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Zheng G, Xia H, Lai Z, Shi H, Zhang J, Wang C, Tian F, Lin H. Dietary Inflammatory Index and Dietary Diversity Score Associated with Sarcopenia and Its Components: Findings from a Nationwide Cross-Sectional Study. Nutrients 2024; 16:1038. [PMID: 38613070 PMCID: PMC11013103 DOI: 10.3390/nu16071038] [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: 03/10/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Little is known about the independent and joint effects of the energy-adjusted dietary inflammatory index (E-DII) and dietary diversity score (DDS) on sarcopenia and its components (low muscle mass, low muscle strength, and low physical performance). A total of 155,669 UK Biobank participants with ≥1 (maximum 5) 24 h dietary assessments were included in this cross-sectional analysis. We used logistic regression models to investigate the associations of E-DII and DDS with sarcopenia and its three components. We further examined the joint effects of E-DII and DDS on sarcopenia and its components using additive and multiplicative interaction analyses. We observed that lower E-DII and higher DDS were associated with lower odds of sarcopenia and its components. There were significant joint associations of E-DII and DDS with sarcopenia and low physical performance (p-interaction < 0.05) on the multiplicative interactive scale. Our study suggests that lower dietary inflammatory potential and higher dietary diversity might be important protective factors against sarcopenia and its components. More cases of sarcopenia and low physical performance might be preventable by adherence to a more anti-inflammatory diet combined with a higher dietary diversity.
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Affiliation(s)
- Guzhengyue Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou 510080, China; (G.Z.); (Z.L.); (H.S.); (J.Z.); (F.T.)
| | - Hui Xia
- Center for Health Care, Longhua District, Shenzhen 518109, China;
| | - Zhihan Lai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou 510080, China; (G.Z.); (Z.L.); (H.S.); (J.Z.); (F.T.)
| | - Hui Shi
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou 510080, China; (G.Z.); (Z.L.); (H.S.); (J.Z.); (F.T.)
| | - Junguo Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou 510080, China; (G.Z.); (Z.L.); (H.S.); (J.Z.); (F.T.)
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China;
| | - Fei Tian
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou 510080, China; (G.Z.); (Z.L.); (H.S.); (J.Z.); (F.T.)
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou 510080, China; (G.Z.); (Z.L.); (H.S.); (J.Z.); (F.T.)
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Chen YC, Lo YTC, Wu HY, Huang YC. Adherence to dietary guidelines associated with lower medical service utilization in preschoolers: a longitudinal study. Nutr Diabetes 2024; 14:11. [PMID: 38519466 PMCID: PMC10959943 DOI: 10.1038/s41387-024-00270-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE We aimed to evaluate the association between dietary guideline adherence and overall, outpatient, and emergency medical service utilization in Taiwanese preschoolers. METHODS We selected 614 preschoolers (2-6 years) who had one day of 24-h dietary recall data from the 2013-2016 Nutrition and Health Survey in Taiwan. The Taiwanese Children Healthy Eating Index (TCHEI) was developed on the basis of Taiwanese Food-Based Dietary Guidelines; it assesses dietary adequacy and eating behavior. Data on the participants' outpatient and emergency medical service utilization were obtained for 2013-2018 from the National Health Insurance Research Database. A multivariable generalized linear model was used to evaluate the association between the TCHEI and medical service utilization for all disease and respiratory diseases. RESULTS After adjustment for confounding factors, children aged 2-3 years in the Tertile (T) 2 and T3 groups of the TCHEI exhibited 25% (95% CI 0.69-0.83) and 16% (95% CI 0.77-0.92) lower overall medical visits, respectively. The same pattern was noted in the outpatient and emergency visits for all diseases and respiratory diseases. The children aged 4-6 years in the T2 group exhibited 15% (95% CI 0.80-0.91) and 11% (95% CI 0.82-0.97) lower overall visits and visits for respiratory diseases, respectively. Moreover, preschoolers in the T2 group exhibited lower overall medical expenditures than did those in the T1 group. CONCLUSIONS TCHEI score was positively correlated with better nutritional status. Optimal dietary intake associated with lower medical service utilization among Taiwan preschoolers.
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Affiliation(s)
- Yi-Chieh Chen
- Department of Nutrition, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun District, Taichung, 406040, Taiwan
- Department of Nutrition, Chang Bing Show Chwan Memorial Hospital, No. 6, Lugong Rd., Lukang Township, Changhua County, 50544, Taiwan
| | - Yuan-Ting C Lo
- Department of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Niehu District, Taipei, 11490, Taiwan
| | - Hsin-Yun Wu
- Department of Nutrition, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun District, Taichung, 406040, Taiwan
| | - Yi-Chen Huang
- Department of Nutrition, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun District, Taichung, 406040, Taiwan.
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Nuijten MAH, Eijsvogels TMH, Sanders B, Vriese LM, Monpellier VM, Hazebroek EJ, Janssen IMC, Hopman MTE. Changes in Fat-Free Mass, Protein Intake and Habitual Physical Activity Following Roux-en-Y Gastric Bypass Surgery: A Prospective Study. Obes Surg 2023; 33:2148-2157. [PMID: 37249699 PMCID: PMC10228447 DOI: 10.1007/s11695-023-06650-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE Large inter-individual variations in post-bariatric fat-free mass loss (FFML) are observed, which might relate to differences in protein intake and physical activity across patients. We performed repetitive assessments of protein intake and physical activity before and after banded Roux-en-Y gastric bypass surgery, and examined its relations to FFML during 6 months of follow-up. MATERIALS AND METHODS FFML (bio-impedance analyses), protein intake (24-h dietary recalls) and moderate-to-vigorous physical activity (MVPA; activPAL) were assessed in 28 patients (4 males, age 42 ± 12 years) before surgery and at 1-, 3- and 6-months post-surgery. Changes in protein intake and MVPA were evaluated with mixed model analysis, whereas associations with FFML were assessed by univariate regression analysis. RESULTS Six-month FFML was -7.3 ± 3.6 kg. Protein intake decreased from 80 ± 29 g/day (pre-surgery) to 45 ± 26 g/day (1 month post-surgery (P < 0.001)) and did not improve thereafter (51 ± 21 g/day; P > 0.05). Seven participants (25%) consumed ≥ 60 g protein/day at 6 months post-surgery. Participants performed 7394 ± 2420 steps/day in 54 ± 20 min/day of MVPA, which did not change from pre- to post-surgery (P > 0.05). A higher step count (B = -0.002; 95%CI = [-0.004 - 0.000]; P = 0.048) and higher level of MVPA (B = -0.29; 95%CI = [-0.54 - -0.03]; P = 0.018) were related to a lower FFML. CONCLUSION A lower post-surgery FFML was attributable to higher MVPA levels but not protein intake. This may be due to the low total protein intake and the observation that only a minority of patients achieved a protein intake ≥ 60 g/day. Future studies should focus on interventions to increase post-bariatric protein intake and MVPA levels.
