Relevance of physical function in the association of red and processed meat intake with all–cause,cardiovascular, and cancer mortality

Background and aimsIntake of red and processed meat has been associated with a higher risk of morbidity and mortality; it is unknown whether these associations are modified by overall physical health. This study examined the associations of red and processed meat consumption with all–cause, cardiovascular, and cancer mortality and investigated whether markers of physical function modified the associations.Methods and resultsThis observational cohort study used UK Biobank data derived from 419,075 participants free from cancer and cardiovascular disease. Cox models assessed the association of red and processed meat consumption (obtained from a baseline food frequency questionnaire) with mortality, adjusted for potential confounders. Objectively measured handgrip strength and self-reported walking pace were used as interaction terms. The median age was 57 (interquartile range, 49–63) years and 54.9% were women. Over 7 years of follow–up, 8586 all–cause, 1660 cardiovascular, and 4812 cancer deaths occurred. Each additional serving per week of red and processed meat was associated with a hazard ratio (HR) of 1.037 (95% CI: 1.028–1.047) for all–cause; 1.030 (1.009–1.051) for cardiovascular; and 1.029 (1.016–1.042) for cancer mortality. The association of red and processed meat consumption was modified by walking pace, with brisk walkers having the lowest risk per additional serving for all–cause and cancer mortality (HR 1.025; 1.006–1.045 and 1.015; 0.990–1.040, respectively); no interaction was observed for handgrip strength.ConclusionThe known risk of mortality associated with red and processed meat consumption may be lower in those with high physical function.     

Handgrip strength measurement in patients with chronic obstructive pulmonary disease: Possible predictor of exercise capacity

BackgroundImpaired exercise capacity is one of the most important prognostic factors for patients with chronic obstructive pulmonary disease (COPD). The 6-min walk test (6MWT) is a widely used method for assessing exercise capacity in patients with COPD. However, the 6MWT requires considerable effort from patients. Therefore, a less physically demanding, but also noninvasive, method is warranted. The objective of this study was to determine the predictors of the 6MWT distance (6MWD) in patients with COPD.MethodsThis retrospective observational study enrolled 133 Japanese patients with COPD. All patients underwent the 6MWT, COPD assessment test (CAT), spirometry, respiratory muscle strength evaluation, body composition assessment, and handgrip strength (HGS) measurement. We examined the associations between the 6MWD and evaluated parameters.ResultsFrom single regression analysis, the 6MWD was significantly correlated with age, CAT score, several spirometric measurements (e.g., percentages of forced vital capacity, forced expiratory volume in 1 s, and carbon monoxide diffusing capacity of the lungs [%DLCO]), respiratory muscle strength parameters (e.g., percentages of maximal expiratory and inspiratory pressures), skeletal muscle mass index, and HGS. In multiple regression analysis, age, CAT score, %DLCO, and HGS were independent predictors of the 6MWD. The %DLCO and HGS were strongly correlated as predictors of the 6MWD (p < 0.001).ConclusionsWe found that HGS was significantly correlated with the 6MWD compared with spirometric measurements or respiratory muscle strength parameters in Japanese patients with COPD, suggesting that HGS could be a simple and noninvasive predictor of the 6MWD in patients with COPD.     

Exercise-induced shear stress is associated with changes in plasma von Willebrand factor in older humans

Shear stress is the frictional force of blood against the endothelium, a stimulus for endothelial activation and the release of von Willebrand factor (vWF). This study tested the hypothesis that the increase in shear stress associated with exercise correlates with plasma vWF. Young (n = 14, 25.7 ± 5.4 years) and older (n = 13, 65.6 ± 10.7 years) individuals participated in 30 min of dynamic handgrip exercise at a moderate intensity. Brachial artery diameter and blood flow were measured using ultrasound Doppler and blood samples were collected before, immediately after, and following 30 min of recovery from exercise with plasma levels of vWF. Plasma levels of vWF increased (P < 0.05) by 6 ± 2% in young individuals and 4 ± 1% in older individuals immediately after exercise. The change in plasma vWF was linearly correlated with the increase in shear stress during exercise in older individuals (post-exercise: r = 0.78, 30 min recovery: r = 0.77, P < 0.01), but no association was found in the young individuals. These changes in plasma levels of vWF in humans suggest that aging influences endothelial activation and hemostasis.     

