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Motokawa K, Shirobe M, Iwasaki M, Wada Y, Tabata F, Shigemoto K, Mikami Y, Hayakawa M, Osuka Y, Kojima N, Sasai H, Inagaki H, Miyamae F, Okamura T, Hirano H, Awata S. Serum albumin redox state as an indicator of dietary protein intake among community-dwelling older adults. Clin Nutr ESPEN 2024; 63:157-161. [PMID: 38944830 DOI: 10.1016/j.clnesp.2024.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND AND AIMS Serum markers capable of detecting mild levels of undernutrition, such as insufficient dietary protein intake (IDPI), have not been established among community-dwelling older adults. Although the serum albumin redox state, expressed as the ratio of reduced albumin (Alb) to total Alb (the reduced albumin ratio), has the potential to overcome this challenge, empirical epidemiological data are lacking. This study aimed to investigate the association between a serum reduced Alb ratio and dietary protein intake among community-dwelling older adults. METHODS This study analyzed cross-sectional data from 1,005 community dwelling population (572 males and 433 females) aged 70-84 years who participated in the Itabashi Longitudinal Study on Aging. Exclusion criteria included participants with incomplete data, individuals with a history of kidney disease and high C-reactive protein (CRP) levels. The dietary protein intake was estimated using validated food frequency questionnaires. The IDPI was defined as not meeting the level recommended by the Dietary Reference Intakes for Japanese (Men ≥60 g/day, Women ≥50 g/day). RESULTS IDPI was observed in 14.1% of the study population. Logistic regression analyses adjusted for sex, age, body weight and malnutrition showed that a serum reduced Alb ratio was significantly associated with IDPI (odds ratio = 0.962, 95% confidence interval = 0.926-0.999), whereas serum albumin concentration was not (odds ratio = 0.549, 95% confidence interval = 0.285-1.061). CONCLUSIONS A serum reduced Alb ratio would be a useful indicator of protein insufficiency among community-dwelling older adults.
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Affiliation(s)
- Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Yasuaki Wada
- Innovative Research Institute, Morinaga Milk Industry Co., Ltd., Zama, Japan
| | - Fuka Tabata
- Health Care & Nutritional Science Institute, Morinaga Milk Industry Co., Ltd., Zama, Japan
| | - Kazuhiro Shigemoto
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yurie Mikami
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Misato Hayakawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan; National Center for Geriatrics and Gerontology, Japan
| | - Narumi Kojima
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Fumiko Miyamae
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Boucham M, Salhi A, El Hajji N, Gbenonsi GY, Belyamani L, Khalis M. Factors associated with frailty in older people: an umbrella review. BMC Geriatr 2024; 24:737. [PMID: 39237866 PMCID: PMC11376099 DOI: 10.1186/s12877-024-05288-4] [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: 01/10/2024] [Accepted: 08/07/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND The number of frail older people is increasing worldwide, and all countries will be confronted with their growing needs for healthcare and social support. The aim of this umbrella review was to summarize the evidence on the factors associated with frailty in older people, using a socioecological approach. METHODS PubMed (MEDLINE), Scopus, Web of Science, ScienceDirect, Hinari (research4life), and the Trip database were systematically searched up to April 2023. Systematic reviews of observational studies that explored factors associated with frailty in older adults aged 60 years and over were considered for inclusion. No language, geographical or setting restrictions were applied. However, we excluded systematic reviews that investigated frailty factors in the context of specific diseases. The Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and the ROBIS tool were used to assess the quality and risk of bias in the included studies. RESULTS Forty-four systematic reviews were included, covering 1,150 primary studies with approximately 2,687,911 participants overall. Several risk factors, protective factors and biomarkers were found to be associated with frailty, especially in community-dwelling older people, including 67 significant associations from meta-analyses. The certainty of the evidence was rated as moderate or reached moderate levels for seven factors relevant to older people. These factors include depression (OR 4.66, 95% CI 4.07 to 5.34), loneliness (OR 3.51, 95% CI 2.70 to 4.56), limitations in activities of daily living (OR 2.59, 95% CI 1.71 to 3.48), risk of malnutrition (OR 3.52, 95% CI 2.96 to 4.17), Dietary Inflammatory Index score (OR 1.24, 95% CI 1.16 to 1.33), maximal walking speed (Standardized Mean Difference (SMD) -0.97, 95% CI -1.25 to -0.68), and self-reported masticatory dysfunction (OR 1.83, 95% CI 1.55 to 2.18). Additionally, only greater adherence to a Mediterranean diet showed a high level of evidence (OR 0.44, 95% CI 0.31 to 0.64). CONCLUSIONS This umbrella review will provide guidance for prevention strategies and clinical practice by promoting healthy lifestyles and addressing all modifiable risk factors associated with frailty. Future systematic reviews should consider heterogeneity and publication bias, as these were the main reasons for downgrading the level of evidence in our review. REGISTRATION PROSPERO 2022, CRD42022328902.
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Affiliation(s)
- Mouna Boucham
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco.
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco.
| | - Amal Salhi
- National School of Public Health, Rabat, Morocco
| | - Naoual El Hajji
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Gloria Yawavi Gbenonsi
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
| | - Lahcen Belyamani
- Mohammed VI Center for Research and Innovation, Mohammed VI University of Sciences and Health, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Khalis
- Department of Public Health, Mohammed VI Center for Research and Innovation, Rabat, Morocco
- Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, & Laboratory of Community Health (Public Health, Preventive Medicine and Hygiene), Department of Public Health, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
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Liu B, Zhang X, Jia S, Wang W, Huang J, Kang L, Shi L, Man Q, Zhang J. Association of foods consumption and physical activity with prefrailty and frailty among Chinese older adults in urban communities: A cross-sectional study. Asia Pac J Clin Nutr 2024; 33:447-456. [PMID: 38965732 PMCID: PMC11397568 DOI: 10.6133/apjcn.202409_33(3).0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/24/2024] [Accepted: 04/13/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND AND OBJECTIVES Frailty has become a public health challenge in China. To investigate the association of foods consumption and physical activity with prefrailty and frailty among older Chinese adults in urban communities. METHODS AND STUDY DESIGN In a cross-sectional study from February to July 2023, 1183 older adults aged between 65y-88y were enrolled from urban communities in Chongqing and Shandong province, China. Frailty Index (FI) was applied to measure prefrailty and frailty. Partial proportional odds model was used to assess the association between foods consumption, physical activity and prefrailty/frailty. RESULTS Higher Dietary Diversity Score (DDS), (OR=0.61, 95% CI=0.46-0.80; OR=0.47, 95% CI=0.28-0.79), Consuming animal-based foods ≥2 times/day (OR=0.62, 95% CI=0.47-0.82; OR=0.54, 95% CI=0.33-0.88), soy products ≥2 times/week (OR=0.69, 95% CI=0.53-0.89; OR=0.51, 95% CI=0.31-0.84), fresh vegetables ≥2 times/day (OR=0.42, 95% CI=0.31-0.57; OR=0.41, 95% CI=0.23-0.72), and nuts ≥2 times/week (OR=0.71, 95% CI=0.55-0.91; OR=0.52, 95% CI=0.32-0.85) was associated with a lower risk of prefrailty and frailty. In addition, higher frequency and longer duration of walking (OR=0.61, 95% CI=0.42-0.88; OR=0.63, 95% CI=0.48-0.81), exercise (OR=0.48, 95% CI=0.35-0.64; OR=0.44, 95% CI=0.32-0.61) per week were significantly associated with lower risk of prefrailty. Furthermore, higher frequency and longer duration of walking (OR=0.42, 95% CI=0.25-0.72; OR=0.46, 95% CI=0.29-0.74), and housework (OR=0.39, 95% CI=0.24-0.65; OR=0.57, 95% CI=0.34-0.96) per week, were significantly associated with lower frailty. CONCLUSIONS Higher DDS and higher frequency of animal-based foods, soy products, fresh vegetables, and nuts consumption is significantly associated with lower risk of prefrailty and frailty. Additionally, walking and exercising are significantly associated with lower risk of prefrailty, while walking and doing housework is significantly associated with lower frailty.
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Affiliation(s)
- Beibei Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaona Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shanshan Jia
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weiguo Wang
- Sinopec Shengli Petroleum Administration Co., Ltd., Dongying, Shandong, China
| | - Jing Huang
- Sinopec Shengli Petroleum Administration Co., Ltd., Dongying, Shandong, China
| | - Liping Kang
- Shengdong Hospital, Dongying, Shandong, China
| | - Lingyun Shi
- Maoershi Community Healthcare Center, Jiangbei District, Chongqing, China
| | - Qingqing Man
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
- Key Laboratory of Public Health and Nutrition, National Health Commission of the People's Republic of China, Beijing, China
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Naito Y, Yasuda T, Kitae H, Takagi T, Mizushima K, Koyoma T, Inoue R, Ouchi N, Adachi A, Kamitani T, Matoba S. A cross-sectional study on the relationship between nutrient/food intake and gut microbiota in frailty among older community residents: The Kyotango study. J Clin Biochem Nutr 2024; 75:161-173. [PMID: 39345290 PMCID: PMC11425074 DOI: 10.3164/jcbn.24-93] [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: 06/18/2024] [Accepted: 06/25/2024] [Indexed: 10/01/2024] Open
Abstract
In strategies to extend a healthy lifespan, early detection and prevention of frailty are critical. The purpose of this study was to analyze the current state and clinical risk factors of frailty among community-dwelling older to conduct a cross-sectional analysis of the individuals, correlation between frailty and nutrient intake, dietary diversity, and dietary patterns, and to elucidate the correlation between frailty-related dietary factors and the gut microbiota. The study included 786 participants aged ≥65 years from the Kyotango Multipurpose Cohort Study who had available data on their gut microbiota. Frailty was quantitatively assessed by selecting 32 items from the previously reported frailty index, with those scoring ≥0.21 classified as frailty (n = 119) and those with scores <0.21 as non-frailty (n = 667), followed by group comparisons. The frailty group had significantly higher values and rates than the non-frailty group for the following items: age, obesity (in females only), diabetes, hypertension, history of cancer treatment, polypharmacy, disturbed sleep quality, low physical activity, serum insulin levels, and high-sensitivity C-reactive protein. The frailty group had significantly lower levels of nutrients, including plant proteins, potassium (K), magnesium (Mg), iron (Fe), copper (Cu), vitamins B and C, folic acid, and total, soluble, and insoluble dietary fiber. When analyzed by food groups of dietary fiber, the frailty group had significantly lower intakes of soy products and non-green-yellow vegetables, specifically. The Japanese Diet Index score (rJDI12) was significantly lower in the frailty group, with significant deficiencies in soy products and mushrooms included in the rJDI12. Cluster analysis of the Spearman correlation values between nutrient intake related to frailty and the gut microbiota abundance revealed a positive correlation between the cluster containing dietary fiber and the abundance of the phylum Bacillota, including the [Eubacterium]_eligens_group. In conclusion, our findings clarify the current state of frailty among older community residents and suggest the importance of a diverse range of plant-based foods, including soy products and non-green yellow vegetables, through correlation analysis with nutrients and food groups, and partially reveal the involvement of the gut microbiota.
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Affiliation(s)
- Yuji Naito
- Human Immunology and Nutrition Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takeshi Yasuda
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroaki Kitae
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomohisa Takagi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department for Medical Innovation Translational Medical Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Katsura Mizushima
- Human Immunology and Nutrition Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Teruhide Koyoma
- Epidemiology for Community Health and Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Ryo Inoue
- Laboratory of Animal Science, Department of Applied Biological Sciences, Faculty of Agriculture, Setsunan University, Hirakata, Japan
| | - Norihiro Ouchi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Kyotango City Yasaka Hospital, Kyotango, Japan
| | - Atsuo Adachi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Kyotango City Yasaka Hospital, Kyotango, Japan
| | - Tadaaki Kamitani
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Kyotango City Yasaka Hospital, Kyotango, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
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Park SG, Kim H. Lack of Association between Insufficient Intake of Multiple Vitamins and Frailty in Older Adults Who Consume Sufficient Energy and Protein: A Nationwide Cross-Sectional Study. Nutrients 2024; 16:2586. [PMID: 39203722 PMCID: PMC11357227 DOI: 10.3390/nu16162586] [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: 07/12/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024] Open
Abstract
Frailty is a complex condition that intensifies with age and is marked by decreased physiological function. We rigorously investigated the effects of lower vitamin intake on frailty using data from 665 adults aged over 65 years who consumed sufficient recommended daily energy and protein intakes from the Korean Nutrition and Health Survey, 2016-2019. The definition of frailty was modified based on Fried et al.'s definition of weight loss, exhaustion, weakness, slowness, and low energy expenditure. Based on daily intake, we analyzed vitamins such as vitamin A, thiamine, riboflavin, niacin, folic acid, and vitamin C. Our results of logistic regression showed that increasing multiple deficiencies in several kinds of vitamins (mild to moderate to severe) is not associated with frailty (odds ratio: 1, 1.24 (0.24-3.10), 0.82 (0.28-2.39), p for trend = 0.626) in older adults who consumed sufficient calories and proteins. A subgroup analysis of age and sex, which may interfere with the relationship between vitamin intake and frailty, showed that vitamin intake was not associated with frailty when sufficient energy and proteins were consumed. Furthermore, there was no difference in the prevalence of frailty between the groups with sufficient and insufficient intakes of individual vitamins.