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Affiliation(s)
- Malou A H Nuijten
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
- Nederlandse Obesitas Kliniek, Huis Ter Heide, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
| | - Boy Sanders
- Nederlandse Obesitas Kliniek, Huis Ter Heide, The Netherlands
| | - Laura M Vriese
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
| | | | - Eric J Hazebroek
- Department of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, The Netherlands
| | | | - Maria T E Hopman
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands.
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Tuan SH, Chang LH, Sun SF, Lin KL, Tsai YJ. Using exergame-based exercise to prevent and postpone the loss of muscle mass, muscle strength, cognition, and functional performance among elders in rural long-term care facilities: A protocol for a randomized controlled trial. Front Med (Lausanne) 2022; 9:1071409. [PMID: 36582297 PMCID: PMC9792490 DOI: 10.3389/fmed.2022.1071409] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Objective Elderly individuals in long-term care facilities (LTCFs) have a higher prevalence of sarcopenia than those in the community. Exercise is the gold standard for preventing and treating sarcopenia. Regarding exercise, multicomponent exercises, including progressive resistance training (PRT), are beneficial. However, developing routine, structured exercise programs for the elderly in LTCFs is difficult because of a shortage of healthcare providers, particularly in rural regions. Exergame-based exercises can increase a player's motivation and reduce staff time for an intervention. Nintendo Switch RingFit Adventure (RFA) is a novel exergame that combines resistance, aerobic, and balance exercises. In this study, we aim to investigate the clinical effectiveness of RFA on muscle and functional performance parameters among the elderly in LTCFs. Methods The EXPPLORE (using EXergame to Prevent and Postpone the LOss of muscle mass, muscle strength, and functional performance in Rural Elders) trial is a single-center randomized controlled trial involving elderly individuals (≥60 years) living in LTCFs in rural southern Taiwan. The participants will be equally randomized to the intervention group (exergame-based exercise plus standard care) or the control group (standard care alone). Both groups will receive standard care except that the intervention group will receive exergame-based exercises at the time previously scheduled for sedentary activities in the LTCFs. The exergame-based exercise will be performed using RFA in the sitting position with a specialized design, including arm fit skills and knee assist mode. Each session of the exercise lasts 30 mins and will be performed two times per week for 12 weeks. The primary outcomes will be the osteoporotic fracture index, appendicular skeletal muscle mass index, dominant handgrip strength, and gait speed. Meanwhile, the secondary outcomes will be the dexterity and agility, muscle strength and thickness, range of motion of the joints of the dominant upper extremity, Kihon checklist, Medical Outcomes Study 36-Item Short-Form Health Survey, and Brain Health Test. Discussion This trial will provide valuable knowledge on whether exergames using RFA can counteract physical decline and improve quality of life and cognition among the elderly in LTCFs. Clinical trial registration [www.ClinicalTrials.gov], identifier [NCT05360667].
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Affiliation(s)
- Sheng-Hui Tuan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,Department of Rehabilitation Medicine, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung City, Taiwan
| | - Ling-Hui Chang
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Shu-Fen Sun
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung city, Taiwan,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Ko-Long Lin
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung city, Taiwan,School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan,School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yi-Ju Tsai
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan,*Correspondence: Yi-Ju Tsai,
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Viecelli C, Ewald CY. The non-modifiable factors age, gender, and genetics influence resistance exercise. FRONTIERS IN AGING 2022; 3:1005848. [PMID: 36172603 PMCID: PMC9510838 DOI: 10.3389/fragi.2022.1005848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 06/13/2023]
Abstract
Muscle mass and force are key for movement, life quality, and health. It is well established that resistance exercise is a potent anabolic stimulus increasing muscle mass and force. The response of a physiological system to resistance exercise is composed of non-modifiable (i.e., age, gender, genetics) and modifiable factors (i.e., exercise, nutrition, training status, etc.). Both factors are integrated by systemic responses (i.e., molecular signaling, genetic responses, protein metabolism, etc.), consequently resulting in functional and physiological adaptations. Herein, we discuss the influence of non-modifiable factors on resistance exercise: age, gender, and genetics. A solid understanding of the role of non-modifiable factors might help to adjust training regimes towards optimal muscle mass maintenance and health.
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Affiliation(s)
- Claudio Viecelli
- Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland
| | - Collin Y. Ewald
- Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
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Chen L, Wu L, Li Q, Hu Y, Ma H, Lin H, Gao X. Hyperuricemia Associated with Low Skeletal Muscle in the Middle-Aged and Elderly Population in China. Exp Clin Endocrinol Diabetes 2022; 130:546-553. [PMID: 35609819 DOI: 10.1055/a-1785-3729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous studies have presented inconsistent results on the relationship between serum uric acid and skeletal muscle mass (SMM). We aimed to explore whether a higher serum uric acid level was associated with low SMM in the Chinese population. METHODS We performed a cross-sectional analysis of 6595 subjects aged 45 years or older. They were tested for fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, uric acid, blood urea nitrogen, creatinine, and estimated glomerular filtration rate. SMM was accessed by dual-energy x-ray absorptiometry using two approaches: weight-adjusted appendicular skeletal muscle mass (ASM)% and ASM/BMI (body mass index (kg/m2)). Low SMM was defined as a cut-off point of ASM/BMI<0.789 for men and<0.512 for women. RESULTS Compared with their normal group, patients with hyperuricemia had lower ASM% (29.33±2.33 vs 30.03±2.34 for males and 24.71±1.99 vs 25.19±2.07 for females, P<0.01) and ASM/BMI (0.83±0.10 vs 0.85±0.10 for male and 0.60±0.07 vs 0.62±0.07 for female), with a higher prevalence of the associated low SMM in both sexes (35.2 vs 26.5% for male and 10.5 vs 5.9% for female, P<0.01). Pearson analysis showed that ASM% and ASM/BMI were negatively correlated with SUA (male: ASM/BMI, r=-0.097, ASM%, r=-0.146; female: ASM/BMI, r=-0.151, ASM%, r=-0.157; all P<0.001). Logistic regression analysis showed a positive association of hyperuricemia with adjusted risk of low SMM association. CONCLUSIONS In a middle-aged and elderly Chinese population, hyperuricemia is independently and positively associated with low SMM and can vary by age and gender.