Normalizing handgrip strength in older adults: An allometric approach

PurposeHandgrip strength is an important variable to assess as part of any health intervention among older adults. Although the use of allometric normalization is the appropriate approach for removing the body size effect in handgrip performance, the best body size variable for this normalization is still unclear. Therefore, the aim of the present study was to compare the use of three body size variables (body mass, fat-free mass and body height) in allometric normalization for Handgrip strength among older adults. Methods: Data from individuals admitted to the Elderly Care Center of the Open University of the Third Age were used, the sample consisting of 263 individuals (140 women), aged between 60–87.ResultsThe results provided allometric exponents for normalization of HGS in each body size variable (body mass: 0.31; fat-free mass: 0.11; body height: 0.46). The correlations between normalized HGS and body size variables were significant (p < 0.05) when HGS were normalized by body mass or fat-free mass. On the contrary, no significant correlations were found when HGS were normalized by body height.ConclusionsBody height seems to be the best body size variable for performing allometric normalization of HGS among older adults.     

Timed Up and Go in men and women with Multiple Sclerosis: Effect of muscular strength

ObjectivePeople with Multiple Sclerosis (pwMS) often exhibit generalized weakness that affects several activities of daily life, particularly those relying on balance and gait. While it is known that such a symptom has a strong impact on mobility, to what extent muscular strength is linked with functional mobility in men and women with MS remains mostly unexplored. The aim of this study is to assess the existence of possible sex-related differences in functional mobility in pwMS, also considering the muscular strength capacity.MethodsFunctional mobility and hand-grip strength (HGS) were assessed in 49 pwMS with mild-moderate disability using instrumental Timed-up-and-go (TUG) test carried out using an inertial sensor and digital dynamometry. We investigated the existence of sex-related differences in the duration of each TUG sub-phase and their correlation with the HGS.ResultsNo sex-related differences in TUG performance (either in terms of overall or sub-phase time) were found. Similar large negative correlations were found in men and women with MS between HGS and overall TUG and walking phase duration. However, changes in strength have a more marked impact in women as indicated by the different slope of the HGS-TUG time relationship., In women, HGS also appears significantly correlated with all TUG sub-phases, while in men this occurs only for overall TUG and walking time.Conclusions: Rehabilitation and training programs for pwMS should take into account the peculiar features associated with the interaction between strength and mobility specific for each individual's sex to optimize their effectiveness.     

Association of handgrip strength with the prevalence of hypertension in a Chinese Han population

ObjectiveHandgrip strength (HGS) exercise has been reported to reduce blood pressure in both hypertensive and normotensive patients. In this study, we evaluated the association of HGS with hypertension in a Chinese Han Population.MethodsA total of 11,151 subjects mainly consisting of a rural population were recruited with a multi-stage sampling method in Jurong city, Jiangsu Province, China. Besides hypertension and diabetes, major chronic diseases were excluded. HGS was categorized into tertiles by age and gender. Logistic regression was used to estimate the association of HGS and hypertension with the odds ratio (OR) and 95% confidence interval (CI).ResultsFrom low to high tertiles of HGS, diastolic blood pressure (DBP) was significantly increased (74.52 ± 7.39, 74.70 ± 7.03, and 75.54 ± 7.01 mmHg, respectively; P_trend = 0.001), as well as in females (P_trend=0.003). The differences in DBP among the tertiles of HGS were still significant in females even after adjusting for covariates (P_trend=0.048). No significant differences in systolic blood pressure (SBP) were observed among the tertiles of HGS (P>0.05). Compared to low HGS, high HGS was significantly associated with hypertension after adjustment for age and gender (adjusted OR, 1.19; 95% CI, 1.06–1.34; P =0.004). A stratified analysis showed that the significant association of high HGS and hypertension was also observed with the following factors even after adjusting for age and gender: female gender (adjusted OR, 1.25; 95% CI, 1.08–1.46; P=0.004), ages of 60–69 years (adjusted OR, 1.29; 95% CI, 1.06–1.57; P=0.011), and married (adjusted OR, 1.20; 95% CI, 1.06–1.37; P=0.005). However, no significant associations were found after adjusting for age, gender, smoking status, drinking status, body mass index, physical activity level, glucose, high- and low-density lipoprotein cholesterol, total cholesterol, and triglyceride (P>0.05).ConclusionThe findings of the current study suggest that HGS was positively correlated with DBP in a rural population, and high HGS was associated with hypertension in females; however, the association may be modified by smoking status, drinking status, body mass index, physical activity, cholesterol level, and glucose level. Further utilization of HGS exercises to intervene in the development and prognosis of hypertension should be verified in the future.     

