Journal of Nutrition Health & Aging最新文献

Objectives: To examine the relationship between pain, sleep, and intrinsic capacity (IC).

Design: A cohort study.

Setting and participants: Data were obtained from participants in China Health and Retirement Longitudinal Study (CHARLS) 2011-2015. The study population consisted of older adults who completed assessments on pain, sleep duration, sleep quality and IC at baseline.

Measurements: Pain, sleep duration, and sleep quality were assessed through self-reports from participants. The total IC score was derived from five domains: psychological, sensory, cognitive, locomotor, and vitality. The relationships between pain, sleep duration, sleep quality and IC were analyzed using linear mixed models. The relationship between sleep duration and IC was analyzed using quadratic analysis. Stratified analyses by gender and age were also performed.

Results: A total of 3517 participants were included in the analysis. After adjusting for all covariates, single-site pain (β = -0.29, 95% confidence interval [CI] = -0.38 to -0.20) and multisite pain (β = -0.41, 95% CI = -0.48 to -0.34) were significantly associated with a decrease in IC compared with older adults without pain; long sleep duration (β = -0.15, 95% CI = -0.24 to -0.06) was significantly associated with a decrease in IC compared with older adults with moderate sleep duration; and poor sleep quality (β = -0.63, 95% CI = -0.71 to -0.55) and fair sleep quality (β = -0.33, 95% CI = -0.40 to -0.27) were significantly associated with a decrease in IC compared with older adults with good sleep quality.

Conclusion: To maintain IC, it is important to ensure approximately 7.5 h of sleep duration, improve sleep quality, and manage pain. Interventions should begin as early as possible.

Objectives: Although calcium supplementation is reported to play a role in preventing falls, few studies have examined the relationship between dietary intake of calcium and falls. Therefore, this study investigated the association of calcium intake with falls in community-dwelling adults.

Design: Cross-sectional and longitudinal analyses of a prospective cohort study.

Setting and participants: A 5-year follow-up of a community-based cohort study was conducted with participants aged 40 years or older (mean age, 63.1 years). The cross-sectional and longitudinal analyses included 38,566 and 24,066 participants, respectively.

Measurements: Dietary calcium intake was assessed using a validated food frequency questionnaire, with energy adjustment. The outcome was any falls in the preceding year, which were recorded in the self-administered questionnaire. The association of calcium intake with falls was estimated by multivariable logistic regression analysis.

Results: The median intake of dietary calcium was 463 mg/day and 577 mg/day in men and women, respectively. In the cross-sectional analysis, lower intake of dietary calcium was associated with falls. The adjusted odds ratio for falls in the lowest quartile versus the highest quartile was found to be 1.29 (95%CI, 1.16, 1.45) in men and 1.12 (95%CI, 1.01, 1.25) in women. The results of the longitudinal analysis were consistent, with the adjusted odds ratio for falls in the lowest quartile versus the highest quartile being 1.20 (95%CI, 1.04, 1.40) in men and 1.23 (95%CI, 1.09, 1.39) in women.

Conclusions: Lower intake of dietary calcium was associated with a higher risk of falls. Adequate intake of dietary calcium might help to reduce the occurrence of falls.

Background: Identifying patients at risk for postoperative pneumonia and preventing it in advance is crucial for improving the prognoses of patients undergoing surgery. This review aimed to interpret the predictive value of sarcopenia on postoperative pneumonia.

Methods: Science Citation Index Expanded (SCIE), Embase, Medline, and Cochrane Central Register of Controlled Trials were searched from inception to August 2nd, 2023 to retrieve eligible studies. The risk of bias was assessed by the Newcastle-Ottawa Scale (NOS). For each study, we computed the odds ratio (OR) and 95% confidence interval (CI) for postoperative pneumonia in patients with and without preoperative sarcopenia, and the I-squared (I²) test was employed to estimate heterogeneity.

Results: The search identified 6530 studies, and 32 studies including 114,532 participants were analyzed in this review. In most of the studies included, the risk of bias was moderate. The most reported surgical site was the chest and abdomen, followed by the abdomen, chest, limbs and spine, and head and neck. Overall, patients with preoperative sarcopenia have a 2.62-fold increased risk of developing postoperative pneumonia compared to non-sarcopenic patients [OR 2.62 (I² = 67.5%, 95%CI 2.04-3.37). Subgroup analysis focusing on different surgical sites revealed that sarcopenia has the strongest predictive effect on postoperative pneumonia following abdominal surgery (OR 4.69, I² = 0, 95% CI 3.06-7.19). Subgroup analyses targeting different types of research revealed that sarcopenia has a stronger predictive effect on postoperative pneumonia in prospective studies (OR 5.84 vs. 2.22).

Conclusions: Our research findings indicate that preoperative sarcopenia significantly increases the risk of postoperative pneumonia. Future high-quality prospective studies and intervention studies are needed to validate the relationship between sarcopenia and postoperative pneumonia and improve patient outcomes.

Objective: Plant-based diets (PBD) are generally promoted as beneficial for health. However, whether this is also the case at older ages, when energy deficits, muscle loss and frailty affect health, is unclear. Research has shown that among older adults, particularly in men, a healthful PBD is associated with a lower frailty risk. This relation was however, not studied in the context of socio-economic status (SES), a major factor influencing the risk of frailty. Therefore, we aim to assess whether plant-based diets associate with frailty risk at older ages and whether this association is moderated by sex and income in a large population-based dataset.

Methods: We investigated baseline data from the UK Biobank cohort study (UKB) cross-sectionally (n = 73 180, mean age = 55.48 ± 7.87). We applied a plant-based diet index [range 17-85], differentiating between a healthful (hPDI) and unhealthful plant-based diet (uPDI). Frailty was assessed by the Fried frailty phenotype and categorized into 0-4 symptoms of frailty. Average annual household income was divided into three categories: low (<18.000 £), medium (18.000-52.000 £) and high (>52.000 £). We applied an ordinal logistic regression model with frailty as the categorical outcome and PDI as continuous predictor while adjusting for age, sex, ethnicity, education, BMI and UKB assessment center. Secondly, we included an interaction term (PDI*sex*income). To identify subgroups driving any interactions, we stratified by sex and subsequently by income group to determine the effect of PDI in subgroups while additionally adjusting for lifestyle factors.

Results: A 10-unit increase in hPDI was associated with 3.4% lower odds for frailty (OR = 0.966, 95%CI [0.946, 0.987]), whereas a 10-unit increase in uPDI was associated with 7.7% greater odds for frailty (OR = 1.077, 95%CI [1.054, 1.101]). The association between uPDI and frailty was moderated by income and sex (uPDI*income*sex, p = 0.002), whereas no such moderation was found for hPDI (p = 0.602). Subsequent stratification reveals a significant effect of uPDI on frailty particularly among men with low income (OR = 1.177, 95% CI [1.069, 1.298]), but not for women. This association in men largely persisted after adjustment for additional lifestyle factors (OR = 1.119, 95%CI [0.995, 1.258]).

Conclusion: We observed that adherence to an unhealthful plant-based diet was associated with a higher risk for frailty. This relation was especially observed for men with lower incomes and not explained by other lifestyle factors. While future research may investigate more specific determinants of health and diet behavior in men of low household income, this group in particular may profit from diet intervention improving diet quality.