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Rautakallio-Järvinen P, Kunvik S, Laaksonen M, Fogelholm L, Nykänen I, Schwab U. Cost-effectiveness of protein-rich meals and snacks for increasing protein intake in older adults. J Nutr Health Aging 2024; 28:100381. [PMID: 39341032 DOI: 10.1016/j.jnha.2024.100381] [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: 06/18/2024] [Revised: 09/24/2024] [Accepted: 09/24/2024] [Indexed: 09/30/2024]
Abstract
OBJECTIVES To investigate the cost-effectiveness of protein-rich meals and snacks for increasing protein intake in home-dwelling older adults. DESIGN Cost effectiveness analysis from a randomized controlled trial, the Power Meals study. SETTING Participants were randomized into one of three groups for eight weeks: a protein-rich meal, snack and bread (Protein), a regular meal (Normal) and a control group without meal service (Control). PARTICIPANTS Home-dwelling home care clients, caregivers and care recipients aged ≥65 years (n = 65). MEASUREMENTS Protein intake was assessed by a three-day food diary at the end of the study. Cost for the daily diet was estimated by using Finnish grocery store databases and the prices of the food service. The cost-effectiveness was assessed by an incremental cost-effectiveness ratio (ICER). RESULTS Costs for the daily diet in the Protein (8.35 €/d) and the Normal (7.94 €/d) groups were significantly higher than in the control group (5.65 €/d) (p < 0.001). Incremental cost-effectiveness analysis showed that increasing protein intake was cost-effective in the Protein group as incremental cost-effectiveness ratio was 8.11 in the Protein, 8.72 in the Normal and 6.45 in the Control group. CONCLUSIONS Including protein rich meals and snacks in a diet increases protein intake in home-dwelling older adults cost-effectively.
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Affiliation(s)
- P Rautakallio-Järvinen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - S Kunvik
- Satakunta Wellbeing County, Finland
| | | | | | - I Nykänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - U Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland
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Furtado CDC, Jamar G, Barbosa ACB, Dourado VZ, Nascimento JRD, Oliveira GCAFD, Hi EMB, Souza TDA, Parada MJG, Souza FGD, Juzwiak CR, Lombardi I. Whey Protein Supplementation in Older Adults With Type 2 Diabetes Undergoing a Resistance Training Program: A Double-Blind Randomized Controlled Trial. J Aging Phys Act 2024:1-13. [PMID: 39214521 DOI: 10.1123/japa.2023-0370] [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: 10/26/2023] [Revised: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND/OBJECTIVE This study aims to analyze the effect of whey protein (WP) supplementation on glycemic control, muscle strength, quality of life, and body composition in older adults with non-insulin-dependent diabetes undergoing a resistance training program. METHODS A double-blind, placebo-controlled, randomized study was carried out with older adults with Type 2 diabetes. Body composition, food intake, muscle strength, glycemic profile, markers of renal function, cardiopulmonary capacity, and quality of life were evaluated. Older adults were randomized into a supplementation group with 33 g of WP consumed twice a week on days of resistance training for 12 weeks supplemented group and a placebo group. RESULTS In total, 39 older adults were randomized into two groups, 19 in the supplement group and 20 in the placebo group. Both groups showed improvement in muscle strength, with the WP group failing to exceed that of the control group. WP supplementation slightly increased blood urea compared with the placebo group (p = .05), but values remained within normal limits. The group that used WP showed a small improvement in mental health, according to the 12-Item Short-Form Health Survey questionnaire, but without clinically important improvements. CONCLUSION Both groups showed improvements in muscle strength and mass, regardless of supplementation, showing that resistance exercises performed twice a week can contribute to the nonprogression of sarcopenia in older adults with Type 2 diabetes. More studies are needed to determine the safe and effective amount of supplementation to improve muscle strength without renal impairment in older adults with diabetes.
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Affiliation(s)
- Celine de Carvalho Furtado
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Federal University of São Paulo, Santos, SP, Brazil
| | - Giovana Jamar
- Programa de Pós-Graduação em Nutrição, Federal University of São Paulo, Santos, SP, Brazil
| | - Alan Carlos Brisola Barbosa
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Federal University of São Paulo, Santos, SP, Brazil
| | - Victor Zuniga Dourado
- Department of Human Movement Sciences, Federal University of São Paulo, Santos, SP, Brazil
| | | | | | - Edgar Matias Bach Hi
- Faculty of Medical Sciences of Santos, Lusíada University Center, Santos, SP, Brazil
- Department of Emergency Medicine, University of São Paulo, Santos, SP, Brazil
| | - Thiago de Arruda Souza
- Federal University of São Paulo-Hospital Universitário, Lusíada University Centre, Sao Paulo, SP, Brazil
| | | | | | - Claudia Ridel Juzwiak
- Department of Human Movement Sciences, Federal University of São Paulo, Santos, SP, Brazil
| | - Império Lombardi
- Department of Human Movement Sciences, Federal University of São Paulo, Santos, SP, Brazil
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Fujimoto Y, Dotare T, Maekawa E, Kamiya K, Kitai T, Kuwahara K, Sugano T, Konishi M, Ohtani T, Sakamoto Y, Jujo K, Noda C, Ako J, Yanagisawa N, Matsue Y. Oral nutritional supplements in older outpatients with heart failure: rationale and design of the ALIMENT-HF trial. ESC Heart Fail 2024; 11:2379-2386. [PMID: 38628048 PMCID: PMC11287343 DOI: 10.1002/ehf2.14800] [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: 12/21/2023] [Revised: 03/04/2024] [Accepted: 03/25/2024] [Indexed: 07/31/2024] Open
Abstract
AIMS The ALIMENT-HF trial aims to determine whether high-calorie and high-protein oral nutritional supplements (ONS) are safe and beneficial for older adult outpatients with heart failure (HF). METHODS AND RESULTS This multicentre, single-arm, interventional pilot trial is designed to evaluate the tolerance, efficacy, and safety of ONS in older adult outpatients with chronic HF, malnutrition, and anorexia. In total, 80 outpatients with HF regardless of their left ventricular ejection fraction will be treated with ONS, including high-energy (900 kcal/day) and high protein (36 g/day) supplementation, at eight sites in Japan. Inclusion criteria are as follows: age, ≥65 years; outpatients receiving maximally tolerated guideline-directed medical therapy for HF and without change in their diuretic dosage during the last 3 months; outpatients at risk of malnutrition, defined as a Malnutrition Universal Screening Tool score ≥1 point, and anorexia, defined using a Simplified Nutritional Appetite Questionnaire for the Japanese Elderly (SNAQ-JE) score of ≤14 points. Nutritional intervention will continue for up to 120 days, with an observational period lasting for a further 60 days. The primary outcome is a change in body weight between baseline and day 120. CONCLUSIONS The ALIMENT-HF trial will evaluate the tolerance, efficacy, and safety of high-calorie and high-protein-rich ONS in older outpatients with HF co-morbid with malnutrition and anorexia and will provide insightful information for future randomized controlled trials.
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Affiliation(s)
- Yudai Fujimoto
- Department of Cardiovascular Biology and MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Taishi Dotare
- Department of Cardiovascular Biology and MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Emi Maekawa
- Department of Cardiovascular MedicineKitasato University School of MedicineSagamiharaJapan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health SciencesKitasato UniversitySagamiharaJapan
| | - Takeshi Kitai
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CentreSuitaJapan
| | - Koichiro Kuwahara
- Department of Cardiovascular MedicineShinshu University School of MedicineMatsumotoJapan
| | - Teruyasu Sugano
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Masaaki Konishi
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Tomohito Ohtani
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Yoko Sakamoto
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Kentaro Jujo
- Department of CardiologySaitama Medical UniversityKawagoeJapan
| | | | - Junya Ako
- Department of Cardiovascular MedicineKitasato University School of MedicineSagamiharaJapan
| | - Naotake Yanagisawa
- Medical Technology Innovation Center, Clinical Research and Trial CenterJuntendo UniversityTokyoJapan
| | - Yuya Matsue
- Department of Cardiovascular Biology and MedicineJuntendo University Graduate School of MedicineTokyoJapan
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Pabla P, Jones E, Piasecki M, Phillips B. Skeletal muscle dysfunction with advancing age. Clin Sci (Lond) 2024; 138:863-882. [PMID: 38994723 PMCID: PMC11250095 DOI: 10.1042/cs20231197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 07/13/2024]
Abstract
As a result of advances in medical treatments and associated policy over the last century, life expectancy has risen substantially and continues to increase globally. However, the disconnect between lifespan and 'health span' (the length of time spent in a healthy, disease-free state) has also increased, with skeletal muscle being a substantial contributor to this. Biological ageing is accompanied by declines in both skeletal muscle mass and function, termed sarcopenia. The mechanisms underpinning sarcopenia are multifactorial and are known to include marked alterations in muscle protein turnover and adaptations to the neural input to muscle. However, to date, the relative contribution of each factor remains largely unexplored. Specifically, muscle protein synthetic responses to key anabolic stimuli are blunted with advancing age, whilst alterations to neural components, spanning from the motor cortex and motoneuron excitability to the neuromuscular junction, may explain the greater magnitude of function losses when compared with mass. The consequences of these losses can be devastating for individuals, their support networks, and healthcare services; with clear detrimental impacts on both clinical (e.g., mortality, frailty, and post-treatment complications) and societal (e.g., independence maintenance) outcomes. Whether declines in muscle quantity and quality are an inevitable component of ageing remains to be completely understood. Nevertheless, strategies to mitigate these declines are of vital importance to improve the health span of older adults. This review aims to provide an overview of the declines in skeletal muscle mass and function with advancing age, describes the wide-ranging implications of these declines, and finally suggests strategies to mitigate them, including the merits of emerging pharmaceutical agents.
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Affiliation(s)
- Pardeep Pabla
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
| | - Eleanor J. Jones
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
| | - Mathew Piasecki
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), U.K
- NIHR Nottingham Biomedical Research Centre (BRC), U.K
| | - Bethan E. Phillips
- Centre of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital, Derby, DE22 3DT, U.K
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR), U.K
- NIHR Nottingham Biomedical Research Centre (BRC), U.K
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5
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Honfo SH, Senior AM, Legault V, Presse N, Turcot V, Gaudreau P, Simpson SJ, Raubenheimer D, Cohen AA. Evidence for protein leverage on total energy intake, but not body mass index, in a large cohort of older adults. Int J Obes (Lond) 2024; 48:654-661. [PMID: 38145994 DOI: 10.1038/s41366-023-01455-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Protein leverage (PL) is the phenomenon of consuming food until absolute intake of protein approaches a 'target value', such that total energy intake (TEI) varies passively with the ratio of protein: non-protein energy (fat + carbohydrate) in the diet. The PL hypothesis (PLH) suggests that the dilution of protein in energy-dense foods, particularly those rich in carbohydrates and fats, combines with protein leverage to contribute to the global obesity epidemic. Evidence for PL has been reported in younger adults, children and adolescents. This study aimed to test for PL and the protein leverage hypothesis (PLH) in a cohort of older adults. METHODS We conducted a retrospective analysis of dietary intake in a cohort of 1699 community-dwelling older adults aged 67-84 years from the NuAge cohort. We computed TEI and the energy contribution (EC) from each macronutrient. The strength of leverage of macronutrients was assessed through power functions ( TEI = μ * EC L ). Body mass index (BMI) was calculated, and mixture models were fitted to predict TEI and BMI from macronutrients' ECs. RESULTS In this cohort of older adults, 53% of individuals had obesity and 1.5% had severe cases. The mean TEI was 7673 kJ and macronutrients' ECs were 50.4%, 33.2% and 16.4%, respectively for carbohydrates, fat, and protein. There was a strong negative association (L = -0.37; p < 0.001) between the protein EC and TEI. Each percent of energy intake from protein reduced TEI by 77 kJ on average, ceteris paribus. However, BMI was unassociated with TEI in this cohort. CONCLUSIONS Findings indicate clear evidence for PL on TEI, but not on BMI, likely because of aging, body composition, sarcopenia, or protein wasting.