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Affiliation(s)
- Lingyan Chen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Li Wu
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China
| | - Qian Li
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Hui Ma
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Huandong Lin
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China.,Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
| | - Xin Gao
- Fudan Institute for Metabolic Diseases, Fenglin Road, Shanghai, China.,Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Fenglin Road, Shanghai, China
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Pap Z, Kalabiska I, Balogh Á, Bhattoa HP. Prevalence of sarcopenia in community dwelling outpatient postmenopausal Hungarian women. BMC Musculoskelet Disord 2022; 23:207. [PMID: 35246081 PMCID: PMC8897857 DOI: 10.1186/s12891-022-05167-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Ageing is an inherent feature of life and as per the United Nations, in the year 2020, 985 million women were ≥ 50 years of age worldwide, and the figure is expected to rise to 1.65 billion by 2050. Preservation of health and well-being in the elderly are challenging, and on the same note generalized changes in the musculoskeletal system contribute to this scenario. Musculoskeletal changes with ageing are referred to as sarcopenia. Reduced muscle mass and physical performance are hallmarks of sarcopenia, exclaimed with difficulty in independent activity and poor quality of life. Knowing that there is a hiatus in our knowledge as regards to the prevalence of sarcopenia in Hungary, the aim of this study was to determine the prevalence of sarcopenia in a community dwelling outpatient postmenopausal Hungarian cohort using the EWGSOP2 consensus recommendation. Methods In this cross-sectional study, women arriving for routine bone densitometry examination at the Regional Osteoporosis Center, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen were invited to participate in the study. A total of a 100 community-dwelling women were recruited who confirmed to the inclusion criteria of self-reported postmenopausal status, ≥ 50 years of age and gave written informed consent. The study procedures included the self-administered SARC-F questionnaire, followed by assessment of muscle strength, muscle quantity and physical preformance. Muscle strength was determined with the hand grip strength (HGS), appendicular skeletal muscle mass was assessed using dual energy X-ray absorptiometry and physical performance was determined by the gait speed (GS) test. Results As per the EWGSOP2 definition, the percentage of study participants with probable sarcopenia (low muscle strength), sarcopenia (low muscle strength and low muscle quantity) and severe sarcopenia (low muscle strength, muscle quantity and low physical performance) was 36, 31 and 8%, respectively. Multiple linear regression analysis revealed that height, weight, HGS and GS were all independent predictors of appendicular skeletal muscle mass. Conclusion The 31% prevalence of sarcopenia in the studied post-menopausal women highlights the need for adequate assessment of the condition in the elderly. Our findings most probably bear public health implications and may accelerate formulation of policies promoting healthy ageing. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05167-2.
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Affiliation(s)
- Zoltán Pap
- Kalman Laki Doctoral School of the University of Debrecen, Department of Traumatology and Hand Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Irina Kalabiska
- University of Physical Education, Research Center for Sport Physiology, Budapest, Hungary
| | - Ádám Balogh
- Regional Osteoporosis Center, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd. 98, Debrecen, H-4032, Hungary.
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Ramadas A, Law HH, Krishnamoorthy R, Ku JWS, Mohanty P, Lim MZC, Shyam S. Diet Quality and Measures of Sarcopenia in Developing Economies: A Systematic Review. Nutrients 2022; 14:nu14040868. [PMID: 35215518 PMCID: PMC8874949 DOI: 10.3390/nu14040868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 12/24/2022] Open
Abstract
Sarcopenia refers to common age-related changes characterised by loss of muscle mass, strength, and physical performance that results in physical disability, poorer health status, and higher mortality in older adults. Diet quality is indicated as a potentially modifiable risk factor for sarcopenia. However, the association between diet quality and sarcopenia in developing economies appears to be conflicting. Hence, we conducted a systematic review of the literature from developing economies examining the relationship between diet quality and at least one of the three components of sarcopenia, including muscle mass, muscle strength, and physical performance, and the overall risk of sarcopenia. No restrictions on age and study design were employed. We identified 15 studies that met review inclusion criteria. There was heterogeneity among the studies in the diet quality metric used and sarcopenia-related outcomes evaluated. Longitudinal evidence and studies relating diet quality to a holistic definition of sarcopenia were lacking. Although limited and predominantly cross-sectional, the evidence consistently showed that diet quality defined by diversity and nutrient adequacy was positively associated with sarcopenia components, such as muscle mass, muscle strength, and physical performance.
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Affiliation(s)
- Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia; (A.R.); (H.H.L.); (J.W.S.K.); (M.Z.C.L.)
| | - Hian Hui Law
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia; (A.R.); (H.H.L.); (J.W.S.K.); (M.Z.C.L.)
| | - Raanita Krishnamoorthy
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur 50603, Malaysia;
| | - Jordan Wei Shan Ku
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia; (A.R.); (H.H.L.); (J.W.S.K.); (M.Z.C.L.)
| | - Parimala Mohanty
- Department of Community Medicine, Institute of Medical Sciences & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), K8 Lane, Kalinganagar, Bhubaneswar 751003, India;
| | - Matteus Zhen Chien Lim
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Malaysia; (A.R.); (H.H.L.); (J.W.S.K.); (M.Z.C.L.)
