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Dr. Andreas Nilsson
School of Health Sciences, Örebro University, Örebro, Sweden

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Journal article
Published: 16 August 2021 in Nutrients
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Healthy Diet and physical activity may play important roles in the maintenance of muscle health during aging. The aim of the present study was to explore the impact of adherence to healthy dietary patterns on sarcopenia risk in a sample of physically active older men and women, while considering adherence to guidelines on muscle strengthening activities (MSA) and protein intake. Based on a sample of 191 physically active men and women (65–70 years), dietary intake was assessed using a 90-items food-frequency-questionnaire (FFQ) and Healthy Diet Score (HDS) was calculated. Physical activity was assessed by accelerometry and self-report. A sarcopenia risk score (SRS) was derived based on three indicators of muscle health: muscle mass was assessed using bioelectrical impedance and handgrip strength and 5 times sit-to-stand (5-STS) were determined by standardized procedures. Analysis of covariance (ANCOVA) was used to examine differences in SRS and its components across sex-specific tertiles of HDS, with adjustments for covariates including total energy intake, protein intake and MSA. A significant main effect (p< 0.05) of HDS on SRS was observed, where those belonging to the highest HDS tertile had lower SRS compared to those in the lowest tertile. A corresponding significant effect was observed for 5-STS performance, with better performance in those with the highest HDS adherence compared to those with the lowest. The present study supports guidelines emphasizing diet quality beyond amounts of macro- and micronutrients in the prevention of age-related deterioration of muscle health. Importantly, the benefits from healthy dietary patterns are evident in older adults who already adhere to guidelines for health-enhancing physical activity.

ACS Style

Konstantinos-Georgios Papaioannou; Andreas Nilsson; Lena Maria Nilsson; Fawzi Kadi. Healthy Eating Is Associated with Sarcopenia Risk in Physically Active Older Adults. Nutrients 2021, 13, 2813 .

AMA Style

Konstantinos-Georgios Papaioannou, Andreas Nilsson, Lena Maria Nilsson, Fawzi Kadi. Healthy Eating Is Associated with Sarcopenia Risk in Physically Active Older Adults. Nutrients. 2021; 13 (8):2813.

Chicago/Turabian Style

Konstantinos-Georgios Papaioannou; Andreas Nilsson; Lena Maria Nilsson; Fawzi Kadi. 2021. "Healthy Eating Is Associated with Sarcopenia Risk in Physically Active Older Adults." Nutrients 13, no. 8: 2813.

Journal article
Published: 28 January 2021 in Experimental Gerontology
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The impact of regular exercise habits at middle-age on muscle mass and function at old age remains inconclusive. While regular exercise likely represents a primary source of health-enhancing physical activity (PA), the physical demand of occupation needs to be considered. Additionally, PA level at old age should be taken into account in order to elucidate true associations between past exercise behaviors and muscle mass and function at old age. Therefore, the aim of the study was to examine the impact of regular exercise habits during middle age years on muscle mass and physical function at old age, while considering occupation and objectively assessed PA level at old age. Self-reported leisure-time PA during middle age years [35–65 years] and present accelerometer-derived PA level were assessed in a population of community-dwelling older women (65–70 years; n = 112). Participants who accumulated at least 600 MET-min of PA per week during middle age years were classified as physically active. Skeletal muscle mass index (SMI), aerobic fitness and maximal isometric arm and leg strength were determined. Analyses of differences in muscle mass and physical function between physically active and inactive at middle age were adjusted by present PA, adiposity level, and the physical demand of former occupation (sedentary vs manual). Participants accumulating at least 600 MET-min of exercise-related activities during middle-age years had higher aerobic fitness (P < 0.01) and SMI (P < 0.05) at old age compared to their less active peers. Notably, these beneficial impacts were driven by exercise habits during late middle-age period [50 to 65 years], and remained significant after further adjustment by the physical demand of former occupation and present PA behavior at old age. Finally, middle-age engagement in exercise-related activities had no influence on maximal arm and leg isometric strength at old age. Our findings highlight the importance of engaging in regular PA of at least moderate intensity during middle age years in order to promote benefits at the level of muscle mass and aerobic fitness. This clearly supports the potential of PA in delaying aerobic capacity impairment and the occurrence of clinically manifest sarcopenia at old age.

ACS Style

Peter Edholm; Jort Veen; Fawzi Kadi; Andreas Nilsson. Muscle mass and aerobic capacity in older women: Impact of regular exercise at middle age. Experimental Gerontology 2021, 147, 111259 .

AMA Style

Peter Edholm, Jort Veen, Fawzi Kadi, Andreas Nilsson. Muscle mass and aerobic capacity in older women: Impact of regular exercise at middle age. Experimental Gerontology. 2021; 147 ():111259.

Chicago/Turabian Style

Peter Edholm; Jort Veen; Fawzi Kadi; Andreas Nilsson. 2021. "Muscle mass and aerobic capacity in older women: Impact of regular exercise at middle age." Experimental Gerontology 147, no. : 111259.

Journal article
Published: 22 January 2021 in International Journal of Environmental Research and Public Health
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Sarcopenia in older adults is associated with a higher risk of falls, disability, loss of independence, and mortality. Current physical activity (PA) guidelines recommend engagement in muscle-strengthening activities (MSA) in addition to aerobic moderate-to-vigorous physical activity (MVPA). However, little is known about the impact of MSA in addition to adherence to the MVPA recommendation in the guidelines. The aim of the present cross-sectional study was to determine whether or not engagement in MSA is linked to sarcopenia risk in older adults who meet the PA guidelines of 150 min of MVPA per week. A total of 193 community-dwelling older men and women (65–70 years) were included in the study. A continuous sex-specific clustered sarcopenia risk score (SRS) was created based on muscle mass assessed using bioelectrical impedance analysis, handgrip strength, and five times sit-to-stand (5STS) time, assessed using standardized procedures. Adherence to PA guidelines was assessed using the Actigraph GT3x accelerometer and the EPAQ2 questionnaire. Guideline adherence to MSA twice a week was related to a significantly (p < 0.05) lower SRS compared to those who did not. This finding was evident after adjustment for adherence to the protein intake guideline and abdominal obesity. Similar impacts were observed for muscle mass and 5-STS but not for handgrip strength. In conclusion, guideline adherence to MSA is related to lower sarcopenia risk in older adults who already accumulate 150 weekly minutes of MVPA, which reinforces the promotion of the MSA guideline, alongside the MVPA guideline, to fight against sarcopenia progression in ageing populations.

