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Krok-Schoen JL, Chaplow ZL, Chase C, Spees C, Rosko A, Naughton MJ, Smith J, Soufi S, Beck M, Focht BC. E-PROOF: E-intervention for protein intake and resistance training to optimize function: A study protocol. PLoS One 2024; 19:e0302727. [PMID: 38718069 PMCID: PMC11078354 DOI: 10.1371/journal.pone.0302727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Accounting for more than 60% of cancer survivors, older (≥65 years) cancer survivors have a 2- to 5-fold risk of physical function impairment, compared to cancer-free peers. One strategy to improve physical function is dietary and resistance training interventions, which improve muscle strength and mass by stimulating muscle protein synthesis. The E-PROOF (E-intervention for Protein Intake and Resistance Training to Optimize Function) study will examine the feasibility, acceptability, and preliminary efficacy of a 12-week randomized controlled trial of an online, tailored nutritional and resistance training education and counseling intervention to improve physical function and associated health outcomes (muscle strength, health-related quality of life (HRQoL), self-efficacy, and weight management). METHODS In this study, 70 older cancer survivors will be randomized to one of two groups: experimental (receiving remote behavioral counseling and evidence-based education and resources), and control (general survivorship education). We will examine the intervention effects on physical function, muscle strength, HRQoL, self-efficacy, weight, and waist circumference during a 12-week period between the experimental and control groups. Three months following the end of the intervention, we will conduct a follow-up assessment to measure physical function, muscle strength, and HRQoL. SIGNIFICANCE AND IMPACT This study is the first synchronous, online protein-focused diet and resistance training intervention among older cancer survivors. This novel study advances science by promoting independent health behaviors among older cancer survivors to improve health outcomes, and provide foundational knowledge to further address this growing problem on a wider scale through online platforms.
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Affiliation(s)
- Jessica L. Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Zachary L. Chaplow
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, United States of America
| | - Cara Chase
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Colleen Spees
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Ashley Rosko
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Michelle J. Naughton
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Jade Smith
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, United States of America
| | - Sam Soufi
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, United States of America
| | - Mike Beck
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, United States of America
| | - Brian C. Focht
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, United States of America
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Goldman DM, Warbeck CB, Karlsen MC. Completely Plant-Based Diets That Meet Energy Requirements for Resistance Training Can Supply Enough Protein and Leucine to Maximize Hypertrophy and Strength in Male Bodybuilders: A Modeling Study. Nutrients 2024; 16:1122. [PMID: 38674813 PMCID: PMC11054926 DOI: 10.3390/nu16081122] [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: 03/03/2024] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Despite increasing awareness of plant-based diets for health and athletic performance, athletes are cautioned that careful dietary monitoring is necessary. Whether commonly consumed plant-based diets are nutritionally adequate for maximal muscular hypertrophy remains unknown. This modeling study assessed the nutrient composition of completely plant-based diets scaled to the caloric demands of maximal muscle mass and strength development in adult male bodybuilders. To model calorie requirements, anthropometric data from bodybuilders were input into the Tinsley resting metabolic rate prediction equation, and an appropriate physical activity factor and calorie surplus were applied. Dietary data from a large cohort following completely plant-based diets were then scaled to meet these needs. Modeled intakes for nutrients of interest were calculated as 1.8 g/kg/day of protein and 2.75 g/meal of leucine, which surpass mean requirements for maximal increases in muscle mass and strength and muscle protein synthesis, respectively. Daily levels for all micronutrients, except vitamin D, also exceeded requirements. Saturated fat levels were aligned with dietary guidelines, although sodium levels exceeded recommended limits. Consumption of larger portions of commonplace plant-based diets, scaled to meet the energy demands of maximal accrual of muscle mass and strength, satisfied protein and leucine requirements without the need for additional planning.
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Affiliation(s)
- David M. Goldman
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
- Department of Research and Development, Metabite Inc., New York, NY 10036, USA
| | - Cassandra B. Warbeck
- Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Micaela C. Karlsen
- Department of Research, American College of Lifestyle Medicine, Chesterfield, MO 63006, USA;
- Departments of Applied Nutrition and Global Public Health, Adjunct Faculty, University of New England, Biddeford, ME 04005, USA
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3
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Geirsdóttir ÓG, Pajari AM. Protein - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10261. [PMID: 38187790 PMCID: PMC10770649 DOI: 10.29219/fnr.v67.10261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/16/2023] [Accepted: 09/27/2023] [Indexed: 01/09/2024] Open
Abstract
Proteins are needed for providing essential amino acids, nitrogen, and fuel for the body's needs in all age groups. Proteins are especially required during active growth in pregnancy, lactation, childhood, and tissue growth in general. An adequate protein intake is needed in old adults to avoid premature muscle loss. According to the current dietary surveys, protein intake in the Nordic and Baltic countries varies from 15 to 19% of the total energy intake in adults. Comprehensive data regarding children and older adults are lacking. No good measure for protein status exists, and the estimation of physiological requirements is based on N-balance studies having some weaknesses. Protein quality is assessed by considering the protein digestibility of individual indispensable amino acids and their utilization (bioavailability), which is affected by food antinutrients and processing. The evidence regarding the association of protein intake per se with health outcomes is limited or suggestive. It is difficult to separate from the effect of other nutrients or ingredients in protein-rich foods. Proteins are widespread in foods, deriving from both animal and plant sources. Animal-sourced protein production puts more strain on the environment than plant-sourced proteins and contributes significantly to greenhouse gas emissions, thereby enhancing climate change. In Nordic and Baltic countries, consumption of animal-sourced proteins is relatively high. A shift toward more plant-based protein diets would be advisable for promoting a healthy and sustainable diet.
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Affiliation(s)
- Ólöf Guðný Geirsdóttir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - Anne-Maria Pajari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Stoodley IL, Williams LM, Wood LG. Effects of Plant-Based Protein Interventions, with and without an Exercise Component, on Body Composition, Strength and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2023; 15:4060. [PMID: 37764843 PMCID: PMC10537483 DOI: 10.3390/nu15184060] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Maintaining muscle mass, strength, and function is crucial for our aging population. Exercise and dietary protein intake are recommended strategies; however, animal proteins have been the most studied. Plant-based protein sources have lower digestibility and incomplete amino acid profiles. However new innovative plant-based proteins and products may have overcome these issues. Therefore, this systematic review aimed to synthesize the current research and evaluate the effects of plant-based protein interventions compared to placebo on body composition, strength, and physical function in older adults (≥60 years old). The secondary aim was whether exercise improved the effectiveness of plant-based protein on these outcomes. Randomized controlled trials up to January 2023 were identified through Medline, EMBASE, CINAHL, and Cochrane Library databases. Studies contained a plant-protein intervention, and assessed body composition, strength, and/or physical function. Thirteen articles were included, all using soy protein (0.6-60 g daily), from 12 weeks to 1 year. Narrative summary reported positive effects on muscle mass over time, with no significant differences compared to controls (no intervention, exercise only, animal protein, or exercise + animal protein interventions). There was limited impact on strength and function. Meta-analysis showed that plant-protein interventions were comparable to controls, in all outcomes. In conclusion, plant-protein interventions improved muscle mass over time, and were comparable to other interventions, warranting further investigation as an anabolic stimulus in this vulnerable population.
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Affiliation(s)
- Isobel L. Stoodley
- Immune Health Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (I.L.S.); (L.M.W.)
- School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Lily M. Williams
- Immune Health Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (I.L.S.); (L.M.W.)
- School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Lisa G. Wood
- Immune Health Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; (I.L.S.); (L.M.W.)
- School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW 2308, Australia
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Ye H, Yang JM, Luo Y, Long Y, Zhang JH, Zhong YB, Gao F, Wang MY. Do dietary supplements prevent loss of muscle mass and strength during muscle disuse? A systematic review and meta-analysis of randomized controlled trials. Front Nutr 2023; 10:1093988. [PMID: 37252241 PMCID: PMC10210142 DOI: 10.3389/fnut.2023.1093988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Objective We performed a systematic review and meta-analysis of existing randomized controlled trials (RCTs) to assess whether dietary supplements can prevent loss of muscle mass and strength during muscle disuse. Methods We searched the following databases: PubMed, Embase, Cochrane, Scopus, Web of Science, and CINAHL for RCTs assessing the effect of dietary supplements on disuse muscular atrophy without language and time restrictions. Muscle strength and leg lean mass were used as the primary outcome indicators. Muscle cross-sectional area (CSA), muscle fiber type distribution, peak aerobic capacity and muscle volume were used as secondary outcome indicators. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Heterogeneity was tested using the I2 statistic index. Mean and standard deviation of outcome indicators were extracted from the intervention and control groups to calculate effect sizes and 95% confidence intervals, with the significance level set at P < 0.05. Results Twenty RCTs were included with a total of 339 subjects. The results showed that dietary supplements had no effect on muscle strength, CSA, muscle fiber type distribution, peak aerobic capacity or muscle volume. But dietary supplements have a protective effect on the lean mass of the legs. Conclusion Dietary supplements can improve lean leg mass, but did not show a tendency to have an effect on muscle strength, CSA, muscle fiber type distribution, peak aerobic capacity or muscle volume during muscle disuse. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42022370230.
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Affiliation(s)
- Hua Ye
- Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Jia-Ming Yang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Yun Luo
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Yi Long
- Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Jia-Hong Zhang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Yan-Biao Zhong
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou, Jiangxi, China
| | - Feng Gao
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Mao-Yuan Wang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi, China
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6
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Aragon AA, Tipton KD, Schoenfeld BJ. Age-related muscle anabolic resistance: inevitable or preventable? Nutr Rev 2023; 81:441-454. [PMID: 36018750 DOI: 10.1093/nutrit/nuac062] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Age-related loss of muscle mass, strength, and performance, commonly referred to as sarcopenia, has wide-ranging detrimental effects on human health, the ramifications of which can have serious implications for both morbidity and mortality. Various interventional strategies have been proposed to counteract sarcopenia, with a particular emphasis on those employing a combination of exercise and nutrition. However, the efficacy of these interventions can be confounded by an age-related blunting of the muscle protein synthesis response to a given dose of protein/amino acids, which has been termed "anabolic resistance." While the pathophysiology of sarcopenia is undoubtedly complex, anabolic resistance is implicated in the progression of age-related muscle loss and its underlying complications. Several mechanisms have been proposed as underlying age-related impairments in the anabolic response to protein consumption. These include decreased anabolic molecular signaling activity, reduced insulin-mediated capillary recruitment (thus, reduced amino acid delivery), and increased splanchnic retention of amino acids (thus, reduced availability for muscular uptake). Obesity and sedentarism can exacerbate, or at least facilitate, anabolic resistance, mediated in part by insulin resistance and systemic inflammation. This narrative review addresses the key factors and contextual elements involved in reduction of the acute muscle protein synthesis response associated with aging and its varied consequences. Practical interventions focused on dietary protein manipulation are proposed to prevent the onset of anabolic resistance and mitigate its progression.
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Affiliation(s)
- Alan A Aragon
- is with the Department of Family and Consumer Sciences, California State University, Northridge, California, USA
| | - Kevin D Tipton
- is with the Institute of Performance Nutrition, Edinburgh, Scotland
| | - Brad J Schoenfeld
- is with the Department of Health Sciences, CUNY Lehman College, Bronx, New York, USA
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7
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Effects of Whey Protein Supplement on 4-Week Resistance Exercise-Induced Improvements in Muscle Mass and Isokinetic Muscular Function under Dietary Control. Nutrients 2023; 15:nu15041003. [PMID: 36839361 PMCID: PMC9963065 DOI: 10.3390/nu15041003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
(1) The purpose of this study was to investigate the effect of whey protein supplementation under dietary control on improvements in muscle mass and function following resistance exercise training. (2) Thirty-two men were randomly assigned to a whey protein supplementation group taking whey protein isolate (PSG, n = 17) and a placebo group (CON, n = 15). Participants were provided with three meals per day corresponding to the estimated individual daily energy intake. The supervised resistance exercise program was conducted 60 min per day, six days per week, for four weeks. (3) Post-intervention, there was a significant interaction between groups in terms of muscle mass increase (p = 0.033, η2 = 0.14), with a greater increase in the PSG. There were also significant interactions between the groups and increases in peak torque of the dominant knee flexors (p = 0.048, η2 = 0.12), dominant shoulder extensors, and non-dominant shoulder extensors (p = 0.028, η2 = 0.15; p = 0.015, η2 = 0.18), and the total work of the dominant knee and shoulder extensors (p = 0.012, η2 = 0.19; p = 0.013, η2 = 0.19), with greater increases in the PSG. (4) These results suggest that whey protein supplementation enhances resistance exercise-induced increase in muscle mass and overall muscular strength and endurance, independent of dietary influence.
