Lower Mid-arm Muscle Circumference Research Articles

SARC-F Score: A Quick Bedside Tool to Screen Sarcopenia in Patients With Cirrhosis

Sarcopenia is often ignored in clinical practice despite being an important prognostic marker. SARC-F is a simple bedside score to assess muscle abnormalities in cirrhosis patients. However, there is limited Indian data on the validity of this score. Hence, we aimed to assess the validity of SARC-F score in a tertiary care center. A prospective observational study including consecutive 100 cirrhosis patients attending the gastroenterology outpatient department in Osmania Medical College and Hospital, Hyderabad, India, was conducted from Jan 2018 to Dec 2019. The primary aim was to assess the mean muscle volume loss (MVL) by computed tomography and handgrip (HG) strength for muscle strength decline (MSD) and compare the SARC-F score with standard cut-off values. We included 100 cirrhosis patients (mean age: 45 years; males: 86%; child-pugh class B/C: 42/58). Sixty-nine percent of the patients had a SARC-F score of ≥4, whereas MVL and MSD were noted in 62% and 86% patients, respectively. Mid-arm circumference, skin-fold thickness, mid-arm muscle circumference (MAMC), and HG strength were significantly lower in patients with SARC-F score ≥4 than in those with SARC-F score <4 (P<0.05). The Pearson correlation plot suggested a significant inverse correlation between the SARC-F score and MSD and SARC-F score and MVL. A SARC-F score of ≥4 had a sensitivity and specificity of 80.7% and 50% for MVL and 75.6% and 71.4% for MSD, respectively, whereas it was 83.3% and 52.5% for MSD and MVL combined, respectively. Area under the receiver operating characteristic curve for SARC-F as a predictor of MVL was 0.75 (95% confidence interval: 0.64-0.82; P=<0.001). On multivariate analysis, a high SARC-F score and low MAMC were predictive of MVL in cirrhosis patients. SARC-F score has good sensitivity as a bedside screening tool for sarcopenia in patients with cirrhosis. A high SARC-F score and low MAMC indicates the presence of MVL and warrants further evaluation for sarcopenia.

#6600 ASSOCIATION BETWEEN ADVANCED GLYCATION END-PRODUCTS AND SARCOPENIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract Background and Aims In patients with chronic kidney disease (CKD), there is an overproduction and accumulation of advanced glycation end-products (AGEs). Since AGEs may have detrimental effects on muscular trophism and performance, we evaluated whether they may contribute to the onset of sarcopenia in CKD patients. Method We enrolled 117 patients. The AGEs were quantified by fluorescence intensity using a fluorescence spectrophotometer and soluble receptor for AGE (sRAGE) isoforms by ELISA. As for the sarcopenia definition, we used the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Results The average age was 80 ± 11 years, 70% were males, and the mean eGFR was 25 + 11 mL/min/1.73 m2. Sarcopenia was diagnosed in 26 patients (with a prevalence of 22%). The sarcopenic patients had higher levels of circulating AGEs (3405 ± 951 vs. 2912 ± 722 A.U., p = 0.005). AGEs were higher in subjects with a lower midarm muscle circumference (MAMC) (3322 ± 919 vs. 2883 ± 700 A.U., respectively; p = 0.005) and were directly correlated with the gait test time (r = 0.180, p = 0.049). The total sRAGE and its different isoforms (esRAGE and cRAGE) did not differ in patients with or without sarcopenia. Conclusion In older CKD patients, AGEs, but not sRAGE, are associated with the presence of sarcopenia. Therefore, AGEs may contribute to the complex pathophysiology leading to the development of sarcopenia in CKD patients.

Diagnosis, Prevalence and Significance of Obesity in a Cohort of CKD Patients

data regarding the association between obesity and morbidity/mortality in patients with chronic kidney disease (CKD) are uncertain and sometimes contradictory. The aims of our study were to determine the associations among different measures of obesity and adiposity, and the risk of all-cause mortality or dialysis entry in stage 3-5 CKD patients. this observational cohort study included 178 CKD patients followed for a median of 71 months. Biochemistry, anthropometric measures such as body mass index (BMI), waist-to-hip ratio, mid-arm muscle circumference (MAMC) and body composition by bioimpedance analysis were evaluated. we found a weak agreement between BMI and other measures of adiposity. In multivariable regression analysis, all measures of obesity such as BMI, waist circumference and waist-to-height ratio were not associated with dialysis entry and/or mortality. Instead, MAMC was associated with dialysis entry HR 0.82 [95% CI: 0.75-0.89] and high FM% with mortality HR 2.08 [95% CI: 1.04-4.18]. in our CKD population, lower MAMC was predictive of dialysis commencing, while a higher percentage of fatty mass was a predictor of mortality. Instead, obesity, as defined by BMI, is not associated with dialysis commencing or all-cause mortality.

