Association of Fat Mass with SARC-F in Older Patients Undergoing Haemodialysis.

BACKGROUND/OBJECTIVES: An increase in fat mass is accompanied by a loss of muscle mass and function in chronic kidney disease. However, no studies in haemodialysis (HD) patients have investigated the relationship between fat mass and sarcopenia. The primary aim of this study is to assess the prevalence of sarcopenia, while the secondary aim is to verify the association between the fat mass percentage and SARC-F and SARC-F combined with calf circumference (SARC-F+CC) in elderly HD patients. SUBJECTS/METHODS: A cross-sectional study enrolled 96 HD older patients (male, n = 66). SARC-F ≥4 is used to define the muscle function loss, whereas SARC-F ≥6 or SARC-F ≥11 (with the calf circumference added) are the thresholds to diagnose sarcopenia. The fat mass percentage is obtained using bioelectrical impedance analysis. RESULTS: We found that 37.5% had a risk of muscle function loss due to SARC-F ≥4, 21.8% risk of sarcopenia using the SARC-F ≥6, and when using CC, the prevalence of risk of sarcopenia increased to 41.6% according to SARC-F+CC ≥11. In addition, there was an association between adiposity and sarcopenia for SARC-F ≥6 (OR: 1.25, p= 0.028) and SARC-F+CC ≥11 (OR: 1.25, p= 0.0003), but not with muscle function loss (SARC-F ≥4). CONCLUSION: In conclusion, we found that 37.5% of HD patients had a risk of muscle function loss and 21-41% presented sarcopenia, depending on the cut-off point used. In addition, higher adiposity was associated with an increased likelihood of having sarcopenia by 25%.

Fatigue Is Not Associated with Phase Angle in Hemodialysis Patients.

PURPOSE: The aim of this study was to investigate the association between fatigue and phase angle (PA) in patients with chronic kidney disease (CKD) on hemodialysis (HD). METHODS: A cross-sectional study with older patients than 18 years diagnosed with CKD undergoing HD. From 160 (58.36±15.05 years) patients, (n=96; 60%) are men. Body mass and height were assessed using a portable scale and stadiometer, followed by body mass index (BMI) calculus. The bioimpedance electrical analysis was performed using the Bodystat QuadScan 4000. The sample size was dichotomized in two groups, using the median of our sample, either normal when PA ≥5.4º, or low when the PA <5.4º. The Chalder fatigue questionnaire was used the assess the fatigue. The multiple regression was applied to assess the association between fatigue questionnaire and PA. RESULTS: Were considered normal PA≥5.4º (n=78, 48.8%) and low PA<5.4º (n=82, 51.2%). The patients of the PA<5.4º group are older compared to the PA≥5.4º group (63.1±15.1 vs. 53.3±13.4 years, p<0.001). There was no association between PA and fatigue score in the crude model (OR: 1.02, 95%CI: 0.96-1.08, p=0.47) and after confounding variables (OR: 1.03, CI: 0.95-1.12, p=0.43). CONCLUSIONS: In HD patients, we found that patients with lower PA values are older. In addition, we did not find association between fatigue and PA.

25OH Vitamin D Is No Associated with Muscle Function Loss in Adults and Elderly Patients Undergoing Hemodialysis.

OBJECTIVES: In patients with chronic kidney disease, sarcopenia is associated with dialysis treatment, accelerated protein catabolism, and high energy demand. Thus, this study aimed to assess the association between 25-OH vitamin D concentrations and muscle function in patients undergoing hemodialysis. DESIGN: A cross-sectional study. SETTING: Performed in a hemodialysis clinic. PARTICIPANTS: 79 adult and elderly patients undergoing hemodialysis. MEASUREMENTS: The sample was divided according to the SARC-F definition, being 55 patients allocated in the SARC-F <4 group and 24 in the SARC-F ≥4 group. Normal 25-OH vitamin D concentrations was considered when ≥30 ng/dL. RESULTS: Vitamin D concentrations and number of patients with low or normal muscle function did not differ between the groups. There was no correlation between SARC-F and 25-OH vitamin D levels (r: -0.09, p=0.42). CONCLUSIONS: 25-OH vitamin D has no association with muscle function loss in adults and elderly patients undergoing hemodialysis.

