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Gupta P, Vu TA, Man REK, Fenwick EK, Tay L, Yee Sien N, Ng D, Frederick KHX, Yong EL, Chew STH, Lamoureux EL. The prevalence patterns and risk factor profiles of poor muscle health and its associated components in multiethnic older Asians: The PIONEER study. J Cachexia Sarcopenia Muscle 2024. [PMID: 38646827 DOI: 10.1002/jcsm.13483] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/30/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND We aim to determine the multiethnic patterns of the prevalence and associated factors of poor muscle health and its associated components in older Chinese, Malays, and Indian Asian adults. METHODS We included 2199 participants (mean age ± SD: 72.9 ± 8.3 years; 54.3% female) from the baseline assessment of the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER; 2017-2022) cohort study. Poor muscle health was defined as the presence of either low muscle mass (DEXA), or low muscle strength (handgrip strength), or low physical performance (gait speed). Its components include poor muscle function (low muscle strength and/or low physical performance without low muscle mass), pre-sarcopenia (low muscle mass only), and any sarcopenia (low muscle mass with low muscle strength and/or low physical performance). Sociodemographic, clinical, and lifestyle factors were assessed using biochemistry, clinical tests, and validated questionnaires. Regression models were utilized to evaluate the independent risk factors of poor muscle health and its components. RESULTS The national census-adjusted prevalence of poor muscle health (88%) was similar across the three ethnic groups. However, Chinese individuals had higher prevalence of pre-sarcopenia and any sarcopenia, and a lower prevalence of poor muscle function compared with Indians or Malays. We observed ethnic differences in modifiable risk factors (low physical activity, diabetes, osteoporosis, and obesity) of poor muscle health and its components. Although obesity was protective of pre-sarcopenia (RRR = 0.19, 95% CI: 0.11, 0.36) and any sarcopenia (RRR = 0.29, 95% CI: 0.18, 0.47) in the overall population and across ethnic groups, it was associated with 1.7 times (95% CI: 1.07, 2.67) the likelihood of poor muscle function in the entire population. CONCLUSIONS Almost 90% of community dwelling Singaporean aged ≥60 years have poor muscle health across the three ethnic groups with ethnic disparities in modifiable risk factors, highlighting an urgent need for community-wide targeted interventions to promote muscle health.
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Affiliation(s)
- Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- The Ophthalmology and Visual Sciences Academic Clinical Programme (EYE ACP), Duke-NUS Medical School, Singapore
| | - Tai-Anh Vu
- The Ophthalmology and Visual Sciences Academic Clinical Programme (EYE ACP), Duke-NUS Medical School, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- The Ophthalmology and Visual Sciences Academic Clinical Programme (EYE ACP), Duke-NUS Medical School, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- The Ophthalmology and Visual Sciences Academic Clinical Programme (EYE ACP), Duke-NUS Medical School, Singapore
| | - Laura Tay
- Department of Geriatric Medicine, Sengkang General Hospital, Singapore
| | - Ng Yee Sien
- Department of Rehabilitation Medicine, Division of Medicine, Singapore General Hospital, Singapore
| | - David Ng
- Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore
| | | | - Eu-Leong Yong
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore
| | - Samuel T H Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore
- SingHealth Duke-NUS Medicine Academic Clinical Programme, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- The Ophthalmology and Visual Sciences Academic Clinical Programme (EYE ACP), Duke-NUS Medical School, Singapore
- The University of Melbourne, Australia
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Peng LN, Lin MH, Tseng SH, Yen KH, Lee HF, Hsiao FY, Chen LK. Protein-enriched soup and weekly exercise improve muscle health: A randomized trial in mid-to-old age with inadequate protein intake. J Cachexia Sarcopenia Muscle 2024. [PMID: 38641937 DOI: 10.1002/jcsm.13481] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/27/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Prior research has highlighted the synergistic impact of protein supplementation on muscle function post-exercise in adults; however, evidence supporting the combined effects were less robust and inconsistent on those with protein insufficiency. This investigation aims to explore efficacy of protein-enriched soup coupled with exercise on muscle health and metabolism in middle-aged and older adults with suboptimal protein intake. METHODS An open-label, 12-week, randomized controlled trial involving participants with insufficient protein intake (<1.0 g/kg/day) was done. The intervention group consumed protein-enriched soup (24-30 g protein daily) and 1-h weekly exercise, while controls received health education. Assessments included laboratory tests, functional assessments, and body composition. RESULTS In this trial, 97 out of 100 randomized participants (mean age: 64.65 ± 4.84 years, 81.8% female) completed the study (47 in intervention group and 50 in control group). Compared results of baselines, at 1 and 3 months of intervention, significant improvements in waist circumference (83.48 ± 10.22 vs. 82.5 ± 9.88 vs. 82.37 ± 9.42 cm, P for trend = 0.046), 6-min walking distance (525.65 ± 58.46 vs. 534.47 ± 51.87 vs. 552.02 ± 57.66 m, P for trend = 0.001), five-time sit-to-stand time (7.63 ± 1.63 vs. 6.81 ± 1.8 vs. 6.4 ± 1.42 s, P for trend <0.001), grip strength (26.74 ± 6.54 vs. 27.53 ± 6.99 vs. 28.52 ± 7.09 kg, P for trend <0.001), and MNA score (26.8 ± 2.14 vs. 27.73 ± 1.74 vs. 27.55 ± 1.72, P for trend <0.001) were discerned within the intervention group. The intervention demonstrated a significant reduction in serum triglyceride (105.32 ± 49.84 vs. 101.36 ± 42.58 vs. 93.43 ± 41.49 mg/dL, P for trend = 0.023), increased HDL-C (60.04 ± 16.21 vs. 60 ± 17.37 vs. 62.55 ± 18.27 mg/dL, P for trend = 0.02), and DHEA-S levels (97.11 ± 54.39 vs. 103.39 ± 56.75 vs. 106.83 ± 60.56 μg/dL, P for trend = 0.002). Serum myostatin did not differ in both groups, but serum leptin levels significantly increased (9118.88 ± 5811.68 vs. 11508.97 ± 7151.08 vs. 11220.80 ± 7190.71 pg/mL, P for trend = 0.016) in controls. The intervention group showed greater improvements in 6 min walking distance (β = 0.71, 95% CI: 6.88 to 40.79, P = 0.006), five-time sit-to-stand test (β = -0.87, 95% CI: -1.59 to -0.15, P = 0.017), MNA score (β = 0.96, 95% CI: 0.20 to 1.71, P = 0.013), serum triglycerides (β = -15.01, 95% CI: -27.83 to -2.20, P = 0.022), LDL-C (β = -9.23, 95% CI: -16.98 to -1.47, P = 0.020), and DHEA-S levels (β = 9.98, 95% CI: 0.45 to 19.51, P = 0.04) than controls. CONCLUSIONS Protein-enriched soup with weekly exercise over 12 weeks significantly improved physical performance, lipid profile, and DHEA-S levels among middle-aged and older adults with inadequate protein intake, while studies assessing long-term benefits of the intervention are needed.
