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Blondal BS, Geirsdottir OG, Beck AM, Halldorsson TI, Jonsson PV, Sveinsdottir K, Ramel A. HOMEFOOD randomized trial-beneficial effects of 6-month nutrition therapy on body weight and physical function in older adults at risk for malnutrition after hospital discharge. Eur J Clin Nutr 2023; 77:45-54. [PMID: 36028775 PMCID: PMC9876791 DOI: 10.1038/s41430-022-01195-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 07/21/2022] [Accepted: 08/03/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND/OBJECTIVES Malnutrition is common among older adults. Dietary intervention studies in older adults aiming to improve anthropometrics measures and physical function have been inconsistent. We aimed to investigate the effects of nutrition therapy in combination with home delivered meals and oral nutritional supplements (ONS) in community-dwelling older adults discharged from hospital. METHODS A total of 106 participants (>65 years) were randomized into the intervention group (n = 53) and into the control group (n = 53). The intervention group received individual nutrition therapy (five in person visits and three phone calls) and freely delivered energy- and protein- rich foods, while the control group received standard care. Dietary intake, anthropometrics, and short physical performance battery (SPPB) were assessed at baseline and at endpoint. RESULTS Energy intake at baseline was similar in both groups (~1500 kcal at the hospital) but there was a significant increase in energy intake and body weight in the intervention group (+919 kcal/day and 1.7 kg, P < 0.001 in both cases) during the study period, compared to a significant decrease in both measures among controls (-815 kcal/day and -3.5 kg, P < 0.001 in both cases). SPPB score increased significantly in the intervention group while no changes were observed among controls. CONCLUSIONS Most Icelandic older adults experience substantial weight loss after hospital discharge when receiving current standard care. However, a 6-month multi-component nutrition therapy, provided by a clinical nutritionist in combination with freely delivered supplemental energy- and protein-dense foods has beneficial effects on body weight, physical function, and nutritional status. STUDY REGISTRATION This study was registered at ClinicalTrials.gov ( NCT03995303 ).
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Affiliation(s)
- B S Blondal
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland.
| | - O G Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - A M Beck
- University College Copenhagen, Institute of Nursing and Nutrition, Sigurdsgade 26, 2200, Copenhagen, Denmark
- The Dietetic and Nutritional Research Unit, EFFECT, Herlev and Gentofte University Hospital, Borgmester Ib Juuls Vej 50, 2730, Herlev, Denmark
| | - T I Halldorsson
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - P V Jonsson
- The Icelandic Gerontological Research Institute, Tungata 26, 101, Reykjavik, Iceland
- Faculty of Medicine, School of Health, University of Iceland, Reykjavík, Iceland
- Department of Geriatrics, The National University Hospital of Iceland, Reykjavík, Iceland
| | | | - A Ramel
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
- Matís ohf, Vinlandsleið 12, 113, Reykjavik, Iceland
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Blondal BS, Geirsdottir OG, Halldorsson TI, Beck AM, Jonsson PV, Ramel A. HOMEFOOD Randomised Trial - Six-Month Nutrition Therapy in Discharged Older Adults Reduces Hospital Readmissions and Length of Stay at Hospital Up to 18 Months of Follow-Up. J Nutr Health Aging 2023; 27:632-640. [PMID: 37702336 DOI: 10.1007/s12603-023-1962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/29/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Malnutrition is frequently observed in older adults and is associated with hospital readmissions, length of stay (LOS), and mortality in discharged patients. OBJECTIVE The aim of this study was to investigate effects of six-month nutrition therapy on hospital readmissions, LOS, mortality and need for long-term care residence 1-, 6-, 12- and 18-months post-discharge in older Icelandic adults. DESIGN Secondary analysis of a randomized controlled trial. PARTICIPANTS Participants (>65 years) were randomised into intervention (n=53) and control (n=53) before discharge from a geriatric unit. INTERVENTION The intervention group received nutrition therapy based on the Nutrition Care Process, including home visits, phone calls, freely delivered energy- and protein-rich foods and supplements for six months after hospital discharge. MEASUREMENTS The Icelandic electronic hospital registry was accessed to gain information on emergency room visits (ER), hospital readmissions, LOS, mortality and need for long-term care residence. RESULTS The intervention group had a lower proportion of participants with at least one readmission compared to control (1 month: 1.9% vs 15.8%, P=0.033; 6 months: 25.0% vs 46.2%, P=0.021; 12 months: 38.5% vs 55.8%, P=0.051; and 18 months: 51.9% vs 65.4%, P=0.107). There was also a lower total number of readmissions per participant (1 month: 0.02 vs 0.19, P=0.015; 6 month: 0.33 vs 0.77, P=0.014; 0.62 vs 1.12, P=0.044) and a shorter LOS (1 month: 0.02 vs 0.92, P=0.013; 6 months: 2.44 vs 13.21; P=0.006; 12 months: 5.83 vs 19.40, P=0.034; 18 months: 10.42 vs 26.00, P=0.033) in the intervention group. However, there were no differences between groups in ER visits, mortality and need for long-term care residence. CONCLUSION A six-month nutrition therapy in older Icelandic adults discharged from hospital reduced hospital readmissions and shortens LOS at the hospital up to 18-months post-discharge. However, it did neither affect mortality, ER, nor need of long-term care residence in this group.