| | - Sangeetha Shyam
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia
- Centre for Translational Research, IMU Institute for Research and Development (IRDI), International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia
- Correspondence:
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Mo YH, Su YD, Dong X, Zhong J, Yang C, Deng WY, Yao XM, Liu BB, Wang XH. Development and Validation of a Nomogram for Predicting Sarcopenia in Community-Dwelling Older Adults. J Am Med Dir Assoc 2021; 23:715-721.e5. [PMID: 34932988 DOI: 10.1016/j.jamda.2021.11.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To establish and validate a nomogram that predicts the risk of sarcopenia for community-dwelling older residents. DESIGN Retrospective study. SETTING AND PARTICIPANTS A total of 1050 community-dwelling older adults. METHODS Data from a survey of community-dwelling older residents (≥60 years old) in Hunan, China, from June to September 2019 were retrospectively analyzed. The survey included general demographic information, diet, and exercise habits. Sarcopenia diagnosis was according to 2019 Asian Working Group for Sarcopenia criteria. Participants were randomly divided into the development group and validation groups. Independent risk factors were screened by multivariate logistic regression analysis. Based on the independent risk factors, a nomogram model was developed to predict the risk of sarcopenia for community-dwelling older adults. Both in the development and validation sets, the discrimination, calibration, and clinical practicability of the nomogram were verified using receiver operating characteristic curve analysis, Hosmer-Lemeshow test, and decision curve analysis, respectively. RESULTS Sarcopenia was identified in 263 (25.0%) participants. Age, body mass index, marital status, regular physical activity habit, uninterrupted sedentary time, and dietary diversity score were significant contributors to sarcopenia risk. A nomogram for predicting sarcopenia in community-dwelling older adults was developed using these factors. Receiver operating characteristic curve analysis showed that the area under the curve was 0.827 (95% CI 0.792-0.860) and 0.755 (95% CI 0.680-0.837) in the development and validation sets, respectively. The Hosmer-Lemeshow test yielded P values of .609 and .565, respectively, for the 2 sets. The nomogram demonstrated a high net benefit in the clinical decision curve in both sets. CONCLUSIONS AND IMPLICATIONS This study developed and validated a risk prediction nomogram for sarcopenia among community-dwelling older adults. Sarcopenia risk was classified as low (<11%), moderate (11%-70%), and high (>70%). This nomogram provides an accurate visual tool to medical staff, caregivers, and older adults for prediction, early intervention, and graded management of sarcopenia.
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Affiliation(s)
- Yi-Han Mo
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Yi-Dong Su
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Xin Dong
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Jing Zhong
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wen-Yu Deng
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Xue-Mei Yao
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Bei-Bei Liu
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Xiu-Hua Wang
- Xiangya Nursing School, The Central South University, Changsha, China.
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Yagi T, Inoue T, Ogawa M, Shimada Y, Heguri Y, Okada R, Iwata S, Kishimoto M. Sarcopenia affects activities of daily living recovery and hospitalization costs in older adults in convalescent rehabilitation wards. Eur Geriatr Med 2021; 12:1237-1245. [PMID: 34403114 DOI: 10.1007/s41999-021-00552-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/02/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to investigate the impact of sarcopenia on activities of daily living (ADL) recovery and hospitalization costs in older patients admitted to convalescent rehabilitation wards. METHODS This prospective cohort study included 104 patients aged ≥ 65 years who were admitted to convalescent rehabilitation wards. The primary outcome was ADL recovery as evaluated by the Functional Independence Measure (FIM) efficiency during hospitalization, and the secondary outcome was hospital-related costs. Univariate and multivariate analyses were performed to identify whether sarcopenia was associated with FIM-motor efficiency and hospitalization costs. RESULTS Among the patients, 68.3% were females, and the mean age was 82.3 ± 8.3 years. The prevalence of sarcopenia was 73.1%. The FIM-motor efficiency score was significantly lower in patients with sarcopenia (median 0.38; interquartile range 0.27-0.52) than in those without sarcopenia (median 0.55; interquartile range 0.34-0.87) (P = 0.009). Hospitalization costs were higher in patients with sarcopenia (32,813 ± 15,184 dollars) than in those without sarcopenia (26,879 ± 10,248 dollars) (P = 0.058). Multivariate analysis showed that sarcopenia was independently associated with FIM-motor efficiency (standardized β = - 0.236, P = 0.014, R2 = 0.40) and hospitalization costs (standardized β = 0.15, P = 0.027, R2 = 0.70) after adjusting for confounding factors. CONCLUSION We found that sarcopenia reduces the FIM-motor efficiency and increases direct hospitalization costs in older patients admitted to convalescent rehabilitation wards. Therefore, it is necessary to design interventions to prevent sarcopenia and improve the efficiency of ADL recovery and reduce direct hospitalization cost.
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Affiliation(s)
- Takuma Yagi
- Department of Rehabilitation, Hattori Hospital, 218-3 Otsuka, Miki City, Hyogo, 673-0413, Japan
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City, 950-3198, Japan.
| | - Masato Ogawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, 5-2 7-chome Kusunokicho, Kobe Chuo-ku, Hyogo, 650-0017, Japan
| | - Yusuke Shimada
- Department of Rehabilitation, Hattori Hospital, 218-3 Otsuka, Miki City, Hyogo, 673-0413, Japan
| | - Yasunori Heguri
- Department of Rehabilitation, Hattori Hospital, 218-3 Otsuka, Miki City, Hyogo, 673-0413, Japan
| | - Risa Okada
- Department of Rehabilitation, Hattori Hospital, 218-3 Otsuka, Miki City, Hyogo, 673-0413, Japan
| | - Shuto Iwata
- Department of Rehabilitation, Hattori Hospital, 218-3 Otsuka, Miki City, Hyogo, 673-0413, Japan
| | - Mizuho Kishimoto
- Department of Rehabilitation, Hattori Hospital, 218-3 Otsuka, Miki City, Hyogo, 673-0413, Japan
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11
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Tey SL, Huynh DTT, Berde Y, Baggs G, How CH, Low YL, Cheong M, Chow WL, Tan NC, Chew STH. Prevalence of low muscle mass and associated factors in community-dwelling older adults in Singapore. Sci Rep 2021; 11:23071. [PMID: 34845250 PMCID: PMC8630119 DOI: 10.1038/s41598-021-02274-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/08/2021] [Indexed: 12/25/2022] Open
Abstract
The population is rapidly aging worldwide, and there is an age-related decline in muscle mass. Therefore, it is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. The objectives of this cross-sectional study were (i) to determine the prevalence of low ASMI (ASM/height2) and (ii) to identify factors associated with low ASMI. This study included 1211 community-dwelling adults aged ≥ 65 years. Low ASMI was defined as < 7.0 kg/m2 in males and < 5.7 kg/m2 in females (bioelectrical impedance analysis). Gender-specific cut-off values of calf circumference for low ASMI were determined. The prevalence of low ASMI in the overall cohort was 59.9%, i.e., 57.0% among males and 61.8% among females, with no significant difference between genders (P = 0.1068). The prevalence of low ASMI was 81.3% in individuals at risk of malnutrition compared to 20.6% in their counterparts with normal nutritional status (P < 0.0001). Participants with low ASMI were older, had lower physical activity scores, and greater likelihood of hospitalization in prior 6 months compared with normal ASMI (all P < 0.0001). Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). Cut-off values of calf circumference for low ASMI for males was 33.4 cm and for females was 32.2 cm. In conclusion, we found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Other significant factors associated with low ASMI were age, smoking, drinking, calf circumference, and bone mass. Screening community-dwelling older adults for risk of malnutrition can prevent or delay onset of low ASMI.
