scholarly journals Dietary protein and exercise for preservation of lean mass and perspectives on type 2 diabetes prevention

2019 ◽  
Vol 244 (12) ◽  
pp. 992-1004
Author(s):  
Maysa Vieira de Sousa ◽  
Diana Bento da Silva Soares ◽  
Elaine Reis Caraça ◽  
Ronaldo Cardoso
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Dietary Protein ◽  
The Elderly ◽  
Sarcopenic Obesity ◽  
Nutritional Interventions

Sedentary lifestyle and aging favor the increasing prevalence of obesity and type 2 diabetes and their comorbidities. The loss of lean body mass reduces muscle strength, resulting in impaired functional capacity and leading to increased risks of chronic diseases with advancing age. Besides aging, conditions such as inappetence, social isolation, and inadequate dietary intake cause the loss of lean body mass and increased abdominal fatty mass, resulting in sarcopenic obesity and predisposition to type 2 diabetes. Compared to younger people, this condition is more common in the elderly owing to natural changes in body composition associated with aging. Lifestyle changes such as increased physical activity and improved dietary behaviors are effective for preventing the occurrence of comorbidities. Regarding muscle nutrition, besides caloric adequacy, meeting the requirements for the consumption of dietary amino acids and proteins is important for treating sarcopenia and sarcopenic obesity because muscle tissue mainly consists of proteins and is, therefore, the largest reservoir of amino acids in the body. Thus, this review discusses the effects of dietary protein on the preservation of lean body mass, improvements in the functional capacity of muscle tissue, and prevention of chronic diseases such as type 2 diabetes. In addition, we address the effects of regular physical training associated with dietary protein strategies on lean body mass, body fat loss, and muscle strength in the elderly at a risk for type 2 diabetes development. Impact statement Diabetes mellitus is a worldwide health problem associated with obesity and sedentary lifestyle, which predisposes affected individuals to mortality and morbidity. Additionally, aging and unhealthy lifestyle behaviors increase inflammation and insulin resistance, contributing to the reduction of cytokines related to muscle nutrition and the suppression of lipogenesis, resulting in the development of sarcopenic obesity. One strategy for the prevention of T2D is the avoidance of secondary aging by participating in healthy action programs, including exercise and nutritional interventions. This minireview of several studies demonstrates the impact of physical activity and nutritional interventions on gaining or preserving muscle mass and on the functional aspects of muscles with aging. It provides information on the effect of protein, leucine, β-hydroxy-β-methylbutyrate (HMB), and creatine supplementation on muscle mass, strength, and volume gain and on the prevention of the progressive decrease in muscle mass with aging in combination with maintaining regular physical activity.

scholarly journals Low Physical Activity in Patients with Complicated Type 2 Diabetes Mellitus Is Associated with Low Muscle Mass and Low Protein Intake

2020 ◽  
Vol 9 (10) ◽  
pp. 3104
Author(s):  
Ilse J. M. Hagedoorn ◽  
Niala den Braber ◽  
Milou M. Oosterwijk ◽  
Christina M. Gant ◽  
Gerjan Navis ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Muscle Mass ◽  
Dietary Protein ◽  
Protein Intake ◽  
Outcome Variable ◽  
Dietary Protein Intake ◽  
Cross Sectional ◽  
Creatinine Excretion

Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary protein intake, and PA. Methods: We performed cross-sectional analyses in all patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT) between November 2016 and November 2018. Patients were divided into four groups: <5000, 5000–6999, 7000–9999, ≥ 10,000 steps/day. We studied the association between muscle mass (24 h urinary creatinine excretion rate, CER) and protein intake (by Maroni formula), and the main outcome variable PA (steps/day, Fitbit Flex device) using multivariate linear regression analyses. Results: In the 217 included patients, the median steps/day were 6118 (4115–8638). Of these patients, 48 patients (22%) took 7000–9999 steps/day, 37 patients (17%) took ≥ 10,000 steps/day, and 78 patients (36%) took <5000 steps/day. Patients with <5000 steps/day had, in comparison to patients who took ≥10,000 steps/day, a higher body mass index (BMI) (33 ± 6 vs. 30 ± 5 kg/m2, p = 0.009), lower CER (11.7 ± 4.8 vs. 14.8 ± 3.8 mmol/24 h, p = 0.001), and lower protein intake (0.84 ± 0.29 vs. 1.08 ± 0.22 g/kg/day, p < 0.001). Both creatinine excretion (β = 0.26, p < 0.001) and dietary protein intake (β = 0.31, p < 0.001) were strongly associated with PA, which remained unchanged after adjustment for potential confounders. Conclusions: Prevalent insufficient protein intake and low muscle mass co-exist in obese patients with low physical activity. Dedicated intervention studies are needed to study the role of sufficient protein intake and physical activity in increasing or maintaining muscle mass in patients with type 2 diabetes.

