Evaluar la prevalencia de riesgo de desnutrición (RD) en adultos mayores de dos municipios de Yucatán, México, e identificar algunos factores asociados. Estudio transversal con muestreo intencional no probabilístico en 6 centros de atención geriátrica, una clínica universitaria y visitas domiciliares. Noventa y seis adultos mayores de 60 años (76% mujeres), 42 residentes de estancias geriátricas y 54 no institucionalizados. Se evaluó el RD con la escala de Valoración Mínima del Estado de Nutrición (VMEN), junto con variables demográficas, de funcionalidad, comorbilidades, depresión y apetito. La composición corporal se evaluó con ecuaciones basadas en antropometría e impedancia bioeléctrica. Se realizaron análisis descriptivos, t de Student, Kolmogorov-Smirnov, chi cuadrado, análisis univariado y análisis de regresión múltiple. El 47,9 % (46 sujetos; 37 mujeres y 9 varones) presentaron RD de acuerdo con la VMEN y 52,1% de los participantes fueron clasificados con estado nutricio normal de acuerdo con dicha escala. Los valores promedio de la masa corporal libre de grasa y la masa muscular esquelética en extremidades de sujetos con RD, fueron más bajos que en aquellos con estado de nutrición normal (p< 0,05). El análisis de regresión logístico múltiple ajustado por género indicó que la edad (OR=1,08, p=0,005) y la depresión (OR=3,79, p=0,017) fueron factores predictores asociados con RD. El 47,9 % de los participantes presentaron RD. Se requieren acciones para diagnosticar y atender el RD y evitar que progrese a desnutrición. La edad y la depresión se debieran incluir como posibles marcadores tempranos de desnutrición en futuros estudios poblacionales e intervenciones nutricionales en adultos mayores en comunidad e institucionalizados en Yucatán. To assess the prevalence of Malnutrition Risk (MR) in older adults from two municipalities of Yucatan, Mexico, and to identify some associated factors. Cross-sectional study, using non-probabilistic sample in six geriatric care centers, a university clinic, and home visits. Ninety-six adults over 60 years (76% women), 42 residents of geriatric care homes, and 54 non-institutionalized. The MR was assessed by the Mini Nutritional Assessment scale (MNA), along with demographic, functionality, comorbidities, depression, and appetite variables. Body composition was also assessed by bioelectrical impedance analysis. Descriptive analyzes, Student's t, Kolmogorov-Smirnov, chi-square, univariate, and multiple regression analysis were performed. Of the total sample, 47.9% (46 subjects; 37 women and 9 men) presented RD according to the VMEN and 52.1% of the participants were classified with normal nutritional status according to the scale. Mean values of fat-free mass and appendicular skeletal muscle mass were lower in subjects with MR than in those with normal nutritional status (p <0.05). The multiple logistic regression analysis adjusted by gender indicated that age (OR = 1.08, p = 0.005) and depression (OR = 3.79, p = 0.017) were predictor associated factors with MR. Almost forty eight percent of the participants present MR. Actions are required to diagnose and treat MR, avoiding progressing to malnutrition. Age and depression should be included as possible early markers of malnutrition in future population studies and nutritional interventions, in the community and institutionalized older adults in Yucatan.
Background: Phase angle (PhA) has been used as mortality prognostic, but there are no studies about its possible use as a screening tool. Therefore, an assessment of the possible utility of PhA in clinical practice is required. The aim of this systematic review was to explore all recent available evidence of PhA, and its possible utility as a screening tool in clinical practice in subjects with chronic metabolic diseases. Materials and Methods: This systematic review was performed and written as stated in the PRISMA 2020 guidelines. The search was conducted in PubMed, ScienceDirect and SciElo. In order to be considered eligible, within the entire search, only articles involving PhA and their utility in metabolic diseases were included. Results: PhA was associated with hyperuricemia and vitamin D deficiency in obese subjects, and decreased cardiovascular risk and malnutrition in hospitalized patients. Conclusion: PhA may be a potential screening tool in clinical practice to evaluate different biomarkers, cardiovascular risk, and nutritional diagnosis in metabolic diseases in adults.
