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Dagbasi A, Warner J, Catterall V, Smith K, Crabtree DR, Carroll B, Frost G, Holliday A. Augmented gut hormone response to feeding in older adults exhibiting low appetite. Appetite 2024; 201:107415. [PMID: 38761969 DOI: 10.1016/j.appet.2024.107415] [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: 12/21/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
Age-related changes in gut hormones may play a role in anorexia of ageing. The aim of this study was to determine concentrations of ghrelin, PYY, and GLP-1 in older adults exhibiting an anorexia of ageing phenotype. Thirteen older adults with healthy appetite (OA-HA; 8f, 75 ± 7 years, 26.0 ± 3.2 kg m-2), fifteen older adults with low appetite (OA-LA; 10f, 72 ± 7 years, 23.6 ± 3.1 kg m-2), and twelve young adults (YA; 6f, 22 ± 2 years, 24.4 ± 2.0 kg m-2) completed the study. Healthy appetite and low appetite were determined based on BMI, habitual energy intake, self-reported appetite, and laboratory-assessed ad libitum lunch intake. Participants provided a fasted measure of subjective appetite and blood sample (0 min) before consuming a standardised breakfast (450 kcal). Appetite was measured and blood samples were drawn throughout a 240-min rest period. At 240 min, an ad libitum lunch meal was consumed. Relative intake at lunch (expressed as percentage of estimated total energy requirement) was lower for OA-LA (19.8 ± 7.7%) than YA (41.5 ± 9.2%, p < 0.001) and OA-HA (37.3 ± 10.0%, p < 0.001). Ghrelin suppression was greater for OA-LA (net AUC, -78719 ± 74788 pg mL-1·240min-1) than both YA (-23899 ± 27733 pg mL-1·240min-1, p = 0.016) and OA-HA (-21144 ± 31161 pg mL-1·240min-1, p = 0.009). There were trends for higher GLP-1 concentrations in OA-LA compared with YA at 90 min (8.85 ± 10.4 pM vs. 1.88 ± 4.63 pM, p = 0.073) and 180 min (5.00 ± 4.71 pM vs. 1.07 ± 2.83 pM, p = 0.065). There was a trend for a greater PYY response for OA-LA compared with OA-HA (net AUC p = 0.062). "Anorexigenic response score" - a composite score of gut hormone responses to feeding - showed greater anorexigenic response in OA-LA, compared with YA and OA-HA. No differences were seen in subjective appetite. These observations suggest augmented anorexigenic responses of gut hormones to feeding may be causal mechanisms of anorexia of ageing.
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Affiliation(s)
- Aygul Dagbasi
- Section of Nutrition, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London, UK
| | - Jordan Warner
- School of Biomedical, Nutritional, and Sport Science, Newcastle University, Newcastle Upon Tyne, UK
| | - Victoria Catterall
- School of Biomedical, Nutritional, and Sport Science, Newcastle University, Newcastle Upon Tyne, UK
| | - Kieran Smith
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Daniel R Crabtree
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Bernadette Carroll
- School of Biochemistry, University of Bristol, University Walk, Bristol, UK
| | - Gary Frost
- Section of Nutrition, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London, UK
| | - Adrian Holliday
- School of Biomedical, Nutritional, and Sport Science, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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Cui G, Zhang S, Zhang X, Li S. Development and validation of a nomogram for predicting anorexia of aging in older people. Appetite 2024; 201:107606. [PMID: 39029530 DOI: 10.1016/j.appet.2024.107606] [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: 05/17/2024] [Revised: 06/24/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Anorexia of aging (AA) is a common geriatric syndrome that seriously endangers the health of older adults. Early identification of populations at risk of AAand the implementation of appropriate intervention measures hold significant public health importance. This study aimed to develop a nomogram for predicting the risk of AA among older people. METHODS We conducted a cross-sectional study involving 2144 community-dwelling older adults to evaluate the AA using the Simplified Nutritional Appetite Questionnaire. We utilized the Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression analysis to select variables and develop a nomogram prediction model. The predictive performance of the nomogram was evaluated using the Receiver Operating Characteristic (ROC) curves, calibration curves, Decision Curve Analysis (DCA), and internal validation. RESULTS The prevalence of AA among Chinese older adults was 21.7% (95%CI: 20.0%-23.5%). Age, sex, family economic level, smoking status, dysphagia, loneliness, depressive symptoms, living alone, health literacy, life satisfaction, and body mass index have been identified as predictive factors for AA among older people. The nomogram constructed based on these predictive factors showed an area under the curve (AUC) of 0.766 (95%CI: 0.742-0.791), indicating good calibration and discrimination ability. Additionally, the results obtained from the 10-fold cross-validation process confirmed the nomogram's good predictive capabilities. Furthermore, the DCA results showed that the nomogram has clinical utility. CONCLUSION The nomogram constructed in this study serves as an effective tool for predicting anorexia of aging among community-dwelling older adults. Its implementation can help community healthcare workers evaluate the risk of AA in this population and identify high-risk groups.
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Affiliation(s)
- Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Shengkai Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Xiaochen Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China.
