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Kojima K, Ishikawa H, Watanabe S, Nosaka N, Mutoh T. A Randomized, Double-Blind, Controlled Trial Assessing If Medium-Chain Triglycerides in Combination with Moderate-Intensity Exercise Increase Muscle Strength in Healthy Middle-Aged and Older Adults. Nutrients 2023; 15:3275. [PMID: 37513691 PMCID: PMC10383836 DOI: 10.3390/nu15143275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
An adequate nutritional intake is recommended for the prevention of physical frailty and sarcopenia. In particular, medium-chain fatty acids (MCFAs) are reportedly important for muscle strength in nursing home residents. However, the effects of MCFAs on healthy adults at risk for frailty remain unknown. Hence, a randomized, placebo-controlled study was conducted to investigate the effects of 12 weeks of medium-chain triglycerides (MCTs) intake and walking on muscle mass and function in healthy, sedentary, middle-aged and older adults with a low body mass index. Three MCT intake groups with different amounts of octanoic and decanoic acid intake were compared with a control group. After 12 weeks, knee extension strength increased in all groups, with the increases in all MCT intake groups being significantly higher than those in the control group (p < 0.05). Grip strength significantly increased from baseline in the MCT 6 g/day intake group (p < 0.05). The combination of aerobic exercise and MCT intake may be effective in preventing decline in muscle strength and promoting increase in muscle strength as they can improve muscle energy production, thereby contributing to the maintenance of good health for middle-aged and older adults at high risk for frailty and sarcopenia.
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Affiliation(s)
- Keiichi Kojima
- Central Research Laboratory, The Nisshin OilliO Group, Ltd., Yokohama 235-8558, Kanagawa, Japan
| | - Haruna Ishikawa
- Central Research Laboratory, The Nisshin OilliO Group, Ltd., Yokohama 235-8558, Kanagawa, Japan
| | - Shinji Watanabe
- Central Research Laboratory, The Nisshin OilliO Group, Ltd., Yokohama 235-8558, Kanagawa, Japan
| | - Naohisa Nosaka
- Central Research Laboratory, The Nisshin OilliO Group, Ltd., Yokohama 235-8558, Kanagawa, Japan
| | - Tatsushi Mutoh
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai 980-8574, Miyagi, Japan
- Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita-City 010-0874, Akita, Japan
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Is It Time to Reconsider the U.S. Recommendations for Dietary Protein and Amino Acid Intake? Nutrients 2023; 15:nu15040838. [PMID: 36839196 PMCID: PMC9963165 DOI: 10.3390/nu15040838] [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: 11/10/2022] [Revised: 01/06/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
Since the U.S. Institute of Medicine's recommendations on protein and amino acid intake in 2005, new information supports the need to re-evaluate these recommendations. New lines of evidence include: (1) re-analysis/re-interpretation of nitrogen balance data; (2) results from indicator amino acid oxidation studies; (3) studies of positive functional outcomes associated with protein intakes higher than recommended; (4) dietary guidance and protein recommendations from some professional nutrition societies; and (5) recognition that the synthesis of certain dispensable amino acids may be insufficient to meet physiological requirements more often than previously understood. The empirical estimates, theoretical calculations and clinical functional outcomes converge on a similar theme, that recommendations for intake of protein and some amino acids may be too low in several populations, including for older adults (≥65 years), pregnant and lactating women, and healthy children older than 3 years. Additional influential factors that should be considered are protein quality that meets operational sufficiency (adequate intake to support healthy functional outcomes), interactions between protein and energy intake, and functional roles of amino acids which could impact the pool of available amino acids for use in protein synthesis. Going forward, the definition of "adequacy" as it pertains to protein and amino acid intake recommendations must take into consideration these critical factors.
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3
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Li CW, Chiu CJ. Incorporating gerontological and geriatrics information into picture books for 9-12 year-old children: A stakeholder engagement design. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:102-117. [PMID: 34549668 DOI: 10.1080/02701960.2021.1979537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study explored the preferences of different stakeholders when translating geriatrics and gerontology concepts into children's picture books, with the aim of developing a feasible model. Following the stakeholder engagement design and qualitative method, three types of stakeholders were enrolled: medical and educational professionals (n = 9), older adults aged over 65 (n = 9), and children aged 9 to 12 (n = 7). Individual interviews and focus groups were used to collect the views of the stakeholders as a basis for revising the picture book, as well as to analyze the opinions of different stakeholders. Results show that medical professionals' recommendations focused on intellectual content (18.0%) and written verbal narratives (16.5%). Education experts tended to recommend textual verbal narratives (18.8%) and storyline (6.0%). Older adults's suggestions focused on story content (6.8%) and included detailed descriptions of older adults. Children's suggestions were focused on plot arrangement (2.3%) and text size (2.3%). Mean scores for the appropriateness of the three picture book materials increased after the stakeholder engagement, with the communication literacy picture book achieved statistical significance (p = .042). It is concluded that the stakeholder engagement design is a viable development model for achieving intergenerational understanding, realistic and theoretical goals, and bridging heterogeneity across the stakeholders.
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Affiliation(s)
- Chia-Wei Li
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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4
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Kim YJ, Moon S, Yu JM, Chung HS. Implication of diet and exercise on the management of age‐related sarcopenic obesity in Asians. Geriatr Gerontol Int 2022; 22:695-704. [PMID: 35871525 PMCID: PMC9544230 DOI: 10.1111/ggi.14442] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/25/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
The incidence of sarcopenic obesity among adults aged ≥65 years is rising worldwide. Sarcopenic obesity is a high‐risk geriatric syndrome defined as a gain in the amount of adipose tissue along with the age‐related loss of muscle mass and strength or physical performance. Sarcopenic obesity is associated with increased risks of falls, physical limitations, cardiovascular diseases, metabolic diseases, and/or mortality. Thus, the identification of preventive and treatment strategies against sarcopenic obesity is important for healthy aging. Diet and exercise are the reasons for the development of sarcopenic obesity and are key targets in its prevention and treatment. Regarding weight reduction alone, it is most effective to maintain a negative energy balance with dietary calorie restriction and aerobic exercise. However, it is important to preserve skeletal muscle mass while reducing fat mass. Resistance exercise and appropriate protein supply are the main ways of preserving skeletal muscle mass, as well as muscle function. Therefore, in order to improve sarcopenic obesity, a complex treatment strategy is needed to limit energy ingestion with proper nutrition and to increase multimodal exercises. In this review, we focus on recently updated interventions for diet and exercise and potential future management strategies for Asian individuals with aging‐related sarcopenic obesity. Geriatr Gerontol Int 2022; 22: 695–704.
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Affiliation(s)
- Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
| | - Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangnam Sacred Heart Hospital College of Medicine, Hallym University Seoul South Korea
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5
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Bardon LA, Corish CA, Lane M, Bizzaro MG, Loayza Villarroel K, Clarke M, Power LC, Gibney ER, Dominguez Castro P. Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: a systematic review and narrative synthesis. BMC Geriatr 2021; 21:676. [PMID: 34863118 PMCID: PMC8642873 DOI: 10.1186/s12877-021-02583-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malnutrition negatively impacts on health, quality of life and disease outcomes in older adults. The reported factors associated with, and determinants of malnutrition, are inconsistent between studies. These factors may vary according to differences in rate of ageing. This review critically examines the evidence for the most frequently reported sociodemographic factors and determinants of malnutrition and identifies differences according to rates of ageing. METHODS A systematic search of the PubMed Central and Embase databases was conducted in April 2019 to identify papers on ageing and poor nutritional status. Numerous factors were identified, including factors from demographic, food intake, lifestyle, social, physical functioning, psychological and disease-related domains. Where possible, community-dwelling populations assessed within the included studies (N = 68) were categorised according to their ageing rate: 'successful', 'usual' or 'accelerated'. RESULTS Low education level and unmarried status appear to be more frequently associated with malnutrition within the successful ageing category. Indicators of declining mobility and function are associated with malnutrition and increase in severity across the ageing categories. Falls and hospitalisation are associated with malnutrition irrespective of rate of ageing. Factors associated with malnutrition from the food intake, social and disease-related domains increase in severity in the accelerated ageing category. Having a cognitive impairment appears to be a determinant of malnutrition in successfully ageing populations whilst dementia is reported to be associated with malnutrition within usual and accelerated ageing populations. CONCLUSIONS This review summarises the factors associated with malnutrition and malnutrition risk reported in community-dwelling older adults focusing on differences identified according to rate of ageing. As the rate of ageing speeds up, an increasing number of factors are reported within the food intake, social and disease-related domains; these factors increase in severity in the accelerated ageing category. Knowledge of the specific factors and determinants associated with malnutrition according to older adults' ageing rate could contribute to the identification and prevention of malnutrition. As most studies included in this review were cross-sectional, longitudinal studies and meta-analyses comprehensively assessing potential contributory factors are required to establish the true determinants of malnutrition.
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Affiliation(s)
- Laura A Bardon
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland.
