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Lee H, Moyo GT, Theophilus RJ, Oldewage-Theron W. Association of Dietary Changes with Risk Factors of Type 2 Diabetes among Older Adults in Sharpeville, South Africa, from 2004 to 2014. Nutrients 2023; 15:4751. [PMID: 38004145 PMCID: PMC10675501 DOI: 10.3390/nu15224751] [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: 09/29/2023] [Revised: 10/17/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
This study aimed to evaluate the associations of dietary changes with risk factors of type 2 diabetes among older populations in Sharpeville, South Africa. A 24 h recall assessment, dietary diversity, and anthropometrics were measured. Blood samples were collected to assess fasting glucose and insulin. Regression analysis was performed using SPSS version 20. The mean BMI of the total of 103 participants was 30.63 kg/m2 at baseline and 29.66 kg/m2 at follow-up. Significantly higher BMI levels were reported in women than men both at baseline (p = 0.003) and follow-up (p = 0.009). Waist circumference significantly decreased from 96.20 cm to 93.16 cm (p = 0.046). The mean levels of HOMA-B significantly increased from 88.99 to 111.19 (p = 0.021). BMI was positively associated with intakes of total energy (p = 0.22), polyunsaturated fatty acids (p = 0.050), and cholesterol (p = 0.006). Waist circumference was strongly associated with total energy (p = 0.048), polyunsaturated fatty acids (p = 0.037), trans fatty acids (p = 0.039), and cholesterol (p = 0.000). HOMA-IR and HOMA-B were associated with intakes of fat (HOMA-IR: p = 0.013; HOMA-B: p = 0.040) and monounsaturated fatty acids (HOMA-IR: p = 0.003; HOMA-B: p = 0.040).
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Affiliation(s)
- Hyunjung Lee
- Department of Nutrition, Texas A&M University, College Station, TX 77843, USA
| | - Gugulethu T. Moyo
- Center for Health and Wellbeing, Princeton School of Public and International Affairs, Princeton University, Princeton, NJ 08544, USA;
| | - Rufus J. Theophilus
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein 9301, South Africa
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Nutritional and Nutrition-Related Biomarkers as Prognostic Factors of Sarcopenia, and Their Role in Disease Progression. Diseases 2022; 10:diseases10030042. [PMID: 35892736 PMCID: PMC9326750 DOI: 10.3390/diseases10030042] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 12/25/2022] Open
Abstract
Due to the multifactorial pathogenesis of sarcopenia, it is crucial to identify biomarkers that are risk factors for sarcopenia, and which therefore have a prognostic function. Aim: This narrative review aims to define a set of biomarkers associated with nutrition and sarcopenia. These biomarkers could contribute to individualized monitoring and enable preventive and therapeutic methods. Methods: Two electronic databases, PubMed and Google Scholar, were used. The search strategy was based on a controlled vocabulary (MeSH) and includes studies published up to February 2022. Discussion: Higher levels of serum uric acid are associated with higher handgrip strength and better muscle function in elderly people and, thus, may slow the progression of sarcopenia. Leptin, an adipokine secreted by adipose tissue, promotes the production of pro-inflammatory cytokines, which in turn lead to sarcopenia. This makes leptin a significant indirect biomarker for physical disability and sarcopenic obesity. Additionally, creatinine is a reliable biomarker for muscle mass status because of its easy accessibility and cost-effectiveness. Vitamin D status acts as a useful biomarker for predicting total mortality, hip fractures, early death, and the development of sarcopenia. Therefore, there is an increasing interest in dietary antioxidants and their effects on age-related losses of muscle mass and function. On the other hand, 3-Methylhistidine is a valuable biomarker for detecting increased muscle catabolism, as it is excreted through urine during muscle degradation. In addition, IGF-1, whose concentration in plasma is stimulated by food intake, is associated with the loss of skeletal muscle mass, which probably plays a crucial role in the progression of sarcopenia. Conclusions: Many nutritional biomarkers were found to be associated with sarcopenia, and can therefore be used as prognostic indexes and risk factors. Nutrition plays an important role in the prevention and management of sarcopenia, affecting muscle mass, strength, and function in elderly people.
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Fuloria S, Subramaniyan V, Meenakshi DU, Sekar M, Chakravarthi S, Kumar DH, Kumari U, Vanteddu VG, Patel TD, Narra K, Sharma PK, Fuloria NK. Etiopathophysiological role of the renin–angiotensin–aldosterone system in age‐related muscular weakening: RAAS‐independent beneficial role of ACE2 in muscle weakness. J Biochem Mol Toxicol 2022; 36:e23030. [DOI: 10.1002/jbt.23030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/17/2021] [Accepted: 01/28/2022] [Indexed: 11/08/2022]
Affiliation(s)
| | - Vetriselvan Subramaniyan
- Faculty of Medicine, Bioscience and Nursing, Faculty of Medicine MAHSA University Jenjarom Selangor Malaysia
| | | | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak Universiti Kuala Lumpur Ipoh Perak Malaysia
| | - Srikumar Chakravarthi
- Faculty of Medicine, Bioscience and Nursing, Faculty of Medicine MAHSA University Jenjarom Selangor Malaysia
| | - Darnal H. Kumar
- Jeffrey Cheah School of Medicine & Health Sciences Monash University Johor Johor Bahru Malaysia
| | - Usha Kumari
- Faculty of Medicine AIMST University Kedah Malaysia
| | | | | | | | | | - Neeraj K. Fuloria
- Faculty of Pharmacy AIMST University Kedah Malaysia
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospital Saveetha University Chennai India
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Amankwaa I, Nelson K, Rook H, Hales C. Association between body mass index, multi-morbidity and activities of daily living among New Zealand nursing home older adults: a retrospective analysis of nationwide InterRAI data. BMC Geriatr 2022; 22:62. [PMID: 35042475 PMCID: PMC8767739 DOI: 10.1186/s12877-021-02696-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background Obesity is a well-established risk factor for multi-morbidity and disability among older adults in the community and acute care settings. However, nursing home residents with body mass index (BMI) below 18.5 kg/m2 and above 25.0 kg/m2 have been understudied. We examined the prevalence of multi-morbidity and disability in activities of daily living (ADL) by BMI category and further investigated the association between BMI, multi-morbidity, and disability of ADL in a large cohort of older adults in nursing homes in New Zealand. Methods A retrospective review of nursing home residents’ data obtained from the New Zealand International Resident Assessment Instrument national dataset from 2015 to 2018. One hundred ninety-eight thousand seven hundred ninety older adults (≥60 years) living in nursing homes were included. BMI was calculated as weight in kilograms (kg) divided by height in meters squared (m2). Multimorbidity was defined as the presence of ≥2 health conditions. The risk of disability was measured by a 4-item ADL self-performance scale. The prevalence ratio (PR) of the association between BMI and multi-morbidity and between BMI and disability in ADL was assessed using Poisson regression with robust variance. Results Of the 198,790 residents, 10.6, 26.6, 11.3 and 5.4% were underweight, overweight, obese, and extremely obese, respectively. 26.4, 31.3 and 21.3% had one, two and three disease conditions, respectively, while 14.3% had four or more conditions. 24.1% could perform only one ADL, and 16.1% could perform none. The prevalence of multi-morbidity increased with increasing BMI, whereas mean disability in ADL decreased with increasing BMI. The risk of multi-morbidity was higher for the overweight (PR, 95%CI: 1.03, 1.02–1.03) and obese (PR, 95% CI: 1.07, 1.06–1.08) compared to normal weight after controlling for age, sex, ethnicity, and region. BMI was inversely associated with mean ADL; β, 95% CI for overweight (− 0.30, − 0.32, − 0.28) and obese − 0.43, − 0.45, − 0.40 compared to normal weight. Conclusion Being underweight was associated with a decline in the performance of ADL in nursing home residents. In contrast, being overweight and obese positively affected functional performance, demonstrating that the obesity paradox plays an important role in this population. The observed associations highlight areas where detection and management of underweight and healthy aging initiatives may be merited.
