Journal of Nutrition Health & Aging最新文献_第10页

Development of an older adult Nutrition Equity Index (NEI) and association with the Healthy Eating Index (HEI) in older Black and White U.S. adults 美国黑人和白人老年人营养公平指数（NEI）的制定及其与健康饮食指数（HEI）的联系

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-25 DOI: 10.1016/j.jnha.2024.100343

Aarohee P. Fulay , Samaneh Farsijani , Kerri Freeland , Jimmie Roberts , Andrea L. Rosso , Denise K. Houston , Elsa S. Strotmeyer

Objectives

We developed a novel measure for older U.S. adults called the Nutrition Equity Index (NEI), which includes functional ability. We compared both the NEI and food insufficiency with Healthy Eating Index (HEI) scores.

Design

The Health, Aging, and Body Composition Study is a prospective, longitudinal cohort of Medicare-eligible, community-dwelling Black and White men and women.

Setting

Pittsburgh, PA and Memphis, TN.

Participants

Participants (N = 2468, aged 74.7 ± 2.9 years) had baseline (1997−98) and 1-year follow-up NEI data; and 1 year follow-up for food insufficiency, key covariates, and the HEI (diet quality measure) from a 108-item interviewer-administered food frequency questionnaire.

Measurements

Food insufficiency was defined from a modified validated question on ample food amount/variety from the U.S. Department of Agriculture. NEI was constructed from 8 questions in three subdomains: food insecurity (food insufficiency, hunger, anxiety about limited food, limited money for food), food access (groceries), and food acquisition (difficulty shopping, preparing meals, carrying groceries). Final NEI categories were low nutrition equity (0), moderate nutrition equity (1), and high nutrition equity (2). Multivariable linear regression compared both NEI and food insufficiency with HEI, adjusted for sociodemographic, lifestyle and comorbidity factors.

Results

Of participants, 13.5% had food insufficiency, 12.1% had low NEI, and 32.5% had moderate NEI. Participants with food insufficiency (vs. food sufficiency) or low NEI (vs. high NEI) were more likely to be Black and have < high school education (both p < 0.0001). In minimally adjusted models, food insufficiency was associated with 2.2 point lower HEI score (p = 0.001), low NEI with 2.6 point lower HEI score (p = 0.001), and moderate NEI with 1.0 point lower HEI score (p < 0.05). Adjusting for race attenuated NEI associations with HEI to non-significance. After multivariable adjustment, food insufficiency was associated with 1.5 point lower HEI score (p = 0.03).

Conclusion

Food insufficiency was associated with lower dietary quality in this sample of older Black and White U.S. adults. NEI performed similarly to food insufficiency for HEI associations prior to multivariable adjustment and identified more older adults with nutrition inequity, who may be at risk for poor health outcomes.

目标我们为美国老年人开发了一种名为营养公平指数（NEI）的新测量方法，其中包括功能能力。我们将营养公平指数和食物不足指数与健康饮食指数 (HEI) 的得分进行了比较。参与者（N = 2468，年龄为 74.7 ± 2.9 岁）拥有基线（1997-1998 年）和 1 年随访的 NEI 数据；以及 1 年随访的食物不足、主要协变量和 HEI（饮食质量测量）数据，这些数据来自由访问者管理的 108 项食物频率问卷。NEI由三个子域中的8个问题构成：食物不安全（食物不足、饥饿、对食物有限的焦虑、购买食物的钱有限）、食物获取（杂货）和食物获取（购物、准备膳食、携带杂货的困难）。最终的营养公平指数类别为低营养公平指数（0）、中营养公平指数（1）和高营养公平指数（2）。多变量线性回归比较了NEI和食物不足与HEI，并对社会人口学、生活方式和合并症等因素进行了调整。结果在参与者中，13.5%的人存在食物不足，12.1%的人存在低NEI，32.5%的人存在中度NEI。食物不足（vs.食物充足）或低NEI（vs.高NEI）的参与者更有可能是黑人且具有<高中学历（均为p<0.0001）。在最小调整模型中，食物不足与 HEI 分数降低 2.2 分相关（p = 0.001），低 NEI 与 HEI 分数降低 2.6 分相关（p = 0.001），中度 NEI 与 HEI 分数降低 1.0 分相关（p <0.05）。调整种族因素后，NEI 与 HEI 的相关性减弱至不显著。结论在美国老年黑人和白人样本中，食物不足与较低的膳食质量有关。在进行多变量调整之前，NEI 与食物不足在 HEI 关联性方面的表现类似，并且发现了更多存在营养不均的老年人，他们可能面临不良健康后果的风险。

