Journal of Nutrition Health & Aging最新文献

Objective: To evaluate the association between dairy products consumption and the probability of frailty transitions in community-dwelling older adults.

Design: Longitudinal study.

Setting and participants: We included 863 community-dwelling participants ≥65 years from the Chianti region in Italy.

Mesurements: Habitual dietary intake of dairy products (i.e., milk, yogurt, and cheese) was assessed in daily servings using a validated food frequency questionnaire (FFQ) at baseline, 3-, 6-, and 9-years of follow-up. Frailty status at each visit was defined using the Fried criteria, and the probability of transitions between different frailty status and death was assessed through multistate models. The associations between dairy product intakes and frailty transitions during the 9-year period were expressed as hazard ratios (HRs) derived from proportional intensity models.

Results: The mean age at baseline was 74 ± 7 years and 46% of the participants were male. There were no statistically significant associations between the consumption of total, fermented, or non-fermented dairy products and the probabilities of transition from robust or from pre-frail to any of the other frailty conditions or to death. Conversely, a direct association between the consumption of fermented dairy products and the probability of transition from frail to pre-frail was observed in a model adjusted for age, sex, and energy intake (HR_{per serving/day} = 1.90, 95%CI 1.12-3.22). This association was primarily related to yogurt consumption (HR_{per serving/day} = 4.07, 95%CI 1.38-12.02), as the association with cheese consumption was not significant (HR_{per serving/day} = 1.57, 95%CI 0.91-2.71). In the fully adjusted model, only the association between yogurt consumption and frail to pre-frail transition remained statistically significant (HR_{per serving/day} = 3.68, 95%CI 1.10-12.31).

Conclusion: Dairy products, such as milk, yogurt, and cheese, are unlikely to play a predominant role in frailty development in an Italian community-dwelling older population. However, it is advisable to maintain a moderate consumption of dairy products, especially fermented ones, as part of a well-balanced diet to promote healthy aging.

Introduction: Intermittent fasting (IF) has emerged as a potential lifestyle intervention for mitigating cognitive decline and enhancing brain health in individuals with mild to major neurocognitive disorders. Unlike preventive strategies, this review evaluates IF as a therapeutic approach, focusing on its effects on neuroplasticity, inflammation, and cognitive function.

Methods: A narrative review was conducted using a comprehensive PubMed search with the terms "intermittent fasting AND neurocognition" and "intermittent fasting AND neuroplasticity". Studies published in English within the last ten years involving human and animal models were included. Exclusion criteria focused on studies primarily examining mood disorders or unrelated metabolic outcomes.

Results: Preclinical evidence demonstrates that IF enhances hippocampal neurogenesis and synaptic plasticity through pathways involving BDNF and CREB. IF also reduces neuroinflammation, as shown in animal models of Alzheimer's disease, vascular cognitive impairment, and high-fat diet-induced cognitive impairment. Human studies, though limited, suggest that regular IF may improve cognitive function and reduce markers of oxidative stress and inflammation in individuals with mild cognitive impairment.

Conclusion: Current findings highlight the therapeutic potential of IF for individuals with existing cognitive impairment. While preclinical studies provide robust evidence of neuroprotective mechanisms, human studies remain sparse and require standardization. Further clinical research is necessary to confirm long-term safety and efficacy and to refine IF protocols for broader clinical application.

Background: Calf circumference (CC), which is easy to measure and noninvasive, may be a predictor of functional outcome in patients with acute stroke. However, the association between CC and long-term functional outcome is unclear. The purpose of this study was to investigate whether low CC is associated with functional outcome at 12 months post-stroke.

Methods: This multicenter retrospective cohort study included patients with acute stroke. Low CC was defined as less than 30 cm for men and 29 cm for women. Poor functional outcome was defined as a modified Rankin Scale (mRS) score of greater than 3 (i.e., 3-6) and the inability to return pre-stroke mRS score at 12 months post-stroke. Multivariate logistic regression analysis was performed with low CC as the independent variable and outcome as the dependent variable.

Results: This study included 445 patients (median age 75 years, 277 men). The prevalence of low CC was 26.7%. Multiple logistic regression analysis showed that low CC was significantly associated with poor functional outcome (OR = 3.036, 95% CI: 1.700-5.422, p < 0.001).