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The Critical Role of Oxidative Stress in Sarcopenic Obesity. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:4493817. [PMID: 34676021 PMCID: PMC8526202 DOI: 10.1155/2021/4493817] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022]
Abstract
Sarcopenic obesity (SO) is a combination of obesity and sarcopenia that primarily develops in older people. Patients with SO have high fat mass, low muscle mass, low muscle strength, and low physical function. SO relates to metabolic syndrome and an increased risk of morbimortality. The prevalence of SO varies because of lacking consensus criteria regarding its definition and the methodological difficulty in diagnosing sarcopenia and obesity. SO includes systemic alterations such as insulin resistance, increased proinflammatory cytokines, age-associated hormonal changes, and decreased physical activity at pathophysiological levels. Interestingly, these alterations are influenced by oxidative stress, which is a critical factor in altering muscle function and the generation of metabolic dysfunctions. Thus, oxidative stress in SO alters muscle mass, the signaling pathways that control it, satellite cell functions, and mitochondrial and endoplasmic reticulum activities. Considering this background, our objectives in this review are to describe SO as a highly prevalent condition and look at the role of oxidative stress in SO pathophysiology.
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Barzilay JI, Buzkova P, Shlipak MG, Lyles MF, Bansal N, Garimella PS, Ix JH, Kizer JR, Strotmeyer ES, Djousse L, Biggs ML, Siscovick D, Mukamal KJ. Urine creatinine concentration and clinical outcomes in older adults: The Cardiovascular Health Study. J Am Geriatr Soc 2021; 69:3486-3496. [PMID: 34363689 DOI: 10.1111/jgs.17388] [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: 02/03/2021] [Revised: 07/02/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Loss of muscle mass and strength are associated with long-term adverse health outcomes in older adults. Urine creatinine concentrations (Ucr; mg/dl) are a measure of muscle tissue mass and turnover. This study assessed the associations of a spot Ucr level with muscle mass and with risk of hospitalization, mortality, and diabetes mellitus in older adults. METHODS We examined 3424 participants from the Cardiovascular Health Study who provided spot urine samples in 1996-1997 and who were followed through June 2015. All participants underwent baseline measurement of grip strength. In a sub-cohort, 1331 participants underwent dual energy X-ray absorptiometry (DEXA) scans, from which lean muscle mass was derived. Participants were followed for a median of 10 years for hospitalizations and mortality, and 9 years for diabetes mellitus. RESULTS In linear regression analysis, a one standard deviation higher Ucr concentration (64.6 mg/dl) was associated with greater grip strength (kg force) β = 0.44 [0.16, 0.72]; p = 0.002) and higher lean muscle mass (kg) (β = 0.43 [0.08, 0.78]; p = 0.02). In Cox regression analyses, each standard deviation greater Ucr concentration was associated with lower rates of hospitalizations (0.94 [95% confidence interval, 0.90, 0.98]; p < 0.001) and lower mortality risk (0.92 [0.88, 0.97]; p < 0.001), while a one standard deviation increase in muscle mass derived from DEXA had no such significant association. Ucr levels were not associated with incident diabetes mellitus risk (0.97 [0.85, 1.11]; p = 0.65). CONCLUSION A higher spot Ucr concentration was favorably associated with muscle mass and strength and with health outcomes in older community-living adults. The ease of obtaining a spot Ucr makes it an attractive analyte to use for gauging the health of older adults.
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Affiliation(s)
- Joshua I Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, Georgia, USA.,Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Petra Buzkova
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, USA
| | - Michael G Shlipak
- Kidney Health Research Collaborative, San Francisco VA Medical Center, San Francisco, California, USA
| | - Mary F Lyles
- Department of Medicine, Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nisha Bansal
- Division of Nephrology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Pranav S Garimella
- Division of Nephrology-Hypertension, University of California-San Diego, San Diego, California, USA
| | - Joachim H Ix
- Division of Nephrology-Hypertension, University of California-San Diego, San Diego, California, USA.,Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Jorge R Kizer
- Cardiology Section, San Francisco Veterans Affairs Health Care System, San Francisco, California, USA.,Departments of Medicine, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Luc Djousse
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mary L Biggs
- Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington, USA
| | | | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Srivastava S, Joseph K J V, Dristhi D, Muhammad T. Interaction of physical activity on the association of obesity-related measures with multimorbidity among older adults: a population-based cross-sectional study in India. BMJ Open 2021; 11:e050245. [PMID: 34020981 PMCID: PMC8144051 DOI: 10.1136/bmjopen-2021-050245] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/29/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the associations between obesity-related measures and multimorbidity among older Indian adults and the interactive effects of physical activity in those associations. DESIGN A cross-sectional study was conducted using large representative survey data. SETTING AND PARTICIPANTS The present study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India. PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable was multimorbidity among older adults coded as no and yes. Descriptive statistics along with bivariate analysis are presented in the paper. Additionally, binary logistic regression analysis was used to fulfil the study objectives. RESULTS About 24% of older adults in the LASI cohort suffered from multimorbidity. Older adults who were overweight/obese (adjusted OR (AOR): 1.61, CI 1.48 to 1.74), had high-risk waist circumference (AOR: 1.66, CI 1.52 to 1.80) and had high-risk waist to hip ratio (AOR: 1.45, CI 1.33 to 1.59) were significantly more likely to suffer from multimorbidity compared with their counterparts. Older adults who were obese and physically inactive had significantly increased odds of suffering from multimorbidity compared with older adults who were obese and physically active. Similarly, older adults with high-risk waist circumference (AOR: 1.30, CI 1.11 to 1.53) and high-risk waist to hip ratio (AOR: 1.32, CI 1.20 to 1.46) along with being physically inactive had significantly higher odds of suffering from multimorbidity in comparison with older adults with high-risk waist circumference and waist to hip ratio along with being physically active. CONCLUSION While developing health strategies for older adults, physical activity needs to be recognised as a way of minimising comorbidities. Further, the study highlights the importance of using multiple obesity-related measures to predict chronic conditions in the older population.
