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Impact of Cognition and Handfeeding Assistance on Nutritional Intake for Nursing Home Residents. 认知能力和人工喂养对养老院居民营养摄入的影响。
Q3 Medicine Pub Date : 2019-07-01 Epub Date: 2019-05-24 DOI: 10.1080/21551197.2019.1617221
Melissa Batchelor-Murphy, Susan M Kennerly, Susan D Horn, Ryan Barrett, Nancy Bergstrom, Lisa Boss, Tracey L Yap

In nursing homes (NHs), residents are at risk for malnutrition and weight loss. The purpose of this secondary data analysis was to examine the impact of resident cognitive status and level of feeding assistance provided by NH staff on resident's daily nutritional intake and body weight. As part of a large, multisite clinical trial (N = 786), residents with and without dementia were examined according to level of feeding assistance required during mealtimes (independent, set-up only, needs help eating) over a 21-day period. Outcomes analyzed were percent of meal intake by meal type (breakfast, lunch, dinner) and overall daily intake (meals + snacks/supplements). Residents with dementia who required meal set-up assistance had significantly lower meal intake for all three meals. Residents without dementia requiring meal set-up assistance experienced significantly lower intake for breakfast and dinner, but not lunch. When snacks and supplements were offered between meals, residents with dementia consumed approximately 163 additional calories/day, and residents without dementia consumed approximately 156 additional calories/day. This study adds new evidence that residents at greatest risk for low intake are those who are only provided set-up assistance for meals and/or have cognitive impairment.

在疗养院(NHs)中,住院者面临着营养不良和体重减轻的风险。这项二手数据分析的目的是研究住院者的认知状况和疗养院工作人员提供的喂食协助水平对住院者每日营养摄入量和体重的影响。作为一项大型多地点临床试验(N = 786)的一部分,在为期 21 天的时间内,根据进餐时所需的喂食协助程度(独立、只需设置、需要帮助进食)对患有和未患有痴呆症的住院患者进行了检查。分析的结果是膳食类型(早餐、午餐、晚餐)和每日总摄入量(正餐+零食/补充剂)的膳食摄入百分比。需要就餐协助的痴呆住院患者三餐的摄入量都明显较低。没有痴呆症但需要协助安排膳食的住院患者的早餐和晚餐摄入量明显较低,但午餐的摄入量却没有明显下降。如果在两餐之间提供零食和营养补充品,患有痴呆症的住院者每天会多摄入大约 163 卡路里的热量,而不患有痴呆症的住院者每天会多摄入大约 156 卡路里的热量。这项研究为我们提供了新的证据,证明那些只在就餐时得到帮助和/或有认知障碍的居民摄入量低的风险最大。
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引用次数: 0
Identifying Geriatric Patients at Risk for Malnutrition: A Quality Improvement Project. 识别有营养不良风险的老年患者:一个质量改进项目。
Q3 Medicine Pub Date : 2019-04-01 Epub Date: 2019-04-24 DOI: 10.1080/21551197.2019.1604464
Lauren C Mays, Jennifer W Drummonds, Summer Powers, David R Buys, Penni I Watts

Malnourishment leads to poor outcomes in the geriatric surgical population and national guidelines recommend preoperative nutrition screening. However, care practices do not reflect current recommendations. As a quality-improvement project, a validated nutritional screening tool, the Mini Nutritional Assessment-Short Form (MNA-SF), was implemented in the preoperative clinic of a large academic health center to identify patients at-risk for malnutrition prior to elective surgery. Patients were screened during the nursing intake process and categorized as no nutritional risk; at-risk for malnourishment; or severely malnourished. During the four-week screening period, 413 patients met inclusion criteria with 67.8% (n = 280) screened. No nutritional risk was identified in 77.5% (n = 215) of patients, 18.2% (n = 51) were at-risk, and 4.3% (n = 12) were malnourished. This project will inform and guide a prehabilitation plan for nutrition optimization to improve healthcare quality, outcomes, and costs in the geriatric surgical population.

