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Ma A, Chen H, Yin H, Zhang Z, Zhao G, Luo C, Zhuang R, Chen A, Han T. Association of serum iron metabolism with muscle mass and frailty in older adults: A cross-sectional study of community-dwelling older adults. Medicine (Baltimore) 2024; 103:e39348. [PMID: 39151527 PMCID: PMC11332760 DOI: 10.1097/md.0000000000039348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/15/2024] [Accepted: 07/26/2024] [Indexed: 08/19/2024] Open
Abstract
This study aimed to explore the correlation between serum ferritin and additional biomarkers associated with iron metabolism, as well as their connection to muscle atrophy and frailty in the community-dwelling middle-aged and elderly population. The study included 110 middle-aged and elderly participants. Participants were categorized into an iron accumulation group (31 cases) and a normal iron group (79 cases) based on the standard ferritin values for men and women. Based on the criteria of the Asian Working Group on Muscular Dystrophy, participants were classified into a sarcopenia group (31 cases) and a non-sarcopenia group (79 cases). Using the Fried frailty syndrome criteria, participants were categorized into non-frailty (7 cases), pre-frailty (50 cases), and frailty (53 cases) groups. We employed multiple linear regression, binary logistic regression, partial correlation analysis, and ordinal logistic regression to assess the associations between iron metabolism indices and the presence of muscle atrophy and frailty. Compared with the normal iron group, the iron overload group had significantly higher ferritin, weight loss, fatigue, slow gait, and frailty scores (P < .05). Among the 3 models we set, ferritin was not significantly correlated with muscle mass in models 1 and 3 (P > .05), ferritin was positively correlated with muscle mass in model 2 (Pmodel2 = .048), but Transferrin saturation was positively correlated with muscle mass in all 3 models (Pmodel1 = .047, Pmodel2 = .026, Pmodel3 = .024). Ferritin, body mass index and iron overload were the influencing factors of sarcopenia (Pferritin = .027, PBMI < .001, Piron overload = .028). Ferritin was positively correlated with weight loss, fatigue, slow gait, frailty score, and frailty grade (P < .05). Age, gender and ferritin were the influencing factors of frailty classification (P < .05). Disrupted iron metabolism can lead to decreased muscle mass and function among the middle-aged and elderly, increasing frailty risk. It's crucial to prioritize community-based frailty screening and prevention, focusing on iron utilization as well as storage, since accelerating the body's iron metabolism cycle might influence muscle health more significantly than iron reserves.
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Affiliation(s)
- Anpei Ma
- Department of Orthopaedics, Yancheng First People’s Hospital, Yancheng City, China
| | - Honggu Chen
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Hong Yin
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Ziyi Zhang
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Guoyang Zhao
- Department of Orthopedics, the Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Caifeng Luo
- Nursing Department, School of Medicine, Jiangsu University, Yancheng City, China
| | - Ruo Zhuang
- Department of Orthopedics, the Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Aihua Chen
- Department of Orthopedics, the Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Tingxia Han
- Yancheng Yanfu Orthopedic Hospital, Yancheng City, China
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Park CY, Shin S. Low dietary vitamin C intake is associated with low muscle strength among elderly Korean women. Nutr Res 2024; 127:75-83. [PMID: 38889453 DOI: 10.1016/j.nutres.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024]
Abstract
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.
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Affiliation(s)
- Chan Yoon Park
- Department of Food and Nutrition, The University of Suwon, Hwaseong 18323, South Korea
| | - Sunhye Shin
- Department of Food and Nutrition, Seoul Women's University, Seoul 01797, South Korea.
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Abeywickrama HM, Uchiyama M, Sumiyoshi T, Okuda A, Koyama Y. The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review. Nutr Rev 2024; 82:988-1011. [PMID: 37550266 PMCID: PMC11163457 DOI: 10.1093/nutrit/nuad094] [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] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Zinc (Zn) deficiency, malnutrition, sarcopenia, and frailty are prevalent among older adults and are prominent factors contributing to disability and mortality. OBJECTIVE This scoping review was conducted to aid understanding of the extent and types of research addressing the role of Zn in nutritional status, sarcopenia, and frailty, among older individuals. METHOD A systematic search was performed in August 2022 of 3 electronic databases (PubMed, Web of Science, and ProQuest) using predefined search terms. The review was conducted referring to the Arksey and O'Malley framework and PRISMA-ScR. RESULTS The search retrieved 16 018 records, and a total of 49 studies were included in this review after the screening. Of those, 30 were based on dietary Zn intake, 18 on tissue Zn levels, and 1 on both. Most studies were based on cross-sectional data from community-dwelling older adults. Studies addressing the associations between Zn status and individual anthropometric and sarcopenia-related variables reported inconsistent results. However, most studies reported inverse associations between malnutrition, frailty, and Zn status. CONCLUSION There was more consistent evidence of the relationship of Zn status with malnutrition, sarcopenia, and frailty rather than with individual nutritional parameters. Validated screening and assessment tools and criteria and prospective studies are required to elucidate the relationship of Zn with sarcopenia and frailty in the older population.