Association between Advanced Glycation End-Products and Sarcopenia in Patients with Chronic Kidney Disease.

Background: In patients with chronic kidney disease (CKD), there is an overproduction and accumulation of advanced glycation end-products (AGEs). Since AGEs may have detrimental effects on muscular trophism and performance, we evaluated whether they may contribute to the onset of sarcopenia in CKD patients. Methods: We enrolled 117 patients. The AGEs were quantified by fluorescence intensity using a fluorescence spectrophotometer and soluble receptor for AGE (sRAGE) isoforms by ELISA. As for the sarcopenia definition, we used the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria. Results: The average age was 80 ± 11 years, 70% were males, and the mean eGFR was 25 + 11 mL/min/1.73 m2. Sarcopenia was diagnosed in 26 patients (with a prevalence of 22%). The sarcopenic patients had higher levels of circulating AGEs (3405 ± 951 vs. 2912 ± 722 A.U., p = 0.005). AGEs were higher in subjects with a lower midarm muscle circumference (MAMC) (3322 ± 919 vs. 2883 ± 700 A.U., respectively; p = 0.005) and were directly correlated with the gait test time (r = 0.180, p = 0.049). The total sRAGE and its different isoforms (esRAGE and cRAGE) did not differ in patients with or without sarcopenia. Conclusions: In older CKD patients, AGEs, but not sRAGE, are associated with the presence of sarcopenia. Therefore, AGEs may contribute to the complex pathophysiology leading to the development of sarcopenia in CKD patients.

Sarcopenia as Manifested by L3SMI Is Associated with Increased Long-Term Mortality amongst Internal Medicine Patients-A Prospective Cohort Study.

Background: Sarcopenia and Frailty are syndromes that affect the clinical outcomes of patients suffering from a wide range of diseases. The use of Computed Tomography (CT) is well established for Sarcopenia evaluation via estimation of the Skeletal Muscle Index (SMI) at the level of the third lumbar vertebra (L3SMI). Nevertheless, the association of more readily available biomarkers of Sarcopenia and clinical outcomes is desired. Recent studies have associated low Alanine amino-transferase ALT (SGPT) levels with Sarcopenia and frailty. The current study aimed to establish the association between low L3SMI and the aforementioned indices of Sarcopenia, frailty and poor clinical outcomes. Methods: A cohort study of patients admitted to the internal medicine department at a tertiary medical center. Sarcopenia was determined as L3SMI, lower than 53 cm2/m2 in men and 41 cm2/m2 in women. Clinical and mortality data was collected from the medical record. Results: Of the 187 patients recruited (mean age 70.4 ± 9.2, 59% males), 116 (62%) had Sarcopenia, based on L3SMI values. Sarcopenic patients were older, predominantly male, had lower BMI, lower mid-arm muscle circumference (MAMC) and low ALT values upon admission. L3SMI values significantly correlated with age and MAMC among males (R = −0.38, p < 0.001, R = 0.35, p < 0.001, respectively). Sarcopenia was associated with higher, one-year mortality (HR = 2.60, 95% CI 1.06–6.37, p = 0.036) and shorter all-time survival (HR = 2.91, 95% CI 1.35–6.29, p = 0.007). The association with all-time survival remained after adjusting for age and sex (HR = 2.38, 95% CI 1.07–5.29, p = 0.034). Conclusion: As defined by low L3SMI value, Sarcopenia is a poor prognostic factor for the general internal ward patient population. As part of personalized medicine, physicians may benefit from measuring L3SMI value, as indicated by commonly performed CT scans, to objectively assess their patient’s risk of suffering from Sarcopenia and frailty-associated complications.

Nutritional and Functional Indicators and Their Association With Mortality Among Older Adults With Alzheimer's Disease.