Muscle Function Loss and Gain of Body Weight during the COVID-19 Pandemic in Elderly Women: Effects of One Year of Lockdown.

OBJECTIVE: This study aimed to screen for a one year Brazilian elderly women who were physically active before of COVID-19 pandemic-induced lockdown and to assess the consequences of physical inactivity on body weight and muscle function loss. MEASUREMENTS: A cohort study of one-year was conducted with twenty-nine physically active elderly (65.5±5.6y) women. Pre-assessment was took in December 2019 and post (a year later) was performed in January 2021, during the lockdown induced by COVID-19 pandemic. Body mass (kg) was obtained using the digital scale. Handgrip strength (HGS) of the non-dominant hand was determined using an electronic dynamometer. Muscle function loss was assessed using the SARC-F questionnaire. RESULTS: After one year, body weight (p=0.002) and BMI (p=0.001) increased significantly, with an average percentage of change in body mass of +3.0±5.2%. Consequently, there was a change in classification of BMI pre- and post-one year (malnutrition: 17.2% to 17.2%, normal weight: 41.4% to 37.9%, and overweight: 41.4% to 44.9%). Additionally, was found increased muscle function loss (SARC-F≥4) of 13.8% to 27.6% of elderly women. CONCLUSION: In Brazilian physically active elderly women, we found that the physical inactivity imposed by during the lockdown increased the body mass and muscle function loss.

Correlation between the SARC-F Score and Hydration Status in Older Gastrointestinal Cancer Outpatients.

OBJECTIVES: The aim of this study was to assess the association between the extracellular water/total body weight ratio (ECW/TBW) and SARC-F scores among elderly gastrointestinal cancer patients. MEASUREMENTS: A cross-sectional study was performed with 57 older male patients with gastrointestinal cancer. Muscle function was assessed using the SARC-F questionnaire. Total body water (TBW) and extracellular water (ECW) were determined using bioelectrical impedance analysis, and fluid retention was assessed as the ratio of ECW to TBW (ECW/TBW). Pearson´s correlation analysis was used to assess the relationship between the SARC-F score and ECW/TBW, TBW and water intake. Results were considered significant at p < 0.05. RESULTS: Of the 57 older patients evaluated (65 ± 7 y), 13 ± 8% presented severe weight loss in the last 6 months. The median SARC-F score was 1.0 (0-10), and only four patients had SARC-F ≥4, which indicates the risk of sarcopenia. There was a positive correlation between the SARC-F score and ECW/TBW (r = 0.26, p = 0.02). However, no correlation was found between daily water intake or TBW and the SARC-F score. CONCLUSION: In older gastrointestinal cancer outpatients, we found a positive, albeit low, correlation between the SARC-F score and the ECW/TBW ratio. This outcome indicates the likelihood of muscle function loss due to accumulation of extracellular fluid.

Correlation between SARC-F Score and Ultrasound-Measured Thigh Muscle Thickness in Older Hospitalized Cancer Patients.

BACKGROUND: Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F) score is frequently used for screening the sarcopenia risk in older people. However, the agreement between SARC-F and loss of ultrasound-derived muscle thickness in hospitalized older cancer patients is unexplored. OBJECTIVE: The primary objective was to evaluate the relationship between the SARC-F score and ultrasound-derived muscle thickness of rectus femoris and vastus intermedius in older hospitalised cancer patients. The secondary objective was to identify the presence of sarcopenia. MEASUREMENTS: A cross-sectional study enrolled forty-one older hospitalised cancer patients ongoing chemotherapy or surgical treatment. Body weight (kg) was measured using a digital scale and height using a portable stadiometer to assess body mass index. SARC-F was performed to assess and classify sarcopenia risk (with (SARC-F: ≥4), without (SARC-F: <4). US-derived muscle thickness of rectus femoris and vastus intermedius was assessed using a portable ultrasound. Relationship between the SARC-F and muscle thickness was tested using Pearson´s correlation and Bland-Altman analyses. RESULTS: Approximately, 46.3% of the patients presented sarcopenia and a lower non-significant muscle thickness of rectus femoris and vastus intermedius (SARC-F ≥4: 18.54±6.28 vs. SARC-F <4: 22.22±9.16 mm, p=0.07). There was a moderate negative correlation between SARC-F and muscle thickness (r=-0.40, p=0.004). Additionally, Bland-Altman plots no found systematic bias risk between SARC-F and ultrasound-derived muscle thickness. CONCLUSIONS: Approximately, 46.3% of older hospitalized cancer patients presented sarcopenia. Additionally, we found a moderate inverse correlation and no systematic bias risk between SARC-F and ultrasound-measured muscle thickness.

