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Mechanick JI, Butsch WS, Christensen SM, Hamdy O, Li Z, Prado CM, Heymsfield SB. Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity. Obes Rev 2024:e13841. [PMID: 39295512 DOI: 10.1111/obr.13841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 08/16/2024] [Accepted: 08/22/2024] [Indexed: 09/21/2024]
Abstract
The rapid and widespread clinical adoption of highly effective incretin-mimetic drugs (IMDs), particularly semaglutide and tirzepatide, for the treatment of obesity has outpaced the updating of clinical practice guidelines. Consequently, many patients may be at risk for adverse effects and uncertain long-term outcomes related to the use of these drugs. Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction; such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes. Available evidence suggests that clinical trial participants receiving IMDs for the treatment of obesity lost 10% or more of their muscle mass during the 68- to 72-week interventions, approximately equivalent to 20 years of age-related muscle loss. The ability to maintain muscle mass during caloric restriction-induced weight reduction is influenced by two key factors: nutrition and physical exercise. Nutrition therapy should ensure adequate intake and absorption of high-quality protein and micronutrients, which may require the use of oral nutritional supplements. Additionally, concurrent physical activity, especially resistance training, has been shown to effectively minimize loss of muscle mass and function during weight reduction therapy. All patients receiving IMDs for obesity should participate in comprehensive treatment programs emphasizing adequate protein and micronutrient intakes, as well as resistance training, to preserve muscle mass and function, maximize the benefit of IMD therapy, and minimize potential risks.
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Affiliation(s)
- Jeffrey I Mechanick
- Marie-Josée and Henry R. Kravis Center for Clinical Cardiovascular Health at Mount Sinai Fuster Heart Hospital and the Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - W Scott Butsch
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Osama Hamdy
- Harvard Medical School and Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Zhaoping Li
- Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Steven B Heymsfield
- Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, Louisiana, USA
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2
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Hao JQ, Zhuang ZX, Hu SY, Zhang YJ, Zhang JW, He FJ, Wang R, Zhuang W, Wang MJ. Exploring the impact of protein intake on the association between oxidative balance score and lean mass in adults aged 20-59: NHANES 2011-2018. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:137. [PMID: 39223682 PMCID: PMC11370309 DOI: 10.1186/s41043-024-00629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Previous studies have established a correlation between the pathogenesis of oxidative stress and sarcopenia. The Oxidative Balance Score (OBS) is an integrated measure that reflects the overall balance of antioxidants and pro-oxidants in dietary components and lifestyle. However, there are limited reports on the association between OBS and lean mass and the impact of protein intake on the association between OBS and lean mass. METHODS Using data from the National Health and Nutrition Examination Survey from 2011 to 2018, multivariate linear and logistic regression analyses were conducted to explore the associations between OBS and outcomes. The findings were then illustrated through fitted smoothing curves and threshold effect analyses. RESULTS This study included 2,441 participants, demonstrating that higher OBS is significantly associated with an increased ratio of appendicular lean mass to body mass index. Key inflection points at OBS 31 mark pronounced changes in these associations, with age and protein intake notably affecting the association. The effect of OBS on lean mass varies among populations with high and low protein intake. CONCLUSIONS Our findings suggest that OBS is significantly and positively associated with lean mass. A high protein intake of more than 84.5 g/day may enhance the role of OBS in influencing muscle health to improve muscle outcomes.
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Affiliation(s)
- Jia-Qi Hao
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zi-Xuan Zhuang
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shu-Yue Hu
- Neonatology Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yu-Jie Zhang
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jia-Wan Zhang
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Feng-Jun He
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Wang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen Zhuang
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mo-Jin Wang
- Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Christensen S, Robinson K, Thomas S, Williams DR. Dietary intake by patients taking GLP-1 and dual GIP/GLP-1 receptor agonists: A narrative review and discussion of research needs. OBESITY PILLARS 2024; 11:100121. [PMID: 39175746 PMCID: PMC11340591 DOI: 10.1016/j.obpill.2024.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024]
Abstract
Background Obesity and type 2 diabetes mellitus (T2DM) are increasingly common in the United States and worldwide. Because both conditions are associated with serious health consequences, weight reduction is recommended by professional medical and nutrition societies to improve outcomes. Due to the striking efficacy of glucagon-like peptide receptor agonists (GLP-1RAs) and dual mechanism glucose-dependent insulinotropic polypeptide/glucagon-like peptide receptor agonists (GIP/GLP-1RAs) for weight reduction and glycemic control, there is increased utilization for patients with obesity and/or T2DM. Yet, the impact of these medications on dietary intake is less understood. Methods This narrative literature review summarizes clinical studies quantifying and characterizing dietary intake in people with obesity and/or T2DM using GLP-1 or GIP/GLP-1 RAs. Results Though data from these studies reveal that total caloric intake was reduced by 16-39 %, few studies evaluated the actual composition of the diet. Conclusions Further research is needed to understand the unique nutritional needs of adults on GLP-1 or dual GIP/GLP-1RAs and to support the development of nutritional guidelines for these individuals.
