@article{SpiraBuchmannKoenigetal.2019, author = {Spira, Dominik and Buchmann, Nikolaus and Koenig, Maximilian and Rosada, Adrian and Steinhagen-Thiessen, Elisabeth and Demuth, Ilja and Norman, Kristina}, title = {Sex-specific differences in the association of vitamin D with low lean mass and frailty}, series = {Nutrition}, volume = {62}, journal = {Nutrition}, publisher = {Elsevier}, address = {New York}, issn = {0899-9007}, doi = {10.1016/j.nut.2018.11.020}, pages = {1 -- 6}, year = {2019}, abstract = {Background: Sex-specific differences in factors associated with aging and lifespan, such as sarcopenia and disease development, are increasingly recognized. The study aims to assess sex-specific aspects of the association between vitamin D insufficiency and low lean mass as well as between vitamin D insufficiency and the frailty phenotype. Methods: A total of 1102 participants (51\% women) from the Berlin Aging Study II were included in this cross-sectional study. Vitamin D insufficiency was defined as a 25(OH)D level <50 nmol/L. Lean mass was assessed with dual-energy x-ray absorptiometry and corrected by body mass index. Low lean mass was defined according to the Foundations for the National Institutes of Health Sarcopenia Project criteria (appendicular lean mass/body mass index <0.789 in men and <0.512 in women) and frailty defined according to the Fried criteria. Results: In a risk factor adjusted analysis, the association of vitamin D insufficiency was significantly influenced by sex (P for interaction < 0.001). Men with vitamin D insufficiency had 1.8 times higher odds of having low lean mass, with no association between vitamin D insufficiency and low lean mass in women. Participants with vitamin D insufficiency had 1.5 higher odds of being prefrail/frail with no significant effect modification by sex. Conclusions: We found notable sex-specific differences in the association of vitamin D insufficiency with low lean mass but not of vitamin D insufficiency with frailty. Vitamin D might play a relevant role in the loss of lean mass in men but not women and might be a biological marker of an unfavorable aging process associated with early development of frailty regardless of sex.}, language = {en} } @article{FranzOttenMuellerWerdanetal.2019, author = {Franz, Kristina and Otten, Lindsey and M{\"u}ller-Werdan, Ursula and D{\"o}hner, Wolfram and Norman, Kristina}, title = {Severe Weight Loss and Its Association with Fatigue in Old Patients at Discharge from a Geriatric Hospital}, series = {Nutrients}, volume = {11}, journal = {Nutrients}, number = {10}, publisher = {MDPI}, address = {Basel}, issn = {2072-6643}, doi = {10.3390/nu11102415}, pages = {10}, year = {2019}, abstract = {Although malnutrition is frequent in the old, little is known about its association with fatigue. We evaluated the relation of self-reported severe weight loss with fatigue and the predictors for fatigue in old patients at hospital discharge. Severe weight loss was defined according to involuntary weight loss >= 5\% in the last three months. We determined fatigue with the validated Brief Fatigue Inventory questionnaire. The regression analyses were adjusted for age, sex, number of comorbidities, medications/day, and BMI. Of 424 patients aged between 61 and 98 y, 34.1\% had severe weight loss. Fatigue was higher in patients with severe weight loss (3.7 +/- 2.3 vs. 3.2 +/- 2.3 points, p = 0.021). In a multinomial regression model, weight loss was independently associated with higher risk for moderate fatigue (OR:1.172, CI:1.026-1.338, p = 0.019) and with increased risk for severe fatigue (OR:1.209, CI:1.047-1.395, p = 0.010) together with the number of medications/day (OR:1.220, CI:1.023-1.455, p = 0.027). In a binary regression model, severe weight loss predicted moderate-to-severe fatigue in the study population (OR:1.651, CI:1.052-2.590, p = 0.029). In summary, patients with self-reported severe weight loss at hospital discharge exhibited higher fatigue levels and severe weight loss was an independent predictor of moderate and severe fatigue, placing these patients at risk for impaired outcome in the post-hospital period.}, language = {en} } @article{HerpichHassKochliketal.2021, author = {Herpich, Catrin and Haß, Ulrike and Kochlik, Bastian Max and Franz, Kristina and Laeger, Thomas and Klaus, Susanne and Bosy-Westphal, Anja and Norman, Kristina}, title = {Postprandial dynamics and response of fibroblast growth factor 21 in older adults}, series = {Clinical Nutrition}, volume = {40}, journal = {Clinical Nutrition}, number = {6}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0261-5614}, doi = {10.1016/j.clnu.2021.04.037}, pages = {3765 -- 3771}, year = {2021}, abstract = {Background \& aims: Fibroblast growth factor 21 (FGF21) plays a pivotal role in glucose and lipid metabolism and has been proposed as a longevity hormone. However, elevated plasma FGF21 concentrations are