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Affiliation(s)
- Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Sung-Hua Tseng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ko-Han Yen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Huei-Fang Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
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Abstract
The age-related loss of skeletal muscle function starts from midlife and if left unaddressed can lead to an impaired quality of life. A growing body of evidence indicates that mitochondrial dysfunction is causally involved with muscle aging. Muscles are tissues with high metabolic requirements, and contain rich mitochondria supply to support their continual energy needs. Cellular mitochondrial health is maintained by expansing of the mitochondrial pool though mitochondrial biogenesis, by preserving the natural mitochondrial dynamic process, via fusion and fission, and by ensuring the removal of damaged mitochondria through mitophagy. During aging, mitophagy levels decline and negatively impact skeletal muscle performance. Nutritional and pharmacological approaches have been proposed to manage the decline in muscle function due to impaired mitochondria bioenergetics. The natural postbiotic Urolithin A has been shown to promote mitophagy, mitochondrial function and improved muscle function across species in different experimental models and across multiple clinical studies. In this review, we explore the biology of Urolithin A and the clinical evidence of its impact on promoting healthy skeletal muscles during age-associated muscle decline.
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Affiliation(s)
- Julie Faitg
- Amazentis SA, EPFL Innovation Park, 1024, Ecublens, Switzerland.
| | - Davide D'Amico
- Amazentis SA, EPFL Innovation Park, 1024, Ecublens, Switzerland
| | - Chris Rinsch
- Amazentis SA, EPFL Innovation Park, 1024, Ecublens, Switzerland
| | - Anurag Singh
- Amazentis SA, EPFL Innovation Park, 1024, Ecublens, Switzerland.
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Contillo AT, Chun OK, Rodriguez NR. Considerations for a protein-focused screening instrument in clinical nutrition assessment. Clin Nutr ESPEN 2023; 58:111-116. [PMID: 38056993 DOI: 10.1016/j.clnesp.2023.09.915] [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: 02/08/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 12/08/2023]
Abstract
Physiological stress during injury and surgery negatively impacts protein balance and muscle mass maintenance. Adequate perioperative protein intake may attenuate muscle atrophy to maintain and facilitate functional recovery, particularly in older adults; yet, screening tools routinely used in clinical settings do not specifically assess protein intake when assessing nutrition risk. Although assessing malnutrition is a priority, suboptimal protein intake in non-malnourished patients should also be identified given protein's critical role in muscle health. This opinion paper highlights the potential for using a clinically appropriate protein-focused screener for rapid and efficient characterization of protein intake.
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Affiliation(s)
- Allison T Contillo
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT, 06269, USA.
| | - Ock K Chun
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT, 06269, USA.
| | - Nancy R Rodriguez
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT, 06269, USA.
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Song J, Shahsavarani S, Vatsia S, Katz AD, Ngan A, Fallon J, Strigenz A, Seitz M, Silber J, Essig D, Qureshi SA, Virk S. Association between history of lumbar spine surgery and paralumbar muscle health: a propensity score-matched analysis. Spine J 2023; 23:1659-1666. [PMID: 37437696 DOI: 10.1016/j.spinee.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/13/2023] [Accepted: 07/01/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND CONTEXT Prior studies have suggested that muscle strength and quality may be associated with low back pain. Recently, a novel magnetic resonance imaging (MRI)-based lumbar muscle health grade was shown to correlate with health-related quality of life scores after spine surgery. However, the potential association between history of lumbar spine surgery and paralumbar muscle health requires further investigation. PURPOSE To compare MRI-based paralumbar muscle health parameters between patients with versus without a history of surgery for degenerative lumbar spinal disease. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Consecutive series of patients who presented to the spine surgery clinic of a single surgeon. OUTCOME MEASURES MRI-based measurements of paralumbar cross-sectional area (PL-CSA), Goutallier grade, lumbar indentation value (LIV). METHODS A retrospective analysis was performed on a consecutive series of patients of a single surgeon, and patients were included based on availability of lumbar MRI. Axial T2-weighted lumbar MRIs were analyzed for PL-CSA, Goutallier classification, and LIV. Measurements were performed at the center of disc spaces from L1 to L5. Patients with and without history of spine surgery were matched based on age, sex, race, ethnicity, and body mass index (BMI) via propensity score matching. Normality of each muscle health variable was assessed using Kolmogorov-Smirnov test. Mann-Whitney U test or independent t-test performed to compare the matched cohorts, as appropriate. RESULTS A total of 615 patients were assessed. For final analysis, 89 patients with a history of previous spine surgery were matched with 89 patients without a history of spine surgery. There were no statistically significant differences in age, sex, race, ethnicity, or BMI between the matched cohorts. History of spine surgery was generally associated with worse lumbar muscle health. At all 4 intervertebral levels between L1-L5, PL-CSA was significantly smaller among patients with history of spine surgery. At L4-L5, patients with prior spine surgery had significantly smaller PL-CSA/BMI. Patients with prior spine surgery were found to have greater fatty infiltration of the muscles, with higher average Goutallier grades at levels L1-L2, L2-L3, and L4-L5. In addition, history of spine surgery was associated with smaller LIV at L1-L2, L3-L4, and L4-L5. CONCLUSIONS The current study demonstrates that history of lumbar spine surgery is associated with worse paralumbar muscle health based on quantitative and qualitative measurements on MRI. On average, patients with history of spine surgery were found to have smaller cross-sectional areas of the paralumbar muscles, greater amounts of fatty infiltration based on Goutallier classification, and smaller lumbar indentation values.
