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Abdel-Aal NM, Kamil RM, Tayel DI, Hamed RH, Ragab MM, Abd El-Azeim AS. Impact of adding Mediterranean diet to aerobic and strengthening exercise program on pain, inflammation, and muscle performance in females with rheumatoid arthritis: a randomized controlled trial. Physiother Theory Pract 2024:1-17. [PMID: 38804549 DOI: 10.1080/09593985.2024.2358122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND People with rheumatoid arthritis (RA) frequently use dietary interventions such as Mediterranean diet (MedDiet) and exercises to complement pharmacotherapy. OBJECTIVE To investigate the effect of adding MedDiet to a designed exercise program on quadriceps and hamstrings muscles performance, pain, C-reactive protein (CRP), handgrip strength, bodyweight, and function in females with RA. METHODS Sixty females were allocated randomly to the MedDiet plus exercise program (n = 30) or exercise program only (n = 30). The interventions continued for 6 months followed by 6 months of follow-up with no intervention. The primary outcome was the quadriceps and hamstrings muscles performance (agonist-antagonist ratio). The secondary outcomes were visual analog scale (VAS) for pain, CRP blood marker for inflammation, handheld dynamometer for handgrip strength, Health AssessmentQuestionnaire disability index (HAQ-DI) for function, and body weight. All outcomes were measured at baseline, 6-month post-intervention, and 12 months from baseline as a follow-up. RESULTS The MedDiet group showed statistically significant improvements in all the measured outcomes than the control group (p < .05) after 6 and 12 months. After 6 months of intervention, the mean±SD for agonist-antagonist ratio, pain, and HAQ-DI were 84.59 ± 5.33 and 69.92 ± 5.56 (p < .001, ƞ2 = 0.65), 42.33 ± 8.98 and 54.33 ± 10.06 (p < .001, ƞ2 = 0.3), 1.13 ± 0.48 and 1.9 ± 0.59 (p < .001, ƞ2 = 0.34) in the MedDiet and control groups, respectively. CONCLUSION Adding MedDiet to aerobic and strengthening exercise program improved quadriceps and hamstrings muscles performance, pain, functional ability, CRP, handgrip strength, and body weight. Consequently, Mediterranean diet should be considered as adjunctive therapy in treating females with RA.
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Affiliation(s)
- Nabil M Abdel-Aal
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ragia M Kamil
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Dalia I Tayel
- Department of Nutrition, High institute of public health Alexander University, Alexandria, Egypt
| | - Rania H Hamed
- Faculty of Physical Therapy, Nahda University, Beni Suef, Egypt
| | - Mohamed M Ragab
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Alshaymaa S Abd El-Azeim
- Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Abidin SW, Citrakesumasari C, Bahar B, Jafar N, Hidayanti H, Hadju V. The effect of extra virgin olive oil (EVOO) on fat mass and fat-free mass for breastfeeding mothers (0-24 months) in Makassar City, Indonesia. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:127. [PMID: 38784279 PMCID: PMC11114483 DOI: 10.4103/jehp.jehp_907_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/19/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Extra Virgin Olive Oil (EVOO) is a fat source classified as monounsaturated fatty acid. Previous studies have shown that 47.5% of breastfeeding mothers have less fat intake when compared to the Adequacy of Nutrition Rate (RDA). EVOO consumption can improve the composition of breast milk. However, no research has been found regarding the body composition of breastfeeding mothers after consuming EVOO. This study aims to determine the effect of EVOO on the body composition of breastfeeding mothers 0-24 months. MATERIALS AND METHODS The study was conducted at the Sudiang Raya and Tamalanrea Health Centers in Makassar City with a randomized clinical trial design from January to February 2023. The sample was breastfeeding mothers 0-24 months divided into the intervention group (EVOO and Nutrition Education, n = 17) and the control (Nutrition Education, n = 17). Instruments with Bioelectrical Impedence Analysis tools. Data analysis using t-test. RESULTS The sample is breastfeeding mothers aged between ≤19 and >35 years. The results of the analysis showed that the average pre-post test, % fat mass (FM) P = 0.426 and % fat free mass (FFM) P = 0.508 (P > 0.05), meant that there was no significant difference. Between the two groups there was no significant difference at the end of the study, %FM P = 0.469 and %FFM P = 0.529 (P > 0.05). CONCLUSIONS In the intervention group that was given EVOO, it was possible to maintain%FM and%FFM in the normal percentage range, while in the control group, there was a decrease from the normal to less/low range.
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Affiliation(s)
- Sri W. Abidin
- Master Program in Nutritional Sciences, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | | | - Burhanuddin Bahar
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Nurhaedar Jafar
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Healthy Hidayanti
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Veni Hadju
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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Melguizo-Ibáñez E, Ubago-Jiménez JL, Sanz-Martín D, Alonso-Vargas JM. Health-Related Quality of Life and Injuries in Physical Education Students: A Multi-Group Model According to the Degree of Adherence to the Mediterranean Diet. Eur J Investig Health Psychol Educ 2024; 14:1140-1152. [PMID: 38785573 PMCID: PMC11120319 DOI: 10.3390/ejihpe14050075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
The Mediterranean diet is considered a healthy eating pattern. It has been shown to improve people's quality of life. When a person suffers injuries, their quality of life suffers. This research aims to accomplish the following: (a) to study the differences in the effect of the health-related quality of life on injuries according to the degree of adherence to the Mediterranean diet, (b) to analyse the existing differences in the variables that make up the health-related quality of life according to the degree of adherence to the Mediterranean diet, and (c) to analyse the degree of adherence to the Mediterranean diet according to whether the participants have suffered any injury. The study was descriptive, cross-sectional, and exploratory in a sample of 556 physical education students. The PREDIMED questionnaire, the SF-36 questionnaire, and a self-administered questionnaire were used. The results showed that high adherence to the Mediterranean diet was associated with higher quality of life and lower injury rates. It was also observed that high adherence to the Mediterranean diet improved the effect of the quality of life on injuries. In conclusion, the Mediterranean diet is beneficial for the quality of life of young university students.
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Affiliation(s)
- Eduardo Melguizo-Ibáñez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain; (E.M.-I.); (J.L.U.-J.); (J.M.A.-V.)
| | - José Luis Ubago-Jiménez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain; (E.M.-I.); (J.L.U.-J.); (J.M.A.-V.)
| | - Daniel Sanz-Martín
- Faculty of Humanities and Social Sciences, Universidad Isabel I, 09003 Burgos, Spain
| | - José Manuel Alonso-Vargas
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain; (E.M.-I.); (J.L.U.-J.); (J.M.A.-V.)
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4
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Andreo-López MC, Zarco-Martín MT, Contreras-Bolívar V, Fernández-Soto ML. Prevalence of Sarcopenia and Dynapenia and Related Clinical Outcomes in Patients with Type 1 Diabetes Mellitus. Nutrients 2023; 15:4914. [PMID: 38068772 PMCID: PMC10708144 DOI: 10.3390/nu15234914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Sarcopenia has recently been recognized as a complication of diabetes. However, there are few results about the prevalence of sarcopenia and dynapenia and the related clinical outcomes in type 1 diabetes mellitus (T1DM). Our objectives were to evaluate the prevalence of sarcopenia and dynapenia and to determine whether there are any associations with disease-related factors in people with T1DM. METHODS A cross-sectional study was conducted in people with T1DM. We assessed appendicular skeletal mass index (ASMI) using bioimpedance 50 Hz (Nutrilab Akern). Muscle function was assessed through handgrip strength (HGS) using a Jamar dynamometer. Sarcopenia was defined as a low HGS with low ASMI, whereas dynapenia was defined as low HGS with a normal ASMI. We used HGS data from the Spanish population percentile table and a cut-off point at p5 as dynapenia. The association of clinical, metabolic, and lifestyle variables with sarcopenia and dynapenia was studied. RESULTS This study included 62 T1DM patients (66% females, mean age of 38 ± 14 years, body mass index (BMI) of 24.9 ± 4.7 kg/m2). The prevalence of sarcopenia and dynapenia was 8% and 23%, respectively. In our sample, there were more men in the sarcopenic and dynapenic groups. The sarcopenic group showed a significantly higher mean HbA1c value. Lower diabetes duration, PREDIMED score, BMI, and muscle mass measures (fat-free mass index (FFMI), ASMI, and body cell mass index (BCMI)) were significantly associated with sarcopenia. Decreased diabetes duration, PREDIMED score, phase angle (PhA), and HGS values showed a significant association with dynapenia. CONCLUSIONS The prevalence of sarcopenia and dynapenia was high in people with T1DM in our study. Specifically, the proportion of dynapenia was quite high. HGS and ASMI are practical tools for the assessment of muscle health status in T1DM, and low values are associated with poor glycemic control, underweight, and low adherence to the Mediterranean diet. Thus, dynapenia may predict accelerated muscle aging in T1DM.
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Affiliation(s)
- María Carmen Andreo-López
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain; (M.C.A.-L.); (V.C.-B.); (M.L.F.-S.)
| | - María Teresa Zarco-Martín
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain; (M.C.A.-L.); (V.C.-B.); (M.L.F.-S.)
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18012 Granada, Spain
| | - Victoria Contreras-Bolívar
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain; (M.C.A.-L.); (V.C.-B.); (M.L.F.-S.)
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18012 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
| | - María Luisa Fernández-Soto
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain; (M.C.A.-L.); (V.C.-B.); (M.L.F.-S.)
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18012 Granada, Spain
- Department of Medicine, University of Granada, 18016 Granada, Spain
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Khemka S, Reddy A, Garcia RI, Jacobs M, Reddy RP, Roghani AK, Pattoor V, Basu T, Sehar U, Reddy PH. Role of diet and exercise in aging, Alzheimer's disease, and other chronic diseases. Ageing Res Rev 2023; 91:102091. [PMID: 37832608 PMCID: PMC10842571 DOI: 10.1016/j.arr.2023.102091] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease, characterized by memory loss and multiple cognitive impairments. Genetic mutations cause a small proportion (1-2%) of early-onset AD, with mutations in amyloid precursor protein (APP), presenilin 1 (PS1) and presenilin 2 (PS2). Major contributing factors of late-onset AD are ApoE4 genotype, traumatic brain injury, diabetes, obesity, hypertension, cardiovascular conditions, in addition to lifestyle factors, such as unhealthy diet and lack of physical exercise. Disease progression can be delayed and/or prevented to a greater extent by adopting healthy lifestyle with balanced and antioxidant enriched diet and daily exercise. The interaction and interplay of diet, exercise, age, and pharmacological interventions holds a crucial role in the progression, pathogenesis and management of AD and its comorbidities, including diabetes, obesity, hypertension and cardiovascular conditions. Antioxidant enriched diet contributes to brain health, glucose control, weight management, and cardiovascular well-being. Regular exercise removes toxins including free radicals and enhances insulin sensitivity, and supports cardiovascular function. In the current article, we discussed, the role of diet, and exercise in aging, AD and other conditions including diabetes, obesity, hypertension, cardiovascular conditions. This article also highlights the impact of medication, socioeconomic and lifestyle factors, and pharmacological interventions. These aspects were discussed in different races and ethnic groups in Texas, and the US.