营养不良导致老年手术人群预后不良,国家指南建议术前进行营养筛查。然而,护理实践并未反映当前的建议。作为一项质量改进项目,在一家大型学术医疗中心的术前诊所实施了一种经过验证的营养筛查工具——迷你营养评估简表(MNA-SF),以确定选择性手术前有营养不良风险的患者。在护理摄入过程中对患者进行筛选,并将其归类为无营养风险;面临营养不良风险;或者严重营养不良。在为期四周的筛选期间,413例患者符合纳入标准,其中67.8% (n = 280)被筛选。77.5% (n = 215)的患者未发现营养风险,18.2% (n = 51)存在风险,4.3% (n = 12)存在营养不良。该项目将为营养优化的康复计划提供信息和指导,以提高老年外科人群的医疗质量、结果和成本。
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引用次数: 4
Validation of a Diet Quality Screening Tool for Use in the Oldest Old. 老年人饮食质量筛选工具的验证
Q3 Medicine Pub Date : 2019-04-01 Epub Date: 2019-05-03 DOI: 10.1080/21551197.2019.1601604
Yi-Hsuan Liu, Xiang Gao, Diane C Mitchell, G Craig Wood, Regan K Bailey, Christopher D Still, Gordon L Jensen

The oldest old (aged ≥80 years) are often the population subgroup at high nutritional risk due to age-related metabolic changes. We performed a validation analysis of a dietary screening tool (DST) which was developed for older adults among the oldest old. We examined dietary intakes using three 24-hour dietary recalls and the DST among 122 participants (aged 82-97) of the Geisinger Rural Aging Study. DST scores were compared with the Health Eating Index (HEI)-2015 scores, which were calculated based on three-day dietary recalls. Pearson correlations were used to characterize concurrent validity and Bland-Altman plots were used to identify potential bias. DST scores were significantly correlated with HEI scores (adjusted r = 0.68; p < 0.001) in an age- and sex-adjusted model. Those within the not-at-risk DST group had significantly higher HEI scores (adjusted means = 79.6 ± 3.68) compared with those who were in the at-risk (adjusted means = 51.2 ± 1.56) and the possibly-at-risk (adjusted means = 66.3 ± 1.79) groups (p-trend < 0.001). The DST appears to be a valid measure of diet quality in the oldest old when compared with the HEI and may be a potential tool to assess overall diet quality in this population.

年龄最大的老年人(≥80岁)往往是由于年龄相关的代谢变化而处于高营养风险的人群亚群。我们对膳食筛查工具(DST)进行了验证分析,该工具是为老年人中的老年人开发的。我们对Geisinger农村老龄化研究的122名参与者(82-97岁)进行了三次24小时饮食回顾和DST检查饮食摄入量。将DST分数与健康饮食指数(HEI)-2015分数进行比较,后者是根据三天的饮食回忆计算得出的。使用Pearson相关来表征并发效度,使用Bland-Altman图来识别潜在偏倚。DST评分与HEI评分显著相关(经校正r = 0.68;p
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引用次数: 7
Mental Illness, Not Obesity Status, is Associated with Food Insecurity Among the Elderly in the Health and Retirement Study. 在健康和退休研究中,精神疾病,而不是肥胖,与老年人的食物不安全有关。
Q3 Medicine Pub Date : 2019-04-01 Epub Date: 2019-02-22 DOI: 10.1080/21551197.2019.1565901
Diana P Brostow, Elise Gunzburger, Lauren M Abbate, Lisa A Brenner, Kali S Thomas

Objectives: Food insecurity, limited or uncertain access to adequate nutrition, is an increasingly recognized determinant of health outcomes and is often associated with having obesity. It is unclear, however, if this association persists in elderly populations.

Methods: We conducted a cross-sectional study of 2868 participants' aged 65+ years from the Health and Retirement Study. Multivariate logistic regression was used to assess associations between food insecurity and body mass index, demographic characteristics, psychiatric history, and medical history.

