Advances in muscle health and nutrition: A toolkit for healthcare professionals

Prado, Carla M.; Landi, Francesco; Chew, Samuel Teong Huang; Atherton, Philip J.; Molinger, Jeroen; Ruck, Tobias; Gonzalez, Maria Cristina

doi:10.1016/j.clnu.2022.07.041

Cited by 44 publications

(24 citation statements)

References 225 publications

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“…In an energy deficient diet, amino acids and muscle are broken down and oxidized to generate energy to sustain life preserving functions. In a protein deficient diet, muscle protein turnover is in favor of muscle protein breakdown leading to a negative nitrogen balance and progressive loss of both muscle mass and function [ 42 , 55 ]. Malnutrition also leads to deficiencies of micronutrients that are essential for the integrity and function of muscle, e.g., vitamin D and vitamin B12, leading to further muscle loss and function [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…These findings suggest there is a need to conduct concomitant screening for muscle health and nutritional health in at-risk older adults. Early interventions can then be instituted to prevent further progression and to reverse deficits for both muscle and nutritional health [2,[41][42][43].…”

Section: Discussionmentioning

confidence: 99%

“…Protein intake and physical activity are modifiable risk factors for sarcopenia, so these are ideal targets to prevent or delay the onset of sarcopenia [41,42,[67][68][69][70][71]. Chew and others recently summarized evidence-based use of nutrition and progressive resistance exercise training as interventions to improve muscle health in older Asian adults [30].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and associated factors of sarcopenia in community-dwelling older adults at risk of malnutrition

et al. 2022

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Background There is an increasingly strong association between sarcopenia and malnutrition in research findings. We aimed to determine the prevalence and factors associated with sarcopenia in community-dwelling older adults (≥ 65 years) at risk of malnutrition based on Malnutrition Universal Screening Tool (MUST). Methods This was a cross-sectional study of 811 participants. Participants were recruited from the general population, community centers, senior activity centers, polyclinics, and hospital. Community-dwelling older adults at risk of malnutrition participated in the study. Participants’ data and measurements were collected at the baseline visit. Data included socio-demographic information, anthropometric measurements, body composition, dietary intakes, and functional assessments. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus. Results Of the 694 participants with complete datasets, overall prevalence of sarcopenia was 76% (n = 530); 57% (n = 393) had severe sarcopenia. In the overall cohort, compared to participants without sarcopenia, those with sarcopenia were older, had lower physical activity scale for the elderly score, leg strength, handgrip endurance, mid-upper arm circumference, calf circumference, and bone mass, and had lower dietary protein intake and poorer nutritional status (all p ≤ 0.015). After adjusting for confounders, sarcopenia was significantly associated with older age, male gender, higher risk of malnutrition, lower calf circumference, and lower bone mass (all p ≤ 0.044). Conclusions In community-dwelling older adults at risk of malnutrition, there is a high prevalence of sarcopenia and severe sarcopenia. As such, screening positive for either malnutrition risk or sarcopenia in older adults should prompt screening for the other risk factor, to allow early institution of disease modifying interventions to forestall adverse outcomes for both malnutrition and sarcopenia. Trial registration The study was registered at clinicaltrials.gov as NCT03245047.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence and associated factors of sarcopenia in community-dwelling older adults at risk of malnutrition

et al. 2022

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“…In this sense, PhA has been proposed as an independent predictor of disease severity in clinical conditions, such as malnutrition [ 40 ], increased nutritional risk [ 41 ], and sarcopenia [ 42 ]. These conditions all have inflammation in common [ 43 ], which affects tissue electrical properties, body cell mass, cell membrane integrity, and ultimately PhA [ 44 ]. Nevertheless, a systematic review of 33 articles could not conclusively indicate that PhA can independently predict malnutrition in clinical populations, as assessed by Subjective Global Assessment [ 45 ].…”

