Cross-Sectional Associations Between Dietary Antioxidant Vitamins C, E and Carotenoid Intakes and Sarcopenic Indices in Women Aged 18-79 Years

The association between dietary vitamins and the risk of sarcopenia in adults aged 20-59: a study based on the NHANES database

Background

Sarcopenia has emerged as a global health concern, but the association between dietary vitamin levels and sarcopenia is not elucidated. This study aims to shed light on the link of 11 dietary vitamins to the risk of sarcopenia in adults at the age of 20-59.

Methods

This cross-sectional study encompassed 2011-2018 data from the National Health and Nutrition Examination Survey (NHANES) for adults aged 20-59. Sarcopenia was defined through the appendicular lean mass to body mass index ratio calculated via Dual-Energy X-ray Absorptiometry (DXA), with sarcopenia determined as a ratio of <0.789 for the male and <0.512 for the female. Multivariate weighted logistic regression assisted in assessing the connection of dietary vitamins with sarcopenia, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs). The dose-response association of various vitamins with sarcopenia was visualized through restricted cubic splines (RCS). Subgroup analyses were carried out to examine the consistency of the aforementioned associations. Sensitivity analysis was performed utilizing propensity score matching (PSM) to adjust for confounding factors and enhance the robustness of the results.

Results

Among the 7,864 participants, 677 (8.6%) had sarcopenia, and 7,187 (91.4%) did not. Multivariate weighted logistic regression and RCS analyses indicated that higher intakes of VA, VB1, VB2, VB3, VB6, VB9, VB12, VC, VE, and VK were notably linked to a lowered risk of sarcopenia (P < 0.05). Among these, VA, VC, and VE exhibited a non-linear negative association with sarcopenia risk (P for non-linear < 0.05), while VB1, VB2, VB3, VB6, VB9, VB12, and VK exhibited a linear negative association (P for non-linear > 0.05). Subgroup analysis yielded largely consistent results. After confounding factors were adjusted through PSM, the results suggest that the intake of VA, VB2, VB6, and VC remains significantly associated with a lowered risk of sarcopenia (P < 0.05).

Conclusion

Higher dietary levels of VA, VB2, VB6, and VC are significantly related to a lower livelihood of sarcopenia. These findings provide new evidence and insights for early dietary interventions aimed at preventing sarcopenia.

Impact of the dietary antioxidant index on bone mineral density gain among mexican adults: a prospective study

In the Mexican population, low dietary antioxidant intake (DAI) is associated with reduced bone mineral density (BMD). A decline in DAI over time further contributes to BMD loss, particularly at the total hip, femoral neck, and lumbar spine, with a more pronounced effect in women over 45 years old.

PURPOSE

Bone remodeling, balancing resorption and formation, is crucial for bone health. Aging shifts this balance, reducing BMD and increasing osteoporosis risk. Reactive oxygen species (ROS) contribute to bone loss through oxidative stress. Antioxidants may help mitigate this damage, but their impact on BMD in populations with inadequate nutrient intake, like Mexicans, needs to be better understood. This study explores the association between DAI changes and BMD in a Mexican population.

METHODS

Data were sourced from the Health Worker Cohort Study (HWCS), including 1,318 participants (aged ≥ 20) with BMD measurements and complete dietary information at two time points. The study employed a longitudinal design was used, whit data from two waves of the study (2010-2012 and 2017-2019), providing a median follow-up time of 6.4 years for men and 6.8 years for women. Dietary antioxidant intake was assessed using a validated Food Frequency Questionnaire for the Mexican diet. BMD was measured at the femoral neck, total hip, and lumbar spine using dual-energy X-ray absorptiometry (DEXA). Fixed-effects regression models were applied to analyze the association between DAI and BMD at different sites, adjusting for time-varying covariates.

RESULTS

Changes in DAI scores were associated with lower BMD at various sites. Each unit decrease in DAI over time was associated with a BMD loss of -0.002,-0.004 g/cm2 at the total hip, femoral neck, and lumbar spine. Notable declines were observed in women, particularly those over 45 years old, where specific antioxidant components, like zinc, magnesium, and selenium, were linked to lower BMD.

CONCLUSION

This study underscores the role of reduced dietary antioxidant intake in contributing lower BMD, particularly among older adults. Diets low in antioxidant may increase the risk of osteoporosis, especially in populations with insufficient nutrient intake.

Association between the composite dietary antioxidant index and sarcopenia among United States adults: A cross-sectional study

BACKGROUND

Diets high in antioxidants are associated with decreased prevalence of sarcopenia. This study aimed to investigate whether the composite dietary antioxidant index (CDAI) and sarcopenia have an underlying relationship.

METHODS

We used the data from the National Health and Nutrition Examination Survey 2011-2018. According to dietary antioxidant intake, the CDAI was calculated for each individual. Appendicular skeletal muscle mass index was employed to determine sarcopenia. Multivariate weighted logistic models and restricted cubic spline regression analysis was undertaken to determine the association between CDAI and sarcopenia.

RESULTS

A total of 7012 participants were enrolled in this study, including 473 with sarcopenia (weighted percentage, 5.6%). Compared with the lowest tertile, those in the highest tertile of the CDAI exhibited a greater likelihood of being male, with lower body mass index, higher education level and economic standard, and more chance of being single or separated. In multivariate weighted logistic models, model 3 revealed a noteworthy inverse association between the CDAI and sarcopenia (odds ratio = 0.94; 95% CI, 0.91-0.98; P = 0.003). Compared with the lowest tertile, the highest tertile of CDAI was associated with a 0.57-fold risk of sarcopenia (95% CI, 0.42-0.77; P < 0.001). The inverse association between CDAI and sarcopenia strengthened in the participants with elevated education levels (P for interaction = 0.003).

CONCLUSION

The CDAI was inversely correlated with the prevalence of sarcopenia. As a comprehensive measurement representing antioxidant status, the CDAI may help manage and prevent sarcopenia.

Association between the composite dietary antioxidant index and sarcopenia risk in American adults: a cross-sectional NHANES study

Background

Given the absence of specific pharmacological treatments for sarcopenia, identifying effective lifestyle and dietary interventions is imperative. This study aims to explore the association between the composite dietary antioxidant index (CDAI) and sarcopenia, offering new insights into nutritional strategies for sarcopenia-prone populations.

Methods

This cross-sectional study analysed secondary data from the National Health and Nutrition Examination Survey cycles spanning 2001-2006 and 2011-2018. Weighted multivariate logistic regression and restricted cubic spline (RCS) analyses were employed to evaluate the non-linear association between CDAI and sarcopenia and to perform stratified analyses.

Results

In this study, encompassing 19 683 American adults, representative of the national population of 132 140 502 residents, 7.97% were diagnosed with sarcopenia. Across all adjusted models, a higher CDAI was inversely associated with the risk of sarcopenia (OR 0.94, 95% CI 0.92, 0.96; P<0.0001). The highest quartile of CDAI scores to those in the lowest revealed significantly reduced odds of sarcopenia (OR 0.46, 95% CI 0.38, 0.56; P<0.0001). RCS analysis demonstrated a non-linear relationship between CDAI and sarcopenia. Additionally, stratified analyses indicated that the inverse association between CDAI and sarcopenia was more pronounced among participants with higher educational levels and those diagnosed with tumours.