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Affiliation(s)
- Sewanou H Honfo
- PRIMUS Research Group, Department of Family Medicine, Université de Sherbrooke, 3001 12e Ave N, Sherbrooke, QC, J1H 5N4, Canada
| | - Alistair M Senior
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
- University of Sydney, Sydney Precision Data Science Centre, Camperdown, NSW, 2006, Australia
| | - Véronique Legault
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Nancy Presse
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Valérie Turcot
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Pierrette Gaudreau
- Department of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Stephen J Simpson
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
| | - David Raubenheimer
- University of Sydney, Charles Perkins Centre, Camperdown, NSW, 2006, Australia
- University of Sydney, School of Life and Environmental Science, Camperdown, NSW, 2006, Australia
| | - Alan A Cohen
- PRIMUS Research Group, Department of Family Medicine, Université de Sherbrooke, 3001 12e Ave N, Sherbrooke, QC, J1H 5N4, Canada.
- Research Center on Aging, CIUSSS-de-l'Estrie-CHUS, Sherbrooke, QC, Canada.
- Department of Environmental Health Sciences, Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Shiota C, Kusama T, Takeuchi K, Kiuchi S, Osaka K. Oral Hypofunction and Risk of Weight Change among Independent Older Adults. Nutrients 2023; 15:4370. [PMID: 37892444 PMCID: PMC10610140 DOI: 10.3390/nu15204370] [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: 09/08/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Oral health is essential for nutritional status; however, little is known about its association with weight change. This study aimed to investigate whether the risk of weight change differs according to the presence of each important component of oral hypofunction (fewer remaining teeth, low chewing efficiency, swallowing problems, and xerostomia) among independent older adults. This was a three-year follow-up cohort study based on self-reported questionnaires. The participants were independent older adults aged ≥65 from the Japan Gerontological Evaluation Study (JAGES). We used >5% weight loss/gain during follow-up as the outcome variables, and the number of remaining teeth (≥20/10-19/0-9), the presence of chewing difficulty, swallowing problems, and xerostomia (yes/no) as the exposure variables. We fitted the Poisson regression model, including possible confounders to estimate the risk ratios (RRs) and 95% confidence intervals (CIs). For weight loss, RRs were significantly higher among those with 0-9 remaining teeth (RR = 1.17; 95% CI = 1.11-1.23), chewing difficulty (RR = 1.12; 95% CI = 1.07-1.16), and xerostomia (RR = 1.11; 95% CI = 1.06-1.16), but there was no significant association with swallowing problems (RR = 1.01; 95% CI = 0.97-1.06). For weight gain, we also found similar associations with oral hypofunction. Oral hypofunction among older adults could have non-negligible health impacts on nutritional status.
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Grants
- 15H01972, 19H03861, 22K17265, 22H03299 Japan Society for the Promotion of Science
- H28-Choju-Ippan-002, 23FA1022 Health Labour Sciences Research Grant
- JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP21lk0310073, JP21dk0110037, JP22lk0310087, JP22rea522107 Japan Agency for Medical Research and Development
- OPERA, JPMJOP1831 Open Innovation Platform with Enterprises, Research Institute and Academia
- 1-4 a grant from Innovative Research Program on Suicide Countermeasures
- adopted number: 19-2-06 a grant from Sasakawa Sports Foundation, a grant from Japan Health Promotion & Fitness Foundation, a grant from Chiba Foundation for Health Promotion & Disease Prevention, the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation
- 29-42, 30-22,20-19, 21-20 grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology
- JPMJSP2114 JST SPRING
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Affiliation(s)
- Chihiro Shiota
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
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Shefflette A, Patel N, Caruso J. Mitigating Sarcopenia with Diet and Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6652. [PMID: 37681791 PMCID: PMC10487983 DOI: 10.3390/ijerph20176652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/22/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
Sarcopenia is the loss of muscle mass and function from aging, inactivity, or disuse. It is a comorbidity to numerous conditions that exacerbates their severity and adversely impacts activities of daily living. While sarcopenia now receives more attention from the medical community, people with sarcopenia as a comorbidity nevertheless still sometimes receives less attention than other presenting diseases or conditions. Inevitable doctors' visits or hospital stays for those with sarcopenia as a comorbidity have far higher healthcare costs than those without this condition, which imposes a greater financial burden on the medical insurance and healthcare industries. This review offers information and guidance on this topic. Treatments for sarcopenia include dietary, exercise, and pharmacological interventions. Yet, the latter treatment is only recommended in extreme cases as it may evoke numerous side effects and has little support in the scientific literature. Currently, a more holistic approach, with an emphasis on lifestyle modification, to reduce the likelihood of sarcopenia is examined. The current review discusses dietary and exercise interventions to limit the occurrence and severity of sarcopenia. References cited in this review conformed to the Declaration of Helsinki requirements for the use of human research subjects. Most of this review's references (~97%) came from a PubMed search that spanned from 1997 to 2023. Search terms included "sarcopenia" OR "muscle wasting" OR "geriatrics"; OR "ageing"; and AND "diet" OR "exercise". In addition, papers relevant or supportive of the topic as well as those considered seminal were included in the review. Over 96% of the references were peer-reviewed articles.
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Affiliation(s)
| | | | - John Caruso
- Exercise Physiology Program, University of Louisville, Louisville, KY 40292, USA; (A.S.); (N.P.)
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Damluji AA, Alfaraidhy M, AlHajri N, Rohant NN, Kumar M, Al Malouf C, Bahrainy S, Ji Kwak M, Batchelor WB, Forman DE, Rich MW, Kirkpatrick J, Krishnaswami A, Alexander KP, Gerstenblith G, Cawthon P, deFilippi CR, Goyal P. Sarcopenia and Cardiovascular Diseases. Circulation 2023; 147:1534-1553. [PMID: 37186680 PMCID: PMC10180053 DOI: 10.1161/circulationaha.123.064071] [Citation(s) in RCA: 102] [Impact Index Per Article: 102.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Sarcopenia is the loss of muscle strength, mass, and function, which is often exacerbated by chronic comorbidities including cardiovascular diseases, chronic kidney disease, and cancer. Sarcopenia is associated with faster progression of cardiovascular diseases and higher risk of mortality, falls, and reduced quality of life, particularly among older adults. Although the pathophysiologic mechanisms are complex, the broad underlying cause of sarcopenia includes an imbalance between anabolic and catabolic muscle homeostasis with or without neuronal degeneration. The intrinsic molecular mechanisms of aging, chronic illness, malnutrition, and immobility are associated with the development of sarcopenia. Screening and testing for sarcopenia may be particularly important among those with chronic disease states. Early recognition of sarcopenia is important because it can provide an opportunity for interventions to reverse or delay the progression of muscle disorder, which may ultimately impact cardiovascular outcomes. Relying on body mass index is not useful for screening because many patients will have sarcopenic obesity, a particularly important phenotype among older cardiac patients. In this review, we aimed to: (1) provide a definition of sarcopenia within the context of muscle wasting disorders; (2) summarize the associations between sarcopenia and different cardiovascular diseases; (3) highlight an approach for a diagnostic evaluation; (4) discuss management strategies for sarcopenia; and (5) outline key gaps in knowledge with implications for the future of the field.
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Affiliation(s)
- Abdulla A. Damluji
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | - Maha Alfaraidhy
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | - Noora AlHajri
- Cleveland Clinic, Abu Dhabi, United Arab Emirates (N.A.)
| | | | | | | | | | | | - Wayne B. Batchelor
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
| | - Daniel E. Forman
- University of Pittsburgh and the Pittsburgh Geriatric Research Education and Clinical Center, PA (D.E.F.)
| | | | | | | | | | - Gary Gerstenblith
- Johns Hopkins University School of Medicine, Baltimore, MD (A.A.D., M.A., G.G.)
| | | | - Christopher R. deFilippi
- Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (A.A.D., W.B.B., C.R.D.)
| | - Parag Goyal
- University of Arizona, Tucson (N.N.R., P.G.)
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9
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Yano T, Godai K, Kabayama M, Akasaka H, Takeya Y, Yamamoto K, Yasumoto S, Masui Y, Arai Y, Ikebe K, Ishizaki T, Gondo Y, Rakugi H, Kamide K. Factors associated with weight loss by age among community-dwelling older people. BMC Geriatr 2023; 23:277. [PMID: 37149581 PMCID: PMC10164313 DOI: 10.1186/s12877-023-03993-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/24/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Factors associated with weight loss in community-dwelling older people have been reported in several studies, but few studies have examined factors associated with weight loss by age groups. The purpose of this study was to clarify factors associated with weight loss by age in community-dwelling older people through a longitudinal study. METHODS Participants in the SONIC study (Longitudinal Epidemiological Study of the Elderly) were community-dwelling people aged 70 or older. The participants were divided into two groups: 5% weight loss and maintenance groups, and compared. In addition, we examined factors affecting weight loss by age. The analysis method used was the χ2 test, and the t-test was used for comparison of the two groups. Factors associated with 5% weight loss at 3 years were examined using logistic regression analysis with sex, age, married couple, cognitive function, grip strength, and the serum albumin level as explanatory variables. RESULTS Of the 1157 subjects, the proportions showing 5% weight loss after 3 years among all subjects, those aged 70 years, 80 years, and 90 years, were 20.5, 13.8, 26.8, and 30.5%, respectively. In logistic regression analysis, factors associated with 5% weight loss at 3 years by age were influenced by BMI of 25 or higher (OR = 1.90, 95%CI = 1.08-3.34, p = 0.026), a married couple (OR = 0.49, 95% = 0.28-0.86, p = 0.013), serum albumin level below 3.8 g/dL (OR = 10.75, 95% = 1.90-60.73, p = 0.007) at age 70, and the grip strength at age 90 (OR = 1.24, 95%CI = 1.02-1.51, p = 0.034), respectively. CONCLUSIONS The results suggest that factors associated with weight loss by age in community-dwelling older people through a longitudinal study differ by age. In the future, this study will be useful to propose effective interventions to prevent factors associated with weight loss by age in community-dwelling older people.