SARC-F Is Better Correlated with Muscle Function Indicators than Muscle Mass in Older Hemodialysis Patients.

BACKGROUND: Sarcopenia can be characterized by European Consensus for Sarcopenia (EWGSOP2) criteria, but it methods are not easily accessible. Likewise, the Strength, Assistance with walking, Rise from a Chair, Climb stairs and Falls (SARC-F) has been proposed. OBJECTIVE: The aim of this study was i) to evaluate the prevalence for risk sarcopenia and ii) to correlate the SARC-F with components of the EWGSOP2 consensus in hemodialysis (HD) patients. MEASUREMENTS: This cross-sectional study enrolled ninety-five (male n= 59; 62%) HD older patients. Sarcopenia risk was assessed using the SARC-F, which ≥4 score indicates sarcopenia risk. Sarcopenia was confirmed through of the EWGSOP2 consensus, including the handgrip strength (HGS <27kg for men and <16kg for women) using the dynamometer, muscle mass through appendicular muscle mass (ASMI/m2 <7.0 kg/m2 for men and 5.5 kg/m2 for women) using the bioimpedance electrical, and physical performance through of gait speed (GS <0.8 m/s). RESULTS: From 95 patients, n=21(22%) presented sarcopenia risk. SARC-F ≥4 group are older (64.9±13.9 vs. 56.9±14.6 y, p= 0.028), presented lower ASMI (7.4±1.2 vs. 8.3±1.8 kg/m2, p=0.033), HGS (20.5±5.7 vs. 27.2±10.2 kg, p=0.005), and GS (0.5±0.1 vs. 0.7±0.1 m/s, p=0.001) than SARC-F<4 group. SARC-F score was negatively correlated with EWGSOP2 components: ASMI x SARC-F (r=-0.27, p=0.007), HGS x SARC-F (r=-0.35, p=0.0005), and GS x SARC-F (r=-0.47, p<0.0001). Although, no difference of number of patients with low or normal ASMI values was found, 62% and 95% of SARC-F≥4 group patients presented low HGS and gait speed, respectively. CONCLUSIONS: In older HD patients, 22% presented sarcopenia risk. In addition, SARC-F is better correlated with muscle function indicators (HGS and gait speed) than muscle mass.

Deleterious effects of lard-enriched diet on tissues fatty acids composition and hypothalamic insulin actions.

Altered tissue fatty acid (FA) composition may affect mechanisms involved in the control of energy homeostasis, including central insulin actions. In rats fed either standard chow or a lard-enriched chow (high in saturated/low in polyunsaturated FA, HS-LP) for eight weeks, we examined the FA composition of blood, hypothalamus, liver, and retroperitoneal, epididymal and mesenteric adipose tissues. Insulin-induced hypophagia and hypothalamic signaling were evaluated after intracerebroventricular insulin injection. HS-LP feeding increased saturated FA content in adipose tissues and serum while it decreased polyunsaturated FA content of adipose tissues, serum, and liver. Hypothalamic C20:5n-3 and C20:3n-6 contents increased while monounsaturated FA content decreased. HS-LP rats showed hyperglycemia, impaired insulin-induced hypophagia and hypothalamic insulin signaling. The results showed that, upon HS-LP feeding, peripheral tissues underwent potentially deleterious alterations in their FA composition, whist the hypothalamus was relatively preserved. However, hypothalamic insulin signaling and hypophagia were drastically impaired. These findings suggest that impairment of hypothalamic insulin actions by HS-LP feeding was not related to tissue FA composition.