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Affiliation(s)
- Sachi Khemka
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Aananya Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Lubbock High School, Lubbock, TX 79401, USA
| | - Ricardo Isaiah Garcia
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Micheal Jacobs
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Biology, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Ruhananhad P Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Lubbock High School, Lubbock, TX 79401, USA
| | - Aryan Kia Roghani
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Frenship High School, Lubbock, TX 79382, USA
| | - Vasanthkumar Pattoor
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; University of South Florida, Tampa, FL 33620, USA
| | - Tanisha Basu
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department pf Speech, Language and Hearing Services, School Health Professions, Texas Tech University Healthy Sciences Center, Lubbock, TX 79430, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
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Flor-Alemany M, Acosta-Manzano P, Migueles JH, Henriksson P, Löf M, Aparicio VA. Impact of Exercise Intervention Combined with Optimal Mediterranean Diet Adherence during Pregnancy on Postpartum Body Composition: A Quasi-Experimental Study-The GESTAFIT Project. Nutrients 2023; 15:4413. [PMID: 37892487 PMCID: PMC10609918 DOI: 10.3390/nu15204413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to investigate whether the effects of an exercise program during pregnancy on postpartum body composition are moderated by following a healthy dietary pattern (i.e., Mediterranean diet (MD)). Eighty-three pregnant women (control n = 40, exercise n = 43) were included in the present quasi-experimental study. The exercise intervention consisted of a 60 min, 3 day/week throughout pregnancy from gestational week 17, supervised concurrent (aerobic + resistance) exercise program. A food frequency questionnaire and the MD Score (min-max: 0-50) were employed to assess dietary habits and the MD adherence during pregnancy, respectively. Postpartum body composition was measured with dual-energy X-ray absorptiometry, 6 weeks postpartum. The body mass index and the gynecoid fat mass at postpartum were lower in the exercise compared to the control group (p = 0.018 and p = 0.047, respectively). There was an interaction showing that the MD adherence during pregnancy positively moderated the effects of the exercise intervention on postpartum lean mass (p = 0.024), fat mass percentage (p = 0.092), android fat mass (p = 0.076), and android-to-gynecoid fat mass (p = 0.019). The Johnson-Neyman technique revealed that the effects of exercise were enhanced at a MD score of ~31 for lean mass, ~25 for fat mass, ~23 for android fat mass and ~29 for android-to-gynecoid fat mass. Our results suggest that a concurrent-exercise training plus an optimal MD adherence during pregnancy might be a useful strategy to promote a healthier body composition at the postpartum period.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
| | - Pedro Acosta-Manzano
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Jairo H. Migueles
- PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden;
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Huddinge, Sweden;
| | - Virginia A. Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
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Andreo-López MC, Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. The Influence of the Mediterranean Dietary Pattern on Osteoporosis and Sarcopenia. Nutrients 2023; 15:3224. [PMID: 37513646 PMCID: PMC10385532 DOI: 10.3390/nu15143224] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Diet is a modifiable factor in bone and muscle health. The Mediterranean diet (MedDiet) is rich in nutrients and contains key bioactive components with probable protective effects on muscle and bone deterioration. Osteoporosis (OP) and sarcopenia are diseases that increase frailty and susceptibility to fracture, morbidity and mortality. Therefore, it is necessary to combat them in the population. In this regard, MedDiet adherence has proven to be beneficial to bone mineral density (BMD), muscle mass, physical function, OP and sarcopenia. Hence, this diet is proposed as a therapeutic tool that could slow the onset of osteoporosis and sarcopenia. However, there is doubt about the interaction between the MedDiet, strength and fracture risk. Perhaps the amount of EVOO (extra virgin olive oil), fruits, vegetables and fish rich in anti-inflammatory and antioxidant nutrients ingested has an influence, though the results remain controversial.
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Affiliation(s)
| | - Victoria Contreras-Bolívar
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
| | - Beatriz García-Fontana
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
- Department of Cell Biology, University of Granada, 18016 Granada, Spain
| | - Cristina García-Fontana
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
| | - Manuel Muñoz-Torres
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
- Department of Medicine, University of Granada, 18016 Granada, Spain
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Bian D, Xuan C, Li X, Zhou W, Lu Y, Ding T, Shen J, Shi Y, Li G. The association of dietary inflammatory potential with sarcopenia in Chinese community-dwelling older adults. BMC Geriatr 2023; 23:281. [PMID: 37165340 PMCID: PMC10173667 DOI: 10.1186/s12877-023-03938-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/28/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Dietary-induced inflammation is potentially associated with sarcopenia. Nevertheless, few studies have investigated the structure of the inflammatory diet and its correlation with muscle function and performance in both the upper and lower limbs. This study was performed to explore the association of the dietary inflammatory index (DII) with sarcopenia and its diagnostic parameters. METHODS We conducted a cross-sectional survey on a sample of 515 Chinese community-dwelling older adults selected through multistage cluster sampling from three districts in Shanghai. DII scores were calculated using a validated food frequency questionnaire. Sarcopenia and its diagnostic parameters were determined based on the definition set by the Asian Working Group on Sarcopenia (AWGS). RESULTS The mean age of study participants was 71.31 ± 4.71 years. The prevalence of sarcopenia in the cohort was 12.4%. Older adults in the highest DII quartile had a 3.339 times increased risk of sarcopenia compared to those in the lowest quartile (OR Quartile4vs1:3.339, 95%CI: 1.232, 9.052, p-trend: 0.004) after adjusting for confounding factors. Additionally, a more pro-inflammatory diet was associated with lower appendicular skeletal muscle index (ASMI) (OR Quartile4vs1: 3.005, 95%CI: 1.275, 7.318, p-trend: 0.005), a higher 5-times sit-stand test time score (OR Quartile4vs1: 4.942, 95%CI: 1.745, 13.993, p-trend: 0.005), and lower gait speed (OR Quartile4vs1: 2.392, 95%CI: 1.104, 5.185, p-trend: 0.041) after adjusting for confounding factors. However, there was no significant association between DII, handgrip strength, and Short Physical Performance Battery (SPPB) score in either the unadjusted or adjusted model. CONCLUSION This study found that the association between consuming a more pro-inflammatory diet and sarcopenia in Chinese community-dwelling older adults was mainly due to underlying low intakes of dietary energy, protein, and anti-inflammatory foods, and not due to the high intake of pro-inflammatory foods. Meanwhile, DII was more highly correlated with lower limb muscle strength and performance compared to upper limb muscle strength.
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Affiliation(s)
- Dongsheng Bian
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Chengjie Xuan
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiyang Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wendi Zhou
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yaxiong Lu
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Tianze Ding
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Junhao Shen
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yongmei Shi
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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López-Sampalo A, Cobos-Palacios L, Vilches-Pérez A, Sanz-Cánovas J, Vargas-Candela A, Mancebo-Sevilla JJ, Hernández-Negrín H, Gómez-Huelgas R, Bernal-López MR. COVID-19 in Older Patients: Assessment of Post-COVID-19 Sarcopenia. Biomedicines 2023; 11:biomedicines11030733. [PMID: 36979712 PMCID: PMC10045496 DOI: 10.3390/biomedicines11030733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023] Open
Abstract
(1) Background: Acute COVID-19 infections produce alterations in the skeletal muscle, leading to acute sarcopenia, but the medium- and long-term consequences are still unknown. The aim of this study was to evaluate: (1) body composition; (2) muscle strength and the prevalence of sarcopenia; and (3) the relationship between muscle strength with symptomatic and functional evolution in older patients affected by/recovered from COVID-19; (2) Methods: A prospective, longitudinal study of patients aged ≥65 years who had suffered from COVID-19 infection between 1 March and 31 May 2020, as confirmed by PCR or subsequent seroconversion. Persistent symptoms, as well as anthropometric, clinical, and analytical characteristics, were analyzed at 3 and 12 months after infection. The degree of sarcopenia was determined by dynamometry and with SARC-F; (3) Results: 106 participants, aged 76.8 ± 7 years, were included. At 3 months postinfection, a high percentage of sarcopenic patients was found, especially among women and in those with hospitalization. At 12 months postinfection, this percentage had decreased, coinciding with a functional and symptomatic recovery, and the normalization of inflammatory parameters, especially interleukin-6 (4.7 ± 11.6 pg/mL vs. 1.5 ± 2.4 pg/mL, p < 0.05). The improvement in muscle strength was accompanied by significant weight gain (71.9 ± 12.1 kg vs. 74.7 ± 12.7 kg, p < 0.001), but not by an increase in lean mass (49.6 ± 10 vs. 49.9 ± 10, p 0.29); (4) Conclusions: Older COVID-19 survivors presented a functional, clinical, and muscular recovery 12 months postinfection. Even so, it is necessary to carry out comprehensive follow-ups and assessments that include aspects of nutrition and physical activity.
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Affiliation(s)
- Almudena López-Sampalo
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Lidia Cobos-Palacios
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Alberto Vilches-Pérez
- Endocrinology and Nutrition Department, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), 29010 Málaga, Spain
| | - Jaime Sanz-Cánovas
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Antonio Vargas-Candela
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Juan José Mancebo-Sevilla
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Halbert Hernández-Negrín
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
- Ciber Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (R.G.-H.); (M.R.B.-L.)
| | - María Rosa Bernal-López
- Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Avda. Hospital Civil s/n, 29009 Málaga, Spain
- Ciber Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (R.G.-H.); (M.R.B.-L.)
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10
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Bagheri A, Asoudeh F, Rezaei S, Babaei M, Esmaillzadeh A. The Effect of Mediterranean Diet on Body Composition, Inflammatory Factors, and Nutritional Status in Patients with Cachexia Induced by Colorectal Cancer: A Randomized Clinical Trial. Integr Cancer Ther 2023; 22:15347354231195322. [PMID: 37621140 PMCID: PMC10467242 DOI: 10.1177/15347354231195322] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Along with high calorie and high protein diet, a new comprehensive dietary approach is needed to control cachexia caused by cancer and its related outcomes. This study was done to evaluate the effect of a Mediterranean diet on body composition, nutritional status, and inflammatory markers among cancer cachexia patients. METHODS In this randomized clinical trial, 46 patients with colorectal cancer-induced cachexia were included. After randomization, 23 patients were allocated to the intervention group (Mediterranean diet) and 23 to the control group (nutritional counseling for weight gain and prevention of weight loss in cancer patients). The primary outcome including muscle health, nutritional status, and inflammatory markers along with secondary outcomes such as quality of life, and serum proteins were evaluated at the start and the eighth week of the study. Statistical analysis was performed according to the intention-to-treat concept. To compare changes in dependent variables between the 2 groups, analysis of covariance (ANCOVA) was performed. RESULTS After adjustment for the baseline values, age, sex, and supplements use, in the Mediterranean diet group mean of weight (P < .001), lean body mass (P = .001), fat mass (P = .002), and muscle strength (P < .001) were significantly increased compared to the control group. Regarding inflammatory markers, the mean serum level of tumor necrosis factor-alpha (TNF-α) (P < .001), high sensitive-C-reactive protein (hs-CRP) (P = .01) and Interleukin 6 (IL-6) (P < .001) were significantly improved in the Mediterranean diet group. Moreover, in the Mediterranean diet group, the score for global health status (P = .02) and physical performance score (P < .001) were significantly increased. CONCLUSION It appears that the implementation of the Mediterranean diet might be a strategy to improve nutritional status, quality of life, inflammatory markers, and body composition in patients with colorectal cancer cachexia. TRIAL REGISTRATION Iranian Registry of Clinical Trials (www.irct.ir); ID: IRCT20211027052884N1.
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Affiliation(s)
- Amir Bagheri
- Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saied Rezaei
- Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Esmaillzadeh
- Tehran University of Medical Sciences, Tehran, Iran
- Isfahan University of Medical Sciences, Isfahan, Iran
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11
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El Ghoch M, Rossi AP, Verde L, Barrea L, Muscogiuri G, Savastano S, Colao A. Understanding sarcopenic obesity in young adults in clinical practice: a review of three unsolved questions. Panminerva Med 2022; 64:537-547. [PMID: 36533664 DOI: 10.23736/s0031-0808.22.04784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
INTRODUCTION Our aim was to summarize the available literature on three yet unsolved questions, namely: 1) the dilemma surrounding definition of sarcopenic obesity (SO), especially in young adults; 2) the potential impact of this phenotype on weight-loss programme outcomes; and 3) the strategies for optimum management (prevention/treatment) of SO in clinical practice. EVIDENCE ACQUISITION A literature review using the PubMed/Medline database was conducted, and data were summarized based on a narrative approach. EVIDENCE SYNTHESIS Firstly, SO can be screened by the 30-sec sit-to-stand test; ≤25 and ≤21; and confirmed by the ratio of (appendicular lean mass/Body Mass Index) ≤0.789 and 0.512 in males and females, respectively. Secondly, SO is associated with impaired physical fitness, reduced resting energy expenditure and an inactive lifestyle, that seems to negatively impact on weight-management outcomes, namely increasing early dropout and difficulty in maintaining weight loss in the long term. Finally, prevention/treatment of SO in young adults must be realized through tailored lifestyle intervention (diet+exercise) to preserve and improve strength and muscle mass, even where weight loss is necessary. CONCLUSIONS Our findings have clinical implications since they may help in screening, managing and improving the weight-loss outcomes of patients with SO in clinical settings.