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Affiliation(s)
- Tomoko Yano
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamada, Suita, Osaka, 565-0871, Japan
| | - Kayo Godai
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamada, Suita, Osaka, 565-0871, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamada, Suita, Osaka, 565-0871, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Takeya
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamada, Suita, Osaka, 565-0871, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Saori Yasumoto
- Department of Clinical Thanatology and Geriatric Behavioral Sciences, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric and Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yasumichi Arai
- Center of Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics and Oral Rehabilitation, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric and Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Sciences, Osaka University Graduate School of Human Sciences, Osaka, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamada, Suita, Osaka, 565-0871, Japan.
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10
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Kusama T, Takeuchi K, Kiuchi S, Aida J, Kondo K, Osaka K. Weight Loss Mediated the Relationship between Tooth Loss and Mortality Risk. J Dent Res 2023; 102:45-52. [PMID: 36068707 DOI: 10.1177/00220345221120642] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Tooth loss is a risk factor for increased mortality; however, the underlying mechanism remains unclear. This study aimed to evaluate the mediating effect of weight change on the relationship between tooth loss and mortality risk. This was a 10-y follow-up prospective cohort study using the data from the Japan Gerontological Evaluation Study (JAGES). The participants were independent older adults aged ≥65 y at baseline and were followed up from 2010 to 2020. The incidence of death in 2013 and 2020, incidence of >5% weight loss/gain in 2010 and 2013, and the number of remaining teeth in 2010 were used as the outcome, mediator, and explanatory variables, respectively. We conducted causal mediation analysis by fitting the Cox proportional hazard model, including possible confounders. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the total effect (TE), natural indirect effect (NIE), and proportion mediated (PM) were estimated. Among the 34,510 participants, the mean age was 72.6 (SD = 5.4) y, and 47.6% were men. From 2013 to 2020, 14.0% of the participants (n = 4,825) died, 60.5% (n = 20,871) had 0 to 19 remaining teeth, and 17.2% (n = 5,927) and 8.4% (n = 2,907) experienced >5% weight loss and gain, respectively. The mortality rate was 0.016 per person-year among those with ≥20 remaining teeth and 0.027 per person-year among those with 0 to 19 remaining teeth. Weight loss of >5% significantly mediated the association between tooth loss and higher mortality risk (TE: HR, 1.28 [95% CI, 1.16 to 1.40]; NIE: HR, 1.03 [95% CI, 1.02 to 1.04]; PM, 13.1%); however, we observed a slight mediating effect for >5% weight gain (NIE: HR, 1.003 [95%CI, 1.0001 to 1.01]; PM, 1.3%). The present study suggests that a clinically meaningful level of weight loss mediated the association between tooth loss and increased risk of mortality among independent older adults.
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Affiliation(s)
- T Kusama
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - K Takeuchi
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - S Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - J Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - K Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - K Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
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11
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Rautakallio-Järvinen P, Kunvik S, Laaksonen M, Salonoja M, Fogelholm L, Suominen M, Sievänen H, Vähä-Ypyä H, Nykänen I, Schwab U. Risk of Malnutrition and Insufficient Protein Intake among Older People Living at Home: Baseline Findings of the Power Meals Study. J Nutr Gerontol Geriatr 2022; 41:257-269. [PMID: 36459463 DOI: 10.1080/21551197.2022.2148803] [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: 12/05/2022]
Abstract
This study aimed to investigate the nutritional status, nutrient intake and associated factors among older home care clients, caregivers and care recipients (≥65 years) living at home. There were a total of 78 participants, with a mean age of 78 ± 7.4 years. Nutritional status was assessed with the Mini Nutritional Assessment (MNA), nutrient intake with a three-day food record, sarcopenia with a Simple Questionnaire to Rapidly Diagnose Sarcopenia (SARC) and depression with The Geriatric Depression Scale (GDS-15). Almost one-third (32.1%) were at risk of malnutrition and 2.6% suffered from malnutrition. Impaired nutritional status was associated with depressive symptoms (β = -0.277, p = 0.015) and risk of sarcopenia (SARC points) (β = -0.401, p = 0.001). Mean protein intake was 0.9 ± 0.3 g/adjusted body weight/day. Intakes of protein and multiple vitamins and minerals were lower than recommended. In conclusion, a third of older people living at home were at risk of malnutrition or malnourished. Multiple physical, psychological and social factors in older adults were associated with nutritional status and protein intake.
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Affiliation(s)
- Petra Rautakallio-Järvinen
- Pori Health and Social Services, Pori, Finland.,School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | | | | | | | - Merja Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Irma Nykänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
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12
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Sakr-Ashour FA, Wambogo E, Sahyoun NR. Social Relationships, Food Security, Protein Intake, and Hospitalization in Homebound Older Adults: A PATH Analysis. J Nutr Gerontol Geriatr 2022; 41:201-216. [PMID: 35703450 DOI: 10.1080/21551197.2022.2084203] [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: 10/18/2022]
Abstract
The objective of this study was to measure direct and indirect relationships between food insecurity (FI), protein intake, social relationships, depressive symptoms, and their impact on hospitalization among home-delivered meal (HDM) recipients, compared to controls, using structural equation modeling. The analysis used data from the National Outcomes Evaluation Study (2015-2017) of the OAANSP. HDM recipients' mean usual protein intake was significantly higher than controls, but both groups had mean intakes below recommendations. Eating alone was inversely associated with lower protein intake and greater hospitalizations in controls. FI, prevalent in 25.1% of HDM recipient and 16% of controls, was associated with lower protein intake in both groups. Receiving instrumental social support was directly associated with lesser severity of FI in recipients. and more depressive symptoms only in controls. HDM recipients and controls may be at high risk for protein insufficiency, underscored by high prevalence of FI.
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Affiliation(s)
- Fayrouz A Sakr-Ashour
- School of Sciences & Engineering, Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo, Egypt
| | - Edwina Wambogo
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA
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13
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Park YJ, Chung S, Hwang JT, Shon J, Kim E. A review of recent evidence of dietary protein intake and health. Nutr Res Pract 2022; 16:S37-S46. [PMID: 35651841 PMCID: PMC9127511 DOI: 10.4162/nrp.2022.16.s1.s37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/20/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
The Korea National Health and Nutrition Examination Survey of 2013 to 2017 reported that the average protein consumption of the Korean population is above the current recommended nutrient intake of protein proposed by the Dietary Reference Intakes for Koreans. Some health professionals and the media often advise consuming diets high in protein for promoting metabolic regulation, weight control, and muscle synthesis. However, due to lack of scientific evidence, the validity and safety of high protein consumption are yet to be fully ascertained. The present review assesses recent evidence published in 2014-2020 from human studies, focusing on adequate protein intake and protein sources for the prevention of chronic diseases, particularly metabolic disorders and sarcopenia.
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Affiliation(s)
- Yoon Jung Park
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
- Graduate Program in System Health & Engineering, Ewha Womans University, Seoul 03760, Korea
| | - Sangwon Chung
- Food Functionality Research Division, Korea Food Research Institute, Wanju 55365, Korea
| | - Jin-Taek Hwang
- Food Functionality Research Division, Korea Food Research Institute, Wanju 55365, Korea
- Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Korea
| | - Jinyoung Shon
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Eunjung Kim
- Department of Food Science and Nutrition, Daegu Catholic University, Gyeongsan 38430, Korea
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14
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Fasullo M, Omer E, Kaspar M. Sarcopenia in Chronic Pancreatitis - Prevalence, Diagnosis, Mechanisms and Potential Therapies. Curr Gastroenterol Rep 2022; 24:53-63. [PMID: 35167003 DOI: 10.1007/s11894-022-00837-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE OF REVIEW To investigate the prevalence, pathogenesis, diagnosis, clinical sequelae, and management of sarcopenia to improve mortality and quality of life in those with Chronic Pancreatitis. RECENT FINDINGS Sarcopenia is prevalent in chronic pancreatitis and can significantly affect clinical outcomes. Sarcopenia is prevalent in chronic pancreatitis. While effects on some clinical outcomes is has been shown, there is a significant gap in knowledge regarding effects on outcomes, pathophysiology, and options for management.
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Affiliation(s)
- Matthew Fasullo
- Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Endashaw Omer
- Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY, USA
| | - Matthew Kaspar
- Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University (VCU), Richmond, VA, USA.
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15
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Kusama T, Kiuchi S, Tani Y, Aida J, Kondo K, Osaka K. The lack of opportunity to eat together is associated with an increased risk of weight loss among independent older adults: a prospective cohort study based on the JAGES. Age Ageing 2022; 51:6540137. [PMID: 35231092 DOI: 10.1093/ageing/afac022] [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: 09/01/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE the present study aimed to investigate the relationship between the frequency of eating together and the risk of weight loss in older adults. METHODS this was a three-year follow-up prospective cohort study based on a self-reported questionnaire. We used data from the Japan Gerontological Evaluation Study (JAGES) conducted in 2016 and 2019. The participants were independent older adults aged ≥65 years in Japan. We used >5% weight loss during follow-up as the outcome variable and frequency of eating together as the explanatory variable. The relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated based on the Poisson regression model with a Huber-White sandwich estimator for standard errors, including possible confounders. RESULTS among 56,919 participants, the mean age was 73.0 years (1SD = 5.5) at baseline, and 47.9% were male. About 15.1% (n = 8,596) of the participants experienced >5% weight loss during follow-up. The proportion of each category of the eating together frequency was 36.6% for 'every day', 10.3% for 'several times a week', 26.8% for 'several times a month', 20.5% for 'several times a year' and 5.8% for 'seldom'. Compared to 'every day', only 'several times a year (RR = 1.07, 95% CI = 1.01-1.13)' and 'seldom (RR = 1.17, 95% CI = 1.08-1.27)' were significantly associated with the increased risk of >5% weight loss. CONCLUSION there is a temporal association between less frequent opportunities to eat together and the increased risk of weight loss among independent older adults.
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Affiliation(s)
- Taro Kusama
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, 113-8510, Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, 113-8510, Tokyo, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chuo-ku, Chiba, 263-8522, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, 474-8511, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
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16
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Low awareness of community-dwelling older adults on the importance of dietary protein: new insights from four qualitative studies. J Nutr Sci 2022; 10:e102. [PMID: 35059183 PMCID: PMC8727701 DOI: 10.1017/jns.2021.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/27/2021] [Accepted: 10/09/2021] [Indexed: 01/11/2023] Open
Abstract
Meeting the recommended daily protein intake can be a challenge for community-dwelling older adults (CDOA). In order to understand why, we studied attitudes towards protein-rich products and healthy eating in general; identified needs and preferences, barriers and promotors and knowledge regarding dietary behaviour and implementation of high protein products. Attitudes towards protein-rich products and healthy eating were evaluated in focus groups (study 1, n 17). To gain insights in the needs and preferences of older adults with regard to meals and meal products (study 2, n 30), visual information on eating behaviour was assessed using photovoicing and verified in post-photovoice interviews. In studies 3 and 4, semi-structured interviews were conducted to identify protein consumption-related barriers, opportunities (n 20) and knowledge and communication channels (n 40), respectively. Risk of low protein intake was assessed using ProteinScreener55+ (Pro55+) in studies 2–4 (n 90). Focus groups showed that participants were unaware of potential inadequate dietary protein. Photovoicing showed that sixteen of thirty participants mainly consumed traditional Dutch products. In post-photovoice interviews, participants indicated that they were satisfied with their current eating behaviour. Barriers for adequate use of protein-rich products were ‘lack of knowledge’, ‘resistance to change habits’ and ‘no urge to receive dietary advice’. Promotors were ‘trust in professionals’ and ‘product offers’. Sixty-two percent had a low risk of low protein intake. CDOA feel low urgency to increase protein intake, possibly linked to low knowledge levels. A challenge for professionals would be to motivate older adults to change their eating pattern, to optimise protein intake.