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Affiliation(s)
| | - Hyoeun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan 48108, Republic of Korea;
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Nishio K, Yoshida T, Arai Y, Ito T, Okada S, Ikeda T, Abe Y, Takayama M, Iinuma T. Relationship between malnutrition according to the global leadership initiative on malnutrition criteria and oral health among community-dwelling elderly aged 85 years and older: a cross-sectional study. BMC Oral Health 2024; 24:887. [PMID: 39097715 PMCID: PMC11297638 DOI: 10.1186/s12903-024-04568-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 07/03/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND A new diagnostic criterion for malnutrition, the Global Leadership Initiative on Malnutrition (GLIM) criteria, has been proposed. Despite a recognized link between malnutrition and oral health, further clarification is needed regarding this association when using the GLIM criteria. This study examined the association between malnutrition and oral health in community-dwelling older adults aged ≥ 85. METHODS This study was conducted using data from the Tokyo Oldest Old Survey on Total Health study, and altogether 519 participants ≥ 85 years were enrolled. Malnutrition was assessed using the GLIM criteria. Oral health information, on the number of teeth, maximum occlusal force (MOF), saliva production, denture-related questions (dissatisfaction and frequency of use), dental visit history in the past year, whether participants enjoyed meals, and oral-related quality of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI) were collected. MOF was assessed the average values of three measurements and lower tertile by sex as decline in MOF. For GOHAI, the score for each items (Q1-Q12) was also evaluated, and further, the decline in each item (score: 1-2 points on a 5-point scale) was assessed as a "problem with each items." Oral health factors differing between those with and without malnutrition were analyzed. For differing items, malnutrition risk was evaluated using Cox regression. RESULTS Eighty-nine (17.1%) participants experienced malnutrition. Significant differences were observed in the decline in MOF, enjoyment of meals, individual scores for Q2, Q4, and Q6, and the problem with Q3, Q6, Q7, and Q11. Cox regression analysis showed that decline in MOF (odds ratio [OR]: 1.728, 95% confidence interval [CI]: 1.010-2.959), enjoyment of meals (OR: 0.502, 95% CI: 0.289-0.873), problem with Q3 (OR: 5.474, 95% CI: 1.301-23.028), Q6 (OR: 5.325, 95% CI: 1.026-27.636), and Q7 (OR: 2.867, 95% CI: 1.397-5.882) were associated with ORs of malnutrition. CONCLUSION Decline in MOF, enjoyment of meals, swallowing problem (problem with Q3), limit contact due to oral condition (problem with Q6), and esthetics problem (problem with Q7) were associated with malnutrition as assessed using the GLIM criteria.
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Affiliation(s)
- Kensuke Nishio
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan.
| | - Takamasa Yoshida
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Tomoka Ito
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Shinji Okada
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Takayuki Ikeda
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Michiyo Takayama
- Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Toshimitsu Iinuma
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
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Celik HI, Koc F, Siyasal K, Ay B, Ilter NB, Celik OM. Exploring the complex associations among risks of malnutrition, sarcopenia, and frailty in community-dwelling older adults. Eur Rev Aging Phys Act 2024; 21:18. [PMID: 38982337 PMCID: PMC11232342 DOI: 10.1186/s11556-024-00354-7] [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: 01/08/2024] [Accepted: 07/04/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Malnutrition, sarcopenia, and frailty are age-related conditions that are associated with multiple health-related negative outcomes. However, the complex associations between them remain to be elucidated. The aims of the study were to explore: (1) whether the risk of sarcopenia has a mediator effect on the association between risks of malnutrition and frailty; and (2) whether physical activity (PA) level modulates this mediator effect in community-dwelling older adults. METHODS This cross-sectional study involved 593 older adults (62.73% female; mean age = 71.35 ± 5.86 years). The Mini Nutritional Assessment-Short Form (MNA-SF), the SARC-F Questionnaire, and the FRAIL Questionnaire were used to assess the risks of malnutrition, sarcopenia, and frailty, respectively. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was employed to assess PA level. Using the Hayes PROCESS macro (Models 4 and 7), mediation and moderated mediation analyses were performed. RESULTS The mediation analysis demonstrated that the MNA-SF had a significant effect on the SARC-F (B=-0.325; p < 0.001) and the SARC-F, in turn, had a significant effect on the FRAIL (B = 0.341; p < 0.001). The total (B=-0.171; p < 0.001), direct (B=-0.061; p = 0.001), and indirect (B=-0.111; bootstrap CI did not include zero, which indicates a significant effect) effects of MNA-SF on FRAIL were significant, showing that 65% of the association between the MNA-SF and FRAIL was explained by the SARC-F acting as a mediator. The moderated mediation analysis demonstrated that the association between MNA and SARC-F was moderated by the PA level (B = 0.253; p = 0.016). The SARC-F mediated and relatively enhanced the association between MNA-SF and FRAIL only in older adults with a moderate PA level (B=-0.120; CI: -0.154 to -0.085). CONCLUSIONS The SARC-F partially mediates the association between the MNA-SF and the FRAIL, indicating that malnutrition affects frailty through an indirect path via sarcopenia. Furthermore, the PA level moderates this mediator effect, with sarcopenia serving as a mediator in older adults with moderate a PA level but not in those with a low PA level. These findings reveal that it may be beneficial to consider PA level in combination with malnutrition and sarcopenia in the management and prevention of frailty in community-dwelling older adults.
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Affiliation(s)
- Halil Ibrahim Celik
- Bilge Çocuk Special Education and Rehabilitation Center, Beysukent, Çankaya, Ankara, s06800, Turkey.
| | - Ferda Koc
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Kübra Siyasal
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Büsra Ay
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Nazlı Bengu Ilter
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
| | - Ozge Mengi Celik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Health Sciences, Ankara, Turkey
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Zhao B, Zhang S, Chen Y, Zhang T, Zhang C. Risk factors for preoperative frailty in older patients with gastric cancer: a systematic review and meta-analysis. Support Care Cancer 2024; 32:450. [PMID: 38904837 DOI: 10.1007/s00520-024-08654-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE To summarize the available evidence on risk factors for preoperative frailty in older gastric cancer patients. METHODS We comprehensively searched the CNKI, Wanfang, VIP, CBM, PubMed, Embase, The Cochrane Library, Web of Science, and CINAHL databases for preoperative articles on risk factors for frailty in older gastric cancer patients. The search was conducted from the time of construction of the library to January 27, 2024, with no language restrictions. The quality of the included studies was rated by the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality tool. RESULTS A total of 20 studies were included, including 16 cohort studies and 4 cross-sectional studies, with a total sample size of 51,717 individuals. The results of the meta-analysis showed that age, albumin, hemoglobin, cancer stage III-IV, Charlson Comorbidity Index score ≥ 3, Eastern Cooperative Oncology Group score > 2, American Society of Anesthesiologists score > 2, smoking, nutritional risk, high school degree or above, and sleep disorders are the main influencing factors for the occurrence of preoperative frailty in older gastric cancer patients. Among them, high school degree or above was a protective factor. CONCLUSIONS Our study provides valid evidence of risk factors for preoperative frailty in older patients with gastric cancer and informs clinical healthcare professionals to make targeted interventions.
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Affiliation(s)
- Bingyan Zhao
- Graduate School of Tianjin University of Chinese Medicine, Tianjin, 301617, China
| | - Siai Zhang
- Cardiac Intensive Care Unit, Meizhou People's Hospital, Meizhou, 514031, Guangdong, China
| | - Yu Chen
- Graduate School of Tianjin University of Chinese Medicine, Tianjin, 301617, China
| | - Tongyu Zhang
- Graduate School of Tianjin University of Chinese Medicine, Tianjin, 301617, China
| | - Chunmei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
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Chinese Guidelines for Medical Nutrition Therapy for Patients with Diabetes (2022 Edition). Asia Pac J Clin Nutr 2024; 33:118-152. [PMID: 38794974 PMCID: PMC11170023 DOI: 10.6133/apjcn.202406_33(2).0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/27/2024]
Abstract
Medical nutrition therapy (MNT) is the foundation of the comprehensive treatment of patients with diabetes. In 2010, the Chinese Clinical Nutritionist Center of the Chinese Medical Doctor Association developed the first Chinese guideline on MNT for patients with diabetes, and it was updated in 2015. Since then, new evidence has emerged in the field of MNT and metabolic therapy in patients with diabetes. The Nutrition and Metabolic Management Branch of the China International Exchange and Promotive Association for Medical and Health Care organized a team of experts from related institutions, including the Clinical Nutrition Branch of the Chinese Nutrition Society, Chinese Diabetes Society, Chinese Society for Parenteral and Enteral Nutri-tion, and Chinese Clinical Nutritionist Center of the Chinese Medical Doctor Association. Their task was to develop the Chinese Guidelines of Medical Nutrition Therapy in Diabetes (2022 Edition) in accordance with the requirements of the Guidelines for the Formulation/Revision of Clinical Guidelines in China (2022 Edition) by combining the questions raised and evidence gathered in clinical practices in China, to guide and standardize the clinical MNT.
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10
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van Eijnatten EJM, Roelofs JJM, Camps G, Huppertz T, Lambers TT, Smeets PAM. Gastric coagulation and postprandial amino acid absorption of milk is affected by mineral composition: a randomized crossover trial. Food Funct 2024; 15:3098-3107. [PMID: 38416477 DOI: 10.1039/d3fo04063a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Background: In vitro studies suggest that casein coagulation of milk is influenced by its mineral composition, and may therefore affect the dynamics of protein digestion, gastric emptying and appearance of amino acids (AA) in the blood, but this remains to be confirmed in vivo. Objective: This study aimed to compare gastrointestinal digestion between two milks with the same total calcium content but different casein mineralization (CM). Design: Fifteen males (age 30.9 ± 13.8 years, BMI 22.5 ± 2.2 kg m-2) participated in this randomized cross-over study with two treatments. Participants underwent gastric magnetic resonance imaging (MRI) scans at the baseline and every 10 min up to 90 min after consumption of 600 ml milk with low or high CM. Blood samples were taken at the baseline and up to 5 hours postprandially. Primary outcomes were postprandial plasma AA concentrations and gastric emptying rate. Secondary outcomes were postprandial glucose and insulin levels, gastric coagulation as estimated by image texture metrics, and appetite ratings. Results: Gastric content volume over time was similar for both treatments. However, gastric content image analysis suggested that the liquid fraction emptied quicker in the high CM milk, while the coagulum emptied slower. Relative to high CM, low CM showed earlier appearance of AAs that are more dominant in casein, such as proline (MD 4.18 μmol L-1, 95% CI [2.38-5.98], p < 0.001), while there was no difference in appearance of AAs that are more dominant in whey protein, such as leucine. The image texture metrics homogeneity and busyness differed significantly between treatments (MD 0.007, 95% CI [0.001, 0.012], p = 0.022; MD 0.005, 95% CI [0.001, 0.010], p = 0.012) likely because of a reduced coagulation in the low CM milk. Conclusions: Mineral composition of milk can influence postprandial serum AA kinetics, likely due to differences in coagulation dynamics. The clinical trial registry number is NL8959 (https://clinicaltrials.gov).
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Affiliation(s)
- Elise J M van Eijnatten
- Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708 PB Wageningen, The Netherlands.
| | - Julia J M Roelofs
- Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708 PB Wageningen, The Netherlands.
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708 PB Wageningen, The Netherlands.
| | - Thom Huppertz
- Food Quality and Design group, Wageningen University, Bornse Weilanden 9, 6708 WG Wageningen, The Netherlands
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands
| | - Tim T Lambers
- FrieslandCampina, Stationsplein 4, 3818 LE Amersfoort, The Netherlands
| | - Paul A M Smeets
- Division of Human Nutrition and Health, Wageningen University, Stippeneng 4, 6708 PB Wageningen, The Netherlands.
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11
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Yeh CY, Chini LC, Davidson JW, Garcia GG, Gallagher MS, Freichels IT, Calubag MF, Rodgers AC, Green CL, Babygirija R, Sonsalla MM, Pak HH, Trautman M, Hacker TA, Miller RA, Simcox J, Lamming DW. Late-life isoleucine restriction promotes physiological and molecular signatures of healthy aging. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.02.06.527311. [PMID: 36798157 PMCID: PMC9934591 DOI: 10.1101/2023.02.06.527311] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
In defiance of the paradigm that calories from all sources are equivalent, we and others have shown that dietary protein is a dominant regulator of healthy aging. The restriction of protein or the branched-chain amino acid isoleucine promotes healthspan and extends lifespan when initiated in young or adult mice. However, many interventions are less efficacious or even deleterious when initiated in aged animals. Here, we investigate the physiological, metabolic, and molecular consequences of consuming a diet with a 67% reduction of all amino acids (Low AA), or of isoleucine alone (Low Ile), in male and female C57BL/6J.Nia mice starting at 20 months of age. We find that both diet regimens effectively reduce adiposity and improve glucose tolerance, which were benefits that were not mediated by reduced calorie intake. Both diets improve specific aspects of frailty, slow multiple molecular indicators of aging rate, and rejuvenate the aging heart and liver at the molecular level. These results demonstrate that Low AA and Low Ile diets can drive youthful physiological and molecular signatures, and support the possibility that these dietary interventions could help to promote healthy aging in older adults.