ACS Style

Jort Veen; Diego Montiel-Rojas; Andreas Nilsson; Fawzi Kadi. Engagement in Muscle-Strengthening Activities Lowers Sarcopenia Risk in Older Adults Already Adhering to the Aerobic Physical Activity Guidelines. International Journal of Environmental Research and Public Health 2021, 18, 989 .

AMA Style

Jort Veen, Diego Montiel-Rojas, Andreas Nilsson, Fawzi Kadi. Engagement in Muscle-Strengthening Activities Lowers Sarcopenia Risk in Older Adults Already Adhering to the Aerobic Physical Activity Guidelines. International Journal of Environmental Research and Public Health. 2021; 18 (3):989.

Chicago/Turabian Style

Jort Veen; Diego Montiel-Rojas; Andreas Nilsson; Fawzi Kadi. 2021. "Engagement in Muscle-Strengthening Activities Lowers Sarcopenia Risk in Older Adults Already Adhering to the Aerobic Physical Activity Guidelines." International Journal of Environmental Research and Public Health 18, no. 3: 989.

Journal article
Published: 24 November 2020 in Nutrients
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While an adequate protein intake is important for the maintenance of muscle mass during ageing, the amount and source of protein necessary for optimal prevention of sarcopenia remains to be determined. The present study aimed to investigate the influence of the amount and source of dietary proteins on sarcopenia risk in a cohort of 65–79-year-old European adults within the frame of the NU-AGE study. A total of 986 participants were included in the analysis. Skeletal muscle index (SMI), assessed by dual-energy X-ray absorptiometry (DXA), and handgrip strength (HG) were employed to create a continuous sex-specific sarcopenia risk score (SRS). Total amount together with animal- and plant-derived sources of proteins were obtained from a 7-day food record. Differences in SRS were analysed across groups of total protein intake (<0.8 g/body weight (BW); 0.8–<1.0 g/BW; 1.0–<1.2 g/BW; and ≥1.2 g/BW). The association between SRS and the different sources of protein was assessed using isocaloric substitution models adjusted by demographic, medical, and lifestyle factors. A significant linear dose-response relationship was observed, with a lower SRS linked to higher protein intakes. Based on the isocaloric substitution modelling, a reduced SRS was observed when increasing plant protein to the detriment of animal protein, while holding total protein intake constant. Further, this result remained significant after stratifying the analysis by adherence to different levels of protein intake. Our findings suggest that older adults may benefit from increasing protein intakes above current recommendations. Besides total amount, protein source should be considered when promoting health dietary habits in older adults for the prevention of sarcopenia.

ACS Style

Diego Montiel-Rojas; Andreas Nilsson; Aurelia Santoro; Alberto Bazzocchi; Lisette C. P. G. M. De Groot; Edith J. M. Feskens; Agnes A. M. Berendsen; Dawid Madej; Joanna Kaluza; Barbara Pietruszka; Amy Jennings; Susan Fairweather-Tait; Giuseppe Battista; Miriam Capri; Claudio Franceschi; Fawzi Kadi. Fighting Sarcopenia in Ageing European Adults: The Importance of the Amount and Source of Dietary Proteins. Nutrients 2020, 12, 3601 .

AMA Style

Diego Montiel-Rojas, Andreas Nilsson, Aurelia Santoro, Alberto Bazzocchi, Lisette C. P. G. M. De Groot, Edith J. M. Feskens, Agnes A. M. Berendsen, Dawid Madej, Joanna Kaluza, Barbara Pietruszka, Amy Jennings, Susan Fairweather-Tait, Giuseppe Battista, Miriam Capri, Claudio Franceschi, Fawzi Kadi. Fighting Sarcopenia in Ageing European Adults: The Importance of the Amount and Source of Dietary Proteins. Nutrients. 2020; 12 (12):3601.

Chicago/Turabian Style

Diego Montiel-Rojas; Andreas Nilsson; Aurelia Santoro; Alberto Bazzocchi; Lisette C. P. G. M. De Groot; Edith J. M. Feskens; Agnes A. M. Berendsen; Dawid Madej; Joanna Kaluza; Barbara Pietruszka; Amy Jennings; Susan Fairweather-Tait; Giuseppe Battista; Miriam Capri; Claudio Franceschi; Fawzi Kadi. 2020. "Fighting Sarcopenia in Ageing European Adults: The Importance of the Amount and Source of Dietary Proteins." Nutrients 12, no. 12: 3601.

Journal article
Published: 09 October 2020 in Nutrients
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Dietary fat subtypes may play an important role in the regulation of muscle mass and function during ageing. The aim of the present study was to determine the impact of isocaloric macronutrient substitutions, including different fat subtypes, on sarcopenia risk in older men and women, while accounting for physical activity (PA) and metabolic risk. A total of 986 participants, aged 65–79 years, completed a 7-day food record and wore an accelerometer for a week. A continuous sex-specific sarcopenia risk score (SRS), including skeletal muscle mass assessed by dual-energy X-ray absorptiometry (DXA) and handgrip strength, was derived. The impact of the isocaloric replacement of saturated fatty acids (SFAs) by either mono- (MUFAs) or poly-unsaturated (PUFAs) fatty acids on SRS was determined using regression analysis based on the whole sample and stratified by adherence to a recommended protein intake (1.1 g/BW). Isocaloric reduction of SFAs for the benefit of PUFAs was associated with a lower SRS in the whole population, and in those with a protein intake below 1.1 g/BW, after accounting for age, smoking habits, metabolic disturbances, and adherence to PA guidelines. The present study highlighted the potential of promoting healthy diets with optimised fat subtype distribution in the prevention of sarcopenia in older adults.