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17
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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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18
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Mathewson SL, Azevedo PS, Gordon AL, Phillips BE, Greig CA. Overcoming protein-energy malnutrition in older adults in the residential care setting: A narrative review of causes and interventions. Ageing Res Rev 2021; 70:101401. [PMID: 34237434 DOI: 10.1016/j.arr.2021.101401] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/10/2021] [Accepted: 07/02/2021] [Indexed: 01/06/2023]
Abstract
Malnutrition, in particular protein-energy malnutrition, is a highly prevalent condition in older adults, and is associated with low muscle mass and function, and increased prevalence of physical frailty. Malnutrition is often exacerbated in the residential care setting due to factors including lack of dentition and appetite, and increased prevalence of dementia and dysphagia. This review aims to provide an overview of the available literature in older adults in the residential care setting regarding the following: links between sarcopenia, frailty, and malnutrition (in particular, protein-energy malnutrition (PEM)), recognition and diagnosis of malnutrition, factors contributing to PEM, and the effectiveness of different forms of protein supplementation (in particular, oral nutritional supplementation (ONS) and protein-fortified foods (PFF)) to target PEM. This review found a lack of consensus on effective malnutrition diagnostic tools and lack of universal requirement for malnutrition screening in the residential care setting, making identifying and treating malnutrition in this population a challenge. When assessing the use of protein supplementation in the residential care setting, the two primary forms of supplementation were ONS and PFF. There is evidence that ONS and PFF increase protein and energy intakes in residential care setting, yet compliance with supplementation and their impact on functional status is unclear and conflicting. Further research comparing the use of ONS and PFF is needed to fully determine feasibility and efficacy of protein supplementation in the residential care setting.
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19
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Kusama T, Nakazawa N, Kiuchi S, Kondo K, Osaka K, Aida J. Dental prosthetic treatment reduced the risk of weight loss among older adults with tooth loss. J Am Geriatr Soc 2021; 69:2498-2506. [PMID: 34081343 DOI: 10.1111/jgs.17279] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Weight loss is a critical health issue in older adults. Oral function is essential for nutrient intake and can be restored using dental prosthetic treatments in patients with tooth loss. This study aimed to investigate the relationship between tooth loss and weight loss among the older adults and to evaluate the magnitude of its risk reduction by dental prosthetic treatment. DESIGN Three-year follow-up longitudinal study based on a self-reported questionnaire. SETTING Community-dwelling older adults in Japan. PARTICIPANTS Adults aged 65 and older (n = 53,690). MEASUREMENTS We used >10% weight loss during follow-up, the number of remaining teeth, and the use of dental prostheses as the outcome variable, exposure variable, and mediator, respectively. We fitted the logistic regression model including possible confounders and calculated the odds ratios (ORs) and 95% confidence intervals (95% CIs) of the controlled direct effect (CDE) at the level of use or nonuse of the dental prosthesis based on a causal mediation analysis framework. Additionally, we calculated the proportion eliminated by the dental prosthesis. RESULTS The mean age of participants was 72.6 years (1 SD = 5.5), and 47.4% were males. About 5.8% (n = 3132) of them experienced >10% weight loss during the follow-up. Weight loss was observed in 6.8% of the participants with 0-19 remaining teeth and in 4.3% of them with ≥20 remaining teeth. The CDE of 0-19 remaining teeth was greater when no one used dental prosthesis (OR = 1.41; 95% CI = 1.26-1.59) compared with that when all participants used dental prosthesis (OR = 1.26; 95% CI = 1.08-1.46). This indicated that dental prosthesis decreased the risk of weight loss by 37.3%. CONCLUSION Our study revealed that tooth loss increased the risk of clinically critical levels of weight loss among community-dwelling older adults. However, this risk was reduced by dental prosthetic treatment.
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Affiliation(s)
- Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Noriko Nakazawa
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Division for Regional Community Development, Tohoku University Graduate School of Dentistry, Sendai, Japan
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20
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Kehoe L, Walton J, McNulty BA, Nugent AP, Flynn A. Energy, Macronutrients, Dietary Fibre and Salt Intakes in Older Adults in Ireland: Key Sources and Compliance with Recommendations. Nutrients 2021; 13:nu13030876. [PMID: 33800312 PMCID: PMC8001736 DOI: 10.3390/nu13030876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/03/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
The global population is rapidly ageing. Adequate nutritional status can play a key role in preventing or delaying the progression of age-related diseases. The aim of this study was to estimate the usual intake of energy, macronutrients, dietary fibre and salt in order to determine compliance with recommendations and to identify the sources of these nutrients in older adults (≥65 years) in Ireland. This study is based on data from the cohort of older adults aged ≥65 years (n = 226) in the Irish National Adult Nutrition Survey (NANS) (2008-2010) which estimated food and nutrient intakes in a representative sample of adults 18-90 years using a 4 day weighed food record. This study found that while intakes of macronutrients are generally sufficient in this population group, older adults in Ireland have high intakes of total fat, saturated fat, sugar and salt and low intakes of dietary fibre. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt) to support successful ageing of our population.
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Affiliation(s)
- Laura Kehoe
- School of Food & Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland; (J.W.); (A.F.)
- Correspondence: ; Tel.: +353-(0)21-490-3387
| | - Janette Walton
- School of Food & Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland; (J.W.); (A.F.)
- Department of Biological Sciences, Munster Technological University, T12 P928 Cork, Ireland
| | - Breige A. McNulty
- UCD Institute of Food & Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (B.A.M.); (A.P.N.)
| | - Anne P. Nugent
- UCD Institute of Food & Health, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland; (B.A.M.); (A.P.N.)
- Institute for Global Food Security, Queens University Belfast, Belfast BT7 1NN, UK
| | - Albert Flynn
- School of Food & Nutritional Sciences, University College Cork, T12 K8AF Cork, Ireland; (J.W.); (A.F.)
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Jungert A, Eichner G, Neuhäuser-Berthold M. Trajectories of Body Composition during Advanced Aging in Consideration of Diet and Physical Activity: A 20-Year Longitudinal Study. Nutrients 2020; 12:nu12123626. [PMID: 33255771 PMCID: PMC7761400 DOI: 10.3390/nu12123626] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/10/2020] [Accepted: 11/21/2020] [Indexed: 12/24/2022] Open
Abstract
This prospective study investigates age-dependent changes in anthropometric data and body composition over a period of two decades in consideration of physical activity and diet in community-dwelling subjects ≥60 years. Overall, 401 subjects with median follow-up time of 12 years were examined. Fat-free mass (FFM) and fat mass (FM) were analyzed using bioelectrical impedance analysis. Physical activity was assessed via a self-administered questionnaire. Dietary intake was examined by 3-day dietary records. Linear mixed-effects models were used to analyze the influence of age, sex, physical activity and energy/protein intake on anthropometric data and body composition by considering year of entry, use of diuretics and diagnosis of selected diseases. At baseline, median values for daily energy and protein intakes were 8.5 megajoule and 81 g and physical activity index was 1.7. After adjusting for covariates, advancing age was associated with parabolic changes indicating overall changes from age 60 to 90 years in women and men in body mass: −4.7 kg, −5.0 kg; body mass index: +0.04 kg/m2, −0.33 kg/m2; absolute FFM: −2.8 kg, −3.5 kg; absolute FM: −1.8 kg, −1.2 kg and waist circumference: +16 cm, +12 cm, respectively. No age-dependent changes were found for upper arm circumference and relative (%) FFM. Dietary and lifestyle factors were not associated with changes in anthropometric or body composition parameters. In summary, the results indicate non-linear age-dependent changes in anthropometric data and body composition, which are largely unaffected by the degree of habitual physical activity and dietary protein intake in well-nourished community-dwelling subjects.
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Affiliation(s)
- Alexandra Jungert
- Institute of Nutritional Science, Justus Liebig University, Goethestr. 55, D-35390 Giessen, Germany;
- Interdisciplinary Research Center for Biosystems, Land Use and Nutrition (IFZ), Justus Liebig University, Heinrich-Buff-Ring 26-32, D-35392 Giessen, Germany
| | - Gerrit Eichner
- Mathematical Institute, Arndtstr. 2, Justus Liebig University, D-35392 Giessen, Germany;
| | - Monika Neuhäuser-Berthold
- Institute of Nutritional Science, Justus Liebig University, Goethestr. 55, D-35390 Giessen, Germany;
- Correspondence: ; Tel.: +49-(0)641-99-39067
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Reinders I, Wijnhoven HAH, Jyväkorpi SK, Suominen MH, Niskanen R, Bosmans JE, Brouwer IA, Fluitman KS, Klein MCA, Kuijper LD, van der Lubbe LM, Olthof MR, Pitkälä KH, Vijlbrief R, Visser M. Effectiveness and cost-effectiveness of personalised dietary advice aiming at increasing protein intake on physical functioning in community-dwelling older adults with lower habitual protein intake: rationale and design of the PROMISS randomised controlled trial. BMJ Open 2020; 10:e040637. [PMID: 33444206 PMCID: PMC7682452 DOI: 10.1136/bmjopen-2020-040637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/18/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Short-term metabolic and observational studies suggest that protein intake above the recommended dietary allowance of 0.83 g/kg body weight (BW)/day may support preservation of lean body mass and physical function in old age, but evidence from randomised controlled trials is inconclusive. METHODS AND ANALYSIS The PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) trial examines the effect of personalised dietary advice aiming at increasing protein intake with or without advice regarding timing of protein intake to close proximity of usual physical activity, on change in physical functioning after 6 months among community-dwelling older adults (≥65 years) with a habitual protein intake of <1.0 g/kg adjusted (a)BW/day. Participants (n=264) will be recruited in Finland and the Netherlands, and will be randomised into three groups; two intervention groups and one control group. Intervention group 1 (n=88) receives personalised dietary advice and protein-enriched food products in order to increase their protein intake to at least 1.2 g/kg aBW/day. Intervention group 2 (n=88) receives the same advice as described for intervention group 1, and in addition advice to consume 7.5-10 g protein through protein-(en)rich(ed) foods within half an hour after performing usual physical activity. The control group (n=88) receives no intervention. All participants will be invited to attend lectures not related to health. The primary outcome is a 6-month change in physical functioning measured by change in walk time using a 400 m walk test. Secondary outcomes are: 6-month change in the Short Physical Performance Battery score, muscle strength, body composition, self-reported mobility limitations, quality of life, incidence of frailty, incidence of sarcopenia risk and incidence of malnutrition. We also investigate cost-effectiveness by change in healthcare costs. DISCUSSION The PROMISS trial will provide evidence whether increasing protein intake, and additionally optimising the timing of protein intake, has a positive effect on the course of physical functioning after 6 months among community-dwelling older adults with a habitual protein intake of <1.0 g/kg aBW/day. ETHICS AND DISSEMINATION The study has been approved by the Ethics Committee of the Helsinki University Central Hospital, Finland (ID of the approval: HUS/1530/2018) and The Medical Ethical Committee of the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (ID of the approval: 2018.399). All participants provided written informed consent prior to being enrolled onto the study. Results will be submitted for publication in peer-reviewed journals and will be made available to stakeholders (ie, older adults, healthcare professionals and industry). TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03712306).