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Affiliation(s)
- Chung-Yang Yeh
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
| | - Lucas C.S. Chini
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
| | - Jessica W. Davidson
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706
| | - Gonzalo G. Garcia
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109
| | - Meredith S. Gallagher
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
| | - Isaac T. Freichels
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
| | - Mariah F. Calubag
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
- Graduate Program in Cellular and Molecular Biology, University of Wisconsin-Madison, Madison, WI 53706
| | - Allison C. Rodgers
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- Cardiovascular Physiology Core Facility, University of Wisconsin-Madison, Madison, WI 53706
| | - Cara L. Green
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
| | - Reji Babygirija
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
- Nutrition and Metabolism Graduate Program, University of Wisconsin-Madison, Madison, WI 53706
| | - Michelle M. Sonsalla
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
- Comparative Biomedical Sciences Graduate Training Program, University of Wisconsin-Madison, Madison, WI 53706
| | - Heidi H. Pak
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
- Nutrition and Metabolism Graduate Program, University of Wisconsin-Madison, Madison, WI 53706
| | - Michaela Trautman
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
- Nutrition and Metabolism Graduate Program, University of Wisconsin-Madison, Madison, WI 53706
| | - Timothy A. Hacker
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- Cardiovascular Physiology Core Facility, University of Wisconsin-Madison, Madison, WI 53706
| | - Richard A Miller
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI 48109
| | - Judith Simcox
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706
- Howard Hughes Medical Institute, Department of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Dudley W. Lamming
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705
- Graduate Program in Cellular and Molecular Biology, University of Wisconsin-Madison, Madison, WI 53706
- Nutrition and Metabolism Graduate Program, University of Wisconsin-Madison, Madison, WI 53706
- Comparative Biomedical Sciences Graduate Training Program, University of Wisconsin-Madison, Madison, WI 53706
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12
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Okada M, Hama Y, Futatsuya R, Sasaki Y, Noritake K, Yamaguchi K, Matsuzaki M, Kubota C, Hosoda A, Minakuchi S. Association between Masticatory Performance, Nutritional Intake, and Frailty in Japanese Older Adults. Nutrients 2023; 15:5075. [PMID: 38140333 PMCID: PMC10746083 DOI: 10.3390/nu15245075] [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: 10/28/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The older adult population in Japan is expected to increase. Therefore, long-term care and frailty prevention are important. However, the relationship between masticatory performance, nutritional intake, and frailty remains unclear. This cross-sectional study aimed to examine energy, protein, and vitamin D intake and its association with frailty and masticatory performance in older adults. Patients between January 2022 and January 2023 were recruited and divided into robust and frail groups. Masticatory performance, nutrition, frailty, and other data, such as age and sex, were evaluated through onsite measurements and a questionnaire. Logistic regression analysis was conducted with frailty as a dependent variable and masticatory performance as an independent variable, adjusting for age, sex, skeletal muscle mass, living alone, energy intake, protein-energy ratio, and vitamin D intake. No significant differences were observed between the groups regarding age or sex. The robust group showed significantly better results for protein-energy ratio, vitamin D intake, and subjective and objective masticatory performance than the frail group. Logistic regression analysis revealed a significant correlation between skeletal muscle mass, protein-energy ratio, and objective masticatory performance with frailty. Masticatory performance was associated with frailty, independent of the intake of nutrients such as energy, protein, and vitamin D.
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Affiliation(s)
- Mitsuzumi Okada
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Yohei Hama
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Ryota Futatsuya
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Yoshiyuki Sasaki
- Clinical Dental Research Promotion Unit, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo 113-8549, Japan;
| | - Kanako Noritake
- Oral Diagnosis and General Dentistry, Tokyo Medical and Dental University Hospital, Tokyo 113-8549, Japan;
| | - Kohei Yamaguchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Mayuko Matsuzaki
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
| | - Chieko Kubota
- Department of Oral Health Sciences, Meikai University, Chiba 279-8550, Japan;
| | - Akemi Hosoda
- Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University, Tokyo 141-8648, Japan;
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan; (M.O.); (R.F.); (K.Y.); (M.M.); (S.M.)
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13
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Yildirim Borazan F, Citar Daziroglu ME, Erdogan Govez N, Acar-Tek N, Varan HD. The relationship between the quantity and type of macronutrients in diet and frailty in older outpatients. Aging Clin Exp Res 2023; 35:3033-3040. [PMID: 37930590 DOI: 10.1007/s40520-023-02599-1] [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: 07/18/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND AIM The aim of this study is to determine the relationship between the quantity and type of macronutrients in the diet and frailty. MATERIAL AND METHODS A total of 106 patients were included in the study. Exclusion criteria included patients with pacemakers, edema, advanced dementia, acute infectious and inflammatory disease, and those using oral or enteral nutritional supplements. Frailty was assessed using the Fried Frailty Phenotype. Three-day dietary records were taken, 2 days on weekdays and 1 day on weekends. The Nutrition Information System (BeBis) 8.2 full version program was used to analyze the average energy and nutrient values of the consumed foods. Insufficient protein and energy intake were defined as taking less than 1 or 1.2 g/kg/day for protein and less than 30 kcal/kg/day for energy, respectively. RESULTS The mean age of the participants was 74.3 (± 6.75), and 68.9% (n = 73) of them were women. 26.4% (n = 28) of the patients were classified as frail. There was no difference between the energy consumption of < 30 kcal/kg/day in the frail and non-frail groups. Protein consumption of less than 1.2 g/kg/day had a significant relationship with frailty. There was no significant difference between the consumed plant/animal protein ratio and frailty, but plant protein, polyunsaturated fatty acids, and fiber intake were significantly lower in frail patients. Decreased consumption of polyunsaturated fatty acids (PUFAs), advanced age, and increased number of medications were identified as independently associated factors with frailty. CONCLUSION This study found that frailty was associated with less than 1.2 g/kg/day protein consumption, lower fiber, and PUFA consumption.
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Affiliation(s)
- Funda Yildirim Borazan
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Gazi University, Ankara, 06500, Turkey.
| | | | - Nazlican Erdogan Govez
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Nilufer Acar-Tek
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Hacer Dogan Varan
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Gazi University, Ankara, 06500, Turkey
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14
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McCormick SJ, Smith-Holmquist N, Benton MJ. Personal health behaviors and physical activity and nutrition counseling by nurse practitioners: An online survey. J Am Assoc Nurse Pract 2023; 35:794-801. [PMID: 37584492 DOI: 10.1097/jxx.0000000000000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/13/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Healthy lifestyle counseling improves nutritional intake and participation in exercise, yet the rate of patient counseling varies and clinicians' personal behaviors can influence counseling practices. PURPOSE This cross-sectional study evaluated lifestyle counseling by nurse practitioners (NPs) and the relationship between their personal behaviors and patient counseling. METHODOLOGY Practicing NPs ( N = 1,220) completed an online survey regarding personal behaviors and counseling for healthy body weight, moderate-vigorous physical activity, muscle strengthening, fruit and vegetable consumption, and dietary protein. RESULTS The majority reported counseling "usually" or "often" for healthy weight (54%), moderate-vigorous physical activity (53%), and fruits/vegetables (57%), whereas only 44% and 17% reported "usually" or "often" counseling for dietary protein and muscle strengthening. When NPs did not personally engage in the behavior, the odds for counseling were significantly reduced: NPs were 21% less likely to counsel for moderate-vigorous physical activity (odds ratio [OR] = 0.79 [0.65-0.97], p = .026), 27% less likely to counsel for muscle strengthening (OR = 0.73 [0.60-0.90], p = .004), 57% less likely to counsel for fruit/vegetable consumption (OR = 0.43 [0.35-0.54], p < .001), and 72% less likely to counsel for dietary protein (OR = 0.28 [0.18-0.45], p < .001). Personal body mass index did not predict counseling for a healthy weight. CONCLUSION Although NPs report regular patient counseling regarding healthy lifestyle behaviors, the odds for counseling are increased approximately 20-75% when they engage in the behaviors themselves. IMPLICATIONS Promotion of healthy behaviors during professional education may have long-term implications for preventive health counseling.
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Affiliation(s)
- Sherry J McCormick
- Department of Nursing, University of Colorado, Colorado Springs, Colorado
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15
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Morgan PT, Witard OC, Højfeldt G, Church DD, Breen L. Dietary protein recommendations to support healthy muscle ageing in the 21st century and beyond: considerations and future directions. Proc Nutr Soc 2023:1-14. [PMID: 37818636 DOI: 10.1017/s0029665123003750] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
This review explores the evolution of dietary protein intake requirements and recommendations, with a focus on skeletal muscle remodelling to support healthy ageing based on presentations at the 2023 Nutrition Society summer conference. In this review, we describe the role of dietary protein for metabolic health and ageing muscle, explain the origins of protein and amino acid (AA) requirements and discuss current recommendations for dietary protein intake, which currently sits at about 0⋅8 g/kg/d. We also critique existing (e.g. nitrogen balance) and contemporary (e.g. indicator AA oxidation) methods to determine protein/AA intake requirements and suggest that existing methods may underestimate requirements, with more contemporary assessments indicating protein recommendations may need to be increased to >1⋅0 g/kg/d. One example of evolution in dietary protein guidance is the transition from protein requirements to recommendations. Hence, we discuss the refinement of protein/AA requirements for skeletal muscle maintenance with advanced age beyond simply the dose (e.g. source, type, quality, timing, pattern, nutrient co-ingestion) and explore the efficacy and sustainability of alternative protein sources beyond animal-based proteins to facilitate skeletal muscle remodelling in older age. We conclude that, whilst a growing body of research has demonstrated that animal-free protein sources can effectively stimulate and support muscle remodelling in a manner that is comparable to animal-based proteins, food systems need to sustainably provide a diversity of both plant and animal source foods, not least for their protein content but other vital nutrients. Finally, we propose some priority research directions for the field of protein nutrition and healthy ageing.
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Affiliation(s)
- Paul T Morgan
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, 99 Oxford Road, Manchester M1 7EL, UK
| | - Oliver C Witard
- Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Grith Højfeldt
- Department of Orthopedic Surgery, Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David D Church
- Department of Geriatrics, Donald W. Reynolds Institute on Aging, Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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16
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Niskanen RT, Reinders I, Wijnhoven HAH, Hyvönen AA, Pols-Vrijmoeth M, Trommel-Bout M, Visser M, Pitkälä KH, Suominen MH, Öhman H, Jyväkorpi SK. The feasibility of a 6-month dietary intervention aiming to increase protein intake among community-dwelling older adults with low habitual protein intake: A secondary analysis of the PROMISS randomised controlled trial. J Hum Nutr Diet 2023; 36:1811-1820. [PMID: 37347495 DOI: 10.1111/jhn.13197] [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: 11/28/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The PROMISS randomised controlled trial showed that personalised dietary advice increased protein intake and improved 400-m walk time and leg strength among community-dwelling older adults with a low habitual protein intake. This secondary analysis describes and further evaluates the methods and feasibility of the model used to carry out dietary intervention in the PROMISS randomised controlled trial. METHODS In total, 185 participants (≥65 years, 54% women) with a habitual low protein intake (<1.0 g/kg adjusted body weight/day) in Finland and the Netherlands received personalised dietary advice and complimentary protein-enriched food products for 6 months with two main objectives: (1) to increase protein intake to ≥1.2 g/kg adjusted body weight/day (energy-neutral) and (2) to include each day a 'high-protein meal' containing ≥ 30-35 g of protein. The feasibility of the model was evaluated by the adoption of the advice, feedback from the participants, and practical experiences by the nutritionists. RESULTS In all, 174 participants (93.5%) completed the intervention. At the 6-month follow-up, 41.8% reached both main objectives of the advice. The participants' general rating for the dietary advice was 8.6 (SD 1.0) (on a scale of 1-10; 10 indicating very good). Sticking to the advice was (very) easy for 79.2% of the participants. The nutritionists perceived the model feasible for the participants except for those with low food intake. CONCLUSIONS The methods used in this model are mainly feasible, well-received and effective in increasing protein intake among community-dwelling older adults with low habitual protein intake.
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Affiliation(s)
- Riikka T Niskanen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Ilse Reinders
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Aliisa A Hyvönen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Merel Pols-Vrijmoeth
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mariska Trommel-Bout
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, The Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Hanna Öhman
- Geriatric Medicine, University of Helsinki (UH) and Helsinki University Central Hospital (HUCH), Helsinki, Finland
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital (HUCH), Helsinki, Finland
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17
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Rakyoo K, Vichayanrat T, Anunmana C, Kriengsinyos W, Gaewkhiew P. Effect of dentures and dietary advice on protein intake in older Thai adults with missing posterior occluding teeth. Gerodontology 2023; 40:382-389. [PMID: 36415170 DOI: 10.1111/ger.12667] [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: 05/05/2022] [Revised: 10/15/2022] [Accepted: 11/01/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare the effectiveness of dentures with dietary advice and dentures alone on protein intake in older Thai adults. BACKGROUND Dentures combined with nutritional advice may improve protein intake in older adults with posterior tooth loss. However, evidence is limited, especially in developing countries. METHODS A randomised-control trial including 69 older adults with less than four pairs of posterior occluding teeth was conducted for 3 months. The experimental group received dentures and dietary advice based on the Health Belief Model (HBM); the control group received dentures alone. Three-day dietary records were collected and protein intake was assessed using INMUCAL-NUTRIENTS V.4.0 software at baseline, 1 month, and 3 months after the intervention. Data were analysed using a t-test, Mann-Whitney U test, chi-square test, and repeated-measure ANOVA. RESULTS Both groups reported significantly increased protein intake (control group = 0.4, 0.5, 0.6 g kg BW-1 d-1 , intervention = 0.4, 0.6, 0.7 g kg BW-1 d-1 , at baseline, 1 month and 3 months, respectively). However, participants in the experimental group had significantly higher total protein (36.3 vs. 39.8 g/d, P = .032) and animal protein intake (18.9 vs. 23.2 g/day, P = .020) than those in the control group at 3 months after the intervention; plant protein intake was similar (10.9 vs. 11.5 g/day, P = .923). In addition, the HBM scores of the experimental group were higher than those of the control group after the intervention (P < .001). CONCLUSION Dentures combined with dietary advice significantly increased the total and animal protein intake of older people with posterior tooth loss more than dentures alone. To maintain optimal protein intake, dental practitioners should incorporate dietary advice when providing dental prostheses to older adults with posterior tooth loss.
