Association between dietary intake and resistance exercise with - PowerPoint PPT Presentation

Association between dietary intake and resistance exercise with change in body composition and physical function among elderly O G Geirsdóttir , Ramel A, Chang M, Jonsson PV, Thorsdottir I University of Iceland & The Icelandic Geriatric Research Institute

CONFLICT OF INTEREST DISCLOSURE I have no potential conflict of interest to report Research Support: Icelandic Technology Development Fund (No 071323008) Research Fund of the University of Iceland Landspitali University Hospital Research Fund Helga Jónsdóttir & Sigurliði Kristjánsson, Geriatric Research Fund The Icelandic Gerontological Research Institute Consultant: None Discussion of Off-Label, Investigational, or Experimental Drug Use: None This study does not necessary reflect the views of the sponsors.

Background • Body composition is an important factor in the development of disease. – Lean body mass 1,2,3,4 Aging is associated with – Fat mass 5,6 changes in body composition – Distribution • Underlying mechanisms – Inadequate food intake 8 – Inactivity 9 – Altered endocrine function 1,2 – Inflammation 7 1.Cree, M.G., et al. 2004, The Journal of clinical endocrinology and metabolism. 2.Roriz-Cruz M, Rosset I, Wada T, et al. 2007 J Am Geriatr Soc. 3.Harris, T., Kovar, et al. 1989, American Journal of Public Health. 4.Guralnik, J.M., Simonsick, et al. 1994, Journal of gerontology. 5.Singh, J.A. & Strand, V. 2009, The Journal of rheumatology. 6.Berger, M.J. & Doherty, T.J. 2010, Interdisciplinary topics in gerontology. 7.Lenk, K., Schuler, G. & Adams, V. 2010, Journal of cachexia, sarcopenia and muscle. 8.Walrand, S. & Boirie, Y. 2005, Current opinion in clinical nutrition and metabolic care. 9.Guo, S.S., Zeller, C., et al. 1999, Am JCN 3

IceProQualita study • The overall aim was to increase knowledge on physical activity and nutrition among older adults and to investigate how these factors possibly modify body composition, muscle strength, physical function and other health parameters • Research question – to characterize participants who did not respond to the resistance training with regards to lean body mass. 1) Geirsdottir OG, Ramel A, Chang M, Briem K, Jonsson PV, Thorsdottir I. J Food Nutr Disor 2016,5:2. 2) Ramel A, Geirsdottir OG, Jonsson PV, Thorsdottiri I. J Nutr Health Aging. 2015;19:792-6. 3) Arnarson A, Ramel A, Geirsdottir OG, Jonsson PV, Thorsdottir I. J Nutr Health Aging, 2015;19:856-60. 4) Geirsdottir OG, Arnarson A, Ramel A, et al.. Scandinavian Journal of Public Health 2015;43:76-8 5) Arnarson A, Ramel A, Geirsdottir OG, Jonsson PV, Thorsdottir I. Aging Clin Exp Res. 2014;26:287-92. 6) Geirsdottir OG, Arnarson A, Ramel A, Jonsson PV, Thorsdottir I. Nutr Res. 2013;33:608-12. 7) Arnarson A, Geirsdottir OG, Ramel A, Briem K, Jonsson PV, Thorsdottir I. European Journal of Clinical Nutrition 2013;67:821-6. 4

Study overview 6-, 12- & 18 months after endpoint Follow-up Baseline Endpoint Intervention n=149 – > 30% (n=237) n=213 – > 12% dropout (12 weeks) dropout • Measurements; • Measurements; June 2010 Six training groups of 20 – 30 • Questionnaires; • Questionnaires; participants in each group from • Nutrient intake October 2008 to December 2009 • Nutrient intake

Methods Baseline (n=237) -> Endpoint (n=213) • Measurements; • Questionnaires; – Blood sample – Demographic status – Anthropometry – Health & medication • BMI – MMSE • Waist – HRQL – Body composition – Physical activity • DXA • Nutrient intake; – Physical function • • 3 day weighed food diary 6MWD • • FFQ TUG – Muscle strength • Quadriceps strength