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引用次数: 0

Intake of vegetables and fruits at midlife and the risk of physical frailty in later life 中年时蔬菜和水果的摄入量与晚年身体虚弱的风险

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-23 DOI: 10.1016/j.jnha.2024.100374

Kevin Yiqiang Chua , Huiqi Li , Li-Ting Sheng , Wee-Shiong Lim , Woon-Puay Koh

Objectives

Our study evaluated the independent and overall associations of vegetable and fruit consumption at midlife with the likelihood of physical frailty in later life. We also investigated whether specific nutrients in these foods could have accounted for these associations, if present.

Design

Prospective cohort study.

Setting

A population-based cohort of Chinese adults followed over a period of 20 years in Singapore.

Participants

We used data from 11,959 subjects who participated in the baseline (1993–1998) and follow-up 3 (2014–2017) interviews of the Singapore Chinese Health Study.

Measurements

At baseline, dietary intake was evaluated using a validated food frequency questionnaire. During the follow-up 3 visits, physical frailty was assessed using a modified Cardiovascular Health Study phenotype that included weakness, slowness, exhaustion and weight loss. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations with physical frailty.

Results

Participants had mean ages of 52 years at baseline, and 72 years at follow-up 3. Baseline intake of vegetables, but not of fruits, showed a dose-dependent inverse relationship with physical frailty at follow-up 3 (P_trend = 0.001). Compared to participants in the lowest quintile of vegetable intake, those in the highest quintile had reduced odds of frailty [OR (95% CI): 0.73 (0.60−0.89)]. Among the components of physical frailty, vegetable intake had the strongest inverse association with weakness defined by handgrip strength [OR (95% CI) between extreme quintiles: 0.62 (0.52−0.73); P_trend < 0.001]. In models that were individually adjusted for nutrients, the vegetable-frailty association was attenuated and no longer statistically significant after adjusting for the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates.

Conclusion

: Increased midlife intake of vegetables was associated with reduced odds of physical frailty in later life, and the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates could have accounted for this association.

我们的研究评估了中年时蔬菜和水果消费量与晚年身体虚弱可能性之间的独立和整体关联。我们使用了 11959 名受试者的数据，这些受试者参加了新加坡华人健康研究的基线（1993-1998 年）和后续 3 次（2014-2017 年）访谈。测量基线时，我们使用经过验证的食物频率问卷评估了饮食摄入量。在后续 3 次访谈中，使用修改后的心血管健康研究表型评估身体虚弱情况，包括虚弱、迟钝、疲惫和体重减轻。采用多变量逻辑回归模型估算了与身体虚弱相关的几率比（OR）和 95% 的置信区间（CI）。与蔬菜摄入量最低五分位数的参与者相比，蔬菜摄入量最高五分位数的参与者身体虚弱的几率较低[OR (95% CI)：0.73 (0.60-0.89)]。在体质虚弱的各组成部分中，蔬菜摄入量与以手握强度定义的体质虚弱的反向关系最为密切[极端五分位数之间的OR（95% CI）：0.62（0.52-0.73）；Ptrend < 0.001]。在对营养素进行单独调整的模型中，在调整了β-胡萝卜素、叶黄素、叶酸、α-胡萝卜素和异硫氰酸盐的摄入量后，蔬菜与肥胖的关系有所减弱，不再具有显著的统计学意义：结论：中年时期蔬菜摄入量的增加与晚年身体虚弱几率的降低有关，β-胡萝卜素、叶黄素、叶酸、α-胡萝卜素和异硫氰酸盐的摄入量可能是造成这种关联的原因。