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Affiliation(s)
- Sandra Christensen
- Integrative Medical Weight Management, 2611 NE 125th St, Suite 100B, Seattle, WA, USA
| | - Katie Robinson
- Abbott Laboratories, 2900 Easton Square Place, ES1, Columbus, OH, USA
| | - Sara Thomas
- Abbott Laboratories, 2900 Easton Square Place, ES1, Columbus, OH, USA
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Wang Q, Chen PP, Guo JY, Wang SJ, Bao YY, Zhang Y, Yu K. Dietary vitamin K intake in relation to skeletal muscle mass and strength among adults: a cross-sectional study based on NHANES. Front Nutr 2024; 11:1378853. [PMID: 39279900 PMCID: PMC11392788 DOI: 10.3389/fnut.2024.1378853] [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] [Received: 01/30/2024] [Accepted: 08/19/2024] [Indexed: 09/18/2024] Open
Abstract
Background Previous studies revealed that vitamin K might help maintain muscle homeostasis, but this association has received little attention. We aimed to explore the associations of vitamin K intake with skeletal muscle mass and strength. Methods We included cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES, 2011-2018). Vitamin K intake was assessed via 24-h recall. Covariate-adjusted multiple linear regression and restricted cubic splines were used to evaluate the associations of dietary vitamin K intake with skeletal muscle mass and strength, measured by dual-energy X-ray absorptiometry and handgrip dynamometer, respectively. Results Dietary vitamin K intake was positively associated with skeletal muscle mass in males (β = 0.05747, p = 0.0204) but not in females. We also revealed a positive association between dietary vitamin K intake and handgrip strength within the range of 0-59.871 μg/d (P nonlinear = 0.049). However, beyond this threshold, increasing vitamin K intake did not cause additional handgrip strength improvements. Conclusion We provided evidence for a positive relationship between dietary vitamin K intake and skeletal muscle mass in males. Moreover, our study revealed a nonlinear relationship between dietary vitamin K intake and handgrip strength, highlighting an optimal intake range.
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Affiliation(s)
- Qiong Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Pei-Pei Chen
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia-Yu Guo
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shi-Jia Wang
- Department of Clinical Nutrition, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuan-Yuan Bao
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Zhang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Lu H, Zhang Q, Long J. Prospective study of protein intake and mortality among US adults with chronic obstructive pulmonary disease. Front Nutr 2024; 11:1399038. [PMID: 39114119 PMCID: PMC11303319 DOI: 10.3389/fnut.2024.1399038] [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] [Received: 03/11/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Background Protein is crucial for the rehabilitation of patients with chronic obstructive pulmonary disease (COPD), and appropriate daily protein intake is essential for COPD patients. However, the specific role of protein intake in COPD and its impact on mortality remain uncertain. This study aims to ascertain the relationship between protein intake and mortality in COPD patients. Methods This investigation included 522 adult COPD patients from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2018, with a focus on evaluating protein intake. Multivariate Cox proportional hazard models were constructed to analyze the correlation between protein intake and the prognosis of COPD patients. Additionally, the restricted cubic spline (RCS) was employed to investigate the potential non-linear association between protein intake and mortality. Results A total of 522 patients with COPD were categorized into 4 groups based on the quartiles of protein intake: Q1 (< 25th percentile, 11.7-48.5 gm), Q2 (25-50th percentile, 48.5-67.7 gm), Q3 (50-75th percentile, 67.7-94.3 gm), and Q4 (≥ 75th percentile, 94.3-266.6 gm). Cox regression analysis revealed a significant trend in the p value of the Q3 group compared to the Q1 group when adjusting for other variables. The RCS-fitted Cox regression model indicated no non-linear relationship between protein intake levels and COPD mortality. Conclusion There is no evidence of a non-linear relationship between protein intake and all-cause mortality in COPD patients. Further investigation is warranted to comprehend the intricate relationship between protein intake and COPD outcomes.
