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Delgado-Lima AH, Bouhaben J, Delgado-Losada ML. The efficacy of olfactory training in improving olfactory function: a meta-analysis. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08733-7. [PMID: 38802578 DOI: 10.1007/s00405-024-08733-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Study the efficacy of olfactory training in smell recovery. METHODS An extensive search was performed through different databases in order to find articles analyzing the efficacy of olfactory training as a treatment for olfactory dysfunction. Methodological quality of primary studies within the final sample was assessed following PRISMA guidelines. Standardized mean differences in pre-post olfactory training groups, and also in experimental-control and pre-follow up if possible, were computed by Hedges' g effect size statistic. Each effect size was weighted by its inverse variance. RESULTS Final sample was composed of 36 articles (45 pre-post effect sizes). Contrasts were performed separately for odor identification, odor discrimination, odor threshold and general olfactory function. Moderate to large and heterogeneous effect was obtained for olfactory function (g = 0.755, k = 45, SE = 0.093, CI 95% = [0.572, 0.937]), different moderators had a significant effects, such as, training duration, age and anosmia diagnosis. CONCLUSION Olfactory training was found to have a positive and significant effect on rehabilitating the olfactory function.
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Affiliation(s)
- Alice Helena Delgado-Lima
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain
| | - Jaime Bouhaben
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain
| | - María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain.
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2
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Dagbasi A, Warner J, Catterall V, Smith K, Crabtree DR, Carroll B, Frost G, Holliday A. Augmented gut hormone response to feeding in older adults exhibiting low appetite. Appetite 2024:107415. [PMID: 38761969 DOI: 10.1016/j.appet.2024.107415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
Age-related changes in gut hormones may play a role in anorexia of ageing. The aim of this study was to determine concentrations of ghrelin, PYY, and GLP-1 in older adults exhibiting an anorexia of ageing phenotype. Thirteen older adults with healthy appetite (OA-HA; 8f, 75±7 years, 26.0±3.2 kg·m-2), fifteen older adults with low appetite (OA-LA; 10f, 72±7 years, 23.6±3.1 kg·m-2), and twelve young adults (YA; 6f, 22±2 years, 24.4±2.0 kg·m-2) completed the study. Healthy appetite and low appetite were determined based on BMI, habitual energy intake, self-reported appetite, and laboratory-assessed ad libitum lunch intake. Participants provided a fasted measure of subjective appetite and blood sample (0 minutes) before consuming a standardised breakfast (450 kcal). Appetite was measured and blood samples were drawn throughout a 240-minute rest period. At 240 minutes, an ad libitum lunch meal was consumed. Relative intake at lunch (expressed as percentage of estimated total energy requirement) was lower for OA-LA (19.8±7.7%) than YA (41.5±9.2%, p<0.001) and OA-HA (37.3±10.0%, p<0.001). Ghrelin suppression was greater for OA-LA (net AUC, -78719±74788 pg·mL-1·240min-1) than both YA (-23899±27733 pg·mL-1·240min-1, p=0.016) and OA-HA (-21144±31161 pg·mL-1·240min-1, p=0.009). There were trends for higher GLP-1 concentrations in OA-LA compared with YA at 90 minutes (8.85±10.4 pM vs. 1.88±4.63 pM, p=0.073) and 180 minutes (5.00±4.71 pM vs. 1.07±2.83 pM, p=0.065). There was a trend for a greater PYY response for OA-LA compared with OA-HA (net AUC p=0.062). "Anorexigenic response score" - a composite score of gut hormone responses to feeding - showed greater anorexigenic response in OA-LA, compared with YA and OA-HA. No differences were seen in subjective appetite. These observations suggest augmented anorexigenic responses of gut hormones to feeding may be causal mechanisms of anorexia of ageing.
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Affiliation(s)
- Aygul Dagbasi
- Section of Nutrition, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London, UK
| | - Jordan Warner
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Victoria Catterall
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Kieran Smith
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Daniel R Crabtree
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Bernadette Carroll
- School of Biochemistry, University of Bristol, University Walk, Bristol, UK
| | - Gary Frost
- Section of Nutrition, Faculty of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Hospital, London, UK
| | - Adrian Holliday
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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3
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Ono S, Sasabuchi Y, Yamana H, Yokota I, Okada A, Matsui H, Itai S, Yonenaga K, Tonosaki K, Watanabe R, Ono Y, Yasunaga H, Hoshi K. Weight loss and functional decline in older Japanese people: A cohort study using large-scale claims data. Arch Gerontol Geriatr 2024; 120:105354. [PMID: 38309105 DOI: 10.1016/j.archger.2024.105354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/19/2024] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The association between weight loss and subsequent functional decline is uncertain. The study aims to elucidate the association between weight loss over a year and subsequent functional decline requiring assistance in performing their activities of daily living in older individuals. METHODS The study used data from the publicly funded Long-Term Care Insurance service in Japan, which provides coverage for long-term care services for individuals unable to perform activities of daily living due to physical or cognitive impairment. The study enrolled people born in or before 1949, who underwent health checkups in both 2014 and 2015. The participants were followed from 2015 to the worsening of functional decline requiring long-term care services, death, or February 28, 2019, whichever occurred first. The risk of subsequent functional decline in each weight loss category was estimated using a Cox regression model adjusted for age, sex, baseline body mass index, smoking, and Charlson comorbidity index. RESULTS We identified 67,452 eligible individuals from the database. The median follow-up period was 1,284 days. The hazard ratios (95 % confidence interval) of functional decline for -1 %, -2 %, -3 %, -4 %, and ≤-5% weight change compared to 0 % weight change were 1.17 (1.03-1.32), 1.26 (1.11-1.43), 1.29 (1.12-1.49), 1.61 (1.39-1.87), and 1.79 (1.58-1.99), respectively. CONCLUSIONS AND IMPLICATIONS Older people with weight loss of 1 % or more were at risk of functional decline. Close weight monitoring may serve as an easy and inexpensive means of identifying older individuals at risk of functional decline.
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Affiliation(s)
- Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan.
| | - Yusuke Sasabuchi
- Department of Real World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hayato Yamana
- Data Science Center, Jichi Medical University, Tochigi, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Data Science Center, Jichi Medical University, Tochigi, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Itai
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Kazumichi Yonenaga
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Kanata Tonosaki
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Rinji Watanabe
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Hideo Yasunaga
- Data Science Center, Jichi Medical University, Tochigi, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kazuto Hoshi
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
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Holliday A, Warner J, Hulston CJ, Corfe BM, Crabtree DR. Anorexia of ageing is associated with elevated fasted and lower post-prandial ghrelin, independent of ghrelin O-acyltransferase. Appetite 2024; 196:107259. [PMID: 38341037 DOI: 10.1016/j.appet.2024.107259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
The role of ghrelin metabolism in anorexia of ageing is unclear. The aim of this study was to determine acyl-ghrelin, total ghrelin, and ghrelin O-acyltransferase concentrations when fasted and in responses to feeding in older adults exhibiting anorexia of ageing. Twenty-five older adults (OA; 15f, 74 ± 7 years, 24.5 kg·m-2) and twelve younger adults (YA; 6f, 21 ± 2 years, 24.4 kg·m-2) provided a fasted measure of subjective appetite and fasted blood sample (0 min) before consuming a standardised porridge breakfast meal (450 kcal). Appetite was measured every 30 min for 240 min and blood was sampled at 30, 60, 90, 120, 180 and 240 min while participants rested. At 240 min, an ad libitum pasta-based lunch meal was consumed. Older adults were identified as those with healthy appetite (HA-OA) or low appetite (LA-OA), based on habitual energy intake, self-report appetite, BMI, and ad libitum lunch intake. YA ate more at lunch (1108 ± 235 kcal) than HA-OA (653 ± 133 kcal, p = 0.007) and LA-OA (369 ± 168 kcal; p < 0.001). LA-OA, but not HA-OA, had higher fasted concentrations of acyl- and total ghrelin than YA (acyl-ghrelin: 621 ± 307 pg·mL-1 vs. 353 ± 166 pg·mL-1, p = 0.047; total ghrelin: 1333 ± 702 pg·mL-1 vs. 636 ± 251 pg·mL-1, p = 0.006). Acyl-ghrelin (60 min and 90 min) and total ghrelin (90 min) were suppressed to a greater extent for LA-OA than for YA (p < 0.05). No differences were observed in subjective appetite, acyl-to-total ghrelin ratio, or plasma GOAT content (p > 0.1). Higher fasting ghrelin and an augmented ghrelin response to feeding in LA-OA, but not HA-OA, suggests that alterations to ghrelin metabolism are not functions of ageing per se and may be independent causal mechanisms of anorexia of ageing.
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Affiliation(s)
- Adrian Holliday
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Jordan Warner
- School of Biomedical, Nutritional, and Sport Science, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Carl J Hulston
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Bernard M Corfe
- Human Nutrition and Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Daniel R Crabtree
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Capurso C, Lo Buglio A, Bellanti F, Vendemiale G. Prognostic Nutritional Index and Instant Nutritional Assessement Are Associated with Clinical Outcomes in a Geriatric Cohort of Acutely Inpatients. Nutrients 2024; 16:1359. [PMID: 38732604 PMCID: PMC11085456 DOI: 10.3390/nu16091359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/23/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Among elderly inpatients, malnutrition is one of the most important predictive factors affecting length of stay (LOS), mortality, and risk of re-hospitalization. METHODS We conducted an observational, retrospective study on a cohort of 2206 acutely inpatients. Serum albumin and lymphocytes were evaluated. Instant Nutritional Assessment (INA) and the Prognostic Nutritional Index (PNI) were calculated to predict in-hospital mortality, LOS, and risk of rehospitalization. RESULTS An inverse relationship between LOS, serum albumin, and PNI were found. Deceased patients had lower albumin levels, lower PNI values, and third- and fourth-degree INA scores. An accurate predictor of mortality was PNI (AUC = 0.785) after ROC curve analysis; both lower PNI values (HR = 3.56) and third- and fourth-degree INA scores (HR = 3.12) could be independent risk factors for mortality during hospitalization after Cox regression analysis. Moreover, among 309 subjects with a lower PNI value or third- and fourth-class INA, hospitalization was re-hospitalization. CONCLUSIONS PNI and INA are two simple and quick-to-calculate tools that can help in classifying the condition of hospitalized elderly patients also based on their nutritional status, or in assessing their mortality risk. A poor nutritional status at the time of discharge may represent an important risk factor for rehospitalization in the following thirty days. This study confirms the importance of evaluating nutritional status at the time of hospitalization, especially in older patients. This study also confirms the importance for adequate training of doctors and nurses regarding the importance of maintaining a good nutritional status as an integral part of the therapeutic process of hospitalization in acute departments.