DIABETES OR OBESITY; MAJOR EFFECTOR OF ALTERED LEVELS OF GHRELIN AND LEPTIN

2021 ◽  
pp. 55-59
Author(s):  
Lakshmi G.L ◽  
Shruti Dasgupta ◽  
Mohammed Salman ◽  
Sanjay K. R
Keyword(s):  
Type 2 Diabetes ◽  
Lean Body Mass ◽  
Body Mass ◽  
Fat Mass ◽  
Postprandial Glucose ◽  
Independent Effect ◽  
Mass Percentage ◽  
Obesity And Diabetes ◽  
Obese Subjects

Background: Ghrelin and leptin are the key hormones involved in the energy homeostasis and plays a relevant role in regulating hunger and satiety stimuli afferent to the brain. Abnormalities in the levels of ghrelin and leptin are often associated with the obesity and type 2 diabetes complications. However, there are no studies clarifying whether ghrelin and leptin levels have stronger association with obesity or Type 2 diabetes (T2DM). Aims:To evaluate and compare the independent effect of major dening factors of obesity and diabetes on ghrelin and leptin concentrations. Materials And Methods: Anthropometric measures such as height, weight, waist (WC) and hip circumference (HC), Body mass index (BMI), Basal metabolic rate (BMR), fat percentage, lean body mass, were taken. Assessed daily physical activity and energy intake. Biochemical parameters such as fasting glucose, postprandial glucose, HBA1c, ghrelin, leptin and insulin levels were measured. Statistical Analysis: One-way analysis of variance (ANOVA), Chi-square (χ2) test Pearson's correlation coefcients, Multiple stepwise linear regression model analysis were performed. Result: The diabetic subjects irrespective of obesity showed signicantly higher waist to hip ratio, HOMAIR levels of fasting blood glucose, postprandial glucose and signicantly lower levels of Ghrelin than non-diabetics. Similarly, obese subjects irrespective of diabetes have signicantly higher BMR and higher levels of Leptin than non-diabetics. Asignicantly higher BMI, fat mass percentage and lower lean body mass percentage were observed in obese subjects irrespective of diabetes than non-obese subjects. Among non-obese, diabetics have higher BMI, Fat mass percentage and lower lean body mass percentage. The levels of insulin were signicantly higher in diabetic obese subjects. HOMAIR (P≤0.0001) and Postprandial glucose (P≤0.05) showed negative independent effect and QUICKI (P≤0.0001) showed positive independent effect on the levels of ghrelin. BMI (P≤0.05) showed a positive effect and lean body mass percentage (P≤0.0001) showed an inverse effect on levels of leptin. Conclusion: It is evident from the study that low levels of ghrelin are predominantly associated with diabetes parameters when compared to parameters of obesity and on the contrary increased leptin levels have much stronger association with measures of obesity than diabetes. Evidence of altered leptin and ghrelin levels in these disorders infers vice versa, their respective roles in obesity and lean diabetes.

scholarly journals Role of Menopausal Transition and Physical Activity in Loss of Lean and Muscle Mass: A Follow-Up Study in Middle-Aged Finnish Women

2020 ◽  
Vol 9 (5) ◽  
pp. 1588
Author(s):  
Hanna-Kaarina Juppi ◽  
Sarianna Sipilä ◽  
Neil J. Cronin ◽  
Sira Karvinen ◽  
Jari E. Karppinen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Muscle Fiber ◽  
Lean Mass ◽  
Menopausal Transition ◽  
Thigh Muscle ◽  
Appendicular Lean Mass ◽  
Early Postmenopause

In midlife, women experience hormonal changes due to menopausal transition. A decrease especially in estradiol has been hypothesized to cause loss of muscle mass. This study investigated the effect of menopausal transition on changes in lean and muscle mass, from the total body to the muscle fiber level, among 47–55-year-old women. Data were used from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, where 234 women were followed from perimenopause to early postmenopause. Hormone levels (estradiol and follicle stimulating hormone), total and regional body composition (dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) scans), physical activity level (self-reported and accelerometer-measured) and muscle fiber properties (muscle biopsy) were assessed at baseline and at early postmenopause. Significant decreases were seen in lean body mass (LBM), lean body mass index (LBMI), appendicular lean mass (ALM), appendicular lean mass index (ALMI), leg lean mass and thigh muscle cross-sectional area (CSA). Menopausal status was a significant predictor for all tested muscle mass variables, while physical activity was an additional significant contributor for LBM, ALM, ALMI, leg lean mass and relative muscle CSA. Menopausal transition was associated with loss of muscle mass at multiple anatomical levels, while physical activity was beneficial for the maintenance of skeletal muscle mass.