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Affiliation(s)
- Ilse Reinders
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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, 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, Helsinki, Finland
| | - Riikka Niskanen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kristien S Fluitman
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, The Netherlands
- Wallenburg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michel C A Klein
- Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lothar D Kuijper
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura M van der Lubbe
- Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, and 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, Helsinki, Finland
| | - Rachel Vijlbrief
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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23
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Elstgeest LEM, Schaap LA, Heymans MW, Hengeveld LM, Naumann E, Houston DK, Kritchevsky SB, Simonsick EM, Newman AB, Farsijani S, Visser M, Wijnhoven HAH. Sex-and race-specific associations of protein intake with change in muscle mass and physical function in older adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2020; 112:84-95. [PMID: 32520344 PMCID: PMC7326591 DOI: 10.1093/ajcn/nqaa099] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/16/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Protein intake recommendations advise ≥0.8 g/kg body weight (BW)/d, whereas experts propose a higher intake for older adults (1.0-1.2 g/kg BW/d). It is unknown whether optimal protein intake differs by sex or race. OBJECTIVES We examined the shape of sex- and race-specific associations of dietary protein intake with 3- and 6-y changes in appendicular lean mass (aLM) and gait speed and also 6-y incidence of mobility limitation in community-dwelling older men and women. METHODS We used data on men (n = 1163) and women (n = 1237) aged 70-81 y of the Health, Aging, and Body Composition Study. Protein intake was assessed using an FFQ (1998-1999). aLM and gait speed were measured at baseline and at 3 and 6 y. Difficulty walking one-quarter mile or climbing stairs was measured every 6 mo over 6 y. Prospective associations were evaluated with linear and Cox regression models, comparing fit of models with and without spline functions. All analyses were stratified by sex and additionally by race. RESULTS Mean ± SD protein intake was 0.94 ± 0.36 g/kg adjusted body weight (aBW)/d in men and 0.95 ± 0.36 g/kg aBW/d in women. There were no strong indications of nonlinear associations. In women, higher protein intake was associated with less aLM loss over 3 y (adjusted B per 0.1 g/kg aBW/d: 39.4; 95% CI: 11.6, 67.2), specifically in black women, but not over 6 y or with gait speed decline. In men, protein intake was not associated with changes in aLM and gait speed. Higher protein intake was associated with a lower risk of mobility limitation in men (adjusted HR per 1.0 g/kg aBW/d: 0.55; 95% CI: 0.34, 0.91) and women (adjusted HR: 0.56; 95% CI: 0.33, 0.94), specifically white women. CONCLUSIONS Associations between protein intake and physical outcomes may vary by sex and race. Therefore, it is important to consider sex and race in future studies regarding protein needs in older adults.
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Affiliation(s)
- Liset E M Elstgeest
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC – Location VU University Medical Center, Amsterdam, the Netherlands
| | - Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Elke Naumann
- Department of Nutrition and Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
- European Federation of the Associations of Dietitians (EFAD), The Hague, the Netherlands
| | - Denise K Houston
- Sticht Center for Healthy Aging and Alzheimer's Prevention and Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention and Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, MD, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samaneh Farsijani
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Vrije University Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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24
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Effects of slow- v. fast-digested protein supplementation combined with mixed power training on muscle function and functional capacities in older men. Br J Nutr 2020; 125:1017-1033. [PMID: 32498755 DOI: 10.1017/s0007114520001932] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Ageing leads to a progressive loss of muscle function (MF) and quality (MQ: muscle strength (MS)/lean muscle mass (LM)). Power training and protein (PROT) supplementation have been proposed as efficient interventions to improve MF and MQ. Discrepancies between results appear to be mainly related to the type and/or dose of proteins used. The present study aimed at determining whether or not mixed power training (MPT) combined with fast-digested PROT (F-PROT) leads to greater improvements in MF and MQ in elderly men than MPT combined with slow-digested PROT (S-PROT) or MPT alone. Sixty elderly men (age 69 (sd 7) years; BMI 18-30 kg/m2) were randomised into three groups: (1) placebo + MPT (PLA; n 19); (2) F-PROT + MPT (n 21) and (3) S-PROT + MPT (n 20) completed the intervention. LM, handgrip and knee extensor MS and MQ, functional capacity, serum metabolic markers, skeletal muscle characteristics, dietary intake and total energy expenditure were measured. The interventions consisted in 12 weeks of MPT (3 times/week; 1 h/session) combined with a supplement (30 g:10 g per meal) of F-PROT (whey) or S-PROT (casein) or a placebo. No difference was observed among groups for age, BMI, number of steps and dietary intake pre- and post-intervention. All groups improved significantly their LM, lower limb MS/MQ, functional capacity, muscle characteristics and serum parameters following the MPT. Importantly, no difference between groups was observed following the MPT. Altogether, adding 30 g PROT/d to MPT, regardless of the type, does not provide additional benefits to MPT alone in older men ingesting an adequate (i.e. above RDA) amount of protein per d.
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25
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Hayashi AP, de Capitani MD, Dias SF, de Souza Gonçalves L, Fernandes AL, Jambassi-Filho JC, de Santana DA, Lixandrão M, Tavares dos Santos Pereira R, Riani L, Hevia-Larraín V, Pereira RMR, Gualano B, Roschel H. Number of high-protein containing meals correlates with muscle mass in pre-frail and frail elderly. Eur J Clin Nutr 2020; 74:1047-1053. [DOI: 10.1038/s41430-020-0618-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 01/24/2023]
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26
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Hengeveld LM, Wijnhoven HAH, Olthof MR, Brouwer IA, Simonsick EM, Kritchevsky SB, Houston DK, Newman AB, Visser M. Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study. J Am Geriatr Soc 2019; 67:1835-1842. [PMID: 31267522 PMCID: PMC6771787 DOI: 10.1111/jgs.16011] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/19/2019] [Accepted: 05/02/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine associations of diet quality indicators with 4-year incidence of frailty in community-dwelling older adults. DESIGN Prospective cohort study. SETTING Health, Aging, and Body Composition Study, United States. PARTICIPANTS Community-dwelling men and women, aged 70 to 81 years in 1998 to 1999 (first follow-up, present study's baseline; n = 2154). MEASUREMENTS At first follow-up, dietary intake over the preceding year was assessed with a food frequency questionnaire. Indicators of diet quality include the Healthy Eating Index (categorized as poor, medium, and good), energy intake, and protein intake (a priori adjusted for energy intake using the nutrient residual model). Frailty status was determined using Fried's five-component frailty phenotype and categorized into "robust" (0 components present), "pre-frailty" (1 - 2 components present), or "frail" (3-5 components present). Cox proportional hazards analysis was used to examine associations of the diet quality indicators with 4-year incidence of (1) frailty and (2) pre-frailty or frailty. Competing risk analysis was used to examine associations with frailty by accounting for competing risks of death. RESULTS During the 4-year follow-up, 277 of the 2154 participants, robust or pre-frail at baseline, developed frailty, and 629 of the 1020 participants, robust at baseline, developed pre-frailty or frailty. Among the robust and pre-frail, after adjustment for confounders including energy intake, those consuming poor- and medium-quality diets had a higher frailty incidence than those consuming good-quality diets (hazard ratio [HR] = 1.92 [95% confidence interval {CI} = 1.17-3.17] and HR = 1.40 [95% CI = 0.99-1.98], respectively). No associations for energy or protein intake were observed. Competing risk analyses yielded similar results. Among the robust, those with lower vegetable protein intake had a higher "pre-frailty or frailty" incidence (per -10 g/d: HR = 1.20; 95% CI = 1.04-1.39). No other associations were observed. CONCLUSION Poorer overall diet quality and lower vegetable protein intake may increase the risk of becoming frail in old age. We found no association for intakes of energy, total protein, or animal protein. J Am Geriatr Soc 67:1835-1842, 2019.
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Affiliation(s)
- Linda M. Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Hanneke A. H. Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Margreet R. Olthof
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Ingeborg A. Brouwer
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | - Stephen B. Kritchevsky
- Department of Internal MedicineWake Forest School of MedicineWinston‐SalemNorth Carolina
| | - Denise K. Houston
- Department of Internal MedicineWake Forest School of MedicineWinston‐SalemNorth Carolina
| | - Anne B. Newman
- Department of EpidemiologyGraduate School of Public Health, University of PittsburghPittsburghPennsylvania
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
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Damanti S, Azzolino D, Roncaglione C, Arosio B, Rossi P, Cesari M. Efficacy of Nutritional Interventions as Stand-Alone or Synergistic Treatments with Exercise for the Management of Sarcopenia. Nutrients 2019; 11:E1991. [PMID: 31443594 PMCID: PMC6770476 DOI: 10.3390/nu11091991] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 12/13/2022] Open
Abstract
Sarcopenia is an age-related and accelerated process characterized by a progressive loss of muscle mass and strength/function. It is a multifactorial process associated with several adverse outcomes including falls, frailty, functional decline, hospitalization, and mortality. Hence, sarcopenia represents a major public health problem and has become the focus of intense research. Unfortunately, no pharmacological treatments are yet available to prevent or treat this age-related condition. At present, the only strategies for the management of sarcopenia are mainly based on nutritional and physical exercise interventions. The purpose of this review is, thus, to provide an overview on the role of proteins and other key nutrients, alone or in combination with physical exercise, on muscle parameters.