ACS Style

Diego Montiel-Rojas; Aurelia Santoro; Andreas Nilsson; Claudio Franceschi; Miriam Capri; Alberto Bazzocchi; Giuseppe Battista; Lisette De Groot; Edith Feskens; Agnes Berendsen; Agata Bialecka-Debek; Olga Surala; Barbara Pietruszka; Susan Fairweather-Tait; Amy Jennings; Frederic Capel; Fawzi Kadi. Beneficial Role of Replacing Dietary Saturated Fatty Acids with Polyunsaturated Fatty Acids in the Prevention of Sarcopenia: Findings from the NU-AGE Cohort. Nutrients 2020, 12, 3079 .

AMA Style

Diego Montiel-Rojas, Aurelia Santoro, Andreas Nilsson, Claudio Franceschi, Miriam Capri, Alberto Bazzocchi, Giuseppe Battista, Lisette De Groot, Edith Feskens, Agnes Berendsen, Agata Bialecka-Debek, Olga Surala, Barbara Pietruszka, Susan Fairweather-Tait, Amy Jennings, Frederic Capel, Fawzi Kadi. Beneficial Role of Replacing Dietary Saturated Fatty Acids with Polyunsaturated Fatty Acids in the Prevention of Sarcopenia: Findings from the NU-AGE Cohort. Nutrients. 2020; 12 (10):3079.

Chicago/Turabian Style

Diego Montiel-Rojas; Aurelia Santoro; Andreas Nilsson; Claudio Franceschi; Miriam Capri; Alberto Bazzocchi; Giuseppe Battista; Lisette De Groot; Edith Feskens; Agnes Berendsen; Agata Bialecka-Debek; Olga Surala; Barbara Pietruszka; Susan Fairweather-Tait; Amy Jennings; Frederic Capel; Fawzi Kadi. 2020. "Beneficial Role of Replacing Dietary Saturated Fatty Acids with Polyunsaturated Fatty Acids in the Prevention of Sarcopenia: Findings from the NU-AGE Cohort." Nutrients 12, no. 10: 3079.

Journal article
Published: 13 April 2020 in Nutrients
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Sarcopenia is characterised by a progressive loss of skeletal muscle mass and physical function as well as related metabolic disturbances. While fibre-rich diets can influence metabolic health outcomes, the impact on skeletal muscle mass and function is yet to be determined, and the moderating effects by physical activity (PA) need to be considered. The aim of the present study was to examine links between fibre intake, skeletal muscle mass and physical function in a cohort of older adults from the NU-AGE study. In 981 older adults (71 ± 4 years, 58% female), physical function was assessed using the short-physical performance battery test and handgrip strength. Skeletal muscle mass index (SMI) was derived using dual-energy X-ray absorptiometry (DXA). Dietary fibre intake (FI) was assessed by 7-day food record and PA was objectively determined by accelerometery. General linear models accounting for covariates including PA level, protein intake and metabolic syndrome (MetS) were used. Women above the median FI had significantly higher SMI compared to those below, which remained in fully adjusted models (24.7 ± 0.2% vs. 24.2 ± 0.1%, p = 0.011, η2p = 0.012). In men, the same association was only evident in those without MetS (above median FI: 32.4 ± 0.3% vs. below median FI: 31.3 ± 0.3%, p = 0.005, η2p = 0.035). There was no significant impact of FI on physical function outcomes. The findings from this study suggest a beneficial impact of FI on skeletal muscle mass in older adults. Importantly, this impact is independent of adherence to guidelines for protein intake and PA, which further strengthens the potential role of dietary fibre in preventing sarcopenia. Further experimental work is warranted in order to elucidate the mechanisms underpinning the action of dietary fibre on the regulation of muscle mass.

ACS Style

Diego Montiel-Rojas; Andreas Nilsson; Aurelia Santoro; Claudio Franceschi; Alberto Bazzocchi; Giuseppe Battista; Lisette C. P. G. M. De Groot; Edith J. M. Feskens; Agnes Berendsen; Barbara Pietruszka; Olga Januszko; Susan Fairweather-Tait; Amy Jennings; Claudio Nicoletti; Fawzi Kadi. Dietary Fibre May Mitigate Sarcopenia Risk: Findings from the NU-AGE Cohort of Older European Adults. Nutrients 2020, 12, 1075 .

AMA Style

Diego Montiel-Rojas, Andreas Nilsson, Aurelia Santoro, Claudio Franceschi, Alberto Bazzocchi, Giuseppe Battista, Lisette C. P. G. M. De Groot, Edith J. M. Feskens, Agnes Berendsen, Barbara Pietruszka, Olga Januszko, Susan Fairweather-Tait, Amy Jennings, Claudio Nicoletti, Fawzi Kadi. Dietary Fibre May Mitigate Sarcopenia Risk: Findings from the NU-AGE Cohort of Older European Adults. Nutrients. 2020; 12 (4):1075.

Chicago/Turabian Style

Diego Montiel-Rojas; Andreas Nilsson; Aurelia Santoro; Claudio Franceschi; Alberto Bazzocchi; Giuseppe Battista; Lisette C. P. G. M. De Groot; Edith J. M. Feskens; Agnes Berendsen; Barbara Pietruszka; Olga Januszko; Susan Fairweather-Tait; Amy Jennings; Claudio Nicoletti; Fawzi Kadi. 2020. "Dietary Fibre May Mitigate Sarcopenia Risk: Findings from the NU-AGE Cohort of Older European Adults." Nutrients 12, no. 4: 1075.