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Affiliation(s)
| | - Mieko Uchiyama
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Tomoko Sumiyoshi
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Akiko Okuda
- Department of Medical Technology, Graduate School of Health Sciences, Niigata University, Niigata, Japan
| | - Yu Koyama
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, Japan
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Wizgier D, Meng Y, Das A, Naganathan V, Blyth F, Le Couteur DG, Handelsman DJ, Waite LM, Ribeiro RV, Shivappa N, Hébert JR, Hirani V. The association of dietary antioxidants and the inflammatory potential of the diet with poor physical function and disability in older Australian men: the Concord Health and Ageing in Men Project. Br J Nutr 2024; 131:1528-1539. [PMID: 38220224 PMCID: PMC11043910 DOI: 10.1017/s0007114524000126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/18/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
Our objective was to evaluate the association of antioxidant intake and the inflammatory potential of the diet with functional decline in older men. A diet history questionnaire was used to collect dietary intake data from men aged ≥ 75 years (n 794) participating in the Concord Health and Aging in Men Project cohort study. Intake of vitamins A, C, E and Zn were compared with the Australian Nutrient Reference Values to determine adequacy. The Energy-adjusted Dietary Inflammatory Index (E-DIITM) was used to assess the inflammatory potential of the diet. Physical performance data were collected via handgrip strength and walking speed tests, and activities of daily living (ADL) and instrumental activities of daily living (IADL) questionnaires, at baseline and 3-year follow-up (n 616). Logistic regression analysis was used to identify associations between diet and incident poor physical function and disability. Both poor antioxidant intake and high E-DII scores at baseline were significantly associated with poor grip strength and ADL disability at 3-year follow-up. No significant associations with walking speed or IADL disability were observed. Individual micronutrient analysis revealed a significant association between the lowest two quartiles of vitamin C intake and poor grip strength. The lowest quartiles of intake for vitamins A, C, E and Zn were significantly associated with incident ADL disability. The study observed that poor antioxidant and anti-inflammatory food intake were associated with odds of developing disability and declining muscle strength in older men. Further interventional research is necessary to clarify the causality of these associations.
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Affiliation(s)
- Daniela Wizgier
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Ying Meng
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Arpita Das
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Concord Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW2006, Australia
| | - Fiona Blyth
- School of Public Health, University of Sydney, Sydney, NSW2006, Australia
| | - David G. Le Couteur
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - David J. Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
| | - Louise M. Waite
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
| | - Rosilene V. Ribeiro
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- School of Life and Environmental Science (SoLES), University of Sydney, Sydney, NSW, Australia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
| | - Vasant Hirani
- Discipline of Nutrition and Dietetics, Sydney School of Nursing, FMH, University of Sydney, Sydney, NSW2006, Australia
- Centre for Education and Research on Ageing, Department of Geriatric Medicine, Concord Repatriation Hospital, University of Sydney, Sydney, NSW2139, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW2006, Australia
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, NSW, Australia
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Shen Y, Zhang C, Dai C, Zhang Y, Wang K, Gao Z, Chen X, Yang X, Sun H, Yao X, Xu L, Liu H. Nutritional Strategies for Muscle Atrophy: Current Evidence and Underlying Mechanisms. Mol Nutr Food Res 2024; 68:e2300347. [PMID: 38712453 DOI: 10.1002/mnfr.202300347] [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: 05/26/2023] [Revised: 02/28/2024] [Indexed: 05/08/2024]
Abstract
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.
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Grants
- 81901933 National Natural Science Foundation of China
- 82072160 National Natural Science Foundation of China
- 20KJA310012 Major Natural Science Research Projects in Universities of Jiangsu Province
- BK20202013 Natural Science Foundation of Jiangsu Province, and the Scientific Research Project of The Health Commission of Jiangsu Province
- BK20201209 Natural Science Foundation of Jiangsu Province, and the Scientific Research Project of The Health Commission of Jiangsu Province
- ZDB2020003 Natural Science Foundation of Jiangsu Province, and the Scientific Research Project of The Health Commission of Jiangsu Province
- QingLan Project in Jiangsu Universities
- JC22022037 The Priority Academic Program Development of Jiangsu Higher Education Institutions, and Nantong Science and Technology Program, and Nantong Health Medical Research Center
- MS22022010 The Priority Academic Program Development of Jiangsu Higher Education Institutions, and Nantong Science and Technology Program, and Nantong Health Medical Research Center
- JC12022010 The Priority Academic Program Development of Jiangsu Higher Education Institutions, and Nantong Science and Technology Program, and Nantong Health Medical Research Center
- HS2022003 The Priority Academic Program Development of Jiangsu Higher Education Institutions, and Nantong Science and Technology Program, and Nantong Health Medical Research Center
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Affiliation(s)
- Yuntian Shen
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Chen Zhang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Chaolun Dai
- Department of Clinical Medicine, Medical College, Nantong University, Nantong, P. R. China, 226001
| | - Yijie Zhang
- Department of Clinical Medicine, Medical College, Nantong University, Nantong, P. R. China, 226001
| | - Kexin Wang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Zihui Gao
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Xin Chen
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Xiaoming Yang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Hualin Sun
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Xinlei Yao
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Lingchi Xu
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Nantong University, Nantong, Jiangsu Province, 226001, P. R. China
| | - Hua Liu
- Department of Orthopedics, Haian Hospital of Traditional Chinese Medicine, Nantong, Jiangsu Province, 226600, P. R. China
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Kong FS, Ma CM. Dietary Zinc Intakes Are Associated With Skeletal Muscle Mass and Strength in Children and Adolescents: Zinc and Muscle in Children. Clin Pediatr (Phila) 2024; 63:313-317. [PMID: 37139808 DOI: 10.1177/00099228231171242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The purpose of this study was to evaluate the relationship between dietary zinc intakes and skeletal muscle mass and strength in children and adolescents. A retrospective study was conducted using data on United States adolescents aged 8 to 19 years. Data were extracted from the National Health and Nutrition Examination Survey 2011-2014 cycles. Subjects were divided into 3 groups based on the tertiles of dietary zinc intakes. The levels of appendicular skeletal muscle mass divided by weight (ASM/Wt, %) and grip in subjects with the highest tertile were higher than those in subjects with the middle and lowest tertiles (P < .05). Dietary zinc intakes were positively correlated with ASM/Wt (r = .221, P < .001) and grip (r = 0.169, P < .001). After a multivariate analysis, dietary zinc intakes were still significantly associated with ASM/Wt (β = 0.059, P < .001) and grip (β = 0.245, P < .001). The present study demonstrates that dietary zinc intakes were positively associated with skeletal muscle mass and strength in children and adolescents.