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Affiliation(s)
- HuiLun Lu
- The Department of Respiratory Medicine, Shenzhen Longgang Second People’s Hospital, Shenzhen, Guangdong, China
| | - Qi Zhang
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Jiao Long
- Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
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Assaf S, Park J, Chowdhry N, Ganapuram M, Mattathil S, Alakeel R, Kelly OJ. Unraveling the Evolutionary Diet Mismatch and Its Contribution to the Deterioration of Body Composition. Metabolites 2024; 14:379. [PMID: 39057702 PMCID: PMC11279030 DOI: 10.3390/metabo14070379] [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: 06/01/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
Over the millennia, patterns of food consumption have changed; however, foods were always whole foods. Ultra-processed foods (UPFs) have been a very recent development and have become the primary food source for many people. The purpose of this review is to propose the hypothesis that, forsaking the evolutionary dietary environment, and its complex milieu of compounds resulting in an extensive metabolome, contributes to chronic disease in modern humans. This evolutionary metabolome may have contributed to the success of early hominins. This hypothesis is based on the following assumptions: (1) whole foods promote health, (2) essential nutrients cannot explain all the benefits of whole foods, (3) UPFs are much lower in phytonutrients and other compounds compared to whole foods, and (4) evolutionary diets contributed to a more diverse metabolome. Evidence will be presented to support this hypothesis. Nutrition is a matter of systems biology, and investigating the evolutionary metabolome, as compared to the metabolome of modern humans, will help elucidate the hidden connections between diet and health. The effect of the diet on the metabolome may also help shape future dietary guidelines, and help define healthy foods.
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Affiliation(s)
| | | | | | | | | | | | - Owen J. Kelly
- College of Osteopathic Medicine, Sam Houston State University, Conroe, TX 77304, USA; (S.A.); (J.P.); (N.C.); (M.G.); (S.M.); (R.A.)
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Thomas S, Besecker B, Choe Y, Christofides E. Postprandial glycemic response to a high-protein diabetes-specific nutritional shake compared to isocaloric instant oatmeal in people with type 2 diabetes: a randomized, controlled, crossover trial. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1399410. [PMID: 38903056 PMCID: PMC11188454 DOI: 10.3389/fcdhc.2024.1399410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/30/2024] [Indexed: 06/22/2024]
Abstract
Introduction Minimizing postprandial glucose response is an important goal for overall diabetes management. Diabetes-specific nutritional shakes (DSNS) have been clinically shown to minimize postprandial glucose response in people with type 2 diabetes (T2DM) compared to high-glycemic foods. However, it is unknown how a high-protein, low-fat DSNS impacts the GLP-1 response. Methods We tested the postprandial glucose, insulin, and GLP-1 response to a high-protein, low-fat diabetes-specific nutritional shake (DSNS-HP) compared to isocaloric instant oatmeal (IOM) in a randomized, controlled, crossover study in adults with T2DM (n = 24). Participants were randomly selected to receive IOM or DSNS-HP on two test days. Glucose, insulin, and total GLP-1 concentration were measured at baseline and 15, 30, 45, 60, 90, 120, 180, and 240 min postprandially. Results Compared to IOM, the glucose-positive area under the curve (pAUC) was significantly lower (P = .021). DSNS-HP significantly increased GLP-1 pAUC response by 213% (P <.001) with a corresponding increase in insulin pAUC (P = .033) compared to IOM. Discussion A high-protein, low-fat DSNS leads to favorable changes in GLP-1 response and is a suitable option to minimize blood glucose response in people with type 2 diabetes.