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Affiliation(s)
- Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Arab University of Beirut, Beirut, Lebanon
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea P Rossi
- Division of Geriatrics, Department of Medicine, Healthy Aging Center, University of Verona, Verona, Italy
- Division of Geriatrics, Department of Medicine, Ospedale Ca' Foncello ULSS2 Treviso, Treviso, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Luigi Barrea
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Human Sciences, Pegaso Telematic University, Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy -
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
- UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - Silvia Savastano
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il benessere del paziente (C.I.B.O), Unit of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Department of Clinical Medicine and Surgery, Section of Endocrinology, University Federico II, Naples, Italy
- UNESCO Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
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12
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Bizzozero-Peroni B, Brazo-Sayavera J, Martínez-Vizcaíno V, Fernández-Rodríguez R, López-Gil JF, Díaz-Goñi V, Cavero-Redondo I, Mesas AE. High Adherence to the Mediterranean Diet is Associated with Higher Physical Fitness in Adults: a Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:2195-2206. [PMID: 36166848 PMCID: PMC9776663 DOI: 10.1093/advances/nmac104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/29/2022] [Accepted: 09/22/2022] [Indexed: 01/29/2023] Open
Abstract
Although prior research has synthesized the relationships between the Mediterranean diet (MD) and components of physical fitness (PF) in adults, they are limited and inconclusive. This study aimed to synthesize the associations between high (compared with low) MD adherence and PF levels with each of its components (cardiorespiratory, motor, and musculoskeletal) in adulthood. We conducted a systematic search in 5 databases from inception to January 2022. Observational studies and randomized controlled trials were included. Pooled odds ratios (ORs) and effect sizes (Cohen d index) with their 95% CIs were calculated via a random effects model. A total of 30 studies were included (19 cross-sectional in young, middle-aged, and older adults; 10 prospective cohort in older adults; and 1 randomized controlled trial in young adults) involving 36,807 individuals (mean age range: 20.9-86.3 y). Pooled effect sizes showed a significant cross-sectional association between higher MD adherence scores (as a continuous variable) and overall PF (d = 0.45; 95% CI: 0.14, 0.75; I2 = 91.0%, n = 6). The pooled ORs from cross-sectional data showed that high adherence to MD was associated with higher cardiorespiratory fitness (OR: 2.26; 95% CI: 2.06, 2.47; I2 = 0%, n = 4), musculoskeletal fitness (OR: 1.26; 95% CI: 1.05, 1.47; I2 = 61.4%, n = 13), and overall PF (OR: 1.44; 95% CI: 1.20, 1.68; I2 = 83.2%, n = 17) than low adherence to MD (reference category: 1). Pooled ORs from prospective cohort studies (3- to 12-y follow-up) showed that high adherence to MD was associated with higher musculoskeletal fitness (OR: 1.20; 95% CI: 1.01, 1.38; I2 = 0%, n = 4) and overall PF (OR: 1.14; 95% CI: 1.02, 1.26; I2 = 9.7%, n = 7) than low adherence to MD (reference category: 1). Conversely, no significant association was observed between MD and motor fitness. High adherence to MD was associated with higher PF levels, a crucial marker of health status throughout adulthood. This trial was registered at PROSPERO as CRD42022308259.
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Affiliation(s)
- Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain,Instituto Superior de Educación Física, Universidad de la República, Rivera, Uruguay,Grupo de Investigación en Análisis del Rendimiento Humano, Universidad de la República, Rivera, Uruguay
| | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | | | - José F López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Valentina Díaz-Goñi
- Grupo de Investigación en Análisis del Rendimiento Humano, Universidad de la República, Rivera, Uruguay,Instituto Superior de Educación Física, Universidad de la República, Maldonado, Uruguay
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Arthur E Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain,Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
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13
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Nazri NSM, Vanoh D, Soo KL. Natural Food for Sarcopenia: A Narrative Review. Malays J Med Sci 2022; 29:28-42. [PMID: 36101538 PMCID: PMC9438863 DOI: 10.21315/mjms2022.29.4.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/13/2022] [Indexed: 10/26/2022] Open
Abstract
Sarcopenia is a syndrome characterised by progressive loss of skeletal muscle mass and strength. Proper nutrition is essential for management of sarcopenia. Thus, this article aims to review the association between dietary pattern or food groups consisting of natural food and sarcopenia. A literature search was performed using four databases namely PubMed, Scopus, Sage and ScienceDirect. The search terms used were 'fruits', 'vegetables', 'egg', 'fish', 'chicken', 'protein food', 'ulam', 'fresh herbs', 'sarcopenia', 'elderly and 'older adults'. A total of 18 studies were included in the final review. Adherence to Mediterranean and Japanese dietary pattern were associated with lower prevalence of sarcopenia whereas Western dietary pattern was significantly associated with higher risk of sarcopenia. For food groups, there is a significant association between dietary protein intake and sarcopenia. There are also significant associations between the intake of vegetables, fruits or both vegetables and fruits, and lower risk of sarcopenia. Consumption of natural food comprising of high-quality protein, fruits and vegetables have been associated with protection against muscle wasting and sarcopenia. Therefore, it is possible that a well-planned diet may works just as effectively as or possibly better than individual nutrient supplements for the prevention and treatment for sarcopenia among older adults.
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Affiliation(s)
- Nurul Syahidah Mohd Nazri
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Divya Vanoh
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Kah Leng Soo
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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14
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Dyal RN, Deschamps BA, McGraw SM, Jayne JM, Karl JP, Cole RE. Healthy Eating Score-7 as a Measure of Diet Quality in a Military Population. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:455-464. [PMID: 35000832 DOI: 10.1016/j.jneb.2021.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Identify potential revisions to the Healthy Eating Score (HES-5) that improve associations with the Healthy Eating Index (HEI) -2015 total and component scores. METHODS Pearson r correlations were determined from soldiers' (n = 433) survey data, including the HES, proposed additional questions, and the Block Food Frequency Questionnaire. RESULTS Adding sugar-sweetened beverages and energy drink questions (HES-7) strengthened the HES and HEI-2015 correlation (HES-5; r = 0.42, n = 433, r2 = 0.18, P < 0.001) (HES-7; r = 0.52, r2 = 0.27, P < 0.001). The HES components and Block Food Frequency Questionnaire consumption correlations were as follows: quantity of fruit (r = 0.37, r2 = 0.14, P < 0.001), vegetables (r = 0.41, r2 = 0.17, P < 0.001), whole grains (r = 0.35, r2 = 0.12 P < 0.001), dairy (r = 0.34, r2 = 0.12, P < 0.001), fish (r = 0.31, r2 = 0.10, P < 0.001), and energy drink (r = 0.59, r2 = 0.35, P < 0.001). CONCLUSIONS AND IMPLICATIONS HES-7 had the strongest correlation with HEI-2015. Future studies can explore if including consumption quantity in the HES improves its representation of diet quality.
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Affiliation(s)
- Rachel N Dyal
- Madigan Army Medical Center, Nutrition Care Division, Joint Base Lewis McChord, WA.
| | - Bethany A Deschamps
- Madigan Army Medical Center, Nutrition Care Division, Joint Base Lewis McChord, WA
| | - Susan M McGraw
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA
| | - Julianna M Jayne
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA
| | - J Philip Karl
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA
| | - Renee E Cole
- Medical Center of Excellence, Graduate Program in Nutrition, Joint Base San Antonio, Fort Sam Houston, TX
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15
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Pourreza S, Shahinfar H, Bazshahi E, Gholami F, Djafarian K, Shab‐Bidar S. Association of the Mediterranean Dietary Quality Index with handgrip strength and muscle endurance: A cross‐sectional study. FOOD SCIENCE & NUTRITION 2022; 10:2749-2759. [PMID: 35959253 PMCID: PMC9361462 DOI: 10.1002/fsn3.2878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/19/2022] [Accepted: 03/27/2022] [Indexed: 11/05/2022]
Abstract
Mediterranean diet is a healthy eating pattern associated with various health advantages. Different scoring methods of adherence to this diet have been used to investigate the association between the Mediterranean diet and muscle outcomes. The present study aimed to investigate the association of the Mediterranean Dietary Quality Index (Med‐DQI) with handgrip strength (HS) and muscle endurance (ME). The current cross‐sectional study involved 268 Iranian adults aged 18–70 years. Anthropometric measures were evaluated. We used the 168‐item food frequency questionnaire (FFQ) to develop the Med‐DQI score. The Med‐DQI score ranges from 0 to 14 (lower score suggests higher adherence to Mediterranean diet). HS was measured by a digital handgrip dynamometer, and ME was the amount of time to reach a maximum of 50% of grip strength. Multiple regression analysis was used to determine the association of Med‐DQI and its components with HS and ME. Med‐DQI score was not associated with mean handgrip strength (MHS) (p = .34) and mean muscle endurance (MME) (p = .69) in the crude model. The associations remained insignificant after the adjustment of covariates (p = .16, .31, respectively). Among the components of Med‐DQI, cholesterol, meats, fish, and cereals were positively correlated with MHS (p < .001 for all). Meats (p = .02), olive oil (p < .001), cereals (p = .04), fruits and vegetables (p < .001 for all) were also positively correlated with MME. According to our findings, Med‐DQI score is not associated with MHS and MME in a population of Iranian adults. Further longitudinal studies are required to confirm these findings.
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Affiliation(s)
- Sanaz Pourreza
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences (TUMS) Tehran Iran
| | - Hossein Shahinfar
- Department of Nutrition School of Public Health Iran University of Medical Sciences Tehran Iran
| | - Elham Bazshahi
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences (TUMS) Tehran Iran
| | - Fateme Gholami
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences (TUMS) Tehran Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences (TUMS) Tehran Iran
| | - Sakineh Shab‐Bidar
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences (TUMS) Tehran Iran
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16
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Jiang J, Ma M, He L. Comment on "Effect of the Mediterranean diet in patients with chronic spontaneous urticaria". Rev Assoc Med Bras (1992) 2022; 68:301. [PMID: 35442352 DOI: 10.1590/1806-9282.20211190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Meilin Ma
- Taizhou University, School of Medicine - Taizhou, China
| | - Lianping He
- Taizhou University, School of Medicine - Taizhou, China
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17
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Tatta J, Nijs J, Elma Ö, Malfliet A, Magnusson D. The Critical Role of Nutrition Care to Improve Pain Management: A Global Call to Action for Physical Therapist Practice. Phys Ther 2022; 102:6492043. [PMID: 35023558 DOI: 10.1093/ptj/pzab296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/06/2021] [Accepted: 11/29/2021] [Indexed: 02/06/2023]
Abstract
UNLABELLED Physical therapists have unique education in the comprehensive biopsychosocial assessment and treatment of chronic pain and its mechanisms. Recently, physical therapists have raised awareness regarding the impact of nutrition on promoting health and managing noncommunicable diseases. Robust evidence supports the implementation of nutrition in physical therapist education and practice. Of particular interest for the physical therapist are investigations that use dietary interventions for the treatment of chronic pain. Yet physical therapists have received little guidance regarding their role in nutrition care for pain management and may pass on opportunities to counsel their patients on the connection between nutrition and pain. Therefore, a clinical paradigm shift and unified voice within the profession is called on to encourage physical therapists to develop tailored multimodal lifestyle interventions that include nutrition care for the management of chronic pain. This Perspective describes evidence supporting the implementation of nutrition care in physical therapist practice, supports the role of nutritional pain management for physical therapists, and encourages the use of nutrition care for primary, secondary, tertiary, prevention, health promotion, and wellness related to chronic pain. To achieve these aims, this Perspective offers suggestions for how physical therapists can (1) enhance clinical decision making; (2) expand professional, jurisdictional, and personal scope of practice; (3) evolve entry-level education; and (4) stimulate new investigations in nutrition care and pain science research. In doing so, physical therapists can assert their role throughout the pain management continuum, champion innovative research initiatives, and enhance public health by reducing the impact of chronic pain. IMPACT The nutrition care process for pain management is defined as the basic duty to provide adequate and appropriate nutrition education and counseling to people living with pain. Including the nutrition care process as part of a multimodal approach to pain management provides an opportunity for physical therapists to assert their role throughout the pain management continuum. This includes championing innovative research initiatives and enhancing public health by reducing the impact of chronic pain for over 50 million Americans.