Relationship between body mass index with dietary fiber intake and skinfolds--differences among bodybuilders who train during morning and nocturne period.

BACKGROUND: The prevalence of overweight individuals has increased in recent years. Moreover, the importance of a healthy diet is associated with the practice of physical activity and attempt to verify the achievement of physical exercise influences on food choice. However, it relationship between food intake and physical activity have not been studied. AIM: To evaluate if the period in which the trainings are conducted, morning and nocturne, interfere qualitatively and quantitatively in food consumption as well as verify possible associations between anthropometric profiles and dietary habits. METHODS: We collected data from 33 adult volunteers, between men and women, practitioners of bodybuilding. RESULTS: A total of 33 volunteers were interviewed (18 (54.5%) were men and 15 (45.5%) were women). Regarding anthropometric data, it turns out that that the volunteers of the two periods had similar characteristics, differentiating only weight. The consumption of nutritional supplements was observed in 30.77% of the practitioners in the morning period vs. 35% for the nocturne. Considering macronutrient intake, there was a significant difference in the consumption of protein between the periods. The consumption during nocturne period was greater (126 ± 5% of the daily requirement) than the morning period (115.7 ± 2%). As for micro-nutrients, calcium intake was greater among men when compared to women. There was a positive correlation between the BMI, and arm circumference for practitioners of the morning period. CONCLUSION: This study show that the practitioners who train in the morning have quietly better eating habits than those in the nocturne period, however both are inappropriate.

Chronic exercise promotes alterations in the neuroendocrine profile of elderly people.

Aging and physical inactivity are 2 factors that favour the development of cardiovascular disease, metabolic syndrome, obesity, and diabetes. In contrast, adopting a habitual moderate exercise routine may be a nonpharmacological treatment alternative for neuroendocrine aging disorders. We aimed to assess the effects of moderate exercise training on the metabolic profiles of elderly people with sedentary lifestyles. Fourteen sedentary, healthy, elderly male volunteers participated in a moderate training regimen for 60 min/day, 3 days/week for 24 weeks at a work rate equivalent to their ventilatory aerobic threshold. The environment was maintained at a temperature of 23±2°C, with a humidity of 60±5%. Blood samples for analysis were collected at 3 intervals: at baseline (1 week before training began), and 3 and 6 months after training. The training promoted increased aerobic capacity (relative VO(2), and time and velocity to VO(2)max; (p<0.05)) and reduced serum α-MSH (p<0.05) after 3 months of training when compared with the baseline data. In addition, serum thyroid hormone (T3 and T4) was reduced after 6 months of training compared with baseline levels. Our results demonstrate that a moderate exercise training protocol improves the metabolic profile of older people, and metabolic adaptation is dependent on time.

Sugar intake is correlated with adiposity and obesity indicators and sedentary lifestyle in Brazilian individuals with morbid obesity.

Obesity is a chronic disease characterized by increased accumulation of body fat. We evaluated the socioeconomic aspects, body composition, risk of metabolic complications associated with obesity, eating habits and lifestyle in both women and men adults and elderly with body mass index (BMI) > 40 kg/m². Among the subjects studied, 79% (n = 32) are female, 5% (n = 2) smokers, 39% (n = 16) use alcohol and only 24% (n = 10) are practitioners of physical exercise. The higher food intake was breads, followed by rice. The daily intake of fruits and vegetables is low. Positive correlation between consumption of sugar and BMI and abdominal circumference (AC) was observed. In summary, was found that morbidly obese patients that looking for nutritional counseling presents increased body fat, poor eating habits and sedentary lifestyle.

Sagital abdominal diameter, but not waist circumference is strongly associated with glycemia, triacilglycerols and HDL-C levels in overweight adults.

