Loss of Muscle Mass and Strength After Hip Fracture: an Intervention Target for Nutrition Supplementation.

PURPOSEOF REVIEW: To summarize what is known about the deleterious effect of hip fracture on muscle mass and strength as well as the scientific evidence for post-surgical nutrition supplementation to maintain muscle and improve function. RECENT FINDINGS: This review provides a discussion of the relationship between muscle mass, strength, and physical function following hip fracture, briefly describes the approaches to measuring lean mass, discusses prevalence of sarcopenia and malnutrition among older men and women with hip fracture, and reviews the effects of essential amino acids on muscle. Loss of muscle mass and strength following hip fracture is substantial with consequences for recovery of functional independence. EAA-based nutrition supplementation, which directly effects muscle, has potential to improve outcomes.

Optimizing Outcomes By Optimizing Bone Health.

Orthopaedic surgeons have long been aware of the importance of metabolic bone health for fracture healing; however, recent attention has focused on optimization of bone health before elective surgery and also regarding pathways to ensure patients have appropriate evaluation and treatment for bone health issues. It is important to describe issues of importance to fragility fracture care and prevention and optimization of outcomes before elective or fracture surgery. To address the challenge of who has the time, expertise, and appropriate patient contact to identify and treat patients at risk of bone metabolic issues, one model for a suggested pathway to ensure these patients are identified and treated is outlined.

Motivation and exercise in rural postmenopausal women: A literature review.

PURPOSE: Most rural Americans are not meeting recommended guidelines for physical activity (PA); rural postmenopausal women (RPMW) have the highest inactivity rates. Self-Determination Theory, a motivational theory which examines the effects of qualitatively different types of motivation is used to conceptualize how RPMW make decisions regarding PA. The purpose of this review is to examine published literature related to motivation and exercise or PA in RPMW. The research questions include (a) what is known about the relationship of motivation to exercise in RPMW; and (b) how have motivation and exercise been measured in RPMW? METHODS: An electronic database search resulted in a sample of 251 articles, with an additional 9 articles acquired by scanning reference lists. Search terms included motivation, exercise, rural women, urban women, and PA. Criteria for inclusion were postmenopausal women, primary research published before 2019, reported in English, and taking place in the United States. FINDINGS: Thirteen articles involving RPMW were included. The sample contained four qualitative, eight quantitative, and one mixed-method studies. There is little research regarding motivation and PA in RPMW. Barriers and facilitators to PA have been measured. Motivation was mentioned in two studies but not measured. PA is most often measured with self-report questionnaires. CONCLUSION: The decision to be active or sedentary is embedded in motivation. Additional research that objectively measures both motivation and PA in a consistent manner is required to provide a knowledge base regarding motivation and PA behavior in RPMW.

Changing measures to evaluate changing bone.

Osteoporosis is a silent, progressive disease affecting millions of Americans, costing $23.5 billion annually (). Fragility fractures, painful and costly sequelae of osteoporosis, are frequently underdiagnosed and undertreated partially because of limited assessment measures. Currently, bone mineral density measured by dual-energy x-ray absorptiometry is the surrogate marker of bone health () but has shortcomings predicting fragility fractures. Bone turnover markers and magnetic resonance spectroscopy are promising techniques for earlier, more accurate assessment of bone physiology and structure. Bone turnover markers reflect the dynamic nature of living bone (), thus providing a more comprehensive picture of bone health. Magnetic resonance spectroscopy may hold predictive power in determining fast and slow bone mineral density losers (). The use of these tools may assist with diagnosis of osteoporosis, allowing earlier determination of the effectiveness of prescribed therapies to improve bone health.

Aging in Amazonia: blood pressure and culture change among the Cofán of Ecuador.

There has been an increasing interest by researchers to study aging among various "traditional societies." However, few studies have specifically examined the differences between lifestyle variables and cardiovascular risk factors among sex-specific age cohorts in Amazon populations. In Western societies, age, obesity, fat distribution, and diet are common correlates of blood pressure (BP). However, these variables may not be significant correlates of BP in more traditional-living societies. For example, outside pressures placed upon their environments and lifestyles can ultimately affect their overall health status. Currently, there are few isolated Amazonian groups pursuing even modified versions of their traditional lifeways. Those that do exist have been reduced by numerous factors, including land conflicts, pollution, infectious diseases, and persistent pressures to acculturate into the dominant society. In most traditional living groups, older individuals appear to be the most resistant to social change. However, the definition of 'older' in these populations is a group-specific cultural construct. This study examines intravillage and intervillage sex-specific cohorts to investigate the complex relationships between age, cultural change and cardiovascular risk factors among an Amazonian population, the Cofán of Northeastern Ecuador.

Population genetics of apolipoproteins A-IV, E, and H, and the angiotensin converting enzyme (ACE): associations with lipids, and apolipoprotein levels in American Samoans.

Distributions of alleles at three apolipoprotein loci (APO E, APO H, and APO A-IV) and an insertion/deletion (I/D) polymorphism at the angiotensin converting enzyme (ACE) locus among 274 American Samoans are described here. Genotypes at each locus are examined for associations with quantitative lipid (total cholesterol (total-c), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), and triglycerides) and apolipoprotein (APO AI, APO AII, APO E, and APO B) levels. Genotype frequencies at all four loci are in Hardy-Weinberg equilibrium. The most common APO A-IV genotype (1-1) was observed in 252 American Samoans (97%). The three most common APO E genotypes were 3-3 (47%), 3-4 (30%), and 2-3 (12%). The most frequent APO H genotype was 2-2 (86%). The most common ACE genotype (I/I) was observed in 75% of sampled individuals, and 23% were I/D heterozygotes. APO E genotypic variation was associated with total-c, HDL-c, LDL-c, and all four quantitative apolipoproteins (AI, AII, E, and B). APO A-IV genotypes were associated significantly with total cholesterol, LDL-c, and APO-B levels. APO H showed little association with any quantitative lipid or apolipoprotein. ACE D/D homozygotes had higher AII levels. ACE showed a consistent association with APO AII levels, with either APO A-IV or APO E as a covariate. The interaction term between ACE and APO E was also significantly associated with total-c and APO E levels, and the ACE genotype showed a significant main effect on APO AI levels in multivariate analyses.

Helminthiasis and culture change among the Cofán of Ecuador.

Blood and fecal samples and lifestyle interviews were obtained in August 1996 from two Cofán villages in Ecuador, Dureno and Zabalo, that are experiencing different degrees of acculturation. Dureno's territory has been divided by roads and encroached upon by oil companies and colonists, whereas Zabalo, 95 km downriver from Dureno, is located in the Cuyabeno Fauna Reserve, a protected area. This study examines how culture change affects the prevalence of parasitic infections. Fecal samples were examined for helminth eggs to determine helminthiasis in each village sample. Seventy-four samples were collected (Dureno n = 50; Zabalo n = 24), representing 20% of the population in each village. Hemoglobin (Hb) levels and eosinophil counts were determined for all adult participants (Dureno n = 39; Zabalo n = 13). Microscopic examination of prepared samples revealed ova from two parasitic nematodes: roundworm (Ascaris lumbercoides) and hookworm (Ancylostoma duodenale or Necator americanus). Roundworm and hookworm infections were higher in Dureno (44% positive) compared to Zabalo (17% positive), with infected adults from both villages showing eosinophilia. Hb levels were not significantly correlated with the prevalence of helminth infections. It appears that the transmission and prevalence of parasitic infections within each community is associated with the interaction of biological, cultural, and environmental factors. Am. J. Hum. Biol. 12:465-477, 2000. Copyright 2000 Wiley-Liss, Inc.