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Mutoh T, Kataoka H, Tatewaki Y, Taki Y. Medium-Chain Triglyceride Dietary Supplements Reduce Glucose Metabolism of Gait-Related Skeletal Muscle in Older Adults: A Longitudinal 18F-FDG PET/CT Analysis. Nutrients 2025; 17:1707. [PMID: 40431447 PMCID: PMC12113714 DOI: 10.3390/nu17101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2025] [Revised: 05/13/2025] [Accepted: 05/15/2025] [Indexed: 05/29/2025] Open
Abstract
BACKGROUND/OBJECTIVES Dietary supplementation with medium-chain triglycerides (MCTs) improves walking balance and cognitive function in healthy older adults. This study aimed to determine the biological effects of MCTs on gait-related skeletal muscles in healthy older adults by analyzing muscle density and glucose metabolism. METHODS 18F-FDG-PET/CT imaging data from 63 participants (18 g/day of MCTs and matching placebo in the form of a jelly stick [6 g each, ingested 3 times/day]) in a randomized clinical trial were analyzed. The three-dimensional regions of interest were set as muscles associated with walking balance (bilateral triceps, psoas, and vastus medialis). Each muscle's mean standardized uptake value (SUVmean) and Hounsfield units (HU) were calculated for relative quantitative measurements. RESULTS MCT supplementation for 3 months decreased the SUVmean (p < 0.001) and increased the HU of the psoas (r = -0.61) and vastus medialis muscles (r = -0.59) (p < 0.001); no changes were apparent in participants supplemented with long-chain triglycerides. The changes in the SUVmean for each muscle were correlated negatively with those of plasma β-hydroxybutyrate in MCT-supplemented participants (r = -0.57 [psoas] and -0.59 [vastus medialis]; p < 0.001). CONCLUSION A 3-month MCT supplementation suppressed glucose metabolism and increased the muscle density in gait-related skeletal muscles, consistent with previous findings that MCT supplementation stabilizes balance functions during walking in healthy older adults.
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Affiliation(s)
- Tatsushi Mutoh
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai 980-8575, Japan
- Division of Neurocritical Care, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Senshu-Kubota-machi, Akita 010-0874, Japan
| | - Hiroki Kataoka
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai 980-8575, Japan
| | - Yasuko Tatewaki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai 980-8575, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai 980-8575, Japan
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Yoshimura Y, Nagano F, Matsumoto A, Shimazu S, Shiraishi A, Kido Y, Bise T, Hamada T, Yoneda K. Synergistic Effects of Medium-Chain Triglyceride Supplementation and Resistance Training on Physical Function and Muscle Health in Post-Stroke Patients. Nutrients 2025; 17:1599. [PMID: 40362908 PMCID: PMC12073753 DOI: 10.3390/nu17091599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2025] [Revised: 04/29/2025] [Accepted: 05/06/2025] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Sarcopenia and malnutrition are common in post-stroke patients, impairing recovery. Medium-chain triglycerides (MCT) may support muscle metabolism, while chair-stand exercises improve strength and mobility. However, their combined effects remain unclear. This study evaluated the synergistic effects of MCT supplementation and high-frequency chair-stand exercise on physical function and muscle health in post-stroke patients. Methods: A retrospective cohort study included 1080 post-stroke patients categorized into three groups: (1) MCT supplementation alone, (2) chair-stand exercise alone, and (3) both combined. MCT supplementation consisted of ~40 g/day MCT oil or powder. Functional outcomes were assessed using the Functional Independence Measure (FIM-motor), while muscle health was evaluated by handgrip strength (HGS) and skeletal muscle index (SMI). Multiple linear regression analyses were performed, adjusting for confounders. Results: The combined intervention group showed significantly greater improvements in FIM-motor scores at discharge (B = 8.79, 95% CI: 5.64-11.95, β = 0.32, p < 0.001) and FIM-motor gain (B = 6.02, 95% CI: 3.42-8.62, β = 0.29, p < 0.001) compared to the control. Increases in HGS (B = 2.441, 95% CI: 0.483-4.398, β = 0.18, p = 0.015) and SMI (B = 0.194, 95% CI: 0.102-0.419, β = 0.12, p = 0.039) were also observed. Chair-stand exercise was performed a median of 62 times/day and independently improved outcomes, while MCT alone had limited effects. Conclusions: MCT supplementation combined with chair-stand exercise enhances functional recovery and muscle health in post-stroke patients, supporting its role in rehabilitation. Further research is needed to evaluate long-term effects and to examine the pharmacokinetics of MCTs, including blood concentrations, in broader populations.