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Holliday A, Warner J, Hulston CJ, Corfe BM, Crabtree DR. Anorexia of ageing is associated with elevated fasted and lower post-prandial ghrelin, independent of ghrelin O-acyltransferase. Appetite 2024; 196:107259. [PMID: 38341037 DOI: 10.1016/j.appet.2024.107259] [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: 12/02/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
The role of ghrelin metabolism in anorexia of ageing is unclear. The aim of this study was to determine acyl-ghrelin, total ghrelin, and ghrelin O-acyltransferase concentrations when fasted and in responses to feeding in older adults exhibiting anorexia of ageing. Twenty-five older adults (OA; 15f, 74 ± 7 years, 24.5 kg·m-2) and twelve younger adults (YA; 6f, 21 ± 2 years, 24.4 kg·m-2) provided a fasted measure of subjective appetite and fasted blood sample (0 min) before consuming a standardised porridge breakfast meal (450 kcal). Appetite was measured every 30 min for 240 min and blood was sampled at 30, 60, 90, 120, 180 and 240 min while participants rested. At 240 min, an ad libitum pasta-based lunch meal was consumed. Older adults were identified as those with healthy appetite (HA-OA) or low appetite (LA-OA), based on habitual energy intake, self-report appetite, BMI, and ad libitum lunch intake. YA ate more at lunch (1108 ± 235 kcal) than HA-OA (653 ± 133 kcal, p = 0.007) and LA-OA (369 ± 168 kcal; p < 0.001). LA-OA, but not HA-OA, had higher fasted concentrations of acyl- and total ghrelin than YA (acyl-ghrelin: 621 ± 307 pg·mL-1 vs. 353 ± 166 pg·mL-1, p = 0.047; total ghrelin: 1333 ± 702 pg·mL-1 vs. 636 ± 251 pg·mL-1, p = 0.006). Acyl-ghrelin (60 min and 90 min) and total ghrelin (90 min) were suppressed to a greater extent for LA-OA than for YA (p < 0.05). No differences were observed in subjective appetite, acyl-to-total ghrelin ratio, or plasma GOAT content (p > 0.1). Higher fasting ghrelin and an augmented ghrelin response to feeding in LA-OA, but not HA-OA, suggests that alterations to ghrelin metabolism are not functions of ageing per se and may be independent causal mechanisms of anorexia of ageing.
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Affiliation(s)
- Adrian Holliday
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Jordan Warner
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Carl J Hulston
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Bernard M Corfe
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Daniel R Crabtree
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Zhao X, Meng L, Wang D, Shi J, Wu W, Fan G, Shi H, Dong J, Yu P, Yang R. Targeted metabolomic profiles of serum amino acids are independently correlated with malnutrition in older adults. BMC Geriatr 2024; 24:341. [PMID: 38622502 PMCID: PMC11020810 DOI: 10.1186/s12877-024-04937-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/31/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Malnutrition is a common geriatric syndrome that is closely associated with adverse clinical outcomes and poses significant harm to older adults. Early assessment of nutritional status plays a crucial role in preventing and intervening in cases of malnutrition. However, there is currently a lack of measurable methods and biomarkers to evaluate malnutrition in older adults accurately. The aim of this study is to investigate the independent correlation between serum levels of amino acids and malnutrition in older adults, and to identify effective metabolomics biomarkers that can aid in the early detection of geriatric malnutrition. METHODS A total of 254 geriatric medical examination participants from Beijing Hospital were included in the study, consisting of 182 individuals with normal nutritional status (Normal group) and 72 patients at risk of malnutrition or already malnourished (MN group). Malnutrition was assessed using the Mini-Nutritional Assessment Short-Form (MNA-SF). Demographic data were collected, and muscle-related and lipid indexes were determined. Serum amino acid concentrations were measured using isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). The correlation between serum amino acid levels and malnutrition was analyzed using non-parametric tests, partial correlation analysis, linear regression, and logistic regression. RESULTS The geriatric MN group exhibited significantly lower serum aromatic amino acid levels (P < 0.05) compared to the normal group. A positive correlation was observed between serum aromatic amino acid levels and the MNA-SF score (P = 0.002), as well as with known biomarkers of malnutrition such as body mass index (BMI) (P < 0.001) and hemoglobin (HGB) (P = 0.005). Multivariable logistic or linear regression analyses showed that aromatic amino acid levels were negatively correlated with MN and positively correlated with the MNA-SF score, after adjusting for some confounding factors, such as age, gender, BMI, smoking status, history of dyslipidemia, diabetes mellitus and frailty. Stratified analyses revealed that these trends were more pronounced in individuals without a history of frailty compared to those with a history of frailty, and there was an interaction between aromatic amino acid levels and frailty history (P = 0.004). CONCLUSION Our study suggests that serum aromatic amino acids are independently associated with malnutrition in older adults. These results have important implications for identifying potential biomarkers to predict geriatric malnutrition or monitor its progression and severity, as malnutrition can result in poor clinical outcomes.
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Affiliation(s)
- Xianghui Zhao
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Li Meng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Daguang Wang
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jing Shi
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Wenbin Wu
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Guoqing Fan
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, National Clinical Research Center for Geriatrics, Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Jun Dong
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Pulin Yu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China.
| | - Ruiyue Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, 100730, Beijing, China.