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Affiliation(s)
- Joe Tatta
- Integrative Pain Science Institute, New York, New York, USA
| | - Jo Nijs
- Integrative Pain Science Institute, New York, New York, USA.,Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.,Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Sweden. University of Gothenburg Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ömer Elma
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Brussels, Belgium.,Research Foundation Flanders (FWO), Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Dawn Magnusson
- Department of Physical Medicine and Rehabilitation-Physical Therapy Program, University of Colorado, USA
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Nutritional status mediates the relationship between sarcopenia and cognitive impairment: findings from the WCHAT study. Aging Clin Exp Res 2021; 33:3215-3222. [PMID: 34028708 PMCID: PMC8141547 DOI: 10.1007/s40520-021-01883-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/05/2021] [Indexed: 02/05/2023]
Abstract
Background Sarcopenia is associated with cognitive impairment in older adults. However, the underlying mechanisms are not fully understood. Aim To explore the mediating role of nutritional status in the relationship between sarcopenia and cognitive impairment. Methods Three thousand eight hundred and ten participants (mean age 61.94 ± 8.01 years) from the West China Health and Aging Trend (WCHAT) study were included. We defined sarcopenia using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Cognitive status and nutritional status were measured using the Short Portable Mental Status Questionnaire (SPMSQ) and the Mini Nutritional Assessment Short Form (MNA-SF). Relationships between sarcopenia, nutritional status, and cognitive function were explored using multiple linear regression. Two mediation models were generated to examine whether nutritional status mediates the association between sarcopenia and cognitive function using PROCESS macro version 3.5. Results The study involved 3147 (82.6%) non-sarcopenic, 387 (10.2%) sarcopenic, and 276 (7.2%) severely sarcopenic individuals. In mediation model 1, sarcopenia (β = 0.208, 95% CI 0.072 to 0.344, P = 0.0028) was significantly associated with cognitive impairment, and nutritional status mediated this association (indirect effect = 0.162, bootstrap 95% CI 0.116 to 0.212). Mediation model 2 indicated that nutritional status exhibited a full mediating effect regarding the association between sarcopenia and cognitive impairment (indirect effect = 0.131, bootstrap 95% CI: 0.08 to 0.188; direct effect = 0.046, bootstrap 95% CI − 0.115 to 0.21) and a partial mediating effect regarding the association between severe sarcopenia and cognitive impairment (indirect effect = 0.21, bootstrap 95% CI: 0.143 to 0.283; direct effect = 0.476, bootstrap 95% CI: 0.234–0.724). Conclusions The relationship between sarcopenia and cognitive impairment was significantly mediated by nutritional status. Early nutritional interventions may prevent cognitive decline in sarcopenic older adults.
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Adherence to Mediterranean diet and its associations with circulating cytokines, musculoskeletal health and incident falls in community-dwelling older men: The Concord Health and Ageing in Men Project. Clin Nutr 2021; 40:5753-5763. [PMID: 34763260 DOI: 10.1016/j.clnu.2021.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Mediterranean dietary patterns may exert favourable effects on various health conditions. This study aimed to determine associations of adherence to Mediterranean diet as well as its components, with circulating cytokine levels, musculoskeletal health and incident falls in community-dwelling older men. METHODS Seven hundred ninety-four (794) community-dwelling men with mean age 81.1 ± 4.5 years, who participated in the five-year follow-up of the Concord Health and Ageing in Men Project (CHAMP) were included in the cross-sectional analysis, and 616 attended follow-up three years later. Adherence to Mediterranean diet was assessed using MEDI-LITE (literature-derived Mediterranean diet) score which was obtained using a validated diet history questionnaire. Twenty-four evaluable circulating cytokines were analyzed using Bio-Plex Pro Human Cytokine 27-plex Assay kit. Appendicular lean mass (ALM) and bone mineral density (BMD) were measured using dual-energy x-ray absorptiometry (DXA). Three-year changes in gait speed and hand grip strength were assessed by walking a 6-m course and using a dynamometer respectively and analyzed using linear mixed-effects models. Incident falls over three years were determined through telephone interviews every four months. Multivariable linear regression was utilized to determine the cross-sectional associations between MEDI-LITE scores and circulating cytokines, bone mineral density, ALM, and ALMBMI. Linear mixed-effects models were performed to estimate associations between MEDI-LITE scores and three-year change in hand grip strength and gait speed while negative binomial regression was applied to estimate associations between MEDI-LITE scores and three-year incident falls as well as associations between each MEDI-LITE component and three-year incident falls. Adjustments for multiple comparisons were performed using Benjamini-Hochberg adjustment for multiple testing. RESULTS A higher MEDI-LITE score, indicating greater adherence to Mediterranean diet, was associated with higher appendicular lean mass adjusted for body mass index (ALMBMI) (β: 0.004 kg; 95% CI: 0.000, 0.008), and lower incident falls rates (IRR: 0.94; 95% CI: 0.89, 0.99). Higher consumption of monounsaturated fatty acids (IRR: 0.76; 95% CI: 0.59, 0.98) and monounsaturated fatty acids to saturated fatty acids ratio (IRR: 0.72; 95% CI: 0.57, 0.90) were associated with 24%, and 28% lower falls risk in older men respectively. MEDI-LITE scores were not associated with BMD or physical function parameters. CONCLUSIONS Adherence to a Mediterranean diet is associated with higher ALMBMI, and fewer falls in community-dwelling older men. Monounsaturated and saturated fatty acids were the most important contributors to the association between Mediterranean diet and falls risk.
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Healthy Eating Index-2015 Is Associated with Grip Strength among the US Adult Population. Nutrients 2021; 13:nu13103358. [PMID: 34684359 PMCID: PMC8540420 DOI: 10.3390/nu13103358] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 01/04/2023] Open
Abstract
The Healthy Eating Index-2015 (HEI-2015) was designed to reflect adherence to the 2015-2020 Dietary Guidelines for Americans (DGA). The study aims to examine the association between HEI-2015 and grip strength in a nationally representative sample of the U.S. adult population. This cross-sectional study used data from the National Health and Nutrition Examination Surveys of 2011-2014. Low grip strength was defined as <35.5 kg for men and <20 kg for women. HEI-2015 was computed from two days of 24-h dietary recalls and comprised 13 components. Each component was scored on the density out of 1000 calories and summed to a total score divided into quartiles. Weighted logistic regressions examined the study aim while controlling for associated covariates. The sample included 9006 eligible participants, of those, 14.4% (aged 20+ years), and 24.8% (aged ≥50 years) had low grip strength. Mean (±SD) HEI-2015 total score was 54.2 ± 13.6 and in the lowest and highest quartiles 37.3 ± 5.1 and 72.0 ± 6.5, respectively. In the multivariable model, participants in the highest vs. lowest HEI-2015 quartile had 24% lower odds of having low grip strength (Odds Ratio (OR) = 0.76; 95% CI: 0.60-0.96). Specifically, participants who met the DGA for protein intakes, whole grains, greens and beans, vegetables, or whole fruits had 20-35% lower odds of having low grip strength than those who did not. Higher compliance to the DGA might reduce the risk for low grip strength as a proxy measure for sarcopenia among U.S. adults, particularly adequate intakes of proteins, whole grains, greens and beans, vegetables, and whole fruits.
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The role of a Mediterranean diet and physical activity in decreasing age-related inflammation through modulation of the gut microbiota composition. Br J Nutr 2021; 128:1299-1314. [PMID: 34423757 DOI: 10.1017/s0007114521003251] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic inflammation is known to be a predominant factor in the development of many age-related conditions including CVD, type II diabetes and neurodegenerative diseases. Previous studies have demonstrated that during the ageing process there is an increase in inflammatory biomarkers, which may be partially brought about by detrimental changes in the gut microbiota. The Mediterranean diet (MedDiet) and physical activity (PA) are protective against inflammation and chronic disease, and emerging evidence has shown that these effects may be partially mediated through favourable changes in the gut microbiota. In this review, we have evaluated the published literature on the effect of a MedDiet and PA on the gut microbiota. We also discuss the relationship between the gut microbiota and inflammation with a focus on healthy ageing. While inconsistent study designs make forming definitive conclusions challenging, the current evidence suggests that both a MedDiet and PA are capable of modifying the gut microbiota in a way that is beneficial to host health. For example, the increases in the relative abundance of SCFA producing bacteria that are considered to possess anti-inflammatory properties. Modification of the gut microbiota through a MedDiet and PA presents as a potential method to attenuate age-related increases in inflammation, and additional studies utilising older individuals are needed to fill the knowledge gaps existing in current literature.
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Silva TR, Oppermann K, Reis FM, Spritzer PM. Nutrition in Menopausal Women: A Narrative Review. Nutrients 2021; 13:nu13072149. [PMID: 34201460 PMCID: PMC8308420 DOI: 10.3390/nu13072149] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women, such as body composition, bone mass, and risk markers for cardiovascular disease. Current evidence suggests that low-fat, plant-based diets are associated with beneficial effects on body composition, but further studies are needed to confirm these results in postmenopausal women. The Mediterranean diet pattern along with other healthy habits may help the primary prevention of bone, metabolic, and cardiovascular diseases in the postmenopausal period. It consists on the use of healthy foods that have anti-inflammatory and antioxidant properties, and is associated with a small but significant decrease in blood pressure, reduction of fat mass, and improvement in cholesterol levels. These effects remain to be evaluated over a longer period of time, with the assessment of hard outcomes such as bone fractures, diabetes, and coronary ischemia.
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Affiliation(s)
- Thais R. Silva
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre 90035-003, Brazil;
- Laboratory of Molecular Endocrinology, Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
| | - Karen Oppermann
- Medical School of Universidade de Passo Fundo, São Vicente de Paulo Hospital, Passo Fundo 99052-900, Brazil;
| | - Fernando M. Reis
- Division of Human Reproduction, Hospital das Clínicas, Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil
- Correspondence: (F.M.R.); (P.M.S.); Tel.: +55-51-3359-8027 (P.M.S.)
| | - Poli Mara Spritzer
- Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre 90035-003, Brazil;
- Laboratory of Molecular Endocrinology, Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
- Correspondence: (F.M.R.); (P.M.S.); Tel.: +55-51-3359-8027 (P.M.S.)
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Gojanovic M, Holloway-Kew KL, Hyde NK, Mohebbi M, Shivappa N, Hebert JR, O’Neil A, Pasco JA. The Dietary Inflammatory Index Is Associated with Low Muscle Mass and Low Muscle Function in Older Australians. Nutrients 2021; 13:nu13041166. [PMID: 33916033 PMCID: PMC8065722 DOI: 10.3390/nu13041166] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 01/02/2023] Open
Abstract
Age-associated chronic, low grade systemic inflammation has been recognised as an important contributing factor in the development of sarcopenia; importantly, diet may regulate this process. This cross-sectional study examined the association of diet-related inflammation with components of sarcopenia. Participants (n = 809) aged 60–95 years from the Geelong Osteoporosis Study were studied. Body composition was measured by dual energy X-ray absorptiometry. In this study, low appendicular lean mass (ALM/height2, kg/m2) was defined as T-score < −1 and low muscle function as Timed-Up-and-Go >10 s over 3 m (TUG > 10). Dietary inflammatory index (DII®) scores, based on specific foods and nutrients, were computed using dietary data collected from a food frequency questionnaire. Associations between DII scores and low muscle mass and low muscle function, alone and combined, were determined using linear and logistic regression. After adjusting for covariates, higher DII score was associated with lower ALM/height2 (β −0.05, standard error (SE) 0.02, p = 0.028), and higher natural log-transformed (ln) (TUG) (β 0.02, standard error 0.01, p = 0.035) and higher likelihood for these components combined (odds ratio 1.33, 95% confidence interval 1.05 to 1.69, p = 0.015). A pro-inflammatory diet, as indicated by higher DII score, is associated with lower muscle mass, poorer muscle function and increased likelihood for the combination of low muscle mass and low muscle function. Further studies investigating whether anti-inflammatory dietary interventions could reduce the risk of sarcopenia are needed.
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Affiliation(s)
- Marlene Gojanovic
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
- Correspondence:
| | - Kara L. Holloway-Kew
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
| | - Natalie K. Hyde
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia;
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Adrienne O’Neil
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
| | - Julie A. Pasco
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
- Department of Medicine-Western Health, University of Melbourne, St Albans, Victoria 3021, Australia
- University Hospital Geelong, Barwon Health, Geelong, Victoria 3220, Australia
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Hart MJ, Torres SJ, McNaughton SA, Milte CM. Dietary patterns and associations with biomarkers of inflammation in adults: a systematic review of observational studies. Nutr J 2021; 20:24. [PMID: 33712009 PMCID: PMC7955619 DOI: 10.1186/s12937-021-00674-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Background Evidence indicates that low-grade inflammation is involved in manychronic diseases of ageing. Modifiable lifestyle factors including dietcan affect low-grade inflammation. Dietary patterns allow assessment of the complex interactions of food nutrients and health and may be associated with inflammatory status. This systematic review aimed to summarises current evidence from observational studies for associations between dietary patterns and inflammatory biomarkers in the general adult population. This review followed the PRISMA guidelines. Methods We conducted a systematic search in Embase, CINAHL Complete, Global Health and MEDLINE complete databases. Search terms included terms for diet (“dietary patterns”, “diet scores”) and inflammation (“inflammation“, “c-reactive protein“, “interleukin“). Results The search produced 7161 records. Duplicates were removed leaving 3164 for screening. There were 69 studies included (60 cross-sectional, 9 longitudinal). Papers included studies that were: 1) observational studies; 2) conducted in community-dwelling adults over 18 years of age; 3) assessed dietary patterns; 4) measured specified biomarkers of inflammation and 5) published in English. Dietary patterns were assessed using diet scores (n = 45), data-driven approaches (n = 22), both a data-driven approach and diet score (n = 2). The most frequently assessed biomarkers were CRP (n = 64) and/or IL-6 (n = 22). Cross-sectionally the majority of analyses reported an association between higher diet scores (mostly Mediterranean and anti-inflammatory diet scores) and lower inflammatory markers with 82 significant associations from 133 analyses. Only 22 of 145 cross-sectional analyses using data-driven approaches reported an association between a dietary patterns and lower inflammatory markers; the majority reported no association. Evidence of an association between dietary patterns and inflammatory markers longitudinally is limited, with the majority reporting no association. Conclusions Adherence to healthy, Mediterranean and anti-inflammatory dietary scores, appear to be associated with lower inflammatory status cross-sectionally. Future research could focus on longitudinal studies using a potential outcomes approach in the data analysis. Trial registration PROSPERO Registration Number CRD42019114501. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00674-9.
