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Mechanisms Underlying Metabolic Syndrome-Related Sarcopenia and Possible Therapeutic Measures.
Rubio-Ruiz, ME, Guarner-Lans, V, Pérez-Torres, I, Soto, ME
International journal of molecular sciences. 2019;20(3)
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Sarcopenia is a multifactorial process in which losses occur in both muscle mass and function. Although several studies indicate an association between sarcopenia and metabolic syndrome (MetS), the connection has not been extensively reviewed. The aim of this study is to examine the relationship between sarcopenia and MetS to better understand the mechanisms underlying disease and assess current therapeutic options. According to the existing literature, this study found insulin resistance, inflammation and obesity to be major underlying factors of MetS-related sarcopenia. Based on this information, the authors suggest the best option for managing MetS-related sarcopenia is preventative lifestyle change around diet and exercise until a consensus on a therapeutic treatment can be established.
Abstract
Although there are several reviews that report the interrelationship between sarcopenia and obesity and insulin resistance, the relation between sarcopenia and the other signs that compose the metabolic syndrome (MetS) has not been extensively revised. Here, we review the mechanisms underlying MetS-related sarcopenia and discuss the possible therapeutic measures proposed. A vicious cycle between the loss of muscle and the accumulation of intramuscular fat might be associated with MetS via a complex interplay of factors including nutritional intake, physical activity, body fat, oxidative stress, proinflammatory cytokines, insulin resistance, hormonal changes, and mitochondrial dysfunction. The enormous differences in lipid storage capacities between the two genders and elevated amounts of endogenous fat having lipotoxic effects that lead to the loss of muscle mass are discussed. The important repercussions of MetS-related sarcopenia on other illnesses that lead to increased disability, morbidity, and mortality are also addressed. Additional research is needed to better understand the pathophysiology of MetS-related sarcopenia and its consequences. Although there is currently no consensus on the treatment, lifestyle changes including diet and power exercise seem to be the best options.
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Changes in Eating Behaviors of Children with Obesity in Response to Carbohydrate-Modified and Portion-Controlled Diets.
Kirk, S, Woo, JG, Brehm, B, Daniels, SR, Saelens, BE
Childhood obesity (Print). 2017;13(5):377-383
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Paediatric obesity has been shown to be managed most effectively when interventions with multiple components, such as dietary changes, physical activity, supportive parental involvement, and behavioural strategies are included. The aim to the study was to evaluate whether baseline or changes in psychological dimensions of eating behaviours could account for variability in weight status outcomes. For this study, children aged between 7 – 12 years with a fasting blood glucose level of ≤100mg/dl and with a BMI z-score of 1.60 – 2.65 were recruited. The participants were randomly assigned to one of the three diet groups (low carbohydrate, reduced glycaemic load or portion-controlled diet). The study results show that eating behaviours improved significantly with all diets, and increased cognitive restraint and decreased hunger were sustained at 12 months. Disinhibition also remained significantly lower at 12 months for the reduced glycaemic load group. Authors conclude that targeting diets to youth with obesity who have specific characteristics such as sex, race, and/or lower baseline hunger or higher baseline cognitive restraint scores may lead to better outcomes.
Abstract
OBJECTIVE This study's objective was to determine whether two distinct carbohydrate (CHO)-modified diets and a standard portion-controlled (PC) diet differentially impacted children's eating behaviors and whether eating behavior scores predicted lower BMI among children with obesity. METHODS Children (n = 102) aged 7-12 years with obesity were randomly assigned to a 12-month intervention of a low-carbohydrate (LC), reduced glycemic load (RGL), or standard PC diet. The Three-Factor Eating Questionnaire (TFEQ) was completed at baseline, 3, 6, and 12 months by parents to characterize their child's hunger (H), disinhibition (D), and cognitive restraint (CR). Baseline and follow-up TFEQ scores by diet were evaluated relative to BMI status over time. RESULTS All diet groups showed increased CR and decreased H and D from baseline to 3 months, with differences from baseline remaining at 12 months for CR and H. Lower BMI status during study follow-up was associated with different TFEQ scores by diet group (LC and RGL: higher CR; PC: lower H), adjusting for sex, age, and race. Higher CR at follow-up was predicted by race and higher baseline CR; only lower H at baseline predicted lower H at follow-up. CONCLUSION Eating behaviors improved significantly with all diets during the initial 3 months; higher CR and lower H were sustained at treatment's end. BMI outcomes were associated with different eating behaviors in CHO-modified diet groups compared with PC diets. Targeting diets of children with obesity with specific baseline characteristics may lead to improved outcomes.