DOI QR코드

DOI QR Code

Association of Low Hand Grip Strength with Protein Intake in Korean Female Elderly: based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018

한국인 여성 노인의 단백질 섭취 수준과 근력의 상관성 연구: 국민건강영양조사 제 7기(2016-2018년) 자료를 이용하여

  • Jang, Won (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Ryu, Ho Kyung (Department of Food Science and Nutrition, Pusan National University, Research Institute of Ecology)
  • 장원 (이화여자대학교 식품영양학과) ;
  • 류호경 (부산대학교 생활환경대학 식품영양학과, 부산대학교 생활환경연구소)
  • Received : 2020.04.28
  • Accepted : 2020.06.19
  • Published : 2020.06.30

Abstract

Objectives: Decreasing muscle strength in old age has become a significant health problem because it increases the risk of falls or fractures and transfers to other diseases. The precise role of dietary protein intake in preventing or reducing muscle weakness is unclear. This study examined the relationship between handgrip strength and protein intake in Korean female elderly. Methods: This was a cross-sectional study that used data from the Seventh Korean National Health and Nutrition Examination Surveys (KNHANES) on female subjects aged 65 years and older. Low handgrip strength (LHGS) was defined as a handgrip strength below than 18 kg. Dietary intake data were obtained using the 1-day 24-hour recall method. Multiple regression was performed to test whether there is an independent relationship between the grip strength and protein intake, and the association between protein intake and LHGS was confirmed through multiple logistic regression. Results: The mean age of the 2,083 elderly females was 73.3 ± 0.1 years, and the prevalence of LHGS was 35% (n=734). Elderly women with an LHGS consumed less energy, total protein, and animal-based protein than those in the normal group. A multiple regression analysis after adjusting for covariate revealed a significant positive association between the handgrip strength and energy, protein, and animal-based protein intake. Multiple logistic regression analysis showed that the odds ratio (OR) of LHGS in female elderly with the highest quartiles of consumption of energy [OR, 0.65; 95% confidence interval (CI), 0.43-0.82; P for trend=0.004], and animal-based protein [OR, 0.59; CI, 0.40-0.87; P for trend=0.037] were significantly lower than those in the lowest quartiles. Conclusions: The energy intake and animal-based protein intake were negatively associated with the LHGS. These results suggest that adequate energy intake and protein intake, particularly those from animal-based sources, for elderly women in Korea are beneficial in lowering the risk of LHGS.