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引用次数: 0

Gender-specific capacity of insulin resistance proxies to predict functional decline in older adults 胰岛素抵抗代用指标预测老年人功能衰退的能力因性别而异

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-23 DOI: 10.1016/j.jnha.2024.100376

Mariam El Assar , Javier Angulo , José Antonio Carnicero , Begoña Molina-Baena , Francisco José García-García , Patricia Sosa , Leocadio Rodríguez-Mañas

Objectives

Insulin resistance determined by Homeostasis Model of Insulin Resistance (HOMA-IR) has been associated with functional decline in non-diabetic older subjects. However, insulin is not routinely assessed. The study evaluated the predictive value of non-insulin-dependent IR surrogates on functional decline in non-diabetic older men and women.

Design and participants

Prospective cohort study over 5 years. The study included 615 older participants from the Toledo Study of Healthy Aging.

Methods

Frailty was assessed by the Frailty Trait Scale-5 (FTS-5) at baseline and after 5 years follow-up. 193 subjects experienced functional decline (2.5-point reduction in the FTS-5 score). Multivariate regression models analysed the effect of five described IR surrogates on functional decline considering potential confounders.

Results

Among evaluated IR proxies, triglyceride glucose-body mass index (TyG-BMI) and HOMA-IR were significantly associated with an increased risk of functional decline (odd ratio (95% confidence interval) TyG-BMI: 1.16 (1.05, 1.28), p = 0.0035 and HOMA-IR: 1.59 (1.15, 2.21), p = 0.0056) among all participants. When stratified by gender, HOMA-IR was related to functional decline in men [2.02 (1.13, 3.59), p = 0.0173] and TyG-BMI in women [1.19 (1.05, 1.35), p = 0.0057].

Conclusions

Only TyG-BMI index mimics the predictive capacity of insulin-based IR marker. The predictive ability of IR indexes is gender-specific, being TyG-BMI the only index able to predict functional decline in women and HOMA-IR in men.

目的通过胰岛素抵抗稳态模型（HOMA-IR）确定的胰岛素抵抗与非糖尿病老年人的功能衰退有关。然而，胰岛素并不是常规评估指标。该研究评估了非胰岛素依赖型红外替代物对非糖尿病老年男性和女性功能衰退的预测价值。研究对象包括托莱多健康老龄化研究（Toledo Study of Healthy Aging）中的 615 名老年参与者。方法在基线和随访 5 年后，用虚弱特质量表-5（FTS-5）评估虚弱程度。193名受试者出现功能衰退（FTS-5得分下降2.5分）。考虑到潜在的混杂因素，多变量回归模型分析了五种已描述的 IR 代用指标对功能衰退的影响。结果在所有参与者中，甘油三酯血糖-体重指数（TyG-BMI）和 HOMA-IR 与功能衰退风险增加显著相关（奇异比（95% 置信区间）TyG-BMI：1.16 (1.05, 1.28)，p = 0.0035；HOMA-IR：1.59 (1.15, 2.21)，p = 0.0056）。结论只有 TyG-BMI 指数模拟了基于胰岛素的 IR 指标的预测能力。IR指标的预测能力具有性别特异性，TyG-BMI是唯一能够预测女性功能衰退的指标，而HOMA-IR则是唯一能够预测男性功能衰退的指标。

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引用次数: 0

Osteosarcopenia predicts greater risk of functional disability than sarcopenia: a longitudinal analysis of FraDySMex cohort study 骨肉疏松症比肌肉疏松症更容易导致功能性残疾：FraDySMex 队列研究的纵向分析。

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-21 DOI: 10.1016/j.jnha.2024.100368

Oscar Rosas-Carrasco , Betty Manrique-Espinoza , Juan Carlos López-Alvarenga , Beatriz Mena-Montes , Isabel Omaña-Guzmán

Objectives

Aging involves significant changes in body composition, marked by declines in muscle mass and bone mineral density alongside an increase in fat mass. Sarcopenia is characterized by low strength and muscle mass, and osteosarcopenia is the coexistence of sarcopenia and osteopenia/osteoporosis. Physiologically, there is a crosstalk between muscle and bone tissues mediated by several pathways. Both, sarcopenia and osteosarcopenia, have been related with adverse outcomes such as functional disability. However, there is a lack of longitudinal studies. Therefore, this study aimed to assess whether sarcopenia and osteosarcopenia phenotypes increased the risk of functional disability in a longitudinal cohort of community-dwelling adults.

