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This study examined the effects and feasibility of a twice-weekly combined therapy of branched-chain amino acids (BCAAs) and exercise on physical function improvement in frail and pre-frail elderly people requiring long-term care. We used a crossover design in which the combination of exercise and nutritional interventions was carried out twice a w...
Citations
... When implementing interventions for this population, it is advisable to address not only nutritional aspects but also the broader context of eating, food, and other relevant psychosocial factors. Despite the importance of dietary and exercise factors for community-dwelling older adults, many studies [6,7,[9][10][11][12][13][14] have not emphasized the significance. However, there is a noticeable gap when it comes to investigating the efficacy of interventions that combine both food and exercise for the older adults. ...
This systematic review and meta-analysis discusses the available data on the efficacy of diet, food intake, and exercise mixed interventions (DEMI) for community-dwelling older adults in Japan and assesses the evidence level. We searched the literature regarding the research questions using electronic and hand-searching methods. To ensure the reliability and quality of the evidence, we used the Cochrane risk of bias tool and GRADE system. All studies included DEMI; other interventions included group activities, health education, and community participation. All interventions were categorized into three classifications, namely “Diet and food intake”, “Exercise”, and “Other”. Programs included lectures, practical exercises, group activities, consulting, and programs that could be implemented at home. By comparing groups and measuring outcomes at various time points, most studies reported positive results regarding the impact of the interventions. Specifically, usual gait speed, Food Frequency Questionnaire Score, and Diet Variety Score demonstrated significant improvement. Additionally, three studies demonstrated improvement in frailty. This review suggests that DEMI resulted in improvements in some outcome variables. However, the efficacy of all variables was not fully examined. The results of the meta-analysis revealed positive outcomes for some variables, although the evidence level for these outcomes was considered moderate.
... Primary outcomes. The primary outcomes will be skeletal muscle mass (e.g., using dual-energy X-ray absorptiometry, [5,14,[16][17][18] bioelectrical impedance method, [26,27] ultrasonic reflectoscope, [28,29] or circumference of the limbs [30,31] ) or muscle strength (e.g., knee extensor strength, [26,28,29,31,32] grip strength, [16,18,[28][29][30]32] and leg-press strength [27,32] ). If different assessment methods are adopted, standardization will be conducted as standardized mean difference. ...
... Primary outcomes. The primary outcomes will be skeletal muscle mass (e.g., using dual-energy X-ray absorptiometry, [5,14,[16][17][18] bioelectrical impedance method, [26,27] ultrasonic reflectoscope, [28,29] or circumference of the limbs [30,31] ) or muscle strength (e.g., knee extensor strength, [26,28,29,31,32] grip strength, [16,18,[28][29][30]32] and leg-press strength [27,32] ). If different assessment methods are adopted, standardization will be conducted as standardized mean difference. ...
... Primary outcomes. The primary outcomes will be skeletal muscle mass (e.g., using dual-energy X-ray absorptiometry, [5,14,[16][17][18] bioelectrical impedance method, [26,27] ultrasonic reflectoscope, [28,29] or circumference of the limbs [30,31] ) or muscle strength (e.g., knee extensor strength, [26,28,29,31,32] grip strength, [16,18,[28][29][30]32] and leg-press strength [27,32] ). If different assessment methods are adopted, standardization will be conducted as standardized mean difference. ...
Background
In recent years, prevention of sarcopenia and frailty is a matter of concern for community dwelling older persons. The recommended protein daily intake is not fulfilled by 10% of community-dwelling elderly and 35% of residents in aged-care facilities. Furthermore, the optimum time of protein consumption is unclear because of the varying combinations of intake timing and exercise. Although it is desirable to increase protein intake at breakfast and lunch without reducing intake at supper to maximize muscle protein synthesis, this is not clear for older people. Therefore, before considering whether protein consumption at breakfast is superior to other times of the day, its effectiveness needs to be clarified in older adults.
Methods
The inclusion criterion will be healthy or frail adults older than 60 years. This protocol of systematic review adhered to the PRISMA 2020 statement. A comprehensive study strategy is designed for PubMed, EMBASE, CENTRAL, and Clinical Trials.gov. Search strategies will be made using Boolean Search Logic by an experienced librarian in systematic review search formula design. Two authors will carry out independent screening of titles, abstracts, and data extraction for randomized controlled trials. Statistical heterogeneity will be assessed by meta-analysis. Assessment of the risk of bias will be conducted using the Risk-of-bias 2 tool. Integrated data will be analyzed using Review Manager software to create summary tables. Findings summary tables for primary and secondary outcomes will be produced in accordance with the procedures in the Cochrane Handbook.