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Affiliation(s)
- Kasamaporn Rakyoo
- Master of Science Program in Geriatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Tippanart Vichayanrat
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Chuchai Anunmana
- Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Piyada Gaewkhiew
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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18
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Kurata H, Meguro S, Abe Y, Sasaki T, Asakura K, Arai Y, Itoh H. Dietary protein intake and all-cause mortality: results from The Kawasaki Aging and Wellbeing Project. BMC Geriatr 2023; 23:479. [PMID: 37558986 PMCID: PMC10413626 DOI: 10.1186/s12877-023-04173-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] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/15/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Increased protein intake has been recommended to prevent sarcopenia/frailty, reports on the quantity and quality of protein intake needed and the associated prognosis, particularly in the aging population of Asia, are limited. In this study, we aimed to investigate the relationship between protein intake and mortality in Japanese individuals, aged 85 years and older. METHODS The data were obtained from The Kawasaki Aging and Wellbeing Project, which is a prospective cohort study of older adults aged between 85 and 89 years with no physical disability at baseline. Of the 1,026 adults in the cohort, 833 were included in the analysis, after excluding those who had not completed a brief, self-administered diet history questionnaire or those who scored less than 24 on the Mini-Mental State Examination. The participants were grouped into quartiles based on protein intake: Q1 (protein < 14.7, %Energy), Q2 (14.7 ≤ protein < 16.7, %Energy), Q3 (16.7 ≤ protein < 19.1, %Energy), and Q4 (≥ 19.1, %Energy). Multivariate Cox proportional hazards models were utilized to evaluate the association between protein intake and all-cause mortality. Kaplan-Meier survival curves were employed to investigate the relationship between protein intake and all-cause mortality. RESULTS The mean protein intake of our study population was 17.0% of total energy. Animal protein intake, particularly fish intake, increased significantly along with total protein intake. The study had an average observation period of 1,218 days and recorded 89 deaths. After adjusting for age, sex, skeletal muscle mass index, cardiovascular disease, cancer, education, and serum albumin levels, a lower risk of all-cause mortality was observed in the highest protein intake (Q4) group than in the lowest protein intake (Q1) group (hazard ratio: 0.44, 95% confidence interval: 0.22-0.90, p-value: 0.020). CONCLUSION Protein intake is associated with a reduced risk of all-cause mortality in older adults (aged ≥ 85 years) who engage in independent activities of daily living. This association may impact all-cause mortality independent of muscle mass.
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Affiliation(s)
- Hideaki Kurata
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University, School of Medicine, Shinjuku-ku, Tokyo, 160-0016, Japan.
| | - Shu Meguro
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University, School of Medicine, Shinjuku-ku, Tokyo, 160-0016, Japan
| | - Yukiko Abe
- Centre for Supercentenarian Medical Research, Keio University School of Medicine, Shinjuku- ku, Tokyo, 160-0016, Japan
| | - Takashi Sasaki
- Centre for Supercentenarian Medical Research, Keio University School of Medicine, Shinjuku- ku, Tokyo, 160-0016, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Ohta-ku, Tokyo, 143-8540, Japan
| | - Yasumichi Arai
- Centre for Supercentenarian Medical Research, Keio University School of Medicine, Shinjuku- ku, Tokyo, 160-0016, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University, School of Medicine, Shinjuku-ku, Tokyo, 160-0016, Japan
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19
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Soma S, Tazawa Y, Yamada S, Szuki N, Narita D. Peripheral Parenteral Nutrition and Activities of Daily Living in Hospitalized Older Frail Patients. Cureus 2023; 15:e44423. [PMID: 37791209 PMCID: PMC10544267 DOI: 10.7759/cureus.44423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Frail older adults require nursing care following hospitalization for acute illnesses. Frailty is reversible, and appropriate nutritional management and rehabilitation during hospitalization are essential. However, optimal nutritional management for patients who are unable to obtain adequate nutrition via oral intake has not been established. We aimed to determine whether peripheral parenteral nutrition (PPN) promotes the recovery of activities of daily living (ADLs) in frail older patients. METHODS This was a retrospective, observational cohort study conducted at the General Medicine Department of Aomori Prefectural Central Hospital in Aomori, Japan. The primary outcome was recovery of the Barthel index (BI) from the beginning of rehabilitation to discharge, and the secondary outcomes were the proportion of patients transferred for rehabilitation and the nutritional status. RESULTS In total, 342 patients hospitalized during the period of April 2018 to January 2022 were included, of whom 127 (37.1%) received PPN and 215 (62.9%) did not. Contrary to our expectations, recovery of the BI was lower in the PPN group than that in the non-PPN group (12.2 (95% confidence interval (CI): 8.5-16.0) vs. 22.4 (18.8-23.0); p < 0.01). Multivariable analysis revealed PPN as an independent risk factor for poor BI recovery (mean difference = -7.3 (95% CI = -12.7 to -1.9)). CONCLUSION Nutritional management through PPN for frail older adults may not improve physical activity. The nutritional management of frail patients with inadequate oral intake remains challenging.
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Affiliation(s)
- Shunsuke Soma
- Emergency and Critical Care Center, Aomori Prefectural Central Hospital, Aomori, JPN
| | - Yuuichi Tazawa
- Nutrition Management, Aomori Prefectural Central Hospital, Aomori, JPN
| | - Shin Yamada
- Rehabilitation, Aomori Prefectural Central Hospital, Aomori, JPN
| | - Nao Szuki
- Rehabilitation, Aomori Prefectural Central Hospital, Aomori, JPN
| | - Daiki Narita
- Rehabilitation, Aomori Prefectural Central Hospital, Aomori, JPN
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20
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Osadnik CR, Brighton LJ, Burtin C, Cesari M, Lahousse L, Man WDC, Marengoni A, Sajnic A, Singer JP, Ter Beek L, Tsiligianni I, Varga JT, Pavanello S, Maddocks M. European Respiratory Society statement on frailty in adults with chronic lung disease. Eur Respir J 2023; 62:2300442. [PMID: 37414420 DOI: 10.1183/13993003.00442-2023] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/11/2023] [Indexed: 07/08/2023]
Abstract
Frailty is a complex, multidimensional syndrome characterised by a loss of physiological reserves that increases a person's susceptibility to adverse health outcomes. Most knowledge regarding frailty originates from geriatric medicine; however, awareness of its importance as a treatable trait for people with chronic respiratory disease (including asthma, COPD and interstitial lung disease) is emerging. A clearer understanding of frailty and its impact in chronic respiratory disease is a prerequisite to optimise clinical management in the future. This unmet need underpins the rationale for undertaking the present work. This European Respiratory Society statement synthesises current evidence and clinical insights from international experts and people affected by chronic respiratory conditions regarding frailty in adults with chronic respiratory disease. The scope includes coverage of frailty within international respiratory guidelines, prevalence and risk factors, review of clinical management options (including comprehensive geriatric care, rehabilitation, nutrition, pharmacological and psychological therapies) and identification of evidence gaps to inform future priority areas of research. Frailty is underrepresented in international respiratory guidelines, despite being common and related to increased hospitalisation and mortality. Validated screening instruments can detect frailty to prompt comprehensive assessment and personalised clinical management. Clinical trials targeting people with chronic respiratory disease and frailty are needed.
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Affiliation(s)
- Christian R Osadnik
- Monash University, Department of Physiotherapy, Frankston, Australia
- Monash Health, Monash Lung, Sleep, Allergy and Immunology, Frankston, Australia
| | - Lisa J Brighton
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Chris Burtin
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Ghent, Belgium
| | - Will D C Man
- Heart Lung and Critical Care Group, Guy's and St Thomas' NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Alessandra Marengoni
- Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Andreja Sajnic
- Department for Respiratory Diseases Jordanovac, University Hospital Center, Zagreb, Croatia
| | - Jonathan P Singer
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Lies Ter Beek
- Vrije Universiteit Amsterdam, University Medical Center Groningen, Amsterdam, The Netherlands
| | - Ioanna Tsiligianni
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Janos T Varga
- Semmelweis University, Department of Pulmonology, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Department of Pulmonary Rehabilitation, Budapest, Hungary
| | | | - Matthew Maddocks
- King's College London, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
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21
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Blanquet M, Guiguet-Auclair C, Berland P, Ducher G, Sauvage A, Dadet S, Guiyedi V, Farigon N, Bohatier J, Gerbaud L, Boirie Y. Are Energy and Protein Intakes Lower Than Requirements in Older Adults? An Urgent Issue in Hospitals and Nursing Homes. Nutrients 2023; 15:3307. [PMID: 37571245 PMCID: PMC10421298 DOI: 10.3390/nu15153307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Energy and protein intakes lower than requirements are associated with worsening health outcomes. Here we set out to evaluate gaps between energy and protein intakes and requirements in older adults in hospitals and in nursing homes (NH). A cross-sectional study included 360 inpatients and residents aged 75 years and older in two acute care wards; i.e., a multidisciplinary care unit (MCU) and a geriatric care unit (GCU), a geriatric rehabilitation unit (GRU), and two NH. Intakes were measured for three days. Requirements were based on French National Health Authority recommendations. Energy and protein intakes were under the minimum requirement of 30 kcal/kg/day and 1.2 g/kg/day in 89.5% and 100% of MCU patients, respectively, 75.5% and 64.2% of GCU patients, 92.7% and 90.9% of GRU patients, and 83.8% and 83.8 of NH residents. Intake-to-requirement gaps were not significantly associated with malnutrition, except in the GCU group where non-malnourished patients had higher energy gaps than malnourished patients. Intakes fell dramatically short of requirements in older adults in both hospital and NH settings irrespective of malnutrition status. A new paradigm based on a patient-centered approach should be developed to adapt meals served in hospital and in NH.
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Affiliation(s)
- Marie Blanquet
- Unité de Recherche Clinique, CH Mauriac, 15200 Mauriac, France;
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Candy Guiguet-Auclair
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Pauline Berland
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | | | - Anaïs Sauvage
- Recherche et Développement, Nutriset, 76770 Malaunay, France;
| | | | - Vincent Guiyedi
- Unité de Recherche Clinique, CH Mauriac, 15200 Mauriac, France;
| | - Nicolas Farigon
- Nutrition Clinique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (N.F.); (Y.B.)
| | | | - Laurent Gerbaud
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- Nutrition Clinique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (N.F.); (Y.B.)
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRA, UMR 1019, 63000 Clermont-Ferrand, France
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22
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Magalhães NV, Waitzberg DL, Lopes NC, Vicedomini ACC, Prudêncio APA, Jacob-Filho W, Busse AL, Ferdinando D, Alves TP, Pereira RMR, Torrinhas RS, Belarmino G. High Prevalence of Energy and Nutrients Inadequacy among Brazilian Older Adults. Nutrients 2023; 15:3246. [PMID: 37513664 PMCID: PMC10384757 DOI: 10.3390/nu15143246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Poor nutrition increases the risk of diseases and adverse health outcomes in older adults. We evaluated the potential inadequacy of nutrient intake among older adults in Brazil and its association with body anthropometry and composition outcomes. Dietary intake was obtained from 295 community-living older adults (>60 years old), of both genders, using a seven-day food record. Nutrient inadequacy was further identified based on the Dietary Reference Intakes and European Guidelines. Skeletal muscle mass (SM), strength and performance, and the diagnosis of sarcopenia were assessed using reference methods. Nutritional inadequacy was high, with energy, dietary fiber, and six micronutrients exhibiting the greatest inadequacy levels (>80%). Energy intake was correlated with SM strength (p = 0.000) and performance (p = 0.001). Inadequate energy, fiber, and protein intakes influenced BMI, while inadequate intake of vitamin B6 directly affected the diagnosis of sarcopenia (p ≤ 0.005). Further research is required to investigate whether these inadequacies can be associated with other clinical health outcomes.
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Affiliation(s)
- Natalia Vieira Magalhães
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Dan Linetzky Waitzberg
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Natalia Correia Lopes
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Ana Carolina Costa Vicedomini
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Ana Paula Aguiar Prudêncio
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Wilson Jacob-Filho
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Alexandre Leopold Busse
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Douglas Ferdinando
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Tatiana Pereira Alves
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo 01246-903, SP, Brazil
| | - Rosa Maria Rodrigues Pereira
- Research Laboratory in Rheumatology, LIM-17, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Raquel Susana Torrinhas
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
| | - Giliane Belarmino
- Laboratory of Nutrition and Metabolic Surgery of the Digestive System, LIM 35, Department of Gastroenterology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
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23
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Paavola SS, Jyväkorpi SK, Suominen MH. Nutrition Education Improves Intakes of Protein, Polyunsaturated Fatty Acids, and Vitamins C and E in Community-Dwelling Older Adults. J Nutr Gerontol Geriatr 2023; 42:161-177. [PMID: 37527060 DOI: 10.1080/21551197.2023.2240259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
This study investigated the effect of nutrition education program on protein and nutrient intake, physical performance, and health-related quality of life (HRQoL) in community-dwelling older adults (≥65 years). The participants were randomized in clusters to intervention (IG, n = 51) and control (CG, n = 45) groups. Those in IG took part in the Eating for Strong Aging education program consisting of nutrition education in peer groups, written materials, and personal advice. Nutrient intake was assessed with 3-day food diaries, physical performance with Short Physical Performance Battery (SPPB) and HRQoL with 15-D-QoL instrument. Total of 89 participants completed the study. The mean age was 76 years (IG) and 74 years (CG). At three months, the mean change in protein intake was 0.10 g/adjusted bodyweight (ABW) kg/d in the IG, and -0.07 g/ABW kg/d in the CG (p = 0.024). Intakes of polyunsaturated fatty acids and vitamins C and E increased in the IG compared to the CG (p < 0.05). Changes in SPPB or total HRQoL scores between the IG and the CG did not differ. HRQoL dimension mobility improved in the IG compared to the CG (p = 0.035). In conclusion, the Eating for Strong Aging educational program improved nutrition and may be beneficial for mobility-related QoL.
