Predictive Capability of 5 Sarcopenia Diagnostic Criteria for Fall Incidents in Older Japanese Women: The Otassha Study.

OBJECTIVES: The association between sarcopenia diagnosis according to various diagnostic criteria and falls is unclear. We examined the association between sarcopenia defined by 5 different international criteria, and fall and injurious fall numbers among older community-dwelling Japanese women. DESIGN: Prospective observational study. SETTING AND PARTICIPANTS: Two population-based cohort studies in Itabashi, Japan, were integrated, including 552 community-dwelling Japanese women >75 years of age. METHODS: Muscle mass, muscle strength, and physical performance were assessed by bioimpedance analysis, handgrip strength, and gait speed, respectively. We recorded the fall and injurious fall numbers for 1 year using a diary. The association between sarcopenia diagnosis defined by the Asian Working Group for Sarcopenia (AWGS) 2019, European Working Group on Sarcopenia in Older People 2, Foundation for the National Institutes of Health (FNIH), International Working Group on Sarcopenia, and Society on Sarcopenia, Cachexia, and Wasting Disorders, and fall numbers was assessed by Poisson regression analysis to estimate the incidence rate ratio (IRR) and 95% CI for the presence or absence of sarcopenia. RESULTS: Of 470 participants (mean age 77.1 ± 8.1 years), 144 reported a combined 352 falls. Overall, 80 individuals experienced a single fall, 64 experienced multiple falls, and 91 experienced injurious falls. Sarcopenia defined by the AWGS 2019 (IRR 1.39, 95% CI 1.10-1.76) and FNIH (IRR 2.55, 95% CI 1.99-3.26) was significantly associated with the number of falls. In addition, sarcopenia defined by the FNIH (IRR 2.72, 95% CI 1.84-4.03) was significantly associated also with the number of injurious falls. No significant association was observed between sarcopenia diagnosis based on the other definitions and fall outcomes. CONCLUSIONS AND IMPLICATIONS: The AWGS 2019 and FNIH sarcopenia definitions were associated with the fall and injurious fall numbers in older Japanese women, indicating they can help in predicting falls in this population.

ß-Hydroxy-ß-Methylbutyrate Supplementation May Not Enhance Additional Effects of Exercise on Muscle Quality in Older Women.

PURPOSE: The combined treatment effects of nutritional supplementation and exercise on muscle quality (MQ) remain unexamined in individuals at risk for sarcopenia. This secondary analysis aimed to test whether ß-hydroxy-ß-methylbutyrate (HMB) supplementation enhances the effects of resistance training (RT) on MQ in older women with low muscle mass. METHODS: This randomized, double-blind, placebo-controlled, two-by-two factorial design trial was conducted at the Tokyo Metropolitan Institute of Gerontology. Women age 65-79 yr with a skeletal muscle mass index of <5.7 kg·m-2 were randomly allocated to one of four arms (RT + HMB, RT + placebo, education + HMB, and education + placebo). Participants attended supervised RT sessions twice weekly or education programs every 2 wk and were provided calcium-HMB (1500 mg) or placebo supplements once daily for 12 wk. The main outcomes were changes in functional MQ, assessed by knee extension strength per quadriceps thickness, and compositional MQ, assessed by the echo intensity of the rectus femoris muscle. RESULTS: Overall, 156 and 149 participants completed baseline and follow-up assessments, respectively. Two-factorial analysis of variance showed no significant interaction of HMB supplementation with RT in terms of functional or compositional MQ. Main-effects analyses revealed that the decline in functional MQ of the group performing RT was smaller by 0.71 N·mm-1 (95% confidence interval, 0.11-1.31) compared with that in the education group. No significant main effects of RT or HMB supplementation on compositional MQ were observed. CONCLUSIONS: HMB supplementation did not enhance the treatment effects of RT for either MQ parameter; however, RT reduced the decline in functional MQ. Thus, adding HMB supplementation to RT is not significantly useful for improving MQ in this population.

Effectiveness and Components of Web-Based Interventions on Weight Changes in Adults Who Were Overweight and Obese: A Systematic Review with Meta-Analyses.

Overweight and obesity have reached epidemic proportions worldwide. The COVID-19 pandemic resulted in an increased need for remote implementation of weight-loss interventions; therefore, the effectiveness of web-based interventions needed to be assessed. This study aimed to examine the effectiveness of web-based interventions and their potency in facilitating weight changes in adults who were overweight or obese. We searched PubMed and Ichu-shi Web from the first year of inclusion in each database until the search date (30 September 2020). Among 1466 articles retrieved from the two databases and manual search, 97 were selected to undergo qualitative analysis and 51 articles were subjected to quantitative analysis. Qualitative analysis of 97 articles demonstrated that articles showing significant effectiveness mostly used the following components: social support, self-monitoring for behavior, self-monitoring for the outcome (weight), behavioral goal setting, information about health consequences, and outcome goal setting. Quantitative analysis of 51 articles showed a significant effectiveness of web-based intervention (standardized mean difference, -0.57; 95% confidence interval, -0.75 to -0.40). This study demonstrated the effectiveness of web-based interventions on weight change in adults with overweight and obesity. Subgroup meta-analyses identified personalized information provision and expert advice to be remarkably effective components.