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Affiliation(s)
- Shobhit Srivastava
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Vinod Joseph K J
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Drishti Dristhi
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - T Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Abstract
"Aging alters the way the body digests food, absorbs nutrients, and metabolizes energy. Changes in deglutition, digestion, and metabolism in this population are well described and may lead to alterations in oral intake, body composition, and overall health status. Elderly persons are at high risk for developing sarcopenia as well as sarcopenic obesity characterized by accelerated reduction in lean muscle mass and enhancement of body fat. Nutritional screening is important to identify high-risk individuals and facilitate care management planning. The most common assessment tool in elderly patients is the Mini Nutritional Assessment, which analyzes oral intake, health status, and anthropometrics."
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Affiliation(s)
- Carolyn Newberry
- Division of Gastroenterology, Weill Cornell Medical Center, 1305 York Avenue, 4th Floor, New York, NY 10021, USA.
| | - Gregory Dakin
- Division of GI, Metabolic, & Bariatric Surgery, 525 East 68th Street, Box 294, New York, NY 10065, USA
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Thompson J, Parkinson M, Collery R. Care home staff's experiences and views of supporting the dietary management and choices of older residents with obesity. Int J Older People Nurs 2020; 15:e12343. [DOI: 10.1111/opn.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Juliana Thompson
- Department of Nursing, Midwifery and Health Faculty of Health and Life Sciences Northumbria University Newcastle upon Tyne UK
| | - Mark Parkinson
- Department of Social Work, Education and Community Wellbeing Northumbria University Newcastle upon Tyne UK
| | - Robyn Collery
- Nutrition and Dietetics Department: Clinical Support and Screening Services Gateshead Health NHS Foundation Trust Gateshead UK
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Estrella-Castillo DF, Gómez-de-Regil L. Comparison of body mass index range criteria and their association with cognition, functioning and depression: a cross-sectional study in Mexican older adults. BMC Geriatr 2019; 19:339. [PMID: 31795994 PMCID: PMC6889317 DOI: 10.1186/s12877-019-1363-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 11/21/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND World population is living longer, demanding adjustments in public health policies. Body mass index (BMI) is widely known and used as a parameter and predictor of health status although an adapted criterion for older adults is usually overlooked. BMI has been extensively analysed in relation to mortality but fewer studies address its association with cognition, functioning and depression in older adults. The present study aimed at 1) comparing BMI distribution according to the ranges proposed by the World Health Organization (WHO) and the United States National Research Council Committee on Diet and Health (CDH), 2) analysing their association with cognitive functioning, physical functioning and depression and 3) analysing a possible, interaction of BMI criteria with sex on the outcome measures. METHODS This cross-sectional study included 395 participants recruited by convenience sampling; 283 (71.6%) women and 112 (24.58%) men. Mean age was 74.68 (SD = 8.50, range: 60-98). Outcome measures included the Short Portable Mental State Questionnaire for cognitive status, the Barthel's Index of Activities of Daily Living for physical functioning, and the Geriatric Depression Scale. RESULTS WHO criterion classified most cases (65.3%) as overweight, followed by normal weight (32.2%) and underweight (2.5%) whereas CDH criterion considered most (48.1%) as normal weight, and followed by overweight (31.4%) and underweight (20.5%). Analysing cognitive status, independent physical functioning and depression mean scores, significant differences (p ≤ .001) were found when comparing the three weight groups (underweight, normal weight and overweight) using either the WHO- or the CDH criterion. Post-hoc tests revealed that in all comparisons the underweight group scored the lowest in all three outcome measures. According to the CDH criterion, overweight was favourable for females but unfavourable for males regarding cognitive status (interaction F(2,389) = 4.52, p ≤ .01) and independent functioning (interaction F(2,389) = 3.86, p ≤ .05). CONCLUSIONS BMI and its associations to relevant outcome measures in the older adults must rely on criteria that take into account the particular features of this population, such as the CDH criterion. Underweight was associated with decremented cognition, less independent physical functioning and more depression. Overweight seemed favourable for women but unfavourable for men.
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Affiliation(s)
- Damaris Francis Estrella-Castillo
- Universidad Autónoma de Yucatán. Facultad de Medicina. Licenciatura en Rehabilitación, Avenida Itzáes No. 498 x 59 y 59A. Colonia Centro. Mérida, 97000 Merida, Yucatán Mexico
| | - Lizzette Gómez-de-Regil
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Calle 7, No. 433 por 20 y 22, Fraccionamiento Altabrisa. Mérida, 97130 Merida, Yucatán Mexico
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Maliszewska K, Adamska-Patruno E, Goscik J, Lipinska D, Citko A, Krahel A, Miniewska K, Fiedorczuk J, Moroz M, Gorska M, Kretowski A. The Role of Muscle Decline in Type 2 Diabetes Development: A 5-Year Prospective Observational Cohort Study. Nutrients 2019; 11:E834. [PMID: 31013777 PMCID: PMC6521281 DOI: 10.3390/nu11040834] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 04/01/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022] Open
Abstract
The major risk factors of T2DM (type 2 diabetes mellitus) development are still under investigation. We evaluate the possible risk factors associated with type 2 diabetes (T2DM) in adult subjects during a five-year prospective cohort study. We recruited 1160 subjects who underwent oral glucose tolerance test, anthropometric measurements, and body composition and body fat distribution analysis at a baseline visit and again at follow-up after approximately five years. The conclusions of this study are based on observation of 219 subjects who attended both the first and follow-up visits. The fasting serum insulin was measured, and HOMA-IR (homeostatic model assessment of insulin resistance) was calculated. During the follow-up period, T2DM was diagnosed in 7.4% of participants, impaired fasting glucose in 37.7%, and impaired glucose tolerance in 9.3%. Logistic regression models, adjusted for age, were constructed. The changes in glucose concentration, visceral fat tissue content, insulin resistance, and %loss of muscle mass were chosen as the potential predictors for T2DM development. A set of independent variables was extracted. The constructed feature set comprised change in HOMA-IR (OR (odds ratio) = 1.01, p < 0.01) and change in %loss of muscle mass (OR = 0.84, p < 0.03). With an aim to validate the prediction capability using the selected attributes, a support vector machine classifier and leave-one-out cross-validation procedure was applied, yielding 92.78% classification accuracy. Our results show the correlation between the %loss of muscle mass and T2DM development in adults, independent of changes in insulin resistance.