Clinical trial protocol
Published: 01 April 2020 in Medicine
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Introduction: Healthy dietary patterns and physical activity (PA) represent important lifestyle behaviors with considerable potential to influence on age-related metabolic health. Yet, data on the combined effects of these lifestyle behaviors on metabolic health including low-grade systemic inflammation in aging populations remain scarce. Therefore, this protocol describes a randomized controlled trial aiming to examine the impacts of healthy dietary patterns alone or combined with PA on metabolic health in middle-aged and older men and women. Material and Methods: The ORUDIET study is a 3-arm randomized controlled 16-week trial: Healthy Diet (HD), Healthy diet plus PA (HD-PA), and control (CON). The trial is open label, randomized with allocation concealment, parallel groups with passive controls. Participants without overt disease aged between 55 and 70 years, with BMI below 35, a current intake of a maximum of 1 serving of fruit and vegetable per day, and noncompliance to PA guidelines are eligible for inclusion. Participants in HD are instructed to increase fruit and vegetable intake to 5 servings per day (equivalent to 500 g). Participants in HD-PA receive the same dietary intervention as the HD and are additionally instructed to engage in moderate-to-vigorous physical activities for at least 150 minutes per week. The primary study outcomes are changes in metabolic and inflammatory health biomarkers. Secondary outcomes are changes in body composition and perceived health. Ethics and dissemination: The study protocol has been approved by the ethical review board in Uppsala, Sweden. The results will be published in peer-reviewed journals and disseminated in national and international conferences. Trial registration number: NCT04062682 Pre-results

ACS Style

Oscar Bergens; Jort Veen; Diego Montiel-Rojas; Peter Edholm; Fawzi Kadi; Andreas Nilsson. Impact of healthy diet and physical activity on metabolic health in men and women. Medicine 2020, 99, e19584 .

AMA Style

Oscar Bergens, Jort Veen, Diego Montiel-Rojas, Peter Edholm, Fawzi Kadi, Andreas Nilsson. Impact of healthy diet and physical activity on metabolic health in men and women. Medicine. 2020; 99 (16):e19584.

Chicago/Turabian Style

Oscar Bergens; Jort Veen; Diego Montiel-Rojas; Peter Edholm; Fawzi Kadi; Andreas Nilsson. 2020. "Impact of healthy diet and physical activity on metabolic health in men and women." Medicine 99, no. 16: e19584.

Journal article
Published: 01 June 2019 in Medicine & Science in Sports & Exercise
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ACS Style

Andreas Nilsson; Janelle Tarum; Fawzi Kadi. Detrimental Links Between Inflammation and Muscle Mass are Moderated by Physical Activity in Older Adults. Medicine & Science in Sports & Exercise 2019, 51, 215 -215.

AMA Style

Andreas Nilsson, Janelle Tarum, Fawzi Kadi. Detrimental Links Between Inflammation and Muscle Mass are Moderated by Physical Activity in Older Adults. Medicine & Science in Sports & Exercise. 2019; 51 (6S):215-215.

Chicago/Turabian Style

Andreas Nilsson; Janelle Tarum; Fawzi Kadi. 2019. "Detrimental Links Between Inflammation and Muscle Mass are Moderated by Physical Activity in Older Adults." Medicine & Science in Sports & Exercise 51, no. 6S: 215-215.

Journal article
Published: 31 May 2019 in Experimental Gerontology
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N-linked enzymatic glycosylation modulates the function of proteins and contributes to development of age-related metabolic abnormalities. Whether physical activity (PA) is linked to a specific N-glycan profile and can offset detrimental links between N-glycans and metabolic risk profile has never been explored. The aim of the present study is to assess serum N-glycan profile in older women with different PA levels and metabolic risk status. Components of the metabolic syndrome (MetS) and serum N-glycans analyzed using DSA-FACE technology were assessed in 109 older community-dwelling women (65–70 yrs). Ten peaks, each representing a unique N-glycan structure were detected. Moderate-to-vigorous PA (MVPA) was assessed objectively using accelerometry. All analyses were adjusted by covariates. Significantly elevated levels of NGA2FB (peak 2) and NA3F (peak 9) and lower level of the α(1,6)-arm monogalactosylated (NG1(6)A2F) (peak 3) were demonstrated in women with MetS compared to their healthier peers (p < 0.05). Importantly, women adhering to the PA guideline of time in MVPA had a 10% and a 12% lower level of NA3 (peak 8) and NA4 (peak 10), respectively, compared to those less active even after adjustment by MetS and covariates (p < 0.05). Interestingly, time spent in PA below the MVPA threshold was not linked to N-glycans. Novel links between PA behaviors and N-glycan profile are demonstrated in older adults, regardless of metabolic risk status. This proposed effect on N-glycans requires engagement in MVPA. This supports public health efforts to promote adherence to PA guidelines in older adults across different stages of disease prevention.

ACS Style

Andreas Nilsson; Aurelia Santoro; Claudio Franceschi; Fawzi Kadi. Detrimental links between physical inactivity, metabolic risk and N-glycomic biomarkers of aging. Experimental Gerontology 2019, 124, 110626 .

AMA Style

Andreas Nilsson, Aurelia Santoro, Claudio Franceschi, Fawzi Kadi. Detrimental links between physical inactivity, metabolic risk and N-glycomic biomarkers of aging. Experimental Gerontology. 2019; 124 ():110626.

Chicago/Turabian Style

Andreas Nilsson; Aurelia Santoro; Claudio Franceschi; Fawzi Kadi. 2019. "Detrimental links between physical inactivity, metabolic risk and N-glycomic biomarkers of aging." Experimental Gerontology 124, no. : 110626.