Results
We believe that the effects of protein or BCAA intake at breakfast in older people analysed in this review will provide evidence that contributes to the establishment of treatment strategies to prevent frailty and sarcopenia.
Conclusion
The benefits of protein intake at breakfast for the elderly will be clarified. This will encourage hospitals and elderly care facilities to review the content of the diet and encourage the elderly to change their own behavior. This is expected to ultimately reduce healthcare costs.
... 13 The combination of BCAA intake and exercise is known to have a superior effect than each administered alone. [13][14][15] Sarcopenia occurs widely among orthopedic patients 16 and those with stroke. 17 Besides, >40% of Japanese patients with degenerative scoliosis and hip fracture have had concomitant sarcopenia. ...
Background and Aims
This study examined the feasibility of nutritional support combined with exercise intervention for restoring muscle and physical functions in convalescent orthopedic patients.
Methods
We used a crossover design in which nutritional support combined with exercise intervention was administered daily during the early (1 month) and late (1 month) cycles with a 1‐week washout period. The exercise intervention was performed twice daily for 2 months in the early and late groups. The exercise intervention consisted of one set of muscle strength, stretching, and physical activity exercises for 20 min each. Nutritional interventions were administered immediately after the exercise. A 3.4 g of branched‐chain amino acid supplements (BCAAs) or 1.2 g of starch was ingested. We measured the skeletal muscle mass and isometric muscle strength of the limbs and performed balance tests. After the crossover, the BCAA and Placebo groups were compared.
Results
The ratio of improvement in the echo intensity of the rectus femoris (RF) was significantly higher in the BCAA group. A comparison of the order of nutritional intervention showed a significant effect on the RF echo intensity in both groups only when BCAAs were administered.
Conclusion
This study's results suggest that the proposed combined intervention improves muscle quality and mass in convalescent orthopedic patients.
... Amino acid intake can enhance the effects of exercise in older women with sarcopenia [3]. Moreover, amino acid intake in older adults with frailty or pre-frailty can improve the lower limb muscle strength and physical function [25]. Therefore, it is important to evaluate the nutritional status and nutritional guidance including detail intake to improve physical function and quality of life. ...
Background:
Malnutrition impairs quality of life and prognosis of patients with cardiovascular disease. The Mini Nutritional Assessment (MNA) is a screening tool developed for the nutritional assessment of older adults. However, usefulness of MNA for patients undergoing cardiac rehabilitation (CR) has not been fully investigated.
Methods:
From March 2017 to September 2019, the MNA-short form (MNA-SF) and the MNA total score in patients undergoing phase II CR at the Juntendo University Hospital were evaluated.
Results:
A total of 336 patients (mean age 70.1 ± 11.4 years; males: 209) were analyzed. In the MNA-SF, 157 patients (47%) were found to be malnourished or at risk of malnutrition. In MNA total score, 168 patients (50%) were found to be malnourished or at risk of malnutrition. The MNA-SF < 12 group had significantly lower body mass index (BMI), hemoglobin level, low MNA scores for protein/water intake, self-evaluation of nutrition and health, and upper arm and calf circumferences compared to the MNA-SF ≥ 12 group. Assuming BMI < 18.5 as malnutrition, the sensitivity and specificity for malnutrition were 100% and 58.9% for MNA-SF, and 96.9% and 54.9% for MNA total score, respectively.
Conclusions:
MNA is useful in screening for malnutrition in patients undergoing CR. Approximately 50% of them were determined to be malnourished or at risk of malnutrition, suggesting the need for detailed evaluation regarding their food intake and dietary intervention.
... Open access exercise has the problem of low efficacy compared with high-load exercise. 4 Previous studies [5][6][7] have suggested that combining supplementation with branched chain amino acids (BCAAs) and exercise therapy offers an effective method for bridging this gap. However, patients with cardiac disease often have reduced renal function and are, thus, unable to benefit from this approach. ...
... 11 12 The combination of BCAAs and exercise therapy has been shown to be more useful in achieving muscle strengthening than either BCAA intake or exercise therapy alone. [5][6][7] Significantly greater increases in muscle strength and mass have been reported with a combined approach compared with the increases seen in older people receiving BCAAs alone. Beta-hydroxy beta-methyl butyrate (HMB) is a metabolite of leucine, a kind of BCAA. ...
... 28 In preliminary studies, the Pearson correlation for knee extensor strength was 0.83 between the preintervention period and 1 month after the intervention 29 and 0.82 between the preintervention period and 3 months after intervention. 7 Since the sample size required for hypothesis testing using a two-sided analysis of covariance model with alpha=0.05 and beta=0.2 will be 48, the number of cases to be enrolled is set at 52 subjects. ...
