Regional differences in the associations of diet quality, obesity, and possible sarcopenia using the seventh Korea National Health and Nutrition Examination Survey (2016-2018)

Evaluation of Dietary Guideline Adherence and Risk of Sarcopenia in Elder Taiwanese

Dietary strategies play an important role in determining longevity and healthy aging. There is an increasing awareness of dietary factors and sarcopenia, which presents as a decline in muscle mass and function, mainly in the senior population. The aim of this study is to explore the association of adherence to the Dietary Guideline (DG) on muscle health in the elder Taiwanese. We included 410 adults aged 65 or older, of whom 189 (46.1%) were women, in the Nutrition and Health Survey in Taiwan (NAHSIT) during 2014-2016 with comprehensive records of food frequency questionnaires and 24-h dietary recalls, as well as measurements of dual-energy X-ray absorptiometry (DXA) for muscle mass and 8-m gait speed for physical performance. A novel indicator, named Healthy Eating Index for Taiwanese (HEI-TW), was developed as an amended version of HEI-2015 to assess how dietary patterns adhere to the DG of Taiwan. Participants who fulfilled "low muscle mass" and "poor physical performance" defined by the Asian Working Group for Sarcopenia (AWGS) criteria were recognized as having sarcopenia; others, in contrast, were recognized as healthy controls. Seventy-one (17.3%) participants categorized into the sarcopenia group had significantly lower mean scores of overall HEI-TW, total vegetables, unrefined grains, and dairy products. The adjusted odds ratios (95% confidence intervals) for sarcopenia were 0.98 (0.95-1.00) for overall HEI-TW, 0.78 (0.66-0.94) for total vegetables, and 0.85 (0.76-0.95) for dairy, respectively, for one unit increase in these components. In subgroup analysis stratified by sex and age, the overall HEI-TW was inversely associated with the odds of sarcopenia among men and individuals aged 75 or older. This study showed that a higher HEI-TW score adhering to Taiwan DG and abundant consumption of total vegetables and dairy products is associated with lower prevalence of muscle loss and sarcopenia in elder Taiwanese.

Association between triglyceride-glucose index and sarcopenic obesity in adults: a population-based study

Background

Sarcopenic obesity is characterized by the coexistence of sarcopenia and obesity, which has been demonstrated to be linked to insulin resistance. The triglyceride-glucose (TyG) index is a novel surrogate indicator of insulin resistance. However, the relationship between sarcopenic obesity and the TyG index remains unclear. This population-based study aimed to investigate the association between TyG index and sarcopenic obesity in adults.

Methods

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), individuals aged over 45 years were categorized into sarcopenia, obesity, sarcopenic obesity, and control groups. Baseline characteristics were analyzed across these groups. Logistic regression models were employed to explore the association between the TyG index and sarcopenic obesity, adjusting for confounding variables. Subgroup analyses were conducted to explore the potential variations in this association across different demographic and clinical variables.

Results

A total of 9,485 individuals were included in the study, with the sarcopenic obesity group exhibiting a higher TyG index (8.96 ± 0.61) compared to other groups (p < 0.001). A significant and independent association was observed between higher TyG index and increased likelihood of sarcopenic obesity, even after adjusting for confounders. Participants in the highest TyG index tertile had a 1.82-fold increase in the risk of sarcopenic obesity compared to those in the lowest tertile. Subgroup analyses revealed significant associations between TyG index and sarcopenic obesity across various demographic and clinical variables, particularly in individuals aged over 60 years, females, and those with chronic diseases.

Conclusion

The findings suggest a strong association between elevated TyG index and sarcopenic obesity in adults, independent of demographic and clinical factors. Further large-scale prospective studies are warranted to validate and expand upon these findings.

Longitudinal association between soft drink consumption and handgrip strength in adults: a prospective analysis from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study

Soft drink consumption has become a highly controversial public health issue. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. Due to containing high levels of fructose, a soft drink may have a deleterious effect on handgrip strength (HGS) due to oxidative stress, inflammation and insulin resistance. However, few studies show an association between soft drink consumption and HGS in adults. We aimed to investigate the association between soft drink consumption and longitudinal changes in HGS among a Chinese adult population. A longitudinal population-based cohort study (5-year follow-up, median: 3·66 years) was conducted in Tianjin, China. A total of 11 125 participants (56·7 % men) were enrolled. HGS was measured using a handheld digital dynamometer. Soft drink consumption (mainly sugar-containing carbonated beverages) was measured at baseline using a validated FFQ. ANCOVA was used to evaluate the association between soft drink consumption and annual change in HGS or weight-adjusted HGS. After adjusting for multiple confounding factors, the least square means (95 % CI) of annual change in HGS across soft drink consumption frequencies were -0·70 (-2·49, 1·09) for rarely drinks, -0·82 (-2·62, 0·97) for < 1 cup/week and -0·86 (-2·66, 0·93) for ≥ 1 cup/week (Pfor trend < 0·05). Likewise, a similar association was observed between soft drink consumption and annual change in weight-adjusted HGS. The results indicate that higher soft drink consumption was associated with faster HGS decline in Chinese adults.