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Affiliation(s)
- Michael J Hart
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
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Davis JA, Mohebbi M, Collier F, Loughman A, Shivappa N, Hébert JR, Pasco JA, Jacka FN. Diet quality and a traditional dietary pattern predict lean mass in Australian women: Longitudinal data from the Geelong Osteoporosis Study. Prev Med Rep 2021; 21:101316. [PMID: 33505843 PMCID: PMC7815486 DOI: 10.1016/j.pmedr.2021.101316] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/01/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022] Open
Abstract
Low muscle mass is associated with reduced independence and increased risk for falls and fractures. Identification of modifiable risk factors for low muscle mass is thus imperative. This study aimed to examine the longitudinal relationship between both diet quality and patterns and lean mass in Australian women. Data from n = 494 participants of the Geelong Osteoporosis Study's 10- and 15-year women's follow-ups were used (conducted in 2004-08 and 2011-14, respectively), and participants were aged 21-89 years. Self-reported lifestyle and demographics were collected, and food frequency questionnaire data informed the dietary exposure variables: the Australian Recommended Food Score (ARFS); the Dietary Inflammatory Index (DII); and a posteriori dietary patterns. The outcome, Skeletal Muscle Index (SMI), was calculated from DXA-derived appendicular lean mass (ALM) relative to height (ALM kg/m2). Analyses employed Generalised Estimating Equations. A higher ARFS score positively predicted SMI over 5-years, and adjustments for age and physical activity did not attenuate this relationship (B:0.044, (95%CI 0.004, 0.084) kg/m2). Following adjustment, both an anti-inflammatory diet (B:-0.034, (95%CI -0.070, -0.002) kg/m2) and a 'traditional' dietary pattern predicted higher SMI (B:0.081, (95%CI 0.004, 0.158) kg/m2). No other associations were observed. Our study reinforces the importance of diet quality for healthy, aging muscle mass. Furthermore, a less inflammatory diet and a diet comprising a wide variety of plant and animal foods may be conducive to maintenance of muscle mass in women. Further studies investigating diet quality's impact on various muscle health measures over longer time periods are warranted.
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Affiliation(s)
- Jessica A. Davis
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
| | - Mohammadreza Mohebbi
- Deakin University, Faculty of Health, Biostatistics Unit, Building BC, Room BC4.121, 221 Burwood Highway, Geelong, Burwood, VIC 3125, Australia
| | - Fiona Collier
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Geelong Centre for Emerging Infectious Diseases (GCEID), Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Barwon Health, PO Box 281, Geelong, VIC 3220, Australia
| | - Amy Loughman
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Discovery 1 Building, Suite 200, 915 Greene Street, Columbia, SC 29208, USA
| | - Julie A. Pasco
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Barwon Health, PO Box 281, Geelong, VIC 3220, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, 553 St Kilda Rd, Melbourne, VIC 3004, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, Furlong Rd, St Albans, VIC 3021, Australia
| | - Felice N. Jacka
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, HERB Building, Level 3, 285-299 Ryrie St, Geelong, VIC 3220, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Flemington Road, Parkville, VIC 3052, Australia
- Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia
- James Cook University, 1 James Cook Dr, Douglas, QLD 4811, Australia
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Abstract
PURPOSE Hand grip strength (HGS) can predict physical function in next year when it is positively associated with nutritional and health status. This study aimed to determine the relationship between the healthy eating index (HEI)-2015 and hand grip strength. METHODS This cross-sectional study was conducted on data from 4010 participants in the Ravansar non-communicable disease (RaNCD) cohort study. HGS was measured using a hand-held hydraulic hand grip dynamometer. HEI-2015 was calculated using data from the food frequency questionnaire. RESULTS The mean of total HEI-2015 score was significantly higher in participants with an optimal HGS than in participants with a weak HGS (P = 0.006). Higher adherence to healthy eating was associated with optimal muscle strength (OR 1.26; CI 95% 1.02-1.62). This association was remained after being adjusted for potential confounders (P = 0.01). Among the HEI-2015 components, we only found association between whole fruit, added sugar, and HGS (P = 0.01, 0.019). CONCLUSIONS Our findings indicated that adherence to HEI-2015 could promote muscle strength. Among the HEI-2015 components, higher intake of whole fruit and lower adherence to added sugar had significantly positive effects on HGS. LEVEL OF EVIDENCE Level V, descriptive cross-sectional study.
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Mazza E, Ferro Y, Pujia R, Mare R, Maurotti S, Montalcini T, Pujia A. Mediterranean Diet In Healthy Aging. J Nutr Health Aging 2021; 25:1076-1083. [PMID: 34725664 PMCID: PMC8442641 DOI: 10.1007/s12603-021-1675-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/22/2021] [Indexed: 12/28/2022]
Abstract
The World elderly population is expected to double before 2050. Unhealthy habits and unhealthy lifestyles are commonly associated with age-related diseases or their worsening. Modification in daily lifestyle and diet may help preventing age-related diseases onset and efficiently affecting their evolution, thus promoting the Healthy Aging process, concept recently coined to describe the disease-free aging process. This review highlights the role of nutrition science in promoting healthy aging. Since the Mediterranean Model demonstrated to be a useful style in supporting healthy aging, promotion of this correct lifestyle by health policies seems to be the best approach to achieve this target.
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Affiliation(s)
- E Mazza
- Elisa Mazza, Department of Medical and Surgical Science, University Magna Grecia, Viale Europa, 88100 Catanzaro, Italy. E-mail: , telephone numbers: +3909613697231
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The relationship between dietary patterns and grip strength in the general population: the TCLSIH cohort study. Eur J Nutr 2020; 60:2409-2421. [PMID: 33130949 DOI: 10.1007/s00394-020-02385-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Previous studies have shown that many nutrients play an essential role in maintaining skeletal muscle strength. Hand grip strength (HGS) is frequently used as an objective and reliable method to evaluate overall body muscle strength and physical function. Some studies have demonstrated that some specific single nutrients such as PUFA, fiber, vitamin C, fruits and vegetables are associated with muscle strength. However, few studies have explored the relationship between dietary patterns and HGS in the adult population. The aim of this study was to investigate how dietary patterns are related to HGS in a large-scale Chinese population. METHODS A cross-sectional study (n = 35,175) was performed in Tianjin, China. Adherence to dietary patterns was measured by a valid self-administered food frequency questionnaire with 81 food items. Principal-components analysis was used to derive three major dietary patterns: "sweet", "healthy" and "animal food". HGS was measured using a handheld digital dynamometer. Analysis of covariance and multiple logistic regression were employed to explore the relationship between dietary patterns and HGS. RESULTS After adjustment for potential confounders, the means (95% confidence interval) of HGS for increasing quartile of dietary patterns were as follows: "sweet", 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.48-0.51) (P value = 0.07); "healthy" 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.50 (0.49-0.51) (P value < 0.0001); "animal food" 0.51(0.50-0.52), 0.50 (0.49-0.51), 0.50 (0.49-0.51), 0.49 (0.48-0.51) (P value < 0.0001), respectively. CONCLUSIONS The present study demonstrated a slight improvement between healthy dietary pattern and HGS across the quartiles. On the contrary, this study also showed higher adherence to the animal food dietary pattern (i.e., higher quartile) had lower grip strength. A long-term prospective study or randomized trials are required to clarify this association.
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Khaled K, Hundley V, Almilaji O, Koeppen M, Tsofliou F. A Priori and a Posteriori Dietary Patterns in Women of Childbearing Age in the UK. Nutrients 2020; 12:E2921. [PMID: 32987718 PMCID: PMC7598658 DOI: 10.3390/nu12102921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022] Open
Abstract
Poor diet quality is a major cause of maternal obesity. We aimed to investigate a priori and a-posteriori derived dietary patterns in childbearing-aged women in UK. An online survey assessed food intake, physical activity (PA), anthropometry and socio-demographics. An a priori defined diet quality was determined via Mediterranean diet (MD) adherence score and Exploratory Factor Analysis (EFA) derived dietary patterns (DPs). Multiple linear regression explored associations between DPs with anthropometric measures, PA and socio-demographics. Participants (n = 123) had low-to-medium MD adherence (average MD-score: 4.0 (2.0)). Age was positively associated with higher MD adherence (X2 (2) = 13.14, p = 0.01). EFA revealed three DPs: 'fruits, nuts, vegetables and legumes' ("Vegetarian-style" DP); 'sweets, cereals, dairy products and potatoes' ("Dairy, sweets and starchy foods" DP); and 'eggs, seafood and meats' ("Protein-rich" DP). "Vegetarian-style" DP was positively associated with higher maternal educational level (p < 0.01) and PA (p = 0.01), but negatively with white ethnicity (p < 0.01). "Dairy, sweets and starchy foods" DP was positively associated with white ethnicity (p = 0.03) and negatively with age (p = 0.03). "Protein-rich" DP was positively associated with age (p < 0.001) and negatively with PA (p = 0.01). A poor diet quality was found among childbearing-aged women; notably in the younger age category, those of white ethnicity, that were more physically inactive and with a lower socioeconomic background.
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Affiliation(s)
- Karim Khaled
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
| | - Orouba Almilaji
- Department of Medical Science and Public Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
| | - Mareike Koeppen
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
| | - Fotini Tsofliou
- Department of Rehabilitation & Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK; (K.K.); (M.K.)
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH1 3LT, UK;
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Association of major dietary patterns with muscle strength and muscle mass index in middle-aged men and women: Results from a cross-sectional study. Clin Nutr ESPEN 2020; 39:215-221. [PMID: 32859319 DOI: 10.1016/j.clnesp.2020.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dietary patterns may affect muscle mass, strength, and function; hence, we evaluated the association of major dietary patterns in relation to muscle mass index (MMI) and muscle strength in middle-aged adults. We hypothesized that unhealthy dietary patterns are associated with reduced muscle mass and muscle strength. SUBJECTS and methods: The present cross-sectional study recruited 270 adults (118 males and 152 females) aged between 18 and 75 years' old. Socio-demographic data, body composition and muscle strength were determined. MMI was calculated by total fat free mass (FFM) (kg)/height2 (m). Dietary intake was assessed using a 168-item validated food frequency questionnaire. Factor analysis was conducted, and as a result, 3 factors were extracted. These factors were labeled as healthy, mixed and western dietary patterns. RESULTS After control for potential confounders, there were a positive trend between tertiles of "healthy dietary pattern" and muscle strength (p = 0.03). Moreover, we found that those who were in the third tertile of "mixed dietary pattern" compared to those at the first tertile had no significant relationship with muscle strength (p = 0.42) and MMI (p = 0.36) even after controlling for potential confounders. In contrast, the adherence to the "Western dietary pattern" was associated with reduced MMI (p = 0.02). CONCLUSION Adherence to healthy dietary pattern might be associated with better muscle strength and greater adherence to Western pattern appears to reduce MMI.
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Nutrition and Sarcopenia-What Do We Know? Nutrients 2020; 12:nu12061755. [PMID: 32545408 PMCID: PMC7353446 DOI: 10.3390/nu12061755] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023] Open
Abstract
Muscle health is important for the functionality and independence of older adults, and certain nutrients as well as dietary patterns have been shown to offer protective effects against declines in strength and function associated with aging. In this paper, micronutrients, macronutrients, and food groups have been reviewed, along with their studied effects on the prevalence and incidence of sarcopenia, as well as their ability to preserve muscle mass and optimize physical performance. Randomized controlled trials appear to suggest a critical role for dietary intake of protein in preventing sarcopenia and muscle loss, although the optimal dose and type of protein is unknown. There are some promising data regarding the role of vitamin D and sarcopenia, but it is unclear whether the dose, frequency of dose, or length of treatment impacts the efficacy of vitamin D on improving muscle mass or function. Selenium, magnesium, and omega 3 fatty acids have been studied as supplements in clinical trials and in the diet, and they appear to demonstrate a potential association with physical activity and muscle performance in older individuals. Following the Mediterranean diet and higher consumption of fruits and vegetables have been associated with improved physical performance and protection against muscle wasting, sarcopenia, and frailty.
