Sarcopenic obesity can be negatively associated with active physical activity and adequate intake of some nutrients in Korean elderly: Findings from the Korea National Health and Nutrition Examination Survey (2008-2011)원문보기논문타임라인
BACKGROUND/OBJECTIVES: The aim of this study was to analyze the factors related to sarcopenic obesity among the elderly in South Korea. SUBJECTS/METHODS: A total of 3,367 elderly (${\geq}65years$) from the Korea National Health and Nutrition Examination Survey (2008-2011) were included in...
BACKGROUND/OBJECTIVES: The aim of this study was to analyze the factors related to sarcopenic obesity among the elderly in South Korea. SUBJECTS/METHODS: A total of 3,367 elderly (${\geq}65years$) from the Korea National Health and Nutrition Examination Survey (2008-2011) were included in this analysis. The subjects were assessed to determine their sarcopenia and obesity status. Sarcopenia was assessed by determining their appendicular skeletal muscle mass (ASM). Obesity was defined by the waist circumference. An association of sarcopenic obesity and the related factors was analyzed using multiple logistic regression models. RESULTS: The risk of sarcopenic obesity of the subjects was decreased by active physical activity. After adjusting for age, smoking, and alcohol consumption, the risk of sarcopenic obesity in men of the highest level group (Q4) decreased by 45% (OR = 0.550, 95% CI = 0.334-0.905, P trend 0.018) compared to that in the reference group (Q1). Among the women, the risk of sarcopenic obesity in the Q3 and Q4 groups decreased by 29.0% (OR = 0.710, 95% CI = 0.512-0,984) and 56.7% (OR = 0.433, 95% CI = 0.281-0.668), respectively, compared to that in the Q1 group (P trend < 0.001). The mean daily energy intake was higher in the non-sarcopenia group than in the sarcopenia group. The risk of sarcopenic obesity in subjects not meeting the recommended intakes of energy, riboflavin, and vitamin C increased significantly by 25.4%, and 36.6%, and 32.6%, respectively, compared to that in the subjects meeting the recommended nutrient intake. CONCLUSION: Active physical activity as well as an adequate intake of energy and some vitamins might be negatively associated with the development of sarcopenia and sarcopenic obesity in the elderly.
BACKGROUND/OBJECTIVES: The aim of this study was to analyze the factors related to sarcopenic obesity among the elderly in South Korea. SUBJECTS/METHODS: A total of 3,367 elderly (${\geq}65years$) from the Korea National Health and Nutrition Examination Survey (2008-2011) were included in this analysis. The subjects were assessed to determine their sarcopenia and obesity status. Sarcopenia was assessed by determining their appendicular skeletal muscle mass (ASM). Obesity was defined by the waist circumference. An association of sarcopenic obesity and the related factors was analyzed using multiple logistic regression models. RESULTS: The risk of sarcopenic obesity of the subjects was decreased by active physical activity. After adjusting for age, smoking, and alcohol consumption, the risk of sarcopenic obesity in men of the highest level group (Q4) decreased by 45% (OR = 0.550, 95% CI = 0.334-0.905, P trend 0.018) compared to that in the reference group (Q1). Among the women, the risk of sarcopenic obesity in the Q3 and Q4 groups decreased by 29.0% (OR = 0.710, 95% CI = 0.512-0,984) and 56.7% (OR = 0.433, 95% CI = 0.281-0.668), respectively, compared to that in the Q1 group (P trend < 0.001). The mean daily energy intake was higher in the non-sarcopenia group than in the sarcopenia group. The risk of sarcopenic obesity in subjects not meeting the recommended intakes of energy, riboflavin, and vitamin C increased significantly by 25.4%, and 36.6%, and 32.6%, respectively, compared to that in the subjects meeting the recommended nutrient intake. CONCLUSION: Active physical activity as well as an adequate intake of energy and some vitamins might be negatively associated with the development of sarcopenia and sarcopenic obesity in the elderly.
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제안 방법
All analyses were extracted by stratified cluster sampling, and the standard plots and weights were used so that the data used in this study would represent the Korean people using the data analysis method of complex sampling. To compare the general characteristics of the sarcopenia and non-sarcopenia groups, chi-squares and Student’s t-tests were used to analyze the categorical variables and continuous variables, respectively.
In this study, the nutrient intake of elderly subjects was analyzed using the food consumption data from a 24-hour recall. Bathalon et al.
[20] was used to diagnose sarcopenia in this study. The appendicular skeletal muscle mass (ASM) was calculated by subtracting the weight of bone and fat from the weight of the limbs based on the DXA results. After converting the ASM (kg) to ASM/body weight x 100, the subjects were diagnosed as being sarcopenic when their ASM estimate was less than one standard deviation below the gender-specific mean ASM for healthy young adults.