Results: Participants with overweight/obesity had a higher prevalence of food insecurity than leaner counterparts, however, weight status was not a significant predictor of food insecurity after multivariate adjustment. Instead, mental illness, current smoking status, and non-White race were all independently associated with food insecurity.

Discussion: Beyond financial status, health care providers are encouraged to use these characteristics to identify elderly patients that may be at risk of food insecurity.

目标:粮食不安全,即获得充足营养的机会有限或不确定,日益被认为是健康结果的决定因素,而且往往与肥胖有关。然而,目前尚不清楚这种关联是否在老年人中持续存在。方法:我们对来自健康与退休研究的2868名65岁以上的参与者进行了横断面研究。采用多变量logistic回归评估食品不安全与体重指数、人口统计学特征、精神病史和病史之间的关系。结果:超重/肥胖的参与者比瘦弱的参与者有更高的粮食不安全患病率,然而,在多变量调整后,体重状况不是粮食不安全的显著预测因子。相反,精神疾病、当前吸烟状况和非白人种族都与食品不安全独立相关。讨论:除了经济状况,鼓励卫生保健提供者使用这些特征来识别可能面临粮食不安全风险的老年患者。
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引用次数: 12
Relationship Between B-Vitamin Biomarkers and Dietary Intake with Apolipoprotein E є4 in Alzheimer's Disease. 阿尔茨海默病b族维生素生物标志物与膳食摄入与载脂蛋白E є4的关系
Q3 Medicine Pub Date : 2019-04-01 Epub Date: 2019-03-29 DOI: 10.1080/21551197.2019.1590287
Nathan M D'Cunha, Ekavi N Georgousopoulou, Lyndell Boyd, Martin Veysey, Jonathan Sturm, Bill O'Brien, Mark Lucock, Andrew J McKune, Duane D Mellor, Paul D Roach, Nenad Naumovski

The potential for B-vitamins to reduce plasma homocysteine (Hcy) and reduce the risk of Alzheimer's disease (AD) has been described previously. However, the role of Apolipoprotein E є4 (APOE4) in this relationship has not been adequately addressed. This case-control study explored APOE4 genotype in an Australian sample of 63 healthy individuals (female = 38; age = 76.9 ± 4.7 y) and 63 individuals with AD (female = 35, age = 77.1 ± 5.3 y). Findings revealed 55 of 126 participants expressed the APOE4 genotype with 37 of 126 having both AD and the APOE4 genotype. Analysis revealed an increased likelihood of AD when Hcy levels are >11.0 µmol/L (p = 0.012), cysteine levels were <255 µmol/L (p = 0.033) and serum folate was <22.0 nmol/L (p = 0.003; in males only). In females, dietary intake of total folate <336 µg/day (p=0.001), natural folate <270 µg/day (p = 0.011), and vitamin B2 < 1.12 mg/day (p = 0.028) was associated with an increased AD risk. These results support Hcy, Cys, and SF as useful biomarkers for AD, irrespective of APOE4 genotype and as such should be considered as part of screening and managing risk of AD.

b族维生素具有降低血浆同型半胱氨酸(Hcy)和降低阿尔茨海默病(AD)风险的潜力。然而,载脂蛋白E є4 (APOE4)在这种关系中的作用尚未得到充分解决。本病例对照研究探讨了澳大利亚63例健康个体(女性= 38;年龄= 76.9±4.7岁)和63名AD患者(女性= 35岁,年龄= 77.1±5.3岁)。研究结果显示,126名参与者中有55人表达APOE4基因型,126名参与者中有37人同时患有AD和APOE4基因型。分析显示,当Hcy水平>11.0µmol/L时,AD的可能性增加(p = 0.012),半胱氨酸水平则增加
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引用次数: 11
Technology for Behavioral Change in Rural Older Adults with Obesity. 农村老年人肥胖症行为改变技术。
Q3 Medicine Pub Date : 2019-04-01 Epub Date: 2019-04-11 DOI: 10.1080/21551197.2019.1600097
John A Batsis, John A Naslund, Alexandra B Zagaria, David Kotz, Rachel Dokko, Stephen J Bartels, Elizabeth Carpenter-Song

Background: Mobile health (mHealth) technologies comprise a multidisciplinary treatment strategy providing potential solutions for overcoming challenges of successfully delivering health promotion interventions in rural areas. We evaluated the potential of using technology in a high-risk population.