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Affiliation(s)
- Katarzyna Maliszewska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Poland M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Edyta Adamska-Patruno
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Joanna Goscik
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Danuta Lipinska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Poland M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Anna Citko
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Aleksandra Krahel
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Poland M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Katarzyna Miniewska
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Joanna Fiedorczuk
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Monika Moroz
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Maria Gorska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Poland M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
| | - Adam Kretowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Poland M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
- Clinical Research Centre, Medical University of Bialystok, Poland; M.C. Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.
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Konz T, Santoro A, Goulet L, Bazzocchi A, Battista G, Nicoletti C, Kadi F, Ostan R, Goy M, Monnard C, Martin FP, Feige JN, Franceschi C, Rezzi S. Sex-Specific Associations of Blood-Based Nutrient Profiling With Body Composition in the Elderly. Front Physiol 2019; 9:1935. [PMID: 30733685 PMCID: PMC6353856 DOI: 10.3389/fphys.2018.01935] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 12/21/2018] [Indexed: 12/12/2022] Open
Abstract
The intake of adequate amounts and types of nutrients is key for sustaining health and a good quality of life, particularly in the elderly population. There is considerable evidence suggesting that physiological changes related to age and sex modify nutritional needs, and this may be related to age-associated changes in body composition (BC), specifically in lean and fat body mass. However, there is a clear lack of understanding about the association of nutrients in blood and BC parameters in the elderly. This study investigated the relationships among blood nutrients (amino acids, fatty acids, major elements, trace-elements, and vitamins), BC and nutrient intake in a population of 176 healthy male and female Italian adults between the ages of 65 and 79 years. 89 blood markers, 77 BC parameters and dietary intake were evaluated. Multivariate data analysis was applied to infer relationships between datasets. As expected, the major variability between BC and the blood nutrient profile (BNP) observed was related to sex. Aside from clear sex-specific differences in BC, female subjects had higher BNP levels of copper, copper-to-zinc ratio, phosphorous and holotranscobalamin II and lower concentrations of branched-chain amino acids (BCAAs) and proline. Fat mass, percentage of fat mass, percentage of lean mass and the skeletal muscle index (SMI) correlated the most with BNP in both sexes. Our data showed positive correlations in male subjects among ethanolamine, glycine, albumin, and sulfur with SMI, while palmitoleic acid and oleic acid exhibited negative correlations. This differed in female subjects, where SMI was positively associated with albumin, folic acid and sulfur, while CRP, proline and cis-8,11,14-eicosatrienoic acid were negatively correlated. We investigated the influence of diet on the observed BNP and BC correlations. Intriguingly, most of the components of the BNP, except for folate, did not exhibit a correlation with nutrient intake data. An understanding of the physiological and biochemical processes underpinning the observed sex-specific correlations between BNP and BC could help in identifying nutritional strategies to manage BC-changes in aging. This would contribute to a deeper understanding of aging-associated nutritional needs with the aim of helping the elderly population to maintain metabolic health.
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Affiliation(s)
- Tobias Konz
- Nestlé Research, Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Nicoletti
- Department of Experimental and Clinical Medicine, Section of Anatomy, University of Florence, Florence, Italy
- Gut Health Institute Strategic Programme, Quadram Institute Bioscience, Norwich, United Kingdom
| | - Fawzi Kadi
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Michael Goy
- Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | | | | | - Jerome N. Feige
- Nestlé Research, EPFL Innovation Park, Lausanne, Switzerland
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Institute of Neurological Sciences (IRCCS), Bologna, Italy
| | - Serge Rezzi
- Nestlé Research, Vers-Chez-Les-Blanc, Lausanne, Switzerland
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Mendonça N, Granic A, Mathers JC, Hill TR, Siervo M, Adamson AJ, Jagger C. Prevalence and determinants of low protein intake in very old adults: insights from the Newcastle 85+ Study. Eur J Nutr 2018; 57:2713-2722. [PMID: 28948346 PMCID: PMC6267410 DOI: 10.1007/s00394-017-1537-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/17/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The very old (aged ≥ 85 years), fastest growing age group in most western societies, are at especially high risk of muscle mass and strength loss. The amount, sources and timing of protein intake may play important roles in the aetiology and management of sarcopenia. This study investigated the prevalence and determinants of low protein intake in 722 very old adults participating in the Newcastle 85+ Study. METHODS Protein intake was estimated with 2 × 24-h multiple pass recalls (24 h-MPR) and contribution (%) of food groups to protein intake was calculated. Low protein intake was defined as intake < 0.8 g of protein per adjusted body weight per day. A backward stepwise multivariate linear regression model was used to explore socioeconomic, health and lifestyle predictors of protein intake. RESULTS Twenty-eight percent (n = 199) of the community-living very old in the Newcastle 85+ Study had low protein intake. Low protein intake was less likely when participants had a higher percent contribution of meat and meat products to total protein intake (OR 0.97, 95% CI 0.95, 1.00) but more likely with a higher percent contribution of cereal and cereal products and non-alcoholic beverages. Morning eating occasions contributed more to total protein intake in the low than in the adequate protein intake group (p < 0.001). Being a woman (p < 0.001), having higher energy intake (p < 0.001) and higher tooth count (p = 0.047) was associated with higher protein intake in adjusted models. CONCLUSION This study provides novel evidence on the prevalence of low protein intake, diurnal protein intake patterns and food group contributors to protein intake in the very old.
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Affiliation(s)
- Nuno Mendonça
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
| | - Antoneta Granic
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, NE4 5PL, UK
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Tom R Hill
- School of Agriculture Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Mario Siervo
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Ashley J Adamson
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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Takemoto M, Manini TM, Rosenberg DE, Lazar A, Zlatar ZZ, Das SK, Kerr J. Diet and Activity Assessments and Interventions Using Technology in Older Adults. Am J Prev Med 2018; 55:e105-e115. [PMID: 30241621 PMCID: PMC7176031 DOI: 10.1016/j.amepre.2018.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/27/2018] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Abstract
UNLABELLED This paper reports on the findings and recommendations specific to older adults from the "Tech Summit: Innovative Tools for Assessing Diet and Physical Activity for Health Promotion" forum organized by the North American branch of the International Life Sciences Institute. The summit aimed to investigate current and emerging challenges related to improving energy balance behavior assessment and intervention via technology. The current manuscript focuses on how novel technologies are applied in older adult populations and enumerated the barriers and facilitators to using technology within this population. Given the multiple applications for technology in this population, including the ability to monitor health events and behaviors in real time, technology presents an innovative method to aid with the changes associated with aging. Although older adults are often perceived as lacking interest in and ability to adopt technologies, recent studies show they are comfortable adopting technology and user uptake is high with proper training and guided facilitation. Finally, the conclusions suggest recommendations for future research, including the need for larger trials with clinical outcomes and more research using end-user design that includes older adults as technology partners who are part of the design process. THEME INFORMATION This article is part of a theme issue entitled Innovative Tools for Assessing Diet and Physical Activity for Health Promotion, which is sponsored by the North American branch of the International Life Sciences Institute.