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland.
| | - Clare A Corish
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Meabh Lane
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
| | - Maria Gabriella Bizzaro
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Katherine Loayza Villarroel
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Michelle Clarke
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Lauren C Power
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
| | - Eileen R Gibney
- School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
| | - Patricia Dominguez Castro
- Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland
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6
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Coelho-Júnior HJ, Uchida MC. Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults. Front Med (Lausanne) 2021; 8:702436. [PMID: 34381802 PMCID: PMC8350041 DOI: 10.3389/fmed.2021.702436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/22/2021] [Indexed: 12/19/2022] Open
Abstract
Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people. Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity. Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate. Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT. Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
| | - Marco Carlos Uchida
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
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7
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Bardon LA, Streicher M, Corish CA, Clarke M, Power LC, Kenny RA, O'Connor DM, Laird E, O'Connor EM, Visser M, Volkert D, Gibney ER. Predictors of Incident Malnutrition in Older Irish Adults from the Irish Longitudinal Study on Ageing Cohort-A MaNuEL study. J Gerontol A Biol Sci Med Sci 2020; 75:249-256. [PMID: 30256900 DOI: 10.1093/gerona/gly225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Indexed: 11/12/2022] Open
Abstract
Older adults are at increased risk of malnutrition, which is associated with poorer health, quality of life, and worse disease outcomes. This study identifies predictors of incident malnutrition using data from a subsample (n = 1,841) of The Irish Longitudinal Study on Ageing. Participants were excluded if they were less than 65 years, missing body mass index data at baseline or follow-up, missing baseline weight loss data or malnourished at baseline (body mass index <20 kg/m2 or unplanned weight loss ≥4.5 kg in the previous year). Logistic regression analysis was performed with incident malnutrition (body mass index <20 kg/m2 and/or calculated weight loss >10% over follow-up) as the dependent variable. Factors showing significant (p < .05) univariate associations with incident malnutrition were entered into a multivariate model. The analysis was then repeated, stratified by sex. The 2-year incidence of malnutrition was 10.7%. Unmarried/separated/divorced status (vs married but not widowed), hospitalization in the previous year, difficulties walking 100 m, or climbing stairs independently predicted incident malnutrition at follow-up. When examined by sex, hospitalization in the previous year, falls during follow-up, and self-reported difficulties climbing stairs predicted malnutrition in males. Receiving social support and cognitive impairment predicted malnutrition in females. The development of malnutrition has a range of predictors. These can be assessed using simple questions to identify vulnerable persons.
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Affiliation(s)
- Laura A Bardon
- UCD School of Agriculture and Food Science, University College Dublin, Ireland.,UCD Institute of Food and Health, University College Dublin, Ireland
| | - Melanie Streicher
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Clare A Corish
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.,UCD Institute of Food and Health, University College Dublin, Ireland
| | - Michelle Clarke
- UCD School of Agriculture and Food Science, University College Dublin, Ireland.,UCD Institute of Food and Health, University College Dublin, Ireland
| | - Lauren C Power
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.,UCD Institute of Food and Health, University College Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin.,Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Deirdre M O'Connor
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin.,Department of Medical Gerontology, Trinity College Dublin, Ireland
| | - Eamon Laird
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland.,School of Medicine, Trinity College Dublin, Ireland
| | - Eibhlis M O'Connor
- Department of Biological Sciences, University of Limerick, Ireland.,Health Research Institute, University of Limerick, Ireland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije University Amsterdam, The Netherlands
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Eileen R Gibney
- UCD School of Agriculture and Food Science, University College Dublin, Ireland.,UCD Institute of Food and Health, University College Dublin, Ireland
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8
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Lee SA, Joshi P, Kim Y, Kang D, Kim WJ. The Association of Dietary Macronutrients with Lung Function in Healthy Adults Using the Ansan-Ansung Cohort Study. Nutrients 2020; 12:nu12092688. [PMID: 32899146 PMCID: PMC7551845 DOI: 10.3390/nu12092688] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
This study is aimed to examine the association between macronutrient intake and lung function in healthy adults (n = 5880) using the Ansan-Ansung cohort study. To identify the index of lung function, we used the percentage difference of predicted Forced Expiratory Volume (%FEV1_diff) between baseline and follow-up. Based on the median %FEV1_diff, subjects were classified by two groups as “decreased vs. unchanged/improved”. The dietary macronutrients were estimated and validated using the food-frequency questionnaire. Multiple logistic regression models were used to evaluate the association after adjusting for confounders. Advanced analysis examined the association after stratifying by age and obesity. The average of %FEV1 is 114.1 and 112.5 at baseline and follow-up, respectively. The positive association of protein and fiber intake with lung function was observed in men. Low fat and high carbohydrate intake decreased the lung function in women only. After stratification by age, the association of protein, fat, and carbohydrate intake with lung function was observed in young men and old women only. Otherwise, the association of protein and fiber with lung function was influenced by abdominal obesity. In conclusion, the lung function was positively associated with high protein and fat intake, but was negatively associated with high carbohydrate intake, which could be influenced by age and obesity.
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Affiliation(s)
- Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; (P.J.); (Y.K.)
- Division of Epidemiology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashuville, TN 37232, USA
- Correspondence: (S.-A.L.); (W.J.K.); Tel.: +84-33-250-8871 (S.-A.L.)
| | - Pankaj Joshi
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; (P.J.); (Y.K.)
| | - Yeonjin Kim
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; (P.J.); (Y.K.)
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 03080, Korea;
| | - Woo Jin Kim
- Department of Internal Medicine, School of Medicine, Kangwon National University, 1, Kangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea
- Environmental Health Center, 156, Baengnyeong-ro, Chuncheon-si, Gangwon-do 24289, Korea
- Correspondence: (S.-A.L.); (W.J.K.); Tel.: +84-33-250-8871 (S.-A.L.)
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Abstract
An individual who is living with frailty has impairments in homeostasis across several body systems and is more vulnerable to stressors that may ultimately predispose them to negative health-related outcomes, disability and increased healthcare use. Approximately a quarter of individuals aged > 85 years are living with frailty and as such the identification of those who are frail is a public health priority. Given that the syndrome of frailty is defined by progressive and gradual loss of physiological reserves there is much scope to attempt to modify the trajectory of the frailty syndrome via physical activity and nutritional interventions. In this review we give an up to date account on the identification of frailty in clinical practice and offer insights into physical activity and nutritional strategies that may be beneficial to modify or reverse the frailty syndrome.
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10
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Effects of slow- v. fast-digested protein supplementation combined with mixed power training on muscle function and functional capacities in older men. Br J Nutr 2020; 125:1017-1033. [PMID: 32498755 DOI: 10.1017/s0007114520001932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Ageing leads to a progressive loss of muscle function (MF) and quality (MQ: muscle strength (MS)/lean muscle mass (LM)). Power training and protein (PROT) supplementation have been proposed as efficient interventions to improve MF and MQ. Discrepancies between results appear to be mainly related to the type and/or dose of proteins used. The present study aimed at determining whether or not mixed power training (MPT) combined with fast-digested PROT (F-PROT) leads to greater improvements in MF and MQ in elderly men than MPT combined with slow-digested PROT (S-PROT) or MPT alone. Sixty elderly men (age 69 (sd 7) years; BMI 18-30 kg/m2) were randomised into three groups: (1) placebo + MPT (PLA; n 19); (2) F-PROT + MPT (n 21) and (3) S-PROT + MPT (n 20) completed the intervention. LM, handgrip and knee extensor MS and MQ, functional capacity, serum metabolic markers, skeletal muscle characteristics, dietary intake and total energy expenditure were measured. The interventions consisted in 12 weeks of MPT (3 times/week; 1 h/session) combined with a supplement (30 g:10 g per meal) of F-PROT (whey) or S-PROT (casein) or a placebo. No difference was observed among groups for age, BMI, number of steps and dietary intake pre- and post-intervention. All groups improved significantly their LM, lower limb MS/MQ, functional capacity, muscle characteristics and serum parameters following the MPT. Importantly, no difference between groups was observed following the MPT. Altogether, adding 30 g PROT/d to MPT, regardless of the type, does not provide additional benefits to MPT alone in older men ingesting an adequate (i.e. above RDA) amount of protein per d.
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11
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Protein Intake at Twice the RDA in Older Men Increases Circulatory Concentrations of the Microbiome Metabolite Trimethylamine-N-Oxide (TMAO). Nutrients 2019; 11:nu11092207. [PMID: 31547446 PMCID: PMC6770800 DOI: 10.3390/nu11092207] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 12/26/2022] Open
Abstract
Higher dietary protein intake is increasingly recommended for the elderly; however, high protein diets have also been linked to increased cardiovascular disease (CVD) risk. Trimethylamine-N-oxide (TMAO) is a bacterial metabolite derived from choline and carnitine abundant from animal protein-rich foods. TMAO may be a novel biomarker for heightened CVD risk. The purpose of this study was to assess the impact of a high protein diet on TMAO. Healthy men (74.2 ± 3.6 years, n = 29) were randomised to consume the recommended dietary allowance of protein (RDA: 0.8 g protein/kg bodyweight/day) or twice the RDA (2RDA) as part of a supplied diet for 10 weeks. Fasting blood samples were collected pre- and post-intervention for measurement of TMAO, blood lipids, glucose tolerance, insulin sensitivity, and inflammatory biomarkers. An oral glucose tolerance test was also performed. In comparison with RDA, the 2RDA diet increased circulatory TMAO (p = 0.002) but unexpectedly decreased renal excretion of TMAO (p = 0.003). LDL cholesterol was increased in 2RDA compared to RDA (p = 0.049), but no differences in other biomarkers of CVD risk and insulin sensitivity were evident between groups. In conclusion, circulatory TMAO is responsive to changes in dietary protein intake in older healthy males.
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12
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Changes in Nutritional Status and Musculoskeletal Health in a Geriatric Post-Fall Care Plan Setting. Nutrients 2019; 11:nu11071551. [PMID: 31324009 PMCID: PMC6682897 DOI: 10.3390/nu11071551] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 12/29/2022] Open
Abstract
Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA®), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA <24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, p < 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.
