The relationship between fat distribution and diabetes in US adults by race/ethnicity.

Introduction: This study examined the relationship between fat distribution and diabetes by sex-specific racial/ethnic groups. Methods: A secondary data analysis of National Health and Nutrition Examination Survey 2011-2018 data (n = 11,972) was completed. Key variables examined were visceral adipose tissue area (VATA), subcutaneous fat area (SFA), diabetes prevalence, and race/ethnicity. The association of VATA and SFA and diabetes prevalence was examined separately and simultaneously using multiple logistic regression. Bonferroni corrections were applied to all multiple comparisons between racial/ethnic groups. All analyses were adjusted for demographics and muscle mass. Results: VATA was positively associated with diabetes in both sexes (p < 0.001) and across all racial/ethnic groups (p < 0.05) except Black females. No statistically significant relationships were observed between SFA and diabetes while accounting for VATA with the exception of White females (p = 0.032). When comparing racial/ethnic groups, the relationship between VATA and diabetes was stronger in White and Hispanic females than in Black females (p < 0.005) while the relationship between SFA and diabetes did not differ between any racial/ethnic groups. Conclusion: This study found that VATA is associated with diabetes for both sexes across almost all racial/ethnic groups independent of SFA whereas the only significant relationship between SFA and diabetes, independent of VATA, was observed in White females. The findings indicated that visceral fat was more strongly associated with diabetes than subcutaneous. Additionally, there are health disparities in sex-specific racial/ethnic groups thus further study is warranted.

A cross-sectional study of the relationship between physical activity, diet quality, and high-sensitivity C-reactive protein in US adults.

BACKGROUND AND AIMS: High-sensitivity C-reactive protein (hs-CRP) is associated with many diseases, especially cardiovascular disease (CVD). Research into the independent and integrated relationships of physical activity and diet quality with hs-CRP across sex-specific cohorts is lacking. METHODS AND RESULTS: National Health and Nutrition Examination Survey data (2015-2018) was used to examine the relationship between physical activity and diet quality with hs-CRP and hs-CRP classified CVD risk using multiple multinormal logistic regression adjusted for covariates including demographics. Physical activity was measured using a self-reported survey and further categorized to those who met (MPAR) or did not meet (NPAR) national recommendations. Diet quality was measured using the Healthy Eating Index-2015, and further categorized to higher (HDQ) and lower (LDQ) diet quality. hs-CRP was also categorized as low, average, and high CVD risk using established cut-points. Physical activity was inversely related to hs-CRP in males (p < 0.001) whereas diet quality was inversely related to hs-CRP in females (p = 0.031). Compared to those with NPAR and LDQ, the hs-CRP for males with NPAR and HDQ and females with MPAR and HDQ was 1.18 mg/L and 0.75 mg/L lower respectively. Although, diet quality was inversely associated with high CVD risk in both sexes (p < 0.05), the lowest proportion of high and average CVD risk was observed in males and females with MPAR and HDQ. CONCLUSION: Physical activity and diet-quality lowered CVD risk regardless of sex. However, the independent effects of physical activity and diet quality on hs-CPR differs between sexes.

The Sex and Race/Ethnicity-Specific Relationships of Abdominal Fat Distribution and Anthropometric Indices in US Adults.

The purpose of this study was to examine demographic-specific relationships between direct abdominal fat measures and anthropometric indices. A cross-sectional study was conducted utilizing abdominal fat measures (visceral fat area, VFA; visceral to subcutaneous adipose area ratio, VSR) and anthropometrics (body mass index, BMI; waist circumference, WC) data from the 2011-2018 National Health and Nutrition Examination Survey. Linear or polynomial linear regression models were used to examine the relationships of abdominal fat measures to anthropometrics with adjustment for demographics. The results revealed that while VFA was linearly related to BMI and WC across all demographics (p < 0.001), the relationships between VSR and both BMI and WC were concave in men and convex in women. The relationships between VFA, VSR, and BMI, WC varied by sex and race/ethnicity. In conclusion, increasing BMI and WC were linearly associated with increased VFA, but their relationships with VSR were nonlinear and differed by sex.

