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Kreidieh D, Itani L, El Masri D, Tannir H, El Ghoch M. Association Between Reduced Daily Steps and Sarcopenic Obesity in Treatment-Seeking Adults With Obesity. Front Endocrinol (Lausanne) 2020; 11:22. [PMID: 32082259 PMCID: PMC7003394 DOI: 10.3389/fendo.2020.00022] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022] Open
Abstract
Objectives: Understanding the condition that describes the coexistence of obesity and sarcopenia, termed sarcopenic obesity (SO), is becoming a scientific and clinical priority. In this study, we aimed to assess the prevalence of SO in treatment-seeking adults with obesity and investigate any potential association between SO and a sedentary lifestyle, expressed in terms of daily steps. Methods: In this cross-sectional, prospective observational study, body composition and daily steps measurements were obtained using a segmental body composition analyser (Tanita BC-418) and an Omron HJ-320 pedometer, respectively, in 111 adults of both genders with obesity (body mass index; BMI ≥ 30 kg/m2), referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon. The participants were then categorized according to the presence of absence of SO, defined as an appendicular lean mass divided by body weight (ALM/weight) × 100%) of less than 23.40 and 29.60 in females and males, respectively. Results: Fifty-five of the 111 participants with obesity, with a mean age of 39.62 ± 16.55 years and a mean BMI of 38.05 ± 5.33 kg/m2 met the criteria for SO and displayed a significantly higher prevalence of inactivity (<5,000 daily steps), i.e., nearly double (54.5% vs. 32.1%; p = 0.017) and they had a lower mean number of daily steps than those in the group without SO (5,279 ± 2,641 vs. 6,732 ± 2,989; p = 0.008). Linear regression analysis showed that SO is associated with a lower number of daily steps by 1,421 (β = -1421.4; -2508.9, -333.9; p = 0.011) after adjusting for age, gender employment and the presence of cardiometabolic disease. Conclusion: Sarcopenic obesity affects nearly 50% of treatment-seeking adults with obesity. Moreover, it seems to be associated with a lower number of daily steps and a sedentary lifestyle. Future studies are needed to clarify whether this may influence clinical outcomes. If this is shown to be the case, weight management programmes should incorporate additional physical activity strategies in this population.
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Nezameddin R, Itani L, Kreidieh D, El Masri D, Tannir H, El Ghoch M. Understanding Sarcopenic Obesity in Terms of Definition and Health Consequences: A Clinical Review. Curr Diabetes Rev 2020; 16:957-961. [PMID: 31916519 DOI: 10.2174/1573399816666200109091449] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/18/2019] [Accepted: 12/26/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Research interests in a new phenotype termed as sarcopenic obesity (SO), which refers to a decrease in lean body mass and muscle strength associated with an increase in body fat deposition, have grown. However, neither SO definition nor its impact on health outcomes is clear. In the current paper, we aim to summarize the available literature on the dilemma surrounding the definition of SO, and the potential health consequences of this phenomenon on individuals with overweight and obesity. METHODS A literature review using the PubMed/Medline database was conducted and data were summarized by applying a narrative approach, based on clinical expertise in the interpretation of the available evidence base in the literature. RESULTS Some definitions that account for body mass (i.e., body weight, body mass index) seem to be more suitable for screening of SO and revealed as clinically useful. The association between SO and certain health outcomes has also been investigated, especially those related to obesity; however, little is known about the association of SO with psychosocial distress and health-related quality of life impairment, as well as harsh outcomes such as mortality. CONCLUSION International consensus regarding SO definition is needed, which would allow for a better understanding of its prevalence. Moreover, future investigations should be conducted in order to determine whether SO has an adverse effect (i.e., cause-effect relationship, in addition to association) on health. Once these issues are achieved, confirmed and clarified, evidenced-based protocols of treatment may become necessary to address the increase in the prevalence of obesity and sarcopenia worldwide.
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Affiliation(s)
- Raya Nezameddin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
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Diagnosis of pre-sarcopenia from a single selectional crosscut at C3 region, using CT scans before radiotherapy. NUTR HOSP 2019; 36:1101-1108. [PMID: 31475837 DOI: 10.20960/nh.02422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Purpose: the main purpose of this study was to diagnose pre-sarcopenia in cancer patients who had lack of computed tomography (CT) abdominal images, with a newly discovered method based on cervical images. Material and methods: a sample of 37 patients with either lung cancer or a cancer that affected the upper digestive system underwent radiotherapy computed simulation which included measurements at C3 and L3 regions. Skeletal muscle mass (SMM) and skeletal muscle index (SMI) were determined by Hounsfield units and compared in both regions. Pre-sarcopenia was identified according to the cut-points currently established: ≤ 41 cm2/m2 in females, ≤ 43 cm2/m2 in males with a BMI ≤ 25 kg/m2, and ≤ 53 cm2/m2 in males with a BMI > 25 kg/m2. Results: the correlation of SMM and SMI between the C3 and L3 regions was R2 = 0.876 and R2 = 0.805, respectively. Moreover, there was a positive association (86.49%) in terms of the diagnosis of pre-sarcopenia according to both regions. In total, eleven pre-sarcopenic patients (29.37%) were identified; three of them being overweight (27.27%) and two of them being obese (18.18%). Conclusion: a single sectional cross at the level of C3 can be used for the diagnosis of pre-sarcopenia. This new method avoids unnecessary irradiation, saves hospital costs and detects malnutrition before starting radiotherapy treatment in cancer patients who have lack of CT abdominal imaging.
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Khadra D, Itani L, Tannir H, Kreidieh D, El Masri D, El Ghoch M. Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: A systematic review and meta-analysis. World J Diabetes 2019; 10:311-323. [PMID: 31139318 PMCID: PMC6522758 DOI: 10.4239/wjd.v10.i5.311] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/17/2019] [Accepted: 05/01/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The coexistence of sarcopenia and obesity is referred to as sarcopenic obesity (SO) and it has been hypothesized that the two components of SO may synergistically increase their negative effects. However, many uncertainties still surround this condition especially with regard to its potential negative effects on health outcomes.
AIM To conduct a systematic review to determine the prevalence of sarcopenia among adults with overweight and obesity and to investigate whether SO was associated with a higher risk of type 2 diabetes (T2D).
METHODS This study was conducted in adherence with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Literature searches, study selection, methodology development and quality appraisal were performed independently by two authors and the data were collated by means of meta-analysis and narrative synthesis.
RESULTS Of the 606 articles retrieved, 11 studies that comprised a total of 60118 adults with overweight and obesity of both genders met the inclusion criteria and were reviewed, revealing two main findings. First, the overall prevalence of sarcopenia is 43% in females and 42% in males who are with overweight and obesity. Secondly, the presence of SO increases the risk of T2D by 38% with respect to those without SO (OR = 1.38, 95%CI: 1.27-1.50).
CONCLUSION A high prevalence of sarcopenia has been found among adults with overweight and obesity regardless of their gender and this condition seems to be associated with a higher risk of T2D. Clinician should be aware of this scenario in their clinical practice for the better management of both obesity and T2D.
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Affiliation(s)
- Dima Khadra
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut 11072809, Lebanon
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Abstract
PURPOSE OF REVIEW Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steato hepatitis have an increasing prevalence among liver diseases. Overweight and obesity are frequently associated conditions in patients with fatty liver. Skeletal muscle mass depletion may also coexist with chronic liver disease even in obese patients. This review will focus on the relationship between sarcopenic obesity and fatty liver. RECENT FINDINGS Obesity and sarcopenia are frequently encountered in patients with NAFLD. Adipose tissue is able to release molecules (adipokines) that regulate lipid metabolism, interact with insulin sensitivity and may contribute to induce fibrogenesis in the liver. Skeletal muscle tissue is able to secrete myokines regulating muscle metabolism and insulin sensitivity. Myokines perturbation has been reported to influence adipose tissue mass and fat deposition in the liver. Sarcopenia has been reported as independent risk factor for the development of NAFLD, and for a more severe liver fibrosis in patients with NAFLD. SUMMARY The interaction between skeletal muscle, adipose tissue and the liver may play a role in the development of NAFLD. Sarcopenia and sarcopenic obesity are risk factors for the development of fatty liver and associated with more severe liver fibrosis. Management is not standardized, but dietary counseling and physical training have been proposed as promising strategies. Bariatric surgery may be considered in patients with severe 'resistant' obesity.
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Affiliation(s)
- Manuela Merli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
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Al-Nimr RI. Optimal Protein Intake during Weight Loss Interventions in Older Adults with Obesity. J Nutr Gerontol Geriatr 2019; 38:50-68. [PMID: 30806592 DOI: 10.1080/21551197.2018.1544533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Obesity rates in people 60 years and older are increasing. While obesity is linked with detrimental health risks, weight loss in this population has previously been considered controversial due to potential worsening of age-related sarcopenia. Protein intake during energy restriction has been linked to lean body mass preservation. No formal guidelines for optimal protein intake during structured weight loss interventions exist for this population, but it appears that the current Recommended Dietary Allowance of 0.8 grams per kilogram of body weight per day may be inadequate. The purpose of this review is to discuss optimal protein intake during structured weight loss interventions in persons 60 years and older with obesity and to present a framework for guidelines to be used by health professionals focusing on weight loss interventions in older adults. Goals for the amount, source, and timing of protein intake, from both food and supplements, are presented and discussed.