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13
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Trevisan C, Crippa A, Ek S, Welmer AK, Sergi G, Maggi S, Manzato E, Bea JW, Cauley JA, Decullier E, Hirani V, LaMonte MJ, Lewis CE, Schott AM, Orsini N, Rizzuto D. Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2018; 20:569-582.e7. [PMID: 30554987 DOI: 10.1016/j.jamda.2018.10.027] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/18/2018] [Accepted: 10/21/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To evaluate the association between nutritional status, defined on the basis of a multidimensional evaluation, and body mass index (BMI) with the risk of falls and recurrent falls in community-dwelling older people. DESIGN Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS Community-dwelling older adults. MEASURES A systematic literature review was conducted on prospective studies identified through electronic and hand searches until October 2017. A random effects meta-analysis was used to evaluate the relative risk (RR) of experiencing falls and recurrent falls (≥2 falls within at least 6 months) on the basis of nutritional status, defined by multidimensional scores. A random effects dose-response meta-analysis was used to evaluate the association between BMI and the risk of falls and recurrent falls. RESULTS People who were malnourished or those at risk for malnutrition had a pooled 45% higher risk of experiencing at least 1 fall than were those well-nourished (9510 subjects). Increased falls risk was observed in subjects malnourished versus well-nourished [RR 1.64, 95% confidence interval (CI) 1.18-2.28; 3 studies, 8379 subjects], whereas no substantial results were observed for risk of recurrent falls. A U-shaped association was detected between BMI and the risk for falls (P < .001), with the nadir between 24.5 and 30 (144,934 subjects). Taking a BMI of 23.5 as reference, the pooled RR of falling ranged between 1.09 (95% CI 1.04-1.15) for a BMI of 17, to 1.07 (95% CI 0.92-1.24) for a BMI of 37.5. No associations were observed between BMI and recurrent falls (120,185 subjects). CONCLUSIONS/IMPLICATIONS The results of our work suggest therefore that nutritional status and BMI should be evaluated when assessing the risk for falls in older age.
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Affiliation(s)
- Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy.
| | - Alessio Crippa
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Stina Ek
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Anna-Karin Welmer
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Enzo Manzato
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy; National Research Council, Neuroscience Institute, Padova, Italy
| | - Jennifer W Bea
- Department of Medicine, College of Medicine, Tucson, AZ; Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Evelyne Decullier
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France
| | - Vasant Hirani
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY
| | - Cora E Lewis
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Anne-Marie Schott
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France; Université de Lyon, EA Health Services and Performance Research (HESPER), Lyon, France
| | - Nicola Orsini
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Coelho-Júnior HJ, Milano-Teixeira L, Rodrigues B, Bacurau R, Marzetti E, Uchida M. Relative Protein Intake and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2018; 10:nu10091330. [PMID: 30235845 PMCID: PMC6163569 DOI: 10.3390/nu10091330] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/03/2018] [Accepted: 09/13/2018] [Indexed: 12/25/2022] Open
Abstract
(1) Background: The present work aims to conduct a systematic review and meta-analysis of observational studies, in order to investigate the association of relative protein intake and physical function in older adults; (2) Methods: Observational studies, that investigated the association between protein intake and physical function in older adults, were retrieved from MEDLINE, SCOPUS, CINAHL, AgeLine, EMBASE, and Cochrane-CENTRAL. Two independent researchers conducted study selection and data extraction; (3) Results: Very high protein intake (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) groups showed better lower limb physical functioning and walking speed (WS) performance, respectively, in comparison to individuals who present relative low protein (<0.80 g/kg/day) intake. On the other hand, relative high protein intake does not seem to propitiate a better performance on isometric handgrip (IHG) and chair rise in comparison to relative low protein intake. In addition, there were no significant differences in the physical functioning of high and middle protein intake groups; (4) Conclusions: In conclusion, findings of the present study indicate that a very high (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) are associated with better lower-limb physical performance, when compared to low protein (<0.80 g/kg/day) intake, in community-dwelling older adults. These findings act as additional evidence regarding the potential need to increase protein guidelines to above the current recommendations. However, large randomized clinical trials are needed to confirm the addictive effects of high-protein diets (≥1.0 g/kg/day) in comparison to the current recommendations on physical functioning. All data are available in the Open ScienceFramework.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
- Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital "Agostino Gemelli", Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Luiz Milano-Teixeira
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
| | - Bruno Rodrigues
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
| | - Reury Bacurau
- School of Arts, Sciences and Humanities, University of São Paulo, Rua Arlindo Béttio, 1000-Ermelino Matarazzo, São Paulo-SP 03828-000, Brazil.
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital "Agostino Gemelli", Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Marco Uchida
- Applied Kinesiology Laboratory⁻AKL, School of Physical Education, University of Campinas, Av. Érico Veríssimo, 701, Cidade Universitária "Zeferino Vaz", Barão Geraldo, Campinas-SP 13.083-851, Brazil.
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15
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Niccoli S, Kolobov A, Bon T, Rafilovich S, Munro H, Tanner K, Pearson T, Lees SJ. Whey Protein Supplementation Improves Rehabilitation Outcomes in Hospitalized Geriatric Patients: A Double Blinded, Randomized Controlled Trial. J Nutr Gerontol Geriatr 2018; 36:149-165. [PMID: 29252150 DOI: 10.1080/21551197.2017.1391732] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Whey protein supplementation (WPS) has been shown to improve functional outcomes in populations that are able to participate in high-intensity resistance training. The purpose of the study was to evaluate the efficacy of WPS on rehabilitation outcomes in a frail, hospitalized elderly population. Men and women (n = 47) were randomly assigned to either a control group or WPS group for the length of their hospital stay. Several functional and serum measures were determined pre- and post-intervention. WPS significantly increased average daily protein intake and was well tolerated. The WPS group exhibited significant improvements in grip strength and knee extensor force over the control group, and a significant positive correlation was found between change in prealbumin and percent-increase knee extensor force. These findings support the use of WPS to improve protein nutritional status and rehabilitation outcomes in a clinical setting involving a frail, elderly population.
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Affiliation(s)
- Sarah Niccoli
- a Medical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Anton Kolobov
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada.,c Clinical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Trevor Bon
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada.,c Clinical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Seda Rafilovich
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada.,c Clinical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada
| | - Heather Munro
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada
| | - Kim Tanner
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada
| | - Trina Pearson
- b Geriatric Assessment and Rehabilitative Care , St. Joseph's Care Group , Thunder Bay , Ontario , Canada
| | - Simon J Lees
- a Medical Sciences Division , Northern Ontario School of Medicine , Thunder Bay , Ontario , Canada.,d Department of Biology , Lakehead University , Thunder Bay , Ontario , Canada.,e Health and Exercise Science , Colorado State University , Fort Collins , Colorado , USA
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16
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Wei K, Nyunt MSZ, Gao Q, Wee SL, Yap KB, Ng TP. Association of Frailty and Malnutrition With Long-term Functional and Mortality Outcomes Among Community-Dwelling Older Adults: Results From the Singapore Longitudinal Aging Study 1. JAMA Netw Open 2018; 1:e180650. [PMID: 30646023 PMCID: PMC6324309 DOI: 10.1001/jamanetworkopen.2018.0650] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Physical frailty and malnutrition are prevalent among older adults and may be associated with functional and mortality outcomes. OBJECTIVE To assess the health outcomes associated with physical frailty and malnutrition singly and in combination among older adults. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study (Singapore Longitudinal Aging Study 1). Included were 2804 community-dwelling adults in Singapore aged 55 years or older at baseline (September 1, 2003, to December 23, 2005), with 2 follow-ups at 2- to 3-year intervals (from March 7, 2005, to September 10, 2007, and from November 13, 2007, to December 12, 2009) and a 12-year mortality follow-up to March 31, 2017. Data analysis was from July 1 to September 28, 2017. MAIN OUTCOMES AND MEASURES Baseline physical frailty (Fried criteria) with participants categorized according to the total score as frail (3-5 points), prefrail (1-2 points), or robust (0 point), and nutritional status (Nutrition Screening Initiative DETERMINE Your Nutritional Health Checklist and Mini Nutritional Assessment Short-Form [MNA-SF]). Baseline (prevalent) and follow-up (incident) instrumental/basic activities of daily living (IADL/ADL) disability, poor quality of life (QOL), and mortality were measured. Estimates of association were by odds ratios (ORs) and hazard ratios (HRs) and their 95% CIs. RESULTS The participants (mean [SD] age, 66.0 [7.7] years; 1033 [36.8%] male; 2611 [93.1%] Chinese) included 1021 (37.6%) categorized as robust with MNA-SF normal nutrition (R-NN), 330 (12.2%) robust with MNA-SF at risk/malnourished (R-ARM), 734 (27.0%) prefrail/frail with MNA-SF normal nutrition (PFF-NN), and 631 (23.2%) prefrail/frail with MNA-SF at risk/malnourished (PFF-ARM). Among these 2804 participants, 44 had missing frailty status, and 78 had missing MNA-SF nutritional status; therefore, 88 participants in total had missing frailty-nutritional status. In cross-sectional analyses, the prevalence of IADL/ADL disability was lowest among the R-NN group (169 [16.9%]) and increased substantially only among the PFF-ARM group (249 [40.2%]) (OR, 1.88; 95% CI, 1.40-2.53). Poor QOL prevalence was lowest among the R-NN group (142 [14.1%]), and the increase in other frailty and nutritional status groups was highest in the PFF-ARM group (255 [41.3%]) (OR, 2.61; 95% CI, 1.96-3.49). In longitudinal analyses, significant association with only incident poor QOL across frailty and nutritional status groups was highest in the PFF-ARM group (89 [34.8%]) compared with the R-NN group (132 [19.2%]) (OR, 1.70; 95% CI, 1.17-2.48). The mortality rate was lowest in the R-NN group (0.54 per 100 person-years) and highest in the PFF-ARM group (3.04 per 100 person-years) (HR, 1.72; 95% CI, 1.01-2.92). The results based on the Nutrition Screening Initiative measure of nutritional status were similar. CONCLUSIONS AND RELEVANCE Reported adverse health outcomes attributed to poor nutrition often appear more likely to be associated with physical frailty. Prefrail/frail older persons with poor nutrition might be targeted for interventions to prevent or delay adverse functional and mortality outcomes.