Adaptation to Low Protein and Energy Intakes

1989 ◽  
Vol 48 (1) ◽  
pp. 20-30 ◽  
Author(s):  
Nevin Scrimshaw ◽  
Vernon Young
Keyword(s):  
Physical Activity ◽  
Amino Acid ◽  
Lean Body Mass ◽  
Body Mass ◽  
Dietary Protein ◽  
Economic Consequences ◽  
Low Protein ◽  
Lower Protein ◽  
Reduced Physical Activity ◽  
Body Energy

This paper focuses on two principal issues. First, what are the consequences of low dietary protein and amino acid intakes? Second, what are the physiological and social limits to restricted energy intakes? The concepts of adaptation and accommodation are presented. It is suggested that the limit of adaptation to low dietary protein is achieved at the intake level considered minimally necessary to maintain health in well-nourished subjects, as judged by nitrogen balance, stable lean body mass and absence of functional impairment. For lower protein intakes survival is prolonged via an accommodation, involving loss of lean body mass and reduced rates of protein and amino acid turnover. There is only a limited metabolic capacity for adaptation to reduced energy intakes, but variations in the level and pattern of physical activity permit a maintenance of body energy balance over a broad range of energy intakes. Where reduced physical activity to balance restricted energy intakes has adverse social, cultural and/or economic consequences the response should be viewed as an accommodation and not as adaptation. The range of adaptation depends on the criteria of normality and the assessment of the biological and social costs of changes with low intakes.

scholarly journals Reduced Lean Body Mass and Cardiometabolic Diseases in Adult Males with Overweight and Obesity: A Pilot Study

2018 ◽  
Vol 15 (12) ◽  
pp. 2754 ◽  
Author(s):  
Shirine Khazem ◽  
Leila Itani ◽  
Dima Kreidieh ◽  
Dana El Masri ◽  
Hana Tannir ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Diseases ◽  
Lean Body Mass ◽  
Body Mass ◽  
Overweight And Obesity ◽  
Treatment Seeking ◽  
Adult Males ◽  
Body Composition Assessment ◽  
Cardiometabolic Diseases

Little is known about the reduction in lean body mass (LBM) and its health consequences in overweight and in obesity, especially in males. Therefore, we aimed to assess the prevalence of low LBM in treatment-seeking adult males with overweight and obesity and the association with cardiometabolic diseases, i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia. A body composition assessment was conducted by a bio-impedance analyzer (InBody 170) among a total of 110 males, of whom 72 were overweight and obese and were referred to the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (BAU) in Lebanon, and 38 were normal-weight participants of similar ages. The participants with overweight and obesity were then categorized as being with or without low LBM. Of the sample of 72 participants, 50 (69.4%) met the criteria for reduced LBM and displayed a significantly higher prevalence of cardiometabolic diseases (i.e., type 2 diabetes, cardiovascular diseases and dyslipidemia) than those with normal LBM (36.0% vs. 9.1%; p = 0.019). Logistic regression analysis showed that low LBM increases the odds of having cardiometabolic diseases by nearly 550% (odds ratio (OR) = 5.46, 95% confidence interval (CI) = 1.31–26.39, p < 0.05) after adjusting for total fat and central adiposity. Treatment-seeking adult males with overweight and obesity displayed a great prevalence of reduced LBM, which seems to be strongly associated with cardiovascular and metabolic diseases.

scholarly journals Low skeletal muscle mass is associated with the risk of all-cause mortality in patients with type 2 diabetes mellitus

2019 ◽  
Vol 10 ◽  
pp. 204201881984297
Author(s):  
Hitomi Miyake ◽  
Ippei Kanazawa ◽  
Ken-ichiro Tanaka ◽  
Toshitsugu Sugimoto
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Type 2 Diabetes Mellitus ◽  
Muscle Mass ◽  
Body Mass ◽  
Skeletal Muscle Mass ◽  
Historical Cohort ◽  
All Cause Mortality

