The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis.

Postbariatric loss of muscle tissue could negatively affect long-term health due to its role in various bodily processes, such as metabolism and functional capacity. This meta-analysis aimed to unravel time-dependent changes in the magnitude and progress of lean body mass (LBM), fat-free mass (FFM), and skeletal muscle mass (SMM) loss following bariatric surgery. A systematic literature search was conducted in Pubmed, Embase, and Web of Science. Fifty-nine studies assessed LBM (n = 37), FFM (n = 20), or SMM (n = 3) preoperatively and ≥1 time points postsurgery. Random-effects meta-analyses were performed to determine pooled loss per outcome parameter and follow-up time point. At 12-month postsurgery, pooled LBM loss was -8.13 kg [95%CI -9.01; -7.26]. FFM loss and SMM loss were -8.23 kg [95%CI -10.74; -5.73] and -3.18 kg [95%CI -5.64; -0.71], respectively. About 55% of 12-month LBM loss occurred within 3-month postsurgery, followed by a more gradual decrease up to 12 months. Similar patterns were seen for FFM and SMM. In conclusion, >8 kg of LBM and FFM loss was observed within 1-year postsurgery. LBM, FFM, and SMM were predominantly lost within 3-month postsurgery, highlighting that interventions to mitigate such losses should be implemented perioperatively

Rate and Determinants of Excessive Fat-Free Mass Loss After Bariatric Surgery.

Contains fulltext : 220961.pdf (Publisher’s version ) (Open Access)PURPOSE: Fat-free mass (FFM) loss is a concerning aspect of bariatric surgery, but little is known about its time-course and factors related with excessive FFM loss. This study examined (i) the progress of FFM loss up to 3 years post-bariatric surgery and (ii) the prevalence and determinants of excessive FFM loss. MATERIALS AND METHODS: A total of 3596 patients (20% males, 43.5 ± 11.1 years old, BMI = 44.2 ± 5.5 kg/m(2)) underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) surgery. Bioelectrical impedance analysis was performed preoperatively and 3, 6, 9, 12, 18, 24 and 36 months post-surgery. Changes in body composition were assessed by mixed model analysis. Prevalence of excessive FFM loss (based on three different cutoff values: ≥ 25%, ≥ 30% and ≥ 35% FFM loss/weight loss (= %FFML/WL)) was estimated and its determinants were assessed by linear regression analysis. RESULTS: Highest rates of FFM loss were found at 3 and 6 months post-surgery, reflecting 57% and 73% of peak FFM loss, respectively. Prevalence of excessive FFM loss ranged from 14 to 46% at 36 months post-surgery, with an older age (β = 0.14, 95%CI = 0.10-0.18, P < .001), being male (β = 3.99, 95%CI = 2.86-5.12, P < .001), higher BMI (β = 0.13, 95%CI = 0.05-0.20, P = .002) and SG (β = 2.56, 95%CI = 1.36-3.76, P < .001) as determinants for a greater %FFML/WL. CONCLUSION: Patients lost most FFM within 3 to 6 months post-surgery. Prevalence of excessive FFM loss was high, emphasizing the need for more vigorous approaches to counteract FFM loss. Furthermore, future studies should assess habitual physical activity and dietary intake shortly after surgery in relation to FFM loss.01 augustus 202

Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults: a systematic review and meta-analysis.

Background: Increasing protein intake has been suggested as an effective strategy to ameliorate age-related loss of muscle mass and strength. Current reviews assessing the effect of protein supplementation are strongly influenced by the inclusion of studies with frail older adults. Objectives: We assessed the effect of protein supplementation on lean body mass, muscle strength, and physical performance in exclusively nonfrail community-dwelling older adults. Moreover, we assessed the superior effects of protein supplementation during concomitant resistance exercise training on muscle characteristics. Design: A systematic literature search was conducted on PubMed, Embase, and Web of Science up to 15 May 2018. We included randomized controlled trials that assessed the effect of protein supplementation on lean body mass, muscle thigh cross-sectional area, muscle strength, gait speed, and chair-rise ability and performed random-effects meta-analyses. Results: Data from 36 studies with 1682 participants showed no significant effects of protein supplementation on changes in lean body mass [standardized mean difference (SMD): 0.11; 95% CI: -0.06, 0.28], handgrip strength (SMD: 0.58; 95% CI: -0.08, 1.24), lower extremity muscle strength (SMD: 0.03; 95% CI: -0.20, 0.27), gait speed (SMD: 0.41; 95% CI: -0.04, 0.85), or chair-rise ability (SMD: 0.10; 95%: CI -0.08, 0.28) compared with a control condition in nonfrail community-dwelling older adults. Moreover, no superior effects of protein supplementation were found during concomitant resistance exercise training on muscle characteristics. Conclusions: Protein supplementation in nonfrail community-dwelling older adults does not lead to increases in lean body mass, muscle cross-sectional area, muscle strength, or physical performance compared with control conditions; nor does it exert superior effects when added to resistance exercise training. Habitual protein intakes of most study participants were already sufficient, and protein interventions differed in terms of type of protein, amount, and timing. Future research should clarify what specific protein supplementation protocol is beneficial for nonfrail community-dwelling older adults with low habitual protein intake

Increase in Physical Activity After Bariatric Surgery Demonstrates Improvement in Weight Loss and Cardiorespiratory Fitness

Contains fulltext : 198470.pdf (Publisher’s version ) (Open Access

Fatigue in chronic myeloid leukemia patients on tyrosine kinase inhibitor therapy: predictors and the relationship with physical activity