Methods: We conducted a convergent, parallel mixed-methods study using semi-structured interviews, focus groups, and self-reported questionnaires, using purposive sampling of 29 older adults, 4 community leaders and 7 clinicians in a rural setting. We developed codes informed by thematic analysis and assessed the quantitative data using descriptive statistics.

Results: All groups expressed that mHealth could improve health behaviors. Older adults were optimistic that mHealth could track health. Participants believed they could improve patient insight into health, motivating change and assuring accountability. Barriers to using technology were described, including infrastructure.

Conclusions: Older rural adults with obesity expressed excitement about the use of mHealth technologies to improve their health, yet barriers to implementation exist.

背景:移动医疗(mHealth)技术是一种多学科治疗策略,为克服在农村地区成功实施健康促进干预措施所面临的挑战提供了潜在的解决方案。我们评估了在高风险人群中使用该技术的潜力:我们采用半结构式访谈、焦点小组和自我报告问卷等方法,对农村地区的 29 名老年人、4 名社区领袖和 7 名临床医生进行了有目的的抽样调查,开展了一项趋同、平行的混合方法研究。我们根据主题分析编制了代码,并使用描述性统计对定量数据进行了评估:所有小组都表示移动医疗可以改善健康行为。老年人对移动医疗可以跟踪健康状况持乐观态度。参与者认为它们可以提高患者对健康的洞察力,促进改变并确保问责制。与会者描述了使用技术的障碍,包括基础设施:患有肥胖症的农村老年人对使用移动医疗技术改善健康状况表示兴奋,但在实施过程中仍存在障碍。
{"title":"Technology for Behavioral Change in Rural Older Adults with Obesity.","authors":"John A Batsis, John A Naslund, Alexandra B Zagaria, David Kotz, Rachel Dokko, Stephen J Bartels, Elizabeth Carpenter-Song","doi":"10.1080/21551197.2019.1600097","DOIUrl":"10.1080/21551197.2019.1600097","url":null,"abstract":"<p><strong>Background: </strong>Mobile health (mHealth) technologies comprise a multidisciplinary treatment strategy providing potential solutions for overcoming challenges of successfully delivering health promotion interventions in rural areas. We evaluated the potential of using technology in a high-risk population.</p><p><strong>Methods: </strong>We conducted a convergent, parallel mixed-methods study using semi-structured interviews, focus groups, and self-reported questionnaires, using purposive sampling of 29 older adults, 4 community leaders and 7 clinicians in a rural setting. We developed codes informed by thematic analysis and assessed the quantitative data using descriptive statistics.</p><p><strong>Results: </strong>All groups expressed that mHealth could improve health behaviors. Older adults were optimistic that mHealth could track health. Participants believed they could improve patient insight into health, motivating change and assuring accountability. Barriers to using technology were described, including infrastructure.</p><p><strong>Conclusions: </strong>Older rural adults with obesity expressed excitement about the use of mHealth technologies to improve their health, yet barriers to implementation exist.</p>","PeriodicalId":38899,"journal":{"name":"Journal of Nutrition in Gerontology and Geriatrics","volume":"38 2","pages":"130-148"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6999857/pdf/nihms-1067074.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37139632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Obesity, Dietary inflammation, and Frailty among Older Adults: Evidence from the National Health and Nutrition Examination Survey. 老年人的肥胖、饮食炎症和虚弱:来自全国健康和营养检查调查的证据。
Q3 Medicine Pub Date : 2019-01-01 Epub Date: 2019-03-08 DOI: 10.1080/21551197.2018.1552226
Matthew C Lohman, Nicholas V Resciniti, Michael D Wirth, Nitin Shivappa, James R Hébert

