Association between Physical Condition and Body Composition, Nutrient Intake, Sociodemographic Characteristics, and Lifestyle Habits in Older Spanish Adults

Correlation between low handgrip strength and metabolic syndrome in older adults: a systematic review

Muscle weakness has been associated to insulin resistance and metabolic syndrome in the general population. However, it is still unclear whether this association is maintained in older adults. This study investigated correlations between low handgrip strength (HGS) and metabolic syndrome, or some of its components, in older adults through a systematic review of the literature. Searches were conducted in the Virtual Health Library Regional Portal, Scopus, Cochrane, Embase, MEDLINE/ PubMed, SciELO, and Web of Science databases for relevant studiesinvestigating muscle weakness (measured by hand dynamometer) and metabolic syndrome or its components in older adult populations, published up to September 2023. From the 2050 references initially identified, 20 studies, comprising a total of 31,264 older adults of both genders, completely met the inclusion/exclusion criteria. Eighteen studies showed that lower HGS was associated with metabolic syndrome or some of its risk factors, such as abdominal obesity, hyperglycemia, insulin resistance, dyslipidemia, or high blood pressure. Two studies found that older men with high blood pressure had increased HGS. Most studies included in this systematic review revealed a significant correlation between reduced HGS and metabolic syndrome or some of its components, especially abdominal obesity and insulin resistance. We conclude that below-average HGS can be associated with metabolic syndrome in older adults.

Relationship between monounsaturated fatty acids and sarcopenia: a systematic review and meta-analysis of observational studies

Accumulating evidence suggests that fatty acids (FAs) play an essential role in regulating skeletal muscle mass and function throughout life. This systematic review and meta-analysis aimed to examine the relationship between dietary or circulatory levels of monounsaturated FAs (MUFAs) and sarcopenia in observational studies. A comprehensive literature search was performed in three databases (PubMed, Scopus, and Web of Science) from inception until August 2022. Of 414 records, a total of 12 observational studies were identified for this review. Ten studies were meta-analysed, comprising a total of 3704 participants. The results revealed that MUFA intake is inversely associated with sarcopenia (standardized mean difference = - 0.28, 95% CI - 0.46 to - 0.11; p < 0.01). Despite the limited number of studies, our results suggest that lower MUFA intake is associated with a higher risk of sarcopenia. However, the available evidence is still insufficient and further investigations are needed to demonstrate this relationship.

Association of Spinal Alignment and Abdominal Circumference with Sarcopenia Status and Fall Risk in Patients with Osteoporosis: A Retrospective Study

Since vertebral kyphosis and abdominal circumference are thought to influence sarcopenia and fall risk in osteoporosis, we evaluated sarcopenia and fall risk in patients with different measurements of abdominal circumference and sagittal longitudinal axis (SVA). In this post hoc study, 227 patients aged 65 years or more who visited an outpatient osteoporosis clinic were included in the analysis. Sarcopenia was determined from lean body mass, grip strength, and walking speed by dual energy X-ray absorptiometry; SVA (median 40 mm) and abdominal circumference (median 80 cm) were compared between the four groups, each divided into two groups. Nutritional management, falls, and fall anxiety scores were also examined. The incidence of sarcopenia was significantly increased in those with abdominal circumference < 80 cm in both the SVA < 40 mm and SVA ≥ 40 mm groups (p < 0.05). Nonetheless, the fall scores of those with SVA < 40 mm were lower than those of individuals with SVA ≥ 40 mm (p < 0.01). Based on the results of this study, SVA and abdominal circumference values may predict the risk of sarcopenia and falls. More research is needed before our results can be translated into clinical practice.

