Publicaties

@article{pmid38944828,

title = {Low muscle quality on a procedural computed tomography scan assessed with deep learning as a practical useful predictor of mortality in patients with severe aortic valve stenosis},

author = {Dennis van Erck and Pim Moeskops and Josje D Schoufour and Peter J M Weijs and Wilma J M Scholte Op Reimer and Martijn S van Mourik and R Nils Planken and Marije M Vis and Jan Baan and Ivana Išgum and José P Henriques and Bob D de Vos and Ronak Delewi},

doi = {10.1016/j.clnesp.2024.06.013},

issn = {2405-4577},

year  = {2024},

date = {2024-10-01},

journal = {Clin Nutr ESPEN},

volume = {63},

pages = {142--147},

abstract = {BACKGROUND & AIMS: Accurate diagnosis of sarcopenia requires evaluation of muscle quality, which refers to the amount of fat infiltration in muscle tissue. In this study, we aim to investigate whether we can independently predict mortality risk in transcatheter aortic valve implantation (TAVI) patients, using automatic deep learning algorithms to assess muscle quality on procedural computed tomography (CT) scans.nnMETHODS: This study included 1199 patients with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) between January 2010 and January 2020. A procedural CT scan was performed as part of the preprocedural-TAVI evaluation, and the scans were analyzed using deep-learning-based software to automatically determine skeletal muscle density (SMD) and intermuscular adipose tissue (IMAT). The association of SMD and IMAT with all-cause mortality was analyzed using a Cox regression model, adjusted for other known mortality predictors, including muscle mass.nnRESULTS: The mean age of the participants was 80 ± 7 years, 53% were female. The median observation time was 1084 days, and the overall mortality rate was 39%. We found that the lowest tertile of muscle quality, as determined by SMD, was associated with an increased risk of mortality (HR 1.40 [95%CI: 1.15-1.70], p < 0.01). Similarly, low muscle quality as defined by high IMAT in the lowest tertile was also associated with increased mortality risk (HR 1.24 [95%CI: 1.01-1.52], p = 0.04).nnCONCLUSIONS: Our findings suggest that deep learning-assessed low muscle quality, as indicated by fat infiltration in muscle tissue, is a practical, useful and independent predictor of mortality after TAVI.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39153816,

title = {Effect of high versus standard protein provision on functional recovery in people with critical illness (PRECISe): an investigator-initiated, double-blinded, multicentre, parallel-group, randomised controlled trial in Belgium and the Netherlands},

author = {Julia L M Bels and Steven Thiessen and Rob J J van Gassel and Albertus Beishuizen and Ashley De Bie Dekker and Vincent Fraipont and Stoffel Lamote and Didier Ledoux and Clarissa Scheeren and Elisabeth De Waele and Arthur R H van Zanten and Laura Bormans-Russell and Bas C T van Bussel and Marlies M J Dictus and Tom Fivez and Ingeborg Harks and Iwan C C van der Horst and Joop Jonckheer and Hugues Marechal and Paul B Massion and Ingrid Meex and Michelle C Paulus and Martin Rinket and Susanne van Santen and Katrien Tartaglia and Adam M Deane and Frieda Demuydt and Zudin Puthucheary and Lilian C M Vloet and Peter J M Weijs and Sander M J van Kuijk and Marcel C G van de Poll and Dieter Mesotten and },

doi = {10.1016/S0140-6736(24)01304-7},

issn = {1474-547X},

year  = {2024},

date = {2024-08-01},

journal = {Lancet},

volume = {404},

number = {10453},

pages = {659--669},

abstract = {BACKGROUND: Increased protein provision might ameliorate muscle wasting and improve long-term outcomes in critically ill patients. The aim of the PRECISe trial was to assess whether higher enteral protein provision (ie, 2·0 g/kg per day) would improve health-related quality of life and functional outcomes in critically ill patients who were mechanically ventilated compared with standard enteral protein provision (ie, 1·3 g/kg per day).nnMETHODS: The PRECISe trial was an investigator-initiated, double-blinded, multicentre, parallel-group, randomised controlled trial in five Dutch hospitals and five Belgian hospitals. Inclusion criteria were initiation of invasive mechanical ventilation within 24 h of intensive care unit (ICU) admission and an expected duration of invasive ventilation of 3 days or longer. Exclusion criteria were contraindications for enteral nutrition, moribund condition, BMI less than 18 kg/m, kidney failure with a no dialysis code, or hepatic encephalopathy. Patients were randomly assigned to one of four randomisation labels, corresponding with two study groups (ie, standard or high protein; two labels per group) in a 1:1:1:1 ratio through an interactive web-response system. Randomisation was done via random permuted-block randomisation in varying block sizes of eight and 12, stratified by centre. Participants, care providers, investigators, outcome assessors, data analysts, and the independent data safety monitoring board were all blinded to group allocation. Patients received isocaloric enteral feeds that contained 1·3 kcal/mL and 0·06 g of protein/mL (ie, standard protein) or 1·3 kcal/mL and 0·10 g of protein/mL (ie, high protein). The study-nutrition intervention was limited to the time period during the patient's ICU stay in which they required enteral feeding, with a maximum of 90 days. The primary outcome was EuroQoL 5-Dimension 5-level (EQ-5D-5L) health utility score at 30 days, 90 days, and 180 days after randomisation, adjusted for baseline EQ-5D-5L health utility score. This trial was registered with ClinicalTrials.gov (NCT04633421) and is closed to new participants.nnFINDINGS: Between Nov 19, 2020, and April 14, 2023, 935 patients were randomly assigned. 335 (35·8%) of 935 patients were female and 600 (64·2%) were male. 465 (49·7%) of 935 were assigned to the standard protein group and 470 (50·3%) were assigned to the high protein group. 430 (92·5%) of 465 patients in the standard protein group and 419 (89·1%) of 470 patients in the high protein group were assessed for the primary outcome. The primary outcome, EQ-5D-5L health utility score during 180 days after randomisation (assessed at 30 days, 90 days, and 180 days), was lower in patients allocated to the high protein group than in those allocated to the standard protein group, with a mean difference of -0·05 (95% CI -0·10 to -0·01; p=0·031). Regarding safety outcomes, the probability of mortality during the entire follow-up was 0·38 (SE 0·02) in the standard protein group and 0·42 (0·02) in the high protein group (hazard ratio 1·14, 95% CI 0·92 to 1·40; p=0·22). There was a higher incidence of symptoms of gastrointestinal intolerance in patients in the high protein group (odds ratio 1·76, 95% CI 1·06 to 2·92; p=0·030). Incidence of other adverse events did not differ between groups.nnINTERPRETATION: High enteral protein provision compared with standard enteral protein provision resulted in worse health-related quality of life in critically ill patients and did not improve functional outcomes during 180 days after ICU admission.nnFUNDING: Netherlands Organisation for Healthcare Research and Development and Belgian Health Care Knowledge Centre.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38653002,

title = {Analysis of behavioral change techniques used in exercise and nutritional interventions targeting adults around retirement age with sarcopenic obesity in a systematic review},

author = {Paula Collazo-Castiñeira and Macarena Sánchez-Izquierdo and Lea Joanne Reiter and Silvia Bauer and Alfonso J Cruz-Jentoft and Josje D Schoufour and Peter J M Weijs and Doris Eglseer},

doi = {10.1016/j.archger.2024.105437},

issn = {1872-6976},

year  = {2024},

date = {2024-08-01},

journal = {Arch Gerontol Geriatr},

volume = {123},

pages = {105437},

abstract = {BACKGROUND: Sarcopenic obesity significantly burdens health and autonomy. Strategies to intervene in or prevent sarcopenic obesity generally focus on losing body fat and building or maintaining muscle mass and function. For a lifestyle intervention, it is important to consider psychological aspects such as behavioral change techniques (BCTs) to elicit a long-lasting behavioral change.nnPURPOSE: The study was carried out to analyze BCTs used in exercise and nutritional interventions targeting community-dwelling adults around retirement age with sarcopenic obesity.nnMETHODS: We conducted an analysis of articles cited in an existing systematic review on the effectiveness of exercise and nutritional interventions on physiological outcomes in community-dwelling adults around retirement age with sarcopenic obesity. We identified BCTs used in these studies by applying a standardized taxonomy.nnRESULTS: Only nine BCTs were identified. Most BCTs were not used intentionally (82 %), and those used derived from the implementation of lifestyle components, such as exercise classes ("instructions on how to perform a behavior," "demonstration of the behavior," "behavioral practice/rehearsal," and "body changes"). Only two studies used BCTs intentionally to reinforce adherence in their interventions.nnCONCLUSIONS: Few studies integrated BCTs in lifestyle interventions for community-dwelling persons around retirement age with sarcopenic obesity. Future studies on interventions to counteract sarcopenic obesity should include well-established BCTs to foster adherence and, therefore, their effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39191118,

title = {Adherence to resistance training and hypocaloric diet among persons near retirement age - A secondary data analysis of three randomized controlled trials},

