Alpha-linolenic acid supplementation and resistance training in older adults. Protein supplementation increases postexercise plasma myostatin concentration after 8 weeks of resistance training in young physically active subjects. Development of a simple screening test for sarcopenia in older adults. Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels. Muscle Mass Gain After Resistance Training Is Inversely Correlated With Trunk Adiposity Gain in Postmenopausal Women Cross-Cultural Adaptation and Validation of the Spanish-Language Version of the SARC-F to Assess Sarcopenia in Mexican Community-Dwelling Older Adults. Cancer cachexia, sarcopenia and biochemical markers in patients with advanced non-small cell lung cancer—chemotherapy toxicity and prognostic value Prevalence of sarcopenia in healthy community-dwelling elderly in an urban area of Barcelona (Spain) Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial. Nutrient-rich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength, exercise capacity and quality of life. Sarcopenia Adversely Impacts Postoperative Clinical Outcomes Following Gastrectomy in Patients with Gastric Cancer: A Prospective Study Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study. Sarcopenia is associated with the neutrophil/lymphocyte and platelet/lymphocyte ratios in operable gastric cancer patients: a prospective study Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food Carbohydrate ingestion attenuates the increase in plasma interleukin-6, but not skeletal muscle interleukin-6 mRNA, during exercise in humans. Epidemiology of sarcopenia among the elderly in New Mexico. Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status.
Increased inflammation with aging has been linked to sarcopenia . The purpose of this study was to evaluate the effects of supplementing older adults with alpha-linolenic acid ( ALA ) during a resistance training program , based on the hypothesis that ALA decreases the plasma concentration of the inflammatory cytokine tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 , which in turn would improve muscle size and strength . Fifty-one older adults ( 65.4 + /- 0.8 years ) were r and omized to receive ALA in flax oil ( ~14 g.day-1 ) or placebo for 12 weeks while completing a resistance training program ( 3 days a week ) . Subjects were evaluated at baseline and after 12 weeks for muscle thickness of knee and elbow flexors and extensors ( B-mode ultrasound ) , muscle strength ( 1 repetition maximum ) , body composition ( dual energy X-ray absorptiometry ) , and concentrations of TNF-alpha and IL-6 . Males supplementing with ALA  decreased IL-6 concentration over the 12 weeks ( 62 + /- 36 % decrease ; p = 0.003 ) , with no other changes in inflammatory cytokines . Chest and leg press strength , lean tissue mass , muscle thickness , hip bone mineral content and density , and total bone mineral content significantly increased , and percent fat and total body mass decreased with training ( p < 0.05 ) , with the only benefit of ALA being a significantly greater increase in knee flexor muscle thickness in males ( p < 0.05 ) . Total-body bone mineral density improved in the placebo group , with no change in the ALA group ( p = 0.05 ) . ALA supplementation lowers the IL-6 concentration in older men but not women , but had minimal effect on muscle mass and strength during resistance training Myostatin ( MSTN ) is a negative regulator of muscle growth even if some studies have shown a counterintuitive positive correlation between MSTN and muscle mass ( MM ) . Our aim was to investigate the influence of 2 months of resistance training ( RT ) and diets with different protein contents  on plasma MSTN , interleukin 1 beta ( IL-1β ) , interleukin 6 ( IL-6 ) , tumor necrosis factor alpha ( TNF-α ) , and insulin-like growth factor 1 ( IGF-1 ) .  Eighteen healthy volunteers were r and omly divided in two groups : high protein ( HP ) and normal protein ( NP ) groups . Different protein diet contents were 1.8 and 0.85 g of protein·kg bw(-1)·day(-1 ) for HP and NP , respectively . Subjects underwent 8 weeks of st and ardized progressive RT  . MSTN , IGF-1 , IL-1β , IL-6 , and TNF-α were analyzed before and after the first and the last training sessions . Lean body mass , MM , upper-limb muscle area , and strength were measured . Plasma MSTN showed a significant increase ( P<.001 ) after the last training in the HP group compared with NP group and with starting value . IGF-1 plasma concentration showed a positive correlation with MSTN in HP after the last training ( r(2)=0.6456 ; P=.0295 ) . No significant differences were found between NP and HP for IL-1β , IL-6 , TNF-α , and strength and MM or area . These findings suggest a " paradoxical " postexercise increase of plasma MSTN after 8 weeks of RT and HP diets . This MSTN elevation correlates positively with IGF-1 plasma level . This double increase of opposite ( catabolic/anabolic ) mediators could explain the substantial overlapping of MM increases in the two groups AIM To develop a simple screening test to identify older adults at high risk for sarcopenia . METHODS We studied 1971 functionally independent , community-dwelling adults aged 65 years or older r and omly selected from the resident register of Kashiwa city , Chiba , Japan . Data collection was carried out between September and November 2012 . Sarcopenia was defined based on low muscle mass measured by bioimpedance analysis and either low muscle strength characterized by h and grip or low physical performance characterized by slow gait speed . RESULTS The prevalence of sarcopenia was 14.2 % in men and 22.1 % in women . After the variable selection procedure , the final model to estimate the probability of sarcopenia included three variables : age , grip strength and calf circumference . The area under the receiver operating characteristic curve , a measure of discrimination , of the final model was 0.939 with 95 % confidence interval ( CI ) of 0.918 - 0.958 for men , and 0.909 with 95 % CI of 0.887 - 0.931 for women . We created a score chart for each sex based on the final model . When the sum of sensitivity and specificity was maximized , sensitivity , specificity , and positive and negative predictive values for sarcopenia were 84.9 % , 88.2 % , 54.4 % , and 97.2 % for men , 75.5 % , 92.0 % , 72.8 % , and 93.0 % for women , respectively . CONCLUSIONS The presence of sarcopenia could be detected using three easily obtainable variables with high accuracy . The screening test we developed could help identify functionally independent older adults with sarcopenia who are good c and i date s for intervention Summary There is no clear consensus on definition , cut-points or st and ardised assessment s of sarcopenia . We found a lower limb strength assessment  was at least as effective in predicting balance , mobility and falls in 419 older people as muscle mass-based measures of sarcopenia . Introduction There is currently no consensus on the definition , cut-points or st and ardised assessment s of sarcopenia . This study aim ed to investigate whether several published definitions of sarcopenia differentiate between older people with respect to important functional and health outcomes . Methods Four hundred nineteen community-living older adults ( mean age 81.2 ± 4.5 , 49 % female ) completed assessment s of body composition ( dual-energy X-ray absorptiometry ) , strength , balance , mobility and disability . Falls were recorded prospect ively for a year using monthly calendars . Sarcopenia was defined according to four skeletal mass-based definitions , two strength-based definitions ( h and grip or knee extensor force ) and a consensus algorithm ( low mass and low strength or slow gait speed ) . Obesity was defined according to percentage fat mass or waist circumference . Results The four skeletal mass-based definitions varied considerably with respect to the percentage of participants classified as sarcopenic and their predictive accuracy for functional and health outcomes . The knee extension strength-based definition was equivalent to or better than the mass-based and consensus algorithm definitions ; i.e. weaker participants performed poorly in tests of leaning balance , stepping reaction time , gait speed and mobility . They also had higher physiological fall risk scores and were 43 % more likely to fall at home than their stronger counterparts . Adding obesity to sarcopenia definitions identified participants with greater self-reported disability . Conclusions A simple lower limb strength assessment was at least as effective in predicting balance , functional mobility and falls in older people as more expensive and time-consuming muscle mass-based measures . These findings imply that functional terms such as muscle weakness or motor impairment are preferable to sarcopenia OBJECTIVES To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)-alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low- grade inflammation . DESIGN A 12-week controlled resistance-training study . SETTING Nursing homes in Copenhagen , Denmark . PARTICIPANTS Twenty-one frail nursing home residents aged 86 to 95 completed the study . INTERVENTION Ten participants were r and omized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks ; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist . MEASUREMENTS Muscle strength , plasma levels of TNF-alpha , soluble TNF receptor (sTNFR)-1 , and interleukin (IL)-6 were measured before and at the end of the intervention period . RESULTS The training program improved muscle strength but did not affect plasma levels of TNF-alpha and sTNFR-I or IL-6 . However , plasma levels of sTNFR-I at baseline were inversely correlated with the increase in muscle strength . CONCLUSION Low- grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old . Furthermore , data suggest that the antiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system , but the small sample size limited this interpretation The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging , also called sarcopenia . The aim of this prospect i ve study was to investigate whether low serum 25-hydroxyvitamin D ( 25-OHD ) and high serum PTH concentration were associated with sarcopenia . In men and women aged 65 yr and older , participants of the Longitudinal Aging Study Amsterdam , grip strength ( n = 1008 ) and appendicular skeletal muscle mass ( n = 331 , using dual-energy x-ray absorptiometry ) were measured in 1995 - 1996 and after a 3-yr follow-up . Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort , translating into a loss of grip strength greater than 40 % or a loss of muscle mass greater than 3 % . After adjustment for physical activity level , season of data collection , serum creatinine concentration , chronic disease , smoking , and body mass index , persons with low ( < 25 nmol/liter ) baseline 25-OHD levels were 2.57 ( 95 % confidence interval 1.40 - 4.70 , based on grip strength ) and 2.14 ( 0.73 - 6.33 , based on muscle mass ) times more likely to experience sarcopenia , compared with those with high ( > 50 nmol/liter ) levels . High PTH levels ( > or=4.0 pmol/liter ) were associated with an increased risk of sarcopenia , compared with low PTH ( < 3.0 pmol/liter ) : odds ratio = 1.71 ( 1.07 - 2.73 ) based on grip strength , odds ratio = 2.35 ( 1.05 - 5.28 ) based on muscle mass . The associations were similar in men and women . The results of this prospect i ve , population -based study show that lower  25-OHD  and higher  PTH levels increase the risk of sarcopenia in older men and women OBJECTIVES To test whether accelerated sarcopenia in older persons with high interleukin (IL)-6 serum levels plays a role in the prospect i ve association between inflammation and disability found in many studies . DESIGN Cohort study of older women with moderate to severe disability . PARTICIPANTS Six hundred twenty older women from the Women 's Health and Aging Study in whom information on baseline IL-6 serum level was available . MEASUREMENTS Self-report of functional status , objective measures of walking performance , and knee extensor strength were assessed at baseline and over six semiannual follow-up visits . Potential confounders were baseline age , race , body mass index , smoking , depression , and medical conditions . RESULTS At baseline , women with high IL-6 were more often disabled and had lower walking speed . After adjusting for confounders , women in the highest IL-6 tertile ( IL-6>3.10 pg/mL ) were at higher risk of developing incident mobility disability ( risk ratio ( RR ) = 1.50 , 95 % confidence interval ( CI ) = 1.01 - 2.27 ) , disability in activities of daily living ( RR = 1.41 , 95 % CI = 1.01 - 1.98 ) , and severe limitation in walking ( RR = 1.61 , 95 % CI = 1.09 - 2.38 ) and experienced steeper declines in walking speed ( P < .001 ) than women in the lowest IL-6 tertile ( IL-6 < or = 1.78 pg/mL ) . Decline in knee extensor strength was also steeper , but differences across IL-6 tertiles were not significant . After adjusting for change over time in knee extensor strength , the association between high IL-6 and accelerated decline of physical function was no longer statistically significant . CONCLUSIONS Older women with high IL-6 serum levels have a higher risk of developing physical disability and experience a steeper decline in walking ability than those with lower levels , which are partially explained by a parallel decline in muscle strength Abstract Orsatti , FL , Nahas , EAP , Orsatti , CL , de Oliveira , EP , Nahas-Neto , J , da Mota , GR , and Burini , RC . Muscle mass gain after resistance training is inversely correlated with trunk adiposity gain in postmenopausal women . J Strength Cond Res 26(8 ) : 2130–2139 , 2012—The aim of this study was to evaluate alterations in trunk adiposity ( TA ) over 9 months of resistance training ( RT ) and associate these changes with the hypertrophy of muscle mass ( MM ) in postmenopausal women ( PW ) . The investigation used a sample that consisted of 22 PW ( 44–69 years old ) . The group was subjected to RT ( 60–80 % of 1 repetition maximum ) for the total body 3 d·wk−1 . Body composition  ( dual-energy x-ray absorptiometry )  and plasma levels of insulin-like growth factor-1 ( IGF-1 ) , follicle-stimulating hormone , E2 ( Immulite system )  , and interleukin-6 ( IL-6  ; enzyme-linked immunosorbent assay ) were assessed at the beginning and end of the experiment . After RT , only women who acquired up to 5 % TA gained MM , whereas women who acquired > 5 % TA exhibited increased IL-6 and no MM gain ( p < 0.05 ) . The & Dgr;MM was negatively associated with time of menopause ( r = −0.45 , p < 0.05 ) and positively associated with baseline IGF-1 ( r = 0.47 , p < 0.05 ) . Only & Dgr;LE ( leg extension ) was negatively associated with baseline IL-6 ( p < 0.05 ) . Trunk adiposity growth ( & Dgr;TF , kilograms ) was positively correlated with changes in IL-6 ( r = 0.68 , p < 0.05 ) . The MM gain was negatively correlated with & Dgr;TF ( r = −0.63 , p < 0.05 ) and changes in IL-6 ( r = −0.73 , p < 0.05 ) . After adjusting all of the confounding variables , only baseline IGF-1 ( positively ) and changes in IL-6 ( negatively ) influenced MM , and only the increase in TA influenced IL-6 . Our study suggests that increased levels of TA during RT increase IL-6 concentrations , which is a significant negative predictor of MM gain in PW OBJECTIVES To cross-culturally adapt and vali date the Spanish- language version of the SARC-F  in Mexican community-dwelling older adults . DESIGN Cross-sectional analysis of a prospect i ve cohort . SETTING The FraDySMex study , a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City . PARTICIPANTS Participants were 487 men and women older than 60 years , living in the design ated area in Mexico City . MEASUREMENTS Information from question naires regarding demographic characteristics , comorbidities , mental status , nutritional status , dependence in activities of daily living , frailty , and quality of life . Objective measurements of muscle mass , strength and function were as follows : skeletal muscle mass index ( SMI ) was taken using dual-energy x-ray , grip strength using a h and dynamometer , 6-meter gait speed using a GAIT Rite instrumented walkway , peak torque and power for knee extension using a isokinetic dynamometer , lower extremity functioning measured by the Short Physical Performance Battery ( SPPB ) , and balance using evaluation on a foam surface , with closed eyes , in the Modified Clinical Test of Sensory Integration . The SARC-F scale translated to Spanish and the consensus panels ' criteria from European , international , and Asian sarcopenia