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Affiliation(s)
- B S Blondal
- Berglind Soffia Blondal, Faculty of Food Science and Nutrition, University of Iceland, Aragata 14, 101 Reykjavik, Iceland, Telephone: +354 842 0242,
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Chang M, Geirsdottir OG, Eymundsdottir H, Thorsdottir I, Jonsson PV, Ramel A. Association between baseline handgrip strength and cognitive function assessed before and after a 12-week resistance exercise intervention among community-living older adults. Aging and Health Research 2022. [DOI: 10.1016/j.ahr.2022.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Chang M, Geirsdottir OG, Launer LJ, Gudnasson V, Visser M, Gunnarsdottir I. A poor appetite or ability to eat and its association with physical function amongst community-dwelling older adults: age, gene/environment susceptibility-Reykjavik study. Eur J Ageing 2021; 18:405-415. [PMID: 34483804 PMCID: PMC8377134 DOI: 10.1007/s10433-020-00588-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 12/25/2022] Open
Abstract
A poor appetite or ability to eat and its association with physical function have not been explored considerably amongst community-dwelling older adults. The current study examined whether having an illness or physical condition affecting one's appetite or ability to eat is associated with body composition, muscle strength, or physical function amongst community-dwelling older adults. This is a secondary analysis of cross-sectional data from the age, gene/environment susceptibility-Reykjavik study (n = 5764). Illnesses or physical conditions affecting one's appetite or ability to eat, activities of daily living, current level of physical activity, and smoking habits were assessed with a questionnaire. Fat mass, fat-free mass, body mass index, knee extension strength, and grip strength were measured, and the 6-m walk test and timed up-and-go test were administered. Individuals who reported illnesses or physical conditions affecting their appetite or ability to eat were considered to have a poor appetite. The associations of appetite or the ability to eat with body composition and physical function were analysed with stepwise linear regression models. A total of 804 (14%) individuals reported having conditions affecting their appetite or ability to eat and had a significantly lower fat-free mass and body mass index, less grip strength, and poorer physical function than did those without any conditions affecting their appetite or ability to eat. Although the factors reported to affect one's appetite or ability to eat are seldom considered severe, their strong associations with physical function suggest that any condition affecting one's appetite or ability to eat requires attention.