This study investigated how different nutritional and functional status indicators are associated with mortality in patients with Alzheimer's disease (AD). A prospective cohort study was conducted among 79 community-dwelling older adults with AD. Follow-up was 60 months. Undernutrition status was evaluated by Mini Nutritional Assessment (MNA), body mass index, mid-arm muscle circumference (MAMC), calf circumference, and phase angle. Functional status was assessed by handgrip strength, and usual gait speed. Twenty-two participants died (27.8%). Results show that undernutrition (hazard ratio [HR] 5.69, 95% confidence interval [CI] 2.21-14.61), weight loss (HR 3.82, 95% CI 1.37-10.63), underweight (HR 3.24, 95% CI 1.18-8.82), low MAMC (HR 4.54, 95% CI 1.65-12.48), calf circumference ≤ 31 (HR 4.27, 95% CI 1.63-11.16), low HGS (HR 3.11, 95% CI 1.18-8.17), and low gait speed (HR 4.73, 95% CI 1.68-13.27) were all associated with mortality. In conclusion, a poor nutritional and functional status was associated with a higher risk of mortality, regardless of sex, age, marital status, education, and cognitive function.

Cachexia in head and neck squamous cell carcinoma (HNSCC) patients (pts) after cisplatin-based chemoradiation (CRT): A cross-sectional study.

e23138 Background: Cachexia is a wasting syndrome that may affect HNSCC pts, contributing to their dismal prognosis. We aimed to study the frequency of cachexia in HNSCC survivors treated with CRT with curative intent. Methods: Cross-sectional study that included 120 consecutive pts from Jan/2014 to Feb/2017, over 18 y.o. and who were previously treated with definitive or adjuvant CRT for HNSCC (nasopharynx, oropharynx [OP], oral cavity [OC], hypopharynx and larynx [L]). Eligible pts were in regular follow-up for at least 2 years in the multidisciplinary team, with no evidence of disease. Medical history, body weight, height, mid-arm muscle circumference (MAMC) and muscle strength (MS, handgrip dynamometer) were measured, and laboratory tests (hemoglobin [Hb], albumin and C-reactive protein [CRP]) were obtained. Cachexia was diagnosed when there was any weight loss in the previous year, and at least 3 of the following: reduced grip muscle strength, fatigue, anorexia, low lean body mass, or laboratorial alterations (Hb &lt; 12 g/dL, serum albumin &lt; 3.2 g/dL or CRP &gt; 5.0 mg/L). A subjective assessment of nutritional status was made based on the Patient-Generated Subjective Global Assessment (PG-SGA) in its short form. Results: Median age 59 y.o. (21-78), 88 male (73%). Most common primary sites were OP (42%), L (24%) and OC (19%). Median follow-up was 42 mo. (24-125). There was a predominance of locally advanced disease at diagnosis: 73% T3/T4 and 72% N+. The mean weight was 64.5 kg (±14.6) pre-CRT, 57.8 kg (±12.2) post-CRT (p 0.02) and 63 kg (±11.8) in the present evaluation (p NS). Dysphagia was a complaint in 88 pts (73%). Cachexia was diagnosed in 42 pts (35%). As expected, cachectic pts (CP) presented lower MAMC (25.1 vs. 27.2 cm, p 0.0002) and MS (24.3 vs. 29.5 kgf, p 0.004). Higher mean CRP (12.7 vs. 4.2 mg/L, p 0.0001) and lower Hb (13.1 vs.13.9 g/dL, p 0.01) were also seen in CP. The PG-SGA score was higher in CP (7.9 vs. 5.7, p 0.006). Conclusions: Cachexia was frequently diagnosed in HNSCC pts with NED after CRT in a long-term follow-up, without evident weight loss. More effective preventive and therapeutic strategies are warranted. Supported in part by FAPESP grant 2014/00172-9.

Reduced Serum Sphingolipids Constitute a Molecular Signature of Malnutrition in Hospitalized Patients With Decompensated Cirrhosis.