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Affiliation(s)
- Junho Song
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Shaya Shahsavarani
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Sohrab Vatsia
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Austen D Katz
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Alex Ngan
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - John Fallon
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Adam Strigenz
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Mitchell Seitz
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Jeff Silber
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - David Essig
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
| | - Sheeraz A Qureshi
- Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
| | - Sohrab Virk
- Northwell Health Long Island Jewish Medical Center, 270-05 76(th) Avenue, Queens, NY 10040, USA
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Urakawa H, Sato K, Vaishnav AS, Lee R, Chaudhary C, Mok JK, Virk S, Sheha E, Katsuura Y, Kaito T, Gang CH, Qureshi SA. Preoperative cross-sectional area of psoas muscle correlates with short-term functional outcomes after posterior lumbar surgery. Eur Spine J 2023; 32:2326-2335. [PMID: 37010611 DOI: 10.1007/s00586-023-07533-7] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/26/2022] [Accepted: 01/09/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To determine the optimal level for the measurement of psoas cross-sectional area and examine the correlation with short-term functional outcomes of posterior lumbar surgery. METHODS Patients who underwent minimally invasive posterior lumbar surgery were included in this study. The cross-sectional area of psoas muscle was measured at each intervertebral level on T2-weighted axial images of preoperative MRI. Normalized total psoas area (NTPA) (mm2/m2) was calculated as total psoas area normalized to patient height. Intraclass Correlation Coefficient (ICC) was calculated for the analysis of inter-rater reliability. Patient reported outcome measures including Oswestry disability index (ODI), visual analog scale (VAS), short form health survey (SF-12) and patient-reported outcomes measurement information system were collected. A multivariate analysis was performed to elucidate independent predictors associated with failure to reach minimal clinically important difference (MCID) in each functional outcome at 6 months. RESULTS The total of 212 patients were included in this study. ICC was highest at L3/4 [0.992 (95% CI: 0.987-0.994)] compared to the other levels [L1/2 0.983 (0.973-0.989), L2/3 0.991 (0.986-0.994), L4/5 0.928 (0.893-0.952)]. Postoperative PROMs were significantly worse in patients with low NTPA. Low NTPA was an independent predictor of failure to reach MCID in ODI (OR = 2.68; 95% CI: 1.26-5.67; p = 0.010) and VAS leg (OR = 2.43; 95% CI: 1.13-5.20; p = 0.022). CONCLUSION Decreased psoas cross-sectional area on preoperative MRI correlated with functional outcomes after posterior lumbar surgery. NTPA was highly reliable, especially at L3/4.
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Affiliation(s)
- Hikari Urakawa
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Kosuke Sato
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Avani S Vaishnav
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Ryan Lee
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Chirag Chaudhary
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Jung Kee Mok
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Sohrab Virk
- North Shore University Hospital, 300 Community Dr, Manhasset, NY, USA
- Long Island Jewish Medical Center, 825 Northern Blvd, Great Neck, NY, USA
| | - Evan Sheha
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
- Weill Cornell Medical College, 1300 York Ave, New York, NY, USA
| | | | - Takashi Kaito
- Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | | | - Sheeraz A Qureshi
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA.
- Weill Cornell Medical College, 1300 York Ave, New York, NY, USA.
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Belzunce MA, Henckel J, Laura AD, Horga LM, Hart AJ. Mid-life cyclists preserve muscle mass and composition: a 3D MRI study. BMC Musculoskelet Disord 2023; 24:209. [PMID: 36941610 PMCID: PMC10026522 DOI: 10.1186/s12891-023-06283-3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/28/2023] [Indexed: 03/23/2023] Open
Abstract
Physical activity and a healthy lifestyle are crucial factors for delaying and reducing the effects of sarcopenia. Cycling has gained popularity in the last decades among midlife men. While the cardiovascular benefits of cycling and other endurance exercises have been extensively proved, the potential benefits of lifelong aerobic exercise on muscle health have not been adequately studied. Our aim was to quantify the benefits of cycling in terms of muscle health in middle-aged men, using magnetic resonance imaging. We ran a cross-sectional study involving two groups of middle-aged male adults (mean age 49 years, range 30-65) that underwent Dixon MRI of the pelvis. The groups consisted of 28 physically inactive (PI) and 28 trained recreational cyclists. The latter had cycled more than 7000 km in the last year and have been training for 15 years on average, while the PI volunteers have not practiced sports for an average of 27 years. We processed the Dixon MRI scans by labelling and computing the fat fraction (FF), volume and lean volume of gluteus maximus (GMAX) and gluteus medius (GMED); and measuring the volume of subcutaneous adipose tissue (SAT). We found that the cyclists group had lower FF levels, a measure of intramuscular fat infiltration, compared to the PI group for GMAX (PI median FF 21.6%, cyclists median FF 14.8%, p < 0.01) and GMED (PI median FF 16.0%, cyclists median FF 11.4%, p < 0.01). Cyclists had also larger GMAX and GMED muscles than the PI group (p < 0.01), after normalizing it by body mass. Muscle mass and fat infiltration were strongly correlated with SAT volume. These results suggest that cycling could help preserve muscle mass and composition in middle-aged men. Although more research is needed to support these results, this study adds new evidence to support public health efforts to promote cycling.