The physical activity levels of each group of subjects were divided into quartiles based on the metabolic equivalent of a task (MET) measured in minutes per week (MET-min/week): low, mid-low, mid-high, and high, as summarized in Table 4. Significant differences in MET levels in both the non-obese and obese men were observed between the sarcopenia and non-sarcopenia groups (P = 0.
The subjects in the present study completed the KNHANES diagnostic surveys regarding their bone density and body fat, which are required to calculate the muscle mass. The number of potential participants was 6370; however, 3003 of those were excluded from participation because they did not provide dual-energy X-ray absorptiometry (DXA), dietary intake, or blood biochemical data.
The subjects were divided into four groups: obese, sarcopenic obese, non-obese, and sarcopenic non-obese. Table 1 lists the general characteristics and physical measurements of each group.
The parameters related to physical activity of the subjects included vigorous physical activity, moderate physical activity, and walking. Vigorous physical activity of the subjects was reported if they answered ever having exercised vigorously for more than 10 minutes per session, 20 minutes per day, and 3 days per week. Moderate physical activity and walking practice rate of the subjects were reported if they answered ever having exercised moderately or having walked more than 10 minutes per session, 30 minutes per day, and 5 days per week, respectively.
대상 데이터
The target subjects in the present study were people aged 65 years and older who participated in the 4th and 5th KNHANES (2008-2011). KNHANES is a survey initiated in 1995 and was initially conducted every three years until it was changed to an annual survey system from the 4th period onward.
The number of potential participants was 6370; however, 3003 of those were excluded from participation because they did not provide dual-energy X-ray absorptiometry (DXA), dietary intake, or blood biochemical data. Therefore, the data obtained from 3,367 subjects were included in this study. The institutional Review Board (IRB) of the Korea Center for Disease Control and Prevention approved the KNHANES (IRB.
데이터처리
2) P-values from a Student’s t-test.
2) P-values from a t-test.
2) P-values from an ANOVA test.
To compare the general characteristics of the sarcopenia and non-sarcopenia groups, chi-squares and Student’s t-tests were used to analyze the categorical variables and continuous variables, respectively.
이론/모형
The dietary intake data of the subjects from a 24-h recall method were analyzed to estimate the energy and nutrient intakes. The dietary intake survey was conducted in a way that people trained by regular education have interviews with the subjects.
성능/효과
The appendicular skeletal muscle mass (ASM) was calculated by subtracting the weight of bone and fat from the weight of the limbs based on the DXA results. After converting the ASM (kg) to ASM/body weight x 100, the subjects were diagnosed as being sarcopenic when their ASM estimate was less than one standard deviation below the gender-specific mean ASM for healthy young adults. Obesity was defined as the presence of a waist circumference > 90 cm for men or > 85 cm for women subjects and was based on the obesity assessment of the Korean Society for the Study of Obesity (2012) [21].
041). For the models 1 and 2 results, there were significantly higher risks of sarcopenic obesity (32.6% increase; 95% CI =1.054-1.666; P = 0.016 and 30.2% increase; 95% CI = 1.032-1.642; P = 0.026, respectively) in the subjects not meeting the recommended vitamin C intake than in those meeting the level.
In conclusion, sarcopenia and sarcopenic obesity increase gradually with aging and are particularly important due to the recent acceleration of aging in the Korean population. Therefore, active participation in physical activity after individualized consideration of the physical activity level and exercise capacity of elderly subjects, as well as ensuring an adequate intake of energy and vitamins, such as vitamin C in the elderly, would help prevent sarcopenia and sarcopenic obesity.
Table 8 lists the odds ratio results of sarcopenic obesity according to the nutrient intake quartile. The energy intake results from model 2 (adjusted for gender, age, smoking, alcohol drinking, physical activity, and energy intake) showed that the risk of sarcopenic obesity was 27.5% lower in Q4 than in Q1(OR = 0.725, 95% CI = 0.529-0.993), but the risk reduction with increasing energy intake was not statistically significant (P for trend = 0.197). Regarding riboflavin, the risk of sarcopenic obesity was significantly lower in model 1 adjusted for gender and age (P trend = 0.
044). The model 1 result for riboflavin showed that the risk of sarcopenic obesity increased by 36.6% in the subjects not meeting the recommended riboflavin intake than the subjects meeting that level (95% CI = 1.012-1.843; P = 0.041). For the models 1 and 2 results, there were significantly higher risks of sarcopenic obesity (32.
In this study, data from the nationally representative KNHANES (2008-2011) were used to determine if physical activity and dietary intake can be associated with sarcopenic obesity among the elderly in South Korea. The results showed that a reduction of the sarcopenic obesity risk was associated with active participation in a physical activity and adequate intake of nutrients.
후속연구
The amount and types of the protein sources were not analyzed in the present study. Further study will be needed to examine the correlation between protein intake and muscle health. In addition, along with the aging effects on muscles, there is anabolic resistance in muscle synthesis from protein intake by foods [36].
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