Design

This study constitutes a secondary longitudinal analysis of data derived from the prospective cohort FraDySMex (Frailty, Dynapenia, and Sarcopenia in Mexican adults).

Setting and participants

FraDySMex is conducted in community-dwelling adults aged 50 years or older living in Mexico City. Data from 2014 to 2015 was considered as baseline evaluation, and the 2019 wave was the follow-up evaluation. Individuals with complete baseline and follow-up evaluations were included in the analysis.

Measurements

Sarcopenia diagnosis adhered to the FNIH criteria, while osteopenia/osteoporosis classification followed WHO guidelines. Osteosarcopenia was defined as the concurrent presence of sarcopenia and osteopenia/osteoporosis. Functional disability was identified by the Lawton Instrumental Activities of Daily Living (IADL) Scale. Adjusted mixed-effects logistic regression models were estimated to evaluate the effect of body composition phenotype on the risk of functional disability.

Results

The final sample included 320 adults with complete longitudinal data. The majority of were women (83.4%) and had 7–12 years of education (48.4%). At the baseline evaluation, 50.9% aged 50–70. The osteosarcopenia phenotype was associated with a higher risk of functional disability (OR: 2.17, p = 0.042) compared with the no osteopenia/sarcopenia group. Conversely, sarcopenia (OR: 1.50, p = 0.448) and osteopenia/osteoporosis (OR: 1.50, p = 0.185) phenotypes were not associated with functional disability.

Conclusions

Our study underscores that osteosarcopenia significantly increased the risk of functional disability, particularly in terms of Instrumental Activities of Daily Living (IADL). These results emphasize the importance of screening for sarcopenia, osteopenia/osteoporosis, and osteosarcopenia across various clinical settings. Early detection and intervention hold promise for averting functional disability and mitigating associated adverse outcomes in adults.

目的：衰老会导致身体成分发生重大变化，表现为肌肉质量和骨矿物质密度下降，同时脂肪量增加。肌肉疏松症的特点是力量和肌肉质量下降，而骨质疏松症则是肌肉疏松症和骨质疏松/骨质疏松症的并存。从生理学角度看，肌肉和骨骼组织之间存在着由多种途径介导的相互影响。肌肉疏松症和骨质疏松症都与功能性残疾等不良后果有关。然而，目前还缺乏纵向研究。因此，本研究旨在评估肌肉疏松症和骨质疏松症表型是否会增加社区成人纵向队列中功能性残疾的风险：本研究是对前瞻性队列 FraDySMex（墨西哥成年人虚弱、动力性和肌少症）数据的二次纵向分析：FraDySMex的研究对象是居住在墨西哥城的50岁或以上的社区成年人。2014年至2015年的数据被视为基线评估，2019年的数据为后续评估。具有完整基线和随访评估的个体均纳入分析：肌少症的诊断遵循 FNIH 标准，而骨质疏松症/骨质疏松症的分类遵循世界卫生组织指南。骨质疏松症是指同时存在肌肉疏松症和骨质疏松/骨质疏松症。功能性残疾通过劳顿日常生活活动量表（IADL）来确定。我们估算了调整后的混合效应逻辑回归模型，以评估身体成分表型对功能性残疾风险的影响：最终样本包括 320 名具有完整纵向数据的成年人。其中大部分为女性（83.4%），受教育年限为 7-12 年（48.4%）。在基线评估中，50.9%的人年龄在 50-70 岁之间。与无骨质疏松症/肌肉疏松症组相比，骨质疏松症表型与较高的功能性残疾风险相关（OR：2.17，p = 0.042）。相反，肌肉疏松症（OR：1.50，p = 0.448）和骨质疏松症/骨质疏松症（OR：1.50，p = 0.185）表型与功能性残疾无关：我们的研究强调，骨肉疏松症会显著增加功能性残疾的风险，尤其是在日常生活工具性活动（IADL）方面。这些结果强调了在各种临床环境中筛查肌肉疏松症、骨质疏松症/骨质疏松症和骨肉疏松症的重要性。早期检测和干预有望避免成人功能性残疾并减轻相关不良后果。