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Affiliation(s)
- Sara Thomas
- Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH, United States
| | - Beth Besecker
- Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH, United States
| | - Yong Choe
- Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH, United States
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Kupisz-Urbanska M, Marcinowska-Suchowierska E, Jankowski P. Association between Blood Parameters of Nutritional Status and Functional Status in Extreme Longevity. Nutrients 2024; 16:1141. [PMID: 38674833 PMCID: PMC11054152 DOI: 10.3390/nu16081141] [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: 03/21/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The relationship between functional and nutritional status in the geriatric population remains an issue of debate and there is a gap in the knowledge regarding this field in long-lived individuals. AIM The main aim of this study was to assess the association between selected blood parameters of nutritional status and functional status in extreme longevity. METHODS The inclusion criteria were centenarians above 100 years of age who were examined at their homes, and blood samples were collected. The study group consisted of 170 individuals (25 men and 145 women, median age 100.75 years [100.29-101.58]). RESULTS Total protein and albumin serum concentration was significantly lower in long-lived individuals with severe functional decline compared to individuals with preserved functional status, p = 0.000001 and p = 0.0000, respectively. Iron serum level was significantly higher in the group with preserved functional status, p = 0.04. Preserved functional status was positively correlated with total protein serum concentration (p = 0.000), albumin concentration (p = 0.000), and iron serum level (p = 0.029). A negative correlation was stated between c-reactive protein (CRP) and functional status (p = 0.032). Univariable logistic regression analysis showed that the functional status of long-lived individuals depends on total protein (OR 2.89, CI 95% [1.67-5.0]) and albumin concentrations (OR 2.34, CI 95% [1.39-3.92]). Multivariable backward stepwise logistic regression analysis showed that a total protein concentration was the only variable independently related to the preserved functional status (OR 3.2, 95% Cl [1.8-5.67]). CONCLUSIONS In long-lived individuals, the total serum protein and albumin levels are lower in centenarians with severe functional decline, and they correlate with functional status. Total protein serum concentration is the only factor independently related to the preserved functional status in extreme longevity.
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Affiliation(s)
- Malgorzata Kupisz-Urbanska
- Department of Geriatrics, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (E.M.-S.); (P.J.)
| | - Ewa Marcinowska-Suchowierska
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (E.M.-S.); (P.J.)
- Department of Geriatrics and Gerontology, School of Public Health, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (E.M.-S.); (P.J.)
- Department of Epidemiology and Health Promotion, School of Public Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
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Hou Y, Xiang J, Wang B, Duan S, Song R, Zhou W, Tan S, He B. Pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 14:1263650. [PMID: 38260146 PMCID: PMC10801049 DOI: 10.3389/fendo.2023.1263650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Sarcopenia and diabetes are two age-related diseases that are common in the elderly population, and have a serious effect on their general health and quality of life. Sarcopenia refers to the progressive loss of muscle mass, strength and function, whereas diabetes is a chronic disease characterized by elevated blood sugar levels. The comorbidity of sarcopenia and diabetes is particularly concerning, as people with diabetes have a higher risk of developing sarcopenia due to the combination of insulin resistance, chronic inflammation and reduced physical activity. In contrast, sarcopenia destroyed blood sugar control and exacerbated the development of people with diabetes, leading to the occurrence of a variety of complications. Fortunately, there are a number of effective treatment strategies for sarcopenia in people with diabetes. Physical exercise and a balanced diet with enough protein and nutrients have been proved to enhance the muscular quality and strength of this population. Additionally, pharmacological therapies and lifestyle changes can optimize blood sugar control, which can prevent further muscle loss and improve overall health outcomes. This review aims to summarize the pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes, which help healthcare professionals recognize their intimate connection and provide a new vision for the treatment of diabetes and its complications in this population. Through early identification and comprehensive treatment, it is possible to improve the muscle function and general quality of life of elderly with diabetes and sarcopenia.
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Affiliation(s)
- Yang Hou
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Jia Xiang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Bo Wang
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Shoufeng Duan
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Rouxuan Song
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Wenhu Zhou
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Songwen Tan
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan, China
| | - Binsheng He
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, Hunan, China
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Lopez-Pedrosa JM, Camprubi-Robles M, Guzman-Rolo G, Lopez-Gonzalez A, Garcia-Almeida JM, Sanz-Paris A, Rueda R. The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases. Nutrients 2024; 16:172. [PMID: 38202001 PMCID: PMC10780454 DOI: 10.3390/nu16010172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/30/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.
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Affiliation(s)
| | | | | | | | - Jose Manuel Garcia-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, 29010 Malaga, Spain;
| | - Alejandro Sanz-Paris
- Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, 50009 Zaragoza, Spain;
| | - Ricardo Rueda
- Abbott Nutrition R&D, 18004 Granada, Spain; (M.C.-R.); (A.L.-G.); (R.R.)
