Low muscle mass and strength in pediatrics patients: Why should we care?

Orsso, Camila E.; Tibães, Jenneffer Rayane Braga; Oliveira, Camila L. P.; Rubin, Daniela A.; Field, Catherine J.; Heymsfield, Steven B.; Prado, Carla M.; Haqq, Andrea M.

doi:10.1016/j.clnu.2019.04.012

Cited by 95 publications

(104 citation statements)

References 176 publications

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“…There is growing recognition that reduced lean tissue, notably skeletal muscle, can co-occur in the presence of obesity, the so-called sarcopenic obesity (12,(36)(37)(38). Clinical evaluation of muscle mass in the obese subjects, however, is a real pitfall, since a reduced skeletal muscle mass may be masked by the presence of excess fat (37).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, no consensus has yet been reached on the best technique to estimate or measure it (42). Among them, computed tomography (CT) and magnetic resonance imaging (MRI) are ideal in terms of accuracy, but their routine use in many clinical settings is compromized by the high cost of instrumentation, concerns of radiation exposure (for CT), contraindications for scanning (for MRI), and limited access to equipment (36)(37)(38)42). Thus, both techniques are not suitable for population screening, nor available at early asymptomatic stages of the disease (37).…”

Section: Discussionmentioning

confidence: 99%

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Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

et al. 2020

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Background: Recent studies in adult non-elderly and elderly individuals have reported a link between nonalcoholic fatty liver disease (NAFLD) and sarcopenia. Nonetheless, whether this relationship would be found outside these populations it is still unknown. Hence, we evaluated the relationship between NAFLD and skeletal muscle mass in children and adolescents with overweight/obesity. Methods: Two-hundred and thirty-four overweight/obese youths were enrolled. NAFLD was diagnosed by ultrasononography, after exclusion of infectious and metabolic disorders. Forty of the patients with NAFLD had also liver biopsy. Total and regional lean body mass and total fat mass measurements were obtained by dual-energy X-ray absorptiometry. The relative muscle mass (RMM) was defined as the percent of muscle mass (kg) relative to the sum of muscle and fat (kg) mass. Appendicular skeletal muscle mass (ASM) was calculated by the sum of muscle masses of the four limbs (kg), and expressed as percent of body weight. Results: Subjects were stratified according to tertiles of RMM. The prevalence of abdominal obesity, dyslipidemia, insulin resistance, metabolic syndrome, NAFLD as well as biopsy-proven nonalcoholic steatohepatitis (NASH) was significantly increased in the lowest tertile of RMM. After controlling for age, sex and Tanner stage, children in the lowest tertile of RMM had an increased risk for NAFLD (OR= 2.80, 95% CI=1.57-5.02) compared to those in the other two tertiles. This association persisted after additional adjustments for clinical and metabolic variables. Similarly, the risk of NAFLD in the lowest tertile of ASM/weight index was significantly higher compared to those in the other two tertiles after adjustment for the above confounders. Conclusions: This is the first study to establish an independent association between low muscle mass and NAFLD/NASH in overweight/obese youths. Considering the worldwide increase of pediatric obesity, measurements of muscle mass may serve as useful method of identifying among obese children those at high metabolic risk who may need intensive lifestyle interventions to prevent NAFLD and its progression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

et al. 2020

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“…A low level of muscular strength and muscular power is a well-recognized risk factor for functional disability and mortality in older adults [31] and, in the same light, children and adolescents appear to be just as vulnerable to the inevitable consequences of dynapenia and neuromuscular dysfunction [26,35,62]. While the term dynapenia has traditionally been associated with older adults to describe the poverty of strength or power often seen in this population [13], the construct of dynapenia also applies to modern day youth who are weaker and slower than previous generations [12,24,27].…”

Section: Introductionmentioning

confidence: 99%

“…These general recommendations that focus on the total amount of aerobic physical activity accumulated throughout the day undervalue the critical importance of resistance exercise to combat physical inactivity and prepare youth for ongoing participation in active play, exercise and sport activities. Since prerequisite levels of muscular strength are needed to jump, hop, kick, and run proficiently [53], concerted efforts are needed to identify and treat deficits in muscular strength early in life before youth become disinterested, disengaged, and predisposed to functional limitations, activity-related injuries and adverse health outcomes [35,62,82].…”