Conclusions

There was a negative relationship between CDAI scores and the prevalence of sarcopenia, suggesting that higher CDAI scores may help in managing and preventing the occurrence of sarcopenia.

Association of food group with the changes in sarcopenia parameters over 1 year in older outpatients in a frailty clinic

PURPOSE

This study investigated the relationship between food group and the changes in sarcopenia parameters in 1 year among older outpatients.

METHODS

A prospective cohort study conducted between July 2017 and April 2021 included patients aged ≥ 65 years attending a frailty clinic. Food group consumption adjusted for energy and body weight was conducted using a self-administered dietary history questionnaire. Ordinal logistic regression analysis was used to examine the association between tertiles of adjusted food group consumption and outcomes, including a handgrip strength decline, prolonged five-time chair stand test (5CST), decreased skeletal muscle mass index (SMI), and decreased gait speed in 1 year. Covariates included age, sex, height, energy intake, number of comorbidities, and the Baecke activity score.

RESULTS

In the analysis of 165 participants (mean age 77.6 ± 6.1 years, 107 women), individuals with higher consumption of sugar and sweeteners had a significantly increased risk for handgrip strength decline (OR 2.46, 95% CI 1.15-5.23, P = 0.020) and prolonged 5CST (OR 3.14, 95% CI 1.38-7.13, P = 0.006). Higher consumption of beverages increased the risk of handgrip strength decline (OR 2.30, 95% CI 1.11-4.76, P = 0.025). Conversely, higher legume consumption decreased the risk of SMI reduction (OR 0.35, 95%CI 0.16-0.76, P = 0.008), higher fruit consumption reduced the risk of prolonged 5CST time (OR 0.29, 95% CI 0.13-0.67, P = 0.004), and higher green yellow vegetables consumption decreased the risk of reduced gait speed (OR 0.38, 95% CI 0.17-0.84, P = 0.017).

CONCLUSION

Sugar, sweeteners, and beverages are associated with worsened sarcopenia parameters, whereas consumption of legumes, vegetables, and fruits is associated with a lower risk.

Associations between dietary total antioxidant capacity and sarcopenia: a cross-sectional study

BACKGROUND

No study has investigated the relationship between dietary total antioxidant capacity and sarcopenia so far.

OBJECTIVE

This study aimed to investigate the association between dietary Total Antioxidant Capacity (d-TAC) and sarcopenia in elderly adults.

METHODS

In this cross-sectional study we enrolled 300 elderly people (150 men and 150 women) aged ≥ 55 years using cluster random sampling method. Sarcopenia was defined based on European Working Group on Sarcopenia (EWGSOP) definition. A DXA scanner, a squeeze bulb dynamometer and a 4-Meter walk gait speed test was used to measure Appendicular Skeletal Muscle (ASM), muscle strength and muscle performance respectively. We also used a Block-format 117-item food frequency questionnaire (FFQ) to assess dietary intakes of participants. Multivariable logistic regression models were applied to examine the association between d-TAC and sarcopenia.

RESULTS

Mean ± SD age of study participants and their BMI was 66.8 ± 7.72 year and 27.3 ± 4.2 kg/m2, respectively. People in the highest tertile of d-TAC had the greatest hand grip strength (11.9 ± 3.63 vs. 10.4 ± 3.55 psi, p = 0.009) and had lower odds of sarcopenia compared with those in the lowest tertile, either before (OR = 0.39; 95% CI: 0.17, 0.88) or after adjustment for potential confounders (OR = 0.33; 95% CI: 0.11, 0.95). No other significant association was seen between d-TAC and components of sarcopenia.

CONCLUSION

We found an inverse association between dietary total antioxidant capacity and odds of sarcopenia. No significant association was seen between d-TAC and individual components of sarcopenia. Further studies are needed to confirm our findings.

Low dietary vitamin C intake is associated with low muscle strength among elderly Korean women

Although vitamin C is one of the most important antioxidants, its effect on muscle quality is not fully understood. Therefore, we hypothesized that low dietary vitamin C intake is associated with low muscle strength. To test the hypothesis, a single 24-h dietary recall and handgrip strength test of 10,883 younger adults 19-64 y and 3,961 older adults ≥65 y from the seventh Korea National Health and Examination Survey (KNHANES VII 2016-2018) was analyzed by multivariable linear and logistic regression models, and low muscle strength was defined as handgrip strength <28 kg for men and <18 kg for women. Approximately 15.5% of Korean adults met the recommended intake of dietary vitamin C, and those with higher dietary vitamin C intake had higher total energy and protein intake. After adjusting for confounding variables, including age, body mass index, total energy intake, household income, alcohol consumption, smoking, resistance exercise, medical condition, and dietary intake of protein, vitamin E, and β-carotene, dietary vitamin C was correlated with maximal handgrip strength in younger women 19-64 y (β = 0.002; SE = 0.001; P-value = .026) and older women ≥65 y (β = 0.005; SE = 0.002; P-value = .013). Among older women ≥65 y, those in the lowest quartile of dietary vitamin C intake had a higher risk of low muscle strength compared to those in the highest quartile after adjustment of confounding factors (odds ratio, 2.16; 95% confidence interval, 1.49-3.15). These results imply that adequate dietary vitamin C intake may reduce the risk of sarcopenia in older Korean women.

Association of fat-to-muscle mass ratio with physical activity and dietary protein, carbohydrate, sodium, and fiber intake in a cross-sectional study

Higher fat-to-muscle mass ratio (FMR) is reported to be a risk factor for various diseases, including type 2 diabetes and cardiovascular diseases, and mortality. Although this association suggests that reducing FMR may help to prevent certain diseases and mortality, the relationship between FMR and lifestyle factors is unclear. Therefore, we performed a cross-sectional study with the aim to elucidate this relationship. This cross-sectional study included 1518 healthy Japanese adults aged 30 to 64 years. We measured FMR in the whole body, arms, legs, and trunk and assessed various lifestyle factors. Then, we performed forced entry multiple regression analyses for FMR with the following variables: sex, age, physical activity, dietary intake, sleep quality, cigarette smoking, stress levels, and body mass index. As a result, whole-body and regional FMRs were correlated with female sex (β = 0.71); age (β = 0.06); physical activity (β = - 0.07); dietary intake of protein (β = - 0.12), carbohydrate (β = 0.04), sodium (β = 0.13), and fiber (β = - 0.16); and body mass index (β = 0.70). The results suggest that in the Japanese middle-aged population, low FMR is associated with certain lifestyle factors, i.e. higher physical activity and a diet with higher protein and fiber and lower carbohydrate and sodium, independent of age, sex, and body mass index.