paradoxically associated with mortality in higher age and little is known about the postprandial regulation of FGF21 in older adults. In this parallel group study, we investigated postprandial FGF21 dynamics and response in older (65-85 years) compared to younger (18-35 years) adults following test meals with varying macronutrient composition. Methods: Participants (n = 60 older; n = 60 younger) were randomized to one of four test meals: dextrose, high carbohydrate (HC), high fat (HF) or high protein (HP). Blood was drawn before and 15, 30, 60, 120, 240 min after meal ingestion. Postprandial dynamics were evaluated using repeated measures ANCOVA. FGF21 response was assessed by incremental area under the curve. Results: Fasting FGF21 concentrations were significantly higher in older adults. FGF21 dynamics were affected by test meal (p < 0.001) and age (p = 0.013), when adjusted for BMI and fasting FGF21. Postprandial FGF21 concentrations steadily declined over 240 min in both age groups after HF and HP, but not after dextrose or HC ingestion. At 240 min, FGF21 concentrations were significantly higher in older than in younger adults following dextrose (133 pg/mL, 95\%CI: 103, 172 versus 91.2 pg/mL, 95\%CI: 70.4, 118; p = 0.044), HC (109 pg/mL, 95\%CI: 85.1, 141 versus 70.3 pg/mL, 95\%CI: 55.2, 89.6; p = 0.014) and HP ingestion (45.4 pg/mL, 95\%CI: 34.4, 59.9 versus 27.9 pg/mL 95\%CI: 20.9, 37.1; p = 0.018). FGF21 dynamics and response to HF were similar for both age groups. Conclusions: The age-specific differences in postprandial FGF21 dynamics and response in healthy adults, potentially explain higher FGF21 concentrations in older age. Furthermore, there appears to be a significant impact of acute and recent protein intake on FGF21 secretion.}, language = {en} } @article{WeberKochlikDemuthetal.2020, author = {Weber, Daniela and Kochlik, Bastian Max and Demuth, Ilja and Steinhagen-Thiessen, Elisabeth and Grune, Tilman and Norman, Kristina}, title = {Plasma carotenoids, tocopherols and retinol}, series = {Redox Biology}, volume = {32}, journal = {Redox Biology}, publisher = {Elsevier}, address = {Amsterdam}, issn = {2213-2317}, doi = {10.1016/j.redox.2020.101461}, pages = {1 -- 8}, year = {2020}, abstract = {Regular consumption of fruits and vegetables, which is related to high plasma levels of lipid-soluble micro-nutrients such as carotenoids and tocopherols, is linked to lower incidences of various age-related diseases. Differences in lipid-soluble micronutrient blood concentrations seem to be associated with age. Our retrospective analysis included men and women aged 22-37 and 60-85 years from the Berlin Aging Study II. Participants with simultaneously available plasma samples and dietary data were included (n = 1973). Differences between young and old groups were found for plasma lycopene, alpha-carotene, alpha-tocopherol, beta-cryptoxanthin (only in women), and gamma-tocopherol (only in men). beta-Carotene, retinol and lutein/zeaxanthin did not differ between young and old participants regardless of the sex. We found significant associations for lycopene, alpha-carotene (both inverse), alpha-tocopherol, gamma-tocopherol, and beta-carotene (all positive) with age. Adjusting for BMI, smoking status, season, cholesterol and dietary intake confirmed these associations, except for beta-carotene. These micronutrients are important antioxidants and associated with lower incidence of age-related diseases, therefore it is important to understand the underlying mechanisms in order to implement dietary strategies for the prevention of age-related diseases. To explain the lower lycopene and alpha-carotene concentration in older subjects, bioavailability studies in older participants are necessary.}, language = {en} } @article{FranzOstOttenetal.2018, author = {Franz, Kristina and Ost, Mario and Otten, Lindsey and Herpich, Catrin and Coleman, Verena and Endres, Anne-Sophie and Klaus, Susanne and M{\"u}ller-Werdan, Ursula and Norman, Kristina}, title = {Higher serum levels of fibroblast growth factor 21 in old patients with cachexia}, series = {Nutrition : the international journal of applied and basic nutritional sciences}, volume = {63-64}, journal = {Nutrition : the international journal of applied and basic nutritional sciences}, publisher = {Elsevier}, address = {New York}, issn = {0899-9007}, doi = {10.1016/j.nut.2018.11.004}, pages = {81 -- 86}, year = {2018}, abstract = {Objective: Fibroblast growth factor (FGF)21 is promptly induced by short fasting in animal models to regulate glucose and fat metabolism. Data on FGF21 in humans are inconsistent and FGF21 has not yet been investigated in old patients with cachexia, a complex syndrome characterized by inflammation and weight loss. The aim of this study was to explore the association of FGF21 with cachexia in old patients compared with their healthy counterparts. Methods: Serum FGF21 and its inactivating enzyme