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Affiliation(s)
- Kai Wei
- Geriatric Education and Research Institute, Singapore
- currently with Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ma-Shwe-Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Shiou-Liang Wee
- Geriatric Education and Research Institute, Singapore
- Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore
| | - Keng-Bee Yap
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore
| | - Tze-Pin Ng
- Geriatric Education and Research Institute, Singapore
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
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17
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Mustafa J, Ellison RC, Singer MR, Bradlee ML, Kalesan B, Holick MF, Moore LL. Dietary Protein and Preservation of Physical Functioning Among Middle-Aged and Older Adults in the Framingham Offspring Study. Am J Epidemiol 2018; 187:1411-1419. [PMID: 29590270 PMCID: PMC7427817 DOI: 10.1093/aje/kwy014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 01/22/2018] [Indexed: 01/05/2023] Open
Abstract
Dietary protein may help prevent age-related declines in strength and functional
capacity. This study examines the independent relationship between dietary protein and
longitudinal changes in physical functioning among adults participating in the Framingham
Offspring Study from examination 5 (1991–1995) to examination 8 (2005–2008). Protein
intakes were derived from 3-day diet records during examinations 3 and 5; functional
status was determined over 12 years using 7 items selected from standardized
questionnaires. Multivariable models adjusted for age, sex, education, physical activity,
smoking, height, and energy intake. Functional tasks that benefitted most from a
higher-protein diet (≥1.2 g/kg/day vs. <0.8 g/kg/day) were doing heavy work at home,
walking 1/2 mile (0.8 km), going up and down stairs, stooping/kneeling/crouching, and
lifting heavy items. Those with higher protein intakes were 41% less likely (95% CI: 0.43,
0.82) to become dependent in 1 or more of the functional tasks over follow-up. Higher
physical activity and lower body mass index were both independently associated with less
functional decline. The greatest risk reductions were found among those with higher
protein intakes combined with either higher physical activity, more skeletal muscle mass,
or lower body mass index. This study demonstrates that dietary protein intakes above the
current US Recommended Daily Allowance may slow functional decline in older adults.
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Affiliation(s)
- Jabed Mustafa
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - R Curtis Ellison
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Martha R Singer
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - M Loring Bradlee
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Bindu Kalesan
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Michael F Holick
- Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Lynn L Moore
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
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18
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Differences in muscle adaptation to a 12-week mixed power training in elderly men, depending on usual protein intake. Exp Gerontol 2018; 104:78-85. [PMID: 29421607 DOI: 10.1016/j.exger.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Normal aging is often associated with a decline of muscle mass (MM), strength (MS) and quality (MQ: MS/MM), leading to functional incapacities. This aging-related deterioration of muscles may involve a decreased protein intake. Mixed power training has been recently shown to induce positive effects on MM, MS and MQ. However, to our knowledge, no study has examined if muscle adaptations following mixed power training could be influenced by the daily amount of protein ingested in elderly men. METHODS Twenty-one men completed the intervention and were divided into 2 groups based on their usual protein intake: PROT 1.1- (<1.1 g·kg-1·d-1 [n = 10; 73 ± 3 years]) and PROT 1.2+ (>1.2 g·kg-1·d-1 [n = 11; 73 ± 3 years]). Body composition (DXA: lean and fat masses), MS (1-maximal repetition on leg-press and handgrip strength), MQ (MS/body mass and MS/lower limb lean mass), functional capacities (Short Physical Performance Battery/Senior Fitness Test), dietary intake (3-day food record) and energy expenditure (accelerometer; 7 days) were measured. Mixed power training intervention consisted in power and functional exercises (12 weeks; 3 times/week; 1 h/session). RESULTS Lower limb MS increase in the PROT 1.2+ group was greater from that of the PROT 1.1- group when normalized to lower limbs lean mass (p = 0.036). In addition, a trend for greater gain in lower limb MS normalized to body mass (p = 0.053) was observed in the PROT 1.2+. CONCLUSION To optimize mixed power training effects on muscle function, healthy older men should ingest daily at least 1.2 g·kg-1·d-1 of protein. These beneficial effects of a higher usual protein intake were observed especially for MQ, which is one of the best predictors of functional capacities in older adults.
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19
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Ispoglou T, Deighton K, King RF, White H, Lees M. Novel essential amino acid supplements enriched with L-leucine facilitate increased protein and energy intakes in older women: a randomised controlled trial. Nutr J 2017; 16:75. [PMID: 29183324 PMCID: PMC5704600 DOI: 10.1186/s12937-017-0298-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/20/2017] [Indexed: 12/27/2022] Open
Abstract
Background Inadequate protein intake (PI), containing a sub-optimal source of essential amino acids (EAAs), and reduced appetite are contributing factors to age-related sarcopenia. The satiating effects of dietary protein per se may negatively affect energy intake (EI), thus there is a need to explore alternative strategies to facilitate PI without compromising appetite and subsequent EI. Methods Older women completed two experiments (EXP1 and EXP2) where they consumed either a Bar (565 kJ), a Gel (477 kJ), both rich in EAAs (7.5 g, 40% L-leucine), or nothing (Control). In EXP1, participants (n = 10, 68 ± 5 years, mean ± SD) consumed Bar, Gel or Control with appetite sensations and appetite-related hormonal responses monitored for one hour, followed by consumption of an ad libitum breakfast (ALB). In EXP2, participants (n = 11, 69 ± 5 years) ingested Bar, Gel or Control alongside an ALB. Results In EXP1, EI at ALB was not different (P = 0.674) between conditions (1179 ± 566, 1254 ± 511, 1206 ± 550 kJ for the Control, Bar, and Gel respectively). However, total EI was significantly higher in the Bar and Gel compared to the Control after accounting for the energy content of the supplements (P < 0.0005). Analysis revealed significantly higher appetite Area under the Curve (AUC) (P < 0.007), a tendency for higher acylated ghrelin AUC (P = 0.087), and significantly lower pancreatic polypeptide AUC (P = 0.02) in the Control compared with the Bar and Gel. In EXP2, EI at ALB was significantly higher (P = 0.028) in the Control (1282 ± 513 kJ) compared to the Bar (1026 ± 565 kJ) and Gel (1064 ± 495 kJ). However, total EI was significantly higher in the Bar and Gel after accounting for the energy content of the supplements (P < 0.007). Conclusions Supplementation with either the Bar or Gel increased total energy intake whether consumed one hour before or during breakfast. This may represent an effective nutritional means for addressing protein and total energy deficiencies in older women. Trial registration Clinical trial register: retrospectively registered, ISRCTN12977929 on.
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Affiliation(s)
- Theocharis Ispoglou
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK. .,Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK.
| | - Kevin Deighton
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK
| | - Roderick Fgj King
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK
| | - Helen White
- School of Applied and Clinical Sciences, Leeds Beckett University, CL413 Calverley Building Civic Quarter, Leeds, LS1 3HE, UK
| | - Matthew Lees
- Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Fairfax Hall, Leeds, LS6 3QS, UK
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Vu HTT, Nguyen TX, Nguyen TN, Nguyen AT, Cumming R, Hilmer S, Pham T. Prevalence of frailty and its associated factors in older hospitalised patients in Vietnam. BMC Geriatr 2017; 17:216. [PMID: 28923012 PMCID: PMC5603186 DOI: 10.1186/s12877-017-0609-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 09/06/2017] [Indexed: 02/07/2023] Open
Abstract
Background Frailty is an emerging issue in geriatrics and gerontology. The prevalence of frailty is increasing as the population ages. Like many developing countries, Vietnam has a rapidly ageing population. However, there have been no studies about frailty in older people in Vietnam. This study aims to investigate the prevalence of frailty and its associated factors in older hospitalised patients at the National Geriatric Hospital in Hanoi, Vietnam. Methods Prospective observational study in inpatients aged ≥60 years at the National Geriatric Hospital in Hanoi, Vietnam from 4/2015 to 10/2015. Frailty was assessed using the Reported Edmonton Frail Scale (REFS) and Fried frailty phenotype. Results A total of 461 patients were recruited (56.8% female, mean age 76.2 ± 8.9 years). The prevalence of frailty was 31.9% according to the REFS. Using the Fried frailty criteria, the percentages of non-frail, pre-frail and frail participants were 24.5, 40.1 and 35.4%, respectively. Factors associated with frailty defined by REFS were age (OR 1.05 per year, 95% CI 1.03–1.08), poor reported nutritional status (OR 4.51, 95% CI 2.15–9.44), and not finishing high school (OR 2.18, 95% CI 1.37–3.46). Factors associated with frailty defined by the Fried frailty criteria included age (OR 1.07 per year, 95% CI 1.05–1.10), poor reported nutritional status (OR 2.96, 95%CI 1.43–6.11), not finishing high school (OR 1.58, 95% CI 1.01–2.46) and cardiovascular disease (OR 1.76, 95% CI 1.16–2.67). Conclusions While further studies are needed to examine the impact of frailty on outcomes in Vietnam, the observed high prevalence of frailty in older inpatients is likely to have implications for health policy and planning for the ageing population in Vietnam.
