Background/Objectives: The effects of ageing on the diaphragm are unclear. This study examined the association between ageing and diaphragm thickness, thickening fraction (TF), and diaphragm excursion (DE) as assessed by ultrasonography after adjusting for other factors. The relationship between these parameters and maximal inspiratory pressure (MIP) was also investigated. Methods: From 2022 to 2024, ambulatory and communicative adult volunteers and outpatients were recruited from four Japanese medical institutions. Each participant’s background factors (including height, weight, and underlying diseases) and pulmonary function test results were assessed. Diaphragm thickness, TF, and DE were evaluated using ultrasonography. Results: The study involved 230 individuals with a mean age of 55.5 years (older adults (65 years and over), n = 117; non-older adults, n = 113). In older adults, the diaphragm was thicker (2.1 vs. 1.7 mm, p < 0.001), and TF was lower (88.7% vs. 116.0%, p < 0.001), with no significant difference in DE. Multivariate linear regression analysis adjusted for sex, height, body mass index, and underlying diseases showed positive associations between age and diaphragm thickness (p = 0.001), but not with TF or DE. MIP was positively associated with DE (p < 0.001) but not with thickness or TF. Age was negatively associated with MIP, regardless of diaphragm thickness, TF, and DE (all p < 0.001). Conclusions: As the diaphragm thickens with age, neither thickness nor TF is associated with MIP; only DE is related to MIP. Additionally, ageing is negatively associated with MIP, independent of diaphragm thickness, TF, and DE. Diaphragm function should be assessed using DE rather than thickness or TF.

Background/Objectives: The diaphragm is important for respiration, but the effects of age-related muscle loss and sarcopenia on diaphragm function are unclear. We evaluated the associations of sarcopenia and skeletal muscle mass (SMM) with diaphragm function. Methods: This study was conducted at three Japanese hospitals from May 2023 to September 2024. The participants underwent bioelectrical impedance for SMM assessment, as well as pulmonary function tests. Diaphragm ultrasound was used to measure the thickness at functional residual capacity (FRC), thickening fraction (TF), and diaphragm excursion (DE) during deep breathing (DB), and their associations with sarcopenia and low skeletal muscle index (SMI) were analyzed. Results: Overall, 148 patients (mean age 78.1 years; sarcopenia, n = 35; non-sarcopenia, n = 103) were included. No statistically significant differences in thickness(FRC), TF and DE were observed between the sarcopenia group and the non-sarcopenia group. The low SMI group had significantly lower thickness (difference −0.22, 95% CI; −0.41, −0.29) and DE (difference −9.2, 95%CI; −14.0, −4.49) than the normal SMI group. Multivariable linear regression analyses adjusted for age, sex, and stature revealed no association between thickness (FRC) and sarcopenia (p = 0.98), but thickness (FRC) was negatively associated with low SMI (p = 0.034). DE during DB was negatively associated with sarcopenia (p = 0.024) and low SMI (p = 0.001). TF showed no associations. Conclusions: DE during DB was reduced in patients with sarcopenia and low SMI, and thickness (FRC) was reduced in those with low SMI without sarcopenia.

Symptoms of diaphragm dysfunction, such as exertional dyspnea and decreased exercise tolerance, share similarities with the symptoms of skeletal muscle mass reduction caused by conditions like sarcopenia. Given that the diaphragm is also a skeletal muscle, sarcopenia may be associated with diaphragm dysfunction, but the specifics of this relationship remain unclear. This study aimed to assess the relationship between diaphragm function—measured by ultrasonography (thickness, thickening fraction, and excursion)—and muscle mass of the extremities, trunk, and whole body using bioimpedance analysis. We recruited older adults from an outpatient clinic for swallowing rehabilitation or frailty. Muscle mass was measured through bioimpedance analysis, and diaphragm function was evaluated with ultrasonography. The relationships between diaphragm ultrasound results and muscle mass measurements were analyzed with regression models adjusted for age, sex, and height. The study included 114 participants (mean age 78.0 years; 45.6% male). The skeletal muscle index was 7.2 kg/m² for men and 5.9 kg/m² for women, with 20% meeting the Asian Working Group for Sarcopenia 2019 criteria. Diaphragm excursion during deep breathing was significantly associated with muscle mass of the extremities, trunk, and whole body (p < 0.001 in simple analysis; p < 0.01 in multiple analysis). Diaphragm thickness and thickening fraction showed no significant associations with muscle mass. Diaphragm excursion could be an adequate indicator of sarcopenia in cases where limb-based measurement is not possible, and therefore unreliable.

Upon reviewing our original publication

Visual cues strongly influence consumer evaluations of food, but sauce presentation may also affect how diners interact with a dish during consumption. In a naturalistic restaurant field study, 57 participants completed a counterbalanced within-participant comparison of minimal and drizzle sauce presentations, with evaluations collected before and after tasting. An integrated 2 (presentation) × 2 (phase) × 2 (presentation order) repeated-measures analysis showed that, before tasting, minimal presentation was rated as healthier than drizzle presentation after adjustment for order (adjusted mean difference = 0.60, 95% CI [0.19, 1.00], p = 0.005; Holm- and FDR-adjusted p = 0.032). After tasting, minimal presentation received higher unadjusted ratings of intention to eat more and overall liking, but neither difference survived multiplicity correction. No presentation × phase interaction was significant. Because sauce placement also changed diners’ opportunity to regulate sauce use, post-consumption findings are interpreted as effects of presentation-and-consumption format rather than visual presentation alone. Thus, the clearest finding concerns pre-consumption healthiness inference, whereas the post-consumption results are smaller and exploratory.