Page 225 - Petelin, Ana. 2021. Ed. Zdravje starostnikov / Health of the Elderly. Proceedings. Koper: University of Primorska Press.
P. 225
, 2017), or 9% among community-dwelling older adults (ter Borg et al., 2016). association between dietary nutrient intake and sarcopenia in older adults 223
Although we observed significant differences in the MNA malnutrition cate-
gory between the sarcopenic and nonsarcopenic group, as in other studies (ter
Borg et al., 2016; Lardiés-Sánchez et al., 2017), it was not identified as a covari-
ate for some of the observed nutrient intake differences.
The energy intake of the present population was 7.1-8.6MJ (1696.9 kcal -
2055.4 kcal) including intake of carbohydrate 48-49 En%, protein 15-16 En%,
and fat 33-35 En%. These results are in line with the intake data of older adults
from systematic literature review (ter Borg et al., 2015), and other studies (van
Rossum et al., 2011; ter Borg et al., 2016) that indicates suboptimal macronutri-
ent intakes among older adults. We did not observe significant differences in
energy intake between the sarcopenic and nonsarcopenic group, similar to the
results of Maastricht Sarcopenia Study (ter Borg et al., 2016).
Even though the greater proportion of the sarcopenic participants meet
the lower range of evidence-based recommendations for optimal dietary pro-
tein intake of 1.0 g/kg bw/d (Bauer et al., 2013), the inadequate nutrition pat-
tern of this group was reflected in the insufficient daily amount of seven nutri-
ents (n-3 fatty acid, vitamins D, K, C, thiamine, biotin and folic acid). Besides,
the evidence shows that protein intake alone is not sufficient to preserve muscle
quality but it is rather an interplay of group of nutrients that contribute to the
prevention of sarcopenia (Verlaan et al., 2018). The literature suggests that ad-
equate intake of proteins (1.2 g/kg bw/d), n-3 fatty acids, and vitamin D, com-
bined with physical exercise, forms part of an integrated management of sarco-
penia (Boirie et al., 2014; Wu et al., 2020).
A significantly lower intake of thiamine, biotin, and folate (21%, 36%, and
28%, respectively) was observed in our sarcopenic group compared to the non-
sarcopenic group. The literature review (ter Borg et al., 2015; ter Borg et al., 2016;
Beaudart et al., 2019) identified six nutrients (thiamin, riboflavin, vitamin D,
Ca, Mg and Se) of potential concern as a result of a high prevalence of micronu-
trient inadequacy in diets among older adults in Europe. Furthermore, a possi-
ble link between vitamins B and the aetiology of sarcopenia was proposed (ter
Borg et al., 2016; Bulut et al., 2017; Aytekin, 2018). The mechanisms are mainly
related to the reduced activity of vitamin B1 dependent enzymes in mitochon-
dria, and folate deficiency with hyperhomocysteinaemia. Deficiencies in these
vitamins can include impairments in oxidative metabolism, and mitochondri-
al function, leading to inflammatory responses associated with increased pro-
duction of reactive oxygen species and excitotoxicity, which causes muscle pro-
tein degradation (ter Borg et al., 2016; Aytekin, 2018).
The comparison of vitamin D intake between the groups showed a signif-
icantly lower vitamin D intake in the sarcopenic group of 67%. Furthermore,
none of the sarcopenic participants were supplemented with vitamin D. Sup-
portive evidence shows the clinical relevance of vitamin D supplementation in
the treatment and prevention of sarcopenia (Cangussu et al., 2015; Verlaan et
al., 2018).
Although we observed significant differences in the MNA malnutrition cate-
gory between the sarcopenic and nonsarcopenic group, as in other studies (ter
Borg et al., 2016; Lardiés-Sánchez et al., 2017), it was not identified as a covari-
ate for some of the observed nutrient intake differences.
The energy intake of the present population was 7.1-8.6MJ (1696.9 kcal -
2055.4 kcal) including intake of carbohydrate 48-49 En%, protein 15-16 En%,
and fat 33-35 En%. These results are in line with the intake data of older adults
from systematic literature review (ter Borg et al., 2015), and other studies (van
Rossum et al., 2011; ter Borg et al., 2016) that indicates suboptimal macronutri-
ent intakes among older adults. We did not observe significant differences in
energy intake between the sarcopenic and nonsarcopenic group, similar to the
results of Maastricht Sarcopenia Study (ter Borg et al., 2016).
Even though the greater proportion of the sarcopenic participants meet
the lower range of evidence-based recommendations for optimal dietary pro-
tein intake of 1.0 g/kg bw/d (Bauer et al., 2013), the inadequate nutrition pat-
tern of this group was reflected in the insufficient daily amount of seven nutri-
ents (n-3 fatty acid, vitamins D, K, C, thiamine, biotin and folic acid). Besides,
the evidence shows that protein intake alone is not sufficient to preserve muscle
quality but it is rather an interplay of group of nutrients that contribute to the
prevention of sarcopenia (Verlaan et al., 2018). The literature suggests that ad-
equate intake of proteins (1.2 g/kg bw/d), n-3 fatty acids, and vitamin D, com-
bined with physical exercise, forms part of an integrated management of sarco-
penia (Boirie et al., 2014; Wu et al., 2020).
A significantly lower intake of thiamine, biotin, and folate (21%, 36%, and
28%, respectively) was observed in our sarcopenic group compared to the non-
sarcopenic group. The literature review (ter Borg et al., 2015; ter Borg et al., 2016;
Beaudart et al., 2019) identified six nutrients (thiamin, riboflavin, vitamin D,
Ca, Mg and Se) of potential concern as a result of a high prevalence of micronu-
trient inadequacy in diets among older adults in Europe. Furthermore, a possi-
ble link between vitamins B and the aetiology of sarcopenia was proposed (ter
Borg et al., 2016; Bulut et al., 2017; Aytekin, 2018). The mechanisms are mainly
related to the reduced activity of vitamin B1 dependent enzymes in mitochon-
dria, and folate deficiency with hyperhomocysteinaemia. Deficiencies in these
vitamins can include impairments in oxidative metabolism, and mitochondri-
al function, leading to inflammatory responses associated with increased pro-
duction of reactive oxygen species and excitotoxicity, which causes muscle pro-
tein degradation (ter Borg et al., 2016; Aytekin, 2018).
The comparison of vitamin D intake between the groups showed a signif-
icantly lower vitamin D intake in the sarcopenic group of 67%. Furthermore,
none of the sarcopenic participants were supplemented with vitamin D. Sup-
portive evidence shows the clinical relevance of vitamin D supplementation in
the treatment and prevention of sarcopenia (Cangussu et al., 2015; Verlaan et
al., 2018).