Effects of exercise and/or ß-hydroxy-ß-methylbutyrate supplementation on muscle mass, muscle strength, and physical performance in older women with low muscle mass: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: The interaction between exercise and nutritional supplementation is unclear among older adults at risk of sarcopenia. OBJECTIVES: We aimed to examine if ß-hydroxy-ß-methylbutyrate (HMB) supplementation enhances the effects of exercise on muscle mass, strength, and physical performance and observe potential residual effects in older women with low muscle mass. METHODS: This 12-wk, randomized, double-blind, placebo-controlled, 2 × 2 factorial design (exercise-only, HMB-only, both, and none) trial included 156 women aged 65-79 y with skeletal muscle index <5.7 kg/m2, and was followed by a 12-wk observational period. Resistance training twice weekly or education programs every 2 wk and calcium-HMB (1500 mg) or placebo supplements daily were provided. The primary outcome was the change in muscle mass from baseline to postintervention. Secondary outcomes included changes in muscle strength and physical performance. RESULTS: In total, 149 and 144 participants completed the assessment at weeks 12 and 24, respectively. ANOVAs based on the intention-to-treat principle showed no significant interactions between exercise and HMB on any primary outcomes. The main-effect analyses revealed that exercise improved the usual and maximal gait speed by 0.16 m/s (95% CI: 0.10, 0.21 m/s) and 0.15 m/s (95% CI: 0.09, 0.22 m/s), respectively; the knee extensor and hip adductor strength by 22.0 N (95% CI: 10.1, 33.9 N) and 21.8 N (95% CI: 12.9, 30.7 N), respectively; and timed up-and-go and sit-to-stand time by -0.5 s (95% CI: -0.7, -0.3 s) and -1.7 s (95% CI: -2.1, -1.3 s), respectively, relative to education. HMB improved usual gait speed by 0.06 m/s (95% CI: 0.01, 0.11 m/s) relative to placebo. Most improvements disappeared during the subsequent 12-wk observation period. CONCLUSIONS: HMB additively improved gait performance with negligible benefit and provided no enhancements in the effects of exercise on other outcomes. Exercise appeared to be the only effective intervention to improve outcomes in older women with low muscle mass.This trial was registered at www.umin.ac.jp/ctr/as UMIN000028560.

Associations of Objectively Measured Physical Activity and Sleep with Weight Loss Maintenance: A Preliminary Study of Japanese Adults.

Maintaining weight loss is considerably more challenging than losing weight. Most previous studies on weight loss maintenance have been conducted in Western countries and have assessed physical activity and sleep with the use of questionnaires. This preliminary study investigated the associations of objectively measured physical activity and sleep with weight loss maintenance among 25 Japanese adults who had intentionally lost ≥ 10% of their original weight. Participants wore tri-axial accelerometers on their waists and sleep monitors on their wrists for two weeks to measure their physical activity and sleep, respectively. A linear regression adjusted for sex, age, maximum weight, and time since losing weight was performed to investigate these associations. Participants had a mean body mass index of 23.4 kg/m2 and a median weight loss of 12.5%. Compared to those who maintained < 12.5% weight loss, those who maintained ≥ 12.5% weight loss slept longer (adjusted mean difference: 66.1 min/night, 95% confidence interval (CI): -14.0, 146.3 min/night, p = 0.10) and performed less moderate-to-vigorous physical activity (adjusted mean difference: -21.7 min/day, 95% CI: -58.0, 14.5 min/day, p = 0.22). Though statistical power was limited, sleep behavior may be an important modifiable factor that facilitates weight loss maintenance. Our findings can be used to establish a well-designed study to confirm this association.

Effects of resistance training and/or beta-hydroxy-beta-methylbutyrate supplementation on muscle mass, muscle strength and physical performance in older women with reduced muscle mass: protocol for a randomised, double-blind, placebo-controlled trial.