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8
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van der Heijden I, Monteyne AJ, Stephens FB, Wall BT. Alternative dietary protein sources to support healthy and active skeletal muscle aging. Nutr Rev 2023; 81:206-230. [PMID: 35960188 DOI: 10.1093/nutrit/nuac049] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
To mitigate the age-related decline in skeletal muscle quantity and quality, and the associated negative health outcomes, it has been proposed that dietary protein recommendations for older adults should be increased alongside an active lifestyle and/or structured exercise training. Concomitantly, there are growing environmental concerns associated with the production of animal-based dietary protein sources. The question therefore arises as to where this dietary protein required for meeting the protein demands of the rapidly aging global population should (or could) be obtained. Various non-animal-derived protein sources possess favorable sustainability credentials, though much less is known (compared with animal-derived proteins) about their ability to influence muscle anabolism. It is also likely that the anabolic potential of various alternative protein sources varies markedly, with the majority of options remaining to be investigated. The purpose of this review was to thoroughly assess the current evidence base for the utility of alternative protein sources (plants, fungi, insects, algae, and lab-grown "meat") to support muscle anabolism in (active) older adults. The solid existing data portfolio requires considerable expansion to encompass the strategic evaluation of the various types of dietary protein sources. Such data will ultimately be necessary to support desirable alterations and refinements in nutritional guidelines to support healthy and active aging, while concomitantly securing a sustainable food future.
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Affiliation(s)
- Ino van der Heijden
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Alistair J Monteyne
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Francis B Stephens
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life Environmental Sciences, University of Exeter, Exeter, United Kingdom
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Devries MC, Giangregorio L. Using the specificity and overload principles to prevent sarcopenia, falls and fractures with exercise. Bone 2023; 166:116573. [PMID: 36208722 DOI: 10.1016/j.bone.2022.116573] [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] [Received: 05/16/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
Abstract
The aim of this narrative review is to discuss the evidence on exercise for fall, fracture and sarcopenia prevention, including evidence that aligns with the specificity and progressive overload principles used in exercise physiology, implementation strategies and future research priorities. We also provide a brief discussion of the influence of protein intake and creatine supplementation as potential effect modifiers. We prioritized evidence from randomized controlled trials and systematic reviews. Resistance training can improve muscle mass, muscle strength and a variety of physical performance measures in older adults. Resistance training may also prevent bone loss or increase bone mass, although whether it needs to be done in combination with impact exercise to be effective is less clear, because many studies use multicomponent interventions. Exercise programs prevent falls, and subgroup and network meta-analyses suggest an emphasis on balance and functional training, or specifically, anticipatory control, dynamic stability, functional stability limits, reactive control and flexibility, to maximize efficacy. Resistance training for major muscle groups at a 6-12 repetitions maximum intensity, and challenging balance exercises should be performed at least twice weekly. Choose resistance training exercises aligned with patient goals or movements done during daily activities (task specificity), alongside balance exercises tailored to ability and aspects of balance that need improvement. Progress the volume, level of difficulty or other aspects to see continuous improvement (progressive overload). A critical future priority will be to address implementation barriers and facilitators to enhance uptake and adherence.
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Affiliation(s)
- M C Devries
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - L Giangregorio
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada.
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Hou V, Madden K. Assessing the Effects of Dietary Protein Supplementation on Sarcopenia in Community-Dwelling Older Adults. Can Geriatr J 2022; 25:390-403. [PMID: 36505918 PMCID: PMC9684029 DOI: 10.5770/cgj.25.608] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Sarcopenia, an age-associated skeletal muscle disorder characterized by muscle loss, is associated with disability in elderly populations. This literature review summarizes the impact of protein intake and supplementation on the indicators of severe sarcopenia-muscle mass, muscle strength, and physical function in community-dwelling older adults. We performed a literature search on PubMed, EMBASE, and MedLine, and included studies that evaluated the effects of protein intake with or without exercise intervention and on sarcopenia in community-dwelling older adults. Information regarding study participants, protein intervention, and sarcopenia-related outcomes were collected. Protein supplementation with or without exercise positively improves muscle mass, and aspects of muscle strength and physical function in sarcopenic and pre-frail older adults, while it elicited inconclusive effects in healthy populations. Greater dietary animal-based and soy-based protein diets can improve muscle mass in older adults. In conclusion, protein supplementation can improve muscle mass and reduce the risk of sarcopenia in sarcopenia and pre-frail older adults, while future studies should continue to investigate the effects of protein supplementation on indicators of sarcopenia in healthy older adults.
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Affiliation(s)
- Vincent Hou
- Department of Medicine, The University of British Columbia, Vancouver, BC
| | - Kenneth Madden
- Department of Medicine, The University of British Columbia, Vancouver, BC,Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, BC,Gerontology and Diabetes Research Laboratory, Vancouver Coastal Health Research Institute, Vancouver, BC
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Oliveira TMD, Machado MR, Garcia MAC, Malaguti C. Commentary: Editorial—Whole-body electromyostimulation: A training technology to improve health and performance in humans? volume II. Front Physiol 2022; 13:1028289. [PMID: 36324310 PMCID: PMC9619042 DOI: 10.3389/fphys.2022.1028289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/30/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Túlio Medina Dutra Oliveira
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | | | - Marco Antonio Cavalcanti Garcia
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Carla Malaguti
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
- *Correspondence: Carla Malaguti,
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12
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Effect of Whey Protein Supplementation in Postmenopausal Women: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194210. [PMID: 36235862 PMCID: PMC9572824 DOI: 10.3390/nu14194210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Whey protein (WP) in combination with resistance training (RT) is beneficial in improving sarcopenic obesity and its damaging effects in older adults, while the difference between men and women should be considered while interpreting results. This review aims to investigate WP's efficacy on postmenopausal women with or without RT; (2) Material and Methods: We searched electronic databases including PubMed, EMBASE, and the Cochrane Library from inception to August 2021 for randomized controlled trials that included comparison groups to evaluate WP's efficacy in women aged 55 years and above. The outcomes included body composition, muscular strength, functional capacity, and dietary intake. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to estimate the effect of WP. We also performed subgroup analysis with or without RT; (3) Results: We included 14 studies in the systematic review and 10 studies in the meta-analysis. Subgroup analyses showed RT was a major confounder for muscle strength, lean mass, and dietary protein intake (PI). In the RT subgroup, WP supplementation had a significant positive effect on biceps curl strength (BC) (SMD: 0.6805, 95% CI: 0.176, 1.185, I2: 0%), and lower limb lean-mass (LLLM) (SMD: 1.103, 95% CI: 0.632, 1.574, I2: 14%). In the subgroup without RT, a significant negative effect on PI (SMD: -0.4225, 95% CI: -0.774, -0.071, I2: 47%) was observed, while no significant effect on muscle strength or lean mass was revealed. WP supplementation did not show a significantly different effect on fat mass or body weight loss in both the subgroups; (4) Conclusions: In postmenopausal women, WP supplementation only in combination with RT enhances BC and LLLM compared to placebo controls. Without RT, WP has no significant benefit on muscle strength or lean mass.
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Ghiotto L, Muollo V, Tatangelo T, Schena F, Rossi AP. Exercise and physical performance in older adults with sarcopenic obesity: A systematic review. Front Endocrinol (Lausanne) 2022; 13:913953. [PMID: 35966077 PMCID: PMC9366852 DOI: 10.3389/fendo.2022.913953] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sarcopenic obesity is characterized by low muscle mass and high body fat; prevalence increases with age, particularly after age 65 years. For this systematic literature review we searched scientific databases for studies on exercise interventions for improving physical performance in adults with sarcopenic obesity; also, we identified potential gaps in clinical practice guidelines that need to be addressed. Methods We followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases were searched for studies published through November 2021 that measured physical performance in adults with sarcopenic obesity. Results Most of the studies applied a strength training protocol in which improvement was noted post-treatment on the Time Chair Rise (TCR), 30-s Chair Stand, and Single Leg Stance (SLS) tests. Discrepancies between the studies were observed when resistance training was combined with or without elastic bands or electromyostimulation, as measured with the Short Physical Performance Battery (SPPB), Physical Performance Test (PPT), Gait Speed, and Timed Up & Go (TUG) test. Post-intervention SPPB, PPT, and gait speed scores showed an increase or maintenance of performance, while TUG test scores were higher according to one study but lower according to another. Conclusions Engagement in physical exercise, and resistance training in particular, can improve or maintain physical performance in adults with sarcopenic obesity. Study samples should include more men. A future area of focus should be the impact of different types of training (aerobic, power training, combined modalities). Finally, studies with longer intervention periods and follow-up periods are needed to gain a better understanding of the effectiveness of exercise on physical function in adults with sarcopenic obesity.
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Affiliation(s)
- Laura Ghiotto
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Toni Tatangelo
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Andrea P. Rossi
- Geriatrics Division, Department of Medicine, Ospedale Cà Foncello ULSS2, Treviso, Italy
- Healthy Aging Center, Department of Medicine, Division of Geriatrics, University of Verona, Verona, Italy
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Michel JM, Lievense KK, Norton SC, Costa JV, Alphin KH, Bailey LA, Miller GD. The Effects of Graded Protein Intake in Conjunction with Progressive Resistance Training on Skeletal Muscle Outcomes in Older Adults: A Preliminary Trial. Nutrients 2022; 14:nu14132739. [PMID: 35807922 PMCID: PMC9268432 DOI: 10.3390/nu14132739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 01/25/2023] Open
Abstract
Many studies have evaluated the effects of resistance training (RT) and protein intake to attenuate the age-related loss of skeletal muscle. However, the effects of graded protein intake with conjunctive RT in older adults are unclear. Older adults (n = 18) performed 10 weeks of whole-body RT with progressions to intensity and volume while consuming either a constant protein (CP) diet (0.8−1.0 g/kg/d) with no protein supplement or a graded protein (GP) diet progressing from 0.8 g/kg/d at week 1 to 2.2 g/kg/d at week 10 with a whey protein supplement. Data were collected prior to commencement of the RT protocol (PRE), after week 5 (MID), and after week 10 (POST). Dual Energy X-ray Absorptiometry derived lean/soft tissue mass, ultrasonography derived muscle thickness, and a proxy of muscle quality were taken at PRE and POST, while isokinetic dynamometry derived peak torque were taken at PRE, MID, and POST. This study demonstrated the feasibility of the RT protocol (attendance = 96%), and protein intake protocol (CP in range all weeks; GP deviation from prescribed = 7%). Peak torque, muscle quality scores, and appendicular lean/soft tissue mass demonstrated the main effects of time (p < 0.05) while no other main effects of time or group * time interactions were seen for any measure. In conclusion, RT improved appendicular lean/soft tissue mass, peak torque, and muscle quality, with no differential effects of graded or constant protein intake.
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Affiliation(s)
- J. Max Michel
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
| | - Kristy K. Lievense
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
| | - Sam C. Norton
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
| | - Juliana V. Costa
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
| | - Kathryn H. Alphin
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
| | - Lydia A. Bailey
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
| | - Gary D. Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27106, USA; (J.M.M.); (K.K.L.); (S.C.N.); (J.V.C.); (K.H.A.); (L.A.B.)