The Demographic Specific Abdominal Fat Composition and Distribution Trends in US Adults from 2011 to 2018.

Despite the rising awareness of abdominal adiposity associated health problems and demographic health disparities, research is lacking about abdominal fat trends using a national representative sample of US adults. Our purpose was to examine national demographic specific abdominal fat composition and distribution trends from 2011 to 2018. This trend analysis was using National Health and Nutrition Examination Survey data (n = 13,163). Visceral adipose percent (VAT%), visceral adipose tissue area (VAA) and visceral to subcutaneous adipose area ratio (VSR) were utilized in data analyses. Multiple polynomial linear regression was utilized with adjustment for confounding variables. Our findings revealed that VAT%, VAA and VSR trends were concave among all demographic groups. The VAT%, VAA and/or VSR changes were observed in most demographic groups (p < 0.05) except younger, White and Black respondents. The pattern was consistent with biennial increases up to 2014 or 2016 followed by decreases in 2017-2018. There were demographic disparities, with middle-aged respondents and Hispanics having the most evident VAT%, VSR and/or VAA changes biennially when compared to their counterparts (p < 0.05). In conclusion, abdominal fat composition and distribution increased before 2014 or 2016 but decreased afterwards with variations by age and/or race/ethnicity. Further research is needed to explore the possible causes of abdominal fat changes overtime.

The Relationships between Total Protein Intake, Protein Sources, Physical Activity, and Lean Mass in a Representative Sample of the US Adults.

BACKGROUND: Although dietary protein and physical activity play essential roles in developing and preserving lean mass, studies exploring these relationships are inconsistent, and large-scale studies on sources of protein and lean mass are lacking. Accordingly, the present study examined the relationship between total protein intake, protein sources, physical activity, and lean mass in a representative sample of US adults. METHODS: This cross-sectional study analyzed data from 2011-2016 US National Health and Nutrition Examination Survey and corresponding Food Patterns Equivalents Database (n = 7547). Multiple linear regression models were performed to examine the sex-specific associations between total protein intake, protein sources (Dairy, Total Protein Foods, Seafood, and Plant Proteins), physical activity, and lean mass adjusting for demographics, weight status, and total daily energy intake. RESULTS: Total protein intake was inversely related to lean mass in females only (Lean mass index: ß= -0.84, 95%CI: -1.06--0.62; Appendicular lean mass index: ß= -0.35, 95%CI: -0.48--0.22). However, protein sources and physical activity was positively associated with lean mass in males and/or females (p < 0.05). CONCLUSION: Study results suggest that consuming more protein daily had a detrimental influence on lean mass in females whereas eating high-quality sources of proteins and being physically active are important for lean mass for men and women. However, the importance of specific protein sources appears to differ by sex and warrants further investigation.

Relationships of Physical Activity and Diet Quality with Body Composition and Fat Distribution in US Adults.

OBJECTIVE: This study aimed to investigate the relationships among physical activity (PA), diet quality, body composition, and fat distribution in a representative sample of US adults. METHODS: A cross-sectional analysis was conducted using publicly accessible data from the 2011 to 2016 National Health and Nutrition Examination Survey and the Food Patterns Equivalents Database (n = 7,423). Variables from the data sets were analyzed for this study, including PA, two 24-hour dietary recalls, and dual-energy x-ray absorptiometry outputs. RESULTS: For men, PA and diet quality were inversely associated with the percentage of body fat (ß = -0.0042, 95% CI: -0.0084 to -0.0001; ß = -0.28, 95% CI: -0.42 to -0.14) and fat mass index (ß = -0.0125, 95% CI: -0.0209 to -0.0041; ß = -0.56, 95% CI: -0.81 to -0.32); meeting the PA recommendation and having good diet quality provided an additive effect on body fat. A similar pattern was observed in women. Additionally, diet quality was inversely associated with all fat distribution measures in both sexes, whereas PA was positively associated with lean mass measures in men only. CONCLUSIONS: Increased PA and/or better diet quality were associated with reduced body fat, a healthier fat distribution, and increased lean mass. Further research examining how changes in PA or diet quality influence body composition and fat distribution in adults is warranted.