working groups were applied to evaluate sarcopenia . RESULTS The Spanish language version of the SARC-F scale showed reliability ( Cronbach alfa = 0.641 . All items in the scale correlated to the scale 's total score , rho = 0.43 to 0.76 ) , temporal consistency evaluated by test-retest ( CCI = 0.80 ) , criterion validity when compared to the consensus panels ' criteria ( high specificity and negative predictive values ) . The scale was also correlated to other measures related to sarcopenia ( such as age , quality of life , self-rated health status , cognition , dependence in activities of daily living , nutritional status , depression , gait speed , grip strength , peak torque and power for knee extension , SPPB , balance , SMI , and frailty ) . CONCLUSION The SARC-F scale was successfully adapted to Spanish language and vali date d in community-dwelling Mexican older adults Purpose Cancer cachexia and sarcopenia are frequently observed in cancer patients and associated with poor survival . The majority of studies of cancer cachexia and sarcopenia have been done in patients with solid tumors of different origins , and there are currently no good predictors of the benefit of chemotherapy or factors that predict survival in advanced cancer . The purpose of our prospect i ve study was to evaluate prevalence of cachexia and sarcopenia using international consensus definition and criteria for diagnosis in patients with diagnosed advanced non-small cell lung cancer ( NSCLC ) stage IIIB and IV and their relation to chemotherapy toxicity and survival prediction . A secondary aim was to compare several biochemical markers ( CRP , IL-6 , protein , and albumin ) with time to tumor progression in order to assess prognostic value or to guide a treatment . Methods Between December 2013 and April 2015 , the prospect i ve cohort study of 100 Caucasian patients with advanced NSCLC stage IIIB or IV , who were referred consecutively to Department for Respiratory Diseases “ Jordanovac , ” was evaluated . Anthropometric measurements and biochemical data ( CRP , albumin , protein , IL-6 , haemoglobin ) together with body composition measurements ( total muscle cross-sectional area , lumbar skeletal muscle index ) were obtained for each patient before starting with platinum-doublet therapy . Skeletal muscle cross-sectional area at the third lumbar vertebra was measured by computerized tomography , and sarcopenia was defined using a previously published cutoff point . Toxicity was assessed after cycle 1 of treatment and time-to-tumor progression was determined prospect ively . Results One hundred patients with advanced lung cancer were recruited : 67 were male and median age was 64 years . The median time to disease progression was 187 days . The prevalence of cachexia and sarcopenia in study cohort was 69 and 47 % , respectively . CRP , IL-6 , and albumin concentration in cachectic compared to non-cachectic patients demonstrated statistically significant difference ( p = 0.020 , p = 0.040 , p = 0.003 ) . Cachexia and sarcopenia were not found to be predictors of chemotoxicity nor was time to tumor progression . On the contrary , albumin concentration with established cutoff point of 37.5 g/L was clearly proved as the predictive factor of both chemotoxicity ( OR ( 95 % CI ) = 0.85 ; p < 0.001 ) and survival ( HR ( 95 % CI ) = 0.55 ) . Conclusions Albumin level has been shown to be more important predictive marker of chemotherapy toxicity and survival than cachexia and sarcopenia are . This approach in clinical setting s can be used to guide the choice of oncologic treatment Introduction The purpose of this study was to evaluate the prevalence of sarcopenia in a cohort of healthy community-dwelling elderly in an urban area in Barcelona ( Spain ) for native benchmarks and compare them with those published in other geographical areas . Material and methods We prospect ively evaluated a series of 200 healthy elderly in the community with preserved functional capacity and absence of cognitive impairment . We performed a comprehensive geriatric assessment and determined anthropometric data , muscle mass ( MM ) and the muscle mass index ( MMI ) . Assessment of muscle mass was performed by bioelectrical impedance analysis ( BIA ) . The cut-off point for defining sarcopenia MMI was established as less than 2 SD of the mean of a reference group comprising 220 healthy volunteers ( 20–42 years ) in the same area . Results were compared with studies undertaken in the USA , France and Taiwan . Results The cut-off points obtained were 8.31 Kg/m2 for men and 6.68 Kg/m2 for women , being similar to those observed in France and Taiwan but different from the USA . The prevalence of sarcopenia observed was 33 % for elderly women and 10 % for males . On comparison of the prevalence of sarcopenia in the four population s , we observed some differences , particularly in males . Conclusions We have defined reference values for sarcopenia , determined by BIA , in our setting . We also observed a remarkable prevalence of sarcopenia in the healthy elderly community , especially in females , showing some differences from those in other geographical regions Summary Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function . This prospect i ve , population -based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults . Introduction The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions . Methods N = 681 volunteers ( 48 % female ; mean ± SD age 61.4 ± 7.0 years ) participated in baseline and follow-up assessment s ( mean 5.1 ± 0.5 years later ) . Appendicular lean mass ( ALM ) was assessed by dual-energy X-ray absorptiometry , h and grip ( HGS ) and lower-limb ( LLS ) strength were assessed by dynamometry , and falls risk was determined using the physiological profile assessment . Anthropometric definitions ( ALM/height squared [ ALM – H ] , ALM/weight × 100 and a residuals method [ ALM – R ] ) and performance-based definitions ( HGS , LLS and upper- and lower-limb muscle quality [ LMQ ] ) of sarcopenia were examined . The lowest 20 % of the sex-specific distribution for each definition at baseline was classified as sarcopenia . Results Sarcopenia prevalence increased after 5 years for all operational definitions except ALM – H ( men : −4.0 % ; women : −5.5 % ) . Men classified with sarcopenia according to anthropometric definitions , and women classified with sarcopenia according to performance-based definitions , had significant increases in falls risk over 5 years ( all P < 0.05 ) compared to individuals without sarcopenia . Significant sex interactions were observed for ALM-R , LLS and LMQ ( all P < 0.05 ) definitions . Conclusions Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions . Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older adults , but sex-specific differences may exist according to different anthropometric or performance-based definitions BACKGROUND Recent evidence suggests that nutritional interventions may improve muscle outcomes in malnutrition and sarcopenia . OBJECTIVES We evaluated the effects of 2 high- quality oral nutritional supplements ( ONS ) differing in amount and type of key nutrients in older adult men and women . DESIGN A multicenter , r and omized , double-blinded , controlled clinical trial . PARTICIPANTS Malnourished and sarcopenic men and women , 65 years and older ( n = 330 ) . INTERVENTION A 24-week intervention period with 2 energy-rich ( 330 kcal ) ONS treatment groups : Control ONS ( CONS , 14 g protein ; 147 IU vitamin D3 ) versus Experimental ONS ( EONS , 20 g protein ; 499 IU vitamin D3 ; 1.5 g CaHMB ) taken twice daily . Both ONS also contained other vitamins , minerals , and nutrients in varying amounts . MEASUREMENTS Isokinetic peak torque ( PT , Nm ) leg strength , grip strength ( kg ) , and gait speed ( m·s-1 ) were assessed at baseline and 12 and 24 weeks . Left and right leg muscle mass ( LMM , kg ) were assessed by dual-energy x-ray absorptiometry ( DXA ) . Muscle quality ( MQ ) was leg strength expressed relative to the tested LMM ( Nm·kg-1 ) . Subgroup analyses were performed : severe sarcopenia ( low skeletal mass index , low grip strength [ < 30 kg men ; < 20 kg women ] , low gait speed [ < 0.8 m·s-1 ] ) and mild-moderate sarcopenia ( low skeletal mass index , normal gait speed , or normal grip strength ) . RESULTS Both ONS groups ( EONS and CONS ) improved PT , MQ , grip strength , and gait speed from baseline with no treatment differences . Those with severe sarcopenia ( 44 % ) exhibited lower baseline PT and MQ , with no differences in strength improvements between treatments . However , participants with mild-moderate sarcopenia exhibited higher baseline PT and MQ , with differences in strength improvements at 12 weeks ( EONS > CONS , P = .032 ) in those with normal grip strength . There were no treatment differences based on sarcopenic severity for either grip strength or gait speed . CONCLUSION ONS improved strength outcomes in malnourished older adults with sarcopenia . In those with mild-moderate sarcopenia , but not severe sarcopenia , consumption of the EONS improved leg muscle strength and quality compared with the st and ard CONS Background At present , it is unknown whether the use of nutrient-rich dairy proteins improves the markers of sarcopenia syndrome . Therefore , our proposal was to investigate whether adding 210 g of ricotta cheese daily would improve skeletal muscle mass , h and grip strength , and physical performance in non-sarcopenic older subjects . Subjects and methods This was a single-blind r and omized clinical trial that included two homogeneous , r and omized groups of men and women over 60 years of age . Participants in the intervention group were asked to consume their habitual diet but add 210 g of ricotta cheese ( IG/HD + RCH ) , while the control group was instructed to consume only their habitual diet ( CG/HD ) . Basal and 12-week follow-up measurements included appendicular skeletal muscle mass ( ASMM ) by dual-energy X-ray absorptiometry , h and grip strength by a h and held dynamometer , and physical performance using the short physical performance battery ( SPPB ) and the stair-climb power test ( SCPT ) . The main outcomes were relative changes in ASMM , strength , SPPB , and SCPT . Results ASMM increased in the IG/HD + RCH ( 0.6±3.5 kg ) , but decreased in the CG/HD ( −1.0±2.6 ) . The relative change between groups was statistically significant ( P=0.009 ) . The relative change in strength in both groups was negative , but the loss of muscle strength was more pronounced in CG/HD , though in this regard statistical analysis found only a tendency ( P=0.07 ) . The relative change in the balance-test scores was positive for the IG/HD + RCH , while in the CG/HD it was negative , as those individuals had poorer balance . In this case , the relative change between groups did reach statistical significance . Conclusion The addition of 210 g of ricotta cheese improves ASMM and balance-test scores , while attenuating the loss of muscle strength . These results suggest that adding ricotta cheese to the habitual diet is a promising dietetic strategy that may improve the markers of sarcopenia in subjects without a pronounced loss of ASMM or sarcopenia BACKGROUND To describe the prevalence of sarcopenia in ambulatory patients with heart failure with preserved ejection fraction ( HFpEF ) and its relation to reduced exercise capacity , muscle strength , and quality of life ( QoL ) . METHODS AND RESULTS A total of 117 symptomatic out patients with HFpEF were prospect ively enrolled in Germany , Engl and , and Slovenia as part of the Studies Investigating Co-morbidities Aggravating Heart Failure ( SICA-HF ) .  