- Translational Science Center, Wake Forest University, Winston-Salem, NC 27106, USA
- Correspondence: ; Tel.: +1-336-758-1901
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Neil-Sztramko SE, Teggart K, Moore C, Sherifali D, Fitzpatrick-Lewis D, Coletta G, Phillips SM, Newbold KB, Alvarez E, Kuspinar A, Kennedy CC, Santaguida PL, Ganann R. Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review. BMC Geriatr 2022; 22:539. [PMID: 35768770 PMCID: PMC9241281 DOI: 10.1186/s12877-022-03170-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity and a healthy diet are important in helping to maintain mobility with aging. This umbrella review aims to identify group-based physical activity and/or nutrition interventions for community-dwelling older adults that improve mobility-related outcomes. METHODS Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Sociological Abstracts) were searched from inception to December 2021. Eligibility criteria included systematic reviews exploring the effectiveness of physical activity or structured exercise, alone or combined with nutrition interventions on mobility-related outcomes (aerobic capacity, physical function, balance, falls/safety, muscle strength, health-related quality of life/wellbeing). Interventions must have been delivered in a group setting to community-dwelling older adults aged 55+. Two reviewers independently performed eligibility screening, critical appraisal (using AMSTAR 2) and data extraction. The GRADE approach was used to reflect the certainty of evidence based on the size of the effect within each mobility-related outcome category. Older adult/provider research partners informed data synthesis and results presentation. RESULTS In total, 62 systematic reviews (1 high, 21 moderate, 40 low/critically low quality) were identified; 53 included physical activity only, and nine included both physical activity and nutritional supplements. No reviews included nutrition interventions alone. Combined aerobic/resistance, general physical activity, and mind-body exercise all improved physical function and balance (moderate-high certainty). Aerobic/resistance training improved aerobic capacity (high certainty). Resistance training and general physical activity improved muscle strength (moderate certainty). Aerobic/resistance training and general physical activity are likely to reduce falls among older adults (moderate certainty). There was no evidence of benefit for nutritional supplementation with physical activity. CONCLUSIONS Group-based physical activity interventions that combine aerobic and resistance, general PA and mind-body exercise can improve measures of mobility in community-dwelling older adults. We found no reviews focused on nutrition only, highlighting a gap in the literature.
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Affiliation(s)
- Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8S 4K1, Canada.
| | - Kylie Teggart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Caroline Moore
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Donna Fitzpatrick-Lewis
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Giulia Coletta
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - K Bruce Newbold
- School of Earth, Environment & Society, Faculty of Science, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8S 4K1, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Courtney C Kennedy
- Department of Medicine, Division of Geriatrics, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Pasqualina L Santaguida
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8S 4K1, Canada
| | - Rebecca Ganann
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, L8S 4K1, Canada
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16
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Vieira AF, Santos JS, Costa RR, Cadore EL, Macedo RCO. Effects of Protein Supplementation Associated with Resistance Training on Body Composition and Muscle Strength in Older Adults: A Systematic Review of Systematic Reviews with Meta-analyses. Sports Med 2022; 52:2511-2522. [PMID: 35689750 DOI: 10.1007/s40279-022-01704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are some controversial findings regarding the benefits of combining protein supplementation with resistance training in order to optimize adaptations to training in older adults. OBJECTIVE The aim of this review was to summarize the evidence from meta-analyses assessing the effects of protein supplementation combined with resistance training on body composition and muscle strength in the older population. METHODS We included systematic reviews with meta-analyses of randomized clinical trials that examined the effects of protein and/or amino acid supplementation associated with resistance training compared with resistance training alone on lean body mass, muscle mass, and muscle strength in older people. The search was performed using the MEDLINE (PubMed), Embase, Cochrane Database of Systematic Reviews, Google Scholar, and OpenGrey databases. Methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 checklist, and the quality of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation system. The pooled effect estimates were computed from the standardized mean difference and the 95% confidence interval achieved by each meta-analysis, using random effects models. RESULTS Five reviews were included, all of moderate methodological quality. In the analyses, protein supplementation combined with resistance training was associated with greater increases in lean body mass and muscle mass when compared with resistance training alone. However, no differences were observed between the interventions on muscle strength increases. The quality of evidence ranged from moderate to very low. CONCLUSION Protein supplementation associated with resistance training induces greater increases in lean body mass compared with resistance training alone. In addition, it is suggested that the use of protein supplementation enhances gains in muscle mass but does not promote greater increases in muscle strength.
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Affiliation(s)
- Alexandra Ferreira Vieira
- Universidade Federal do Rio Grande do Sul, 750, Felizardo Street, Porto Alegre, RS, 90690-200, Brazil. .,Faculdade Sogipa, Porto Alegre, RS, Brazil.
| | | | | | - Eduardo Lusa Cadore
- Universidade Federal do Rio Grande do Sul, 750, Felizardo Street, Porto Alegre, RS, 90690-200, Brazil
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17
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Effect of Whey Protein Supplementation on Weight and Body Composition Indicators: A Meta-Analysis of Randomized Clinical Trials. Clin Nutr ESPEN 2022; 50:74-83. [DOI: 10.1016/j.clnesp.2022.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/08/2022] [Accepted: 05/28/2022] [Indexed: 11/24/2022]
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18
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Effects of Icelandic yogurt consumption and resistance training in healthy untrained older males. Br J Nutr 2022; 127:1334-1342. [PMID: 34121642 DOI: 10.1017/s0007114521002166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Due to the important roles of resistance training and protein consumption in the prevention and treatment of sarcopenia, we assessed the efficacy of post-exercise Icelandic yogurt consumption on lean mass, strength and skeletal muscle regulatory factors in healthy untrained older males. Thirty healthy untrained older males (age = 68 ± 4 years) were randomly assigned to Icelandic yogurt (IR; n 15, 18 g of protein) or an iso-energetic placebo (PR; n 15, 0 g protein) immediately following resistance training (3×/week) for 8 weeks. Before and after training, lean mass, strength and skeletal muscle regulatory factors (insulin-like growth factor-1 (IGF-1), transforming growth factor-beta 1 (TGF-β1), growth differentiation factor 15 (GDF15), Activin A, myostatin (MST) and follistatin (FST)) were assessed. There were group × time interactions (P < 0·05) for body mass (IR: Δ 1, PR: Δ 0·7 kg), BMI (IR: Δ 0·3, PR: Δ 0·2 kg/m2), lean mass (IR: Δ 1·3, PR: Δ 0·6 kg), bench press (IR: Δ 4, PR: 2·3 kg), leg press (IR: Δ 4·2, PR: Δ 2·5 kg), IGF-1 (IR: Δ 0·5, Δ PR: 0·1 ng/ml), TGF-β (IR: Δ - 0·2, PR: Δ - 0·1 ng/ml), GDF15 (IR: Δ - 10·3, PR: Δ - 4·8 pg/ml), Activin A (IR: Δ - 9·8, PR: Δ - 2·9 pg/ml), MST (IR: Δ - 0·1, PR: Δ - 0·04 ng/ml) and FST (IR: Δ 0·09, PR: Δ 0·03 ng/ml), with Icelandic yogurt consumption resulting in greater changes compared with placebo. The addition of Icelandic yogurt consumption to a resistance training programme improved lean mass, strength and altered skeletal muscle regulatory factors in healthy untrained older males compared with placebo. Therefore, Icelandic yogurt as a nutrient-dense source and cost-effective supplement enhances muscular gains mediated by resistance training and consequently may be used as a strategy for the prevention of sarcopenia.
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Dhar M, Kapoor N, Suastika K, Khamseh ME, Selim S, Kumar V, Raza SA, Azmat U, Pathania M, Rai Mahadeb YP, Singhal S, Naseri MW, Aryana IGPS, Thapa SD, Jacob J, Somasundaram N, Latheef A, Dhakal GP, Kalra S. South Asian Working Action Group on SARCOpenia (SWAG-SARCO) – A consensus document. Osteoporos Sarcopenia 2022; 8:35-57. [PMID: 35832416 PMCID: PMC9263178 DOI: 10.1016/j.afos.2022.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/20/2021] [Accepted: 04/23/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
- Minakshi Dhar
- Department of Internal Medicine, AIIMS, Rishikesh, India
| | - Nitin Kapoor
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
- Non Communicable Disease Unit, The Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ketut Suastika
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University Denpasar, Bali, Indonesia
| | - Mohammad E. Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Vijay Kumar
- Department of Geriatric Medicine AIIMS New Delhi, India
| | - Syed Abbas Raza
- Department of Medicine, Shaukat Khanum Cancer Hospital and Research Center, Lahore, Pakistan
| | - Umal Azmat
- Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Monika Pathania
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | | | - Sunny Singhal
- Department of Geriatric Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - Mohammad Wali Naseri
- Internal Medicine, Division of Endocrinology Metabolism and Diabetes, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan
| | - IGP Suka Aryana
- Geriatric Division of Internal Medicine Department, Udayana University, Bali, Indonesia
| | - Subarna Dhoj Thapa
- Department of Endocrinology and Metabolism, Grande International Hospital, Kathmandu, Nepal
| | - Jubbin Jacob
- Department of Endocrinology, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Noel Somasundaram
- Diabetes and Endocrine Unit, National Hospital of Sri Lanka, Colombo, 10, Sri Lanka
| | - Ali Latheef
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Maldives
| | - Guru Prasad Dhakal
- Department of Gastroenterology, Jigme Dorji Wangchuk National Referral Hospital, Thimpu, Bhutan
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
- Corresponding author.
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20
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Effect of Combined Protein-Enriched Enteral Nutrition and Early Cycle Ergometry in Mechanically Ventilated Critically Ill Patients—A Pilot Study. Nutrients 2022; 14:nu14081589. [PMID: 35458151 PMCID: PMC9027967 DOI: 10.3390/nu14081589] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Cycle ergometry (CE) is a method of exercise used in clinical practice. Limited data demonstrate its effectiveness in critically ill patients. We aimed to evaluate the combination of CE and a high-protein diet in critically ill patients. Methods: This was an open label pilot trial comparing conventional physiotherapy with enteral nutrition (EN) (control, Group 1), CE with EN (Group 2), and CE with protein-enriched EN (Group 3). The primary outcome was length of ventilation (LOV). Secondary outcomes were intensive care unit (ICU) mortality, length of ICU stay (ICU LOS), length of hospital stay (Hospital LOS), and rate of re-intubation. Results: Per protocol, 41 ICU patients were enrolled. Thirteen patients were randomized to Group 1 (control), fourteen patients to Group 2, and fourteen patients to Group 3 (study groups). We found no statistically significant difference in LOV between the study arms (14.2 ± 9.6 days, 15.8 ± 7.1 days, and 14.9 ± 9.4 days, respectively, p = 0.89). Secondary outcomes did not demonstrate any significant differences between arms. Conclusions: In this pilot trial, CE combined with either standard EN or protein-enriched EN was not associated with better clinical outcomes, as compared to conventional physiotherapy with standard EN. Larger trials are needed in order to further evaluate this combination.
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21
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de Oliveira TM, Felício DC, Filho JE, Fonseca DS, Durigan JLQ, Malaguti C. Effects of whole-body electromyostimulation on health indicators of older people: Systematic review and meta-analysis of randomized trials. J Bodyw Mov Ther 2022; 31:134-145. [DOI: 10.1016/j.jbmt.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 02/08/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
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22
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Protein Supplement Perceptions, Use, and Associated Performance in Young Lebanese Resistance-Training Athletes. J Nutr Metab 2022; 2022:4150620. [PMID: 35223095 PMCID: PMC8881173 DOI: 10.1155/2022/4150620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
Abstract
The aims of this study were first to evaluate the nutritional knowledge, perception, and source of nutrition information among resistance-trained individuals consuming protein supplements (PS), to determine whether a correlation exists between nutrition-related knowledge and the use of PS, and finally to compare the impact of PS use among participants classified as nonprotein supplement users (NPSUs) and protein supplement users (PSUs). A cross-sectional study was conducted among a highly selected group of resistance-specialized trainees (RSTs). Among the 100 RST participants recruited, the Internet and coaches were the most common source of nutritional information. About one-third of participants believed that there were no health risks after consuming PS. Both NPSU and PSU exhibit performance improvement that was significantly lessened in PSU compared to NPSU. This study demonstrated that RST may have misconceptions regarding the benefits of PS usage to increase strength. Our data also suggest a shortage of knowledge about PS and confirm that PSUs lack proper professional guidance. These findings highlight the need for proper monitoring to ensure adequate perception, awareness, and safety in the Lebanese sports sector.