Scholarlyarticle
Published: 06 May 2019 in The Journal of Clinical Endocrinology & Metabolism
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Context Chronic inflammation increases diabetes risk and may be exacerbated by excess adipose tissue. Whether cardiovascular fitness can offset chronic inflammation associated with excess adipose tissue in older adults is unclear. Objective The study aimed to examine the influence of cardiorespiratory fitness on links between adiposity and pro- and anti-inflammatory biomarkers related to metabolic risk in physically active older women. Design, Setting, and Participants Cross-sectional study comprising older community-dwelling women (n = 109; age, 65 to 70 years). Main Outcome Cardiorespiratory fitness was assessed using a standardized submaximal test and participants were categorized into high- and low-adiposity–related metabolic risk [body mass index, waist-to-hip ratio (WHR), and total fat mass]. The inflammatory biomarkers C-reactive protein (CRP), IL-6, IL-10, IL-18, adiponectin, monocyte chemoattractant protein-1 (MCP-1), and macrophage inflammatory protein (MIP)-1α were analyzed. Results Regardless of adiposity measure, women in the metabolic high-risk group had substantially elevated (P < 0.05) CRP and lower adiponectin levels. Levels of IL-6 and MIP1-α were elevated in the high-risk group defined by WHR and total fat mass. The IL-18 level was elevated in the high-risk group based on WHR only. Importantly, a high cardiorespiratory fitness level did not attenuate the detrimental links between adiposity measures and inflammation. Conclusions Cardiorespiratory fitness does not offset the detrimental links between adiposity and several inflammatory biomarkers related to metabolic risk in physically active older women. Reducing abdominal adipose tissue in older adults should be emphasized in efforts aiming to attenuate age-related systemic inflammation and metabolic risk regardless of cardiorespiratory fitness.

ACS Style

Oscar Bergens; Andreas Nilsson; Fawzi Kadi. Cardiorespiratory Fitness Does Not Offset Adiposity-Related Systemic Inflammation in Physically Active Older Women. The Journal of Clinical Endocrinology & Metabolism 2019, 104, 4119 -4126.

AMA Style

Oscar Bergens, Andreas Nilsson, Fawzi Kadi. Cardiorespiratory Fitness Does Not Offset Adiposity-Related Systemic Inflammation in Physically Active Older Women. The Journal of Clinical Endocrinology & Metabolism. 2019; 104 (9):4119-4126.

Chicago/Turabian Style

Oscar Bergens; Andreas Nilsson; Fawzi Kadi. 2019. "Cardiorespiratory Fitness Does Not Offset Adiposity-Related Systemic Inflammation in Physically Active Older Women." The Journal of Clinical Endocrinology & Metabolism 104, no. 9: 4119-4126.

Journal article
Published: 09 April 2019 in Nutrients
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While dietary patterns are related to the age-related progression of chronic diseases, to what extent different dietary patterns influence inflammatory and metabolic risk factors in older adults remains to be elucidated. Additionally, potential moderating effects by physical activity (PA) become important to clarify. Here, we hypothesize that dietary patterns are linked to inflammatory and metabolic biomarkers and that these links are independent of PA. The present study aims to explore links between two dietary constructs and biomarkers of systemic inflammation and metabolic health in older women, while considering time spent in moderate-to-vigorous PA (MVPA). A cross-sectional analysis of a sample of 112 community-dwelling older women (65–70 years old) was performed. Dietary constructs based on the Dietary Approach to Stop Hypertension (DASH) and the dietary inflammatory index (DII) were determined from food records. MVPA was objectively assessed using accelerometry. Metabolic outcomes (waist circumference, systolic/diastolic blood pressures and levels of glucose, triglycerides and high-density lipoprotein (HDL)-cholesterol) and inflammatory biomarkers (C-reactive protein (CRP), fibrinogen and adiponectin) were determined using standardized procedures and a clustered metabolic risk score was derived. Adherence to DASH-style diet was significantly (p < 0.05) associated with a lower clustered metabolic risk, where women in the highest adherence group had a significantly (p < 0.05) lower waist circumference and blood glucose level compared to those in the lowest group. Further, a significantly higher (p < 0.05) adiponectin level was observed in the high DASH adherence group compared to those with low adherence. Notably, adjustment by waist circumference did not alter links with either adiponectin or blood glucose level. Importantly, all observed links remained significant after further adjustment for time in MVPA. Finally, no significant associations were observed when the dietary pattern was defined by the DII. The findings of this study demonstrate that DASH-style diets promote a systemic anti-inflammatory environment, while also mitigating clustered metabolic risk in older women. A key finding is that favourable impacts of the DASH-style diet are independent of time spent in moderate-to-vigorous PA, which further strengthens healthy eating behaviours as a key target for clinical and public health interventions designed to prevent age-related metabolic abnormalities.

ACS Style

Andreas Nilsson; Patrik Halvardsson; Fawzi Kadi; Kadi. Adherence to DASH-Style Dietary Pattern Impacts on Adiponectin and Clustered Metabolic Risk in Older Women. Nutrients 2019, 11, 805 .

AMA Style

Andreas Nilsson, Patrik Halvardsson, Fawzi Kadi, Kadi. Adherence to DASH-Style Dietary Pattern Impacts on Adiponectin and Clustered Metabolic Risk in Older Women. Nutrients. 2019; 11 (4):805.

Chicago/Turabian Style

Andreas Nilsson; Patrik Halvardsson; Fawzi Kadi; Kadi. 2019. "Adherence to DASH-Style Dietary Pattern Impacts on Adiponectin and Clustered Metabolic Risk in Older Women." Nutrients 11, no. 4: 805.

Original article
Published: 01 December 2018 in Scandinavian Journal of Medicine & Science in Sports
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While physical activity (PA) may counteract age‐related functional decline and loss of independence at old age, to what extent physical function is influenced by past or present PA behaviors is currently unclear. Therefore, the aim of the study was to examine relationships between both past and present PA behaviors and components of physical function in older women. A physical function score based on the six‐minute walk test, squat jump and single‐leg‐stance balance was aggregated in 60 older women (65‐70 years). Present PA behavior was assessed by accelerometry (Actigraph) and past leisure‐time PA was self‐reported, where times in sports‐related activities and in walking were analyzed separately. Analysis of differences in physical function across tertiles of PA behaviors was adjusted by DXA‐derived fat mass. PA level at present age and engagements in sports‐related activities before retirement age, excluding walking, were both associated (p < 0.05) to physical function. Time spent in PA of at least moderate intensity was associated to physical function (p < 0.05), whereas no corresponding relationships to either sedentary time or time in light intensity PA were observed. In conclusion, PA behaviors at present age and engagement in sports‐related activities performed during adulthood are both related to physical function in older women. Being physically active at old age infers beneficial effects on physical function, even in individuals with a past or present sedentary lifestyle, which supports public health efforts aiming at increasing daily time in PA of at least moderate intensity to preserve physical function in older women. This article is protected by copyright. All rights reserved.