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Affiliation(s)
- Martin A Belzunce
- Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
- Instituto de Ciencias Físicas (ICIFI-CONICET), Center for Complex Systems and Brain Sciences (CEMSC3), Escuela de Ciencia y Tecnología, Centro Universitario de Imágenes Médicas (CEUNIM), Universidad Nacional de Gral. San Martín, Campus Miguelete, 25 de Mayo y Francia, (1650), San Martín, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Godoy Cruz 2290, (1425), Buenos Aires, Argentina
- Centro Universitario de Imágenes Médicas (CEUNIM), Universidad Nacional de Gral. San Martín, Campus Miguelete, 25 de Mayo 901, San Martín (1650), Buenos Aires, Argentina
| | - Johann Henckel
- Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
| | - Anna Di Laura
- Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
- Institute of Mechanical Engineering, University College London, University College London, Stanmore, HA7 4LP, UK
| | - Laura M Horga
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Stanmore, HA7 4LP, UK
| | - Alister James Hart
- Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK.
- Institute of Orthopaedics and Musculoskeletal Science, University College London, Stanmore, HA7 4LP, UK.
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Wang B, Davies TB, Way KL, Tran DL, Davis GM, Singh MF, Hackett DA. Effect of resistance training on local muscle endurance in middle-aged and older adults: A systematic review with meta-analysis and meta-regression. Arch Gerontol Geriatr 2023; 109:104954. [PMID: 36758486 DOI: 10.1016/j.archger.2023.104954] [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: 12/30/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 02/06/2023]
Abstract
BACKGROUND Local muscle endurance (LME) is a significant indicator of muscle health and function in middle-aged and older adults. However, resistance training (RT) practices which optimise performance in this population are currently unclear. This study examined: 1) the effect of RT on LME; and 2) the impact of acute resistance exercise program variables on LME in middle-aged and older adults. METHODS Five electronic databases were searched using terms related to RT, LME, and older adults. Random effects (Hedges' g) meta-analyses were undertaken to estimate the effect of RT on upper and lower body LME assessed via maximal repetitions during an isotonic test. The impact of resistance exercise program variables on LME effects was explored using meta-regression analyses. RESULTS Fifteen studies met the inclusion criteria for this review. Upon sensitivity analysis, one study was removed. Large effects favoured RT for LME of the upper body (g = 1.10, p < 0.001) and lower body (g = 1.18, p < 0.001). Large effects on LME from RT were found irrespective of training intensity or other resistance exercise program variables. Moderate heterogeneity and publication bias were found in most analyses. DISCUSSION RT is an effective means for improving LME in middle-aged and older adults. Optimal training characteristics have not been defined by this review, as improvement in LME was unrelated to RT volume or loading intensity. Caution is warranted when interpreting the findings due to heterogeneity and bias present in existing literature. Additional studies are needed with direct comparisons of various training techniques.
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Affiliation(s)
- Boliang Wang
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Timothy B Davies
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Kimberley L Way
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Derek L Tran
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; The University of Sydney School of Medicine, Central Clinical School, Camperdown, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Glen M Davis
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Maria Fiatarone Singh
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; The University of New South Wales, Australia; Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Daniel A Hackett
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
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Bradley AP, Klawitter L, Carver E, Johnson Z, McGrath R, Stastny S, Christensen B, Hackney KJ. Reliability of a Novel Automated Ultrasound Technology for Body Composition Assessment and Comparisons with Dual Energy X-Ray Absorptiometry. Int J Exerc Sci 2023; 16:393-401. [PMID: 37125216 PMCID: PMC10128116] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Body composition tools vary in reliability, portability, and accessibility. The purpose of this study was to evaluate test-retest reliability of MuscleSound® (MS) and dual-energy x-ray absorptiometry (DXA) for both two compartment (region) and three compartment (tissue) models. A secondary aim was to compare body composition values produced by both devices. Fifty participants (n = 25 male, n = 25 female) aged 18-39 years completed two body composition assessments, twice in a single session. Participants arrived at the lab after a 12-hour fast. DXA required participants to lay supine for 10-15 minutes during the scanning process. Thereafter, MS was utilized to measure subcutaneous adipose tissue thickness at seven sites: chest, subscapula, triceps, axilla, suprailium, abdomen, and mid-thigh. MS automatically estimated body composition utilizing a modified Jackson-Pollock equation and the Siri equation within the software. The sequence of assessments was then repeated. Statistical analysis included paired T-tests with Pearson correlations, intraclass correlation coefficients (ICC), and least significant change (LSC). Both methods were strongly reliable (ICCMS = .997, ICCDXA-region = .999, ICCDXA-tissue = .999). MS and DXA-region body fat percentages were significantly different (mean difference (%): 2.60 ± 1.32, p < .001) but highly correlated (r = .928, p < .001). Notably, the mean difference was within DXA-region's calculated least significant change of 3.24%. MS is reliable for assessing body fat percentage in young and middle-aged adults and operators can utilize MS to collect body composition data in the field.
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Affiliation(s)
- Adam P Bradley
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Lukus Klawitter
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Emma Carver
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Zach Johnson
- Department of Statistics, North Dakota State University, Fargo, ND, USA
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Sherri Stastny
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Bryan Christensen
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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10
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Peng LN, Lin MH, Lee HF, Hsu CC, Chang SJ, Chen LK. Clinical efficacy of oligonol® supplementation on metabolism and muscle health in middle-aged and older adults: A double-blinded randomized controlled trial. Arch Gerontol Geriatr 2022; 103:104784. [PMID: 35985196 DOI: 10.1016/j.archger.2022.104784] [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: 07/01/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Oligonol® is a low-molecular-weight polyphenol that has biological effects on metabolism in animals. However, little is known about its roles in muscle function and muscle quality in middle-aged and older adults. METHODS 120 participants were enrolled for study based on 1:1 randomization. Participants in the intervention group were provided 200 mg oligonol® prepared as capsules, and 200 mg placebo (dextrin) was provided in control group. RESULTS Data from 103 participants (52 in the intervention group and 51 in the control group) were available for analysis. The mean age of all participants was 64.0 ± 8.2 years, and two-thirds of the participants were females. Baseline demographic characteristics, functional assessment, laboratory data and muscle parameters were similar between groups. Hip circumference decreased (p = 0.009) during the study period, and the 6-m walking speed increased (p = 0.001) in women in the intervention group. In contrast, 6-m walking speed, 6-min walking distance and handgrip strength were significantly improved in men in the intervention group, but increased total body fat percentage (p = 0.038) and decreased mid-thigh cross-muscle area (CMA) (p = 0.007) were observed in the control group. Compared to the control group, the 12-week interval change in the percentage of mid-thigh CMA was maintained in men in the intervention group but was significantly decreased in the control group (p = 0.03, 95% CI:0.002-0.05). CONCLUSIONS Oligonol supplementation (200 mg per day) significantly improved physical performance and muscle mass in men. Further studies are needed to confirm the potential favorable effects of oligonol® supplementation.