Appendicular skeletal muscle ( ASM ) mass ( the sum of muscle mass in both arms and legs ) was assessed by DEXA . Echocardiography , 6-minute walk testing ( 6-MWT ) , muscle strength assessment , spiroergometry and QoL evaluation using EQ-5D Question naire were performed . Sarcopenia was defined as ASM 2 st and ard deviations below the mean of a healthy reference group aged 18 - 40years . Patients were divided into 3 groups according to the E/e ' value : ≤8 , 9 - 14 , and ≥15 . Sarcopenia was detected in 19.7 % of all patients . These patients performed worse during 6-MWT ( 404±116 vs. 307±145 m , p=0.003 ) and showed lower absolute peak oxygen consumption ( 1579±474 vs. 1211±442mL/min , p<0.05 ) . Both ASM and muscle strength were lowest in patients with E/e ' > 15 ( p<0.05 ) . Higher values of muscle strength/ASM were associated with a better QoL ( r=0.5 , p<0.0005 ) . Logistic regression showed ASM to be independently associated with reduced distance walked during the 6-MWT adjusted for NYHA , height , left atrium diameter , ferritin and forced expiratory volume in 1s ( FEV1 ) ( odds ratio 1.2 , p=0.02 ) . CONCLUSION Sarcopenia affects a clinical ly relevant proportion of patients with HFpEF  . Low ASM is strongly linked to reduced muscle strength , exercise capacity and QoL in these patients Background Sarcopenia is characterized by decreased skeletal muscle plus low muscle strength and /or physical performance . This study was performed to determine the association of sarcopenia with short-term postoperative outcomes after gastrectomy for gastric cancer . Methods We conducted a prospect i ve study of 255 consecutive patients with gastric cancer who underwent curative gastrectomy .  The sarcopenia elements , including lumbar skeletal muscle index , h and grip strength , and gait speed , were measured before surgery . Patients were followed up after gastrectomy to gain the actual clinical outcomes . Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis . Results Sarcopenia was present in 32 of 255 patients ( 12.5 % ) , and was significantly correlated with advance age , lower body mass index , higher nutritional risk screening ( NRS ) 2002 score , and lower preoperative serum albumin and hemoglobin . Compared with non-sarcopenic patients , sarcopenic patients had a higher risk of postoperative complications , longer postoperative hospital stay , and more hospital costs . In univariate analysis , sarcopenia ( p < 0.001 ) , nutritional risk ( NRS 2002 score ≥3 ; p = 0.003 ) , advanced age ( ≥75 years ; p = 0.014 ) , anemia ( p = 0.012 ) , hypoalbuminemia ( p = 0.029 ) , and diabetes ( p = 0.014 ) were associated with postoperative complications . Multivariable analysis revealed that sarcopenia ( p < 0.001 ) and diabetes ( p = 0.006 ) were independent predictors of postoperative complications . Conclusions Sarcopenia is an independent predictor of postoperative complications in patients with gastric cancer after gastrectomy BACKGROUND AND AIMS sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals . We evaluated the impact of sarcopenia on the risk of all-cause death in a population of frail older persons living in community . METHODS we analysed data from the Aging and Longevity Study , a prospect i ve cohort study that collected data on all subjects aged 80 years and older residing in the Sirente geographic area ( n = 364 ) . The present analysis was conducted among those subjects who were between 80 and 85 years of age at the time of the baseline assessment ( n = 197 ) . The main outcome measure was all-cause mortality over 7-year follow-up . According to the European Working Group on Sarcopenia in Older People ( EWGSOP ) criteria , the diagnosis of sarcopenia required the documentation of low muscle mass and the documentation of either low muscle strength or low physical performance . Cox proportional regression models were used to estimate crude and adjusted hazard ratios and 95 % confidence intervals of death by the presence of sarcopenia . RESULTS using the EWGSOP-suggested criteria , 43 subjects with sarcopenia ( 21.8 % ) were identified . During the 7-year follow-up , 29 ( 67.4 % ) participants died among subjects with sarcopenia compared with 63 subjects ( 41.2 % ) without sarcopenia ( P < 0.001 ) . After adjusting for potential confounders including age , gender , education , activities of daily living ( ADL ) impairment , body mass index , hypertension , congestive heart failure , chronic obstructive pulmonary disease , number of diseases , TNF-α , participants with sarcopenia had a higher risk of death for all causes compared with non-sarcopenic subjects ( HR : 2.32 , 95 % CI : 1.01 - 5.43 ) . CONCLUSIONS our results obtained from a representative sample of very old and frail subjects show that sarcopenia is associated with mortality , independently of age and other clinical and functional variables Purpose Sarcopenia is distinguished by decreased skeletal muscle plus low muscle strength and /or physical performance . This study was design ed to demonstrate the relationship between sarcopenia and systemic inflammatory response ( neutrophil/lymphocyte ratio [ NLR ] , platelet/lymphocyte ratio [ PLR ] , and large platelet/lymphocyte ratio [ LPLR ] ) prior to radical gastrectomy for gastric cancer . Patients and methods We conducted a prospect i ve study of gastric cancer patients who underwent radical gastrectomy .  