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Affiliation(s)
- Rima Itani Al-Nimr
- a The Geisel School of Medicine at Dartmouth , Hanover , NH , USA.,b Department of Medicine , Dartmouth-Hitchcock Medical Center , Lebanon , NH , USA
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Rubio-Ruiz ME, Guarner-Lans V, Pérez-Torres I, Soto ME. Mechanisms Underlying Metabolic Syndrome-Related Sarcopenia and Possible Therapeutic Measures. Int J Mol Sci 2019; 20:ijms20030647. [PMID: 30717377 PMCID: PMC6387003 DOI: 10.3390/ijms20030647] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 12/15/2022] Open
Abstract
Although there are several reviews that report the interrelationship between sarcopenia and obesity and insulin resistance, the relation between sarcopenia and the other signs that compose the metabolic syndrome (MetS) has not been extensively revised. Here, we review the mechanisms underlying MetS-related sarcopenia and discuss the possible therapeutic measures proposed. A vicious cycle between the loss of muscle and the accumulation of intramuscular fat might be associated with MetS via a complex interplay of factors including nutritional intake, physical activity, body fat, oxidative stress, proinflammatory cytokines, insulin resistance, hormonal changes, and mitochondrial dysfunction. The enormous differences in lipid storage capacities between the two genders and elevated amounts of endogenous fat having lipotoxic effects that lead to the loss of muscle mass are discussed. The important repercussions of MetS-related sarcopenia on other illnesses that lead to increased disability, morbidity, and mortality are also addressed. Additional research is needed to better understand the pathophysiology of MetS-related sarcopenia and its consequences. Although there is currently no consensus on the treatment, lifestyle changes including diet and power exercise seem to be the best options.
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Affiliation(s)
- María Esther Rubio-Ruiz
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Verónica Guarner-Lans
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - Israel Pérez-Torres
- Department of Pathology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
| | - María Elena Soto
- Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico.
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Ladas EJ, Orjuela M, Stevenson K, Cole PD, Lin M, Athale UH, Clavell LA, Leclerc JM, Laverdiere C, Michon B, Schorin MA, Welch JG, Asselin BL, Sallan SE, Silverman LB, Kelly KM. Fluctuations in dietary intake during treatment for childhood leukemia: A report from the DALLT cohort. Clin Nutr 2019; 38:2866-2874. [PMID: 30639117 DOI: 10.1016/j.clnu.2018.12.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Nutritional morbidities are a persistent problem facing pediatric patients during and after treatment and age-gender groups that are at risk for nutritional conditions have not been clearly identified. Therapy is a contributing factor; however, the role of dietary intake remains largely unknown. Prior to conduct of interventional trials, an understanding of the effects of treatment on fluctuations in dietary intake is necessary. METHODS We enrolled 794 children with ALL in a prospective clinical trial. Dietary intake was collected with a food frequency questionnaire at diagnosis and throughout the course of treatment for pediatric ALL. Reported values were compared to the Dietary Recommended Intake (DRI), and normative values (NHANES). Hierarchical linear models and multilevel mixed-effects ordered logistic regression models were used to evaluate longitudinal changes in dietary intake; independent samples t-test with Bonferroni correction was performed to compare to NHANES. RESULTS Of the evaluable participants at each timepoint, dietary intake was obtained on 81% (n = 640), 74% (n = 580) and 74% (n = 558) at diagnosis, end of induction phase of treatment, and continuation, respectively. Despite exposure to corticosteroids, caloric intake decreased over therapy for most age-gender groups. Predictive models of excess intake found reduced odds of over-consuming calories (OR 0.738, P < 0.05); however, increased odds of over-consuming fat (OR 6.971, P < 0.001). When compared to NHANES, we consistently found that ≥1/3 of children were consuming calories in excess of normative values. For select micronutrients, a small proportion of participants were above or below the DRI at each time evaluated. CONCLUSIONS Our study suggests that dietary intake fluctuates during treatment for ALL as compared to age-gender recommended and normative values. Improving our understanding of nutrient fluctuations and dietary quality will facilitate subsequent analyses addressing relationships of dietary intake, toxicity, and survival.
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Affiliation(s)
- Elena J Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY, United States; Institute of Human Nutrition, Columbia University, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, United States.
| | - Manuela Orjuela
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, United States
| | - Kristen Stevenson
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, MA, United States
| | - Peter D Cole
- Albert Einstein College of Medicine, Bronx, NY, United States; Rutgers Cancer Institute of New Jersey, United States
| | - Meiko Lin
- Teachers College, Columbia University, United States
| | - Uma H Athale
- Division of Hematology/Oncology, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Luis A Clavell
- San Jorge Children's Hospital, San Juan, PR, United States
| | - Jean-Marie Leclerc
- Hematology-Oncology Division, Charles Bruneau Cancer Center, Sainte-Justine University Hospital, University of Montreal, Montreal, QC, Canada
| | - Caroline Laverdiere
- Hematology-Oncology Division, Charles Bruneau Cancer Center, Sainte-Justine University Hospital, University of Montreal, Montreal, QC, Canada
| | - Bruno Michon
- Centre Hospitalier Universitaire de Quebec, Sainte-Foy, QC, Canada
| | | | - Jennifer Greene Welch
- Division of Pediatric Hematology/Oncology, Hasbro Children's Hospital, Brown University, Providence, RI, United States
| | - Barbara L Asselin
- Department of Pediatrics, University of Rochester School of Medicine, Golisano Children's Hospital at URMC, Rochester, NY, United States
| | - Stephen E Sallan
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, MA, United States
| | - Lewis B Silverman
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, MA, United States
| | - Kara M Kelly
- Department of Pediatrics, Roswell Park Cancer Institute and University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, United States
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Sasaki T, Sugawara M, Fukuda M. Sodium-glucose cotransporter 2 inhibitor-induced changes in body composition and simultaneous changes in metabolic profile: 52-week prospective LIGHT (Luseogliflozin: the Components of Weight Loss in Japanese Patients with Type 2 Diabetes Mellitus) Study. J Diabetes Investig 2019; 10:108-117. [PMID: 29660782 PMCID: PMC6319483 DOI: 10.1111/jdi.12851] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION It is unclear how changes in body composition induced by sodium-glucose cotransporter 2 (SGLT2) inhibitor treatment correlate with metabolic profile changes. We aimed to clarify how metabolic profile changes correlate with body component changes, and if SGLT2 inhibitor treatment causes sarcopenia and bone mineral content (BMC) loss. MATERIALS AND METHODS Moderately obese Japanese type 2 diabetes patients, treated with luseogliflozin for a year, were observed prospectively and evaluated for body composition changes. We analyzed the changes in the individual body components during treatment, and their correlation with other clinical variables. RESULTS The efficacy analysis set comprised 37 of 43 enrolled patients. The total fat mass significantly decreased early in the treatment at and after week 4, with a mean decrease of -1.97 kg (95% confidence interval -2.66 to -1.28) at week 24. The visceral fat area at week 24 showed an average downward trend, although this was not significant. The changes in visceral fat area in individual patients showed a significant negative correlation with the extent of the baseline visceral fat area (r = -0.399, P = 0.023). The skeletal muscle mass index showed a significant but small change at and after week 36. The BMC profile showed a transient significant decrease only at week 12. No significant change in BMC was noted at other time-points. CONCLUSIONS Luseogliflozin treatment brought about favorable changes in body composition and metabolism of moderately obese Japanese type 2 diabetes patients, accompanied by body fat reduction, and minimal muscle and BMC reduction.
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Affiliation(s)
- Takashi Sasaki
- Institute of Clinical Medicine and ResearchResearch Center for Medical SciencesThe Jikei University School of MedicineKashiwaChiba
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60
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Solmi M, Köhler CA, Stubbs B, Koyanagi A, Bortolato B, Monaco F, Vancampfort D, Machado MO, Maes M, Tzoulaki I, Firth J, Ioannidis JPA, Carvalho AF. Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta-analyses of cohort studies and randomized controlled trials. Eur J Clin Invest 2018; 48:e12982. [PMID: 29923186 DOI: 10.1111/eci.12982] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Multiple environmental factors have been implicated in obesity, and multiple interventions, besides drugs and surgery, have been assessed in obese patients. Results are scattered across many studies and meta-analyses, and they often mix obese and overweight individuals. MATERIALS AND METHODS PubMed and Cochrane Database of Systematic Reviews were searched through 21 January 2017 for meta-analyses of cohort studies assessing environmental risk factors for obesity, and randomized controlled trials investigating nonpharmacological and nonsurgical therapeutic interventions for obesity. We excluded data on overweight participants. Evidence from observational studies was graded according to criteria that included the statistical significance of the random-effects summary estimate and of the largest study in a meta-analysis, the number of obesity cases, heterogeneity between studies, 95% prediction intervals, small-study effects and excess significance. The evidence of intervention studies for obesity was assessed with the GRADE framework. RESULTS Fifty-four articles met eligibility criteria, including 26 meta-analyses of environmental risk factors (166 studies) and 46 meta-analyses of nondrug, nonsurgical interventions (206 trials). In adults, the only risk factor with convincing evidence was depression, and childhood obesity, adolescent obesity, childhood abuse and short sleep duration had highly suggestive evidence. Infancy weight gain during the first year of life, depression and low maternal education had convincing evidence for association with paediatric obesity. All interventions had low or very-low-quality evidence with one exception of moderate-quality evidence for one comparison (no differences in efficacy between brief lifestyle primary care interventions and other interventions for paediatric obesity). Summary effect sizes were mostly small across compared interventions (maximum 5.1 kg in adults and 1.78 kg in children) and even these estimates may be inflated. CONCLUSIONS Depression, obesity in earlier age groups, short sleep duration, childhood abuse and low maternal education have the strongest support among proposed risk factors for obesity. Furthermore, there is no high-quality evidence to recommend treating obesity with a specific nonpharmacological and nonsurgical intervention among many available, and whatever benefits in terms of magnitude of weight loss appear small.
