The document discusses sarcopenia, dynapenia, and sarcopenic obesity in aging adults and their impacts. It covers:
- Definitions of sarcopenia, dynapenia, and sarcopenic obesity
- Clinical outcomes like increased risk of disability from sarcopenia and metabolic consequences from sarcopenic obesity
- Treatments including weight loss through diet and exercise while preserving muscle mass, resistance exercise to increase strength and function, and adequate protein intake over 1g/kg daily to support muscle mass.
Abstract
Introduction: Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength associated with ageing. Regular exercise has been indicated to be the only strategy which consistently improves sarcopenia and physical function in elderly. The aims of this study are to review the mechanisms of sarcopenia and to evaluate the role of exercise in the elderly with sarcopenia and the current recommendations about the exercise interventions.
Discussion: Exercise significantly improve mobility, functionality, muscle mass, bone mineral density, balance and proprioception; thus, decreasing the risk of falls, increasing quality of life and reducing morbidity and mortality. Different types of exercise may be of interest in patients with sarcopenia: aerobic, progressive resistance, flexibility and balance training. Supervised or group exercise programs may be preferable for elders, with regard to both safety and compliance.
Conclusion: Sarcopenia is a strong predictor of disability, morbidity, and mortality in elderly. Anaerobic exercise seems to be the most important tool to prevent and treat sarcopenia.
The Challenges of Sarcopenia: Definition, Underlying Mechanisms, Intervention...InsideScientific
During this webinar, Drs. Peterson and Guralnik will discuss sarcopenia, the physiological mechanisms underlying the disease, and the current avenues of treatment and assessment that are being researched and developed for patients.
Sarcopenia is the age-related loss of muscle that causes decreased strength and functional limitations. Muscle loss occurs universally in people as we age, but some people lose muscle at an accelerated rate compared to others. While chronic disease can cause sarcopenia, it can also result from a sedentary lifestyle, hospitalizations and extended bed rest due to other conditions.
A gradual decline in muscle mass and strength begins around 30 years of age with this condition, and annual losses get larger throughout life. The self-reporting of functional difficulties to health care providers may give an indication that sarcopenia is present, but a more precise definition is needed for research and clinical use.
Efforts made in Europe and the US have used grip strength, gait speed and lean mass to define sarcopenia, but these definitions lead to large differences in prevalence rate and discordance in who is labelled as “sarcopenic”. To assess this condition, lean mass as measured by dual x-ray absorptiometry (DXA) may not accurately reflect actual muscle mass, but a new technique using dilution of deuterium-labelled creatine may prove to be superior in clinically diagnosing sarcopenia. Currently, a consensus has not been reached on the clinical outcome assessments that can be used by regulatory agencies to judge the effectiveness of drugs for sarcopenia.
A number of potential interventions are being explored to treat sarcopenia in older people, but no drugs are currently approved for this condition. The antidiabetic drug metformin shows promise in preventing many age-associated conditions, but appears to blunt the benefits of exercise on muscle. Senolytic drugs, which clear senescent cells, may improve muscle repair following injury preferentially in older individuals.
Abstract
Introduction: Sarcopenia is a progressive and generalized loss of skeletal muscle mass and strength associated with ageing. Regular exercise has been indicated to be the only strategy which consistently improves sarcopenia and physical function in elderly. The aims of this study are to review the mechanisms of sarcopenia and to evaluate the role of exercise in the elderly with sarcopenia and the current recommendations about the exercise interventions.
Discussion: Exercise significantly improve mobility, functionality, muscle mass, bone mineral density, balance and proprioception; thus, decreasing the risk of falls, increasing quality of life and reducing morbidity and mortality. Different types of exercise may be of interest in patients with sarcopenia: aerobic, progressive resistance, flexibility and balance training. Supervised or group exercise programs may be preferable for elders, with regard to both safety and compliance.
Conclusion: Sarcopenia is a strong predictor of disability, morbidity, and mortality in elderly. Anaerobic exercise seems to be the most important tool to prevent and treat sarcopenia.
