• Nutrition Research and Practice
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• v.15 no.4
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• pp.528-540
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• 2021

BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1-2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008-2009) and V (2010-2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45-86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; 'Diverse', 'Western', 'Traditional', and 'Snacks and beverages'. The 'Western' pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07-2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS: The study findings suggest that the 'Western' dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

• The Journal of Internal Korean Medicine
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• v.44 no.6
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• pp.1118-1138
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• 2023

Objectives: Sarcopenia is an age-associated skeletal muscle disorder that can profoundly impact the health of elderly people. However, the efficacy of herbal medicine in sarcopenia is uncertain. This review aims to investigate evidence of the effect of herbal medicine on sarcopenia. Methods: We systematically searched 12 electronic databases for relevant randomized controlled trials (RCTs). Only trials that met the inclusion criteria were selected, and the characteristics of the included studies were extracted and synthesized in a narrative manner. The quality of the included studies was assessed using Cochrane's Risk of Bias (RoB) 2.0 tool. Results: 7 RCTs involving 672 participants with sarcopenia met the inclusion criteria. The intervention combining herbal medicine and conventional treatment (i.e., exercise, nutritional support) had a significant therapeutic effect compared with the conventional treatment, showing improvement in muscle strength (i.e., grip strength), muscle mass (i.e., appendicular skeletal muscle mass index), and physical function (i.e., gait speed, short physical performance battery, and timed up and go test). However, the methodological quality of the included RCTs was relatively low due to their high RoB, making it difficult to evaluate the efficacy of herbal medicine in sarcopenia. In terms of safety, several adverse events were reported. Conclusion: This review suggests that herbal medicine has a positive effect on muscle strength, muscle mass, and physical performance in elderly patients with sarcopenia, but there is a clear need for further research in this area.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.219-226
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• 2018

Background: Although studies and interest in sarcopenia have increased, it is still a matter of debate which muscle mass index better represents the aging process. We compared 3 indices for muscle mass (appendicular skeletal muscle mass [ASM]/weight, $ASM/height^2$, and the body mass index [BMI]-adjusted muscle mass index [ASM/BMI]) to determine which better reflected the aging process in terms of the decline in bone mineral density (BMD), visual acuity (VA), hearing power, renal function, pulmonary function, and handgrip strength. Methods: We performed a retrospective cross-sectional study using the Korea National Health and Nutrition Examination Survey in the Korean population. Between 2008 and 2011, a total of 14,415 men and 17,971 women aged 10 years or older participated in the study. We plotted the changes in the 3 indices of muscle mass and compared these with changes in BMD, VA, hearing power, renal function, pulmonary function, and handgrip strength according to each age group. Results: The ASM/BMI showed similar changes in terms of surrogate markers of the aging process, while the ASM/weight and $ASM/height^2$ showed no correlation. Conclusions: Among muscle indices for sarcopenia, only the ASM/BMI represented the aging process.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.199-209
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• 2020

Purpose : This study used a sarcopenia diagnostic algorithm proposed by the Asia working group in adults over 50 to diagnose sarcopenia and analyze body function. The purpose of this study is to prepare basic data for the management and prevention of sarcopenia. Methods : We performed a diagnostic evaluation of sarcopenia in 97 adults over the age of 50 years with the cooperation of the Seongnam senior experience complex in Seongnam-si, Gyeonggi-do. As a result of the diagnostic process, 24 subjects were placed into the sarcopenia group, while 73 subjects were placed into the normal group. We measured each subject's body, performed the timed up and go test to evaluate functional mobility, and conducted a questionnaire on the pre-symptom of locomotive syndrome and locomotive syndrome. Results : There were statistically significant differences in height, weight, and skeletal muscle mass between the two groups. There was also a statistically significant difference in the timed up and go test, which confirmed the difference in functional mobility between the two groups. In addition, there was a statistically significant difference between the two groups in the proportion and the mean score of subjects with pre-symptom of locomotive syndrome and locomotive syndrome. In the correlation analysis, grip strength was statistically significantly correlated with height, weight, skeletal muscle mass, waist circumference, timed up and go test, pre-symptom of locomotive syndrome and locomotive syndrome. Gait speed was significantly correlated with the timed up and go test and locomotive syndrome. Appendicular skeletal muscle index was significantly correlated with height, weight, waist circumference, hip circumference, and the pre-symptom of locomotive syndrome. Conclusion : In conclusion, sarcopenia is closely related to height, weight, skeletal muscle mass and functional mobility, as well as the pre-symptom of locomotive syndrome and, locomotive syndrome. In consideration of this, the prevention and management of sarcopenia should be made accordingly.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.165-173
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• 2022