author = {S Bauer and L Reiter and P J M Weijs and J D Schoufour and Y Boirie and E Topinková and R G Memelink and A M Verreijen and A Borenich and D Eglseer and },

doi = {10.1016/j.jnha.2024.100344},

issn = {1760-4788},

year  = {2024},

date = {2024-08-01},

journal = {J Nutr Health Aging},

volume = {28},

number = {10},

pages = {100344},

abstract = {OBJECTIVES: Adherence to lifestyle interventions is crucial for the treatment of obesity. However, there is little research about adherence to lifestyle interventions in persons around retirement age. The objectives of this study are (1) to identify factors associated with the adherence to resistance training and a hypocaloric diet and (2) to describe the association between adherence and changes in body composition outcome parameters.nnDESIGN: This secondary data analysis included three randomized controlled trials.nnSETTING & PARTICIPANTS: The inclusion criteria of the participants were an age of 55-75 years, a BMI ≥ 25 kg/m and receiving both a hypocaloric diet and resistance training. All participants were residing in the community.nnMEASUREMENTS: Adherence to hypocaloric diet was measured through the mean dietary intake on the basis of a 3-day dietary record. If the participant consumed at least 600 kcal less than the individual caloric requirements, they were considered adherent. Adherence to resistance training was achieved if ≥67% of the recommended training sessions were attended over the course of the study periods.nnRESULTS: 232 participants were included, 47.0% female, mean age 64.0 (±5.5) years. 80.2% adhered to resistance training and 51.3% adhered to a hypocaloric diet. Older age (Beta 0.41; 95% CI 0.05, 0.78; p = 0.028) and male sex (Beta 7.7; 95% CI 3.6, 11; p < 0.001) were associated with higher resistance training adherence. A higher BMI at baseline (Beta 6.4; 95% CI 3.6, 9.2; p < 0.001) and male sex (Beta 65; 95% CI 41, 88; p < 0.001) were associated with higher adherence to hypocaloric diet.nnCONCLUSION: We identified several associated factors (sex, age and BMI at baseline) that should be considered to promote adherence in future lifestyle intervention studies in persons around retirement age. We recommend including behavior change techniques in lifestyle interventions and consider sex-specific interventions to improve the adherence of women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38527636,

title = {The effect of a combined lifestyle intervention with and without protein drink on inflammation in older adults with obesity and type 2 diabetes},

author = {Robert G Memelink and Rose Njemini and Minse J J de Bos Kuil and Suzan Wopereis and Johan de Vogel-van den Bosch and Josje D Schoufour and Michael Tieland and Peter J M Weijs and Ivan Bautmans},

doi = {10.1016/j.exger.2024.112410},

issn = {1873-6815},

year  = {2024},

date = {2024-06-01},

journal = {Exp Gerontol},

volume = {190},

pages = {112410},

abstract = {BACKGROUND: Chronic low-grade inflammatory profile (CLIP) is one of the pathways involved in type 2 diabetes (T2D). Currently, there is limited evidence for ameliorating effects of combined lifestyle interventions on CLIP in type 2 diabetes. We investigated whether a 13-week combined lifestyle intervention, using hypocaloric diet and resistance exercise plus high-intensity interval training with or without consumption of a protein drink, affected CLIP in older adults with T2D.nnMETHODS: In this post-hoc analysis of the PROBE study 114 adults (≥55 years) with obesity and type 2 (pre-)diabetes had measurements of C-reactive protein (CRP), pro-inflammatory cytokines interleukin (IL)-6, tumor-necrosis-factor (TNF)-α, and monocyte chemoattractant protein (MCP)-1, anti-inflammatory cytokines IL-10, IL-1 receptor antagonist (RA), and soluble tumor-necrosis-factor receptor (sTNFR)1, adipokines leptin and adiponectin, and glycation biomarkers carboxymethyl-lysine (CML) and soluble receptor for advanced glycation end products (sRAGE) from fasting blood samples. A linear mixed model was used to evaluate change in inflammatory biomarkers after lifestyle intervention and effect of the protein drink. Linear regression analysis was performed with parameters of body composition (by dual-energy X-ray absorptiometry) and parameters of insulin resistance (by oral glucose tolerance test).nnRESULTS: There were no significant differences in CLIP responses between the protein and the control groups. For all participants combined, IL-1RA, leptin and adiponectin decreased after 13 weeks (p = 0.002, p < 0.001 and p < 0.001), while ratios TNF-α/IL-10 and TNF-α/IL-1RA increased (p = 0.003 and p = 0.035). CRP increased by 12 % in participants with low to average CLIP (pre 1.91 ± 0.39 mg/L, post 2.13 ± 1.16 mg/L, p = 0.006) and decreased by 36 % in those with high CLIP (pre 5.14 mg/L ± 1.20, post 3.30 ± 2.29 mg/L, p < 0.001). Change in leptin and IL-1RA was positively associated with change in fat mass (β = 0.133, p < 0.001; β = 0.017, p < 0.001) and insulin resistance (β = 0.095, p = 0.024; β = 0.020, p = 0.001). Change in lean mass was not associated with any of the biomarkers.nnCONCLUSION: 13 weeks of combined lifestyle intervention, either with or without protein drink, reduced circulating adipokines and anti-inflammatory cytokine IL-1RA, and increased inflammatory ratios TNF-α/IL-10 and TNF-α/IL-1RA in older adults with obesity and T2D. Effect on CLIP was inversely related to baseline inflammatory status.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38701709,

title = {Identification of factors associated with sarcopenic obesity development: Literature review and expert panel voting},

author = {A Pinel and C Guillet and F Capel and M Pouget and M De Antonio and B Pereira and E Topinkova and D Eglseer and R Barazzoni and A J Cruz-Jentoft and J D Schoufour and P J M Weijs and Y Boirie},

doi = {10.1016/j.clnu.2024.04.033},

issn = {1532-1983},

year  = {2024},

date = {2024-06-01},

journal = {Clin Nutr},

volume = {43},

number = {6},

pages = {1414--1424},

abstract = {Sarcopenic obesity (SO) is defined as the combination of excess fat mass (obesity) and low skeletal muscle mass and function (sarcopenia). The identification and classification of factors related to SO would favor better prevention and diagnosis. The present article aimed to (i) define a list of factors related with SO based on literature analysis, (ii) identify clinical conditions linked with SO development from literature search and (iii) evaluate their relevance and the potential research gaps by consulting an expert panel. From 4746 articles screened, 240 articles were selected for extraction of the factors associated with SO. Factors were classified according to their frequency in the literature. Clinical conditions were also recorded. Then, they were evaluated by a panel of expert for evaluation of their relevance in SO development. Experts also suggested additional factors. Thirty-nine unique factors were extracted from the papers and additional eleven factors suggested by a panel of experts in the SO field. The frequency in the literature showed insulin resistance, dyslipidemia, lack of exercise training, inflammation and hypertension as the most frequent factors associated with SO whereas experts ranked low spontaneous physical activity, protein and energy intakes, low exercise training and aging as the most important. Although literature and expert panel presented some differences, this first list of associated factors could help to identify patients at risk of SO. Further work is needed to confirm the contribution of factors associated with SO among the population overtime or in randomized controlled trials to demonstrate causality.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36165036,

title = {Lifestyle and health changes in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application},

author = {Dirk Hoevenaars and Jasmijn F M Holla and Sonja de Groot and Peter J M Weijs and Wessel Kraaij and Thomas W J Janssen},

doi = {10.1080/17483107.2022.2115563},

issn = {1748-3115},

year  = {2024},

date = {2024-04-01},

journal = {Disabil Rehabil Assist Technol},

volume = {19},

number = {3},

pages = {648--657},

abstract = {PURPOSE: The aim of this study was to determine changes in physical activity, nutrition, sleep behaviour and body composition in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application (app).nnMETHODS: A 12-week pre-post intervention study was performed, starting with a 1-week control period. Physical activity and sleep behaviour were continuously measured with a Fitbit charge 3. Self-reported nutritional intake, body mass and waist circumference were collected. Pre-post outcomes were compared with a paired-sample t-test or Wilcoxon signed-rank test. Fitbit data were analysed with a mixed model or a panel linear model. Effect sizes were determined and significance was accepted at  < .05.nnRESULTS: Thirty participants completed the study. No significant changes in physical activity (+1.5 √steps) and sleep quality (-9.7 sleep minutes; -1.2% sleep efficiency) were found. Significant reduction in energy (-1022 kJ,  = 0.71), protein (-8.3 g,  = 0.61) and fat (-13.1 g,  = 0.87) intake, body mass (-2.2 kg,  = 0.61) and waist circumference (-3.3 cm,  = 0.80) were found.nnCONCLUSION: Positive changes were found in nutritional behaviour and body composition, but not in physical activity and sleep quality. The WHEELS app seems to partly support healthy lifestyle behaviour.Implications for RehabilitationHealthy lifestyle promotion is crucial, especially for wheelchair users as they tend to show poorer lifestyle behaviour despite an increased risk of obesity and comorbidity.The WHEELS lifestyle app seems to be a valuable tool to support healthy nutrition choices and weight loss and to improve body satisfaction, mental health and vitality.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38526491,

