Low Muscle Mass in the Limps Increases the Mortality Risk of Seniors

Karina Toledo wrote . . . . . . . . .

Evaluating body composition, especially appendicular muscle mass, can be an effective strategy for predicting longevity in people over 65 years of age, according to a study conducted by researchers at the University of São Paulo’s Medical School (FM-USP) in Brazil.

The appendicular muscles are the muscles that move the appendages or extremities – the arms and legs. They also play a key role in stabilizing the shoulders and hips.

The researchers studied a group of 839 men and women over the age of 65 for approximately four years. They observed that all-cause mortality risk increased nearly 63-fold during the follow-up period in women with low appendicular muscle mass and 11.4-fold in men.

An article with results of the study, which was supported by FAPESP, is published in the Journal of Bone and Mineral Research.

“We evaluated the body composition of this group, focusing on appendicular muscle mass, subcutaneous fat and visceral fat. We then sought to determine which of these factors could predict mortality in the ensuing years. We concluded that the key factor was the amount of appendicular lean mass,” Rosa Maria Rodrigues Pereira, Full Professor and Head of Rheumatology at FM-USP and principal investigator for the study, told Agência FAPESP.

Body composition was determined by dual energy X-ray absorptiometry (DXA), also known as bone density scanning, using a densitometer purchased with funding from FAPESP during a previous project led by Pereira to assess the prevalence of osteoporosis and fractures in older women living in Butantã, a neighborhood in western São Paulo city. The same cohort of individuals over 65 years of age was studied in both projects.

“Participants were selected on the basis of the census performed by IBGE [Brazil’s national census bureau]. The sample was representative of the older members of the country’s population,” Pereira said.

The study sample comprised 323 men (39%) and 516 women (61%). The frequency of low muscle mass was approximately 20% for both men and women.

Silent disease

The gradual loss of muscle mass and quality associated with aging is known as age-related sarcopenia. Approximately 46% of Brazilians aged 80 or older have sarcopenia, according to the Brazilian Association of Geriatrics and Gerontology.

Especially when combined with osteoporosis, sarcopenia can increase the vulnerability of older people in that they become more prone to falls, fractures and other physical injuries. Low bone mineral density, particularly in the femur, was shown to correlate with mortality in elderly individuals by research published in 2016.

Pereira and her group developed an equation to determine which individuals can be considered to have sarcopenia based on the characteristics of the community studied.

“According to the most widely used criteria [appendicular lean mass in kg divided by height squared in m], most of the individuals identified as having sarcopenia are lean. However, our sample had a higher-than-average BMI [body mass index], so we substituted muscle mass for fat mass. Subjects with muscle mass that was 20% below average were classified as having sarcopenia,” Pereira said.

The researchers discussed this topic in articles published in Osteoporosis International in 2013 and 2014.

In addition to bone density, the researchers also analyzed blood samples and responses to questionnaires to evaluate diet, physical activity, smoking, consumption of alcoholic beverages, and the presence of chronic diseases such as diabetes, high blood pressure and dyslipidemia (abnormally elevated levels of fat in the blood).

At the end of the four-year period, 15.8% (132) of the volunteers had died; 43.2% had died from cardiovascular problems. The mortality rate was 20% for the men and 13% for the women in the sample.

“We then conducted a number of statistical analyses to detect differences between the subjects who died and those who remained alive, particularly, whether it was possible to predict a person’s death on the basis of body composition measured by the DXA examination,” Pereira said.

Differences

Generally, subjects who died were older, exercised less, and suffered more from diabetes and cardiovascular problems than those who remained alive. In the case of the women who died, they also had decreased BMIs. The men who died were more likely to suffer falls. All these variables were fed into the statistical model and adjusted for the end-result to show which body composition factor correlated best with mortality risk.

Only low muscle mass was found to be significant in the women, considering the adjustment variables, while visceral fat was also significant among the men. The mortality risk doubled with each 6 cm2 increase in abdominal fat. Curiously, a higher proportion of subcutaneous fat had a protective effect in the men.

“We found that other parameters also negatively influenced mortality in the men, statistically reducing the significance of appendicular muscle mass. In the women, however, muscle mass stood out as a key factor and hence had more influence,” Pereira said.

Menopause-related hormone changes may help explain the difference between men and women. “The rapid and significant transition from a protective estrogenic environment to a deleterious hypoestrogenic environment, which is particularly adverse for the cardiovascular system, may make the protective metabolic role of skeletal muscles, including the production of anti-inflammatory cytokines, more important in the postmenopause period. This hormone change is far less abrupt in men,” she said.