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Affiliation(s)
- Cristiano Capurso
- Department of Medical and Surgical Sciences, University of Foggia, Viale Luigi Pinto 1, 71122 Foggia, Italy; (A.L.B.); (F.B.); (G.V.)
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6
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Moughan PJ, Fulgoni VL, Wolfe RR. The Importance of Dietary Protein Quality in Mid- to High-Income Countries. J Nutr 2024; 154:804-814. [PMID: 38253225 DOI: 10.1016/j.tjnut.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
In wealthy countries, the protein intake of adults is usually considered to be adequate, and considerations of protein quality are often deemed irrelevant. The objective was to examine dietary protein intakes of adults in developed countries in the context of dietary protein quality. An analysis of NHANES population data on actual protein intakes in the United States (a developed country) demonstrated that for a dietary Digestible Indispensable Amino Acid Score (DIAAS) of 100%, 11% of the adult (19-50 y) population had habitual protein intakes below the Estimated Average Requirement (EAR) and 22% below the Recommended Dietary Allowance. The percentage of the population with utilizable protein intakes potentially falling below the EAR increased as the assumed DIAAS declined. Analysis of the NHANES data and several other datasets also indicated that total protein intakes can be limiting or close to limiting for the elderly and some vegetarians and vegans. Here, lower dietary protein quality can potentially lead to inadequate utilizable protein intakes. For many people in specific physiological states (e.g., weight loss, endurance sports, resistance exercise) attempting to meet higher dietary protein targets often with accompanying lowered energy intakes, low dietary protein quality can lead to protein calories expressed as a proportion of total calories, falling outside what may be acceptable limits (maximum of 30% protein calories from total calories). In general, individuals within the adult population may be susceptible to macronutrient imbalance (whenever total protein intakes are high, daily energy intakes low) and for diets with lower protein quality (DIAAS <100%). Our analysis shows that dietary protein quality is relevant in mid- to high-income countries.
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Affiliation(s)
- Paul J Moughan
- Riddet Institute, Massey University, Palmerston North, New Zealand.
| | | | - Robert R Wolfe
- University of Arkansas for Medical Sciences, Little Rock, AR, United States
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7
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Mak WS, Jones CP, McBride KE, Fritz EAP, Hirsch J, German JB, Siegel JB. Acid-active proteases to optimize dietary protein digestibility: a step towards sustainable nutrition. Front Nutr 2024; 11:1291685. [PMID: 38389801 PMCID: PMC10881760 DOI: 10.3389/fnut.2024.1291685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Introduction Historically, prioritizing abundant food production often resulted in overlooking nutrient quality and bioavailability, however, environmental concerns have now propelled sustainable nutrition and health efficacy to the forefront of global attention. In fact, increasing demand for protein is the major challenge facing the food system in the 21st century with an estimation that 70% more food is needed by 2050. This shift has spurred interest in plant-based proteins for their sustainability and health benefits, but most alternative sources of protein are poorly digestible. There are two approaches to solve digestibility: improve the digestibility of food proteins or improve the digestive capacity of consumers. Enhancing nutrient digestibility and bioavailability across diverse protein sources is crucial, with proteases presenting a promising avenue. Research, inspired by the proteases of human breast milk, has demonstrated that exogenous microbial proteases can activate within the human digestive tract and substantially increase the digestion of targeted proteins that are otherwise difficult to fully digest. Methods Here, we introduce the use of an acid-active family of bacterial proteases (S53) to improve the digestibility and nutritional quality of a variety of protein sources, evaluated using the INFOGEST 2.0 protocol. Results Results from in vitro digestibility indicate that the most effective protease in the S53 family substantially improves the digestibility of an array of animal and plant-derived proteins-soy, pea, chickpea, rice, casein, and whey. On average, this protease elevated protein digestibility by 115% during the gastric phase and by 15% in the intestinal phase, based on the degree of hydrolysis. Discussion The widespread adoption of these proteases has the potential to enhance nutritional value and contribute to food security and sustainability. This approach would complement ongoing efforts to improve proteins in the food supply, increase the quality of more sustainable protein sources and aid in the nourishment of patients with clinically compromised, fragile intestines and individuals like older adults and high-performance athletes who have elevated protein needs.
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Affiliation(s)
- Wai Shun Mak
- Department of Chemistry, University of California, Davis, Davis, CA, United States
- Digestiva, Inc., Davis, CA, United States
| | | | | | | | | | - J Bruce German
- Department of Food Science and Technology, University of California, Davis, Davis, CA, United States
| | - Justin B Siegel
- Department of Chemistry, University of California, Davis, Davis, CA, United States
- Digestiva, Inc., Davis, CA, United States
- Genome Center, University of California, Davis, Davis, CA, United States
- Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis, CA, United States
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Zanetti M, Veronese N, Riso S, Boccardi V, Bolli C, Cintoni M, Francesco VD, Mazza L, Onfiani G, Zenaro D, Pilotto A. Polypharmacy and malnutrition in older people: A narrative review. Nutrition 2023; 115:112134. [PMID: 37453210 DOI: 10.1016/j.nut.2023.112134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
Polypharmacy is the simultaneous use of multiple medicines, usually more than five. Polypharmacy is highly prevalent among older individuals and is associated with several adverse health outcomes, including frailty. The role of polypharmacy in nutritional status seems to be crucial: although a clear association between polypharmacy and malnutrition has been widely reported in older people, the magnitude of the effect of increased number of drugs in combination with their type on the risk for malnutrition remains to be largely explored. Therefore, this review aims to discuss the association between polypharmacy and malnutrition in older people and to provide suggestions for its management. Polypharmacy is prevalent among malnourished frail patients, and the relative contribution of comorbidities and polypharmacy to malnutrition is difficult to be determined. Several mechanisms by which commonly used medications have the potential to affect nutritional status have been identified and described. Deprescribing (i.e., a systematic process of identification and discontinuation of drugs or a reduction of drug regimens) could be an essential step for minimizing the effects of polypharmacy on malnutrition. In this regard, the literature suggests that in older patients taking several medications, the best method to solve this problem is the comprehensive geriatric assessment, based on a holistic approach, including drug review, to find potential unnecessary and inappropriate medications. Nutritional and deprescribing interventions must be tailored to patient needs and to the local context to overcome barriers when applied in different settings.
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Affiliation(s)
- Michela Zanetti
- Geriatric Clinic, Maggiore Hospital of Trieste, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy; Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Sergio Riso
- Clinical Nutrition and Dietetics Unit, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Virginia Boccardi
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Carolina Bolli
- Clinical Nutrition Unit, Presidio Ospedaliero "San Filippo Neri", Rome, Italy
| | - Marco Cintoni
- Clinical Nutrition Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Liliana Mazza
- Department of Integration, Azienda USL di Bologna, Bologna, Italy
| | - Giovanna Onfiani
- Clinical Nutrition Unit, Complex Structure of Endocrinology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Zenaro
- Direzione Tecnica Socio Sanitaria Coopselios, Reggio Emilia, Italy
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy; Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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9
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Xu J, Wei Y, Huang Y, Weng X, Wei X. Current understanding and future perspectives on the extraction, structures, and regulation of muscle function of tea pigments. Crit Rev Food Sci Nutr 2023; 63:11522-11544. [PMID: 35770615 DOI: 10.1080/10408398.2022.2093327] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the aggravating aging of modern society, the sarcopenia-based aging syndrome poses a serious potential threat to the health of the elderly. Natural dietary supplements show great potential to reduce muscle wasting and enhance muscle performance. Tea has been widely recognized for its health-promoting effects. which contains active ingredients such as tea polyphenols, tea pigments, tea polysaccharides, theanine, caffeine, and vitamins. In different tea production processes, the oxidative condensation and microbial transformation of catechins and other natural substances from tea promotes the production of various tea pigments, including theaflavins (TFs), thearubigins (TRs), and theabrownins (TBs). Tea pigments have shown a positive effect on maintaining muscle health. Nevertheless, the relationship between tea pigments and skeletal muscle function has not been comprehensively elucidated. In addition, the numerous research on the extraction and purification of tea pigments is disordered with the limited recent progress due to the complexity of species and molecular structure. In this review, we sort out the strategies for the separation of tea pigments, and discuss the structures of tea pigments. On this basis, the regulation mechanisms of tea pigments on muscle functional were emphasized. This review highlights the current understanding on the extraction methods, molecular structures and regulation mechanisms of muscle function of tea pigments. Furthermore, main limitations and future perspectives are proposed to provide new insights into broadening theoretical research and industrial applications of tea pigments in the future.
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Affiliation(s)
- Jia Xu
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- School of Environmental and Chemical Engineering, Shanghai University, Baoshan, Shanghai, People's Republic of China
| | - Yang Wei
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yi Huang
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xinchu Weng
- School of Environmental and Chemical Engineering, Shanghai University, Baoshan, Shanghai, People's Republic of China
| | - Xinlin Wei
- School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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10
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Colloca GF, Bellieni A, Di Capua B, Iervolino M, Bracci S, Fusco D, Tagliaferri L, Landi F, Valentini V. Sarcopenia Diagnosis and Management in Hematological Malignancies and Differences with Cachexia and Frailty. Cancers (Basel) 2023; 15:4600. [PMID: 37760569 PMCID: PMC10527381 DOI: 10.3390/cancers15184600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Sarcopenia is a geriatric syndrome characterized by a progressive loss of systemic muscle mass and decreased muscle strength or physical function. Several conditions have a role in its pathogenesis, significantly impacting adverse outcomes such as falls, functional decline, frailty, disability, multiple hospitalizations, and mortality. In the oncological setting, sarcopenia is associated with an increased risk of treatment toxicity, postoperative complications, and a higher mortality rate related to other causes (e.g., pneumonia). In the hematological field, even more so, sarcopenia predicts toxicity and response to treatments. In patients with hematologic malignancy, low muscle mass is associated with adverse outcomes and is a predictor of overall survival and non-relapse mortality. Therefore, it is essential to correctly recognize sarcopenia, evaluate the risk factors and their impact on the patient's trajectory, and effectively treat sarcopenia. Sarcopenia is a reversible condition. The most effective intervention for reversing it is physical exercise combined with nutrition. The objective of clinical assessment focused on sarcopenia is to be able to carry out a "tailor-made treatment".
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Affiliation(s)
- Giuseppe Ferdinando Colloca
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Andrea Bellieni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Beatrice Di Capua
- Centro di Eccellenza Oncologia Radioterapica e Medica e Radioterapia, Ospedale Fatebenefratelli Isola Tiberina—Gemelli Isola, 00186 Rome, Italy
| | - Marialuisa Iervolino
- Dipartimento Universitario di Scienze Geriatriche ed Ortopediche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Serena Bracci
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Domenico Fusco
- Dipartimento di Scienze dell’Invecchiamento, Ortopediche e Reumatologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (D.F.); (F.L.)
| | - Luca Tagliaferri
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
| | - Francesco Landi
- Dipartimento di Scienze dell’Invecchiamento, Ortopediche e Reumatologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (D.F.); (F.L.)
| | - Vincenzo Valentini
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (G.F.C.); (S.B.); (V.V.)