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Hashimoto Y, Takahashi F, Okamura T, Hamaguchi M, Fukui M. Diet, exercise, and pharmacotherapy for sarcopenia in people with diabetes. Metabolism 2023; 144:155585. [PMID: 37156410 DOI: 10.1016/j.metabol.2023.155585] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
Diabetes prevalence is increasing rapidly in older people, and sarcopenia is prevalent as a novel complication, particularly in patients with type 2 diabetes mellitus (T2DM). Therefore, sarcopenia prevention and treatment in these people is necessary. Diabetes accelerates sarcopenia through several mechanisms, such as hyperglycemia, chronic inflammation and oxidative stress. The effects of diet, exercise, and pharmacotherapy on sarcopenia in patients with T2DM need to be considered. In diet, low intake of energy, protein, vitamin D, and ω-3 fatty acid are associated with sarcopenia risk. In exercises, although intervention studies in people, especially older and non-obese patients with diabetes, are few, accumulating evidence shows the usefulness of exercise, particularly resistance exercise for muscle mass and strength, and aerobic exercise for physical performance in sarcopenia. In pharmacotherapy, certain classes of anti-diabetes compounds have possibility of preventing sarcopenia. However, much data on diet, exercise, and pharmacotherapy were obtained in obese and non-elderly patients with T2DM, demanding actual clinical data on non-obese and older patients with diabetes.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan.
| | - Fuyuko Takahashi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Li RM, Dai GH, Guan H, Gao WL, Ren LL, Wang XM, Qu HW. Association between handgrip strength and heart failure in adults aged 45 years and older from NHANES 2011-2014. Sci Rep 2023; 13:4551. [PMID: 36941323 PMCID: PMC10027666 DOI: 10.1038/s41598-023-31578-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
Growing evidence indicates that handgrip strength (HGS) is a conspicuous marker for assessing some diseases affecting middle-aged and elderly individuals. However, research regarding HGS and heart failure (HF) is sparse and controversial. Hence, we aimed to investigate the association between HGS and HF among adults aged 45 years and older in the United States. In this cross-sectional study, we included 4524 adults older than 45 years who were part of the National Health and Nutrition Examination Survey. A generalized additive model was used to estimate the association between HGS and HF. Age, gender, race, income, education, body mass index, smoking status, drinking status, diabetes, hypertension, stroke, vigorous physical activity, total energy intake, total protein intake, total sugars intake, and total fat intake covariates were adjusted using multiple regression models. And further subgroup analysis was conducted. We documented 189 cases of HF, including 106 men and 83 women. HGS was negatively associated with HF after adjusting for all the covariates (odds ratio = 0.97, 95% confidence interval = 0.96-0.99; P < 0.001). Compared with the lowest quintile, the highest quintile was associated with an 82% lower incidence of HF (odds ratio = 0.18, 95% confidence interval = 0.08-0.43; P < 0.001). Subgroup analysis showed that the results remained stable. In US adults older than 45, HGS was negatively associated with HF after adjusting for covariates. This finding had the potential to draw attention to the physiological and pathological effects of decreased muscle function on HF and may influence further prospective studies with intervention trials.
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Affiliation(s)
- Run-Min Li
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guo-Hua Dai
- Department of Geriatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 16369 Jing-Shi Road, Jinan, 250014, China.
| | - Hui Guan
- Department of Geriatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 16369 Jing-Shi Road, Jinan, 250014, China
| | - Wu-Lin Gao
- Department of Geriatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, 16369 Jing-Shi Road, Jinan, 250014, China
| | - Li-Li Ren
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xing-Meng Wang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hui-Wen Qu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
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Protein and Leucine Intake at Main Meals in Elderly People with Type 2 Diabetes. Nutrients 2023; 15:nu15061345. [PMID: 36986075 PMCID: PMC10053961 DOI: 10.3390/nu15061345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Background: The recommended protein intake for the elderly is 25–30 g at main meals, with at least 2500–2800 mg of leucine at each meal. There is still little evidence regarding the amount and distribution of protein and leucine intake with meals in the elderly with type 2 diabetes (T2D). In this cross-sectional study, we evaluated protein and leucine intake at each meal in elderly patients with T2D. Methods: A total of 138 patients (91 men and 47 women) with T2D, aged 65 years or older, were included. Participants performed three 24-h dietary recalls for the evaluation of their dietary habits and protein and leucine intake at meals. Results: The average protein intake was 0.9 ± 0.2 g/kg body weight/day, and only 23% of patients complied with the recommendations. The average protein intake was 6.9 g at breakfast, 29 g at lunch, and 21 g at dinner. None of the patients reached the recommended protein intake at breakfast; 59% of patients complied with the recommendations at lunch; and 32% at dinner. The average leucine intake was 579 mg at breakfast, 2195 g at lunch, and 1583 mg at dinner. The recommended leucine intake was not reached by any patient at breakfast, by 29% of patients at lunch, and by 13% at dinner. Conclusions: Our data show that, in elderly patients with T2D, the average protein intake is low, particularly at breakfast and dinner, and that leucine intake is remarkably lower than the recommended levels. These data raise the need to implement nutritional strategies capable of increasing protein and leucine intake in the elderly with T2D.