Loss of muscle mass, which occurs naturally after the age of 40, can be unnoticed owing to weight gain, which is also common in middle age. Between 1% and 2% of muscle mass is lost annually after the age of 50, according to estimates. The factors that may accelerate muscle loss include sedentary habits, a protein-poor diet, chronic diseases and hospitalization.

In addition to their obvious importance in posture, balance and movement, the skeletal muscles have other functions that are essential to the body. They help regulate blood sugar by consuming energy during contraction and maintain the body temperature by trembling when cold. They also produce messenger hormones, such as myokinase, that assist communication with different organs and influence inflammatory responses.

The good news is that sarcopenia is preventable and can even be reversed by physical exercise, especially muscle toning. Attention to protein ingestion is also recommended.

The article “Association of appendicular lean mass and subcutaneous and visceral adipose tissue with mortality in older Brazilians: The São Paulo Ageing & Health Study” by Felipe M. de Santana, Diogo S. Domiciano, Michel A. Gonçalves, Luana G. Machado, Camille P. Figueiredo, Jaqueline B. Lopes, Valéria F. Caparbo, Liliam Takayama, Paulo R. Menezes and Rosa M. R. Pereira can be retrieved from: onlinelibrary.wiley.com/doi/pdf/10.1002/jbmr.3710.
 
Source: Agencia FAPESP

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You Could Gain Years of Life by Keeping Heart Disease at Bay

Heart disease is the nation’s No. 1 cause of death, killing about 650,000 people every year. Life expectancy is cut short by the disease and the health problems that stem from it. But by how much – and what can people do to take those years back?

For heart attacks alone, more than 16 years of life are lost on average, according to American Heart Association statistics. Researchers estimate people with heart failure lose nearly 10 years of life compared to those without heart failure.

“In the past few years, there have been tremendous gains in reducing cardiovascular disease and increasing life expectancy, but we’ve hit a plateau,” said Paul Muntner, an epidemiologist at the University of Alabama at Birmingham.

Some people are at greater risk than others.

African Americans, for example, are more likely to have high blood pressure, obesity and diabetes, and they live 3.4 years less than their white counterparts. Among the six largest Asian American subgroups, research shows Asian Indian, Filipino and Vietnamese populations lose the most years of life to heart disease – up to 18 years for some – compared with white people.

The risk of early death also is high for people with a history of diabetes, stroke and heart attack. Reporting in the Journal of the American Medical Association in 2015, researchers found people with all three conditions had their life expectancy cut by 15 years compared to those without any of the health problems. Even having just two of the conditions reduced life expectancy by 12 years.

But there is hope.

A 2012 study found non-smokers without diabetes who had optimal cholesterol and blood pressure lived an average of 14 years longer than people with two or more of those risk factors.

“Applying a healthy lifestyle, even taking a small step, like a brisk 30-minute walk five times a week, can add up to a longer life,” said Yanping Li, a senior research scientist at the Harvard T.H. Chan School of Public Health.

Li led a recent study showing women who adapted a healthy lifestyle could expect to live 14 years longer than those who didn’t, while men would have 12 additional years of life.

“The healthier lifestyle, the longer life expectancy,” Li said.

“Even modest changes have been shown to reduce cardiovascular risk by 20% to 30%,” Muntner said. “If we can just shift the curve a little bit, there will be incredible gains in terms of life expectancy as well as reducing cardiovascular risk.”

Great strides have been made in the past 50 years, Muntner said. Far fewer people develop hypertension and high cholesterol, and many who do are being treated. Rates of obesity and diabetes, on the other hand, are skyrocketing.

“We have a long way to go, but I think we can do it just based on what we’ve seen in the past,” Muntner said. “It’s not just about living longer. Preventing heart disease and strokes will also lead to a higher quality of life.”

Source: HealthDay


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Happiness Linked with Longer, Healthier Lives

Dennis Thompson wrote . . . . . . . . .

Happiness may truly be some of the best medicine available to us, a new study suggests.

People happy with themselves and their well-being tend to live longer and healthier lives than those who are perpetually down in the dumps, British researchers report.

Women in their 50s who reported enjoying their lives had a projected live expectancy of nearly 37 more years, compared with just 31 years in those who felt depressed and unhappy in their lives, according to researchers with University College London.

The same went for men in their 50s — guys who were happy had a life expectancy of 33 more years, compared with about 27 years for miserable men.

Happier men and women also tended to age more gracefully and enjoy more years free from disability or chronic disease, the investigators found.

The new study is “one of many that are pointing in the same general direction, that people who are happier and more optimistic and have a higher degree of life satisfaction, they tend to be healthier and they tend to live longer,” said James Maddux, a professor emeritus of clinical psychology with George Mason University in Fairfax, Va. He had no role in the study.