Association between Physical Activity and Non-Alcoholic Fatty Liver Disease in Adults with Metabolic Syndrome: The FLIPAN Study

Background: A lifestyle with regular PA (physical activity) and Mediterranean diet has benefits on NAFLD (non-alcoholic fatty liver disease) and MetS (metabolic syndrome). Objectives: To assess the association between physical activity and NAFLD in adults with MetS. Design: Cross-sectional study in 155 participants (40−60 years old) from Balearic Islands and Navarra (Spain) with diagnosis of NAFLD and MetS, and BMI (body mass index) between 27 and 40 Kg/m2. Methods: PA level was categorized into two groups according to weekly METs (metabolic equivalents of tasks). PA was assessed using a validated Minnesota questionnaire and accelerometers. MetS parameters were assessed by blood collection analysis and NAFLD by abdominal MRI (magnetic resonance imaging). Results: Participants with high PA showed more energy expenditure and expended more calories than ingested (−143.9 Kcal/day; p < 0.001). PA was a risk factor for AST (aspartate aminotransferase) (adjusted OR: 7.26; 95% CI: 1.79−29.40) and a protective factor for ALT (alanine aminotransferase) (adjusted OR: 0.24; 95% CI: 0.12−0.48), GGT (gamma-glutamyl transferase) (adjusted OR: 0.52; 95% CI: 0.29−0.94) and IFC-NMR (intrahepatic fat content by nuclear magnetic resonance) (adjusted OR: 0.26; 95% CI: 0.12−0.56) when sociodemographic confounders were considered. Conclusions: NAFLD patients with high PA showed more positive relationship on MetS parameters and liver profile (ALT, GGT, IFC-NMR) than subjects with low PA, but not for AST. Difference between calories ingested and expended influenced this relationship.

Dietary Intervention Effectiveness, Clinical Outcomes and Nutrient and Salicylate Intakes in Older Adults Living in Long-Term Care Homes: The Results from the Senior’s Plate Project

Optimal nutrition is an important part of the therapeutic process offered to patients in long-term care, as it can significantly influence their nutritional and health status. The aim of this study was to assess the impacts of a dietary intervention on the nutritional status, clinical outcomes and selected nutrient and salicylate intakes among older adults living in a long-term care nursing home. To achieve the research goal, a prospective, non-randomized, baseline-controlled intervention study was conducted. The study was conducted within the framework of the “Senior’s Plate Project”, a project established in 2018 by the Polish Society of Dietetics. Methods: A 3 month dietary intervention, which included one serving of supplementary food, served as a second breakfast (Nestle Sinlac). Energy, nutrients and salicylates intakes were estimated on the basis of the menus. Food and beverage intakes among residents were verified by health care personnel. Anthropometric measurements and clinical examinations were conducted according to standard procedures at baseline and after intervention. Results: Of the 38 residents qualified for the study, 29 completed the program. Residents’ body mass index (BMI) values ranged from 13.3 kg/m2 to 34 kg/m2. A BMI <22 kg/m2, indicating underweight, was found in 19 subjects. The dietary intervention resulted in increased body weight (57.8 ± 12.3 vs. 59.4 ± 12.6 kg), BMI (22.4 ± 4.0 vs. 23.0 ± 4.1 kg/m2) and body fat (19.2 ± 8.7 vs. 20.6 ± 8.9 kg). Significant changes in the levels of biochemical parameters, including serum calcium (8.7 vs. 9.5 mg/dL), potassium (4.1 ± 0.6 vs. 4.5 ± 0.5 mmol/L) and zinc (74.1 ± 10.9 vs. 109.0 ± 20.4 µg/dL), were observed. Energy, protein, fat and carbohydrate intakes were significantly higher in the third month of the intervention as compared to the baseline. The estimated medial daily intake of salicylates was low and ranged from 0.34 mg to 0.39 mg. Conclusions: The dietary intervention resulted in beneficial and significant changes in the nutritional status, biochemical parameters and nutrition of residents of the long-term care home. These results suggest that practical and individualized approaches are required to improve the nutritional status and clinical outcomes of nursing homes residents.