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Laskou F, Patel HP, Cooper C, Dennison E. A pas de deux of osteoporosis and sarcopenia: osteosarcopenia. Climacteric 2022; 25:88-95. [PMID: 34308725 DOI: 10.1080/13697137.2021.1951204] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022]
Abstract
The musculoskeletal conditions osteoporosis and sarcopenia are highly prevalent in older adults. Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone, whereas sarcopenia is identified by the loss of muscle strength, function and mass. Osteoporosis represents a major health problem contributing to millions of fractures worldwide on an annual basis, whereas sarcopenia is associated with a range of adverse physical and metabolic outcomes. They both affect physical and social function, confidence and quality of life as well as contributing to high health-care costs worldwide. Osteosarcopenia is the term given when both conditions occur concomitantly and it has been suggested that interactions between these two conditions may accelerate individual disease progression as co-existence of osteoporosis and sarcopenia is associated with higher morbidity from falls, fracture, disability as well as mortality. In this review, we will outline the epidemiology, pathogenesis and clinical consequences of osteosarcopenia and discuss available management strategies.
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Affiliation(s)
- F Laskou
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - H P Patel
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - E Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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Strategies to Prevent Sarcopenia in the Aging Process: Role of Protein Intake and Exercise. Nutrients 2021; 14:nu14010052. [PMID: 35010928 PMCID: PMC8746908 DOI: 10.3390/nu14010052] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022] Open
Abstract
Sarcopenia is one of the main issues associated with the process of aging. Characterized by muscle mass loss, it is triggered by several conditions, including sedentary habits and negative net protein balance. According to World Health Organization, it is expected a 38% increase in older individuals by 2025. Therefore, it is noteworthy to establish recommendations to prevent sarcopenia and several events and comorbidities associated with this health issue condition. In this review, we discuss the role of these factors, prevention strategies, and recommendations, with a focus on protein intake and exercise.
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Griffen C, Duncan M, Hattersley J, Weickert MO, Dallaway A, Renshaw D. Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial. Exp Gerontol 2021; 158:111651. [PMID: 34896568 DOI: 10.1016/j.exger.2021.111651] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To determine the individual and combined effects of 12 weeks of resistance exercise (RE) and whey protein supplementation on skeletal muscle strength (primary outcome), mass and physical function, and hormonal and inflammatory biomarkers in older adults. METHODS Thirty-six healthy older men [(mean±SE) age: 67±1 y; BMI: 25.5±0.4 kg/m2] were randomised to either control (CON; n=9), whey protein (PRO; n=9), RE+control (EX+CON; n=9), or RE+whey protein (EX+PRO; n=9) in a double-blinded fashion. Whole-body RE (2 sets of 8 repetitions and 1 set to volitional failure at 80% 1RM) was performed twice weekly. Supplements (PRO, 25 g whey protein isolate; CON, 23.75 g maltodextrin) were consumed twice daily. RESULTS EX+CON and EX+PRO increased leg extension (+19±3 kg and +20±3 kg, respectively) and leg press 1RM (+27±3 kg and +39±2 kg, respectively) greater than the CON and PRO groups (P<0.001, Cohen's d=1.50-1.90). RE (EX+CON and EX+PRO groups pooled) also increased fat-free mass (FFM) (+0.9±0.3 kg) and 6-min walk test distance (+21±5 m) and decreased fat mass (-0.4±0.4 kg), and interleukin-6 (-1.0±0.4 pg/mL) and tumor necrosis factor-alpha concentration (-0.7±0.3 pg/mL) greater than non-exercise (CON and PRO groups pooled; P<0.05, Cohen's f=0.37-0.45). Whey protein supplementation (PRO and EX+PRO groups pooled) increased 4-m gait speed greater than control (CON and EX+CON groups pooled) (+0.08±0.03 m/s; P=0.007, f=0.51). CONCLUSION RE increased muscle strength, FFM and physical function, and decreased markers of systemic inflammation in healthy active older men. Whey protein supplementation alone increased gait speed. No synergistic effects were observed. This study was registered at clinicaltrials.gov as NCT03299972.
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Affiliation(s)
- Corbin Griffen
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom.
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 2DS, United Kingdom
| | - John Hattersley
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; School of Engineering, University of Warwick, Coventry, CV4 7HL, United Kingdom
| | - Martin O Weickert
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Department of Endocrinology and Diabetes, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Alexander Dallaway
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom
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Hengeveld LM, de Goede J, Afman LA, Bakker SJL, Beulens JWJ, Blaak EE, Boersma E, Geleijnse JM, van Goudoever J(HB, Hopman MTE, Iestra JA, Kremers SPJ, Mensink RP, de Roos NM, Stehouwer CDA, Verkaik-Kloosterman J, de Vet E, Visser M. Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands. Adv Nutr 2021; 13:1083-1117. [PMID: 35016214 PMCID: PMC9340973 DOI: 10.1093/advances/nmab140] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/07/2021] [Accepted: 11/17/2021] [Indexed: 01/06/2023] Open
Abstract
Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or "some concerns" (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0-29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.
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Affiliation(s)
| | | | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Eric Boersma
- Erasmus MC, University Medical Center, Department of Cardiology, Rotterdam, The Netherlands
| | - Johanna M Geleijnse
- Health Council of the Netherlands, The Hague, The Netherlands,Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Johannes (Hans) B van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Department of Pediatrics, Amsterdam, The Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jolein A Iestra
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicole M de Roos
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands,Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Emely de Vet
- Department of Social Sciences, Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Dorhout BG, Doets EL, van Dongen EJI, de Groot LCPGM, Haveman-Nies A. In-Depth Analyses of the Effects of a Diet and Resistance Exercise Intervention in Older Adults: Who Benefits Most From ProMuscle in Practice? J Gerontol A Biol Sci Med Sci 2021; 76:2204-2212. [PMID: 33835166 PMCID: PMC8599037 DOI: 10.1093/gerona/glab104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The ProMuscle in Practice intervention, comprising resistance exercise and an increased protein intake, was effective in improving muscle strength, lean body mass, and physical functioning in older adults aged 65 years and older (N = 168). However, a heterogeneous response to such interventions is common. Therefore, we explored the differences in responsiveness to the intervention in subgroups based on demographic characteristics and mobility-impairing disorders. METHOD Multiple regression analyses were performed to study mean changes between baseline and 12 weeks on the Short Physical Performance Battery, chair rise test, lean body mass, knee extension strength, leg press strength, and leg extension strength. The interaction term Treatment × Subgroup was included to study differences in effects between subgroups. Subgroups comprised age (≤75 vs >75 years), sex (men vs women), presence of frailty, presence of sarcopenia, and presence of osteoarthritis. RESULTS A significant interaction effect including age was found on lean body mass (β = -0.8; 95% CI: -1.5, -0.2), favoring participants aged 75 years and younger. A significant interaction effect including sex was found on leg press strength (β = 15.5; 95% CI: 0.6, 30.3), favoring women. Participants with or without frailty, sarcopenia, or osteoarthritis responded equally to the intervention in terms of absolute effects. CONCLUSIONS Participants aged 75 years and younger and women benefited to a great extent from the intervention, as they improved significantly on nearly every outcome. Effects in participants with and without a mobility-impairing disorder were comparable, indicating that the intervention is suitable for both groups.
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Affiliation(s)
- Berber G Dorhout
- Division of Human Nutrition and Health, Wageningen University and Research, The Netherlands
| | - Esmée L Doets
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, The Netherlands
| | - Ellen J I van Dongen
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, The Netherlands
| | | | - Annemien Haveman-Nies
- Chair Group Consumption and Healthy Lifestyles, Wageningen University and Research, The Netherlands
- GGD Noord- en Oost-Gelderland, Academic Collaborative Center AGORA, Zutphen, The Netherlands
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Lee JB, Kwon DK, Jeon YJ, Song YJ. Mealworm (Tenebrio molitor)-derived protein supplementation attenuates skeletal muscle atrophy in hindlimb casting immobilized rats. CHINESE J PHYSIOL 2021; 64:211-217. [PMID: 34708712 DOI: 10.4103/cjp.cjp_40_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This study aimed to investigate the effect of mealworm (Tenebrio molitor) derived protein supplementation on skeletal muscle atrophy of hindlimb casted immobilized rats. Twenty-four six-week-old male Sprague-Dawley rats were randomly divided into three groups: control sedentary group (CD, n = 8), control diet casting group (CDC, n = 8), and the mealworm-derived protein supplemented casting group (MDC, n = 8). CD and CDC group was supplemented AIN-76G diet and mealworm-derived protein supplemented diet for MDC group was substituted as 5% casein protein to 5% mealworm protein for 5 weeks and left hindlimb casting immobilization using casting tape for CDC and MDC group was done 1 week before sacrifice. After 5 weeks of mealworm supplementation, the soleus muscle weight of the MDC group was significantly higher compared to the CDC group. In addition, the level of muscle protein synthesis factors p-Akt/Akt, p-4EBP1/4EBP1, and p-S6K/S6K significantly increased in the MDC group compared to the CDC group. On contrary, the level of muscle protein degradation factors (MuRF1 and atrogin-1) was significantly lower in the MDC group than that of the CDC group. These results suggest that mealworm-derived protein supplementation may have a significant role in the prevention of skeletal muscle atrophy via stimulation of muscle protein synthesis factors and inhibition of muscle protein degradation factors, and therefore a promising intervention in sarcopenia.
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Affiliation(s)
- Jeong-Beom Lee
- Department of Physiology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Dae-Keun Kwon
- Department of Sports Science, Institute of Sports Health Science, Sunmoon University, Asan, South Korea
| | - Yoo-Jeong Jeon
- Department of Sports Science, Institute of Sports Health Science, Sunmoon University, Asan, South Korea
| | - Young-Ju Song
- Department of Sports Science, Institute of Sports Health Science, Sunmoon University, Asan, South Korea
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Effects of Milk Protein in Resistance Training-Induced Lean Mass Gains for Older Adults Aged ≥ 60 y: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13082815. [PMID: 34444975 PMCID: PMC8398205 DOI: 10.3390/nu13082815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
This review evaluated the effects of milk-based protein supplementation on resistance training (RT)-induced gains in lean body mass or fat free mass (LBM/FFM) and muscle strength for older adults. A systematic search of PubMed, Scopus and EBSCOhost/SPORTDiscus was conducted. Eligibility criteria: Randomized controlled trials comparing all types of milk-based protein supplements with control supplements for the training older adults at mean age ≥ 60 y. Twenty studies were included in the qualitative synthesis, whilst seventeen studies were included in the quantitative synthesis. A dose of 10-15 g of milk protein supplementation was sufficient to augment RT-induced LBM/FFM. Intriguingly, four out of five studies show negative effect of whey protein supplementation at the same dose range (or even higher) compared with control supplementation (-0.49 kg, 95% CI: -0.69, -0.29, I2 = 14%, Z = 4.82, p < 0.001). For milk-based protein supplementation, RT-induced improvements in muscle strength were observed only when the protein doses ≥22 g (+0.66 kg, 95% CI: 0.07, 1.25, I2 = 0%, Z = 2.18, p = 0.03). Conclusion: Milk protein is superior to whey protein in enhancing RT-induced LBM/FFM gains for older adults. Optimal daily protein intake can dilute the protein supplementation effect.
