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膳食模式和低蛋白摄入对高龄老人肌少症风险的影响:纽卡斯尔 85+研究。

Effects of dietary patterns and low protein intake on sarcopenia risk in the very old: The Newcastle 85+ study.

机构信息

AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, United Kingdom; NIHR Newcastle Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle Upon Tyne, United Kingdom; Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom.

Newcastle University Institute for Ageing, Newcastle Upon Tyne, United Kingdom; Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, United Kingdom; Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, United Kingdom.

出版信息

Clin Nutr. 2020 Jan;39(1):166-173. doi: 10.1016/j.clnu.2019.01.009. Epub 2019 Jan 21.

Abstract

BACKGROUND

Sarcopenia, a progressive age-related loss of skeletal muscle mass and strength, leads to disability, falls, and hospitalisation. Individual variation in sarcopenia onset may be partly explained by lifestyle factors such as physical activity and diet. Healthy dietary patterns (DPs) have been linked to better physical functioning in older adults, but their role in sarcopenia in the very old (aged ≥85) is unknown.

AIMS

To investigate the association between DPs and the risk of sarcopenia over 3 years, and to determine whether protein intake influences this relationship in community-dwelling older adults from the Newcastle 85 + Study.

METHODS

The analytic sample consisted of 757 participants (61.2% women) who had dietary assessment at baseline. After two-step clustering with 30 food groups to derive DPs, we used logistic regression to determine the risk of prevalent and incident sarcopenia across DPs in all participants, and in those with low (<1 g/kg adjusted body weight/day [g/kg aBW/d]) and good protein intake (≥1 g/kg aBW/d).

RESULTS

We identified three DPs (DP1: 'Low Red Meat', DP2: 'Traditional British' and DP3: 'Low Butter') that varied by unsaturated fat spreads/oils, butter, red meat, gravy and potato consumption. Compared with participants in DP3, those in DP2 had an increased risk of prevalent (OR = 2.42, 95% CI: 1.15-5.09, p = 0.02) but not 3-year incident sarcopenia (OR = 1.67, 0.59-4.67, p = 0.33) adjusted for socio-demographic, anthropometry, health and lifestyle factors. Furthermore, DP2 was associated with an increased risk of prevalent sarcopenia at baseline (OR = 2.14, 1.01-4.53, p = 0.05) and 3-year follow-up (OR = 5.45, 1.81-16.39, p = 0.003) after adjustment for key covariates in participants with good protein intake.

CONCLUSION

A DP high in foods characteristic of a traditional British diet (butter, red meat, gravy and potato) was associated with an increased risk of sarcopenia even when overall protein intake was good. The results need to be replicated in other cohorts of the very old to understand the role of DPs in sarcopenia onset and management.

摘要

背景

肌少症是一种与年龄相关的进行性骨骼肌质量和力量丧失,可导致残疾、跌倒和住院。肌少症发病的个体差异部分可以用生活方式因素来解释,如体力活动和饮食。健康的饮食模式(DP)与老年人更好的身体机能有关,但它们在非常高龄(≥85 岁)人群中的肌少症中的作用尚不清楚。

目的

研究 DP 与 3 年内肌少症风险的关系,并确定在纽卡斯尔 85+研究中,蛋白质摄入是否影响社区居住的高龄老年人中的这种关系。

方法

分析样本包括 757 名参与者(61.2%为女性),他们在基线时进行了饮食评估。通过 30 种食物组进行两步聚类得出 DP 后,我们使用逻辑回归来确定所有参与者以及蛋白质摄入量低(<1 g/kg 调整体重/天 [g/kg aBW/d])和高(≥1 g/kg aBW/d)的参与者中 DP 与肌少症的发病风险。

结果

我们确定了三种 DP(DP1:“低红肉”、DP2:“传统英国”和 DP3:“低黄油”),它们因不饱和脂肪涂抹/油、黄油、红肉、肉汁和土豆的摄入而有所不同。与 DP3 组相比,DP2 组肌少症发病风险增加(OR=2.42,95%CI:1.15-5.09,p=0.02),但 3 年肌少症发病风险无差异(OR=1.67,0.59-4.67,p=0.33),调整了社会人口统计学、人体测量学、健康和生活方式因素。此外,DP2 与基线时肌少症发病风险增加相关(OR=2.14,1.01-4.53,p=0.05)和 3 年随访时(OR=5.45,1.81-16.39,p=0.003),调整了蛋白质摄入量良好的参与者的关键协变量。

结论

富含传统英国饮食特征的食物(黄油、红肉、肉汁和土豆)的 DP 与肌少症发病风险增加有关,即使总体蛋白质摄入良好也是如此。需要在其他高龄人群队列中复制这些结果,以了解 DP 在肌少症发病和管理中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0b3/6961212/984eac14dd25/gr1.jpg

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