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Affiliation(s)
- Sarah Damanti
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Phd Course in Nutritional Sciences, University of Milan, 20122 Milan, Italy
| | - Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
- Phd Course in Nutritional Sciences, University of Milan, 20122 Milan, Italy.
| | - Carlotta Roncaglione
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Paolo Rossi
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Dietary Protein and Amino Acid Intake: Links to the Maintenance of Cognitive Health. Nutrients 2019; 11:nu11061315. [PMID: 31212755 PMCID: PMC6627761 DOI: 10.3390/nu11061315] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 05/31/2019] [Accepted: 06/07/2019] [Indexed: 01/03/2023] Open
Abstract
With the rapid growth in the aging population, there has been a subsequent increase in the rates of Alzheimer's disease and related dementias (ADRD). To combat these increases in ADRD, scientists and clinicians have begun to place an increased emphasis on preventative methods to ameliorate disease rates, with a primary focus area on dietary intake. Protein/amino acid intake is a burgeoning area of research as it relates to the prevention of ADRD, and consumption is directly related to a number of disease-related risk factors as such low-muscle mass, sleep, stress, depression, and anxiety. As a result, the role that protein/amino acid intake plays in affecting modifiable risk factors for cognitive decline has provided a robust area for scientific exploration; however, this research is still speculative and specific mechanisms have to be proven. The purpose of this review is to describe the current understanding of protein and amino acids and the preventative roles they play with regard to ADRD, while providing future recommendations for this body of research. Additionally, we will discuss the current recommendations for protein intake and how much protein older adults should consume in order to properly manage their long-term risk for cognitive decline.
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29
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Carbone JW, Pasiakos SM. Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients 2019; 11:nu11051136. [PMID: 31121843 PMCID: PMC6566799 DOI: 10.3390/nu11051136] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/08/2019] [Accepted: 05/20/2019] [Indexed: 12/14/2022] Open
Abstract
Adequate consumption of dietary protein is critical for the maintenance of optimal health during normal growth and aging. The current Recommended Dietary Allowance (RDA) for protein is defined as the minimum amount required to prevent lean body mass loss, but is often misrepresented and misinterpreted as a recommended optimal intake. Over the past two decades, the potential muscle-related benefits achieved by consuming higher-protein diets have become increasingly clear. Despite greater awareness of how higher-protein diets might be advantageous for muscle mass, actual dietary patterns, particularly as they pertain to protein, have remained relatively unchanged in American adults. This lack of change may, in part, result from confusion over the purported detrimental effects of higher-protein diets. This manuscript will highlight common perceptions and benefits of dietary protein on muscle mass, address misperceptions related to higher-protein diets, and comment on the translation of academic advances to real-life application and health benefit. Given the vast research evidence supporting the positive effects of dietary protein intake on optimal health, we encourage critical evaluation of current protein intake recommendations and responsible representation and application of the RDA as a minimum protein requirement rather than one determined to optimally meet the needs of the population.
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Affiliation(s)
- John W Carbone
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI 48197, USA.
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM), Natick, MA 01760, USA.
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30
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Inadequate Protein Intake at Specific Meals Is Associated with Higher Risk of Impaired Functionality in Middle to Older Aged Mexican Adults. J Aging Res 2019; 2019:6597617. [PMID: 31089426 PMCID: PMC6476034 DOI: 10.1155/2019/6597617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/29/2019] [Accepted: 02/17/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose To describe the proportions of inadequate protein intake (IPI) per day and per meal and their association with functionality in middle to older aged Mexican adults. Materials and Methods In a cross-sectional design, we evaluated the protein intake and functionality of instrumental activities of daily living (IADL) and activities of daily living (ADL) of 190 middle to older aged Mexican adults. IPI was considered as any protein intake: <1.2 g/kg/day, <30 g/meal, or <0.4 g/kg/meal. Functionality was organized into three groups: high, middle, and low scores. The first was set as the reference, and the other was considered as impaired functionality. With a multinomial logistic regression, we analyzed the association between IPI per day and per meal with impaired functionality. Results A high proportion of participants showed IPI per day. The meal with the highest proportion of IPI was dinner, followed by breakfast and lunch for both criteria. IPI at lunch was a significant risk factor for impaired functionality in ADL when assessed with the 30 g/meal criterion (low scores, OR 3.82 (95% CI, 1.15–12.65); middle scores, OR 2.40 [1.03–5.62]). For the 0.4 g/kg/meal criterion, IPI at dinner was a significant risk factor for IADL middle scores only (OR 7.64, [1.27–45.85]). Conclusion IPI per meal is high in middle to older aged Mexican adults, and at specific meals, it is a significant risk factor for impaired functionality in activities of daily living.
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Abstract
Population ageing is rapidly progressing and it is estimated that by 2050 one in every five people globally will be aged 60 years or over. Research has shown that adequate nutritional status can positively impact the ageing process, resulting in improved quality of life and the prevention of chronic disease and mortality. However, due to physiological and social changes associated with ageing, older adults may be at increased risk of nutrient deficiencies. This review aims to investigate the nutrient intake and status of older adults in Europe and to explore the potential role of fortified foods and nutritional supplements in addressing some of the nutritional challenges identified in this population group. The available literature has highlighted unfavourable intakes of total and saturated fat, sugar, salt and dietary fibre together with low intakes and suboptimal status of key micronutrients such as vitamins D, B2, B12, folate and calcium. Evidence has shown that the consumption of fortified foods and use of nutritional supplements make significant contributions to intakes and status of these micronutrients in older adults. Continued monitoring of nutrient intake and status is important in light of changing fortification practices and food consumption patterns. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt), food fortification or supplementation to support successful ageing of our populations.
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Sandoval-Insausti H, Pérez-Tasigchana RF, López-García E, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. Protein Intake and Risk of Falls: A Prospective Analysis in Older Adults. J Am Geriatr Soc 2018; 67:329-335. [DOI: 10.1111/jgs.15681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- Service of Preventive Medicine; Hospital Universitario de La Princesa; Madrid Spain
| | - Raúl F. Pérez-Tasigchana
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- School of Medicine, Universidad San Francisco de Quito; Quito Ecuador
| | - Esther López-García
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid Spain
| | - José R. Banegas
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health; School of Medicine, Universidad Autónoma de Madrid-IdiPaz; Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP); Madrid Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid Spain
- Welch Center for Prevention; Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health; Baltimore Maryland
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Yokoyama Y, Kitamura A, Nishi M, Seino S, Taniguchi Y, Amano H, Ikeuchi T, Shinkai S. Frequency of Balanced-Meal Consumption and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study. J Epidemiol 2018; 29:370-376. [PMID: 30449768 PMCID: PMC6737190 DOI: 10.2188/jea.je20180076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although meals that combine a staple food, main dish, and side dish (balanced meals) are recommended in Japan, the health effects of such meals are unclear. We investigated the association of frequency of eating balanced meals with frailty among community-dwelling older Japanese. METHODS We analyzed data from 912 persons aged 65 years or older who participated in the Hatoyama Cohort Study or Kusatsu Longitudinal Study. The frequency of eating two or more balanced meals daily was self-reported as ≤1 day/week, 2 or 3 days/week, 4 or 5 days/week, and daily. Frailty was defined as the presence of at least three, and pre-frailty as the presence of one or two, of the following criteria: weight loss, muscle weakness, exhaustion, slowness, and low physical activity. Adjusted logistic regression was used to study associations of frequency of balanced-meal consumption with frailty (prefrailty and frailty combined) and frailty criteria. RESULTS Participants reporting a frequency of balanced-meal consumption of ≤2 or 3 days/week had a higher prevalence of frailty (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.21-2.64) than did those reporting a frequency of daily. Lower frequency of balanced-meal consumption was also associated with higher prevalences of weight loss (OR, 4.10; 95% CI, 1.90-8.85), exhaustion (OR, 6.35; 95% CI, 2.49-16.17), and low physical activity (OR, 1.92; 95% CI, 1.22-3.01). CONCLUSIONS Our findings suggest that more frequent twice daily consumption of meals with a staple food, main dish, and side dish decreases the risks of prefrailty and frailty.
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Affiliation(s)
- Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Mariko Nishi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Yu Taniguchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Hidenori Amano
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
| | - Tomoko Ikeuchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology
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Wijnhoven HAH, Elstgeest LEM, de Vet HCW, Nicolaou M, Snijder MB, Visser M. Development and validation of a short food questionnaire to screen for low protein intake in community-dwelling older adults: The Protein Screener 55+ (Pro55+). PLoS One 2018; 13:e0196406. [PMID: 29791454 PMCID: PMC5965846 DOI: 10.1371/journal.pone.0196406] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/12/2018] [Indexed: 01/10/2023] Open
Abstract
In old age, sufficient protein intake is important to preserve muscle mass and function. Around 50% of older adults (65+ y) consumes ≤1.0 g/kg adjusted body weight (BW)/day (d). There is no rapid method available to screen for low protein intake in old age. Therefore, we aimed to develop and validate a short food questionnaire to screen for low protein intake in community-dwelling older adults. We used data of 1348 older men and women (56-101 y) of the LASA study (the Netherlands) to develop the questionnaire and data of 563 older men and women (55-71 y) of the HELIUS study (the Netherlands) for external validation. In both samples, protein intake was measured by the 238-item semi-quantitative HELIUS food frequency questionnaire (FFQ). Multivariable logistic regression analysis was used to predict protein intake ≤1.0 g/kg adjusted BW/d (based on the HELIUS FFQ). Candidate predictor variables were FFQ questions on frequency and amount of intake of specific foods. In both samples, 30% had a protein intake ≤1.0 g/kg adjusted BW/d. Our final model included adjusted body weight and 10 questions on the consumption (amount on average day or frequency in 4 weeks) of: slices of bread (number); glasses of milk (number); meat with warm meal (portion size); cheese (amount and frequency); dairy products (like yoghurt) (frequency); egg(s) (frequency); pasta/noodles (frequency); fish (frequency); and nuts/peanuts (frequency). The area under the receiver operating characteristic curve (AUC) was 0.889 (95% CI 0.870-0.907). The calibration slope was 1.03 (optimal slope 1.00). At a cut-off of ≤0.8 g/kg adjusted BW/d, the AUC was 0.916 (96% CI 0.897-0.936). Applying the regression equation to the HELIUS sample, the AUC was 0.856 (95% CI 0.824-0.888) and the calibration slope 0.92. Regression coefficients were therefore subsequently shrunken by a linear factor 0.92. To conclude, the short food questionnaire (Pro55+) can be used to validly screen for protein intake ≤1.0 g/kg adjusted BW/d in community-dwelling older adults. An online version can be found at www.proteinscreener.nl. External validation in other countries is recommended.
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Affiliation(s)
- Hanneke A. H. Wijnhoven
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Liset E. M. Elstgeest
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Henrica C. W. de Vet
- Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Mary Nicolaou
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marieke B. Snijder
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Carracedo J, Ramírez-Carracedo R, Martínez de Toda I, Vida C, Alique M, De la Fuente M, Ramírez-Chamond R. Protein Carbamylation: A Marker Reflecting Increased Age-Related Cell Oxidation. Int J Mol Sci 2018; 19:ijms19051495. [PMID: 29772765 PMCID: PMC5983744 DOI: 10.3390/ijms19051495] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/30/2022] Open
Abstract
Carbamylation is a post-translational modification of proteins that may partake in the oxidative stress-associated cell damage, and its increment has been recently proposed as a “hallmark of aging”. The molecular mechanisms associated with aging are related to an increased release of free radicals. We have studied whether carbamylated proteins from the peripheral blood of healthy subjects are related to oxidative damage and aging, taking into account the gender and the immune profile of the subjects. The study was performed in healthy human volunteers. The detection of protein carbamylation and malondialdehyde (MDA) levels was evaluated using commercial kits. The immune profile was calculated using parameters of immune cell function. The results show that the individuals from the elderly group (60–79 years old) have increased carbamylated protein and MDA levels. When considered by gender, only men between 60 and 79 years old showed significantly increased carbamylated proteins and MDA levels. When those subjects were classified by their immune profile, the carbamylated protein levels were higher in those with an older immune profile. In conclusion, the carbamylation of proteins in peripheral blood is related to age-associated oxidative damage and to an aging functional immunological signature. Our results suggest that carbamylated proteins may play an important role at the cellular level in the aging process.
