Methods, Diagnostic Criteria, Cutoff Points, and Prevalence of Sarcopenia among Older People

Aim. To identify methods, index, diagnostic criteria, and corresponding cutoff points used to estimate the prevalence of sarcopenia in older people in different countries. Methods. A systematic review was carried out in accordance with PRISMA Statement. The search encompassed the MEDLINE and LILACS databases and was executed during March 2012 using the keyword sarcopenia. Results. A total of 671 studies were identified by the search strategy, and 30 meet all inclusion criteria. Specifically for dual-X-ray absorptiometry, prevalence ranged from 2.2% to 95% in men and from 0.1% to 33.9% in women. For bioelectrical impedance analysis, the range was from 6.2% to 85.4% in men and 2.8% to 23.6% in women. Regarding anthropometric and computed tomography, prevalence rates were, respectively, 14.1% and 55.9%. Conclusions. Heterogeneity in prevalence of sarcopenia was identified, due to diagnostic method choice, cutoff points, and, characteristics of the population as well as reference population. These factors should be considered in research designs to enable comparison and validation of results. Despite the limitations of most studies that indicated high prevalence rates, the results indicate the need for early detection of this syndrome

Sarcopenia and mortality risk in community-dwelling Brazilian older adults

We estimated the impact of sarcopenia parameters on mortality risk and assessed its prevalence and associated factors in the older adults according to the European Working Group on Sarcopenia in Older People’s 2010 (EWGSOP1) and 2018 (EWGSOP2) criteria. This was a 10-year follow-up cohort study. Low muscle mass (MM) was defined as low skeletal muscle mass index (SMI) using dual-energy X-ray absorptiometry (DXA), and low calf circumference (CC). Cox regression and the Kaplan–Meier method were performed. The prevalence of sarcopenia and associated factors were influenced by the MM measurement method and diagnostic criteria used [6.8% (SMI and EWGSOP2), 12.8% (CC and EWGSOP2; and SMI and EWGSOP1) and 17.4% (CC and EWGSOP1)]. While a low BMI was associated with sarcopenia regardless of the sarcopenia definitions, diabetes, and high TGs were associated with sarcopenia only when using the EWGSOP1 criteria. Low SMI increased mortality risk (EWGSOP1: HR = 2.01, 95% CI 1.03–3.92; EWGSOP2: HR = 2.07, 95% CI 1.05–4.06). The prevalence of sarcopenia was higher according to EWGSOP1 than EWGSOP2. A low BMI, diabetes, and high TGs were associated with sarcopenia. A low SMI doubled the risk of mortality in community-dwelling older adults

Low muscle mass and mortality risk later in life: A 10-year follow-up study

INTRODUCTION: Little is known about the impact of low muscle mass (MM) assessed by calf circumference (CC), arm circumference (AC), arm muscle circumference (AMC), and corrected arm muscle circumference (CAMC)-on mortality risk later in life. We aimed to investigate the impact of low MM assessed by CC, AC, AMC and, CAMC on all-cause, cardiovascular, and cancer mortality risk. METHODS: Data came from 418 older adults who participated in a 10-year follow-up prospective cohort study. Low MM was defined as a CC < 33 cm for women and < 34 cm for men and by the lowest tertile of AC, AMC, and CAMC stratified by sex. The log rank test, Kaplan-Meier curves, and Cox regression were used. RESULTS: There were 147 deaths: 49 related to CVD and 22 to cancer. A small CC (HR = 1.57, 95% CI, 1.12-2.20), AMC (HR = 1.61, 95% CI, 1.13-2.30) and CAMC (HR = 1.45, 95% CI, 1.03-2.04) were associated with all-cause mortality. A small CAMC was a protective factor for CVD mortality (HR = 0.46, 95% CI, 0.22-0.98). In the Kaplan-Meier analysis, older adults with LMM presented low all-cause mortality survival, with AC (p < 0.05), AMC (p < 0.005), CAMC (p < 0.002), and CC (p < 0.001). Cancer mortality was associated with low CAMC (p < 0.020). CONCLUSIONS: Low MM assessed by anthropometric measures (AC, AMC, CAMC and CC) increased the all-cause mortality risk. A small CAMC decreased the CVD mortality

Factors associated with minor psychiatric disorders among women selected from a healthcare center in Rio de Janeiro, Brazil