Specialty oils differ in fatty acid, phytosterol and antioxidant content, impacting their benefits for cardiovascular health. The lipid (fatty acid, phytosterol) and antioxidant (total phenolics, radical scavenging capacity) profiles of grapeseed (GSO), corn (CO) and coconut (CNO) oils and their physiological (triacylglycerides, total and HDL-cholesterol and antioxidant capacity (FRAP) in serum and fatty acid and phytosterol hepatic deposition) and genomic (HL, LCAT, ApoA-1 and SR-BP1 mRNA hepatic levels) responses after their sub-chronic intake (10% diet for 28 days) was examined in healthy albino rats. Fatty acid, phytosterol and antioxidant profiles differed between oils (p ≤ 0.01). Serum and hepatic triacylglycerides and total cholesterol increased (p ≤ 0.01); serum HDL-Cholesterol decreased (p < 0.05); but serum FRAP did not differ (p > 0.05) in CNO-fed rats as compared to CO or GSO groups. Hepatic phytosterol deposition was higher (+2.2 mg/g; p ≤ 0.001) in CO- than GSO-fed rats, but their fatty acid deposition was similar. All but ApoA-1 mRNA level increased in GSO-fed rats as compared to other groups (p ≤ 0.01). Hepatic fatty acid handling, but not antioxidant response, nor hepatic phytosterol deposition, could be related to a more efficient reverse-cholesterol transport in GSO-fed rats as compared to CO or CNO.
Arterial stiffness may be associated with glucose metabolism parameters, such as HbA1c, mainly via insulin resistance. We aimed to investigate the association between arterial stiffness and HbA1c and explore the mediator effect of insulin resistance. In this cross-sectional study, arterial stiffness (pulse-wave velocity; PWV), HbA1c, and insulin resistance (METS-IR) were determined in Hispanic adults. In addition to sex and age, various biochemical measurements (glucose, lipid profile, etc.) and adipose tissue (fat mass and visceral fat mass) were considered as potential confounding variables. A multivariate regression analysis shows that HbA1c is associated with PWV, even after adjusting for several confounding variables. Importantly, the results show that insulin resistance mediated 17.9% of the effect of HbA1c over PWV. In conclusion, HbA1c may be a potential resource for predicting arterial stiffness due to the influence of insulin resistance in Hispanic subjects.
Age- and obesity-related body composition changes could influence the hydration factor (HF) and, as a result, body composition estimates derived from hydrometry. The aim of the present study was to compare the HF in older Hispanic-American adults to some published values. This cross-sectional study included a sample of 412 subjects, men and women, aged ≥60 years from northern Mexico. HF values were calculated based on the ratio of total body water-using the deuterium dilution technique-to fat-free mass, derived from the four-compartment model. The mean HF value for the total sample (0.748 ± 0.034) was statistically (p ≤ 0.01) higher than the traditionally assumed value of 0.732 derived from chemical analysis, the “grand mean’’ value of 0.725 derived from in vivo methods, and the 0.734 value calculated for older French adults via the three-compartment model. The HF of the older women did not differ across the fat mass index categories, but in men the obese group was lower than the normal and excess fat groups. The hydration factor calculated for the total sample of older Hispanic-American people is higher than the HF values reported in the literature. Therefore, the indiscriminate use of these assumed values could produce inaccurate body composition estimates in older Hispanic-American people.
There are several equations based on bioelectrical impedance analysis (BIA) to estimate with high precision appendicular skeletal muscle mass (ASM). However, most of the external validation studies have reported that these equations are inaccurate or biased when applied to different populations. Furthermore, none of the published studies has derived correction factors (CFs) in samples of community-dwelling older adults, and none of the published studies have assessed the influence of the dual-energy X-ray absorptiometry (DXA) model on the validation process. This study assessed the agreement between six BIA equations and DXA to estimate ASM in non-Caucasian older adults considering the DXA model and proposed a CF for three of them. This analysis included 547 non-institutionalized subjects over 60 years old from the northwest of Mexico who were physically independent and without cognitive impairment: 192 subjects were measured using DXA Hologic, while 355 were measured by DXA Lunar. The agreement between each of the equations and DXA was tested considering the DXA model used as a reference method for the design of each equation, using the Bland and Altman procedure, a paired t test, and simple linear regression as objective tests. This process was supported by the differences reported in the literature and confirmed in a subsample of 70 subjects measured with both models. Only six published BIA equations were included. The results showed that four equations overestimated ASMDXA, and two underestimated it (p < 0.001, 95% CI for Kim's equation:−5.86-−5.45, Toselli's:−0.51-−0.15, Kyle's: 1.43–1.84, Rangel-Peniche's: 0.32–0.74, Sergi's: 0.83–1.23, and Yoshida's: 4.16–4.63 kg). However, Toselli's, Kyle's and Rangel-Peniche's equations were the only ones that complied with having a homogeneous bias. This finding allowed the derivation of CFs, which consisted of subtracting or adding the mean of the differences from the original equation. After estimating ASM applying the respective CF, the new ASM estimations showed no significant bias and its distribution remained homogeneously distributed. Therefore, agreement with DXA in the sample of non-Caucasian was achieved. Adding valid CFs to some BIA equations allowed to reduce the bias of some equations, making them valid to estimate the mean values of ASM at group level.
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