{"title":"Osteosarcopenia predicts greater risk of functional disability than sarcopenia: a longitudinal analysis of FraDySMex cohort study","authors":"Oscar Rosas-Carrasco , Betty Manrique-Espinoza , Juan Carlos López-Alvarenga , Beatriz Mena-Montes , Isabel Omaña-Guzmán","doi":"10.1016/j.jnha.2024.100368","DOIUrl":"10.1016/j.jnha.2024.100368","url":null,"abstract":"<div><h3>Objectives</h3><div>Aging involves significant changes in body composition, marked by declines in muscle mass and bone mineral density alongside an increase in fat mass. Sarcopenia is characterized by low strength and muscle mass, and osteosarcopenia is the coexistence of sarcopenia and osteopenia/osteoporosis. Physiologically, there is a crosstalk between muscle and bone tissues mediated by several pathways. Both, sarcopenia and osteosarcopenia, have been related with adverse outcomes such as functional disability. However, there is a lack of longitudinal studies. Therefore, this study aimed to assess whether sarcopenia and osteosarcopenia phenotypes increased the risk of functional disability in a longitudinal cohort of community-dwelling adults.</div></div><div><h3>Design</h3><div>This study constitutes a secondary longitudinal analysis of data derived from the prospective cohort FraDySMex (Frailty, Dynapenia, and Sarcopenia in Mexican adults).</div></div><div><h3>Setting and participants</h3><div>FraDySMex is conducted in community-dwelling adults aged 50 years or older living in Mexico City. Data from 2014 to 2015 was considered as baseline evaluation, and the 2019 wave was the follow-up evaluation. Individuals with complete baseline and follow-up evaluations were included in the analysis.</div></div><div><h3>Measurements</h3><div>Sarcopenia diagnosis adhered to the FNIH criteria, while osteopenia/osteoporosis classification followed WHO guidelines. Osteosarcopenia was defined as the concurrent presence of sarcopenia and osteopenia/osteoporosis. Functional disability was identified by the Lawton Instrumental Activities of Daily Living (IADL) Scale. Adjusted mixed-effects logistic regression models were estimated to evaluate the effect of body composition phenotype on the risk of functional disability.</div></div><div><h3>Results</h3><div>The final sample included 320 adults with complete longitudinal data. The majority of were women (83.4%) and had 7–12 years of education (48.4%). At the baseline evaluation, 50.9% aged 50–70. The osteosarcopenia phenotype was associated with a higher risk of functional disability (OR: 2.17, p = 0.042) compared with the no osteopenia/sarcopenia group. Conversely, sarcopenia (OR: 1.50, p = 0.448) and osteopenia/osteoporosis (OR: 1.50, p = 0.185) phenotypes were not associated with functional disability.</div></div><div><h3>Conclusions</h3><div>Our study underscores that osteosarcopenia significantly increased the risk of functional disability, particularly in terms of Instrumental Activities of Daily Living (IADL). These results emphasize the importance of screening for sarcopenia, osteopenia/osteoporosis, and osteosarcopenia across various clinical settings. Early detection and intervention hold promise for averting functional disability and mitigating associated adverse outcomes in adults.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"28 11","pages":"Article 100368"},"PeriodicalIF":4.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S127977072400455X/pdfft?md5=886f20e9acb2a732ef2178384db5d845&pid=1-s2.0-S127977072400455X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enhancing the role of social work in addressing social frailty and diet quality among older adults 加强社会工作在解决老年人社会脆弱性和饮食质量方面的作用。

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-21 DOI: 10.1016/j.jnha.2024.100375