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Affiliation(s)
- Fan-Shuo Kong
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Chun-Ming Ma
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
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Yokokawa H, Morita Y, Hamada I, Ohta Y, Fukui N, Makino N, Ohata E, Naito T. Demographic and clinical characteristics of patients with zinc deficiency: analysis of a nationwide Japanese medical claims database. Sci Rep 2024; 14:2791. [PMID: 38307882 PMCID: PMC10837122 DOI: 10.1038/s41598-024-53202-0] [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: 08/08/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
Zinc deficiency, affecting more than 2 billion people globally, poses a significant public health burden due to its numerous unfavorable effects, such as impaired immune function, taste and smell disorders, pneumonia, growth retardation, visual impairment, and skin disorders. Despite its critical role, extensive large-scale studies investigating the correlation between patient characteristics and zinc deficiency still need to be completed. We conducted a retrospective, cross-sectional observational study using a nationwide Japanese claims database from January 2019 to December 2021. The study population included 13,100 patients with available serum zinc concentration data, excluding individuals under 20 and those assessed for zinc concentrations after being prescribed zinc-containing medication. Significant associations with zinc deficiency were noted among older adults, males, and inpatients. Multivariate analysis, adjusting for age and sex, indicated significant associations with comorbidities, including pneumonitis due to solids and liquids with an adjusted Odds Ratio (aOR) of 2.959; decubitus ulcer and pressure area (aOR 2.403), sarcopenia (aOR 2.217), COVID-19 (aOR 1.889), and chronic kidney disease (aOR 1.835). Significant association with medications, including spironolactone (aOR 2.523), systemic antibacterials (aOR 2.419), furosemide (aOR 2.138), antianemic preparations (aOR 2.027), and thyroid hormones (aOR 1.864) were also found. These results may aid clinicians in identifying patients at risk of zinc deficiency, potentially improving care outcomes.
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Affiliation(s)
- Hirohide Yokokawa
- Department of General Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yusuke Morita
- Department of Data Science, Nobelpharma Co. Ltd, Tokyo, Japan
| | - Izumi Hamada
- Department of Data Science, Nobelpharma Co. Ltd, Tokyo, Japan
| | - Yuji Ohta
- Department of Data Science, Nobelpharma Co. Ltd, Tokyo, Japan
| | - Nobuyuki Fukui
- Department of Academic Services, 4DIN Ltd., #805 Shinbashiekimae Bldg.1 2-20-15 Shinbashi Minato-ku, Tokyo, 105-0004, Japan.
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Nao Makino
- Department of Academic Services, 4DIN Ltd., #805 Shinbashiekimae Bldg.1 2-20-15 Shinbashi Minato-ku, Tokyo, 105-0004, Japan
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Emi Ohata
- Department of Academic Services, 4DIN Ltd., #805 Shinbashiekimae Bldg.1 2-20-15 Shinbashi Minato-ku, Tokyo, 105-0004, Japan
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshio Naito
- Department of General Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
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van Dronkelaar C, Fultinga M, Hummel M, Kruizenga H, Weijs PJM, Tieland M. Minerals and Sarcopenia in Older Adults: An Updated Systematic Review. J Am Med Dir Assoc 2023:S1525-8610(23)00481-4. [PMID: 37355247 DOI: 10.1016/j.jamda.2023.05.017] [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: 02/22/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE This systematic review aims to reevaluate the role of minerals on muscle mass, muscle strength, physical performance, and the prevalence of sarcopenia in community-dwelling and institutionalized older adults. DESIGN Systematic review. SETTING AND PARTICIPANTS In March 2022, a systematic search was performed in PubMed, Scopus, and Web of Sciences using predefined search terms. Original studies on dietary mineral intake or mineral serum blood concentrations on muscle mass, muscle strength, and physical performance or the prevalence of sarcopenia in older adults (average age ≥65 years) were included. METHODS Eligibility screening and data extraction was performed by 2 independent reviewers. Quality assessment was performed with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Risk of bias was evaluated using the Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) tool. RESULTS From the 15,622 identified articles, a total of 45 studies were included in the review, mainly being cross-sectional and observational studies. Moderate quality of evidence showed that selenium (n = 8) and magnesium (n = 7) were significantly associated with muscle mass, strength, and physical performance as well as the prevalence of sarcopenia. For calcium and zinc, no association could be found. For potassium, iron, sodium, and phosphorus, the association with sarcopenic outcomes remains unclear as not enough studies could be included or were nonconclusive (low quality of evidence). CONCLUSIONS AND IMPLICATIONS This systematic review shows a potential role for selenium and magnesium on the prevention and treatment of sarcopenia in older adults. More randomized controlled trials are warranted to determine the impact of minerals on sarcopenia in older adults.