title = {Sarcopenia and Sarcopenic Obesity and Mortality Among Older People},

author = {Elizabeth Benz and Alexandre Pinel and Christelle Guillet and Frederic Capel and Bruno Pereira and Marie De Antonio and Melanie Pouget and Alfonso J Cruz-Jentoft and Doris Eglseer and Eva Topinkova and Rocco Barazzoni and Fernando Rivadeneira and M Arfan Ikram and Marinka Steur and Trudy Voortman and Josje D Schoufour and Peter J M Weijs and Yves Boirie},

doi = {10.1001/jamanetworkopen.2024.3604},

issn = {2574-3805},

year  = {2024},

date = {2024-03-01},

journal = {JAMA Netw Open},

volume = {7},

number = {3},

pages = {e243604},

abstract = {IMPORTANCE: Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited.nnOBJECTIVE: To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality.nnDESIGN, SETTING, AND PARTICIPANTS: This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023.nnEXPOSURES: The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength.nnMAIN OUTCOME AND MEASURE: The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022.nnRESULTS: In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater.nnCONCLUSIONS AND RELEVANCE: In this study, sarcopenia and SO were found to be prevalent phenotypes in older people and were associated with all-cause mortality. Additional alterations of BC amplified this risk independently of age, sex, and BMI. The use of low muscle strength as a first step of both diagnoses may allow for early identification of individuals at risk for premature mortality.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38413171,

title = {Long-term effectiveness of a lifestyle intervention for rheumatoid arthritis and osteoarthritis: 1-year follow-up of the 'Plants for Joints' randomised clinical trial},

author = {Carlijn A Wagenaar and Wendy Walrabenstein and Marike van der Leeden and Franktien Turkstra and Martijn Gerritsen and Jos W R Twisk and Maarten Boers and Martin van der Esch and Henriët van Middendorp and Peter J M Weijs and Dirkjan van Schaardenburg},

doi = {10.1136/rmdopen-2023-004025},

issn = {2056-5933},

year  = {2024},

date = {2024-02-01},

journal = {RMD Open},

volume = {10},

number = {1},

abstract = {OBJECTIVES: In two randomised controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. The current study investigated long-term outcomes.nnMETHODS: After completion of two 16-week trials in people with (1) RA or (2) MSOA, control groups switched to the active PFJ intervention. At the end of the intervention, all participants were followed up in a 1-year observational extension study. Primary outcomes were 28-joint Disease Activity Score (DAS28) (RA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes and intervention adherence. An intention-to-treat analysis with a linear mixed model was used to analyse within-group changes.nnRESULTS: 65 (84%) of 77 RA participants and 49 (77%) of 64 MSOA participants completed the extension study. The effects of the PFJ intervention were replicated in the original control groups and sustained within the RA group a year after intervention completion (mean DAS28 -0.9 points; p<0.001), while in the MSOA group mean WOMAC increased towards but remained well under the starting value (-7.8 points, p<0.001). Improvements in C-reactive protein, waist circumference (RA and MSOA); low-density lipoprotein cholesterol (RA); and weight, haemoglobin A1c, blood pressure (MSOA) were also sustained. Participants had a net decrease of medication, and intervention adherence was largely sustained.nnCONCLUSIONS: A year after the PFJ lifestyle intervention, improvements of disease activity and metabolic outcomes within RA and MSOA groups were largely sustained and related to sustained adherence, with a net decrease of medication.nnTRIAL REGISTRATION NUMBERS: NL7800, NL7801.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38337689,

title = {The Impact of Combined Nutrition and Exercise Interventions in Patients with Chronic Kidney Disease},

author = {Manon de Geus and Manouk Dam and Wesley J Visser and Karin J R Ipema and Anneke M E de Mik-van Egmond and Michael Tieland and Peter J M Weijs and Hinke M Kruizenga},

doi = {10.3390/nu16030406},

issn = {2072-6643},

year  = {2024},

date = {2024-01-01},

journal = {Nutrients},

volume = {16},

number = {3},

abstract = {Combined nutrition and exercise interventions potentially improve protein-energy wasting/malnutrition-related outcomes in patients with chronic kidney disease (CKD). The aim was to systematically review the effect of combined interventions on nutritional status, muscle strength, physical performance and QoL. MEDLINE, Cochrane, Embase, Web of Science and Google Scholar were searched for studies up to the date of July 2023. Methodological quality was appraised with the Cochrane risk-of-bias tool. Ten randomized controlled trials (nine publications) were included (334 patients). No differences were observed in body mass index, lean body mass or leg strength. An improvement was found in the six-minute walk test (6-MWT) ( = 3, MD 27.2, 95%CI [7 to 48],  = 0.008), but not in the timed up-and-go test. No effect was found on QoL. A positive impact on 6-MWT was observed, but no improvements were detected in nutritional status, muscle strength or QoL. Concerns about reliability and generalizability arise due to limited statistical power and study heterogeneity of the studies included.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38140387,

title = {Malnutrition Screening Tools Are Not Sensitive Enough to Identify Older Hospital Patients with Malnutrition},

author = {Carliene van Dronkelaar and Michael Tieland and Tommy Cederholm and Esmee M Reijnierse and Peter J M Weijs and Hinke Kruizenga},

doi = {10.3390/nu15245126},

issn = {2072-6643},

year  = {2023},

date = {2023-12-01},

journal = {Nutrients},

volume = {15},

number = {24},

abstract = {This study evaluates the concurrent validity of five malnutrition screening tools to identify older hospitalized patients against the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria as limited evidence is available. The screening tools Short Nutritional Assessment Questionnaire (SNAQ), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Patient-Generated Subjective Global Assessment-Short Form (PG-SGA-SF) with cut-offs for both malnutrition (conservative) and moderate malnutrition or risk of malnutrition (liberal) were used. The concurrent validity was determined by the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the level of agreement by Cohen's kappa. In total, 356 patients were included in the analyses (median age 70 y (IQR 63-77); 54% male). The prevalence of malnutrition according to the GLIM criteria without prior screening was 42%. The conservative cut-offs showed a low-to-moderate sensitivity (32-68%) and moderate-to-high specificity (61-98%). The PPV and NPV ranged from 59 to 94% and 67-86%, respectively. The Cohen's kappa showed poor agreement (k = 0.21-0.59). The liberal cut-offs displayed a moderate-to-high sensitivity (66-89%) and a low-to-high specificity (46-95%). The agreement was fair to good (k = 0.33-0.75). The currently used screening tools vary in their capacity to identify hospitalized older patients with malnutrition. The screening process in the GLIM framework requires further consideration.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37862825,

title = {High protein provision of more than 1.2 g/kg improves muscle mass preservation and mortality in ICU patients: A systematic review and meta-analyses},

author = {Isabel M van Ruijven and José Abma and Anja H Brunsveld-Reinders and Sandra N Stapel and Faridi van Etten-Jamaludin and Yves Boirie and Rocco Barazzoni and Peter J M Weijs},

doi = {10.1016/j.clnu.2023.09.026},

issn = {1532-1983},

year  = {2023},

date = {2023-12-01},

journal = {Clin Nutr},

volume = {42},

number = {12},

pages = {2395--2403},

abstract = {BACKGROUND: ICU patients lose muscle mass rapidly and maintenance of muscle mass may contribute to improved survival rates and quality of life. Protein provision may be beneficial for preservation of muscle mass and other clinical outcomes, including survival. Current protein recommendations are expert-based and range from 1.2 to 2.0 g/kg. Thus, we performed a systematic review and meta-analysis on protein provision and all clinically relevant outcomes recorded in the available literature.nnMETHODS: We conducted a systematic review and meta-analyses, including studies of all designs except case control and case studies, with patients aged ≥18 years with an ICU stay of ≥2 days and a mean protein provision group of ≥1.2 g/kg as compared to <1.2 g/kg with a difference of ≥0.2 g/kg between protein provision groups. All clinically relevant outcomes were studied. Meta-analyses were performed for all clinically relevant outcomes that were recorded in ≥3 included studies.nnRESULTS: A total of 29 studies published between 2012 and 2022 were included. Outcomes reported in the included studies were ICU, hospital, 28-day, 30-day, 42-day, 60-day, 90-day and 6-month mortality, ICU and hospital length of stay, duration of mechanical ventilation, vomiting, diarrhea, gastric residual volume, pneumonia, overall infections, nitrogen balance, changes in muscle mass, destination at hospital discharge, physical performance and psychological status. Meta-analyses showed differences between groups in favour of high protein provision for 60-day mortality, nitrogen balance and changes in muscle mass.nnCONCLUSION: High protein provision of more than 1.2 g/kg in critically ill patients seemed to improve nitrogen balance and changes in muscle mass on the short-term and likely 60-day mortality. Data on long-term effects on quality of life are urgently needed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37328047,