The Challenges of Sarcopenia: Definition, Underlying Mechanisms, Intervention...InsideScientific
During this webinar, Drs. Peterson and Guralnik will discuss sarcopenia, the physiological mechanisms underlying the disease, and the current avenues of treatment and assessment that are being researched and developed for patients.
Sarcopenia is the age-related loss of muscle that causes decreased strength and functional limitations. Muscle loss occurs universally in people as we age, but some people lose muscle at an accelerated rate compared to others. While chronic disease can cause sarcopenia, it can also result from a sedentary lifestyle, hospitalizations and extended bed rest due to other conditions.
A gradual decline in muscle mass and strength begins around 30 years of age with this condition, and annual losses get larger throughout life. The self-reporting of functional difficulties to health care providers may give an indication that sarcopenia is present, but a more precise definition is needed for research and clinical use.
Efforts made in Europe and the US have used grip strength, gait speed and lean mass to define sarcopenia, but these definitions lead to large differences in prevalence rate and discordance in who is labelled as “sarcopenic”. To assess this condition, lean mass as measured by dual x-ray absorptiometry (DXA) may not accurately reflect actual muscle mass, but a new technique using dilution of deuterium-labelled creatine may prove to be superior in clinically diagnosing sarcopenia. Currently, a consensus has not been reached on the clinical outcome assessments that can be used by regulatory agencies to judge the effectiveness of drugs for sarcopenia.
A number of potential interventions are being explored to treat sarcopenia in older people, but no drugs are currently approved for this condition. The antidiabetic drug metformin shows promise in preventing many age-associated conditions, but appears to blunt the benefits of exercise on muscle. Senolytic drugs, which clear senescent cells, may improve muscle repair following injury preferentially in older individuals.
Kate Ward's presentation from Osteoporosis 2016: Relationships between muscle function and bone microarchitecture in the Hertfordshire cohort study.
Find out more at: https://nos.org.uk/conference
What happens as athletes age? The physiological changes are important to note, so that training, recovery and overal healthcare can adapt to maximize the athlete's performance year after year. Dr. David Carfagno offers a unique insider's perspective, as a practitioner of sports medicine, internal medicine and a competitive athlete.
Kate Ward's presentation from Osteoporosis 2016: Relationships between muscle function and bone microarchitecture in the Hertfordshire cohort study.
Find out more at: https://nos.org.uk/conference
What happens as athletes age? The physiological changes are important to note, so that training, recovery and overal healthcare can adapt to maximize the athlete's performance year after year. Dr. David Carfagno offers a unique insider's perspective, as a practitioner of sports medicine, internal medicine and a competitive athlete.
MYOPATHIES A SPECIAL AND SEPERATE ENTITY WITH SPECIFIC FEATURES IN EACH DISORDER MAKING US EASY FOR DIAGNOSIS,CONFIRMATION BY MUSCLE BIOPSY.THE SEMINAR WAS PRSENTED ON 06/07/2011...AT 09.00AM
HAVE A LOOK ..AND COMMENT..WITHOUT BIAS..
The muscle are biological motors which convert chemical energy into force and mechanical work.
This biological machinery is composed of proteins – which is actomyosin and the fuel is ATP.
With the use of muscles we are able to act on our environment.
Physical Activity in the Management of Abdominal ObesityMy Healthy Waist
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29Oct14 - ILC Global Alliance Ageing and Mobility SymposiumILC- UK
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This event took place as part of the ILC Global Alliance visit to the UK.
Speakers at the event included:
Rosy Pereyra – ILC-Dominican Republic: Sarcopenia: A forgotten cause of mobility problems in old age
Susana Concordo Harding – ILC-Singapore: Are we living longer and healthier? Exploring gender differences in health expectancy among older Singaporeans
Sebastiana Kalula – ILC-South Africa: Prevalence and risks factors for falls, and the impact on mobility in later life: The Cape Town study
Didier Halimi – ILC-France: MOBILAGE: how to maintain frail people mobility? An ongoing experiment at Broca Hospital in Paris.