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Affiliation(s)
- Marco Solmi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Cristiano A Köhler
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Francesco Monaco
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium.,University Psychiatric Centre, KU Leuven, University of Leuven, Leuven-Kortenberg, Belgium
| | - Myrela O Machado
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,IMPACT Strategic Research Center, Deakin University, Geelong, Vic., Australia
| | - Ioanna Tzoulaki
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,MRC-PHE Centre for Environment, School of Public Health, Imperial College London, London, UK.,Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Joseph Firth
- NICM, School of Science and Health, University of Western Sydney, Sydney, NSW, Australia.,Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - John P A Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.,Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.,Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California.,Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, California
| | - André F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
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Crupi AN, Nunnelee JS, Taylor DJ, Thomas A, Vit JP, Riera CE, Gottlieb RA, Goodridge HS. Oxidative muscles have better mitochondrial homeostasis than glycolytic muscles throughout life and maintain mitochondrial function during aging. Aging (Albany NY) 2018; 10:3327-3352. [PMID: 30449736 PMCID: PMC6286850 DOI: 10.18632/aging.101643] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/05/2018] [Indexed: 01/05/2023]
Abstract
Preservation of mitochondrial function, which is dependent on mitochondrial homeostasis (biogenesis, dynamics, disposal/recycling), is critical for maintenance of skeletal muscle function. Skeletal muscle performance declines upon aging (sarcopenia) and is accompanied by decreased mitochondrial function in fast-glycolytic muscles. Oxidative metabolism promotes mitochondrial homeostasis, so we investigated whether mitochondrial function is preserved in oxidative muscles. We compared tibialis anterior (predominantly glycolytic) and soleus (oxidative) muscles from young (3 mo) and old (28-29 mo) C57BL/6J mice. Throughout life, the soleus remained more oxidative than the tibialis anterior and expressed higher levels of markers of mitochondrial biogenesis, fission/fusion and autophagy. The respiratory capacity of mitochondria isolated from the tibialis anterior, but not the soleus, declined upon aging. The soleus and tibialis anterior exhibited similar aging-associated changes in mitochondrial biogenesis, fission/fusion, disposal and autophagy marker expression, but opposite changes in fiber composition: the most oxidative fibers declined in the tibialis anterior, while the more glycolytic fibers declined in the soleus. In conclusion, oxidative muscles are protected from mitochondrial aging, probably due to better mitochondrial homeostasis ab initio and aging-associated changes in fiber composition. Exercise training aimed at enriching oxidative fibers may be valuable in preventing mitochondria-related aging and its contribution to sarcopenia.
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Affiliation(s)
- Annunziata N. Crupi
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jordan S. Nunnelee
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - David J. Taylor
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Smidt Heart Institute and Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Amandine Thomas
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Smidt Heart Institute and Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jean-Philippe Vit
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Biobehavioral Research Core, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Celine E. Riera
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Center for Neural Science and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Roberta A. Gottlieb
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Smidt Heart Institute and Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Equal contribution
| | - Helen S. Goodridge
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Equal contribution
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Association between Sarcopenic Obesity, Type 2 Diabetes, and Hypertension in Overweight and Obese Treatment-Seeking Adult Women. J Cardiovasc Dev Dis 2018; 5:jcdd5040051. [PMID: 30347794 PMCID: PMC6306700 DOI: 10.3390/jcdd5040051] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/14/2022] Open
Abstract
The last decade has seen a new condition that describes the coexistence of obesity and sarcopenia, termed sarcopenic obesity (SO). We aimed to assess the prevalence of SO in overweight and obese treatment-seeking adult women and the association with type 2 diabetes, hypertension, and dyslipidemia. A body composition assessment was conducted with an InBody bioimpedance analyser in 154 overweight and obese women referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon, and 30 normal-weight participants of similar age. The overweight and obese patients were then categorized as being with or without sarcopenia. Thirty-one out of the 154 overweight or obese participants met the criteria for SO and displayed a significantly higher prevalence of type 2 diabetes and hypertension than those without SO. Logistic regression analysis showed that SO increases the odds of having type 2 diabetes and hypertension by nearly 550% (odds ratio = 5.42, 95% confidence interval = 1.37⁻21.40, p < 0.05) after adjusting for central fat, eating habits, level of physical activity, and smoking. SO affects nearly 20% of treatment-seeking overweight and obese adult women. Moreover, SO seems to be strongly associated with type 2 diabetes and hypertension.
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El Ghoch M, Calugi S, Grave RD. Sarcopenic Obesity: Definition, Health Consequences and Clinical Management. ACTA ACUST UNITED AC 2018. [DOI: 10.2174/1874288201812010070] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Over the last decade, a new condition, which occurs in the presence of both sarcopenia and obesity, has been termed “sarcopenic obesity”. The term describes the coexistence of obesity, defined as the increase in body fat mass deposition, and sarcopenia, defined as the reduction in lean mass and muscle strength. However, many uncertainties still surround the condition of sarcopenic obesity in terms of its definition, the adverse short- and long-term health effects (i.e., medical disease, psychosocial functioning, quality of life and mortality) and its clinical management. The aim of this short communication is to emphasize some crucial aspects that future research should take into account in order to avoid bias and misinterpretations and to underline that the study of sarcopenic obesity should be considered a scientific and clinical priority, as reported by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO).
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Eslamparast T, Montano-Loza AJ, Raman M, Tandon P. Sarcopenic obesity in cirrhosis-The confluence of 2 prognostic titans. Liver Int 2018; 38:1706-1717. [PMID: 29738109 DOI: 10.1111/liv.13876] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/17/2018] [Indexed: 02/13/2023]
Abstract
Sarcopenia and obesity are 2 major health conditions with a growing prevalence in cirrhosis. The concordance of these 2 conditions, sarcopenic obesity, is associated with higher rates of mortality and impact on the metabolic profile and physical function than either condition alone. To date, there is little consensus surrounding the diagnostic criteria for sarcopenia, obesity or as a result, sarcopenic obesity in patients with cirrhosis. Cross-sectional imaging, although the most accurate diagnostic technique, has practical limitations for routine use in clinical practice. Management strategies are focused on increasing muscle mass and strength. The present review provides an overview of the diagnosis, pathophysiology, prognostic implications and management strategies available for sarcopenic obesity in cirrhosis. We also discuss the associated condition myosteatosis, the pathological accumulation of fat in skeletal muscle. Much work needs to be done to advance both clinical care and research in this area. Future directions require consensus definitions for sarcopenia, obesity and sarcopenic obesity, an expansion of our understanding of the complex pathogenesis of the muscle-liver-adipose tissue axis in cirrhosis and evidence to support management recommendations for nutrition, exercise and pharmacological therapies.
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Affiliation(s)
| | | | - Maitreyi Raman
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Puneeta Tandon
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
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65
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El Ghoch M, Rossi AP, Calugi S, Rubele S, Soave F, Zamboni M, Chignola E, Mazzali G, Bazzani PV, Dalle Grave R. Physical performance measures in screening for reduced lean body mass in adult females with obesity. Nutr Metab Cardiovasc Dis 2018; 28:917-921. [PMID: 30017438 DOI: 10.1016/j.numecd.2018.06.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Little is known about the reduction of lean body mass (LBM) in obesity, or how to identify it in standard clinical settings. We therefore aimed to assess the prevalence of low LBM in adult females with obesity, and to identify the reliability of simple tools for its screening in this population. METHODS AND RESULTS Dual-energy X-ray absorptiometry (DXA) body composition assessment was used to categorise 147 female participants with obesity as with or without low LBM, according to the new definition that takes into account both appendicular lean mass (ALM) and body mass index (BMI)-ALM/BMI <0.512. Participants were also administered the six-minute walking test, handgrip-strength test and 4-metre gait-speed test. Of the sample of 147 participants, 93 (63.3%) met the criteria for reduced LBM. Stepwise multivariate logistic regression analysis showed that the six-minute walking test was the only independent test associated with low LBM (OR = 0.992, 95%CI 0.987-0.998). Receiver operating characteristic (ROC) curve analysis found that the discriminating cut-off points of the tests considered were 470 m, 3.30 s (gait speed = 1.2 m/sec) and 23.5 kg respectively; the 4-metre gait-speed test seems to provide the best balance of sensitivity and specificity, and the greatest discriminatory power at 90% sensitivity. CONCLUSIONS Treatment-seeking adult females with obesity display a great prevalence of reduced LBM. The six-minute walking test was the only independent test associated with low LBM, but the 4-metre gait-speed test seems to be the most accurate functional test for screening for this condition in that population.