Keywords

References

  1. Jafari Nasabian P, Inglis JE, Reilly W, Kelly OJ, Ilich JZ. Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. J Endocrinol 2017; 234(1): R37-R51. https://doi.org/10.1530/JOE-16-0603
  2. Reinders I, Visser M, Schaap L. Body weight and body composition in old age and their relationship with frailty. Curr Opin Clin Nutr Metab Care 2017; 20(1): 11-15. https://doi.org/10.1097/MCO.0000000000000332
  3. Jura M, Kozak LP. Obesity and related consequences to ageing. Age 2016; 38(1): 23. https://doi.org/10.1007/s11357-016-9884-3
  4. Sacitharan PK. Ageing and osteoarthritis. Singapore: Springer; 2019. p. 123-159.
  5. Hassler N, Brozek W, Eriksen EF, Rauch F, Glorieux FH, Shane E et al. Aging versus postmenopausal osteoporosis: Bone composition and maturation kinetics at actively-forming trabecular surfaces of female subjects aged 1 to 84 years. J Bone Miner Res 2016; 31(2): 347-357. https://doi.org/10.1002/jbmr.2696
  6. Boskey AL, Imbert L. Bone quality changes associated with aging and disease: a review. Ann N Y Acad Sci 2017; 1410(1): 93-106. https://doi.org/10.1111/nyas.13572
  7. Abyad A, Boyer JT. Arthritis and aging. Curr Opin Rheumatol 1992; 4(2): 153-159. https://doi.org/10.1097/00002281-199204000-00004
  8. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr 1997; 127(5S): 990S-991S. https://doi.org/10.1093/jn/127.5.990S
  9. Cao L, Morley JE. Sarcopenia is recognized as an independent condition by an international classification of disease, tenth revision, clinical modification (ICD-10-CM) code. J Am Med Dir Assoc 2016; 17(8): 675-677. https://doi.org/10.1016/j.jamda.2016.06.001
  10. Tournadre A, Vial G, Capel F, Soubrier M, Boirie Y. Sarcopenia. Joint Bone Spine 2019; 86(3): 309-314. https://doi.org/10.1016/j.jbspin.2018.08.001
  11. Ozturk ZA, Turkbeyler IH, Abiyev A, Kul S, Edizer B, Yakaryilmaz FD et al. Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity. Intern Med J 2018; 48(8): 973-981. https://doi.org/10.1111/imj.13935
  12. Tolea MI, Galvin JE. Sarcopenia and impairment in cognitive and physical performance. Clin Interv Aging 2015; 10: 663-671. https://doi.org/10.2147/CIA.S76275
  13. Tsekoura M, Kastrinis A, Katsoulaki M, Billis E, Gliatis J. Sarcopenia and its impact on quality of life. Adv Exp Med Biol 2017; 987: 213-218. https://doi.org/10.1007/978-3-319-57379-3_19
  14. Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B. Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis. Maturitas 2017; 103: 16-22. https://doi.org/10.1016/j.maturitas.2017.04.007
  15. Bellanti F, Romano AD, Lo Buglio A, Castriotta V, Guglielmi G, Greco A et al. Oxidative stress is increased in sarcopenia and associated with cardiovascular disease risk in sarcopenic obesity. Maturitas 2018; 109: 6-12. https://doi.org/10.1016/j.maturitas.2017.12.002
  16. Zhang H, Lin S, Gao T, Zhong F, Cai J, Sun Y et al. Association between sarcopenia and metabolic syndrome in middle-aged and older non-obese adults: A systematic review and meta-analysis. Nutrients 2018; 10(3): 364. https://doi.org/10.3390/nu10030364
  17. Steffl M, Bohannon RW, Sontakova L, Tufano JJ, Shiells K, Holmerova I. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis. Clin Interv Aging 2017; 12: 835-845. https://doi.org/10.2147/CIA.S132940
  18. Bloom I, Shand C, Cooper C, Robinson S, Baird J. Diet quality and sarcopenia in older adults: A systematic review. Nutrients 2018; 10(3): 308. https://doi.org/10.3390/nu10030308
  19. Morley JE, Malmstrom TK, Rodriguez-Manas L, Sinclair AJ. Frailty, sarcopenia and diabetes. J Am Med Dir Assoc 2014; 15(12): 853-859. https://doi.org/10.1016/j.jamda.2014.10.001