The study results were published online in JAMA Network Open. For the study, the researchers analyzed survey data from nearly 9,800 participants in the English Longitudinal Study of Ageing. The information was collected between 2002 and 2013, and average age was 64.

The team specifically looked at each participant’s report of “subjective well-being” — essentially, how much they are enjoying their life and how they feel about their own health and mood.

Nancy Mramor, a psychologist in Pittsburgh who specializes in health, stress and wellness, said, “It’s the perception of how well you are, not the actual fact of how well you are.” Mramor wasn’t involved in the study.

The researchers then tracked participants to see how well their sense of their own well-being jibed with their actual health.

People with a more positive outlook not only tacked more years onto their life, they also tended to enjoy better health, the results showed.

For example, 50-year-old men completely happy with their lives could expect to live nearly 30 more years free from disability and 21 years free from chronic disease. That compared with 20 and 11 years, respectively, for depressed men who aren’t enjoying life.

Women at age 50 who enjoy life can expect to live more than 31 years free from disability and 22 years free from chronic disease, compared with about 21 years and 12 years for those who are unhappy and depressed.

The health advantage associated with a positive outlook persisted as folks grew older. At ages 60, 70 and 80, those with a high enjoyment of life and no depression lived longer and healthier than those who didn’t.

There’s no clear explanation yet for why this association between happiness and health exists, the experts said. And the study does not prove cause and effect.

One possibility is that a constant state of unhappiness produces a lot of stress, Mramor said.

“Automatic negative thoughts create a stress response in the nervous system, which creates wear and tear on the body,” Mramor said. “When you’re thinking I’m in great health, even when you’re not, you’re sending all these positive signals to the body. There’s evidence that freedom from stress takes a heavy burden off your body.”

It’s also possible that folks who are happier just tend to lead healthier lives, Maddux said.

“Happier people have something to live for,” Maddux said. “They like their lives, and so they tend to take care of themselves more than people who are miserable.”

People can change their outlook on life if they want, Mramor and Maddux agreed.

Mramor said, “You can definitely retrain your thinking. But you have to recognize there’s a need for it, and you have to have a desire to do it.”

Cognitive behavioral therapy and psychotherapy can help adults adjust the way they view their lives and respond to stress, Maddux said.

It’s even better if, as children, we are taught how to manage our stress and focus on the pleasures in life, Mramor said.

“It’s much harder to change long-held negative or pessimistic beliefs than it is to train positive ones in the first place,” said Mramor, who teaches stress management techniques to children. “The younger you start, the quicker they learn and the more deeply those patterns of thought become embedded. It can take six months in adults what I can accomplish with children in six weeks.”

However, there’s no guarantee that changing your outlook will lengthen your healthy life span. Maddux noted that genetics also plays a strong role in whether you are upbeat or downcast.

“It could be the same genetic ingredients that produce people who are generally happy and optimistic and upbeat also maybe programs their bodies to live longer and healthier,” Maddux said.

Source: HealthDay

Low Fruit and Vegetable Intake May Account for Millions of Deaths

Chiara Townley wrote . . . . . . . . .

Findings from a new study suggest that inadequate consumption of fruits and vegetables may be a major factor in heart disease death.

Fruits and vegetables are rich in vitamins, fiber, potassium, magnesium, and antioxidants.

A diet that includes fruits and vegetables can lower blood pressure, reduce the risk of heart disease and cancer, and improve digestive health.

Previous research — part of the Harvard-based Nurses’ Health Study and Health Professionals Follow-up Study — confirmed that a diet containing lots of fruits and vegetables can even lower the risk of heart disease and stroke.

After analyzing these results and combining them with findings from other studies, researchers estimated that the risk of heart disease is 20% lower among individuals who eat more than five servings of fruits and vegetables per day, compared with those who eat fewer than three servings per day.

The United States Department of Agriculture recommend that adults eat at least 1.5 to 2 cups per day of fruit and 2–3 cups per day of vegetables. According to another study by the Centers for Disease Control and Prevention (CDC), only around 1 in 10 adults meet these guidelines.

The global impact of inadequate nutrition

Now, a new study — the results of which the researchers presented at Nutrition 2019, the American Society for Nutrition annual meeting in Baltimore, MD — suggests that a low fruit intake can cause 1 in 7 deaths from heart disease, and that a low vegetable intake can cause 1 in 12 deaths from heart disease.

Analyzing data from 2010, researchers found that low fruit consumption resulted in almost 2 million deaths from cardiovascular disease, while low vegetable intake resulted in 1 million deaths. The global impact was more significant in countries with a low average consumption of fruits and vegetables.

The data suggest that low fruit consumption results in more than 1 million deaths from stroke and more than 500,000 deaths from heart disease worldwide every year, while low vegetable intake results in about 200,000 deaths from stroke and more than 800,000 deaths from heart disease per year.