Temporal Association between Abdominal Weight Status and Healthy Aging: Findings from the 2011-2018 National Health and Aging Trends Study.

BACKGROUND/OBJECTIVES: The longitudinal effect of abdominal weight status (AWS) defined by waist circumference (WC) on healthy aging has not yet been comprehensively examined. Therefore, the purpose of the present study was to examine the temporal association between WC-defined AWS and a comprehensive assessment for healthy aging. SUBJECTS/METHODS: This study utilized data from 5211 respondents aged 65+ who participated in the National Health and Aging Trends Study from 2011 to 2018. Mixed effects regression models were used to examine the association between baseline AWS and the annual change rate in healthy aging score (HAS) via interaction terms (AWS*round) adjusting for confounding effects. Further multiple mixed models examined the relationship of AWS and HAS over an 8-year period. RESULTS: There were no annual change rate differences in HAS by baseline AWS, regardless of sex. However, males with abdominal obesity were more likely to have a lower HAS than males with normal AWS (ß = -0.20, 95% CI: -0.30, -0.10, p < 0.001) but no difference in HAS was observed between males with overweight and normal AWS. A similar pattern was observed among females. CONCLUSIONS: Study results indicate that AWS was associated with HAS but it did not modify annual HAS change rate over time.

Longitudinal Sex-Specific Physical Function Trends by Age, Race/Ethnicity, and Weight Status.

BACKGROUND: There is a need to assess longitudinal trends in physical function and to understand the prevalence of physical function status in the older population using objectively measured physical function. Therefore, the primary purpose of this study was to examine longitudinal sex-specific physical function trends and prevalence of physical function status by age, race/ethnicity, and weight status in older adults, aged 65 years and older. METHODS: The present study used longitudinal data from the National Health and Aging Trends Study. Physical function was measured annually from 2011 to 2018 using the Short Physical Performance Battery, and classified as poor (0-6), fair (7-9), or good (10-12). Mixed effect regression and generalized estimating equation models were used to estimate unadjusted trends and annual changes in physical function, adjusting for confounders and accounting for complex sampling. RESULTS: Respondents' physical function declined over time regardless of sex, age, race/ethnicity, and weight status (P < .001). Respondents aged 75 to 84 years (males: ß = -.18; 95% confidence interval (CI) = -.22 to -.13; females: ß = -.23; 95% CI = -.27 to -.20) and 85 years and older (males: ß = -.39; 95% CI = -.47 to -.30; females: ß = -.33; 95% CI = -.39 to -.28) had a greater annual physical function rate of decline than respondents aged 65 to 74 years. Respondents aged 75 years and older also had a greater annual increase in the proportion classified as having poor physical function than respondents aged 65 to 74 years (P < .001), regardless of sex. Compared with non-Hispanic whites, Hispanic females had a lower annual physical function rate of decline (ß = .14; 95% CI = 0.07-0.20), and Hispanic and/or non-Hispanic blacks had slower annual changes in the proportion classified as having good physical function (P < .05). Compared with normal weight males, overweight males had lower annual changes in physical function (P = .003) and proportion of those with poor physical function (P = .004), but no differences between weight status were observed in females. CONCLUSIONS: Physical function declines with age, but temporal changes in physical function and physical function status varied by sex, age, race/ethnicity, and weight status. J Am Geriatr Soc 68:2270-2278, 2020.

Factors Influencing Dietary Intake Frequencies and Nutritional Risk among Community-Residing Older Adults.

Older adult (OA) dietary practices may be placing them at nutritional risk. This cross-sectional study examined the dietary intake frequencies (DIF) and nutritional risk (NR) using the Dietary Screening Tool (DST) of OA attending community-based nutrition education and physical activity programs. Most were white females aged 60-80 years. The majority (80.1%) were classified as "at NR" or "at possible NR." Participants had "low" lean protein, dairy, and processed meat DIF and "moderate" whole fruit and juice, total and whole grains, vegetables and added fats, sugars, and sweets DIF. State influenced whole fruit and juice (p ≤ .001) and vegetable (p = .021) DIF, age influenced processed meat DIF (p = .001), and gender influenced NR (p = .006), vegetable (p = .022), and processed meat (p = .033) DIF. Results indicate that OA participating in lifestyle interventions are at NR. When developing future nutrition education programs, educators should consider sociodemographic factors to promote dairy and protein-rich foods to OA at NR.