  20. Landi F, Calvani R, Cesari M, Tosato M, Martone AM, Ortolani E et al. Sarcopenia: An overview on current definitions, diagnosis and treatment. Curr Protein Pept Sci 2018; 19(7): 633-638. https://doi.org/10.2174/1389203718666170607113459
  21. Chen LK, Lee WJ, Peng LN, Liu LK, Arai H, Akishita M et al. Recent advances in sarcopenia research in Asia: 2016 update from the Asian working group for sarcopenia. J Am Med Dir Assoc 2016; 17(8): 767.e1-767.e7.
  22. Okamura T, Miki A, Hashimoto Y, Kaji A, Sakai R, Osaka T et al. Shortage of energy intake rather than protein intake is associated with sarcopenia in elderly patients with type 2 diabetes: A cross-sectional study of the KAMOGAWA-DM cohort. J Diabetes 2019; 11(6): 477-483. https://doi.org/10.1111/1753-0407.12874
  23. Castaneda C, Charnley JM, Evans WJ, Crim MC. Elderly women accommodate to a low-protein diet with losses of body cell mass, muscle function, and immune response. Am J Clin Nutr 1995; 62(1): 30-39. https://doi.org/10.1093/ajcn/62.1.30
  24. Campbell WW, Trappe TA, Jozsi AC, Kruskall LJ, Wolfe RR, Evans WJ. Dietary protein adequacy and lower body versus whole body resistive training in older humans. J Physiol 2002; 542(2): 631-642. https://doi.org/10.1113/jphysiol.2002.020685
  25. Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, Woods N et al. Protein intake and incident frailty in the Women's Health Initiative observational study. J Am Geriatr Soc 2010; 58(6): 1063-1071. https://doi.org/10.1111/j.1532-5415.2010.02866.x
  26. Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008; 87(1): 150-155. https://doi.org/10.1093/ajcn/87.1.150
  27. Cholewa JM, Dardevet D, Lima-Soares F, de Araújo Pessoa K, Oliveira PH, Dos Santos Pinho JR et al. Dietary proteins and amino acids in the control of the muscle mass during immobilization and aging: role of the MPS response. Amino Acids 2017; 49(5): 811-820. https://doi.org/10.1007/s00726-017-2390-9
  28. Sahni S, Mangano KM, Hannan MT, Kiel DP, McLean RR. Higher protein intake is associated with higher lean mass and quadriceps muscle strength in adult men and women. J Nutr 2015; 145(7): 1569-1575. https://doi.org/10.3945/jn.114.204925
  29. Chan R, Leung J, Woo J, Kwok T. Associations of dietary protein intake on subsequent decline in muscle mass and physical functions over four years in ambulant older Chinese people. J Nutr Health Aging 2014; 18(2): 171-177. https://doi.org/10.1007/s12603-013-0379-y
  30. Ter Borg S, de Groot LC, Mijnarends DM, de Vries JH, Verlaan S, Meijboom S et al. Differences in nutrient intake and biochemical nutrient status between sarcopenic and nonsarcopenic older adults-results from the Maastricht Sarcopenia Study. J Am Med Dir Assoc 2016; 17(5): 393-401. https://doi.org/10.1016/j.jamda.2015.12.015
  31. Kim HY, Kim CW, Park CH, Choi JY, Han K, Merchant AT et al. Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults: the Fifth Korea National Health and Nutrition Examination Survey. Hepatobiliary Pancreat Dis Int 2016; 15(1): 39-47. https://doi.org/10.1016/S1499-3872(15)60030-3
  32. Kim TN, Lee EJ, Hong JW, Kim JM, Won JC, Kim MK et al. Relationship between sarcopenia and albuminuria: The 2011 Korea National Health and Nutrition Examination Survey. Medicine 2016; 95(3): e2500. https://doi.org/10.1097/MD.0000000000002500
  33. Yoo JI, Ha YC, Kwon HB, Lee YK, Koo KH, Yoo MJ. High prevalence of sarcopenia in Korean patients after hip fracture: a case-control study. J Korean Med Sci 2016; 31(9): 1479-1484. https://doi.org/10.3346/jkms.2016.31.9.1479
  34. Lim J, Park HS. Relationship between underweight, bone mineral density and skeletal muscle index in premenopausal Korean women. Int J Clin Pract 2016; 70(6): 462-468. https://doi.org/10.1111/ijcp.12801