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Affiliation(s)
- Milan Chang
- The Icelandic Gerontological Research Center, Landspitali University Hospital and University of Iceland, Reykjavík, Iceland.,Sport Science, School of Science and Engineering, Reykjavik University, Reykjavík, Iceland
| | - Olof G Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavík, Iceland.,Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavík, Iceland
| | - Lenore J Launer
- Epidemiology and Pop Science Lab, National Institute on Aging, National Institute of Health, Bethesda, MD USA
| | - Vilmundur Gudnasson
- Icelandic Heart Association, Kopavogur, Reykjavík, Iceland.,Faculty of Medicine, School of Health Science, University of Iceland, Reykjavík, Iceland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingibjorg Gunnarsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavík, Iceland.,Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavík, Iceland
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Eymundsdottir H, Ramel A, Geirsdottir OG, Skuladottir SS, Gudmundsson LS, Jonsson PV, Gudnason V, Launer L, Jonsdottir MK, Chang M. Body weight changes and longitudinal associations with cognitive decline among community-dwelling older adults. Alzheimers Dement (Amst) 2021; 13:e12163. [PMID: 33665348 PMCID: PMC7896555 DOI: 10.1002/dad2.12163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION We aim to investigate the longitudinal associations between changes in body weight (BW) and declines in cognitive function and risk of mild cognitive impairment (MCI)/dementia among cognitively normal individuals 65 years or older. METHODS Data from the Age Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik Study) including 2620 participants, were examined using multiple logistic regression models. Cognitive function included speed of processing (SP), executive function (EF), and memory function (MF). Changes in BW were classified as; weight loss (WL), weight gain (WG), and stable weight (SW). RESULTS Mean follow-up time was 5.2 years and 61.3% were stable weight. Participants who experienced WL (13.4%) were significantly more likely to have declines in MF and SP compared to the SW group. Weight changes were not associated with EF. WL was associated with a higher risk of MCI, while WG (25.3%) was associated with a higher dementia risk, when compared to SW. DISCUSSION Significant BW changes in older adulthood may indicate impending changes in cognitive function.
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Affiliation(s)
- Hrafnhildur Eymundsdottir
- Food Science and NutritionUniversity of IcelandReykjavikIceland
- The Icelandic Gerontological Research Centerthe National University Hospital of IcelandReykjavikIceland
| | - Alfons Ramel
- Food Science and NutritionUniversity of IcelandReykjavikIceland
- The Icelandic Gerontological Research Centerthe National University Hospital of IcelandReykjavikIceland
| | - Olof G. Geirsdottir
- Food Science and NutritionUniversity of IcelandReykjavikIceland
- The Icelandic Gerontological Research Centerthe National University Hospital of IcelandReykjavikIceland
| | - Sigrun S. Skuladottir
- Food Science and NutritionUniversity of IcelandReykjavikIceland
- The Icelandic Gerontological Research Centerthe National University Hospital of IcelandReykjavikIceland
| | | | - Palmi V. Jonsson
- The Icelandic Gerontological Research Centerthe National University Hospital of IcelandReykjavikIceland
- MedicineUniversity of IcelandReykjavikIceland
- Department of Geriatricsthe National University Hospital of IcelandReykjavikIceland
| | - Vilmundur Gudnason
- MedicineUniversity of IcelandReykjavikIceland
- Icelandic Heart AssociationKopavogurIceland
| | - Lenore Launer
- Laboratory of Epidemiology and Population SciencesNational Institute on AgingNational Institutes of HealthBethesdaMarylandUSA
| | - Maria K. Jonsdottir
- Department of PsychologyReykjavik UniversityReykjavikIceland
- Mental Health ServicesLandspitali–The National University Hospital of IcelandIceland
| | - Milan Chang
- The Icelandic Gerontological Research Centerthe National University Hospital of IcelandReykjavikIceland
- Health PromotionSport, and Leisure StudiesSchool of EducationUniversity of IcelandReykjavikIceland
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Elidottir AS, Sveinsdottir K, Ingadottir B, Geirsdottir OG, Jonsson PV, Rothenberg E, Hardardottir I, Freysdottir J, Ramel A. Seaweed Extract Improves Carbohydrate Metabolism in Overweight and Obese Adults. CNF 2021. [DOI: 10.2174/1573401316999200706012619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Background: Obesity is characterized by chronic low-grade inflammation and associated
with type 2 diabetes. Seaweed is one of the largest producers of biomass in the marine environment
and is a rich arsenal of functional ingredients that may possess the potential to prevent type 2 diabetes.
Objective:
The aim was to investigate the effects of seaweed extract on glucose metabolism and
markers of inflammation in overweight and obese individuals.
Methods:
Participants (N=76, ≥40 years, body mass index ≥25 kg/m2) who volunteered for this 10-
week randomized, controlled, doubly blinded intervention study, were randomized into an intervention
group (seaweed extract, 3 capsules=1200 mg/day) or a control group (placebo, 3 capsules/day).