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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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12
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Delgado-Lima AH, Bouhaben J, Martínez-Zujeros S, Pallardo-Rodil B, Gómez-Pavón J, Delgado-Losada ML. Could olfactory identification be a prognostic factor in detecting cognitive impairment risk in the elderly? GeroScience 2023:10.1007/s11357-023-00779-5. [PMID: 37084121 PMCID: PMC10119830 DOI: 10.1007/s11357-023-00779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023] Open
Abstract
Aging contributes to the deterioration of the olfactory system in humans. Several studies indicate that the olfactory identification test alone may function as a screening test for olfactory dysfunction and they are more feasible to apply in clinical practice. Olfactory identification may be a predictor for cognitive impairment. Multiple studies have considered the use of odor identification as a measure to identify the conversion from normality to mild cognitive impairment or dementia. The objectives were (i) to elucidate the associations between cognitive status and olfactory identification performance in aging; (ii) understand the predictive value of olfactory capacity in identifying subjects with cognitive impairment risk; and (iii) to study how cognitive status and olfactory identification relate with other variables of wellness in aging, such as functional capabilities and clinical measures. For this purpose, a group of 149 participants (77.15 ± 7.29 years; 73 women of 76.7 ± 8 years and 76 men of 77.6 ± 6.52 years) were recruited and were subjected to a sociodemographic questionnaire, a psychological screening tool of general cognitive status, an olfactory identification evaluation, and clinical measures. The participants were divided into groups based on their cutoff scores of previous scientific reports about the Spanish version of Montreal Cognitive Assessment. Our results indicate an age-associated decline in olfactory identification ability and intensity of odor perception. The predictive ability of olfactory identification scores for the risk of mild and severe impairment is around 80%. Olfactory identification decreases with cognitive function. Performance in odor identification is associated with impairment of episodic memory and executive functions. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.
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Affiliation(s)
- Alice Helena Delgado-Lima
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain
| | - Jaime Bouhaben
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain
| | - Sergio Martínez-Zujeros
- Geriatric Department, Hospital Central de La Cruz Roja "San José Y Santa Adela", 28003, Madrid, Spain
| | - Beatriz Pallardo-Rodil
- Geriatric Department, Hospital Central de La Cruz Roja "San José Y Santa Adela", 28003, Madrid, Spain
| | - Javier Gómez-Pavón
- Geriatric Department, Hospital Central de La Cruz Roja "San José Y Santa Adela", 28003, Madrid, Spain
| | - María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, 28223, Pozuelo de Alarcón, Spain.
- Group of Neurosciences: Psychoneuroendocrinology, Neuroimaging and Molecular Genetics in Neuropsychiatric Diseases, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico de Madrid, 28040, Madrid, Spain.
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13
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Saleem S, Tarar ZI, Aziz M, Ishtiaq R, Guzman Rojas P, Abell TL. Gastroparesis in geriatrics population: A United States population study. Am J Med Sci 2023; 365:226-231. [PMID: 36521532 DOI: 10.1016/j.amjms.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/18/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Older patients with upper gastrointestinal diseases may lack disease-specific symptoms that are required to make the correct diagnosis. This study aimed to compare the gastroparesis demographics, clinical presentation, and surgical management between the older adult and young populations. METHODS The National Inpatient Sample database was used between the years 2012 and 2014 with the primary diagnosis of gastroparesis. Patients were further divided based on their age into two groups: 70 years or older and younger than 70 years. RESULTS The older adults were more likely to have early satiety and bloating compared to younger population with an odds ratio (OR) = 3.79; 95% Confidence Interval (95%CI) 2.80- 5.11, p < 0.0001 and OR = 2.80, 95%CI 2.07-3.78, p<0.0001 respectively. Older adults had low odds of having nausea with vomiting (OR = 0.86, 95%CI 0.76-0.95, p = 0.003), or abdominal pain (OR = 0.56, 95%CI 0.50-0.63, p<0.0001). CONCLUSIONS Older adults had more early satiety and bloating, whereas younger patients had more nausea with vomiting and abdominal pain.
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Affiliation(s)
- Saad Saleem
- Department of Internal Medicine, Sunrise Hospital and Medical Center, Las Vegas, NV, United States
| | - Zahid Ijaz Tarar
- Department of Internal Medicine, University of Missouri, Columbia, MO, United States
| | - Muhammad Aziz
- Department of Gastroenterology, University of Toledo, Toledo, OH, United States
| | - Rizwan Ishtiaq
- Department of Internal Medicine, St. Vincent Mercy Medical Center, Toledo, OH, United States
| | - Patricia Guzman Rojas
- Department of Internal Medicine, University of Louisville, Louisville, KY, United States
| | - Thomas L Abell
- Department of Medicine, University of Louisville, Louisville, KY, United States.
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14
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Sinclair AJ, Abdelhafiz AH. Metabolic Impact of Frailty Changes Diabetes Trajectory. Metabolites 2023; 13:metabo13020295. [PMID: 36837914 PMCID: PMC9960364 DOI: 10.3390/metabo13020295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/25/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
Diabetes mellitus prevalence increases with increasing age. In older people with diabetes, frailty is a newly emerging and significant complication. Frailty induces body composition changes that influence the metabolic state and affect diabetes trajectory. Frailty appears to have a wide metabolic spectrum, which can present with an anorexic malnourished phenotype and a sarcopenic obese phenotype. The sarcopenic obese phenotype individuals have significant loss of muscle mass and increased visceral fat. This phenotype is characterised by increased insulin resistance and a synergistic increase in the cardiovascular risk more than that induced by obesity or sarcopenia alone. Therefore, in this phenotype, the trajectory of diabetes is accelerated, which needs further intensification of hypoglycaemic therapy and a focus on cardiovascular risk reduction. Anorexic malnourished individuals have significant weight loss and reduced insulin resistance. In this phenotype, the trajectory of diabetes is decelerated, which needs deintensification of hypoglycaemic therapy and a focus on symptom control and quality of life. In the sarcopenic obese phenotype, the early use of sodium-glucose transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists is reasonable due to their weight loss and cardio-renal protection properties. In the malnourished anorexic phenotype, the early use of long-acting insulin analogues is reasonable due to their weight gain and anabolic properties, regimen simplicity and the convenience of once-daily administration.
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Affiliation(s)
- Alan J. Sinclair
- Foundation for Diabetes Research in Older People (fDROP), King’s College, London WC2R 2LS, UK
| | - Ahmed H. Abdelhafiz
- Foundation for Diabetes Research in Older People (fDROP), King’s College, London WC2R 2LS, UK
- Department of Geriatric Medicine Rotherham General Hospital, Rotherham S60 2UD, UK
- Correspondence:
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15
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Transitioning food environments and diets of African migrants: implications for non-communicable diseases. Proc Nutr Soc 2023; 82:69-79. [PMID: 36453152 DOI: 10.1017/s0029665122002828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Non-communicable diseases disproportionately affect African migrants from sub-Saharan Africa living in high-income countries (HICs). Evidence suggests this is largely driven by forces that include migration, globalisation of unhealthy lifestyles (poor diet, physical inactivity and smoking), unhealthy food environments, socio-economic status and population ageing. Changes in lifestyle behaviours that accompany migration are exemplified primarily by shifts in dietary behaviours from more traditional diets to a diet that incorporates that of the host culture, which promotes the development of obesity, diabetes, hypertension and CVD. The current paper presents a critical analysis of dietary change and how this is influenced by the food environment and the socio-economic context following migration. We used a food systems framework to structure the discussion of the interaction of factors across the food system that shape food environments and subsequent dietary changes among African migrant populations living in HICs.
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Kaneko K, Tokuyama Y, Taniguchi E, Abe S, Nakato J, Iwakura H, Sato M, Kurabayashi A, Suzuki H, Ito A, Higuchi Y, Nakayama R, Uchiyama K, Takahashi H, Ohinata K. Rice Endoplasmic Protein-Derived Peptides, Rice-Ghretropins A and B, Stimulate Ghrelin Release in MGN3-1 Cells and Increase Plasma Acylated Ghrelin and Food Intake in Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:421-429. [PMID: 36580688 DOI: 10.1021/acs.jafc.2c05965] [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: 06/17/2023]
Abstract
In this study, we demonstrated that novel rice-derived bioactive peptides promote the secretion of ghrelin, an endogenous orexigenic hormone secreted from the stomach. The enzymatic digest of rice endosperm protein with subtilisin, a microorganism-derived enzyme, stimulated acylated ghrelin secretion in the ghrelin-releasing cell line MGN3-1 and increased food intake after oral administration in mice. By performing a comprehensive analysis based on structure-activity relationships, we selected candidate peptides from over 30,000 peptides in the rice digest. Among them, we found that QAFEPIRSV and TNPWHSPRQGSF, corresponding to the amino acid sequence of the rice endoplasmic proteins glutelin A1 or A2(52-60) and B1 or B2(31-42), respectively, stimulated acylated ghrelin release in MGN3-1 cells. We named them rice-ghretropins A and B. Pyroglutamate formation of rice-ghretropin A, [pyr1]-rice-ghretropin A, also promoted ghrelin secretion. Furthermore, oral administration of rice-ghretropins increased food intake, plasma ghrelin concentration, and small intestinal transit in mice. In addition, the subtilisin digest of the rice protein significantly increased food intake for 4 h in 9 month-old (control: 0.61 ± 0.049 g; digest: 0.83 ± 0.059 g) and 24 month-old mice (control: 0.52 ± 0.067 g; digest: 1.01 ± 0.064 g). In summary, we found that novel bioactive peptides, namely, rice-ghretropins, from the enzymatic digest of rice endosperm stimulated acylated ghrelin secretion and increased food intake. This is the first report of rice-derived exogenous bioactive peptides that increase acylated ghrelin secretion.