Estimation of Skeletal Muscle Mass Relative to Adiposity Improves Prediction of Physical Performance and Incident Disability.

Purpose: We assessed the discrimination of lean mass estimates that have been adjusted for adiposity for physical functioning deficits and prediction of incident disability. Methods: Included were 2,846 participants from the Health, Aging and Body Composition Study with available whole-body dual energy absorptiometry measures of appendicular lean mass index (ALMI, kg/m2) and fat mass index (FMI, kg/m2). Age-, sex-, and race-specific Z-Scores and T-Scores were determined by comparison to published reference ranges. ALMI values were adjusted for FMI (ALMIFMI) using a novel published method. Sex-stratified analyses assessed associations between lean mass estimates and the physical performance score, ability to complete a 400-meter walk, grip strength, and incident disability. Dichotomized definitions of low lean for age and sarcopenia were examined and their performance compared to the ALM-to-BMI ratio. Results: Compared to ALMI T-Scores and Z-Scores, the ALMIFMI scores demonstrated stronger associations with physical functioning, and were similarly associated with grip strength. Greater FMI Z-Scores and T-Scores were associated with poor physical functioning and incident disability. Definitions of low lean for age and sarcopenia using ALMIFMI (compared to ALMI) better discriminated those with poor physical functioning and a greater risk of incident disability. The ALM-to-BMI ratio was modestly associated with grip strength and physical performance, but was not associated with completion of the 400-meter walk or incident disability, independent of adiposity and height. Conclusion: Estimation of skeletal muscle mass relative to adiposity improves correlations with physical performance and prediction of incident disability suggesting it is an informative outcome for clinical studies.

The Current Understanding of Sarcopenia: Emerging Tools and Interventional Possibilities.

The purpose of this review is to provide health practitioners and physicians the most current state of the research on sarcopenia, its consequences, and to offer a summary of consensus guidelines for identification based on the most recent and compelling investigations and analyses. To accomplish this, the causes and consequences of sarcopenia will be described, and definitions and screening methods are updated. Importantly, interventional recommendations for sarcopenia will be discussed with a special emphasis on the effects of resistance training on sarcopenia-related outcomes. Furthermore, due to the increasing usage of hormone treatment as a strategy to combat sarcopenia, special consideration on the effects of hormone changes with aging and as interventions will be briefly reviewed.

Cognitive status and cardio-metabolic risk of patients with acquired brain injury and Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) and acquired brain injury (ABI) share common symptoms. People with PD and ABI risk nutritional decline at diagnosis, but little is known about their long-term health a year or more after diagnosis. OBJECTIVE: This cross-sectional study describes cognitive and dietary characteristics of people living with PD or ABI 12 months or more post diagnosis to identify cardio-metabolic risk factors. METHODS: Twelve community-dwelling participants (8 PD, 4 ABI) received interdisciplinary evaluations. Cognitive-linguistic status was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Nutritional and cardio-metabolic statuses were measured using the dietary screening tool (DST), anthropometrics, biochemical, and clinical measures. Descriptive statistics, independent t-tests and correlations were used to analyze the data. RESULTS: Mean BMI (n = 12) was 26.8 ± 3.0 kg/m(2) and the majority of participants were overweight. Participants with PD had significantly higher total RBANS scores than participants with ABI (87.1 ± 14.6 vs. 66.0 ± 12.6, p = 0.034, d = 2.455). DST scores indicated 58% (N = 7) at possible nutrition risk and 25% (N = 3) were at nutrition risk. A positive correlation was found between general activity level and DST scores (r = 0.697, p = 0.012). Multiple risk factors for development of cardiovascular disease (CVD) were present in all participants. CONCLUSION: These findings confirmed the presence of cognitive and dietary deficits in our participant group and support the need for an interdisciplinary team approach to improve health and prevent the development of symptoms for these populations a year or more after diagnosis.