The clinical utility of the NLR , PLR , and LPLR was evaluated by receiver operating characteristic curves . Sarcopenia components including skeletal muscle index , h and grip strength , and 6 m usual gait speed were measured . Logistic analysis was used to identify the independent indices associated with sarcopenia . Results A total of 670 patients were included , representing 504 men and 166 women . Of these , 104 patients ( 15.5 % ) were diagnosed with sarcopenia and 567 ( 84.5 % ) were non-sarcopenia . PLR has a diagnostic sensitivity of 91.3 % for sarcopenia . In addition to the indicators of preoperative age , nutritional risk screening , body mass index , preoperative albumin , and diabetes , the NLR and PLR were independent predictors for sarcopenia ( P<0.05 ) . Conclusion The present study showed that at-diagnosis sarcopenia was associated with inflammation in patients with operable gastric cancer . Due to the complex assessment of muscle condition , PLR may be used as a primary screening test for sarcopenia . How systemic inflammatory response influences changes in sarcopenia may provide new therapeutic perception toward improving outcomes Background Sarcopenia is strongly associated with an inadequate intake of dietary protein . Dietary protein supplementation boosts muscle-protein synthesis and increases muscle mass in the elderly . This study tested whether adding a protein-rich food , ricotta cheese , to the habitual diet increased total appendicular skeletal muscle mass and strength in elderly people . Methods Participants ( n = 40 ) , were sarcopenic elderly men and women over 60 years of age . Two comparison groups were formed at r and om and followed for 3 months : the intervention group received 210 g/day of ricotta cheese plus the habitual diet , while the control group followed the habitual diet with no additional intervention . Total appendicular skeletal muscle ( TASM ) was assessed by dual-energy X-ray absorptiometry , while strength was measured using a h and held dynamometer at baseline and after the intervention period . The primary outcomes were the percentage of relative change in TASM and strength . Results The percentage of relative change in TASM was not significant between the groups after the intervention period . Muscle strength improved in the intervention group , but showed only a tendency towards significance ( P = 0.06 ) . Secondary analysis showed that the men in the intervention group gained 270 g in TASM compared to those in the control group , and improved their fasting insulin levels ( P = 0.05 ) , muscle strength , lean body mass in the arms , and body weight variables . Conclusion The results of this study indicate that a nutritional intervention using a high- quality protein food , specifically ricotta cheese , in order to increase the amount of protein intake might not be regarded as fully promising in elderly men and women with sarcopenia . However , the gender effects on muscle strength , lean tissue in the arms , homeostatic assessment of insulin resistance , and body weight detected in this study suggest that additional research is needed on elderly male subjects with sarcopenia 1 . The present study was undertaken to examine the effects of exercise and carbohydrate ( CHO ) ingestion on interleukin-6 ( IL-6 ) gene expression in skeletal muscle and plasma IL-6 concentration . 2 . Seven moderately trained men completed 60 min of exercise  at a workload corresponding to each individual 's lactate threshold on four r and omised occasions . Two trials were conducted on a bicycle ergometer ( Cyc ) and two on a running treadmill ( Run ) either with ( CHO ) or without ( Con ) the ingestion of a CHO beverage throughout the exercise . Muscle biopsies were obtained from the vastus lateralis before and immediately after exercise and IL-6 gene expression in these sample s was determined using real-time PCR . In addition , venous blood sample s were collected at rest , and after 30 min during and at the cessation of exercise . These sample s were analysed for plasma IL-6 . 3 . Irrespective of exercise mode or CHO ingestion , exercise result ed in a 21 + /- 4-fold increase ( P < 0.01 ; main exercise effect ) in IL-6 mRNA expression . In contrast , while the mode of exercise did not affect the exercise-induced increase in plasma IL-6 , CHO ingestion blunted ( P < 0.01 ) this response . 