Knowledge related to the relationship between obesity and frailty is limited. This study aimed to investigate associations between obesity, dietary inflammation, and frailty among older adults. Study data came from National Health and Nutrition Examination Survey (2007-2014) examinations of adults age ≥60 years (n = 7182). Dietary inflammatory potential was determined using the Dietary Inflammatory Index (DII®) derived from 24-h dietary recall. We analyzed independent and joint associations of obesity and DII with frailty to evaluate interaction. Multivariable logistic regression revealed that both obesity (Odds Ratio [OR] = 2.24, 95% CI: 1.68, 2.99) and moderately pro-inflammatory DII (OR = 1.68, 95% CI: 1.10, 2.58) were independently associated with greater frailty prevalence. A negative multiplicative interaction between obesity and highest pro-inflammatory diet also was found (adjusted odds in non-obese and obese were 2.07 and 2.37, respectively; p = 0.046). Results indicate the importance of considering obesity and dietary inflammatory potential when screening for frailty or developing treatments.

有关肥胖和虚弱之间关系的知识是有限的。这项研究旨在调查老年人肥胖、饮食炎症和虚弱之间的关系。研究数据来自国家健康和营养检查调查(2007-2014)对年龄≥60岁的成年人的检查(n = 7182)。通过24小时饮食回忆得出的饮食炎症指数(DII®)来确定饮食炎症潜力。我们分析了肥胖和DII与虚弱的独立和联合关联,以评估相互作用。多变量logistic回归显示,肥胖(比值比[OR] = 2.24, 95% CI: 1.68, 2.99)和中度促炎DII (OR = 1.68, 95% CI: 1.10, 2.58)与更大的虚弱患病率独立相关。肥胖和最高促炎饮食之间也存在负乘法交互作用(非肥胖和肥胖的校正比值分别为2.07和2.37;p = 0.046)。结果表明,在筛查虚弱或开发治疗方法时,考虑肥胖和饮食炎症潜力的重要性。
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引用次数: 16
Long-Term Effects of Randomization to a Weight Loss Intervention in Older Adults: A Pilot Study. 随机化对老年人减肥干预的长期影响:一项试点研究。
Q3 Medicine Pub Date : 2019-01-01 Epub Date: 2019-03-08 DOI: 10.1080/21551197.2019.1572570
Denise K Houston, Michael E Miller, Dalane W Kitzman, W Jack Rejeski, Stephen P Messier, Mary F Lyles, Stephen B Kritchevsky, Barbara J Nicklas

Randomized, controlled trials (RCTs) show intentional weight loss improves body composition and physical function in older adults; however, the long-term benefits (and risks) are unknown. We conducted a pilot study to assess the feasibility of recalling prior RCT participants to examine the long-term effects of intentional weight loss on body composition and physical function. A weighted, random sample of 60 older adults who were randomized to caloric restriction plus exercise (CR + EX) or exercise (EX) only in 5 prior RCTs (mean age at randomization, 67.3 years; 69% women, 80% white) were invited to participate. Follow-up was obtained on 89% (42 clinic visits, 10 phone interviews, 1 death) an average of 3.5 years (range, 2.2-5.8 years) after RCT completion. Despite greater weight, fat and lean mass loss during the RCT (mean difference in change (95% CI): -4.19 (-7.52, -0.86), -2.75 (-5.10, -0.40), and -2.32 (-3.69, -0.95) kg, respectively) in those randomized to CR + EX, long-term changes in weight (2.05 (-2.35, 6.45) kg) and body composition (1.80 (-1.56, 5.17) and 0.03 (-2.20, 2.26) kg for fat and lean mass, respectively) from baseline and physical function at long-term follow-up (mean difference in 400-m walk and SPPB (95% CI): 23.2 (-19.3, 65.6) sec and -0.03 (-1.02, 0.96) points, respectively) were similar in CR + EX and EX only. Although improvements in weight and body composition following intentional weight loss may not be sustained long-term, physical function does not appear to be negatively impacted. A larger study is needed to confirm these results.

