Effect of Dietary Restriction and Exercise on Lower Extremity Tissue Compartments in Obese, Older Women: A Pilot Study

Manini, Todd M.; Buford, Thomas W.; Lott, Donovan J.; Vandenborne, Krista; Daniels, Michael J.; Knaggs, Jeffrey D.; Patel, Hetain; Pahor, Marco; Perri, Michael G.; Anton, Stephen D.

doi:10.1093/gerona/gls337

Cited by 40 publications

(31 citation statements)

References 36 publications

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“…Dietary weight loss can directly impact physical function by improving muscle quality and reducing intramuscular adipose tissue(Manini, Buford, Lott, Vandenborne, Daniels, Knaggs, Patel, Pahor, Perri, and Anton 2014) and decreasing joint load (Messier, Loeser, Miller, Morgan, Rejeski, Sevick, Ettinger, Pahor, and Williamson 2004). Weight reduction in overweight individuals can also impact physical function indirectly by reducing pain(McCarthy, Bigal, Katz, Derby, and Lipton 2009) and fatigue.…”

Section: Discussionmentioning

confidence: 99%

Successful aging: Advancing the science of physical independence in older adults

Anton

Woods

Ashizawa

et al. 2015

Ageing Research Reviews

208

162

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The concept of ‘Successful Aging’ has long intrigued the scientific community. Despite this long-standing interest, a consensus definition has proven to be a difficult task, due to the inherent challenge involved in defining such a complex, multi-dimensional phenomenon. The lack of a clear set of defining characteristics for the construct of successful aging has made comparison of findings across studies difficult and has limited advances in aging research. The domain in which consensus on markers of successful aging is furthest developed is the domain of physical functioning. For example, walking speed appears to be an excellent surrogate marker of overall health and predicts the maintenance of physical independence, a cornerstone of successful aging. The purpose of the present article is to provide an overview and discussion of specific health conditions, behavioral factors, and biological mechanisms that mark declining mobility and physical function and promising interventions to counter these effects. With life expectancy continuing to increase in the United States and developed countries throughout the world, there is an increasing public health focus on the maintenance of physical independence among all older adults.

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Section: Discussionmentioning

confidence: 99%

Successful aging: Advancing the science of physical independence in older adults

Anton

Woods

Ashizawa

et al. 2015

Ageing Research Reviews

208

162

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“…For example, increased fat infiltration into muscle bundles can lead to the accumulation of intermuscular adipose tissue, 62,63 which has been found to adversely affect mitochondrial function 64,65 and insulin signaling. 66 Converging evidence suggests that reductions in mitochondrial function have a pivotal role in the pathogenesis of muscle degradation 67,68 and cardiometabolic disorders.…”

Section: Discussionmentioning

confidence: 99%

Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults

Mainous

Tanner

Anton

et al. 2015

American Journal of Preventive Medicine

129

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Introduction Muscle strength may play a role in cardiometabolic disease. We examined the relationship between hand grip strength and diabetes and hypertension in a sample of healthy weight adults. Methods In 2015, we analyzed the National Health and Nutrition Examination Survey 2011–2012 for adults aged ≥20 years with healthy BMIs (between 18.5 and <25 kg/m2) and no history of cardiovascular disease (unweighted n=1,469; weighted n=61,672,082). Hand grip strength was assessed with a dynamometer. Diabetes was based on hemoglobin A1c level and reported diabetes diagnosis. Hypertension was based on measured blood pressure and reported hypertension diagnosis. Results Individuals with undiagnosed diabetes compared with individuals without diabetes had lower grip strength (51.9 vs 69.8, p=0.0001), as well as among individuals with diagnosed diabetes compared with individuals without diabetes (61.7 vs 69.8, p=0.008). Mean grip strength was lower among individuals with undiagnosed hypertension compared with individuals without hypertension (63.5 vs 71.5, p=0.008) as well as among individuals with diagnosed hypertension compared with those without hypertension (60.8 vs 71.5, p<0.0001). In adjusted analyses controlling for age, sex, race, smoking status, and first-degree relative with disease, mean grip strength was lower for undiagnosed diabetes (β= −10.02, p<0.0001) and diagnosed diabetes (β= −8.21, p=0.03) compared with individuals without diabetes. In adjusted analyses, grip strength was lower among individuals with undiagnosed hypertension (β= −6.6, p=0.004) and diagnosed hypertension (β= −4.27, p=0.04) compared with individuals without hypertension. Conclusions Among healthy weight adults, combined grip strength is lower in individuals with diagnosed and undiagnosed diabetes and hypertension.