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Affiliation(s)
- Huyen Thi Thanh Vu
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam. .,The National Geriatric Hospital, 01 Ton That Tung, Hanoi, Vietnam.
| | | | - Tu N Nguyen
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam.,The National Geriatric Hospital, 01 Ton That Tung, Hanoi, Vietnam
| | - Anh Trung Nguyen
- The National Geriatric Hospital, 01 Ton That Tung, Hanoi, Vietnam
| | - Robert Cumming
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Sarah Hilmer
- Departments of Clinical Pharmacology and Aged Care, Royal North Shore Hospital and Kolling Institute of Medical Research, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Thang Pham
- Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam.,The National Geriatric Hospital, 01 Ton That Tung, Hanoi, Vietnam
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Fukuda Y, Ishikawa M, Yokoyama T, Hayashi T, Nakaya T, Takemi Y, Kusama K, Yoshiike N, Nozue M, Yoshiba K, Murayama N. Physical and social determinants of dietary variety among older adults living alone in Japan. Geriatr Gerontol Int 2017; 17:2232-2238. [DOI: 10.1111/ggi.13004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 11/25/2016] [Accepted: 12/19/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Yoshiharu Fukuda
- Teikyo University; Graduate School of Public Health; Itabashi Japan
| | | | | | | | | | | | - Kaoru Kusama
- Aomori University of Health and Welfare; Aomori Japan
| | | | - Miho Nozue
- National institutes of Biomedical Innovation; Health and Nutrition; Shinjuku Japan
| | - Kaori Yoshiba
- Japan Association for Development of Community Medicine; Chiyoda Japan
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22
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The determinants of malnutrition in the Irish elderly population: preliminary results from The Irish Longitudinal Study on Ageing (TILDA). Proc Nutr Soc 2017. [DOI: 10.1017/s0029665117001884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Martinez JA, Wertheim BC, Thomson CA, Bea JW, Wallace R, Allison M, Snetselaar L, Chen Z, Nassir R, Thompson PA. Physical Activity Modifies the Association between Dietary Protein and Lean Mass of Postmenopausal Women. J Acad Nutr Diet 2016; 117:192-203.e1. [PMID: 27914915 DOI: 10.1016/j.jand.2016.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 10/04/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Maintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women. OBJECTIVE Our aim was to evaluate whether the association between dietary protein and lean mass differs by physical activity level, amino acid composition, and body mass index categories. DESIGN We performed a cross-sectional analysis of a prospective cohort. PARTICIPANTS/SETTING Participants were postmenopausal women from the Women's Health Initiative with body composition measurements by dual-energy x-ray absorptiometry (n=8,298). MAIN OUTCOME MEASURES Our study measured percent lean mass, percent fat mass, and lean body mass index. STATISTICAL ANALYSES PERFORMED Linear regression models adjusted for scanner serial number, age, calibrated energy intake, race/ethnicity, neighborhood socioeconomic status, and recreational physical activity were used to determine the relationship between protein intake and body composition measures. Likelihood ratio tests and stratified analysis were used to investigate physical activity and body mass index as potential effect modifiers. RESULTS Biomarker-calibrated protein intake was positively associated with percent lean mass; women in the highest protein quintile had 6.3 percentage points higher lean mass than the lowest quintile (P<0.001). This difference rose to 8.5 percentage points for physically active women in the highest protein quintile (Pinteraction=0.023). Percent fat mass and lean body mass index were both inversely related to protein intake (both P<0.001). Physical activity further reduced percent fat mass (Pinteraction=0.022) and lean body mass index (Pinteraction=0.011). Leucine intake was associated with lean mass, as were branched chain amino acids combined (both P<0.001), but not independent of total protein. All associations were observed for normal-weight, overweight, and obese women. CONCLUSIONS Protein consumption up to 2.02 g/kg body weight daily is positively associated with lean mass in postmenopausal women. Importantly, those that also engage in physical activity have the highest lean mass across body mass index categories.
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Hamirudin AH, Walton K, Charlton K, Carrie A, Tapsell L, Milosavljevic M, Pang G, Potter J. Feasibility of home-based dietetic intervention to improve the nutritional status of older adults post-hospital discharge. Nutr Diet 2016; 74:217-223. [PMID: 28731606 DOI: 10.1111/1747-0080.12305] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/19/2016] [Accepted: 06/10/2016] [Indexed: 11/30/2022]
Abstract
AIM To determine if a model of home-based dietetic care improves dietary intake and weight status in a specific group of older adults post-hospitalisation. METHODS The Department of Veterans' Affairs clients aged 65 years and over were recruited from hospitals in a regional area of New South Wales, Australia (n = 32 men, n = 36 women). Nutritional status was assessed at home at baseline (within two weeks post-discharge) and three months post-discharge using a diet history, a food frequency checklist and Mini Nutritional Assessment (MNA). Personalised dietary advice was provided by a single dietitian according to participants' nutritional status. RESULTS Mean body weight improved significantly (P = 0.048), as well as mean MNA score (21.9 ± 3.5 vs 25.2 ± 3.1) (P < 0.001). Mean energy, protein and micronutrient intakes were adequate at baseline and three months, except for vitamin D. At three months, the underweight group (body mass index (BMI) < 23 kg/m2 ) had significantly higher mean protein intake per body weight (1.7 ± 0.4 g/kg) compared to those who were a desirable weight (BMI 23-27 kg/m2 ) (1.4 ± 0.3 g/kg) or overweight (BMI>27 kg/m2 ) (1.1 ± 0.3 g/kg) peers (P < 0.001). There was significant improvement in energy intake contributed from oral nutrition supplements (+95.5 ± 388.2 kJ/day) and milk (+259.6 ± 659.8 kJ/day). CONCLUSIONS Dietetic intervention improved nutritional status 3 months after hospital discharge in older adults living in the community.
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Affiliation(s)
- Aliza Haslinda Hamirudin
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Karen Walton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Karen Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Amanda Carrie
- Illawarra Shoalhaven Local Health District, New South Wales Health, Wollongong, New South Wales, Australia
| | - Linda Tapsell
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Marianna Milosavljevic
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, New South Wales Health, Wollongong, New South Wales, Australia
| | - Glen Pang
- Agency for Clinical Innovation, New South Wales Health, Sydney, New South Wales, Australia
| | - Jan Potter
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, New South Wales Health, Wollongong, New South Wales, Australia
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Otsuka R, Kato Y, Nishita Y, Tange C, Tomida M, Nakamoto M, Imai T, Ando F, Shimokata H. Age-related Changes in Energy Intake and Weight in Community-dwelling Middle-aged and Elderly Japanese. J Nutr Health Aging 2016; 20:383-90. [PMID: 26999237 DOI: 10.1007/s12603-016-0715-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study attempts to describe trends in energy intake and weight change over 12 years according to age at first participation in the study. DESIGN Prospective cohort study. SETTING The National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA), a community-based study. PARTICIPANTS Participants included 922 men and 879 women who participated in the first study-wave (age 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Each study-wave was conducted biennially. For individuals, the entire follow-up period was 12 years. MEASUREMENTS Energy intake was calculated from 3-day dietary records with photographs. Weight and height were measured under a fasting state. To estimate linear changes in energy intake and weight over 12 years according to age at first study-wave, we used the mixed-effects model. RESULTS Mean (SD) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8) times, respectively. The fixed effect of the interaction of age and time in energy intake and weight was statistically or marginally statistically significant both in men (p<0.01) and in women (p<0.06). In men, when energy intake was estimated according to age, the rate of decrease in energy intake increased from -6.8 to -33.8 kcal/year for ages 40-79 years. In women, the rate of decrease in energy intake slightly increased in older age groups (-9.1 to -16.7 kcal/year for ages 40-79 years). Weight increased in males in their 40s (0.07 kg/year from age 40) and started to decline by age 53. In women, weight started to decline around age 47 (-0.04 kg/year). CONCLUSION Twelve-year longitudinal data showed energy intake declined both in men and women in their 40s, and the rate of decrease increased in older males. Weight started to decline in men in their mid-50s and women in their late 40s. Further studies that focus on energy intake and weight reduction are needed to prevent weight loss or underweight in an increasingly aging society.
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Affiliation(s)
- R Otsuka
- Rei Otsuka, Section of NILS-LSA, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi 474-8511, Japan; , Tel: +81-562-46-2311, Fax: +81-562-44-6593
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Growing older with health and vitality: a nexus of physical activity, exercise and nutrition. Biogerontology 2016; 17:529-46. [PMID: 26878863 PMCID: PMC4889705 DOI: 10.1007/s10522-016-9637-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/02/2016] [Indexed: 02/07/2023]
Abstract
The preservation of skeletal muscle mass and strength with advancing age are, we propose, critical aspects of ageing with health and vitality. Physical inactivity and poor nutrition are known to accelerate the gradual age-related decline in muscle mass and strength—sarcopenia—however, both are subject to modification. The main purpose of this review is to present the latest, evidence-based recommendations for physical activity and exercise, as well as diet for older adults that would help in preserving muscle mass and strength. We take the position that future physical activity/exercise guidelines need to make specific reference to resistance exercise and highlight the benefits of higher-intensity aerobic exercise training, alongside advocating older adults perform aerobic-based physical activity and household tasks (e.g., carrying groceries). In terms of dietary recommendations, greater emphasis should be placed on optimal rather than minimum protein intakes for older adults. Indeed, guidelines that endorse a daily protein intake of 1.2–1.5 g/kg BM/day, which are levels 50–90 % greater than the current protein Recommendation Dietary Allowance (0.8 g/kg BM/day), are likely to help preserve muscle mass and strength and are safe for healthy older adults. Being cognisant of factors (e.g., reduced appetite) that may preclude older adults from increasing their total daily protein intake, we echo the viewpoint of other active researchers in advocating that protein recommendations for older adults be based on a per meal approach in order to maximize muscle protein synthesis (MPS). On this basis, assuming three meals are consumed daily, a protein dose of 0.4–0.5 g/kg BM should be contained in each meal. We are beginning to understand ways in which to increase the utilization of ingested protein for the stimulation of MPS, namely by increasing the proportion of leucine contained in a given dose of protein, co-ingesting other nutrients (e.g., carbohydrate and fat or supplementation with n-3 polyunsaturated fatty acids) or being physically active prior to protein intake. Clearly, developing simple lifestyle interventions targeted at preserving muscle mass and strength with advancing age is crucial for facilitating longer, healthier lives into older age.
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Abizanda P, Sinclair A, Barcons N, Lizán L, Rodríguez-Mañas L. Costs of Malnutrition in Institutionalized and Community-Dwelling Older Adults: A Systematic Review. J Am Med Dir Assoc 2016; 17:17-23. [DOI: 10.1016/j.jamda.2015.07.005] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 07/04/2015] [Accepted: 07/06/2015] [Indexed: 11/26/2022]
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28
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Nowson C, O'Connell S. Protein Requirements and Recommendations for Older People: A Review. Nutrients 2015; 7:6874-99. [PMID: 26287239 PMCID: PMC4555150 DOI: 10.3390/nu7085311] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/27/2015] [Accepted: 08/04/2015] [Indexed: 12/22/2022] Open
Abstract
Declines in skeletal muscle mass and strength are major contributors to increased mortality, morbidity and reduced quality of life in older people. Recommended Dietary Allowances/Intakes have failed to adequately consider the protein requirements of the elderly with respect to function. The aim of this paper was to review definitions of optimal protein status and the evidence base for optimal dietary protein. Current recommended protein intakes for older people do not account for the compensatory loss of muscle mass that occurs on lower protein intakes. Older people have lower rates of protein synthesis and whole-body proteolysis in response to an anabolic stimulus (food or resistance exercise). Recommendations for the level of adequate dietary intake of protein for older people should be informed by evidence derived from functional outcomes. Randomized controlled trials report a clear benefit of increased dietary protein on lean mass gain and leg strength, particularly when combined with resistance exercise. There is good consistent evidence (level III-2 to IV) that consumption of 1.0 to 1.3 g/kg/day dietary protein combined with twice-weekly progressive resistance exercise reduces age-related muscle mass loss. Older people appear to require 1.0 to 1.3 g/kg/day dietary protein to optimize physical function, particularly whilst undertaking resistance exercise recommendations.