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Affiliation(s)
- Michelle Takemoto
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Amanda Lazar
- College of Information Studies, University of Maryland, College Park, Maryland
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Sai Krupa Das
- Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
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Decreased Basal Metabolic Rate Can Be an Objective Marker for Sarcopenia and Frailty in Older Males. J Am Med Dir Assoc 2018; 20:58-63. [PMID: 30122323 DOI: 10.1016/j.jamda.2018.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/28/2018] [Accepted: 07/01/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The aim of this study is to demonstrate the ability of the basal metabolic rate (BMR) to detect frailty and sarcopenia in older males. SETTING AND PARTICIPANTS A total of 305 male patients undergoing comprehensive geriatric assessment were included in the study. MEASURES The frailty status was assessed with the Fried criteria. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People criteria. BMR is calculated by bioimpedance analysis. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of BMR in detecting sarcopenia. RESULTS The mean age was 74.52 ± 7.51 years. Among the patients in the sample, 95 (31.1%) had sarcopenia and 55 (18%) had frailty. Patients who had a BMR <1612 kcal/d had a higher frequency of frailty than those who had a BMR ≥1612 kcal/d (67.3 vs 32.7, P < .001). Results were similar for sarcopenia (77.9 vs 22.1, P < .001). When BMR was divided by body surface area (BSA), BMR/BSA with a cut-off of 874 kcal/m2 had a sensitivity of 80% and a specificity of 68%, and the AUC was 0.82 for BMR/BSA, in diagnosing sarcopenia (P < .01). The participants without sarcopenia had a higher BMR/BSA for the unadjusted (OR = 8.00, 95% CI 4.52-14.19, P < .001) and adjusted analyses (OR = 6.60, 95% CI 3.52-12.38, P < .001). CONCLUSIONS Older male patients with sarcopenia and frailty have a higher BMR reduction. Therefore, it should be kept in mind that patients with low BMR should alert us to screen sarcopenia and frailty. BMR/BSA may play a role in objective screening to detect sarcopenia in older males.
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Asp M, Simonsson B, Larm P, Molarius A. Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey. Public Health 2017; 147:84-91. [PMID: 28404503 DOI: 10.1016/j.puhe.2017.01.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/16/2016] [Accepted: 01/31/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine how physical activity and physical mobility are related to obesity in the elderly. STUDY DESIGN A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. METHODS Obesity (body mass index ≥30 kg/m2) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. RESULTS The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. CONCLUSION It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.
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Affiliation(s)
- M Asp
- School of Health, Care and Social Welfare, Mälardalens University, Högskoleplan 1, P.O. Box 883, 721 23 Västerås, Sweden
| | - B Simonsson
- Competence Centre for Health, Region Västmanland, Adelsögatan, 721 89 Västerås, Sweden.
| | - P Larm
- School of Health, Care and Social Welfare, Mälardalens University, Högskoleplan 1, P.O. Box 883, 721 23 Västerås, Sweden; Centre for Clinical Research, Uppsala University, Region Västmanland, Adelsögatan, 721 89 Västerås, Sweden
| | - A Molarius
- Competence Centre for Health, Region Västmanland, Adelsögatan, 721 89 Västerås, Sweden; Karlstad University, Department of Health Sciences, Universitetsvägen 2, 651 88 Karlstad, Sweden
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Çetin İ, Nalbantcilar MT, İnci R, Güler MS, Tosun K, Nazik A. Correlation of drinking water nutritional element levels with body composition of women aged 55-70 years living in Batman province. DICLE MEDICAL JOURNAL 2017. [DOI: 10.5798/dicletip.298617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Prevalent Long-Term Trends of Hypertension in Austria: The Impact of Obesity and Socio-Demography. PLoS One 2015; 10:e0140461. [PMID: 26469176 PMCID: PMC4607455 DOI: 10.1371/journal.pone.0140461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/25/2015] [Indexed: 12/31/2022] Open
Abstract
Background Globally there are only less long-term-studies on hypertension available to provide reliable estimates and identify risk groups. This study aims to analyse the prevalence and long-term-trend of hypertension in Austria, recognize affected subpopulations and investigate social inequalities. Methods This representative population-based study is based on self-reported data of adults (mean age: 47.7 ± 17.5; n = 178,818) that were taken from five health surveys between 1973 and 2007. An adjustment of self-reported BMI was performed based on a preliminary validation study. Absolute changes (AC) and aetiologic fractions (AF) were calculated from logistic regressions in order to measure trends. To quantify the extent of social inequality, a relative index of inequality (RII) was computed. Results During the study period the age-standardized hypertension prevalence increased from 1.0% to 18.8%, with a considerable rise from 1991 onwards. There was a positive trend in all subpopulations, with the highest AC among obese women (+50.2%) and obese subjects aged 75 years and older (+54.4%), whereas the highest risk was observed among the youngest obese adults (AF: 99.4%). The RII for hypertension was higher for women than men, but in general unstable during the investigation period. Conclusions Obesity and older age are significant factors for increased morbidity of hypertension. The most undesirable trends occurred in obese women and obese subjects aged 75 years and older. These risk groups should be given special attention when planning hypertension prevention programs. The high increase in the prevalence of hypertension is due to different aspects, e.g. a demographic change and a change in the definition of hypertension. These findings help to understand why hypertension is becoming more common in the Austrian population.
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Food and addiction among the ageing population. Ageing Res Rev 2015; 20:79-85. [PMID: 25449527 DOI: 10.1016/j.arr.2014.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/25/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022]
Abstract
Obesity among the elderly is a growing public health concern. Among the various factors that may contribute to the current rates of obesity is the rewarding aspect of highly palatable foods and beverages, which may lead to overconsumption and excess caloric intake. The present review describes recent research supporting the hypothesis that, for some individuals, the consumption these highly palatable foods and beverages may lead to the development of addictive-like behaviors. In particular, the authors consider the relevance of this hypothesis to the ageing population.