Section: Introductionmentioning

confidence: 99%

Resistance Exercise for the Prevention and Treatment of Pediatric Dynapenia

Faigenbaum

Rebullido²,

Peña

et al. 2019

J. of SCI. IN SPORT AND EXERCISE

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Temporal trends of youth muscular fitness (i.e., muscular strength, muscular power and local muscular endurance) indicate that contemporary children and adolescents are weaker and slower than previous generations. Consequently, this generation of millennials appear to be just as vulnerable as older adults to the inevitable consequences of muscle disuse and neuromuscular dysfunction. The modern-day construct of pediatric dynapenia describes an identifiable and treatable condition in youth characterized by low levels of muscular strength and power and consequent physical and psychosocial limitations not caused by neurologic or muscular disease. An interaction of modifiable physical and psychosocial factors can influence the development and progression of pediatric dynapenia. Without structured interventions that target strength deficits and build strength reserves in a supporting environment, the divergence in performance between weaker and stronger children may persist into adolescence because weaker youth may be unable to break through a so-called strength barrier. Regular participation in a well-designed youth resistance training program provides an opportunity for youth to enhance their health and fitness while acquiring the physical skills and behaviors that support an active lifestyle. New insights have highlighted the importance of initiating strength-building interventions early in life to optimize performance gains in other important components of physical fitness. Developmentally appropriate resistance training should be integrated into school-and community-based youth fitness programs and strength-building activities should take a more prominent position in public health physical activity recommendations for children and adolescents.

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“…Moreover, HGS has shown to be associated with many diseases in children, such as metabolic syndrome and NAFLD. (11,14) Adequate dietary intake is essential for children and adolescents' health. Unbalanced dietary-intake habits are known to contribute to obesity in adolescents (15,16); besides, they are associated with major health problems, including metabolic syndrome, mental disorders, and even cancer.…”

Section: Introductionmentioning

confidence: 99%

Association between dietary patterns and handgrip strength: analysis of the Korean National Health and Nutrition Examination Survey data between 2014 and 2017

Kang

Kim

et al. 2020

Preprint

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Background Non-invasive anthropometric measurement methods such as those for measuring height and weight are crucial in pediatric patients. However, research focusing on the association between the type of dietary pattern and handgrip strength and handgrip-to-weight ratio in adolescents has not been carried out yet. Methods The current work aims to investigate the association between handgrip strength and dietary patterns in Korean adolescents. This cross-sectional analyses of the 2014-2017 Korean National Health and Nutrition Examination Survey assessed 2,327 adolescent (aged 10-18 years) who had measured handgrip strength and analyzed association between dietary pattern. The mean of three handgrip strength measurements, per hand, was used in the analysis. Handgrip-to-weight ratio was calculated by the following equation: Handgrip strength/body weight (kg)×100). The overall food intake data were subcategorized into 25 food groups from the Korean Nutrient Database. The clusters were examined for nutritional values, and the ready-to-eat , balanced, and western-style fast-food clusters were ultimately generated. The association between handgrip strength, handgrip-to-weight ratio, and dietary intake was analyzed. Results Overall, 85.6% of the participants were assigned to a ready-to-eat dietary pattern, 9.3% to a western-style fast-food dietary pattern, and 5.1% to a balanced dietary pattern. Compared with the participants following a balanced dietary pattern, those following a ready-to-eat dietary pattern were shown to have significantly lower handgrip strength and handgrip-to-weight ratio. However, no significant association was found between handgrip strength or handgrip-to-weight ratio when the western-style fast-food dietary pattern was compared to the balanced dietary pattern. Conclusions Decreased handgrip strength and handgrip-to-weight ratio value in participants following ready-to-eat dietary patterns indicate a diffuse problem in adolescents’ health and possibly imply an association between reduced muscle quality and dietary pattern. Moreover, the overall environmental factors potentially inducing such unhealthy dietary preferences should be investigated, and appropriate lifestyle changes in Korean adolescents should be encouraged.

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Low muscle mass and strength in pediatrics patients: Why should we care?

Cited by 95 publications

References 176 publications

Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

Resistance Exercise for the Prevention and Treatment of Pediatric Dynapenia

Association between dietary patterns and handgrip strength: analysis of the Korean National Health and Nutrition Examination Survey data between 2014 and 2017

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