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Affiliation(s)
- Caryl Nowson
- School of Exercise and Nutrition Sciences, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong 3220, VIC, Australia.
| | - Stella O'Connell
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne 3125, VIC, Australia.
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Yamada M, Nishiguchi S, Fukutani N, Aoyama T, Arai H. Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study. J Am Med Dir Assoc 2015; 16:654-60. [PMID: 25858281 DOI: 10.1016/j.jamda.2015.02.017] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 02/23/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. DESIGN A cluster-randomized controlled trial. SETTING AND PARTICIPANTS This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. INTERVENTION Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). MEASUREMENTS The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. RESULTS Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. CONCLUSION These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail.
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Affiliation(s)
- Minoru Yamada
- Department of Lifespan Development Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.
| | - Shu Nishiguchi
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoto Fukutani
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
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30
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van der Meij BS, Wijnhoven HA, Finlayson GS, Oosten BS, Visser M. Specific food preferences of older adults with a poor appetite. A forced-choice test conducted in various care settings. Appetite 2015; 90:168-75. [DOI: 10.1016/j.appet.2015.03.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 12/16/2014] [Accepted: 03/07/2015] [Indexed: 01/04/2023]
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31
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Karelis AD, Messier V, Suppère C, Briand P, Rabasa-Lhoret R. Effect of cysteine-rich whey protein (immunocal®) supplementation in combination with resistance training on muscle strength and lean body mass in non-frail elderly subjects: a randomized, double-blind controlled study. J Nutr Health Aging 2015; 19:531-6. [PMID: 25923482 DOI: 10.1007/s12603-015-0442-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The purpose of the present study was to examine the effect of a cysteine-rich whey protein (Immunocal®) supplementation in combination with resistance training on muscle strength and lean body mass (LBM) in elderly individuals. We hypothesized that the cysteine-rich whey protein (Immunocal®) group would experience a greater increase in muscle strength and lean body mass versus the control group (casein). DESIGN Randomized double-blind controlled intervention study. SETTING Institut de Recherches Cliniques de Montréal in Montreal, Canada. PARTICIPANTS Ninety-nine non-frail elderly subjects were recruited. INTERVENTION Participants were randomly assigned into two groups. The experimental group received a cysteine-rich whey protein isolate (Immunocal®) (20 g/day) and the control group received casein (20 g/day) during a 135-day period. In addition, both groups performed the same resistance training program (3 times per week). MEASUREMENTS Body composition (DXA) and muscle strength (leg press) were measured. RESULTS Of the 99 recruited participants, 84 completed the 135-day study period. Of these, 67 subjects (33 in the casein group and 34 in the Immunocal® group) complied and used at least 80 % of the study product and completed at least 80 % of their training sessions. Results in this selected group show an increase in all three muscle strength variables (absolute, normalized by BW and by LBM) by 31.0 %, 30.9 % and 30.0 %, respectively in the casein group as well as 39.3 %, 39.9 % and 43.3 %, respectively in the Immunocal® group after the intervention (p < 0.05). The increases in muscle strength favored Immunocal® versus casein by approximately 10 % when expressed in kg per kg BW and in kg per kg LBM (p < 0.05). No significant changes were found between pre-and-post intervention in both groups for total LBM. CONCLUSIONS Our findings showed increases in muscle strength in both groups after resistance training, however, significant additional increases were observed in muscle strength with the addition of a cysteine-rich whey protein (Immunocal®) versus casein.
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Affiliation(s)
- A D Karelis
- Antony Karelis, PhD, Department of Kinanthropology, Université du Québec à Montréal, 8888, succ centre-ville, Montreal, Quebec, Canada, H3C 3P8, Tel: 001-514-987-3000 ext. 5082, Fax: 001-514-987-6616,
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32
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Rafii M, Chapman K, Elango R, Campbell WW, Ball RO, Pencharz PB, Courtney-Martin G. Dietary Protein Requirement of Men >65 Years Old Determined by the Indicator Amino Acid Oxidation Technique Is Higher than the Current Estimated Average Requirement. J Nutr 2015; 146:681-687. [PMID: 26962173 DOI: 10.3945/jn.115.225631] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 11/08/2015] [Accepted: 01/21/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The current estimated average requirement (EAR) and RDA for protein of 0.66 and 0.8 g ⋅ kg-1 ⋅ d-1, respectively, for adults, including older men, are based on nitrogen balance data analyzed by monolinear regression. Recent studies in young men and older women that used the indicator amino acid oxidation (IAAO) technique suggest that those values may be too low. This observation is supported by 2-phase linear crossover analysis of the nitrogen balance data. OBJECTIVE The main objective of this study was to determine the protein requirement for older men by using the IAAO technique. METHODS Six men aged >65 y were studied; each individual was tested 7 times with protein intakes ranging from 0.2 to 2.0 g ⋅ kg-1 ⋅ d-1 in random order for a total of 42 studies. The diets provided energy at 1.5 times the resting energy expenditure and were isocaloric. Protein was consumed hourly for 8 h as an amino acid mixture with the composition of egg protein with L-[1-13C]phenylalanine as the indicator amino acid. The group mean protein requirement was determined by applying a mixed-effects change-point regression analysis to F13CO2 (label tracer oxidation in breath 13CO2), which identified a breakpoint in F13CO2 in response to graded intakes of protein. RESULTS The estimated protein requirement and RDA for older men were 0.94 and 1.24 g ⋅ kg-1 ⋅ d-1, respectively, which are not different from values we published using the same method in young men and older women. CONCLUSIONS The current intake recommendations for older adults for dietary protein of 0.66 g ⋅ kg-1 ⋅ d-1 for the EAR and 0.8 g ⋅ kg-1 ⋅ d-1 for the RDA appear to be underestimated by ∼30%. Future longer-term studies should be conducted to validate these results. This trial was registered at clinicaltrials.gov as NCT01948492.
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Affiliation(s)
- Mahroukh Rafii
- Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen Chapman
- Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rajavel Elango
- Department of Pediatrics, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Child and Family Research Institute, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Ronald O Ball
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Paul B Pencharz
- Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Glenda Courtney-Martin
- Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guérin O, Hanon O, Jeandel C, Paillaud E, Raynaud-Simon A, Ruault G, Rolland Y. Frailty and nutrition: searching for evidence. J Nutr Health Aging 2015; 19:250-7. [PMID: 25732208 DOI: 10.1007/s12603-014-0568-3] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Frailty is a geriatric syndrome that predicts disability, morbidity and mortality in the elderly. Poor nutritional status is one of the main risk factors for frailty. Macronutrients and micronutrients deficiencies are associated with frailty. Recent studies suggest that improving nutritional status for macronutrients and micronutrients may reduce the risk of frailty. Specific diets such as the Mediterranean diet rich in anti-oxidants, is currently investigated in the prevention of frailty. The aim of this paper is to summarize the current body of knowledge on the relations between nutrition and frailty, and provide recommendations for future nutritional research on the field of frailty.
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Affiliation(s)
- M Bonnefoy
- Marc Bonnefoy - service universitaire de gériatrie - Groupement Hospitalier Sud - 69495 Pierre-Bénite Cedex - France - tél 33 (0)4 78 86 15 80 - Fax 33 (0)4 78 86 57 27 -
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Sewo Sampaio PY, Sampaio RAC, Yamada M, Ogita M, Arai H. Comparison of frailty among Japanese, Brazilian Japanese descendants and Brazilian community-dwelling older women. Geriatr Gerontol Int 2014; 15:762-9. [DOI: 10.1111/ggi.12348] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Minoru Yamada
- Department of Human Health Sciences; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Mihoko Ogita
- Department of Health Science; Kyoto Koka Women's University; Kyoto Japan
| | - Hidenori Arai
- Department of Human Health Sciences; Kyoto University Graduate School of Medicine; Kyoto Japan
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35
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Genaro PDS, Pinheiro MDM, Szejnfeld VL, Martini LA. Dietary protein intake in elderly women: association with muscle and bone mass. Nutr Clin Pract 2014; 30:283-9. [PMID: 25107954 DOI: 10.1177/0884533614545404] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND An inadequate food intake, mainly with regard to protein intake, seems to contribute to a reduction of skeletal muscle and bone mass in the elderly. This study was undertaken to evaluate differences in protein intake in women with or without sarcopenia and verify the intake level that is related to a better bone and muscle mass. METHODS Elderly women older than 65 years with sarcopenia (n = 35) and without sarcopenia (n = 165) participated in the study. Assessment of bone mineral density of the lumbar spine and femur was taken, body composition was evaluated by dual-energy x-ray absorptiometry, and an evaluation of protein intake was performed through 3-day dietary records. RESULTS Muscle, bone, and fat mass was significantly higher in women who had protein intake >1.2 g/kg/d. A lower intake of essential amino acids in women with sarcopenia was also observed. Protein and energy intake were significant predictors of muscle mass. The presence of osteoporosis was a predictor of muscle strength. In conclusion, the present study demonstrated that in elderly women, an adequate protein intake in terms of quality and quantity, without need of supplementation, could have a positive impact on bone mineral density, lean mass, and skeletal muscle mass.