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Affiliation(s)
- Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto 869-1106, Japan; (F.N.); (A.M.); (S.S.); (A.S.); (Y.K.); (T.B.); (T.H.); (K.Y.)
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Tomizawa M, Hori S, Yoneda T, Maesaka F, Onishi S, Shimizu T, Onishi K, Morizawa Y, Gotoh D, Nakai Y, Miyake M, Torimoto K, Tanaka N, Fujimoto K. Immunosuppressant-Induced Alteration of Gut Microbiota Causes Loss of Skeletal Muscle Mass: Evidence from Animal Experiments Using Mice and Observational Study on Humans. J Clin Med 2025; 14:1628. [PMID: 40095615 PMCID: PMC11900293 DOI: 10.3390/jcm14051628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Revised: 01/16/2025] [Accepted: 02/26/2025] [Indexed: 03/19/2025] Open
Abstract
Background/Objectives: The number of older adults requiring a kidney transplant (KT) is increasing; hence, postoperative sarcopenia prevention is necessary. KT recipients require permanent oral immunosuppressants (ISs), and the gut microbiota (GM) plays a role in various systemic diseases. However, few studies have evaluated post-kidney transplantation frailty and the associations among ISs, GM, and muscle mass alterations. Therefore, we investigated the effects of ISs on GM and skeletal muscle mass in mice and human KT recipients. Methods: Mice were treated with six different ISs, and their skeletal muscle mass, GM diversity, and colonic mucosal function were assessed. Human KT recipients and donors were monitored before and after surgery for 1 year, and GM diversity was evaluated before and 1 month after surgery. Results: The abundance of Akkermansia, crypt depth, and mucin 2 expression were lower in tacrolimus- and prednisolone-treated mice. The psoas muscle volume changes at 1 month and 1 year after surgery were lower in KT recipients than in donors. Furthermore, the beta diversity was significantly different between the operative groups (p = 0.001), and the KT group showed the lowest Shannon index. Conclusions: The findings of this study indicate potential links among ISs, GM, and muscle mass decline. Further investigation is required to improve therapeutic strategies and patient outcomes.
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Affiliation(s)
- Mitsuru Tomizawa
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Shunta Hori
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Tatsuo Yoneda
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Fumisato Maesaka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Sayuri Onishi
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Takuto Shimizu
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Kenta Onishi
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Yosuke Morizawa
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Daisuke Gotoh
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Yasushi Nakai
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Makito Miyake
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Kazumasa Torimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
- Department of Prostate Brachytherapy, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan
| | - Kiyohide Fujimoto
- Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan; (M.T.); (S.H.); (T.Y.); (F.M.); (S.O.); (T.S.); (K.O.); (Y.M.); (D.G.); (Y.N.); (M.M.); (K.T.); (N.T.)