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Suominen MH, Jyvakorpi SK, Pitkala KH, Finne-Soveri H, Hakala P, Mannisto S, Soini H, Sarlio-Lahteenkorva S. Nutritional guidelines for older people in Finland. J Nutr Health Aging 2014; 18:861-7. [PMID: 25470800 DOI: 10.1007/s12603-014-0509-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Ageing is associated with an increased risk of malnutrition, decreased nutrient intake, unintentional weight loss and sarcopenia, which lead to frailty, functional disabilities and increased mortality. Nutrition combined with exercise is important in supporting older people's health, functional capacity and quality of life. OBJECTIVE To identify nutritional needs in various groups of older individuals and to present the nutritional guidelines for older people in Finland. DESIGN A review of the existing literature on older people's nutritional needs and problems. The draft guidelines were written by a multidisciplinary expert panel; they were then revised, based on comments by expert organisations. The guidelines were approved by the National Nutritional Council in Finland. RESULTS The heterogeneity of the older population is highlighted. The five key guidelines are: 1. The nutritional needs in different age and disability groups should be considered. 2. The nutritional status and food intake of older individuals should be assessed regularly. 3. An adequate intake of energy, protein, fiber, other nutrients and fluids should be guaranteed. 4. The use of a vitamin D supplement (20 μg per day) recommended. 5. The importance of physical activity is highlighted. In addition, weight changes, oral health, constipation, obesity, implementing nutritional care are highlighted. CONCLUSIONS Owing to the impact that good nutrition has on health and well-being in later life, nutrition among older people should be given more attention. These nutritional guidelines are intended to improve the nutrition and nutritional care of the older population.
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Affiliation(s)
- M H Suominen
- MH Suominen, Unit of General Practice, Helsinki University Central Hospital and Department of General Practice and Primary Health Care, University of Helsinki, Finland,
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Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol 2014; 2:819-29. [PMID: 24731660 PMCID: PMC4156923 DOI: 10.1016/s2213-8587(14)70034-8] [Citation(s) in RCA: 652] [Impact Index Per Article: 65.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The term sarcopenia refers to the loss of muscle mass that occurs with ageing. On the basis of study results showing that muscle mass is only moderately related to functional outcomes, international working groups have proposed that loss of muscle strength or physical function should also be included in the definition. Irrespective of how sarcopenia is defined, both low muscle mass and poor muscle strength are clearly highly prevalent and important risk factors for disability and potentially mortality in individuals as they age. Many chronic diseases, in addition to ageing, could also accelerate decrease of muscle mass and strength, and this effect could be a main underlying mechanism by which chronic diseases cause physical disability. In this Review, we address both age-related and disease-related muscle loss, with a focus on diabetes and obesity but including other disease states, and potential common mechanisms and treatments. Development of treatments for age-related and disease-related muscle loss might improve active life expectancy in older people, and lead to substantial health-care savings and improved quality of life.
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Affiliation(s)
- Rita Rastogi Kalyani
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Mark Corriere
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA.
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Chan JSY, Yan JH, Payne VG. The impact of obesity and exercise on cognitive aging. Front Aging Neurosci 2013; 5:97. [PMID: 24391586 PMCID: PMC3869042 DOI: 10.3389/fnagi.2013.00097] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 12/06/2013] [Indexed: 12/11/2022] Open
Abstract
Obesity is a major concern in the aging population and degrades health, motor functions and cognition in older adults. The effects of obesity are pervasive and challenging to health-care systems, making this a widespread and critically important public health dilemma. In this review, we examine the relationship between obesity, cognitive aging, and related dysfunctions. Potential neural mechanisms underlying such relationship are described. We propose that cost-effective exercises can be employed to cope with obesity and cognitive declines in older adults. Finally, we discuss implications and future research directions.
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Affiliation(s)
- John S. Y. Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Jin H. Yan
- Institute of Affective and Social Neuroscience, Shenzhen University, Shenzhen, China
- Department of Psychology, Tsinghua University, Beijing, China
| | - V. Gregory Payne
- Department of Kinesiology, San Jose State University, San Jose, CA, USA
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Longitudinal association between dairy consumption and changes of body weight and waist circumference: the Framingham Heart Study. Int J Obes (Lond) 2013; 38:299-305. [PMID: 23736371 PMCID: PMC3809320 DOI: 10.1038/ijo.2013.78] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 04/08/2013] [Accepted: 05/08/2013] [Indexed: 12/16/2022]
Abstract
Background Dairy foods are nutrient-dense and may be protective against long-term weight gain. Objective We aimed to examine the longitudinal association between dairy consumption and annualized changes in weight and waist circumference (WC) in adults. Methods Members of the Framingham Heart Study Offspring Cohort who participated in the 5th through 8th study examinations (1991–2008) were included in these analyses (3,440 participants with 11,683 observations). At each exam, dietary intake was assessed by a validated food frequency questionnaire, and weight and WC were assessed following standardized procedures. Repeated measures models were used for the longitudinal analyses by adjusting for time-varying or invariant covariates. Results On average, participants gained weight and WC during follow-up. Dairy intake increased across exams. After adjusting for demographic and lifestyle factors (including diet quality), participants who consumed ≥3 servings/d of total dairy had 0.10 [±0.04] kg smaller annualized increment of weight (Ptrend=0.04) than those consuming <1 serving/d. Higher total dairy intake was also marginally associated with less WC gain (Ptrend=0.05). Similarly, participants who consumed ≥3 servings/wk of yogurt had a 0.10 [±0.04] kg and 0.13 [±0.05] cm smaller annualized increment of weight (Ptrend=0.03) and WC (Ptrend=0.008) than those consuming <1 serving/wk, respectively. Skim/low-fat milk, cheese, total high-fat or total low-fat dairy intake was not associated with long-term change of weight or WC. Conclusion Further longitudinal and interventional studies are warranted to confirm the beneficial role of increasing total dairy and yogurt intake, as part of a healthy and calorie-balanced dietary pattern, in the long-term prevention of gain in weight and WC.
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Berner LA, Becker G, Wise M, Doi J. Characterization of dietary protein among older adults in the United States: amount, animal sources, and meal patterns. J Acad Nutr Diet 2013; 113:809-15. [PMID: 23491327 DOI: 10.1016/j.jand.2013.01.014] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 01/10/2013] [Indexed: 12/17/2022]
Abstract
Although protein intakes in the United States are widely regarded as adequate, attention has been given to potential inadequacy of recommendations or patterns of intake in older adults. The objectives of this research were to update and expand estimates of protein intake and adequacy in older US adults, with additional focus on contributions of animal source protein. Data were obtained from 1,768 adults aged 51 years and older in the National Health and Nutrition Examination Survey 2005-2006, the Food and Nutrient Database for Dietary Studies, and US Department of Agriculture Standard Reference datasets. Estimates of inadequate intakes ranged from <1% to 5% of men aged 51 to 70 years to 9% to 24% of women aged ≥71 years, depending on whether adjusted or actual body weights were used to calculate grams of protein per kilogram of body weight. Mean usual protein intakes were 94±22 g/day and 56±13 g/day in those same groups, with 15.3%±2.3% and 15.4%±2.4% of energy from protein. Animal sources provided >60% of protein intake, on average. In regression models with energy intake, age, sex, ethnicity, and education as covariables, percent protein from animal sources predicted protein intake and odds of meeting the Recommended Dietary Allowances (P<0.001). Consumption of total and animal-source protein was skewed to the evening meal. Findings highlight the influence of body weight choice (actual vs adjusted) on estimates of protein inadequacy, and suggest the need for careful consideration of protein source in adults at risk for inadequacy. Research is needed to establish optimal protein intakes, sources, and patterns.