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Döschner L, Schulze K, Göger L, Bosy-Westphal A, Krüger N, Franz K, Müller-Werdan U, Herpich C, Norman K. Effects of a Short-Term Vegan Challenge in Older Adults on Metabolic and Inflammatory Parameters-A Randomized Controlled Crossover Study. Mol Nutr Food Res 2024; 68:e2300623. [PMID: 38185769 DOI: 10.1002/mnfr.202300623] [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: 09/01/2023] [Revised: 11/20/2023] [Indexed: 01/09/2024]
Abstract
SCOPE A long-term vegan diet carries the risk of insufficient protein and micronutrient intake for older adults. However, even a short-term (48 h) vegan diet exerts positive metabolic effects in younger adults. In this study, we investigate the feasibility and effects of a short-term vegan challenge on metabolic and inflammatory markers in older adults. METHOD AND RESULTS In this randomized controlled crossover-study, 30 healthy older adults (≥65 years) are assigned to either a 48 h ad libitum vegan or omnivorous diet. During the vegan diet, participants exhibit lower protein (p = 0.001) and fat intake as well as higher carbohydrate and dietary fiber intake, resulting in a lower caloric intake (all p < 0.001). Insulin concentrations (p = 0.042) and insulin resistance (p = 0.036) decline only after the vegan diet. The study observes reductions in serum glucose (p < 0.001), triglyceride (p = 0.005), and hsCRP (p = 0.044) concentrations and weight (p < 0.001), independent of the diet. Participants with low-grade inflammation exhibit notable metabolic improvements after the vegan diet. CONCLUSION Improvements in insulin homeostasis are observed after the vegan diet, but meeting protein requirements are not feasible during the short-term vegan challenge despite dietary counseling, which warrants concern.
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Affiliation(s)
- Lary Döschner
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Kora Schulze
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Lea Göger
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558, Nuthetal, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, 24098, Kiel, Germany
| | - Nele Krüger
- Institute of Nutritional Science, University of Potsdam, 14558, Nuthetal, Germany
| | - Kristina Franz
- Experimental and Clinical Research Center, a cooperation between Charité - Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, 13125, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Max Delbrück Center, 13125, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, 10785, Berlin, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Evangelisches Geriatriezentrum Berlin gGmbH, 13347, Berlin, Germany
| | - Catrin Herpich
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558, Nuthetal, Germany
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, 14558, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, 14558, Nuthetal, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, 10785, Berlin, Germany
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Anderson KC, Hasan F, Grammer EE, Kranz S. Endogenous Ghrelin Levels and Perception of Hunger: A Systematic Review and Meta-Analysis. Adv Nutr 2023; 14:1226-1236. [PMID: 37536563 PMCID: PMC10509419 DOI: 10.1016/j.advnut.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/11/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Ghrelin is an orexigenic hormone primarily released by the stomach and has 2 isoforms: acylated ghrelin (AG) and de-acylated ghrelin (DAG), that appear to have different functions in humans. OBJECTIVES To perform a systematic review and meta-analysis of the association between plasma concentrations of total ghrelin (TG), AG, and DAG and perceptions of hunger in healthy adults. METHODS The following criteria were used for inclusion: 1) sample contained adults ≥18 y of age, 2) body mass index [BMI kg/m2] was ≥18.5, 3) ghrelin was sampled through blood, 4) subjective hunger was measured on a validated scale, 5) study reported a Pearson product correlation of ghrelin or had relevant figure(s) for data extraction, 6) participants were healthy with no overt disease, 7) protocols contained no physical activity or weight loss medication that suppressed appetite, 8) interventions were conducted without environmental manipulations. Moderators assessed were age, BMI, percentage of body fat (%BF), macronutrient content of test meals, energy intake (kcals), sex, and ghrelin isoform (AG, DAG, or TG). RESULTS The analysis included 47 studies (110 trials, n = 1799, age: 31.4 ± 12.0 y, BMI: 26.0 ± 4.75 kg/m2) and measured AG (n = 47 trials), DAG (n = 12 trials), and TG (n = 51 trials). The overall model indicated that ghrelin concentrations and perceptions of hunger were moderately correlated (r = 0.43, P < 0.001), and ghrelin isoform significantly moderated this relationship (AG: r = 0.60, P < 0.001; TG: r = 0.215, P = 0.01; DAG: r = 0.53, P = 0.695). Other significant moderators included age (b = -0.02, P = 0.01), BMI (b = -0.03, P = 0.05), %BF (b = -0.03, P = 0.05), energy intake (b = 0.0003, P = 0.04), and percentage of carbohydrates of test meals (b = 0.008, P = 0.05). CONCLUSIONS Ghrelin is associated with perceptions of hunger in humans, and this relationship is strengthened when AG is isolated; thus, AG may have a large impact on hunger signals in various populations. Future research should attempt to understand the role of DAG in hunger sensations.
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Affiliation(s)
- Kara C Anderson
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Faten Hasan
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Emily E Grammer
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Sibylle Kranz
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, VA, United States.