Nutritional Strategies for Muscle Atrophy: Current Evidence and Underlying Mechanisms

Skeletal muscle can undergo detrimental changes in various diseases, leading to muscle dysfunction and atrophy, thus severely affecting people's lives. Along with exercise, there is a growing interest in the potential of nutritional support against muscle atrophy. This review provides a brief overview of the molecular mechanisms driving skeletal muscle atrophy and summarizes recent advances in nutritional interventions for preventing and treating muscle atrophy. The nutritional supplements include amino acids and their derivatives (such as leucine, β-hydroxy, β-methylbutyrate, and creatine), various antioxidant supplements (like Coenzyme Q10 and mitoquinone, resveratrol, curcumin, quercetin, Omega 3 fatty acids), minerals (such as magnesium and selenium), and vitamins (such as vitamin B, vitamin C, vitamin D, and vitamin E), as well as probiotics and prebiotics (like Lactobacillus, Bifidobacterium, and 1-kestose). Furthermore, the study discusses the impact of a combined approach involving nutritional support and physical therapy to prevent muscle atrophy, suggests appropriate multi-nutritional and multi-modal interventions based on individual conditions to optimize treatment outcomes, and enhances the recovery of muscle function for patients. By understanding the molecular mechanisms behind skeletal muscle atrophy and implementing appropriate interventions, it is possible to enhance the recovery of muscle function and improve patients' quality of life.

Association between the oxidative balance score and low muscle mass in middle-aged US adults

Background

Oxidative Balance Score (OBS) is a tool for assessing the oxidative stress-related exposures of diet and lifestyle. The study aimed to investigate the association between OBS and low muscle mass.

Methods

Overall, 6,307 individuals over the age of 18 were assessed using data from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression and models were used, together with adjusted models.

Results

There was a negative relationship between OBS and low muscle mass [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94-0.97, p< 0.0001] using the first OBS level as reference. The values (all 95% CI) were 0.745 (0.527-1.054) for the second level, 0.650 (0.456-0.927) for the third level, and 0.326 (0.206-0.514) for the fourth level (P for trend <0.0001). Independent links with low muscle mass were found for diet and lifestyle factors. A restricted cubic spline model indicated a non-linear association between OBS and low muscle mass risk (P for non-linearity<0.05). In addition, the inflection points of the nonlinear curves for the relationship between OBS and risk of low muscle mass were 20.

Conclusion

OBS and low muscle mass were found to be significantly negatively correlated. By modulating oxidative balance, a healthy lifestyle and antioxidant rich diet could be a preventive strategy for low muscle mass.

Relationship between Eating Alone and Handgrip Strength in Korean Older Adults

Sarcopenia is defined as an age-related decline in muscle mass, muscle strength, and physical performance. Eating alone has been linked to various health issues in older adults. This study investigated the relationship between eating alone and handgrip strength (HGS) in older adults using data from 7278 individuals (≥65 years) who participated in the 2014-2019 Korea National Health and Nutrition Examination Survey. HGS was measured using a digital grip strength dynamometer, relative HGS was calculated by dividing HGS by body mass index, and dynapenia was defined as an HGS < 28 kg for men and <18 kg for women. Multivariable logistic regression analysis showed that women who ate two meals alone were more likely to exhibit dynapenia than those who never ate alone (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.03-1.77). If the groups that never ate alone or ate one meal alone were combined as the reference group, the probability of dynapenia was higher in the combined groups that ate two or three meals alone (OR, 1.25; 95% CI, 1.04-1.50). No association was observed between eating alone and dynapenia in men. This suggests that eating alone is a modifiable related factor of dynapenia in older women.

Associations of plasma retinol and α-tocopherol levels with skeletal muscle health in Chinese children

Childhood is a critical period for muscle accumulation. Studies in elders have reported that antioxidant vitamins could improve muscle health. However, limited studies have assessed such associations in children. This study included 243 boys and 183 girls. A seventy-nine-item FFQ was used to investigate dietary nutrients intake. Plasma levels of retinol and α-tocopherol were measured using high-performance liquid chromatography with MS. Dual X-ray absorptiometry was used to assess appendicular skeletal muscle mass (ASM) and total body fat. The ASM index (ASMI) and ASMI Z-score were then calculated. Hand grip strength was measured using a Jamar® Plus+ Hand Dynamometer. Fully adjusted multiple linear regression models showed that for each unit increase in plasma retinol content, ASM, ASMI, left HGS and ASMI Z-score increased by 2·43 × 10-3 kg, 1·33 × 10-3 kg/m2, 3·72 × 10-3 kg and 2·45 × 10-3 in girls, respectively (P < 0·001-0·050). ANCOVA revealed a dose-response relationship between tertiles of plasma retinol level and muscle indicators (Ptrend: 0·001-0·007). The percentage differences between the top and bottom tertiles were 8·38 %, 6·26 %, 13·2 %, 12·1 % and 116 % for ASM, ASMI, left HGS, right HGS and ASMI Z-score in girls, respectively (Pdiff: 0·005-0·020). No such associations were observed in boys. Plasma α-tocopherol levels were not correlated with muscle indicators in either sex. In conclusion, high circulating retinol levels are positively associated with muscle mass and strength in school-age girls.

Bioactive compounds in cruciferous sprouts and microgreens and the effects of sulfur nutrition

Cruciferous sprouts and microgreens are a good source of bioactive compounds for human health as they are rich in glucosinolates, polyphenols, carotenoids, and vitamins. Glucosinolates - sulfur-containing bioactive phytochemicals - have anti-cancer effects. They mainly exist in cruciferous vegetables. Sulfur is one of the essential elements for plants and is an indispensable component of glucosinolates. This paper summarizes the nutritional value of cruciferous spouts and microgreens, along with the effects of sulfur nutrition on bioactive phytochemical compounds of cruciferous sprouts and microgreens, especially glucosinolates, with the aim of providing information about the dietary effects of cruciferous sprouts and microgreens. © 2023 Society of Chemical Industry.

Association of the composite dietary antioxidant index with bone mineral density in the United States general population: data from NHANES 2005-2010

INTRODUCTION

There is evidence that individual antioxidants may increase bone mineral density (BMD) in patients with low BMD. However, the association between overall dietary antioxidant intake and BMD is unclear. The objective of this study was to examine how overall dietary antioxidant intake is related to BMD.

MATERIALS AND METHODS

A total of 14,069 people participated in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010. Dietary Antioxidant Index (DAI) was calculated from the intake of vitamins A, C, E, zinc, selenium, and magnesium, which indicates a nutritional tool to assess the overall antioxidant properties of the diet. The correlation between the Composite Dietary Antioxidant Index (CDAI) and BMD was examined using multivariate logistic regression models. In addition to fitting smoothing curves, we fitted generalized additive models as well. Furthermore, to ensure data stability and avoid confounding factors, subgroup analysis was also conducted on gender and body mass index (BMI).

RESULTS

A significant association was demonstrated by the study between CDAI and total spine BMD (β = 0.001, 95% CI 0-0.001, P = 0.00039). And just like that, CDAI was positively correlated with femoral neck (β = 0.003, 95% CI 0.003-0.004, P < 0.00001) and trochanter (β = 0.004, 95% CI 0.003-0.004, P < 0.00001). In the gender subgroup analysis, CDAI maintained a strong positive correlation with femoral neck and trochanter BMD in males and females. Nevertheless, the link with total spine BMD was only observed in males. In addition, in the subgroup analysis stratified by BMI, CDAI showed a significantly positive relation to BMD of the femoral neck and trochanter in each group. However, the significant relationship between CDAI and BMD of the total spine was only maintained when BMI was above 30 kg/m2.