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Jyväkorpi SK, Urtamo A, Kivimäki M, Strandberg TE. Associations of protein source, distribution and healthy dietary pattern with appendicular lean mass in oldest-old men: the Helsinki Businessmen Study (HBS). Eur Geriatr Med 2020; 11:699-704. [PMID: 32444996 PMCID: PMC7438287 DOI: 10.1007/s41999-020-00330-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/29/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE We explored how food and dietary intakes, protein daily distribution and source are associated with appendicular lean mass (ALM)/m2 of the oldest-old community-dwelling men. METHODS Cross-sectional analyses of Helsinki Businessmen Study (HBS, mean age 87 years) participants who came to clinic visit in 2017/2018. Nutritional status, physical performance and fasting blood samples were measured. Food and dietary intakes were retrieved from 3-day food diaries. Body composition was measured and appendicular lean mass (ALM) per m2 was dichotomized as ALM/m2 < 7 kg/m2 and ≥ 7 kg/m2. Differences between lower and higher ALM were analyzed using t test or Mann-Whitney U test. Analysis of covariance was used to investigate independent associations with ALM/m2. RESULTS Random sample of 130 participants took part in the medical examinations, 126 returned food diaries, and 102 underwent DXA-scan. ALM/m2 was associated with total protein (p = 0.033), animal protein (p = 0.043) and meat protein (p = 0.033) intakes. Protein distribution between daily meals differed at lunch; those with higher ALM/m2 ate more protein (p = .047) at lunch. Consumption of fruits, vegetables (p = 0.022) and meat (p = 0.006) was associated with ALM/m2. CONCLUSION Protein intake, source and distribution as well fruit and vegetable intakes were associated with higher ALM in oldest-old men. STUDY REGISTRATION The study is registered with ClinicalTrials.gov identifier: NCT02526082.
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Affiliation(s)
- S K Jyväkorpi
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Unit of Primary Health Care, Tukholmankatu 8 B, 00014, Helsinki, Finland.
| | - A Urtamo
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Unit of Primary Health Care, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | - M Kivimäki
- University of Helsinki, Clinicum and Helsinki University Central Hospital, Unit of Primary Health Care, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | - T E Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland
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Aparecida Silveira E, Danésio de Souza J, dos Santos Rodrigues AP, Lima RM, de Souza Cardoso CK, de Oliveira C. Effects of Extra Virgin Olive Oil (EVOO) and the Traditional Brazilian Diet on Sarcopenia in Severe Obesity: A Randomized Clinical Trial. Nutrients 2020; 12:E1498. [PMID: 32455620 PMCID: PMC7284637 DOI: 10.3390/nu12051498] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Nutritional interventions may have positive effects on sarcopenia and body composition. OBJECTIVE to evaluate the effectiveness of extra virgin olive oil (EVOO) consumption and a healthy traditional Brazilian diet (DieTBra) on improving sarcopenia indicators and reducing total body fat in severe obesity. METHODS A randomized controlled trial registered at ClinicalTrials.gov (NCT02463435) conducted with 111 severely obese participants randomized into three treatment groups-(1) EVOO (52 mL/day), (2) DieTBra, (3) DieTBra + EVOO (52 mL/day)-for 12 weeks. Body composition was assessed by dual-energy X-ray absorptiometry and sarcopenia by walking speed and handgrip strength. RESULTS Significant reductions in total body fat (p = 0.041) and body weight (p = 0.003) were observed in the DieTBra group. In the DietBra + olive oil group there was also a significant reduction in body weight (0.001) compared to the olive oil-only group. ANCOVA analyses showed reductions in total body fat in the DieTBra (p = 0.016) and DieTBra + olive oil (p = 0.004) groups. Individuals in the DieTBra group had significant improvements in their walking speed (p = 0.042) and handgrip strength (p = 0.044). CONCLUSIONS DieTBra contributes to improvements in handgrip strength, walking speed, and total body fat in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).
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Affiliation(s)
- Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
- Affiliate Academic at the Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK
| | - Jacqueline Danésio de Souza
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
| | - Ricardo M. Lima
- Faculty of Physical Education, University of Brasília, Darcy Ribeiro University Campus, Brasília CEP 70910-900, Distrito Federal, Brazil;
| | - Camila Kellen de Souza Cardoso
- School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goias, Goiânia 74605-020, Brazil;
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK;
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Mediterranean diet, tobacco consumption and body composition during perimenopause. The FLAMENCO project. Maturitas 2020; 137:30-36. [PMID: 32498934 DOI: 10.1016/j.maturitas.2020.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 03/16/2020] [Accepted: 04/02/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To study the association of the adherence to the Mediterranean diet (MD) and tobacco consumption with body composition during perimenopause. STUDY DESIGN AND METHODS A cross-sectional study in 176 perimenopausal women from the FLAMENCO project. A food frequency questionnaire and the Mediterranean Diet Score were assessed. Body composition was measured using dual-energy X-ray absorptiometry. MAIN OUTCOMES MEASURES Body mass index (BMI), fat mass (FM), ratio of gynecoid to total fat mass (G/T), ratio of android to gynecoid fat mass (A/G), visceral adipose tissue (VAT) and waist circumference (WC). RESULTS Intake of whole-grain cereals was associated with lower WC, FM percentage, android FM, VAT and higher G/T (all p < 0.05). Intake of nuts was associated with lower BMI and FM percentage and intake of fruits with lower BMI, WC, total and android FM, FM percentage, A/G, VAT and higher G/T (all p < 0.05). Intake of pulses was associated with lower weight, BMI and android FM. Intake of whole dairy products was associated with lower weight, BMI, WC, total and android FM and VAT (all p < 0.05). Intake of olive oil was associated with lower WC and FM percentage (all p < 0.05). Intake of sweetened beverages was associated with higher weight, BMI, WC, FM percentage, android FM, VAT and total FM (all, p < 0.05). Smokers had a lower MD adherence (p < 0.05). Finally, a greater MD adherence was associated with higher G/T (p < 0.01) and lower A/G (p < 0.05). CONCLUSIONS A higher MD adherence, avoiding tobacco, an increased consumption of whole-grain cereals, nuts, fruits, pulses, whole dairy products and olive oil, and a lower consumption of sweetened beverages might contribute to a healthier body composition during perimenopause.
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A Mediterranean Diet Is Positively Associated with Bone and Muscle Health in a Non-Mediterranean Region in 25,450 Men and Women from EPIC-Norfolk. Nutrients 2020; 12:nu12041154. [PMID: 32326165 PMCID: PMC7231007 DOI: 10.3390/nu12041154] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 12/25/2022] Open
Abstract
Research on Mediterranean diet (MD) adherence and musculoskeletal health is limited. The current study determined if adherence to the alternative MD score (aMED) and MD score (MDS), quantified from 7-d food diaries, was associated with fracture incidence, bone density (calcaneal broadband ultrasound attenuation (BUA)) and fat free mass (expressed over BMI (FFMBMI) using bioelectrical impedance) in 25,450 men and women recruited to the European Prospective Investigation into Cancer study in Norfolk, UK. During 17.4 years of follow up (443,178 total person years) 2195 incident fractures occurred. Higher aMED adherence was associated with 23% reduced total (Q5–Q1 HR 0.77; 95% CI 0.67, 0.88; p-trend < 0.01) and 21% reduced hip (Q5–Q1 HR 0.79; 95% CI 0.65, 0.96; p-trend = 0.01) fracture incidence, and significantly higher BUA (Q5–Q1 1.0 dB/MHz 95% CI 0.2, 1.9; p-trend < 0.01) and FFMBMI (Q5–Q1 0.05 kg/(kg/m2) 95% CI 0.04, 0.06; p-trend < 0.01), comparing extreme adherence quintiles. Higher MDS was also associated with reduced total fractures (Q5–Q1 HR 0.83; 95% CI 0.71, 0.96; p-trend = 0.03) and significantly higher BUA (Q5–Q1 1.4 dB/MHz 95% CI 0.5, 2.3; p-trend < 0.01) and FFMBMI (Q5–Q1 0.03 kg/(kg/m2) 95% CI 0.01, 0.04; p-trend < 0.01). This evidence supports the need to develop interventions to enhance MD adherence, particularly in women, where evidence for associations was stronger.
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Mendes J, Afonso C, Borges N, Santos A, Moreira P, Padrão P, Negrão R, Amaral TF. Adherence to a Mediterranean Dietary Pattern and Functional Parameters: A Cross-Sectional Study in an Older Population. J Nutr Health Aging 2020; 24:138-146. [PMID: 32003402 DOI: 10.1007/s12603-019-1300-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES In older adults, diet and physical activity are among the most important behaviours that influence health. The Mediterranean Dietary Pattern has been related to longevity and can benefit physical function in older adults. The present study aims to quantify the association of adherence to a Mediterranean Dietary Pattern with physical functioning through by handgrip strength, as well as, with sedentary behaviour based on sitting time, in a sample of older adults. METHODS A cross-sectional study was conducted in 1,491 older adults ≥ 65 years old. The adherence or non-adherence to a Mediterranean Dietary Pattern was assessed using the previously validated and translated 14 item questionnaire, the PREDIMED (Prevención com Dieta Mediterránea). Handgrip strength was measured with a Jamar Dynamometer. Sitting time per day was used as an indicator of sedentary behaviour. Multinomial logistic regressions were performed to quantify the association of adherence to a Mediterranean Dietary Pattern with handgrip strength and sitting time. RESULTS Compared to participants who adhered to a Mediterranean Dietary Pattern, those who did not adhere to this diet have a significantly higher adjusted odds ratio for low handgrip strength [adjusted odds ratio: 1.50; 95% confidence interval: 1.09-2.05], as well as for longer sitting time [adjusted odds ratio: 1.43; 95% confidence interval: 1.04-1.96]. CONCLUSION In older adults, the non-adherence to a Mediterranean Dietary Pattern was associated with both lower values of handgrip strength and longer sitting time.
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Affiliation(s)
- J Mendes
- Joana Mendes, Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal, Address: Rua Dr. Roberto Frias, 4200-465 Porto, Portugal, Telephone: +351 225 074 320/ Fax: +351 225 074 329, E-mail:
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Capurso C, Bellanti F, Lo Buglio A, Vendemiale G. The Mediterranean Diet Slows Down the Progression of Aging and Helps to Prevent the Onset of Frailty: A Narrative Review. Nutrients 2019; 12:nu12010035. [PMID: 31877702 PMCID: PMC7019245 DOI: 10.3390/nu12010035] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 02/05/2023] Open
Abstract
The aging population is rapidly increasing all over the world. This results in significant implications for the planning and provision of health and social care. Aging is physiologically characterized by a decrease in lean mass, bone mineral density and, to a lesser extent, fat mass. The onset of sarcopenia leads to weakness and a further decrease in physical activity. An insufficient protein intake, which we often observe in patients of advanced age, certainly accelerates the progression of sarcopenia. In addition, many other factors (e.g., insulin resistance, impaired protein digestion and absorption of amino acids) reduce the stimulation of muscle protein synthesis in the elderly, even if the protein intake is adequate. Inadequate intake of foods can also cause micronutrient deficiencies that contribute to the development of frailty. We know that a healthy eating style in middle age predisposes to so-called "healthy and successful" aging, which is the condition of the absence of serious chronic diseases or of an important decline in cognitive or physical functions, or mental health. The Mediterranean diet is recognized to be a "healthy food" dietary pattern; high adherence to this dietary pattern is associated with a lower incidence of chronic diseases and lower physical impairment in old age. The aim of our review was to analyze observational studies (cohort and case-control studies) that investigated the effects of following a healthy diet, and especially the effect of adherence to a Mediterranean diet (MD), on the progression of aging and on onset of frailty.
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Nutrient patterns and the skeletal muscle mass index among Polish women: a cross-sectional study. Sci Rep 2019; 9:18930. [PMID: 31831799 PMCID: PMC6908721 DOI: 10.1038/s41598-019-55367-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 11/27/2019] [Indexed: 12/21/2022] Open
Abstract
Ageing involves significant changes in skeletal muscle mass and its functioning. This study aimed to identify the major nutrient patterns (NPs) present in a sample of adult Polish women and evaluate their associations with the skeletal muscle mass index (SMI). A cross-sectional study initially recruited 527 women, and a final analysis was carried out on 275 women aged 32–60 years. Nutrient intake was assessed using fourteen repetitions of 24-hour dietary recall. NPs were derived using principal component analysis. Associations between adherence to NPs and the SMI were evaluated using linear regression models. Three NPs were identified: ‘Animal Protein-Vitamins’, ‘Fibre-Plant Protein-Minerals’ and ‘Fats’. In the adjusted model, the upper tertile compared to the bottom tertile of the ‘Animal Protein-Vitamins’ NP was related to a higher SMI (β = 0.123 95% CI: 0.019; 0.227; P for 1-SD increase of NP score = 0.009). No associations between the SMI and the ‘Fibre-Plant Protein-Minerals’ and ‘Fats’ NPs were observed. Our results indicate that high adherence to animal product-rich patterns might be related to higher muscle mass in adult women. Research on the influence of dietary and nutrient patterns on the quality of muscle tissue may contribute to the setting of guidelines for nutritional protection of skeletal muscle with ageing and, consequently, dietary recommendations that would improve the quality of women’s lives at the later stage of life.