The extract derived from the brown seaweed bladder wrack (Fucus vesiculosus). At baseline and
endpoint of the study, fasting samples were analysed for blood glucose, insulin, inflammation markers,
liver enzymes and creatinine (renal function).
Results:
Drop out was 11.8% and not significantly different between groups. Fasting blood glucose
and insulin were improved at the endpoint in the intervention group, but no changes were observed in
the control group (corrected endpoint differences between groups: glucose=0.61 mmol/L, P=0.038;
insulin=0.72 μU/L, P=0.038). Measures of inflammation, liver enzymes and renal function did not
change significantly during the study.
Conclusion:
Ingestion of seaweed extract over 10 weeks improves glucose metabolism without affecting
measures of inflammation, liver function or renal function.
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Affiliation(s)
- Anita S. Elidottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | | | - Olof G. Geirsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Palmi V. Jonsson
- The Icelandic Gerontological Research Institute, Reykjavik, Iceland
| | - Elisabeth Rothenberg
- Department of Food and Meal Science, Kristianstad University, kristianstad, Sweden
| | | | - Jona Freysdottir
- Department of Immunology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Alfons Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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Eymundsdottir H, Chang M, Geirsdottir OG, Gudmundsson LS, Jonsson PV, Gudnason V, Launer L, Jonsdottir MK, Ramel A. Lifestyle and 25-hydroxy-vitamin D among community-dwelling old adults with dementia, mild cognitive impairment, or normal cognitive function. Aging Clin Exp Res 2020; 32:2649-2656. [PMID: 32248358 DOI: 10.1007/s40520-020-01531-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 01/22/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Several studies have indicated that older adults with cognitive impairment have a poorer lifestyle than their healthy peers including lower 25-hydroxy-vitamin D levels (25OHD). AIM To investigate the associations between lifestyle and 25OHD depending on cognitive status among old adults. METHODS Community-dwelling old adults (65-96 years) participated in this cross-sectional study based on the Age-Gene/Environment-Susceptibility-Reykjavik-Study. The analytical sample included 5162 subjects who were stratified by cognitive status, i.e., dementia (n = 307), mild cognitive impairment (MCI, n = 492), and normal cognitive status (NCS, n = 4363). Lifestyle variables were assessed and 25OHD was measured. The associations between lifestyle and 25OHD were calculated using linear models correcting for potential confounders. RESULTS According to linear regression models, 25OHD was significantly lower in older people with dementia (53.8 ± 19.6 nmol/L) than in NCS participants (57.6 ± 17.7 nmol/L). Cod liver oil (7.1-9.2 nmol/L, P < 0.001) and dietary supplements (4.4-11.5 nmol/L, P < 0.001) were associated with higher 25OHD in all three groups. However, physical activity ≥ 3 h/week (2.82 nmol/L, P < 0.001), BMI < 30 kg/m2 (5.2 nmol/L, P < 0.001), non-smoking (4.8 nmol/L, P < 0.001), alcohol consumption (2.7 nmol/L, P < 0.001), and fatty fish consumption ≥ 3x/week (2.6 nmol/L, P < 0.001) were related to higher 25OHD in NCS only, but not in participants with dementia or MCI. DISCUSSION Older people living in Iceland with dementia are at higher risk for 25OHD deficiency when compared to healthy individuals. Physical activity reported among participants with dementia, and MCI is low and is not significantly associated with 25OHD. CONCLUSIONS Lifestyle factors among NCS participants are associated with 25OHD levels. Importantly, healthy lifestyle should be promoted among individuals with MCI and dementia.
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Affiliation(s)
- Hrafnhildur Eymundsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavík, Iceland.