Kunio Mizuta – ILC-Japan: Long-term care prevention in Japan: To maintain older people’s mobility
Lia Daichman – ILC-Argentina: Loss of mobility, loss of Autonomy, loss of quality of life
Iva Holmerová – ILC-Czech Republic: Local and national initiatives to support active ageing and improve quality of long-term care in the Czech Republic.
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Trials were organized according to the kind of nutrition intervention, dietary guidance, food supplement, and multimodal therapies are given to participants in the experimental arm.
For #Enquiry:
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Physical Fitness for Elderly of a University Project Participants, Practitioners of Weight and Welcoming House Residents by Lidiane Requia Alli Feldmann in Geriatrics Studies Journal
Nutritional Interventional trials in muscle and cachexia PhD research directi...PhD Assistance
Trials were organized according to the kind of nutrition intervention, dietary guidance, food supplement, and multimodal therapies are given to participants in the experimental arm.
For #Enquiry:
Website: https://www.phdassistance.com/blog/nutritional-interventional-trials-in-muscle-and-cachexia/
India: +91 91769 66446
Email: info@phdassistance.com
Nutritional Practices & Habits of Boomer Consumers: Why Active Snacking is the Most Effective Method of Nutritional Supplementation. Nutritional tools to minimize age accelerators and enhance an active and healthy functional lifestyle.
View more at http://www.GoBeneVia.com/blog
Physical Activity during Pregnancy and the Effect on Mothers and Fet.docxmattjtoni51554
Physical Activity during Pregnancy and the Effect on Mothers and Fetal Health
Abstract
1.2 Introduction:
Physical activity is an essential role that all people should engaged, aerobic and muscle strength exercises are an easy to do where the benefits of it are great, prevention, treatment of disease and keeping fit in all stage of life even in pregnancy period and this exercises can be modify to suit physical condition of the pregnant womens
Pregnancy is a blessing from Allah that every woman wishes. Pregnancy it’s condition that many changes it happened on women bodies from the day of fertilization to the day after delivery of the baby and the popular effect in women bodies it’s the increment of body weight, as it's known that many women they didn’t control them weight and they become overweight or obese, in this condition the pregnant woman she will be in danger, many diseases start with increase of the body weight and it may lead to a serious health problems. Without controlling the body weight increment, woman with a normal weight it may become an overweight or even obese.
In general overweight and obesity one of prevalence public issue that affect many countries in the world where it’s observe in all ages, adults, adolescents, and children it maybe became a global epidemic , the impact of this issue has a strong relationship with mortality and morbidity also this relationship have been known for more than 2000 between health professionals[1-2]. body mass index (BMI) is the way that give a right measurement for the total body fat compare with body weight, the method for calculation by determining the body weight in kilogram and divide it by height in meter squared, this way determine the degree of overweight easy with a reliable number.
There are interventions that can control the body weight before pregnancy period, during pregnancy period and after it, but the most important intervention that we will cover it’s the physical activity or exercise and the advantages for this intervention on the mother health and the outcome also the disadvantages that it can happen if available.
Physical activity and exercise has a great impact on health status, where there are many study done to prove this relation. where health outcome in people with physical inactivity is a major problem in the world and specially in developed countries. In worldwide physical inactivity appear in a huge number where one out of every five adults is physically inactive and the long period of sitting independent show that is a risk factor for mortality[3]
The healthy body weight in pregnancy it depends on the body mass index (BMI) so the WHO classify the BMI into four categories underweight: <18.5 kg/m2, normal weight: 18.5-24.99 kg/m2, overweight: 25-29.9 kg/m2, and obese ≥30 kg/m2 [4-5]. With this category, recognizing every case will be easy and right grouping will be more accurate.
all pregnant women are included in all age and different country.
Delivered (Feb 2014) as part of 12th MDRF–UAB International Seminar on Prevention and control of non-communicable diseases organized by Madras Diabetes Research Foundation (MDRF), Chennai, India in association with Florida International University(FIU), University Of Alabama at Birmingham (UAB), & University Of Minnesota, Supported by National Institutes of Health (NIH), USA
Myths and legacy of exercisemedicine in chronic diseasesAnn Gates
London Sports and Exercise Medicine Presentation.