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Affiliation(s)
- Louise A Berner
- Food Science and Nutrition Department, California Polytechnic State University, San Luis Obispo, CA 93407, USA.
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Sakuma K, Yamaguchi A. Sarcopenic obesity and endocrinal adaptation with age. Int J Endocrinol 2013; 2013:204164. [PMID: 23690769 PMCID: PMC3639625 DOI: 10.1155/2013/204164] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/01/2013] [Indexed: 02/06/2023] Open
Abstract
In normal aging, changes in the body composition occur that result in a shift toward decreased muscle mass and increased fat mass. The loss of muscle mass that occurs with aging is termed sarcopenia and is an important cause of frailty, disability, and loss of independence in older adults. Age-related changes in the body composition as well as the increased prevalence of obesity determine a combination of excess weight and reduced muscle mass or strength, recently defined as sarcopenic obesity. Weight gain increases total/abdominal fat, which, in turn, elicits inflammation and fatty infiltration in muscle. Sarcopenic obesity appears to be linked with the upregulation of TNF-α, interleukin (IL)-6, leptin, and myostatin and the downregulation of adiponectin and IL-15. Multiple combined exercise and mild caloric restriction markedly attenuate the symptoms of sarcopenic obesity. Intriguingly, the inhibition of myostatin induced by gene manipulation or neutralizing antibody ameliorates sarcopenic obesity via increased skeletal muscle mass and improved glucose homeostasis. In this review, we describe the possible influence of endocrinal changes with age on sarcopenic obesity.
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Affiliation(s)
- Kunihiro Sakuma
- Research Center for Physical Fitness, Sports and Health, Toyohashi University of Technology, 1-1 Hibarigaoka, Tenpaku-cho, Toyohashi 441-8580, Japan
- *Kunihiro Sakuma:
| | - Akihiko Yamaguchi
- School of Dentistry, Health Sciences University of Hokkaido, Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293, Japan
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Abstract
The prevalence of obesity is rising progressively, even among older age groups. By the year 2030 to 2035 over 20% of the adult US population and over 25% of the Europeans will be aged 65 years or older. The predicted prevalence of obesity in Americans, 60 years and older was 37% in 2010. The predicted prevalence of obesity in Europe in 2015 varies between 20% and 30% dependent on the model used. This means 20.9 million obese 60 years or older people in the United States in 2010 and 32 million obese elders in 2015 in EU. Although cutoff values of body mass index, waist circumference, and percentages of fat mass have not been defined for the elderly, it is clear from several meta-analyses that mortality and morbidity associated with overweight and obesity only increases at a body mass index >30 kg/m(2). Thus, treatment should only be offered to patients who are obese rather than overweight and who have functional impairments, metabolic complications, or obesity-related diseases, that can benefit from weight loss. The weight loss therapy should minimize muscle and bone loss and vigilance as regards the development of sarcopenic obesity--a combination of an unhealthy excess of body fat with a detrimental loss of muscle and fat-free mass including bone--is important. Lifestyle intervention should be the first step and consists of a diet with a 500 kcal energy deficit and an adequate intake of protein of high biological quality, together with calcium and vitamin D, behavioral therapy, and multicomponent exercise. Multicomponent exercise includes flexibility training, balance training, aerobic exercise, and resistance training. The adherence rate in most studies is around 75%. Knowledge of constraints and modulators of physical inactivity should be of help to engage the elderly in physical activity. The role of pharmacotherapy and bariatric surgery in the elderly is largely unknown as in most studies people aged 65 years and older were excluded.
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Jesus P, Desport JC, Massoulard A, Villemonteix C, Baptiste A, Gindre-Poulvelarie L, Lorgueuilleux S, Javerliat V, Fraysse JL, Preux PM. Nutritional assessment and follow-up of residents with and without dementia in nursing homes in the Limousin region of France: a health network initiative. J Nutr Health Aging 2012; 16:504-8. [PMID: 22555799 DOI: 10.1007/s12603-012-0017-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Limousin in France has the second oldest regional population in Europe, with people over 65-years-old who have Alzheimer's disease accounting for more than 9%. In France as a whole, a large number of residents in nursing homes (NH) have dementia, leading to many nutritional problems. LINUT is a health network that assesses the nutritional status of elderly NH residents and provides support where necessary. Aims of the present study were to use this network to evaluate the nutritional status of NH residents with and without dementia and to review changes after 4 months of intervention. METHODS A cross-sectional survey was conducted by a doctor and a dietician at baseline (T0) and 4 months (T4) among residents at the 26 NH in Limousin that agreed to take part. The evaluation criteria included presence of dementia, depression and autonomy, weight, height, body mass index, Mini Nutritional Assessement (MNA™), and a 3-day survey of food intake. RESULTS The 346 residents assessed at T0 were aged 87.9±6.9 years, 83.4% were women, 66.8% had dementia, 53.3% were malnourished and 27.4% obese. Autonomy was not affected by obesity. Residents with dementia had a lower Activities of Daily Living score and a lower weight than non-demented individuals (2.2±1.2 vs. 2.7±1.7 p=0.03 and 60.1±16.3 vs. 64.7±20.0 kg p=0.03, respectively), were more often malnourished (56.1% vs. 46.4% p=0.004) and less often obese (22.0% vs. 39.1% p=0.004) but consumed more protein (62.6±17.8 vs. 58.2±16.9 g/d p=0.04, 1.1±0.4 vs. 1.0±0.4 g/kg/d p=0.005). Energy intake was at the lower limit of French recommendations (26.4±8.8 vs. >25.0 kcal/kg/d). Assessment of all residents at T4 showed improved MNA™ (+0.4 points/month p=0.02), protein intake (+3.3 g/d p=0.0007), and energy intake (+41.4 kcal/d p=0.01 and 0.1 kcal/kg/d p=0.03). Variations in prevalences of malnutrition and obesity were not statistically significant. MNA™ increased in the dementia group (+0.29±0.8 points/month p=0.003). All other changes were comparable, and nutritional status did not differ more between the two groups at T4 than at T0. CONCLUSION The prevalence of dementia was high in the population studied. Malnutrition was the main problem, particularly if residents had dementia. Protein intake was satisfactory, but energy intake often insufficient. The nutritional status of dementia patients improved after 4 months of follow-up, suggesting that effective action to support such services would be worthwhile.
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Affiliation(s)
- P Jesus
- Unité de Nutrition, CHU de Limoges
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28
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Abstract
The frailty syndrome is defined as unintentional weight and muscle loss, exhaustion, and declines in grip strength, gait speed, and activity. Evidence with respect to the clinical definition, epidemiology, mechanisms, interactions, assessment, prevention, and treatment of frailty in the older adult is reviewed.