INTRODUCTION:Malnutrition is a leading cause of morbidity and mortality in cirrhosis. Although multiple noninvasive measures of nutritional status have been studied, no consensus exists for early identification of malnutrition in cirrhosis. Serum metabolomics offers a novel approach for identifying biomarkers in multiple disease states. To characterize alterations in metabolic pathways associated with malnutrition in hospitalized cirrhotic patients and to identify biomarkers for disease prognosis.METHODS:In this cross-sectional, observational cohort study, 51 hospitalized cirrhotic patients were classified as malnourished (42.3%) or nourished (57.7%) based on low mid-arm muscle circumference and dominant handgrip strength. Anthropometric measurements and computed tomography body composition analysis were performed. Serum was collected after overnight fasting for unbiased metabolomics analysis.RESULTS:Malnourished cirrhotic patients exhibited mild reductions in skeletal muscle index, with more marked reductions in visceral fat index. Seventy-one biochemicals were significantly altered in malnourished subjects. The serum metabolite profile was significantly different between nourished and malnourished cirrhotic patients. Pathway analysis demonstrated that only sphingolipid metabolic pathways were significantly enriched in altered metabolites. Hierarchical clustering revealed that sphingolipid metabolites clustered into nourished and malnourished cohorts. Spearman analysis demonstrated multiple statistically significant correlations between sphingolipid species and Model for End-Stage Liver Disease-Sodium. Using logistic regression, we identified 8 sphingolipids that were significantly associated with malnutrition after controlling for Model for End-Stage Liver Disease-Sodium, age, and gender.CONCLUSIONS:Malnutrition in hospitalized cirrhotic patients is characterized by reductions in multiple sphingolipid species. Dysregulated sphingolipid metabolism may be involved in the pathophysiology of malnutrition in cirrhosis and potentially serve as a biomarker of nutritional status in this population.

Association of Anthropometric Indexes With Disease Severity in Male Patients With Chronic Obstructive Pulmonary Disease in Qazvin, Iran.

Malnutrition is one of the most important factors that lead to lower quality of life in patients suffering from chronic obstructive pulmonary disease (COPD). There are several methods for assessing malnutrition including anthropometric indexes. The aim of this study was to determine the association of anthropometric indexes with disease severity in male patients with COPD in Qazvin, Iran. This cross-sectional study was conducted on 72 male patients with COPD in Qazvin, Iran, from May to December 2014. Spirometry was performed for all participants. Disease severity was determined using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. Body mass index (BMI), mid-arm muscle circumference (MAMC), and triceps skinfold thickness (TSF) were measured. MAMC and TSF were categorized into three subgroups as <25th P, between 25th P and 75th P, and >75th P (Where P is the abbreviation for percentile.). Data were analyzed using ANOVA and logistic regression analysis. Mean age was 60.23 ± 11.39 years. Mean BMI was 23.23 ± 4.42 Kg/m2, mean MAMC was 28.34 ± 3.72 cm2, and mean TSF was 10.15 ± 6.03 mm. Mean BMI and MAMC in the GOLD stage IV were significantly lower than other stages. Of 72, 18.1% were underweight while 6.9% were obese. The GOLD stage IV was associated with 16 times increased risk of underweight and nine times increased risk of MAMC < 25th P. Disease severity was associated with BMI and MAMC as indexes of malnutrition in patients with COPD in the present study. The GOLD stage IV was associated with increased risk of underweight and low MAMC.

Low serum sodium is associated with protein energy wasting and increased interdialytic weight gain in haemodialysis patients

BackgroundLow serum sodium (Na) has been associated with decreased body mass index and increased cardiovascular mortality in haemodialysis (HD) patients. We examined the relationship between serum Na and selected nutritional parameters of protein energy wasting that are not affected from the hydration status in a cohort of HD patients.MethodsTriceps skinfold thickness (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), handgrip strength (HGS) and subjective global assessment (SGA) were assessed in maintenance HD patients using standard techniques. MAMC was calculated with the formula MAMC (cm) = MAC (cm) −3.142 × TSF cm. Pre-dialysis serum Na values from routine monthly laboratory measurements were averaged for the last 6 months prior to the nutritional assessment.ResultsAltogether 172 patients with anthropometric data were included in the final analysis. Mean age was 66 ± 14, females 62 (36%) and diabetics 48 (28.9%). Patients with pre-dialysis serum Na below the mean value (136.2 mEq/L) had lower MAMC, HGS, SGA scores and albumin levels (23.50 ± 3.16 cm versus 24.58 ± 3.71 cm, P = 0.048; 21.7 ± 13.6 kg versus 28.0 ± 12.4 kg, P = 0.030; 5.1 ± 1.2 versus 5.7 ± 1.0, P = 0.012 and 31.65 ± 4.73 mg/L versus 32.25 ± 3.91 mg/L, P = 0.022, respectively) and higher interdialytic weight gains. Pre-dialysis serum Na correlated positively with MAMC, handgrip and SGA (Pearson's correlation r = 0.165, P = 0.031, r = 0.237, P = 0.022 and r = 0.195, P = 0.011, respectively).ConclusionThis study demonstrates that low serum sodium is associated with protein energy wasting and increased interdialytic weight gain in HD patients.

Low muscle mass in older men: the role of lifestyle, diet and cardiovascular risk factors.

