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      Effects of Leucine Administration in Sarcopenia: A Randomized and Placebo-controlled Clinical Trial

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          Abstract

          Treating sarcopenia in older individuals remains a challenge, and nutritional interventions present promising approaches in individuals that perform limited physical exercise. We assessed the efficacy of leucine administration to evaluate whether the regular intake of this essential amino acid can improve muscle mass, muscle strength and functional performance and respiratory muscle function in institutionalized older individuals. The study was a placebo-controlled, randomized, double-blind design in fifty participants aged 65 and over (ClinicalTrials.gov identifier NCT03831399). The participants were randomized to a parallel group intervention of 13 weeks’ duration with a daily intake of leucine (6 g/day) or placebo (lactose, 6 g/day). The primary outcome was to study the effect on sarcopenia and respiratory muscle function. The secondary outcomes were changes in the geriatric evaluation scales, such as cognitive function, functional impairment and nutritional assessments. We also evaluated whether leucine administration alters blood analytical parameters and inflammatory markers. Administration of leucine was well-tolerated and significantly improves some criteria of sarcopenia in elderly individuals such as functional performance measured by walking time ( p = 0.011), and improved lean mass index. For respiratory muscle function, the leucine-treated group improved significantly ( p = 0.026) in maximum static expiratory force compared to the placebo. No significant effects on functional impairment, cognitive function or nutritional assessment, inflammatory cytokines IL-6, TNF-alpha were observed after leucine administration compared to the placebo. The use of l-leucine supplementation can have some beneficial effects on sarcopenia and could be considered for the treatment of sarcopenia in older individuals.

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          Estimation of skeletal muscle mass by bioelectrical impedance analysis.

          The purpose of this study was to develop and cross-validate predictive equations for estimating skeletal muscle (SM) mass using bioelectrical impedance analysis (BIA). Whole body SM mass, determined by magnetic resonance imaging, was compared with BIA measurements in a multiethnic sample of 388 men and women, aged 18-86 yr, at two different laboratories. Within each laboratory, equations for predicting SM mass from BIA measurements were derived using the data of the Caucasian subjects. These equations were then applied to the Caucasian subjects from the other laboratory to cross-validate the BIA method. Because the equations cross-validated (i.e., were not different), the data from both laboratories were pooled to generate the final regression equation SM mass (kg) = [(Ht 2 / R x 0.401) + (gender x 3.825) + (age x -0. 071)] + 5.102 where Ht is height in centimeters; R is BIA resistance in ohms; for gender, men = 1 and women = 0; and age is in years. The r(2) and SE of estimate of the regression equation were 0.86 and 2.7 kg (9%), respectively. The Caucasian-derived equation was applicable to Hispanics and African-Americans, but it underestimated SM mass in Asians. These results suggest that the BIA equation provides valid estimates of SM mass in healthy adults varying in age and adiposity.
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            Skeletal muscle performance and ageing

            Abstract The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co‐morbidity, and premature death. An important cause of physical limitations is the age‐related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation–contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing.
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              Inflammation and sarcopenia: A systematic review and meta-analysis.

              Inflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. However, the possible association between inflammatory parameters and sarcopenia is poorly understood. We therefore aimed to summarize the current evidence about this topic with a meta-analysis of studies reporting serum inflammatory parameters in patients with sarcopenia vs. people without sarcopenia (controls). An electronic PubMed and Scopus search through to 09/01/2016 and meta-analysis of cross-sectional studies comparing serum levels of inflammatory cytokines between patients with sarcopenia and controls was made, calculating random-effects standardized mean differences (SMDs) ±95% confidence intervals (CIs) as the effect size. Out of 1370 initial hits, 17 studies with a total of 11249 participants (3072 with sarcopenia and 8177 without) were meta-analyzed. Sarcopenic participants had significantly higher levels of CRP (SMD=0.51; 95%CI 0.26, 0.77; p<0.0001; I2=96%) than controls. Conversely, serum IL6 levels were not significantly different (SMD=0.35; 95%CI: -0.19, 0.89; p=0.21; I2=97%) in people with sarcopenia versus controls. Sarcopenic people did not have higher levels of TNF-α than controls (SMD=0.28; 95%CI -0.26, 0.83; p=0.31; I2=97%). In conclusion, sarcopenia seems to be associated with elevated serum CRP levels; future longitudinal studies are needed to clarify this relationship.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                27 March 2020
                April 2020
                : 12
                : 4
                : 932
                Affiliations
                [1 ]Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain; francisco.m.martinez@ 123456uv.es
                [2 ]Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; rosa.fonfria@ 123456uv.es (R.F.-V.); cristina.buigues@ 123456uv.es (C.B.); julio.fernandez@ 123456uv.es (J.F.-G.)
                [3 ]Department of Nursing, University of Valencia, 46010 Valencia, Spain
                [4 ]La Saleta, Armonea Group, 46015 Valencia, Spain; supbetera@ 123456lasaleta.com (Y.C.); pmolina@ 123456lasaleta.com (P.M.)
                [5 ]Natura Foundation, 3281 NC Numansdorp, The Netherlands; a.hoogland@ 123456bonusan.nl (A.J.H.); F.vanDoesburg@ 123456naturafoundation.com (F.v.D.)
                [6 ]University of Groningen, University Medical Center Groningen (UMCG), 9712 CP Groningen, The Netherlands; cpni.pruimboom@ 123456icloud.com
                [7 ]Psychoneuroimmunologie (PNI) Europe, 2491 The Hague, The Netherlands
                Author notes
                [* ]Correspondence: omar.cauli@ 123456uv.es ; Tel.: +34-963-86-41-82
                Author information
                https://orcid.org/0000-0003-1949-3290
                https://orcid.org/0000-0002-8023-8646
                https://orcid.org/0000-0003-2955-4675
                https://orcid.org/0000-0001-5669-4943
                Article
                nutrients-12-00932
                10.3390/nu12040932
                7230494
                32230954
                0eb13bfa-ed0e-4546-9167-bf97dc340c80
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 02 March 2020
                : 26 March 2020
                Categories
                Article

                Nutrition & Dietetics
                respiratory muscles,sarcopenia,muscle mass,muscle strength,elderly,nutrition
                Nutrition & Dietetics
                respiratory muscles, sarcopenia, muscle mass, muscle strength, elderly, nutrition

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