Fatigue is a common side effect of tyrosine kinase inhibitor (TKI) therapy in chronic myeloid leukemia (CML) patients. However, the prevalence of TKI-induced fatigue remains uncertain and little is known about predictors of fatigue and its relationship with physical activity. In this study, 220 CML patients receiving TKI therapy and 110 gender- and age-matched controls completed an online questionnaire to assess fatigue severity and fatigue predictors (Part 1). In addition, physical activity levels were objectively assessed for 7 consecutive days in 138 severely fatigued and non-fatigued CML patients using an activity monitor (Part 2). We demonstrated that the prevalence of severe fatigue was 55.5% in CML patients and 10.9% in controls (P<0.001). We identified five predictors of fatigue in our CML population: age (OR 0.96, 95% CI 0.93-0.99), female gender (OR 1.76, 95% CI 0.92-3.34), Charlson Comorbidity Index (OR 1.91, 95% CI 1.16-3.13), the use of comedication known to cause fatigue (OR 3.43, 95% CI 1.58-7.44), and physical inactivity (OR of moderately active, vigorously active and very vigorously active compared to inactivity 0.43 (95% CI 0.12-1.52), 0.22 (95% CI 0.06-0.74), and 0.08 (95% CI 0.02-0.26), respectively). Objective monitoring of activity patterns confirmed that fatigued CML patients performed less physical activity on both light (P=0.017) and moderate to vigorous intensity (P=0.009). In fact, compared to the non-fatigued patients, fatigued CML patients performed 1 hour less of physical activity per day and took 2000 fewer steps per day. Our findings facilitate the identification of patients at risk of severe fatigue and highlight the importance to set the reduction of fatigue as a treatment goal in CML care. This study was registered at The Netherlands Trial Registry, NTR7308 (Part 1) and NTR7309 (Part 2)

Identifying reasons for nonattendance and noncompletion of cardiac rehabilitation insights from Germany and the Netherlands

Purpose: Despite strong recommendations and beneficial health effects of cardiac rehabilitation (CR), participation rates remain low. Little data are available on reasons beyond quantitative factors in the underutilization of CR. The aim of this study was to identify personal reasons for nonattenders and noncompletions of CR among Dutch and German patients with cardiovascular diseases (CVD) eligible for CR. Methods: Between December 2017 and January 2019, a total of 4265 questionnaires were distributed among eligible patients for CR in the bordering area of the eastern Netherlands and western Germany. Patients were eligible if they had an indication for CR according to national guidelines. Questionnaires were used to assess reasons of nonattendance and noncompletion of CR, when applicable. Results: A total of 1829 patients with CVD completed the questionnaire. Of these, 1278 indicated that they received referral to CR. Despite referral, 192 patients decided not to participate in CR and 88 patients with CVD withdrew from the CR program. The three most reported reasons for nonattendance were as follows: (1) did not need the supervision (56%, n = 108), (2) did not need the CR trajectory (55%, n = 105), and (3) already exercised regularly (39%, n = 74). The most reported reasons for noncompletion were as follows: (1) could no longer participate because of other physical problems (30%, n = 26), (2) did not need the CR trajectory (26%, n = 23), and (3) the CR program was not personal enough (23%, n = 20). Conclusions: Most patients had motivational or perceptive reasons for nonattendance or noncompletion to CR. These possible misconceptions as well as perceived shortcomings of traditional CR underline the need for adequate motivation, information, and more personalized solutions (eg, eHealth, home-based CR) to increase the uptake and completion of CR

Prolonged Moderate-Intensity Exercise Does Not Increase Muscle Injury Markers in Symptomatic or Asymptomatic Statin Users.

BACKGROUND: Statin use may exacerbate exercise-induced skeletal muscle injury caused by reduced coenzyme Q10 (CoQ10) levels, which are postulated to produce mitochondrial dysfunction. OBJECTIVES: We determined the effect of prolonged moderate-intensity exercise on markers of muscle injury in statin users with and without statin-associated muscle symptoms. We also examined the association between leukocyte CoQ10 levels and muscle markers, muscle performance, and reported muscle symptoms. METHODS: Symptomatic (n = 35; age 62 ± 7 years) and asymptomatic statin users (n = 34; age 66 ± 7 years) and control subjects (n = 31; age 66 ± 5 years) walked 30, 40, or 50 km/d for 4 consecutive days. Muscle injury markers (lactate dehydrogenase, creatine kinase, myoglobin, cardiac troponin I, and N-terminal pro-brain natriuretic peptide), muscle performance, and reported muscle symptoms were assessed at baseline and after exercise. Leukocyte CoQ10 was measured at baseline. RESULTS: All muscle injury markers were comparable at baseline (P > 0.05) and increased following exercise (P  0.05). Muscle pain scores were higher at baseline in symptomatic statin users (P < 0.001) and increased similarly in all groups following exercise (P < 0.001). Muscle relaxation time increased more in symptomatic statin users than in control subjects following exercise (P = 0.035). CoQ10 levels did not differ among symptomatic (2.3 nmol/U; IQR: 1.8-2.9 nmol/U), asymptomatic statin users (2.1 nmol/U; IQR: 1.8-2.5 nmol/U), and control subjects (2.1 nmol/U; IQR: 1.8-2.3 nmol/U; P = 0.20), and did not relate to muscle injury markers, fatigue resistance, or reported muscle symptoms. CONCLUSIONS: Statin use and the presence of statin-associated muscle symptoms does not exacerbate exercise-induced muscle injury after moderate exercise. Muscle injury markers were not related to leukocyte CoQ10 levels. (Exercise-induced Muscle Damage in Statin Users; NCT05011643)