The aim was to investigate factors potentially associated with minor psychiatric disorders, including maternal nutritional status variables. A cohort was studied with 479 women 15-45 years of age. The reduced General Health Questionnaire (GHQ &shy; 12 items) was applied at nine months post-partum with the 312 women who had completed follow-up. Minor psychiatric disorder was defined as a GHQ score of > 4 points and was treated as the response variable. Statistical analysis used hierarchical multivariate logistic regression models. The prevalence of minor psychiatric morbidity was 54.2% (95%CI: 48.6-59.7). According to the final model, the following variables remained statistically associated with minor psychiatric morbidity: level 1: total family income (1st quartile: OR = 2.71, 95%CI: 1.42-5.19; 2nd quartile: OR = 2.13; 95%CI: 1.13-4.04); level 3: body fat > 30% (OR = 1.66; 95%CI: 1.03-2.65). In conclusion, low income and obesity were the only factors potentially associated with minor psychiatric disorders, even after adjusting for confounding variables, while there are few studies relating maternal nutritional status and minor psychiatric morbidity.O objetivo foi investigar fatores potencialmente associados às morbidades psiquiátricas menores, incluindo variáveis do estado nutricional materno. Foi estudada uma coorte com 479 mulheres entre 15 &shy; 45 anos. O General Health Questionnaire (GHQ) reduzido (12 itens) foi aplicado, aos nove meses pós-parto, nas 312 mulheres que completaram o seguimento. A presença de morbidades psiquiátricas menores foi definida como valores do escore derivado do GHQ > 4 pontos, sendo analisada como variável dependente. As análises foram realizadas com modelos de regressão logística multivariados hierarquizados. A prevalência de morbidades psiquiátricas menores foi de 54,2% (IC95%: 48,6-59,7). Os resultados do modelo final revelaram que as seguintes variáveis permaneceram estatisticamente associadas: nível 1: renda familiar (1º quartil: OR = 2,71; IC95%: 1,42-5,19; 2º quartil: OR = 2,13; IC95%: 1,13-4,04); nível 3: gordura corporal > 30% (OR = 1,66; IC95%: 1,03-2,65). Conclui-se que a baixa renda e a obesidade foram os únicos fatores potencialmente associados à probabilidade de ocorrência de morbidades psiquiátricas menores, mesmo após o controle para variáveis de confusão, e que são escassos os estudos relacionando estado nutricional materno e morbidades psiquiátricas menores.Universidade Federal do Rio de Janeiro Instituto de Nutrição Josué de CastroUniversidade Federal de Minas Gerais Departamento de Medicina Social e PreventivaUniversidade Federal de Goiás Faculdade de NutriçãoUniversidade Federal de São Paulo (UNIFESP) Departamento de PsiquiatriaUNIFESP, Depto. de PsiquiatriaSciEL