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Affiliation(s)
- Saila S Paavola
- Society for Gerontological Nutrition in Finland, Helsinki, Finland
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Merja H Suominen
- Society for Gerontological Nutrition in Finland, Helsinki, Finland
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
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24
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Duan Y, Qi Q, Cui Y, Yang L, Zhang M, Liu H. Effects of dietary diversity on frailty in Chinese older adults: a 3-year cohort study. BMC Geriatr 2023; 23:141. [PMID: 36918767 PMCID: PMC10012609 DOI: 10.1186/s12877-023-03875-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Frailty has emerged as a global health burden with increased population aging. A diverse diet is essential for an adequate and balanced supply of nutrients. However, limited evidence supports the relationship between dietary diversity and frailty. We therefore assessed the associations of dietary diversity with the risk of frailty. METHODS We used the Chinese Longitudinal Healthy Longevity Survey to analyze a prospective cohort of Chinese older adults. A total of 1948 non-frail older adults were included in the final sample. Participants were categorized into groups with high or low dietary diversity scores (DDSs) using a food frequency questionnaire. A Generalized Estimating Equation were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for determining frailty incidence. RESULTS Among 1,948 participants, 381 had frailty with the prevalence of 19.56% during the 3-year follow-up period. Compared with the low DDS group, the high DDS group exhibited a lower risk of frailty (RR, 0.72; 95% CI: 0.57-0.91). Compared with those with a consistently low DDS, the RR of participants with a consistently high DDS for frailty was 0.56 (95% CI: 0.42-0.74). Moreover, meat, beans, fish, nuts, fresh fruits, and fresh vegetables were inversely associated with frailty. In stratified analysis, a consistently high DDS, compared with a consistently low DDS, reduced the risk of frailty for people aged 65-79 years and those living in town and rural areas. CONCLUSION This study found a prospective association between dietary diversity and frailty among Chinese older adults. These findings stressed that it is important to improve dietary diversity for older adults to promote healthy ageing, particularly for young older adults and in town and rural areas.
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Affiliation(s)
- Ying Duan
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Qi Qi
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Yan Cui
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Ling Yang
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, Anhui, China
| | - Huaqing Liu
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China.
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25
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Cappe M, Laterre PF, Dechamps M. Preoperative frailty screening, assessment and management. Curr Opin Anaesthesiol 2023; 36:83-88. [PMID: 36476726 PMCID: PMC9794163 DOI: 10.1097/aco.0000000000001221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW To highlight the importance of frailty assessment in thoracic surgery patients. RECENT FINDINGS Frailty results from an accelerated loss of functional reserve associated with ageing and leads to increased vulnerability following surgery. It is a complex and multidimensional syndrome involving physiological and psychosocial systems. Frailty is a separate entity from comorbidities and disabilities. Frailty is associated with an increased risk of complications and a higher mortality rate after thoracic surgery. Patients can easily be screened for frailty and frail patients can benefit from further assessment of all areas of frailty secondarily. Prehabilitation and rehabilitation can help limit frailty-related complications after thoracic surgery. SUMMARY Frailty should be part of the routine preoperative evaluation for thoracic surgery. Frailty must be considered in assessing eligibility for surgery and in planning prehabilitation and rehabilitation if necessary.
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Affiliation(s)
- Maximilien Cappe
- Department of Cardiovascular Anesthesiology, University Hospital Saint-Luc, Université Catholique de Louvain (UCLouvain)
| | - Pierre-François Laterre
- Critical Care Coordinating Center (4Cs), Brussels
- Department of Intensive Care, Centre Hospitalier Régional Mons-Hainaut, Mons
| | - Mélanie Dechamps
- Critical Care Coordinating Center (4Cs), Brussels
- Department of Cardiovascular Intensive Care, University Hospital Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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26
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Zhou S, Ding X, Leung JTY. Healthy Aging at Family Mealtimes: Associations of Clean Cooking, Protein Intake, and Dining Together with Mental Health of Chinese Older Adults amid COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1672. [PMID: 36767039 PMCID: PMC9914416 DOI: 10.3390/ijerph20031672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample of 7858 Chinese older adults, the associations between diet and depressive symptoms, along with the rural-urban divide, were examined using zero-inflated negative binomial regression. Overall, protein intake (incidence-rate ratio [IRR] = 0.89, p < 0.001), frequency of family dining together (IRR = 0.98, p < 0.001), and using tap water for cooking (IRR = 0.92, p < 0.01) were associated with lower incidence rates of depressive symptoms among older adults. Among rural older adults, frequency of family dining together (IRR = 0.97, p < 0.001) and tap water use (IRR = 0.89, p < 0.001) were associated with fewer depressive symptoms. However, urban residents who had a higher frequency of family dining together (IRR = 0.98, p < 0.05) and protein intake (IRR = 0.81, p < 0.001) exhibited fewer depressive symptoms. The findings revealed multifaceted dietary pathways towards healthy aging, which call for policies and interventions that improve diet quality for community-dwelling older adults.
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27
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Farsijani S, Cauley JA, Peddada SD, Langsetmo L, Shikany JM, Orwoll ES, Ensrud KE, Cawthon PM, Newman AB. Relation Between Dietary Protein Intake and Gut Microbiome Composition in Community-Dwelling Older Men: Findings from the Osteoporotic Fractures in Men Study (MrOS). J Nutr 2023; 152:2877-2887. [PMID: 36205552 PMCID: PMC9839986 DOI: 10.1093/jn/nxac231] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/12/2022] [Accepted: 09/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Little is known about the association of specific nutrients, especially proteins, on age-related gut dysbiosis. OBJECTIVES To determine the associations between the quantity and sources (vegetable and animal) of dietary protein intake and gut microbiome composition in community-dwelling older men. METHODS We performed a cross-sectional analysis on 775 older men from the Osteoporotic Fractures in Men Study (MrOS) (age 84.2 ± 4.0 y) with available dietary information and stool samples at visit 4 (2014-2016). Protein intake was estimated from a brief FFQ and adjusted to total energy intake. The gut microbiome composition was determined by 16S (v4) sequencing (processed by DADA2 and SILVA). A total of 11,534 amplicon sequence variants (ASVs) were identified and assigned to 21 phyla with dominance of Firmicutes (45%) and Bacteroidetes (43%). We performed α-diversity, β-diversity, and taxa abundance (by Analysis of Compositions of Microbiomes with Bias Correction [ANCOM-BC]) to determine the associations between protein intake and the gut microbiome. RESULTS Median protein intake was 0.7 g/(kg body weight · d). Participants with higher energy-adjusted protein intakes had higher Shannon and Chao1 α-diversity indices (P < 0.05). For β-diversity analysis, participants with higher protein intakes had a different center in weighted and unweighted UniFrac Principal Co-ordinates Analysis (PCoA) compared with those with lower intake (P < 0.05), adjusted for age, race, education, clinical center, batch number, fiber and energy intake, weight, height, and medications. Similarly, higher protein consumptions from either animal or vegetable sources were associated with higher gut microbiome diversity. Several genus-level ASVs, including Christensenellaceae, Veillonella, Haemophilus, and Klebsiella were more abundant in participants with higher protein intakes, whereas Clostridiales bacterium DTU089 and Desulfovibrio were more abundant in participants with lower protein intake (Bonferroni corrected P < 0.05). CONCLUSIONS We observed significant associations between protein intake and gut microbiome diversity in community-living older men. Further studies are needed to elucidate the mediation role of the gut microbiome on the relation between protein intake and health outcomes in older adults.
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Affiliation(s)
- Samaneh Farsijani
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Claude D. Pepper Older Americans Independence Center (OAICs), University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shyamal D Peddada
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Lisa Langsetmo
- Center for Care Delivery and Outcomes Research, VA Health Care System, Minneapolis, MN, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric S Orwoll
- Division of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kristine E Ensrud
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, University of California San Francisco, San Francisco, CA, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Claude D. Pepper Older Americans Independence Center (OAICs), University of Pittsburgh, Pittsburgh, PA, USA
- Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, USA
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Park W, Lee J, Hong K, Park HY, Park S, Kim N, Park J. Protein-Added Healthy Lunch-Boxes Combined with Exercise for Improving Physical Fitness and Vascular Function in Pre-Frail Older Women: A Community-Based Randomized Controlled Trial. Clin Interv Aging 2023; 18:13-27. [PMID: 36636457 PMCID: PMC9830714 DOI: 10.2147/cia.s391700] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Purpose Preventive or therapeutic interventions are key to maintaining independence in pre-frail and/or frail elderly. Therefore, we investigated whether multi-component interventions were effective in physical fitness levels and vascular functions in pre-frail older women. Patients and Methods Sixty participants aged ≥ 65 years (81.5 ± 4.3 yrs) were divided equally into control group, diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group. For 8 weeks, the participants received a set of protein-added meals twice daily on weekdays. The aerobic exercise groups performed 45 mins of stepping exercise at 50-70% of the maximal heart rate for 3 days/week, and the aerobic exercise with electromyostimulation was applied on each limb in 8 weeks. Blood pressure, physical fitness, cardiovascular biomarkers, pulse wave velocity, and flow-mediated dilation were measured before and after the 8-week. Results There were no group differences in age, height, weight, body mass index, free fat mass, and %body fat at baseline. The right grip strength significantly increased in the diet group, aerobic exercise and diet group, and aerobic exercise with electromyostimulation and diet group (p < 0.05). Short physical performance battery, 6-min walking distance, and flow-mediated dilation significantly increased in the aerobic exercise and diet group and aerobic exercise with electromyostimulation and diet group (p < 0.05). Blood pressure and pulse wave velocity did not differ between interventions. High-density lipoprotein-cholesterol levels significantly increased after 8 weeks in all intervention groups (p < 0.05). There were no significant differences in glucose, HbA1c, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, Homeostatic Model Assessment for Insulin Resistance, nitric oxide, and C-reactive protein levels. Conclusion These results show that multi-component interventions appear to improve physical fitness and vascular function in pre-frail older women. Thus, possible strategies to prevent early frailty including proper nutrition and exercise may be needed.
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Affiliation(s)
- Wonil Park
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea,Physical Education Laboratory, Chung-Ang University, Seoul, South Korea
| | - Jaesung Lee
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea
| | - Kwangseok Hong
- Department of Physical Education, College of Education, Chung-Ang University, Seoul, South Korea
| | - Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea,Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
| | - Saejong Park
- Department of Sports Science, Korea Institute of Sport Science, Seoul, South Korea
| | - Nahyun Kim
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea
| | - Jonghoon Park
- Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, Seoul, South Korea,Correspondence: Jonghoon Park, Exercise Nutrition and Biochemistry Laboratory, Department of Physical Education, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea, Tel/Fax +82 (2) 3290-2315, Email
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Kashtanova DA, Erema VV, Gusakova MS, Sutulova ER, Yakovchik AY, Ivanov MV, Taraskina AN, Terekhov MV, Matkava LR, Rumyantseva AM, Yudin VS, Akopyan AA, Strazhesko ID, Kordiukova IS, Akinshina AI, Makarov VV, Tkacheva ON, Kraevoy SA, Yudin SM. Mortality and survival in nonagenarians during the COVID-19 pandemic: Unstable equilibrium of aging. Front Med (Lausanne) 2023; 10:1132476. [PMID: 36936206 PMCID: PMC10018166 DOI: 10.3389/fmed.2023.1132476] [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: 12/27/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Aging puts the human body under an immense stress and makes it extremely susceptible to many diseases, often leading to poor outcomes and even death. Long-living individuals represent a unique group of people who withstood the stress of time and offer an abundance of information on the body's ability to endure the pressure of aging. In this study, we sought to identify predictors of overall one-year mortality in 1641 long-living individuals. Additionally, we analyzed risk factors for COVID-19-related morality, since statistics demonstrated an extreme vulnerability of older adults. Methods We conducted a two-stage evaluation, including a comprehensive geriatric assessment for major aging-associated: frailty, cognitive impairment, frontal lobe dysfunction, chronic pain, anxiety, risk of falls, sensory deficit, depression, sarcopenia, risk of malnutrition, fecal and urinary incontinence, dependence in Activities of Daily Living, dependence in Instrumental Activities of Daily Living, polypragmasia, and orthostatic hypotension; extensive blood testing, a survey, and a one-year follow-up interview. Results The most reliable predictors of overall mortality were cognitive impairment, malnutrition, frailty, aging-associated diseases and blood markers indicating malnutrition-induced metabolic dysfunctions (decreased levels of protein fractions, iron, 25-hydroxyvitamin D, and HDL), and aging biomarkers, such as IGF-1 and N-terminal pro b-type natriuretic peptide. In post-COVID 19 participants, the most significant mortality predictors among geriatric syndromes were depression, frontal lobe dysfunction and frailty, and similar to overall mortality blood biomarkers - 25-hydroxyvitamin D, IGF-1, HDL as well as high white blood cell, neutrophils counts and proinflammatory markers. Based on the results, we built a predictive model of overall mortality in the long-living individuals with f-score=0.76. Conclusion The most sensitive and reliable predictors of mortality were modifiable. This is another evidence of the critical importance of proper geriatric care and support for individuals in their "golden years". These results could facilitate geriatric institutions in their pursuit for providing improved care and could aid physicians in detecting early signs of potentially deadly outcomes. Additionally, our findings could be used in developing day-to-day care guidelines, which would greatly improve prevention statistics.
