Impact of dietary protein intake on the incidence of low muscle strength in middle-aged and older adults.

BACKGROUND: A reduction in skeletal muscle strength is a prognostic indicator of negative consequences, such as physical disability, frailty, and mortality in older adults. Studies investigating associations between the risk of reduction in skeletal muscle strength and the amount of dietary protein which is a factor influenced muscle health are scarce, particularly in Asian populations. Therefore, we investigated the association between the amount and change in daily protein intake and the prospective risk of developing low skeletal muscle strength in middle-aged and older adults. METHODS: This study used data from the Korean Genome and Epidemiology Study as an ongoing population-based cohort study of adults aged 40 years and over. The amount of daily protein consumed was assessed using a semi-quantitative food frequency questionnaire. Low skeletal muscle strength was measured with a handgrip strength dynamometer. RESULTS: In total, 32,458 adults (11,358 males and 21,100 females) were evaluated. The amount of daily dietary protein consumed was not associated with the risk of low muscle strength over the 4-year follow-up period after adjusting for covariates. No associations between low muscle strength events according to the change in the amount of protein consumed from the baseline to the follow-up surveys were identified. CONCLUSIONS: The amount of and change in dietary protein consumed were not associated with developing low muscle strength in middle-aged and older adults. Further studies with a focus on physical activity-protein intake interactions and specific conditions, such as mobility-limited adults or hospitalized patients, are warranted to clarify the relationship between protein intake status and the incidence of low skeletal muscle strength.

The effects of repetitive transcranial magnetic stimulation on body weight and food consumption in obese adults: A randomized controlled study.

BACKGROUND: Although some studies have reported significant reductions in food cravings following the single-session of repetitive transcranial magnetic stimulation (rTMS), there is little research on the effects of multi-session of rTMS on food consumption and body weight in obese subjects. OBJECTIVE: We conducted 4-week randomized, sham-controlled, single-blind, parallel-group trial to examine the effect of rTMS on body weight in obese adults. METHODS: Forty-three obese patients (body mass index [BMI] ≥25 kg/m2) aged between 18 and 70 years were randomized to the sham or real treatment group (21 in the TMS group and 22 in the sham treatment group). A total of 8 sessions of rTMS targeting the left dorsolateral prefrontal cortex (DLPFC) was provided over a period of 4 weeks. The primary outcome measure was weight change in kilograms from baseline to 4 weeks. Secondary endpoints included changes in anthropometric measures, cardiovascular risk factors, food intake, and appetite. RESULTS: Participants in the rTMS group showed significantly greater weight loss from baseline following the 8 session of rTMS (-2.75 ±â€¯2.37 kg vs. 0.38 ±â€¯1.0 kg, p < 0.01). Consistent with weight loss, there was a significant reduction in fat mass and visceral adipose tissue at week 4 in the rTMS group compared with the control group (p < 0.01). After the 8 sessions of rTMS, the TMS group consumed fewer total kilocalories and carbohydrates per day than the control group (p < 0.05). CONCLUSIONS: 8 sessions of HF rTMS delivered to the left DLPFC were effective in inducing weight loss and decreasing food intake in obese patients. TRIAL REGISTRATION: Clinical trial registered with the Clinical Trials Registry at http://cris.cdc.go.kr (KCT0002548).

The effects of high-frequency repetitive transcranial magnetic stimulation on resting-state functional connectivity in obese adults.

AIMS: We conducted a 4-week randomized, sham-controlled, single-blind, parallel-group trial to examine the effect of repetitive transcranial magnetic stimulation (rTMS) delivered to the left dorsolateral prefrontal cortex (DLPFC) on functional brain connectivity and body weight in adults with obesity. MATERIALS AND METHODS: Of the 45 volunteers with obesity, aged between 18 and 70 years (body mass index [BMI] ≥25 kg/m2 according to the obesity criterion for an Asian population), 36 participants (54.1 ± 11.0 years, BMI 30.2 ± 3.5 kg/m2 , 77.8% female) completed the 4 weeks of follow-up, undergoing two resting state fMRI scans (20 in the real stimulation group and 16 in the sham stimulation group). A total of eight sessions of high-frequency rTMS targeting the left DLPFC were provided over a period of 4 weeks (5-second trains with 25-second inter-train intervals, 10 Hz, 110% motor threshold; 2000 pulses over 20 minutes). RESULTS: Participants in the real stimulation group showed significantly greater weight loss from baseline following the eight session of rTMS (-2.53 ± 2.41 kg vs 0.38 ± 1.13 kg, P < 0.01). For intrinsic brain connectivity comparisons, the between-ness centrality values within the right frontoparietal network tended to increase with rTMS, and a significant interaction effect was identified for time (pre vs post) × rTMS (real vs sham) in the right frontoparietal network (P = 0.031, FDR corrected). CONCLUSIONS: We observed that rTMS selectively increased resting state functional connectivity within the right frontoparietal network. Our findings suggest that high-frequency rTMS to the left DLPFC might strengthen the frontoparietal network that orchestrates top-down inhibitory control to reduce food intake.

Serum folate and vitamin B12 levels are not associated with the incidence risk of atherosclerotic events over 12 years: the Korean Genome and Epidemiology Study.