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Malnutrition in Older Adults-Recent Advances and Remaining Challenges. Nutrients 2021; 13:nu13082764. [PMID: 34444924 PMCID: PMC8399049 DOI: 10.3390/nu13082764] [Citation(s) in RCA: 241] [Impact Index Per Article: 80.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/04/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022] Open
Abstract
Malnutrition in older adults has been recognised as a challenging health concern associated with not only increased mortality and morbidity, but also with physical decline, which has wide ranging acute implications for activities of daily living and quality of life in general. Malnutrition is common and may also contribute to the development of the geriatric syndromes in older adults. Malnutrition in the old is reflected by either involuntary weight loss or low body mass index, but hidden deficiencies such as micronutrient deficiencies are more difficult to assess and therefore frequently overlooked in the community-dwelling old. In developed countries, the most cited cause of malnutrition is disease, as both acute and chronic disorders have the potential to result in or aggravate malnutrition. Therefore, as higher age is one risk factor for developing disease, older adults have the highest risk of being at nutritional risk or becoming malnourished. However, the aetiology of malnutrition is complex and multifactorial, and the development of malnutrition in the old is most likely also facilitated by ageing processes. This comprehensive narrative review summarizes current evidence on the prevalence and determinants of malnutrition in old adults spanning from age-related changes to disease-associated risk factors, and outlines remaining challenges in the understanding, identification as well as treatment of malnutrition, which in some cases may include targeted supplementation of macro- and/or micronutrients, when diet alone is not sufficient to meet age-specific requirements.
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Appetite Control across the Lifecourse: The Acute Impact of Breakfast Drink Quantity and Protein Content. The Full4Health Project. Nutrients 2020; 12:nu12123710. [PMID: 33266325 PMCID: PMC7759987 DOI: 10.3390/nu12123710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
Understanding the mechanisms of hunger, satiety and how nutrients affect appetite control is important for successful weight management across the lifecourse. The primary aim of this study was to describe acute appetite control across the lifecourse, comparing age groups (children, adolescents, adults, elderly), weight categories, genders and European sites (Scotland and Greece). Participants (n = 391) consumed four test drinks, varying in composition (15% (normal protein, NP) and 30% (high protein, HP) of energy from protein) and quantity (based on 100% basal metabolic rate (BMR) and 140% BMR), on four separate days in a double-blind randomized controlled study. Ad libitum energy intake (EI), subjective appetite and biomarkers of appetite and metabolism (adults and elderly only) were measured. The adults' appetite was significantly greater than that of the elderly across all drink types (p < 0.004) and in response to drink quantities (p < 0.001). There were no significant differences in EI between age groups, weight categories, genders or sites. Concentrations of glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) were significantly greater in the elderly than the adults (p < 0.001). Ghrelin and fasting leptin concentrations differed significantly between weight categories, genders and sites (p < 0.05), while GLP-1 and PYY concentrations differed significantly between genders only (p < 0.05). Compared to NP drinks, HP drinks significantly increased postprandial GLP-1 and PYY (p < 0.001). Advanced age was concomitant with reduced appetite and elevated anorectic hormone release, which may contribute to the development of malnutrition. In addition, appetite hormone concentrations differed between weight categories, genders and geographical locations.
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Duszka K, Gregor A, Reichel MW, Baierl A, Fahrngruber C, König J. Visual stimulation with food pictures in the regulation of hunger hormones and nutrient deposition, a potential contributor to the obesity crisis. PLoS One 2020; 15:e0232099. [PMID: 32330183 PMCID: PMC7182185 DOI: 10.1371/journal.pone.0232099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/07/2020] [Indexed: 12/11/2022] Open
Abstract
Food cues affect hunger and nutritional choices. Omnipresent stimulation with palatable food contributes to the epidemics of obesity. The objective of the study was to investigate the impact of food cues on appetite-related hormones and to assess the functionality of the secreted hormones on macronutrient uptake in healthy subjects. Additionally, we aimed at verifying differences in the response of total and active ghrelin to stimulation with food pictures and to a meal followed by the stimulation. We were also interested in the identification of factors contributing to response to food cues. We recruited healthy, non-obese participants for two independent cross-over studies. During the first study, the subjects were presented random non-food pictures on the first day and pictures of foods on the second day of the study. Throughout the second study, following the picture session, the participants were additionally asked to drink a milkshake. Concentrations of blood glucose, triglycerides and hunger-related hormones were measured. The results showed that concentrations of several hormones measured in the blood are interdependent. In the case of ghrelin and gastric inhibitory peptide (GIP) as well as ghrelin and glucagon-like peptide-1 (GLP-1), this co-occurrence relies on the visual cues. Regulation of total ghrelin concentration following food stimulation is highly individual and responders showed upregulated total ghrelin, while the concentration of active ghrelin decreases following a meal. Protein content and colour intensity of food pictures reversely correlated with participants’ rating of the pictures. We conclude that observation of food pictures influences the concentration of several appetite-related hormones. The close link of visual clues to physiological responses is likely of clinical relevance. Additionally, the protein content of displayed foods and green colour intensity in pictures may serve as a predictor of subjective attractiveness of the presented meal.