fibroblast activation protein (FAP)-cc were measured with enzyme-linked immunoassays. Cachexia was defined as >= 5\% weight loss in the previous 3 mo and concurrent anorexia (Council on Nutrition appetite questionnaire). Results: We included 103 patients with and without cachexia (76.9 +/- 5.2 y of age) and 56 healthy controls (72.9 +/- 5.9 y of age). Cachexia was present in 16.5\% of patients. These patients had significantly higher total FGF21 levels than controls (952.1 +/- 821.3 versus 525.2 +/- 560.3 pg/mL; P= 0.012) and the lowest FGF21 levels (293.3 +/- 150.9 pg/mL) were found in the control group (global P < 0.001). Although FAP-alpha did not differ between the three groups (global P = 0.082), bioactive FGF21 was significantly higher in patients with cachexia (global P = 0.002). Risk factor-adjusted regression analyses revealed a significant association between cachexia and total ((beta = 649.745 pg/mL; P < 0.001) and bioactive FGF21 (beta = 393.200 pg/mL; P <0.001), independent of sex, age, and body mass index. Conclusions: Patients with cachexia exhibited the highest FGF21 levels. Clarification is needed to determine whether this is an adaptive response to nutrient deprivation in disease-related cachexia or whether the increased FGF21 values contribute to the catabolic state. (C) 2018 Elsevier Inc. All rights reserved.}, language = {en} } @article{VolkertKiesswetterCederholmetal.2019, author = {Volkert, Dorothee and Kiesswetter, Eva and Cederholm, Tommy and Donini, Lorenzo M. and Egiseer, Doris and Norman, Kristina and Schneider, Stephane M. and Stroebele-Benschop, Nanette and Torbahn, Gabriel and Wirth, Rainer and Visser, Marjolein}, title = {Development of a Model on Determinants of Malnutrition in Aged Persons}, series = {Gerontology and Geriatric Medicine}, volume = {5}, journal = {Gerontology and Geriatric Medicine}, publisher = {Sage Publ.}, address = {Thousand Oaks}, issn = {2333-7214}, doi = {10.1177/2333721419858438}, pages = {8}, year = {2019}, abstract = {In older persons, the origin of malnutrition is often multifactorial with a multitude of factors involved. Presently, a common understanding about potential causes and their mode of action is lacking, and a consensus on the theoretical framework on the etiology of malnutrition does not exist. Within the European Knowledge Hub "Malnutrition in the Elderly (MaNuEL)," a model of "Determinants of Malnutrition in Aged Persons" (DoMAP) was developed in a multistage consensus process with live meetings and written feedback (modified Delphi process) by a multiprofessional group of 33 experts in geriatric nutrition. DoMAP consists of three triangle-shaped levels with malnutrition in the center, surrounded by the three principal conditions through which malnutrition develops in the innermost level: low intake, high requirements, and impaired nutrient bioavailability. The middle level consists of factors directly causing one of these conditions, and the outermost level contains factors indirectly causing one of the three conditions through the direct factors. The DoMAP model may contribute to a common understanding about the multitude of factors involved in the etiology of malnutrition, and about potential causative mechanisms. It may serve as basis for future research and may also be helpful in clinical routine to identify persons at increased risk of malnutrition.}, language = {en} } @article{HassHerpichNorman2019, author = {Haß, Ulrike and Herpich, Catrin and Norman, Kristina}, title = {Anti-Inflammatory Diets and Fatigue}, series = {Nutrients}, volume = {11}, journal = {Nutrients}, number = {10}, publisher = {MDPI}, address = {Basel}, issn = {2072-6643}, doi = {10.3390/nu11102315}, pages = {24}, year = {2019}, abstract = {Accumulating data indicates a link between a pro-inflammatory status and occurrence of chronic disease-related fatigue. The questions are whether the observed inflammatory profile can be (a) improved by anti-inflammatory diets, and (b) if this improvement can in turn be translated into a significant fatigue reduction. The aim of this narrative review was to investigate the effect of anti-inflammatory nutrients, foods, and diets on inflammatory markers and fatigue in various patient populations. Next to observational and epidemiological studies, a total of 21 human trials have been evaluated in this work. Current available research is indicative, rather than evident, regarding the effectiveness of individuals' use of single nutrients with anti-inflammatory and fatigue-reducing effects. In contrast, clinical studies demonstrate that a balanced diet with whole grains high in fibers, polyphenol-rich vegetables, and omega-3 fatty acid-rich foods might be able to improve disease-related fatigue symptoms. Nonetheless, further research is needed to clarify conflicting results in the literature and substantiate the promising results from human trials on fatigue.}, language = {en} }