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Title:	Effectiveness of an exercise intervention and protein supplementation on body composition, functional fitness, oxidative stress and quality of life of Malaysia elderly with sarcopenia
Authors:	Norshafarina Shari @ Kamaruddin (P43590)
Supervisor:	Suzana Shahar, Prof. Dr.
Keywords:	Exercise Protein supplementation Sarkopenia Older adults Dissertations, Academic -- Malaysia Universiti Kebangsaan Malaysia -- Dissertations
Issue Date:	14-Aug-2012
Description:	Gradual loss of muscle mass and strength with aging also known as sarcopenia results in a reduction in muscle function and performance. Although exercise and nutritional supplementation have been found to improve various measures of physical functioning in older adults, the effectiveness is still inconclusive particularly among sarcopenic subjects. Therefore, the purpose of this study was to evaluate the effectiveness of exercise and protein supplementation on their body composition, functional fitness, oxidative stress and quality of life among the subjects. In addition, the prevalence and risk factors of sarcopenia among subjects were also determined. This study was conducted in low cost housing area around Cheras and involved two phases. In Phase I (screening phase), a total of 388 subjects (mean age 67.3 ± 6.5 years) were screened using Bioimpedance analysis (BIA) to determine their body composition and subsequently categorized as sarcopenic if skeletal muscle mass index was below -1 to - 2 SD as compared to young adults. Subjects were interviewed for socio-demographic data, health, appetite, food intake and quality of life. A total of 15 ml of blood was drawn for analysis of lipid profile, blood glucose and oxidative stress. In Phase II (intervention phase), 65 sarcopenic subjects (men = 47, women =18; mean age 67.1± 5.3 years) identified from Phase I were divided into four groups for a 12 weeks intervention of which consist of control group (CG; n=16), exercise group (ExG; n=19), protein supplementation group (PrG; n=15) and combination of exercise and protein supplementation group (Ex+PrG; n=15). The CrG were not prescribed any intervention. Exercise group received exercise prescription consisting of 1 hour/session biweekly for 12 weeks. The PrG group received soy protein supplementation for a total of 20 g/day in women and 40 g/day in men in 12 weeks. Measurement of body composition, functional fitness, blood profile, oxidative stress, food intake, appetite and quality of life were carried out at baseline, 6 and 12 weeks. The prevalence of sarcopenia was 80.9% in men and 40.3% in women, with the overall prevalence rate of 59.8%. Interaction effect was found on protein supplemented group with the highest reductions were in body weight (F3,61 = 2.476; p<0.05) and body mass index (BMI; F3,61 = 2.278; p<0.05) after 12 weeks of intervention (Δ body weight: - 2.1%, Δ BMI: -1.8%). In addition, a significant interaction effect was found with decrease in % body fat (F3,61 = 2.567; p<0.05) and an increase of fat free mass (FFM; F3,61 = 2.815; p<0.05), highest in ExG (Δ % body fat: -11.6% , Δ FFM: +5.1%). The highest improvement in lower muscle strength with a significant in interaction, group and time effect were observed in the PrG (F3,61 = 3.833; p<0.05; Δ PrG : +73.2%). Whilst, a significant in interaction, group and time effect in upper body muscle strength was observed, with the ExG showed the highest improvement ( F3,61 = 2.737; p<0.05; Δ ExG: 47.6%). An interaction effect with the improvements were observed on the dimension of mental health in all intervention groups as compared to the control (F3,61 = 2.429; p<0.05). Protein carbonyl showed reduction in all intervention groups, as compared to control after 12 weeks of intervention with significant group and time effect (F3,61 = 2.969; p<0.05). Overall, there was a reduction at the occurrence of sarcopenia post intervention with the highest in PrG (20%). In conclusion, the prevalence of sarcopenia was high among elderly people in this