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      Association of Body Composition, Physical Functioning, and Protein Intake in Adult Patients With Mitochondrial Diseases

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          Abstract

          Background

          Whether decreased physical functioning of patients with mitochondrial disease (MD) is related to altered body composition or low protein intake needs clarification at the background of the nutrition state.

          Methods

          In this 2‐site cross‐sectional study, MD patients were age‐, body mass index (BMI)–, and gender‐matched to controls. Body composition was assessed by dual‐energy x‐ray absorptiometry. Physical functioning was measured by handgrip strength, 6‐minute walking test, 30‐second sit‐to‐stand test (30SCT), and 6‐minute mastication test. Total daily protein intake was calculated by 3‐day food records. Malnutrition was assessed by Patient‐Generated Subjective Global Assessment and the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia by the 2018 consensus. Data were analyzed using independent samples t‐tests, Fisher exact test, and Spearman and Pearson correlation coefficients.

          Results

          Thirty‐seven MD patients (42 ± 12 years, BMI: 23 ± 4 kg/m 2, 59% females) and 37 matched controls were included. Handgrip strength was moderate, inversely related to fat mass index in both MD patients and controls, whereas it correlated with fat‐free mass index in controls solely. Protein intake was associated with muscle strength (handgrip strength and 30SCT) in MD patients but not in controls. Twenty‐seven MD patients (73%) were malnourished, and 5 (14%) were classified as sarcopenic.

          Conclusions

          Muscle strength is related to body composition and protein intake in MD patients. This, in combination with the high incidence of both malnutrition and sarcopenia, warrants individual nutrition assessment in MD patients.

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          Most cited references41

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          Sarcopenia: revised European consensus on definition and diagnosis

          Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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            A 30-s chair-stand test as a measure of lower body strength in community-residing older adults.

            Measuring lower body strength is critical in evaluating the functional performance of older adults. The purpose of this study was to assess the test-retest reliability and the criterion-related and construct validity of a 30-s chair stand as a measure of lower body strength in adults over the age of 60 years. Seventy-six community-dwelling older adults (M age = 70.5 years) volunteered to participate in the study, which involved performing two 30-s chair-stand tests and two maximum leg-press tests, each conducted on separate days 2-5 days apart. Test-retest intraclass correlations of .84 for men and .92 for women, utilizing one-way analysis of variance procedures appropriate for a single trial, together with a nonsignificant change in scores from Day 1 testing to Day 2, indicate that the 30-s chair stand has good stability reliability. A moderately high correlation between chair-stand performance and maximum weight-adjusted leg-press performance for both men and women (r = .78 and .71, respectively) supports the criterion-related validity of the chair stand as a measure of lower body strength. Construct (or discriminant) validity of the chair stand was demonstrated by the test's ability to detect differences between various age and physical activity level groups. As expected, chair-stand performance decreased significantly across age groups in decades--from the 60s to the 70s to the 80s (p < .01) and was significantly lower for low-active participants than for high-active participants (p < .0001). It was concluded that the 30-s chair stand provides a reasonably reliable and valid indicator of lower body strength in generally active, community-dwelling older adults.
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              Bioelectrical impedance analysis--part I: review of principles and methods.

              U KYLE (2004)
              The use of bioelectrical impedance analysis (BIA) is widespread both in healthy subjects and patients, but suffers from a lack of standardized method and quality control procedures. BIA allows the determination of the fat-free mass (FFM) and total body water (TBW) in subjects without significant fluid and electrolyte abnormalities, when using appropriate population, age or pathology-specific BIA equations and established procedures. Published BIA equations validated against a reference method in a sufficiently large number of subjects are presented and ranked according to the standard error of the estimate. The determination of changes in body cell mass (BCM), extra cellular (ECW) and intra cellular water (ICW) requires further research using a valid model that guarantees that ECW changes do not corrupt the ICW. The use of segmental-BIA, multifrequency BIA, or bioelectrical spectroscopy in altered hydration states also requires further research. ESPEN guidelines for the clinical use of BIA measurements are described in a paper to appear soon in Clinical Nutrition.
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                Author and article information

                Contributors
                heidi.zweers-vanessen@radboudumc.nl
                Journal
                JPEN J Parenter Enteral Nutr
                JPEN J Parenter Enteral Nutr
                10.1002/(ISSN)1941-2444
                JPEN
                JPEN. Journal of Parenteral and Enteral Nutrition
                John Wiley and Sons Inc. (Hoboken )
                0148-6071
                1941-2444
                19 March 2020
                January 2021
                : 45
                : 1 ( doiID: 10.1002/jpen.v45.1 )
                : 165-174
                Affiliations
                [ 1 ] Department of Gastroenterology and Hepatology‐Dietetics Radboudumc Nijmegen the Netherlands
                [ 2 ] Department of Nutrition and dietetics HAN University of Applied Sciences Nijmegen the Netherlands
                [ 3 ] Department of Health Science and Technology ETHZ Zurich Switzerland
                [ 4 ] Nutrition and Health Wageningen University Wageningen the Netherlands
                [ 5 ] Department of Internal Medicine Radboudumc Nijmegen the Netherlands
                [ 6 ] Department of Gastroenterology and Hepatology Radboudumc Nijmegen the Netherlands
                Author notes
                [*] [* ] Corresponding Author:

                Heidi E. E. Zweers, BSc, Department of Gastroenterology and Hepatology‐Dietetics, Radboudumc, Nijmegen, the Netherlands, Postbus 9101 6500 HB Nijmegen.

                Email: heidi.zweers-vanessen@ 123456radboudumc.nl

                Author information
                https://orcid.org/0000-0003-3465-4646
                Article
                JPEN1826
                10.1002/jpen.1826
                7891597
                32189351
                e220f5e2-12d7-4213-a0a8-0180aa9467e3
                © 2020 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 31 May 2019
                : 08 November 2019
                : 25 February 2020
                Page count
                Figures: 3, Tables: 3, Pages: 10, Words: 6009
                Categories
                Original Communication
                Original Communications
                Custom metadata
                2.0
                January 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.7 mode:remove_FC converted:18.02.2021

                Nutrition & Dietetics
                bia,body composition,dxa,handgrip strength,malnutrition,mitochondrial disease,nutrition assessment,physical functioning,sarcopenia

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