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Affiliation(s)
- Kentaro Kaneko
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - Yuki Tokuyama
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - Eriko Taniguchi
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - Shimon Abe
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - Junya Nakato
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
| | - Hiroshi Iwakura
- The First Department of Medicine, Wakayama Medical University, Wakayama 841-8509, Japan
| | - Masaru Sato
- Department of Applied Genomics, Kazusa DNA Research Institute, 2-6-7 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Atsushi Kurabayashi
- Department of Applied Genomics, Kazusa DNA Research Institute, 2-6-7 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Hideyuki Suzuki
- Department of Applied Genomics, Kazusa DNA Research Institute, 2-6-7 Kazusakamatari, Kisarazu, Chiba 292-0818, Japan
| | - Akira Ito
- Rice Research Institute, Kameda Seika CO., LTD. 3-1-1Kameda-kogyodanchi, Konan, Niigata, Niigata 950-0198, Japan
| | - Yuki Higuchi
- Rice Research Institute, Kameda Seika CO., LTD. 3-1-1Kameda-kogyodanchi, Konan, Niigata, Niigata 950-0198, Japan
| | - Ryoko Nakayama
- Rice Research Institute, Kameda Seika CO., LTD. 3-1-1Kameda-kogyodanchi, Konan, Niigata, Niigata 950-0198, Japan
| | - Kimiko Uchiyama
- Rice Research Institute, Kameda Seika CO., LTD. 3-1-1Kameda-kogyodanchi, Konan, Niigata, Niigata 950-0198, Japan
| | - Hajime Takahashi
- Rice Research Institute, Kameda Seika CO., LTD. 3-1-1Kameda-kogyodanchi, Konan, Niigata, Niigata 950-0198, Japan
| | - Kousaku Ohinata
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan
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Pink AE, Lee LL, Low DY, Yang Y, Fong LZ, Kang AYH, Liu P, Kim H, Wang Y, Padmanabhan P, Cobiac L, Gulyás B, Pettersson S, Cheon BK. Implicit satiety goals and food-related expectations predict portion size in older adults: Findings from the BAMMBE cohort. Appetite 2023; 180:106361. [PMID: 36332849 PMCID: PMC9742320 DOI: 10.1016/j.appet.2022.106361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/07/2022]
Abstract
Portion size selection is an indicator of appetite and within younger adults, is predicted by factors such as expected satiety, liking and motivations to achieve an ideal sensation of fullness (i.e., implicit satiety goals). Currently, there is limited research available on the determinants of portion size selection within older adults. Therefore, the current study aimed to examine the relationship between individual differences in implicit satiety goals, food-related expectations, and portion size selection in older adults. Free-living older adult Singaporeans (N = 115; Nmales = 62; age: M = 66.21 years, SD = 4.78, range = 60-83 years) participated as part of the Brain, Ageing, Microbiome, Muscle, Bone, and Exercise Study (BAMMBE). Participants completed questionnaires on their subjective requirements for experiencing different states of satiety and food-related expectations (i.e., liking, how filling) as well as a computerised portion size selection task. Using a multiple regression, we found that goals to feel comfortably full (B = 3.08, SE = 1.04, t = 2.96, p = .004) and to stop hunger (B = -2.25, SE = 0.82, t = -2.75, p = .007) significantly predicted larger portion size selection (R2 = 0.24, F(4,87) = 6.74, p < .001). Larger portion sizes (R2 = 0.53, F(5,90) = 20.58, p < .001) were also predicted by greater expected satiety (B = 0.47, SE = 0.09, t = 5.15, p < .001) and lower perceptions of how filling foods are (B = -2.92, SE = 0.77, t = -3.79, p < .001) but not liking (B = -0.09, SE = 0.91, t = -0.10, p = .925) or frequency (B = -18.42, SE = 16.91, t = -1.09, p = .279) of consumption of target foods. Comparing our findings to results of studies conducted with younger adults suggests the influence of factors such as satiety related goals on portion size selection may change with ageing while the influence of other factors (e.g., expected satiety/fullness delivered by foods) may remain consistent. These findings may inform future strategies to increase/decrease portion size accordingly to ensure older adults maintain an appropriate healthy weight.
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Affiliation(s)
- Aimee E Pink
- School of Social Sciences, Nanyang Technological University, 639818, Singapore; Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR), 138632, Singapore; Singapore Institute for Clinical Sciences (A*STAR), Agency for Science, Technology and Research (A*STAR), Singapore, 117599.
| | - Li Ling Lee
- School of Social Sciences, Nanyang Technological University, 639818, Singapore.
| | - Dorrain Yanwen Low
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Yifan Yang
- Physical Education and Sports Science, National Institute of Education (NIE), Nanyang Technological University, 637616, Singapore; Office of Education Research, National Institute of Education (NIE), Nanyang Technological University, 637616, Singapore.
| | - LaiGuan Zoey Fong
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Alicia Yi Hui Kang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Peijia Liu
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Hyejin Kim
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore.
| | - Yulan Wang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Singapore Phenome Centre (SPC), Nanyang Technological University, 636921, Singapore.
| | | | - Lynne Cobiac
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity, Adelaide, South Australia, 5001, Australia.
| | - Balázs Gulyás
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Cognitive Neuroimaging Centre (CONIC), Nanyang Technological University, 636921, Singapore; Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Sven Pettersson
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore; Department of Neurobiology, Care and Society, Karolinska Institutet, 171 77, Stockholm, Sweden; National Neuroscience Institute, Tan Tock Seng Hospital, 308433, Singapore; Sunway University, Faculty of Medical Sciences, Kuala Lumpur, 47500, Malaysia.
| | - Bobby K Cheon
- Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA, 20847.
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Rushby HJ, Andrews ZB, Piper MD, Mirth CK. Ageing impairs protein leveraging in a sex-specific manner in Drosophila melanogaster. Anim Behav 2023. [DOI: 10.1016/j.anbehav.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abstract
BACKGROUND The oropharyngeal dysphagia is an underestimated symptom with various causes in the geriatric population. Clinical presentation is often insidious and dysphagia symptoms are seldomly mentioned by elderly patients although causing many life-threatening complications. The aim of this work was to introduce an easy applicable tool to be used by the caregivers and general practitioners for screening of dysphagia in geriatrics for early detection of at risk individuals. METHODS A sample of 200 Egyptian Arabic-speaking elderly patients (65 years or older) not complaining of dysphagia was recruited from nursing homes in Greater Cairo Area. They or their caregivers completed the designed screening tool, including; the designed questionnaires of dysphagia manifestations and eating habits. General, oral motor and bedside evaluation were also performed. In addition to filling in the EAT10 questionnaire and FEES that was performed for only suspected cases for the purpose of validation of the screening tool. RESULTS The dysphagia manifestations questionnaire was significantly correlated with EAT 10 with p value of 0.001. It was correlated in some of its aspects with FEES showing quite reliability with p values' range between 0.012 and 0.044. The Questionnaire of eating habits reliability of r- value of 0.568 slightly exceeding EAT10 reliability of r -value of 0.721 in the subjects under study. The cutoff point of total score of the dysphagia manifestations was > 5, with a sensitivity of 17.65% & a specificity of 94.20%. The cutoff point of total score of the bedside evaluation was ≤ 1 with a sensitivity of 66.9% & a specificity of 56.9%. CONCLUSION the use of this easy applicable screening tool managed to suspect and later on diagnose cases with oropharyngeal dysphagia in non-complaining aging subjects.
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20
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Urgessa M. The Mini Nutritional Assessment tool's applicability for the elderly in Ethiopia: validation study. PeerJ 2022; 10:e14396. [PMID: 36411835 PMCID: PMC9675339 DOI: 10.7717/peerj.14396] [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: 04/05/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Mini Nutrition Assessment (MNA) is a widely used and valid tool for screening and assessment of malnutrition among the elderly population worldwide. However, MNA has not been validated among the Ethiopian elderly population and this study assessed the validity of the tool for the target population. Methods Cross-sectional validation study design employed to validate MNA in Meki town, East Ethiopia. This study included 176 randomly selected elders living in the community, whereas amputated, bedridden, visible deformity, known liver and/or renal disorders were excluded. The original MNA questionnaires were translated to local language and administered to each participant after doing the pretest. The anthropometric, self-perception of nutritional status and serum albumin concentrations were measured. Reliability, validity, sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated. Receiver-operating characteristic (ROC) curve analysis was plotted to identify the area under the curve (AUC) and optimal cut-off value for the prediction of malnutrition. Result A total of one hundred and seventy-six elders participated in this study. Of the total participants, 78(44.3%) were males. The mean (SD) age of the participants was 67.6 (±5.8) years and ranged from 60 to 84 years. The prevalence of malnutrition based on the MNA criteria (MNA < 17 points) was 18.2%, and 13.1% based on serum albumin concentration (<3 g/dl).The MNA had an overall Internal consistency of Cronbach's alpha 0.61. The tool also demonstrated significant criterion-related validity (0.75, p < 0.001) and concurrent validity (0.51, p < 0.001) with serum albumin concentration and self-perception of nutritional status respectively. Using the original cut-off point, the sensitivity, specificity, PPV and NPV of the tool were 93.5%, 44.6%, 65.4% and 86.0%, respectively. By modifying, the cut-off point to a value of <20.5, the sensitivity and specificity of the tool increases to 97.6% and 82.8% respectively. The AUC (95%CI) showed an overall accuracy of 92.7% (88.5, 96.9). Conclusion The MNA tool can be used as a valid malnutrition screening tool for the Ethiopian elderly population by modifying the original cut-off point.
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Affiliation(s)
- Megersso Urgessa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Shashemene, Oromia, Ethiopia
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Gungabissoon U, Broadbent M, Perera G, Ashworth M, Galwey N, Stewart R. The Impact of Dementia on Diabetes Control: An Evaluation of HbA 1c Trajectories and Care Outcomes in Linked Primary and Specialist Care Data. J Am Med Dir Assoc 2022; 23:1555-1563.e4. [PMID: 35661655 DOI: 10.1016/j.jamda.2022.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Diabetes self-care may become increasingly challenging as cognition declines. We sought to characterize glycated hemoglobin A1c (HbA1c) trajectories, markers of diabetes-related management, health care utilization, and mortality in people with preexisting type 2 diabetes (T2D) with and without dementia and based on the extent of cognitive impairment at the time of dementia diagnosis. DESIGN Retrospective matched cohort study. SETTING AND PARTICIPANTS Using a linkage between a primary care (Lambeth DataNet) and a secondary mental healthcare database, up to 5 individuals aged ≥65 y with preexisting T2D without dementia were matched to each individual with dementia based on age, sex, and general practice. METHODS Comparisons were made for HbA1c trajectories (linear mixed effects models), markers of diabetes-related management and severity at dementia diagnosis (logistic regression), mortality (Cox regression), and health care utilization (multilevel mixed effects binomial regression). RESULTS In 725 incident dementia and 3154 matched comparators, HbA1c trajectories differed by dementia status; HbA1c increased over time for mild dementia and non-dementia, but the increase was greater in the mild dementia group; for those with moderate-severe dementia, HbA1c decreased over time. Despite individuals with dementia having increased health care utilization around the time of dementia diagnosis, they were less likely to have had routine diabetes-related management. Patients with dementia had a higher prevalence of macrovascular complications and diabetes foot morbidity at dementia diagnosis and a higher mortality risk than those without dementia; these relationships were most marked in those with moderate-severe dementia. CONCLUSIONS AND IMPLICATIONS Our study has highlighted important differences in the monitoring, management, and control of diabetes in people with dementia. The effects of frailty and the extent of cognitive impairment on the ability to self-manage diabetes and on glycemic control may need to be considered in treatment guidelines and by primary care.