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Affiliation(s)
- M El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy.
| | - A P Rossi
- Department of Medicine, Geriatrics Division, University of Verona, Italy
| | - S Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
| | - S Rubele
- Department of Medicine, Geriatrics Division, University of Verona, Italy
| | - F Soave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
| | - M Zamboni
- Department of Medicine, Geriatrics Division, University of Verona, Italy
| | - E Chignola
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
| | - G Mazzali
- Department of Medicine, Geriatrics Division, University of Verona, Italy
| | - P V Bazzani
- Department of Radiology, Villa Garda Hospital, Via Montebaldo 89, Garda, 37016, Italy
| | - R Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
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66
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Trouwborst I, Verreijen A, Memelink R, Massanet P, Boirie Y, Weijs P, Tieland M. Exercise and Nutrition Strategies to Counteract Sarcopenic Obesity. Nutrients 2018; 10:E605. [PMID: 29757230 PMCID: PMC5986485 DOI: 10.3390/nu10050605] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/03/2018] [Accepted: 05/09/2018] [Indexed: 02/08/2023] Open
Abstract
As the population is aging rapidly, there is a strong increase in the number of individuals with chronic disease and physical limitations. The decrease in skeletal muscle mass and function (sarcopenia) and the increase in fat mass (obesity) are important contributors to the development of physical limitations, which aggravates the chronic diseases prognosis. The combination of the two conditions, which is referred to as sarcopenic obesity, amplifies the risk for these negative health outcomes, which demonstrates the importance of preventing or counteracting sarcopenic obesity. One of the main challenges is the preservation of the skeletal muscle mass and function, while simultaneously reducing the fat mass in this population. Exercise and nutrition are two key components in the development, as well as the prevention and treatment of sarcopenic obesity. The main aim of this narrative review is to summarize the different, both separate and combined, exercise and nutrition strategies so as to prevent and/or counteract sarcopenic obesity. This review therefore provides a current update of the various exercise and nutritional strategies to improve the contrasting body composition changes and physical functioning in sarcopenic obese individuals.
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Affiliation(s)
- Inez Trouwborst
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1097 SM Amsterdam, The Netherlands.
| | - Amely Verreijen
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1097 SM Amsterdam, The Netherlands.
| | - Robert Memelink
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1097 SM Amsterdam, The Netherlands.
| | - Pablo Massanet
- Medical Intensive Care Unit, Nimes University Hospital, place du Pr Debré, 30029 Nimes, France.
| | - Yves Boirie
- Medical Intensive Care Unit, Nimes University Hospital, place du Pr Debré, 30029 Nimes, France.
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRA, CRNH Auvergne, CHU Clermont-Ferrand, Service Nutrition Clinique, F-63000 Clermont-Ferrand, France.
| | - Peter Weijs
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1097 SM Amsterdam, The Netherlands.
- Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, De Boelenlaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - Michael Tieland
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1097 SM Amsterdam, The Netherlands.
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Murphy CH, Shankaran M, Churchward-Venne TA, Mitchell CJ, Kolar NM, Burke LM, Hawley JA, Kassis A, Karagounis LG, Li K, King C, Hellerstein M, Phillips SM. Effect of resistance training and protein intake pattern on myofibrillar protein synthesis and proteome kinetics in older men in energy restriction. J Physiol 2018. [PMID: 29532476 DOI: 10.1113/jp275246] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Strategies to enhance the loss of fat while preserving muscle mass during energy restriction are of great importance to prevent sarcopenia in overweight older adults. We show for the first time that the integrated rate of synthesis of numerous individual contractile, cytosolic and mitochondrial skeletal muscle proteins was increased by resistance training (RT) and unaffected by dietary protein intake pattern during energy restriction in free-living, obese older men. We observed a correlation between the synthetic rates of skeletal muscle-derived proteins obtained in serum (creatine kinase M-type, carbonic anhydrase 3) and the synthetic rates of proteins obtained via muscle sampling; and that the synthesis rates of these proteins in serum revealed the stimulatory effects of RT. These results have ramifications for understanding the influence of RT on skeletal muscle and are consistent with the role of RT in maintaining muscle protein synthesis and potentially supporting muscle mass preservation during weight loss. ABSTRACT We determined how the pattern of protein intake and resistance training (RT) influenced longer-term (2 weeks) integrated myofibrillar protein synthesis (MyoPS) during energy restriction (ER). MyoPS and proteome kinetics were measured during 2 weeks of ER alone and 2 weeks of ER plus RT (ER + RT) in overweight/obese older men. Participants were randomized to consume dietary protein in a balanced (BAL: 25% daily protein per meal × 4 meals) or skewed (SKEW: 7:17:72:4% daily protein per meal) pattern (n = 10 per group). Participants ingested deuterated water during the consecutive 2-week periods, and skeletal muscle biopsies and serum were obtained at the beginning and conclusion of ER and ER + RT. Bulk MyoPS (i.e. synthesis of the myofibrillar protein sub-fraction) and the synthetic rates of numerous individual skeletal muscle proteins were quantified. Bulk MyoPS was not affected by protein distribution during ER or ER + RT (ER: BAL = 1.24 ± 0.31%/day, SKEW = 1.26 ± 0.37%/day; ER + RT: BAL = 1.64 ± 0.48%/day, SKEW = 1.52 ± 0.66%/day) but was ∼26% higher during ER + RT than during ER (P = 0.023). The synthetic rates of 175 of 190 contractile, cytosolic and mitochondrial skeletal muscle proteins, as well as synthesis of muscle-derived proteins measured in serum, creatine kinase M-type (CK-M) and carbonic anhydrase 3 (CA-3), were higher during ER + RT than during ER (P < 0.05). In addition, the synthetic rates of CK-M and CA-3 measured in serum correlated with the synthetic rates of proteins obtained via muscle sampling (P < 0.05). This study provides novel data on the skeletal muscle adaptations to RT and dietary protein distribution.
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Affiliation(s)
| | - Mahalakshmi Shankaran
- KineMed, Inc., Emeryville, CA, USA.,Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | | | | | | | - Louise M Burke
- Department of Sports Nutrition, Australian Institute of Sport, Canberra, Australia
| | - John A Hawley
- Exercise and Nutrition Research Group, Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, UK
| | - Amira Kassis
- Nestlé Research Center, Nestec Ltd, Lausanne, Switzerland
| | | | - Kelvin Li
- KineMed, Inc., Emeryville, CA, USA.,Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | | | - Marc Hellerstein
- KineMed, Inc., Emeryville, CA, USA.,Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
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Garcia-Contreras C, Vazquez-Gomez M, Torres-Rovira L, Gonzalez J, Porrini E, Gonzalez-Colaço M, Isabel B, Astiz S, Gonzalez-Bulnes A. Characterization of Ageing- and Diet-Related Swine Models of Sarcopenia and Sarcopenic Obesity. Int J Mol Sci 2018. [PMID: 29534532 PMCID: PMC5877684 DOI: 10.3390/ijms19030823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Sarcopenia and sarcopenic obesity are currently considered major global threats for health and well-being. However, there is a lack of adequate preclinical models for their study. The present trial evaluated the suitability of aged swine by determining changes in adiposity, fatty acids composition, antioxidant status and lipid peroxidation, development of metabolic disturbances and structural changes in tissues and organs. Iberian sows with clinical evidence of aging-related sarcopenia were fed a standard diet fulfilling their maintenance requirements or an obesogenic diet for 100 days. Aging and sarcopenia were related to increased lipid accumulation and cellular dysfunction at both adipose tissue and non-adipose ectopic tissues (liver and pancreas). Obesity concomitant to sarcopenia aggravates the condition by increasing visceral adiposity and causing dyslipidemia, insulin resistance and lipotoxicity in non-adipose tissues. These results support that the Iberian swine model represents certain features of sarcopenia and sarcopenic obesity in humans, paving the way for future research on physiopathology of these conditions and possible therapeutic targets.
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Affiliation(s)
| | - Marta Vazquez-Gomez
- Faculty of Veterinary Sciences, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | | | - Jorge Gonzalez
- Micros Veterinaria, Campus de Vegazana, 24007 Leon, Spain.
| | - Esteban Porrini
- Institute of Biomedical Technology (ITB), Universidad de La Laguna, 38200 Tenerife, Spain.
| | - Magali Gonzalez-Colaço
- Central Unit of Clinical Research and Clinical Assays (UCICEC), Universitary Hospital of Canary Island, 28010 Tenerife, Spain.
| | - Beatriz Isabel
- Faculty of Veterinary Sciences, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Susana Astiz
- Comparative Physiology Group, SGIT-INIA, 28040 Madrid, Spain.
| | - Antonio Gonzalez-Bulnes
- Comparative Physiology Group, SGIT-INIA, 28040 Madrid, Spain.
- Faculty of Veterinary Sciences, Universidad Complutense de Madrid, 28040 Madrid, Spain.
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Vecchié A, Dallegri F, Carbone F, Bonaventura A, Liberale L, Portincasa P, Frühbeck G, Montecucco F. Obesity phenotypes and their paradoxical association with cardiovascular diseases. Eur J Intern Med 2018; 48:6-17. [PMID: 29100895 DOI: 10.1016/j.ejim.2017.10.020] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 12/15/2022]
Abstract
The pro-inflammatory state of the visceral adipose tissue (VAT) is supposed to accelerate cardiovascular (CV) and metabolic diseases in obese subjects. Some studies have recently reported an improved CV prognosis in certain obese and overweight patients as compared with leaner ones. This phenomenon, known as the "obesity paradox" (OP), has been described in many chronic diseases. This narrative review is based on the material searched for and obtained via PubMed and Web of Science up to May 2017. The search terms we used were: "obesity, paradox, adipose tissue" in combination with "cardiovascular, coronary heart disease, heart failure, arrhythmias". Using the current Body Mass Index (BMI)-based obesity definition, individuals with different clinical and biochemical characteristics are gathered together in the same category. Emerging evidence point to the existence of many "Obesity phenotypes" with different association with CV risk, accordingly to physical and life-style features. In this narrative review, we discussed if obesity phenotypes may be associated with a different CV risk, potentially explaining the OP. As a globally accepted definition of obesity is still lacking, we emphasized the need of a new approach, which should consider the heterogeneity of obesity. Better defining "obesities" and related CV risk is critical to markedly improve the classical BMI-based definition of obesity.