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Affiliation(s)
- Siew Ling Tey
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore.
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Yatin Berde
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd., Mumbai, India
| | - Geraldine Baggs
- Abbott Nutrition Research and Development, Columbus, OH, 43219, USA
| | - Choon How How
- Care and Health Integration, Changi General Hospital, Singapore, 529889, Singapore.,SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Yen Ling Low
- Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, 138668, Singapore
| | - Magdalin Cheong
- Department of Dietetic & Food Services, Changi General Hospital, Singapore, 529889, Singapore
| | - Wai Leng Chow
- Health Services Research, Changi General Hospital, Singapore, 529889, Singapore
| | - Ngiap Chuan Tan
- SingHealth-Duke NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore.,SingHealth Polyclinics, Singapore, 150167, Singapore
| | - Samuel Teong Huang Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore, 529889, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
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12
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Chew STH, Kayambu G, Lew CCH, Ng TP, Ong F, Tan J, Tan NC, Tham SL. Singapore multidisciplinary consensus recommendations on muscle health in older adults: assessment and multimodal targeted intervention across the continuum of care. BMC Geriatr 2021; 21:314. [PMID: 34001023 PMCID: PMC8127264 DOI: 10.1186/s12877-021-02240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The rapidly aging societies worldwide and in Singapore present a unique challenge, requiring an integrated multidisciplinary approach to address high-value targets such as muscle health. We propose pragmatic evidence-based multidisciplinary consensus recommendations for the assessment and multi-modal management of muscle health in older adults (≥65 years) across the continuum of care. METHODS The recommendations are derived from an in-depth review of published literature by a multidisciplinary working group with clinical experience in the care of the older population in both acute and community settings. RESULTS The panel recommends screening for muscle impairment using the SARC-F questionnaire, followed by assessment for low muscle strength (handgrip strength or 5-times chair stand test ≥10 s as a surrogate for lower limb strength) to diagnose possible/probable sarcopenia. For uncomplicated cases, lifestyle modifications in exercise and diet can be initiated in the community setting without further assessment. Where indicated, individuals diagnosed with possible/probable sarcopenia should undergo further assessment. Diagnosis of sarcopenia should be based on low muscle strength and low muscle mass (bioimpedance analysis, dual-energy X-ray absorptiometry or calf circumference as a surrogate). The severity of sarcopenia should be determined by assessment of physical performance (gait speed or 5-times chair stand test ≥12 s as a surrogate for gait speed). To treat sarcopenia, we recommend a combination of progressive resistance-based exercise training and optimization of nutritional intake (energy, protein and functional ingredients). High quality protein in sufficient quantity, to overcome anabolic resistance in older adults, and distributed throughout the day to enable maximum muscle protein synthesis, is essential. The addition of resistance-based exercise training is synergistic in improving the sensitivity of muscle protein synthesis response to the provision of amino acids and reducing anabolic resistance. An expected dose-response relationship between the intensity of resistance-based training, lean mass and muscle strength is described. CONCLUSIONS Reviewed and endorsed by the Society of Rehabilitation Medicine Singapore and the Singapore Nutrition and Dietetics Association, these multidisciplinary consensus recommendations can provide guidance in the formulation of comprehensive and pragmatic management plans to improve muscle health in older adults in Singapore and Asia.
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Affiliation(s)
- Samuel T H Chew
- Department of Geriatric Medicine, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
- Society for Geriatric Medicine Singapore, Singapore, Singapore.
| | - Geetha Kayambu
- Department of Rehabilitation, National University Hospital, Singapore, Singapore
| | | | - Tze Pin Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Fangyi Ong
- Singapore Nutrition and Dietetics Association, Singapore, Singapore
| | - Jonathan Tan
- Mount Elizabeth Novena Hospital, Singapore, Singapore
| | - Ngiap Chuan Tan
- Department of Research, SingHealth Polyclinics, Singapore, Singapore
| | - Shuen-Loong Tham
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Society of Rehabilitation Medicine, Singapore, Singapore
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13
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Chan LC, Yang YC, Lin HC, Wahlqvist ML, Hung YJ, Lee MS. Nutrition counseling is associated with less sarcopenia in diabetes: A cross-sectional and retrospective cohort study. Nutrition 2021; 91-92:111269. [PMID: 34343727 DOI: 10.1016/j.nut.2021.111269] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/14/2021] [Accepted: 04/03/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Muscle is crucial for blood glucose regulation. There is a need to prevent and treat sarcopenia in diabetes mellitus (DM). This study aimed to estimate the prevalence of sarcopenia and evaluate the association of nutritional counseling with the development of sarcopenia for people with DM. METHODS In a cross-sectional and retrospective cohort study, people with type 2 DM were recruited from the Diabetes Shared Care Program of a teaching hospital. Muscle mass, muscle strength, and physical functional performance were evaluated using the Asian Working Group for Sarcopenia criteria. The skeletal muscle mass index was determined by dividing muscle mass by the square of the height. Clinical information, including the nutrition counseling record, was retrospectively obtained from medical records for a 2-y period. RESULTS The prevalence of low skeletal muscle mass index (presarcopenia) and sarcopenia were, respectively, 20.4% and 9.6% (including 3.1% severe) among 1292 participants. Specifically, 15.3% of participants age ≥ 65 y were categorized as having sarcopenia. With more frequent nutritional counseling, there was a lesser risk of sarcopenia; the adjusted odds ratio (95% confidence interval) was 0.51 (0.27-0.94) for ≥ 3 times/2 y compared to no counseling. DM duration and age, glycemic status and medication, and body mass index and counseling frequency had no joint effects; however, these variables (except HbA1 c) were independent risk factors for low skeletal muscle mass index and sarcopenia. CONCLUSIONS People with type 2 DM have a high risk of sarcopenia. Increased nutrition counseling in outpatients was associated with less sarcopenia. Education about sarcopenia-associated risk factors should be encouraged early in the onset of DM.