ACS Style

Peter Edholm; Andreas Nilsson; Fawzi Kadi. Physical function in older adults: Impacts of past and present physical activity behaviors. Scandinavian Journal of Medicine & Science in Sports 2018, 29, 415 -421.

AMA Style

Peter Edholm, Andreas Nilsson, Fawzi Kadi. Physical function in older adults: Impacts of past and present physical activity behaviors. Scandinavian Journal of Medicine & Science in Sports. 2018; 29 (3):415-421.

Chicago/Turabian Style

Peter Edholm; Andreas Nilsson; Fawzi Kadi. 2018. "Physical function in older adults: Impacts of past and present physical activity behaviors." Scandinavian Journal of Medicine & Science in Sports 29, no. 3: 415-421.

Comparative study
Published: 24 August 2018 in Nutrients
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The role of dietary protein intake on muscle mass and physical function in older adults is important for the prevention of age-related physical limitations. The aim of the present study was to elucidate links between dietary protein intake and muscle mass and physical function in older women meeting current guidelines of objectively assessed physical activity. In 106 women (65 to 70 years old), protein intake was assessed using a 6-day food record and participants were classified into high and low protein intake groups using two Recommended Dietary Allowance (RDA) thresholds (0.8 g·kg−1 bodyweight (BW) and 1.1 g·kg−1 BW). Body composition, aerobic fitness, and quadriceps strength were determined using standardized procedures, and self-reported physical function was assessed using the SF-12 Health Survey. Physical activity was assessed by accelerometry and self-report. Women below the 0.8 g·kg−1 BW threshold had a lower muscle mass (p < 0.05) with no differences in physical function variables. When based on the higher RDA threshold (1.1 g·kg−1 BW), in addition to significant differences in muscle mass, women below the higher threshold had a significantly (p < 0.05) higher likelihood of having physical limitations. In conclusion, the present study supports the RDA threshold of 0.8 g·kg−1 BW of proteins to prevent the loss of muscle mass and emphasizes the importance of the higher RDA threshold of at least 1.1 g·kg−1 BW to infer additional benefits on constructs of physical function. Our study also supports the role of protein intake for healthy ageing, even in older adults meeting guidelines for physical activity.

ACS Style

Andreas Nilsson; Diego Montiel Rojas; Fawzi Kadi. Impact of Meeting Different Guidelines for Protein Intake on Muscle Mass and Physical Function in Physically Active Older Women. Nutrients 2018, 10, 1156 .

AMA Style

Andreas Nilsson, Diego Montiel Rojas, Fawzi Kadi. Impact of Meeting Different Guidelines for Protein Intake on Muscle Mass and Physical Function in Physically Active Older Women. Nutrients. 2018; 10 (9):1156.

Chicago/Turabian Style

Andreas Nilsson; Diego Montiel Rojas; Fawzi Kadi. 2018. "Impact of Meeting Different Guidelines for Protein Intake on Muscle Mass and Physical Function in Physically Active Older Women." Nutrients 10, no. 9: 1156.

Original research article
Published: 10 August 2018 in Frontiers in Physiology
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The present study aims to explore the potential influence of leucocyte telomere length (LTL) on both a single indicator and a composite construct of physical functioning in a large European population of elderly men and women across diverse geographical locations. A total of 1,221 adults (65–79 years) were recruited from five European countries within the framework of NU-AGE study. The physical functioning construct was based on the 36-item Short Form Health Survey. Handgrip strength was used as a single indicator of muscle function and LTL was assessed using quantitative real-time PCR. Women had significantly longer (p < 0.05) LTL than men. Participants in Poland had significantly shorter LTL than in the other study centers, whereas participants in the Netherlands had significantly longer LTL than most of the other centers (p < 0.01). An analysis of LTL as a continuous outcome against physical functioning by using linear models revealed inconsistent findings. In contrast, based on an analysis of contrasting telomere lengths (first vs. fifth quintile of LTL), a significant odds ratio (OR) of 1.7 (95% CI: 1.1 – 2.6; p < 0.05) of having functional limitation was observed in those belonging to the first LTL quintile compared to the fifth. Interestingly, having the shortest LTL was still related to a higher likelihood of having physical limitation when compared to all remaining quintiles (OR: 1.5, 95% CI: 1.1 – 2.1; p < 0.05), even after adjustment by study center, age, sex, and overweight status. Collectively, our findings suggest that short LTL is an independent risk factor that accounts for functional decline in elderly European populations. The influence of LTL on functional limitation seems driven by the detrimental effect of having short telomeres rather than reflecting a linear dose-response relationship.

ACS Style

Diego Montiel Rojas; Andreas Nilsson; Elodie Ponsot; Robert J. Brummer; Susan Fairweather-Tait; Amy Jennings; Lisette C. P. G. M. De Groot; Agnes Berendsen; Barbara Pietruszka; Dawid Madej; Elodie Caumon; Nathalie Meunier; Corinne Malpuech-Brugère; Giulia Guidarelli; Aurelia Santoro; Claudio Franceschi; Fawzi Kadi. Short Telomere Length Is Related to Limitations in Physical Function in Elderly European Adults. Frontiers in Physiology 2018, 9, 1 .

AMA Style

Diego Montiel Rojas, Andreas Nilsson, Elodie Ponsot, Robert J. Brummer, Susan Fairweather-Tait, Amy Jennings, Lisette C. P. G. M. De Groot, Agnes Berendsen, Barbara Pietruszka, Dawid Madej, Elodie Caumon, Nathalie Meunier, Corinne Malpuech-Brugère, Giulia Guidarelli, Aurelia Santoro, Claudio Franceschi, Fawzi Kadi. Short Telomere Length Is Related to Limitations in Physical Function in Elderly European Adults. Frontiers in Physiology. 2018; 9 ():1.