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Affiliation(s)
- Alessandra Vecchié
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, 10 Largo Benzi, 16132 Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Aldo Bonaventura
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; Centre for Molecular Cardiology, University of Zürich, 12 Wagistrasse, 8952 Schlieren, Switzerland
| | - Piero Portincasa
- Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Gema Frühbeck
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain; Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; Ospedale Policlinico San Martino, Istituto di Ricovero e Cura a Carattere Scientifico per l'Oncologia, 10 Largo Benzi, 16132 Genoa, Italy; Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132 Genoa, Italy.
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Nutritional Considerations in Preventing Muscle Atrophy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:497-528. [DOI: 10.1007/978-981-13-1435-3_23] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Cho HJ, Ahn SH, Lee YS, Lee SH, Im DS, Kim I, Koh JM, Kim S, Kim BJ. Free Fatty Acid Receptor 4 Mediates the Beneficial Effects of n-3 Fatty Acids on Body Composition in Mice. Calcif Tissue Int 2017; 101:654-662. [PMID: 28900676 DOI: 10.1007/s00223-017-0323-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/05/2017] [Indexed: 12/21/2022]
Abstract
As populations continue to age worldwide, sarcopenic obesity has heightened interest due to its medical importance. Although much evidence now indicates that n-3 fatty acids (FAs) may have beneficial effects on body composition including fat and muscle, their exact mechanisms have not yet been elucidated. Because free FA receptor 4 (FFA4) has been reported to be a receptor for n-3 FAs, we hypothesized that the protective role of n-3 FAs on body composition could be mediated by FFA4. To test this possibility, we generated mice overexpressing n-3 FAs but lacking FFA4 by crossing fat-1 transgenic (fat-1 Tg+) and FFA4 knockout (Ffar4 -/-) mice. Because fat-1 Tg+ mice, in which n-6 is endogenously converted into n-3 FAs, contain high n-3 FA levels, they could be a good animal model for studying the effects of n-3 FAs in vivo. Male and female littermates were included in high-fat-diet- (HFD) and ovariectomy-induced models, respectively. In the HFD model, male fat-1 Tg+ mice had a lower percentage of fat mass and a higher percentage of lean mass than their wild-type littermates only when they had the Ffar4 +/+ not the Ffar4 -/- background. Female fat-1 Tg+ mice showed less increase of fat mass percentage and less decrease of lean mass percentage after ovariectomy than wild-type littermates. However, these effects on body composition were attenuated in the Ffar4 -/- background. Taken together, our results indicate that the beneficial effects of n-3 FAs on body composition were mediated by FFA4 and thus suggest that FFA4 may be a potential therapeutic target for modulating sarcopenic obesity.
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Affiliation(s)
- Han Jin Cho
- Asan Medical Center, Asan Institute for Life Sciences, Seoul, 05505, South Korea
| | - Seong Hee Ahn
- Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Inchon, 22332, South Korea
| | - Young-Sun Lee
- Asan Medical Center, Asan Institute for Life Sciences, Seoul, 05505, South Korea
| | - Seung Hun Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Dong-Soon Im
- Molecular Inflammation Research Center for Aging Intervention (MRCA) and College of Pharmacy, Pusan National University, Pusan, 46241, South Korea
| | - Inki Kim
- Asan Medical Center, Asan Institute for Life Sciences, Seoul, 05505, South Korea
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, 05505, South Korea
| | - Jung-Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Sungsub Kim
- Graduate School of New Drug Discovery and Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Taejon, 34134, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Abstract
PURPOSE OF REVIEW The worldwide prevalence of obesity is increasing. Obesity is strongly associated with many chronic health conditions that have been shown to improve with weight loss. However, counseling patients on weight loss can be challenging. Identifying specific aspects of weight management may personalize the conversation about weight loss and better address the individual patient's health goals and perceived barriers to change. RECENT FINDINGS Physical and behavioral phenotypes are being identified to better tailor treatment recommendations, given lack of efficacy of currently available interventions. The current review provides a summary of the evidence behind the management of several recognized clinical phenotypes, to include body fat distribution (e.g., central obesity), muscle mass (e.g., sarcopenic obesity of the elderly), and problematic eating behaviors (e.g., cravings). Identifying specific aspects of weight management may personalize the conversation about weight loss and better address the individual patient's health goals and perceived barriers to change.
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Affiliation(s)
- Meera Shah
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Ryan T Hurt
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
- Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA
| | - Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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Villareal DT, Aguirre L, Gurney AB, Waters DL, Sinacore DR, Colombo E, Armamento-Villareal R, Qualls C. Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults. N Engl J Med 2017; 376:1943-1955. [PMID: 28514618 PMCID: PMC5552187 DOI: 10.1056/nejmoa1616338] [Citation(s) in RCA: 375] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Obesity causes frailty in older adults; however, weight loss might accelerate age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia. METHODS In this clinical trial involving 160 obese older adults, we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss. Participants were randomly assigned to a weight-management program plus one of three exercise programs - aerobic training, resistance training, or combined aerobic and resistance training - or to a control group (no weight-management or exercise program). The primary outcome was the change in Physical Performance Test score from baseline to 6 months (scores range from 0 to 36 points; higher scores indicate better performance). Secondary outcomes included changes in other frailty measures, body composition, bone mineral density, and physical functions. RESULTS A total of 141 participants completed the study. The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups (27.9 to 33.4 points [21% increase] vs. 29.3 to 33.2 points [14% increase] and 28.8 to 32.7 points [14% increase], respectively; P=0.01 and P=0.02 after Bonferroni correction); the scores increased more in all exercise groups than in the control group (P<0.001 for between-group comparisons). Peak oxygen consumption (milliliters per kilogram of body weight per minute) increased more in the combination and aerobic groups (17.2 to 20.3 [17% increase] and 17.6 to 20.9 [18% increase], respectively) than in the resistance group (17.0 to 18.3 [8% increase]) (P<0.001 for both comparisons). Strength increased more in the combination and resistance groups (272 to 320 kg [18% increase] and 288 to 337 kg [19% increase], respectively) than in the aerobic group (265 to 270 kg [4% increase]) (P<0.001 for both comparisons). Body weight decreased by 9% in all exercise groups but did not change significantly in the control group. Lean mass decreased less in the combination and resistance groups than in the aerobic group (56.5 to 54.8 kg [3% decrease] and 58.1 to 57.1 kg [2% decrease], respectively, vs. 55.0 to 52.3 kg [5% decrease]), as did bone mineral density at the total hip (grams per square centimeter; 1.010 to 0.996 [1% decrease] and 1.047 to 1.041 [0.5% decrease], respectively, vs. 1.018 to 0.991 [3% decrease]) (P<0.05 for all comparisons). Exercise-related adverse events included musculoskeletal injuries. CONCLUSIONS Of the methods tested, weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults. (Funded by the National Institutes of Health; LITOE ClinicalTrials.gov number, NCT01065636 .).
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Affiliation(s)
- Dennis T Villareal
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - Lina Aguirre
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - A Burke Gurney
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - Debra L Waters
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - David R Sinacore
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - Elizabeth Colombo
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - Reina Armamento-Villareal
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
| | - Clifford Qualls
- From the Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, and the Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center - both in Houston (D.T.V., R.A.-V.); Medicine Care Line, New Mexico VA Health Care System (L.A., D.L.W., E.C.), and the Department of Internal Medicine (L.A., E.C.), the Division of Physical Therapy (A.B.G.), and the Department of Mathematics and Statistics (C.Q.), University of New Mexico School of Medicine - both in Albuquerque; the Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand (D.L.W.); and the Program in Physical Therapy, Washington University School of Medicine, St. Louis (D.R.S.)
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Santos CM, Dias JMD, Samora GAR, Perracini MR, Guerra RO, Dias RC. Prevalence of obesity, sarcopenic obesity and associated factors: A FIBRA Network study. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.s01.ao16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Sarcopenic obesity in older adults may lead to an inability to use muscles efficiently and has been associated with functional deficits and disabilities. Objective: To identify the prevalence of obesity and sarcopenic obesity (SO) among community-dwelling older adults, and to characterize associated sociodemographics, health conditions and functional performance. Methods: Study data are from the FIBRA Network database of the Federal University of Minas Gerais. There were 1,373 older adult participants, subdivided into three groups: 1) non-obese; 2) non-sarcopenic obese; and 3) sarcopenic obese (SO). The latter is defined as a BMI ≥30 kg/m2 and weak palmar grip strength (PGS). Results: The overall prevalence of obesity and SO among older adults was 25.85% and 4.44%, respectively, with levels of frailty and pre-frailty among at 36.1% and 59%, respectively. Gait speed (GS) was lower in the SO group as well, compared to the other groups. An average increase in GS of 0.1 m/sec reduced the likelihood of SO by 85.1%, in average. Sarcopenic obese older adults were 14.2 times more likely to be pre-fragile and 112.9 times more likely to be fragile than the other groups. Conclusion: The prevalence of obesity found in this study was higher than that in the general population, but similar to national statistics for the sample’s mean age and gender. SO was directly associated with frailty in advanced and instrumental activities of daily living as well as gait speed and significantly increased the likelihood of being pre-frail and frail. GS may be an extremely useful tool for monitoring the progress of SO in older adults.
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75
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Chang MY, Chen HY. Body Composition Outcomes of a Qigong Intervention Among Community-Dwelling Aging Adults. West J Nurs Res 2016; 38:1574-1594. [PMID: 27330046 DOI: 10.1177/0193945916654907] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.