December 2015.
Copyright Exercise Works Ltd. All rights reserved.
Contact ann@exercise-works.org for permissions.
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Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
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Recognize different abnormalities of taste perception and their causes.
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Influence on behavior
Selection of food based on metabolic needs
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Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
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Taste Blindness:
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Dynapenia, Sarcopenia and Obesity: Clinical Impacts and Treatments
1. 2013-10-07
1
Dynapenia, Sarcopenia
and Obesity : Clinical
Impacts and Treatments
Isabelle J. Dionne, PhD
Faculté d’éducation physique et sportive
Université de Sherbrooke
Striking a Balance... Weigh in with Knowledge, Research, Practice
SYMPOSIUM
Ottawa Chapter - Diabetes Educator Sector, Canadian Diabetes
Association
Monday, September 30, 2013
OUTLINEOUTLINEOUTLINEOUTLINE
Body composition and aging
Sarcopenia and Dynapenia
Sarcopenic and dynapenic obesity
Clinical outcomes
- Dynapenic obesity and physical capacity
- Dynapenic obesity and metabolic consequences
Treatment
- Weight loss
- Exercise
- Protein intake
2. 2013-10-07
2
Body composition and
Aging
Sarcopenia
Dynapenia
Sarcopenic and Dynapenic Obesity
Striking a Balance... Weigh in with Knowledge, Research, Practice
SYMPOSIUM
Ottawa Chapter - Diabetes Educator Sector, Canadian Diabetes
Association
Monday, September 30, 2013
Body composition and aging
3. 2013-10-07
3
Gallagher et al., Am J Physiol Endocrinol Metab 2000.
Body composition changes inBody composition changes inBody composition changes inBody composition changes in agingagingagingaging
Sarcopenia
4. 2013-10-07
4
Baumgartner et al. Mech Ageing Dev, 1999
Sarcos Flesh
Penia Poverty
DefiningDefiningDefiningDefining sarcopeniasarcopeniasarcopeniasarcopenia
Janssen et al, 2004
Prevalence of sarcopenia
5. 2013-10-07
5
Narichi and Maffulli, Br Med Bull,
2010
Janssen I. Journal of the American
Geriatrics Society , 2006.
Figure 1. Cross-sectional analysis: Odds ratios for
disability according to baseline categories of muscle
mass. Longitudinal analysis: Hazard ratios for disability
according to baseline categories of muscle mass.
Severe sarcopenia is related with
increased risks for disability,
especially when examined cross-
sectionally.
DisabilityDisabilityDisabilityDisability and muscle massand muscle massand muscle massand muscle mass
6. 2013-10-07
6
Men Women Men Women
Quadricep strength Bicep strength
Maximal voluntary strength
14% 11% 28%40%
Beliaeff et al, JAPA 2008, 16(4), 484-493.
Age
Physical activity
Height
Body fat
Muscle mass
HoWHoWHoWHoW muchmuchmuchmuch of muscleof muscleof muscleof muscle strenthstrenthstrenthstrenth isisisis explainedexplainedexplainedexplained
by mass??by mass??by mass??by mass??
Dynapenia
9. 2013-10-07
9
CDC/NCHS, Health,
United States, 2008,
Figure 7. Data from the
National Health and
Nutrition Examination
Survey.
Bouchard DR et al., J Gerontol 2007
Body fat (%)
ASMI (kg/m2)
Age (yrs)
Physical activity
Chronic cond. (n)
Physical capacity
Walking speed
Balance
r=-0.61; p<.001
Hypothetical model for physical capacity in a
cohort of 437 older men.
10. 2013-10-07
10
How body composition
changes impact on
metabolic and functional
health
Metabolic Outcomes
Physical Capacity
Striking a Balance... Weigh in with Knowledge, Research, Practice
SYMPOSIUM
Ottawa Chapter - Diabetes Educator Sector, Canadian Diabetes
Association
Monday, September 30, 2013
Metabolic outcomes
11. 2013-10-07
11
« Sarcopenia and obesity alone were not sufficient to increase CVD risk.