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Affiliation(s)
- Daria A. Kashtanova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
- *Correspondence: Daria A. Kashtanova,
| | - Veronika V. Erema
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Maria S. Gusakova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Ekaterina R. Sutulova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Anna Yu. Yakovchik
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Mikhail V. Ivanov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Anastasiia N. Taraskina
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Mikhail V. Terekhov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Lorena R. Matkava
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Antonina M. Rumyantseva
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Vladimir S. Yudin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Anna A. Akopyan
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Irina D. Strazhesko
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Irina S. Kordiukova
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Alexandra I. Akinshina
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Valentin V. Makarov
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Olga N. Tkacheva
- Russian Clinical Research Center for Gerontology, Pirogov Russian National Research Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Sergey A. Kraevoy
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
| | - Sergey M. Yudin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Moscow, Russia
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Coelho-Júnior HJ, Calvani R, Tosato M, Landi F, Picca A, Marzetti E. Protein intake and physical function in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101731. [PMID: 36087703 DOI: 10.1016/j.arr.2022.101731] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The present study explored cross-sectional and longitudinal associations between protein intake and physical function in older adults. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and measures of physical function in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and physical function as a primary or secondary outcome in people aged 60 + years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences (SMD), MD, log odds ratio (OR) and Z-score.. RESULTS Twenty-two cross-sectional studies examined a total of 11,332 community-dwellers, hospitalized older adults, and elite senior athletes with a mean age of approximately 75 years. The pooled analysis indicated that a protein intake higher than the recommended dietary allowance (RDA) was significantly associated with higher Short Physical Performance Battery (SPPB) scores (SMD: 0.63, 95% CI: 0.27, 0.99, P-value: 0.0006), faster walking speed, greater lower-limb (SMD: 0.22, 95% CI: 0.04, 0.40, P-value: 0.02) and isometric handgrip strength (Z-score: 0.087, 95% CI: 0.046-0.128, P-value: 0.0001), and better balance (SMD: 0.33, 95% CI: 0.05, 0.62, P-value: 0.02). Nine longitudinal studies investigated 12,424 community-dwelling and native older adults with a mean age of approximately 85 years. A protein intake higher than the current RDA was not associated with lower decline in either isometric handgrip strength (logOR: 0.99, 95% CI: 0.97-1.02, P-value= 0.67) or walking speed (logOR: 0.92, 95% CI: 0.77-1.10, P-value= 0.35). CONCLUSIONS A protein intake higher than the RDA is cross-sectionally associated with better physical performance and greater muscle strength in older adults. However, a high consumption of proteins does not seem to prevent physical function decline over time.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
| | - Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
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31
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Jayasinghe TN, Harrass S, Erdrich S, King S, Eberhard J. Protein Intake and Oral Health in Older Adults-A Narrative Review. Nutrients 2022; 14:4478. [PMID: 36364741 PMCID: PMC9653899 DOI: 10.3390/nu14214478] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 08/31/2023] Open
Abstract
Oral health is vital to general health and well-being for all ages, and as with other chronic conditions, oral health problems increase with age. There is a bi-directional link between nutrition and oral health, in that nutrition affects the health of oral tissues and saliva, and the health of the mouth may affect the foods consumed. Evidence suggests that a healthy diet generally has a positive impact on oral health in older adults. Although studies examining the direct link between oral health and protein intake in older adults are limited, some have explored the relationship via malnutrition, which is also prevalent among older adults. Protein-energy malnutrition (PEM) may be associated with poor oral health, dental caries, enamel hypoplasia, and salivary gland atrophy. This narrative review presents the theoretical evidence on the impact of dietary protein and amino acid composition on oral health, and their combined impact on overall health in older adults.
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Affiliation(s)
- Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sanaa Harrass
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Sharon Erdrich
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Shalinie King
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Yang J, Wang A, Shang L, Sun C, Jia X, Hou L, Xu R, Wang X. Study on the Association Between Dietary Habits, Patterns and Frailty of the Elderly: A Cross-Sectional Survey from Communities in China. Clin Interv Aging 2022; 17:1527-1538. [PMID: 36247201 PMCID: PMC9556274 DOI: 10.2147/cia.s378138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/27/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The purpose of this study was to explore the effects of Chinese dietary habits and patterns on frailty among elderly people in Xi’an the community. We also sought to provide dietary suggestions for prevention of frailty. Methods A cross-sectional survey was conducted and participants were divided into three groups: non-frail group, pre-frail group, and frail group. Our sample included 100 individuals randomly selected from each group for the dietary survey. Information regarding general socio-demographic characteristics and the types and quantity of food intake in the past 3 days was collected by a questionnaire. Factor analysis was used to identify dietary patterns; multiple logistic regression analysis was used to explore the correlation between dietary pattern and frailty. Results (1) 1693 elderly individuals were screened. The prevalence of pre-frailty and frailty was 41.0% and 16.2%, respectively. (2) Two dietary patterns were defined: ordinary dietary pattern and high-fat dietary pattern. Compared with the high-fat diet, the intake of iron, vitamin E, polyunsaturated fatty acids, and legume protein was significantly lower in the ordinary diet (P < 0.05). (3) Multivariate regression analysis showed that the ordinary dietary pattern score was positively correlated with frailty, which was consistent after adjusting for confounding factors (P < 0.05). Conclusion The low-fat and low-protein diet was positively correlated with the risk of frailty. Appropriate increase in fat and protein intake can help improve the frailty of the elderly in China.
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Affiliation(s)
- Jie Yang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Anhui Wang
- Department of Epidemiology, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Lei Shang
- Department of Health Statistics, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Chao Sun
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Xin Jia
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Liming Hou
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Rong Xu
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China
| | - Xiaoming Wang
- Department of Geriatrics, Xijing Hospital, Air Force Medical University, Xi’an, 710032, People’s Republic of China,Correspondence: Xiaoming Wang, Department of Geriatrics, Xijing Hospital, Air Force Medical University, 127 Changle West Road, Xi’an, 710032, People’s Republic of China, Tel +86-29-84775543, Email
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Coelho-Junior HJ, Calvani R, Azzolino D, Picca A, Tosato M, Landi F, Cesari M, Marzetti E. Protein Intake and Sarcopenia in Older Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148718. [PMID: 35886571 PMCID: PMC9320473 DOI: 10.3390/ijerph19148718] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/02/2022] [Accepted: 07/09/2022] [Indexed: 11/16/2022]
Abstract
Background: The present systematic review and meta-analysis investigated the cross-sectional and longitudinal associations between protein intake and sarcopenia in older adults. Methods: Observational studies that investigated the association between protein intake and sarcopenia as the primary or secondary outcome in people aged 60 years and older were included. Studies published in languages other than English, Italian, Portuguese, and Spanish were excluded. Studies were retrieved from MEDLINE, SCOPUS, EMBASE, CINAHL, AgeLine, and Food Science Source databases through January 31, 2022. A pooled effect size was calculated based on standard mean differences. Results: Five cross-sectional studies, one longitudinal study, and one case-control study that investigated 3353 community-dwelling older adults with a mean age of approximately 73 years were included. The meta-analysis of four studies indicated that older adults with sarcopenia consumed significantly less protein than their peers with no sarcopenia. Conclusions: Results of the present study suggest that an inadequate protein intake might be associated with sarcopenia in older adults.
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Affiliation(s)
- Hélio José Coelho-Junior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Domenico Azzolino
- Department of Clinical and Community Sciences, Università di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138 Milan, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Matteo Cesari
- Department of Clinical and Community Sciences, Università di Milano, Via Festa del Perdono 7, 20122 Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138 Milan, Italy
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
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Bisset ES, Howlett SE. The Use of Dietary Supplements and Amino Acid Restriction Interventions to Reduce Frailty in Pre-Clinical Models. Nutrients 2022; 14:2806. [PMID: 35889763 PMCID: PMC9316446 DOI: 10.3390/nu14142806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/06/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Frailty is a state of accelerated aging that increases susceptibility to adverse health outcomes. Due to its high societal and personal costs, there is growing interest in discovering beneficial interventions to attenuate frailty. Many of these interventions involve the use of lifestyle modifications such as dietary supplements. Testing these interventions in pre-clinical models can facilitate our understanding of their impact on underlying mechanisms of frailty. We conducted a narrative review of studies that investigated the impact of dietary modifications on measures of frailty or overall health in rodent models. These interventions include vitamin supplements, dietary supplements, or amino acid restriction diets. We found that vitamins, amino acid restriction diets, and dietary supplements can have beneficial effects on frailty and other measures of overall health in rodent models. Mechanistic studies show that these effects are mediated by modifying one or more mechanisms underlying frailty, in particular effects on chronic inflammation. However, many interventions do not measure frailty directly and most do not investigate effects in both sexes, which limits their applicability. Examining dietary interventions in animal models allows for detailed investigation of underlying mechanisms involved in their beneficial effects. This may lead to more successful, translatable interventions to attenuate frailty.
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Affiliation(s)
- Elise S. Bisset
- Department of Pharmacology, Dalhousie University, P.O. Box 15000, Halifax, NS B3H 4R2, Canada;
| | - Susan E. Howlett
- Department of Pharmacology, Dalhousie University, P.O. Box 15000, Halifax, NS B3H 4R2, Canada;
- Department of Medicine (Geriatric Medicine), Dalhousie University, P.O. Box 15000, Halifax, NS B3H 4R2, Canada
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35
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Coelho-Junior HJ, Calvani R, Picca A, Tosato M, Landi F, Marzetti E. Protein Intake and Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2022; 14:2767. [PMID: 35807947 PMCID: PMC9269106 DOI: 10.3390/nu14132767] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The present systematic review and meta-analysis investigated the cross-sectional and longitudinal associations between protein intake and frailty in older adults. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association between protein intake and frailty in older adults. Cross-sectional, case-control, and longitudinal cohort studies that investigated the association between protein intake and frailty as a primary or secondary outcome in people aged 60+ years were included. Studies published in languages other than English, Italian, Portuguese, or Spanish were excluded. Studies were retrieved on 31 January 2022. RESULTS Twelve cross-sectional and five longitudinal studies that investigated 46,469 community-dwelling older adults were included. The meta-analysis indicated that absolute, bodyweight-adjusted, and percentage of protein relative to total energy consumption were not cross-sectionally associated with frailty. However, frail older adults consumed significantly less animal-derived protein than robust people. Finally, high protein consumption was associated with a significantly lower risk of frailty. CONCLUSIONS Our pooled analysis indicates that protein intake, whether absolute, adjusted, or relative to total energy intake, is not significantly associated with frailty in older adults. However, we observed that frail older adults consumed significantly less animal protein than their robust counterparts.
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Affiliation(s)
- Hélio José Coelho-Junior
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (F.L.); (E.M.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.P.); (M.T.)
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.P.); (M.T.)
| | - Anna Picca
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.P.); (M.T.)
| | - Matteo Tosato
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.P.); (M.T.)
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (F.L.); (E.M.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.P.); (M.T.)
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; (F.L.); (E.M.)
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy; (A.P.); (M.T.)
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Johnson NR, Kotarsky CJ, Mahoney SJ, Sawyer BC, Stone KA, Byun W, Hackney KJ, Mitchell S, Stastny SN. Evenness of Dietary Protein Intake Is Positively Associated with Lean Mass and Strength in Healthy Women. Nutr Metab Insights 2022; 15:11786388221101829. [PMID: 35734029 PMCID: PMC9208033 DOI: 10.1177/11786388221101829] [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: 02/27/2022] [Accepted: 04/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Evenness of protein intake is associated with increased lean mass, but its relationship with muscle strength and performance is uncertain. Objectives: We determined the association of evenness of protein intake with lean mass, muscle strength and endurance, and functional ability. Design: This was a cross-sectional study. Setting: Data were collected at a research university in the upper midwestern United States. Participants: One hundred ninety-two healthy women, aged 18 to 79 years, mean ± SEM 41.9 ± 1.3, completed the study. Measurements: Dietary intake was assessed using 3-day food diaries verified with food frequency questionnaires. To assess evenness of protein intake, the day was divided into 3 periods: waking to 11:30, 11:31 to 16:30, and after 16:30. Lean mass was measured with dual energy X-ray absorptiometry. Lower-body muscle strength and endurance were determined using isokinetic dynamometry. Upper-body muscle strength was maximal handgrip strength. Functional ability was assessed using 6-m gait speed and 30-second chair stand tests. Accelerometry measured physical activity. Results: Intakes of 25 g or more of protein at 1 or more of the 3 periods was positively associated with lean mass (β ± S.E.; 1.067 ± 0.273 kg, P < .001) and upper-body (3.274 ± 0.737 kg, P < .001) and lower-body strength (22.858 ± 7.918 Nm, P = .004) when controlling for age, body mass index, physical activity, and energy and protein intakes. Consuming at least 0.24 g/kg/period for those under 60 years and 0.4 g/kg/period for those 60 years and older was related to lean mass (0.754 ± 0.244 kg, P = .002), upper-body strength (2.451 ± 0.658 kg, P < .001), and lower-body endurance (184.852 ± 77.185 J, P = .018), controlling for the same variables. Conclusions: Evenness of protein intake is related to lean mass, muscle strength, and muscular endurance in women. Spreading protein intake throughout the day maximizes the anabolic response to dietary protein, benefiting muscle mass and performance.
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Affiliation(s)
- Nathaniel R Johnson
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Christopher J Kotarsky
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Sean J Mahoney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Bailee C Sawyer
- Department of Medical Laboratory Sciences, Public Health, and Nutrition Science, Tarleton State University, Stephenville, TX, USA
| | - Kara A Stone
- Department of Kinesiology and Health Studies, University of Central Oklahoma, Edmond, OK, USA
| | - Wonwoo Byun
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | | | - Sherri N Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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Struijk EA, Fung TT, Rodríguez-Artalejo F, Bischoff-Ferrari HA, Hu FB, Willett WC, Lopez-Garcia E. Protein intake and risk of frailty among older women in the Nurses' Health Study. J Cachexia Sarcopenia Muscle 2022; 13:1752-1761. [PMID: 35318829 PMCID: PMC9178161 DOI: 10.1002/jcsm.12972] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/21/2022] [Accepted: 02/15/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is evidence that an overall healthy diet is associated with lower risk of frailty. However, the effect of diet composition, specifically the role of protein intake on frailty, is mostly unclear. The aim of this study was to evaluate the intake of protein, including total, plant, animal, and dairy protein, in relation to frailty incidence in a large cohort of older women. METHODS We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Intake of protein was measured nine times during follow-up from 1980 until 2010. Frailty was defined as having at least three of the following five criteria from the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss of ≥5%. The occurrence of frailty was assessed every 4 years from 1992 up to 2014. RESULTS During follow-up, we identified 13 279 incident cases of frailty. Women with a higher intake of plant protein had a lower risk of developing frailty after adjustment for all relevant confounders [relative risks across quintiles of consumption: 1.00, 0.94, 0.89, 0.86, and 0.86; P-trend < 0.001]. In contrast, those with a higher intake of animal protein intake had a higher risk of frailty [relative risks across quintiles of consumption: 1.00, 0.98, 0.99, 1.00, and 1.07; P-trend 0.04]. The intake of total and dairy protein showed no significant association with frailty in the full model. Substituting 5% of energy from plant protein intake at the expense of animal protein, dairy protein, or non-dairy animal protein was associated with 38% (29%, 47%), 32% (21%, 42%), and 42% (33%, 50%) reduced risk of frailty. CONCLUSIONS A higher intake of plant protein, but not animal or dairy protein, was associated with a lower risk of frailty. Substitution of plant protein for animal protein, especially non-dairy animal protein, was associated with lower risk of frailty.