Introduction
The current treatment for heart disease consists of exercise therapy in addition to pharmacotherapy, nutritional support and lifestyle guidance. In general, nutritional support focuses on protein, salt and energy restrictions, with no active protein or amino acid intake in cases involving moderate or higher renal failure. From this perspective, patients with cardiac disease are at high risk of frailty.
Beta-hydroxy beta-methyl butyrate (HMB) is a metabolite of leucine. HMB is widely used for muscle strengthening and can be safely ingested even by patients with renal failure. The proposed study protocol will investigate the effects of HMB-calcium (HMB-Ca) administered in combination with comprehensive cardiac rehabilitation for muscle strength, muscle mass and cardiac function in patients with cardiac disease during the convalescent period. The primary outcome will be knee extensor strength. Secondary outcomes will be gross isometric limb strength and skeletal muscle mass.
Methods and analysis
This study will be a single-blinded, randomised, controlled trial with parallel comparisons between two groups. The study period will be 60 days from the start of outpatient cardiac rehabilitation. Participants will be randomly divided into two groups: an HMB group consuming HMB-Ca one time per day for 60 days; and a Placebo group consuming reduced maltose once one time per day for 60 days. Exercise therapy will be performed by both groups.
Ethics and dissemination
The study protocol will be published in a peer-reviewed journal. Ethics approval was provided by the Showa University Clinical Research Review Board.
Trial registration number
jRCTs031220139; Japan Registry of Clinical Trails.
... Помимо ОК изучаются добавки некоторых метаболитов, например никотинамидмононуклеотида (NMN) [36], как интервенционный подход против старения человека. Комбинация упражнений и добавок аминокислот с разветвлённой цепью укрепляет мышцы нижних конечностей при физической слабости [37]. ...
Aging of a living organism is closely related to systemic metabolic changes. But due to the multilevel and network nature of metabolic pathways, it is difficult to understand these connections. Today, this problem is solved using one of the main approaches of metabolomics — untargeted metabolome profiling. The purpose of this publication is to systematize the results of metabolomic studies based on such profiling, both in animal models and in humans.
... Some epidemiological studies show that slightly overweight people live longer [39]. In addition to CR, supplementation of food with some metabolites, such as NMN [40], branched-chain amino acid (BCAA) [41], antioxidants, beta-carotene, vitamin A, or vitamin E [42], is being studied as an interventional approach against human aging. ...
Simple Summary
Low-molecular-weight substances are participants in all biochemical processes occurring in the body. Therefore, by measuring them we can obtain new knowledge about aging mechanisms. At the same time, various animals, which are distinguished by different life expectancies, are excellent objects for such studies, and modern science, known as metabolomics, offers efficient methods to measure them, taking into account their huge diversity. This review describes the aging data accumulated today, obtained by such methods in various animal models and humans.
Abstract
Organism aging is closely related to systemic metabolic changes. However, due to the multilevel and network nature of metabolic pathways, it is difficult to understand these connections. Today, scientists are trying to solve this problem using one of the main approaches of metabolomics—untargeted metabolome profiling. The purpose of this publication is to review metabolomic studies based on such profiling, both in animal models and in humans. This review describes metabolites that vary significantly across age groups and include carbohydrates, amino acids, carnitines, biogenic amines, and lipids. Metabolic pathways associated with the aging process are also shown, including those associated with amino acid, lipid, and energy metabolism. The presented data reveal the mechanisms of aging and can be used as a basis for monitoring biological age and predicting age-related diseases in the early stages of their development.
... However, our results revealed that patients with poor performance had increased urinary levels of alanine, valine, and lactate when compared to those with better performance. We can speculate that this difference could be linked to either (1) an increased β-alanine [50,51] and branched-chain amino acid supplementation [52,53] in more frail patients (however, our patients did not take supplements) or (2) a greater release of metabolites involved in the antioxidant and anti-inflammatory reactions. We also observed an increased urine level of trimethylamine N-oxide (TMAO), in patients with poor physical performance compared with those with better performance. ...
In these times of precision and personalized medicine, profiling patients to identify their
needs is crucial to providing the best and most cost-effective treatment. In this study, we used urine metabolomics to explore the characterization of older adults with hip fractures and to explore the forecasting of patient outcomes. Overnight urine specimens were collected from 33 patients (mean age 80 ± 8 years) after hip fracture surgery during their stay at a rehabilitation hospital.
