Relative Muscle Mass Is Inversely Associated with Insulin Resistance and Prediabetes. Findings from The Third National Health and Nutrition Examination Survey

Srikanthan, Preethi; Karlamangla, Arun S.

doi:10.1210/jc.2011-0435

Cited by 617 publications

(520 citation statements)

References 24 publications

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“…Similarly, nutritional patterns entailing large caloric reductions and only-moderate protein consumption can result in the loss of lean body mass and appear inadequate for preserving or increasing lean body mass with resistance training (RT), which is a central part of exercise guidelines [16]. Reduced lean body mass is associated with insulin resistance and prediabetes [17][18][19]. In the Look Ahead protocol, for example, only 1,200 to 1,500 kcal/day with a minimum of 15 % calories from protein was recommended during the initial weight loss phase for people weighing <114 kg.…”

Section: Policymentioning

confidence: 99%

Developing a new treatment paradigm for disease prevention and healthy aging

Winett

Davy

Marinik

et al. 2013

Behav. Med. Pract. Policy Res.

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An increasingly prevalent pattern of risk factors has emerged in middle-aged and older adults that includes the presence of type 2 diabetes or prediabetes, overweight or obese weight status with central obesity and very high body fat, low cardiorespiratory fitness (CRF), low strength, and a low lean-body-mass-to-body-fat ratio. Traditionally, these problems have been approached with a low-fat and low-calorie diet and with lower to moderate intensity activity such as walking. While the treatment has some clear benefits, this approach may no longer be optimal because it does not reflect more recent findings from nutrition and exercise sciences. Specifically, these fields have gained a greater understanding of the metabolic and functional importance of focusing on reducing body fat and central obesity while maintaining or even increasing lean body mass, a quality weight loss, and how to efficiently and effectively increase CRF and strength. Evidence is presented for shifting the treatment paradigm for disease prevention and healthy aging to include the DASH nutrition pattern but with additional protein, higher intensity, brief aerobic training, effortbased, brief resistance training, and structured physical activity. Recent interventions based on social cognitive theory for initiating and then maintaining health behavior changes show the feasibility and efficacy of the approach we are advocating especially within a multiple health behavior change format and the potential for translating the new treatment paradigm into practice. KEYWORDSDiabetes, Quality weight loss, Treatment paradigm, Multiple health behaviors IMPORTANCE OF THE PROBLEM, USUAL TREATMENT, CHANGING THE TREATMENT PARADIGM A pressing public health problem is the high prevalence of engagement in multiple, poor health behaviors, creating patterns of high risk for morbidity and mortality and contributing to considerable individual and societal financial burden [1,2]. One pattern that is becoming increasingly prevalent is the combination of prediabetes, overweight or obese weight status, central obesity (increased visceral adipose tissue), and low cardiorespiratory fitness (CRF) with gradual loss of lean body mass and strength [3], which further increases the risks for type 2 diabetes (T2D), cardiovascular diseases, and some cancers, disabilities, and premature death [4]. The prevalence of T2D, based on fasting glucose or hemoglobin A1c levels in adults, aged 45-64 years old, is~14 %, and the prevalence of prediabetes for adults >20 years old is~35 % [5]. For adults over 65 years old, the prevalence of T2D is 27 % and the prevalence of prediabetes is~50 % [5]. Overweight, not just obesity weight status, is often comorbid for central obesity (waist circumference (WC) ≥102 cm for men and ≥88 cm for women) [3], which is associated with increased risk of T2D, especially for women [6]. Overweight individuals with large WC's, though at high risk, are often not identified for interventions [6,7]. The normal agerelated loss of lean body mass beginning in m...

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Section: Policymentioning

confidence: 99%

Developing a new treatment paradigm for disease prevention and healthy aging

Winett

Davy

Marinik

et al. 2013

Behav. Med. Pract. Policy Res.