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Affiliation(s)
- Usha Gungabissoon
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; Epidemiology, Value, Evidence and Outcomes, Global Medical, GlaxoSmithKline (GSK) R&D, London, United Kingdom.
| | - Matthew Broadbent
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Gayan Perera
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Mark Ashworth
- School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | | | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
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22
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Asche-Godin SL, Graham ZA, Israel A, Harlow LM, Huang W, Wang Z, Brotto M, Mobbs C, Cardozo CP, Ko FC. RNA-sequencing Reveals a Gene Expression Signature in Skeletal Muscle of a Mouse Model of Age-associated Postoperative Functional Decline. J Gerontol A Biol Sci Med Sci 2022; 77:1939-1950. [PMID: 35172336 PMCID: PMC9536457 DOI: 10.1093/gerona/glac043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Indexed: 11/14/2022] Open
Abstract
This study aimed to characterize the effects of laparotomy on postoperative physical function and skeletal muscle gene expression in male C57BL/6N mice at 3, 20, and 24 months of age to investigate late-life vulnerability and resiliency to acute surgical stress. Pre and postoperative physical functioning was assessed by forelimb grip strength on postoperative day (POD) 1 and 3 and motor coordination on POD 2 and 4. Laparotomy-induced an age-associated postoperative decline in forelimb grip strength that was the greatest in the oldest mice. While motor coordination declined with increasing age at baseline, it was unaffected by laparotomy. Baseline physical function as stratified by motor coordination performance (low functioning vs high functioning) in 24-month-old mice did not differentially affect postlaparotomy reduction in grip strength. RNA sequencing of soleus muscles showed that laparotomy-induced age-associated differential gene expression and canonical pathway activation with the greatest effects in the youngest mice. Examples of such age-associated, metabolically important pathways that were only activated in the youngest mice after laparotomy included oxidative phosphorylation and NRF2-mediated oxidative stress response. Analysis of lipid mediators in serum and gastrocnemius muscle showed alterations in profiles during aging and confirmed an association between such changes and functional status in gastrocnemius muscle. These findings demonstrate a mouse model of laparotomy which recapitulated some features of postoperative skeletal muscle decline in older adults, and identified age-associated, laparotomy-induced molecular signatures in skeletal muscles. Future research can build upon this model to study molecular mechanisms of late-life vulnerability and resiliency to acute surgical stress.
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Affiliation(s)
- Samantha L Asche-Godin
- National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zachary A Graham
- Research Service, Birmingham VA Medical Center, Birmingham, Alabama, USA,Department of Cell, Developmental, and Integrative Biology, University of Alabama-Birmingham, Birmingham, USA
| | - Adina Israel
- National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Lauren M Harlow
- National Center for the Medical Consequences of Spinal Cord Injury, James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Weihua Huang
- Department of Pathology, Microbiology and Immunology, New York Medical College, Valhalla, New York, USA
| | - Zhiying Wang
- Bone-Muscle Research Center, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Marco Brotto
- Bone-Muscle Research Center, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Charles Mobbs
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA,Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Fred C Ko
- Address correspondence to: Fred C. Ko, MD, Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA. E-mail:
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23
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Crabtree DR, Holliday A, Buosi W, Fyfe CL, Horgan GW, Johnstone AM. The Acute Effects of Breakfast Drinks with Varying Protein and Energy Contents on Appetite and Free-Living Energy Intake in UK Older Adults. Geriatrics (Basel) 2022; 7:geriatrics7010016. [PMID: 35200521 PMCID: PMC8871635 DOI: 10.3390/geriatrics7010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022] Open
Abstract
Proposed strategies for preventing protein deficiencies in older patients include increasing protein intake at breakfast. However, protein is highly satiating and the effects of very high protein intakes at breakfast on subsequent appetite and free-living energy intake (EI) in older adults are unclear. This study compared the acute effects of two breakfast drinks varying in protein and energy contents on appetite and free-living EI in healthy older adults using a randomized 2 × 2 crossover design. Participants (n = 48 (20 men, 28 women); mean ± SD age: 69 ± 3 years; BMI: 22.2 ± 2.0 kg·m−2; fat-free mass: 45.5 ± 8.0 kg) consumed two drinks for breakfast (high-protein (30.4 ± 5.3 g), low-energy (211.2 ± 37.1 kcal) content (HPLE) and very high-protein (61.8 ± 9.9 g), fed to energy requirements (428.0 ± 68.9 kcal) (VHPER)) one week apart. Appetite perceptions were assessed for 3 h post-drink and free-living EI was measured for the remainder of the day. Appetite was lower in VHPER than HPLE from 30 min onwards (p < 0.01). Free-living energy and protein intake did not differ between conditions (p = 0.814). However, 24 h EI (breakfast drink intake + free-living intake) was greater in VHPER than HPLE (1937 ± 568 kcal vs. 1705 ± 490 kcal; p = 0.001), as was 24 h protein intake (123.0 ± 26.0 g vs. 88.6 ± 20.9 g; p < 0.001). Consuming a very high-protein breakfast drink acutely suppressed appetite more than a low-energy, high-protein drink in older adults, though free-living EI was unaffected. The long-term effects of adopting such a breakfast strategy in older adults at high risk of energy and protein malnutrition warrants exploration.
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Affiliation(s)
- Daniel R. Crabtree
- Division of Biomedical Sciences, University of the Highlands and Islands, Old Perth Road, Inverness IV2 3JH, UK
- Correspondence: ; Tel.: +44-(0)-1463-279405
| | - Adrian Holliday
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK;
| | - William Buosi
- The Rowett Institute, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (W.B.); (C.L.F.); (A.M.J.)
| | - Claire L. Fyfe
- The Rowett Institute, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (W.B.); (C.L.F.); (A.M.J.)
| | - Graham W. Horgan
- Biomathematics and Statistics Scotland, Foresterhill Road, Aberdeen AB25 2ZD, UK;
| | - Alexandra M. Johnstone
- The Rowett Institute, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZD, UK; (W.B.); (C.L.F.); (A.M.J.)
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24
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Naharci MI, Katipoglu B, Tasci I. Association of anticholinergic burden with undernutrition in older adults: A cross-sectional study. Nutr Clin Pract 2022; 37:1215-1224. [PMID: 34994474 DOI: 10.1002/ncp.10821] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Limited data are available concerning the contribution of drugs with anticholinergic properties (DAPs) to undernutrition among older adults. This study aimed to determine the potential association of anticholinergic burden (ACB) to nutrition status in older people. METHODS We prospectively enrolled participants aged over 65 who underwent a comprehensive geriatric assessment between January 2017 and June 2020. Nutrition status was assessed by the Mini Nutritional Assessment-Short Form (MNA-SF). The ACB was assessed using the ACB scale. RESULTS A total of 615 participants were included in the analysis (mean age ± SD, 78.5 ± 6.6 years; male, 55.3%). The prevalence of undernutrition (MNA-SF score <12) was 22.6% (n = 139). Participants with undernutrition were predominantly older (P < 0.001), had lower mean body mass index scores (undernutrition, 27.3 ± 5.4 vs healthy, 29.5 ± 8.0; P = 0.007), had a lower educational level (P = 0.016), had higher cardiovascular disease morbidity (P < 0.001), and had a higher ACB (P < 0.001) when compared with those with normal nutrition status. In adjusted analysis, the odds of having undernutrition were higher among participants with an ACB score >1 (odds ratio, 1.20; 95% CI, 1.01-1.43; P = 0.044). The weighted multivariate linear regression analysis showed a significant inverse association between the total ACB score and MNA-SF score controlling for multiple confounders. CONCLUSION ACB appears to be inversely correlated with nutrition status among older adults. Undernutrition may be considered an additional reason to consider deprescribing DAPs in this population.
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Affiliation(s)
- Mehmet Ilkin Naharci
- Division of Geriatrics, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bilal Katipoglu
- Division of Geriatrics, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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25
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Aprahamian I, Merchant RA, Ouslander JG. Editorial: A Giant in Geriatrics: A Tribute to Professor John Edward Morley. J Nutr Health Aging 2022; 26:539-542. [PMID: 35718859 PMCID: PMC9107212 DOI: 10.1007/s12603-022-1797-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 12/04/2022]
Affiliation(s)
- I Aprahamian
- Ivan Aprahamian, MD, MS, PhD, FACP, FISAD, FSCWD. Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA). Division of Geriatrics, Department of Internal Medicine, Jundiaí Medical School. 250 Francisco Telles st. ZIP 13202-550. Jundiaí. Brazil. E-mail: . Twitter: @IAprahamian
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26
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Veronese N, Ferrari G, Barbagallo M. Nutritional Issues of Older People in Primary Care. PRACTICAL ISSUES IN GERIATRICS 2022:59-69. [DOI: 10.1007/978-3-030-78923-7_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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27
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Chan K, Charles L, Triscott J, Dobbs B. Common Problems of the Elderly. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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28
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Kaneko K. Appetite regulation by plant-derived bioactive peptides for promoting health. Peptides 2021; 144:170608. [PMID: 34265369 DOI: 10.1016/j.peptides.2021.170608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/20/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
Appetite is closely regulated not only by gut hormonal and neuronal peptides but also by exogenous peptides derived from food proteins. Food proteins are now recognized to contain many thousands of bioactive compounds that provide additional health benefits beyond their nutritional effects. Bioactive peptides are beneficial to the life and/or to regulate physiological functions. Although animal protein products have been widely applied in the food industry, exploring the possibilities of developing functional foods based on plant protein-derived peptides is considered attractive for achieving sustainable development goals. In addition, peptides from plant proteins have the potential to treat numerous diseases or risk factors and may therefore facilitate a healthy life expectancy. In this review, we discuss the identified plant-based bioactive peptides and their appetite regulating effects. Plant-based bioactive peptides may provide new opportunities to discover novel approaches that can improve and prevent diseases in a sustainable environment.
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Affiliation(s)
- Kentaro Kaneko
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan.