Section: Phase Angle and Its Determinantsmentioning

confidence: 99%

Phase angle and cellular health: inflammation and oxidative damage

Silva

Orsso

Gonzalez

et al. 2022

Rev Endocr Metab Disord

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Phase angle is a composite measure that combines two raw bioelectrical impedance analysis measures: resistance and reactance. Phase angle has been considered an indicator of cellular health, integrity, and hydration. As inflammation and oxidative stress can damage cellular structures, phase angle has potential utility in early detecting inflammatory and oxidative status. Herein, we aimed to critically review the current understanding on the determinants of phase angle and its relationship with markers of inflammation and oxidative stress. We also discussed the potential role of phase angle in detecting chronic inflammation and related adverse outcomes. Several factors have been identified as predictors of phase angle, including age, sex, extracellular to intracellular water ratio, and fat-free mass. In addition to these factors, body mass index (BMI) also seems to influence phase angle. Available data also show that lower phase angle values are correlated (negligible to high correlation coefficients) with higher c-reactive protein, tumour necrosis factor-α, interleukin-6, and interleukin-10 in studies involving the general and aging populations, as well as patients with chronic conditions. Although fewer studies have evaluated the relationship between phase angle and markers of oxidative stress, available data also suggest that phase angle has potential to be used as an indicator (for screening) of oxidative damage. Future studies including diverse populations and bioelectrical impedance devices are required to confirm the validity and accuracy of phase angle as a marker of inflammation and oxidative stress for clinical use.

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“…Malnutrition has systemic repercussions for muscle mass and function, the gastrointestinal tract, mental health and the endocrine system [ 6 , 7 ]. Disorders affecting these domains are part of the post-intensive care syndrome, known to be associated with a decrease in health-related quality of life and an increase in healthcare utilization [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Measured Energy Expenditure Using Indirect Calorimetry in Post-Intensive Care Unit Hospitalized Survivors: A Comparison with Predictive Equations

et al. 2022

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Actual energy needs after a stay in intensive care units (ICUs) are unknown. The aims of this observational study were to measure the energy expenditure (mEE) of ICU survivors during their post-ICU hospitalization period, and to compare this to the estimations of predictive equations (eEE). Survivors of an ICU stay ≥ 7 days were enrolled in the general ward during the first 7 days after ICU discharge. EE was measured using the Q-NRG calorimeter in canopy mode. This measure was compared to the estimated EE using the Harris–Benedict (HB) equation multiplied by a 1.3 stress factor, the Penn–State (PS) equation or the 30 kcal weight-based (WB) equation. A total of 55 adults were included (67.3% male, age 60 (52–67) y, body mass index 26.1 (22.2–29.7) kg/m2). Indirect calorimetry was performed 4 (3–6) d after an ICU stay of 12 (7–16) d. The mEE was 1682 (1328–1975) kcal/d, corresponding to 22.9 (19.1–24.2) kcal/kg/day. The eEE values derived using HB and WB equations were significantly higher than mEE: 3048 (1805–3332) and 2220 (1890–2640) kcal/d, respectively (both p < 0.001). There was no significant difference between mEE and eEE using the PS equation: 1589 (1443–1809) kcal/d (p = 0.145). The PS equation tended to underestimate mEE with a bias of −61.88 kcal and a wide 95% limit of agreement (−717.8 to 594 kcal). Using the PS equation, agreement within 15% of the mEE was found in 32/55 (58.2%) of the patients. In the present cohort of patients who survived a prolonged ICU stay, mEE was around 22–23 kcal/kg/day. In this post-ICU hospitalization context, none of the tested equations were accurate in predicting the EE measured by indirect calorimetry.

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Advances in muscle health and nutrition: A toolkit for healthcare professionals

Cited by 44 publications

References 225 publications

Prevalence and associated factors of sarcopenia in community-dwelling older adults at risk of malnutrition

Prevalence and associated factors of sarcopenia in community-dwelling older adults at risk of malnutrition

Phase angle and cellular health: inflammation and oxidative damage

Measured Energy Expenditure Using Indirect Calorimetry in Post-Intensive Care Unit Hospitalized Survivors: A Comparison with Predictive Equations

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