CONCLUSION

This study found that CDAI correlated positively with femoral neck, trochanter, and total spine BMD. This suggests that intake of a diet rich in antioxidants can reduce the risk of low bone mass and osteoporosis.

Microalgae Produce Antioxidant Molecules with Potential Preventive Effects on Mitochondrial Functions and Skeletal Muscular Oxidative Stress

In recent years, microalgae have become a source of molecules for a healthy life. Their composition of carbohydrates, peptides, lipids, vitamins and carotenoids makes them a promising new source of antioxidant molecules. Skeletal muscle is a tissue that requires constant remodeling via protein turnover, and its regular functioning consumes energy in the form of adenosine triphosphate (ATP), which is produced by mitochondria. Under conditions of traumatic exercise or muscular diseases, a high production of reactive oxygen species (ROS) at the origin of oxidative stress (OS) will lead to inflammation and muscle atrophy, with life-long consequences. In this review, we describe the potential antioxidant effects of microalgae and their biomolecules on mitochondrial functions and skeletal muscular oxidative stress during exercises or in musculoskeletal diseases, as in sarcopenia, chronic obstructive pulmonary disease (COPD) and Duchenne muscular dystrophy (DMD), through the increase in and regulation of antioxidant pathways and protein synthesis.

Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

Background

The Composite Dietary Antioxidant Index (CDAI), a composite score of multiple dietary antioxidants (including vitamin A, C, and E, selenium, zinc, and carotenoids), represents an individual's comprehensive dietary antioxidant intake profile. CDAI was developed based on its combined effect on pro-inflammatory markers Tumor Necrosis Factor-α (TNF-α) and anti-inflammatory effects of Interleukin-1β (IL-1β), which are associated with many health outcomes, including depression, all-cause mortality, colorectal cancer, etc. Handgrip strength is used as a simple measure of muscle strength, not only is it highly correlated with overall muscle strength, but also serves as a diagnostic tool for many adverse health outcomes, including sarcopenia and frailty syndromes.

Purpose

The association between CDAI and Handgrip strength (HGS) is currently unclear. This study investigated the association between CDAI (including its components) and HGS in 6,019 American adults.

Method

The research data were selected from the 2011-2014 National Health and Nutrition Survey (NHANES), and a total of 6,019 American adults were screened and included. A weighted generalized linear regression model was used to evaluate CDAI (including its components) and HGS.

Results

(1) CDAI was significantly positively correlated with HGS (β = 0.009, 0.005∼0.013, P < 0.001), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.084, 0.042∼0.126, P = 0.002) and significant in trend test (P for trend < 0.0100). Gender subgroup analysis showed that male CDAI was significantly positively correlated with HGS (β = 0.015, 0.007∼0.023, P = 0.002), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.131, 0.049∼0.213, P = 0.006) and the trend test was significant (P for trend < 0.0100). There was no correlation between female CDAI and HGS, and the trend test was not statistically significant (P > 0.05). (2) The intake of dietary vitamin E, Zinc and Selenium showed a significant positive correlation with HGS (β = 0.004, 0.002∼0.007, P = 0.006; β = 0.007, 0.004∼0.009, P < 0.001; β = 0.001, 0.001∼0.001, P < 0.001), vitamin A, vitamin C and carotenoid were significantly associated with HGS in the Crude Model, but this significant association disappeared in the complete model with the increase of control variables. Gender subgroup analysis showed that in model 3, male dietary intake levels of vitamin E, Zinc, and Selenium were significantly positively correlated with HGS (β = 0.005, 0.002∼0.009, P = 0.011; β = 0.007, 0.004∼0.011, P = 0.001; β = 0.001, 0.001∼0.001, P = 0.004), the rest of the indicators had no significant correlation with HGS. Among the female subjects, dietary zinc intake was significantly positively correlated with HGS (β = 0.005, 0.001∼0.008, P = 0.008), and there was no significant correlation between other indicators and HGS (P > 0.05).

Conclusion

There was an association between the CDAI and HGS, but there was a gender difference, and there was an association between the CDAI and HGS in male, but the association was not significant in female. Intake of the dietary antioxidants vitamin E, selenium, and zinc was associated with HGS in male, but only zinc was associated with HGS among dietary antioxidants in female.

A pro-inflammatory diet increases the risk of sarcopenia components and inflammatory biomarkers in postmenopausal women

Inflammation is a risk factor for muscle wasting. The dietary inflammatory index (DII) is a tool used to predict the inflammatory potential of an individual's diet. We hypothesized that consuming a potentially pro-inflammatory diet may be associated with a decreased sarcopenia component in postmenopausal women. Therefore, this study aimed to investigate the association between DII, sarcopenia components (muscle mass, muscle strength, physical performance), and inflammatory biomarkers in postmenopausal women. This cross-sectional study included 70 healthy postmenopausal women aged 50 to 80 years. The DII was calculated based on 3-day food records, and participants were divided into 3 groups according to their DII score. Skeletal muscle mass was measured using dual-energy X-ray absorptiometry. Muscle strength was assessed based on handgrip and leg muscle strength. Associations between DII and sarcopenia components and inflammatory biomarkers were determined using analysis of covariance and a general linear model after adjusting for potential confounders. The DII scores ranged from -6.08 to 5.82. Higher DII scores were significantly associated with decreased appendicular skeletal muscle (ASM) (β = -0.520), height-adjusted ASM (β = -0.116), weight-adjusted ASM (β = -0.469), knee extensor strength (β = -3.175), knee flexion strength (β = -1.941), increased body fat percentage (β = 1.238), and erythrocyte sedimentation rate (β = 5.582) (all P < .05). The present study confirmed a lower DII score, indicating that an anti-inflammatory diet is associated with higher muscle mass and strength and lower levels of inflammatory biomarkers.

Role of Reactive Oxygen Species in Aging and Age-Related Diseases: A Review

Research on the role of reactive oxygen species (ROS) in the aging process has advanced significantly over the last two decades. In light of recent findings, ROS takes part in the aging process of cells along with contributing to various physiological signaling pathways. Antioxidants being cells' natural defense mechanism against ROS-mediated alteration, play an imperative role to maintain intracellular ROS homeostasis. Although the complete understanding of the ROS regulated aging process is yet to be fully comprehended, current insights into various sources of cellular ROS and their correlation with the aging process and age-related diseases are portrayed in this review. In addition, results on the effect of antioxidants on ROS homeostasis and the aging process as well as their advances in clinical trials are also discussed in detail. The future perspective in ROS-antioxidant dynamics on antiaging research is also marshaled to provide future directions for ROS-mediated antiaging research fields.

Natural Food for Sarcopenia: A Narrative Review

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.