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Affiliation(s)
- Kalina Duszka
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- * E-mail:
| | - András Gregor
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | | | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Vienna, Austria
| | | | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
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Giezenaar C, Luscombe-Marsh ND, Hutchison AT, Standfield S, Feinle-Bisset C, Horowitz M, Chapman I, Soenen S. Dose-Dependent Effects of Randomized Intraduodenal Whey-Protein Loads on Glucose, Gut Hormone, and Amino Acid Concentrations in Healthy Older and Younger Men. Nutrients 2018; 10:nu10010078. [PMID: 29329233 PMCID: PMC5793306 DOI: 10.3390/nu10010078] [Citation(s) in RCA: 25] [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: 11/02/2017] [Revised: 12/05/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023] Open
Abstract
Protein-rich supplements are used widely for the prevention and management of malnutrition in older people. We have reported that healthy older, compared to younger, adults have less suppression of energy intake by whey-protein-effects on appetite-related hormones are unknown. The objective was to determine the effects of intraduodenally administered whey-protein on glucose, gut hormone, and amino acid concentrations, and their relation to subsequent ad libitum energy intake at a buffet meal, in healthy older and younger men. Hydrolyzed whey-protein (30 kcal, 90 kcal, and 180 kcal) and a saline control (~0 kcal) were infused intraduodenally for 60 min in 10 younger (19-29 years, 73 ± 2 kg, 22 ± 1 kg/m²) and 10 older (68-81 years, 79 ± 2 kg, 26 ± 1 kg/m²) healthy men in a randomized, double-blind fashion. Plasma insulin, glucagon, gastric inhibitory peptide (GIP), glucagon-like peptide-1 (GLP-1), peptide tyrosine-tyrosine (PYY), and amino acid concentrations, but not blood glucose, increased, while ghrelin decreased during the whey-protein infusions. Plasma GIP concentrations were greater in older than younger men. Energy intake correlated positively with plasma ghrelin and negatively with insulin, glucagon, GIP, GLP-1, PYY, and amino acids concentrations (p < 0.05). In conclusion, intraduodenal whey-protein infusions resulted in increased GIP and comparable ghrelin, insulin, glucagon, GIP, GLP-1, PYY, and amino acid responses in healthy older and younger men, which correlated to subsequent energy intake.
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Affiliation(s)
- Caroline Giezenaar
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
| | - Natalie D Luscombe-Marsh
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Food and Nutrition, Adelaide 5000, Australia
| | - Amy T Hutchison
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
| | - Scott Standfield
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
| | - Christine Feinle-Bisset
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
| | - Michael Horowitz
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
| | - Ian Chapman
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
| | - Stijn Soenen
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, Adelaide 5000, Australia; (C.G.); (N.D.L.-M.); (A.T.H.); (S.S.); (C.F.-B.); (M.H.); (I.C.)
- Correspondence: ; Tel.: +61-8-8313-3638
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Giezenaar C, Hutchison AT, Luscombe-Marsh ND, Chapman I, Horowitz M, Soenen S. Effect of Age on Blood Glucose and Plasma Insulin, Glucagon, Ghrelin, CCK, GIP, and GLP-1 Responses to Whey Protein Ingestion. Nutrients 2017; 10:nu10010002. [PMID: 29267221 PMCID: PMC5793230 DOI: 10.3390/nu10010002] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/11/2017] [Accepted: 12/19/2017] [Indexed: 02/07/2023] Open
Abstract
Protein-rich supplements are used widely to prevent and manage undernutrition in older people. We have previously shown that healthy older, compared to younger, adults have less suppression of energy intake by whey protein-although the effects of age on appetite-related gut hormones are largely unknown. The aim of this study was to determine and compare the acute effects of whey protein loads on blood glucose and plasma gut hormone concentrations in older and younger adults. Sixteen healthy older (eight men, eight women; mean ± SEM: age: 72 ± 1 years; body mass index: 25 ± 1 kg/m²) and 16 younger (eight men, eight women; 24 ± 1 years; 23 ± 0.4 kg/m²) adults were studied on three occasions in which they ingested 30 g (120 kcal) or 70 g (280 kcal) whey protein, or a flavored-water control drink (~2 kcal). At regular intervals over 180 min, blood glucose and plasma insulin, glucagon, ghrelin, cholecystokinin (CCK), gastric inhibitory peptide (GIP), and glucagon-like peptide-1 (GLP-1) concentrations were measured. Plasma ghrelin was dose-dependently suppressed and insulin, glucagon, CCK, GIP, and GLP-1 concentrations were dose-dependently increased by the whey protein ingestion, while blood glucose concentrations were comparable during all study days. The stimulation of plasma CCK and GIP concentrations was greater in older than younger adults. In conclusion, orally ingested whey protein resulted in load-dependent gut hormone responses, which were greater for plasma CCK and GIP in older compared to younger adults.
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Affiliation(s)
- Caroline Giezenaar
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, 5000 Adelaide, Australia.
| | - Amy T Hutchison
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, 5000 Adelaide, Australia.
| | - Natalie D Luscombe-Marsh
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, 5000 Adelaide, Australia.