  35. Oh C, Jeon BH, Reid Storm SN, Jho S, No JK. The most effective factors to offset sarcopenia and obesity in the older Korean: Physical activity, vitamin D, and protein intake. Nutrition 2017; 33: 169-173. https://doi.org/10.1016/j.nut.2016.06.004
  36. Jung JH, Lee JH, Kwon YJ. Difference of low skeletal muscle index according to recommended protein intake in Korean. Korean J Fam Pract 2019; 9(6): 539. https://doi.org/10.21215/kjfp.2019.9.6.539
  37. Kim CR, Jeon YJ, Jeong T. Risk factors associated with low handgrip strength in the older Korean population. PLoS One 2019; 14(3): e0214612. https://doi.org/10.1371/journal.pone.0214612
  38. Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020; 21(3): 300-307. https://doi.org/10.1016/j.jamda.2019.12.012
  39. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. Sejong: Ministry of Health and Welfare; 2015. Report No. 11-1352000-001537-14.
  40. Lee K, Shin Y, Huh J, Sung YS, Lee IS, Yoon KH et al. Recent issues on body composition imaging for sarcopenia evaluation. Korean J Radiol 2019; 20(2): 205-217. https://doi.org/10.3348/kjr.2018.0479
  41. Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002; 50(5): 889-896. https://doi.org/10.1046/j.1532-5415.2002.50216.x
  42. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003; 95(5): 1851-1860. https://doi.org/10.1152/japplphysiol.00246.2003
  43. Dupuy C, Lauwers-Cances V, Guyonnet S, Gentil C, Abellan Van Kan G, Beauchet O et al. Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study. J Cachexia Sarcopenia Muscle 2015; 6(2): 144-154. https://doi.org/10.1002/jcsm.12021
  44. Shafiee G, Keshtkar A, Soltani A, Ahadi Z, Larijani B, Heshmat R. Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies. J Diabetes Metab Disord 2017; 16(1): 21. https://doi.org/10.1186/s40200-017-0302-x
  45. Lee SK, Lee JA, Kim JY, Kim YZ, Park HS. The risk factors of sarcopenia among Korean elderly men: based on 2009 Korean National Health and Nutrition Examination Survey data. Korean J Obes 2014; 23(1): 23-31. https://doi.org/10.7570/kjo.2014.23.1.23
  46. Lorenzo-Lopez L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodriguez-Villamil JL, Millan-Calenti JC. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr 2017; 17(1): 108. https://doi.org/10.1186/s12877-017-0496-2
  47. Brzeszczynska J, Meyer A, McGregor R, Schilb A, Degen S, Tadini V et al. Alterations in the in vitro and in vivo regulation of muscle regeneration in healthy ageing and the influence of sarcopenia. J Cachexia Sarcopenia Muscle 2018; 9(1): 93-105. https://doi.org/10.1002/jcsm.12252
  48. Kim HH, Kim JS, Yu JO. Factors contributing to sarcopenia among community-dwelling older Korean adults. J Korean Gerontol Nurs 2014; 16(2): 170-179. https://doi.org/10.17079/jkgn.2014.16.2.170
  49. Park KB, Park HA, Kang JH, Kim K, Cho YG, Jang J. Animal and plant protein intake and body mass index and waist circumference in a Korean elderly population. Nutrients 2018; 10(5): 577. https://doi.org/10.3390/nu10050577

Cited by

  1. The Effect of Interaction between Obesity and Grip Strength on Health-Related Quality of Life in Elderly: Based on the Korea National Health and Nutrition Examination Survey (2016-2018) vol.46, pp.1, 2020, https://doi.org/10.21032/jhis.2021.46.1.28
  2. 대도시·중소도시·읍면지역 및 동일한 지역내에서의 소득수준에 따른 노인의 영양소 섭취 현황: 국민건강영양조사 2016-2018년 자료 활용 vol.36, pp.1, 2020, https://doi.org/10.7318/kjfc/2021.36.1.92
  3. 광주광역시 서구 재가노인의 노쇠정도에 따른 영양상태 vol.26, pp.5, 2021, https://doi.org/10.5720/kjcn.2021.26.5.382
  4. Dietary phytochemicals as a promising nutritional strategy for sarcopenia: a systematic review and meta-analysis of randomized controlled trials vol.64, pp.1, 2020, https://doi.org/10.1186/s13765-021-00633-2