Yun S, et al. Nutr Res Pract. 2022 Apr;16(2):233-247. https://doi.org/10.4162/nrp.2022.16.2.233

Background: This study was conducted to investigate the effects of combining nutritional and physical activity (PA) factors on four different categories, according to the presence or absence of sarcopenia and central obesity.Methods: From the 2008–2011 Korea National Health and Nutrition Examination Survey, 2971 older adults aged ≥ 65 years were included and divided into four groups based on their sarcopenia and central obesity status: healthy control (39.3%), central obesity (28.9%), sarcopenia (27.4%), and sarcopenic obesity (4.4%). Central obesity was defined as a waist circumference of ≥ 90 cm in men and ≥ 85 cm in women. Sarcopenia was defined as an appendicular skeletal mass index of < 7.0 kg/m²in men and < 5.4 kg/m²in women, and sarcopenic obesity was defined as the coexistence of sarcopenia and central obesity.Results: Participants who consumed more energy and protein than the average requirement had a lower likelihood of having sarcopenia (odds ratio (OR): 0.601, 95% confidence interval (CI): 0.444–0.814) than those who did not consume enough nutrients. The likelihood of central obesity and sarcopenic obesity decreased in groups with recommended PA levels, regardless of whether energy intake met or did not meet the average requirement. Whether PA met or did not meet the recommended level, the likelihood of sarcopenia decreased in groups with energy intake that met the average requirement. However, when PA and energy requirements were met, there was a greater reduction in the likelihood of sarcopenia (OR: 0.436, 95% CI: 0.290–0.655).Conclusion: These findings suggest that adequate energy intake that meets requirements is more likely to be effective as a major prevention and treatment goal for sarcopenia, whereas PA guidelines should be prioritized in the case of sarcopenic obesity.

Objectives: Due to variations in the standards for optimal protein intake and conflicting results across studies for Korean older adults, this study aimed to quantitatively integrate existing research on the association of protein intake with sarcopenia and related indicators in Koreans aged 65 and older through meta-analysis. Methods: A total of 23 studies were selected according to the study selection criteria (PICOS). Sixteen cross-sectional studies, 5 randomized controlled trials (RCTs), and 2 non-RCTs were included in the review, with 9 out of 23 studies included in the meta-analysis. We used fixed-effects models and performed subgroup and sensitivity analyses. Results: A meta-analysis found that the risk of sarcopenia was significantly higher in the <0.8 g/kg/day protein intake group compared to the 0.8–1.2 g/kg/day and ≥1.2 g/kg/day groups, with odds ratios (ORs) of 1.25 (95% confidence interval (CI), 1.10 to 1.42; I² = 55%) and 1.79 (95% CI, 1.53 to 2.10; I² = 71%), respectively. For low hand grip strength (HGS), the risk was higher in the <0.8 g/kg/day group compared to the 0.8–1.2 g/kg/day or ≥1.2 g/kg/day groups (OR 1.31; 95% CI, 1.03 to 1.65; I² = 28%). No significant associations were found with other sarcopenia indicators, such as skeletal muscle mass, short physical performance battery score, balance test, gait speed, and timed up-and-go test. Conclusions: Lower protein intake is associated with a higher risk of sarcopenia and low HGS in Korean older adults. To establish protein intake recommendations for the prevention and management of sarcopenia in this population, further well-designed RCTs incorporating both protein supplementation and resistance training are necessary.

This study aimed to examine whether there is an area difference on diet quality among the Korean elderly population. The effect of personal factors on diet quality is also estimated and compared between rural and urban areas. A cross-sectional data from the 2013–2015 Korea National Health and Nutrition Examination Survey (KNHANES) was used for this study. The participants were older adults aged ≥ 65 years (n = 3207) who participated in the KNHANES. Urban and rural areas classified the region and the Korean Healthy Eating Index (KHEI) assessed the diet quality. Personal factors that were related to diet quality included socio-demographic factors, health behaviors, and health conditions. This study found that the diet quality was different between urban and rural areas in the Korean elderly population, showing a higher mean of KHEI scores in urban areas than rural areas (67.3 for urban seniors, 63.6 for rural seniors, p < 0.001), and the regional difference was still significant, even after adjusting for the personal factors (p < 0.001). Different sets of personal factors were found to be significant that explain the diet quality of participants between areas, such as economic resources, walking exercise, and perceived oral health status in urban areas, and age and food insecurity in rural areas. In conclusions, this study found that there was a regional disparity in diet quality and some personal factors affecting diet quality were dependent on areas, which implied that regional environment with diverse contexts could influence diet quality. These findings emphasize the need to provide targeted intervention programs that take into account both the characteristics of individuals and local food environments in order to improve the overall diet quality in older adults.

Limited attention has been paid to an association between food environment and household economic resources related to food expenditure in food-insecure seniors. The aim of the study was to investigate the relationship between factors of economic resource, food environment, and food insecurity in single seniors residing in rural areas of South Korea. A cross-sectional study was conducted in 170 single senior households aged 65 years or over residing in rural areas. Face-to-face interviews were performed to collect data on demographic characteristics, household economic resources/expenditure, food environmental factors, and food insecurity. Among economic resources, generally limited food expenditures due to housing fees and heating costs during the winter were positively related to food insecurity. Among food environmental factors, food accessibility at community level such as food stores located far from home and inconvenient bus routes was related to food insecurity. The most explainable economic and food environment factors related to food insecurity by stepwise logistic regression analysis were the percentage of total expenditure on housing fee (OR = 1.021, 95% CI: 1.008–1.034), foods purchasing at super supermarket (OR = 0.398, 95% CI: 0.166–0.951), having difficulties in food purchasing due to food stores being located far from home (OR = 14.487, 95% CI: 5.139–40.842) and inconvenient bus routes (OR = 0.083, 95% CI: 0.015–0.460). Inadequate community food environment as well as limited household food resources were an important risk factor for food insecurity in Korean single rural seniors. Findings of this study could help us better understand how characteristics of household food resources and community food environment can serve as barriers or facilitators of food security among single older adults residing in rural areas.

Yoo H, et al. Nutr Res Pract. 2023 Oct;17(5):945-958. https://doi.org/10.4162/nrp.2023.17.5.945