Dataset Information

Effects of resistance training and nutritional support on osteosarcopenia in older, community-dwelling postmenopausal Korean females (ERTO-K study): a study protocol.

ABSTRACT:

Background

Osteosarcopenia is geriatric syndrome defined as the concomitant occurrence of osteopenia/osteoporosis, and sarcopenia. Osteosarcopenia is a relatively new concept in geriatric medicine; however, it may increase the risk of fragility fractures, several morbidities and mortalities, and socioeconomic costs. Although resistance exercises and nutritional support-including protein, calcium, and vitamin D-are potential non-pharmacological management procedures, evidence is still lacking. The objective of this study was therefore to evaluate the effect of combined resistance exercise and nutritional support on the quality and quantity of bone and muscle in postmenopausal females with osteosarcopenia.

Methods

This research proposal presents the protocol for a prospective, single-center, single-blinded, two-armed randomized controlled trial. Thirty-four participants with osteosarcopenia will be recruited and randomly divided into intervention and control groups; both groups will receive nutritional supplements (protein, 40 g; vitamin D, 1600 IU; calcium, 600 mg) daily. The intervention group will undergo 24 weeks of resistance exercise of increasing intensity, achieved through a three-phase step-up process. The primary outcomes will be the changes in skeletal muscle index and bone marrow density of the lumbar spine and femoral neck between the baseline and end of intervention (24 weeks). The secondary outcomes will be the body composition, whole body phase angle, physical function assessment, quality of life, psychological assessment, and bone turnover markers of participants, surveyed at multiple time points.

Discussion

This randomized controlled trial may reveal the effect of resistance exercise and nutritional support on older postmenopausal women with osteosarcopenia. The results will provide evidence for developing proper non-pharmacological management guidelines for postmenopausal women.

Trial registration

Clinical Research Information Service of Republic of Korea, KCT0008291, Registered on 16 March 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/25262 .

SUBMITTER: Lee BC

PROVIDER: S-EPMC10792803 | biostudies-literature | 2024 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effects of resistance training and nutritional support on osteosarcopenia in older, community-dwelling postmenopausal Korean females (ERTO-K study): a study protocol.

Lee Byung Chan BC Kim Kyung Il KI Cho Kang Hee KH Moon Chang-Won CW

BMC geriatrics 20240117 1

<h4>Background</h4>Osteosarcopenia is geriatric syndrome defined as the concomitant occurrence of osteopenia/osteoporosis, and sarcopenia. Osteosarcopenia is a relatively new concept in geriatric medicine; however, it may increase the risk of fragility fractures, several morbidities and mortalities, and socioeconomic costs. Although resistance exercises and nutritional support-including protein, calcium, and vitamin D-are potential non-pharmacological management procedures, evidence is still lac ...[more]

PMID: 38229012

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Project description:BackgroundKorea is expected to become a super-aged society in 2026, and improving nutritional status, which is directly related to health problems, is therefore important for increasing healthy life expectancy. Frailty is the most complex phenotype of aging, and leads to adverse health outcomes, disability, poor quality of life, hospitalization, and mortality. Malnutrition is a major risk factor for frailty syndrome. This study aimed to investigate the incidence of pre-frailty or frailty in the second wave (T2, 2018-2019) according to general characteristics and nutritional status in the first wave (T1, 2016-2017); and examine the longitudinal association of nutritional status in T1 and the incidence of pre-frailty or frailty in T2 among older adults living in a community.MethodsA secondary data analysis was performed using the Korean Frailty and Aging Cohort Study (KFACS). Participants comprised 1125 community-dwelling older Korean adults aged 70-84 years (mean age: 75.03 ± 3.56 years; 53.8% males). Frailty was assessed using the Fried frailty index, and nutritional status was assessed using the Korean version of the Mini Nutritional Assessment Short-Form and blood nutritional biomarkers. Binary logistic regression was used to identify longitudinal associations between the nutritional status at T1 and pre-frailty or frailty at T2.ResultsOver the two-year follow-up period, 32.9% and 1.7% of the participants became pre-frail and frail, respectively. After the potential confounders were adjusted (sociodemographic, health behaviors, and health status characteristics), pre-frailty or frailty had a significant longitudinal association with severe anorexia (adjusted odds ratio [AOR], 4.17; 95% confidence interval [CI], 1.05-16.54), moderate anorexia (AOR, 2.31; 95% CI, 1.46-3.64), psychological stress or acute disease (AOR, 2.61; 95% CI, 1.26-5.39), and body mass index (BMI) less than 19 (AOR, 4.11; 95% CI, 1.20-14.04).ConclusionsAnorexia, psychological stress, acute disease, and low BMI are the most significant longitudinal risk factors for pre-frailty or frailty in older adults. As nutritional risk factors may be preventable or modifiable, it is important to develop interventions targeting the same. Community-based health professionals in health-related fields should recognize and manage these indicators appropriately to prevent frailty among older adults living in the community.