title = {A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the "Plants for Joints" randomized controlled trial},

author = {Wendy Walrabenstein and Carlijn A Wagenaar and Marieke van de Put and Marike van der Leeden and Martijn Gerritsen and Jos W R Twisk and Martin van der Esch and Henriët van Middendorp and Peter J M Weijs and Leo D Roorda and Dirkjan van Schaardenburg},

doi = {10.1016/j.joca.2023.05.014},

issn = {1522-9653},

year  = {2023},

date = {2023-11-01},

journal = {Osteoarthritis Cartilage},

volume = {31},

number = {11},

pages = {1491--1500},

abstract = {OBJECTIVE: To determine the effectiveness of the "Plants for Joints" multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).nnDESIGN: Patients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0-96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.nnRESULTS: Of the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6-16; p = 0.0001) compared to the control group. The intervention group also lost more weight (-5 kg), fat mass (-4 kg), and waist circumference (-6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.nnCONCLUSION: The "Plants for Joints" lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37116438,

title = {Visceral obesity measured using computed tomography scans: No significant association with mortality in critically ill patients},

author = {Michelle R Baggerman and Ingeborg M Dekker and Bjorn Winkens and Steven W M Olde Damink and Sandra N Stapel and Peter J M Weijs and Marcel C G van de Poll},

doi = {10.1016/j.jcrc.2023.154316},

issn = {1557-8615},

year  = {2023},

date = {2023-10-01},

journal = {J Crit Care},

volume = {77},

pages = {154316},

abstract = {INTRODUCTION: The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients.nnMETHOD: In 555 critically ill patients (68% male), the VAT Index(VATI) was measured using Computed Tomography scans on the level of vertebra L3. The association between visceral obesity, BMI and 90-day mortality was investigated using univariable and multivariable analyses, correcting for age, sex, APACHE II score, sarcopenia and muscle quality.nnRESULTS: Visceral obesity was present in 48.1% of the patients and its prevalence was similar in males and females. Mortality was similar amongst patients with and without visceral obesity (27.7% vs 24.0%, p = 0.31). The corrected odds ratio of 90-day mortality for visceral obesity was 0.667 (95%CI 0.424-1.049, p = 0.080). Using normal BMI as reference, the corrected odds ratio for overweight was 0.721 (95%CI 0.447-1.164 p = 0.181) and for obesity 0.462 (95%CI 0.208-1.027, p = 0.058).nnCONCLUSION: No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37249818,

title = {Effects of Nutrition and Exercise Interventions on Persons with Sarcopenic Obesity: An Umbrella Review of Meta-Analyses of Randomised Controlled Trials},

author = {Lea Reiter and Silvia Bauer and Mariella Traxler and Josje D Schoufour and Peter J M Weijs and Alfonso Cruz-Jentoft and Eva Topinková and Doris Eglseer},

doi = {10.1007/s13679-023-00509-0},

issn = {2162-4968},

year  = {2023},

date = {2023-09-01},

journal = {Curr Obes Rep},

volume = {12},

number = {3},

pages = {250--263},

abstract = {BACKGROUND: Sarcopenic obesity (SO) is an increasing phenomenon and has been linked to several negative health consequences. The aim of this umbrella review is the assessment of effectiveness and certainty of evidence of nutrition and exercise interventions in persons with SO.nnMETHOD: We searched for meta-analyses of RCTs in PubMed, EMBASE and CENTRAL that had been conducted in the last five years, focusing on studies on the treatment and prevention of SO. The primary endpoints were parameters for SO, such as body fat in %, skeletal muscle mass index (SMMI), gait speed, leg strength and grip strength. The methodological quality was evaluated using AMSTAR and the certainty of evidence was assessed using GRADE.nnRESULTS: Four systematic reviews with between 30 to 225 participants were included in the umbrella review. These examined four exercise interventions, two nutrition interventions and four interventions that combined nutrition and exercise. Resistance training was the most frequently studied intervention and was found to improve gait speed by 0.14 m/s to 0.17 m/s and lower leg strength by 9.97 kg. Resistance, aerobic, mixed exercise and hypocaloric diet combined with protein supplementation is not significantly effective on selected outcomes for persons with SO compared to no intervention. The low number of primary studies included in the reviews resulted in moderate to very low certainty of evidence.nnCONCLUSION: Despite the lack in certainty of evidence, resistance training may be a suitable intervention for persons with SO, in particular for improving muscle function. Nevertheless, further research is necessary to strengthen the evidence.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37355247,

title = {Minerals and Sarcopenia in Older Adults: An Updated Systematic Review},

author = {Carliene van Dronkelaar and Maaike Fultinga and Mitchell Hummel and Hinke Kruizenga and Peter J M Weijs and Michael Tieland},

doi = {10.1016/j.jamda.2023.05.017},

issn = {1538-9375},

year  = {2023},

date = {2023-08-01},

journal = {J Am Med Dir Assoc},

volume = {24},

number = {8},

pages = {1163--1172},

abstract = {OBJECTIVE: This systematic review aims to reevaluate the role of minerals on muscle mass, muscle strength, physical performance, and the prevalence of sarcopenia in community-dwelling and institutionalized older adults.nnDESIGN: Systematic review.nnSETTING AND PARTICIPANTS: In March 2022, a systematic search was performed in PubMed, Scopus, and Web of Sciences using predefined search terms. Original studies on dietary mineral intake or mineral serum blood concentrations on muscle mass, muscle strength, and physical performance or the prevalence of sarcopenia in older adults (average age ≥65 years) were included.nnMETHODS: Eligibility screening and data extraction was performed by 2 independent reviewers. Quality assessment was performed with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Risk of bias was evaluated using the Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) tool.nnRESULTS: From the 15,622 identified articles, a total of 45 studies were included in the review, mainly being cross-sectional and observational studies. Moderate quality of evidence showed that selenium (n = 8) and magnesium (n = 7) were significantly associated with muscle mass, strength, and physical performance as well as the prevalence of sarcopenia. For calcium and zinc, no association could be found. For potassium, iron, sodium, and phosphorus, the association with sarcopenic outcomes remains unclear as not enough studies could be included or were nonconclusive (low quality of evidence).nnCONCLUSIONS AND IMPLICATIONS: This systematic review shows a potential role for selenium and magnesium on the prevention and treatment of sarcopenia in older adults. More randomized controlled trials are warranted to determine the impact of minerals on sarcopenia in older adults.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36617162,

title = {A multidisciplinary lifestyle program for rheumatoid arthritis: the 'Plants for Joints' randomized controlled trial},

author = {Wendy Walrabenstein and Carlijn A Wagenaar and Marike van der Leeden and Franktien Turkstra and Jos W R Twisk and Maarten Boers and Henriët van Middendorp and Peter J M Weijs and Dirkjan van Schaardenburg},

doi = {10.1093/rheumatology/keac693},

issn = {1462-0332},

year  = {2023},

date = {2023-08-01},

journal = {Rheumatology (Oxford)},

volume = {62},

number = {8},

pages = {2683--2691},

abstract = {OBJECTIVE: To determine the effect of a multidisciplinary lifestyle program in patients with RA with low-moderate disease activity.nnMETHODS: In the 'Plants for Joints' (PFJ) parallel-arm, assessor-blind randomized controlled trial, patients with RA and 28-joint DAS (DAS28) ≥2.6 and ≤5.1 were randomized to the PFJ or control group. The PFJ group followed a 16-week lifestyle program based on a whole-food plant-based diet, physical activity and stress management. The control group received usual care. Medication was kept stable 3 months before and during the trial whenever possible. We hypothesized that PFJ would lower disease activity (DAS28). Secondary outcomes included anthropometric, metabolic and patient-reported measures. An intention-to-treat analysis with a linear mixed model adjusted for baseline values was used to analyse between-group differences.nnRESULTS: Of the 83 people randomized, 77 completed the study. Participants were 92% female with mean (s.d.) age of 55 (12) years, BMI of 26 (4) kg/m2 and mean DAS28 of 3.8 (0.7). After 16 weeks the PFJ group had a mean 0.9-point greater improvement of DAS28 vs the control group (95% CI 0.4, 1.3; P < 0.0001). The PFJ intervention led to greater decreases in body weight (difference -3.9 kg), fat mass (-2.8 kg), waist circumference (-3 cm), HbA1c (-1.3 mmol/mol) and low-density lipoprotein (-0.32 mmol/l), whereas patient-reported outcome measures, blood pressure, glucose and other lipids did not change.nnCONCLUSION: The 16-week PFJ multidisciplinary lifestyle program substantially decreased disease activity and improved metabolic status in people with RA with low-moderate disease activity.nnTRIAL REGISTRATION: International Clinical Trials Registry Platform; https://www.who.int/clinical-trials-registry-platform; NL7800.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36882046,