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Affiliation(s)
- Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA/Food Institute, CEI UAM+CSIC, Madrid, Spain
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Dietary protein and multiple health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies. Clin Nutr 2022; 41:1759-1769. [DOI: 10.1016/j.clnu.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/05/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022]
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da Silva RO, Hastreiter AA, Vivian GK, Dias CC, Santos ACA, Makiyama EN, Borelli P, Fock RA. The influence of association between aging and reduced protein intake on some immunomodulatory aspects of bone marrow mesenchymal stem cells: an experimental study. Eur J Nutr 2022; 61:3391-3406. [PMID: 35508740 DOI: 10.1007/s00394-022-02893-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/12/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Dietary protein deficiency is common in the elderly, compromising hematopoiesis and the immune response, and may cause a greater susceptibility to infections. Mesenchymal stem cells (MSCs) have immunomodulatory properties and are essential to hematopoiesis. Therefore, this study aimed to investigate, in an aging model subjected to malnutrition due a reduced protein intake, aspects related to the immunomodulatory capacity of MSCs. METHODS Male C57BL/6 mice from young and elderly groups were fed with normoproteic or hypoproteic diets (12% and 2% of protein, respectively) and nutritional, biochemical and hematological parameters were evaluated. MSCs from bone marrow were isolated, characterized and their secretory parameters evaluated, along with gene expression. Additionally, the effects of aging and protein malnutrition on MSC immunomodulatory properties were assessed. RESULTS Malnourished mice lost weight and demonstrated anemia, leukopenia, and bone marrow hypoplasia. MSCs from elderly animals from both groups showed reduced CD73 expression and higher senescence rate; also, the malnourished state affected CD73 expression in young animals. The production of IL-1β and IL-6 by MSCs was affected by aging and malnutrition, but the IL-10 production not. Aging also increased the expression of NFκB, reducing the expression of STAT-3. However, MSCs from malnourished groups, regardless of age, showed decreased TGF-β and PGE2 production. Evaluation of the immunomodulatory capacity of MSCs revealed that aging and malnutrition affected, mainly in lymphocytes, the production of IFN-γ and IL-10. CONCLUSION Aging and reduced protein intake are factors that, alone or together, influence the immunomodulatory properties of MSCs and provide basic knowledge that can be further investigated to explore whether MSCs' therapeutic potential may be affected.
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Affiliation(s)
- Renaira Oliveira da Silva
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Araceli Aparecida Hastreiter
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Gabriela Kodja Vivian
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Carolina Carvalho Dias
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Andressa Cristina Antunes Santos
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Edson Naoto Makiyama
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Primavera Borelli
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil
| | - Ricardo Ambrósio Fock
- Laboratory of Experimental Haematology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Avenida Lineu Prestes, 580-Bloco 17, São Paulo, SP, 05508-900, Brazil.
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40
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Sekiguchi T, Kabayama M, Ryuno H, Tanaka K, Kiyoshige E, Akagi Y, Godai K, Sugimoto K, Akasaka H, Takami Y, Takeya Y, Yamamoto K, Yasumoto S, Masui Y, Ikebe K, Gondo Y, Arai Y, Ishizaki T, Rakugi H, Kamide K. Association between protein intake and changes in renal function among Japanese community-dwelling older people: The SONIC study. Geriatr Gerontol Int 2022; 22:286-291. [PMID: 35142012 PMCID: PMC9303602 DOI: 10.1111/ggi.14355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/06/2022] [Accepted: 01/15/2022] [Indexed: 01/22/2023]
Abstract
AIM The aim of this study was to clarify the association between dietary protein intake and decline in the estimated glomerular filtration rate (eGFR) among Japanese older adults. METHODS We used the data of the Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) study, an ongoing narrow-age range cohort study: 69-71 years, 79-81 years and 89-91 years. The outcome variable, change in eGFR, was estimated from serum creatinine measured at the baseline and 3-year follow up, and the exposure variable, protein intake, was calculated using the brief-type self-administered diet history questionnaire at the baseline. Associations between eGFR change and protein intake were determined by multiple linear regression analysis. RESULTS The mean eGFR change per year was -1.89 mL/min/1.73 m2 . The mean protein intake was 1.50 g/kg/day. The results of this study showed that there was no significant association between protein or animal protein intake and change in eGFR per year in the entire population of participants, including the very elderly, but there was a significant positive association in those whose renal function fell into chronic kidney disease stage G3 or G4. CONCLUSIONS Protein intake among community-dwelling older adults was not associated with lower eGFR, and for older chronic kidney disease patients, protein and animal protein intakes were more beneficial in maintaining eGFR. The results provide evidence that protein intake should not be restricted for older patients with chronic kidney disease, including the very elderly. Geriatr Gerontol Int 2022; 22: 286-291.
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Affiliation(s)
- Toshiaki Sekiguchi
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan,Faculty of Health ScienceMorinomiya University of Medical SciencesOsakaJapan
| | - Mai Kabayama
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan
| | - Hirochika Ryuno
- Department of NursingKobe University Graduate School of Health SciencesKobeJapan
| | - Kentaro Tanaka
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan
| | - Eri Kiyoshige
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan
| | - Yuya Akagi
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan
| | - Kayo Godai
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan
| | - Ken Sugimoto
- Department of General and Geriatric MedicineKawasaki Medical SchoolOkayamaJapan
| | - Hiroshi Akasaka
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Yoichi Takami
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Yasushi Takeya
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Koichi Yamamoto
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Saori Yasumoto
- Department of Clinical Thanatology and Geriatric Behavioral ScienceOsaka University, Graduate School of Human SciencesOsakaJapan
| | - Yukie Masui
- Research Team for Human CareTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Kazunori Ikebe
- Department of ProsthodonticsGerodontology and Oral Rehabilitation, Osaka University Graduate School of DentistryOsakaJapan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral ScienceOsaka University, Graduate School of Human SciencesOsakaJapan
| | - Yasumichi Arai
- Center for Supercentenarian Medical ResearchKeio University School of MedicineTokyoJapan
| | - Tatsuro Ishizaki
- Research Team for Human CareTokyo Metropolitan Institute of GerontologyTokyoJapan
| | - Hiromi Rakugi
- Department of Geriatric and General MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Kei Kamide
- Department of Health SciencesOsaka University Graduate School of MedicineOsakaJapan,Department of Geriatric and General MedicineOsaka University Graduate School of MedicineOsakaJapan
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41
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Salmon T, Essa H, Tajik B, Isanejad M, Akpan A, Sankaranarayanan R. The Impact of Frailty and Comorbidities on Heart Failure Outcomes. Card Fail Rev 2022; 8:e07. [PMID: 35399550 PMCID: PMC8977991 DOI: 10.15420/cfr.2021.29] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/19/2022] [Indexed: 12/16/2022] Open
Abstract
Frailty is a multisystemic process leading to reduction of physiological reserve and a reduction in physical activity. Heart failure (HF) is recognised as a global cause of morbidity and mortality, increasing in prevalence over recent decades. Because of shared phenotypes and comorbidities, there is significant overlap and a bidirectional relationship, with frail patients being at increased risk of developing HF and vice versa. Despite this, frailty is not routinely assessed in patients with HF. Identification of these patients to direct multidisciplinary care is key, and the development of a frailty assessment tool validated in a large HF population is also an unmet need that would be of considerable benefit in directing multidisciplinary-team management. Non-pharmacological treatment should be included, as exercise and physical rehabilitation programmes offer dual benefit in frail HF patients, by treating both conditions simultaneously. The evidence for nutritional supplementation is mixed, but there is evidence that a personalised approach to nutritional support in frail HF patients can improve outcomes.
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Affiliation(s)
- Thomas Salmon
- Department of Cardiology, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool UK
| | - Hani Essa
- Department of Cardiology, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool UK; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK
| | | | - Masoud Isanejad
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK; Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool UK
| | - Asangaedem Akpan
- Department of Cardiology, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool UK; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Rajiv Sankaranarayanan
- Department of Cardiology, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool UK; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK; National Institute for Health Research, UK
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Biomarker Changes in Response to a 12-Week Supplementation of an Oral Nutritional Supplement Enriched with Protein, Vitamin D and HMB in Malnourished Community Dwelling Older Adults with Sarcopenia. Nutrients 2022; 14:nu14061196. [PMID: 35334853 PMCID: PMC8953113 DOI: 10.3390/nu14061196] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 02/06/2023] Open
Abstract
Malnutrition and sarcopenia commonly overlap and contribute to adverse health outcomes. Previously, chronic supplementation with two oral nutritional supplements (ONS), control (CONS) and experimental ONS enriched with protein, vitamin D and β-hydroxy β-methylbutyrate (HMB) (EONS), improved muscle strength and quality in malnourished sarcopenic older adults, with EONS demonstrating early strength benefits at 12 weeks. To understand the underlying biological mechanisms contributing to the observed early strength benefits of EONS, we examined serum biomarker changes in response to 12-week supplementation. Serum samples (EONS (n = 90) and CONS (n = 103)) collected at baseline and 12 weeks were analyzed. Biomarkers (n = 243) were measured using multiplexed immunoassay, commercial immunoassays and ELISAs. Sixty markers were excluded with levels below assay detection limits. Sixteen biomarkers significantly changed in response to both interventions including nutritional and metabolic markers. Thirteen biomarkers significantly changed in response to EONS but not CONS. Increases in immunoglobulins, myoglobin, total protein, vitamin E and magnesium were observed with EONS. Inflammation-related ferritin and osteopontin decreased, while soluble receptors for cytokines increased, suggesting decreased inflammation. Sex hormone-binding globulin associated with sarcopenia also decreased with EONS. Biomarkers reflective of multiple biological systems were impacted by nutritional intervention in sarcopenic older adults. Incremental biomarker changes were observed in response to EONS containing HMB that possibly link to improvements in skeletal muscle health.
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Choi KA, Heu E, Nam HC, Park Y, Kim D, Ha YC. Relationship between Low Muscle Strength, and Protein Intake: A Preliminary Study of Elderly Patients with Hip Fracture. J Bone Metab 2022; 29:17-21. [PMID: 35325979 PMCID: PMC8948493 DOI: 10.11005/jbm.2022.29.1.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background: The purpose of the present study was to assess the daily protein uptake and its relationship with sarcopenia, as defined by the Asian Working Group for Sarcopenia (AWGS), among elderly patients with hip fractures.Methods: Forty-seven elderly patients with hip fractures were enrolled in this retrospective observational study. The main outcome measures included protein uptake, muscle mass, and grip strength for sarcopenia in elderly patients. Sarcopenia was diagnosed according to AWGS. Wholebody densitometry was used to measure skeletal muscle mass, and muscle strength was evaluated using handgrip testing.Results: Of 47 patients with hip fractures (12 men and 35 women), 37 (79%) patients exhibited insufficient protein intake (range, 0.01-0.588 g/kg/day), and 10 (21%) patients exhibited excessive protein intake (range, 1.215-2.121 g/kg/day). The mean daily protein intake was 56.5 g (range, 7.2–136.0 g). Prevalence of low muscle strength (handgrip strength <18 kg in women and <26 kg in men) was detected in 13 (37%) women and 8 (67%) men (P=0.076). Sarcopenia (lower muscle mass and lower muscle strength) was detected in 9 (26%) women and 6 (50%) men (P=0.119). Although lower protein intake was marginally associated with sarcopenia (P=0.189), it was significantly associated with lower grip strength (P=0.042).Conclusions: The present study demonstrated that insufficient protein intake in elderly patients with hip fractures was common, and lower protein intake was significantly associated with lower muscle strength.
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Affiliation(s)
- Kyung-A Choi
- National Institute of Medical Welfare, Kangnam University, Yongin,
Korea
| | - Eunseo Heu
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul,
Korea
| | - Hyun-Cheul Nam
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
| | - Yongsoon Park
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul,
Korea
| | - Donghyun Kim
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul,
Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Korea
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Noh HM, Choi YH, Lee SK, Song HJ, Park YS, Kim N, Cho J. Association between Dietary Protein Intake, Regular Exercise, and Low Back Pain among Middle-Aged and Older Korean Adults without Osteoarthritis of the Lumbar Spine. J Clin Med 2022; 11:jcm11051220. [PMID: 35268311 PMCID: PMC8911099 DOI: 10.3390/jcm11051220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 12/13/2022] Open
Abstract
This study aimed to evaluate the effect of dietary protein intake and regular exercise on low back pain (LBP) using data from the Korea National Health and Nutrition Examination Survey. A total of 2367 middle-aged and older adults (≥50 years) who underwent dual-energy X-ray absorptiometry and plain radiography of the lumbar spine were included. LBP was defined using a questionnaire to determine the presence of LBP lasting more than 30 days in the preceding three months. Twenty-four-hour dietary recall data were used to estimate protein intake, and regular exercise was assessed using the International Physical Activity Questionnaire. Multivariable logistic regression analysis revealed that men who did not perform regular exercise had a high probability of LBP (odds ratio [OR] 2.34; 95% confidence interval [CI] 1.24−4.44). Low protein intake (<0.8 g/kg/day) was associated with high odds for LBP in women (OR 1.83; 95% CI 1.12−2.99). Low protein intake and lack of regular exercise were also associated with a higher probability of LBP in women (OR 2.91; 95% CI 1.48−5.72). We recommend that women over 50 years of age consume the recommended daily amount of protein to prevent LBP and engage in regular exercise.