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavík, Iceland.
| | - M Chang
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavík, Iceland
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Reykjavík, Iceland
| | - O G Geirsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavík, Iceland
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavík, Iceland
| | - L S Gudmundsson
- Faculty of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - P V Jonsson
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Geriatrics, The National University Hospital of Iceland, Reykjavík, Iceland
| | - V Gudnason
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Icelandic Heart Association, Kópavogur, Iceland
| | - L Launer
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health (NIH), Bethesda, MD, USA
| | - M K Jonsdottir
- Department of Psychology, Reykjavik University, Reykjavík, Iceland
- Mental Health Services (Memory Clinic) Landspitali-The National University Hospital of Iceland, Reykjavík, Iceland
| | - A Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavík, Iceland
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavík, Iceland
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Chang M, Geirsdottir OG, Sigurdarsdottir SH, Kåreholt I, Ramel A. Associations between education and need for care among community dwelling older adults in Iceland. Scand J Caring Sci 2019; 33:885-891. [PMID: 31058338 DOI: 10.1111/scs.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Older adults in Iceland have good access to social services that support them in maintaining an independent life, although receiving informal care is common for community living older adults in Iceland. The aim of this study was to examine whether the need for care as well as receiving formal and informal care is associated with education among older adults in Iceland. METHODS Among a national sample of 782 Icelandic community dwelling old adults (mean age 76.9 ± 7.4 years, 55% women), a telephone survey was conducted. The survey included questions on: socioeconomic status, social network, health status, activities of daily living and formal/informal care. RESULTS A full data set was available for 720 subjects and among these, 349 (48.5%) had no need for care, 197 (27.4%) received informal care only, 31 (4.3%) received formal care only, and 143 (19.9%) received both type of care. Participants with higher education were significantly less likely to need care (OR 0.67, 95% CI, 0.47-0.97, p = 0.031) when compared with those who had primary education. Categorisation by age showed that this difference was only significant in participants younger than 80 years. Education was not related to formal care, but adults with higher education were less likely to receive informal care compared with older adults who had primary education (OR: 0.65, 95%CI: 0.46, 0.93, p = 0.018). CONCLUSIONS People with higher education were significantly less likely to need care and this association was mainly present among those aged below 80 years. Further, in participants that needed care, the likelihood of receiving informal care was lower in highly educated participants, but no differences in formal care were observed between educational levels.
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Affiliation(s)
- Milan Chang
- Faculty of Health Promotion, Sports and Leisure Studies, School of Education, University of Iceland, Reykjavik, Iceland.,The Icelandic Gerontological Research Institute, National University Hospital of Iceland & Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Olof G Geirsdottir
- The Icelandic Gerontological Research Institute, National University Hospital of Iceland & Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Unit for Nutrition Research, National University Hospital of Iceland & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Ingemar Kåreholt
- Institute of Gerontology and Aging Research Network, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Alfons Ramel
- The Icelandic Gerontological Research Institute, National University Hospital of Iceland & Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Unit for Nutrition Research, National University Hospital of Iceland & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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Abstract
OBJECTIVES C-reactive protein (CRP), an acute phase reactant, has been associated with atherosclerosis and has also been discussed as a target for intervention. The effects of resistance exercise on CRP are currently not clear. The present analysis investigated the response of CRP to resistance exercise in old adults. DESIGN Intervention study. SETTING Community. PARTICIPANTS Old Icelandic adults (N = 235, 73.7 ± 5.7 years, 58.2% female). INTERVENTION Twelve-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80% of the 1-repetition maximum) designed to increase strength and muscle mass of major muscle groups. MEASUREMENTS C-reactive protein (CRP). RESULTS Mean CRP levels were 7.1 ± 4.6 mg/dL at baseline, thirty-six (15.6%) subjects had abnormally high CRP (>10 mg/L) values at baseline. After the resistance exercise program the overall changes in CRP were minor and not significant. However, CRP decreased considerably in participants with high CRP at baseline (-4.28 ± 9.41 mg/L; P = 0.015) but increased slightly in participants with normal CRP (0.81 ± 4.58 mg/L, P = 0.021). CONCLUSIONS Our study shows that the concentrations of circulating CRP decreased considerably after a 12-week resistance exercise program in participants with abnormally high CRP at baseline, possibly reducing thus risk for future disease. CRP changed little in participants with normal CRP at the start of the study.