Background: Patients with type 2 diabetes mellitus (T2DM) have an increased risk of muscle mass reduction. However, the association between muscle mass and mortality in T2DM remains unknown. Methods: This was a historical cohort study with the endpoint of all-cause mortality. This study included 163 Japanese men and 141 postmenopausal women with T2DM whose body compositions were evaluated using dual-energy X-ray absorptiometry. Low muscle mass was defined as a skeletal muscle mass index (SMI) of <7.0 kg/m2 for men and <5.4 kg/m2 for women. Results: During the 6-year follow-up period, 32 men and 14 women died. In a Cox regression analysis adjusted for age, T2DM duration, glycated hemoglobin, serum creatinine, fasting C-peptide, body mass index, and lean body mass were associated with the risk of mortality in men [hazard ratio (HR) = 1.81, 95% confidence interval (CI) = 1.00–3.28 per standard deviation (SD) decrease, p = 0.049] and women (HR = 4.53, 95% CI = 1.14–17.96 per SD decrease, p = 0.032). Neither fat mass nor bone mineral content was associated with mortality. Low SMI was associated with increased mortality in women (HR = 5.97, 95% CI = 1.04–34.37, p = 0.045), while the association between low SMI and mortality was marginal in men (HR = 2.38, 95% CI = 0.92–6.14, p = 0.074). Conclusions: Low muscle mass was independently associated with all-cause mortality in patients with T2DM. The preservation of skeletal muscle mass is important to protect patients with T2DM from increased mortality risk.

scholarly journals PHYSICAL ACTIVITY AS AN IMPORTANT FACTOR IN IMPROVING HEALTH IN THE ELDERLY WITH TYPE 2 DIABETES

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Ivana Crnković ◽  
Aleksandar Aleksandar Racz ◽  
Danica Železnik ◽  
Janko Babić
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Type 2 Diabetes ◽  
Social Relations ◽  
The Elderly ◽  
Activity Level ◽  
Healthy Population ◽  
Quantitative Methodology

The goal of the study was to research the level of the quality of life as a whole and within certain domains, the level of physical activity, and to establish the correlation between physical activity and the quality of life in the elderly suffering from type 2 diabetes and the elderly not suffering from from type 2 diabetes in the Republic of Croatia. Quantitative methodology was used in the research. 120 examinees from 65 to 93 years of age participated in the rand were divided into two groups. The study used a sociodemographic  questionnaire for the examinees, WHOQOL-bref questionnaire for the evaluation of the quality of life and PASE questionnaire for the evaluation of the physical activity level in the elderly.In accordance with the set goals, this research established that the perceived quality of life in the elderly does not deviate from the values to be found in the healthy population. The greatest value within the total sample was taken by the domain of satisfaction with the environmental domain, while the satisfaction with the social relations had the lowest average value compared to the other domains. The range of index ITM results amounts to 18.90 to 46.77 with the mean value of 26.47. Persons with type 2 diabetes have a low level of estimated bodily activity and do not participate in any activities such as walking or moving lasting for longer periods of time or being of a higher intensity, which is due to the primary disease.

scholarly journals Effects of Low Muscle Mass on Albuminuria and Chronic Kidney Disease in Patients With Type 2 Diabetes: The Korean Sarcopenic Obesity Study (KSOS)

2017 ◽  
Vol 73 (3) ◽  
pp. 386-392 ◽  
Author(s):  
Hye Soo Chung ◽  
Soon Young Hwang ◽  
Ju Hee Choi ◽  
Hyun Jung Lee ◽  
Hye Jin Yoo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Sarcopenic Obesity

Incident Type 2 Diabetes in a Large Australian Cohort Study: Does Physical Activity or Sitting Time Alter the Risk Associated With Body Mass Index?

2017 ◽  
Vol 14 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Binh Nguyen ◽  
Adrian Bauman ◽  
Ding Ding
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Sitting Time ◽  
Healthy Weight ◽  
Incident Type ◽  
Incident Type 2 Diabetes

Purpose:To examine the combined effects of body mass index (BMI), physical activity (PA) and sitting on incident type 2 diabetes mellitus (T2DM) among Australian adults.Methods:A sample of 29,572 adults aged ≥45 years from New South Wales, Australia, completed baseline (2006–2008) and follow-up (2010) questionnaires. Incident T2DM was defined as self-reported, physician-diagnosed diabetes at follow-up. BMI was categorized as normal/overweight/obese. PA was tertiled into low/medium/ high. Sitting was dichotomized as higher/lower sitting (≥ 8 hours/day or < 8 hours/day). Odds ratios (OR) were estimated for developing T2DM using logistics regression for individual and combined risk factors, and data stratified by BMI categories.Results:During a mean 2.7 (SD: 0.9) years of follow-up, 611 (2.1%) participants developed T2DM. In fully adjusted models, BMI was the only independent risk factor for incident T2DM. In stratified analyses, the association between BMI and T2DM did not differ significantly across sitting or PA categories. Overweight/obese individuals with high PA and lower sitting had higher odds of incident T2DM than normal counterparts with low PA and higher sitting.Conclusions:High PA/low sitting did not attenuate the risk of T2DM associated with overweight/obesity. Maintaining a healthy weight, by adopting healthy lifestyle behaviors, is critical for T2DM prevention.

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