Impact of a program of Tai Chi plus behaviorally based dietary weight loss on physical functioning and coronary heart disease risk factors: a community-based study in obese older women.

This study employed a quasi-experimental design in a community-based study translating the results of our recent findings on the combined effects of Tai Chi and weight loss on physical function and coronary heart disease (CHD) risk factors. A 16-week intervention was conducted to assess the impact of Tai Chi plus a behavioral weight loss program (TCWL, n = 29) on obese (body mass index [BMI] = 35.4 ± 0.8 kg/m²) older (68.2 ± 1.5 yr.) women compared to a control group (CON, n = 9, BMI = 38.0 ± 1.5 kg/m², 65.6 ± 2.7 yr.), which was asked to maintain their normal lifestyle. The TCWL group lost weight (1.6 ± 2.9 kg, P = 0.006) while the CON group did not (1.2 ± 1.9 kg, P = 0.106). Physical functioning as measured by the short physical performance battery improved in TCWL when compared to the CON group (ß = 1.94, 95% Confidence Interval [CI]: 1.12, 2.76, P < 0.001). TCWL also improved in sit-and-reach flexibility (ß = -2.27, 95% CI: -4.09, -0.46, P = 0.016), body fat mass (BMI, ß = -0.65, 95% CI: -1.03, -0.26, P = 0.002), waist circumference (ß = -1.78, 95% CI: -2.83, -0.72, P = 0.002), systolic blood pressure (ß = -16.41, 95% CI: -21.35, -11.48, P < 0.001), and diastolic blood pressure (ß = -9.52, 95% CI: -12.65, -6.39, P < 0.001). Thus, TCWL intervention may represent an effective strategy to improve physical function and ameliorate CHD risk in the older adult population.

Body composition explains sex differential in physical performance among older adults.

BACKGROUND: Older women have higher percent body fat, poorer physical function, lower strength, and higher rates of nonfatal chronic conditions than men. We sought to determine whether these differences explained physical performance differences between men and women. METHODS: Physical performance was assessed in the Health, Aging and Body Composition study in 2,863 men and women aged 70-79 with a composite 0-4 point score consisting of chair stands, standing balance including one-leg stand, and 6-m usual and narrow walk tests. Total body composition was measured by dual x-ray absorptiometry, thigh composition by computed tomography, and knee extensor strength by isokinetic dynamometer. Analysis of covariance estimated least square mean performance scores for men and women. RESULTS: Men had higher performance scores than women (least square means: 2.33±0.02 vs 2.03±0.02, p < .0001), adjusted for race, study site, age, and height. Body composition measures (total body fat and thigh muscle area, muscle density, subcutaneous fat, and intermuscular fat) accounted for differences between men and women (least square means: 2.15±0.02 vs 2.17±0.02, p = .53). Higher strength in men partly explained the sex difference (least square means: 2.28±0.02 vs 2.12±0.02, p < .0001). Strength attenuated the association of thigh muscle mass with performance. Chronic health conditions did not explain the sex difference. CONCLUSIONS: In a well-functioning cohort, poorer physical function in women compared with men can be explained predominantly by their higher fat mass, but also by other body composition differences. The higher proportion of body fat in women may put them at significant biomechanical disadvantage for greater disability in old age.

Effects of the addition of t'ai chi to a dietary weight loss program on lipoprotein atherogenicity in obese older women.