Sarcopenic-obesity, based on muscle strength but not muscle mass, was
modestly associated with increased CVD risk. These findings imply that
strength may be more important than muscle mass for CVD protection in old
age. »
Stephen and Janssen, JNHA 2009
Hasard
ratio;
P=0.06
Muscle mass Strength
SarcopeniaSarcopeniaSarcopeniaSarcopenia and CVDand CVDand CVDand CVD
Karelis et al., Appl Physiol Nutr Metab, 2007
InsulinInsulinInsulinInsulin sensitivitysensitivitysensitivitysensitivity and muscleand muscleand muscleand muscle strengthstrengthstrengthstrength
12. 2013-10-07
12
Sayer et al., Diabetes care, 2005
MuscleMuscleMuscleMuscle StrengthStrengthStrengthStrength and type 2and type 2and type 2and type 2 diabetesdiabetesdiabetesdiabetes
statusstatusstatusstatus
Jurca R., Med Sci Sports Exerc, 2005
Incident rate ofIncident rate ofIncident rate ofIncident rate of metabolicmetabolicmetabolicmetabolic diseasesdiseasesdiseasesdiseases////yearyearyearyear
perperperper quatilesquatilesquatilesquatiles ofofofof muclemuclemuclemucle strengthstrengthstrengthstrength
13. 2013-10-07
13
Adapted from Sénéchal et al., 2012
Energy intake, lifestyle
behaviors, and age were all
similar between groups.
MetabolicMetabolicMetabolicMetabolic outcomesoutcomesoutcomesoutcomes basedbasedbasedbased onononon dynapeniadynapeniadynapeniadynapenia
andandandand obesityobesityobesityobesity statusesstatusesstatusesstatuses
Impact on physical capacity
14. 2013-10-07
14
Bouchard DR. et al, Obesity, 2009
PhysicalPhysicalPhysicalPhysical capacitycapacitycapacitycapacity,,,, sarcopeniasarcopeniasarcopeniasarcopenia andandandand
obesityobesityobesityobesity
Probability rate of a new mobility
disability (95% confidence intervals)
according to the combination of low
muscle strength and obesity among
persons aged 65–85 years.
Probabilities are adjusted to represent
a 74-year-old female.
Stenholm S., et al. Int J Obes, 2009.
PhysicalPhysicalPhysicalPhysical capacitycapacitycapacitycapacity,,,, strengthstrengthstrengthstrength andandandand ObesityObesityObesityObesity
15. 2013-10-07
15
Physicalcapacityimpairmeents
inthelowesttertileofmobility
Choquette et al, JNHA, 2010
PhysicalPhysicalPhysicalPhysical capacitycapacitycapacitycapacity and relativeand relativeand relativeand relative strengthstrengthstrengthstrength
Cesari M. et al, J Gerontol, 2009
SurvivalSurvivalSurvivalSurvival raterateraterate basedbasedbasedbased onononon sarcopeniasarcopeniasarcopeniasarcopenia orororor
slowslowslowslow walkingwalkingwalkingwalking andandandand obesityobesityobesityobesity
16. 2013-10-07
16
Bouchard and Janssen, J Gerontol., 2010
PhysicalPhysicalPhysicalPhysical functionfunctionfunctionfunction accordingaccordingaccordingaccording totototo ObesityObesityObesityObesity
andandandand DynapeniaDynapeniaDynapeniaDynapenia statusstatusstatusstatus
Treatment
Weight Loss
Exercise
Protein intake
Striking a Balance... Weigh in with Knowledge, Research, Practice
SYMPOSIUM
Ottawa Chapter - Diabetes Educator Sector, Canadian Diabetes
Association
Monday, September 30, 2013
17. 2013-10-07
17
Weight Loss
« The focus of treatment should be
on reduction of intra-abdominal fat
and preservation of muscle mass
and strength. »
18. 2013-10-07
18
Position Statement of the
American Society for Nutrition
and NAASO, The Obesity Society
“…weight-loss therapy that minimizes
muscle and bone losses is recommended for
older persons who are obese and who have
functional impairments or medical
complications that can benefit from weight
loss. “
Villareal et al, American Journal of Clinical Nutrition,
Vol. 82, No. 5, 923-934, 2005
Should weight loss be a goal??
