Sarcopenia risk, sarcopenia-related quality of life, and associated factors in people living with human immunodeficiency virus (HIV): A web-based survey.

OBJECTIVES: We aimed to screen for the risk of sarcopenia and sarcopenia-related quality of life and associated factors of people living with HIV (PLWH). RESEARCH METHODS AND PROCEDURES: This nonprobabilistic web-based survey evaluated PLWH. The participants were invited directly from a university-based inpatient clinic and responded to a web questionnaire that included the SARC-F and SarQoL to screen people at risk of sarcopenia and their quality of life. People at risk of sarcopenia were defined by the proposed cutoff points for SARC-F (≥ 4 points), and SarQoL overall score was categorized according to the median. Moreover, we performed a logistic regression to investigate associations between HIV-, lifestyle-, and health-associated factors (i.e., physical activity, dietary pattern, sleep quality, gastrointestinal symptoms, HIV diagnosis, type, combinations, and duration of ART, smoking, drinking, BMI, and weight loss), and outcomes (SARC-F and SarQoL). RESULTS: The sample comprised 202 PLWH, mainly middle-aged (50.6-60.5 y; n = 101). Only 5.9% (n = 12) are at risk of sarcopenia according to SARC-F, and only 17.3% (n = 35) exhibited lower sarcopenia-related quality of life according to SarQoL. In the multiple models, only the gastrointestinal symptoms increased the odds of sarcopenia risk (OR: 1.058; P = 0.01) and poor sarcopenia-associated quality of life (OR: 1.041; P = 0.013). CONCLUSIONS: We verified that only 5.9% and 17.3% of PLWH are at risk of sarcopenia and presented lower sarcopenia-related quality of life, respectively. Only the gastrointestinal symptoms were associated with a risk of sarcopenia and lower sarcopenia-related quality of life, without significant differences between age groups.

Evaluating the influence of ultra-processed food intake on associations between dietary indices with systemic inflammation in adulthood and old ages.

BACKGROUND & AIMS: Low-grade systemic inflammation (LGSI) is critical to developing many chronic diseases. In turn, it has been shown that the diet can modulate favorably or unfavorably the inflammatory status. Thus, evaluating the diet from appropriate approaches is fundamental; to do so, there are different proposals for dietary indexes. We aimed to: (i) investigate the association between three well-known dietary indexes and LGSI biomarkers; (ii) test these associations individually or in combination with an indicator of ultra-processed foods (UFPs) intake. (iii) as an additional aim, hypothesizing that all the indexes should be capable of identifying the inflammatory potential of diet, we tested the hypothesis that these indexes agree and correlate with each other. METHODS: Cross-sectional population-based data of adults and older persons (n = 583). Dietary data were obtained through two non-consecutive 24-h dietary recalls (24HDR) and calculated for Dietary Inflammatory Index (DII), Mediterranean-Style Dietary Pattern Score (MSDPS); Brazilian Healthy Eating Index - Revised (BHEI-R) and energy ingested from UPFs (UPFs ratio). An LGSI score was created from some plasma inflammatory biomarkers [C-Reactive Protein (CRP), tumor necrosis factor-alpha (TNF-α), and adiponectin]. Logistic and linear regression models tested the associations between dietary indexes and LGSI score. RESULTS: The MSDPS and DII were significantly associated with our inflammatory score, but the BHEI-R did not. Including UPFs in regression models did not increase the strength of these associations. CONCLUSIONS: From the three scores, the dietary inflammatory index and the Mediterranean-style dietary pattern score (MSDPS) were the ones that showed significant association with the inflammatory biomarker. The combination of the indexes with a ratio of UPF intake did not increase the significance of our analyses. The best agreement between the indexes was found between MSDPS and UPFs ratio; the only pair of indexes considered concordant and correlated was the BHEI-R and DII.

Gut microbiota disturbances in hospitalized older adults with malnutrition and clinical outcomes.

OBJECTIVE: Malnutrition is one of the most threatening conditions in geriatric populations. The gut microbiota has an important role in the host's metabolic and muscular health: however, its interplay with disease-related malnutrition is not well understood. We aimed to identify the association of malnutrition with the gut microbiota and predict clinical outcomes in hospitalized acutely ill older adults. METHODS: We performed a secondary longitudinal analysis in 108 geriatric patients from a prospective cohort evaluated at admission and 72 h of hospitalization. We collected clinical, demographic, nutritional, and 16S rRNA gene-sequenced gut microbiota data. Microbiota diversity, overall composition, and differential abundance were calculated and compared between patients with and without malnutrition. Microbiota features associated with malnutrition were used to predict clinical outcomes. RESULTS: Patients with malnutrition (51%) had a different microbiota composition compared to those who were well-nourished during hospitalization (ANOSIM R = 0.079, P = 0.003). Patients with severe malnutrition showed poorer α-diversity at admission (Shannon P = 0.012, Simpson P = 0.018) and follow-up (Shannon P = 0.023, Chao1 P = 0.008). Differential abundance of Lachnospiraceae NK4A136 group, Subdoligranulum, and Faecalibacterium prausnitzii were significantly lower and inversely associated with malnutrition, while Corynebacterium, Ruminococcaceae Incertae Sedis, and Fusobacterium were significantly increased and positively associated with malnutrition. Corynebacterium, Ruminococcaceae Incertae Sedis, and the overall composition were important predictors of critical care in patients with malnutrition during hospitalization. CONCLUSION: Older adults with malnutrition, especially in a severe stage, may be subject to substantial gut microbial disturbances during hospitalization. The gut microbiota profile of patients with malnutrition might help us to predict worse clinical outcomes.

