed; Unit for Ambulatory Geriatric Services, CHS Northern District, Israel
| | - Yan Press
- Unit for Ambulatory Geriatric Services, CHS Southern District and Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Shlomo-Hamelech 17, 8454931 Beer Sheva, Israel
| | - Johanna Rotman
- Educational Programs, CHS Northern District, Shadmot Dvora, Israel
| | - Bracha Klein
- Unit for Ambulatory Geriatric Services, CHS Northern District, Migdal Haemek, Israel
| | - Yonatan Grossman
- Azrieli Faculty of Medicine in Galilee, Bar-Ilan University, Safed; Unit for Home Care, CHS Northern District, Israel
| | - Maya Vainshtein-Tal
- Unit for Clinical Nutrition and Dietetics, CHS Northern District, Afula, Israel
| | - Sophia Eilat-Tsanani
- The Department of Family Medicine, Azrieli Faculty of Medicine, Bar-Ilan University, Safed; The Department of Family Medicine, Clalit Health Services, North district, Israel
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20
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Lee WJ, Peng LN, Loh CH, Chen LK. Effect of Body Weight, Waist Circumference and Their Changes on Mortality: a 10-Year Population-based Study. J Nutr Health Aging 2018; 22:959-964. [PMID: 30272100 DOI: 10.1007/s12603-018-1042-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To investigate the effect of body weight, waist circumference and their changes on all-cause and cardiovascular mortality. DESIGN A nationwide population-based cohort study. PARTICIPANTS 627 community-dwelling older adults. MEASUREMENTS Participants were interviewed for demographic and anthropometric data collected. Blood were drawn for testing biochemistry data. Central obesity was defined as waist circumference is greater than 80 cm for women and 90 cm for men. Obesity, overweight, normal and underweight were defined as BMI ≥27 kg/m2 , ≥24 kg/m2 ,18.5-24 kg/m2 and < 18.5 kg/m2. Cox proportion hazard model was used to explore the impact of body weight and its change on mortality. RESULTS The distribution of weight changes and mortality was right skewed, but U-shape of waist change for all-cause mortality was observed. Compared to normal BMI at baseline, the association between underweight (HR: 1.7, 95% CI: 0.7-4.0), overweight (HR:0.7, 95% CI:0.4-1.2) and obesity (HR:1.3,95% CI:0.8-2.3) showed insignificantly associated with all-cause mortality. The HR of those weight loss >5% (HR: 1.7, 95% CI: 1.1-2.8) and waist decrease >5% (HR: 1.7, 95% CI: 1.0-2.8) were higher than those of stable weight/waist +/- 5% over a 6-year period. Compared to those stable weight/waist, the mortality risk was similar in those of weight gain or waist increase (HR 0.7,95%CI: 0.4-1.5 and HR:0.9, 95%CI:0.4-1.6). CONCLUSION Weight loss and waist decrease were significantly associated with long-term mortality risk, a life-course approach for body weight management is needed to pursuit the most optimal health benefits for the middle-aged and older adults.
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Affiliation(s)
- W-J Lee
- Liang-Kung Chen, MD, PhD, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan, No 201, Sec 2 Shih-Pai Road, Taipei, Taiwan 112, Tel: +886-2-28757830, Fax:+886-2-28757711,
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Jésus P, Guerchet M, Pilleron S, Fayemendy P, Maxime Mouanga A, Mbelesso P, Preux PM, Desport JC. Undernutrition and obesity among elderly people living in two cities of developing countries: Prevalence and associated factors in the EDAC study. Clin Nutr ESPEN 2017; 21:40-50. [PMID: 30014868 DOI: 10.1016/j.clnesp.2017.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/24/2017] [Accepted: 05/30/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Nutritional status among elderly people living in Sub-Saharan Africa is poorly studied, even though undernutrition and obesity are known to cause many complications and are risk factors for progression and death in several diseases. The aims of this study were to assess the nutritional status of the elderly in Central Africa and to study the factors associated with nutritional disorders (undernutrition and obesity). METHODS Two cross-sectional population-based studies were carried out in the capitals of Central African Republic (CAR) and Republic of Congo (ROC) between 2008 and 2009. Participants were aged ≥65 years old and underwent nutritional assessment including the following measurements: weight, height, body mass index (BMI), waist circumference (WC). Diet was also investigated. Nutritional status was defined according to the WHO BMI classification (<18.5 = undernutrition; ≥30 = obesity). Multinomial regression analysis was performed in order to identify factors associated with nutritional status. RESULTS 990 elderly people underwent nutritional assessment (482 in CAR and 508 in ROC). Mean BMI was 22.7 ± 4.8 kg/m2. The prevalence of undernutrition was 19.2% and was lower in ROC than in CAR (9.5% vs. 29.5%; p < 0.0001). The prevalence of obesity was 8.8% and was higher in ROC than in CAR (14.6% vs. 2.7%; p < 0.0001). The mean WC was 85.3 ± 28.4 cm. Adjusted on study site, increasing age (OR = 1.6 [95% CI: 1.1-2.3] for 75-84 years, OR = 2.6 [95% CI: 1.4-4.8] for 85+ years), occupation as farmer/breeder (OR = 2.2 [95% CI: 1.1-4.2]), smoking (OR = 1.71 [95% CI: 1.14-2.56]) and low sugar consumption (OR = 1.7 [95% CI: 1.1-2.7]) were positively associated with undernutrition whereas only female sex was positively associated with obesity (OR = 5.0 [95% CI: 2.2-11.0]). CONCLUSIONS The prevalence of undernutrition is high in the elderly population of these countries, in contrast to obesity. Undernutrition and obesity are associated with different socio-economic factors and food consumption. Simple nutritional advice could contribute to improving the nutritional status of elderly people in Central Africa.