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29
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Pourhassan M, Babel N, Sieske L, Westhoff TH, Wirth R. Longitudinal Changes of Cytokines and Appetite in Older Hospitalized Patients. Nutrients 2021; 13:nu13082508. [PMID: 34444668 PMCID: PMC8400156 DOI: 10.3390/nu13082508] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
There are few data on the longitudinal association of cytokine and appetite among older hospitalized patients. We aimed to investigate the impact of the changes of inflammatory cytokines on appetite in older hospitalized patients. A total of 191 patients (mean age 81.3 ± 6.6 years, 64% women) participated in this prospective longitudinal observational study. Appetite was evaluated using the Edmonton Symptom Assessment System on admission and after seven days. Serum cytokines such as IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17, IL-18, IL-23 and IL-33, IFN-α2, IFN-γ, TNF-α and MCP-1 were measured both times. No significant differences in the mean serum levels of all the cytokines could be detected overtime in relation to appetite changes, except for IL-18. Appetite significantly deteriorated overtime in patients with increasing IL-18 levels and improved in those without significant changes in IL-18 levels. In a stepwise regression analysis, changes of IL-18 levels were the major independent predictor for the changes of patients' appetite and explained 4% of the variance, whereas other cytokines and variables, such as age, sex, infection and disease, did not show any impact on appetite changes. We conclude that IL-18 seems to exert a significant impact on appetite in acutely ill older hospitalized patients and should, therefore, be considered as a potential target in the diagnosis, prevention and treatment of malnutrition.
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Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (L.S.); (R.W.)
- Correspondence: ; Tel.: +49-2323-499-2416; Fax: +49-2323-499-2417
| | - Nina Babel
- Medical Department I, General Internal Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany; (N.B.); (T.H.W.)
| | - Lars Sieske
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (L.S.); (R.W.)
| | - Timm Henning Westhoff
- Medical Department I, General Internal Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany; (N.B.); (T.H.W.)
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (L.S.); (R.W.)
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30
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Older age, smoking, tooth loss and denture-wearing but neither xerostomia nor salivary gland hypofunction are associated with low intakes of fruit and vegetables in older Danish adults. J Nutr Sci 2021; 10:e47. [PMID: 34267893 PMCID: PMC8256315 DOI: 10.1017/jns.2021.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 11/07/2022] Open
Abstract
Xerostomia and salivary gland hypofunction are prevalent conditions in older people and may adversely influence the intake of certain foods, notably fruit and vegetables. Here, we aimed to investigate whether xerostomia and salivary gland hypofunction were associated with a lower intake of fruit and vegetables. The study included 621 community-dwelling adults, mean age 75⋅2 ± 6⋅4 years, 58⋅9 % female, who had participated in the Copenhagen City Heart Study follow-up, and undergone interviews regarding food intake (preceding month), oral and general health (xerostomia, taste alterations, diseases, medication, alcohol consumption and smoking), clinical oral examination and measurements of unstimulated and chewing-stimulated whole saliva flow rates. The average total energy intake (8⋅4 ± 2⋅7 MJ) and protein energy percentage (14⋅8 ± 3⋅1 %) were slightly below recommendations. The average fruit (234⋅7 ± 201⋅2 g/d) and vegetables (317⋅3 ± 157⋅4 g/d) intakes were within recommendations. Xerostomia and hyposalivation were more prevalent in women than in men (16⋅4 v. 7⋅1 %, P < 0⋅001 and 40⋅7 v. 27⋅5 %, P < 0⋅001). Multiple linear regression analyses revealed that older age (β -0⋅009, se 0⋅003, P = 0⋅005), smoking (β -0⋅212, se 0⋅060, P = 0⋅0005) and wearing complete dentures/being partially or fully edentulous (β -0⋅141, se 0⋅048, P = 0⋅003), but neither xerostomia nor salivary flow rates were associated with an inadequate fruit and vegetable intake, after adjustment for covariates. Older age, smoking, tooth loss and denture-wearing were stronger determinants of low fruit and vegetable intakes than xerostomia and salivary hypofunction supporting the importance of dietary counselling and maintenance of oral health and an adequate masticatory performance.
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31
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Ciciliati AMM, Adriazola IO, Souza Farias-Itao D, Pasqualucci CA, Leite REP, Nitrini R, Grinberg LT, Jacob-Filho W, Suemoto CK. Severe Dementia Predicts Weight Loss by the Time of Death. Front Neurol 2021; 12:610302. [PMID: 34054683 PMCID: PMC8160379 DOI: 10.3389/fneur.2021.610302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/30/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Body mass index (BMI) in midlife is associated with dementia. However, the association between BMI and late-life obesity is controversial. Few studies have investigated the association between BMI and cognitive performance near the time of death using data from autopsy examination. We aimed to investigate the association between BMI and dementia in deceased individuals who underwent a full-body autopsy examination. Methods: Weight and height were measured before the autopsy exam. Cognitive function before death was investigated using the Clinical Dementia Rating (CDR) scale. The cross-sectional association between BMI and dementia was investigated using linear regression models adjusted for sociodemographic and clinical variables. Results: We included 1,090 individuals (mean age 69.5 ± 13.5 years old, 46% women). Most participants (56%) had a normal BMI (18.5–24.9 kg/m2), and the prevalence of dementia was 16%. Twenty-four percent of the sample had cancer, including 76 cases diagnosed only by the autopsy examination. Moderate and severe dementia were associated with lower BMI compared with participants with normal cognition in fully adjusted models (moderate: β = −1.92, 95% CI = −3.77 to −0.06, p = 0.042; severe: β = −2.91, 95% CI = −3.97 to −1.86, p < 0.001). Conclusion: BMI was associated with moderate and severe dementia in late life, but we did not find associations of BMI with less advanced dementia stages.
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Affiliation(s)
| | | | | | | | | | - Ricardo Nitrini
- Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Lea T Grinberg
- Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil.,Department of Neurology and Pathology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Wilson Jacob-Filho
- Discipline of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil
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32
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Pancreatic cancer cachexia: three dimensions of a complex syndrome. Br J Cancer 2021; 124:1623-1636. [PMID: 33742145 PMCID: PMC8110983 DOI: 10.1038/s41416-021-01301-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/18/2021] [Accepted: 02/02/2021] [Indexed: 02/08/2023] Open
Abstract
Cancer cachexia is a multifactorial syndrome that is characterised by a loss of skeletal muscle mass, is commonly associated with adipose tissue wasting and malaise, and responds poorly to therapeutic interventions. Although cachexia can affect patients who are severely ill with various malignant or non-malignant conditions, it is particularly common among patients with pancreatic cancer. Pancreatic cancer often leads to the development of cachexia through a combination of distinct factors, which, together, explain its high prevalence and clinical importance in this disease: systemic factors, including metabolic changes and pathogenic signals related to the tumour biology of pancreatic adenocarcinoma; factors resulting from the disruption of the digestive and endocrine functions of the pancreas; and factors related to the close anatomical and functional connection of the pancreas with the gut. In this review, we conceptualise the various insights into the mechanisms underlying pancreatic cancer cachexia according to these three dimensions to expose its particular complexity and the challenges that face clinicians in trying to devise therapeutic interventions.
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33
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Tanikawa K, Kaneko K, Abe S, Nakato J, Tokuyama Y, Odaka S, Iwakura H, Sato M, Kurabayashi A, Suzuki H, Makita M, Ikemoto H, Matsumura S, Inoue K, Ohinata K. Wheat-ghretropins: novel ghrelin-releasing peptides derived from wheat protein. FEBS Open Bio 2021; 11:1144-1152. [PMID: 33605550 PMCID: PMC8016139 DOI: 10.1002/2211-5463.13124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/01/2021] [Accepted: 02/17/2021] [Indexed: 01/09/2023] Open
Abstract
Ghrelin is an endogenous orexigenic hormone mainly produced by stomach cells and is reported to influence appetite, gastrointestinal motility and growth hormone secretion. We observed that enzymatic digest of wheat gluten stimulated ghrelin secretion from mouse ghrelinoma 3-1, a ghrelin-releasing cell line. Further on, we characterized the ghrelin-releasing peptides present in the digest by comprehensive peptide analysis using liquid chromatography-mass spectrometry and structure-activity relationship. Among the candidate peptides, we found that SQQQQPVLPQQPSF, LSVTSPQQVSY and YPTSL stimulated ghrelin release. We then named them wheat-ghretropin A, B and C, respectively. In addition, we observed that wheat-ghretropin A increased plasma ghrelin concentration and food intake in mice after oral administration. Thus, we demonstrated that wheat-ghretropin stimulates ghrelin release both in vitro and in vivo. To the best of our knowledge, this is the first report of a wheat-derived exogenous bioactive peptide that stimulates ghrelin secretion.
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Affiliation(s)
- Kana Tanikawa
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Kentaro Kaneko
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Shimon Abe
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Jyunya Nakato
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Yuki Tokuyama
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Sayano Odaka
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Hiroshi Iwakura
- The First Department of MedicineWakayama Medical UniversityJapan
| | - Masaru Sato
- Department of Applied GenomicsKazusa DNA Research InstitutesKisarazuJapan
| | | | - Hideyuki Suzuki
- Department of Applied GenomicsKazusa DNA Research InstitutesKisarazuJapan
| | - Miki Makita
- Health Care Research CenterNisshin Pharma Inc.FujiminoJapan
| | | | - Shigenobu Matsumura
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Kazuo Inoue
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
| | - Kousaku Ohinata
- Division of Food Science and BiotechnologyGraduate School of AgricultureKyoto UniversityUjiJapan
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Effects of Nutrient Intake on Diagnostic Measures of Sarcopenia among Arab Men: A Cross-Sectional Study. Nutrients 2020; 13:nu13010114. [PMID: 33396961 PMCID: PMC7823489 DOI: 10.3390/nu13010114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 01/16/2023] Open
Abstract
Sarcopenia is a major public health condition and is, therefore, of great clinical interest. However, the role of nutrient intake in sarcopenia is unclear. We examined the associations between nutrient intake and diagnostic measures of sarcopenia, including low muscle mass (appendicular lean mass (ALM) divided by height squared, ALM/h2) and strength (hand-grip strength, HGS) among Arab men. This cross-sectional study included 441 men aged 46.8 ± 15.98 years. Habitual nutrient intake was assessed using a food frequency questionnaire (FFQ). Participants were classified according to different ALM/h2 and HGS reference values. Participants with normal muscle mass, defined by an ALM/h2 cutoff of <8.68 kg/m2 (−1 standard deviation (SD) <reference values Arab men), had greater daily energy, protein and fat intake, and percentage of energy from protein and fat (p < 0.01). Conversely, normal muscle mass was associated with a lower percentage of energy from carbohydrates (CHO) (p < 0.001). Regarding muscle strength, participants with HGS above 42 kg (median HGS of Arab men) had higher daily energy and protein and fat intake, but a lower percentage of energy from CHO and a lower intake of total omega-3 fatty acids (p < 0.05). Individuals with normal muscle mass and high HGS have greater daily energy, protein, and fat intake and a lower percentage of energy from CHO compared to sarcopenic individuals.