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Wu S, Du W, Zhong X, Lu J, Wen F. The association between road traffic noise and type 2 diabetes: a systematic review and meta-analysis of cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:39568-39585. [PMID: 36790703 DOI: 10.1007/s11356-023-25926-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
The association between road traffic noise and type 2 diabetes (T2DM) was inconsistent. To address this, we have synthesized available cohort studies about their association by meta-analysis. PubMed, Web of Science, EBSCO, Cochrane Library, EMBASE, and Scopus databases were searched up to July 2022. The Quality-effect model (QE) was used to incorporate the results of included studies. The possibility of publication bias was assessed by the Doi plots and Luis Furuya-Kanamori index. Sensitivity analyses included leave-one-out meta-analysis, subgroup meta-analysis, and meta-regressions. The Recommendations for Assessment, Development, and Evaluation (GRADE) guidelines were conducted to evaluate the overall quality of evidence. Eight cohort studies with 4,989,846 participants and 416,799 diabetes cases were included. Based on the fully adjusted models from 8 cohort studies (10 estimates; Lden range ≈ 15-98.5 dB(A)), we found "high" evidence of RR per 10 dB(A) = 1.07 (1.05, 1.10), high heterogeneity (I2 = 0.91%, p < 0.001), and high publication bias (LKF index = 4.55). Sensitivity analyses showed stable model results, and the GRADE assessment suggested the current overall quality of evidence is high. Comprehensive evidence from cohort studies supports that increasing exposure to road traffic noise may be associated with higher risk of T2DM.
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Affiliation(s)
- Shan Wu
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
| | - Wenjing Du
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiangbin Zhong
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Junqi Lu
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Fei Wen
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
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15
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Sugar-Sweetened Coffee Intake and Blood Glucose Management in Korean Patients with Diabetes Mellitus. Metabolites 2022; 12:metabo12121177. [PMID: 36557215 PMCID: PMC9782232 DOI: 10.3390/metabo12121177] [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] [Received: 10/25/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
One of the most frequently consumed beverages by Korean adults is 3-in-1 coffee (mixed coffee) with sugar and creamer. Hence, understanding the effect of sugar-sweetened coffee (SSC) consumption on blood sugar levels in patients with diabetes mellitus (DM) is important. This study was conducted using the Korea National Health and Nutrition Examination Survey data from 2008 to 2020. In total, 5671 patients with DM were included in the analysis. Coffee consumption patterns were assessed using a 24 h recall. Fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were used to evaluate whether patients reached the glycemic control targets defined by the Korean Diabetes Association. In total, 46.57% of patients with DM included in this analysis consumed SSC. Patients who frequently consumed SSC had significantly higher FBG and HbA1c levels than those who did not (both p for trend <0.01). In a multivariate logistic regression model, the odds ratios of not achieving the target FBG and HbA1c levels were 1.24 (95% confidence interval [CI]: 1.03−1.48, p for trend = 0.01) and 1.29 (95% CI: 1.05−1.58, p for trend = 0.009), respectively. Frequent consumption of SSC can cause difficulty in FBG and HbA1c management in patients with DM.