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Affiliation(s)
| | - Hsiao-Yu Chen
- National Taichung University of Science and Technology, Taiwan (R.O.C)
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76
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Shen SS, Chu JJ, Cheng L, Zeng XK, He T, Xu LY, Li JR, Chen XJ. Effects of a nutrition plus exercise programme on physical function in sarcopenic obese elderly people: study protocol for a randomised controlled trial. BMJ Open 2016; 6:e012140. [PMID: 27694489 PMCID: PMC5051493 DOI: 10.1136/bmjopen-2016-012140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION With a rapidly ageing population, sarcopenic obesity, defined as decreased muscle mass and function combined with increased body fat, is a complex health problem. Although sarcopenic obesity contributes to a decline in physical function and exacerbates frailty in older adults, evidence from clinical trials about the effect of exercise and nutrition on this complex syndrome in Chinese older adults is lacking. METHODS AND ANALYSIS We devised a study protocol for a single-blind randomised controlled trial. Sarcopenia is described as age-related decline in muscle mass plus low muscle strength and/or low physical performance. Obesity is defined as a percentage of body fat above the 60th centile. Ninety-two eligible participants will be randomly assigned to a control group, nutrition group, exercise group and nutrition plus exercise group to receive an 8-week intervention and 12-week follow-up. The primary outcomes will be the change in short physical performance battery scores, grip strength and 6 m usual gait speed. The secondary outcomes will include basic activities of daily living scores, instrumental activity daily living scores, body composition and body anthropometric indexes. For all main analyses, the principle of intention-to-treat will be used. ETHICS AND DISSEMINATION This study was approved by the medical ethics committee of Zhejiang Hospital on 25 November 2015. The study will present data targeting the clinical effects of nutrition and exercise on physical function and body composition in a Chinese older population with sarcopenic obesity. The results will help to provide important clinical evidence of the role of complex non-pharmaceutical interventions for sarcopenic obese older people. The findings of this study will be submitted to peer-reviewed medical journals for publication and presented at relevant academic conferences. TRIAL REGISTRATION NUMBER ChiCTR-IOR-15007501; Pre-results.
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Affiliation(s)
- Shan-Shan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Jiao-Jiao Chu
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Lei Cheng
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xing-Kun Zeng
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Ting He
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Li-Yu Xu
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Jiang-Ru Li
- Department of Rehabilitation Medicine, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xu-Jiao Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, China
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77
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Lee DC, Shook RP, Drenowatz C, Blair SN. Physical activity and sarcopenic obesity: definition, assessment, prevalence and mechanism. Future Sci OA 2016; 2:FSO127. [PMID: 28031974 PMCID: PMC5137918 DOI: 10.4155/fsoa-2016-0028] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/11/2016] [Indexed: 12/25/2022] Open
Abstract
Sarcopenic obesity is the coexistance of sarcopenia and obesity. Modern sarcopenia definition includes low muscle mass, weak muscle strength (handgrip strength) and poor physical function (slow walking), although the clinical definition of each varies worldwide. The cut-points for low muscle mass for men and women using appendicular lean mass divided by height (kg/m2) are ≤7.0 and ≤5.4 in Asians, and ≤7.23 and ≤5.67 in Caucasians, respectively. The cut-points for weak handgrip strength (kg) for men and women are <26 and <18 in Asians, and <30 and <20 in Caucasians, respectively. The cut-point for slow walking is ≤0.8 m/s in men and women. Current data suggest the potential benefits of physical activity and fitness on sarcopenic obesity in older adults.
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Affiliation(s)
- Duck-chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA 50011, USA
| | - Robin P Shook
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA 50011, USA
| | - Clemens Drenowatz
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, SC 29208, USA
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78
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Vasconcelos KSS, Dias JMD, Araújo MC, Pinheiro AC, Moreira BS, Dias RC. Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial. Braz J Phys Ther 2016; 20:432-440. [PMID: 27410162 PMCID: PMC5123261 DOI: 10.1590/bjpt-rbf.2014.0174] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 03/01/2016] [Indexed: 02/02/2023] Open
Abstract
Background Sarcopenic obesity is associated with disability in older people, especially in
women. Resistance exercises are recommended for this population, but their
efficacy is not clear. Objective To evaluate the effects of a progressive resistance exercise program with
high-speed component on the physical function of older women with sarcopenic
obesity. Method Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2
and handgrip strength ≤21kg were randomly allocated to two groups. The
experimental group underwent a 10-week resistance exercise program designed to
improve strength, power, and endurance of lower-limb muscles, with open chain and
closed chain exercises. The control group had their health status monitored
through telephone calls. The primary outcomes were lower limb muscle performance
measured by knee extensor strength, power and fatigue by isokinetic dynamometry,
and mobility measured by the Short Physical Performance Battery and by gait
velocity. The secondary outcome was health-related quality of life assessed by the
SF-36 Questionnaire. Results The average rate of adherence was 85%, with few mild adverse effects. There were
no significant between-group differences for any of the outcomes. Conclusion In this study, a progressive resistance exercise program with high-speed component
was not effective for improving the physical function of older women with
sarcopenic obesity.
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Affiliation(s)
- Karina S S Vasconcelos
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - João M D Dias
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Marília C Araújo
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana C Pinheiro
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Bruno S Moreira
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rosângela C Dias
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Barbat-Artigas S, Garnier S, Joffroy S, Riesco É, Sanguignol F, Vellas B, Rolland Y, Andrieu S, Aubertin-Leheudre M, Mauriège P. Caloric restriction and aerobic exercise in sarcopenic and non-sarcopenic obese women: an observational and retrospective study. J Cachexia Sarcopenia Muscle 2016; 7:284-9. [PMID: 27247859 PMCID: PMC4867658 DOI: 10.1002/jcsm.12075] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 08/13/2015] [Accepted: 09/01/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Sarcopenic obese (SO) individuals are a unique subset of subjects that combines obesity and sarcopenia. Traditional weight loss programmes including aerobic exercises may worsen their condition by further reducing their lean mass. The objective of this observational and retrospective study was to verify the effect of a mixed weight loss programme combining caloric restriction and exercise on body composition, and lipid-lipoprotein profile of obese women according to their sarcopenic status. METHODS One hundred and forty-six obese women (body mass index ≥ 30 kg/m(2) and fat mass ≥ 40%) participated to the 3 week usual and institutionalized weight-reducing programme combining a dietary plan (1400 ± 200 kcal/day) and aerobic exercise (1 h/day, 6 days/week) of a specialized medical institution. The lean body mass index (LMI; lean mass/height(2)) was calculated, and women in the lowest tertile of LMI were considered SO. RESULTS At baseline, SO women were older, and their body weight and LMI were lower than non-sarcopenic obese (N-SO) women (p < 0.05). N-SO and SO women similarly lost fat mass and improved their lipid-lipoprotein profile (p < 0.05), while differences in LMI between groups persisted at the end of the weight-reducing programme. Indeed, N-SO women lost lean mass (p < 0.05) while SO did not. CONCLUSIONS These findings suggest that a short weight loss programme combining caloric restriction and aerobic exercise may significantly reduce fat mass and improve lipid-lipoprotein profile in obese women, independently of their sarcopenic status. Such programmes may have deleterious effects on lean mass in N-SO subjects, only.
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Affiliation(s)
- Sébastien Barbat-Artigas
- Département de Biologie Université du Québec À Montréal Montréal Canada; Groupe de Recherche en Activité Physique Adaptée Université du Québec À Montréal Montréal Canada
| | - Sophie Garnier
- Faculty of Sport Sciences and Human Kinetics Université P. Sabatier Toulouse France
| | - Sandra Joffroy
- Faculty of Sport Sciences and Human Kinetics Université P. Sabatier Toulouse France
| | - Éléonor Riesco
- University of Sherbrooke, and Research Center on Aging CSSS-IUGS Sherbrooke Canada
| | | | - Bruno Vellas
- Service de Médecine Interne et de Gérontologie Clinique Gérontopôle de Toulouse, Hôpital La Grave-Casselardit Toulouse France; Unité Inserm 1027 Faculté de Médecine de Toulouse Toulouse France
| | - Yves Rolland
- Service de Médecine Interne et de Gérontologie Clinique Gérontopôle de Toulouse, Hôpital La Grave-Casselardit Toulouse France; Unité Inserm 1027 Faculté de Médecine de Toulouse Toulouse France
| | - Sandrine Andrieu
- Unité Inserm 1027 Faculté de Médecine de Toulouse Toulouse France; Department of Epidemiology and Public Health and Gerontopole, Department of Geriatric Medicine Toulouse University Hospital Toulouse France
| | - Mylène Aubertin-Leheudre
- Groupe de Recherche en Activité Physique Adaptée Université du Québec À Montréal Montréal Canada; Département de Kinanthropologie Université du Québec À Montréal Montréal Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM) Montréal Canada
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Tyrovolas S, Haro JM, Mariolis A, Piscopo S, Valacchi G, Bountziouka V, Anastasiou F, Zeimbekis A, Tyrovola D, Foscolou A, Gotsis E, Metallinos G, Tur JA, Matalas A, Lionis C, Polychronopoulos E, Panagiotakos D. Skeletal muscle mass and body fat in relation to successful ageing of older adults: The multi-national MEDIS study. Arch Gerontol Geriatr 2016; 66:95-101. [PMID: 27266673 DOI: 10.1016/j.archger.2016.04.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The determinants that promote successful ageing still remain unknown. The aim of the present work was to evaluate the role of skeletal muscle mass and body fat percentage (BF%), in the level of successful ageing. METHODS during 2005-2011, 2663 older (aged 65-100 years) from 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the study. Appendicular skeletal muscle mass (ASM), skeletal muscle mass index (SMI) and BF% were calculated using population formulas. Dietary habits, energy intake, expenditure and energy balance were derived throughout standard procedures. A successful ageing index ranging from 0 to 10 was used. RESULTS The mean ASM mass was 24±6.0kg, the SMI was 0.84±0.21 and the BF% was 44%. Females had lower SMI and higher BF% in comparison with males, respectively [(SMI: 0.66±0.09 vs. 1.03±0.11; BF%: 51% vs. 34%, (p<0.001)]. High successful agers had better rates in ASM (p=0.01), SMI (p<0.001) and BF% (p<0.001), compared with the medium and low successful ones. Changes in SMI [b-coefficient (95% CI):2.14 (1.57 to 2.71)] were positively associated with successful ageing, while changes in BF% [b-coefficient (95% CI): -0.04 (-0.05 to -0.03)] were inversely associated with successful ageing. Results from sensitivity analysis showed that the effects of variations on body composition were consistent, less pronounced in the positive energy balance group and more pronounced among the oldest old. CONCLUSIONS Body composition changes seem to be associated with lower quality of life in the older adults, as measured through successful ageing.