Conclusions: Low CC at admission in patients with acute stroke is associated with poor functional outcome at 12 months post-stroke. CC, which is easily measured in the acute setting, may serve as a predictor of poor outcomes. Future multicenter prospective interventional studies are needed to clarify the causal relationship between CC and functional outcome.

Background: This study aimed to examine the associations of cystatin C, cystatin C estimated glomerular filtration rate (eGFRcys), and the difference between eGFRs (eGFRdiff) using cystatin C and creatinine levels with incident motoric cognitive risk syndrome (MCR).

Methods: We utilized data from two nationally representative cohort studies, the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015) and the US Health and Retirement Study (HRS, 2010-2018). Baseline serum cystatin C and creatinine levels were measured, and eGFRcys and creatinine estimated GFR (eGFRcr) were calculated. MCR was defined as subjective cognitive complaints plus objectively measured slow gait speed. Multivariable logistic models were used to investigate the longitudinal associations between kidney function measurements and incident MCR.

Results: In CHARLS (N = 2,085) and HRS (N = 1,240) cohorts, 7.4% and 7.2% developed MCR over follow-up. Each SD increment in serum cystatin C level was associated with elevated incident MCR odds, and an inverse association of eGFRcys with incident MCR was observed in both cohorts after multivariable adjustment and meta-analyses. The association between serum cystatin C and incident MCR remained significant even after adjusting for serum creatinine, suggesting that cystatin C is independently associated with MCR, regardless of kidney function levels. Additionally, each SD decrease in the absolute value of eGFRdiff was associated with lower odds of incident MCR among CHARLS participants.

Conclusions: Cystatin C and eGFRcys were correlated with an elevated MCR risk in two distinct populations. Specifically, eGFRdiff also related to incident MCR among Chinese older adults. Monitoring cystatin C-based kidney function could have significant clinical utility for identifying incident MCR risk, and represents a potential intervention target for healthier cognitive aging.

Background: Based on the compelling experimental evidence supporting apelin's beneficial effects on muscle metabolism, our study aimed to evaluate the role of circulating apelin levels as a biomarker for muscle health in humans.

Methods: This investigation employed a cross-sectional design, encompassing 237 community-dwelling older adults aged ≥65 years who underwent comprehensive geriatric evaluations in South Korea. Sarcopenia diagnosis was based on Asian-specific criteria, and serum apelin concentrations were determined using enzyme immunoassay techniques.

Results: Following adjustment for potential confounding factors, no significant disparities in serum apelin levels were observed between sarcopenic and non-sarcopenic individuals, nor were differences detected based on skeletal muscle mass, strength, or physical performance categories (P = 0.335 to 0.765). Furthermore, circulating apelin concentrations showed no significant correlations with any sarcopenia assessment metrics, including skeletal muscle index, grip strength, gait speed, chair stand test duration, or short physical performance battery score (P = 0.170 to 0.832). Elevations in serum apelin levels were not significantly associated with the risk of sarcopenia or compromised muscle phenotypes (P = 0.452 to 0.896). Additionally, stratification of participants into quartiles based on serum apelin concentrations revealed no significant variations in sarcopenia-related parameters across groups (P = 0.197 to 0.592).

Conclusion: These findings suggest that, contrary to previous studies in cellular and animal models where apelin demonstrated a protective impact on muscle homeostasis, such effects may not translate to the human context, and contribute valuable clinical evidence indicating that serum apelin may not serve as a reliable biomarker for sarcopenia.

Objectives: Motor cognitive risk (MCR) syndrome, defined as the cooccurrence of subjective cognitive complaints and a slow gait speed, is a form of pre-dementia condition. Balance has previously been associated with cognitive function. However, to date, no study has examined the relationship between balance and MCR in a large cohort of older adults. We aimed to investigate the associations of balance with MCR among Chinese older adults.

Research design and methods: Data from the wave 1 to wave 3 of the China Health and Retirement Longitudinal Study (CHARLS) were used. Balance was measured using validated tandem stance. Logistic and discrete-time survival cox regression analyses were performed to examine the relationship between baseline balance impairment and prevalent and incident MCR.