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Appetite Control across the Lifecourse: The Acute Impact of Breakfast Drink Quantity and Protein Content. The Full4Health Project. Nutrients 2020; 12:nu12123710. [PMID: 33266325 PMCID: PMC7759987 DOI: 10.3390/nu12123710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/11/2022] Open
Abstract
Understanding the mechanisms of hunger, satiety and how nutrients affect appetite control is important for successful weight management across the lifecourse. The primary aim of this study was to describe acute appetite control across the lifecourse, comparing age groups (children, adolescents, adults, elderly), weight categories, genders and European sites (Scotland and Greece). Participants (n = 391) consumed four test drinks, varying in composition (15% (normal protein, NP) and 30% (high protein, HP) of energy from protein) and quantity (based on 100% basal metabolic rate (BMR) and 140% BMR), on four separate days in a double-blind randomized controlled study. Ad libitum energy intake (EI), subjective appetite and biomarkers of appetite and metabolism (adults and elderly only) were measured. The adults' appetite was significantly greater than that of the elderly across all drink types (p < 0.004) and in response to drink quantities (p < 0.001). There were no significant differences in EI between age groups, weight categories, genders or sites. Concentrations of glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) were significantly greater in the elderly than the adults (p < 0.001). Ghrelin and fasting leptin concentrations differed significantly between weight categories, genders and sites (p < 0.05), while GLP-1 and PYY concentrations differed significantly between genders only (p < 0.05). Compared to NP drinks, HP drinks significantly increased postprandial GLP-1 and PYY (p < 0.001). Advanced age was concomitant with reduced appetite and elevated anorectic hormone release, which may contribute to the development of malnutrition. In addition, appetite hormone concentrations differed between weight categories, genders and geographical locations.
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Nutrition in Cancer Therapy in the Elderly-An Epigenetic Connection? Nutrients 2020; 12:nu12113366. [PMID: 33139626 PMCID: PMC7692262 DOI: 10.3390/nu12113366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/22/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023] Open
Abstract
The continuous increase in life expectancy results in a steady increase of cancer risk, which consequently increases the population of older adults with cancer. Older adults have their age-related nutritional needs and often suffer from comorbidities that may affect cancer therapy. They frequently are malnourished and present advanced-stage cancer. Therefore, this group of patients requires a special multidisciplinary approach to optimize their therapy and increase quality of life impaired by aging, cancer, and the side effects of therapy. Evaluation strategies, taking advantage of comprehensive geriatric assessment tools, including the comprehensive geriatric assessment (CGA), can help individualize treatment. As epigenetics, an emerging element of the regulation of gene expression, is involved in both aging and cancer and the epigenetic profile can be modulated by the diet, it seems to be a candidate to assist with planning a nutritional intervention in elderly populations with cancer. In this review, we present problems associated with the diet and nutrition in the elderly undergoing active cancer therapy and provide some information on epigenetic aspects of aging and cancer transformation. Nutritional interventions modulating the epigenetic profile, including caloric restriction and basal diet with modifications (elimination diet, supplementary diet) are discussed as the ways to improve the efficacy of cancer therapy and maintain the quality of life of older adults with cancer.
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Kushwaha S, Khanna P, Srivastava R, Jain R, Singh T, Kiran T. Estimates of malnutrition and risk of malnutrition among the elderly (≥60 years) in India: A systematic review and meta-analysis. Ageing Res Rev 2020; 63:101137. [PMID: 32805453 DOI: 10.1016/j.arr.2020.101137] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/24/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Death is inevitable, but healthy ageing is possible with proper nutrition and health care. This systematic review and meta-analysis conducted to estimate the nation-wide prevalence and malnutrition and risk of malnutrition among the elderly in India. METHODS PubMed, EMBASE, Web of Science, Cochrane`s library, Google Scholar were searched for the articles reporting the prevalence of malnutrition among the elderly using MNA or MNA-SF tools. The study published between the year 2010-2019 were included. Sensitivity analysis, quality assessment was done using standard methods. The publication biasness was also determined using Doi plot and LFK index. The pooled prevalence was reported with effect size and considering the random effect model and quality effect model. The subgroup analysis was also conducted for gender, study setting, study area and study regions. RESULTS The prevalence of malnutrition and risk of malnutrition among the elderly was 18.29% and 48.17% respectively. The prevalence of malnutrition was higher among female (16.67%), clinic setting (28.87%), urban areas (19.29%) and northern region (27.37%) of India. This trend differs with the prevalence of risk of malnutrition. Meta-regression analysis shows a region-based prediction of malnutrition and setting based prediction of risk of malnutrition. CONCLUSION The prevalence of malnutrition was not considerably higher among the elderly population but about half of the elderly population were at risk of malnutrition. This trend differs with the gender, study setting, study area and study region. Additional study using other nutritional assessment tools were needed. Intervention studies among the elderly were recommended.
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Αntoniadou M, Varzakas T. Breaking the vicious circle of diet, malnutrition and oral health for the independent elderly. Crit Rev Food Sci Nutr 2020; 61:3233-3255. [PMID: 32686465 DOI: 10.1080/10408398.2020.1793729] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aging impairs senses, mastication, oral status and function, causing nutritional needs and diet insufficiencies. The present needs of independent older adults suggest that health research and oral health care should shift from reductionist disease management to integral and personal treatment plans, including lifestyle, psychological, nutritional and oral health coaching approaches. Dentists and other medical professionals that work in the field of gerodontology should be educated on the macro and micronutrient needs of the elderly and incorporate certain nutritional plans early in the life of their patients with their approval and cooperation, in order to postpone tooth loss and masticatory impairment. Old recipes such as the Mediterranean diet should be kept as a base for all the elderly and be enriched in a customized interpersonal way from the dentist as well as the medical professional according to the specific needs of one's oral and general health status. In this nonsystematic review paper, the basic aspects of the vicious cycle of nutrition and oral health status are discussed and suggestions of major nutrients' influence and needs for independent elders are reported. Based on the scientific data collected, suggestions are made for the food industry for better quality and dosage of foods for this category of individuals. Such strategies can be a whole new area of interest for the food industry in order to obtain better quality of food packaging for the independent OA with accepted texture, odor, colors, macronutrients and micronutrients' consistency and in specific portions.
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Affiliation(s)
- Maria Αntoniadou
- Dental School, National and Kapodistrian University of Athens, Greece
| | - Theodoros Varzakas
- Dept. Food Science and Technology, University of the Peloponnese, Kalamata, Greece
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Aging and nutrition. Paving the way to better health. ROMANIAN JOURNAL OF INTERNAL MEDICINE 2020; 58:55-68. [PMID: 32134741 DOI: 10.2478/rjim-2020-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Indexed: 01/04/2023] Open
Abstract
Sufficient caloric intake is important to maintain the balanced health status, especially during the period of aging, as aging and sickness share paths. Maintaining adequate nutritional balance is the best preventive measure to counteract the risk of malnutrition. There are several causes for malnutrition in elderly people, and some techniques such as anthropometric measurements, laboratory and clinical parameters could help to diagnose malnutrition in these patients. The use of a simple validated questionnaire called the 'Mini Nutritional Assessment' measures the nutritional status of elderly patients. In this review, we discuss about the malnutrition in elderly people with and without a known cause and we present some of nutritional intervention. There are promising strategies that help overcoming malnutrition.
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Preparation of easily chewable and swallowable texture-modified Dongchimi. Food Sci Biotechnol 2020; 29:651-655. [PMID: 32419963 DOI: 10.1007/s10068-019-00716-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/30/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022] Open
Abstract
This study aimed to develop texture-modified Dongchimi (TMD) that is safe, well-shaped, and easy to chew and swallow. As the fermentation proceeded, the pH decreased, and the total acidity and total number of lactic acid bacteria increased. The hardness of the TMD decreased significantly by more than 96% (p < 0.05) as compared to that of the control. Significant differences in the hardness and shape were observed between two TMD samples-TMD 1 and TMD 2. Sensory evaluation showed that TMD 1 and TMD 2 were adequate for the elderly people suffering from difficulties in mastication and deglutition. Compared to TMD 1, TMD 2 showed higher values of hardness and swallowness and was more preferred by the elderly. Thus, TMD that is easy to chew and swallow has sufficient competitiveness in food safety, food taste, and food preference.
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Effectiveness and tolerance of an oral nutritional supplement highly concentrated in protein and energy in elderly subjects at risk of malnutrition. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Peters R, White DJ, Scholey A. Resting state fMRI reveals differential effects of glucose administration on central appetite signalling in young and old adults. J Psychopharmacol 2020; 34:304-314. [PMID: 31909672 DOI: 10.1177/0269881119894540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Healthy aging has been associated with reduced appetite and lower energy intake, which can lead to loss of bodyweight, undernutrition and related health problems. The causes for the decline in caloric intake are multifactorial, involving physiological and non-physiological processes. AIMS Here we examined the effect of glucose on brain function in healthy adults as well as age-related, physiological changes in brain responses associated with macronutrient intake. METHODS Using a randomized, double-blind, balanced cross-over design, younger (n = 16, aged 21-30) and older (n = 16, aged 55-78) adults received a drink containing glucose and a taste-matched placebo after an overnight fast. Blood glucose and hunger were assessed at baseline and 20 min post-ingestion, after which participants underwent resting state functional magnetic resonance imaging. RESULTS Frequency-dependent changes associated with glucose administration in slow-5 (0.01-0.027 Hz) and slow-4 (0.027-0.073 Hz) amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) of the blood oxygen level-dependent (BOLD) signal were investigated within the young healthy adults, and then extended to the older age group. Consistent with previous reports, glucose decreased amplitude in slow-5 fALFF within the left orbitofrontal cortex and insular cortex in the young adults. We observed a significant interaction in slow-5 ALFF and fALFF in the left insula, such that younger participants showed a decrease in BOLD amplitude, whereas older participants showed an increase, after glucose administration. We further observed an interaction in slow-4 ALFF in the occipital region and precuneus, with older participants showing an increase in magnitude of slow-4 ALFF and younger participants showing a decrease in the same measure. CONCLUSION These age-related, frequency-dependent changes in the magnitude of the BOLD signal in the insula, a key region related to energy homeostasis following feeding, may point to a change in satiety or homeostatic signalling contributing to behavioural changes in energy intake during senescence.