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Affiliation(s)
- Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 1001, Daxue Rd. East Dist., Hsinchu 300093, Taiwan.
| | - Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 1001, Daxue Rd. East Dist., Hsinchu 300093, Taiwan
| | - Huei-Fang Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 1001, Daxue Rd. East Dist., Hsinchu 300093, Taiwan
| | - Chia-Chia Hsu
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan
| | - Sue-Joan Chang
- Department of Life Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 1001, Daxue Rd. East Dist., Hsinchu 300093, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
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11
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Song J, Araghi K, Dupont MM, Shahi P, Bovonratwet P, Shinn D, Dalal SS, Melissaridou D, Virk SS, Iyer S, Dowdell JE, Sheha ED, Qureshi SA. Association between muscle health and patient-reported outcomes after lumbar microdiscectomy: early results. Spine J 2022; 22:1677-1686. [PMID: 35671940 DOI: 10.1016/j.spinee.2022.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/05/2022] [Accepted: 05/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Poor muscle health has been implicated as a source of back pain among patients with lumbar spine pathology. Recently, a novel magnetic resonance imaging (MRI)-based lumbar muscle health grade was shown to correlate with health-related quality of life scores. However, the impact of muscle health on postoperative functional outcomes following spine surgery remains to be investigated. PURPOSE To determine whether muscle health grade measured by preoperative psoas and paralumbar muscle cross-sectional areas impact the achievement of minimal clinically important difference (MCID) following lumbar microdiscectomy. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE Consecutive patients who underwent 1-level lumbar microdiscectomy in a single institution between 2017 and 2021. OUTCOME MEASURES Rate of MCID achievement, time to MCID achievement, PROMs including Oswestry Disability Index (ODI), visual analog scale for back pain (VAS back), VAS leg, Short Form 12 Physical Component Summary (SF-12 PCS), SF-12 Mental Component Summary (SF-12 MCS), and Patient Reported Outcomes Measurement Information System Physical Function (PROMIS PF). METHODS Two previously validated methods for muscle health grading were applied. Axial T2 MRI were analyzed for muscle measurements. The psoas-based method utilized the normalized total psoas area (NTPA), which is the psoas cross-sectional area divided by the square of patient height (mm2/m2). Patients were divided into low and high NTPA groups based on sex-specific lowest quartile NTPA thresholds. The paralumbar-based method incorporated the paralumbar cross-sectional area normalized by body mass index (PL-CSA/BMI) and Goutallier classification. Score of 1 was added for either PL-CSA/BMI >130 or Goutallier class of ≤2. "Good" muscle health was defined as score of 2, and "poor" muscle health was defined as score of 0 to 1. Prospectively collected PROMs were analyzed at 2-week, 6-week, 3-month, 6-month, 1-year, and 2-year postoperative timepoints. The rate of and time to MCID achievement were compared among the cohorts. Bivariate analyses were performed to assess for correlations between psoas/paralumbar cross-sectional areas and change in PROM scores from baseline. RESULTS The total cohort included 163 patients with minimum follow-up of 6 months and mean follow-up of 16.5 months. 40 patients (24.5%) were categorized into the low NTPA group, and 55 patients (33.7%) were categorized into the poor paralumbar muscle group. Low NTPA was associated with older age, lower BMI, and greater frequencies of Charlson Comorbidity Index (CCI) ≥1. Poor paralumbar muscle health was associated with older age, female sex, higher BMI, and CCI ≥1. There were no differences in rates of MCID achievement for any PROMs between low versus high NTPA groups or between poor versus good paralumbar groups. Low NTPA was associated with longer time to MCID achievement for ODI, VAS back, VAS leg, and SF-12 MCS. Poor paralumbar muscle health was associated with longer time to MCID achievement for VAS back, VAS leg, and SF-12 PCS. NTPA negatively correlated with change in VAS back (6-week, 12-week) and VAS leg (6-month). PL-CSA/BMI positively correlated with change in PROMIS-PF at 3 months follow-up. CONCLUSIONS Among patients undergoing lumbar microdiscectomy, patients with worse muscle health grades achieved MCID at similar rates but required longer time to achieve MCID. Lower NTPA was weakly correlated with larger improvements in pain scores. PL-CSA/BMI positively correlated with change in PROMIS-PF. Our findings suggest that with regards to functional outcomes, patients with worse muscle health may take longer to recuperate postoperatively compared to those with better muscle health.
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Affiliation(s)
- Junho Song
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Kasra Araghi
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Marcel M Dupont
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Pratyush Shahi
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | | | - Daniel Shinn
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Sidhant S Dalal
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | | | - Sohrab S Virk
- Northwell Health Long Island Jewish Medical Center, 270-05 76th Ave, Queens, NY 10040, USA
| | - Sravisht Iyer
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - James E Dowdell
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Evan D Sheha
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Sheeraz A Qureshi
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA.