Self-Reported Sleeping Time Effects on Physical Performance and Body Composition Among Spanish Older Adults: EXERNET-Elder 3.0 study

Objective: To determine the link between physical fitness and body composition with nocturnal and nap time in Spanish older adults. Methods: Eight hundred thirty older adults underwent several tests. Sleep was measured using Jenkins Sleep Scale. Nocturnal sleep was categorized (<7, 7-9, and >9 hours), and nap time (no nap, 1-30 minutes, and >30 minutes).Physical fitness was evaluated using validated tests, and body composition by electric bioimpedance. Results: 75.1% of participants were female, mean age 77.7 ± 5.1 years. Mean nocturnal sleep and nap time was 6.7 hours and 23.3 minutes, respectively. Models showed nocturnal sleep >9 hours was significant and positively associated with body shape index (Odds ratio[OR] = 4.07 (p = .011)) and waist circumference OR = 1.04 (p = .024) in females. Males' waist and hip circumference were positively significantly related to nap time between 1 and 30 minutes, OR = 1.08, p = .009 and OR = 1.08, p = .048, respectively. In females, nap time >30 minutes was associated with greater fat mass and body shape index OR = 1.22, p = .032 and OR = 3.95, p = .027, respectively. Physical fitness showed no associations with sleep outcomes. Conclusions: Sleep patterns do not influence physical fitness but body composition, being more related to female body composition as nocturnal and nap sleep were associated with higher fat mass, waist circumference and body shape index, while only short nap times were related to higher waist and hip circumference in males.

Tailoring Body Mass Index for Prediction of Obesity in Young Adults: A Multi-Centric Study on MBBS Students of Southeast India

INTRODUCTION

Body mass index (BMI) has been used for a long period as a surrogative measure for obesity. But BMI does not differentiate between fat and nonfat tissue (blood, bone, and muscle) due to which it is not considered accurate anymore. But since BMI is easier to estimate and used widely for assessment of obesity, it is better if it is re-standardized according to the body fat percentage (BFP) of a specific population, community, and their ethnicity.

OBJECTIVE

To estimate and propose the BMI cut-off values in young Indian population especially MBBS students taking BFP as a standard.

DESIGN

This is a cross-sectional study. Anthropometric data (age, gender, height, weight, waist circumference, and hip circumference) were collected from the participants after taking consent. BMI was calculated using Quetelet's Rule. BFP was estimated using Omron Body fat Monitor (HBF 385). It measures the BFP by the bioelectrical impedance (BI) method. Data were analyzed with appropriate statistical tests and receiver operating curve (ROC) curves were drawn to find the cut-off values of BMI to determine obesity.

SETTING

The present study is a multi-centric study conducted in four medical colleges (two in each state; Odisha and Andhra Pradesh, India).

PARTICIPANTS

Apparently healthy MBBS students aged 18-24 years were included in this study. Students having any chronic or acute illnesses were excluded from the study. Out of 904 students contacted from four medical colleges, 863 (430 males and 433 females) consented and participated.

RESULTS

Some 863 MBBS students have participated in this study. After adjusting for age, BMI was found to be higher in males. BMI was found to be 29.33 for males and in females it was 29.06. BFP was higher in females (34.23) as compared to males (20.77). Waist hip ratio was found to be higher in females (0.92) than in males (0.84). Whereas, fat free mass (FFM) and fat free mass index (FFMI) are higher in males, i.e., 56.24 and 18.48 respectively. Most appropriate cut-off value for obesity on ROC curve was found to be 22.09 (sensitivity 84.5%, specificity 83.46%) in males and that of females was 23.73 (sensitivity 85.26, specificity 81.23). Whereas, the conventional cut-off of 25 for males had sensitivity of only 46% and that of females was 70.5%. For total population BMI cut-off value was found to be 22.2 with 81% sensitivity and 74% specificity.  Conclusion: We propose the cut-off value for overweight/obesity in males to be 22.09 kg/m² and for females to be 23.73 kg/m² in young adult Indian population. These values were found to have more sensitivity and specificity than current BMI cut-off value.

