In the Journals

Sarcopenia more common among older adults with type 2 diabetes who consume fewer total calories

Older adults with type 2 diabetes are more likely to develop sarcopenia if they have lower levels of total energy intake, not lower levels of specific nutrients, according to findings from researchers in Japan.

“To maintain the human body’s muscle mass, it is necessary to consume sufficient amounts of protein. In addition, we recently demonstrated that protein intake is significantly associated with skeletal muscle mass in elderly patients with [type 2 diabetes],” Yoshitaka Hashimoto, MD, PhD, of the department of endocrinology and metabolism at the Graduate School of Medical Science at Kyoto Prefectural University of Medicine in Japan, and colleagues wrote. “Conversely, energy intake was reported to be associated with muscle mass in healthy elderly people. Together, these findings indicate that to maintain muscle mass, an individual’s energy intake may be as important as his or her protein intake.”

For the cross-sectional study, 391 participants aged at least 65 years and with type 2 diabetes (mean age, 72.4 years; 47.6% women) were recruited from Kyoto Prefectural University of Medicine or Kameoka Municipal Hospital between August 2015 and September 2017. A questionnaire determined diet history while an ad hoc computer algorithm produced estimates for intake of total energy (kilocalories per day), carbohydrates (grams per day), total protein (grams per day) and fat (grams per day). Sarcopenia was identified by grip strength of less than 26 kg for men and 18 kg for women as well as skeletal muscle mass index readings of less than 7 kg/m2 in men and less than 5.7 kg/m2 in women.

Among the cohort, 55 had sarcopenia (49.1% women) and did not differ from those without the condition in respect to age or HbA1c. Among participants with sarcopenia, mean energy intake was 1,498.8 kcal per day compared with 1,786.2 kcal per day in participants without sarcopenia. Energy intake was negatively associated with sarcopenia (OR = 0.89; 95% CI, 0.82-0.97) as were body weight (OR = 0.9; 95% CI, 0.87-0.93), BMI (OR = 0.74; 95% CI, 0.67-0.83) and body fat mass (OR = 0.92; 95% CI, 0.88-0.97). After multivariate logistic regression analyses, the negative association between sarcopenia and energy intake remained (OR = 0.86; 95% CI, 0.78-0.95), but not the associations with protein, carbohydrates or fats.

“Although several studies have showed that energy intake is associated with muscle mass in healthy elderly people, to our knowledge the present study is the first to identify the association between energy intake and sarcopenia in elderly individuals with [type 2 diabetes],” the researchers wrote. – by Phil Neuffer

Disclosures: Hashimoto reports receiving grants from Asahi Kasei Pharma, Fuji Foundation for Protein Research, Japan Society for the Promotion of Science and MSD K.K. Please see the study for all other authors’ relevant financial disclosures.

Older adults with type 2 diabetes are more likely to develop sarcopenia if they have lower levels of total energy intake, not lower levels of specific nutrients, according to findings from researchers in Japan.

“To maintain the human body’s muscle mass, it is necessary to consume sufficient amounts of protein. In addition, we recently demonstrated that protein intake is significantly associated with skeletal muscle mass in elderly patients with [type 2 diabetes],” Yoshitaka Hashimoto, MD, PhD, of the department of endocrinology and metabolism at the Graduate School of Medical Science at Kyoto Prefectural University of Medicine in Japan, and colleagues wrote. “Conversely, energy intake was reported to be associated with muscle mass in healthy elderly people. Together, these findings indicate that to maintain muscle mass, an individual’s energy intake may be as important as his or her protein intake.”

For the cross-sectional study, 391 participants aged at least 65 years and with type 2 diabetes (mean age, 72.4 years; 47.6% women) were recruited from Kyoto Prefectural University of Medicine or Kameoka Municipal Hospital between August 2015 and September 2017. A questionnaire determined diet history while an ad hoc computer algorithm produced estimates for intake of total energy (kilocalories per day), carbohydrates (grams per day), total protein (grams per day) and fat (grams per day). Sarcopenia was identified by grip strength of less than 26 kg for men and 18 kg for women as well as skeletal muscle mass index readings of less than 7 kg/m2 in men and less than 5.7 kg/m2 in women.

Among the cohort, 55 had sarcopenia (49.1% women) and did not differ from those without the condition in respect to age or HbA1c. Among participants with sarcopenia, mean energy intake was 1,498.8 kcal per day compared with 1,786.2 kcal per day in participants without sarcopenia. Energy intake was negatively associated with sarcopenia (OR = 0.89; 95% CI, 0.82-0.97) as were body weight (OR = 0.9; 95% CI, 0.87-0.93), BMI (OR = 0.74; 95% CI, 0.67-0.83) and body fat mass (OR = 0.92; 95% CI, 0.88-0.97). After multivariate logistic regression analyses, the negative association between sarcopenia and energy intake remained (OR = 0.86; 95% CI, 0.78-0.95), but not the associations with protein, carbohydrates or fats.

“Although several studies have showed that energy intake is associated with muscle mass in healthy elderly people, to our knowledge the present study is the first to identify the association between energy intake and sarcopenia in elderly individuals with [type 2 diabetes],” the researchers wrote. – by Phil Neuffer

Disclosures: Hashimoto reports receiving grants from Asahi Kasei Pharma, Fuji Foundation for Protein Research, Japan Society for the Promotion of Science and MSD K.K. Please see the study for all other authors’ relevant financial disclosures.