OBJECTIVE: To examine the additive effect of t'ai chi (TC) to diet education on the traditional coronary heart disease (CHD) risk factor low-density lipoprotein cholesterol (LDL-C) and on emerging CHD risk factors (apolipoprotein B and LDL particle size) in older obese women. DESIGN: Ancillary study of a randomized clinical trial. SETTING: University of Rhode Island. PARTICIPANTS: 26 obese women (mean age±standard deviation, 61.5±6.0 years; mean body mass index, 34.3±4.0 kg/m(2)) were enrolled and randomly assigned to the diet education group (n=13) or the diet education plus TC group (n=13). INTERVENTION: All participants received 45 minutes of diet education per week. The diet education plus TC group also received 45 minutes of TC three times per week for 16 weeks. OUTCOME MEASURES: Anthropometrics (height, weight, BMI, waist circumference, and hip circumference), clinical variables (blood pressure), and biochemical variables (standard lipid profile, apolipoprotein B, LDL particle size) were measured. The primary outcome was LDL-C, and the secondary outcomes were apolipoprotein B and LDL particle size. RESULTS: Neither LDL-C nor apolipoprotein B improved in either group. Percentage of large LDL particles after the intervention was increased in the diet education plus TC group compared with the diet education group. Weight, waist circumference, and high-density lipoprotein cholesterol decreased in both groups from baseline to post-intervention. Triacylglycerol and dietary screening tool scores increased in both groups. Additional improvements were seen in the diet education plus TC group, including a significant increase in Dietary Approaches to Stop Hypertension score from baseline to post-intervention. CONCLUSION: The addition of TC to diet education is more effective than diet education alone at improving diet quality and emerging CHD risk factors, such as LDL particle size, in obese older women.

Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults.

BACKGROUND: Community-based interventions that incorporate resistance training (RT) and dietary changes have not been extensively studied in overweight and obese older adults. The purpose of this investigation was to determine the effects of a community-based RT and dietary intervention on physical function and body composition in overweight and obese older adults. METHODS: Ninety-five overweight and obese (BMI=33.4±4.0 kg/m2) older adults aged 55-80 years completed an 8-week RT and dietary intervention at 4 Rhode Island senior centers. Participants performed RT twice-weekly using resistance tubing, dumbbells, and ankle weights. Participants also attended 1 weekly dietary counseling session on a modified Dietary Approaches to Stop Hypertension diet. Outcome measurements included anthropometrics, body composition, and physical function. RESULTS: There were small changes in body mass (-1.0±1.8 kg, P<.001), waist circumference (-5.2±3.8 cm, P<.001), and percent body fat (-0.5±1.4%, P<.001). In addition, significant improvements were observed in knee extensor torque (+7.9±19.1 N-m, P<.001), handgrip strength (+1.2±2.5 kg, P<.001), and 8-foot up-and-go test time (-0.56±0.89 s, P<.001). CONCLUSION: Community-based RT and dietary modifications can improve body composition, muscle strength, and physical function in overweight and obese older adults. Future investigations should determine if this intervention is effective for long-term changes.

Does insulin-like growth factor 1 genotype influence muscle power response to strength training in older men and women?

The CA-repeat polymorphism in the insulin-like growth factor 1 (IGF1) gene promoter region has been associated with strength and circulating IGF-I protein levels. The purpose of the study was to determine if the IGF1 CA-repeat polymorphism influences muscle power at baseline and in response to ST in older adults. Knee extensor peak power (PP) was measured at 50, 60, and 70% of 1-RM strength before and after 10 weeks of unilateral knee extensor ST in older adults, aged 50-85 years, to determine the changes in absolute and relative PP with ST. Subjects (N = 114) were genotyped for the IGF1 CA-repeat polymorphism and grouped as homozygous for the 192 allele, heterozygous, or non-carriers of the 192 allele. The 192 homozygotes had significantly lower baseline PP at 50, 60, and 70% of 1-RM strength than the non-carriers when age, sex, and baseline fat-free mass were covaried (all P < 0.05). This same relationship was observed when the highest PP within these ranges was compared (e.g., 317.6 ± 13.5 for 192 homozygotes and 380.2 ± 16.3 for non-carriers of the 192 allele, P < 0.05). Both absolute and relative PP increased significantly with ST in all genotype groups as expected, but there were no significant relationships among IGF1 genotypes and any of the PP changes. Despite a significant relationship between IGF1 genotype and knee extensor peak power at baseline, IGF1 genotype does not appear to influence changes in knee extensor peak power with ST.

The effect of the addition of resistance training to a dietary education intervention on apolipoproteins and diet quality in overweight and obese older adults.