INTRODUCTION: Resistance training (RT) and nutritional supplementation seem to have beneficial effects on muscle properties and physical performance in older adults. However, the reported effects of specific RT programmes and supplementation prescriptions vary among studies. The present study aims to examine the acute and residual effects of RT and/or beta-hydroxy-beta-methylbutyrate (HMB) supplementation on muscle mass, muscle strength and physical performance in older women with reduced muscle mass. METHODS AND ANALYSIS: This is a randomised, double-blind, placebo-controlled trial. Older women fitting the eligibility criteria were recruited in February 2018 from a population-based sample identified via screening conducted in October 2017. In March 2018, 156 participants were randomly allocated to undergo one of four interventions (RT + HMB, RT + placebo, education + HMB and education + placebo) for 12 weeks. Supervised RT consisted of body weight, elastic band, ankle weight and machine-based exercises two times per week at the Tokyo Metropolitan Institute of Gerontology (TMIG). Each participant ingested HMB (1200 mg) or placebo supplements once daily. Sessions of education not associated with sarcopenia treatment were conducted every 2 weeks. Post-intervention follow-up will be conducted for 12 weeks, until September 2018. The study includes assessments conducted in March (baseline), June (post-intervention) and September 2018 (follow-up). The primary outcome is the longitudinal change in muscle mass. Secondary outcomes include the longitudinal changes in muscle strength, physical performance, muscle thickness, muscle quality, blood counts, blood biochemistry, calf circumference, skin viscoelasticity, habitual dietary intake, habitual physical activity levels, functional capacity and health-related quality of life. Intention-to-treat analyses will be conducted. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee of the TMIG, Japan. The study is being conducted according to the principles of the Declaration of Helsinki. The findings will be presented at international academic congresses and published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER: UMIN000028560; Post-results.

Impact of Activity-Based Working and Height-Adjustable Desks on Physical Activity, Sedentary Behavior, and Space Utilization among Office Workers: A Natural Experiment.

It has been reported that office environment is an important determinant of physical activity (PA) and sedentary behavior (SB) in office workers. However, the effect of changes in office environment (office renovation) is unclear. The purpose of this study was to examine PA, SB, and space utilization changes among office workers in response to office renovation. This study was a natural experiment at three offices of a single company in Tokyo, Japan. The participants were, 13 workers from one office in the renovation group (mean age: 37.9 ± 10.8 years, percentage of females: 23.1%) and 29 from two offices in the control group (mean age: 42.3 ± 11.2 years, percentage of females: 31.0%). In the renovation, introduction of activity-based working (ABW) and installation of height-adjustable desks (HAD) were adopted. The ABW office was designed to provide various shared workstations, enabling the workers to choose workstations depending on their task or mood. Accelerometer measurement and object detection method using artificial intelligence (AI) technology for video images were used to assess behavior and space utilization before and after the renovation. Two weeks after the renovation, significant improvements in SB (pre- to post-renovation improvements: 346.8 ± 28.6 to 321.2 ± 17.8 min/working-hours) and PA (total PA: 173.2 ± 28.6 to 198.8 ± 17.8 min/working-hours; and light-intensity PA: 130.4 ± 27.1 to 150.7 ± 31.0 min/working-hours) were observed. In addition, the results of the object detection analysis showed that the central aisle of the office and shared HAD workstations near the entrance or window were utilized more frequently than the other spaces. This study suggested that office renovation could improve SB and PA immediately after the renovation. Moreover, utilized spaces and HAD workstations could play an important role to enhance employees' activity in an ABW office.

Professional dietary coaching within a group chat using a smartphone application for weight loss: a randomized controlled trial.

PURPOSE: To test the effectiveness of professional dietary coaching via group chat using a smartphone application (app) for weight loss. METHODS: This study was a 12-week, assessor-blind, parallel-group, waitlist-controlled randomized trial that included a 4-week follow-up period (trial registration, UMIN000025340). Data were collected between October 2016 and May 2017 and were analyzed between July 2017 and January 2018. Participants were 112 overweight, obese, or abdominally obese Japanese adults, aged 20 to 64 years, with at least one cardiometabolic risk factor. Participants were randomized to the coaching group (n=75) or control group (n=37), with a ratio of 2:1. The coaching group received a commercial weight loss program characterizing dietary coaching by a certified nutrition professional via group chat delivered on a smartphone app. Participants posted photos of every meal into the group chat, and the certified professional gave immediate direct feedback and encouragement. The primary outcome was an 8-week weight change. Secondary outcomes included 8-week changes in cardiometabolic risk factors. The frequency of meal photo uploads was recorded as a measure of adherence. RESULTS: Of the 112 randomized participants, 93 (83.0%) and 81 (72.3%) completed 8-week and 12-week visits, respectively. Intention-to-treat analysis demonstrated significantly larger 8-week weight loss in the coaching group (-1.4 kg; 95% confidence interval [CI]: -2.0, -0.8 kg) than that in the control group (-0.1 kg; 95% CI: -0.6, 0.4 kg). Significantly larger improvements in triglyceride and glycated hemoglobin A1c levels were also obtained in the coaching group. These benefits, except for the triglyceride level, were maintained until week 12. The frequent upload of meal photos was associated with a larger 8-week weight loss in a dose-response fashion (P-value for trend <0.001). CONCLUSION: This smartphone-delivered commercial weight loss program characterized as dietary coaching via group chat resulted in modest but significant weight loss. Facilitating participants' active involvement in the program is necessary to achieve greater health benefits.