Results: A total of 3,398 participants were included in the baseline study. The prevalence of balance impairment was 21.1%. In the cross-sectional analysis, balance impairment was significantly associated with higher odds of MCR in the fully-adjusted model (OR: 1.43 95%CI 1.14-1.80, p = 0.002). A total of 2,474 individuals were included in the longitudinal analysis. During a mean follow-up duration of 3.69 years, the incidence of MCR was 9.8%. Baseline balance impairment was also significantly related to incidence of MCR (HR:1.37 95%CI 1.03-1.82, p = 0.032) even adjusting all confounders.

Conclusion: These results show that early recognition of balance disorder may be helpful in the prevention and treatment of cognitive decline in older adults.

Objectives: Adequate protein intake and protein supplementation has a beneficial role in the prevention and treatment of sarcopenia. The achievement and quantification of the recommended total protein intake by sarcopenic older adults receiving protein supplementation has not been studied. The aim of this study was to compare the accuracy of protein intake estimated from a combination of four-day food diaries and weighed protein powders against total protein intake estimated from 24-h urine samples.

Design: Longitudinal data analysis of the ongoing Exercise and Nutrition for Healthy AgeiNg (ENHANce) study.

Setting and participants: This study included community-dwelling older adults aged ≥65 years) diagnosed with sarcopenia (EWGSOP2-criteria).

Measurements: The amount of protein/placebo supplement was individualized to achieve a mean total protein intake of 1.5 g/kg BW/day. Total protein intake in participants was determined by a combination of weighed protein powders and four-day food diaries and by nitrogen-excretion in 24-h urine samples at eight different timepoints during the intervention. Mean differences and Lin's concordance correlation coefficients were used to assess agreement between the two methods.

Results: After 12 weeks, nitrogen analysis showed that the mean total protein intake was 1.31 g/kg BW in the protein powder group (n = 33) and 0.86 g/kg BW in the placebo group (n = 17). Mean protein intake according to the combination of food diaries and weighed powders (87.0 g/day) was overestimated by 7.7 g/day compared to the method using 24-h urine samples (79.3 g/day). Correlation between protein intake derived from the combined method and 24-h urine samples varied between 0.244-0.565 and 0.382-0.641 in the placebo group and protein group, respectively.

Conclusion: Both the 24-h urine samples and combined food diaries with weighed protein powders demonstrated that protein supplementation increased protein intake to meet the daily recommended amount of protein intake for older adults (1.0-1.2 g/kg BW), but not that for sarcopenic older adults (1.5 g/kg BW). While a fair to moderately strong correlation was observed between the methods, there was significant variability in the protein intake estimates. Additional research is needed to assess the accuracy of other potential techniques in determining protein intake in an older population. The ENHANce study was registered on ClinicalTrails.gov (NCT03649698).

Objectives: Postprandial inflammation post-high-fat meals may be linked to cardiovascular disease (CVD). CVD incidence increases with age; however, whether older adults experience greater postprandial inflammation remains unclear. We examined whether analyzing age categorically versus continuously influenced relationships between age and postprandial inflammatory measures.

Design: Cross-sectional.

Setting: Laboratory for Applied Nutrition and Exercise Science at Oklahoma State University (Stillwater, OK, USA).

Participants: 56 apparently healthy adults ages 20-69 years.

Measurements: We measured interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α at baseline, 2-, 4-, and 6 -hs post-high-fat meal (9 kcal/kg; 70% fat). Data were examined in the full sample with paired t-tests (baseline to peak), by pre-defined age groups (i.e., 18-35, 36-49, 50-59, 60-69) using ANCOVA, and continuously using linear regression.

Results: Across the full sample, IL-1β, IL-6, and IL-8 increased after the high-fat meal (p's≤0.018). Cytokine differences post-high-fat meal by age category were generally not observed. However, age was positively associated with IL-6 incremental AUC when examined continuously (b = 0.029; p = 0.010).

Conclusion: These data suggest increasing age is linked to a greater IL-6 response to a high-fat meal. Further, examining age continuously may have greater utility when studying aging and postprandial inflammation.

Registration: N/A (secondary analysis).