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“…It was reported that malnutrition is prevalent among older adults with diseases such T2DM (8) affecting both physical function and psychological wellbeing, both of which are essential for satisfactory HRQoL (9). It is know that tissue sensitivity to insulin can be influenced by diet (10), however, tissue sensitivity to insulin (in addition to improvements in glycemic control) has also been reported to be influenced by improved function (11). It would be expected, therefore, to find a relationship between nutritional status and functional status among those with T2DM.…”

Section: Introductionmentioning

confidence: 99%

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

Alfonso-Rosa

Pozo-Cruz

et al. 2013

The Journal of nutrition, health and aging

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Abstract:Objective: To explore the relationship between nutritional status, functional capacity and healthrelated quality of life (HRQoL) in older adults with type 2 diabetes (T2DM). Design: Cross-sectional study. Setting and participants: Forty two non-insulin dependent older adults from a primary care center in Seville, Spain. Measurements: Function was assessed with a battery of standardized physical fitness tests. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and the European Quality of Life Questionnaire (EQ-5D-3L) was used to assess HRQoL. Results: There was an association between MNAnutritional status and lower body strength as assessed by the chair sit-stand test (rho= .451; p= .037) and between MNA-nutritional status and EQ-5D-3L-HRQoL (EQ-5D-3Lutility, rho= .553; p<.001 and EQ-5D-3LVAS rho= .402; p<.001). An MNA item by item correlation analysis with HRQoL and lower limb strength demonstrated that HRQoL appears to be related to functional capacity (principally lower body strength, motor agility and cardiorespiratory fitness) among participants. These results were maintained when correlations were adjusted for co-morbidity. Conclusion: Our results demonstrated that nutritional status is moderately associated with HRQoL and lower limb strength in patients with T2DM. Our data suggest that more emphasis should be placed on interventions to encourage a correct diet and stress the needed to improve lower body strength to reinforce better mobility in T2DM population

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“…We propose that intestinally derived bacterial products reduce effectiveness of insulin signaling and responses to insulin's anabolic signaling. Exercise training increases both insulin sensitivity and muscle mass in the elderly (Ogawa et al, 2010), and the third National Health and Nutrition Examination Survey reported that skeletal muscle index was related to insulin sensitivity, even after adjusting for obesity measures and age (Srikanthan and Karlamangla, 2011). Maintaining insulin sensitivity by eliminating chronic low-grade inflammation (which may be the result of MT) could support muscle repair and regeneration, thus aiding the maintenance of muscle mass and function in aging.…”

Section: Discussionmentioning

confidence: 99%

Microbial translocation and skeletal muscle in young and old vervet monkeys

Kavanagh

Brown

Davis

et al. 2016

AGE

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Intestinal barrier dysfunction leads to microbial translocation (MT) and inflammation in vertebrate and invertebrate animal models. Age is recently recognized as a factor leading to MT, and in some human and animal model studies, MT was associated with physical function. We evaluated sarcopenia, inflammation, MT biomarkers, and muscle insulin sensitivity in healthy female vervet monkeys (6-27 years old). Monkeys were fed consistent diets and had large and varied environments to facilitate physical activity, and stable social conditions. Aging led to sarcopenia as indicated by reduced walking speeds and muscle mass, but general metabolic health was similar in older monkeys (n = 25) as compared to younger ones (n = 26). When older monkeys were physically active, their MT burden approximated that in young monkeys; however, when older monkeys were sedentary, MT burden was dramatically increased. MT levels were positively associated with inflammatory burden and negatively associated with skeletal muscle insulin sensitivity. Time spent being active was positively associated with insulin sensitivity as expected, but this relationship was specifically modified by the individual monkey's MT, not inflammatory burden. Our data supports clinical observations that MT interacts with physical function as a factor in healthy aging.

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Relative Muscle Mass Is Inversely Associated with Insulin Resistance and Prediabetes. Findings from The Third National Health and Nutrition Examination Survey

Abstract: Across the full range, higher muscle mass (relative to body size) is associated with better insulin sensitivity and lower risk of PDM. Further research is needed to examine the effect of appropriate exercise interventions designed to increase muscle mass on incidence of diabetes.

Cited by 617 publications

References 24 publications

Developing a new treatment paradigm for disease prevention and healthy aging

Developing a new treatment paradigm for disease prevention and healthy aging

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

Microbial translocation and skeletal muscle in young and old vervet monkeys

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