Chicago/Turabian Style

Diego Montiel Rojas; Andreas Nilsson; Elodie Ponsot; Robert J. Brummer; Susan Fairweather-Tait; Amy Jennings; Lisette C. P. G. M. De Groot; Agnes Berendsen; Barbara Pietruszka; Dawid Madej; Elodie Caumon; Nathalie Meunier; Corinne Malpuech-Brugère; Giulia Guidarelli; Aurelia Santoro; Claudio Franceschi; Fawzi Kadi. 2018. "Short Telomere Length Is Related to Limitations in Physical Function in Elderly European Adults." Frontiers in Physiology 9, no. : 1.

Journal article
Published: 01 July 2018 in Medicine & Science in Sports & Exercise
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Purpose To examine the influence of reallocating time spent at different objectively measured physical activity (PA) behaviors on markers of systemic inflammation in older women with different levels of metabolic risk. Methods Accelerometer-based monitoring of PA was conducted in a population of community-dwelling older women (n = 111; age, 65–70 yr) for determination of daily sedentary time, time in light PA (LPA) and moderate-to-vigorous PA (MVPA). Blood samples were collected for the assessment of the systemic inflammatory markers C-reactive protein (CRP), fibrinogen, and adiponectin. Metabolic risk was assessed by standardized procedures based on definitions for the metabolic syndrome. Data were analyzed by linear regression models based on isotemporal substitution analysis. Results Reallocating 30 min of sedentary time with either time in LPA (β = −0.47; P < 0.05) or MVPA (β = −0.42; P < 0.05) was related to reduced fibrinogen level, whereas no corresponding effect was evident when shifting time in LPA with time in MVPA, while holding sedentary time constant. In contrast, reallocating a 30-min period in sedentary (β = −0.70; P < 0.01) or LPA (β = −0.71; P < 0.01) with MVPA was associated with a significant reduction in CRP level, whereas no impact on CRP was observed when a period of sedentary behavior was replaced with LPA. Importantly, all significant influences on fibrinogen and CRP by displacement of different PA behaviors remained after adjustment for metabolic risk status among participants. No significant associations with adiponectin were observed. Conclusions Altogether, this work supports the existence of different intensity thresholds mediating beneficial effects of PA on important clinical markers of systemic inflammation in older women across different stages of disease prevention.

ACS Style

Andreas Nilsson; Oscar Bergens; Fawzi Kadi. Physical Activity Alters Inflammation in Older Adults by Different Intensity Levels. Medicine & Science in Sports & Exercise 2018, 50, 1502 -1507.

AMA Style

Andreas Nilsson, Oscar Bergens, Fawzi Kadi. Physical Activity Alters Inflammation in Older Adults by Different Intensity Levels. Medicine & Science in Sports & Exercise. 2018; 50 (7):1502-1507.

Chicago/Turabian Style

Andreas Nilsson; Oscar Bergens; Fawzi Kadi. 2018. "Physical Activity Alters Inflammation in Older Adults by Different Intensity Levels." Medicine & Science in Sports & Exercise 50, no. 7: 1502-1507.

Journal article
Published: 01 May 2017 in Medicine & Science in Sports & Exercise
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ACS Style

Fawzi Kadi; Andreas Nilsson; Britta Wåhlin-Larsson; Oscar Bergens. Chronic Systemic Inflammation, Physical Activity and Skeletal Muscle in Elderly. Medicine & Science in Sports & Exercise 2017, 49, 234 .

AMA Style

Fawzi Kadi, Andreas Nilsson, Britta Wåhlin-Larsson, Oscar Bergens. Chronic Systemic Inflammation, Physical Activity and Skeletal Muscle in Elderly. Medicine & Science in Sports & Exercise. 2017; 49 (5S):234.

Chicago/Turabian Style

Fawzi Kadi; Andreas Nilsson; Britta Wåhlin-Larsson; Oscar Bergens. 2017. "Chronic Systemic Inflammation, Physical Activity and Skeletal Muscle in Elderly." Medicine & Science in Sports & Exercise 49, no. 5S: 234.

Journal article
Published: 01 May 2017 in Medicine & Science in Sports & Exercise
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ACS Style

Andreas Nilsson; Britta Wåhlin-Larsson; Fawzi Kadi. Physical Activity and not Sedentary Time Influence on Metabolic Risk in Older Community-dwelling Women. Medicine & Science in Sports & Exercise 2017, 49, 789 .

AMA Style

Andreas Nilsson, Britta Wåhlin-Larsson, Fawzi Kadi. Physical Activity and not Sedentary Time Influence on Metabolic Risk in Older Community-dwelling Women. Medicine & Science in Sports & Exercise. 2017; 49 (5S):789.

Chicago/Turabian Style

Andreas Nilsson; Britta Wåhlin-Larsson; Fawzi Kadi. 2017. "Physical Activity and not Sedentary Time Influence on Metabolic Risk in Older Community-dwelling Women." Medicine & Science in Sports & Exercise 49, no. 5S: 789.

Research article
Published: 07 April 2017 in PLOS ONE
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Whether amount of time spent in sedentary activities influences on clustered metabolic risk in elderly, and to what extent such an influence is independent of physical activity behavior, remain unclear. Therefore, the aim of the study was to examine cross-sectional associations of objectively assessed physical activity and sedentary behavior on metabolic risk outcomes in a sample of elderly community-dwelling women. Metabolic risk outcomes including waist circumference, systolic and diastolic blood pressures, fasting levels of plasma glucose, HDL-cholesterol and triglycerides were assessed in 120 community-dwelling older women (65–70 yrs). Accelerometers were used to retrieve daily sedentary time, breaks in sedentary time, daily time in light (LPA) and moderate-to-vigorous physical activity (MVPA), and total amount of accelerometer counts. Multivariate regression models were used to examine influence of physical activity and sedentary behavior on metabolic risk outcomes including a clustered metabolic risk score. When based on isotemporal substitution modeling, replacement of a 10-min time block of MVPA with a corresponding time block of either LPA or sedentary activities was associated with an increase in clustered metabolic risk score (β = 0.06 to 0.08, p < 0.05), and an increase in waist circumference (β = 1.78 to 2.19 p < 0.01). All associations indicated between sedentary time and metabolic risk outcomes were lost once variation in total accelerometer counts was adjusted for. Detrimental influence of a sedentary lifestyle on metabolic health is likely explained by variations in amounts of physical activity rather than amount of sedentary time per se. Given our findings, increased amounts of physical activity with an emphasis on increased time in MVPA should be recommended in order to promote a favorable metabolic health profile in older women.