title = {Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis},

author = {Doris Eglseer and Mariella Traxler and Josje D Schoufour and Peter J M Weijs and Trudy Voortman and Yves Boirie and Alfonso J Cruz-Jentoft and Lea Reiter and Silvia Bauer and },

doi = {10.1093/nutrit/nuad007},

issn = {1753-4887},

year  = {2023},

date = {2023-08-01},

journal = {Nutr Rev},

volume = {81},

number = {9},

pages = {1077--1090},

abstract = {CONTEXT: Retirement is an opportune time for people to establish new healthy routines. Exercise and nutritional interventions are promising in the prevention and treatment of sarcopenic obesity.nnOBJECTIVE: This systematic review aimed.nnto assess the effectiveness of nutritional and exercise interventions for the treatment of sarcopenic obesity in persons of retirement age.nnDATA SOURCES: PubMed, Embase, CINAHL, and CENTRAL databases were searched in September 2021 for randomized controlled trials; a manual search was also conducted. The search yielded 261 studies, of which 11 were eligible for inclusion.nnDATA EXTRACTION: Studies of community-dwelling individuals with sarcopenic obesity receiving any nutritional or exercise intervention ≥ 8 weeks with the mean age  ±  standard deviation between 50 and 70 years were included. Primary endpoint was body composition, and secondary endpoints were body mass index, muscle strength, and physical function. The literature review, study selection, data extraction, and risk-of-bias assessment were performed by two reviewers independently. Data were pooled for meta-analysis when possible.nnRESULTS: Meta-analysis was only possible for the exposure "resistance training" and the exposure "training (resistance or aerobic)" in combination with the exposure "added protein" as compared with "no intervention" or "training alone." Resistance training led to a significant body fat reduction of -1.53% (95%CI, -2.91 to -0.15), an increase in muscle mass of 2.72% (95%CI, 1.23-4.22), an increase in muscle strength of 4.42 kg (95%CI, 2.44-6.04), and a slight improvement in gait speed of 0.17 m/s (95%CI, 0.01-0.34). Protein combined with an exercise intervention significantly reduces fat mass (-0.80 kg; 95%CI, -1.32 to -0.28). Some individual studies of dietary or food supplement interventions for which data could not be pooled showed positive effects on body composition.nnCONCLUSION: Resistance training is an effective treatment for persons of retirement age with sarcopenic obesity. Increased protein intake combined with exercise may increase reductions in fat mass.nnSYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021276461.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36997475,

title = {Additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes: A systematic review and meta-analysis},

author = {Robert G Memelink and Mitchell Hummel and Aveline Hijlkema and Martinet T Streppel and Ivan Bautmans and Peter J M Weijs and Kirsten A Berk and Michael Tieland},

doi = {10.1111/dme.15096},

issn = {1464-5491},

year  = {2023},

date = {2023-07-01},

journal = {Diabet Med},

volume = {40},

number = {7},

pages = {e15096},

abstract = {AIMS: This systematic review and meta-analysis evaluates the additional effect of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes.nnMETHODS: Embase, Medline, Web of Science and Cochrane Central databases were evaluated, and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone.nnRESULTS: Exercise interventions consisted of walking or jogging, cycle ergometer training, football training or resistance training and duration varied from 2 to 52 weeks. Body weight and measures of body composition and glycaemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (-0.77 kg [95% CI: -2.03; 0.50]), BMI (-0.34 kg/m [95% CI: -0.73; 0.05]), waist circumference (-1.42 cm [95% CI: -3.84; 1.00]), fat-free mass (-0.18 kg [95% CI: -0.52; 0.17]), fat mass (-1.61 kg [95% CI: -4.42; 1.19]), fasting glucose (+0.14 mmol/L [95% CI: -0.02; 0.30]), HbA (-1 mmol/mol [95% CI: -3; 1], -0.1% [95% CI: -0.2; 0.1]) and HOMA-IR (+0.01 [95% CI: -0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO and showed significant increases upon the addition of exercise to hypocaloric diet.nnCONCLUSIONS: Based on limited data, we did not find additional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes on body weight, body composition or glycaemic control, while cardio-respiratory fitness improved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37337234,

title = {The impact of high versus standard enteral protein provision on functional recovery following intensive care admission (PRECISE trial): study protocol for a randomized controlled, quadruple blinded, multicenter, parallel group trial in mechanically ventilated patients},

author = {Rob J J van Gassel and Julia L M Bels and Katrien Tartaglia and Bas C T van Bussel and Sander M J van Kuijk and Adam M Deane and Zudin Puthucheary and Peter J M Weijs and Lilian Vloet and Bert Beishuizen and Ashley De Bie Dekker and Vincent Fraipont and Stoffel Lamote and Didier Ledoux and Clarissa Scheeren and Elisabeth De Waele and Arthur R H van Zanten and Dieter Mesotten and Marcel C G van de Poll},

doi = {10.1186/s13063-023-07380-3},

issn = {1745-6215},

year  = {2023},

date = {2023-06-01},

journal = {Trials},

volume = {24},

number = {1},

pages = {416},

abstract = {BACKGROUND: Critically ill patients are subject to severe skeletal muscle wasting during intensive care unit (ICU) stay, resulting in impaired short- and long-term functional outcomes and health-related quality of life. Increased protein provision may improve functional outcomes in ICU patients by attenuating skeletal muscle breakdown. Supporting evidence is limited however and results in great variety in recommended protein targets.nnMETHODS: The PRECISe trial is an investigator-initiated, bi-national, multi-center, quadruple-blinded randomized controlled trial with a parallel group design. In 935 patients, we will compare provision of isocaloric enteral nutrition with either a standard or high protein content, providing 1.3 or 2.0 g of protein/kg/day, respectively, when fed on target. All unplanned ICU admissions with initiation of invasive mechanical ventilation within 24 h of admission and an expected stay on ventilator support of at least 3 days are eligible. The study is designed to assess the effect of the intervention on functional recovery at 1, 3, and 6 months following ICU admission, including health-related quality of life, measures of muscle strength, physical function, and mental health. The primary endpoint of the trial is health-related quality of life as measured by the Euro-QoL-5D-5-level questionnaire Health Utility Score. Overall between-group differences will be assessed over the three time points using linear mixed-effects models.nnDISCUSSION: The PRECISe trial will evaluate the effect of protein on functional recovery including both patient-centered and muscle-related outcomes.nnTRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04633421 . Registered on November 18, 2020. First patient in (FPI) on November 19, 2020. Expected last patient last visit (LPLV) in October 2023.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36228281,

title = {Optimization of Protocols Using Neuromuscular Electrical Stimulation for Paralyzed Lower-Limb Muscles to Increase Energy Expenditure in People With Spinal Cord Injury},

author = {Yiming Ma and Sonja de Groot and Ad Vink and Wouter Harmsen and Christof A J Smit and Janneke M Stolwijk-Swuste and Peter J M Weijs and Thomas W J Janssen},

doi = {10.1097/PHM.0000000000002120},

issn = {1537-7385},

year  = {2023},

date = {2023-06-01},

journal = {Am J Phys Med Rehabil},

volume = {102},

number = {6},

pages = {489--497},

abstract = {OBJECTIVE: The aim of this study was to evaluate whether using surface neuromuscular electrical stimulation (NMES) for paralyzed lower-limb muscles results in an increase in energy expenditure and whether the number of activated muscles and duty cycle affect the potential increase.nnDESIGN: This was a cross-sectional study.nnRESULTS: Energy expenditure during all NMES protocols was significantly higher than the condition without NMES (1.2 ± 0.2 kcal/min), with the highest increase (+51%; +0.7 kcal/min, 95% confidence interval, 0.3-1.2) for the protocol with more muscles activated and the duty cycle with a shorter rest period. A significant decrease in muscle contraction size during NMES was found with a longer stimulation time, more muscles activated, or the duty cycle with a shorter rest period.nnCONCLUSION: Using NMES for paralyzed lower-limb muscles can significantly increase energy expenditure compared with sitting without NMES, with the highest increase for the protocol with more muscles activated and the duty cycle with a shorter rest period. Muscle fatigue occurred significantly with the more intense NMES protocols, which might cause a lower energy expenditure in a longer protocol. Future studies should further optimize the NMES parameters and investigate the long-term effects of NMES on weight management in people with SCI.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37028708,

title = {Nutrition and Exercise Interventions to Improve Body Composition for Persons with Overweight or Obesity Near Retirement Age: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials},

author = {Doris Eglseer and Mariella Traxler and Stefan Embacher and Lea Reiter and Josje D Schoufour and Peter J M Weijs and Trudy Voortman and Yves Boirie and Alfonso Cruz-Jentoft and Silvia Bauer and },