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Food and Nutrition, 5000 Adelaide, Australia.
| | - Ian Chapman
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, 5000 Adelaide, Australia.
| | - Michael Horowitz
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, 5000 Adelaide, Australia.
| | - Stijn Soenen
- Discipline of Medicine and National Health and Medical Research Council of Australia (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, 5000 Adelaide, Australia.
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12
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Giezenaar C, Trahair LG, Luscombe-Marsh ND, Hausken T, Standfield S, Jones KL, Lange K, Horowitz M, Chapman I, Soenen S. Effects of randomized whey-protein loads on energy intake, appetite, gastric emptying, and plasma gut-hormone concentrations in older men and women. Am J Clin Nutr 2017; 106:865-877. [PMID: 28747330 DOI: 10.3945/ajcn.117.154377] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 06/27/2017] [Indexed: 02/05/2023] Open
Abstract
Background: Protein- and energy-rich supplements are used widely for the management of malnutrition in the elderly. Information about the effects of protein on energy intake and related gastrointestinal mechanisms and whether these differ between men and women is limited.Objective: We determined the effects of whey protein on energy intake, appetite, gastric emptying, and gut hormones in healthy older men and women.Design: Eight older women and 8 older men [mean ± SEM age: 72 ± 1 y; body mass index (in kg/m2): 25 ± 1] were studied on 3 occasions in which they received protein loads of 30 g (120 kcal) or 70 g (280 kcal) or a flavored water control drink (0 kcal). At regular intervals over 180 min, appetite (visual analog scales), gastric emptying (3-dimensional ultrasonography), and blood glucose and plasma gut-hormone concentrations [insulin, glucagon, ghrelin, cholecystokinin, gastric inhibitory polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and peptide tyrosine tyrosine (PYY)] were measured, and ad libitum energy intake was quantified from a buffet meal (180-210 min; energy intake, appetite, and gastric emptying in the men have been published previously).Results: Energy intake at the buffet meal was ∼80% higher in older men than in older women (P < 0.001). Energy intake was not suppressed by protein compared with the control in men or women (P > 0.05). There was no effect of sex on gastric emptying, appetite, gastrointestinal symptoms, glucose, or gut hormones (P > 0.05). There was a protein load-dependent slowing of gastric emptying, an increase in concentrations of insulin, glucagon, cholecystokinin, GIP, GLP-1, and PYY, and an increase in total energy intake (drink plus meal: 12% increase with 30 g and 32% increase with 70 g; P < 0.001). Energy intake at the buffet meal was inversely related to the stomach volume and area under the curve of hormone concentrations (P < 0.05).Conclusion: In older men and women, whey-protein drinks load-dependently slow gastric emptying and alter gut hormone secretion compared with a control but have no suppressive effect on subsequent ad libitum energy intake. This trial was registered at www.anzctr.org.au as ACTRN12612000941864.
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Affiliation(s)
- Caroline Giezenaar
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Laurence G Trahair
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Natalie D Luscombe-Marsh
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
- The Commonwealth Scientific and Industrial Research Organisation, Animal, Food and Health Sciences, Adelaide, South Australia, Australia; and
| | - Trygve Hausken
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Scott Standfield
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karen L Jones
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kylie Lange
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Horowitz
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ian Chapman
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Stijn Soenen
- Discipline of Medicine and National Health and Medical Research Council of Australia Center of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia;
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13
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Hickson M, Moss C, Dhillo WS, Bottin J, Frost G. Increased peptide YY blood concentrations, not decreased acyl-ghrelin, are associated with reduced hunger and food intake in healthy older women: Preliminary evidence. Appetite 2016; 105:320-7. [DOI: 10.1016/j.appet.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
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Morley JE. Peptides and aging: Their role in anorexia and memory. Peptides 2015; 72:112-8. [PMID: 25895851 DOI: 10.1016/j.peptides.2015.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/03/2015] [Accepted: 04/04/2015] [Indexed: 12/16/2022]
Abstract
The rapid aging of the world's population has led to a need to increase our understanding of the pathophysiology of the factors leading to frailty and cognitive decline. Peptides have been shown to be involved in the pathophysiology of frailty and cognitive decline. Weight loss is a major component of frailty. In this review, we demonstrate a central role for both peripheral peptides (e.g., cholecystokinin and ghrelin) and neuropeptides (e.g., dynorphin and alpha-MSH) in the pathophysiology of the anorexia of aging. Similarly, peripheral peptides (e.g., ghrelin, glucagon-like peptide 1, and cholecystokinin) are modulators of memory. A number of centrally acting neuropeptides have also been shown to modulate cognitive processes. Amyloid-beta peptide in physiological levels is a memory enhancer, while in high (pathological) levels, it plays a key role in the development of Alzheimer's disease.
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Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St Louis, MO, United States.