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12
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Ford KL, Prado CM, Weimann A, Schuetz P, Lobo DN. Unresolved issues in perioperative nutrition: A narrative review. Clin Nutr 2022; 41:1578-1590. [PMID: 35667274 DOI: 10.1016/j.clnu.2022.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/25/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 12/23/2022]
Abstract
Surgical patients are at an increased risk of negative outcomes if they are malnourished or at risk of malnutrition preoperatively. Optimisation of nutritional status should be a focus throughout the perioperative continuum to promote improved surgical outcomes. Enhanced Recovery after Surgery (ERAS) protocols are increasingly applied in the surgical setting but are not yet widespread. This narrative review focused on areas of perioperative nutrition that are perceived as controversial or are lacking in agreement. A search for available literature was conducted on 1 March 2022 and relevant high-quality articles published since 2015 were considered for inclusion. Most malnutrition screening tools are not specific to the surgical population except for the Perioperative Nutrition Screen (PONS) although more large-scale initiatives are needed to improve the prevalence of preoperative nutrition screening. Poor muscle health is common in patients with malnutrition and further exacerbates negative health outcomes indicating that prevention, detection and treatment is of high importance in this population. Although a lack of consensus remains for who should receive preoperative nutritional therapy, evidence suggests a positive impact on muscle health. Additionally, postoperative nutritional support benefits surgical outcomes, with some patients requiring enteral and/or parenteral feeding routes and showing benefit from immunonutrition. The importance of nutrition extends beyond the time in hospital and should remain a priority post-discharge. The impact of individual or personalised nutrition based on select patient characteristics remains to be further investigated. Overall, the importance of perioperative nutrition is evident in the literature despite select ongoing areas of contention.
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Affiliation(s)
- Katherine L Ford
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Arved Weimann
- Department of General, Visceral and Oncological Surgery, Klinikum St. Georg, Leipzig, Germany
| | - Philipp Schuetz
- Medical University Department, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland; Medical Faculty of the University of Basel, Basel, Switzerland
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
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13
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Jacob I, Johnson MI, Jones G, Jones A, Francis P. Age-related differences of vastus lateralis muscle morphology, contractile properties, upper body grip strength and lower extremity functional capability in healthy adults aged 18 to 70 years. BMC Geriatr 2022; 22:538. [PMID: 35768788 PMCID: PMC9241209 DOI: 10.1186/s12877-022-03183-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/01/2022] [Indexed: 11/19/2022] Open
Abstract
Background There is a lack of of cross-sectional research that has investigated muscle morphology, function, and functional capability in all age-bands of healthy adults. The primary aim of this study was to evaluate age-related differences in indices of vastus lateralis (VL) muscle morphology, function and functional capability in a sample of healthy males and females aged 18-70yrs. Secondary aims were to evaluate relationships between age and VL muscle morphology and function and functional capability. Methods B mode Ultrasonography and Tensiomyography were used to measure VL muscle thickness, pennation angle, fascicle length, and contractile properties in 274 healthy adults aged 18-70yrs. Measurements of grip strength and functional capability (1-min chair rise test) were also taken. Data analysis included descriptive statistics, correlations, one-way ANOVAs, and multiple regressions. Results Negative correlations were found between age and muscle thickness (rs = -.56), pennation angle (rs = -.50), fascicle length (rs = -.30), maximal displacement (rs = -.24), grip strength (rs = -.27) and the 1-min chair rise test (rs = -.32). Positive correlations were observed between age and the echo intensity of the muscle (rs = .40) and total contraction time (rs = .20). Differences in the indices of muscle health were noticeable between the 18–29 age band and the 50–59 and 60–70 age bands (p < 0.05). The interaction of age and level of physical activity predicted changes in the variables (r2 = .04—.32). Conclusion Age-related differences in muscle health are noticeable at 50 years of age, and age-related differences are larger in females compared to males. It was suggested that the thickness of the VL changed the most with age across the adult lifespan and that physical activity likely acts to abate detrimental change. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03183-4.
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Affiliation(s)
- Isobel Jacob
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds, England.
| | - Mark I Johnson
- Centre for Pain Research, Leeds Beckett University, Leeds, England
| | - Gareth Jones
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds, England
| | - Ashley Jones
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds, England
| | - Peter Francis
- Musculoskeletal Health Research Group, Leeds Beckett University, Leeds, England.,Department of Science and Health, Institute of Technology Carlow, Carlow, Ireland
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14
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Anderson B, Ordaz A, Zlomislic V, Allen RT, Garfin SR, Schuepbach R, Farshad M, Schenk S, Ward SR, Shahidi B. Paraspinal Muscle Health is Related to Fibrogenic, Adipogenic, and Myogenic Gene Expression in Patients with Lumbar Spine Pathology. BMC Musculoskelet Disord 2022; 23:608. [PMID: 35739523 PMCID: PMC9229083 DOI: 10.1186/s12891-022-05572-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/14/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Lumbar spine pathology is a common feature of lower back and/or lower extremity pain and is associated with observable degenerative changes in the lumbar paraspinal muscles that are associated with poor clinical prognosis. Despite the commonly observed phenotype of muscle degeneration in this patient population, its underlying molecular mechanisms are not well understood. The aim of this study was to investigate the relationships between groups of genes within the atrophic, myogenic, fibrogenic, adipogenic, and inflammatory pathways and multifidus muscle health in individuals undergoing surgery for lumbar spine pathology. METHODS Multifidus muscle biopsies were obtained from patients (n = 59) undergoing surgery for lumbar spine pathology to analyze 42 genes from relevant adipogenic/metabolic, atrophic, fibrogenic, inflammatory, and myogenic gene pathways using quantitative polymerase chain reaction. Multifidus muscle morphology was examined preoperatively in these patients at the level and side of biopsy using T2-weighted magnetic resonance imaging to determine whole muscle compartment area, lean muscle area, fat cross-sectional areas, and proportion of fat within the muscle compartment. These measures were used to investigate the relationships between gene expression patterns and muscle size and quality. RESULTS Relationships between gene expression and imaging revealed significant associations between decreased expression of adipogenic/metabolic gene (PPARD), increased expression of fibrogenic gene (COL3A1), and lower fat fraction on MRI (r = -0.346, p = 0.018, and r = 0.386, p = 0.047 respectively). Decreased expression of myogenic gene (mTOR) was related to greater lean muscle cross-sectional area (r = 0.388, p = 0.045). CONCLUSION Fibrogenic and adipogenic/metabolic genes were related to pre-operative muscle quality, and myogenic genes were related to pre-operative muscle size. These findings provide insight into molecular pathways associated with muscle health in the presence of lumbar spine pathology, establishing a foundation for future research that addresses how these changes impact outcomes in this patient population.