doi = {10.1016/j.advnut.2023.04.001},

issn = {2156-5376},

year  = {2023},

date = {2023-05-01},

journal = {Adv Nutr},

volume = {14},

number = {3},

pages = {516--538},

abstract = {The retirement phase is an opportunity to integrate healthy (nutrition/exercise) habits into daily life. We conducted this systematic review to assess which nutrition and exercise interventions most effectively improve body composition (fat/muscle mass), body mass index (BMI), and waist circumference (WC) in persons with obesity/overweight near retirement age (ages 55-70 y). We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials, searching 4 databases from their inception up to July 12, 2022. The NMA was based on a random effects model, pooled mean differences, standardized mean differences, their 95% confidence intervals, and correlations with multi-arm studies. Subgroup and sensitivity analyses were also conducted. Ninety-two studies were included, 66 of which with 4957 participants could be used for the NMA. Identified interventions were clustered into 12 groups: no intervention, energy restriction (i.e., 500-1000 kcal), energy restriction plus high-protein intake (1.1-1.7 g/kg/body weight), intermittent fasting, mixed exercise (aerobic and resistance), resistance training, aerobic training, high protein plus resistance training, energy restriction plus high protein plus exercise, energy restriction plus resistance training, energy restriction plus aerobic training, and energy restriction plus mixed exercise. Intervention durations ranged from 8 wk to 6 mo. Body fat was reduced with energy restriction plus any exercise or plus high-protein intake. Energy restriction alone was less effective and tended to decrease muscle mass. Muscle mass was only significantly increased with mixed exercise. All other interventions including exercise effectively preserved muscle mass. A BMI and/or WC decrease was achieved with all interventions except aerobic training/resistance training alone or resistance training plus high protein. Overall, the most effective strategy for nearly all outcomes was combining energy restriction with resistance training or mixed exercise and high protein. Health care professionals involved in the management of persons with obesity need to be aware that an energy-restricted diet alone may contribute to sarcopenic obesity in persons near retirement age. This network meta-analysis is registered at https://www.crd.york.ac.uk/prospero/ as CRD42021276465.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37218833,

title = {Adherence of Older Cardiac Patients to a Home-Based Cardiac Rehabilitation Program},

author = {Dennis van Erck and Michel Terbraak and Christine D Dolman and Peter J M Weijs and José P Henriques and Ronak Delewi and Lotte Verweij and Patricia Jepma and Wilma J M Scholte Op Reimer and Josje D Schoufour},

doi = {10.3390/geriatrics8030053},

issn = {2308-3417},

year  = {2023},

date = {2023-05-01},

journal = {Geriatrics (Basel)},

volume = {8},

number = {3},

abstract = {Referral to home-based cardiac rehabilitation (HBCR) is low among older and frailer patients due to low expectations regarding adherence by healthcare professionals. The aim of this study was to determine adherence to HBCR when old and frail patients are referred, and to explore any differences in baseline characteristics between adherent and nonadherent patients. Data of the Cardiac Care Bridge were used (Dutch trial register NTR6316). The study included hospitalized cardiac patients ≥ 70 years old and at high risk of functional loss. Adherence to HBCR was confirmed when two-thirds of the intended nine sessions were followed. Of the 153 patients included (age: 82 ± 6 years, 54% female), 29% could not be referred due to death before referral, not returning home, or practical problems. Of the 109 patients who were referred, 67% adhered. Characteristics associated with non-adherence were older age (84 ± 6 vs. 82 ± 6,  = 0.05) and higher handgrip strength in men (33 ± 8 vs. 25 ± 11,  = 0.01). There was no difference in comorbidity, symptoms, or physical capacity. Based on these observations, most older cardiac patients who return home after hospital admission appear to adhere to HBCR after referral, suggesting that most older cardiac patients are motivated and capable of receiving HBCR.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35732588,

title = {Nutritional problems of patients with COVID-19 receiving dietetic treatment in primary care},

author = {Anne I Slotegraaf and Marian A E de van der Schueren and Nicolette J Wierdsma and Peter J M Weijs and Hinke M Kruizenga},

doi = {10.1111/jhn.13053},

issn = {1365-277X},

year  = {2023},

date = {2023-02-01},

journal = {J Hum Nutr Diet},

volume = {36},

number = {1},

pages = {20--30},

abstract = {BACKGROUND: The nutritional problems of patients who are hospitalised for COVID-19 are becoming increasingly clear. However, a large group of patients have never been hospitalised and also appear to experience persistent nutritional problems. The present study describes the nutritional status, risk of sarcopaenia and nutrition-related complaints of patients recovering from COVID-19 receiving dietetic treatment in primary care.nnMETHODS: In this retrospective observational study, data were collected during dietetic treatment by a primary care dietitian between April and December 2020. Both patients who had and had not been admitted to the hospital were included at their first visit to a primary care dietitian. Data on nutritional status, risk of sarcopaenia and nutrition-related complaints were collected longitudinally.nnRESULTS: Data from 246 patients with COVID-19 were collected. Mean ± SD age was 57 ± 16 years and 61% of the patient population was female. At first consultation, two thirds of patients were classified as overweight or obese (body mass index >25 kg m ). The majority had experienced unintentional weight loss because of COVID-19. Additionally, 55% of hospitalised and 34% of non-hospitalised patients had a high risk of sarcopaenia. Most commonly reported nutrition-related complaints were decreased appetite, shortness of breath, changed or loss of taste and feeling of being full. Nutrition-related complaints decreased after the first consultation, but remained present over time.nnCONCLUSIONS: In conclusion, weight changes, risk of sarcopaenia and nutrition-related complaints were prevalent in patients with COVID-19, treated by a primary care dietitian. Nutrition-related complaints improved over time, but remained prevalent until several months after infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36812263,

title = {Effect and process evaluation of a preschool-based intervention to promote an early childhood education and care teacher-parent partnership about healthy behaviours in children: Study protocol for the cluster randomised controlled trial CO-HEALTHY},

author = {Nicole Toussaint and Martinette T Streppel and Sandra Mul and Meryem Gündüz and Marloes D A van Verseveld and Mirka Janssen and Peter J M Weijs and Ruben G Fukkink},

doi = {10.1371/journal.pone.0281999},

issn = {1932-6203},

year  = {2023},

date = {2023-01-01},

journal = {PLoS One},

volume = {18},

number = {2},

pages = {e0281999},

abstract = {BACKGROUND: Early Childhood Education and Care (ECEC) teachers at urban preschools are potential key figures to promote healthy behaviours in disadvantaged young children and to engage parents in lifestyle-related topics. An ECEC teacher-parent partnership regarding healthy behaviours may support parents and stimulate their children's development. However, it is not an easy task to establish such a collaboration and ECEC teachers need tools to communicate with parents about lifestyle-related topics. This paper describes the study protocol of a preschool-based intervention (CO-HEALTHY) to promote an ECEC teacher-parent partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children.nnMETHODS: A cluster randomised controlled trial will be performed at preschools in Amsterdam, the Netherlands. Preschools will be randomly allocated to an intervention or control group. The intervention consists of a toolkit with 10 parent-child activities and associated training for ECEC teachers. The activities were composed using the Intervention Mapping protocol. At intervention preschools, ECEC teachers will carry out the activities during standard contact moments. Parents will receive associated intervention materials and will be encouraged to perform similar parent-child activities at home. At control preschools, the toolkit and training will not be implemented. The primary outcome will be the teacher- and parent-reported partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. The perceived partnership will be assessed by a questionnaire at baseline and at 6 months. In addition, short interviews with ECEC teachers will be held. Secondary outcomes include the knowledge, attitude, food- and activity-related practices of ECEC teachers and parents. Furthermore, children's eating, physical (in)activity and sleeping behaviours, and weight development will be assessed. A process evaluation of the intervention will be made.nnDISCUSSION: The intervention aims to provide a practical tool for ECEC teachers at urban preschools to promote an ECEC teacher-parent partnership regarding a healthy lifestyle in young children.nnTRIAL REGISTRATION: Netherlands Trial Register (NTR): NL8883. Date registered: September 8, 2020.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35780202,

title = {Predicting resting energy expenditure in people with chronic spinal cord injury},

author = {Yiming Ma and Sonja de Groot and Dirk Hoevenaars and Wendy Achterberg and Jacinthe Adriaansen and Peter J M Weijs and Thomas W J Janssen},