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Affiliation(s)
- Carliene van Dronkelaar
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Public Health, Aging and Later Life, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Maaike Fultinga
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Mitchell Hummel
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Hinke Kruizenga
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Public Health, Aging and Later Life, Amsterdam, the Netherlands
| | - Michael Tieland
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
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Asano-Hayami E, Morishita Y, Hayami T, Shibata Y, Kiyose T, Sasajima S, Hayashi Y, Motegi M, Kato M, Asano S, Nakai-Shimoda H, Yamada Y, Miura-Yura E, Himeno T, Kondo M, Tsunekawa S, Kato Y, Nakamura J, Kamiya H. Clinical parameters correlated with the psoas muscle index in Japanese individuals with type 2 diabetes mellitus. Diabetol Int 2023; 14:76-85. [PMID: 36636163 PMCID: PMC9829932 DOI: 10.1007/s13340-022-00602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/28/2022] [Indexed: 01/16/2023]
Abstract
Aims Muscle atrophy is a diabetic complication, which results in a deterioration in glycemic control in type 2 diabetes mellitus (T2DM) individuals. The psoas muscle mass index (PMI) is a reliable indicator for estimating whole-body muscle mass. We aimed to examine the relationship between clinical parameters and the PMI to clarify the mechanism underlying muscle atrophy in diabetes. Methods This retrospective, cross-sectional study examined 51 patients (31 men and 20 women) with T2DM and a mean HbA1c value of 9.9 ± 1.7%. These patients were admitted to Aichi Medical University Hospital and underwent abdominal computed tomography imaging from July 2020 to April 2021. Multiple clinical parameters were assessed with the PMI. Results In a multiple regression analysis adjusted for age and sex, the PMI was correlated with body weight, body mass index, serum concentrations of corrected calcium, aspartate aminotransferase, alanine aminotransferase, creatine kinase, thyroid-stimulating hormone (TSH), urinary C-peptide concentrations, the free triiodothyronine/free thyroxine (FT3/FT4) ratio, and the young adult mean score at the femur neck. Receiver operating characteristic curves were created using TSH concentrations and the FT3/FT4 ratio for diagnosing a low PMI. The area under the curve was 0.593 and 0.699, respectively. The cut-off value with maximum accuracy for TSH concentrations was 1.491 μIU/mL, sensitivity was 56.1%, and specificity was 80.0%. Corresponding values for the FT3/FT4 ratio were 1.723, 78.0, and 66.7%, respectively. Conclusion TSH concentrations and the FT3/FT4 ratio are correlated with the PMI, and their thresholds may help prevent muscle mass loss in Japanese individuals with T2DM.
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Affiliation(s)
- Emi Asano-Hayami
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Yoshiaki Morishita
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Tomohide Hayami
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Yuka Shibata
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
- Department of Clinical Laboratory, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Toshiki Kiyose
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Sachiko Sasajima
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Yusuke Hayashi
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Mikio Motegi
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Makoto Kato
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Saeko Asano
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Hiromi Nakai-Shimoda
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Yuichiro Yamada
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Emiri Miura-Yura
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Tatsuhito Himeno
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
- Department of Innovative Diabetes Therapy, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Masaki Kondo
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Shin Tsunekawa
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Yoshiro Kato
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Jiro Nakamura
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
- Department of Innovative Diabetes Therapy, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
| | - Hideki Kamiya
- Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195 Japan
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10
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Nutrition in the prevention and management of sarcopenia - A special focus on Asian Indians. Osteoporos Sarcopenia 2022; 8:135-144. [PMID: 36605171 PMCID: PMC9805983 DOI: 10.1016/j.afos.2022.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/26/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Sarcopenia, characterized by loss of muscle mass and strength, is common in advanced old age but can be accelerated by chronic disease, malnutrition and physical inactivity. Early initiation of intervention to achieve and maintain a higher peak muscle mass and strength may allow for prevention or delay of sarcopenia and facilitate independent living even in old age. In this context, malnutrition, a significant contributor to sarcopenia, is often overlooked among the Indian population. Maintenance of an optimal energy and protein balance with adequate physical activity level is essential to preserve physical function in the aging population. However, research on the role of micronutrients in muscle maintenance, is still in its infancy. This narrative review, therefore, aims to explore the current status of International and Indian research on the role of nutrition in sarcopenia mitigation and the way forward.
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11
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Chen Z, Chen J, Song C, Sun J, Liu W. Association Between Serum Iron Status and Muscle Mass in Adults: Results From NHANES 2015–2018. Front Nutr 2022; 9:941093. [PMID: 35898717 PMCID: PMC9309789 DOI: 10.3389/fnut.2022.941093] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Iron deficiency or overload may contribute to complications associated with diseases, but the link between iron status and skeletal muscle disorder is poorly understood. This study aimed to investigate the relationship between serum iron status, reflected by serum ferritin concentration, and muscle mass in U.S. adults. Methods We utilized data from National Health and Nutrition Examination Survey (NHANES) 2015-2018 for analysis. Data on serum ferritin, appendicular skeletal muscle mass (ASM), body mass index (BMI) and confounding factors were extracted and analyzed. Multivariate linear regression analyses and smooth curve fittings were employed to investigate the association between serum ferritin and muscle mass. Subgroup analysis based on iron status, age, gender and race were performed. Results A total of 2,078 participants were included, and divided into iron deficiency (n = 225), normal iron status (n = 1,366), and iron overload (n = 487) groups. Participants with iron overload had significantly lower ASM and appendicular skeletal muscle index (ASMI) (ASM: 19.329 ± 4.879, ASMI: 0.709 ± 0.138) compared to those with iron deficiency (ASM: 22.660 ± 6.789, ASMI: 0.803 ± 0.206) and normal iron status (ASM: 22.235 ± 6.167, ASMI: 0.807 ± 0.201). The serum ferritin was negatively linked with muscle mass after adjusting for potential confounders (β = −0.0001, 95% CI: −0.0001, −0.0000). When stratified by iron status, the trend test between them remained significant (P for trend: 0.008). Furthermore, subgroup analysis identified a stronger association in men (β = −0.0001, 95% CI: −0.0002, −0.0001), age ≥ 40 years (β = −0.0001, 95% CI: −0.0002, −0.0000), non-Hispanic black (β = −0.0002, 95% CI: −0.0003, −0.0001) and other races (β = −0.0002, 95% CI: −0.0003, −0.0000). Conclusions Our study revealed an inverse relationship between serum iron status and muscle mass in adults. This finding improves our understanding of the impact of serum iron status on muscle mass, and sheds new light on the prevention and treatment of muscle loss.