To explore associations between low muscle mass and a wide range of lifestyle, dietary and cardiovascular risk factors in older men including metabolic risk factors, markers of inflammation, endothelial dysfunction and coagulation. Cross-sectional study. British Regional Heart Study. 4252 men aged 60-79 years. PARTICIPANTS attended a physical examination in 1998-2000, and completed a general questionnaire and a food frequency questionnaire. Low muscle mass was assessed by two measures: midarm muscle circumference (MAMC) and fat-free mass index (FFMI). Associations between risk factors and low muscle mass were analysed using logistic regression. Physical inactivity, insulin resistance, C-reactive protein, von Willebrand factor and fibrinogen were associated with significantly increased odds of low MAMC and FFMI after adjustment for body mass index, lifestyle characteristics and morbidity. Those with higher percent energy intake from carbohydrates showed decreased odds of low MAMC (OR: 0.73, 95% CI: 0.55-0.96) and FFMI (OR: 0.76, 95% CI: 0.58-0.99). Other dietary variables, smoking, alcohol intake, D-dimer, interleukin 6 and homocysteine showed no important associations with MAMC and FFMI. Increasing physical activity, consuming a diet with a high proportion of energy from carbohydrates, and taking steps to prevent insulin resistance and reduce inflammation and endothelial dysfunction may help to reduce the risk of low muscle mass in older men.

Nutritional status in patients with active inflammatory bowel disease: Prevalence of malnutrition and methods for routine nutritional assessment

Background and aim Malnutrition is a common feature of inflammatory bowel disease (IBD). There are numerous methods for the assessment of nutritional status, but the gold standard has not yet been established. The aims of the study were to estimate the prevalence of undernutrition and to evaluate methods for routine nutritional assessment of active IBD patients. Material and methods Twenty-three patients with active Crohn disease, 53 patients with active ulcerative colitis and 30 controls were included in the study. The nutritional status was assessed by extensive anthropometric measurements, percentage of weight loss in the past 1–6 months and biochemical markers of nutrition. Results All investigated nutritional parameters were significantly different in IBD patients compared to control subjects, except MCV, tryglicerides and serum total protein level. Serum albumin level and bodymass index (BMI) were the most predictive parameters of malnutrition. According to different assessment methods the prevalence of undernutrition and severe undernutrition in patients with active IBD were 25.0%–69.7% and 1.3%–31.6%, respectively, while in the control subjects no abnormalities have been detected. There was no statistically significant difference of nutritional parameters between UC and CD patients except lower mid-arm muscle circumference in UC group. Conclusions Malnutrition is common in IBD patients. BMI and serum albumin are simple and convenient methods for the assessment of the nutritional status in IBD patients. Further studies with larger group of patients are necessary to elucidate the prevalence of malnutrition and the most accurate assessment methods in IBD patients.

Midarm muscle circumference, physical performance and mortality: Results from the aging and longevity study in the Sirente geographic area (ilSIRENTE study)

Sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals. We evaluated the relationship between midarm muscle circumference (MAMC) and physical performance, muscle strength, functional status and survival in persons aged 80 years or older. Data are from the baseline evaluation of the Aging and Longevity Study in the Sirente Geographic Area (ilSIRENTE Study) (n = 357). MAMC was calculated taking into account the mid upper arm circumference and the triceps skinfold thickness of the right arm. Physical performance was assessed using the physical performance battery score, which is based on three timed tests: 4-m walking speed test, the balance test and the chair stand test. Analyses of covariance were performed to evaluate the relationship between different MAMC levels and physical function. Cox proportional regression models were used to estimate crude and adjusted hazard ratios and 95% confidence intervals of death by MAMC levels. After adjustment for potential confounders - which included age, gender, living alone, sensory impairments (hearing and vision), body mass index, albumin and cholesterol - physical performance and function (which were measured using the 4-m walking speed test, the Short Physical Performance Battery score, the hand grip strength), improved significantly as MAMC increased. Compared with those in the low MAMC tertile, subjects in the high MAMC tertile had a lower risk of death (adjusted hazard ratio (HR) 0.45; 95% Confidence Interval (CI) 0.23-0.87). The present study suggests that among community-dwelling old-old subjects muscle mass may be positively related to functional performance and survival.