doi = {10.1038/s41393-022-00827-5},

issn = {1476-5624},

year  = {2022},

date = {2022-12-01},

journal = {Spinal Cord},

volume = {60},

number = {12},

pages = {1100--1107},

abstract = {STUDY DESIGN: Cross-sectional study.nnOBJECTIVES: The aims of this study were (1) to validate the two recently developed SCI-specific REE equations; (2) to develop new prediction equations to predict REE in a general population with SCI.nnSETTING: University, the Netherlands.nnMETHODS: Forty-eight community-dwelling men and women with SCI were recruited (age: 18-75 years, time since injury: ≥12 months). Body composition was measured by dual-energy X-ray absorptiometry (DXA), single-frequency bioelectrical impedance analysis (SF-BIA) and skinfold thickness. REE was measured by indirect calorimetry. Personal and lesion characteristics were collected. SCI-specific REE equations by Chun et al. [1] and by Nightingale and Gorgey [2] were validated. New equations for predicting REE were developed using multivariate regression analysis.nnRESULTS: Prediction equations by Chun et al. [1] and by Nightingale and Gorgey [2] significantly underestimated REE (Chun et al.: -11%; Nightingale and Gorgey: -11%). New equations were developed for predicting REE in the general population of people with SCI using FFM measured by SF-BIA and Goosey-Tolfrey et al. skinfold equation (R = 0.45-0.47; SEE = 200 kcal/day). The new equations showed proportional bias (p < 0.001) and wide limits of agreement (LoA, ±23%).nnCONCLUSIONS: Prediction equations by Chun et al. [1] and by Nightingale and Gorgey [2] significantly underestimated REE and showed large individual variations in a general population with SCI. The newly developed REE equations showed proportional bias and a wide LoA (±23%) which limit the predictive power and accuracy to predict REE in the general population with SCI. Alternative methods for measuring REE need to be investigated.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36501166,

title = {The Trajectory of Nutritional Status and Physical Activity before and after Transcatheter Aortic Valve Implantation},

author = {Dennis van Erck and Christine D Dolman and Wilma J M Scholte Op Reimer and José P Henriques and Peter J M Weijs and Ronak Delewi and Josje D Schoufour},

doi = {10.3390/nu14235137},

issn = {2072-6643},

year  = {2022},

date = {2022-12-01},

journal = {Nutrients},

volume = {14},

number = {23},

abstract = {It is suggested that older patients waiting for an elective surgical procedure have a poor nutritional status and low physical activity level. It is unknown if this hypothesis is true and if these conditions improve after a medical procedure. We aimed to determine the trajectory of both conditions before and after transcatheter aortic valve implantation (TAVI). Included patients (n = 112, age 81 ± 5 years, 58% male) received three home visits (preprocedural, one and six months postprocedural). Nutritional status was determined with the mini nutritional assessment—short form (MNA-SF) and physical activity using an ankle-worn monitor (Stepwatch). The median MNA-SF score was 13 (11−14), and 27% of the patients were at risk of malnutrition before the procedure. Physical activity was 6273 ± 3007 steps/day, and 69% of the patients did not meet the physical activity guidelines (>7100 steps/day). We observed that nutritional status and physical activity did not significantly change after the procedure (β 0.02 [95% CI −0.03, 0.07] points/months on the MNA-SF and β 16 [95% CI −47, 79] steps/month, respectively). To conclude, many preprocedural TAVI patients should improve their nutritional status or activity level. Both conditions do not improve naturally after a cardiac procedure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36615825,

title = {Nocturnal Hemodialysis Leads to Improvement in Physical Performance in Comparison with Conventional Hemodialysis},

author = {Manouk Dam and Peter J M Weijs and Frans J van Ittersum and Tiny Hoekstra and Caroline E Douma and Brigit C van Jaarsveld},

doi = {10.3390/nu15010168},

issn = {2072-6643},

year  = {2022},

date = {2022-12-01},

journal = {Nutrients},

volume = {15},

number = {1},

abstract = {End-stage kidney disease patients treated with conventional hemodialysis (CHD) are known to have impaired physical performance and protein-energy wasting (PEW). Nocturnal hemodialysis (NHD) was shown to improve clinical outcomes, but the evidence is limited on physical performance and PEW. We investigate whether NHD improves physical performance and PEW. This prospective, multicenter, non-randomized cohort study compared patients who changed from CHD (2−4 times/week 3−5 h) to NHD (2−3 times/week 7−8 h), with patients who continued CHD. The primary outcome was physical performance at 3, 6 and 12 months, assessed with the short physical performance battery (SPPB). Secondary outcomes were a 6-minute walk test (6MWT), physical activity monitor, handgrip muscle strength, KDQOL-SF physical component score (PCS) and LAPAQ physical activity questionnaire. PEW was assessed with a dietary record, dual-energy X-ray absorptiometry, bioelectrical impedance spectroscopy and subjective global assessment (SGA). Linear mixed models were used to analyze the differences between groups. This study included 33 patients on CHD and 32 who converted to NHD (mean age 55 ± 15.3). No significant difference was found in the SPPB after 1-year of NHD compared to CHD (+0.24, [95% confidence interval −0.51 to 0.99], p = 0.53). Scores of 6MWT, PCS and SGA improved (+54.3 [95%CI 7.78 to 100.8], p = 0.02; +5.61 [−0.51 to 10.7], p = 0.03; +0.71 [0.36 to 1.05], p < 0.001; resp.) in NHD patients, no changes were found in other parameters. We conclude that NHD patients did not experience an improved SPPB score compared to CHD patients; they did obtain an improved walking distance and self-reported PCS as well as SGA after 1-year of NHD, which might be related to the younger age of these patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36184246,

title = {GLIM-based malnutrition, protein intake and diet quality in preprocedural Transcatheter Aortic Valve Implantation (TAVI) patients},

author = {D van Erck and M Tieland and N W Adriaens and P J M Weijs and W J M Scholte Op Reimer and J P Henriques and J D Schoufour},

doi = {10.1016/j.clnesp.2022.08.028},

issn = {2405-4577},

year  = {2022},

date = {2022-10-01},

journal = {Clin Nutr ESPEN},

volume = {51},

pages = {481--485},

abstract = {BACKGROUND & AIMS: Diagnosed prevalence of malnutrition and dietary intake are currently unknown in patients with severe aortic stenosis planned to undergo Transcatheter Aortic Valve Implantation (TAVI). This study describes the preprocedural nutritional status, protein intake and diet quality.nnMETHODS: Consecutive preprocedural TAVI patients were asked to participate in this explorative study. Nutritional status was diagnosed with the global leadership initiative on malnutrition (GLIM) criteria. Preprocedural protein intake and diet quality were assessed with a three-day dietary record. To increase the record's validity, a researcher visited the participants at their homes to confirm the record. Protein intake was reported as an average intake of three days and diet quality was assessed using the Dutch dietary guidelines (score range 0-14, 1 point for adherence to each guideline).nnRESULTS: Of the included patients (n = 50, median age 80 ± 5, 56% male) 32% (n = 16) were diagnosed with malnutrition. Patients diagnosed with malnutrition had a lower protein intake (1.02 ± 0.28 g/kg/day vs 0.87 ± 0.21 g/kg/day, p = 0.04). The difference in protein intake mainly took place during lunch (20 ± 13 g/kg vs 13 ± 7 g/kg, p = 0.03). Patients adhered to 6.4 ± 2.2 out of 14 dietary guidelines. Adherence to the guideline of whole grains and ratio of whole grains was lower in the group of patients with malnutrition than in patients with normal nutritional status (both 62% vs 19%, p = 0.01). In a multivariate analysis diabetes mellitus was found as an independent predictor of malnutrition.nnCONCLUSION: Prevalence of malnutrition among TAVI patients is very high up to 32%. Patients with malnutrition had lower protein and whole grain intake than patients with normal nutritional status. Furthermore, we found diabetes mellitus as independent predictor of malnutrition. Nutrition interventions in this older patient group are highly warranted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35246601,

title = {Early high protein provision and mortality in ICU patients including those receiving continuous renal replacement therapy},

author = {Isabel M van Ruijven and Sandra N Stapel and Armand R J Girbes and Peter J M Weijs},

doi = {10.1038/s41430-022-01103-8},

issn = {1476-5640},

year  = {2022},

date = {2022-09-01},

journal = {Eur J Clin Nutr},

volume = {76},

number = {9},

pages = {1303--1308},

abstract = {BACKGROUND: Findings on the association between early high protein provision and mortality in ICU patients are inconsistent. The relation between early high protein provision and mortality in patients receiving CRRT remains unclear. The aim was to study the association between early high protein provision and hospital and ICU mortality and consistency in subgroups.nnMETHODS: A retrospective cohort study was conducted in 2618 ICU patients with a feeding tube and mechanically ventilated ≥48 h (2003-2016). The association between early high protein provision (≥1.2 g/kg/day at day 4 vs. <1.2 g/kg/day) and hospital and ICU mortality was assessed for the total group, for patients receiving CRRT, and for non-septic and septic patients, by Cox proportional hazards analysis. Adjustments were made for APACHE II score, energy provision, BMI, and age.nnRESULTS: Mean protein provision at day 4 was 0.96 ± 0.48 g/kg/day. A significant association between early high protein provision and lower hospital mortality was found in the total group (HR 0.48, 95% CI 0.39-0.60, p = <0.001), CRRT-receiving patients (HR 0.62, 95% CI 0.39-0.99, p = 0.045) and non-septic patients (HR 0.56, 95% CI 0.44-0.71, p = <0.001). However, no association was found in septic patients (HR 0.71, 95% CI 0.39-1.29, p = 0.264). These associations were very similar for ICU mortality. In a sensitivity analysis for patients receiving a relative energy provision >50%, results remained robust in all groups except for patients receiving CRRT.nnCONCLUSIONS: Early high protein provision is associated with lower hospital and ICU mortality in ICU patients, including CRRT-receiving patients. There was no association for septic patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35331517,