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15
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Rémond D, Shahar DR, Gille D, Pinto P, Kachal J, Peyron MA, Dos Santos CN, Walther B, Bordoni A, Dupont D, Tomás-Cobos L, Vergères G. Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition. Oncotarget 2015; 6:13858-98. [PMID: 26091351 PMCID: PMC4546438 DOI: 10.18632/oncotarget.4030] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/13/2015] [Indexed: 12/11/2022] Open
Abstract
Although the prevalence of malnutrition in the old age is increasing worldwide a synthetic understanding of the impact of aging on the intake, digestion, and absorption of nutrients is still lacking. This review article aims at filling the gap in knowledge between the functional decline of the aging gastrointestinal tract (GIT) and the consequences of malnutrition on the health status of elderly. Changes in the aging GIT include the mechanical disintegration of food, gastrointestinal motor function, food transit, chemical food digestion, and functionality of the intestinal wall. These alterations progressively decrease the ability of the GIT to provide the aging organism with adequate levels of nutrients, what contributes to the development of malnutrition. Malnutrition, in turn, increases the risks for the development of a range of pathologies associated with most organ systems, in particular the nervous-, muscoskeletal-, cardiovascular-, immune-, and skin systems. In addition to psychological, economics, and societal factors, dietary solutions preventing malnutrition should thus propose dietary guidelines and food products that integrate knowledge on the functionality of the aging GIT and the nutritional status of the elderly. Achieving this goal will request the identification, validation, and correlative analysis of biomarkers of food intake, nutrient bioavailability, and malnutrition.
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Affiliation(s)
- Didier Rémond
- UMR 1019, UNH, CRNH Auvergne, INRA, 63000 Clermont-Ferrand, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, 63000 Clermont-Ferrand, France
| | - Danit R. Shahar
- Department of Public Health, The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, 84105 Beer-Sheva, Israel
| | - Doreen Gille
- Institute for Food Sciences IFS, Agroscope, Federal Department of Economic Affairs, Education and Research EAER, 3003 Berne, Switzerland
| | - Paula Pinto
- Escola Superior Agrária, Insituto Politécnico de Santarém, 2001-904 Santarem, Portugal
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, 2780-157 Oeiras, Portugal
| | | | - Marie-Agnès Peyron
- UMR 1019, UNH, CRNH Auvergne, INRA, 63000 Clermont-Ferrand, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, 63000 Clermont-Ferrand, France
| | - Claudia Nunes Dos Santos
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, 2780-157 Oeiras, Portugal
- Instituto de Biologia Experimental e Tecnológica, 2780-157 Oeiras, Portugal
| | - Barbara Walther
- Institute for Food Sciences IFS, Agroscope, Federal Department of Economic Affairs, Education and Research EAER, 3003 Berne, Switzerland
| | - Alessandra Bordoni
- Department of Agri-Food Sciences and Technologies, University of Bologna, 47521 Cesena, Italy
| | - Didier Dupont
- UMR 1253, Science et Technologie du Lait & de l'Œuf, INRA, 35000 Rennes, France
| | | | - Guy Vergères
- Institute for Food Sciences IFS, Agroscope, Federal Department of Economic Affairs, Education and Research EAER, 3003 Berne, Switzerland
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Atalayer D, Astbury NM. Anorexia of aging and gut hormones. Aging Dis 2013; 4:264-75. [PMID: 24124632 DOI: 10.14336/ad.2013.0400264] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 08/02/2013] [Accepted: 08/02/2013] [Indexed: 12/20/2022] Open
Abstract
We are expected to live longer than if we had been born 100 years ago however, the additional years are not necessarily spent in good health or free from disability. Body composition changes dramatically over the course of life. There is a gradual increase in body weight throughout adult life until the age of about 60-65 years. In contrast, body weight appears to decrease with age after the age of 65-75 years, even in those demonstrating a previous healthy body weight. This age related decrease in body weight, often called unintentional weight loss or involuntary weight loss can be a significant problem for the elderly. This has been shown to be related to decline in appetite and food intake is common amongst the elderly and is often referred to the anorexia of aging. Underlying mechanisms regulate energy homeostasis and appetite may change as people age. In this review, peripheral factors regulating appetite have been summarized in regards to their age-dependent changes and role in the etiology of anorexia of aging. Understanding the alterations in the mechanisms regulating appetite and food intake in conjunction with aging may help inform strategies that promote healthy aging and promote health and wellbeing in the elderly years, with the end goal to add life to the years and not just years to our lives.