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The relationships between sarcopenic skeletal muscle loss during ageing and macronutrient metabolism, obesity and onset of diabetes. Proc Nutr Soc 2019; 79:158-169. [PMID: 31685055 DOI: 10.1017/s0029665119001150] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Skeletal muscle is integral to the metabolism and utilisation of macronutrients; however, substantial muscle loss and morphological changes occur with ageing. These are associated with loss of muscle function and accelerate rapidly from the age of 60 years, leading to the conditions of sarcopenia and frailty. As the relationship between muscle ageing and macronutrient metabolism and utilisation has seen limited research to date, this review focuses on the interactions between skeletal muscle changes during ageing, metabolism and utilisation of fat, carbohydrates and overall energy expenditure.Skeletal muscle contributes less to resting energy expenditure during ageing, potentially contributing to onset of obesity from middle age. Age-related changes to skeletal muscle lead to glucose dysregulation, with consequent reduction in glycaemic control, increased insulin resistance and ultimately onset of type-2 diabetes. Recent studies indicate that high total fat and SFA intake are detrimental to skeletal muscle, while higher intakes of PUFA are protective. Age-associated changes in skeletal muscle may also reduce total fatty acid utilisation.In conclusion, further research is needed to understand the relationships between macronutrient metabolism and utilisation and age-related changes to skeletal muscle. No dietary recommendations exist specifically for skeletal muscle health during ageing, but we advise individuals to follow healthy eating guidelines, by consuming sufficient protein, fruit and vegetables, and limited SFA and to maintain physically active lifestyles. Clinicians responsible for managing type-2 diabetes need to be aware of growing evidence relating age-related skeletal muscle changes to diabetes onset and progression.
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Schacht SR, Lind MV, Mertz KH, Bülow J, Bechshøft R, Højfeldt G, Schucany A, Hjulmand M, Sidoli C, Andersen SB, Jensen M, Reitelseder S, Holm L, Tetens I. Development of a Mobility Diet Score (MDS) and Associations With Bone Mineral Density and Muscle Function in Older Adults. Front Nutr 2019; 6:114. [PMID: 31552255 PMCID: PMC6738326 DOI: 10.3389/fnut.2019.00114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/11/2019] [Indexed: 01/19/2023] Open
Abstract
Introduction: Reduced bone mineral density (BMD) and muscle function is associated with increased risk of multiple health related issues. Diet may play a role in sustaining BMD and muscle function throughout old age, but much is still to be learned with regards to which specific food groups and dietary patterns that are important for such outcomes. The aim of the current study was to identify food groups important for both BMD and muscle function. Methods: A narrative review was performed on studies published on dietary patterns and their association with BMD and muscle function, respectively. Based on these findings, two dietary indices were constructed characterizing food groups associated with BMD and muscle function, respectively. Associations between adherence to these indices and BMD and muscle function were then investigated in a population of older community-dwelling Danes. Food groups found to be associated with both BMD and muscle function in our study population were suggested for inclusion into a common dietary index named the Mobility Diet Score. Results: In contrast to previous studies, adherence to a dietary index based on foods previously linked to BMD could not be established as important for BMD in our study population of 184 older individuals (53.3% men). We found that adhering to a dietary index characterized by higher intakes of whole grains, dairy products, fish, legumes, nuts, fruit, and vegetables is associated with faster 400 m walking speeds and an increased number of chair stands measured over a 30 s time period. Since no food group could be established as important for both BMD and muscle function in our study population, a Mobility Diet Score could not be established. However, based on our narrative review, the food groups commonly associated with improved BMD and muscle function are similar. Conclusion: Adherence to a dietary index characterized by high intakes of whole grains, dairy products, fish, legumes, nuts, fruit, and vegetables was not found to be associated with BMD in a group of community-dwelling older Danes. However, our results indicate that the adherence to such foods could be important in sustaining physical function in older individuals.
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Affiliation(s)
- Simon Rønnow Schacht
- Department of Nutrition, Exercise and Sports, Vitality - Centre for Good Older Lives, University of Copenhagen, Copenhagen, Denmark
| | - Mads Vendelbo Lind
- Department of Nutrition, Exercise and Sports, Vitality - Centre for Good Older Lives, University of Copenhagen, Copenhagen, Denmark
| | - Kenneth Hudlebusch Mertz
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jacob Bülow
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Rasmus Bechshøft
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Grith Højfeldt
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Aide Schucany
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Morten Hjulmand
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Chiara Sidoli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Søren Binder Andersen
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Mikkel Jensen
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Søren Reitelseder
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Holm
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Inge Tetens
- Department of Nutrition, Exercise and Sports, Vitality - Centre for Good Older Lives, University of Copenhagen, Copenhagen, Denmark
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Jung M, Park S, Kim H, Kwon O. Association of Diet Quality with Low Muscle Mass-Function in Korean Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152733. [PMID: 31370245 PMCID: PMC6696159 DOI: 10.3390/ijerph16152733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/19/2019] [Accepted: 07/30/2019] [Indexed: 12/26/2022]
Abstract
There is a growing body of evidence that links nutrition to muscle mass and function in the elderly, suggesting that it has an important role to play both in the prevention and management of age-related sarcopenia. Some nutrients have been studied, but less is known about the influence of overall diet quality on the loss of skeletal muscle mass and function. This study investigated the interrelationship between the recommended food score (RFS), as an indicator of overall diet quality, and muscle mass function among the Korean elderly. The sample consisted of 521 participants (263 men and 258 women), aged >65 years, who participated in the 2014–2015 National Fitness Award project. Appendicular skeletal muscle mass (ASM) was assessed by bioelectrical impedance analysis. Low muscle mass was defined as having an ASM corrected for height lower than the cutoff value established by the European Working Group on Sarcopenia in Older People. Muscle function, assessed by handgrip strength (HGS), was defined as low if it was below the 20th percentile of elderly men and women. Low muscle mass-function, defined as low muscle mass with low muscle strength (HGS), was found in 29 men (11.0%) and 22 women (8.5%). In elderly men, the low muscle mass-function group had significantly lower RFS values than the normal group after adjustments for age, body fat percentage, drinking, smoking, education, and physical activity (p = 0.019). However, there was no association between RFS and muscle mass-function in elderly women. Our findings suggest that better diet quality may be associated with higher muscle mass in elderly Korean men.
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Affiliation(s)
- Mikyeong Jung
- Department of Nutrition, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do 14068, Korea
- Department of Clinical Nutrition Science, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Saejong Park
- Department of Sport Science, Korea Institute of Sport Science, Seoul 03760, Korea
| | - Hyesook Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea.
| | - Oran Kwon
- Department of Clinical Nutrition Science, The Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 03760, Korea.
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea.
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Karlsson M, Becker W, Michaëlsson K, Cederholm T, Sjögren P. Associations between dietary patterns at age 71 and the prevalence of sarcopenia 16 years later. Clin Nutr 2019; 39:1077-1084. [PMID: 31036414 DOI: 10.1016/j.clnu.2019.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/04/2019] [Accepted: 04/11/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS The growing recognition of the significance of sarcopenia has highlighted the need to understand etiologic factors, where food intake likely plays a role. The aim was to investigate the association between dietary patterns at mean age 71 and the prevalence of sarcopenia at mean age 87 in a Swedish cohort of community dwelling men. METHODS Dietary habits were assessed using a 7-day food record. Adherences to official dietary guidelines, defined by the World Health Organization (WHO) by using the Healthy Diet Indicator, and Mediterranean-like dietary habits by using the Mediterranean Diet Score, were calculated. Sarcopenia was determined using the definition from the European Working Group on Sarcopenia in Older People (EWGSOP) and associations to each dietary pattern were analyzed using logistic regression, adjusted for potential confounders. RESULTS Our study population included 254 men, mean age 71 at baseline, and 53 (21%) were defined as sarcopenic 16 years later. There was no linear relationship between increased adherence to WHO dietary guidelines and future prevalence of sarcopenia, although those with medium adherence seemed to be protected (crude OR = 0.41, 95% CI 0.19-0.92). On the other hand, an inverse relationship to sarcopenia was found for each SD increment in the Mediterranean diet score (crude OR = 0.68, 95% CI 0.46-0.99), which remained after adjusting for potential confounders. Sensitivity analysis indicated relationships to be independent of changes in physical activity and dietary misreporting. CONCLUSIONS In this prospective study of elderly men, using a single measure of diet at age 71 as a reflection of habitual dietary habits, healthy dietary patterns tended to protect against the development of sarcopenia over 16 years. In particular, we found indications that increased adherence to a Mediterranean dietary pattern might be advantageous.
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Affiliation(s)
- Mikael Karlsson
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Husargatan 3, BMC, SE-751 22, Uppsala, Sweden.
| | - Wulf Becker
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Husargatan 3, BMC, SE-751 22, Uppsala, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Husargatan 3, BMC, SE-751 22, Uppsala, Sweden
| | - Per Sjögren
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Husargatan 3, BMC, SE-751 22, Uppsala, Sweden
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Granic A, Sayer AA, Robinson SM. Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults. Nutrients 2019; 11:nu11040745. [PMID: 30935012 PMCID: PMC6521630 DOI: 10.3390/nu11040745] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 03/24/2019] [Accepted: 03/26/2019] [Indexed: 12/17/2022] Open
Abstract
In recent decades, the significance of diet and dietary patterns (DPs) for skeletal muscle health has been gaining attention in ageing and nutritional research. Sarcopenia, a muscle disease characterised by low muscle strength, mass, and function is associated with an increased risk of functional decline, frailty, hospitalization, and death. The prevalence of sarcopenia increases with age and leads to high personal, social, and economic costs. Finding adequate nutritional measures to maintain muscle health, preserve function, and independence for the growing population of older adults would have important scientific and societal implications. Two main approaches have been employed to study the role of diet/DPs as a modifiable lifestyle factor in sarcopenia. An a priori or hypothesis-driven approach examines the adherence to pre-defined dietary indices such as the Mediterranean diet (MED) and Healthy Eating Index (HEI)—measures of diet quality—in relation to muscle health outcomes. A posteriori or data-driven approaches have used statistical tools—dimension reduction methods or clustering—to study DP-muscle health relationships. Both approaches recognise the importance of the whole diet and potential cumulative, synergistic, and antagonistic effects of foods and nutrients on ageing muscle. In this review, we have aimed to (i) summarise nutritional epidemiology evidence from four recent systematic reviews with updates from new primary studies about the role of DPs in muscle health, sarcopenia, and its components; (ii) hypothesise about the potential mechanisms of ‘myoprotective’ diets, with the MED as an example, and (iii) discuss the challenges facing nutritional epidemiology to produce the higher level evidence needed to understand the relationships between whole diets and healthy muscle ageing.
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Affiliation(s)
- Antoneta Granic
- AGE Research Group, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
| | - Avan A Sayer
- AGE Research Group, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
| | - Sian M Robinson
- AGE Research Group, Institute of Neuroscience, The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
- Institute for Ageing, Newcastle University, Newcastle upon Tyne NE2 4AX, UK.
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Carbone S, Billingsley HE, Rodriguez-Miguelez P, Kirkman DL, Garten R, Franco RL, Lee DC, Lavie CJ. Lean Mass Abnormalities in Heart Failure: The Role of Sarcopenia, Sarcopenic Obesity, and Cachexia. Curr Probl Cardiol 2019; 45:100417. [PMID: 31036371 DOI: 10.1016/j.cpcardiol.2019.03.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 03/24/2019] [Indexed: 02/07/2023]
Abstract
The role of body composition in patients with heart failure (HF) has been receiving much attention in the last few years. Particularly, reduced lean mass (LM), the best surrogate for skeletal muscle mass, is independently associated with abnormal cardiorespiratory fitness (CRF) and muscle strength, ultimately leading to reduced quality of life and worse prognosis. While in the past, reduced CRF in patients with HF was thought to result exclusively from cardiac dysfunction leading to reduced cardiac output at peak exercise, current evidence supports the concept that abnormalities in LM may also play a critical role. Abnormalities in the LM body composition compartment are associated with the development of sarcopenia, sarcopenic obesity, and cachexia. Such conditions have been implicated in the pathophysiology and progression of HF. However, identification of such conditions remains challenging, as universal definitions for sarcopenia, sarcopenic obesity, and cachexia are lacking. In this review article, we describe the most common body composition abnormalities related to the LM compartment, including skeletal and respiratory muscle mass abnormalities, and the consequences of such anomalies on CRF and muscle strength in patients with HF. Finally, we discuss the potential nonpharmacologic therapeutic strategies such as exercise training (ie, aerobic exercise and resistance exercise) and dietary interventions (ie, dietary supplementation and dietary patterns) that have been implemented to target body composition, with a focus on HF.