Qiong Yi , Guang Yao Wang , Zong Xiang Yue

引用次数: 0

Validation of intrinsic capacity and healthy sleep pattern in middle-aged and older adults: a longitudinal Chinese study assessing healthy ageing 验证中老年人的内在能力和健康睡眠模式：一项评估健康老龄化的中国纵向研究。

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-21 DOI: 10.1016/j.jnha.2024.100365

Xing-Ling Chen , Jin Li , Shu-Ning Sun , Xiao-Jiao Zhang , Jia-Hui Chen , Ling-Jun Wang , Zhong-Qi Yang , Shi-Hao Ni , Lu Lu

Objectives

Intrinsic capacity (IC), a multidimensional construct encompassing mental and physical capacities, has been established in the aging framework by the World Health Organization. However, the detailed relationship between IC and Chinese sleep patterns (nighttime sleep and post-lunch naps) remains inadequately elucidated.

Methods

Participants in this study were individuals aged ≥45 years residing in China, included in the China Health and Retirement Longitudinal Study (CHARLS). We analyzed 4 years of CHARLS data from the first wave (May 2011–March 2012) to the second wave (July 2015–January 2016). Data from these waves were utilized for longitudinal analysis. Self-reported data included nighttime sleep and nap duration, along with other baseline characteristics. The IC evaluation involved physical examinations and blood tests. Initially, linear regression was used to assess the relationship between total sleep duration, nighttime sleep duration, nap duration, and IC change between the two waves that were determined by marginal effects (ME) and their corresponding 95% confidence intervals (CIs). Regression splines were employed to explore potential nonlinear associations. Subgroup and sensitivity analyses were conducted to investigate the heterogeneity of IC change under specific conditions and the robustness of our results. Mediation analysis was performed to identify potential factors mediating the relationship between sleep patterns and IC change.

Results

Both excessive (>10 h) (total, ME: −1.12; 95% CI: −1.61, −0.64; nighttime, ME: −1.44; 95% CI: −2.29, −0.59) and insufficient (<6 h) sleep duration (total, ME: −0.43; 95% CI: −0.68, −0.18; nighttime, ME: −0.50; 95% CI: −0.73, −0.27) negatively impacted IC change. Moderate naps (≤60 min) mitigated the decline in IC change (ME: 0.28; 95% CI: 0.07, 0.49). IC values decreased at the slowest rate when nap time constituted one-seventh of total sleep time. The onset of dyslipidemia partially mediated the association between naps (≤60 min) and IC change (P = 0.02).

Conclusions

These findings suggest that maintaining a healthy sleep pattern of 6−8 h of nighttime or total sleep, along with a post-lunch nap of ≤60 min, helps preserve optimal IC or delay its decline. This is particularly beneficial for cognitive, psychological, and locomotion performance among middle-aged and older adults.

目的：内在能力（IC）是一个包含智力和体力的多维结构，已被世界卫生组织纳入老龄化框架。然而，IC 与中国人睡眠模式（夜间睡眠和午后小睡）之间的详细关系仍未得到充分阐明：本研究的参与者为中国健康与退休纵向研究（CHARLS）中年龄≥45岁的中国居民。我们分析了从第一波（2011 年 5 月至 2012 年 3 月）到第二波（2015 年 7 月至 2016 年 1 月）的 4 年 CHARLS 数据。这些波次的数据被用于纵向分析。自我报告的数据包括夜间睡眠和午睡时间，以及其他基线特征。集成电路评估包括体格检查和血液化验。首先，使用线性回归评估总睡眠时间、夜间睡眠时间、午睡时间和两个波次之间的 IC 变化之间的关系，这些关系由边际效应 (ME) 及其相应的 95% 置信区间 (CI) 决定。采用回归样条来探索潜在的非线性关联。为了研究特定条件下 IC 变化的异质性和结果的稳健性，我们进行了分组和敏感性分析。我们还进行了中介分析，以确定睡眠模式与集成电路变化之间关系的潜在中介因素：结果：睡眠时间过长（>10 小时）（总睡眠时间，ME：-1.12；95% CI：-1.61，-0.64；夜间睡眠时间，ME：-1.44；95% CI：-2.29，-0.59）和睡眠时间不足（>10 小时）（总睡眠时间，ME：-1.12；95% CI：-2.29，-0.59）均对 IC 变化有影响：这些研究结果表明，保持健康的睡眠模式，即 6-8 小时的夜间睡眠或全日睡眠，再加上午餐后≤60 分钟的小睡，有助于保持最佳的 IC 状态或延缓其衰退。这对中老年人的认知、心理和运动表现尤其有益。