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Affiliation(s)
| | | | | | - Lígia Araújo Martini
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
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36
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Mosconi L, Murray J, Davies M, Williams S, Pirraglia E, Spector N, Tsui WH, Li Y, Butler T, Osorio RS, Glodzik L, Vallabhajosula S, McHugh P, Marmar CR, de Leon MJ. Nutrient intake and brain biomarkers of Alzheimer's disease in at-risk cognitively normal individuals: a cross-sectional neuroimaging pilot study. BMJ Open 2014; 4:e004850. [PMID: 24961717 PMCID: PMC4078781 DOI: 10.1136/bmjopen-2014-004850] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE There is increasing evidence to suggest that diet, one of the most important modifiable environmental factors, may play a role in preventing or delaying cognitive decline and Alzheimer's disease (AD). This study examines the relationship between dietary nutrients and brain biomarkers of AD in cognitively normal individuals (NL) with and without AD risk factors. DESIGN As part of an ongoing brain imaging study, participants received clinical and laboratory examinations, a neurocognitive test battery, positron emission tomography (PET) with (11)C-Pittsburgh Compound-B (PiB; a measure of amyloid-β (Aβ) load) and (18)F-fluorodeoxyglucose (FDG; a proxy of neuronal activity), and completed semiquantitative food frequency questionnaires. SETTING Research centre affiliated with the Alzheimer's disease Core Center at New York University School of Medicine. PARTICIPANTS 49 NL individuals (age 25-72 years, 69% women) with dietary information, (11)C-PiB and (18)F-FDG PET scans were examined. RESULTS Controlling for age and total caloric intake, higher intake of vitamin B12, vitamin D and ω-3 polyunsaturated fatty acid (PUFA) was associated with lower Aβ load in AD regions on PiB-PET, while higher intake of β-carotene and folate was associated with higher glucose metabolism on FDG-PET. β-carotene and folate were associated with reduced glucose metabolism for women, apolipoprotein E epsilon 4 (APOE4) carriers and participants with positive AD family history, but not for their risk-free counterparts. The associations of vitamin B12, vitamin D and ω-3 PUFA with PiB retention were independent of gender, APOE and family history. The identified nutrient combination was associated with higher intake of vegetables, fruit, whole grains, fish and legumes, and lower intake of high-fat dairies, meat and sweets. CONCLUSIONS Our data provide a potential pathophysiological mechanism for epidemiological findings showing that dietary interventions may play a role in the prevention of AD. Longitudinal studies are needed to determine whether there is a direct link between nutrient intake, brain biomarkers and risk of AD.
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Affiliation(s)
- Lisa Mosconi
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - John Murray
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Michelle Davies
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Schantel Williams
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Elizabeth Pirraglia
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Nicole Spector
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Wai H Tsui
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Yi Li
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Tracy Butler
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Ricardo S Osorio
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Lidia Glodzik
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Shankar Vallabhajosula
- Department of Radiology, Citigroup Biomedical Imaging Center (CBIC), Weill Cornell Medical College, New York, New York, USA
| | - Pauline McHugh
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | - Charles R Marmar
- Department of Psychiatry, New York University School of Medicine, New York, USA
- Steven and Alexandra Cohen Veterans Center for PTSD and TBI, New York, New York, USA
| | - Mony J de Leon
- Department of Psychiatry, New York University School of Medicine, New York, USA
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Otsuka R, Yatsuya H, Tamakoshi K. Descriptive epidemiological study of food intake among Japanese adults: analyses by age, time and birth cohort model. BMC Public Health 2014; 14:328. [PMID: 24712924 PMCID: PMC3997235 DOI: 10.1186/1471-2458-14-328] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 04/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although food and nutrient consumption among the Japanese population, known to have one of the longest life expectancies in the world, has changed markedly after World War II, little is known about the influences age, time and birth cohort have had. The present study examined the effects age, time and birth cohort have had on intake of 14 food groups from 1989 to 2009, using published data from the National Health and Nutrition Survey in Japan. METHODS The survey included 575 adults (271 men and 304 women) in 1989, 8431 (3952 men and 4479 women) in 1999 and 5632 (2629 men and 3003 women) in 2009. The effects of age on energy-adjusted food intakes defined by gender and birth cohort (birth in 1930-1939, 1940-1949, 1950-1959, 1960-1969, 1970-1979) were estimated using the mean polish process. RESULTS Intakes of meat and confectionary increased whereas those of milk and dairy products, sugar, and fats and oils decreased from 1989 to 2009. Both men and women in the 1940's birth cohort consumed more fruit, although differences in food intake by birth cohort were less discernible. Furthermore, meat, fats and oils, and wheat intake decreased while fruits, fish, beans and vegetables consumption increased with aging in both men and women. CONCLUSIONS The present analysis suggests intakes of meat and confectionary have increased in Japan over the past 20 years regardless of age and generation. Also, younger individuals are less likely to consume fruits, fish, beans and vegetables regardless of the birth cohort and time period. Differences in food group consumption by birth cohorts born between 1930 and 1979 were not obvious. The first indication of these findings would be that in order to avoid ongoing increases in meat and confectionery intake, the public health strategy should target the whole Japanese population. Secondly, intervening with the diet of younger individuals, especially today, would be reasonable as it is unknown whether today's younger individuals will adopt a healthier diet when they age as the other generations did.
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Affiliation(s)
- Rei Otsuka
- Section of Longitudinal Study of Aging, National Institute for Longevity Sciences (NILS-LSA), National Center for Geriatrics and Gerontology, 36-3 Gengo, Morioka-cho, Obu, Aichi, 474-8511, Japan.
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Peng LN, Lin MH, Liu LK, Tung HH, Chen LY, Chu KH, Lin KC, Won CW, Chen LK. Nutritional status plays the mediating role of the functional status and comorbidity among older patients admitted to the Geriatric Evaluation and Management Unit: A Tobit model application. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2013.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lemieux FC, Filion ME, Barbat-Artigas S, Karelis AD, Aubertin-Leheudre M. Relationship between different protein intake recommendations with muscle mass and muscle strength. Climacteric 2013; 17:294-300. [DOI: 10.3109/13697137.2013.829440] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Tsai AC, Lai MY. Mini Nutritional Assessment and short-form Mini Nutritional Assessment can predict the future risk of falling in older adults - results of a national cohort study. Clin Nutr 2013; 33:844-9. [PMID: 24225376 DOI: 10.1016/j.clnu.2013.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 10/09/2013] [Accepted: 10/16/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND & AIMS Falling is a major issue in geriatric health. Tools that identify individuals at risk of falling can help reduce the risk of falling. The study aimed to determine whether the full and short-form Mini Nutritional Assessment (MNAs) have the ability to predict the risk of falling in older adults. METHODS Subjects were 3118 ≥ 53-year old Taiwanese who completed both the 1999 and 2003 "Taiwan Longitudinal Study on Aging" surveys. We rated these subjects with normalized versions of the MNA and applied the standard cut-offs to define under-nutrition (≤23.5 and ≤11 points, respectively). We used multivariate logistic regression analysis and receiver operating characteristics to evaluate the ability of these tools in predicting the risk of falling three years later. RESULTS Older adults rated as at risk of malnutrition with the full MNA (OR = 1.87, 95% confidence interval = 1.33-2.63, p < 0.001) or the short-form (1.39, 1.07-1.80, p = 0.014) were associated with increased risk of falling three years later. Both versions significantly predicted the risk of falling and performed slightly better in ≥65-year old persons than in younger (53-64-year old) persons. The short-form performed relatively well compared to the full scale. CONCLUSIONS Results suggest that the full and short-form MNAs, in addition to rating the risk of malnutrition, also predict the risk of falling in older adults. Although the short-form is slightly less effective than the full scale in predicting the future risk of falling, its simplicity, effectiveness and efficiency make it ideal as a multipurpose screening tool in clinical settings.
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Affiliation(s)
- Alan C Tsai
- Department of Healthcare Administration, Asia University, 500 Liufeng Road, Wufeng, Taichung 41354, Taiwan, ROC; Department of Health Services Management, School of Public Health, China Medical University, Taichung 40402, Taiwan, ROC.
| | - Mei-Yen Lai
- Department of Healthcare Administration, Asia University, 500 Liufeng Road, Wufeng, Taichung 41354, Taiwan, ROC; Nursing Department, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
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Bollwein J, Diekmann R, Kaiser MJ, Bauer JM, Uter W, Sieber CC, Volkert D. Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg. Nutr J 2013; 12:109. [PMID: 23915061 PMCID: PMC3750269 DOI: 10.1186/1475-2891-12-109] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 07/23/2013] [Indexed: 11/16/2022] Open
Abstract
Background To preserve muscle mass and therefore limit the risk of disability in older adults protein intake is seen as important factor. Besides the amount of protein, its distribution over the day is thought to affect protein anabolism. This cross-sectional study investigates the association between the amount and distribution of protein intake and frailty in older adults. Methods In 194 community-dwelling seniors (≥75 years) amount of protein intake and its distribution over the day (morning, noon, evening) were assessed using a food frequency questionnaire. Unevenness of protein distribution was calculated as coefficient of variation (CV). Frailty was defined as the presence of at least three, pre-frailty as the presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Results 15.4% of the participants were frail, 40.5% were pre-frail. Median (min.-max.) daily protein intake was 77.5 (38.5–131.5) g, 1.07 (0.58–2.27) g/kg body weight (BW) and 15.9 (11.2–21.8) % of energy intake without significant differences between the frailty groups. The risk of frailty did not differ significantly between participants in the higher compared to the lowest quartile of protein intake. Frail participants consumed significantly less protein in the morning (11.9 vs. 14.9 vs. 17.4%, p = 0,007), but more at noon (61.4 vs. 60.8 vs. 55.3%, p = 0.024) than pre-frail and non-frail. The median (min.-max.) CV of protein distribution was highest in frail (0.76 (0.18–1.33)) compared to pre-frail (0.74 (0.07–1.29)) and non-frail (0.68 (0.15–1.24)) subjects (p = 0.024). Conclusions In this sample of healthy older persons, amount of protein intake was not associated with frailty, but distribution of protein intake was significantly different between frail, pre-frail and non-frail participants. More clinical studies are needed to further clarify the relation between protein intake and frailty.