The specimens were analyzed with 1H NMR spectroscopy. We performed a metabolomics study regarding assessments of frailty status, Functional Independence Measure (FIM), and Short Physical Performance Battery (SPPB). The main metabolic variations concerned 10 identified metabolites: paracetamol derivatives (4 peaks: 2.15 ppm; 2.16 ppm; 7.13 ppm and 7.15 ppm); hippuric acid; acetate; acetone; dimethylamine; glycine; alanine; lactate; valine; TMAO. At baseline, the urinary levels of these metabolites were significantly higher (i) in frail compared with non-frail patients, (ii) in persons with poorer FIM scores, and (iii) in persons with poorer compared SPPB scores. Our findings suggested that patients with increased levels of urine metabolites associated with metabolic, inflammatory, and renal disorders presented clear signs of frailty, impaired functional independence, and poor physical performance. Metabolomics could be a valuable tool to further characterize older adults, especially after major medical events.
Citation: Douzi, W.; Bon, D.; Suikkanen, S.; Soukkio, P.; Boildieu, N.; Nenonen, A.; Hupli, M.; Kukkonen-Harjula, K.; Dugué, B.
... The normal cells or tissues of the human body emit heat when the temperature of the human body rises, accelerate blood flow, and expand blood vessels. Therefore, even if the temperature of the normal tissues or cells of the human body rises to 43°C, it will not cause great damage and can selfdissipate [12][13][14]. In necrosis, the new intercellular blood vessels are malformed and develop abnormally, their shape is abnormal, and the endothelial cells of the internal vascular endothelial cells are very fragile and easy to destroy. ...
As more and more people love football and participate in more and more football matches, the physical injuries in the confrontation are getting more and more serious. In recent years, bionic photothermal nanomaterials have shown great application potential in disease treatment. Biomimetic photothermal nanomaterials are functional and intelligent materials with special excellent performance that are designed and synthesized by using natural biomimetic principles. Photothermal therapy (PTT) technology is a new treatment technology in recent years. On the one hand, photothermal therapy technology can convert light energy into heat energy through photothermal conversion factor (PTCA). Molecular water-soluble drugs penetrate into the skin to replace the existing injection administration methods with higher risk and low patient compliance and oral administration methods that generally cause first-pass effects, improve the utilization and efficiency of drugs, and can give provide patients with better treatment. The purpose of this article is to explore the application of the photothermal effect of bionic nanomaterials in the treatment of football sports injuries. The method adopted in this paper is to synthesize different bionic photothermal nanomaterials and synthesize bionic photothermal nanomaterials that are fused with cell membranes, thereby promoting the application of photothermal therapy technology in the treatment of sports injuries; further, by synthesizing bionics wrapped by fusion membranes, photothermal nanomaterials introduce collaborative photothermal therapy technology. The experimental results show that the photothermal effect of nanobiomimetic materials is used to treat common injuries caused by football sports. Compared with traditional treatment methods, HA-CuS gel and near-infrared treatment are applied to the skin with the injured tissue of the experimental group. It dropped to 85.7% in 2 h then gradually dropped to 84.2%, and the recovery speed was significantly accelerated.
... In recent years, muscle atrophy of older persons with sarcopenia or frailty has been of great interest. Previous reports have shown the efficacy of the combination of exercise and protein intake for gaining muscle strength [8][9][10][11][12][13][14]. Additionally, it has been recommended that older persons must be proactive in taking protein because the level of muscle protein synthesis decreases [15,16]. ...
... It is known that the muscle strength after THA is affected by preoperative strength [19], as well as postoperative physical activity [4], mental status [19], and type of exercise therapy [20]. However, considering the common nutritional characteristics of persons with osteoarthritis, sarcopenia, and frailty [8][9][10][11][12][13][14][15][16][17][18], the factors affecting prolonged hip-muscle weakness after THA may be related to the amount of protein or energy intake, as well as preoperative hip strength or physical activity. Therefore, this study investigated the nutritional factors related to muscle weakness 1 year after THA. ...
Objectives:
Prolonged muscle weakness after total hip arthroplasty (THA) remains a problem. Despite increasing physical activity up to 3 years after surgery, muscle strength was decreased to 80-90% of the healthy side 2 years after THA. The objective of the present study was to identify the nutritional factors related to muscle weakness 1 year after THA.
Methods:
Persons who underwent THA were divided into 2 groups according to the cutoff point of knee extensor strength that represents functional limitation: a normal-strength group of 71 persons and a muscle weakness group of 91 persons. The investigators assessed lower limb isometric strength, the 10-m timed gait test, and daily intakes of energy and nutrients from preoperative to 1 year after THA. The differences in nutrient intakes between the 2 groups (normal-strength group and muscle weakness group) were examined by multiple logistic regression analysis.
Results:
There was a significant difference between the groups in energy intake. Daily protein intake was related to knee extension strength gain above the cutoff point 1 year after THA.
Conclusions and implications:
The present study suggested that to prevent prolonged muscle weakness after THA, a sufficient protein intake as well as an exercise intervention may be needed even half a year or after.