Terapia nutricional nas alterações metabólicas em pessoas vivendo com HIV/aids

OBJECTIVE: To analyze the effect of nutritional treatment on metabolic changes caused by the use of antiretroviral therapy in adults with HIV/AIDS. METHODS: A systematic review of literature was conducted in the PubMed, Lilacs and Cochrane databases, between 1996 and 2010, including crossover and randomized controlled clinical trials performed in adults with HIV/AIDS using antiretroviral therapy and without opportunistic diseases. The intervention of interest was oral nutritional supplementation and/or a change in lifestyle due to specific dietary treatment: dyslipidemia, insulin resistance, lipodystrophy and systemic arterial hypertension. The Jadad scale was used for a qualitative classification of articles. RESULTS: A total of 385 articles were found, of which seven were included. The interventions used in these studies were as follows: diet, diet and physical exercises, diet and supplementation, and only supplementation. Dyslipidemia was the outcome assessed in all studies. Studies that assessed omega-3 supplementation found a significant reduction in triglycerides. The specific diet with omega-3 supplementation showed an increase in HDL-cholesterol. Chrome nicotinate supplementation did not have an effect on dyslipidemia. Changing one's lifestyle, including diet and physical activity, significantly reduced waist circumference, lipodystrophy and systolic blood pressure. CONCLUSIONS: Reduction in tryglicerides with omega-3 supplementation was the nutritional intervention with the strongest scientific evidence. Prescribing a specific diet appeared to be the most adequate intervention to increase HDL-cholesterol. Inferences could not be made about the nutritional treatment of total cholesterol, LDL-cholesterol and insulin resistance. Changes in lifestyle can promote an improvement in lipodystrophy and blood pressure.OBJETIVO: Analisar o efeito do tratamento nutricional sobre as alterações metabólicas provocadas pelo uso da terapia antirretroviral em adultos vivendo com HIV/aids. MÉTODOS: Revisão sistemática de literatura no PubMed, Lilacs e Cochrane, entre 1996 e 2010, do tipo ensaio clínico, controlado, randomizado, crossover, adultos, vivendo com HIV/aids em uso de terapia antirretroviral e sem doenças oportunistas. A intervenção de interesse foi suplementação nutricional via oral e/ou mudança de estilo de vida por tratamento dietoterápico específico: dislipidemia, resistência insulínica, lipodistrofia e hipertensão arterial sistêmica. A escala de Jadad foi utilizada para classificação qualitativa dos artigos. RESULTADOS: Foram localizados 385 artigos e sete foram incluídos. As intervenções utilizadas nesses estudos foram: dieta, dieta mais exercício físico, dieta mais suplemento e somente suplementos. Dislipidemia foi desfecho avaliado em todos os estudos. Os estudos que avaliaram suplementação com ômega 3 encontraram redução significativa dos triglicérides. Dieta específica mais suplementação de ômega 3 mostrou aumento de HDL-colesterol. Suplementação com nicotinato de cromo não teve efeito sobre a dislipidemia. Modificação de estilo de vida, incluindo dieta e atividade física, reduziu significativamente a circunferência da cintura, lipodistrofia e pressão arterial sistólica. CONCLUSÕES: A redução de triglicérides pela suplementação com ômega 3 foi a intervenção nutricional com maiores evidências científicas. A prescrição de dieta específica parece ser a intervenção mais adequada para aumentar HDL-colesterol. Não é possível fazer inferências sobre o tratamento nutricional do colesterol total, LDL-colesterol e resistência insulínica. Modificações no estilo de vida podem promover melhora da lipodistrofia e pressão arterial.OBJETIVO: Analizar el efecto del tratamiento nutricional sobre las alteraciones metabólicas provocadas por el uso de la terapia antirretroviral en adultos viviendo con VIH/Sida. MÉTODOS: Revisión sistemática de literatura en el PubMed, Lilacs y Cochrane, entre 1996 y 2010, del tipo ensayo clínico, controlado, aleatorio, crossover, adultos, viviendo con VIH/Sida en uso de terapia antirretroviral y sin enfermedades oportunistas. La intervención de interés fue suplementación nutricional vía oral y/o cambio de estilo de vida por tratamiento dietoterápico específico: dislipidemia, resistencia insulínica, lipodistrofia e hipertensión arterial sistémica. Se utilizó la escala de Jadad para clasificación cualitativa de los artículos. RESULTADOS: Se localizaron 385 artículos y siete fueron incluidos. Las intervenciones utilizadas en estos estudios fueron: dieta, dieta más ejercicio físico, dieta más suplemento y solamente suplementos. Dislipidemia fue el resultado evaluado en todos los estudios. Los estudios que evaluaron suplementación con omega 3 encontraron reducción significativa de los triglicéridos. La dieta específica más suplementación de omega 3 mostró aumento de HDL-colesterol. Suplementación con nicotinato de cromo no tuvo efecto sobre la dislipidemia. La modificación de estilo de vida, incluyendo dieta y actividad física, redujo significativamente la circunferencia de la cintura, lipodistrofia y presión arterial sistólica. CONCLUSIONES: La reducción de triglicéridos por la suplementación con omega 3 fue la intervención nutricional con mayores evidencias científicas. La prescripción de dieta específica parece ser la intervención más adecuada para aumentar HDL-colesterol. No es posible hacer inferencias sobre el tratamiento nutricional del colesterol total, LDL-colesterol y resistencia insulínica. Las modificaciones en el estilo de vida pueden promover mejoría de la lipodistrofia y presión arterial

The Effectiveness of Extra Virgin Olive Oil and the Traditional Brazilian Diet in Reducing the Inflammatory Profile of Individuals with Severe Obesity: A Randomized Clinical Trial

We analyzed the effectiveness of two nutritional interventions alone and together, EVOO and the DieTBra, on the inflammatory profile of severely obese individuals. This study was an RCT with 149 individuals aged from 18 to 65 years, with a body mass index ≥ 35 kg/m2, randomized into three intervention groups: (1) 52 mL/day of EVOO (n = 50); (2) DieTBra (n = 49); and (3) DieTBra plus 52 mL/day of EVOO (DieTBra + EVOO, n = 50). The primary outcomes we measured were the-neutrophil-to-lymphocyte ratio (NLR) and the secondary outcomes we measured were the lymphocyte-to-monocyte ratio (LMR); leukocytes; and C reactive protein (CRP). After 12 weeks of intervention, DieTBra + EVOO significantly reduced the total leucocytes (p = 0.037) and LMR (p = 0.008). No statistically significant differences were found for the NLR in neither the intra-group and inter-group analyses, although a slight reduction was found in the DieTBra group (-0.22 ± 1.87). We observed reductions in the total leukocytes and LMR in the three groups, though without statistical difference between groups. In conclusion, nutritional intervention with DietBra + EVOO promotes a significant reduction in inflammatory biomarkers, namely leukocytes and LMR. CRP was reduced in EVOO and DieTBra groups and NLR reduced in the DieTBra group. This study was registered at ClinicalTrials.gov under NCT02463435. Keywords: diet; inflammation; leukocytes; lymphocyte; monocytes; nutritional intervention; olive oil; severe obesity