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Affiliation(s)
- A Ramel
- Alfons Ramel, Unit for Nutrition Research, Eiriksgata 29, 101 Reykjavik, Iceland, Telephone: +354 543 8410, Fax: +354 543 4824,
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Arnarson A, Ramel A, Geirsdottir OG, Jonsson PV, Thorsdottir I. Changes in body composition and use of blood cholesterol lowering drugs predict changes in blood lipids during 12 weeks of resistance exercise training in old adults. Aging Clin Exp Res 2014; 26:287-92. [PMID: 24293371 DOI: 10.1007/s40520-013-0172-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 11/12/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE Aging is associated with an impairment of blood lipids. The present study investigated the response of blood lipids to resistance exercise in old adults. The particular aim was to investigate whether the response of blood lipids is associated with changes in body composition of blood lipid medication. METHODS Subjects (N = 236, 73.7 ± 5.7 years, 58.2 % female) participated in a 12-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80 % of the 1-repetition maximum), designed to increase strength and muscle mass of major muscle groups. Body composition, drug use, triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were assessed at baseline and endpoint. RESULTS The concentrations of HDL (-6 mg/dl), LDL (-18 mg/dl), TC (-26 mg/dl) and TG (-12 mg/g) decreased significantly during the study period. A reduction in fat mass by 1 kg predicted a reduction in TG (5.0 mg/dl, P = 0.017) and a gain in lean body mass by 1 kg predicted also a reduction in TG (-4.5 mg/dl, P = 0.023). The use of blood cholesterol lowering drugs predicted greater reductions in TC (-16.9 mg/dl, P = 0.032) and LDL (-11.8 mg/dl, P = 0.038) during training. CONCLUSIONS TG, TC, LDL and HDL decreased significantly after 12 weeks of progressive resistance exercise in old adults. Changes in body composition, i.e., reduction in fat mass and gain in lean body mass improved the blood lipid profile. Use of blood lipid lowering drugs was associated with greater reductions in TC and LDL after the training.
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Affiliation(s)
- A Arnarson
- Unit for Nutrition Research, Faculty of Food Science and Nutrition, University of Iceland, Eiriksgata 29, IS-101, Reykjavik, Iceland
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Arnarson A, Geirsdottir OG, Ramel A, Briem K, Jonsson PV, Thorsdottir I. Response to ‘Increasing physical activity requires increasing energy intake in elderly’. Eur J Clin Nutr 2013; 67:895. [DOI: 10.1038/ejcn.2013.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Geirsdottir OG, Arnarson A, Ramel A, Jonsson PV, Thorsdottir I. Dietary protein intake is associated with lean body mass in community-dwelling older adults. Nutr Res 2013; 33:608-12. [DOI: 10.1016/j.nutres.2013.05.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 05/21/2013] [Accepted: 05/24/2013] [Indexed: 12/25/2022]
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Ramel A, Arnarson A, Geirsdottir OG, Jonsson PV, Thorsdottir I. Glomerular filtration rate after a 12-wk resistance exercise program with post-exercise protein ingestion in community dwelling elderly. Nutrition 2013; 29:719-23. [PMID: 23317926 DOI: 10.1016/j.nut.2012.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 09/11/2012] [Accepted: 10/11/2012] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Increased protein intake and resistance exercise can be beneficial for maintenance of lean body mass (LBM) in older adults. However, these factors could also negatively affect renal function. We investigated changes in renal function after a 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults. METHODS Patients (N = 237, 73.7 ± 5.7 y, 58.2% female) participated in a 12-wk resistance exercise program (3 times/wk) designed to increase strength and muscle mass of major muscle groups. Participants were randomly assigned to one of three dietary supplements consumed directly after training: whey protein drink (20 g whey protein, 20 g carbohydrates), milk protein drink (20 g milk protein, 20 g carbohydrates), or carbohydrate drink (40 g carbohydrates). Renal function was estimated as glomerular filtration rate (GFR, Cockcroft-Gault formula), and dietary intake was measured as 3-d-weighed food record at baseline and endpoint. RESULTS During the intervention, energy intake did not increase. Carbohydrate intake increased in the carbohydrate group and protein intake increased in the milk group, both approximately in accordance with the supplementation. In the whey group, protein intake did not increase, but carbohydrate intake did. GFR increased after the intervention (+4.4 mL/min/1.73 m2; P < 0.001), and the changes were similar in men and women or in the age quartiles. Changes in GFR at endpoint were not associated with LBM, dietary supplements, or total protein intake. CONCLUSIONS A 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults does not negatively affect GFR. The supplementation had only minor effects on total dietary intake.