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Liu J, Wang S, Shen Y, Shi H, Han L. Lipid metabolites and sarcopenia-related traits: a Mendelian randomization study. Diabetol Metab Syndr 2024; 16:231. [PMID: 39285470 PMCID: PMC11406728 DOI: 10.1186/s13098-024-01465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 09/04/2024] [Indexed: 09/19/2024] Open
Abstract
OBJECTIVE To explore the influence of lipid metabolism on the risk of sarcopenia. METHODS Two-sample Mendelian randomization (MR) analysis was used to determine causality. A total of 179 lipid metabolism data points were used for exposure, and the data were obtained from a plasma lipid metabolite study of 7174 participants. The total muscle mass and total muscle strength, as well as the muscle strength and muscle mass of different sex groups, were selected as the relevant traits of sarcopenia. Data for outcomes were obtained from the UK Biobank, and sample sizes ranged from 135 468 to 450 243. Inverse-variance weighted (IVW), as the main method for evaluating the causal relationship between lipid metabolites and sarcopenia, uses the false discovery rate (FDR) for multiple comparisons and conducts heterogeneity, pleiotropy, and reverse causality tests. RESULTS Twenty-seven lipid metabolites, mainly phosphatidylcholine, phosphatidylethanolamine, ceramide, triacylglycerol, sphingomyelin, and sterol ester, were found to be associated with the risk of sarcopenia. Ceramide (d40:1), ceramide (d40:2), and sterol ester are risk factors for decreased muscle mass and strength. There is a positive causal relationship between various phosphatidylcholine lipids and muscle mass and strength. Sphingomyelin (d42:2) is a protective factor for total muscle strength and female muscle strength. There are inconsistent effects between different lipid metabolites, triacylglycerol, and muscle strength and muscle mass. CONCLUSIONS There was a causal relationship between 27 lipid metabolites and sarcopenia traits, and targeting specific lipid metabolites may benefit sarcopenia diagnosis, disease assessment, and treatment.
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Affiliation(s)
- Jianping Liu
- Department of Neurology, Yancheng Third People's Hospital (The Sixth Affiliated Hospital of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, The affiliated hospital of Jiangsu Vocational College of Medicine), Yancheng, Jiangsu, China
| | - Sufang Wang
- Department of Neurology, Yancheng Third People's Hospital (The Sixth Affiliated Hospital of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, The affiliated hospital of Jiangsu Vocational College of Medicine), Yancheng, Jiangsu, China
| | - Yuan Shen
- Department of Neurology, Yancheng Third People's Hospital (The Sixth Affiliated Hospital of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, The affiliated hospital of Jiangsu Vocational College of Medicine), Yancheng, Jiangsu, China
| | - Haicun Shi
- Department of Neurology, Yancheng Third People's Hospital (The Sixth Affiliated Hospital of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, The affiliated hospital of Jiangsu Vocational College of Medicine), Yancheng, Jiangsu, China
| | - Lijian Han
- Department of Neurology, Yancheng Third People's Hospital (The Sixth Affiliated Hospital of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University, The affiliated hospital of Jiangsu Vocational College of Medicine), Yancheng, Jiangsu, China.
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Ezaki O. Possible Extracellular Signals to Ameliorate Sarcopenia in Response to Medium-Chain Triglycerides (8:0 and 10:0) in Frail Older Adults. Nutrients 2024; 16:2606. [PMID: 39203743 PMCID: PMC11357358 DOI: 10.3390/nu16162606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/04/2024] [Accepted: 08/06/2024] [Indexed: 09/03/2024] Open
Abstract
In frail older adults (mean age 85 years old), a 3-month supplementation with a low dose (6 g/day) of medium-chain triglycerides (MCTs; C8:0 and C10:0) given at a meal increased muscle mass and function, relative to supplementation with long-chain triglycerides (LCTs), but it decreased fat mass. The reduction in fat mass was partly due to increased postprandial energy expenditure by stimulation of the sympathetic nervous system (SNS). However, the extracellular signals to ameliorate sarcopenia are unclear. The following three potential extracellular signals to increase muscle mass and function after MCT supplementation are discussed: (1) Activating SNS-the hypothesis for this is based on evidence that a beta2-adrenergic receptor agonist acutely (1-24 h) markedly upregulates isoforms of peroxisomal proliferator-activated receptor gamma coactivator-1alpha (PGC-1alpha) mRNAs, promotes mitochondrial biogenesis, and chronically (~1 month) induces muscle hypertrophy. (2) An increased concentration of plasma acyl-ghrelin stimulates growth hormone secretion. (3) A nitrogen-sparing effect of ketone bodies, which fuel skeletal muscle, may promote muscle protein synthesis and prevent muscle protein breakdown. This review will help guide clinical trials of using MCTs to treat primary (age-related) sarcopenia.
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Affiliation(s)
- Osamu Ezaki
- Institute of Women's Health Science, Showa Women's University, Tokyo 154-8533, Japan
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