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Affiliation(s)
- Pierre Jésus
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France.
| | - Maëlenn Guerchet
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, UK
| | - Sophie Pilleron
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Philippe Fayemendy
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
| | - Alain Maxime Mouanga
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Psychiatry Department, University Hospital of Brazzaville, Brazzaville, Congo
| | - Pascal Mbelesso
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Neurology Department, Amitié Hospital, Bangui, Central African Republic
| | - Pierre Marie Preux
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Medical Information & Evaluation, Clinical Research and Biostatistics Unit, University Hospital of Limoges, Limoges, France
| | - Jean Claude Desport
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
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Rodríguez-Carrio J, López P, Sánchez B, González S, Gueimonde M, Margolles A, de Los Reyes-Gavilán CG, Suárez A. Intestinal Dysbiosis Is Associated with Altered Short-Chain Fatty Acids and Serum-Free Fatty Acids in Systemic Lupus Erythematosus. Front Immunol 2017; 8:23. [PMID: 28167944 PMCID: PMC5253653 DOI: 10.3389/fimmu.2017.00023] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/05/2017] [Indexed: 12/21/2022] Open
Abstract
Metabolic impairments are a frequent hallmark of systemic lupus erythematosus (SLE). Increased serum levels of free fatty acids (FFA) are commonly found in these patients, although the underlying causes remain elusive. Recently, it has been suggested that factors other than inflammation or clinical features may be involved. The gut microbiota is known to influence the host metabolism, the production of short-chain fatty acids (SCFA) playing a potential role. Taking into account that lupus patients exhibit an intestinal dysbiosis, we wondered whether altered FFA levels may be associated with the intestinal microbial composition in lupus patients. To this aim, total and specific serum FFA levels, fecal SCFA levels, and gut microbiota composition were determined in 21 SLE patients and 25 healthy individuals. The Firmicutes to Bacteroidetes (F/B) ratio was strongly associated with serum FFA levels in healthy controls (HC), even after controlling for confounders. However, this association was not found in lupus patients, where a decreased F/B ratio and increased FFA serum levels were noted. An altered production of SCFA was related to the intestinal dysbiosis in lupus, while SCFA levels paralleled those of serum FFA in HC. Although a different serum FFA profile was not found in SLE, specific FFA showed distinct patterns on a principal component analysis. Immunomodulatory omega-3 FFA were positively correlated to the F/B ratio in HC, but not in SLE. Furthermore, divergent associations were observed for pro- and anti-inflammatory FFA with endothelial activation biomarkers in lupus patients. Overall, these findings support a link between the gut microbial ecology and the host metabolism in the pathological framework of SLE. A potential link between intestinal dysbiosis and surrogate markers of endothelial activation in lupus patients is supported, FFA species having a pivotal role.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Patricia López
- Area of Immunology, Department of Functional Biology, University of Oviedo , Oviedo, Asturias , Spain
| | - Borja Sánchez
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Sonia González
- Area of Physiology, Department of Functional Biology, University of Oviedo , Oviedo, Asturias , Spain
| | - Miguel Gueimonde
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Abelardo Margolles
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Clara G de Los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Ana Suárez
- Area of Immunology, Department of Functional Biology, University of Oviedo , Oviedo, Asturias , Spain
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Shlisky J, Bloom DE, Beaudreault AR, Tucker KL, Keller HH, Freund-Levi Y, Fielding RA, Cheng FW, Jensen GL, Wu D, Meydani SN. Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease. Adv Nutr 2017; 8:17-26. [PMID: 28096124 PMCID: PMC5227979 DOI: 10.3945/an.116.013474] [Citation(s) in RCA: 228] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
A projected doubling in the global population of people aged ≥60 y by the year 2050 has major health and economic implications, especially in developing regions. Burdens of unhealthy aging associated with chronic noncommunicable and other age-related diseases may be largely preventable with lifestyle modification, including diet. However, as adults age they become at risk of "nutritional frailty," which can compromise their ability to meet nutritional requirements at a time when specific nutrient needs may be high. This review highlights the role of nutrition science in promoting healthy aging and in improving the prognosis in cases of age-related diseases. It serves to identify key knowledge gaps and implementation challenges to support adequate nutrition for healthy aging, including applicability of metrics used in body-composition and diet adequacy for older adults and mechanisms to reduce nutritional frailty and to promote diet resilience. This review also discusses management recommendations for several leading chronic conditions common in aging populations, including cognitive decline and dementia, sarcopenia, and compromised immunity to infectious disease. The role of health systems in incorporating nutrition care routinely for those aged ≥60 y and living independently and current actions to address nutritional status before hospitalization and the development of disease are discussed.
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Affiliation(s)
- Julie Shlisky
- The Sackler Institute for Nutrition Science at the New York Academy of Sciences, New York, NY;
| | - David E Bloom
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA
| | | | - Katherine L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging, Applied Health Sciences, University of Waterloo, Ontario, Canada
| | - Yvonne Freund-Levi
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Department of Geriatrics, Karolinska University Hospital, Huddinge, Sweden
- Department of Psychiatry, Tiohundra Hospital, Stockholm, Sweden
| | | | - Feon W Cheng
- The Pennsylvania State University, University Park, PA; and
| | | | - Dayong Wu
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Simin N Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
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