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Affiliation(s)
- Julia Carracedo
- Department of Genetics, Physiology, and Microbiology, Faculty of Biology, Complutense University/Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28040 Madrid, Spain.
| | - Rafael Ramírez-Carracedo
- Cardiovascular Joint Research Unit, Francisco de Vitoria University/Hospital Ramon y Cajal Research Unit (IRYCIS), 28223 Madrid, Spain.
| | - Irene Martínez de Toda
- Department of Genetics, Physiology, and Microbiology, Faculty of Biology, Complutense University/Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28040 Madrid, Spain.
| | - Carmen Vida
- Department of Genetics, Physiology, and Microbiology, Faculty of Biology, Complutense University/Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28040 Madrid, Spain.
| | - Matilde Alique
- Biology Systems Department, Physiology, Alcala University, Alcala de Henares, 28805 Madrid, Spain.
| | - Mónica De la Fuente
- Department of Genetics, Physiology, and Microbiology, Faculty of Biology, Complutense University/Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28040 Madrid, Spain.
| | - Rafael Ramírez-Chamond
- Biology Systems Department, Physiology, Alcala University, Alcala de Henares, 28805 Madrid, Spain.
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Differences in muscle adaptation to a 12-week mixed power training in elderly men, depending on usual protein intake. Exp Gerontol 2018; 104:78-85. [PMID: 29421607 DOI: 10.1016/j.exger.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Normal aging is often associated with a decline of muscle mass (MM), strength (MS) and quality (MQ: MS/MM), leading to functional incapacities. This aging-related deterioration of muscles may involve a decreased protein intake. Mixed power training has been recently shown to induce positive effects on MM, MS and MQ. However, to our knowledge, no study has examined if muscle adaptations following mixed power training could be influenced by the daily amount of protein ingested in elderly men. METHODS Twenty-one men completed the intervention and were divided into 2 groups based on their usual protein intake: PROT 1.1- (<1.1 g·kg-1·d-1 [n = 10; 73 ± 3 years]) and PROT 1.2+ (>1.2 g·kg-1·d-1 [n = 11; 73 ± 3 years]). Body composition (DXA: lean and fat masses), MS (1-maximal repetition on leg-press and handgrip strength), MQ (MS/body mass and MS/lower limb lean mass), functional capacities (Short Physical Performance Battery/Senior Fitness Test), dietary intake (3-day food record) and energy expenditure (accelerometer; 7 days) were measured. Mixed power training intervention consisted in power and functional exercises (12 weeks; 3 times/week; 1 h/session). RESULTS Lower limb MS increase in the PROT 1.2+ group was greater from that of the PROT 1.1- group when normalized to lower limbs lean mass (p = 0.036). In addition, a trend for greater gain in lower limb MS normalized to body mass (p = 0.053) was observed in the PROT 1.2+. CONCLUSION To optimize mixed power training effects on muscle function, healthy older men should ingest daily at least 1.2 g·kg-1·d-1 of protein. These beneficial effects of a higher usual protein intake were observed especially for MQ, which is one of the best predictors of functional capacities in older adults.
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Abstract
ABSTRACT Objective We evaluated factors associated with protein consumption by the elderly. Methods We performed a cross-sectional study in a sample of 295 elderly consumers of health facilities in São Caetano do Sul, São Paulo, Brazil. Protein consumption data (g and g/kg) were obtained through 24-hour dietary recalls, which was reapplied in a 30% sub-sample to estimate habitual consumption, with an interval of two weeks. The association between protein consumption and sociodemographic, economic, health, and dietary variables was tested using multiple linear regression. Results There was a positive association between protein consumption (g and g/kg) and better Brazilian Healthy Eating Index-Revised, between protein consumption (g) and male sex, and a negative association between protein consumption (g/kg) and greater calf circumference. Higher average protein consumption (g or g/kg) was observed among married elderly, individuals with higher income and schooling, who were economically active, eutrophic, without dyslipidemia and symptoms of dysphagia, who consumed three main meals and an intermediate snack. Conclusion The results showed that protein consumption was associated with diet quality, sex, and calf circumference. The identification of elderly groups prone to protein inadequacy may direct individual and collective interventions to prevent muscle mass reduction and its implications, such as sarcopenia and other adverse outcomes.
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Kirkpatrick SI, Vanderlee L, Raffoul A, Stapleton J, Csizmadi I, Boucher BA, Massarelli I, Rondeau I, Robson PJ. Self-Report Dietary Assessment Tools Used in Canadian Research: A Scoping Review. Adv Nutr 2017; 8:276-289. [PMID: 28298272 PMCID: PMC5347105 DOI: 10.3945/an.116.014027] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Choosing the most appropriate dietary assessment tool for a study can be a challenge. Through a scoping review, we characterized self-report tools used to assess diet in Canada to identify patterns in tool use and to inform strategies to strengthen nutrition research. The research databases Medline, PubMed, PsycINFO, and CINAHL were used to identify Canadian studies published from 2009 to 2014 that included a self-report assessment of dietary intake. The search elicited 2358 records that were screened to identify those that reported on self-report dietary intake among nonclinical, non-Aboriginal adult populations. A pool of 189 articles (reflecting 92 studies) was examined in-depth to assess the dietary assessment tools used. Food-frequency questionnaires (FFQs) and screeners were used in 64% of studies, whereas food records and 24-h recalls were used in 18% and 14% of studies, respectively. Three studies (3%) used a single question to assess diet, and for 3 studies the tool used was not clear. A variety of distinct FFQs and screeners, including those developed and/or adapted for use in Canada and those developed elsewhere, were used. Some tools were reported to have been evaluated previously in terms of validity or reliability, but details of psychometric testing were often lacking. Energy and fat were the most commonly studied, reported by 42% and 39% of studies, respectively. For ∼20% of studies, dietary data were used to assess dietary quality or patterns, whereas close to half assessed ≤5 dietary components. A variety of dietary assessment tools are used in Canadian research. Strategies to improve the application of current evidence on best practices in dietary assessment have the potential to support a stronger and more cohesive literature on diet and health. Such strategies could benefit from national and global collaboration.
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Affiliation(s)
- Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;
| | - Lana Vanderlee
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada;
| | - Amanda Raffoul
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Ilona Csizmadi
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada;,Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | | | - Paula J Robson
- Cancer Measurement, Outcomes, Research, and Evaluation (C-MORE), Alberta Health Services Cancer Control, Edmonton, Alberta, Canada
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Previdelli AN, Goulart RMM, Aquino RDCD. Balanço de macronutrientes na dieta de idosos brasileiros: análises da Pesquisa Nacional de Alimentação 2008-2009. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 20:70-80. [DOI: 10.1590/1980-5497201700010006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 09/01/2016] [Indexed: 01/16/2023] Open
Abstract
RESUMO: Objetivo: Analisar a contribuição de proteína, lipídio e carboidrato no total de energia da dieta de idosos das diferentes regiões brasileiras. Métodos: Foram analisados dados de 4.286 idosos (60 a 104 anos) provenientes da Pesquisa de Orçamentos Familiares 2008/2009. Baseado no consumo obtido por dois registros alimentares, o programa Multiple Source Method estimou o consumo habitual de macronutrientes e gordura saturada. As recomendações do Institute of Medicine (IOM), segundo os Acceptable Macronutrient Distribution Ranges (AMDR), foram utilizadas para avaliar a participação relativa dos macronutrientes de acordo com percentual energético (PE). Modelos de regressão linear identificaram diferenças entre PE dos macronutrientes, situação do domicílio, macrorregiões e gênero. Resultados: A proteína foi o macronutriente que apresentou maior concordância com o AMDR (99,8%). Com relação ao PE lipídico, observou-se que 9,2% da população ficaram acima da recomendação, sendo o dobro do encontrado para carboidrato (4,9%) e nove vezes o percentual de idosos, cujo PE-proteico (1,0%) foi acima do recomendado. Em 14,5% dos idosos a ingestão de carboidratos foi abaixo da AMDR, sendo que essas dietas apresentaram maior PE lipídico (β = 8,19; p < 0,001), revelando que 50% dos idosos que consumiam carboidratos abaixo do PE recomendado apresentou um consumo excessivo de lipídio. Segundo macrorregiões, o Centro-Oeste foi o único a apresentar diferença para carboidrato, sendo esta de menor percentual (51,6%; p < 0,05). A região Sul (17,9%; p < 0,01) apresentou o menor PE proteico e o maior de lipídios (28,7%; p < 0,01). Conclusões: A elevada frequência de inadequação da ingestão de lipídio pode significar uma pior qualidade da dieta, contribuindo com o aumento no risco de desenvolvimento de doenças crônicas.
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Johansson L, Fouque D, Bellizzi V, Chauveau P, Kolko A, Molina P, Sezer S, ter Wee PM, Teta D, Carrero JJ. As we grow old: nutritional considerations for older patients on dialysis. Nephrol Dial Transplant 2016; 32:1127-1136. [DOI: 10.1093/ndt/gfw201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Growing older with health and vitality: a nexus of physical activity, exercise and nutrition. Biogerontology 2016; 17:529-46. [PMID: 26878863 PMCID: PMC4889705 DOI: 10.1007/s10522-016-9637-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/02/2016] [Indexed: 02/07/2023]
Abstract
The preservation of skeletal muscle mass and strength with advancing age are, we propose, critical aspects of ageing with health and vitality. Physical inactivity and poor nutrition are known to accelerate the gradual age-related decline in muscle mass and strength—sarcopenia—however, both are subject to modification. The main purpose of this review is to present the latest, evidence-based recommendations for physical activity and exercise, as well as diet for older adults that would help in preserving muscle mass and strength. We take the position that future physical activity/exercise guidelines need to make specific reference to resistance exercise and highlight the benefits of higher-intensity aerobic exercise training, alongside advocating older adults perform aerobic-based physical activity and household tasks (e.g., carrying groceries). In terms of dietary recommendations, greater emphasis should be placed on optimal rather than minimum protein intakes for older adults. Indeed, guidelines that endorse a daily protein intake of 1.2–1.5 g/kg BM/day, which are levels 50–90 % greater than the current protein Recommendation Dietary Allowance (0.8 g/kg BM/day), are likely to help preserve muscle mass and strength and are safe for healthy older adults. Being cognisant of factors (e.g., reduced appetite) that may preclude older adults from increasing their total daily protein intake, we echo the viewpoint of other active researchers in advocating that protein recommendations for older adults be based on a per meal approach in order to maximize muscle protein synthesis (MPS). On this basis, assuming three meals are consumed daily, a protein dose of 0.4–0.5 g/kg BM should be contained in each meal. We are beginning to understand ways in which to increase the utilization of ingested protein for the stimulation of MPS, namely by increasing the proportion of leucine contained in a given dose of protein, co-ingesting other nutrients (e.g., carbohydrate and fat or supplementation with n-3 polyunsaturated fatty acids) or being physically active prior to protein intake. Clearly, developing simple lifestyle interventions targeted at preserving muscle mass and strength with advancing age is crucial for facilitating longer, healthier lives into older age.