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Affiliation(s)
- Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (H.-M.N.); (H.J.S.)
| | - Yi Hwa Choi
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (S.K.L.); (N.K.); (J.C.)
- Correspondence: ; Tel.: +82-31-380-3943
| | - Soo Kyung Lee
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (S.K.L.); (N.K.); (J.C.)
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (H.-M.N.); (H.J.S.)
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon 24253, Korea;
| | - Namhyun Kim
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (S.K.L.); (N.K.); (J.C.)
| | - Jeonghoon Cho
- Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Korea; (S.K.L.); (N.K.); (J.C.)
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Vega-Cabello V, Caballero FF, Lana A, Arias-Fernandez L, Banegas JR, Rodriguez-Artalejo F, Lopez-Garcia E, Struijk EA. Association of zinc intake with risk of impaired physical function and frailty among older adults. J Gerontol A Biol Sci Med Sci 2022; 77:2015-2022. [PMID: 35034112 DOI: 10.1093/gerona/glac014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Zinc could be a target nutrient in the prevention of physical impairment and frailty in older adults due to its anti-inflammatory/antioxidant properties. However, prospective studies evaluating this inquiry are scarce. Thus, we aimed to assess the association between zinc intake and impaired lower-extremity function (ILEF) and frailty among community-dwelling older adults. METHODS We examined 2,963 adults aged ≥60 years from the Seniors-ENRICA cohort. At baseline (2008-2010) and subsequent follow-up (2012), zinc intake (mg/d) was estimated with a validated computerized face-to-face diet history and adjusted for total energy intake. From 2012 to 2017, the occurrence of ILEF was ascertained with the Short Physical Performance Battery, and of frailty according to the Fried phenotype criteria. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders, including lifestyle, comorbidity, and dietary factors. RESULTS During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared to participants in the lowest tertile of zinc intake (3.99-8.36 mg/d), those in the highest tertile (9.51-21.2 mg/d) had a lower risk of ILEF [fully-adjusted hazard ratio (95% confidence interval): 0.75 (0.58-0.97); p for trend: 0.03] and of frailty [0.63 (0.44-0.92); p for trend: 0.02]. No differences in the association were seen by strata of socio-demographic and lifestyle factors. CONCLUSIONS Higher zinc intake was prospectively associated with a lower risk of ILEF and frailty among older adults, suggesting that adequate zinc intake, that can be achieved through a healthy diet, may help preserve physical function and reduce the progression to frailty.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | - Lucia Arias-Fernandez
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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Nanri H, Watanabe D, Yoshida T, Yoshimura E, Okabe Y, Ono M, Koizumi T, Kobayashi H, Fujita H, Kimura M, Yamada Y. Adequate Protein Intake on Comprehensive Frailty in Older Adults: Kyoto-Kameoka Study. J Nutr Health Aging 2022; 26:161-168. [PMID: 35166309 DOI: 10.1007/s12603-022-1740-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Defining an adequate protein intake in older adults remains unresolved. We examined the association between calibrated protein intake and comprehensive frailty by sex in the Kyoto-Kameoka study. DESIGN Cross-sectional study of baseline data. SETTING AND PARTICIPANTS The study included 5679 Japanese participants aged 65 years or older. METHODS Calibration coefficients were estimated from food frequency questionnaires and 7-day dietary records as a reference. Comprehensive frailty was evaluated using the 25-item Kihon Checklist (KCL) and defined as a total KCL score of ≥7points. Sex-specific calibrated protein intakes were presented as % of energy, per kg of actual body weight (BW), and per kg of ideal BW. RESULTS Multiple logistic regression analysis showed that calibrated protein intake is inversely associated with comprehensive frailty. The association between protein intake and comprehensive frailty was also evaluated using curve fitting with non-linear regression, a weak U-shaped association was found in males and an L-shaped association in females. Men had a low prevalence of frailty at a calibrated protein intake of 15-17% energy from protein, 1.2 g/kg actual BW/day, or 1.4 g/kg ideal BW/day, and women had a low prevalence of frailty at 17-21% energy from protein or 1.6 g/kg ideal BW/day, with the prevalence of frailty remaining unchanged at higher protein intakes. Meanwhile, the inverse relationship between protein intake per ABW and frailty showed a gradual decrease at 1.4 g/kg ABW/day for protein in women. CONCLUSIONS AND IMPLICATIONS A non-linear relationship was found between calibrated protein intake and frailty, with a U-shaped association in men and an L-shaped association in women. Adequate protein intake in healthy Japanese older adults was higher than the current recommended daily allowance.
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Affiliation(s)
- H Nanri
- Hinako Nanri, Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan, E-mail:
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Abstract
OBJECTIVES The study aimed to apply the frailty index (FI) to assess frailty status among Chinese centenarians and analyse its associated factors. DESIGN The study was a cross-sectional study. SETTING AND PARTICIPANTS The study included 1043 centenarians (742 females and 301 males) aged ≥100 years from the 2018 wave of the China Longitudinal Healthy Longevity Survey. MEASUREMENTS All participants were assessed for frailty by the FI. Basic characteristics, including age, height, weight, calf circumference, waist circumference, hip circumference, sex, years of education, financial status, exercise, fall status, coresidence, smoking, alcohol consumption, number of natural teeth, denture use, toothache, and tooth brushing, were collected. Multivariate logistic regression was used to analyse the associations between risk factors and frailty. RESULTS The average age of the participants was 102.06±2.55 years (range: 100-117 years). The FI ranged between 0.00 and 0.63. The mean FI for all participants was 0.27±0.13 (median 0.25; interquartile range 0.20-0.35). Participants were divided into quartiles. The number of natural teeth and denture use, coresidence, sex, exercise, and financial status showed significant associations with frailty classes (all P<0.05). Multivariate logistic regression analysis indicated that having ≤20 natural teeth without dentures (OR, 95% CI= 1.89(0.004-1.246), P<0.05), having ≤20 natural teeth with dentures (OR, 95% CI=2.21(0.158,1.432), P=0.015), living alone or in an institution (OR, 95% CI=1.68(0.182-0.849), P=0.002), lacking exercise (OR, 95% CI=2.54(0.616-1.246), P<0.001), having insufficient financial resources (OR, 95% CI=2.9(0.664-1.468), P<0.001), and being female (OR, 95% CI=1.47(0.137,0.634), P=0.002) were independent risk factors for frailty. CONCLUSION Chinese centenarian women are frailer than men. Having fewer natural teeth, living alone or in an institution, lacking exercise, and having insufficient financial resources were the factors associated with frailty among Chinese centenarians. Family conditions and healthy lifestyles may be important for frailty status in centenarians.
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Affiliation(s)
- J Zhang
- Liyu Xu, Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, People's Republic of China, Tel +86 13486183817, Fax +86 0571 87985201, Email
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Koponen S, Nykänen I, Savela RM, Välimäki T, Suominen AL, Schwab U. Individually tailored nutritional guidance improved dietary intake of older family caregivers: a randomized controlled trial. Eur J Nutr 2022; 61:3585-3596. [PMID: 35622137 PMCID: PMC9136734 DOI: 10.1007/s00394-022-02908-w] [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: 11/09/2021] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Older family caregivers (FCs) are vulnerable to insufficient dietary intake and risk of malnutrition. The aim of this study was to assess the impact of individually tailored nutritional guidance on the dietary intake and nutritional status of older FCs and their care recipients' (CRs') nutritional status. METHODS This study was a randomized controlled 6-month nutrition intervention in Eastern Finland. The inclusion criteria for FCs were having a home-living CR aged 65 or above and a valid care allowance. The exclusion criterion was CR receiving end-of-life care at baseline. Participants were randomly assigned to an intervention (FCs n = 63, CRs n = 59) and a control (FCs n = 50, CRs n = 48) group. Individually tailored nutritional guidance targeted to FCs was given to an intervention group by a clinical nutritionist. The main outcomes were dietary intake (3-day food record). RESULTS After the 6-month intervention, 63 FCs and 59 CRs in the intervention group and 50 FCs and 48 CRs in the control group were analyzed. In the intervention group of FCs, the intakes of protein, riboflavin, calcium, potassium, phosphorus, and iodine differed significantly (p < 0.05) compared to the control group. In addition, the intake of vitamin D supplementation improved in the intervention group of the FCs and CRs (p < 0.001). CONCLUSION Individually tailored nutrition guidance improves the intake levels of crucial nutrients, such as the intake levels of protein, vitamin D, and calcium of the FCs. Further studies are warranted to optimize the methods to improve the nutrition of FCs. Registration number of Clinical Trials: ClinicalTrials.gov NCT04003493 (1 July 2019).
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Affiliation(s)
- Sohvi Koponen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland ,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland ,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Finland
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Ardeljan AD, Polisetty TS, Palmer J, Vakharia RM, Roche MW. Comparative Analysis on the Effects of Sarcopenia following Primary Total Knee Arthroplasty: A Retrospective Matched-Control Analysis. J Knee Surg 2022; 35:128-134. [PMID: 32629511 DOI: 10.1055/s-0040-1713355] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Despite the high incidence of sarcopenia in the orthopaedic community, studies evaluating the influence of sarcopenia following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study is to determine if sarcopenic patients undergoing primary TKA have higher rates of (1) in-hospital lengths of stay (LOS); (2) medical complications; (3) implant-related complications; (4) fall risk; (5) lower extremity fracture risk; and (6) costs of care. Sarcopenia patients were matched to controls in a 1:5 ratio according to age, sex, and medical comorbidities. The query yielded 90,438 patients with (n = 15,073) and without (n = 75,365) sarcopenia undergoing primary TKA. Primary outcomes analyzed included: in-hospital LOS, 90-day medical complications, 2-year implant-related complications, fall risk, lower extremity fracture risk, and costs of care. A p-value of less than 0.05 was considered statistically significant. Patients with sarcopenia undergoing primary TKA had greater in-hospital LOS (4 vs. 3 days, p < 0.0001). Sarcopenic patients were also found to have increased incidence and odds of 90-day medical complications (2.9 vs. 1.1%; odds ratio [OR] = 2.83, p < 0.0001), falls (0.9 vs. 0.3%; OR = 3.54, p < 0.0001), lower extremity fractures (1.0 vs. 0.2%; OR = 5.54, p < 0.0001), and reoperation (0.9 vs. 0.5%; OR = 1.87, p < 0.0001). Additionally, sarcopenic patients had greater 2-year implant-related complications (4.3 vs. 2.4%; OR = 1.80, p < 0.0001), as well as day of surgery ($52,900 vs. 48,248, p < 0.0001), and 90-day ($68,303 vs. $57,671, p < 0.0001) costs compared with controls. This analysis of over 90,000 patients demonstrates that patients with sarcopenia undergoing primary TKA have greater in-hospital LOS, increased odds of 90-day medical complications, falls, lower extremity fractures, and reoperations. Additionally, sarcopenia was associated with greater 2-year implant-related complications, day of surgery costs, and 90-day costs. The study is useful as it can allow orthopaedic surgeons to properly educate these patients of the potential complications which may occur following their surgery.
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Affiliation(s)
- Andrew D Ardeljan
- Division of Health Professions, Nova Southeastern College of Osteopathic Medicine, Ft. Lauderdale, Florida.,Orthopaedic Research Department, Holy Cross Orthopaedic Research Institute, Ft. Lauderdale, Florida
| | - Teja S Polisetty
- Orthopaedic Research Department, Holy Cross Orthopaedic Research Institute, Ft. Lauderdale, Florida.,Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Joseph Palmer
- Department of Orthopaedic Surgery, Broward Health Medical Center, Ft. Lauderdale, Florida
| | - Rushabh M Vakharia
- Orthopaedic Research Department, Holy Cross Orthopaedic Research Institute, Ft. Lauderdale, Florida
| | - Martin W Roche
- Orthopaedic Research Department, Holy Cross Orthopaedic Research Institute, Ft. Lauderdale, Florida
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50
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Relationship between Oral Hypofunction, and Protein Intake: A Cross-Sectional Study in Local Community-Dwelling Adults. Nutrients 2021; 13:nu13124377. [PMID: 34959928 PMCID: PMC8705970 DOI: 10.3390/nu13124377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 01/09/2023] Open
Abstract
Few studies have investigated the relationship between nutritional status and comprehensive assessment of oral hypofunction, especially protein intake-related sarcopenia. Thus, we explored these relationships in a large-scale cross-sectional cohort study using the seven-item evaluation for oral hypofunction and Diet History Questionnaire for nutritional assessment. We used the data from 1004 individuals who participated in the 2019 health survey of the residents of Tarumizu City, Kagoshima Prefecture, Japan for analysis. We found that individuals with oral hypofunction were significantly older with a lower skeletal muscle index. Although there were few foods that had a significant difference between the groups with and without oral hypofunction, the consumption of beans and meats was significantly lower in women and men in the oral hypofunction group, respectively. According to the lower limit of the tentative dietary goal defined in Japan, comprehensive evaluation of oral hypofunction was significantly and independently associated with protein intake in both men and women (odds ratio, 1.70; 95% confidence interval, 1.21-2.35). In conclusion, we found that oral hypofunction was associated with targeted protein intake for sarcopenia and frailty prevention in middle-aged and older community-dwelling adults. Comprehensive evaluation of oral function with intervention in cases of hypofunction could inform clinicians to better prevent sarcopenia.
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