Insulin is a stimulator of skeletal muscle protein anabolism and insulin resistance might therefore negatively affect muscle protein metabolism. We investigated muscle mass and physical function before and after a resistance exercise program in participants with prediabetes or type 2 diabetes mellitus (T2DM) in comparison to healthy controls. This was a secondary analysis of a randomized controlled intervention designed to investigate resistance training among older adults. Glucose metabolism status was not a selection criteria for the trial, and group designation was done retrospectively. Participants (N = 237, 73.7 ± 5.7 y, 58.2% women) participated in a 12-week resistance exercise program (3 times/week; three sets, six to eight repetitions at 75%–80% of the one-repetition maximum), designed to increase strength and muscle mass of major muscle groups. Body composition, muscular strength, timed up and go test, 6-minute walk for distance, and blood chemical variables were measured at baseline and endpoint. Participants completing the study (n = 213) experienced significant changes in muscle strength or muscle function, which did not differ significantly between healthy (n = 198), prediabetic (n = 20), and T2DM participants (n = 17). Changes in serum glucose during the intervention differed by group: only glucose improved significantly in the prediabetic group, glucose and triacylglycerol improved significantly in the healthy group, whereas no serum parameter improved significantly in the T2DM group. A 12-week resistance exercise program improves muscle strength and muscle function to a similar extent in healthy, prediabetic, and T2DM elderly people. However, according to our data, T2DM participants do not experience favorable changes in fasting glucose or HbA_1C.

Low fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality. Subjects were COPD patients (n = 121) admitted to Landspitali University Hospital from March 2015 to March 2016. Patients were screened for nutritional risk using Icelandic screening tool (ISS) and NRS-2002. Body composition was measured by bioelectrical impedance analysis (BIA). Lung function was measured by spirometry. The prevalence of malnutrition according to the ESPEN criteria was 21%. The association between nutritional assessment, applying different components of the ESPEN criteria, and COPD severity was highly significant, with the highest risk being associated with low FFMI OR (95% CI) 4.77 (2.03, 11.20; p < 0.001). There was a trend towards higher risk of hospitalization for >7 days in subjects with low FFMI (OR 2.46 95% CI 0.92, 6.59; p = 0.074) and increased risk of 6 and 9 months' mortality (OR 2.72 95% CI 0.88, 8.39, P = 0.082 and OR 2.72 95% CI 0.94, 7.87, P = 0.065, respectively) in subjects diagnosed as malnourished by the ESPEN criteria. This study describes the prevalence of malnutrition in hospitalized COPD patients using the ESPEN criteria from 2015. Our findings suggest that FFMI could be used independently of weight loss for the diagnosis of malnutrition in COPD patients, although there remain some problems associated with its measurement in the clinical setting.

Little is known about the effects of resistance training on health related quality of life (HRQL) in the elderly.

Nutritional status of cancer patients in chemotherapy; dietary intake, nitrogen balance and screening

Aims: Benefits of resistance exercise in elderly people are well documented; however, sustaining these benefits can be difficult and adherence is often poor. Muscular strength and physical function usually decline after a supervised resistance exercise program (REP). We investigated these changes in older adults during an observational follow-up and whether leisure time physical activity (LTPA) or unsupervised resistance exercise (RE) limit these changes. Methods: Subjects (N=236, 73.7±5.7 years, 58.2% female) had participated in a supervised 12-week REP. Quadriceps strength and timed-up-and-go performance (TUG) at follow-up were compared to values before and after REP. Multivariate statistics were used to predict changes in strength or function. Results: Two hundred and eleven (90.3%) participants completed REP and 149 (63.1%) completed follow-up (11.4±2.9 months). Quadriceps strength at follow-up decreased significantly compared to after REP (–27N), but was higher than before REP (+30N). TUG did not decrease during follow-up and was better than before REP (–0.9 seconds). LTPA (+38.0N, p<0.001) and RE (+31.6N, p=0.006) predicted strength at follow-up, although they did not completely prevent loss of strength during follow-up. Conclusions: Quadriceps strength declines after a 12-week resistance exercise program in older adults. Neither LTPA nor RE completely prevents loss of quadriceps strength during follow-up, although they limited the loss. TUG did not change during follow-up and was better at follow-up than before the start of the resistance exercise program.