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引用次数: 0

Daily supplementation of lesser mealworm protein for 11-weeks increases skeletal muscle mass in physically active older adults 连续 11 周每天补充较少的黄粉虫蛋白可增加运动量较大的老年人的骨骼肌质量。

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-21 DOI: 10.1016/j.jnha.2024.100364

Lotte Koopmans , Marcia Spoelder , Coen C.W.G. Bongers , Thijs M.H. Eijsvogels , Maria T.E. Hopman

Background

Adequate protein intake is important to maintain skeletal muscle mass in older adults and to prevent sarcopenia. Insect-based supplements were recently introduced to the market as an environmentally friendly protein alternative. We examined the effect of daily supplementation of lesser mealworm (Alphitobius diaperinus) protein for 11 consecutive weeks on muscle mass and muscle strength in older adults.

Methods

In this randomized controlled trial, 70 physically active older adults (>60 years) were randomly allocated to three groups: (I) lesser mealworm protein, (II) whey protein or (III) iso-caloric placebo. Participants received 11 weeks of supplements two times a day (30 gram/day). Muscle mass, fat mass, leg muscle strength and handgrip strength were measured at baseline and after 11 weeks of supplementation.

Results

Of the 70 participants, 59 completed the supplementation period (mealworm n = 16; whey n = 23; iso-caloric placebo n = 20). Overall, skeletal muscle mass increased from 29.0 ± 6.2 kg to 29.3 ± 6.1 kg, with a significantly more profound increase in the lesser mealworm group (+0.67 [0.20–1.14] kg) compared to the whey (+0.03 [-0.20 – 0.28] kg) and placebo group (+0.30 [0.03 – 0.63] kg, P_group*time = 0.030). Fat mass and maximum handgrip strength decreased over time, whereas one-repetition maximum (1RM) leg muscle strength did not change pre- versus post-intervention. No group differences, nor interaction effects, were observed for fat mass, leg muscle strength and handgrip strength

Conclusion

11-weeks of lesser mealworm protein supplementation induced an increase in skeletal muscle mass compared to whey protein supplementation and iso-caloric placebo in physically active older adults. No differences among groups were observed for changes in muscle strength.

背景：摄入充足的蛋白质对维持老年人的骨骼肌质量和预防肌肉疏松症非常重要。最近，昆虫类补充剂作为一种环保型蛋白质替代品被引入市场。我们研究了连续 11 周每天补充小黄粉虫（Alphitobius diaperinus）蛋白质对老年人肌肉质量和肌肉力量的影响：在这项随机对照试验中，70 名身体活跃的老年人（60 岁以上）被随机分配到三组：(I) 小黄粉虫蛋白组；(II) 乳清蛋白组；(III) 等热量安慰剂组。参与者接受为期 11 周的补充剂治疗，每天两次（30 克/天）。分别在基线和补充 11 周后测量肌肉质量、脂肪质量、腿部肌肉力量和手握力量：结果：在 70 名参与者中，59 人完成了补充期（黄粉虫 n = 16；乳清 n = 23；等热量安慰剂 n = 20）。总体而言，骨骼肌质量从 29.0 ± 6.2 千克增加到 29.3 ± 6.1 千克，与乳清组（+0.03 [-0.20 - 0.28] 千克）和安慰剂组（+0.30 [0.03 - 0.63] 千克，Pgroup*时间 = 0.030）相比，黄粉虫组（+0.67 [0.20-1.14] 千克）的增加幅度明显更大。随着时间的推移，脂肪量和最大握力有所下降，而单次重复最大（1RM）腿部肌肉力量在干预前和干预后没有变化。在脂肪量、腿部肌肉力量和手握力方面，没有观察到组间差异，也没有观察到交互效应结论：与补充乳清蛋白和等热量安慰剂相比，在体力活动量大的老年人中，补充 11 周较少的黄粉虫蛋白可诱导骨骼肌质量的增加。在肌肉力量变化方面，没有观察到组间差异。