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Affiliation(s)
- Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Josep-Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Anargiros Mariolis
- Health Center of Aeropolis, General Hospital of Sparta, Aeropolis, Greece
| | - Suzanne Piscopo
- University of Malta, Nutrition, Family and Consumer Studies Office, Msida, Malta
| | - Giuseppe Valacchi
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Vassiliki Bountziouka
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Foteini Anastasiou
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Akis Zeimbekis
- Health Center of Kalloni, General Hospital of Mitilini, Mitilini, Greece
| | - Dimitra Tyrovola
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Alexandra Foscolou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Efthimios Gotsis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - George Metallinos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Josep-Antoni Tur
- Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears & CIBERobn, Guillem Colom Bldg, Campus, E-07122 Palma de Mallorca, Spain
| | - Antonia Matalas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Evangelos Polychronopoulos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
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81
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Cleasby ME, Jamieson PM, Atherton PJ. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol 2016; 229:R67-81. [PMID: 26931135 DOI: 10.1530/joe-15-0533] [Citation(s) in RCA: 332] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/01/2016] [Indexed: 12/15/2022]
Abstract
Insulin resistance (IR) in skeletal muscle is a key defect mediating the link between obesity and type 2 diabetes, a disease that typically affects people in later life. Sarcopenia (age-related loss of muscle mass and quality) is a risk factor for a number of frailty-related conditions that occur in the elderly. In addition, a syndrome of 'sarcopenic obesity' (SO) is now increasingly recognised, which is common in older people and is applied to individuals that simultaneously show obesity, IR and sarcopenia. Such individuals are at an increased risk of adverse health events compared with those who are obese or sarcopenic alone. However, there are no licenced treatments for sarcopenia or SO, the syndrome is poorly defined clinically and the mechanisms that might explain a common aetiology are not yet well characterised. In this review, we detail the nature and extent of the clinical syndrome, highlight some of the key physiological processes that are dysregulated and discuss some candidate molecular pathways that could be implicated in both metabolic and anabolic defects in skeletal muscle, with an eye towards future therapeutic options. In particular, the potential roles of Akt/mammalian target of rapamycin signalling, AMP-activated protein kinase, myostatin, urocortins and vitamin D are discussed.
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Affiliation(s)
- Mark E Cleasby
- Department of Comparative Biomedical SciencesRoyal Veterinary College, University of London, London, UK
| | - Pauline M Jamieson
- Centre for Cardiovascular ScienceQueen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Philip J Atherton
- Division of Medical Sciences and Graduate Entry MedicineUniversity of Nottingham, Medical School, Royal Derby Hospital, Derby, UK
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The FTO gene is associated with a paradoxically favorable cardiometabolic risk profile in frail, obese older adults. Pharmacogenet Genomics 2016; 26:154-160. [PMID: 26709911 DOI: 10.1097/fpc.0000000000000201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Fat mass and obesity-associated (FTO) gene polymorphisms have been reported to be associated with differences in BMI, obesity, and type 2 diabetes. However, previous studies have been predominantly conducted in younger individuals across a spectrum of body weights, whereas little information is available on the older population. We examined the association of FTO gene polymorphisms with cardiometabolic risks among adults who were both obese (BMI≥30 kg/m) and older (age≥65 years). METHODS A total of 165 frail, obese older adults were genotyped for FTO (rs9939609 and rs8050136) single nucleotide polymorphisms and studied for associations with body weight and body composition, components and prevalence of the metabolic syndrome, insulin response to an oral glucose tolerance test, and levels of adipocytokines (e.g. leptin) and vitamin D. RESULTS Carriers of the A allele (CA/AA) of the FTO single nucleotide polymorphism rs8050136 had lower body weight, BMI, body fat, and trunk fat than those without the A allele (CC genotype; all P's<0.05). Moreover, genotype CA/AA was associated with lower levels of triglycerides and higher levels of high-density lipoprotein-cholesterol and carriers of this genotype showed a trend toward a lower waist circumference, resulting in a lower prevalence of metabolic syndrome than in CC genotype carriers. The insulin area under the curve during the oral glucose tolerance test was lower for genotype CA/AA. Despite the lower insulin levels, the glucose area under the curve was unchanged, resulting in a higher insulin sensitivity index. Leptin levels were also lower and adiponectin and 25-hydroxyvitamin levels tended to be higher for genotype CA/AA than for genotype CC. No differences were observed for rs9939609. CONCLUSION Unlike the results from studies in younger individuals, the risk A allele may confer a favorable cardiometabolic risk profile in obese older adults, suggesting selective survival of obese adults into old age. If confirmed in a larger sample of surviving obese older adults, these findings may have implications in the clinical approach to obesity in this population.
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83
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Kemmler W, von Stengel S, Engelke K, Sieber C, Freiberger E. Prevalence of sarcopenic obesity in Germany using established definitions: Baseline data of the FORMOsA study. Osteoporos Int 2016; 27:275-81. [PMID: 26318759 DOI: 10.1007/s00198-015-3303-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/21/2015] [Indexed: 11/27/2022]
Abstract
UNLABELLED The prevalence of sarcopenic obesity in community-dwelling women 70 years and older according to established sarcopenia and obesity definitions averaged between 0 and 2.3 % and can thus be considered as relatively low. However, the converse argument that sarcopenic obesity was incompatible with an independent life cannot be confirmed. INTRODUCTION The primary aim of the study was to determine the prevalence of sarcopenic obesity (SO) in community-dwelling (CD) older females in Germany. The secondary aim was to assess whether these females really live independently and autonomously. METHODS A total of 1325 CD females 70 years and older living in the area of Erlangen-Nürnberg, Germany were assessed. Sarcopenia as defined by (a) the European Working Group on Sarcopenia in older people (EWGSOP) and (b) the International working group on Sarcopenia (IWGS) combined with obesity defined as (a) BMI ≥ 30 kg/m(2) (NIH) or (b) body-fat ≥ 35 % (WHO) was determined. In participants with SO, Barthel Index, care level and social network were retrospectively evaluated via personal interview. RESULTS Based on anthropometric data, family, education and social status, lifestyle, number and distribution of diseases and medication, the present cohort is representative for the corresponding German population. Sarcopenia prevalence was 4.5 % according to EWGSOP and 3.3 % according to the IWGS criteria. Obesity prevalence in our cohort averaged 19.8 % (BMI, NIH) and 63.8 % (body fat, WHO). The overlap between both factors (i.e. SO) ranged from 0 % (EWGSOP + NIH criteria) to 2.3 % (EWGSOP + WHO criteria). Factors that may represent limited autonomy or independence were very rarely identified in this SO cohort. CONCLUSION The prevalence of sarcopenic obesity in the CD (female) German population 70 years + is relatively low. With respect to our second research aim, the hypothesis that SO was incompatible with independent life was rejected. However, the latter finding should be addressed with more dedicated study designs.
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Affiliation(s)
- W Kemmler
- Institute of Medical Physics, University of Erlangen-Nürnberg, 91052, Erlangen, Germany.
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany.
| | - S von Stengel
- Institute of Medical Physics, University of Erlangen-Nürnberg, 91052, Erlangen, Germany
| | - K Engelke
- Institute of Medical Physics, University of Erlangen-Nürnberg, 91052, Erlangen, Germany
| | - C Sieber
- Institute of Biomedicine of Aging, University of Erlangen-Nürnberg, 90408, Nürnberg, Germany
| | - E Freiberger
- Institute of Biomedicine of Aging, University of Erlangen-Nürnberg, 90408, Nürnberg, Germany
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Chong MS, Tay L, Ismail NH, Tan CH, Yew S, Yeo A, Ye R, Leung B, Ding YY. The Case for Stage-Specific Frailty Interventions Spanning Community Aging to Cognitive Impairment. J Am Med Dir Assoc 2015; 16:1003.e13-9. [DOI: 10.1016/j.jamda.2015.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 10/22/2022]
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Goisser S, Kemmler W, Porzel S, Volkert D, Sieber CC, Bollheimer LC, Freiberger E. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review. Clin Interv Aging 2015; 10:1267-82. [PMID: 26346071 PMCID: PMC4531044 DOI: 10.2147/cia.s82454] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity.