Molecular Mechanisms of Inflammation in Sarcopenia: Diagnosis and Therapeutic Update

Sarcopenia is generally an age-related condition that directly impacts the quality of life. It is also related to chronic diseases such as metabolic dysfunction associated with diabetes and obesity. This means that everyone will be vulnerable to sarcopenia at some point in their life. Research to find the precise molecular mechanisms implicated in this condition can increase knowledge for the better prevention, diagnosis, and treatment of sarcopenia. Our work gathered the most recent research regarding inflammation in sarcopenia and new therapeutic agents proposed to target its consequences in pyroptosis and cellular senescence. Finally, we compared dual X-ray absorptiometry (DXA), magnetic resonance imaging (MRI), and ultrasound (US) as imaging techniques to diagnose and follow up on sarcopenia, indicating their respective advantages and disadvantages. Our goal is for the scientific evidence presented here to help guide future research to understand the molecular mechanisms involved in sarcopenia, new treatment strategies, and their translation into clinical practice.

Association Between Paravertebral Muscle Mass and Improvement in Sagittal Imbalance After Decompression Surgery of Lumbar Spinal Stenosis

STUDY DESIGN

Retrospective observational study.

OBJECTIVE

This study examined associated factors for the improvement in spinal imbalance following decompression surgery without fusion.

SUMMARY OF BACKGROUND DATA

Several reports have suggested that decompression surgery without fusion may have a beneficial effect on sagittal balance in patients with lumbar spinal stenosis (LSS) through their postoperative course. However, few reports have examined the association between an improvement in sagittal imbalance and spinal sarcopenia.

METHODS

We retrospectively reviewed 92 patients with LSS and a preoperative sagittal vertical axis (SVA) more than or equal to 40 mm who underwent decompression surgery without fusion at a single institution between April 2017 and October 2018. Patients' background and radiograph parameters and the status of spinal sarcopenia, defined using the relative cross-sectional area (rCSA) of the paravertebral muscle (PVM) and psoas muscle at the L4 caudal endplate level, were assessed. We divided the patients into two groups: those with a postoperative SVA less than 40 mm (balanced group) and those with a postoperative SVA more than or equal to 40 mm (imbalanced group). We then compared the variables between the two groups.

RESULTS

A total of 29 (31.5%) patients obtained an improved sagittal imbalance after decompression surgery. The rCSA-PVM in the balanced group was significantly higher than that in the imbalanced group (P = 0.042). The preoperative pelvic incidence (PI)-lumbar lordosis (LL) mismatch (P = 0.048) and the proportion with compression vertebral fracture (P = 0.028) in the balanced group were significantly lower than those in the imbalanced group. A multivariate logistic regression analysis identified PI-LL less than or equal to 10° and rCSA-PVM more than or equal to 2.5 as significant associated factor for the improvement in spinal imbalance following decompression surgery.

CONCLUSION

A larger volume of paravertebral muscles and a lower PI-LL were associated with an improvement in sagittal balance in patients with LSS who underwent decompression surgery.Level of Evidence: 3.

Musculoskeletal Health of the Adults Over 50 Years of Age in Relation to Antioxidant Vitamin Intakes

As the proportion of the elderly population increases rapidly, interest in musculoskeletal health is also emerging. Here, we investigated how antioxidant vitamin intake and musculoskeletal health are related. Adults aged 50 to 80 years with a body mass index (BMI) of 18.5 to 27.0 kg/m² were included. Bone mineral density (BMD), lean mass (LM), appendicular skeletal muscle mass index (ASMI) were measured using dual-energy X-ray absorptiometry (DXA), and the grip strength and knee extension using hand dynamometer. Nutrient intakes were measured using a 24-hour recall questionnaire. A total of 153 adults (44 men and 109 women) participated in this study. A partial correlation analysis showed a significant positive relationship between vitamin E and BMD and between vitamin C and LM/Height. Participants were classified into three groups according to whether their vitamin E and C intake met the recommended intake for Dietary Reference Intakes for Koreans (KDRIs). The prevalence of having low T-score (< −1.0) and low ASMI (< 7.0 for men and < 5.4 for women) was 51.3% and 15.4% in the group with vitamins C and E intakes below KDRIs. After adjusting for sex, smoking status and energy, protein, vitamin D, and calcium intake, the group with vitamins C and E both below the KDRIs displayed a significantly lower BMD at all test sites and LM/Height compared with vitamin C and/or E intake above the KDRIs groups. We conclude that sufficient intake of vitamin E and C is important for maintaining BMD and lean mass in Korean adults over 50 years of age.

Dietary Intake of Vitamin E and Fats Associated with Sarcopenia in Community-Dwelling Older Japanese People: A Cross-Sectional Study from the Fifth Survey of the ROAD Study

Dietary habits are of considerable interest as a modifiable factor for the maintenance of muscle health, especially sarcopenia. The present study aimed to investigate the association between dietary intake and sarcopenia prevalence in community-dwelling Japanese subjects. This cross-sectional study was conducted using data from the fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability (ROAD) study, and 1345 participants (437 men and 908 women) aged ≥60 years were included in the analysis. Sarcopenia was determined by the definition of the Asian Working Group for Sarcopenia established in 2014, and dietary intake was assessed with the brief-type self-administered diet history questionnaire. Overall, 77 subjects (5.7%) were identified as having sarcopenia, 5.0% of men and 6.1% of women. Multiple logistic regression analysis showed that the odds ratios of sarcopenia for the dietary intake of vitamin E (α-tocopherol, 0.14 (CI 0.04–0.49), β-tocopherol (0.24, CI 0.07–0.78), γ-tocopherol (0.28, CI 0.09–0.87), and fats (fat 0.27, CI 0.08–0.96; monounsaturated fatty acids, 0.22, CI 0.07–0.72, polyunsaturated fatty acids, 0.28, CI 0.09–0.89) at the highest quantile were significantly lower compared with those at the lowest quantile. Therefore, higher dietary intakes of vitamin E and fats would be associated with a lower prevalence of sarcopenia.

Micronutrients and sarcopenia: current perspectives

Sarcopenia, a skeletal muscle disorder that is characterised by loss of muscle strength and mass, is common in older populations and associated with poorer health outcomes. Although the individual and economic costs of sarcopenia are widely recognised, current understanding of its pathophysiology is incomplete, limiting efforts to translate research evidence into effective preventive and treatment strategies. While nutrition is a key field of sarcopenia research, the role of differences in habitual diets, and the effectiveness of dietary change as a prevention or treatment strategy, is uncertain. There is a growing evidence base that links low micronutrient intakes to sarcopenia risk and/or its components (low muscle strength and mass, impaired physical performance), although there remain many gaps in understanding. There is some consistency in findings across studies highlighting potential roles for antioxidant nutrients, B vitamins and magnesium; however, the evidence is largely observational and from cross-sectional studies, often describing associations with different muscle outcomes. As low intakes of some micronutrients are common in older populations, there is a need for new research, particularly from well-characterised prospective cohorts, to improve the understanding of their role and importance in the aetiology of sarcopenia and to generate the evidence needed to inform dietary guidelines to promote muscle health.

