Body composition changes that occur during aging, such as loss of lean mass, are unfavorable at metabolic level and they can explain, in part, the appearance of certain age-associated diseases such as type 2 diabetes (T2D). Separately, T2D is associated with an increase in oxidative stress (OS) which negatively affects skeletal muscle. Our aim was to study the differences in clinical and nutritional parameters, disease control, and OS in a cohort of older patients with T2D classified according to the amount of lean mass they had. We included 100 adults older than 65 years with T2D. We found that women with low fat-free mass and muscle mass have worse T2D metabolic control. Moreover, the patients with a low percentile of muscle mass present a high value of OS. The study shows that the presence of low lean mass (LM) in the geriatric population diagnosed with T2D is associated with poorer glycemic control and greater OS.

Aging has increased the prevalence of frailty, and type 2 diabetes (T2D) has also increased in prevalence. Diabetes and oxidative stress (OS) have been shown to be related to frailty. However, the exact mechanism by which it occurs is not fully known. Our aim was to analyze body composition in community-dwelling older diabetic people treated in our center and to evaluate the possible relation between OS, frailty, and body composition. We included 100 adults older than 65 years with T2D. We found that 15% were frail and 57% were prefrail. The patients included in the nonrobust group showed increased levels of OS. Our study shows that the presence of T2D in the geriatric population is associated with a high prevalence of frailty and high OS levels, conditions that cause greater morbidity and mortality and that highlight the importance of the diagnosis of frailty in this population.

Roux-en-Y gastric bypass (RYGB) is a treatment for severe obesity. However, many patients have insufficient total weight loss (TWL) after RYGB. Although multiple factors have been involved, their influence is incompletely known. The aim of this exploratory study was to evaluate the feasibility and reliability of the use of machine learning (ML) techniques to estimate the success in weight loss after RYGP, based on clinical, anthropometric and biochemical data, in order to identify morbidly obese patients with poor weight responses. We retrospectively analyzed 118 patients, who underwent RYGB at the Hospital Clínico Universitario of Valencia (Spain) between 2013 and 2017. We applied a ML approach using local linear embedding (LLE) as a tool for the evaluation and classification of the main parameters in conjunction with evolutionary algorithms for the optimization and adjustment of the parameter model. The variables associated with one-year postoperative %TWL were obstructive sleep apnea, osteoarthritis, insulin treatment, preoperative weight, insulin resistance index, apolipoprotein A, uric acid, complement component 3, and vitamin B12. The model correctly classified 71.4% of subjects with TWL < 30% although 36.4% with TWL ≥ 30% were incorrectly classified as “unsuccessful procedures”. The ML-model processed moderate discriminatory precision in the validation set. Thus, in severe obesity, ML-models can be useful to assist in the selection of patients before bariatric surgery.

A wide range of factors contribute to the overlap of hyperglycemia—acute or chronic—and sarcopenia, as well as their associated adverse consequences, which can lead to impaired physical function, reduced quality of life, and increased mortality risk. These factors include malnutrition (both overnutrition and undernutrition) and low levels of physical activity. Hyperglycemia and sarcopenia are interconnected through a vicious cycle of events that mutually reinforce and worsen each other. To explore this association, our review compiles evidence on: (i) the impact of hyperglycemia on motor and muscle function, with a focus on the mechanisms underlying biochemical changes in the muscles of individuals with or at risk of diabetes and sarcopenia; (ii) the importance of the clinical assessment and control of sarcopenia under hyperglycemic conditions; and (iii) the potential benefits of medical nutrition therapy and increased physical activity as muscle-targeted treatments for this population. Based on the reviewed evidence, we conclude that a regular intake of key functional nutrients, together with structured and supervised resistance and/or aerobic physical activity, can help maintain euglycemia and improve muscle status in all patients with hyperglycemia and sarcopenia.

Background/Objectives: Malnutrition in cancer adversely affects treatment outcomes and survival. Early intervention through oral nutritional supplements (ONSs) and dietary counseling can improve outcomes. This study evaluated the evolution of nutritional and morphofunctional parameters over three months in malnourished patients with cancer undergoing a comprehensive nutritional support program comprising dietary counseling, physical activity, and a novel concentrated high-protein, high-calorie ONS (cHPHC-ONS) with a high intrinsic leucine content. Methods: A prospective, observational, multicenter cohort study was conducted across 18 public hospitals in Spain. Two hundred thirty malnourished patients with cancer were enrolled: 147 naïve (no ONS treatment in the last three months) and 83 non-naïve (who transitioned to cHPHC-ONS after inadequate response to initial ONSs). Nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria and morphofunctional parameters via bioelectrical impedance analysis, nutritional ultrasound, handgrip strength, the Timed Up and Go (TUG) test, and analysis of biochemical parameters. Results: After three months, 23.8% achieved normal GLIM nutritional status (p < 0.0001), with a greater improvement seen in non-naïve patients (28.4%, p < 0.0001). Weight loss ceased in 42.6% (p < 0.0001). and inflammation resolved for 10.3% (p = 0.0015). Non-naïve patients experienced a significant increase in fat-free mass index (p = 0.0159), appendicular skeletal muscle index (p = 0.0248), and rectus femoris cross-sectional area (p = 0.0016). Muscle strength increased significantly by +1.7 kg (p = 0.0025), and TUG test time decreased by 1.13 s (p = 0.0003) overall. Conclusions: The comprehensive nutritional support program—including a novel cHPHC-ONS, along with dietary and physical activity guidance—significantly improved the nutritional and morphofunctional status of malnourished patients with cancer, with benefits particularly evident in non-naïve individuals. Limitations: Observational design, no control group, short follow-up, and unadjusted non-multivariable comparisons, limiting causal inference.