Atherosclerosis, a common cause of atherosclerotic vascular diseases, is associated with several risk factors including hyperhomocysteinemia, and vitamin B12 and folate are involved in homocysteine metabolism; thus, serum folate and vitamin B12 status may be associated with the risk of atherosclerotic vascular diseases mediated by homocysteine plasma concentrations. Therefore, we hypothesized that low vitamin B12 and folate levels are related to higher risks of atherosclerotic vascular disease and investigated the risk of atherosclerotic vascular events in Korean adults with low serum vitamin B12 and folate levels. This population-based cohort study followed 421 subjects aged 40-69 years for 12 years, 2003-2014. Over the follow-up period, 38 (9.0%) atherosclerotic events occurred. However, serum folate and vitamin B12 levels were not associated with the risk of stroke, coronary artery disease, or myocardial infarction or the development of peripheral arterial disease after adjustment for age, sex, smoking status, alcohol consumption, physical activity, body mass index, serum creatinine, and high-sensitivity C-reactive protein levels and a history of diabetes, hypertension, or dyslipidemia. In conclusion, the incidence of atherosclerotic vascular events in Korean adults aged 40-69 years was not associated with the serum folate or vitamin B12 status.

Effects of zinc, magnesium, and chromium supplementation on cardiometabolic risk in adults with metabolic syndrome: A double-blind, placebo-controlled randomised trial.

The prevalence of metabolic syndrome (MetS) has been increasing rapidly worldwide. The activities of zinc, magnesium and chromium have a potential association with MetS; therefore, we investigated the effects of zinc, magnesium and chromium supplements on metabolic risk factors in adults with MetS. In this double-blind, placebo controlled randomised study, 32 adults with MetS were included in the zinc, magnesium, and chromium-administered group (n = 16) or the placebo group (n = 16) and received either 300 mg magnesium, 600 µg chromium and 36 mg zinc per day or placebo over a 24-week period. The primary endpoint was the change in the MetS components, including serum glucose, triglyceride and high-density lipoprotein cholesterol levels, blood pressure and waist circumference. Data were analysed using repeated-measures analysis of variance. The metabolic risk factors did not change post-intervention, but the serum C-reactive protein level decreased in the mineral-supplemented group compared with that in the placebo group. Further studies with stricter inclusion criteria are needed to better evaluate the potential for zinc, magnesium and chromium to improve metabolic risk in adults with MetS.

Fasting plasma glucose levels and coronary artery calcification in subjects with impaired fasting glucose.

BACKGROUND: Prediabetes is associated with an increased risk of cardiovascular disease (CVD). While the association of impaired glucose tolerance with CVD has been shown in many studies, the relationship between impaired fasting glucose (IFG) and CVD remains unclear. OBJECTIVES: The purpose of this study was to compare the coronary artery calcium (CAC) scores of participants with normal fasting glucose versus those with IFG, according to fasting plasma glucose (FPG) levels, and to assess whether differences in CAC scores were independent of important confounders. DESIGN: Retrospective study. SETTING: Health Promotion Center of the University Hospital (Gyeonggi-do, South Korea), during the period 2010-2014. PATIENTS AND METHODS: Participants were enrolled from the general population who visited for a medical check-up. CAC was assessed in asymptomatic individuals by multidetector computed tomography. Anthropometric parameters and metabolic profiles were also recorded. Subjects were divided into four fasting glucose groups. Participants with a history of CVD or diabetes mellitus were excluded. MAIN OUTCOME MEASURES: Correlation between FPG and CAC scores, CAC score categories, and association between CAC score and FPG categories. RESULTS: Of 1112 participants, 346 (34.2%) had a CAC score > 0. FPG values in the IFG patients were positively but weakly correlated with CAC scores (r=0.099, P=.001). The incidence of CAC differed according to FPG level (P < .001) and in Kruskal-Wallis test the mean CAC score differed by FPG group (P < .001). After adjustment for other factors in a multiple logistic regression analysis, those subjects with FPG >=110 mg/dL had a significantly higher risk of CAC than did subjects with normal fasting glucose (110.

Obesity with metabolic abnormality is associated with the presence of carotid atherosclerosis in Korean men: a cross-sectional study.

BACKGROUND: Obesity is a risk factor for cardiovascular disease, but metabolic disturbances can also lead to the development of this disease. Therefore, we investigated the associations between obesity subtype, considering both body weight and metabolic disturbances, and carotid atherosclerosis as a predictor of cardiovascular disease in Korean men. METHODS: Data from a total of 980 men were analysed in this study. Obesity subtypes were classified as normal weight without metabolic syndrome (metabolically healthy normal weight; MHNW), obesity without metabolic syndrome (metabolically healthy, but obese; MHO), normal weight with metabolic syndrome (metabolically abnormal, but normal weight; MANW) and obesity with metabolic syndrome (metabolically abnormal obese; MAO). Carotid intima-media thickness (CIMT) and carotid plaque were assessed using a high-resolution B-mode ultrasound system. Carotid atherosclerosis was defined as a mean CIMT value >0.9 mm or the presence of carotid plaque. RESULTS: Mean CIMT in the MAO subtype was significantly higher than that in the MHNW control group (0.790 ± 0.019 vs. 0.747 ± 0.013 mm; p < 0.001). The presence of carotid plaque was positively associated with MAO subtype [adjusted odds ratio (aOR) 1.49, 95 % confidence interval (CI) 1.02-2.16; p = 0.039], but not with MHO or MANW, compared to the MHNW control group. The MAO subtype showed a positive association with the presence of carotid atherosclerosis (aOR 1.68, 95 % CI 1.17-2.42; p = 0.006). CONCLUSIONS: Only the MAO subtype showed a higher CIMT value and positive associations with carotid plaque and carotid atherosclerosis, but not with MHO and MANW subtypes, compared to the MHNW control. Additional prospective studies are needed to evaluate preclinical carotid atherosclerosis according to the subtypes of obesity.