Low Serum Vitamin E Level Associated with Low Hand Grip Strength in Community-Dwelling Adults: Korean National Health and Nutrition Examination Survey (KNHANES VII) 2016-2018

This study assessed the association between serum vitamin E levels and hand grip strength (HGS) in community-dwelling adults data of 1011 men aged 50 years and older and 1144 postmenopausal women were analyzed. Low HGS was defined as HGS below the sex-stratified median value. Proportion of low HGS was the greatest in the lowest quintile of serum vitamin E level (<10.51 mg/L, 57.1%), with a decreasing trend toward the highest vitamin E quintile (>17.81 mg/L, 43.6%; p < 0.001). A one-unit (mg/L) decrease in vitamin E levels was associated with lower HGS in men (adjusted beta coefficient −0.10, 95% confidence interval [CI] −0.18 to −0.02, p = 0.019), but not in women (−0.01, 95% CI −0.06 to 0.03, p = 0.550). Compared with the middle quintile (Q3; 12.59–14.69 mg/L), the lowest vitamin E quintile (Q1) was associated with elevated odds of low HGS (adjusted odds ratio [aOR]: 1.38, p = 0.045), independent of sociodemographic factors, health-related lifestyles, comorbidities, dietary intake, and cholesterol level. However, the odds of low HGS did not differ significantly in other vitamin E quintiles (Q2, aOR 1.12; Q4, aOR 1.38; Q5, aOR 1.12; p > 0.05). Individuals with the lowest quintile vitamin E level had elevated odds of low HGS independent of covariates, findings which merit further validation.

Assessment of Body Composition and Dietary Intake in Nursing-Home Residents: Could Lessons Learned from the COVID-19 Pandemic Be Used to Prevent Future Casualties in Older Individuals?

The population of older adults, especially those living in the nursing homes, is growing. The sedentary lifestyle and possible poor nutrition in nursing homes place residents (NHRs) at risk for body composition impairments, malnutrition, and, subsequently, numerous chronic diseases. The aim of this study was to assess body composition (including body fluids) and dietary intake in NHRs. The association between osteosarcopenic adiposity syndrome (OSA) and its components, osteopenic adiposity (OA), sarcopenic adiposity (SA), and adiposity-only (AD), and specific macro- and micro-nutrients was evaluated as well. The study included 84 participants (82.1% women), aged 65.3-95.2 years. Body composition was assessed with an advanced bioelectrical impedance device BIA-ACC® and dietary intake was assessed via 24-h recall and analyzed using "Nutrition" software. The majority (95%) of participants were overweight with a high body fat and low muscle and bone mass, leading to a high prevalence of OSA (>50%), OA (13%), and AD (26%). There were only a few participants with SA, and they were not analyzed. The highest extracellular water/total body water ratio was observed in the OSA participants, indicating a heightened inflammatory state. Participants in all three body composition categories had a similar nutrient intake, with protein, fiber, omega-3 fatty acids, and almost all micronutrients being far below recommendations. In conclusion, a high prevalence of OSA among NHRs accompanied by a poor dietary intake, could place these residents at a very high risk for COVID-19 infections. Therefore, optimization of body composition and nutritional status should be included along with standard medical care in order to provide better health maintenance, particularly in the COVID-19 era.

Functional Frailty, Dietary Intake, and Risk of Malnutrition. Are Nutrients Involved in Muscle Synthesis the Key for Frailty Prevention?

Frailty is a reversible condition, which is strongly related to physical function and nutritional status. Different scales are used to screened older adults and their risk of being frail, however, Short Physical Performance Battery (SPPB) may be more adequate than others to measure physical function in exercise interventions and has been less studied. Thus, the main aims of our study were: (1) to describe differences in nutritional intakes by SPPB groups (robust, pre-frail and frail); (2) to study the relationship between being at risk of malnourishment and frailty; and (3) to describe differences in nutrient intake between those at risk of malnourishment and those without risk in the no-frail individuals. One hundred one participants (80.4 ± 6.0 year old) were included in this cross-sectional study. A validated semi-quantitative food frequency questionnaire was used to determine food intake and Mini Nutritional Assessment to determine malnutrition. Results revealed differences for the intake of carbohydrates, n-3 fatty acids (n3), and saturated fatty acids for frail, pre-frail, and robust individuals and differences in vitamin D intake between frail and robust (all p < 0.05). Those at risk of malnutrition were approximately 8 times more likely to be frail than those with no risk. Significant differences in nutrient intake were found between those at risk of malnourishment and those without risk, specifically in: protein, PUFA n-3, retinol, ascorbic acid, niacin equivalents, folic acid, magnesium, and potassium, respectively. Moreover, differences in alcohol were also observed showing higher intake for those at risk of malnourishment (all p < 0.05). In conclusion, nutrients related to muscle metabolism showed to have different intakes across SPPB physical function groups. The intake of these specific nutrients related with risk of malnourishment need to be promoted in order to prevent frailty.

Positive Associations of Dietary Intake and Plasma Concentrations of Vitamin E with Skeletal Muscle Mass, Heel Bone Ultrasound Attenuation and Fracture Risk in the EPIC-Norfolk Cohort

The prevalence of sarcopenia, frailty and fractures is increasing. Prevention options are limited, but dietary factors including vitamin E have the potential to confer some protection. This study investigated cross-sectional associations between dietary and plasma concentrations of vitamin E with indices of skeletal muscle mass (SMM) (n = 14,179 and 4283, respectively) and bone density (n = 14,694 and 4457, respectively) and longitudinal fracture risk (n = 25,223 and 7291, respectively) in European Prospective Investigation Into Cancer and Nutrition (EPIC)-Norfolk participants, aged 39-79 years at baseline. Participants completed a health and lifestyle questionnaire, a 7-day diet diary (7dDD) and had anthropometric measurements taken. Fat-free mass (as a SMM proxy) was measured using bioimpedance and bone density was measured using calcaneal broadband ultrasound attenuation (BUA) and incident fractures over 18.5 years of follow-up. Associations between indices of SMM, BUA and fracture risk were investigated by quintiles of dietary vitamin E intake or plasma concentrations. Positive trends in SMM indices and BUA were apparent across dietary quintiles for both sexes, with interquintile differences of 0.88%-1.91% (p < 0.001), and protective trends for total and hip fracture risk. Circulating plasma α- and γ-tocopherol results matched the overall dietary findings. Dietary vitamin E may be important for musculoskeletal health but further investigation is required to fully understand the relationships of plasma tocopherols.

Nutritional and Behavioral Approaches to Body Composition and Low-Grade Chronic Inflammation Management for Older Adults in the Ordinary and COVID-19 Times

As more insight is gained into personalized health care, the importance of personalized nutritional and behavioral approaches is even more relevant in the COVID-19 era, in addition to the need for further elucidation regarding several diseases/conditions. One of these concerning body composition (in this context; bone, lean and adipose tissue) is osteosarcopenic adiposity (OSA) syndrome. OSA occurs most often with aging, but also in cases of some chronic diseases and is exacerbated with the presence of low-grade chronic inflammation (LGCI). OSA has been associated with poor nutrition, metabolic disorders and diminished functional abilities. This paper addresses various influences on OSA and LGCI, as well as their mutual action on each other, and provides nutritional and behavioral approaches which could be personalized to help with either preventing or managing OSA and LGCI in general, and specifically in the time of the COVID-19 pandemic. Addressed in more detail are nutritional recommendations for and roles of macro- and micronutrients and bioactive food components; the microbiome; and optimal physical activity regimens. Other issues, such as food insecurity and nutritional inadequacy, circadian misalignment and shift workers are addressed as well. Since there is still a lack of longer-term primary studies in COVID-19 patients (either acute or recovered) and interventions for OSA improvement, this discussion is based on the existing knowledge, scientific hypotheses and observations derived from similar conditions or studies just being published at the time of this writing.

