The concurrent presence of low bone density (osteopenia/osteoporosis) and low muscle mass (sarcopenia) in older adults has led to the recognition of “osteosarcopenia” (OS) as a singular entity. Vitamin D may play important role in the manifestation of OS, in terms of intake, absorption, and bioavailability. Evidence suggests that bioavailable 25(OH)D may be a better indicator of Vitamin D compared to total 25(OH)D due to its weak bind to albumin, increasing its ‘availability’. The aim of this study was to assess total and bioavailable 25(OH)D levels in postmenopausal women and to determine their associations to bone density and muscle mass. We assessed body composition, bone density, and 25(OH)D indices of multiethnic, postmenopausal Malaysian women. A significant and negative correlation was found between body fat % and each index of 25(OH)D. Both bioavailable and total 25(OH)D were positively correlated with serum calcium and negatively correlated with iPTH(intact parathyroid hormone). VDBP(Vitamin D binding protein) level was significantly correlated with bioavailable 25(OH)D level, but not with the total 25(OH)D level. Stepwise regression analysis revealed that bioavailable, but not total, 25(OH)D was significantly correlated to bone density and muscle mass, (where stronger correlation was found with bone density), suggesting its superiority. Nevertheless, the low effect size warrants further studies.

We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p < .05), and participants with higher levels of education provide longer periods of accelerometer wearing hours (p < .01). Eighty-seven percent of participants reported ‘no issues’ with wearing the meter. This study suggests that accelerometry is a feasible method to assess the physical activity level among older Malay adults living in semi-rural areas.

Osteosarcopenic obesity (OSO) describes the concurrent presence of obesity, low bone mass, and low muscle mass in an individual. Currently, no established criteria exist to diagnose OSO. We hypothesized that obese individuals require different cut-points from standard cut-points to define low bone mass and low muscle mass due to their higher weight load. In this study, we determined cutoff values for the screening of osteosarcopenia (OS) in obese postmenopausal Malaysian women based on the measurements of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and functional performance test. Then, we compared the cutoff values derived by 3 different statistical modeling methods, (1) receiver operating characteristic (ROC) curve, (2) lowest quintile of the study population, and (3) 2 standard deviations (SD) below the mean value of a young reference group, and discussed the most suitable method to screen for the presence of OS in obese population. One hundred and forty-one (n = 141) postmenopausal Malaysian women participated in the study. Bone density was assessed using calcaneal quantitative ultrasound. Body composition was assessed using bioelectrical impedance analyzer. Handgrip strength was assessed using a handgrip dynamometer, and physical performance was assessed using a modified Short Physical Performance Battery test. ROC curve was determined to be the most suitable statistical modeling method to derive the cutoffs for the presence of OS in obese population. From the ROC curve method, the final model to estimate the probability of OS in obese postmenopausal women is comprised of five variables: handgrip strength (HGS, with area under the curve (AUC) = 0.698 and threshold ≤ 16.5 kg), skeletal muscle mass index (SMMI, AUC = 0.966 and threshold ≤ 8.2 kg/m2), fat-free mass index (FFMI, AUC = 0.946 and threshold ≤ 15.2 kg/m2), broadband ultrasonic attenuation (BUA, AUC = 0.987 and threshold ≤ 52.85 dB/MHz), and speed of sound (SOS, AUC = 0.991 and threshold ≤ 1492.15 m/s). Portable equipment may be used to screen for OS in obese women. Early identification of OS can help lower the risk of advanced functional impairment that can lead to physical disability in obese postmenopausal women.

BackgroundMenstruation is associated with significant unpleasantness, and wearing a sanitary napkin (SN) during menses causes discomfort. In addition, many Muslim women use a thick type of SN during menses due to the religious requirement that even disposable SNs be washed before disposal. Therefore, the objective of this study was to measure the physiological and psychological responses to wearing SNs of different thicknesses during menstruation and non-menstruation phases at rest and during physical activity/exercise among Muslim women.MethodsEighteen Muslim females were randomly assigned to wear an ultra slim type (US, thin) or a maxi type (MT, thick) SN on two different occasions (i.e., during non-menses and menses). Each subject tested both types of SN. Upon arriving at the laboratory, each subject was equipped with an ambulatory electrocardiograph and rested in a seated position for 10 min. She was then given either an US or MT SN, put it in place, and rested in a seated position for 10 min. Each subject then walked at 3 km/h for 10 min, sat resting for 10 min, and then walked at 5 km/h for another 10 min. At the end of each 10-min stage, subjects marked their feelings of discomfort on the visual analog scale (VAS). Perceived exertion during exercise was evaluated using the Borg scale. Heart rate and low frequency-to-high frequency ratio (LF/HF) of heart rate variability were continuously recorded during rest and exercise.ResultsDuring both the non-menses and menses trials, VAS and LF/HF were significantly lower in subjects using the US SN compared to the MT SN. These results indicate that when wearing the US SN, subjects were more comfortable and did not increase sympathetic activities. Meanwhile, perceived exertion during exercise had no significant difference between US and MT although the means of the scores for US tended to be lower than those of MT.ConclusionsThe results of this study (VAS and LF/HF) indicate that wearing an US SN induces less physiological and psychological stress compared to wearing a MT SN. Thus, use of the former will empower women to live their lives with vitality during menses.