“Our findings indicate the need for population-based efforts to increase fruit and vegetable consumption throughout the world,” says study co-author Victoria Miller, a postdoctoral researcher at the Friedman School of Nutrition Science and Policy at Tufts University in Medford, MA.

Tracking death toll by region, age, and sex

The researchers tracked the death toll by region, age, and sex using diet surveys and food availability data of 113 countries. They combined these with data on causes of death in each country and data on the cardiovascular risk linked to low fruit and vegetable intake.

The findings showed that fruit intake was lower in South Asia, East Asia, and Sub-Saharan Africa, while vegetable consumption was lower in Central Asia and Oceania. Countries in these regions have low average fruit and vegetable intakes and high rates of deaths from heart disease and stroke.

When the researchers analyzed the impact of inadequate fruit and vegetable consumption by age and sex, they found that the biggest impact was among young adults and males. Miller adds that females tend to eat more fruits and vegetables.

“These findings indicate a need to expand the focus to increasing availability and consumption of protective foods like fruits, vegetables, and legumes — a positive message with tremendous potential for improving global health”, said Senior study author Dariush Mozaffarian, Friedman School of Nutrition Science and Policy

Source: Medical News Today

Highly Processed Food Tied to Heart Disease and Earlier Death

People who get many of their meals from packages may have heightened risks of heart disease, stroke and premature death, two large studies suggest.

The findings, published online in the journal BMJ, are the latest to point the finger at “ultra-processed” foods.

They include not only “junk food” — like chips, sweets and fast food — but also the breads, processed meats, jarred sauces and frozen meals that many people consider staples.

In one study, researchers followed more than 100,000 French adults for about five years.

They found that the more ultra-processed foods people ate, the higher their odds of a first-time heart condition or stroke: Those who ate the most processed foods were 23% more likely to suffer cardiovascular trouble compared to those with the lowest intakes.

And it wasn’t only because those foods were loaded with sugar, salt or fat — or because those people were heavier, exercised less or had other unhealthy habits.

Instead, there might be other things about highly processed foods that take a health toll, according to researchers Bernard Srour and Mathilde Touvier, from the University of Paris.

Other studies, they noted, have hinted that additives or contaminants formed during food processing have negative effects on metabolism and the cardiovascular system.

The researchers stressed that their study can’t prove cause and effect.

But taken along with other research linking processed foods to ill health effects, they said the message is straightforward: Strive to eat more “whole” and minimally processed foods.

Dr. Andrew Freeman, a cardiologist not involved in the study, had the same advice.

“I like to say: The longer the shelf life, the shorter your life,” said Freeman, who directs cardiovascular prevention and wellness at National Jewish Health in Denver.

Based on the overall body of research, he said, the most heart-healthy diet is one rich in whole foods — particularly plant-based foods like fruits and vegetables, legumes, whole grains and nuts.

To make that more affordable and convenient, Freeman pointed to healthy, packaged options — like fresh-frozen vegetables.

Srour agreed that not all packaged food is bad. It’s the degree of processing that seems key.

For example, he said a canned soup made of water, vegetables, vegetable oil, herbs and spices would not fall into the “ultra-processed” category. A dried soup loaded with preservatives would.

The French study included more than 105,000 men and women who were, on average, 43 years old at the start. Over the next five years, just over 1,400 suffered a heart attack or stroke, or developed clogged heart arteries.

The risk was 23% greater among those who ate the most ultra-processed foods — even with a host of other factors considered, including body weight, exercise habits, and salt, sugar and fat intake.

In the second study — of nearly 20,000 Spanish adults — ultra-processed foods were linked to a shorter life span: Those with the highest intake were 62% more likely to die over two decades, compared to those with the lowest intake.

Again, factors such as weight and lifestyle habits did not fully explain the link.

Then what else could be going on?

There is growing evidence that heavy processing itself plays a role, said Mark Lawrence, a professor of public health nutrition at Deakin University in Australia. He wrote an editorial published with the studies.

Food additives and compounds produced by industrial processes — such as acrylamide and acrolein — may help explain the health risks tied to highly refined foods, according to Lawrence.

“It’s ultra-processing that’s the problem,” he said, adding that convenient, minimally processed food can fit into a healthy lifestyle. Simple switches — from sugary drinks to water, or sweet treats to fresh fruit — are good starting points, Lawrence said.

The fewer nutritionally empty foods we eat, the more room there is for nutrient-rich ones, Freeman pointed out.

“It behooves us all,” he said, “to use nature to our advantage — to eat more nutritious foods, and rely less on medication.”

Source: HealthDay


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