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Henson J, Arsenyadis F, Redman E, Brady EM, Coull NA, Edwardson CL, Hall AP, James L, Khunti K, Rowlands AV, Stevenson EJ, West DJ, Davies MJ, Yates T. Relative protein intake and associations with markers of physical function in those with type 2 diabetes. Diabet Med 2022; 39:e14851. [PMID: 35426174 PMCID: PMC9546206 DOI: 10.1111/dme.14851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 04/11/2022] [Indexed: 12/02/2022]
Abstract
AIMS To examine the independent associations between relative protein intake (g kg-1 day 1 ) and markers of physical function in those with type 2 diabetes, while also comparing with current guidelines for protein intake. METHODS This analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) study. Functional assessments included: Short Physical Performance Battery (SPPB), 60 s sit-to-stand (STS-60), 4-m gait speed, time to rise from a chair (×5) and handgrip strength. Participants also completed a self-reported 4 day diet diary. Regression analyses assessed whether relative protein intake was associated with markers of physical function. Interaction terms assessed whether the associations were modified by sex, age, HbA1c or body mass index (BMI). RESULTS 413 participants were included (mean ± SD:age = 65.0 ± 7.7 years, 33% female, BMI = 30.6 ± 5.1 kg/m2 ). The average total protein intake was 0.88 ± 0.31 g kg-1 day-1 . 33% of individuals failed to meet the reference nutrient intake for the United Kingdom (≥0.75 g kg-1 day-1 ), and 87% for European recommendations (≥1.2 g kg-1 day-1 ). After adjustment, each 0.5 g/kg of protein intake was associated with an 18.9% (95% CI: 2.3, 35.5) higher SPPB score, 22.7% (1.1, 44.3) more repetitions in STS-60, 21.1% (4.5, 37.7) faster gait speed and 33.2% (16.9, 49.5) lower chair rise time. There were no associations with handgrip strength or any interactions. CONCLUSIONS Relative protein intake was positively associated with physical function outcomes, even after consideration of total energy intake. As a number of individuals were below the current guidelines, protein intake may be a modifiable factor of importance for people with type 2 diabetes.
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Affiliation(s)
- Joseph Henson
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
| | - Frank Arsenyadis
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
- University Hospitals of Leicester NHS TrustLeicesterUK
| | - Emma Redman
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
- University Hospitals of Leicester NHS TrustLeicesterUK
| | - Emer M. Brady
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | - Nicole A. Coull
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
| | - Charlotte L. Edwardson
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
| | - Andrew P. Hall
- University Hospitals of Leicester NHS TrustLeicesterUK
- Department of Health SciencesUniversity of LeicesterLeicesterUK
- Hanning Sleep LaboratoryLeicester General HospitalLeicesterUK
| | - Lewis J. James
- NIHR Leicester Biomedical Research CentreLeicesterUK
- School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Kamlesh Khunti
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
- NIHR Applied Health Research Collaboration – East Midlands (NIHR ARC‐EM)Leicester Diabetes CentreLeicesterUK
| | - Alex V. Rowlands
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
- Alliance for Research in Exercise, Nutrition and Activity (ARENA)Sansom Institute for Health ResearchDivision of Health SciencesUniversity of South AustraliaAdelaideAustralia
| | - Emma J. Stevenson
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Daniel J. West
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Melanie J. Davies
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
| | - Thomas Yates
- NIHR Leicester Biomedical Research CentreLeicesterUK
- Diabetes Research CentreCollege of Life SciencesUniversity of LeicesterLeicesterUK
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Derbyshire E. Fungal-Derived Mycoprotein and Health across the Lifespan: A Narrative Review. J Fungi (Basel) 2022; 8:jof8070653. [PMID: 35887410 PMCID: PMC9320140 DOI: 10.3390/jof8070653] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023] Open
Abstract
Mycoprotein is a filamentous fungal protein that was first identified in the 1960s. A growing number of publications have investigated inter-relationships between mycoprotein intakes and aspects of human health. A narrative review was undertaken focusing on evidence from randomized controlled trials, clinical trials, intervention, and observational studies. Fifteen key publications were identified and undertaken in early/young adulthood, adulthood (mid-life) or older/advanced age. Main findings showed that fungal mycoprotein could contribute to an array of health benefits across the lifespan including improved lipid profiles, glycaemic markers, dietary fibre intakes, satiety effects and muscle/myofibrillar protein synthesis. Continued research is needed which would be worthwhile at both ends of the lifespan spectrum and specific population sub-groups.
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18
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Iizuka K. Protein Amount, Quality, and Physical Activity. Nutrients 2021; 13:nu13113720. [PMID: 34835977 PMCID: PMC8621249 DOI: 10.3390/nu13113720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Katsumi Iizuka
- The Department of Clinical Nutrition, Faculty of Medicine, Fujita Health University, Toyoake 470-1192, Japan;
- Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institution, Kobe 650-0047, Japan
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