4 . These data demonstrate that CHO ingestion attenuates the plasma IL-6 concentration during both cycling and running exercise . However , because IL-6 mRNA expression was unaffected by CHO ingestion , it is likely that the ingestion of CHO during exercise attenuates IL-6 production by tissues other than skeletal muscle Muscle mass decreases with age , leading to " sarcopenia , " or low relative muscle mass , in elderly people . Sarcopenia is believed to be associated with metabolic , physiologic , and functional impairments and disability . Methods of estimating the prevalence of sarcopenia and its associated risks in elderly population s are lacking . Data from a  population -based survey of 883 elderly Hispanic and non-Hispanic white men and women living in New Mexico ( the New Mexico Elder Health Survey , 1993 - 1995 ) were analyzed to develop a method for estimating the prevalence of sarcopenia . An anthropometric equation for predicting appendicular skeletal muscle mass was developed from a r and om sub sample ( n = 199 ) of participants and was extended to the total sample . Sarcopenia was defined as appendicular skeletal muscle mass (kg)/height2 ( m2 ) being less than two st and ard deviations below the mean of a young reference group . Prevalences increased from 13 - 24 % in persons under 70 years of age to > 50 % in persons over 80 years of age , and were slightly greater in Hispanics than in non-Hispanic whites . Sarcopenia was significantly associated with self-reported physical disability in both men and women , independent of ethnicity , age , morbidity , obesity , income , and health behaviors . This study provides some of the first estimates of the extent of the public health problem posed by sarcopenia BACKGROUND AND OBJECTIVES Reduced muscle mass and strength are prevalent conditions in dialysis patients . However , muscle strength and muscle mass are not congruent ; muscle strength can diminish even though muscle mass is maintained or increased . This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination ( i.e. , concurrent loss of muscle mass and strength/mobility , here defined as sarcopenia ) . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS This study included 330 incident dialysis patients ( 203 men , mean age 53±13 years , and mean GFR 7±2 ml/min per 1.73 m(2 ) ) recruited between 1994 and 2010 and followed prospect ively for up to 5 years . Low muscle mass ( by dual-energy x-ray absorptiometry appendicular mass index ) and low muscle strength ( by h and grip ) were defined against young reference population s according to the European Working Group on Sarcopenia in Older People . RESULTS Whereas 20 % of patients had sarcopenia , low muscle mass and low muscle strength alone were observed in a further 24 % and 15 % of patients , respectively . Old age , comorbidities , protein-energy wasting , physical inactivity , low albumin , and inflammation associated with low muscle strength , but not with low muscle mass ( multivariate ANOVA interactions ) . During follow-up , 95 patients ( 29 % ) died and both conditions associated with mortality as separate entities . When combined , individuals with low muscle mass alone were not at increased risk of mortality ( adjusted hazard ratio [ HR ] , 1.23 ; 95 % confidence interval [ 95 % CI ] , 0.56 to 2.67 ) . Individuals with low muscle strength were at increased risk , irrespective of their muscle stores being appropriate ( HR , 1.98 ; 95 % CI , 1.01 to 3.87 ) or low ( HR , 1.93 ; 95 % CI , 1.01 to 3.71 ) . CONCLUSIONS Low muscle strength was more strongly associated with aging , protein-energy wasting , physical inactivity , inflammation , and mortality than low muscle mass . Assessment of muscle functionality may provide additional diagnostic and prognostic information to muscle-mass evaluation BACKGROUND Loss of muscle mass ( sarcopenia ) leads to frailty in older men . The decline in testosterone over the life span may contribute to this muscle loss . We studied the ability of oral testosterone to prevent muscle loss in older men over a 12-month period . METHODS A st and ard dose ( 80 mg twice daily ) of testosterone undecanoate or placebo was administered for 1 year to 76 healthy men aged 60 years or older . All men had a free testosterone index of 0.3 - 0.5 , which represents a value below the normal lower limit for young men ( 19 - 30 years ) , but remains within the overall normal male range . Measurements of body composition , muscle strength , hormones , and safety parameters were obtained at 0 , 6 , and 12 months . RESULTS Lean body mass increased ( p = .0001 ) and fat mass decreased ( p = .02 ) in the testosterone as compared with the placebo-treated group . There were no significant effects on muscle strength . There was a significant increase in hematocrit ( 0.02 % ) in the testosterone-treated group ( p = .03 ) . Plasma triglycerides , total cholesterol , and low-density lipoprotein cholesterol levels were similar in both groups , but there was a decrease in high-density lipoprotein cholesterol ( -0.1 mmol/L ) at 12 months in the testosterone group as compared to the placebo group ( p = 0.026 ) . There were no differences in prostate-specific antigen or systolic or diastolic blood pressure between the groups . CONCLUSION Oral testosterone administration to older relatively hypogonadal men results in an increase in muscle mass and a decrease in body fat
Conclusion This is the first study to demonstrate that a higher predictive IL-6 cut-off level should be determined for aging sarcopenia in men than in women
Background Aging sarcopenia characterized by low muscle mass with low muscle strength affects men and women differently .
The contribution of interleukin-6 ( IL-6 ) to sarcopenia has been suggested based on a negative correlation between plasma IL-6 and muscle function described by some studies .
However , no consensus regarding clinical ly relevant cut-off criteria has been reached .
Another question arises whether pooling male and female data is an accurate way to determine the predictive value of IL-6 in sarcopenia .
The present meta- analysis was design ed to assess : ( 1 ) whether plasma IL-6 in aged population s in fact correlates negatively to muscle strength ; ( 2 ) whether such a correlation exists both in men and in women ; and ( 3 ) whether plasma IL-6 shows a gender difference in old age .