Purpose : This study was conducted to apply a 12-week resistance exercise program to obese elderly people with sarcopenia and verify the risk factors of sarcopenia and metabolic syndrome as well as the effects of this program on improving muscle function, and thus to serve as basic data for preventing and improving sarcopenia. Methods : Forty elderly people aged 65 or older were recruited and underwent dual energy x-ray absorptiometry. Based on the criteria of appendicular skeletal muscle mass (ASM/Height²: less than 5.4 kg/m²) and body fat percentage (at least 30 % for women and 25 % for men), 18 obese elderly people with sarcopenia were finally selected after excluding 22 elderly people who did not meet the criteria. Variables related to sarcopenia, metabolic syndrome, and muscle function were measured before the 12-week resistance exercise program. Results : The 12-week resistance exercise program significantly increased the bone density and muscle mass and decreased the fat mass and fat percentage in obese elderly with sarcopenia. The 12-week resistance exercise program significantly increased the HDL-C and decreased the LDL-C and waist circumference in obese elderly people with sarcopenia (p<.05). The 12-week resistance exercise program significantly increase grip strength, static balance, and 6-minute walking in obese elderly people with sarcopenia (p<.05). Conclusion : Accordingly, resistance exercise is considered a way to reduce the exorbitant medical expenses of patients who are bedridden for long and improve the lowered quality of individuals in a super-aged society.

• Journal of Korean Academy of Nursing
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• v.53 no.1
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• pp.1-11
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• 2023

Purpose: This study aimed to identify the factors influencing quality of life (QoL) of low-income older adults (LOAs) with sarcopenia. Methods: A convenience sample of 125 older adults was recruited from Jeonbuk Province, South Korea. Data were collected using a self-report questionnaire that included nutritional status, the Depression Anxiety Stress Scale-21, and the World Health Organization Quality of Life Instrument-Older Adults Module. Additionally, grip strength and appendicular skeletal muscle mass, were evaluated, along with the short physical performance battery. Results: Sarcopenia and severe sarcopenia were observed in 43.2% and 56.8% of participants, respectively. Using multiple regression analysis, depression (β = - .40, p < .001), nutritional status (β = .24, p = .003), and anxiety (β = - .15, p = .042) were identified as factors affecting the QoL of the older adults in low-income groups with sarcopenia, the explanatory power of these variables was 44%. Conclusion: The results of this study can be used to develop a nursing intervention program and establish policies to improve depression, anxiety, and nutritional status to enhance QoL of LOAs with sarcopenia.

• Nutrition Research and Practice
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• v.15 no.1
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• pp.95-105
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• 2021

BACKGROUND/OBJECTIVES: The measurement of body composition, including muscle and fat mass, remains challenging in large epidemiological studies due to time constraint and cost when using accurate modalities. Therefore, this study aimed to develop and validate prediction equations according to sex to measure lean body mass (LBM), appendicular skeletal muscle mass (ASM), and body fat mass (BFM) using anthropometric measurement, serum creatinine level, and lifestyle factors as independent variables and dual-energy X-ray absorptiometry as the reference method. SUBJECTS/METHODS: A sample of the Korean general adult population (men: 7,599; women: 10,009) from the Korean National Health and Nutrition Examination Survey 2008-2011 was included in this study. The participants were divided into the derivation and validation groups via a random number generator (with a ratio of 70:30). The prediction equations were developed using a series of multivariable linear regressions and validated using the Bland-Altman plot and intraclass correlation coefficient (ICC). RESULTS: The initial and practical equations that included age, height, weight, and waist circumference had a different predictive ability for LBM (men: R2 = 0.85, standard error of estimate [SEE] = 2.7 kg; women: R2 = 0.78, SEE = 2.2 kg), ASM (men: R2 = 0.81, SEE = 1.6 kg; women: R2 = 0.71, SEE = 1.2 kg), and BFM (men: R2 = 0.74, SEE = 2.7 kg; women: R2 = 0.83, SEE = 2.2 kg) according to sex. Compared with the first prediction equation, the addition of other factors, including serum creatinine level, physical activity, smoking status, and alcohol use, resulted in an R2 that is higher by 0.01 and SEE that is lower by 0.1. CONCLUSIONS: All equations had low bias, moderate agreement based on the Bland-Altman plot, and high ICC, and this result showed that these equations can be further applied to other epidemiologic studies.