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Affiliation(s)
- Lin-Chien Chan
- Department of Food and Nutrition, Tri-Service General Hospital, Taipei, Taiwan, Republic of China; School of Nursing, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yun-Chin Yang
- Department of Food and Nutrition, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Hsu-Chen Lin
- Department of Food and Nutrition, Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Mark L Wahlqvist
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China; Monash Asia Institute, Monash University, Melbourne, Victoria, Australia; Department of Nutrition, China Medical University, Taichung, Taiwan, Republic of China; Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan, Republic of China
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan, Republic of China
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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14
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Davis JA, Mohebbi M, Collier F, Loughman A, Shivappa N, Hébert JR, Pasco JA, Jacka FN. Diet quality and a traditional dietary pattern predict lean mass in Australian women: Longitudinal data from the Geelong Osteoporosis Study. Prev Med Rep 2021; 21:101316. [PMID: 33505843 PMCID: PMC7815486 DOI: 10.1016/j.pmedr.2021.101316] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/01/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022] Open
Abstract
Low muscle mass is associated with reduced independence and increased risk for falls and fractures. Identification of modifiable risk factors for low muscle mass is thus imperative. This study aimed to examine the longitudinal relationship between both diet quality and patterns and lean mass in Australian women. Data from n = 494 participants of the Geelong Osteoporosis Study's 10- and 15-year women's follow-ups were used (conducted in 2004-08 and 2011-14, respectively), and participants were aged 21-89 years. Self-reported lifestyle and demographics were collected, and food frequency questionnaire data informed the dietary exposure variables: the Australian Recommended Food Score (ARFS); the Dietary Inflammatory Index (DII); and a posteriori dietary patterns. The outcome, Skeletal Muscle Index (SMI), was calculated from DXA-derived appendicular lean mass (ALM) relative to height (ALM kg/m2). Analyses employed Generalised Estimating Equations. A higher ARFS score positively predicted SMI over 5-years, and adjustments for age and physical activity did not attenuate this relationship (B:0.044, (95%CI 0.004, 0.084) kg/m2). Following adjustment, both an anti-inflammatory diet (B:-0.034, (95%CI -0.070, -0.002) kg/m2) and a 'traditional' dietary pattern predicted higher SMI (B:0.081, (95%CI 0.004, 0.158) kg/m2). No other associations were observed. Our study reinforces the importance of diet quality for healthy, aging muscle mass. Furthermore, a less inflammatory diet and a diet comprising a wide variety of plant and animal foods may be conducive to maintenance of muscle mass in women. Further studies investigating diet quality's impact on various muscle health measures over longer time periods are warranted.
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Affiliation(s)
- Jessica A. Davis
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
| | - Mohammadreza Mohebbi
- Deakin University, Faculty of Health, Biostatistics Unit, Building BC, Room BC4.121, 221 Burwood Highway, Geelong, Burwood, VIC 3125, Australia
| | - Fiona Collier
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Geelong Centre for Emerging Infectious Diseases (GCEID), Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Barwon Health, PO Box 281, Geelong, VIC 3220, Australia
| | - Amy Loughman
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
| | - Julie A. Pasco
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Barwon Health, PO Box 281, Geelong, VIC 3220, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, 553 St Kilda Rd, Melbourne, VIC 3004, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Furlong Rd, St Albans, VIC 3021, Australia
| | - Felice N. Jacka
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Flemington Road, Parkville, VIC 3052, Australia
- Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia
- James Cook University, 1 James Cook Dr, Douglas, QLD 4811, Australia
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15
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Using Virtual Reality-Based Rehabilitation in Sarcopenic Older Adults in Rural Health Care Facilities-A Quasi-Experimental Study. J Aging Phys Act 2021; 29:866-877. [PMID: 33596540 DOI: 10.1123/japa.2020-0222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 11/18/2022]
Abstract
Because of a shortage of health care providers, providing rehabilitation in health care facilities is difficult. Virtual reality-based rehabilitation is effective in older populations. There are only a few studies among patients with sarcopenia. This is a quasi-experimental, single-group, pretest-posttest design evaluating the clinical effectiveness of virtual reality-based progressive resistance training among residents aged over 60 years with sarcopenia in rural care facilities. The authors used Oculus Rift with headsets to provide the virtual reality-based progressive resistance training. The authors administered the program twice per week, 30 min per session, for 12 weeks. The primary outcomes were dominant handgrip strength, walking speed, and appendicular skeletal muscle mass index. Data from 30 participants were analyzed. Significant improvements in handgrip strength and walking speed were observed. Although an increasing trend in appendicular skeletal muscle mass index was observed, it did not reach statistical significance. The authors concluded that the virtual reality-based progressive resistance training is partially effective in older sarcopenic adults in health care facilities.
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16
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Lin YC, Lu YC, Chen FP, Lin YC, Cheung YC, Chan WP. Selecting Appropriate Sarcopenia Screening Methods for Asian Populations. J Clin Med 2020; 9:jcm9082333. [PMID: 32707874 PMCID: PMC7464734 DOI: 10.3390/jcm9082333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 12/05/2022] Open
Abstract
We aimed to determine the most appropriate sarcopenia screening method for Asian populations. We retrospectively studied the physiological differences between the sexes in healthy individuals and prospectively compared using skeletal muscle mass versus handgrip strength (HS) to screen for sarcopenia in a community-based population. Skeletal muscle mass was determined using dual-energy X-ray absorptiometry. Of 5881 healthy individuals recruited, 101 were from urban populations and 349 from a community-based population. The sexes were comparable in total lean muscle mass declines after peaking around 20 years of age. An age-dependent decline in total fat mass was found only among men;a persistent increase in total fat mass was observed only among women. The prevalence of low skeletal muscle mass significantly increased with age in both sexes only when applying the weight-adjusted skeletal muscle index (wSMI); it was significant only among men when applying the height-adjusted skeletal muscle index (hSMI). Using HS resulted in a much higher prevalence of sarcopenia in both sexes. A significant age-dependent increase in fat mass in women showed that the most appropriate adjustment method is wSMI for women and hSMI for men. Nevertheless, a primary HS survey is recommended for both sexes in Asian populations.