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Shatenstein B, Kergoat MJ, Reid I. Outcome of a Targeted Nutritional Intervention Among Older Adults With Early-Stage Alzheimer's Disease: The Nutrition Intervention Study. J Appl Gerontol 2016; 36:782-807. [PMID: 26912730 DOI: 10.1177/0733464816628512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 6-month dietary intervention program was designed for community-dwelling older adults with Alzheimer's disease. Sixty-seven persons aged 70 years and above were recruited with their caregivers from six hospital memory and geriatric outpatient clinics, and allocated to intervention ( n = 34 dyads) or control group ( n = 33 dyads). Usual diet was assessed by a validated food frequency questionnaire and current diet by two nonconsecutive diet recalls or records corroborated by caregivers, at recruitment (T1) and exit from the study (T2). Intervention participants received targeted dietary recommendations; control participants received Canada's Food Guide leaflets. The program was assessed using paired and independent t tests and nonparametric statistics. Fat intakes increased at T2 within intervention participants (54 ± 16 vs. 67 ± 23 g, p = .013), and there was a tendency for higher energy, protein, and calcium intakes at T2 within this group. Proportions with adequate protein intakes almost doubled from T1 to T2 in intervention group women ( p = .028) but decreased in female controls ( p = .030). Longer follow-up is necessary to determine persistence of benefits.
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Affiliation(s)
- Bryna Shatenstein
- 1 Département de nutrition, Université de Montréal, Québec, Canada.,2 Centre de recherchr, Institut universitaire de gériatrie de Montréal, Québec, Canada
| | - Marie-Jeanne Kergoat
- 1 Département de nutrition, Université de Montréal, Québec, Canada.,2 Centre de recherchr, Institut universitaire de gériatrie de Montréal, Québec, Canada
| | - Isabelle Reid
- 2 Centre de recherchr, Institut universitaire de gériatrie de Montréal, Québec, Canada
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Energy and protein intakes and their association with a decline in functional capacity among diabetic older adults from the NuAge cohort. Eur J Nutr 2015; 55:1729-39. [DOI: 10.1007/s00394-015-0991-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 07/03/2015] [Indexed: 12/25/2022]
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Phillips SM. Nutritional supplements in support of resistance exercise to counter age-related sarcopenia. Adv Nutr 2015; 6:452-60. [PMID: 26178029 PMCID: PMC4496741 DOI: 10.3945/an.115.008367] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Age-related sarcopenia, composed of myopenia (a decline in muscle mass) and dynapenia (a decline in muscle strength), can compromise physical function, increase risk of disability, and lower quality of life in older adults. There are no available pharmaceutical treatments for this condition, but evidence shows resistance training (RT) is a viable and relatively low-cost treatment with an exceptionally positive side effect profile. Further evidence suggests that RT-induced increases in muscle mass, strength, and function can be enhanced by certain foods, nutrients, or nutritional supplements. This brief review focuses on adjunctive nutritional strategies, which have a reasonable evidence base, to enhance RT-induced gains in outcomes relevant to sarcopenia and to reducing risk of functional declines.
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Pietro K. Optimizing Protein in the Older Adult. Am J Lifestyle Med 2015. [DOI: 10.1177/1559827615578827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aging is associated with specific physiological changes. One change that influences the functionality of an individual is the decrease in skeletal muscle. Research efforts to maintain skeletal muscle through dietary modifications have primarily focused on protein intake, including composition, quantity, and timing. Evidence demonstrates that adequacy, quality, and balance of protein intake are important; however, it should not replace the other dietary needs of the individual. The purpose of this article is to summarize the vast area of research regarding protein consumption in the aging population and place it in context of other nutritional concerns that affect this demographic. Efforts to educate older adults without providing overcomplicated guidelines will reduce the likelihood of individuals feeling overwhelmed, increasing dietary adherence.
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Affiliation(s)
- Kevin Pietro
- University of New Hampshire, Durham, New Hampshire
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Abstract
PURPOSE OF REVIEW We provide an update on the recent advances in nutrition research regarding the role of protein intake in the development and treatment of sarcopenia of aging. RECENT FINDINGS Specific muscle mass, strength and function cut-points for the diagnosis of sarcopenia have been identified. There is mounting evidence, as highlighted by multiple consensus statements, that the Recommended Dietary Allowance (0.8 g/kg body weight) may be inadequate to promote optimal health in older adults. Recent research indicates that in addition to total daily protein intake the timing of protein intake is also important to best stimulate muscle protein synthesis, and maintain muscle mass and function in older adults. SUMMARY Recent evidence suggests that the Recommended Dietary Allowance for protein is inadequate, and that the timing and distribution of protein consumption throughout daily meals may be as important as the total quantity. Research has continued to advance our understanding of protein's effects on muscle metabolism; however, there remains a need for large, long-term, randomized clinical trials examining whether the positive effects of dietary protein on muscle metabolism seen in acute studies will translate over the long term into gains of muscle mass, function, and the overall health of older adults.
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Affiliation(s)
- Rachel R. Deer
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
- Department of Nutrition and Metabolism, University of Texas Medical Branch, Galveston, TX
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Baker JF, Cannon GW, Ibrahim S, Haroldsen C, Caplan L, Mikuls TR. Predictors of longterm changes in body mass index in rheumatoid arthritis. J Rheumatol 2015; 42:920-7. [PMID: 25834210 DOI: 10.3899/jrheum.141363] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Low body mass index (BMI) is a risk factor for poor longterm outcomes in rheumatoid arthritis (RA). The purpose of this study was to identify factors associated with longterm changes in BMI. METHODS Subjects with RA from the Veterans Affairs (VA) Rheumatoid Arthritis (VARA) Registry (n = 1474) were studied. Information on inflammatory markers, presence of erosions, and smoking status were extracted from the VARA database. BMI was extracted from VA electronic medical records within 14 days of each visit date. VA pharmacy records were queried to identify prescriptions for specific RA therapies within 1 month of the visit date. We used robust generalized estimating equations marginal regression models to calculate independent associations between clinical variables and BMI over time. Similar models determined predictors of change in weight and risk of weight loss over the subsequent study observation period. RESULTS Increasing age, active smoking, and the presence of erosions at baseline were associated with lower BMI. Weight decreased over time among older adults. Factors associated with greater reductions in BMI over time and a greater risk of weight loss were higher inflammatory markers, smoking, older age, higher BMI, and less subsequent improvement in inflammation. Methotrexate use was associated with a lower risk of weight loss. The use of prednisone or anti-tumor necrosis factor therapies was not associated with change in BMI or the risk of weight loss independent of other factors. CONCLUSION Greater age, greater inflammatory activity, and active smoking are associated with greater weight loss in RA over time.
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Affiliation(s)
- Joshua F Baker
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center.
| | - Grant W Cannon
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Said Ibrahim
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Candace Haroldsen
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Liron Caplan
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
| | - Ted R Mikuls
- From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Salt Lake City VA Medical Center and University of Utah, Salt Lake City, Utah; Department of Medicine, Denver VA Medical Center, Denver, Colorado; Department of Medicine, Nebraska-Western Iowa VA Medical Center, Omaha, Nebraska, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; G.W. Cannon, MD, Salt Lake City VA Medical Center and University of Utah; S. Ibrahim, MD, MPH, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania; C. Haroldsen, MSPH, Salt Lake City VA Medical Center and University of Utah; L. Caplan, MD, PhD, Department of Medicine, Denver VA Medical Center; T.R. Mikuls, MD, MSPH, Department of Medicine, Nebraska-Western Iowa VA Medical Center
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Devries MC, Phillips SM. Supplemental Protein in Support of Muscle Mass and Health: Advantage Whey. J Food Sci 2015; 80 Suppl 1:A8-A15. [DOI: 10.1111/1750-3841.12802] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/01/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Michaela C. Devries
- Exercise Metabolism Research Group (EMRG); Dept. of Kinesiology; McMaster Univ; 1280 Main St. W, IWC E210 Hamilton ON L8S 4K1 Canada
| | - Stuart M. Phillips
- Exercise Metabolism Research Group (EMRG); Dept. of Kinesiology; McMaster Univ; 1280 Main St. W, IWC E210 Hamilton ON L8S 4K1 Canada
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Deutz NEP, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznariç Z, Nair KS, Singer P, Teta D, Tipton K, Calder PC. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 2014; 33:929-36. [PMID: 24814383 DOI: 10.1016/j.clnu.2014.04.007] [Citation(s) in RCA: 951] [Impact Index Per Article: 95.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 12/12/2022]
Abstract
The aging process is associated with gradual and progressive loss of muscle mass along with lowered strength and physical endurance. This condition, sarcopenia, has been widely observed with aging in sedentary adults. Regular aerobic and resistance exercise programs have been shown to counteract most aspects of sarcopenia. In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function. With the goal of providing recommendations for health care professionals to help older adults sustain muscle strength and function into older age, the European Society for Clinical Nutrition and Metabolism (ESPEN) hosted a Workshop on Protein Requirements in the Elderly, held in Dubrovnik on November 24 and 25, 2013. Based on the evidence presented and discussed, the following recommendations are made (a) for healthy older people, the diet should provide at least 1.0-1.2 g protein/kg body weight/day, (b) for older people who are malnourished or at risk of malnutrition because they have acute or chronic illness, the diet should provide 1.2-1.5 g protein/kg body weight/day, with even higher intake for individuals with severe illness or injury, and (c) daily physical activity or exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.
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Affiliation(s)
- Nicolaas E P Deutz
- Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
| | - Jürgen M Bauer
- Department of Geriatric Medicine, Carl von Ossietzky University, Klinikum, Oldenburg, Germany
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy
| | - Yves Boirie
- Université d'Auvergne, INRA, CRNH, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Anja Bosy-Westphal
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart, Germany
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Sweden; Department of Geriatric Medicine, Uppsala University Hospital, Sweden
| | | | - Zeljko Krznariç
- Department of Clinical Nutrition, University Hospital Center and School of Medicine, Zagreb, Croatia
| | | | - Pierre Singer
- Department of Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Daniel Teta
- Centre Hospitalier Universitaire Vaudois, Service de Néphrologie, Lausanne, Switzerland
| | - Kevin Tipton
- Health and Exercise Sciences Research Group, University of Stirling, Stirling, Scotland
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
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