study. However, exercise and protein supplementation group both alone or in combination was beneficial in improving body composition, muscle strength, mental health and reduce protein oxidation among elderly subjects with sarcopenia.,Kehilangan jisim dan kekuatan otot disebabkan oleh penuaan atau dikenali sebagai sarkopenia menyebabkan penurunan fungsi dan prestasi otot. Walaupun senaman dan suplementasi nutrisi didapati meningkatkan pelbagai fungsi fizikal pada warga tua, mekanismenya masih belum jelas terutama pada subjek sarkopenia. Oleh itu, kajian ini dilakukan untuk menilai keberkesanan latihan senaman dan suplementasi protein ke atas komposisi tubuh, ketahanan fungsi tubuh, tekanan oksidatif dan kualiti hidup di kalangan warga tua yang mengalami sarkopenia. Prevalens dan faktor risiko subjek sarkopenia juga ditentukan dalam kajian ini. Kajian ini dijalankan di kawasan rumah murah sekitar Cheras dan melibatkan 2 fasa. Dalam Fasa I (fasa saringan), seramai 388 warga tua (min umur: 67.3±6.5 tahun) telah disaring menggunakan analisa Bioimpedans (BIA) untuk mengukur komposisi tubuh. Subjek dikategorikan sebagai sarkopenia sekiranya mempunyai indeks jisim otot = [jumlah otot (kg)/ tinggi (m2)] dibawah -1 dan -2 SP berbanding dengan kumpulan rujukan muda. Subjek juga disoalselidik untuk mendapatkan maklumat profil sosiodemografi, kesihatan, selera makan, pengambilan makanan dan kualiti hidup. Sebanyak 15 ml darah diambil untuk analisa profil darah dan tekanan oksidatif. Dalam Fasa II (fasa intervensi), seramai 65 subjek sarkopenia (47 lelaki; 18 wanita dengan min umur 67.1±5.3 tahun) dipilih dari Fasa I dan dibahagikan kepada empat kumpulan selama 12 minggu. Kumpulan ini terdiri daripada kawalan (CrG;n=16), senaman (ExG;n=19), suplemen protein (PrG;n=15) dan kombinasi keduanya (ExG+PrG;n=15). Kumpulan CrG tidak menerima sebarang intervensi. Kumpulan ExG menerima preskripsi senaman untuk 2 kali/minggu/1 jam/sesi selama 12 minggu. Kumpulan PrG pula menerima suplemen protein soya iaitu 20g/hari untuk wanita dan 40g/hari untuk lelaki selama 12 minggu. Pengukuran komposisi tubuh, ketahanan fungsi fizikal, profil darah, tekanan oksidatif, pengambilan makanan, tahap selera makan dan kualiti hidup di lakukan pada peringkat dasar, 6 dan 12 minggu intervensi. Didapati, prevalens sarkopenia bagi lelaki adalah 80.9%, manakala 40.3%, adalah bagi wanita dengan prevalens keseluruhan adalah 59.8%. Kesan interaksi pada kumpulan protein suplementasi dengan penurunan paling tinggi pada berat badan (F3,61=2.476;p<0.05) dan indeks jisim tubuh (IJT:F3,61=2.278;p<0.05) (Δ berat badan : - 2.1%, Δ IJT: -1.8%). Didapati kesan interaksi yang signifikan dengan penurunan dalam peratus lemak tubuh (F3,61=2.567;p<0.05) dan peningkatan jisim tubuh tanpa lemak (JTTL; (F3,61=2.851;p<0.05) paling tinggi pada ExG (Δ% lemak tubuh = -11.6%, Δ JTTL : +5.1%). Peningkatan pada kekuatan otot bawah tubuh dengan kesan interaksi, kumpulan dan masa diperhatikan pada PrG (F3,61=3.833;p<0.05; Δ PrG: +73.2%). Manakala, kesan interaksi, kumpulan dan masa pada kekuatan otot atas tubuh dengan ExG menunjukkan peningkatan tertinggi (F3,61=2.737;p<0.05; Δ ExG: 47.6%). Diperhatikan, kesan interaksi dengan peningkatan dalam domain dimensi kesihatan mental pada kesemua kumpulan intervensi berbanding kumpulan kawalan (F3,61=2.429;p<0.05). Protein karbonil menunjukkan penurunan pada semua kumpulan intervensi berbanding kawalan (F3,61=2.969;p<0.05). Secara keseluruhan, didapati penurunan pada kejadian sarkopenia selepas intervensi paling tinggi pada kumpulan PrG (20%). Kesimpulannya, keputusan menunjukkan prevalens sarkopenia yang tinggi pada warga tua. Walau bagaimanapun, intervensi senaman dan suplemen protein sama ada bersendirian atau kombinasi adalah berfaedah dan berkesan dalam meningkatkan komposisi tubuh, kekuatan otot, kesihatan mental dan menurunkan oksidasi protein pada warga tua Melayu yang mengalami sarkopenia.,Ph.D.
Pages:	334
Call Number:	WA20.5.N863e 2012 9 tesis
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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