Coffee Consumption and Risk of Hypertension in Adults: Systematic Review and Meta-Analysis

OBJECTIVES: The association between coffee intake and hypertension (HTN) risk is controversial. Therefore, this systematic review and meta-analysis aimed at summarizing the current evidence on the association of coffee with hypertension risk in observational studies. METHODS: PubMed/Medline and Web of Science were searched for observational studies up to February 2023. Observational studies which assessed the risk of HTN in the highest category of coffee consumption in comparison with the lowest intake were included in the current meta-analysis (registration number: CRD42022371494). The pooled effect of coffee on HTN was evaluated using a random-effects model. RESULTS: Twenty-five studies i.e., thirteen cross-sectional studies and twelve cohorts were identified to be eligible. Combining 13 extracted effect sizes from cohort studies showed that higher coffee consumption was associated with 7% reduction in the risk of HTN (95% CI: 0.88, 0.97; I2: 22.3%), whereas combining 16 effect sizes from cross-sectional studies illustrated a greater reduction in HTN risk (RR = 0.79, 95% CI: 0.72, 0.87; I2 = 63.2%). These results varied by studies characteristics, such as the region of study, participants' sex, study quality, and sample size. CONCLUSIONS: An inverse association was found between coffee consumption and hypertension risk in both cross-sectional and cohort studies. However, this association was dependent on studies characteristics. Further studies considering such factors are required to confirm the results of this study

What is the relationship between physical activity and chronic pain in older adults? A systematic review and meta-analysis protocol

INTRODUCTION: Chronic pain is highly prevalent in older adults and can cause functional limitations, negatively affecting health and quality of life. Physical activity is a non-pharmacological approach used to prevent chronic pain as it promotes the release of endogenous opioids that block pain sensitivity. Therefore, we developed a systematic review protocol to analyse the relationship between physical activity and the occurrence and intensity of chronic pain in older adults. METHODS AND ANALYSES: The systematic review will search PubMed, Scopus and Embase databases. The inclusion criteria will be observational studies that had primary chronic pain as an outcome, including persistent and intermittent pain. The population will include older adults from the community, living in a long-stay institution, or in outpatient follow-up. There will be no restriction regarding the year of publication and articles published in Portuguese, English and Spanish will be analysed. Effect or impact measures will be quantified, including OR, HR, prevalence ratio, incidence ratio and relative risk with their 95% CIs. If the data allow, a meta-analysis will be performed. The results may help understand the impact of physical activity as a potential protection factor against the occurrence of pain later in life as well as promote strategic prevention plans and public policies that encourage this practice in older adults. ETHICS AND DISSEMINATION: Ethical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete. PROSPERO REGISTRATION NUMBER: CRD42021282898

The Effect of Ketogenic Diet on Shared Risk Factors of Cardiovascular Disease and Cancer

Cardiovascular disease (CVD) and cancer are the first and second leading causes of death worldwide, respectively. Epidemiological evidence has demonstrated that the incidence of cancer is elevated in patients with CVD and vice versa. However, these conditions are usually regarded as separate events despite the presence of shared risk factors between both conditions, such as metabolic abnormalities and lifestyle. Cohort studies suggested that controlling for CVD risk factors may have an impact on cancer incidence. Therefore, it could be concluded that interventions that improve CVD and cancer shared risk factors may potentially be effective in preventing and treating both diseases. The ketogenic diet (KD), a low-carbohydrate and high-fat diet, has been widely prescribed in weight loss programs for metabolic abnormalities. Furthermore, recent research has investigated the effects of KD on the treatment of numerous diseases, including CVD and cancer, due to its role in promoting ketolysis, ketogenesis, and modifying many other metabolic pathways with potential favorable health effects. However, there is still great debate regarding prescribing KD in patients either with CVD or cancer. Considering the number of studies on this topic, there is a clear need to summarize potential mechanisms through which KD can improve cardiovascular health and control cell proliferation. In this review, we explained the history of KD, its types, and physiological effects and discussed how it could play a role in CVD and cancer treatment and prevention