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Affiliation(s)
- Riccarda Peters
- Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J White
- Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
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Azzolino D, Arosio B, Marzetti E, Calvani R, Cesari M. Nutritional Status as a Mediator of Fatigue and Its Underlying Mechanisms in Older People. Nutrients 2020; 12:E444. [PMID: 32050677 PMCID: PMC7071235 DOI: 10.3390/nu12020444] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/22/2022] Open
Abstract
Fatigue is an often-neglected symptom but frequently complained of by older people, leading to the inability to continue functioning at a normal level of activity. Fatigue is frequently associated with disease conditions and impacts health status and quality of life. Yet, fatigue cannot generally be completely explained as a consequence of a single disease or pathogenetic mechanism. Indeed, fatigue mirrors the exhaustion of the physiological reserves of an older individual. Despite its clinical relevance, fatigue is typically underestimated by healthcare professionals, mainly because reduced stamina is considered to be an unavoidable corollary of aging. The incomplete knowledge of pathophysiological mechanisms of fatigue and the lack of a gold standard tool for its assessment contribute to the poor appreciation of fatigue in clinical practice. Inadequate nutrition is invoked as one of the mechanisms underlying fatigue. Modifications in food intake and body composition changes seem to influence the perception of fatigue, probably through the mechanisms of inflammation and/or mitochondrial dysfunction. Here, we present an overview on the mechanisms that may mediate fatigue levels in old age, with a special focus on nutrition.
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Affiliation(s)
- Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (E.M.); (R.C.)
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (E.M.); (R.C.)
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Abstract
This article gives an outline of the key groups at risk of malnutrition in the community and the effects and clinical consequences of not identifying and managing these groups. It outlines the potential health and social costs of not identifying and treating malnutrition in the community and advises how malnutrition arises in these 'at-risk' groups. As 93% of those affected by malnutrition are living in our communities, advice is given on how community nurses can play a pivotal role in identifying malnutrition by initiating conversations about dietary intake with patients and integrating screening and nutritional care into pathways of care.
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Affiliation(s)
- Anne Holdoway
- Consultant Dietitian, Education Officer, British Association for Parenteral and Enteral Nutrition (BAPEN) and Chair of the Managing Adult Malnutrition in the Community panel
| | - Liz Anderson
- Lead Nurse for Nutrition, Patient Experience Officer, BAPEN and Member of the Managing Adult Malnutrition in the Community panel
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Chan K, Charles L, Triscott J, Dobbs B. Common Problems of the Elderly. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_24-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dogan EIK, Raustøl A, Terragni L. Student nurses’ views of right to food of older adults in care homes. Nurs Ethics 2019; 27:754-766. [DOI: 10.1177/0969733019884614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Human rights are an important part of nursing practice. Although there is increasing recognition regarding the importance of including human rights education in nursing education, few studies have focused on nursing students’ perspectives and experiences in relation to human rights in nursing, especially regarding older nursing home residents’ right to food. Objective: To explore nursing students’ perspectives and experiences in relation to the right to food. Research design: The study followed a qualitative interpretative research design. Data were collected from multistage focus groups before, during and after clinical placement in a nursing home and analysed through thematic analysis. Participants and research context: Participants were 18 first-year nursing students; the study was conducted in 2017. Ethical considerations: This study was approved by the Norwegian Centre for Research Data. Findings: Students’ understanding of older nursing home residents’ right to food was a dynamic process. Their perceptions evolved from a polarized perspective to a reality orientation and finally to retrospective reflection. Discussion: The article discusses how nursing students learn about and understand human rights within and throughout their placements. Conclusion: The study bridges human rights theory and practice. Findings suggest that the human right to food must be enacted in daily practice for students to learn in context. Human rights education, specifically pertaining to nutritional care, thus benefits from a practice-oriented approach preparing students to face ‘real life’ challenges and ethical dilemmas. Findings will help nurse educators tailor education in this field.
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Zhang X, Tang T, Pang L, Sharma SV, Li R, Nyitray AG, Edwards BJ. Malnutrition and overall survival in older adults with cancer: A systematic review and meta-analysis. J Geriatr Oncol 2019; 10:874-883. [DOI: 10.1016/j.jgo.2019.03.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/23/2019] [Accepted: 03/01/2019] [Indexed: 02/07/2023]
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Sase K, Kido K, Ato S, Fujita S. The effect of a bout of resistance exercise on skeletal muscle protein metabolism after severe fasting. Physiol Rep 2019; 7:e14270. [PMID: 31691510 PMCID: PMC6831946 DOI: 10.14814/phy2.14270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 11/24/2022] Open
Abstract
Resistance exercise (RE) activates the mechanistic target of rapamycin complex 1 (mTORC1) signaling pathway and increases muscle protein synthesis. Severe fasting induces 5' adenosine monophosphate-activated protein kinase (AMPK), which attenuates mTORC1 activation. However, the effect of RE on the response of mTORC1 signaling proteins after a period of severe fasting is unclear. We investigated the effect of RE on rat skeletal muscle protein metabolism after a period of severe fasting. We hypothesized that RE-induced activation of mTORC1 signaling protein attenuates protein breakdown by autophagy. Male Sprague-Dawley rats were divided into ordinary-fed (C) and 72-h fasting (F) groups. A bout of RE was replicated by percutaneous electrical stimulation in the right gastrocnemius muscle. The tuberous sclerosis complex 2 (TSC2) Ser1387 and autophagy marker of microtubule-associated protein 1A/1B-light chain 3-II (LC3B-II) expression of the F group increased twice that of the C group in sedentary state (P < 0.05). RE activated the mTORC1 signaling pathway in both groups (P < 0.05); however, in the F group, the magnitude of p70S6K (Thr389) phosphorylation was lower by 40% of that of the C group (P < 0.05). Protein synthesis after RE was increased by 50% from the level at sedentary state in the C group (P < 0.05), but not in the F. In the F group, the expression of LC3B-II at 3 h after RE was decreased by almost 25% from the level at sedentary state (P < 0.05). Our results suggest that RE suppressed fasting-induced autophagy but did not increase protein synthesis during severe fasting in rat skeletal muscle.
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Affiliation(s)
- Kohei Sase
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Kohei Kido
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Satoru Ato
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Satoshi Fujita
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
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Thalacker-Mercer A, Riddle E, Barre L. Protein and amino acids for skeletal muscle health in aging. ADVANCES IN FOOD AND NUTRITION RESEARCH 2019; 91:29-64. [PMID: 32035599 DOI: 10.1016/bs.afnr.2019.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Proteins and its building blocks, amino acids, have many physiological roles in the body. While some amino acids can be synthesized endogenously, exogenous protein and amino acids are necessary to maintain homeostasis. Because skeletal muscle contains a large portion of endogenous protein and plays important roles in movement, regulation, and metabolism, imbalanced protein and amino acid availability may result in clinical conditions including skeletal muscle atrophy, impaired muscle growth or regrowth, and functional decline. Aging is associated with changes in protein metabolism and multiple physiological and functional alterations in the skeletal muscle that are accentuated by decreased dietary protein intake and impaired anabolic responses to stimuli. Inactivity and chronically elevated inflammation of the skeletal muscle can initiate and/or augment pathological remodeling of the tissue (i.e., increase of fat and fibrotic tissues and atrophy of the muscle). Defining an adequate amount of dietary protein that is appropriate to maintain the availability of amino acids for biological needs is necessary but is still widely debated for older adults. This chapter will provide (i) an overview of dietary protein and amino acids and their role in skeletal muscle health; (ii) an overview of skeletal muscle structure and function and the deterioration of muscle that occurs with advancing age; (iii) a discussion of the relationship between protein/amino acid metabolism and skeletal muscle decline with aging; and (iv) a brief discussion of optimal protein intakes for older adults to maintain skeletal muscle health in aging.
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Affiliation(s)
| | | | - Laura Barre
- Cornell University, Ithaca, NY, United States
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Abdulla H, Bass JJ, Stokes T, Gorissen SHM, McGlory C, Phillips BE, Phillips SM, Smith K, Idris I, Atherton PJ. The effect of oral essential amino acids on incretin hormone production in youth and ageing. Endocrinol Diabetes Metab 2019; 2:e00085. [PMID: 31592446 PMCID: PMC6775449 DOI: 10.1002/edm2.85] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/02/2019] [Accepted: 06/15/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The effect of substantive doses of essential amino acids (EAA) on incretin and insulin production, and the impact of age upon this effect, is ill-defined. METHODS A 15-g oral EAA drink was administered to young (N = 8; 26 ± 4.4 years) and older (N = 8; 69 ± 3.8 years) healthy volunteers. Another group of younger volunteers (N = 9; 21 ± 1.9 years) was given IV infusions to achieve equivalent plasma amino acids (AA) profiles. Plasma AA, insulin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) were quantified over 2 hours. RESULTS In younger recruits, EAA-induced rapid insulinaemia and aminoacidaemia with total amino acids(AA), EAA and branched chain amino acids (BCAA) matched between oral and IV groups. Insulin peaked at 39 ± 29 pmol L-1 at 30 minutes following oral feeding compared to 22 ± 9 pmol L-1 at 60 minutes following IV feeding (P: NS). EAA peaked at 3395 μmol L-1 at 45 minutes during IV infusion compared to 2892 μmol L-1 following oral intake (Feeding effect: P < 0.0001. Oral vs IV feeding: P: NS). There was an 11% greater increase in insulin levels in the 120 minutes duration of the study in response to oral EAA as opposed to IV EAA. GIP increased following oral EAA (452 pmol L-1 vs 232 pmol L-1, P < 0.05). Age did not impact insulin or incretins production. CONCLUSION Postprandial rises in EAA levels lead to rapid insulinaemia which is higher with oral compared with IV EAA, that is attributed more to GIP and unaffected by age. This finding supports EAA, on their own or as part of high-protein meal, as nutritive therapeutics in impaired glycaemia and ageing.
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Affiliation(s)
- Haitham Abdulla
- MRC‐ARUK Centre for Musculoskeletal Ageing Research and NIHR BRC, School of MedicineUniversity of NottinghamDerbyUK
- Diabetes and Endocrinology CentreUniversity Hospitals Birmingham NHS Foundation Trust, Heartlands HospitalBirminghamUK
| | - Joseph J. Bass
- MRC‐ARUK Centre for Musculoskeletal Ageing Research and NIHR BRC, School of MedicineUniversity of NottinghamDerbyUK
- Department of Physical Education and Sport SciencesUniversity of LimerickLimerickUK
| | - Tanner Stokes
- Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | | | - Chris McGlory
- Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Bethan E. Phillips
- MRC‐ARUK Centre for Musculoskeletal Ageing Research and NIHR BRC, School of MedicineUniversity of NottinghamDerbyUK
| | | | - Kenneth Smith
- MRC‐ARUK Centre for Musculoskeletal Ageing Research and NIHR BRC, School of MedicineUniversity of NottinghamDerbyUK
| | - Iskandar Idris
- MRC‐ARUK Centre for Musculoskeletal Ageing Research and NIHR BRC, School of MedicineUniversity of NottinghamDerbyUK
- Department of Endocrinology and DiabetesUniversity Hospitals Derby and Burton NHS Foundation TrustDerbyUK
| | - Philip J. Atherton
- MRC‐ARUK Centre for Musculoskeletal Ageing Research and NIHR BRC, School of MedicineUniversity of NottinghamDerbyUK
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