随机对照试验(RCTs)显示,有意减肥可以改善老年人的身体成分和身体功能;然而,长期的好处(和风险)是未知的。我们进行了一项试点研究,以评估召回先前的随机对照试验参与者的可行性,以检查有意减肥对身体成分和身体功能的长期影响。在之前的5项随机对照试验中,60名老年人被随机分为热量限制加运动(CR + EX)或运动(EX)两组(随机化时平均年龄67.3岁;69%的女性,80%的白人)被邀请参加。随访时间为89%(42次诊所就诊,10次电话访谈,1例死亡),随访时间为随机对照试验结束后平均3.5年(范围2.2-5.8年)。尽管随机分配到CR + EX组的患者在RCT期间体重、脂肪和瘦体重损失更大(变化的平均差异(95% CI): -4.19(-7.52, -0.86)、-2.75(-5.10,-0.40)和-2.32 (-3.69,-0.95)kg),但长期随访时,体重(脂肪和瘦体重分别为2.05 (-2.35,6.45)kg)和体成分(分别为1.80(-1.56,5.17)和0.03 (-2.20,2.26)kg)与基线和身体功能的变化(400米步行和SPPB的平均差异(95% CI)):分别为23.2(-19.3,65.6)秒和-0.03(-1.02,0.96)点)。虽然有意减肥后体重和身体成分的改善可能无法长期持续,但身体功能似乎没有受到负面影响。需要更大规模的研究来证实这些结果。
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引用次数: 19
Neuropsychological Functioning in Older Adults with Obesity: Implications for Bariatric Surgery. 老年肥胖患者的神经心理功能:对减肥手术的影响。
Q3 Medicine Pub Date : 2019-01-01 Epub Date: 2019-02-22 DOI: 10.1080/21551197.2018.1564722
Robert M Roth, Sivan Rotenberg, Jeremy Carmasin, Sarah Billmeier, John A Batsis

Bariatric surgery is the most effective approach to treating morbid obesity, resulting in decreased morbidity, mortality, and improved quality of life. Research on outcomes has generally been restricted to young and middle-aged adults, despite a growing epidemic of obesity in older adults. The use of bariatric surgery has been limited in older individuals, in part due to concerns that preexisting cognitive dysfunction increases the risk of poor post-surgical outcomes, including cognitive decline. The literature on the relationship between obesity and cognition in older adults is emerging, but fraught by several methodological limitations. While there is insufficient research to determine the nature of cognitive outcomes following bariatric surgery in older adults, the aim of this paper is to review the existing evidence and make the case for further study.

减肥手术是治疗病态肥胖最有效的方法,可以降低发病率和死亡率,提高生活质量。尽管肥胖在老年人中越来越流行,但对结果的研究通常仅限于年轻人和中年人。减肥手术在老年人中的应用受到限制,部分原因是人们担心先前存在的认知功能障碍会增加术后不良结果的风险,包括认知能力下降。关于老年人肥胖与认知之间关系的文献正在出现,但存在一些方法上的局限性。虽然没有足够的研究来确定老年人减肥手术后认知结果的性质,但本文的目的是回顾现有的证据,并为进一步的研究做准备。
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引用次数: 3
Influence of Weight Reduction and Enhanced Protein Intake on Biomarkers of Inflammation in Older Adults with Obesity. 减肥和增加蛋白质摄入对老年肥胖患者炎症生物标志物的影响
Q3 Medicine Pub Date : 2019-01-01 Epub Date: 2019-02-27 DOI: 10.1080/21551197.2018.1564200
Kathryn N Porter Starr, Melissa Orenduff, Shelley R McDonald, Hillary Mulder, Richard Sloane, Carl F Pieper, Connie W Bales