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Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis. Nutrients 2021; 13:nu13082487. [PMID: 34444645 PMCID: PMC8399515 DOI: 10.3390/nu13082487] [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: 07/04/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/31/2022] Open
Abstract
Older adults with knee osteoarthritis (KOA) are at high risk of sarcopenia. Protein-rich nutritional composition supplementation (PS) combined with resistance exercise training (RET) improves muscle gains and facilitates physical activity in older adults. However, whether PS augments the effects of RET on muscle mass and PA in patients with KOA remains unclear. Therefore, this study identified the effects of PS on sarcopenic indices and PA in older women with KOA subjected to an RET program. Eligible older women aged 60–85 years and diagnosed as having KOA were randomly assigned to either the experimental group (EG) or the control group (CG). Both groups performed RET twice a week for 12 weeks. The EG received additional PS during this period. Outcome measures included appendicular lean mass index, walking speed, physical activity, and scores on the Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC). All measures were tested at baseline and after intervention. With participant characteristics and baseline scores as covariates, analysis of variance was performed to identify between-group differences in changes in all outcome measures after intervention. Statistical significance was defined as p < 0.05. Compared with the CG, the EG achieved greater changes in appendicular lean mass index (adjusted mean difference (aMD) = 0.19 kg/m2, p < 0.01), physical activity (aMD = 30.0 MET-hour/week, p < 0.001), walking speed (aMD = 0.09 m/s, p < 0.05), and WOMAC global function (aMD = −8.21, p < 0.001) after intervention. In conclusion, PS exerted augmentative effects on sarcopenic indices, physical activity, and perceived global WOMAC score in older women with KOA through 12 weeks of RET.
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Wood LG. We can do better in COPD: Time for action to preserve body composition. Respirology 2021; 26:828-829. [PMID: 34291542 DOI: 10.1111/resp.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Lisa G Wood
- School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
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Kim H, Kojima N, Uchida R, Somekawa S, Inoue N, Kobayashi H, Osuka Y. The additive effects of exercise and essential amino acid on muscle mass and strength in community-dwelling older Japanese women with muscle mass decline, but not weakness and slowness: a randomized controlled and placebo trial. Aging Clin Exp Res 2021; 33:1841-1852. [PMID: 32978751 DOI: 10.1007/s40520-020-01713-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/08/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Exercise and essential amino acid supplementation have been separately shown to improve muscle mass in elderly people, however, the combined, added effects of both interventions have yielded inconsistent results on muscle mass, strength, and physical function improvement. AIMS To investigate the additive effects of exercise and essential amino acid supplementation on muscle mass, strength, and walking ability in older Japanese women with muscle mass decline, but not weakness and slowness. METHODS One hundred thirty women over 65 years of age were defined as having muscle decline and randomly assigned into two groups; exercise and amino acid supplementation (n = 65) or exercise and placebo supplementation (n = 65). The exercise group attended a 60-min comprehensive training program once a week and were encouraged to perform a home-based exercise program. The amino acid or placebo group ingested a 3 g supplement daily for 3-month. Body composition was determined by bioelectrical impedance analysis. Interview data and functional fitness measurements, such as muscle strength and walking ability were collected at baseline and after the 3-month intervention. RESULTS There were no significant group × time interactions in primary outcomes such as muscle mass and strength. However, interactions were observed in the degree of low back discomfort (P = 0.014). Percent change of low back discomfort was significantly greater in exercise + amino acid group compared with exercise + placebo group. CONCLUSIONS The combination of exercise and amino acid supplementation had a beneficial effect on low back discomfort. However, additional effects were not observed in primary outcomes including muscle mass and strength in this population.
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Zdzieblik D, Jendricke P, Oesser S, Gollhofer A, König D. The Influence of Specific Bioactive Collagen Peptides on Body Composition and Muscle Strength in Middle-Aged, Untrained Men: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094837. [PMID: 33946565 PMCID: PMC8125453 DOI: 10.3390/ijerph18094837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/18/2022]
Abstract
It has been shown that specific collagen peptides combined with resistance training (RT) improves body composition and muscle strength in elderly sarcopenic men. The main purpose of this RCT study was to investigate the efficacy of the identical specific collagen peptides combined with RT on body composition and muscle strength in middle-aged, untrained men. Furthermore, in the exploratory part of the study, these results were compared with another group that had received whey protein in addition to the RT. Ninety-seven men completed this study and participated in a 12-week RT program. They ingested 15 g of specific collagen peptides (n = 30; CP-G), placebo (n = 31; P-G), or whey protein (n = 36; WP-G) daily. Changes in fat free mass and fat mass were determined by dual-energy X-ray absorptiometry (DXA), and isometric leg strength was measured. All participants had significantly (p < 0.01) improved levels in fat free mass (ΔCP-G = 3.42 ± 2.54 kg; ΔP-G = 1.83 ± 2.09 kg; ΔWP-G = 2.27 ± 2.56 kg), fat mass (ΔCP-G = -5.28 ± 3.19 kg; ΔP-G = -3.39 ± 3.13 kg; ΔWP-G = -4.08 ± 2.80 kg) and leg strength (ΔCP-G = 163 ± 189 N; ΔP-G = 100 ± 154 N; ΔWP-G = 120 ± 233 N). The main analysis revealed a statistically significantly higher increase in fat free mass (p = 0.010) and decrease in fat mass (p = 0.023) in the CP-G compared with the P-G. The exploratory analysis showed no statistically significant differences between WP-G and CP-G or P-G, regarding changes of fat free mass and fat mass. In conclusion, specific collagen peptide supplementation combined with RT was associated with a significantly greater increase in fat free mass and a decrease in fat mass compared with placebo. RT combined with whey protein also had a positive impact on body composition, but the respective effects were more pronounced following the specific collagen peptide administration.
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Affiliation(s)
- Denise Zdzieblik
- Department for Nutrition, Institute for Sports and Sports Science, University of Freiburg, Schwarzwaldstr 175, 79117 Freiburg, Germany; (D.Z.); (A.G.)
| | - Patrick Jendricke
- Department for Nutrition, Institute for Sports and Sports Science, University of Freiburg, Schwarzwaldstr 175, 79117 Freiburg, Germany; (D.Z.); (A.G.)
- Correspondence: ; Tel.: +49-761-20354240
| | - Steffen Oesser
- CRI, Collagen Research Institute, Schauenburgerstr 116, 24118 Kiel, Germany;
| | - Albert Gollhofer
- Department for Nutrition, Institute for Sports and Sports Science, University of Freiburg, Schwarzwaldstr 175, 79117 Freiburg, Germany; (D.Z.); (A.G.)
| | - Daniel König
- Centre of Sports Science, Department for Nutrition, Exercise and Health, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria;
- Department for Nutrition, Exercise and Health, Faculty of Life Sciences, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
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Johnson KO, Mistry N, Holliday A, Ispoglou T. The effects of an acute resistance exercise bout on appetite and energy intake in healthy older adults. Appetite 2021; 164:105271. [PMID: 33915209 DOI: 10.1016/j.appet.2021.105271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 04/08/2021] [Accepted: 04/17/2021] [Indexed: 01/04/2023]
Abstract
Ageing is associated with reductions in appetite and food intake leading to unintentional weight loss. Such weight loss, particularly through muscle mass reduction, is associated with muscle weakness and functional decline, which represent predictors of poor health outcomes and contribute to frailty in older adults. Exercise-induced anorexia is an established phenomenon in young adults; however appetite and energy intake (EI) responses to resistance exercise are unknown in older adults. Twenty healthy older adults (68 ± 5 years, BMI 26.2 ± 4.5 kg m-2) undertook two 5-h experimental trials. Participants rested for 30 min before being provided with a standardised breakfast (196 kcal, 75.2% carbohydrate, 8.9% protein and 15.9% fat). Participants then rested for 1-h before completing: 1-h resistance exercise bout followed by 2-h of rest (RE) or, a control condition (CON) where participants rested for 3 h, in a randomised crossover design. Appetite perceptions were measured throughout both trials and on cessation, an ad libitum meal was provided to assess EI. A repeated-mesures ANOVA revealed no significant condition x time interaction for subjective appetite (p = 0.153). However, area under the curve for appetite was significantly lower in the RE compared with CON (49 ± 8 mm h-1 vs. 52 ± 9 mm h-1, p = 0.007, d = 0.27). There was no difference in EI (RE = 681 ± 246 kcal; CON = 673 ± 235 kcal; p = 0.865), suggesting that resistance exercise does not affect EI 2 h post-exercise in older adults despite a significant but modest reduction in appetite over a 5-h period. In conclusion, resistance exercise may be an appropriate means for optimising muscle mass adaptations without attenuating acute EI of older adults.
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Affiliation(s)
- Kelsie Olivia Johnson
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK; Higher Education Sport, Hartpury University, Hartpury, GL19 3BE, UK.
| | - Nathan Mistry
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK.
| | - Adrian Holliday
- Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK; Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle, NE1 7RU, UK.
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Via JD, Owen PJ, Daly RM, Mundell NL, Livingston PM, Rantalainen T, Foulkes SJ, Millar JL, Murphy DG, Fraser SF. Musculoskeletal Responses to Exercise plus Nutrition in Men with Prostate Cancer on Androgen Deprivation: A 12-month RCT. Med Sci Sports Exerc 2021; 53:2054-2065. [PMID: 33867499 DOI: 10.1249/mss.0000000000002682] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Androgen deprivation therapy (ADT) for prostate cancer (PCa) has multiple adverse effects on musculoskeletal health. This 12-month randomised controlled trial aimed to assess the effects of multi-component exercise training combined with whey protein, calcium and vitamin D supplementation on bone mineral density (BMD), structure and strength, body composition, muscle strength and physical function in ADT-treated men. METHODS Seventy ADT-treated men were randomised to exercise plus supplementation (Ex+Suppl; n=34) or usual care (Control; n=36). Ex+Suppl involved thrice weekly progressive resistance training plus weight-bearing impact exercise with daily multi-nutrient supplementation. Primary outcomes were DXA hip and spine areal BMD. Secondary outcomes included: tibia and radius pQCT volumetric BMD, bone structure and strength; DXA body composition; pQCT muscle and fat cross-sectional area and muscle density; muscle strength and physical function. RESULTS Sixty men (86%) completed the study. Mean exercise and supplement adherence were 56% and 77%, respectively. There were no effects of the intervention on bone or body composition outcomes. Ex+Suppl improved leg muscle strength (net difference [95% CI] 14.5% [-0.2, 29.2], P=0.007) and dynamic mobility (four-square-step test time, -9.3% [-17.3, -1.3], P=0.014) relative to controls. Per-protocol analysis of adherent participants (≥66% exercise, ≥80% supplement) showed Ex+Suppl preserved femoral neck aBMD (1.9% [0.1, 3.8], P=0.026) and improved total body lean mass (1.0 kg [-0.23, 2.22], P=0.044) relative to controls. CONCLUSION Exercise training combined with multi-nutrient supplementation had limited effect on ameliorating the adverse musculoskeletal consequences of ADT, likely related to the modest intervention adherence.
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Affiliation(s)
- Jack Dalla Via
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia Deakin University, Faculty of Health, Geelong, Victoria, Australia Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland Sports Cardiology Lab, Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
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Avula B, Parveen I, Zhao J, Wang M, Techen N, Wang YH, Riaz M, Bae JY, Shami AA, Chittiboyina AG, Khan IA, Sharp JS. A Comprehensive Workflow for the Analysis of Bio-Macromolecular Supplements: Case Study of 20 Whey Protein Products. J Diet Suppl 2021; 19:515-533. [PMID: 33764265 DOI: 10.1080/19390211.2021.1897724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The presence of bio-macromolecules as major ingredients is a primary factor in marketing many biologically derived macromolecular supplements. Workflows for analyzing these supplements for quality assurance, adulteration, and other supply-chain difficulties must include a qualitative assessment of small-molecule and macromolecular components; however, no such integrated protocol has been reported for these bio-macromolecular supplements. Twenty whey protein supplements were analyzed using an integrated workflow to identify protein content, protein adulteration, inorganic elemental content, and macromolecular and small-molecule profiles. Orthogonal analytical methods were employed, including NMR profiling, LC-DAD-QToF analysis of small-molecule components, ICP-MS analysis of inorganic elements, determination of total protein content by a Bradford assay, SDS-PAGE protein profiling, and bottom-up shotgun proteomic analysis using LC-MS-MS. All 20 supplements showed a reduced protein content compared to the claimed content but no evidence of adulteration with protein from an unclaimed source. Many supplements included unlabeled small-molecule additives (but nontoxic) and significant deviations in metal content, highlighting the importance of both macromolecular and small-molecule analysis in the comprehensive profiling of macromolecular supplements. An orthogonal, integrated workflow allowed the detection of crucial product characteristics that would have remained unidentified using traditional workflows involving either analysis of small-molecule nutritional supplements or protein analysis.