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Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Visvanathan R, Volpi E, Boirie Y. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14:542-59. [DOI: 10.1016/j.jamda.2013.05.021] [Citation(s) in RCA: 1068] [Impact Index Per Article: 97.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022]
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Schouten K, Lindeman MA, Reid J. Nutrition and older Indigenous Australians: Service delivery implications in remote communities. A narrative review. Australas J Ageing 2013; 32:204-10. [DOI: 10.1111/ajag.12057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kellie Schouten
- Centre for Remote Health; Flinders University; Alice Springs Northern Territory Australia
| | - Melissa A Lindeman
- Centre for Remote Health; Flinders University; Alice Springs Northern Territory Australia
| | - John Binda Reid
- Poche Centre for Indigenous Health; Flinders University; Alice Springs Northern Territory Australia
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Fortes C, Mastroeni S, Sperati A, Pacifici R, Zuccaro P, Francesco F, Agabiti N, Piras G, Amleto D, Ebrahim S. Walking four times weekly for at least 15min is associated with longevity in a Cohort of very elderly people. Maturitas 2013; 74:246-51. [DOI: 10.1016/j.maturitas.2012.12.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 11/30/2012] [Accepted: 12/01/2012] [Indexed: 12/24/2022]
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Perspective: Dietary protein needs of elderly people: protein supplementation as an effective strategy to counteract sarcopenia. J Am Med Dir Assoc 2012; 14:67-9. [PMID: 23131547 DOI: 10.1016/j.jamda.2012.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 09/19/2012] [Indexed: 01/10/2023]
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Suzuki H, Tanifuji T, Abe N, Fukunaga T. Causes of death in forensic autopsy cases of malnourished persons. Leg Med (Tokyo) 2012; 15:7-11. [PMID: 22981179 DOI: 10.1016/j.legalmed.2012.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 06/25/2012] [Accepted: 08/03/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE Medical examiners and forensic pathologists often encounter emaciated bodies in postmortem examinations. However, the main disease that caused death is often not clear and measures to prevent the unexpected death of malnourished persons have not been established. In this study, we examined the underlying causes of death among a large number of forensic autopsy cases that showed emaciation to clarify the features of sudden, unexpected death in malnourished persons. METHODS Documents of autopsy cases without putrefaction handled during 2007-2010 by the Tokyo Medical Examiner's Office were reviewed (n=7227). The body mass index (BMI) was calculated for each case. The causes of death for cases with severe malnutrition (BMI<16; n=885) were closely examined. RESULTS About 70% of all deaths in malnourished cases (BMI<16) was due to disease, and the causative diseases are more varied than in those with less severe malnutrition and those without malnutrition (BMI⩾16). A higher proportion of malnutrition as the cause of death was observed in younger persons for both sexes, and a higher proportion of having a history of psychiatric diseases was observed in younger deceased women. In addition, a higher proportion of alcohol-related digestive diseases was observed especially in younger men, some of whom had a history of alcohol dependence. On the other hand, the proportion of organic diseases, such as neoplasms and gastroduodenal ulcer, was higher in older deceased persons, especially among men. Around 70% of all respiratory diseases comprised pneumonia in both sexes. Among non-disease-related causes of death, poisoning was the most frequent cause in women under 55years old (35.3%), with the majority having had a history of psychiatric disease. CONCLUSIONS Because autopsy cases of malnourished persons show various causes of death, physicians have to pay more attention in making death diagnosis in such cases. From a preventative point of view, early detection of organic diseases, a better approach toward managing psychiatric diseases, and implementation of vaccination for pneumonia will contribute to reduction of future unexpected deaths among malnourished persons.
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Affiliation(s)
- Hideto Suzuki
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, 4-21-18 Otsuka, Bunkyo-ku, Tokyo, Japan. hideto-@qk9.so-net.ne.jp
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Filion ME, Barbat-Artigas S, Dupontgand S, Fex A, Karelis AD, Aubertin-Leheudre M. Relationship between protein intake and dynapenia in postmenopausal women. J Nutr Health Aging 2012; 16:616-9. [PMID: 22836702 DOI: 10.1007/s12603-012-0054-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the relationship between protein intake and dynapenia. DESIGN A cross-sectional/observational study. SETTING Department of Kinanthropology at the University of Quebec at Montreal. PARTICIPANTS Seventy-two non-frail postmenopausal women aged between 50 to 75 years were recruited. MEASUREMENTS Body weight (BW), lean body mass (LBM; %) and skeletal muscle mass (bio-electrical impedancemetry analysis), maximum voluntary handgrip strength (using hand dynamometer), aerobic capacity (VO2peak) and dietary intake were measured. Women were divided according to dynapenia criteria. RESULTS The strongest correlation between muscle strength and protein intake was observed when we express the amount of protein in g/d/BW. No differences for age, BMI, status of menopause, fat mass and VO2peak were observed between non-dynapenic, type I dynapenic and type II dynapenic women, independently of the criteria used. We observed significant differences in protein intake (g/d/BW) between non-dynapenic and type II dynapenic (p<0.01) as well as between type I dynapenic and type II dynapenic (p<0.01) when dynapenia was expressed in kg/BW and in kg/LBM, respectively. It should be noted that no differences in LBM between the three groups were observed when dynapenia was expressed in kg/BW and kg/LBM. Protein intake for all groups respected the RDA of 0.8 to 1.2 g/d/BW (non-dynapenic: 1.44/1.38; type I dynapenic: 1.30/1.33; type II dynapenic: 1.05/1.08 g/d/BW). CONCLUSIONS Protein intake seems to play a role in the development of dynapenia particularly at the level of type II dynapenia. Therefore, an increase in the recommended daily allowance for protein intake may be warranted.
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Affiliation(s)
- M E Filion
- Faculty of Science, Department of Kinanthropolgy, University of Quebec at Montreal, Case postale 8888, succ Centre Ville, Montreal, Canada
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Meijers JMM, Halfens RJG, Wilson L, Schols JMGA. Estimating the costs associated with malnutrition in Dutch nursing homes. Clin Nutr 2011; 31:65-8. [PMID: 21880401 DOI: 10.1016/j.clnu.2011.08.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 06/23/2011] [Accepted: 08/11/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUNDS & AIMS Malnutrition in western health care involves a tremendous burden of illness. In this study the economic implications of malnutrition in Dutch nursing homes are investigated as part of the Health and Economic Impact of Malnutrition in Europe Study from the European Nutrition for Health Alliance. METHODS A questionnaire was developed, focussing on the additional time and resources spent to execute all relevant nutritional activities in nursing home patients with at risk of malnutrition or malnourished. Results were extrapolated on national level, based on the prevalence rates gathered within the national Prevalence Measurement of Care Problems 2009. RESULTS The normal nutritional costs are 319 million Euro per year. The total additional costs of managing the problem of malnutrition in Dutch nursing homes involve 279 million Euro per year and are related to extra efforts in nutritional screening, monitoring and treatment. The extra costs for managing nursing home residents at risk of malnutrition are 8000 euro per patient and 10000 euro for malnourished patients. CONCLUSIONS The extra costs related to malnutrition are a considerable burden for the nursing home sector and urge for preventive measures.
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Affiliation(s)
- Judith M M Meijers
- Department of Health Services Research, School for Public Heath and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
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Pereira Machado RS, Santa Cruz Coelho MA. Risk of malnutrition among Brazilian institutionalized elderly: a study with the Mini Nutritional Assessment (MNA) questionnaire. J Nutr Health Aging 2011; 15:532-5. [PMID: 21808930 DOI: 10.1007/s12603-011-0059-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Brazilian population has passed for a process of demographic transition throughout latest years, characterized for the increase of the elderly population. Malnutrition is a serious problem to frail elderly. OBJECTIVE The objective of this study was o evaluate the risk of malnutrition among institutionalized elderly resident in municipal shelters in the city of Rio de Janeiro, Brazil, using the tool Mini Nutritional Assessment (MNA). DESIGN 344 institutionalized elderly aged over 60 years old were tested in a cross-sectional study using MNA. This tool classifies the nutricional status of the elderly in three groups: malnutrition (score < 17), risk of malnutrition (score 17 - 23,5) and well-nourished (score > = 24). Anthropometric measurements such as calf circumference (CC), mid-arm circumference (MAC) and Body mass index (BMI) were also evaluated. The variables were evaluated using the chi-square or ANOVA test. To correlate it was used Pearson's Correlation Coefficient (r). RESULTS Mean age were 75.4 (+- 9.4) years old. Most of the elderly were female gender (59.6%). According to MNA 8.3% were with malnutrition, 55.6% at risk of malnutrition and 36.1% well-nourished. BMI classified 10.0% of the elderly as underweight. CC classified 10.0 % of them as inadequate in muscular mass. MNA was well correlated to BMI (r=0.412 p=0.000), age (r=-0.124 p=0.031), CC (r=0.399 p = 0.000) and MAC (r=0.391 p=0.000). CONCLUSION Risk of malnutrition was high among the institutionalized elderly from public shelters in Rio de Janeiro - Brazil. MNA is a useful diagnostic tool for the identification on the frail elderly at risk of malnutrition.
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Affiliation(s)
- R S Pereira Machado
- Multidisciplinary Institute, Rural Federal University of Rio de Janeiro, Brasil.
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Andrich DE, Filion ME, Woods M, Dwyer JT, Gorbach SL, Goldin BR, Adlercreutz H, Aubertin-Leheudre M. Relationship between essential amino acids and muscle mass, independent of habitual diets, in pre- and post-menopausal US women. Int J Food Sci Nutr 2011; 62:719-24. [DOI: 10.3109/09637486.2011.573772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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