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45
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Hao G, Pollock NK, Harris RA, Gutin B, Su S, Wang X. Associations between muscle mass, physical activity and dietary behaviour in adolescents. Pediatr Obes 2019; 14:e12471. [PMID: 30280506 DOI: 10.1111/ijpo.12471] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 07/12/2018] [Accepted: 07/30/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Investigations in older individuals suggest that adequate nutrition and physical activity are particularly important to skeletal muscle health; however, data in adolescents are scant and equivocal. The objective was to determine the associations among diet, physical activity and skeletal muscle mass in adolescents. METHODS We assessed diet with four to seven 24-h recalls and physical activity by accelerometry in 640 adolescents. Using total body measures of fat-free soft tissue mass and fat mass assessed by dual-energy X-ray absorptiometry, the skeletal muscle mass index (SMMI) was derived by adjusting fat-free soft tissue mass for fat mass in addition to height. RESULTS Skeletal muscle mass index (SMMI) was negatively associated with consumption of sugar-sweetened beverages (standardized beta coefficient [β] = -0.10, P = 0.001) and saturated fats (β = -0.28, P < 0.001). SMMI was positively associated with physical activity (moderate + vigorous) (β = 0.20, P < 0.001). In further analysis, we observed a significant interaction between physical activity and sugar-sweetened beverage intake on SMMI (P = 0.002). CONCLUSION Our study in adolescence suggests that physical activity and consumption of both sugar-sweetened beverages and saturated fats are associated with skeletal muscle mass. More importantly, our findings suggest that sugar-sweetened beverage intake may attenuate the beneficial effects of physical activity on skeletal muscle mass.
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Affiliation(s)
- G Hao
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - N K Pollock
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - R A Harris
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - B Gutin
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - S Su
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - X Wang
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Jang BY, Bu SY. A Vegetable and Fish Dietary Pattern Is Positively Associated with Skeletal Muscle Mass in Korean Men. Clin Nutr Res 2019; 8:1-16. [PMID: 30746343 PMCID: PMC6355951 DOI: 10.7762/cnr.2019.8.1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 12/22/2022] Open
Abstract
Isolating the effects of a single nutrient or food in relation to health outcomes including increased skeletal muscle mass is a challenging task because dietary constituents are highly correlated and synergistic. Hence, diet pattern analysis may be used to investigate the role of certain diets in health outcomes. The present study investigated the dietary patterns and their relationship to skeletal muscle mass in Korean adults. Data were extracted from the 2008–2011 Korea National Health and Nutrition Examination Surveys. To explore the dietary patterns of the study subjects, factor analysis was performed using data obtained from a 24-hour recall. The skeletal muscle index according to dietary pattern scores was then investigated to estimate the changes in skeletal muscle mass. Three patterns were initially identified from the factor analysis. Of these vegetables and fish (VF) pattern was the primary factor with high reliability and was a common factor in sex-separated analyses. The VF pattern scores were positively associated with increased skeletal muscle mass in both men and women. Further analysis according to quartile levels of VF pattern scores showed a positive association between skeletal muscle mass and VF pattern in men but not in women. These results suggest that dietary patterns focused on vegetables and seafoods may contribute to increased skeletal muscle mass in Korean men but that sex difference should be considered in nutrition care for skeletal muscle health.
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Affiliation(s)
- Bo Young Jang
- Department of Food and Nutrition, College of Engineering, Daegu University, Gyeongsan 38453, Korea
| | - So Young Bu
- Department of Food and Nutrition, College of Engineering, Daegu University, Gyeongsan 38453, Korea
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Silva TRD, Martins CC, Ferreira LL, Spritzer PM. Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women. Climacteric 2019; 22:162-168. [PMID: 30661407 DOI: 10.1080/13697137.2018.1529747] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to investigate the association between the Mediterranean diet (MD), body composition, and bone mineral density (BMD) in postmenopausal women. METHODS In this cross-sectional study, 105 apparently healthy postmenopausal women aged between 45 and 65 years were included. BMD, percentage body fat, and appendicular lean mass index (ALMI, appendicular lean mass/height squared) were assessed by dual-energy X-ray absorptiometry. Dietary intake was assessed by a validated food frequency questionnaire. Assessment of MD adherence was based on intake of cereals, vegetables, fruits, meats, dairy products, fish, red wine, and olive oil, and expressed as the Mediterranean diet score (MDS). RESULTS Women with higher adherence to the MD had higher ALMI (6.6 ± 0.8 kg/m2 vs. 6.3 ± 0.7 kg/m2; p = 0.039) and lumbar spine BMD (1.076 ± 0.149 vs. 0.997 ± 0.143 g/cm2; p = 0.007) compared to those with lower MDS. Linear regression analysis adjusted for previous hormone therapy, previous smoking behavior, and habitual physical activity showed an independent positive contribution of MDS to lumbar spine BMD (mean difference 0.088 g/cm2, 95% confidence interval 0.028-0.147; p = 0.004) and ALMI (mean difference 0.296 kg/m2, 95% confidence interval 0.020-0.591; p = 0.049). CONCLUSION Bone mineral density at the lumbar spine and ALMI were positively associated with the MDS in a sample of postmenopausal women from a non-Mediterranean region.
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Affiliation(s)
- T R da Silva
- a Gynecological Endocrinology Unit, Division of Endocrinology , Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil.,b Post-graduate Program in Endocrinology and Metabolism , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - C C Martins
- a Gynecological Endocrinology Unit, Division of Endocrinology , Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - L L Ferreira
- a Gynecological Endocrinology Unit, Division of Endocrinology , Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil.,b Post-graduate Program in Endocrinology and Metabolism , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - P M Spritzer
- a Gynecological Endocrinology Unit, Division of Endocrinology , Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil.,b Post-graduate Program in Endocrinology and Metabolism , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil.,c Laboratory of Molecular Endocrinology, Department of Physiology , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
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48
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Lee JY, Lee S. Dietary Patterns Related to Appendicular Skeletal Muscle Mass: The Korea National Health and Nutrition Examination Survey 2008-2011. J Am Coll Nutr 2018; 38:358-363. [PMID: 30570371 DOI: 10.1080/07315724.2018.1523759] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Muscle mass plays an important role in healthy aging among elderly adults. We investigated the association between dietary patterns and appendicular skeletal muscle mass (ASM) among 3,488 adults ages 60 years or older. METHODS The Korea National Health and Nutrition Examination Survey (KNHANES) data for 2008-2011 were analyzed. Dietary information from a food frequency questionnaire was utilized. To identify dietary patterns, factor analysis was performed. Dual-energy x-ray absorptiometry was used to ascertain ASM. To examine the association between dietary patterns and ASM, a multivariable regression model was used after adjusting for potential confounding factors. RESULTS Two dietary patterns were identified: Healthy and Western dietary patterns. The Healthy dietary pattern was characterized as high frequencies of intake in vegetables, fish, fruits, seaweeds, legumes, mushrooms, whole grains, potatoes, eggs, dairy products, and red meat. In contrast, the Western dietary pattern was characterized by high intake of red meat, bread, noodles, fast food, rice cake, poultry, and soft drinks. Men showed a significant association between the Healthy dietary pattern and higher ASM, even after adjusting for covariates (p value =0.034). CONCLUSION In this cross-sectional study, we observed that men ages 60 years and older with the Healthy dietary pattern had higher muscle mass.
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Affiliation(s)
- Jae Yeon Lee
- a Department of Public Health , General Graduate School, Kyungpook National University , South Korea
| | - Sunghee Lee
- b Department of Food and Nutrition , College of Health Science, Kangwon National University , South Korea
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49
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Veronese N, Koyanagi A, Stubbs B, Cooper C, Guglielmi G, Rizzoli R, Punzi L, Rogoli D, Caruso MG, Rotolo O, Notarnicola M, Al-Daghri N, Smith L, Reginster JY, Maggi S. Mediterranean diet and knee osteoarthritis outcomes: A longitudinal cohort study. Clin Nutr 2018; 38:2735-2739. [PMID: 30553579 DOI: 10.1016/j.clnu.2018.11.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. METHODS Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes included incident (1) ROA, (2) SxOA, as the new onset of a combination of a painful knee and ROA, (3) knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam of ≥14%. RESULTS 4330 subjects (mean age: 61.1 years; 58.0% females) were included. Based on a multivariable Poisson regression analysis, during a mean follow-up period of 4 years, participants who were more highly adherent to a Mediterranean diet (Q5) reported lower risk of pain worsening (relative risk, RR = 0.96; 95% CI: 0.91-0.999) compared to those in Q1. In 2994 people free from SxOA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk for SxOA during follow-up by 9% (Q5 vs. Q1; RR = 0.91; 95% CI: 0.82-0.998). No significant associations emerged between aMED and incident ROA. CONCLUSION Higher adherence to Mediterranean diet is associated with a lower risk of pain worsening and symptomatic forms of knee OA.
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Affiliation(s)
- Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, De Crespigny Park, London SE5 8AF, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK
| | - Cyrus Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK; National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Renè Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Leonardo Punzi
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Domenico Rogoli
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Maria Gabriella Caruso
- National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - Ornella Rotolo
- National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - Maria Notarnicola
- National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - Nasser Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jean-Yves Reginster
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia; Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
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50
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Barrea L, Muscogiuri G, Di Somma C, Tramontano G, De Luca V, Illario M, Colao A, Savastano S. Association between Mediterranean diet and hand grip strength in older adult women. Clin Nutr 2018; 38:721-729. [PMID: 29643004 DOI: 10.1016/j.clnu.2018.03.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 03/07/2018] [Accepted: 03/17/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND & AIMS Mediterranean Diet (MD) is an eating pattern associated with multiple healthy benefits, including the conservation of skeletal muscle. Frailty is a major geriatric syndrome characterized by low muscle strength. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity for clinical purposes. The association between the adherence to the MD and HGS in elderly has not yet fully investigated. The goal of this study was to examine the association between the adherence to the MD and HGS in a not hospitalized elderly who participated in the project PERsonalised ict Supported Services for Independent Living and Active Ageing (PERSSILAA). METHODS Eighty-four elderly women were consecutively enrolled (aged 60-85 years) in this cross-sectional observational study. Anthropometric measures were evaluated. A validated 14-item questionnaire PREDIMED (PREvención con DIeta MEDiterránea) was used for the assessment of adherence to the MD. Dietary data were collected by a 7-day food records. Muscle strength was measured by HGS using a grip strength dynamometer (KERN & SOHN GmbH). RESULTS The majority of participants were overweight (46.4%). An average adherence to the MD was found in 52.4% of participants, while the minority of them showed a low adherence (21.4%). HGS > cut-point of 20 kg were found in 43 subjects (51.2%). According to the adherence to MD, 39% participants with HGS values higher than cut-point presented a high adherence score compared with 14% of those with lower values of HGS (p = 0.018). The participants with HGS > cut-point presented significantly higher PREDIMED score than those with HGS < cut-point (p < 0.001). Based on ROC curves, the most sensitive and specific cut-point for the PREDIMED score to predict HGS categories was ≥8. No evident correlations were observed between HGS and age, while HGS was negatively correlated with hip circumference (r = -0.233, p = 0.033) and BMI (r = -0.219, p = 0.045), and positively correlated with PREDIMED score (r = 0.598, p < 0.001). At binomial logistic regression analysis almost all 14-items of PREDIMED questionnaire were significantly associated with HGS adjusted for BMI. At multinomial logistic regression analysis to assess the association of the three classes of adherence to the MD with the HGS, after adjusting for BMI the lowest adherence to MD was associated with the lowest Odds Ratio of HGS (p < 0.001). CONCLUSIONS This study evidenced a positive association between the adherence to the MD and muscle strength in a sample of active elderly women, stratified according to the HGS > cut-point of 20 kg. Our study highlights the usefulness of the developing health services to detect and prevent age-associated decline in physical performance in elderly subjects by addressing nutritional and physical intervention.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Giovanni Tramontano
- Research and Development Unit, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Vincenzo De Luca
- Research and Development Unit, Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy.
| | | | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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