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Affiliation(s)
- Bharathi Avula
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Iffat Parveen
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Jianping Zhao
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Mei Wang
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Natascha Techen
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Yan-Hong Wang
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Mohammad Riaz
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, MS, USA University
| | - Ji-Yeong Bae
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,College of Pharmacy, Jeju National University, Jeju, South Korea
| | - Anter A Shami
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, MS, USA University
| | - Amar G Chittiboyina
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA
| | - Ikhlas A Khan
- National Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, MS, USA University
| | - Joshua S Sharp
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, MS, USA University.,Department of Chemistry and Biochemistry, University of Mississippi, University, MS, USA
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Dos Santos Quaresma MV, Marques CG, Magalhães ACO, Dos Santos RVT. Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study. Nutrition 2021; 90:111223. [PMID: 33934054 PMCID: PMC7941022 DOI: 10.1016/j.nut.2021.111223] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/20/2021] [Accepted: 02/24/2021] [Indexed: 12/16/2022]
Abstract
Objectives Coronavirus disease 2019 (COVID-19) emerged and rapidly spread worldwide. Several countries have imposed lockdown and isolation in attempt to mitigate viral spread. However, social isolation has a negative effect on psychological aspects, increasing stress, fear, anxiety, anger and emotional disturbance, as well as affecting sleep pattern and the practice of physical activity. Negative emotions and lifestyle changes trigger overeating, consequently affecting dietary practices. The aim of this study was to verify the prevalence of lifestyle factors (i.e., sleep time/quality and practice of physical exercise), eating behavior dimensions, chronotype, and association with dietary practices (planning, domestic organization, food choice, ways of eating) in home confinement during the COVID-19 pandemic in São Paulo, Brazil. Methods This cross-sectional study was conducted between April 27 and May 25, 2020. An anonymous online questionnaire (Microsoft Forms) was used for data collection by the snowball method. We verified dietary practices (outcome), eating behavior, physical exercise practice, sleep quality and duration, and chronotype (exposure variables). Sex, age, educational and social status were assessed as covariates and confounders. We evaluated 724 adults (585 women and 139 men). Mean age was 32.6 y (±11.3) for women and 33.5 y (±10.5) for men. Results Emotional eating (EE) and binge eating (BE) were positively correlated (r = 0.66; P <0.001). Dietary practices were negatively correlated with BE (r = –0.41; P <0.001), EE (r = –0.33; P <0.001) and body mass index (r = –0.24; P <0.001). Linear regression demonstrated that EE (β = –0.1351; t = –2.841; P = 0.005; ηp2 = 0.013), BE (β = –0.2580; t = –5.612; P < 0.001; ηp2 = 0.050), no practice of physical exercise at home (β = –0.4271; t = –5.933; P < 0.001; ηp2 = 0.055), being vespertine (β = –0.3435; t = 2.076; P = 0.038; ηp2 = 0.019), and age (β = –0.082; t = –2.210; P = 0.027; ηp2 = 0.008) are negative predictors of dietary practices. Finally, cognitive restraint (β = 0.1407; t = 3.858; P < 0.001; ηp2 = 0.024), better sleep quality (β = 0.1768; t = 2.506; P = 0.012; ηp2 = 0.010), receiving 4–10 wages per month (according to a minimum wage in Brazil that corresponds to US $ 183.01) (β = 0.2568; t = 2.573; P = 0.10; ηp2 = 0.027) and 10 – 20 wages per month (β = 0.4490; t = 3.726; P < 0.001; ηp2 = 0.027) are positive predictors of dietary practices. Conclusion Eating behavior, physical exercise, sleep, and social factors can be important predictors for dietary practices during COVID-19 social confinement. Longitudinal studies in Brazil are needed to confirm these findings.
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Affiliation(s)
| | | | | | - Ronaldo Vagner Thomatieli Dos Santos
- Postgraduate program in Psychobiology, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Department of Biosciences, Universidade Federal de São Paulo, Santos, SP, Brazil.
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Agostini F, Bernetti A, Di Giacomo G, Viva MG, Paoloni M, Mangone M, Santilli V, Masiero S. Rehabilitative Good Practices in the Treatment of Sarcopenia: A Narrative Review. Am J Phys Med Rehabil 2021; 100:280-287. [PMID: 33595941 DOI: 10.1097/phm.0000000000001572] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
ABSTRACT To date, rehabilitative good practices that analyze all aspects of the rehabilitation management of the patient with sarcopenia are absent in the literature. The purpose of this article is to carry out research and evaluation of the evidence, good practice, and recommendations in the literature relating to the rehabilitative treatment of disabilities associated with sarcopenia. Bibliographic research was conducted on Medline, PEDro, Cochrane Database, and Google Scholar. All articles published in the last 10 yrs were analyzed. The results of this research generated three guidelines, eight meta-analyses, five systematic reviews, a Cochrane review, 17 reviews, and seven consensus conferences. From the analysis of the literature, it seems that most of the works agree in affirming that exercise and diet supplementation are the cornerstones of rehabilitation treatment of patients with sarcopenia. The practice of an adequate lifestyle received numerous high-grade recommendations in the included guidelines. Based on the data obtained, the rehabilitation management of the patient with sarcopenia must be personalized and must include exercise and nutritional supplementation. These factors are important in increasing the autonomy of the elderly essential for safe walking without neglecting stretching exercises that are important for flexibility and balance and coordination exercises.
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Affiliation(s)
- Francesco Agostini
- From the Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy (FA, AB, GDG, MGV, MP, MM, VS); and Department of Neuroscience, University of Padua, Padua, Italy (SM)
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Dorhout BG, Haveman-Nies A, van Dongen EJI, Wezenbeek NLW, Doets EL, Bulten A, de Wit GA, de Groot LCPGM. Cost-effectiveness of a Diet and Resistance Exercise Intervention in Community-Dwelling Older Adults: ProMuscle in Practice. J Am Med Dir Assoc 2021; 22:792-802.e2. [PMID: 33548182 DOI: 10.1016/j.jamda.2020.12.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Ageing is associated with a decline in functioning and a loss of independence, which will lead to increased health care costs in the future. The ProMuscle in Practice intervention was found to be effective in improving muscle strength, muscle mass, and functioning of older adults. The current study assesses the cost-effectiveness and perceived benefits of the intervention. DESIGN Trial-based cost-effectiveness analysis complemented by interviews. SETTING AND PARTICIPANTS A total of 168 community-dwelling older adults were included. Intervention participants started with a 12-week intensive support program, comprising resistance exercise guided by physiotherapists and consultations with a dietitian to increase protein intake. To maintain the adapted lifestyle pattern, they continued with a 12-week moderate support intervention. The control group received usual care. METHODS Costs and outcomes were measured at baseline, after 12 and 24 weeks. Costs were assessed from a societal perspective. Health care use, out-of-pocket costs, and productivity losses were measured using questionnaires. Intervention costs were quantified according to bottom-up micro-costing. Outcomes included quality of life (EQ-5D-5L) and physical functioning (Short Physical Performance Battery [SPPB]). Bootstrap analyses were used to generate cost-effectiveness planes and acceptability curves. Interviews with participants and professionals were conducted after 24 weeks to measure perceived benefits. RESULTS An Incremental Cost-Effectiveness Ratio of €2988 ($3385)/point increase in SPPB was found. The intervention has an 82.4% probability of being cost-effective at a willingness to pay (WTP) of €12.000 ($13.559)/point increase in SPPB. No change in quality of life was found according to EQ-5D-5L. Interviews, however, revealed a wide range of function-related perceived benefits. CONCLUSIONS AND IMPLICATIONS At a WTP of €12.000 ($13.559)/point increase in SPPB, the intervention was found to have an 82.4% probability of being cost-effective. Because generic quality of life questionnaires seem unable to detect subtle changes in public health interventions, future studies are advised to include targeted and specific questionnaires.
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Affiliation(s)
- Berber G Dorhout
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands.
| | - Annemien Haveman-Nies
- Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, the Netherlands; GGD Noord- en Oost-Gelderland, Academic Collaborative Center AGORA, Zutphen, the Netherlands
| | - Ellen J I van Dongen
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, Wageningen, the Netherlands
| | - Nick L W Wezenbeek
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - Esmée L Doets
- Food, Health and Consumer Research, Wageningen Food and Biobased Research, Wageningen, the Netherlands
| | - Anneke Bulten
- Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands
| | - G Ardine de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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Reinders I, Wijnhoven HAH, Jyväkorpi SK, Suominen MH, Niskanen R, Bosmans JE, Brouwer IA, Fluitman KS, Klein MCA, Kuijper LD, van der Lubbe LM, Olthof MR, Pitkälä KH, Vijlbrief R, Visser M. Effectiveness and cost-effectiveness of personalised dietary advice aiming at increasing protein intake on physical functioning in community-dwelling older adults with lower habitual protein intake: rationale and design of the PROMISS randomised controlled trial. BMJ Open 2020; 10:e040637. [PMID: 33444206 PMCID: PMC7682452 DOI: 10.1136/bmjopen-2020-040637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Short-term metabolic and observational studies suggest that protein intake above the recommended dietary allowance of 0.83 g/kg body weight (BW)/day may support preservation of lean body mass and physical function in old age, but evidence from randomised controlled trials is inconclusive. METHODS AND ANALYSIS The PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) trial examines the effect of personalised dietary advice aiming at increasing protein intake with or without advice regarding timing of protein intake to close proximity of usual physical activity, on change in physical functioning after 6 months among community-dwelling older adults (≥65 years) with a habitual protein intake of <1.0 g/kg adjusted (a)BW/day. Participants (n=264) will be recruited in Finland and the Netherlands, and will be randomised into three groups; two intervention groups and one control group. Intervention group 1 (n=88) receives personalised dietary advice and protein-enriched food products in order to increase their protein intake to at least 1.2 g/kg aBW/day. Intervention group 2 (n=88) receives the same advice as described for intervention group 1, and in addition advice to consume 7.5-10 g protein through protein-(en)rich(ed) foods within half an hour after performing usual physical activity. The control group (n=88) receives no intervention. All participants will be invited to attend lectures not related to health. The primary outcome is a 6-month change in physical functioning measured by change in walk time using a 400 m walk test. Secondary outcomes are: 6-month change in the Short Physical Performance Battery score, muscle strength, body composition, self-reported mobility limitations, quality of life, incidence of frailty, incidence of sarcopenia risk and incidence of malnutrition. We also investigate cost-effectiveness by change in healthcare costs. DISCUSSION The PROMISS trial will provide evidence whether increasing protein intake, and additionally optimising the timing of protein intake, has a positive effect on the course of physical functioning after 6 months among community-dwelling older adults with a habitual protein intake of <1.0 g/kg aBW/day. ETHICS AND DISSEMINATION The study has been approved by the Ethics Committee of the Helsinki University Central Hospital, Finland (ID of the approval: HUS/1530/2018) and The Medical Ethical Committee of the Amsterdam UMC, location VUmc, Amsterdam, the Netherlands (ID of the approval: 2018.399). All participants provided written informed consent prior to being enrolled onto the study. Results will be submitted for publication in peer-reviewed journals and will be made available to stakeholders (ie, older adults, healthcare professionals and industry). TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03712306).