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Affiliation(s)
- Deniz Atalayer
- Department of Institute of Human Nutrition, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA ; Department of Medicine, New York Obesity Research and Nutrition Center, St. Luke's-Roosevelt Hospital, New York, NY 10025, USA
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Serra-Prat M, Mans E, Palomera E, Clavé P. Gastrointestinal peptides, gastrointestinal motility, and anorexia of aging in frail elderly persons. Neurogastroenterol Motil 2013; 25:291-e245. [PMID: 23240772 DOI: 10.1111/nmo.12055] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The mechanisms involved in anorexia in frail elderly people remain unclear. The objective of this study was to establish whether fasting and postprandial levels of gastrointestinal peptides, gastrointestinal motility, and hunger are modified by age and frailty. METHODS Three groups of subjects were studied: (a) frail elderly (>70 years) persons, (b) non-frail elderly (>70 years) persons, and (c) healthy adults (aged 25-65 years). After an overnight fast, participants ingested a 400 Kcal liquid meal and appetite, hormonal, and gastrointestinal responses were monitored during early (0-60 min) and late (60-240 min) postprandial periods. KEY RESULTS Frail persons showed poor nutritional status, sarcopenia, and almost absence of hunger during fasting and postprandial periods. Older persons presented higher levels of glucose and insulin during fasting, enhanced postprandial CCK release in early postprandial period and postprandial hyperglycemia and hyperinsulinemia, but similar ghrelin levels than younger adults. Ultrasound scan showed that the fasting antral area was higher and antral compliance lower in old persons. The paracetamol absorption test showed enhanced postprandial gastric emptying in the frail. Non-gallbladder contractors showed no CCK peak in younger and non-frail groups, but the same high CCK peak as contractors in the frail. CONCLUSIONS & INFERENCES Frailty was associated with anorexia, risk of malnutrition, and sarcopenia. Frail persons showed impaired gastric motility (larger antral area at rest, impaired antral compliance, and enhanced postprandial emptying), impaired gallbladder motility, and fasting and/or postprandial alterations in CCK, glucose, and insulin release. Further studies are needed to determine if these factors may contribute to anorexia of aging in frail persons.
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Affiliation(s)
- M Serra-Prat
- Research Unit, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain.
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Malafarina V, Uriz-Otano F, Gil-Guerrero L, Iniesta R. The anorexia of ageing: Physiopathology, prevalence, associated comorbidity and mortality. A systematic review. Maturitas 2013; 74:293-302. [DOI: 10.1016/j.maturitas.2013.01.016] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 01/04/2013] [Indexed: 10/27/2022]
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de Boer A, Ter Horst GJ, Lorist MM. Physiological and psychosocial age-related changes associated with reduced food intake in older persons. Ageing Res Rev 2013; 12:316-28. [PMID: 22974653 DOI: 10.1016/j.arr.2012.08.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 08/02/2012] [Accepted: 08/29/2012] [Indexed: 01/23/2023]
Abstract
Dietary intake changes during the course of aging. Normally an increase in food intake is observed around 55 years of age, which is followed by a reduction in food intake in individuals over 65 years of age. This reduction in dietary intake results in lowered levels of body fat and body weight, a phenomenon known as anorexia of aging. Anorexia of aging has a variety of consequences, including a decline in functional status, impaired muscle function, decreased bone mass, micronutrient deficiencies, reduced cognitive functions, increased hospital admission and even premature death. Several changes during lifetime have been implicated to play a role in the reduction in food intake and the development of anorexia of aging. These changes are both physiological, involving peripheral hormones, senses and central brain regulation and non-physiological, with differences in psychological and social factors. In the present review, we will focus on age-related changes in physiological and especially non-physiological factors, that play a role in the age-related changes in food intake and in the etiology of anorexia of aging. At the end we conclude with suggestions for future nutritional research to gain greater understanding of the development of anorexia of aging which could lead to earlier detection and better prevention.
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Moss C, Dhillo WS, Frost G, Hickson M. Gastrointestinal hormones: the regulation of appetite and the anorexia of ageing. J Hum Nutr Diet 2011; 25:3-15. [DOI: 10.1111/j.1365-277x.2011.01211.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Baatar D, Patel K, Taub DD. The effects of ghrelin on inflammation and the immune system. Mol Cell Endocrinol 2011; 340:44-58. [PMID: 21565248 DOI: 10.1016/j.mce.2011.04.019] [Citation(s) in RCA: 189] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 04/15/2011] [Accepted: 04/22/2011] [Indexed: 12/25/2022]
Abstract
A number of hormones and metabolic mediators signal the brain of changes in the body's energy status and when an imbalance occurs; the brain coordinates the appropriate changes in energy intake and utilization via the control of appetite and food consumption. Under conditions of chronic inflammation and immune activation, there is often a significant loss of body mass and appetite suggesting the presence of shared ligands and signaling pathways mediating "crosstalk" between the immune and neuroendocrine systems. Ghrelin, the endogenous ligand for growth hormone secretagogue receptor (GHS-R), is produced primarily by cells in the stomach and serves as a potent circulating orexigenic hormone controlling food intake, energy expenditure, adiposity and GH secretion. The functional roles of ghrelin and other growth hormone secretagogues (GHS) within the immune system and under states of inflammatory stress and injury are only now coming to light. A number of reports over the past decade have described ghrelin to be a potent anti-inflammatory mediator both in vitro and in vivo and a promising therapeutic agent in the treatment of inflammatory diseases and injury. Moreover, ghrelin has also been shown to promote lymphocyte development in the primary lymphoid organs (bone marrow and thymus) and to ablate age-associated thymic involution. In the current report, we review the literature supporting a role for ghrelin as an anti-inflammatory agent and immunoregulatory hormone/cytokine and its potential use in the treatment of inflammatory diseases and injury.
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Affiliation(s)
- Dolgor Baatar
- Laboratory of Molecular Biology and Immunology, NIA-IRP, NIH, Biomedical Research Center, Baltimore, MD 21224, USA
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