Both aging and obesity are associated with increased levels of pro-inflammatory metabolites, while weight reduction is associated with improvements in inflammatory status. However, few studies have explored the response of key inflammatory markers to the combined settings of weight reduction in an aging population. There are also few studies that have investigated the potential impact of diet composition on inflammatory marker responses. In the MEASUR-UP trial, we evaluated changes in baseline levels of inflammatory markers with post-study levels for a traditional weight loss control group versus a group with generous, balanced protein intake. In this 6-month randomized controlled trial (RCT), older (≥60 years) adults with obesity (BMI ≥30 kg/m2) and Short Physical Performance Battery (SPPB) score of 4-10 were randomly assigned to either a traditional weight loss regimen, (Control, n = 14) or one with higher protein intake (≥30 g) at each meal (Protein, n = 25). All participants were prescribed a hypo-caloric diet and attended weekly support and education groups and weigh-ins. Protein participants consumed ≥30 g of high-quality protein/meal, including lean and extra lean beef provided to them for two of the three meals per day. Protein intakes were 0.8 and 1.2 g/kg/day for Control and Protein, respectively. Adiponectin, leptin, C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), IL-6, IL-8, serum amyloid A (SAA), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and glycated serum protein (GSP) levels were measured at 0 and 6-month time points. At the 6-month endpoint, there was significant weight loss and decrease in BMI in both the Control (-4.8 ± 8.2 kg; -2.3 ± 2.4 kg/m2; p = 0.05) and Protein (-8.7 ± 7.4 kg; -2.9 ± 2.3 kg/m2; p < 0.0001) groups. SPPB scores improved in both arms, with a superior functional response in Protein (p < 0.05). Body fat (%) at baseline was positively correlated with leptin, hs-CRP, VCAM-1, ICAM-1, and GSP. Several markers of inflammation responded to the Protein group: leptin (p < 0.001), hs-CRP (p < 0.01), and ICAM-1 (p < 0.01) were decreased and adiponectin increased (p < 0.01). There were no significant changes in any inflammatory markers in the Control arm. In the between group comparison, only adiponectin trended towards a group difference (more improvement in Protein; p < 0.07). Our findings in the MEASUR-UP trial show that a weight loss diet with enhanced protein intake is comparable to an adequate protein diet in terms of weight loss success and that it can lead to improvements in inflammatory status, specifically for adiponectin, leptin, hs-CRP, and ICAM-1. These findings are important given current recommendations for higher protein intakes in older adults and justify the additional study of the inflammatory impact of an enhanced protein diet. (ClinicalTrials.gov identifier: NCT01715753).

衰老和肥胖都与促炎代谢物水平的增加有关,而体重减轻与炎症状态的改善有关。然而,很少有研究探讨了关键炎症标志物对老年人减肥联合设置的反应。也很少有研究调查饮食成分对炎症标志物反应的潜在影响。在measure - up试验中,我们评估了传统减肥对照组与大量均衡蛋白质摄入组的炎症标志物基线水平和研究后水平的变化。在这项为期6个月的随机对照试验(RCT)中,年龄≥60岁的肥胖(BMI≥30 kg/m2)且SPPB评分为4-10分的成年人被随机分配到传统减肥方案(对照组,n = 14)或每餐蛋白质摄入量较高(≥30 g)的方案(蛋白质组,n = 25)。所有的参与者都被规定了低热量饮食,并参加每周的支持和教育小组和称重。蛋白质参与者每顿饭摄入≥30克的优质蛋白质,包括每天三餐中的两顿提供给他们的瘦牛肉和额外的瘦牛肉。对照组和蛋白质组蛋白质摄入量分别为0.8和1.2 g/kg/d。在0和6个月时间点测定脂联素、瘦素、c反应蛋白(hs-CRP)、肿瘤坏死因子-α (TNF-α)、白细胞介素-1 (IL-1)、IL-6、IL-8、血清淀粉样蛋白A (SAA)、血管细胞粘附分子-1 (VCAM-1)、细胞间粘附分子-1 (ICAM-1)、血清糖化蛋白(GSP)水平。在6个月的终点,对照组的体重和BMI均有显著下降(-4.8±8.2 kg;-2.3±2.4 kg/m2;p = 0.05)和蛋白质(-8.7±7.4 kg;-2.9±2.3 kg/m2;p
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引用次数: 17
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Journal of Nutrition in Gerontology and Geriatrics
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