Abdominal obesity,dynapenia and dynapenic-abdominal obesity as factors associated with falls

ObjectiveTo investigate whether abdominal obesity, dynapenia and dynapenic-abdominal obesity are associated to the prevalence of single or recurrent falls in older adults.MethodsWe analyzed data from 1,046 community-dwelling participants of the SABE Study (Saúde, Bem-estar e Envelhecimento/Health, Well-Being and Ageing). Participants were classified as non-dynapenic/non-abdominal obese, abdominal obese only, dynapenic only, and dynapenic-abdominal obese based on waist circumference (>102 cm for men and >88 cm for women) and handgrip strength (<26 kg for men and <16 kg for women). Multinomial logistic regression models were ran to determine associations between dynapenia/obesity/dynapenic-abdominal obesity and single/recurring falls, taking non-fallers as reference.ResultsAbdominal obesity (RRR = 1.90 95% CI: 1.02–3.55), dynapenia (RRR = 1.80 95% CI: 1.02–3.19), and dynapenic-abdominal obesity (RRR = 2.06 95% CI: 1.04–4.10) were associated with a single fall. A stronger association for dynapenic-abdominal obesity compared to the other two conditions alone was found. Dynapenia was the unique condition associated with recurrent falls (RRR = 2.33, 95% CI: 1.13–4.81).ConclusionThe present findings have important implications for the identification of older adults with a greater chance of falls and can help in the development of rehabilitation strategies. Therefore, abdominal obese, dynapenic, and dynapenic abdominal obese individuals should be target groups for the management of falls and their consequences.     

Age-stratified differences of physical capacity in rural community-dwelling Taiwanese older women: A cross-sectional study

ObjectivesPhysical capacity decline may precede physical disability. We explored age-related physical capacity decline among rural community-dwelling Taiwanese older women to provide reference values and to identify indicators of early-onset decline in physical capacity.MethodsOlder women aged 65–96 were recruited from rural community centers. Physical capacity was measured by handgrip strength (HS), gait speed (GS), five-times-sit-to-stand (5xSTS), timed up and go (TUG), and the Berg balance scale (BBS). Participants were stratified into four age groups: 65–69, 70–74, 75–79, and ≥80 years.ResultsOf 137 participants, 61 % exhibited poor 5xSTS, 34–49 % showed low HS, poor TUG and BBS, and 26 % had slow GS. The mean values in GS, HS, 5xSTS, TUG, and BBS were 1.02 m/s, 17.8 kg, 14.5 s, 12.6 s, and 50 points, respectively. Abnormal mean values were first noted at age 70–74 years for 5xSTS, age 75–79 years for HS, TUG, and BBS, and age ≥80 years for GS. Also, more than half the participants exhibited the first poor 5xSTS at age 70–74 years; the first poor HS and TUG at age 75–79 years; and lastly, the first poor BBS and GS at age ≥80 years. At age 65–69 years, 14–41 % of participants reported poor performance in all measures except for GS.ConclusionsLow HS and poor 5xSTS and TUG performance were more common and had earlier onset than slow GS. More attention should be directed toward the 5xSTS, TUG, and HS in rural community-dwelling Taiwanese older women.     

Performance evaluation of phase angle and handgrip strength in patients undergoing cardiac surgery: Prospective cohort study

Background and aims

The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity. This study aimed to evaluate the behaviour of PA and HGS in patients undergoing cardiac surgery and associate these factors with clinical outcomes and prognosis.

Low handgrip strength is a predictor of osteoporotic fractures: cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study

Handgrip strength (HGS) is a potentially useful objective parameter to predict fracture since it is an indicator of general muscle strength and is associated with fragility and propensity to fall. Our objective was to examine the association of HGS with fracture, to evaluate the accuracy of HGS in predicting incident fracture, and to identify subjects at risk of fracture. We analyzed a cross-sectional cohort with 2,793 subjects (1,217 men and 1,576 women aged 50-101 years) and a subset of 1,702 subjects which were followed for a total of 4,855 person-years. The primary outcome measures were prevalent fractures and incident major fragility fractures. Each standard deviation (SD) reduction in HGS was associated with a 1.24-fold increased odds for major clinical fractures even after adjustment for other clinical factors. A similar result was obtained in the prospective cohort with each SD reduction in HGS being associated with a 1.57-fold increased hazard ratio of fracture even after adjustment for clinical factors. A combination of HGS and femoral neck bone mineral density (FN BMD) T-score values (combined T-score), together with other clinical factors, had a better predictive power of incident fractures than FN BMD or HGS T-score alone with clinical factors. In addition, combined T-score has better sensitivity and specificity in predicting incidence fractures than FN BMD alone. This study is the first study to compare the predictive ability of HGS and BMD. We showed that HGS is an independent risk factor for major clinical fractures. Compared with using FN BMD T-score of -2.5 alone, HGS alone has a comparable predictive power to BMD, and the combined T-score may be useful to identify extra subjects at risk of clinical fractures with improved specificity.