Energy intake and expenditure profile in chronic peritoneal dialysis patients complicated with circulatory congestion

BackgroundCirculatory congestion is an adverse predictor of mortality in peritoneal dialysis (PD) patients. ObjectiveThis study evaluated the nutritional status, energy intake, and expenditure profile of PD patients with and without previous circulatory congestion. DesignWe conducted a cross-sectional study in 244 PD patients, of whom 92 had previous circulatory congestion. We estimated dietary energy intake by using a locally validated 7-d food-frequency questionnaire and by assessing resting energy expenditure (REE) and total energy expenditure (TEE) with indirect calorimetry and a locally validated physical activity questionnaire, respectively. ResultsIn comparison with those without circulatory congestion, patients with previous circulatory congestion were more malnourished by subjective global assessment (59% compared with 36%; P < 0.001), had lower handgrip strength, had lower midarm muscle circumference, had lower dietary protein (0.98 ± 0.45 compared with 1.19 ± 0.44 g · kg−1 · d−1; P < 0.001), and had lower energy intake (92.5 ± 37.0 compared with 110.9 ± 35.7 kJ · kg−1 · d−1; P < 0.001) but had higher C-reactive protein (P = 0.025) and higher REE (P < 0.001). However, no difference in TEE was noted between the 2 groups, which indicated lower activity energy expenditure among patients with previous circulatory congestion. The resulting energy balance was significantly more negative for patients with previous circulatory congestion than for those without previous circulatory congestion (P = 0.050). Furthermore, the prevalence of malnutrition increased with increasing episodes of circulatory congestion (P = 0.017). ConclusionsPatients with previous circulatory congestion had significantly more inflammation, more muscle wasting, and higher REE but lower activity energy expenditure and energy and protein intakes in keeping with an anorexia-cachexia syndrome. The mechanisms of increased REE and reduced energy intake among patients with previous circulatory congestion warrant further investigation.

The combination of low midarm muscle circumference and high waist circumference predicted higher mortality in older men

Source Citation Wannamethee SG, Shaper AG, Lennon L, Whincup PH. Decreased muscle mass and increased central adiposity are independently related to mortality in older men. Am J Clin Nutr. 2007;86:1...

BMI and cardiorespiratory fitness predicted mortality in older adults

ACP Journal Club20 May 2008BMI and cardiorespiratory fitness predicted mortality in older adultsAnna Peeters, PhDAnna Peeters, PhDMonash University, Melbourne, Victoria, Australia (A.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-10-200805200-02012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationSui X, LaMonte MJ, Laditka JN, et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA. 2007;298:2507-16. https://pubmed.ncbi.nlm.nih.gov/185056904Clinical Impact RatingsGIM/FP/GP: Geriatrics: References1 Villareal DT, Apovian CM, Kushner RF, et al. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res. 2005;13:1849-63. [PMID: 16339115] Google Scholar2 Janssen I, Mark AE. Elevated body mass index and mortality risk in the elderly. Obes Rev. 2007;8:41-59. [PMID: 17212795] Google Scholar Author, Article, and Disclosure InformationAffiliations: Monash University, Melbourne, Victoria, Australia (A.P.)This article was published at Annals.org on 6 May 2008. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIncreasing BMI was associated with increasing risk for overall cancer incidence and mortality in middle-aged women Anna Peeters The combination of low midarm muscle circumference and high waist circumference predicted higher mortality in older men Anna Peeters Metrics 20 May 2008Volume 148, Issue 10Page: JC3-12KeywordsAdipose tissueBody mass indexCohort studiesElderlyExerciseMortalityMusclesObesityOverweightPopulation statistics ePublished: 20 May 2008 Issue Published: 20 May 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Nutritional status of institutionalized children and adolescents with developmental disabilities

The relationship was explored between anomalies associated with developmental disabilities and nutritional status of institutionalized children and adolescents who received comprehensive interdisciplinary services. Variables included dietary intake, serum laboratory values, anthropometric measurements, feeding skills assessment, and clinical assessment. Mean intakes of nutrients were greater than 67% of Recommended Daily Allowances. Laboratory values were within normal ranges with the exceptions of serum ferritin, which was borderline or below normal in 46% of the males and 55% of the females, and alkaline phosphatase, which was elevated in 70% of residents receiving anticonvulsants. Energy intake was highest in residents with adequate feeding skills, followed by nonfeeders and feeders requiring behavior management. Subjects had greater triceps skinfold and lower mid-arm muscle circumference and weight measurements as compared to reference data. Findings of this study suggest that these developmentally disabled children and adolescents who received comprehensive interdisciplinary nutritional services, in general, are adequately nourished and have nutrient intakes that meet the RDA requirements.