Nutritional strategies for metabolic health in aging

衰老过程中代谢健康的营养策略

基本信息

批准号：
10207678
负责人：
ROBERT H. COKER
金额：
$ 19.34万
依托单位：
UNIVERSITY OF ALASKA FAIRBANKS
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-16 至 2022-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10207678
关键词：
Accelerometer Activities of Daily Living Address Adipose tissue Adult Age Age-Years Aging Alaska American Heart Association Bariatrics Body Composition Body Weight Body Weight decreased Body mass index Caloric Restriction Cardiology Chronic Clinical Collaborations Consumption Data Devices Diet Modification Dual-Energy X-Ray Absorptiometry Economics Effectiveness Elderly Energy Intake Equilibrium Essential Amino Acids Essential amino acids supplementation Exercise Fostering Future Gait speed Guidelines Health Health Status Hibernation Individual Inflammation Insulin Resistance Intervention Lead Link Lipids Magnetic Resonance Imaging Maintenance Measures Metabolic Metabolic Diseases Metabolism Morbidity - disease rate Muscle Muscle Proteins Muscular Atrophy Names Nutritional Obesity Physical Function Physical Performance Physical activity Population Process Protein Biosynthesis Proteins Randomized Research Resistance Risk Risk Factors Scanning Skeletal Muscle Societies Testing Thinness Tissues United States Universities Variant Walking Whey Protein actigraphy aging population base blood lipid college design disability risk energy balance exercise training fitness functional outcomes gut microbiome gut microbiota high risk improved indexing insulin sensitivity intrahepatic metabolic rate middle age mortality mortality risk muscle strength negative affect obese person preservation primary endpoint protein intake psychosocial reduced muscle strength sarcopenia sarcopenic obesity skeletal preservation spectroscopic imaging walking speed weight maintenance

项目摘要

Project Summary Project 3 –Nutritional strategies for metabolic health in aging The health status of the aging population is negatively affected by sarcopenic obesity as described by the progressive loss of lean tissue and an increase in adipose tissue. This condition presents a clinical conundrum as it predisposes older obese individuals to a high risk for disability, morbidity and mortality. Insulin resistance, chronic inflammation, elevations in intrahepatic lipid and detrimental alterations in the gut microbiome are also evident. The application of caloric restriction-induced weight loss (CRWL) used to address these health risks in younger individuals may exacerbate muscle wasting and increase morbidity in older adults. Unfortunately, low fitness levels and poor compliance limit the mitigating influence of weight loss through exercise training on sarcopenic obesity. In order to address anabolic resistance or the decreased ability to maintain protein synthesis that contributes to sarcopenic obesity, we have developed a complete meal replacement that contains a mechanism-targeted profile of essential amino acids (17 grams). This profile is designed to overcome anabolic resistance and maintain net protein balance even in the hypocaloric state. It is our overarching hypothesis that EMR will promote the retention of lean tissue mass, and improve metabolic and functional outcomes following 12 weeks of CRWL, and that those endpoints will be sustained over a 12 week maintenance period with the once per day (q.d.) consumption of EMR. We will randomly assign older obese individuals to either EMR or an isocaloric serving of Bariatrics Advantage (meal replacement that contains 27 grams of intact protein) during these interventions. We will execute these specific aims to test our hypotheses: SA1. Establish the importance of EMR in the preservation of lean tissue mass during CRWL. Lean tissue mass and adipose tissue mass will be determined by dual energy x-ray absorptiometry (DXA) and magnetic resonance imaging/spectroscopy (MRI/MRS) scans. MRI/MRS will be used to measure intrahepatic lipid, and we will evaluate alterations in insulin sensitivity using the HOMA score. We will measure potential changes in gut microbiota in collaboration with Dr. Duddleston at the University of Alaska Anchorage. SA2. Determine the influence of EMR on physical function and increased daily activity during CRWL. Slow walking speed is a strong predictor of morbidity and mortality. We chose the 6-minute walk test to represent the primary endpoint for this aim. We will also determine alterations in gait speed, skeletal muscle power and strength and stair climbing ability, and changes in physical activity using Actigraph GT3X+ devices. SA3. Identify whether EMR q.d. will sustain improvements in body composition, physical function and metabolic parameters over a 12 week, maintenance period following CRWL. Since the preservation of lean tissue mass is directly linked to optimal function and metabolic health, we will measure the influence of EMR q.d. on the indices of metabolic health (ie., intrahepatic lipid, insulin sensitivity) and physical function.

项目摘要项目 3 – 衰老过程中代谢健康的营养策略老年人口的健康状况受到肌肉减少性肥胖的负面影响，正如瘦肉组织的逐渐减少和脂肪组织的增加是一个临床难题。因为它会使老年肥胖者面临较高的残疾、发病和死亡风险，慢性炎症、肝内脂质升高和肠道微生物群的疼痛改变也与热量限制诱导减肥（CRWL）的应用用于解决这些健康风险。不幸的是，年轻人可能会加剧肌肉萎缩并增加老年人的发病率。健身水平和较差的依从性限制了通过运动训练减轻体重的影响为了解决合成代谢抵抗或维持蛋白质能力下降的问题。合成导致肌肉减少性肥胖，我们开发了一种完整的代餐，含有针对机制的必需氨基酸（17 克）。即使在低热量状态下也能克服合成代谢阻力并保持净蛋白质平衡。总体假设是，EMR 将促进瘦肉组织质量的保留，并改善代谢和 CRWL 12 周后的功能结果，并且这些终点将在 12 周内持续每天一次 (q.d.) 消耗 EMR 的维持期我们将随机分配老年肥胖者。个体接受 EMR 或等热量的 Bariatrics Advantage（含有 27 在这些干预措施期间，我们将执行这些具体目标来检验我们的假设： SA1. 确定 EMR 在 CRWL 期间保存瘦肉组织量中的重要性。脂肪组织质量将通过双能 X 射线吸收测定法 (DXA) 和磁力测定法测定磁共振成像/光谱 (MRI/MRS) 扫描将用于测量肝内脂质，以及我们将使用 HOMA 评分评估胰岛素敏感性的变化我们将测量胰岛素敏感性的潜在变化。与阿拉斯加大学安克雷奇分校的 Duddleston 博士合作确定肠道微生物群 SA2。 EMR 对 CRWL 期间身体功能和日常活动增加的影响慢步行速度是一个因素。我们选择 6 分钟步行测试作为主要终点。为此，我们还将确定步态速度、骨骼肌力量和力量以及楼梯的变化。使用 Actigraph GT3X+ 设备识别攀爬能力和身体活动变化是否为 EMR SA3。 q.d. 将持续改善身体成分、身体机能和代谢参数超过 12 周，CRWL 后的维持期，因为瘦组织质量的保存与此直接相关。最佳功能和代谢健康，我们将测量 EMR q.d 对代谢指标的影响。健康（即肝内脂质、胰岛素敏感性）和身体功能。