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Affiliation(s)
- Yu-Ching Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan 33001, Taiwan;
- Keelung Osteoporosis Prevention and Treatment Center, Keelung 200131, Taiwan;
| | - Yi-Chien Lu
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan;
| | - Fang-Ping Chen
- Keelung Osteoporosis Prevention and Treatment Center, Keelung 200131, Taiwan;
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan 33001, Taiwan
| | - Ying Chin Lin
- Department of Family Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan;
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 10001, Taiwan
| | - Yun-Chung Cheung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Institute for Radiological Research, Chang Gung University, Taoyuan 33001, Taiwan;
| | - Wing P. Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan;
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 10001, Taiwan
- Medical Innovation Development Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Correspondence: ; Tel.: +886-6(2)29307930 (ext. 1300); Fax: +886-6(2)29316809
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17
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Using smartphone accelerometer data to obtain scientific mechanical-biological descriptors of resistance exercise training. PLoS One 2020; 15:e0235156. [PMID: 32667945 PMCID: PMC7363108 DOI: 10.1371/journal.pone.0235156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background Single repetition, contraction-phase specific and total time-under-tension (TUT) are crucial mechano-biological descriptors associated with distinct morphological, molecular and metabolic muscular adaptations in response to exercise, rehabilitation and/or fighting sarcopenia. However, to date, no simple, reliable and valid method has been developed to measure these descriptors. Objective In this study we aimed to test whether accelerometer data obtained from a standard smartphone placed on the weight stack can be used to extract single repetition, contraction-phase specific and total TUT. Methods Twenty-two participants performed two sets of ten repetitions of their 60% one repetition maximum with a self-paced velocity on nine commonly used resistance exercise machines. Two identical smartphones were attached on the resistance exercise weight stacks and recorded all user-exerted accelerations. An algorithm extracted the number of repetitions, single repetition, contraction-phase specific and total TUT. All exercises were video-recorded. The TUT determined from the algorithmically-derived mechano-biological descriptors was compared with the video recordings that served as the gold standard. The agreement between the methods was examined using Limits of Agreement (LoA). The association was calculated using the Pearson correlation coefficients and interrater reliability was determined using the intraclass correlation coefficient (ICC 2.1). Results The error rate of the algorithmic detection of single repetitions derived from two smartphones accelerometers was 0.16%. Comparing algorithmically-derived, contraction-phase specific TUT against video, showed a high degree of correlation (r>0.93) for all exercise machines. Agreement between the two methods was high on all exercise machines as follows: LoA ranged from -0.3 to 0.3 seconds for single repetition TUT (0.1% of mean TUT), from -0.6 to 0.3 seconds for concentric contraction TUT (7.1% of mean TUT), from -0.3 to 0.5 seconds for eccentric contraction TUT (4.1% of mean TUT) and from -1.9 to 1.1 seconds for total TUT (0.5% of mean TUT). Interrater reliability for single repetition, contraction-phase specific TUT was high (ICC > 0.99). Conclusion Data from smartphone accelerometer derived resistance exercise can be used to validly and reliably extract crucial mechano-biological descriptors. Moreover, the presented multi-analytical algorithmic approach enables researchers and clinicians to reliably and validly report missing mechano-biological descriptors.
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18
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Imagining a habitable planet through food and health. Eur J Clin Nutr 2020; 75:219-229. [PMID: 32555318 DOI: 10.1038/s41430-020-0672-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/21/2020] [Accepted: 06/04/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Whether and how it might be possible to imagine a habitable planet through food and health. METHODS Reflection on childhood happenstances, sociodemographic circumstances, educational opportunities, persons of influence and lifetime experiences insofar as they might have shaped a view of the past, present and future world as the sole rational home of us all. Confirmation of these notions by personal, kindred, and other contemporary records and publications. RESULTS The need to live with uncertainty and an appreciation of connectedness with things animate and inanimate; and for this to be belief, identity, reason and professional imprimatur. That these things have unwittingly informed a near lifetime of interest and enthusiasm for how food and health systems are best served by socioecological approaches. CONCLUSIONS That we are socioecological beings with a destiny dependent on reconciling ourselves, as earthlings, as to how well we keep our place in the cosmos habitable. To that end we must dream and work.
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Lu Y, Karagounis LG, Ng TP, Carre C, Narang V, Wong G, Tan CTY, Zin Nyunt MS, Gao Q, Abel B, Poidinger M, Fulop T, Bosco N, Larbi A. Systemic and Metabolic Signature of Sarcopenia in Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci 2019; 75:309-317. [DOI: 10.1093/gerona/glz001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Yanxia Lu
- Biology of Aging Laboratory, Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
| | - Leonidas G Karagounis
- Experimental Myology and Integrative Physiology Cluster, Plymouth Marjon University, UK
- Nestle Health Science, Vevey, Switzerland
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christophe Carre
- Biostat, Bioinformatics & Omics, Sanofi Pasteur, Marcy l’Etoile, France
| | | | - Glenn Wong
- Biology of Aging Laboratory, Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
| | - Crystal Tze Ying Tan
- Biology of Aging Laboratory, Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
| | - Ma Shwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Brian Abel
- Immunomonitoring Platform, Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
| | | | - Tamas Fulop
- Geriatrics Division, Department of Medicine, Research Center on Ageing, University of Sherbrooke, Quebec, Canada
| | | | - Anis Larbi
- Biology of Aging Laboratory, Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Biopolis, Singapore
- Geriatrics Division, Department of Medicine, Research Center on Ageing, University of Sherbrooke, Quebec, Canada
- Department of Biology, Faculty of Sciences, University Tunis El Manar, Tunisia
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Bruyère O, Beaudart C, Ethgen O, Reginster JY, Locquet M. The health economics burden of sarcopenia: a systematic review. Maturitas 2019; 119:61-69. [DOI: 10.1016/j.maturitas.2018.11.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 11/08/2018] [Indexed: 12/12/2022]
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Woo J, Ong S, Chan R, Li L, Sun J, Chan YM, Wee SL, Thu NN, Thang P, Setiati S, Huang YC, Wahlqvist ML, de Groot LCPGM. Nutrition, sarcopenia and frailty: An Asian perspective. TRANSLATIONAL MEDICINE OF AGING 2019. [DOI: 10.1016/j.tma.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Norman K, Otten L. Financial impact of sarcopenia or low muscle mass - A short review. Clin Nutr 2018; 38:1489-1495. [PMID: 30316536 DOI: 10.1016/j.clnu.2018.09.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/03/2018] [Accepted: 09/24/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND & AIMS Low muscle mass is associated with increased falls, medical complications, length of hospital stay and loss of independence. An increasing number of studies has also shown the association between sarcopenia and health care expenditure. The following narrative review summarizes the current evidence on the economic relevance of low muscle mass (MM) or sarcopenia. METHODS An extensive search of the literature in Medline identified twelve studies in English, which evaluated direct and indirect health care expenditure in patients with low muscle mass or sarcopenia (low MM and strength or mobility). RESULTS Three studies analysed the cost of age-related loss of MM or strength in large surveys of the general, older population. Six retrospective analyses evaluated perioperative medical costs related to low MM in primarily older patients from different medical areas. One prospective study presented hospital costs related to sarcopenia in patients with gastric cancer. Two studies presented data from general hospital patients. Despite the difference in diagnostic criteria, study population and statistical design, low MM and sarcopenia were consistently identified as predictors of increased health care expenditure in community, perioperative and general hospital settings. CONCLUSIONS Low MM and sarcopenia are prevalent and associated with significantly higher health care costs. Considering the demographic change, which will lead to an increasing number of patients with sarcopenia, every effort should be made to identify and treat patients with sarcopenia. The use of a unified definition and diagnostic criteria would allow a better comparison of data.