Sex-Specific Effects of Dietary Factors on Sarcopenic Obesity in Korean Elderly: A Nationwide Cross-Sectional Study

This study aimed to compare the dietary factors related to sarcopenia and obesity status in 5458 elderly individuals (2391 men and 3076 women) aged ≥65 years from the Korean National Health and Nutrition Examination Survey (2016-2019). Participants were categorized into normal, sarcopenia, obesity, and sarcopenic obesity groups. Sarcopenic obesity showed a higher prevalence of diabetes and lower HDL cholesterol levels compared to obesity. Sarcopenic obesity exhibited a lower total KHEI score and lower adequacy, including meat/fish/eggs/beans, than normal or obesity. In women, sarcopenic obesity scored lower than obesity on the total KHEI, adequacy for most foods, and balance of energy intake, and lower than sarcopenia on the adequacy of breakfast and milk/milk products. Sarcopenic obesity showed no significant difference in energy intake compared to sarcopenia, and less physical activity compared to sarcopenia and obesity, with a BMI/waist circumference comparable to that of obesity. Low total KHEI scores and scores for meat/fish/eggs/beans were most closely associated with sarcopenia in men and with sarcopenic obesity in women. In conclusion, low dietary quality and inadequate protein-rich foods are possibly associated with the prevalence of sarcopenic obesity in elderly Koreans, especially in women. Adequate energy intake and dietary diversity may be effective in managing sarcopenic obesity.

Association of Combining Diet and Physical Activity on Sarcopenia and Obesity in Elderly Koreans with Diabetes

This study aimed to identify the combined factors of physical activity and diet associated with non-sarcopenic non-obese status in 1586 diabetic patients aged ≥65 years from the Korean National Health and Nutrition Examination Survey (2016 to 2019). Participants were categorized into non-sarcopenic non-obesity (NSNO), sarcopenia non-obesity (SNO), non-sarcopenic obesity (NSO), and sarcopenic obesity (SO) groups. NSNO had lower insulin, HOMA-IR, and triglycerides compared to NSO and SO. NSNO had lower perceived stress, higher nutrition education and dietary supplement intake. As assessed by the Korean Healthy Eating Index, NSNO scored higher total than SNO and SO, in breakfast and energy balance compared to SO, and in the adequacy of vegetables and meat/fish/egg/bean compared to SNO. NSNO had significantly higher energy and protein intake and physical activity, with BMI/waist circumference lower than NSO, SO, and comparable to SNO. Physical activity was positively associated with NSNO. Low Total KHEI score and protein intake level reduced the odds ratio (OR) of NSNO, particularly when physical activity was insufficient, with OR = 0.38 for KHEI Q1 and OR = 0.32 for protein T1. In conclusion, physical activity, diet quality, and protein intake are associated with NSNO prevalence in Korean elderly with diabetes, and energy balance through active intake and expenditure may be effective.

Association of Dietary Protein Sources and Their Adequacy, Body Composition and Risk of Sarcopenic Obesity in South Korean Populations: A Cross-Sectional Study

Dietary protein sources and protein adequacy are crucial modulators of muscle quality and body composition. We investigated the association between dietary protein sources (and their adequacy) and body composition and the risk of sarcopenic obesity (SO) in South Korean populations. The participants (n = 1967) were classified into SO, obese, sarcopenia, and normal groups. A cross-sectional survey was conducted using the KS-15 questionnaire, short-form food frequency questionnaire, and anthropometric measurements. The percentage of body fat (male: 35.36 ± 0.51%; female: 44.14 ± 0.36%) was significantly high, while appendicular skeletal muscle (ASM; male: 36.39 ± 0.30%, female: 30.32 ± 0.19%) was low in the SO group. Beef and pork consumption was negatively associated with ASM (%) but positively associated with body fat (%) in the normal group and positively associated with ASM (kg/m2: beta = 0.002, p = 0.02) and BFM (kg: beta = 0.012, p = 0.03) in the SO group, respectively. The highest quintile (Q5: 173.6 g/day) showed a decreased risk of SO prevalence (AORs: 0.46, CI: 0.22-0.94) compared with that in the lowest quintile (Q1: 21.6 g/day) among the people with inadequacy protein intake. Daily poultry and egg intake was positively linked with body composition in the participants with SO, while red meat showed a negative effect on imbalanced body composition in participants in the normal and SO groups. Furthermore, a lower intake of poultry and eggs was strongly associated with SO prevalence in people who consumed inadequate amounts of daily dietary protein.