Sarcopenia, Diet, Physical Activity and Obesity in European Middle-Aged and Older Adults: The LifeAge Study

The revised European consensus defined sarcopenia as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. The aim of this study was to determine the prevalence of sarcopenia and analyse the influence of diet, physical activity (PA) and obesity index as risk factors of each criteria of sarcopenia. A total of 629 European middle-aged and older adults were enrolled in this cross-sectional study. Anthropometrics were assessed. Self-reported PA and adherence to the Mediterranean diet were evaluated with the Global Physical Activity Questionnaire (GPAQ) and Prevention with Mediterranean Diet questionnaire (PREDIMED), respectively. The functional assessment included handgrip strength, lower body muscle strength, gait speed and agility/dynamic balance. Of the participants, 4.84% to 7.33% showed probable sarcopenia. Sarcopenia was confirmed in 1.16% to 2.93% of participants. Severe sarcopenia was shown by 0.86% to 1.49% of participants. Male; age group ≤65 years; lower body mass index (BMI); high levels of vigorous PA; and the consumption of more than one portion per day of red meat, hamburgers, sausages or cold cuts and/or preferential consumption of rabbit, chicken or turkey instead of beef, pork, hamburgers or sausages (OR = 0.126-0.454; all p < 0.013) resulted as protective factors, and more time of sedentary time (OR = 1.608-2.368; p = 0.032-0.041) resulted as a risk factor for some criteria of sarcopenia. In conclusion, age, diet, PA, and obesity can affect the risk of having low muscle strength, low muscle mass or low functional performance, factors connected with sarcopenia.

Eating Habits in Older Adults: Compliance with the Recommended Daily Intakes and Its Relationship with Sociodemographic Characteristics, Clinical Conditions, and Lifestyles

Background: Older people have different nutritional requirements from those of the general population; in particular, they need a lower energy intake, higher protein content to preserve muscle mass, and a greater supply of vitamins and minerals to maintain good bone health. The objective of this study is to evaluate the degree of compliance with nutritional recommendations, and its relationship with sociodemographic characteristics, clinical conditions, and lifestyles in older people residing in the Spanish Mediterranean.

METHODS

Cross-sectional study with 341 people over 60 years old. Participants were selected using a snowball strategy. A validated food intake frequency questionnaire for older populations was used to determine the daily food intake. This evaluation was carried out at two time points from which the average nutrient intake was obtained. Sociodemographic, clinical, and lifestyle variables were obtained from an ad hoc elaborated questionnaire.

RESULTS

Compliance with dietary intakes was low, by deficiency, such as in vitamin D, where none of the participating subjects met the requirements, and iodine, where the compliance rate did not exceed 20%, or by excess, such as with monounsaturated fatty acids, fiber, iron, B vitamins, vitamin E, and vitamin C. People with better blood pressure, cholesterol, and glucose levels observed a higher degree of compliance with the recommended intakes. Living in rural areas, being divorced, or being illiterate negatively influence meeting the recommended intakes of certain nutrients. Increased physical activity was associated with an increased compliance with Kcal recommendations, cholesterol, and vitamin B2 intake.

CONCLUSION

this study highlights the importance of accurately knowing the dietary intakes in the older population, and what factors, such as lifestyles or sociodemographic characteristics, may predispose to better or worse compliance with the recommendations.