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Affiliation(s)
- Zhi Chen
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing Chen
- Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, China
| | - Chenyang Song
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jun Sun
- Department of Emergency, Zhaotong Traditional Chinese Medicine Hospital, Zhaotong, China
| | - Wenge Liu
- Department of Orthopedic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- *Correspondence: Wenge Liu
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12
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Prokopidis K, Giannos P, Katsikas Triantafyllidis K, Kechagias KS, Mesinovic J, Witard OC, Scott D. Effect of vitamin D monotherapy on indices of sarcopenia in community-dwelling older adults: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2022; 13:1642-1652. [PMID: 35261183 PMCID: PMC9178168 DOI: 10.1002/jcsm.12976] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/24/2022] [Accepted: 02/21/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Vitamin D supplementation is proposed as a potentially effective nutritional intervention to mitigate the risk of sarcopenia. The aim of this systematic review and meta-analysis was to investigate the impact of vitamin D supplementation monotherapy on indices of sarcopenia in community-dwelling older adults. METHODS A comprehensive search of the literature was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Eligible randomized controlled trials (RCTs) compared the effect of vitamin D supplementation (as monotherapy) with placebo on indices of sarcopenia in older (>50 years) adults. Using the random effects inverse-variance model, we calculated the mean difference (MD) in handgrip strength (HGS), short physical performance battery (SPPB), timed up and go (TUG), and appendicular lean mass (ALM) between groups. We also calculated the standardized mean difference (SMD) in general muscle strength and general physical performance (composite plot of all muscle strength and physical performance outcomes, respectively) between groups. RESULTS Ten RCTs were included in the meta-analysis. A significant decrease in SPPB scores was observed with vitamin D supplementation compared with placebo (MD: -0.23; 95% CI -0.40 to -0.06; I2 = 0%; P = 0.007). Vitamin D supplementation conferred no effect on HGS (MD: -0.07 kg; 95% CI -0.70 to 0.55; I2 = 51%, P = 0.82), TUG (MD: 0.07 s; 95% CI -0.08 to 0.22; I2 = 0%, P = 0.35), ALM (MD: 0.06 kg/m2 ; 95% CI: -0.32 to 0.44; I2 = 73%, P = 0.77), general muscle strength (SMD: -0.01; 95% CI -0.17 to 0.15; I2 = 42%, P = 0.90), or general physical performance (SMD: -0.02; 95% CI -0.23 to 0.18; I2 = 71%, P = 0.83). CONCLUSIONS Vitamin D supplementation did not improve any sarcopenia indices in community-dwelling older adults and may compromise some aspects of physical performance. Future studies are warranted to investigate the impact of vitamin D supplementation on individual indices of SPPB, including mobility and balance, in older adults.
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Affiliation(s)
- Konstantinos Prokopidis
- Department of Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,Society of Meta-research and Biomedical Innovation, London, UK
| | - Panagiotis Giannos
- Society of Meta-research and Biomedical Innovation, London, UK.,Department of Life Sciences, Faculty of Natural Sciences, Imperial College London, London, UK
| | - Konstantinos Katsikas Triantafyllidis
- Society of Meta-research and Biomedical Innovation, London, UK.,Department of Nutrition & Dietetics, Musgrove Park Hospital, Taunton & Somerset NHS Foundation Trust, Taunton, UK
| | - Konstantinos S Kechagias
- Society of Meta-research and Biomedical Innovation, London, UK.,Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Oliver C Witard
- Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
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13
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Vega-Cabello V, Caballero FF, Lana A, Arias-Fernandez L, Banegas JR, Rodriguez-Artalejo F, Lopez-Garcia E, Struijk EA. Association of zinc intake with risk of impaired physical function and frailty among older adults. J Gerontol A Biol Sci Med Sci 2022; 77:2015-2022. [PMID: 35034112 DOI: 10.1093/gerona/glac014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Zinc could be a target nutrient in the prevention of physical impairment and frailty in older adults due to its anti-inflammatory/antioxidant properties. However, prospective studies evaluating this inquiry are scarce. Thus, we aimed to assess the association between zinc intake and impaired lower-extremity function (ILEF) and frailty among community-dwelling older adults. METHODS We examined 2,963 adults aged ≥60 years from the Seniors-ENRICA cohort. At baseline (2008-2010) and subsequent follow-up (2012), zinc intake (mg/d) was estimated with a validated computerized face-to-face diet history and adjusted for total energy intake. From 2012 to 2017, the occurrence of ILEF was ascertained with the Short Physical Performance Battery, and of frailty according to the Fried phenotype criteria. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders, including lifestyle, comorbidity, and dietary factors. RESULTS During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared to participants in the lowest tertile of zinc intake (3.99-8.36 mg/d), those in the highest tertile (9.51-21.2 mg/d) had a lower risk of ILEF [fully-adjusted hazard ratio (95% confidence interval): 0.75 (0.58-0.97); p for trend: 0.03] and of frailty [0.63 (0.44-0.92); p for trend: 0.02]. No differences in the association were seen by strata of socio-demographic and lifestyle factors. CONCLUSIONS Higher zinc intake was prospectively associated with a lower risk of ILEF and frailty among older adults, suggesting that adequate zinc intake, that can be achieved through a healthy diet, may help preserve physical function and reduce the progression to frailty.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | - Lucia Arias-Fernandez