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Affiliation(s)
- Brad Anderson
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
| | - Angel Ordaz
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA.
| | - Vinko Zlomislic
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
| | - R Todd Allen
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
| | - Steven R Garfin
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
| | - Regula Schuepbach
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Mazda Farshad
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Simon Schenk
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
| | - Samuel R Ward
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
| | - Bahar Shahidi
- Department of Orthopaedic Surgery, University of California San Diego, 350 Dickinson Street, Suite 121, Mail Code 8894, San Diego, CA, 92103-8894, USA
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Atkins KD, Bickel CS. Effects of functional electrical stimulation on muscle health after spinal cord injury. Curr Opin Pharmacol 2021; 60:226-231. [PMID: 34464934 DOI: 10.1016/j.coph.2021.07.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Spinal cord injury is a devastating condition interrupting voluntary movement and motor control. In response to unloading, skeletal muscle undergoes numerous adaptations, including rapid and profound atrophy, intramuscular fat accumulation, impaired muscular glucose metabolism and decreased force generation and muscle performance. Functional electrical stimulation (FES) involves electrically stimulating affected muscles to contract in a coordinated manner to create a functional movement or task. Effects of FES-cycling, rowing and resistance training on muscle health are described here. Briefly, FES-cycling and resistance training may slow muscle atrophy or facilitate muscle hypertrophy, and all modalities benefit muscle composition and performance to some extent. These interventions show promise as future rehabilitative tools after spinal cord injury.
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Affiliation(s)
- Kelly D Atkins
- Department of Physical Therapy, Samford University, Birmingham, AL, USA
| | - C Scott Bickel
- Department of Physical Therapy, Samford University, Birmingham, AL, USA.
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Jäger R, Zaragoza J, Purpura M, Iametti S, Marengo M, Tinsley GM, Anzalone AJ, Oliver JM, Fiore W, Biffi A, Urbina S, Taylor L. Probiotic Administration Increases Amino Acid Absorption from Plant Protein: a Placebo-Controlled, Randomized, Double-Blind, Multicenter, Crossover Study. Probiotics Antimicrob Proteins 2021; 12:1330-1339. [PMID: 32358640 PMCID: PMC7641926 DOI: 10.1007/s12602-020-09656-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The fate of dietary protein in the gut is determined by microbial and host digestion and utilization. Fermentation of proteins generates bioactive molecules that have wide-ranging health effects on the host. The type of protein can affect amino acid absorption, with animal proteins generally being more efficiently absorbed compared with plant proteins. In contrast to animal proteins, most plant proteins, such as pea protein, are incomplete proteins. Pea protein is low in methionine and contains lower amounts of branched-chain amino acids (BCAAs), which play a crucial role in muscle health. We hypothesized that probiotic supplementation results in favorable changes in the gut microbiota, aiding the absorption of amino acids from plant proteins by the host. Fifteen physically active men (24.2 ± 5.0 years; 85.3 ± 12.9 kg; 178.0 ± 7.6 cm; 16.7 ± 5.8% body fat) co-ingested 20 g of pea protein with either AminoAlta™, a multi-strain probiotic (5 billion CFU L. paracasei LP-DG® (CNCM I-1572) plus 5 billion CFU L. paracasei LPC-S01 (DSM 26760), SOFAR S.p.A., Italy) or a placebo for 2 weeks in a randomized, double-blind, crossover design, separated by a 4-week washout period. Blood samples were taken at baseline and at 30-, 60-, 120-, and 180-min post-ingestion and analyzed for amino acid content. Probiotic administration significantly increased methionine, histidine, valine, leucine, isoleucine, tyrosine, total BCAA, and total EAA maximum concentrations (Cmax) and AUC without significantly changing the time to reach maximum concentrations. Probiotic supplementation can be an important nutritional strategy to improve post-prandial changes in blood amino acids and to overcome compositional shortcomings of plant proteins. ClinicalTrials.gov Identifier: ISRCTN38903788.
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Affiliation(s)
| | - Javier Zaragoza
- Human Performance Laboratory, School of Exercise & Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | | | - Stefania Iametti
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, Italy
| | - Mauro Marengo
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, Italy
| | - Grant M Tinsley
- Energy Balance & Body Composition Laboratory, Texas Tech University, Lubbock, TX, USA
| | | | | | | | | | - Stacie Urbina
- Human Performance Laboratory, School of Exercise & Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | - Lem Taylor
- Human Performance Laboratory, School of Exercise & Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
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Virk S, Sandhu M, Wright-Chisem J, Vaishnav A, Albert T, Qureshi SA. The association between spondylolisthesis and decreased muscle health throughout the lumbar spine for patients with operative lumbar spinal stenosis. Eur Spine J 2021; 30:2605-2612. [PMID: 33893871 DOI: 10.1007/s00586-021-06832-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/02/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE There are data underlining the relationship between muscle health and spine related pathology, but little data regarding changes in paralumbar muscle associated with lumbar spondylolisthesis. We aimed to define changes in paralumbar muscle health associated with spondylolisthesis. METHODS A retrospective review was performed on consecutive patients with lumbar spine pathology requiring an operation. A pre-operative lumbar MRI was analysed for muscle health measurements including lumbar indentation value (LIV), paralumbar cross-sectional area divided by body mass index (PL-CSA/BMI), and Goutallier classification of fatty atrophy. All measurements were taken from an axial slice of a T2-weighted image at lumbar disc spaces. Baseline health-related quality of life scores (HRQOLs), narcotic use and areas of stenosis were tracked. We performed Chi-square analyses and student's t test to determine statistically significant differences between cohorts. RESULTS There were 307 patients (average age 56.1 ± 16.7 years, 141 females) included within our analysis. 112 patients had spondylolisthesis. There were no differences in baseline HRQOLs between the spondylolisthesis cohort (SC) and non-spondylolisthesis cohort (non-SC). There were significantly worse PL-CSA/BMI at L2-L3 (p = 0.03), L3-L4 (p = 0.04) and L4-L5 (p = 0.02) for the SC. Goutallier classification of paralumbar muscle was worse for SC at L1-L2 (p = 0.04) and at L4-L5 (p < 0.001). Increased grade of spondylolisthesis was associated with worse PL-CSA at L1-L2 (p = 0.02), L2-L3 (p = 0.03) and L3-L4 (p = 0.05). Similarly, there were worse Goutallier classification scores associated with higher-grade spondylolisthesis at all levels (p < 0.05). CONCLUSION There are significant detrimental changes to paralumbar muscle health throughout the lumbar spine associated with spondylolisthesis.