AIM: To correlate the sagittal abdominal diameter (SAD) and waist circumference (WC) with metabolic syndrome-associated abnormalities in adults. METHODS: This cross-sectional study included onehundred twelve adults (M=27, F=85) aging 54.0±11.2 yrs and average body mass index (BMI) of 30.5±9.0 kg/m². The assessment included blood pressure, plasma and anthropometric measurements. RESULTS: In both men and female, SAD and WC were associated positively with body fat% (r=0.53 vs r=0.55), uric acid (r=0.45 vs r=0.45), us-PCR (r=0.50 vs r=0.44), insulin (r=0.89 vs r=0.75), insulin resistance HOMA-IR (r=0.86 vs r=0.65), LDL-ox (r=0.51 vs r=0.28), GGT (r=0.70 vs r=0.61), and diastolic blood pressure (r=0.35 vs r=0.33), and negatively with insulin sensibility QUICKI (r=-0.89 vs r=-0.82) and total cholesterol/TG ratio (r=-0.40 vs r=-0.22). Glycemia, TG, and HDL-c were associated significantly only with SAD (r=0.31; r = 39, r=-0.43, respectively). CONCLUSION: Though the SAD and WC were associated with numerous metabolic abnormalities, only SAD correlated with dyslipidemia (TG and HDL-c) and hyperglycemia (glycemia).

Waist circumference is better associated with high density lipoprotein (HDL-c) than with body mass index (BMI) in adults with metabolic syndrome.

BACKGROUND: The measurement of waist circumference (WC) is the most prevalent cause of the metabolic syndrome (MS). OBJECTIVE: The aim of this study was to correlate WC and BMI with high-density lipoprotein (HDL-c) levels in patients with MS being consulted by the Family Health Program (PSF), Brazil. METHODS: This cross-sectional study was conducted from September to November 2008 with 42 patients (29 women and 13 men) from 35 to 77 years. Dietary intake was reported, and biochemical and body composition measures were taken. RESULTS: The HDL-c levels were higher in women when compared to men (48.4 ± 8.1 mg/dL vs. 36.4 ± 7.8 mg/dL). However, the triglycerides (TG)/HDL-c ratio and TG concentrations were lower in women (3.8 ± 1.5 and 178.0 ± 57.8 mg/dL, respectively) than in men (9.4 ± 8.5 and 471.5 ± 501.5 mg/dL, respectively). Regarding skinfold profile, the triceps was greater in females (37.0 ± 8.4 cm vs. 20.7 ± 10.5 cm). The dietetic profile showed that women had a lower intake of energy, fiber, phosphorus and sodium. The fruits and vegetables intake was diminished in the participants of this study, as less than 60% of the women and 50% of men met the daily recommendations. Approximately 54% of men and 28% of women had a lower intake of dairy products daily. Moreover, the results shows that the WC was negatively correlated to HDL-c (r = -0.41, p < 0.05) whereas the BMI is not associated with HDL-c (r = -0.34, p > 0.06). CONCLUSION: Our findings showed that WC is a better predictor of changes in HDL-c than BMI.

Bioelectric impedance overestimates the body fat in overweight and underestimates in Brazilian obese women: a comparison with Segal equation 1.

INTRODUCTION: Overweight and obesity are risk factors to appearance of cardiovascular diseases and anthropometry is important as clinical tool for planning and health policymaking at population level. Thus, aim of this work was to compare the simple body fat percentage (%BF) obtained straight by bioeletric impedance (BIA) to the one obtained by the equation of Segal et al (1988), which uses the BIA resistance value, overweight among adult women. METHODS: This study conducted with 86 adult women (50.5±11.0 years old). Body weight and height were measured and estimated the body mass index (BMI). %BF was assessed by BIA (Biodynamics® model 450) and Segal equation. RESULTS: %BF derived from BIA (38.0±4.6%) and Segal et al (1988) (38.7±8.1%) were similar (p=0.85). However, when the women were distributed, in two groups based on their BMI, overweight (n=40; BMI=27.3±1.2 kg/m²) and obesity (n=46; BMI= 36.2±5.1 kg/m²), the two methods presented results significant different (p=0.000). The %BF of overweight women was 34.6±3.6% by BIA and 30.3±2.1% when estimated by Segal equation. In obese women, the %BF was 41.0±3.0% and 46.0±2.6%, respectively. CONCLUSION: BIA overestimated %BF in overweight (+14.2%; +3.0 kg) and underestimated in obese (-10.9%;-4.4 kg) women.