It is not clear whether weight loss benefits longevity and
hence whether weight reduction is justified as a prime goal
for all older individuals who are overweight (BMI > 25
kg/m2).
Other aspects of a healthy lifestyle, especially exercise and
dietary quality, should be considered.
Further trial evidence is needed with regards to the effect of
weight loss with and without exercise on CVD risk, quality of
life and physical function, especially in the “older” older
adults.
Harrington, M. et al. (2009) Nutrition research reviews
Witham and Avenell (2010) Age and Ageing
19. 2013-10-07
19
Exercise
Increases strength
Decreases fat mass
Improves physical function
Physical
independence
Toth et al, MSSE, 1999;
Raguso et al, Clin Nutr, 2006;
Bouchard et al, Menopause, 2009;
Paterson and Warburton, Int J Behav Nutr Phys Act, 2010.
20. 2013-10-07
20
Hunter et al., 2004
AgingAgingAgingAging
vsvsvsvs
trainingtrainingtrainingtraining
◦ During the first weeks off
training, improvements are
mostly neurological
◦ Gains in strength are improved
without gains in muscle mass
McDonagh et al, 1983
ResistanceResistanceResistanceResistance traningtraningtraningtraning
22. 2013-10-07
22
Diet and exercise to improveDiet and exercise to improveDiet and exercise to improveDiet and exercise to improve
physical function in olderphysical function in olderphysical function in olderphysical function in older
adultsadultsadultsadults
* *
*
*
23. 2013-10-07
23
Protein intake
• Protein intake goes down with aging;
• Actual Recommended Daily Intake
(0,8 g/kg/d) have been suggested to be
insufficient (Wolfe et al, 2008);
• An intake of 1,25 g/kg/d has been
suggested as safe and optimal for
muscle mass maintenance (Wolfe et al,
2008).
• Our results show that protein intake
from healthy animal sources is the best
nutritional determinant of fat-free mass
in older adults (Lord et al., 2007).
ProteinProteinProteinProtein intakeintakeintakeintake andandandand AAAAgingginggingging
24. 2013-10-07
24
• Leucine appears to be the
main mediator in the
balance between protein
degradation and synthesis
(Katsanos et al, 2006);
• This may explain the
association between
animal protein intake and
muscle mass.
EssentialEssentialEssentialEssential AminoAminoAminoAmino
AcidsAcidsAcidsAcids
AnimalAnimalAnimalAnimal proteinsproteinsproteinsproteins, muscle, muscle, muscle, muscle functionfunctionfunctionfunction,,,,
and glucoseand glucoseand glucoseand glucose metabolisMmetabolisMmetabolisMmetabolisM
Maltais et al., IJNSM, 2011
25. 2013-10-07
25
Fiatarone, M.A. et al, 1994
+15g/d of proteins
ExerciseExerciseExerciseExercise XXXX proteinsproteinsproteinsproteins
Tieland et al, J Am Diet Ass, 2012
Prot. Suppl. 15g 2X day
ExerciseExerciseExerciseExercise XXXX proteinsproteinsproteinsproteins
26. 2013-10-07
26
Kukuljan et al., JAP, 2009
Resistance
exercise and
fortified milk on
muscle size
Timing?
Conclusion
Striking a Balance... Weigh in with Knowledge, Research, Practice
SYMPOSIUM
Ottawa Chapter - Diabetes Educator Sector, Canadian Diabetes
Association
Monday, September 30, 2013
27. 2013-10-07
27
…CONCLUSIONS
Losses in muscle strength have a
significant impact on metabolic
outcomes and physical capacity.
The presence of obesity exacerbates
these problems.
…CONCLUSIONS
Interventions aiming to counteract dynapenic obesity
should focus on resistance and aerobic training.
Weight loss may be considered if it includes an
exercise component.
Adequate protein intake is also
important.
Few questions remaining: Animal?
Milk? Timimg?