The Gut-Muscle Axis in Older Subjects with Low Muscle Mass and Performance: A Proof of Concept Study Exploring Fecal Microbiota Composition and Function with Shotgun Metagenomics Sequencing

The gut microbiota could influence the pathophysiology of age-related sarcopenia through multiple mechanisms implying modulation of chronic inflammation and anabolic resistance. The aim of this study was to compare the fecal microbiota composition and functionality, assessed by shotgun metagenomics sequencing, between two groups of elderly outpatients, differing only for the presence of primary sarcopenia. Five sarcopenic elderly subjects and twelve non-sarcopenic controls, classified according to lower limb function and bioimpedance-derived skeletal muscle index, provided a stool sample, which was analyzed with shotgun metagenomics approaches, to determine the overall microbiota composition, the representation of bacteria at the species level, and the prediction of bacterial genes involved in functional metabolic pathways. Sarcopenic subjects displayed different fecal microbiota compositions at the species level, with significant depletion of two species known for their metabolic capacity of producing short-chain fatty acids (SCFAs), Faecalibacterium prausnitzii and Roseburia inulinivorans, and of Alistipes shahii. Additionally, their fecal metagenome had different representation of genes belonging to 108 metabolic pathways, namely, depletion of genes involved in SCFA synthesis, carotenoid and isoflavone biotransformation, and amino acid interconversion. These results support the hypothesis of an association between microbiota and sarcopenia, indicating novel possible mediators, whose clinical relevance should be investigated in future studies.

Nutritional profiling of frail and obese, community dwelling older subjects: Results from a national survey

INTRODUCTION

Less attention has been given to the detection and nutritional status and needs of obese frail/sarcopenic older subjects. The aim of this study was to characterize the nutritional composition in older (≥65 years), frail-prone, obese subjects (defined by either waist circumference [WC] or body mass index [BMI]).

METHODS

A cross-sectional study with analysis of the national survey "Mabat Zahav". Random sample of 1751 community dwelling Israeli older adults (≥65 years). Eleven nutritional factors formerly linked to frailty were a-priori selected based on the current literature. Data was extracted from a 24-hour dietary recall. Adherence for each nutritional factor was defined using the Dietary Reference Intakes (DRI), and aggregated into a sum score of the overall adherence (ranging from "0" to "11", where "fair" adherence was defined as ≥6; inadequate adherence otherwise). Frailty likelihood was estimated using a validated non-direct model, and associations of nutritional factors with frailty-likelihood in obese vs non-obese individuals were examined. Additionally, a decision tree procedure based on machine learning was applied in order to capture nutritional factors related to frailty, stratified by gender, as well as by WC and/or BMI.

RESULTS

Overall, the prevalence rates of frailty and pre-frailty were 7.1 and 57.6%, respectively. A "fair nutritional adherence" was less common among frail-prone compared to robust subjects (23.1% vs. 32.1%; p < 0.0001). The intake of most frailty-related nutritional factors did not co-segregate according to the presence of abdominal or BMI-defined obesity. Still, compared to robust normal/overweight subjects, frail-prone obese (by BMI) individuals had a higher rate of inadequate nutritional adherence (odds-ratio 1.842; p < 0.05). Of all 11 nutritional factors, folate in obese women and vitamin A (as retinol) and calcium in non-obese and obese men, respectively, were recognized as the most prominent predictors of frail-prone prevalence by the machine learning process. Although BMI was more closely associated with impaired intake of the 11 selected nutritional components than WC, this association was eliminated when frailty status, low income and education were considered.

CONCLUSIONS

Frail-prone subjects differed from robust subjects in their nutritional intake. Nutritional inadequacies related to frailty-likelihood were mostly seen among obese women and non-obese men. In the prediction of inadequate adherence to the DRI of 11 nutritional components, obesity is a weaker predictor than frailty, lower education and low income in older Israeli adults.

Lower Dietary and Circulating Vitamin C in Middle- and Older-Aged Men and Women Are Associated with Lower Estimated Skeletal Muscle Mass

BACKGROUND

Age-related loss of skeletal muscle mass contributes to poor outcomes including sarcopenia, physical disability, frailty, type 2 diabetes, and mortality. Vitamin C has physiological relevance to skeletal muscle and may protect it during aging, but few studies have investigated its importance in older populations.

OBJECTIVES

We aimed to investigate cross-sectional associations of dietary and plasma vitamin C with proxy measures of skeletal muscle mass in a large cohort of middle- and older-aged individuals.

METHODS

We analyzed data from >13,000 men and women in the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, aged 42-82 y. Fat-free mass (FFM), as a proxy for skeletal muscle mass, was estimated using bioelectrical impedance analysis and expressed as a percentage of total mass (FFM%) or standardized by BMI (FFMBMI). Dietary vitamin C intakes were calculated from 7-d food diary data, and plasma vitamin C was measured in peripheral blood. Multivariable regression models, including relevant lifestyle, dietary, and biological covariates, were used to determine associations between FFM measures and quintiles of dietary vitamin C or insufficient compared with sufficient plasma vitamin C (<50 μmol/L and ≥50 μmol/L).

RESULTS

Positive trends were found across quintiles of dietary vitamin C and FFM measures for both sexes, with interquintile differences in FFM% and FFMBMI of 1.0% and 2.3% for men and 1.9% and 2.9% for women, respectively (all P < 0.001). Similarly, FFM% and FFMBMI measures were higher in participants with sufficient than with insufficient plasma vitamin C: by 1.6% and 2.0% in men, and 3.4% and 3.9% in women, respectively (all P < 0.001). Associations were also evident in analyses stratified into <65-y and ≥65-y age groups.

CONCLUSIONS

Our findings of positive associations, of both dietary and circulating vitamin C with measures of skeletal muscle mass in middle- and older-aged men and women, suggest that dietary vitamin C intake may be useful for reducing age-related muscle loss.

Antioxidants in Sport Sarcopenia

The decline of skeletal muscle mass and strength that leads to sarcopenia is a pathology that might represent an emergency healthcare issue in future years. Decreased muscle mass is also a condition that mainly affects master athletes involved in endurance physical activities. Skeletal muscles respond to exercise by reshaping the biochemical, morphological, and physiological state of myofibrils. Adaptive responses involve the activation of intracellular signaling pathways and genetic reprogramming, causing alterations in contractile properties, metabolic status, and muscle mass. One of the mechanisms leading to sarcopenia is an increase in reactive oxygen and nitrogen species levels and a reduction in enzymatic antioxidant protection. The present review shows the recent experimental models of sarcopenia that explore molecular mechanisms. Furthermore, the clinical aspect of sport sarcopenia will be highlighted, and new strategies based on nutritional supplements, which may contribute to reducing indices of oxidative stress by reinforcing natural endogenous protection, will be suggested.

