Nutritional status, muscle mass and strength of elderly in Southern Brazil Nutr Hosp. 2015;31(1):363-370 ISSN 0212-1611 • CODEN NUHOEQ S.V.R. 318 Original / Ancianos Nutritional status, muscle mass and strength of elderly in Southern Brazil Maria Helena Klee Oehlschlaeger1,2, Carla Alberici Pastore1,3, Adriana Schüler Cavalli2,4 and Maria Cristina Gonzalez1 1Post-Graduation Program on Health and Behavior – Catholic University of Pelotas. 2Physical Education College – Federal University of Pelotas. 3Nutrition College – Federal University of Pelotas. 4Post-Graduation Program on Physical Education – Federal University of Pelotas. Brazil. Abstract ESTADIO NUTRICIONAL, MASA MUSCULAR Y FUERZA DE ANCIANOS EN EL SUR DE BRASIL Aims: to assess and compare nutritional status and functional capacity of elderly goers of groups for guided physical activity or for guided recreational activities. Resumen Methods: Cross-sectional study with 210 elderly (60 Objetivos: evaluar y comparar el estado nutricional years old or more) of coexistence groups (for physical or y la capacidad funcional de ancianos frecuentadores de recreational activities). Nutritional status was assessed grupos de actividad física o de actividad recreacional. by the Mini Nutritional Assessment and Body Mass In- Métodos: estudio transversal con 210 ancianos (edad dex. Muscle mass was estimated by calf circumference igual o superior a 60 años) de grupos de convivencia (de (cut point of 31cm for both genders) and strength was actividad física o recreacional). El estado nutricional fue evaluated by hydraulic dynamometer, which measures evaluado por la Mini Evaluación Nutricional y por el Ín- the opponent’s finger maximal strength. The study was dice de Masa Corporal. La masa muscular fue estimada approved by Research Ethics Committee. por la circunferencia de la pantorrilla (punto de corte Results: Were enrolled 106 elderly in recreational 31cm para ambos géneros) y la fuerza fue evaluada por group and 104 in physical activity group. Most of the dinamómetro hidráulico, que mide la fuerza máxima de sample (86.7%) were female. The mean age was 69.3 pinza de la mano. Este proyecto fue aprobado por Comi- years old. Body Mass Index showed 82.9% of seniors té Ético de Investigación. with excessive weight (87.7% in recreational and 77.9% Resultados: Participaron 106 ancianos del grupo re- in physical activity group, p=0.04). When assessed by creacional y 104 del grupo de actividad física. La ma- Mini Nutritional Assessment, 22.9% was classified as yoría eran mujeres (86.7%). La edad promedio fue 69.3 malnourished or at risk of malnutrition, with no diffe- años. El Índice de Masa Corporal presentó 82.9% de los rence between groups. The mean calf circumference was ancianos con peso excesivo (87.7% en el grupo recreacio- 37.3 ± 4.1 cm, decreasing significantly with aging (p=0.05) nal y 77.9% en el grupo actividad física, p=0.04). Cuan- and being higher in elderly with higher BMI (p=0.001). do evaluado por la Mini Evaluación Nutricional, 22.9% Calf circumference was also greater in physical activity de los ancianos presentaron desnutrición o riesgo para group. Muscle strength’s mean was 6.77 (IQR: 5.83, 7.90) desnutrir. La circunferencia de la pantorrilla fue de 37.3 kg, with significantly higher values among men. There ±4.1cm, decreciente con el envejecimiento (p=0.05) y was no significant variation between age, nutritional sta- siendo mayor en ancianos con IMC más alto (p=0.001). tus or between groups. La pantorrilla también fue mayor en el grupo de activi- Conclusions: This study presented as its main findings dad física. La fuerza muscular tuvo promedio de 6.77Kg, that most seniors showed no nutritional risk, with high con valores significantemente mayores entre los hom- prevalence of overweight. The practice of physical activi- bres. No hubo diferencias significativas entre distintas ties was associated with greater CP and greater functio- edades, estado nutricional o entre los grupos. nality of the opposing finger muscles, which indicates the Conclusiones: este estudio tiene como principales importance of maintaining physical activity in the aging contribuciones que la mayoría de los ancianos que fre- process, in order to prevent frailty and disability. cuentan grupos de convivencia no presentaron riesgo (Nutr Hosp. 2015;31:363-370) nutricional, con alta prevalencia de exceso de peso. La práctica física fue asociada con mayor masa muscular y DOI:10.3305/nh.2015.31.1.7264 funcionalidad, lo que indica la importancia de mantener Key Words: Aging. Physical capacity. Frailty. Calf cir- la práctica física en el proceso de envejecimiento para cumference. Dynamometry. prevenir fragilidad y disfunción. (Nutr Hosp. 2015;31:363-370) Correspondence: Carla Alberici Pastore. Rua Taquari, 617, Laranjal. CEP: 96090-770, Pelotas - RS - Brazil. DOI:10.3305/nh.2015.31.1.7264 E-mail: [email protected] Palabras Clave: Envejecimiento. Capacidad física. Fragi- Recibido: 8-I-2014. lidad. Circunferencia de la pantorrilla. Dinamometria. 1.ª Revisión: 5-III-2014. Aceptado: 16-IX-2014. 