Project description:To date, there has been no study on the long-term effects of resistance exercise on sarcopenia and obesity indices for people with sarcopenia. The present study thus aimed to determine the effect of 18 months of periodized, high-velocity/intensity/effort progressive resistance training (HIT-RT) on body composition and strength in older men with osteosarcopenia. Using a single-blind, two-group parallel design, 43 community-dwelling men, 72 years and older, with osteopenia and sarcopenia in Erlangen-Nürnberg, Germany, were randomly assigned to two study arms by drawing lots: (1) an exercise group that conducted a consistently supervised periodized high-velocity/intensity/effort protocol (HIT-RT; n = 21) on machines twice a week for 18 months or (2) a control group (CG; n = 22) that maintained their physical activity/exercise habits. Both groups were supplied with protein, cholecalciferol, and calcium according to current recommendations. The study outcomes were lean body mass (LBM), total and abdominal body fat as determined by dual-energy X-ray absorptiometry and maximum hip/leg extensor strength as assessed on an isokinetic leg press at baseline and after 8, 12, and 18 months of follow-up. The intention-to-treat principle and multiple imputation were applied to calculated study outcomes. After 18 months of HIT-RT, altogether five participants were lost to follow up (HIT-RT: n = 2, CG: n = 3). The attendance rates (95%) for HIT-RT were high; relevant adverse effects were not observed. Significant effects (i.e., differences between HIT-RT vs. CG) in favor of HIT-RT were determined for LBM (+1.73 kg, 95% CI: +1.13 to +2.32 kg), total body fat mass (-2.44 kg, 95% CI: -1.28 to 3.60 kg), abdominal body fat percentage (-2.68, 95% CI: -1.70 to -3.66), and maximum hip/leg extensor strength (+533 N, 95% CI: +397 to +670 N; all p < 0.001). Even after adjusting for multiple testing, all effects remained significant. Of note, after 8 months of HIT-RT, only slight (LBM and fat indices) to moderate (maximum strength) ongoing effects were observed. Carefully introduced, continuously supervised HIT-RT is an effective, attractive, feasible, and safe method to improve body composition and muscle strength in older community-dwelling men with sarcopenia. However, even when consequently applying principles of exercise intensity progression within the RT protocol, only slight further positive changes were observed after 8 months of exercise.

Project description:BackgroundDemographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal's health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool.MethodsA cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated.Results111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p<0.001). The diagnostic accuracy, sensitivity and specificity of MNA were 81%, 86% and 67% respectively. Of the 242 elderly sampled, 24% were malnourished and 65% were at risk of malnutrition. Malnutrition was more prevalent among females (29%) than males (18%), and most prevalent among the marginalized Dalit ethnic group (40%). Elderly persons who were married and literate had better nutritional health than their counterparts.ConclusionsThe MNA appears to be a valid and sensitive tool for rapid nutritional screening of the elderly in Nepal. The prevalence of malnutrition was high among Nepalese elderly in the Okharpauwa VDC, which requires urgent health monitoring and management attention.

Project description:Background: Whether multiple nutritional deficiencies have a synergic effect on mobility loss remains unknown. This study aims to evaluate associations between multi-nutritional deficits and physical performance evolution among community-dwelling older adults. Methods: We included 386 participants from the Multidomain Alzheimer Preventive Trial (MAPT) (75.6 ± 4.5 years) not receiving omega-3 polyunsaturated fatty acid (PUFA) supplementation and who had available data on nutritional deficits. Baseline nutritional deficits were defined as plasma 25 hydroxyvitamin D <20 ng/ml, plasma homocysteine >14 μmol/L, or erythrocyte omega-3 PUFA index ≤ 4.87% (lower quartile). The Short Physical Performance Battery (SPPB), gait speed, and chair rise time were used to assess physical performance at baseline and after 6, 12, 24, 36, 48, and 60 months. We explored if nutrition-physical performance associations varied according to the presence of low-grade inflammation (LGI) and brain imaging indicators. Results: Within-group comparisons showed that physical function (decreased SPPB and gait speed, increased chair rise time) worsened over time, particularly in participants with ≥2 nutritional deficits; however, no between-group differences were observed when individuals without deficit and those with either 1 or ≥2 deficits were compared. Our exploratory analysis on nutritional deficit-LGI interactions showed that, among people with ≥2 deficits, chair rise time was increased over time in participants with LGI (adjusted mean difference: 3.47; 95% CI: 1.03, 5.91; p = 0.017), compared with individuals with no LGI. Conclusions: Accumulated deficits on vitamin D, homocysteine, and omega-3 PUFA were not associated with physical performance evolution in older adults, but they determined declined chair rise performance in subjects with low-grade inflammation. Clinical Trial Registration: [https://clinicaltrials.gov/ct2/show/NCT00672685], identifier [NCT00672685].

Dataset Information

Effects of resistance training and nutritional support on osteosarcopenia in older, community-dwelling postmenopausal Korean females (ERTO-K study): a study protocol.

Background

Methods

Discussion

Trial registration

Publications

Effects of resistance training and nutritional support on osteosarcopenia in older, community-dwelling postmenopausal Korean females (ERTO-K study): a study protocol.

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