Reference value for the TUGT in healthy older people: A systematic review and meta-analysis

The timed up and go test (TUGT) was recently proposed as a strong predictor of adverse outcomes. Few reviews have been conducted to identify a standard for the TUGT in healthy older people, and the aims of this study were to explore the source of heterogeneity and evaluate the range of reference values for the TUGT in healthy people over 60 years old stratified by age and sex. The VIP, EMBASE, Web of Science and PubMed databases were searched from January 1, 2000, to December 31, 2018. A subgroup analysis and meta-regression were used to assess heterogeneity. Thirty-four eligible studies were included. The mean TUGT results for the total population, males and females in the sample were 9.21 s [95% CI (9.11, 9.31)], 9.33 s [95% CI (7.82, 11.08)] and 8.87 s [95% CI (8.40, 9.38)], respectively. The mean TUGT results for older people in their 60 s, 70 s, and 80 s were 7.91 s [95% CI (6.62, 9.20)], 8.67 s [95% CI (7.23, 10.12)] and 11.68 s [95% CI (8.11, 15.26)], respectively. The meta-regression analysis results showed that the heterogeneity was related to age (P < 0.01). Age affects the results of the TUGT, and it is necessary to take age into consideration when conducting stratified physical evaluations for the evaluation of older people individuals' physical fitness.

Factors Associated with Sarcopenia and 7-Year Mortality in Very Old Patients with Hip Fracture Admitted to Rehabilitation Units: A Pragmatic Study

Background: Admitted bedridden older patients are at risk of the development of sarcopenia during hospital stay (incident sarcopenia). The objective of this study was to assess the factors associated with sarcopenia (incident and chronic) and its impact on mortality in older people with hip fracture. Methods: A multicenter, pragmatic, prospective observational study was designed. Older subjects with hip fracture admitted to two rehabilitation units were included. Sarcopenia was assessed at admission and at discharge according to the revised EWGSOP (European Working Group on Sarcopenia in Older People) consensus definition. The mortality was evaluated after 7 years of follow-up. Results: A total of 187 subjects (73.8% women) age 85.2 ± 6.3 years were included. Risk factors associated to incident and chronic sarcopenia were undernutrition (body mass index—BMI and Mini Nutritional Assessment−Short Form—MNA-SF), hand-grip strength and skeletal muscle index. During follow-up 114 patients died (60.5% sarcopenic vs. 39.5% non-sarcopenic, p = 0.001). Cox regression analyses showed that factors associated to increased risk of mortality were sarcopenia (HR: 1.67, 95% CI 1.11–2.51) and low hand-grip strength (HR: 1.76, 95% CI 1.08–2.88). Conclusions: Older patients with undernutrition have a higher risk of developing sarcopenia during hospital stay, and sarcopenic patients have almost two times more risk of mortality than non-sarcopenic patients during follow-up after hip fracture.

Fast food consumption and its associations with heart rate, blood pressure, cognitive function and quality of life. Pilot study

BACKGROUND

To investigate the relationship of fast food consumption with cognitive and metabolic function of adults (18-25 years old) in Riyadh, Kingdom of Saudi Arabia.

MATERIALS AND METHOD

This cross-sectional study was conducted at the College of Medicine at King Khalid University Hospital, Riyadh, Saudi Arabia. The conventionally recruited subjects underwent an evaluation that included demographic data, quality of life (wellness, stress, sleepiness, and physical activity), mini-mental status examination, and the frequency of fast food consumption. To investigate metabolic function, blood was drawn to evaluate serum HDL, LDL, cholesterol, and triglyceride levels. Cognitive function was assessed by the Cambridge neuropsychological test automated battery. The participants were divided into 2 groups based on fast food consumption: those who consumed fast food 3 times per week or less (Group 1) and those who consumed fast food more than 3 times per week (Group 2).

RESULTS

The mean diastolic blood pressure in Group 1 and Group 2 was 72 mmHg and 77 mmHg, respectively, a significant difference (p = 0.04). There was no significant difference for cognitive function and quality of life between the two groups. There was significant correlation of HDL with AST correct mean latency and the AST correct mean latency congruent (p = 0.02, p = 0.01, respectively) and TC with diastolic blood pressure (p = 0.003).

CONCLUSIONS

We concluded that fast food consumption has an effect on blood pressure but has no direct effect on cognition or quality of life.