Article

Decreased muscle mass and increased central adiposity are independently related to mortality in older men

Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, United Kingdom.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 11/2007; 86(5):1339-46.
Source: PubMed

ABSTRACT

Aging is associated with significant changes in body composition. Body mass index (BMI; in kg/m(2)) is not an accurate indicator of overweight and obesity in the elderly.
We examined the relation between other anthropometric indexes of body composition (both muscle mass and body fat) and all-cause mortality in men aged 60-79 y.
The study was a prospective study of 4107 men aged 60-79 y with no diagnosis of heart failure and who were followed for a mean period of 6 y, during which time there were 713 deaths.
Underweight men (BMI < 18.5) had exceptionally high mortality rates. After the exclusion of these men, increased adiposity [BMI, waist circumference (WC), and waist-to-hip ratio] showed little relation with mortality after adjustment for lifestyle characteristics. Muscle mass [indicated by midarm muscle circumference (MAMC)] was significantly and inversely associated with mortality. After adjustment for MAMC, obesity markers, particularly high WC (>102 cm) and waist-to-hip ratio (top quartile), were associated with increased mortality. A composite measure of MAMC and WC most effectively predicted mortality. Men with low WC (</=102 cm) and above-median muscle mass showed the lowest mortality risk. Men with WC > 102 cm and above-median muscle mass showed significantly increased mortality [age-adjusted relative risk: 1.36; 95% CI: 1.07, 1.74), and this increased to 1.55 (95% CI: 1.01, 2.39) in those with WC > 102 and low MAMC.
The findings suggest that the combined use of both WC and MAMC provides simple measures of body composition to assess mortality risk in older men.

Full-text preview

Available from: ajcn.org
    • "They suggested MUAC as an important measurement to evaluate health status of oldest old[47]. In another study, Wannamethee et al. showed a positive relationship between MUAMC and survival in elderly[41]. MAMA was especially used for children and overestimation was noted as much as 25% when applied to adults[29]. "
    [Show abstract] [Hide abstract] ABSTRACT: The aim of this study was to determine the prevalence of malnutrition risk and sarcopenia in our elderly (≥ 65 years) nursing home residents and find out their association with mortality.
    No preview · Article · Jan 2016 · European geriatric medicine
  • Source
    • "Iwao et al. [35] observed that WC only modestly added to BMI in the prediction of cardiovascular disease risk factors in younger subjects and added little predictive value in older subjects (n = 1941). A prospective study of 4107 men aged 60–79 [36] suggested that the combination of WC and midarm muscle circumference provided the best estimation of the total mortality risk in the elderly. Importantly, a significant synergistic effect between NC and visceral adipose tissue on cardiometabolic risk factors was noted in the Framingham Heart Study [37]. "
    [Show abstract] [Hide abstract] ABSTRACT: Previous studies have indicated that neck circumference is a valuable predictor for obesity and metabolic syndrome, but little evidence is available for fatty liver disease. We examined the association of neck circumference with fatty liver disease and evaluated its predictive value in Chinese adults. This cross-sectional study comprised 4053 participants (1617 women and 2436 men, aged 20-88) recruited from the Health Examination Center in Guangzhou, China between May 2009 and April 2010. Anthropometric measurements were taken, abdominal ultrasonography was conducted and blood biochemical parameters were measured. Covariance, logistic regression and receiver operating characteristic curve analyses were employed. The mean neck circumference was greater in subjects with fatty liver disease than those without the disease in both women and men after adjusting for age (P<0.001). Logistic regression analysis showed that the age-adjusted ORs (95% CI) of fatty liver disease for quartile 4 (vs. quartile 1) of neck circumference were 7.70 (4.95-11.99) for women and 12.42 (9.22-16.74) for men. After further adjusting for other anthropometric indices, both individually and combined, the corresponding ORs remained significant (all P-trends<0.05) but were attenuated to 1.94-2.53 for women and 1.45-2.08 for men. An additive interaction existed between neck circumference and the other anthropometric measures (all P<0.05). A high neck circumference value was associated with a much greater prevalence of fatty liver disease in participants with both high and normal BMI, waist circumference and waist-to-hip ratio values. Neck circumference was an independent predictor for fatty liver disease and provided an additional contribution when applied with other anthropometric measures.
    Full-text · Article · Feb 2015 · PLoS ONE
  • Source
    • "We adjusted for body mass index (BMI, kg m À 2 in quintiles) to assess whether it mediates the association of interest. As BMI is not an accurate indicator of overweight and obesity in the elderly (Wannamethee et al, 2007), we conducted sensitivity analysis adjusting for waist circumference, a measure of abdominal obesity and a potential independent risk factor for colorectal cancer (Wang et al, 2008), among a subsample of men who reported their waist information in 1987 and 1996. We examined if the association between TV watching and risk of adenoma differed by age, family history of colorectal cancer (yes/no), BMI (o25, 25–29.9, and 30 þ kg m À 2 ) and employment status (yes/no). "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Prolonged TV watching, a major sedentary behaviour, is associated with increased risk of obesity and diabetes and may involve in colorectal carcinogenesis. Methods: We conducted a cross-sectional analysis among 31 065 men with ⩾1 endoscopy in the Health Professionals Follow-up Study (1988-2008) to evaluate sitting while watching TV and its joint influence with leisure-time physical activity on risk of colorectal adenoma. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Prolonged sitting while watching TV was significantly associated with increased risk of colorectal adenoma (n=4280), and adjusting for physical activity or a potential mediator body mass index did not change the estimates. The ORs (95% CIs) across categories of TV watching (0-6, 7-13, 14-20, and 21+ h per week) were 1.00 (referent), 1.09 (1.01-1.17), 1.16 (1.06-1.27), and 1.10 (0.97-1.25) (OR per 14-h per week increment=1.11; 95% CI: 1.04-1.18; Ptrend=0.001). Compared with the least sedentary (0-6 h per week of TV) and most physically active (highest quintile) men, the most sedentary (14+ h per week) and least active (lowest quintile) men had a significant increased risk of adenoma (OR=1.25; 95% CI: 1.05-1.49), particularly for high-risk adenoma. Conclusions: Prolonged TV viewing is associated with modest increased risk of colorectal adenoma independent of leisure-time physical activity and minimally mediated by obesity.
    Full-text · Article · Jan 2015 · British Journal of Cancer
Show more