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Affiliation(s)
- Sohrab Virk
- Hospital for Special Surgery, 535 E. 70th St., New York, NY, 10021, USA
| | - Milan Sandhu
- Weill Cornell Medical College, New York, NY, USA
| | | | - Avani Vaishnav
- Hospital for Special Surgery, 535 E. 70th St., New York, NY, 10021, USA
| | - Todd Albert
- Hospital for Special Surgery, 535 E. 70th St., New York, NY, 10021, USA.,Weill Cornell Medical College, New York, NY, USA
| | - Sheeraz A Qureshi
- Hospital for Special Surgery, 535 E. 70th St., New York, NY, 10021, USA. .,Weill Cornell Medical College, New York, NY, USA.
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Doets EL, de Hoogh IM, Holthuysen N, Wopereis S, Verain MCD, van den Puttelaar J, Hogenelst K, Boorsma A, Bouwman EP, Timmer M, Pasman WJ, van Erk M, Reinders MJ. Beneficial effect of personalized lifestyle advice compared to generic advice on wellbeing among Dutch seniors - An explorative study. Physiol Behav 2019; 210:112642. [PMID: 31394106 DOI: 10.1016/j.physbeh.2019.112642] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/02/2019] [Accepted: 08/03/2019] [Indexed: 01/20/2023]
Abstract
The aim of this explorative study is to evaluate whether personalized compared to generic lifestyle advice improves wellbeing in a senior population. We conducted a nine-week single-blind randomized controlled trial including 59 participants (age 67.7 ± 4.8 years) from Wageningen and its surrounding areas in the Netherlands. Three times during the intervention period, participants received either personalized advice (PA), or generic advice (GA) to improve lifestyle behavior. Personalization was based on metabolic health measures and dietary intake resulting in an advice that highlighted food groups and physical activity types for which behavior change was most urgent. Before and after the intervention period self-perceived health was evaluated as parameter of wellbeing using a self-perceived health score (single-item) and two questionnaires (Vita-16 and Short Form-12). Additionally, anthropometry and physical functioning (short physical performance battery, SPPB) were assessed. Overall scores for self-perceived health did not change over time in any group. Resilience and motivation (Vita-16) slightly improved only in the PA group, whilst mental health (SF-12) and energy (Vita-16) showed slight improvement only in the GA group. SPPB scores improved over time in both the PA and GA group. PA participants also showed a reduction in body fat percentage and hip circumference, whereas these parameters increased in the GA group Our findings suggest that although no clear effects on wellbeing were found, still, at least on the short term, personalized advice may evoke health benefits in a population of seniors as compared to generic advice.
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19
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Beaudart C, Locquet M, Touvier M, Reginster JY, Bruyère O. Association between dietary nutrient intake and sarcopenia in the SarcoPhAge study. Aging Clin Exp Res 2019; 31:815-824. [PMID: 30955158 DOI: 10.1007/s40520-019-01186-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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: 02/28/2019] [Accepted: 03/28/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND It has been suggested that a balanced nutritional intake may be useful in preventing or even reversing sarcopenia. AIM To describe cross-sectional associations between dietary nutrient intake and sarcopenia. METHODS Subjects recruited from the SarcoPhAge study population completed a food frequency questionnaire. The micronutrient and macronutrient intake was evaluated in both sarcopenic and non-sarcopenic participants. The Nutritional Belgian Recommendations of 2016 were used, i.e., adequate intake and estimated average requirement (EAR). For micronutrients, the prevalence of insufficient intake was estimated as the proportion of subjects whose intake was below the EAR. RESULTS A total of 331 subjects (mean age of 74.8 ± 5.9 years, 58.9% women) had complete data and were included in this study. Among them, 51 were diagnosed with sarcopenia (15.4%). In the fully adjusted model, analyses revealed that sarcopenic subjects consumed significantly lower amounts of two macronutrients (proteins, lipids) and five micronutrients (potassium, magnesium, phosphorus, iron, and vitamin K) than non-sarcopenic subjects (all p values < 0.005). A significantly increased prevalence of insufficiency was found for sarcopenic subjects compared to non-sarcopenic subjects for potassium, magnesium, iron, calcium and vitamins E and C (all p values < 0.005). The prevalence of sarcopenic subjects who were also below the Nutritional Belgian Recommendations for protein and lipids was significantly higher than that of non-sarcopenic subjects. DISCUSSION AND CONCLUSIONS Sarcopenic subjects seem to consume significantly reduced amounts of many micronutrients and macronutrients compared to non-sarcopenic subjects. These results suggest that a poorly balanced diet may be associated with sarcopenia and poor musculoskeletal health, although prospective studies are needed to confirm these findings.
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Affiliation(s)
- Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium.
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium.
| | - Médéa Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
| | - Mathilde Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN, UMR U1153 Inserm/U1125 Inra/Cnam/Universités Paris 5, 7 et 13, Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité (CRESS), Paris, France
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
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