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Affiliation(s)
- Alfons Ramel
- Unit for Nutrition Research, National University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
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Geirsdottir OG, Arnarson A, Briem K, Ramel A, Jonsson PV, Thorsdottir I. Effect of 12-week resistance exercise program on body composition, muscle strength, physical function, and glucose metabolism in healthy, insulin-resistant, and diabetic elderly Icelanders. J Gerontol A Biol Sci Med Sci 2012; 67:1259-65. [PMID: 22496538 DOI: 10.1093/gerona/gls096] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Insulin is a stimulator of skeletal muscle protein anabolism and insulin resistance might therefore negatively affect muscle protein metabolism. We investigated muscle mass and physical function before and after a resistance exercise program in participants with prediabetes or type 2 diabetes mellitus (T2DM) in comparison to healthy controls. METHODS This was a secondary analysis of a randomized controlled intervention designed to investigate resistance training among older adults. Glucose metabolism status was not a selection criteria for the trial, and group designation was done retrospectively. Participants (N = 237, 73.7 ± 5.7 y, 58.2% women) participated in a 12-week resistance exercise program (3 times/week; three sets, six to eight repetitions at 75%-80% of the one-repetition maximum), designed to increase strength and muscle mass of major muscle groups. Body composition, muscular strength, timed up and go test, 6-minute walk for distance, and blood chemical variables were measured at baseline and endpoint. RESULTS Participants completing the study (n = 213) experienced significant changes in muscle strength or muscle function, which did not differ significantly between healthy (n = 198), prediabetic (n = 20), and T2DM participants (n = 17). Changes in serum glucose during the intervention differed by group: only glucose improved significantly in the prediabetic group, glucose and triacylglycerol improved significantly in the healthy group, whereas no serum parameter improved significantly in the T2DM group. CONCLUSIONS A 12-week resistance exercise program improves muscle strength and muscle function to a similar extent in healthy, prediabetic, and T2DM elderly people. However, according to our data, T2DM participants do not experience favorable changes in fasting glucose or HbA(1C).
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Affiliation(s)
- O G Geirsdottir
- Unit for Nutrition Research, Eiriksgata 29, Landspitali National University Hospital, IS-101 Reykjavik, Iceland.
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Geirsdottir OG, Arnarson A, Briem K, Ramel A, Tomasson K, Jonsson PV, Thorsdottir I. Physical function predicts improvement in quality of life in elderly Icelanders after 12 weeks of resistance exercise. J Nutr Health Aging 2012; 16:62-6. [PMID: 22238003 DOI: 10.1007/s12603-011-0076-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is known about the effects of resistance training on health related quality of life (HRQL) in the elderly. AIM The main purpose of the study was to investigate the effects of resistance training on strength, body composition, functional capacity and HRQL in independent living elderly people. We hypothesised that resistance training would improve lean mass, muscle strength, physical function and HRQL. METHODS Subjects (N = 237, 73.7±5.7 yrs, 58.2% female) participated in a 12-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80% of the 1-repetition maximum) designed to increase strength and muscle mass of major muscle groups. Body composition, quadriceps- and grip strength, timed up and go test (TUG), six minute walk for distance (6MW) and HRQL were measured at baseline and endpoint. RESULTS Two hundred-and-four participants completed the study. Although the increase in lean mass was small (+0.8 kg, P<0.01), quadriceps strength (+53.5 N), grip strength (+3.0 lb), TUG (-0.6 sec), 6MW (+33.6 m) and HRQL (+1.2 t-score) improved significantly (all P<0.01). Changes in 6MW predicted improvement in HRQL after 12 weeks. CONCLUSIONS Our study shows that a 12-week resistance exercise program significantly improves lean mass, muscle strength, physical function and HRQL in elderly individuals, and that improvements in physical function predict improvements in HRQL. Our study indicates that resistance training should be promoted for the elderly as it has the potential to improve physical performance, thereby prolonging healthy, independent aging.
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Affiliation(s)
- O G Geirsdottir
- Unit for Nutrition Research, National University Hospital of Iceland, Reykjavik, Iceland.
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