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引用次数: 0

Pacing longevity: Serial gait speed measurements and survival in older adults 长寿的步伐：连续步速测量与老年人的存活率

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-17 DOI: 10.1016/j.jnha.2024.100363

Riccardo Calvani , Matteo Cesari , Emanuele Marzetti

引用次数: 0

Letter to the editor on: “Physical performance changes as clues to late-life blood pressure changes with advanced age: the osteoporotic fractures in men study” 致编辑的信"作为晚年血压变化线索的体能变化：男性骨质疏松性骨折研究"

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-17 DOI: 10.1016/j.jnha.2024.100366

Ping Xu, Jianyang Luo

引用次数: 0

Comfort feeding in hospitalised people with dementia: a retrospective study of survival following comfort feeding recommendations 痴呆症住院患者的舒适喂养：根据舒适喂养建议生存情况的回顾性研究

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging

Pub Date : 2024-09-14 DOI: 10.1016/j.jnha.2024.100362

Christine Davis , Nasime Mokari-Manshadi , Viviane De Menezes Caceres , Patrick Russell , Toby Gilbert , Stephen Hedger , Udul Hewage , Dirk Hoffman , Yogesh Sharma , Alice O’Connell , Amrit Sandhu , Jeff Faunt , Campbell Thompson

Objectives

Persistent and significant swallowing impairment can occur in individuals with dementia. Determining prognosis and establishing realistic goals of care in this population is complex and comfort feeding may be recommended. This study aimed to establish evidence relating to patient outcomes following recommendation of comfort feeding to aid informed decision making.

Design

A multi-centre, retrospective audit was conducted for a two-year period to establish the survival and readmission rates for hospitalised people with dementia, following recommendation of a comfort feeding plan.

Setting

The study was conducted at three acute care hospitals in Adelaide, South Australia.

Participants

A total of 163 participants were included, 90 male and 73 female, with a median age of 88 years.

Measurements

Mortality within 30 and 90 days of admission and readmission rates within 30 days of discharge were calculated.

Results

Forty-two percent of participants died during the admission during which a comfort feeding plan was recommended. Overall median survival time and one month survival was 13 days and 25%, respectively. Readmission rates were low (7.4% of those discharged). Comfort feeding recommendations aligned with dysphagia severity and those for whom Nil By Mouth (NBM) or ice chips only were recommended were at highest risk of dying in hospital, those recommended thickened fluids +/− ice chips were most likely to be alive 30 days after their original admission date.

Conclusion

Dementia and comfort feeding were associated with high mortality rates, high rates of discharge to a supportive care facility and low readmission rates. Dysphagia severity associated with the consistency of fluids recommended.

目标痴呆症患者可能会出现持续而严重的吞咽障碍。确定这类患者的预后和制定切实可行的护理目标非常复杂，因此可能会建议进行舒适喂养。本研究旨在确定建议舒适喂养后患者预后的相关证据，以帮助患者做出明智的决策。设计进行了一项为期两年的多中心回顾性审计，以确定建议舒适喂养计划后住院痴呆症患者的存活率和再入院率。研究在南澳大利亚州阿德莱德市的三家急症护理医院进行。结果42%的参与者在入院期间死亡，在此期间推荐了舒适喂养计划。总存活时间和一个月存活时间的中位数分别为 13 天和 25%。再入院率较低（占出院人数的 7.4%）。舒适喂养的建议与吞咽困难的严重程度相一致，只建议口服无糖（NBM）或冰片的患者在医院内死亡的风险最高，建议使用浓稠液体+/-冰片的患者在最初入院日期30天后存活的可能性最大。吞咽困难的严重程度与推荐的液体浓度有关。

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