Total Dietary Antioxidant Capacity and Longitudinal Trajectories of Body Composition

Although there is some evidence that total dietary antioxidant capacity (TDAC) is inversely associated with the presence of obesity, no longitudinal studies have been performed investigating the effect of TDAC on comprehensive measures of body composition over time. In this study, we included 4595 middle-aged and elderly participants from the Rotterdam Study, a population-based cohort. We estimated TDAC among these individuals by calculating a ferric reducing ability of plasma (FRAP) score based on data from food-frequency questionnaires. Body composition was assessed by means of dual X-ray absorptiometry at baseline and every subsequent 3–5 years. From these data, we calculated fat mass index (FMI), fat-free mass index (FFMI), android-to-gynoid fat ratio (AGR), body fat percentage (BF%) and body mass index (BMI). We also assessed hand grip strength at two time points and prevalence of sarcopenia at one time point in a subset of participants. Data were analyzed using linear mixed models or multinomial logistic regression models with multivariable adjustment. We found that higher FRAP score was associated with higher FFMI (0.091 kg/m² per standard deviation (SD) higher FRAP score, 95% CI 0.031; 0.150), lower AGR (−0.028, 95% CI −0.053; −0.003), higher BMI (0.115, 95% CI 0.020; 0.209) and lower BF% (−0.223, 95% CI −0.383; −0.064) across follow-up after multivariable adjustment. FRAP score was not associated with hand grip strength or sarcopenia. Additional adjustment for adherence to dietary guidelines and exclusion of individuals with comorbid disease at baseline did not change our results. In conclusion, dietary intake of antioxidants may positively affect the amount of lean mass and overall body composition among the middle-aged and elderly.

NOVEL antioxidant and oxidant biomarkers related to sarcopenia in COPD

BACKGROUND

The relation between oxidative stress (OS) and sarcopenia in COPD remains unknown.

OBJECTIVE

To analyze OS levels and its association with sarcopenia in COPD.

METHODS

Thirty-nine individuals with COPD (69±7years; 41%female) and thirty-five for the control group (69±7years; 43%female) were included. Advanced oxidation protein products (AOPP), paraoxonase-1 (PON1), superoxide dismutase activity (SOD), catalase dismutase activity (CAT), sulfhydryl group (SH), nitric oxide metabolites (NOX), total radical trapping antioxidant parameter (TRAP) were analysed. OS markers were correlated with handgrip and quadriceps strength, gait speed, skeletal muscle mass index, fat-free mass index, maximum inspiratory and expiratory pressure. European criteria were used to identify sarcopenia.

RESULTS

In COPD, antioxidant capacity was correlated with muscle mass and strength (r from 0.5 to 0.64) P<0.05 for all. TRAP≤ 850 μM/trolox and AOPP≤65 μM/l were associated with sarcopenia (OR:8.3; 95% CI: 1.4-49.6 and OR:14; 95%CI: 2.2-87.1, respectively; P<0.05 for both).

CONCLUSION

OS is associated with sarcopenia in COPD.

Nutrition and Sarcopenia-What Do We Know?

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.

Experimental Models of Sarcopenia: Bridging Molecular Mechanism and Therapeutic Strategy

Sarcopenia has been defined as a progressive decline of skeletal muscle mass, strength, and functions in elderly people. It is accompanied by physical frailty, functional disability, falls, hospitalization, and mortality, and is becoming a major geriatric disorder owing to the increasing life expectancy and growing older population worldwide. Experimental models are critical to understand the pathophysiology of sarcopenia and develop therapeutic strategies. Although its etiologies remain to be further elucidated, several mechanisms of sarcopenia have been identified, including cellular senescence, proteostasis imbalance, oxidative stress, and "inflammaging." In this article, we address three main aspects. First, we describe the fundamental aging mechanisms. Next, we discuss both in vitro and in vivo experimental models based on molecular mechanisms that have the potential to elucidate the biochemical processes integral to sarcopenia. The use of appropriate models to reflect sarcopenia and/or its underlying pathways will enable researchers to understand sarcopenia and develop novel therapeutic strategies for sarcopenia. Lastly, we discuss the possible molecular targets and the current status of drug candidates for sarcopenia treatment. In conclusion, the development of experimental models for sarcopenia is essential to discover molecular targets that are valuable as biochemical biomarkers and/or therapeutic targets for sarcopenia.

Targeting reactive oxygen species (ROS) to combat the age-related loss of muscle mass and function

The loss of muscle mass and function with age, termed sarcopenia, is an inevitable process, which has a significant impact on quality of life. During ageing we observe a progressive loss of total muscle fibres and a reduction in cross-sectional area of the remaining fibres, resulting in a significant reduction in force output. The mechanisms which underpin sarcopenia are complex and poorly understood, ranging from inflammation, dysregulation of protein metabolism and denervation. However, there is significant evidence to demonstrate that modified ROS generation, redox dis-homeostasis and mitochondrial dysfunction may have an important role to play. Based on this, significant interest and research has interrogated potential ROS-targeted therapies, ranging from nutritional-based interventions such as vitamin E/C, polyphenols (resveratrol) and targeted pharmacological compounds, using molecules such as SS-31 and MitoQ. In this review we evaluate these approaches to target aberrant age-related ROS generation and the impact on muscle mass and function.

Effects of Dietary or Supplementary Micronutrients on Sex Hormones and IGF-1 in Middle and Older Age: A Systematic Review and Meta-Analysis

Observational research suggests that micronutrients may be protective for sarcopenia, a key health issue during ageing, potentially via effects on hormone synthesis and metabolism. We aimed to carry out a systematic review of RCTs investigating effects of increasing dietary or supplemental micronutrient intake on sex hormones and IGF-1 in individuals aged 45 years or older. We searched MEDLINE, EMBASE and Cochrane databases for RCTs reporting the effects of different micronutrients (vitamins A, C, D, or E; carotenoids; iron; copper; zinc; magnesium; selenium; and potassium) on sex hormones or IGF-1. Of the 26 RCTs identified, nine examined effects of vitamin D, nine of multi-nutrients, four of carotenoids, two of selenium, one of zinc, and one of vitamin E. For IGF-1 increasing vitamin D (MD: -0.53 nmol/L, 95% CI: -1.58, 0.52), multi-nutrients (MD: 0.60 nmol/L, 95% CI -1.12 to 2.33) and carotenoids (MD -1.32 nmol/L; 95% CI -2.76 to 0.11) had no significant effect on circulating concentrations. No significant effects on sex hormones of other micronutrients were found, but data were very limited. All trials had significant methodological limitations making effects of micronutrient supplementation on sex hormones unclear. Further high quality RCTs with physiological doses of micronutrients in people with low baseline intakes or circulating concentrations, using robust methodology, are required to assess effects of supplementation adequately.