• Culinary science and hospitality research
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• v.20 no.5
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• pp.84-92
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• 2014

Present study classified body composition to 4 groups categorized as sarcopenic obesity (SO), sarcopenic nonobesity (SNO), nonsarcopenic obesity (NSO), and nonsarcopenic nonobesity (NSNO) and then was performed to investigate that body composition associated with food consumption frequency as well as MS in individual aged 60 years or older. Body mass index and an appendicular skeletal muscle mass (ASM) divided by weight (Wt) of < 1 standard deviation (SD) below the sex-specific mean for young adults were used to define obesity and sarcopenia. A total of 1,433 subjects (658 male and 775 females) 60 years or older from the fifth Korea National Health and Nutritional Examination Survey 2010 participated in this study. One of the interesting findings was that the association of the prevalence of MS with body composition was higher in women than man. Other finding was that there were different food frequency and food preference according to 4 different groups between men and women. In addition, men are much more influenced by food than women. In conclusion, body composition changes were more related with food frequency in elderly men (60 years or older) than women. Women had a higher prevalence of MS than men, suggesting early nutritional intervention in elderly women may help them prevent body composition changes.

• Nutrition Research and Practice
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• v.15 no.5
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• pp.604-612
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• 2021

BACKGROUND/OBJECTIVES: We aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently. SUBJECTS/METHODS: We analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates. RESULTS: We observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5-18.3), 21.0 (20.6-21.5), 22.1 (21.5-22.8), and 25.1 (24.2-26.1) in men and 29.7 (29.4-30.0), 32.0 (31.6-32.3), 32.9 (32.4-33.4), and 34.7 (33.2-36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m²) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51-7.59), 7.62 (7.56-7.68), 7.65 (7.56-7.74), and 7.22 (7.04-7.41) in men and 5.83 (5.80-5.85), 5.96 (5.92-6.00), 6.03 (5.96-6.10), and 5.88 (5.73-6.03). CONCLUSIONS: There was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.

• Clinical Nutrition Research
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• v.11 no.2
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• pp.84-97
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• 2022

As the proportion of the elderly population increases rapidly, interest in musculoskeletal health is also emerging. Here, we investigated how antioxidant vitamin intake and musculoskeletal health are related. Adults aged 50 to 80 years with a body mass index (BMI) of 18.5 to 27.0 kg/m² were included. Bone mineral density (BMD), lean mass (LM), appendicular skeletal muscle mass index (ASMI) were measured using dual-energy X-ray absorptiometry (DXA), and the grip strength and knee extension using hand dynamometer. Nutrient intakes were measured using a 24-hour recall questionnaire. A total of 153 adults (44 men and 109 women) participated in this study. A partial correlation analysis showed a significant positive relationship between vitamin E and BMD and between vitamin C and LM/Height. Participants were classified into three groups according to whether their vitamin E and C intake met the recommended intake for Dietary Reference Intakes for Koreans (KDRIs). The prevalence of having low T-score (< -1.0) and low ASMI (< 7.0 for men and < 5.4 for women) was 51.3% and 15.4% in the group with vitamins C and E intakes below KDRIs. After adjusting for sex, smoking status and energy, protein, vitamin D, and calcium intake, the group with vitamins C and E both below the KDRIs displayed a significantly lower BMD at all test sites and LM/Height compared with vitamin C and/or E intake above the KDRIs groups. We conclude that sufficient intake of vitamin E and C is important for maintaining BMD and lean mass in Korean adults over 50 years of age.