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Affiliation(s)
- Ilse Reinders
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Riikka Niskanen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kristien S Fluitman
- Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam UMC, Amsterdam, The Netherlands
- Wallenburg Laboratory, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michel C A Klein
- Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lothar D Kuijper
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura M van der Lubbe
- Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland
| | - Rachel Vijlbrief
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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A 4-week exercise and protein program improves muscle mass and physical functioning in older adults - A pilot study. Exp Gerontol 2020; 141:111094. [PMID: 32950613 DOI: 10.1016/j.exger.2020.111094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Prehabilitation might attenuate common surgery-induced losses in muscle mass and physical performance. Beneficial effects of physical exercise with protein supplementation have been reported in older adults, but typically after an intervention of at least 12 weeks. The time-window for pre-surgery training is often limited to around 30 days, and it is not known if it is possible to achieve comparable results in such a short time window. OBJECTIVES The aim of this study was to pilot-test the effectiveness of a controlled four-week combined exercise and protein supplementation program on skeletal muscle-related outcomes in a Dutch older adult population. DESIGN This study was a one-armed pilot trial. PARTICIPANTS Seventeen older men and women, aged 55-75y, not scheduled for surgery. INTERVENTION A 4-week intervention program consisting of a twice-weekly supervised resistance and high-intensity aerobic exercise training of 75 min, combined with daily protein supplementation (2 doses of 15.5 g/day at breakfast and lunch). MEASUREMENT After two and four weeks, isometric quadriceps maximal voluntary contraction (MVC) was assessed via Biodex and quadriceps cross-sectional area (CSA) via magnetic resonance imaging. Other outcome measures were handgrip strength, chair rise time and maximal aerobic capacity (VO2-max), as assessed from a submaximal exercise test. RESULTS Compliance to the supervised training sessions (99.3%) and the protein supplementation (97%) was very high. The 4-week exercise and protein program led to an increase in quadriceps CSA of 2.3 ± 0.7 cm2 (P = 0.008) in the dominant leg and 3.2 ± 0.7 cm2 (P < 0.001) in the non-dominant leg. Isometric quadriceps MVC increased in the dominant leg (Δ14 ± 4 Nm, P = 0.001) and in the non-dominant leg (Δ17 ± 5 Nm, P = 0.003). Chair rise test time improved with -3.8 ± 0.5 s (P < 0.0001), and VO2-max improved with 3.3 ± 1.1 ml/min/kg (P = 0.014). We observed no changes in body weight and handgrip strength. CONCLUSION A 4-week exercise and protein intervention led to improvements in muscle-related outcomes in older adults with low levels of physical activity.
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Kemmler W, Kohl M, Fröhlich M, Jakob F, Engelke K, von Stengel S, Schoene D. Effects of High-Intensity Resistance Training on Osteopenia and Sarcopenia Parameters in Older Men with Osteosarcopenia-One-Year Results of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST). J Bone Miner Res 2020; 35:1634-1644. [PMID: 32270891 DOI: 10.1002/jbmr.4027] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/19/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023]
Abstract
Dynamic resistance exercise (DRT) might be the most promising agent for fighting sarcopenia in older people. However, the positive effect of DRT on osteopenia/osteoporosis in men has still to be confirmed. To evaluate the effect of low-volume/high-intensity (HIT)-DRT on bone mineral density (BMD) and skeletal muscle mass index (SMI) in men with osteosarcopenia, we initiated the Franconian Osteopenia and Sarcopenia Trial (FrOST). Forty-three sedentary community-dwelling older men (aged 73 to 91 years) with osteopenia/osteoporosis and SMI-based sarcopenia were randomly assigned to a HIT-RT exercise group (EG; n = 21) or a control group (CG; n = 22). HIT-RT provided a progressive, periodized single-set DRT on machines with high intensity, effort, and velocity twice a week, while CG maintained their lifestyle. Both groups were adequately supplemented with whey protein, vitamin D, and calcium. Primary study endpoint was integral lumbar spine (LS) BMD as determined by quantitative computed tomography. Core secondary study endpoint was SMI as determined by dual-energy X-ray absorptiometry. Additional study endpoints were BMD at the total hip and maximum isokinetic hip-/leg-extensor strength (leg press). After 12 months of exercise, LS-BMD was maintained in the EG and decreased significantly in the CG, resulting in significant between-group differences (p < 0.001; standardized mean difference [SMD] = 0.90). In parallel, SMI increased significantly in the EG and decreased significantly in the CG (p < 0.001; SMD = 1.95). Total hip BMD changes did not differ significantly between the groups (p = 0.064; SMD = 0.65), whereas changes in maximum hip-/leg-extensor strength were much more prominent (p < 0.001; SMD = 1.92) in the EG. Considering dropout (n = 2), attendance rate (95%), and unintended side effects/injuries (n = 0), we believe our HIT-RT protocol to be feasible, attractive, and safe. In summary, we conclude that our combined low-threshold HIT-RT/protein/vitamin D/calcium intervention was feasible, safe, and effective for tackling sarcopenia and osteopenia/osteoporosis in older men with osteosarcopenia. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, Germany
| | - Michael Fröhlich
- Department of Sports Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Franz Jakob
- Bernhard-Heine-Center for Locomotion Research, Würzburg, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.,Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
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Effectiveness of Protein Supplementation Combined with Resistance Training on Muscle Strength and Physical Performance in Elderly: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12092607. [PMID: 32867103 PMCID: PMC7551830 DOI: 10.3390/nu12092607] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of the combination of resistance training (RT) and protein supplementation (PS), compared to RT alone or combined with a placebo (plS), in the improvement of muscle strength and physical performance. The search strategy in PubMed, Cochrane Library, and Web of Sciences databases found a total of 294 studies. Once inclusion and exclusion criteria were applied, 16 studies were included for the qualitative analysis. A total of 657 healthy elderly (>60 years) participants were analysed. Finally, 15 articles were included in the quantitative analysis with one being excluded due to issues with data availability. Upper-limb, lower-limb, and handgrip strength were the primary outcomes of the meta-analysis. The secondary outcomes, related to physical performance, were Short Physical Performance Battery (SPPB), gait speed, and the five-chair-rise test (5CRT). The main results of the meta-analysis show no statistical differences for upper-limb (SMD: 0.56, 95% CI: −0.09, 1.21, p = 0.09, I2 = 68%), lower-limb (SMD: 0.00, 95% CI: −0.18, 0.18, p = 1.0, I2 = 11%), and handgrip strength (SMD: 0.03, 95% CI: −0.26, 0.32, p = 0.84, I2 = 0%) between the RT + PS and the RT alone (or combined with plS). Moreover, no statistical differences were found relating to physical performance. In view of these results, protein supplementation combined with RT does not provide additional benefits compared to RT alone or with plS in healthy elderly adults.
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Liao CD, Wu YT, Tsauo JY, Chen PR, Tu YK, Chen HC, Liou TH. Effects of Protein Supplementation Combined with Exercise Training on Muscle Mass and Function in Older Adults with Lower-Extremity Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients 2020; 12:nu12082422. [PMID: 32806718 PMCID: PMC7468926 DOI: 10.3390/nu12082422] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Aging and osteoarthritis (OA) are associated with a high risk of muscle mass loss, which can lead to physical disability. This study investigated the effectiveness of protein supplementation combined with exercise training (PS + ET) in improving muscle mass and functional outcomes in older adults with lower-limb OA. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) on the effectiveness of PS + ET in older adults with hip or knee OA. Meta-analysis and risk of bias assessment of the included RCTs were conducted. Six RCTs were included in this systemic review; they had a median (range/total) Physiotherapy Evidence Database (PEDro) score of 7 (6-9) out of 10, respectively. Five RCTs that enrolled patients who underwent total joint replacement were included in this meta-analysis. The PS + ET group exhibited significant improvements in muscle mass (standard mean difference [SMD] = 1.13, p < 0.00001), pain (SMD = 1.36, p < 0.00001), and muscle strength (SMD = 0.44, p = 0.04). Our findings suggest that PS + ET improves muscle mass, muscle strength, and functional outcomes and reduces pain in older adults with lower-limb OA, particularly in those who have undergone total joint replacement.
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Affiliation(s)
- Chun-De Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; (C.-D.L.); (Y.-T.W.); (J.-Y.T.)
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan;
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; (C.-D.L.); (Y.-T.W.); (J.-Y.T.)
- Physical Therapy Center, National Taiwan University Hospital, Taipei 100229, Taiwan
| | - Jau-Yih Tsauo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; (C.-D.L.); (Y.-T.W.); (J.-Y.T.)
| | - Pey-Rong Chen
- Department of Dietetics, National Taiwan University Hospital, Taipei 100225, Taiwan;
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110301, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100025, Taiwan;
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan;
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan;
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Correspondence: ; Tel.: +886-2-2249-0088 (ext. 1600); Fax: +886-2-2248-0577
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Kemmler W, Kohl M, Jakob F, Engelke K, von Stengel S. Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study. Nutrients 2020; 12:E2341. [PMID: 32764397 PMCID: PMC7468852 DOI: 10.3390/nu12082341] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
The present study aimed to evaluate the effect of high intensity dynamic resistance exercise (HIT-DRT) and whey protein supplementation (WPS) on bone mineral density (BMD) and sarcopenia parameters in osteosarcopenic men. Men ≥ 72 years with osteosarcopenia (n = 43) were randomly assigned to a HIT-RT (HIT-RT: n = 21) or a non-training control group (n = 22). Supervised HIT-RT twice/week was applied for 18 months, while the control group maintained their habitual lifestyle. Supplying WPS, total protein intake amounted to 1.5-1.6 (HIT-RT) and 1.2 g/kg/body mass/d (control). Both groups were supplied with calcium and vitamin D. Primary study outcomes were BMD and the sarcopenia Z-score. After adjusting for multiplicity, we observed significant positive effects for sarcopenia Z-score (standardized mean difference (SMD): 1.40), BMD at lumbar spine (SMD: 0.72) and total hip (SMD: 0.72). In detail, effect sizes for skeletal muscle mass changes were very pronounced (1.97, p < 0.001), while effects for functional sarcopenia parameters were moderate (0.87, p = 0.008; handgrip strength) or low (0.39, p = 0.209; gait velocity). Apart from one man who reported short periods of temporary worsening of existing joint pain, no HIT-RT/WPS-related adverse effects or injuries were reported. We consider HIT-RT supported by whey protein supplementation as a feasible, attractive, safe and highly effective option to fight osteosarcopenia in older men.
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Affiliation(s)
- Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91053 Erlangen, Germany; (K.E.); (S.v.S.)
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Neckarstrasse 1, 78054 Villingen-Schwenningen, Germany;
| | - Franz Jakob
- Bernhard-Heine-Center for Locomotion Research, University of Würzburg, Brettreichstrasse 11, 97074 Würzburg, Germany;
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91053 Erlangen, Germany; (K.E.); (S.v.S.)
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054 Erlangen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Henkestrasse 91, 91053 Erlangen, Germany; (K.E.); (S.v.S.)
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Mendonça N, Kingston A, Granic A, Hill TR, Mathers JC, Jagger C. Contribution of protein intake and its interaction with physical activity to transitions between disability states and to death in very old adults: the Newcastle 85+ Study. Eur J Nutr 2020; 59:1909-1918. [PMID: 31292749 PMCID: PMC7351810 DOI: 10.1007/s00394-019-02041-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 06/30/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Growth in the number of very old (≥ 85 years) adults will likely lead to increased prevalence of disability. Our aim was to determine the contribution of protein intake, and the interaction between protein intake and physical activity (PA), to the transition between disability states and to death in the very old using the Newcastle 85+ Study. METHODS The analytic sample comprised of 717 older adults aged 85 years at baseline and living in the community. Protein intake was estimated with 2 × 24-h multiple pass recalls (24 h-MPR) at baseline. Disability was measured as difficulty performing 17 activities of daily living (ADL) at baseline, at 18, 36, and 60 months, and defined as having difficulties in one or more ADL. The contribution of protein intake [g/kg adjusted body weight/day (g/kg aBW/d)] to transition probabilities to and from disability, and to death over 5 years was examined by multi-state models adjusted for key health covariates. RESULTS Participants were expected to spend 0.8 years (95% CI 0.6-1.0) disability-free and 2.8 years (95% CI 2.6-2.9) with disability between the ages 85 and 90 years. One unit increase in protein intake (g/kg aBW/d) halved the likelihood of incident disability (HR 0.44, 95% CI 0.24-0.83) but not for other transitions. Similar reductions in disability incidence were also found in individuals with protein intake ≥ 0.8 (HR 0.50, 95% CI 0.31-0.80) and ≥ 1 g/kg aBW/d (HR 0.49, 95% CI 0.33-0.73). Participants with high PA and protein intake ≥ 1 g/kg aBW/d were less likely to transition from disability-free to disability than those within the same PA level but with protein intake < 1 g/kg aBW/d (HR 0.45, 95% CI 0.28-0.72). CONCLUSION Higher protein intake, especially in combination with higher physical activity, may delay the incidence of disability in very old adults.