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Affiliation(s)
- Sabine Goisser
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics (IMP), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Simone Porzel
- Nutricia GmbH, Danone Medical Nutrition, Erlangen, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany ; Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder), Regensburg, Germany
| | - Leo Cornelius Bollheimer
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany ; Department of Internal Medicine and Geriatrics, St John of God Hospital (Barmherzige Brüder), Regensburg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Nuremberg, Germany
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86
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Pietro K. Optimizing Protein in the Older Adult. Am J Lifestyle Med 2015. [DOI: 10.1177/1559827615578827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aging is associated with specific physiological changes. One change that influences the functionality of an individual is the decrease in skeletal muscle. Research efforts to maintain skeletal muscle through dietary modifications have primarily focused on protein intake, including composition, quantity, and timing. Evidence demonstrates that adequacy, quality, and balance of protein intake are important; however, it should not replace the other dietary needs of the individual. The purpose of this article is to summarize the vast area of research regarding protein consumption in the aging population and place it in context of other nutritional concerns that affect this demographic. Efforts to educate older adults without providing overcomplicated guidelines will reduce the likelihood of individuals feeling overwhelmed, increasing dietary adherence.
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Affiliation(s)
- Kevin Pietro
- University of New Hampshire, Durham, New Hampshire
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87
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Jang H, Kim JH, Choi SH, Lee Y, Hong CH, Jeong JH, Han HJ, Moon SY, Park KW, Han SH, Park KH, Kim HJ, Na DL, Seo SW. Body Mass Index and Mortality Rate in Korean Patients with Alzheimer’s Disease. J Alzheimers Dis 2015; 46:399-406. [DOI: 10.3233/jad-142790] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Hun Kim
- Department of Neurology, Dementia Center, Stroke Center, Ilsan hospital, National Health Insurance Corporation, Goyang-shi, South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea
| | | | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - Kyung Won Park
- Department of Neurology, Dona-A University College of Medicine, Pusan, Korea
| | - Seol-Hee Han
- Department of Neurology, Konkuk University College of Medicine, Seoul, Korea
| | - Kee Hyung Park
- Department of Neurology, Gachon University of Medicine and Science, Gil Medical Center, Incheon
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Neuroscience Center, Samsung Medical Center
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University
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Murphy CH, Churchward-Venne TA, Mitchell CJ, Kolar NM, Kassis A, Karagounis LG, Burke LM, Hawley JA, Phillips SM. Hypoenergetic diet-induced reductions in myofibrillar protein synthesis are restored with resistance training and balanced daily protein ingestion in older men. Am J Physiol Endocrinol Metab 2015; 308:E734-43. [PMID: 25738784 PMCID: PMC4420900 DOI: 10.1152/ajpendo.00550.2014] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 02/23/2015] [Indexed: 01/22/2023]
Abstract
Strategies to enhance weight loss with a high fat-to-lean ratio in overweight/obese older adults are important since lean loss could exacerbate sarcopenia. We examined how dietary protein distribution affected muscle protein synthesis during energy balance (EB), energy restriction (ER), and energy restriction plus resistance training (ER + RT). A 4-wk ER diet was provided to overweight/obese older men (66 ± 4 yr, 31 ± 5 kg/m(2)) who were randomized to either a balanced (BAL: 25% daily protein/meal × 4) or skewed (SKEW: 7:17:72:4% daily protein/meal; n = 10/group) pattern. Myofibrillar and sarcoplasmic protein fractional synthetic rates (FSR) were measured during a 13-h primed continuous infusion of l-[ring-(13)C6]phenylalanine with BAL and SKEW pattern of protein intake in EB, after 2 wk ER, and after 2 wk ER + RT. Fed-state myofibrillar FSR was lower in ER than EB in both groups (P < 0.001), but was greater in BAL than SKEW (P = 0.014). In ER + RT, fed-state myofibrillar FSR increased above ER in both groups and in BAL was not different from EB (P = 0.903). In SKEW myofibrillar FSR remained lower than EB (P = 0.002) and lower than BAL (P = 0.006). Fed-state sarcoplasmic protein FSR was reduced similarly in ER and ER + RT compared with EB (P < 0.01) in both groups. During ER in overweight/obese older men a BAL consumption of protein stimulated the synthesis of muscle contractile proteins more effectively than traditional, SKEW distribution. Combining RT with a BAL protein distribution "rescued" the lower rates of myofibrillar protein synthesis during moderate ER.
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Affiliation(s)
- Caoileann H Murphy
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | | | - Cameron J Mitchell
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Nathan M Kolar
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Amira Kassis
- Nestlé Research Center, Nestec, Lausanne, Switzerland
| | | | - Louise M Burke
- Department of Sports Nutrition, Australian Institute of Sport, Canberra, Australia
| | - John A Hawley
- Exercise and Nutrition Research Group, School of Exercise Science, Australian Catholic University, Fitzroy, Victoria, Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom; and
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada;
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Burman M, Säätelä S, Carlsson M, Olofsson B, Gustafson Y, Hörnsten C. Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people. J Nutr Health Aging 2015; 19:461-7. [PMID: 25809811 DOI: 10.1007/s12603-015-0443-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people. DESIGN A prospective cohort study. SETTING A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community. PARTICIPANTS Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years). MEASUREMENTS Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed. RESULTS The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (P<0.001). Thirteen percent were malnourished (MNA<17) and 40.3% at risk of malnutrition (MNA 17-23.5) according to MNA. Also, 34.8% of those with a MNA score <17 still had a BMI value ≥22.2 kg/m2. A BMI value <22.2 kg/m2 and a MNA score<17 were associated with lower survival. The association with mortality seemed to be J-shaped for BMI, and linear for MNA. CONCLUSIONS Malnutrition according to MNA was common, but a substantial portion of those with a low MNA score still had a high BMI value, and vice versa. The association with mortality appeared to be J-shaped for BMI, and linear for MNA. The MNA seems to be a good measurement of malnutrition in very old people, and BMI might be misleading and could underestimate the prevalence of malnutrition, especially in women.
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Affiliation(s)
- M Burman
- M. Burman, Geriatric Medicine, Department of Community Medicine and Rehabilitation, Umea Universitet, Umea, Sweden SE-90187,
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Zhou D, You J, Li QY, Li HZ, Wu WF, Zhang XD, Zhang JH, Tang SS, Wang YK, Liu T. Synthesis and biological evaluation of novel structure-related hGHRH agonistic analogs. Growth Factors 2015; 33:160-8. [PMID: 25798996 DOI: 10.3109/08977194.2015.1010644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Activity and half-life play key roles in the application of GHRH analogues. The GHRH monomers produced in a solid synthesizer were incubated, respectively, in NH4OH solution and lyophilized to obtain their dimers. The activities, specificities, and receptor affinities of the GHRH dimers were evaluated in rGH release/inhibition, rACTH/LH/PRL release, pituitary homogenate binding, and fluorescent staining. Compared to hGHRH(1-44)NH2 (S), PP-hGHRH(1-44)-GGC-CGG-hGHRH(44-1)-PP (2D), P-hGHRH(1-44)-GGC-CGG-hGHRH(44-1)-P (2E), (1)P-hGHRH(2-44)-GGC-CGG-hGHRH(44-2)-(1)P (2F), or hGHRH(1-44)-GGC-CGG-hGHRH(44-1) (2Y) had potency of 104 ± 16.7%, 94 ± 32.6%, 114 ± 16.6%, or 122 ± 14.5% and similar specificities. The inhibition effect of GHIH on rGH stimulated by GHRH dimer was in dose-/time-dependent manner. The staining of FITC-labeled dimer showed cytomembrane distribution and the binding ranking was 2F>2D>2Y>2E>S. 2F presents the strongest activity and the highest affinity to pituitary cells. The dimer with (1)Pro-GHRH stimulates stronger rGH release than that with (1)Tyr-GHRH and the N-terminal single cyclic amino acid is required for the stimulation.
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Affiliation(s)
- Dong Zhou
- Department of Biochemistry and Molecular Biology, School of Basic Courses, Guangdong Pharmaceutical University , Guangzhou , China
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Valencia WM, Stoutenberg M, Florez H. Weight loss and physical activity for disease prevention in obese older adults: an important role for lifestyle management. Curr Diab Rep 2014; 14:539. [PMID: 25183491 DOI: 10.1007/s11892-014-0539-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Weight loss in older adults has been a controversial topic for more than a decade. An obesity paradox has been previously described and the issue of weight status on health outcomes remains a highly debated topic. However, there is little doubt that physical activity (PA) has a myriad of benefits in older adults, especially in obese individuals who are inactive and have a poor cardiometabolic profile. In this review, we offer a critical view to clarify misunderstandings regarding the obesity paradox, particularly as it relates to obese older adults. We also review the evidence on PA and lifestyle interventions for the improvement of cardiorespiratory fitness, which can prevent disease and provide benefits to obese older adults, independent of weight changes.
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Affiliation(s)
- Willy Marcos Valencia
- Geriatrics Research, Education and Clinical Center (GRECC), Miami VA Healthcare System, Miami, FL, USA,
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92
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Wimalawansa SJ. Stigma of obesity: A major barrier to overcome. J Clin Transl Endocrinol 2014; 1:73-76. [PMID: 29159086 PMCID: PMC5685031 DOI: 10.1016/j.jcte.2014.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/06/2014] [Accepted: 06/11/2014] [Indexed: 11/09/2022] Open
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Affiliation(s)
- Rama Vaidya
- Reproductive Endocrinologist and Director, Unit of Endocrine and Metabolic Disorders, Medical Research Centre of Kasturba Health Society, Mumbai, Maharashtra, India E-mail:
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