363 040_7264 Nutritional Status, Muscle Mass and Strength of Elderly in Southern Brazil.indd 363 29/12/14 21:47 Abbreviations in the elderly. Works interested in anthropometric me- asurements suggest the CC as an important measure BMI: Body Mass Index. for evaluating the loss of muscle mass. This measure CC: Calf Circumference. would indicate changes in lean mass that occur with GSOT: Grip Strength of the Opposable Thumb. age and the decrease in physical activity5, 10, 11. IQR: Inter Quartile Range . Currently, another simple method that has been used MNA: Mini Nutritional Assessment. to monitor the nutritional status is the handgrip dyna- PAG: Physical Activity Group. mometry, which can be taken by different equipment. RG: Recreational Group. The tools that feature the highest coefficient of validity WHO: World Health Organization. and reliability are used to measure handgrip strength and the clamping forces of the opposing thumb, res- pectively. Handgrip dynamometry is widely used for Introduction a specific measure of hand strength12. The assessment of hand function and, specifically, of clamping forces, Currently many discussions focus on the implica- allows us to identify seniors who may be unable to tions of global aging on public health. Demographics perform simple activities of daily living and provides show that the world’s population aged 60 or older will us important information to measure the effectiveness triple in 50 years, from 600 million in 2000 to over two of treatment13, 14. This evaluation provides us simple billion by 2050, with two-thirds of seniors currently information, such as force levels and their relationship living in the developed world1. This global aging will to healthy or not populations, of different genders and have a major impact on the health system due to in- different age groups. It also identifies the manual func- creased morbidity and increased need for hospitaliza- tion deterioration that occurs as a result of the normal tion and / or institutionalization of individuals, as age aging and diseases often found in older people, such as advances2. osteoporosis, osteoarthritis and rheumatoid arthritis12. Good health is essential for older people to remain The Pinch Gauge (finger hydraulic dynamometer) is a independent and to continue to participate actively in tool to assess the grip strength of the opposable thumb the life of family and community. Health promotion (GSOT), and was chosen for this study because there is the guarantee of preventing or delaying the onset of are few references on its use and it presents itself as chronic diseases such as cardiovascular diseases, can- more user-friendly for the elderly, as these can often be cer and diabetes2. affected by diseases that impair hand mobility. The relationship between physical activity, health Therefore, this study aims to assess the nutritio- and aging has been increasingly discussed and studied nal status and functional capacity of elderly seen in in scientific circles. During the aging process, body groups of coexistence. In this context, this work aims changes occur, among which the decrease in lean body to compare elderly groups who meet to practice guided mass with loss in muscle strength, affecting the func- physical activity with those who gather for guided re- tional capacity3, 4. creational activities. Several instruments have been developed to assess nutritional status in the elderly, including the Mini Nu- tritional Assessment (MNA). This is a validated instru- Methods ment and considered the golden standard for this po- pulation for being practical, non-invasive, with simple measurements and quick questions5-7 Population and sample The Body Mass Index (BMI) is also an indicator of nutritional status often used due to the ease of its appli- We conducted a cross-sectional study with a con- cation, the existence of reference patterns that allow venience sample consisting of 210 elderly (60 years comparisons between populations, it not being invasive or more, according to the Ministry of Health of Bra- and also not an expensive process8. However, there are zil) linked to coexistence groups in the city of Pelotas, constraints to their use in the elderly, as it fails to iden- RS, Brazil. Of this total, 104 individuals attending a tify the exchange that takes place between body com- group whose goal was the practice of regular, super- partments (lean mass and fat) during the aging process. vised physical activities, according to WHO recom- Another widely used parameter, considered a very mendations (Physical Activity Group - PAG), and 106 important anthropometric measurement of muscle attended a group that met for social and recreational mass in elderly, is the calf circumference (CC). The activities (Recreational Group - RG ). CC provides an estimate of protein reserve and can be used in nutritional assessment programs, assisting in the detection of risks to ensure appropriate inter- Instruments and data collection ventions, improving the quality of life of elderly9.