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, Oviedo, Asturias, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health. School of Medicine. Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
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14
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Kim HK, Chijiki H, Fukazawa M, Okubo J, Ozaki M, Nanba T, Higashi S, Shioyama M, Takahashi M, Nakaoka T, Shibata S. Supplementation of Protein at Breakfast Rather Than at Dinner and Lunch Is Effective on Skeletal Muscle Mass in Older Adults. Front Nutr 2022; 8:797004. [PMID: 34993224 PMCID: PMC8724572 DOI: 10.3389/fnut.2021.797004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/01/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The effects of different intake patterns of meal protein on muscle mass have not been clarified. We cross-sectionally and longitudinally examined the effect of different timing of protein intake on sarcopenia-related factors in older adults. Methods: This cross-sectional study 1 included 219 (male, n = 69, female, n = 150) elderly subjects aged ≥65 years. Subjects who consumed more protein at breakfast than at dinner were grouped into the morning group (MG, n = 76; male, n = 26; female, n = 50), and those who consumed more protein at dinner than at breakfast were grouped into the evening group (EG, n = 143; male, n = 43; female, n = 100). In cross-sectional study 2-1 (female, n = 125), the subjects were classified into four groups according to the number of meals with sufficient protein intake. In cross-sectional studies 2-2 (female, n = 125) and 2-3 (female, n = 27), the subjects were classified into eight groups and three groups according to whether they had consumed sufficient protein at three meals; sarcopenia-related factors were compared. The intervention study was a placebo-controlled, double-blind, randomized controlled trial that included 40 elderly women with low daily breakfast protein intake. The subjects were divided into four groups: morning protein and placebo intake groups and evening protein and placebo intake groups. Each group consumed the test food (containing 10 g milk protein) or placebo in the morning or evening for 12 weeks. Blood indices and physical function were assessed before and after the intervention. Results: Comparing all subjects, MG showed significantly higher handgrip strength than did EG (P < 0.05). The higher ratio of morning protein intake relative to the total protein intake, the better the muscle mass (r = 0.452, P < 0.05) and handgrip strength (r = 0.383, P < 0.05). The intervention study showed an increase in muscle mass with the intake of milk protein in the morning rather than in the evening (P < 0.05). Conclusions: Protein intake at breakfast might have relatively stronger effects on skeletal muscle mass than at lunch and dinner.
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Affiliation(s)
- Hyeon-Ki Kim
- Faculty of Science and Engineering, Waseda University, Shinjuku City, Japan
| | - Hanako Chijiki
- Graduate School of Advanced Science and Engineering, Waseda University, Shinjuku City, Japan
| | - Mayuko Fukazawa
- Graduate School of Advanced Science and Engineering, Waseda University, Shinjuku City, Japan
| | - Jin Okubo
- Graduate School of Advanced Science and Engineering, Waseda University, Shinjuku City, Japan
| | - Mamiho Ozaki
- Graduate School of Advanced Science and Engineering, Waseda University, Shinjuku City, Japan
| | - Takuya Nanba
- Graduate School of Advanced Science and Engineering, Waseda University, Shinjuku City, Japan
| | | | | | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Meguro City, Japan
| | | | - Shigenobu Shibata
- Faculty of Science and Engineering, Waseda University, Shinjuku City, Japan
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15
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Jones MD, Wewege MA, Hackett DA, Keogh JWL, Hagstrom AD. Sex Differences in Adaptations in Muscle Strength and Size Following Resistance Training in Older Adults: A Systematic Review and Meta-analysis. Sports Med 2021; 51:503-517. [PMID: 33332016 DOI: 10.1007/s40279-020-01388-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Reductions in muscle size and strength occur with aging. These changes can be mitigated by participation in resistance training. At present, it is unknown if sex contributes to differences in adaptation to resistance training in older adults. OBJECTIVE The aim of this systematic review was to determine if sex differences are apparent in adaptations to resistance training in older adults. DESIGN Systematic review with meta-analysis. DATA SOURCES Web of Science; Science Direct; SPORTDiscus; CINAHL; and MEDLINE were searched from inception to June 2020. ELIGIBILITY CRITERIA Studies where males and females older than 50 years of age performed identical resistance training interventions and had outcome measures of muscle strength or size. RESULTS We initially screened 5337 studies. 30 studies (with 41 comparison groups) were included in our review (1410 participants; 651 males, 759 females). Mean study quality was 14.7/29 on a modified Downs and Black checklist, considered moderate quality. Females gained more relative lower-body strength than males (g = - 0.21 [95% CI - 0.33, - 0.10], p = 0.0003) but there were no differences in relative change for upper-body strength (g = - 0.29 [95% CI - 0.62, 0.04], p = 0.08) or relative muscle size (g = 0.10 [95% CI - 0.04, 0.23], p = 0.16). Males gained more absolute upper-body strength (g = 0.48 [95% CI 0.09, 0.88], p = 0.016), absolute lower-body strength (g = 0.33 [95% CI 0.19, 0.47], p < 0.0001), and absolute muscle size (g = 0.45 [95% CI 0.23, 0.66], p < 0.0001). CONCLUSION Our results indicate that sex differences in adaptations to resistance training are apparent in older adults. However, it is evident that the interpretation of sex-dependent adaptations to resistance training is heavily influenced by the presentation of the results in either an absolute or relative context. STUDY REGISTRATION Open Science Framework (osf.io/afn3y/).