Comparison and convergent validity of five Mediterranean dietary indexes applied to Brazilian adults and older adults: data from a population-based study (2015 ISA-Nutrition).

Different dietary indexes are proposed to investigate adherence to the Mediterranean diet (MD). However, they are based on different methodologies, and limited research has compared them to each other, particularly in non-Mediterranean populations. We aimed to compare five indexes intended to measure adherence to the MD. The sample was composed of adults and older adults (n 1187) from 2015 ISA-Nutrition, a cross-sectional population-based study in São Paulo, SP, Brazil. Dietary data obtained through two 24-h dietary recalls (24HDR) from which the Mediterranean diet scale (MDS), Mediterranean diet Score (MedDietscore), Mediterranean dietary pattern (MDP), Mediterranean Adequacy Index (MAI) and Mediterranean-Style Dietary Pattern Score (MSDPS) were calculated. The correlations and agreements between them were analysed by Spearman's correlation and linearly weighted Cohen's Kappa coefficients, respectively. Confirmatory factor analyses (CFAs) were applied to investigate their convergent validity. The highest correlations were found between MDP and MAI (r = 0⋅76; 95% CI 0⋅74-0⋅79) and between MDP and MDS (r = 0⋅72; 95% CI 0⋅69-0⋅75). The greatest agreements observed were moderate, between MDP v. MAI (κ = 0⋅57, P < 0⋅001) and MDP v. MDS (κ = 0⋅48, P < 0⋅001). The goodness-of-fit of CFA for MedDietscore (RMSEA = 0⋅033, 90% CI 0⋅02-0⋅042; SRMR = 0⋅042) and MSDPS (RMSEA = 0⋅028, 90% CI 0⋅019-0⋅037; SRMR = 0⋅031) had acceptable values for absolute fit indices. Vegetables, olive oil, MUFA:SFA ratio and cereals with legumes were more relevant to characterise the MD (factor loadings ≥0⋅50). The MDS, MAI and MDP classified the population similarly, but the MedDietscore showed better performances in evaluating adherence to the MD. These results provided guidance for the most appropriate Mediterranean dietary index to be applied in non-Mediterranean populations.

Exercise prevents the effects of experimental arthritis on the metabolism and function of immune cells.

Active lymphocytes (LY) and macrophages (MPhi) are involved in the pathophysiology of rheumatoid arthritis (RA). Due to its anti-inflammatory effect, physical exercise may be beneficial in RA by acting on the immune system (IS). Thus, female Wistar rats with type II collagen-induced arthritis (CIA) were submitted to swimming training (6 weeks, 5 days/week, 60 min/day) and some biochemical and immune parameters, such as the metabolism of glucose and glutamine and function of LY and MPhi, were evaluated. In addition, plasma levels of some hormones and of interleukin-2 (IL-2) were also determined. Results demonstrate that CIA increased lymphocyte proliferation (1.9- and 1.7-fold, respectively, in response to concanavalin A (ConA) and lipopolysaccharide (LPS)), as well as macrophage H(2)O(2) production (1.6-fold), in comparison to control. Exercise training prevented the activation of immune cells, induced by CIA, and established a pattern of substrate utilization similar to that described as normal for these cells. Exercise also promoted an elevation of plasma levels of corticosterone (22.2%), progesterone (1.7-fold) and IL-2 (2.6-fold). Our data suggest that chronic exercise is able to counterbalance the effects of CIA on cells of the IS, reinforcing the proposal that the benefits of exercise may not be restricted to aerobic capacity and/or strength improvement.

Fruit and vegetable intake, physical activity, and depressive symptoms in the African American Health (AAH) study.