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Affiliation(s)
- Nuno Mendonça
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
| | - Andrew Kingston
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Antoneta Granic
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- NIHR Newcastle Biomedical Research Centre in Ageing and Chronic Disease, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, NE4 5PL, UK
| | - Tom R Hill
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - John C Mathers
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Carol Jagger
- Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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Daly RM, Gianoudis J, De Ross B, O'Connell SL, Kruger M, Schollum L, Gunn C. Effects of a multinutrient-fortified milk drink combined with exercise on functional performance, muscle strength, body composition, inflammation, and oxidative stress in middle-aged women: a 4-month, double-blind, placebo-controlled, randomized trial. Am J Clin Nutr 2020; 112:427-446. [PMID: 32469393 DOI: 10.1093/ajcn/nqaa126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 05/07/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multinutrient protein-enriched supplements are promoted to augment the effects of exercise on muscle mass and strength, but their effectiveness in middle-aged women, or whether there are any additional benefits to physical function, remains uncertain. OBJECTIVES We aimed to evaluate whether a multinutrient-fortified milk drink (MFMD) could enhance the effects of exercise on functional muscle power (stair climbing) in middle-aged women. Secondary aims were to evaluate the intervention effects on physical function, muscle strength, lean mass (LM), fat mass (FM), bone mineral content (BMC), muscle cross-sectional area (CSA), muscle density, balance, flexibility, aerobic fitness, inflammation, oxidative stress, bone and cartilage turnover, blood pressure, and blood lipids. METHODS In this 4-mo, double-blind, placebo-controlled, randomized trial, 244 women (45-65 y) participated in a multimodal resistance-type exercise program 3 d/wk, with random allocation to a twice-daily MFMD containing added protein, vitamin D, calcium, milk fat globule membrane (phospholipids and other bioactives), and other micronutrients (Ex + MFMD, n = 123) or an energy-matched placebo (Ex + placebo, n = 121). RESULTS A total of 216 women (89%) completed the study. After 4 mo, both groups experienced similar 3.6%-4.3% improvements in the primary outcomes of fast-pace 5- and 10-step stair ascent power. In contrast, Ex + MFMD experienced greater improvements in 5-step regular-pace stair descent time [net difference (95% CI): -0.09 s (-0.18, 0.00 s), P = 0.045], countermovement jump height [0.5 cm (0.04, 1.0 cm), P = 0.038], total body LM [0.3 kg (0.04, 0.60 kg), P = 0.020], FM [-0.6 kg (-1.0, -0.2 kg), P = 0.004], BMC [0.4% (0.1%, 0.6%), P = 0.020], muscle CSA [thigh: 1.8% (0.6%, 2.9%), P = 0.003; lower leg: 0.9% (0.3%, 1.6%), P = 0.005], balance eyes closed [3.3 s (1.1, 5.4 s), P = 0.005], 2-min step performance [8 steps (3, 12 steps), P = 0.003], and sit-and-reach flexibility [1.4 cm (0.6, 2.2 cm), P = 0.026]. MFMD did not enhance the effects of exercise on any measures of muscle strength, gait speed, dynamic balance, reaction time, or blood lipids, and there was no effect of either intervention on blood pressure, markers of inflammation, or cartilage turnover. Ex + placebo had a greater improvement in the oxidative stress marker protein carbonyls (P < 0.01). CONCLUSIONS In middle-aged women, daily consumption of an MFMD did not enhance the effects of a multimodal exercise program on the primary outcome of stair climbing ascent power, but did elicit greater improvements in multiple secondary outcomes including various other measures of functional performance, LM, muscle size, FM, balance, aerobic capacity, flexibility, and bone metabolism.This trial was registered at www.anzctr.org.au as ACTRN12617000383369.
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Affiliation(s)
- Robin M Daly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Victoria, Australia
| | - Jenny Gianoudis
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Victoria, Australia
| | - Belinda De Ross
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Victoria, Australia
| | - Stella L O'Connell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Melbourne, Victoria, Australia
| | - Marlena Kruger
- School of Health Sciences, Massey University, Palmerston North, New Zealand
| | - Linda Schollum
- Fonterra Co-operative Group Ltd, Palmerston, North New Zealand
| | - Caroline Gunn
- Fonterra Co-operative Group Ltd, Palmerston, North New Zealand
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48
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van Wijngaarden JP, Wojzischke J, van den Berg C, Cetinyurek-Yavuz A, Diekmann R, Luiking YC, Bauer JM. Effects of Nutritional Interventions on Nutritional and Functional Outcomes in Geriatric Rehabilitation Patients: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2020; 21:1207-1215.e9. [PMID: 32723538 DOI: 10.1016/j.jamda.2020.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/19/2020] [Accepted: 04/13/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES It has been recognized that nutritional interventions play a role in improving the nutritional and functional status of older persons. This systematic review summarizes the evidence on nutritional and functional outcomes of nutritional interventions alone or in combination with physical exercise in geriatric rehabilitation patients. DESIGN Eight electronic databases were searched until July 1, 2019 to identify nutritional intervention studies in patients aged ≥60 years who were admitted to geriatric rehabilitation. A meta-analysis was performed to quantify intervention effects on serum albumin, muscle mass, and hand grip strength (HGS). RESULTS A total of 1962 studies were screened and 13 included in the systematic review. Studies were heterogeneous in interventions (4 nutritional interventions, 6 physical exercise + nutritional intervention, 1 timing of protein provision, 1 exercise + dietary advice, 1 nutrition-related nursing care) and outcomes. Among the 9 interventions that tested oral nutritional supplements (ONS) with protein, with or without exercise, 7 studies reported protein intake and 6 showed increased protein intakes, 2 of 5 studies showed increased albumin levels, and 5 of 9 reported an improvement in functional outcomes (BI, Functional Independence Measure, mobility). Meta-analyses showed no significant intervention effects on albumin [standardized mean difference (SMD) 0.45, 95% confidence interval (CI) -0.14, 1.04 (4 studies)], muscle mass [mean difference (MD) 2.14 kg, 95% CI -2.17, 6.45 (3 studies)], and HGS [SMD -0.04, 95% CI -0.55, 0.63 (3 studies)], but was based on a very limited number of studies. CONCLUSIONS AND IMPLICATIONS Only a limited number of studies with heterogeneous nutritional interventions and outcomes were available in the geriatric rehabilitation population. Studies that included ONS improved nutritional outcomes, especially protein intake and albumin levels. Functional outcomes improved in the majority of reporting studies. This indicates benefits of protein supplementation, with or without exercise, in this population. Future well-designed and well-powered clinical trials are needed to clarify existing controversial aspects.
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Affiliation(s)
| | - Julia Wojzischke
- Carl von Ossietzky Universität Oldenburg, Department of Health Services Research, Oldenburg, Germany
| | - Claudia van den Berg
- Danone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands
| | | | - Rebecca Diekmann
- Carl von Ossietzky Universität Oldenburg, Department of Health Services Research, Oldenburg, Germany
| | - Yvette C Luiking
- Danone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands
| | - Jürgen M Bauer
- Center for Geriatric Medicine, and Network Aging Research, University Heidelberg, Heidelberg, Germany
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49
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Straight CR, Fedewa MV, Toth MJ, Miller MS. Improvements in skeletal muscle fiber size with resistance training are age-dependent in older adults: a systematic review and meta-analysis. J Appl Physiol (1985) 2020; 129:392-403. [PMID: 32702280 DOI: 10.1152/japplphysiol.00170.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As studies examining the hypertrophic effects of resistance training (RT) at the cellular level have produced inconsistent results, we performed a systematic review and meta-analysis to investigate muscle fiber size before and after a structured RT intervention in older adults. A random-effects model was used to calculate mean effect size (ES) and 95% confidence intervals (CI). Thirty-five studies were included (age range: 59.0-88.5 yr), and 44 and 30 effects were used to estimate RT impact on myosin heavy chain (MHC) I and II fiber size. RT produced moderate-to-large increases in MHC I (ES = +0.51, 95%CI +0.31 to +0.71; P < 0.001) and II (ES = +0.81, 95%CI +0.56 to +1.05; P < 0.001) fiber size, with men and women having a similar response. Age was negatively associated with change in muscle fiber size for both fiber types (MHC I: R2 = 0.11, β = -0.33, P = 0.002; MHC II: R2 = 0.10, β = -0.32, P = 0.04), indicating a less robust hypertrophic response as age increases in older adults. Unexpectedly, a higher training intensity (defined as percentage of one-repetition maximum) was associated with a smaller increase in MHC II fiber size (R2 = 15.09%, β = -0.39, P = 0.01). Notably, MHC II fiber subtypes (IIA, IIX, IIAX) were examined less frequently, but RT improved their size. Overall, our findings indicate that RT induces cellular hypertrophy in older adults, although the effect is attenuated with increasing age. In addition, hypertrophy of MHC II fibers was reduced with higher training intensity, which may suggest a failure of muscle fibers to hypertrophy in response to high loads in older adults.
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Affiliation(s)
- Chad R Straight
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Michael V Fedewa
- Department of Kinesiology, University of Alabama, Tuscaloosa, Alabama
| | - Michael J Toth
- Departments of Medicine, Molecular Physiology and Biophysics, and Orthopedics and Rehabilitation, University of Vermont, Burlington, Vermont
| | - Mark S Miller
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
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50
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Yamamoto K, Tsuchihashi-Makaya M, Kinugasa Y, Iida Y, Kamiya K, Kihara Y, Kono Y, Sato Y, Suzuki N, Takeuchi H, Higo T, Miyazawa Y, Miyajima I, Yamashina A, Yoshita K, Washida K, Kuzuya M, Takahashi T, Nakaya Y, Hasebe N, Tsutsui H. Japanese Heart Failure Society 2018 Scientific Statement on Nutritional Assessment and Management in Heart Failure Patients. Circ J 2020; 84:1408-1444. [PMID: 32655089 DOI: 10.1253/circj.cj-20-0322] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kazuhiro Yamamoto
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | | | - Yoshiharu Kinugasa
- Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Yuki Iida
- Department of Rehabilitation Medicine, Kainan Hospital
| | | | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical & Health Sciences
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane Hospital
| | - Yukihito Sato
- Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki General Medical Center
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital
| | - Harumi Takeuchi
- Department of Clinical Nutrition, Nagoya University Hospital
| | - Taiki Higo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
| | - Yasushi Miyazawa
- Department of Clinical Nutrition, Tokyo Medical University Hospital
| | - Isao Miyajima
- Department of Clinical Nutrition, Chikamori Hospital
| | | | - Katsushi Yoshita
- Department of Food and Human Health Science, Osaka City University Graduate School of Human Life Science
| | - Koichi Washida
- Faculty of Nursing, Kobe Women's University.,Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center
| | - Masafumi Kuzuya
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine
| | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University.,Department of Rehabilitation, Juntendo University Hospital
| | - Yutaka Nakaya
- Department of Internal Medicine, Touto Kasukabe Hospital
| | - Naoyuki Hasebe
- Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
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