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Affiliation(s)
- Roschelle A Heuberger
- Department of Human Environmental Studies, Central Michigan University, Mt. Pleasant, Michigan 48859, USA.
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30
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Mathus-Vliegen EMH. Prevalence, pathophysiology, health consequences and treatment options of obesity in the elderly: a guideline. Obes Facts 2012; 5:460-83. [PMID: 22797374 DOI: 10.1159/000341193] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 06/04/2012] [Indexed: 01/18/2023] Open
Abstract
The prevalence of obesity is rising progressively, even among older age groups. By the year 2030-2035 over 20% of the adult US population and over 25% of the Europeans will be aged 65 years and older. The predicted prevalence of obesity in Americans, 60 years and older was 37% in 2010. The predicted prevalence of obesity in Europe in 2015 varies between 20 and 30% dependent on the model used. This means 20.9 million obese 60+ people in the USA in 2010 and 32 million obese elders in 2015 in the EU. Although cut-off values of BMI, waist circumference and percentages of fat mass have not been defined for the elderly (nor for the elderly of different ethnicity), it is clear from several meta-analyses that mortality and morbidity associated with overweight and obesity only increases at a BMI above 30 kg/m(2). Thus, treatment should only be offered to patients who are obese rather than overweight and who also have functional impairments, metabolic complications or obesity-related diseases, that can benefit from weight loss. The weight loss therapy should aim to minimize muscle and bone loss but also vigilance as regards the development of sarcopenic obesity - a combination of an unhealthy excess of body fat with a detrimental loss of muscle and fat-free mass including bone - is important in the elderly, who are vulnerable to this outcome. Life-style intervention should be the first step and consists of a diet with a 500 kcal (2.1 MJ) energy deficit and an adequate intake of protein of high biological quality together with calcium and vitamin D, behavioural therapy and multi-component exercise. Multi-component exercise includes flexibility training, balance training, aerobic exercise and resistance training. The adherence rate in most studies is around 75%. Knowledge of constraints and modulators of physical inactivity should be of help to engage the elderly in physical activity. The role of pharmacotherapy and bariatric surgery in the elderly is largely unknown as in most studies people aged 65 years and older have been excluded.
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Affiliation(s)
- Elisabeth M H Mathus-Vliegen
- Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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31
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Dorner TE, Rieder A. Obesity paradox in elderly patients with cardiovascular diseases. Int J Cardiol 2011; 155:56-65. [PMID: 21345498 DOI: 10.1016/j.ijcard.2011.01.076] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/01/2011] [Indexed: 12/21/2022]
Abstract
Many elderly people are affected by cardiovascular diseases (CVD) and the majority of CVD patients are elderly people. For both patient populations, studies have shown that a high body mass index (BMI) is associated with lower mortality when compared to normal weight subjects, a fact commonly known as the "obesity paradox". Whether the correlation between obesity and better survival is based on methodological influences and other non-causal factors alone, or whether there is a causal link between obesity and a better survival in these subjects remains widely unexplored. The interrelation between aging, obesity, CVD, frailty and inflammation is a current issue of intensive research. For the elderly, parameters which include measures of body composition, fat and fat-free mass are of greater importance than BMI. Weight management in elderly people with cardiovascular diseases should aim at improvement and maintenance of physical function and quality of life rather than prevention of medical problems associated with obesity in younger and middle aged patients. Although many studies have shown that weight loss in elderly patients is associated with a poor prognosis, recent data demonstrate that intentional weight reduction in obese elderly people ameliorates the cardiovascular risk profile, reduces chronic inflammation and is correlated with an improved quality of life. An individual approach to weight management that includes the participation of the patient, co-morbidity, functional status, and social support should be aspired.
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Affiliation(s)
- Thomas E Dorner
- Institute of Social Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
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Romaguera D, Norat T, Vergnaud AC, Mouw T, May AM, Agudo A, Buckland G, Slimani N, Rinaldi S, Couto E, Clavel-Chapelon F, Boutron-Ruault MC, Cottet V, Rohrmann S, Teucher B, Bergmann M, Boeing H, Tjønneland A, Halkjaer J, Jakobsen MU, Dahm CC, Travier N, Rodriguez L, Sanchez MJ, Amiano P, Barricarte A, Huerta JM, Luan J, Wareham N, Key TJ, Spencer EA, Orfanos P, Naska A, Trichopoulou A, Palli D, Agnoli C, Mattiello A, Tumino R, Vineis P, Bueno-de-Mesquita HB, Büchner FL, Manjer J, Wirfält E, Johansson I, Hellstrom V, Lund E, Braaten T, Engeset D, Odysseos A, Riboli E, Peeters PH. Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr 2010; 92:912-21. [PMID: 20810975 DOI: 10.3945/ajcn.2010.29482] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is an association between a greater adherence to a Mediterranean diet and a reduced risk of developing chronic diseases. However, it is not clear whether this dietary pattern may be protective also against the development of obesity. OBJECTIVE We assessed the association between the adherence to the Mediterranean dietary pattern (MDP), prospective weight change, and the incidence of overweight or obesity. DESIGN We conducted a prospective cohort study [the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol Consumption, Cessation of Smoking, Eating Out of Home, and Obesity (EPIC-PANACEA) project] in 373,803 individuals (103,455 men and 270,348 women; age range: 25-70 y) from 10 European countries. Anthropometric measurements were obtained at recruitment and after a median follow-up time of 5 y. The relative Mediterranean Diet Score (rMED; score range: 0-18) was used to assess adherence to the MDP according to the consumption of 9 dietary components that are characteristic of the Mediterranean diet. The association between the rMED and 5-y weight change was modeled through multiadjusted mixed-effects linear regression. RESULTS Individuals with a high adherence to the MDP according to the rMED (11-18 points) showed a 5-y weight change of -0.16 kg (95% CI: -0.24, -0.07 kg) and were 10% (95% CI: 4%, 18%) less likely to develop overweight or obesity than were individuals with a low adherence to the MDP (0-6 points). The low meat content of the Mediterranean diet seemed to account for most of its positive effect against weight gain. CONCLUSION This study shows that promoting the MDP as a model of healthy eating may help to prevent weight gain and the development of obesity.
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Affiliation(s)
- Dora Romaguera
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
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McCabe-Sellers BJ. Position of the American Dietetic Association: Integration of Medical Nutrition Therapy and Pharmacotherapy. ACTA ACUST UNITED AC 2010; 110:950-6. [DOI: 10.1016/j.jada.2010.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mandas A, Congiu MG, Balestrieri C, Mereu A, Iorio EL. Nutritional status and oxidative stress in an elderly Sardinian population. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2008. [DOI: 10.1007/s12349-008-0016-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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