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Affiliation(s)
- Matthew D Jones
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Michael A Wewege
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Daniel A Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
- Human Potential Centre, AUT University, Auckland, New Zealand
- Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, QLD, Australia
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amanda D Hagstrom
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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16
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Shahinfar H, Djafari F, Shahavandi M, Jalilpiran Y, Davarzani S, Clark CCT, Djafarian K, Shab-Bidar S. The lack of association between dietary antioxidant quality score with handgrip strength and handgrip endurance amongst Tehranian adults: A cross-sectional study from a Middle East country. Int J Clin Pract 2021; 75:e13876. [PMID: 33253498 DOI: 10.1111/ijcp.13876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 11/25/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The association between dietary antioxidant quality score (DAQS) and handgrip strength (HS) and handgrip endurance (HE) is still unclear. We aimed to investigate whether adherence to dietary antioxidant quality score (DAQS) is associated with handgrip strength (HS) and handgrip endurance (HE) amongst adults in Tehran. METHODS This cross-sectional study was conducted on 270 (43.7% males, mean age 37 years and 56.3% females, mean age 35 years) apparently healthy adult subjects (53.2% were married) selected from different parts of Tehran, Iran. Dietary intake was assessed using a 168-item validated food frequency questionnaire. DAQS was calculated using antioxidant-nutrient intake. Body composition was measured using a body composition analyser. Handgrip strength and endurance were measured by a digital handgrip dynamometer. Relative muscle strength was expressed as the ratio of handgrip strength by body mass index (BMI). RESULTS The results showed that DAQs had no significant association with HS (P = .67, adjusted R2 = .60) and HE (P = .19, adjusted R2 = .08) after adjusting for potential confounders. However, a significant positive association was found between selenium intake and HE even after adjusting for potential confounders (P = .01, adjusted R2 = .10). After controlling for potential confounders no differences in the mean of HS (P = .29) and also HE (P = .61) amongst tertiles of DAQS was found. Positive linear association was found between vitamin C (P = .02, adjusted R2 = .53) and vitamin E (P = .03, adjusted R2 = .55) intake with relative muscle strength. CONCLUSION Our results revealed that no significant association between DAQS and HE and HS. It was found that more intake of selenium was positively linked to HE. Dietary intake of vitamin C and vitamin E are associated with higher relative muscle strength. It is evident that more prospective studies are needed to confirm the veracity of our results.
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Affiliation(s)
- Hossein Shahinfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahshid Shahavandi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Yahya Jalilpiran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Samira Davarzani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C T Clark
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry, UK
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, 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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17
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Kim YS, Hong KW, Han K, Park YC, Park JM, Kim K, Kim BT. Longitudinal Observation of Muscle Mass over 10 Years According to Serum Calcium Levels and Calcium Intake among Korean Adults Aged 50 and Older: The Korean Genome and Epidemiology Study. Nutrients 2020; 12:nu12092856. [PMID: 32961901 PMCID: PMC7551872 DOI: 10.3390/nu12092856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to investigate the longitudinal change in muscle mass over 10 years according to serum calcium levels and calcium intake. A total of 1497 men and 1845 women aged 50 years and older were included. Significant muscle loss (SML) was defined as a 5% or greater loss from baseline, while time-dependent development of SML was assessed according to quartiles for corrected calcium level and daily calcium intake using Cox regression models. The incidence of SML was 6.7 and 7.7 per 100-person-years among men and women, respectively. Groups with the lowest corrected calcium levels had more prominent SML than those with higher calcium levels, regardless of sex. The relationship between SML and calcium intake was significant only among women. The hazard ratio for SML per 1 mmol/L increase in corrected calcium level was 0.236 and 0.237 for men and women, respectively. In conclusion, low serum calcium levels may predict SML among adults aged ≥ 50 years, while low calcium intake may be a predictor for muscle loss among women. Therefore, encouraging dietary calcium intake among middle-aged and older adults for preservation of muscle mass should be considered.
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Affiliation(s)
- Young-Sang Kim
- Department of Family Medicine, CHA Bundang Medical Centre, CHA University, Seongnam 13496, Korea;
| | - Kyung-Won Hong
- Healthcare R&D Division, Theragen Bio Co. Ltd., Suwon 16229, Korea;
| | - Kunhee Han
- Department of Family Medicine, Seonam Hospital, Seoul 08049, Korea;
| | - Yon Chul Park
- Department of Family Medicine, Wonju Severance Christian Hospital, Wonju 26426, Korea;
- Department of Medical Education, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
| | - Jae-Min Park
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea;
| | - Kwangyoon Kim
- Department of Family Practice and Community Health, Ajou University Hospital, Ajou University, Suwon 16499, Korea;
| | - Bom-Taeck Kim
- Department of Family Practice and Community Health, Ajou University Hospital, Ajou University, Suwon 16499, Korea;
- Correspondence: ; Tel.: +82-31-219-5309; Fax: +82-31-219-5218
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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: 186] [Impact Index Per Article: 37.2] [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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Du Y, Oh C, No J. Advantage of Dairy for Improving Aging Muscle. J Obes Metab Syndr 2019; 28:167-174. [PMID: 31583381 PMCID: PMC6774446 DOI: 10.7570/jomes.2019.28.3.167] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/12/2019] [Accepted: 08/13/2019] [Indexed: 12/22/2022] Open
Abstract
The risk of sarcopenia increases with aging. Malnutrition in the elderly population is an important risk factor for sarcopenia. Calcium (Ca), phosphate (P), vitamin D and protein are key nutrients for the human body and affect muscle mass and quality. Dairy products are rich in these nutrients, which implicates that dairy products might be ideal for elderly population. This systematic review highlights the effects of dairy products on muscle mass, muscle strength and body performance in the elderly population in the perspective of Ca, P, vitamin D and protein.