OBJECTIVES: The aim of the study was to examine the additive effect of resistance training (RT) to a dietary education (DE) intervention on emerging coronary heart disease (CHD) risk factors, concentration of apolipoproteins B (apoB) and A-I (apoA-I), and Dietary Approaches to Stop Hypertension (DASH) Diet Index scores in overweight and obese older adults. PATIENTS AND METHODS: This was an ancillary study of a randomized clinical trial held in the Fall of 2008 at the University of Rhode Island. Participants were overweight or obese subjects (mean body mass index [BMI] of 31.7 kg/m(2)) randomized into two groups, one participating in DE only (n = 12) and the other participating in DE plus RT (DERT) (n = 15). The intervention involved all subjects participating in 30 minutes of DE per week for 10 weeks. Subjects in the DERT group participated in an additional 40 minutes of RT three times per week for 10 weeks. Measurements taken were anthropometric (height, weight, waist circumference, and body composition using the BOD POD(®) [Body Composition System, v 2.14; Life Measurement Instruments, Concord, CA]), clinical (blood pressure), and biochemical (lipid profile and apoB and apoA-I concentrations), and the DASH Diet Index was used to measure diet quality. RESULTS: 27 subjects (11 males, 16 females), with a mean age of 66.6 ± 4.3 years, were included in analyses. The DERT subjects had significantly better triacylglycerol and apoB concentrations and DASH Diet Index scores than the DE subjects post-intervention. Improvements were seen within the DE group in energy intake, fat-free mass, and systolic blood pressure and within the DERT group in body weight, percentage of body fat, BMI, diastolic blood pressure, and oxidized low-density lipoprotein (all P < 0.05). CONCLUSION: The addition of RT effectively reduced CHD risk factors, body composition, and diet quality in overweight and obese older adults; DERT was more effective than DE alone in improving DASH Diet Index scores and lowering apoB concentrations but was not more effective in increasing apoA-I concentrations. Future research is needed to determine if apolipoproteins are superior to lipoprotein cholesterol concentrations in predicting CHD risk.

Age-related changes in adult muscle morphology.

Skeletal muscle undergoes numerous morphological changes from early adulthood to old age including muscle size, configuration, and structure. This review discusses these changes, considers the limitations in interpreting studies, addresses the potential health implications, and describes some mechanisms and interventions to ameliorate aging-related changes in skeletal muscle. Discussion in each section focuses on measurement and analysis techniques of muscle morphology, limitations of human research, and the discussion uses animal work to support findings in humans. We examine the discrepancies in the study of fiber type distribution with age, and special emphasis is given to two topics: fiber-type distribution and intra- and intercellular fat. Finally, training adaptations and health implications are briefly discussed. The focus of the current review is the morphological changes that occur in skeletal muscle during the normal aging process, with emphasis on human studies.

Clustering of strength, physical function, muscle, and adiposity characteristics and risk of disability in older adults.

OBJECTIVES: To empirically identify groupings of strength, physical performance, adiposity, and lean mass and test how such groupings of these interrelated measures may relate to disability risk. DESIGN: Prospective Health, Aging and Body Composition Study. SETTING: Two U.S. clinical centers. PARTICIPANTS: One thousand two hundred sixty-three women and 1,221 men. MEASUREMENTS: Weight, strength (knee extension, grip); walking speed, chair stands, dual X-ray absorptiometry (fat and lean mass for total body, arm, and leg; percent fat), and thigh computed tomography scans (muscle area, muscle density). Analyses were stratified according to sex. Factor analysis reduced these variables into a smaller number of components, and proportional hazards models assessed risk of major disability for the components identified. RESULTS: In both sexes, factor analysis reduced the 14 individual variables into three components that explained 76% to 77% of the data variance: Factor 1, an adiposity component, with strong loading by fat mass, weight, and muscle density; Factor 2, a strength and lean body size component with strong loading by lean mass, weight, and strength; Factor 3, a physical performance component with positive loading by walking speed and chair stand performance. Factor 1 (adiposity) and Factor 3 (performance) but not Factor 2 (strength and lean body size) were associated with disability over 6.1 ± 2.6 years. CONCLUSION: The adiposity and physical performance constructs but not the strength and lean body size construct were associated with disability risk, suggesting that adiposity and performance should be considered as risk factors for disability.