Methods • Resistance exercise for 12 weeks – 3 times /week • 10-15 min. warm-up • 10 resistant exercise in equipment – 3 sets, 6-8 repetitions » 60% of 1-RM first week , 75-80% of 1-RM second week » Load ↑5 -10% /week • 10-15 min. stretching exercise – Supervised • Double blind intervention with 3 different isocaloric R a n d o m i z e d n = supplement 2 3 6 W h e y p r o t e i n n = M i l – Milk protein 8 3 k p r o t e n i n C = 7 o n 5 t r o l n = 7 8 – Whey protein A n a l y z e d a t e n d p o i n t 20 g protein /serving 176 kcal/serving A n a n l y z = 6 e d 6 a t e n d p o i n t A n n a l y = z e d 6 7 a t e n d p – Carbohydrate o i n t n = 7 5 40 g CHO /serving

Participants • Recruited by advertisements in the Reykjavik area – Inclusion criteria • Community dwelling adults • 65 years and older • Apparently healthy • MMSE score > 19 points 8

Characteristics of the participants All (n=237) Male (n=99) Female (n =138) 73.6 ± 5.7 74.6 ± 5.9 72.9 ± 5.5 Age (years) 28.8 ± 4.8 29.6 ± 4.6 28.2 ± 4.9 BMI [kg/m 2 ] 2.1 ± 1.5 2.3 ± 1.4 1.9 ± 1.6 Medication [count] 54.9 ± 6.1 54.8 ± 6.2 54.9 ± 6.1 HRQL (t-score) 27.5 ± 2.1 27.1 ± 2.1 27.8 ± 2.0 MMSE (points) 2093 ± 2116 2303 ± 2375 1944 ± 1907 PA [kcal/week] Mean ± SD 9

Dietary intake Supplementation did neither affect total energy- nor protein intake.

Anthropometrical changes after the intervention Geirsdottir OG, Arnarson A, Briem K, Ramel A, Jonsson PV, Thorsdottir I. J Gerontol A Biol Sci Med Sci. 2012 Changes in ASM are around 2/3 of total LM changes

BUT - 19% did not gain LM 17.6% P = 0.587 21.7%

Characteristics of LM losers (n= 42) and gainers (n= 169) Gainers Loosers P Energy [kcal] 1724±490 1551±394 0.046 CHO [g] 176±54 162±41 0.137 Fat [g] 71±26 63±21 0.095 Protein [g] 80±25 69±21 0.012 Protein 0.98±0.27 0.86±0.24 0.009 [g/BW]

LM losers and gainers – multivariate regression Independently for statistical models, protein intake (g/kg BW) remains a significant predictor of gaining ASM with an OR mostly between 7 and 9

Improvement in physical function No significant differences between losers and gainers.

Conclusion • In elderly community-living a 12 week resistance exercise program increase lean body mass, muscle strength and physical function. • There is no added benefit from post-exercise ingestion of 20 g of protein beyond what is achieved by ingesting isocaloric carbohydrates. Arnarson A, Geirsdottir OG, Ramel A, Briem K, Jonsson PV, Thorsdottir I. European Journal of Clinical Nutrition 2013;67:821-6.

Conclusion • According to our results, dietary intake predicts whether you lose or gain ASM. • Loss in ASM does not translate into poorer function after 12 weeks. – Long term consequeces? • Physical activity is an important factor in healthy aging, however without proper dietary intake it could be questionable

Thank you!

Acknowledgements Other co-workers : • Principal Investigators : Steinunn Guðnadóttir Hafsteinn Þórðarson Björn S. Gunnarsson - Inga Þórsdóttir Ólafur Unnarsson Bryndís Elfa Gunnarsdóttir - Alfons Ramel Tinna Eysteinsdóttir Svandís Erna Jónsdóttir - Ólöf Guðný Geirsdóttir Óla Kallý Magnúsdóttir Ása Vala Þórisdóttir • Co-authors : Cindy Mari Imai Ólöf Helga Jónsdóttir Margrét Þóra Jónsdóttir – Atli Arnarson Aníta Gústavsdóttir Erna Héðinsdóttir – Kristín Briem Elísabet Margeirsdóttir Hrund Valgeirsdóttir – Pálmi V. Jónsson Hrafnhildur Eva Stephensen Rakel Dögg Hafliðadóttir – Milan Chang Hrafnhildur Guðjónsdóttir Fimleikafélagið Björk MS Iceland Dairies 20