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Affiliation(s)
- Kristina Norman
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Research Group on Geriatrics, Working Group Nutrition and Body Composition, Berlin, Germany; German Institute of Human Nutrition Potsdam-Rehbrücke, Dept. of Nutrition and Gerontology, Germany; University of Potsdam, Institute of Nutritional Science, Potsdam, Germany.
| | - Lindsey Otten
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Research Group on Geriatrics, Working Group Nutrition and Body Composition, Berlin, Germany; German Institute of Human Nutrition Potsdam-Rehbrücke, Dept. of Nutrition and Gerontology, Germany
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Mijnarends DM, Luiking YC, Halfens RJG, Evers SMAA, Lenaerts ELA, Verlaan S, Wallace M, Schols JMGA, Meijers JMM. Muscle, Health and Costs: A Glance at their Relationship. J Nutr Health Aging 2018; 22:766-773. [PMID: 30080217 PMCID: PMC6061527 DOI: 10.1007/s12603-018-1058-9] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/15/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the association between muscle parameters (mass, strength, physical performance) and activities of daily living (ADL), quality of life (QoL), and health care costs. DESIGN Cross-sectional Maastricht Sarcopenia Study (MaSS). SETTING Community-dwelling, assisted-living, residential living facility. PARTICIPANTS 227 adults aged 65 and older. MEASUREMENTS Muscle mass, hand grip strength and physical performance were assessed by bio-electrical impedance, JAMAR dynamometer and the Short Physical Performance Battery, respectively. Health outcomes were measured by the Groningen Activity Restriction Scale (disability in ADL) and the EQ-5D-5L (QoL). Health care costs were calculated based on health care use in the past three months. RESULTS Muscle strength and physical performance showed a strong correlation with ADL, QoL, and health care costs (P<.01); for muscle mass no significant correlations were observed. Regression analyses showed that higher gait speed (OR 0.06, 95%CI 0.01-0.55) was associated with a lower probability of ADL disability. Furthermore, slower chair stand (OR 1.23, 95%CI 1.08-1.42), and more comorbidities (OR 1.58, 95%CI 1.23-2.02) were explanatory factors for higher ADL disability. Explanatory factors for QoL and costs were: more disability in ADL (OR 1.26, 95%CI 1.12-1.41 for QoL; B = 0.09, P<.01 for costs) and more comorbidities (OR 1.44, 95%CI 1.14-1.82 for QoL; B = 0.35, P<.01 for costs). CONCLUSION Lower gait speed and chair stand were potential drivers of disability in ADL. Disability in ADL and comorbidities were associated with QoL and health care costs in community-dwelling older adults. Improving physical performance may be a valuable target for future intervention and research to impact health burden and costs.
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Affiliation(s)
- D M Mijnarends
- Jos Schols, School CAPHRI, Department of Family Medicine, Maastricht University, P.O Box 616, 6200 MD, Maastricht, the Netherlands,
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Espinel-Bermúdez MC, Ramírez-García E, García-Peña C, Salvà-Casanovas A, Ruiz-Arregui L, Cárdenas-Bahena Á, Sánchez-García S. Prevalence of sarcopenia in community-dwelling older people of Mexico City using the EGWSOP (European Working Group on Sarcopenia in Older People) diagnostic criteria. JCSM CLINICAL REPORTS 2017. [DOI: 10.17987/jcsm-cr.v2i2.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The aim of this study is to determine the prevalence of sarcopenia in community-dwelling older people living in Mexico City using the EGWSOP (European Working Group on Sarcopenia in Older People) diagnostic criteria that include muscle mass, muscle strength and physical performance.Methods: The sample population was based on older people (≥60 years) affiliated with the Mexican Institute of Social Security in Mexico City. Data were derived from the database of the “Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults” (COSFOMA). Sarcopenia was diagnosed using the EGWSOP criteria: gait speed (4 m) <0.8 m/s; handgrip strength (using a dynamometer) <20 kg in females or <30 kg in males, and muscle mass index (MMI) <6.1 kg/m2 in females or <8.5 kg/m2 in males (using bioimpedance analysis).Results: Thousand hundred seventy-seven subjects were included (median age 68.4 years, 60.2% females). 20.5% had low gait speed (19.1% females and 22.6% males); 62.4% had low handgrip strength (69.9% females and 51.2% males) and 12.3% had low muscle mass (9.9% females and 16.0% males). Only 9.9% of older people with sarcopenia (9.0% females and 11.1% males): 1.9% with severe sarcopenia (1.4% females and 2.6% males) and 8.0% with moderate sarcopenia (7.6% females and 8.5% males).Conclusions: Sarcopenia is present in one of ten community-dwelling older people residing in Mexico City. According to what has been reported in the literature, the prevalence of sarcopenia in older Mexican adults is similar to the community-dwelling population.
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