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“…3,19 Specifically, this cutoff may indicate an increased risk of abnormal gait (including declines in gait speed and step length) or falls. 36,37,38 Reduced torque from the gastrocnemius and soleus may diminish one’s ability to slow the forward progression of the body about the ankle when recovering from a perturbation. 38 Indeed, Landi et al reported that individuals who are sarcopenic are at 3.23 times higher risk for falls than individuals without sarcopenia regardless of age, gender, BMI, or secondary impairments (e.g., diabetes, stroke).…”

Section: Discussionmentioning

confidence: 99%

“…7,8,11 Moreover, the reliance on measures of grip strength fails to characterize muscle function in the lower extremity (particularly calf muscles), which is severely affected by type 2 diabetes + PN, and is more closely associated with physical function than thigh or upper extremity musculature. 12 Measures of lower extremity strength and functional power, therefore, may provide a more accurate basis for sarcopenic classification, particularly in individuals with diabesity. Additionally, because changes in muscle composition are critical to muscle quality, and excess IMAT infiltration reduces muscle quality and performance, we hypothesized that there may be relationships between leg IMAT accumulation and sarcopenic decline, particularly in diabesity – a condition characterized by progressive IMAT accumulation and accelerated sarcopenia.…”

Section: Introductionmentioning

confidence: 99%

Explanators of Sarcopenia in Individuals With Diabesity: A Cross-Sectional Analysis

Bittel

Tuttle

et al. 2017

Journal of Geriatric Physical Therapy

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Background and Purpose Excess lower extremity intermuscular adipose tissue (IMAT), reduced strength, and functional limitations are common in obese individuals with and without diabetes (the former termed diabesity). Individuals with diabesity are particularly susceptible to accelerated sarcopenia, which may be under-diagnosed. The purpose of this study was to determine critical values for leg IMAT volume, plantar flexor muscle strength, and physical performance that help identify individuals with diabesity who have sarcopenia. Methods 43 age- and sex-matched obese adults were studied; 12 with type 2 diabetes, 21 with diabetes and peripheral neuropathy, and 10 non-diabetic controls. Dual-energy x-ray absorptiometry (DXA)-derived skeletal muscle index determined classification of sarcopenia. Leg fat (%IMAT), ankle plantar flexor (PF) peak torque and power while ascending 10 steps were used as explanators of sarcopenia. Receiver operating curves (ROC) identified critical values for each explanator individually. Logistic regression models using all 3 explanators, and only PF torque and stair power, were also created. ROC analyses identified the predicted probability that maximized each model’s sensitivity and specificity. A leave one out cross validation was used to simulate the models’ performance in an independent sample. Results & Discussion 32 participants were sarcopenic, 11 were not. Critical values for individual explanators were: 21% IMAT, 68 Nm PF torque, and 441 watts of stair power. Predicted probabilities of .76 and .67 were chosen as the optimal cutoff probabilities for the model combining all 3 explanators, and the model combining PF torque and stair power respectively. The cross validation analysis produced an accuracy of 82.4%, using the cutoff probability of .5, and an accuracy of 76.5%, using the cutoff of .76. The area under the curve (AUC) for the cross validation ROC analysis was .82. Critical values of leg %IMAT, PF torque, and stair power can classify individuals with diabesity as sarcopenic. The results of the cross validation give us confidence that the sample used in this study was representative of the target population, and suggests models created from this sample may perform well in externally derived datasets Conclusion Clinicians may be able to use these critical values to select interventions that specifically target sarcopenia. Measures of %IMAT, PF torque, and stair power may offer a customized alternative to traditional sarcopenic classification systems, which may not be optimally suited to the common impairments among individuals with diabesity.

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Effect of Dietary Restriction and Exercise on Lower Extremity Tissue Compartments in Obese, Older Women: A Pilot Study

Cited by 40 publications

References 36 publications

Successful aging: Advancing the science of physical independence in older adults

Successful aging: Advancing the science of physical independence in older adults

Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults

Explanators of Sarcopenia in Individuals With Diabesity: A Cross-Sectional Analysis

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