BACKGROUND: Healthy diet and physical activity (PA) have been associated with reduced depressive symptoms, but few studies have examined them simultaneously in African Americans. AIMS: To investigate fruit and vegetable intake (FVI) and PA as predictors of clinically-relevant levels of depressive symptoms (CRLDS) in African Americans. METHODS: African American Health (AAH) is a population-based longitudinal study of African Americans in St. Louis, MO, who were born in 1936-1950 (inclusive) and empaneled in 2000-01 (wave 1). At wave 8, participants self-reported fruit and vegetable intake (FVI) and completed the Yale Physical Activity Scale. At both waves 8 and 10, the CES-D 11-item scale was used to identify those who met criteria for CRLDS. Sequential logistic regression modeling was used to examine the associations of components of FVI/PA with CRLDS, both cross-sectionally (n = 680, including imputed values) and longitudinally (n = 582, including imputed values). Modeling employed gender, age, perceived income adequacy, and education as potential confounders. RESULTS: Cross-sectionally, vigorous PA, and leisurely walking PA, were independently associated with lower odds of CRLDS in all but the fifth model and green vegetables in all models. Longitudinally, green vegetables and interactions between the FVI summary score, the PA summary score, and other factors at wave 8 were most consistently associated with CRLDS at wave 10. In both cross-sectional and longitudinal models, the socioeconomic variables showed the strongest association as risk factors for CRLDS. LIMITATIONS: Both FVI and PA were self-reported rather than observed, our cohort had limited geographic- and age-ranges, and confidence intervals for some results were broad. CONCLUSIONS: Green vegetables, total FVI, and various aspects of PA showed protective effects regarding CRLDS. Therefore, the promotion of such lifestyles is likely to help prevent CRLDS in this population.

Sarcopenia and the analysis of body composition.

Reduction of lean mass is a primary body composition change associated with aging. Because many factors contribute to lean mass reduction, the problem has been given various names depending on the proposed cause, such as "age-related sarcopenia," "dynapenia," "myopenia," "sarcopenic obesity," or simply "sarcopenia." There is currently no consensus on how to best diagnose the reduction of lean mass and its consequences on health. We propose that simple body composition methods can be used to indirectly evaluate sarcopenia, provided that those techniques are validated against the "quality of lean" criterion that associates muscle mass and metabolic function with the components of fat-free mass. Promising field methods include the use of stable isotopes for the evaluation of water compartments and new approaches to bioelectrical impedance analysis, which is also associated with the monitoring of water homeostasis.

Comparação entre o estado nutricional de mulheres idosas e mulheres jovens: relação com a leptina e o IGF-I / Comparison of nutritional status between young and elderly women: relation with leptin and IGF-I

Objetivos: comparar, entre mulheres idosas e mulheres jovens, o estado nutricional a partir de variáveis antropométricas, dietéticas e bioquímicas, buscando relação com as concentrações plasmáticas de leptina e IGF-I. Métodos: 18 mulheres voluntariamente recrutadas foram distribuídas em dois grupos: I= idosas (mais de 60 anos, n=10) e J= jovens (entre 20-30anos, n=8). Foram avaliados: índice de massa corporal (IMC), circunferência de cintura (CC) e composição corporal (massa gorda e massa livre de gordura) por bioimpedância elétrica; três diários alimentares calculados quantitativamente em energia, macronutrientes e colesterol; concentrações plasmáticas de glicose, lipídeos, albumina, leptina e IGF-I. Resultados: O grupo I apresentou maiores valores de IMC, CC, percentual de gordura corporal e concentração plasmática de leptina e lipoproteínas de baixa densidade. O grupo J apresentou maiores valores para as concentrações plasmáticas de IGF-I e para o percentual de massa magra. A leptina correlacionou-se positiva e significativamente com a massa gorda e com a CC na análise do grupo todo. Após o ajuste da leptina pela massa gorda, não foram observadas diferenças entre os grupos. Após o ajuste do IGF-I pela massa livre de gordura, o grupo J apresentou maiores valores. As concentrações plasmáticas de albumina e de glicose apresentaram-se dentro da normalidade e sem diferenças entre os grupos. Conclusões: as concentrações de leptina são mais elevadas em mulheres idosas, proporcionalmente ao aumento da massa gorda, em especial a gordura visceral. Foi possível identificar relação entre leptina, eixo somatotrófico, e metabolismo hepático de lipoproteínas. O balanço energético foi negativo para ambos os grupos, porém não foram identificados desvios no estado nutricional, o que pode indicar subnotificação de relatos alimentares e supernotificação de atividade física.

Aim: to compare nutritional status between old and young women, from anthropometric, dietetic and biochemical variables, looking for relation with leptin and IGF-Iconcentration. Methods: 18 voluntary women were distributed in two groups: -more than 60 yearsold (n=10), named “old” (O); - between 20-30 years (n=8), named “young” (Y). They were evaluated:body mass index (BMI), waist circumference (WC) and body composition by bioelectric impedance (fat mass and fat free mass); diet evaluation by three food diary calculated by energy, macronutrients and cholesterol; plasmatic concentration of lipids, glucose, albumin, leptin and IGF-I. Results: “O”group presented higher values from BMI, WC, percent body fat, leptin levels and low density lipoproteins. “Y” group presented higher values from IGF-I and percent lean body mass. Leptin correlated positive and significantly with fat mass and WC, when analyzed for all individuals. After adjustment of leptin for body fat, there were not significant differences between groups. After adjustment of IGF-I by body lean mass, “Y” presented higher values. Conclusions: leptin levels are higher in old women, proportional to an increase in body fat, specifically visceral fat. It was possible to identify a relation among leptin, somatotrophic axis and liver lipoprotein metabolism. Energetic balance was negative for all the subjects without any deviation in nutritional status; its hould be due to underreporting of food ingestion and overreporting of physical activity.