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Affiliation(s)
- Yang Du
- Department of Food and Nutrition, Kyungsung University, Busan, Korea
| | - Chorong Oh
- Department of Food and Nutrition, Kyungsung University, Busan, Korea
| | - Jaekyung No
- Department of Food and Nutrition, Kyungsung University, Busan, Korea
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Beaudart C, Locquet M, Touvier M, Reginster JY, Bruyère O. Association between dietary nutrient intake and sarcopenia in the SarcoPhAge study. Aging Clin Exp Res 2019; 31:815-824. [PMID: 30955158 DOI: 10.1007/s40520-019-01186-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/28/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND It has been suggested that a balanced nutritional intake may be useful in preventing or even reversing sarcopenia. AIM To describe cross-sectional associations between dietary nutrient intake and sarcopenia. METHODS Subjects recruited from the SarcoPhAge study population completed a food frequency questionnaire. The micronutrient and macronutrient intake was evaluated in both sarcopenic and non-sarcopenic participants. The Nutritional Belgian Recommendations of 2016 were used, i.e., adequate intake and estimated average requirement (EAR). For micronutrients, the prevalence of insufficient intake was estimated as the proportion of subjects whose intake was below the EAR. RESULTS A total of 331 subjects (mean age of 74.8 ± 5.9 years, 58.9% women) had complete data and were included in this study. Among them, 51 were diagnosed with sarcopenia (15.4%). In the fully adjusted model, analyses revealed that sarcopenic subjects consumed significantly lower amounts of two macronutrients (proteins, lipids) and five micronutrients (potassium, magnesium, phosphorus, iron, and vitamin K) than non-sarcopenic subjects (all p values < 0.005). A significantly increased prevalence of insufficiency was found for sarcopenic subjects compared to non-sarcopenic subjects for potassium, magnesium, iron, calcium and vitamins E and C (all p values < 0.005). The prevalence of sarcopenic subjects who were also below the Nutritional Belgian Recommendations for protein and lipids was significantly higher than that of non-sarcopenic subjects. DISCUSSION AND CONCLUSIONS Sarcopenic subjects seem to consume significantly reduced amounts of many micronutrients and macronutrients compared to non-sarcopenic subjects. These results suggest that a poorly balanced diet may be associated with sarcopenia and poor musculoskeletal health, although prospective studies are needed to confirm these findings.
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Affiliation(s)
- Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium.
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium.
| | - Médéa Locquet
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
| | - Mathilde Touvier
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN, UMR U1153 Inserm/U1125 Inra/Cnam/Universités Paris 5, 7 et 13, Centre de Recherche en Epidémiologie et Statistiques Sorbonne Paris Cité (CRESS), Paris, France
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
| | - Olivier Bruyère
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Aging, Liège, Belgium
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Tieland M, Trouwborst I, Clark BC. Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle 2018; 9:3-19. [PMID: 29151281 PMCID: PMC5803609 DOI: 10.1002/jcsm.12238] [Citation(s) in RCA: 493] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/20/2017] [Accepted: 08/05/2017] [Indexed: 02/06/2023] Open
Abstract
The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing.
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Affiliation(s)
- Michael Tieland
- Faculty of Sports and NutritionAmsterdam University of Applied SciencesDr. Meurerlaan 81067 SMAmsterdamthe Netherlands
| | - Inez Trouwborst
- Faculty of Sports and NutritionAmsterdam University of Applied SciencesDr. Meurerlaan 81067 SMAmsterdamthe Netherlands
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI)Ohio University250 Irvine HallAthensOH 45701USA
- Department of Biomedical SciencesOhio UniversityAthensOH 45701USA
- Department of Geriatric MedicineOhio UniversityAthensOH 45701USA
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Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review. J Am Med Dir Assoc 2018; 19:6-11.e3. [DOI: 10.1016/j.jamda.2017.05.026] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/30/2017] [Accepted: 05/30/2017] [Indexed: 01/06/2023]
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Ritt M, Schülein S, Lubrich H, Bollheimer LC, Sieber CC, Gaßmann KG. High-Technology Based Gait Assessment in Frail People: Associations between Spatio-Temporal and Three-Dimensional Gait Characteristics with Frailty Status across Four Different Frailty Measures. J Nutr Health Aging 2017; 21:346-353. [PMID: 28244577 DOI: 10.1007/s12603-016-0764-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We analyzed associations between a battery of gait characteristics and frailty status across four different frailty instruments in old patients. DESIGN Cross-sectional study. SETTING Geriatric wards of a general hospital. PARTICIPANTS 123 hospitalized patients aged ≥65 years. MEASUREMENTS Spatio-temporal and three-dimensional gait characteristics were assessed by an electronic walkway and a shoe-mounted, inertial sensor-based mobile gait analysis system. Frailty status was assessed by the frailty phenotype (FP), Clinical Frailty Scale (CFS), frailty index (FI), and frailty index based on a comprehensive geriatric assessment (FI-CGA). RESULTS A reduction in walking speed (FP, FI, FI-CGA), stride length (FP, FI, FI-CGA), maximum toe clearance (FP, CFS, FI, FI-CGA), toe off angle (FP, CFS, FI, FI-CGA), heal strike angle (FI-CGA) and greater stride length variability (FP, CFS, FI, FI-CGA), stride time variability (FP, FI), double support time (FP, FI), and stride width (CFA, FI-CGA) were associated with frailty status across the four frailty instruments (all P < 0.05, respectively). Walking speed (FP, CFS, FI, FI-CGA), stride length (FP, CFS, FI, FI-CGA), maximum toe clearance (FP, CFS, FI, FI-CGA), toe off angle (FP, CFS, FI, FI-CGA), heal strike angle (FP, FI), stride length variability (CFS, FI, FI-CGA), stride time variability (FI), double support time (FP), and stride width (FP, CFS, FI) were related with frailty severity across the four frailty instruments independent of age and sex (all P adjusted < 0.05, respectively). CONCLUSIONS Gait changes in frail patients include more than solely a reduction in walking speed.
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Affiliation(s)
- M Ritt
- Martin Ritt, Department of Internal Medicine III (Medicine of Ageing), Geriatrics Center Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen, Rathsbergerstraße 57, D-91054 Erlangen, Tel: +49-(0)9131 822 3702, Fax: +49-(0)9131 822 3703,
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