ACS Style

Andreas Nilsson; Britta Wåhlin-Larsson; Fawzi Kadi. Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women. PLOS ONE 2017, 12, e0175496 .

AMA Style

Andreas Nilsson, Britta Wåhlin-Larsson, Fawzi Kadi. Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women. PLOS ONE. 2017; 12 (4):e0175496.

Chicago/Turabian Style

Andreas Nilsson; Britta Wåhlin-Larsson; Fawzi Kadi. 2017. "Physical activity and not sedentary time per se influences on clustered metabolic risk in elderly community-dwelling women." PLOS ONE 12, no. 4: e0175496.

Journal article
Published: 23 April 2016 in Maturitas
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It is hypothesized that chronic systemic inflammation contributes to the age-related decline in cardiovascular function. The aim of the present study was to combine an assessment of the relationship between the serum level of C-reactive protein (CRP) and systolic and diastolic blood pressure in 108 elderly women (65 and 70 years) with an in-vitro exploration of the effects of CRP on the proliferative and angiogenic potential of endothelial cells exposed to serum in elderly women. Based on the median CRP level in our population, LowCRP (CRP1.3mg/L) groups were identified. Body mass index, waist circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in the HighCRP group than in the LowCRP group (p<0.05). The influence of CRP on SBP and DBP remained significant after adjustments for BMI and use of antihypertensive medication (p<0.05). When adjusting for waist circumference the observed influence of CRP on SPB was attenuated (p=0.062). We next evaluated the ability to form capillary tubes (angiogenesis assay) and the proliferation rate of endothelial cells exposed to the sera of elderly women. Increased serum CRP levels were associated with an increased doubling time of endothelial cells (R(2)=0.39; p<0.05) and decreased capillary tube length (R(2)=0.30; p<0.05), indicating a reduction in the proliferation rate of endothelial cells and angiogenic potential. In conclusion, chronic inflammation influences blood pressure in elderly women and compromises endothelial cell function, thus contributing to the age-related decline in vascular health.

ACS Style

Adrian Hosford-Donovan; Andreas Nilsson; Britta Wåhlin-Larsson; Fawzi Kadi. Observational and mechanistic links between C-reactive protein and blood pressure in elderly women. Maturitas 2016, 89, 52 -57.

AMA Style

Adrian Hosford-Donovan, Andreas Nilsson, Britta Wåhlin-Larsson, Fawzi Kadi. Observational and mechanistic links between C-reactive protein and blood pressure in elderly women. Maturitas. 2016; 89 ():52-57.

Chicago/Turabian Style

Adrian Hosford-Donovan; Andreas Nilsson; Britta Wåhlin-Larsson; Fawzi Kadi. 2016. "Observational and mechanistic links between C-reactive protein and blood pressure in elderly women." Maturitas 89, no. : 52-57.

Randomized controlled trial
Published: 15 October 2015 in Journal of Applied Physiology
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The delivery of efficient nonpharmacological treatment to prevent the loss of muscle mass in older adults is a major challenge, and information on the combined effects of training and diet is particularly important. Here we aimed to evaluate the effects of 24 wk of resistance training combined with a healthy dietary approach (n-6/n-3 ratio < 2) in a population of healthy and physically active older women (65-70 years). The three-armed randomized controlled trial included a resistance training + healthy diet group (RT-HD), a resistance training group (RT), and controls (CON). All subjects included in the study were physically active and had low levels of serum inflammatory markers. In accordance with the dietary goals, the n-6/n-3 ratio dietary intake significantly decreased only in RT-HD by 42%. An increase in 1 repetition maximum in leg extension occurred in RT (+20.4%) and RT-HD (+20.8%), but not in CON. Interestingly, leg lean mass significantly increased only in RT-HD (+1.8%). While there were no changes in serum C-reactive protein and IL-6 levels, a significant decrease in serum level of the pro-inflammatory precursor arachidonic acid (−5.3 ± 9.4%) together with an increase in serum n-3 docosahexaenoic acid (+8.3%) occurred only in RT-HD. Altogether, this study demonstrates that the effects of resistance training on muscle mass in healthy older adults can be optimized by the adoption of a healthy diet.

ACS Style

Emelie Strandberg; Peter Edholm; Elodie Ponsot; Britta Wåhlin-Larsson; Erik Hellmén; Andreas Nilsson; Peter Engfeldt; Tommy Cederholm; Ulf Riserus; Fawzi Kadi. Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial. Journal of Applied Physiology 2015, 119, 918 -925.

AMA Style

Emelie Strandberg, Peter Edholm, Elodie Ponsot, Britta Wåhlin-Larsson, Erik Hellmén, Andreas Nilsson, Peter Engfeldt, Tommy Cederholm, Ulf Riserus, Fawzi Kadi. Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial. Journal of Applied Physiology. 2015; 119 (8):918-925.

Chicago/Turabian Style

Emelie Strandberg; Peter Edholm; Elodie Ponsot; Britta Wåhlin-Larsson; Erik Hellmén; Andreas Nilsson; Peter Engfeldt; Tommy Cederholm; Ulf Riserus; Fawzi Kadi. 2015. "Influence of combined resistance training and healthy diet on muscle mass in healthy elderly women: a randomized controlled trial." Journal of Applied Physiology 119, no. 8: 918-925.