title = {Calculation of protein requirements; a comparison of calculations based on bodyweight and fat free mass},

author = {Ingeborg M Dekker and Natascha M van Rijssen and Amely Verreijen and Peter Jm Weijs and W B Elsbeth de Boer and Dominique Terpstra and Hinke M Kruizenga},

doi = {10.1016/j.clnesp.2022.01.014},

issn = {2405-4577},

year  = {2022},

date = {2022-04-01},

journal = {Clin Nutr ESPEN},

volume = {48},

pages = {378--385},

abstract = {BACKGROUND & AIMS: In dietary practice, it is common to estimate protein requirements on actual bodyweight, but corrected bodyweight (in cases with BMI <20 kg/m and BMI ≥30 kg/m) and fat free mass (FFM) are also used. Large differences on individual level are noticed in protein requirements using these different approaches. To continue this discussion, the answer is sought in a large population to the following question: Will choosing actual bodyweight, corrected bodyweight or FFM to calculate protein requirements result in clinically relevant differences?nnMETHODS: This retrospective database study, used data from healthy persons ≥55 years of age and in- and outpatients ≥18 years of age. FFM was measured by air displacement plethysmography technology or bioelectrical impedance analysis. Protein requirements were calculated as 1) 1.2 g (g) per kilogram (kg) actual bodyweight or 2) corrected bodyweight or 3) 1.5 g per kg FFM. To compare these three approaches, the approach in which protein requirement is based on FFM, was used as reference method. Bland-Altman plots with limits of agreement were used to determine differences, analyses were performed for both populations separately and stratified by BMI category and gender.nnRESULTS: In total 2291 subjects were included. In the population with relatively healthy persons (n = 506, ≥55 years of age) mean weight is 86.5 ± 18.2 kg, FFM is 51 ± 12 kg and in the population with adult in- and outpatients (n = 1785, ≥18 years of age) mean weight is 72.5 ± 18.4 kg, FFM is 51 ± 11 kg. Clinically relevant differences were found in protein requirement between actual bodyweight and FFM in most of the participants with overweight, obesity or severe obesity (78-100%). Using corrected bodyweight, an overestimation in 48-92% of the participants with underweight, healthy weight and overweight is found. Only in the Amsterdam UMC population, protein requirement is underestimated when using the approach of corrected bodyweight in participants with severe obesity.nnCONCLUSION: The three approaches in estimation of protein requirement show large differences. In the majority of the population protein requirement based on FFM is lower compared to actual or corrected bodyweight. Correction of bodyweight reduces the differences, but remain unacceptably large. It is yet unknown which method is the best for estimation of protein requirement. Since differences vary by gender due to differences in body composition, it seems more accurate to estimate protein requirement based on FFM. Therefore, we would like to advocate for more frequent measurement of FFM to determine protein requirements, especially when a deviating body composition is to be expected, for instance in elderly and persons with overweight, obesity or severe obesity.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32894680,

title = {Sarcopenia and its relation to protein intake across older ethnic populations in the Netherlands: the HELIUS study},

author = {Berber G Dorhout and Elvera Overdevest and Michael Tieland and Mary Nicolaou and Peter J M Weijs and Marieke B Snijder and Ron J G Peters and Irene G M van Valkengoed and Annemien Haveman-Nies and Lisette C P G M de Groot},

doi = {10.1080/13557858.2020.1814207},

issn = {1465-3419},

year  = {2022},

date = {2022-04-01},

journal = {Ethn Health},

volume = {27},

number = {3},

pages = {705--720},

abstract = {: To examine the prevalence of sarcopenia and its association with protein intake in men and women in a multi-ethnic population. We used cross-sectional data from the HELIUS (Healthy Life in an Urban Setting) study, which includes nearly 25,000 participants (aged 18-70 years) of Dutch, South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian ethnic origin. For the current study, we included 5161 individuals aged 55 years and older. Sarcopenia was defined according to the EWGSOP2. In a subsample ( = 1371), protein intake was measured using ethnic-specific Food Frequency Questionnaires. Descriptive analyses were performed to study sarcopenia prevalence across ethnic groups in men and women, and logistic regression analyses were used to study associations between protein intake and sarcopenia. Sarcopenia prevalence was found to be sex- and ethnic-specific, varying from 29.8% in Turkish to 61.3% in South-Asian Surinamese men and ranging from 2.4% in Turkish up to 30.5% in South-Asian Surinamese women. Higher protein intake was associated with a 4% lower odds of sarcopenia in the subsample (OR = 0.96, 95%-CI: 0.92-0.99) and across ethnic groups, being only significant in the South-Asian Surinamese group. Ethnic differences in the prevalence of sarcopenia and its association with protein intake suggest the need to target specific ethnic groups for prevention or treatment of sarcopenia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35331521,

title = {Computed tomography reference values for visceral obesity and increased metabolic risk in a Caucasian cohort},

author = {Michelle R Baggerman and Ingeborg M Dekker and Bjorn Winkens and Steven W M Olde Damink and Peter J M Weijs and Marcel C G van de Poll},

doi = {10.1016/j.clnesp.2022.01.009},

issn = {2405-4577},

year  = {2022},

date = {2022-04-01},

journal = {Clin Nutr ESPEN},

volume = {48},

pages = {408--413},

abstract = {BACKGROUND: Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography (CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue (VAT) and markers of increased metabolic risk.nnMETHODS: Visceral Adipose Tissue Area Index (VATI cm/m) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic (ROC) curves.nnRESULTS: In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs (p ≤ 0.013). In males and females respectively, a value of VATI of ≥38.7 cm/m and ≥24.9 cm/m was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC) = 0.702 vs AUC = 0.556 in males and AUC = 0.757 vs AUC = 0.630 in females).nnCONCLUSION: Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34385607,

title = {Accuracy of bioelectrical impedance analysis and skinfold thickness in the assessment of body composition in people with chronic spinal cord injury},

author = {Yiming Ma and Sonja de Groot and Peter J M Weijs and Wendy Achterberg and Jacinthe Adriaansen and Thomas W J Janssen},

doi = {10.1038/s41393-021-00682-w},

issn = {1476-5624},

year  = {2022},

date = {2022-03-01},

journal = {Spinal Cord},

volume = {60},

number = {3},

pages = {228--236},

abstract = {STUDY DESIGN: Cross-sectional study.nnOBJECTIVES: This study: (1) investigated the accuracy of bioelectrical impedance analysis (BIA) and skinfold thickness relative to dual-energy X-ray absorptiometry (DXA) in the assessment of body composition in people with spinal cord injury (SCI), and whether sex and lesion characteristics affect the accuracy, (2) developed new prediction equations to estimate fat free mass (FFM) and percentage fat mass (FM%) in a general SCI population using BIA and skinfolds outcomes.nnSETTING: University, the Netherlands.nnMETHODS: Fifty participants with SCI (19 females; median time since injury: 15 years) were tested by DXA, single-frequency BIA (SF-BIA), segmental multi-frequency BIA (segmental MF-BIA), and anthropometry (height, body mass, calf circumference, and skinfold thickness) during a visit. Personal and lesion characteristics were registered.nnRESULTS: Compared to DXA, SF-BIA showed the smallest mean difference in estimating FM%, but with large limits of agreement (mean difference = -2.2%; limits of agreement: -12.8 to 8.3%). BIA and skinfold thickness tended to show a better estimation of FM% in females, participants with tetraplegia, or with motor incomplete injury. New equations for predicting FFM and FM% were developed with good explained variances (FFM: R = 0.94; FM%: R = 0.66).nnCONCLUSIONS: None of the measurement techniques accurately estimated FM% because of the wide individual variation and, therefore, should be used with caution. The accuracy of the techniques differed in different subgroups. The newly developed equations for predicting FFM and FM% should be cross-validated in future studies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34997689,

title = {Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19},

author = {Madu N Soares and Moritz Eggelbusch and Elie Naddaf and Karin H L Gerrits and Marike van der Schaaf and Bram van den Borst and W Joost Wiersinga and Michele van Vugt and Peter J M Weijs and Andrew J Murray and Rob C I Wüst},

doi = {10.1002/jcsm.12896},

issn = {2190-6009},

year  = {2022},

date = {2022-02-01},

journal = {J Cachexia Sarcopenia Muscle},

volume = {13},

number = {1},

pages = {11--22},

abstract = {Skeletal muscle-related symptoms are common in both acute coronavirus disease (Covid)-19 and post-acute sequelae of Covid-19 (PASC). In this narrative review, we discuss cellular and molecular pathways that are affected and consider these in regard to skeletal muscle involvement in other conditions, such as acute respiratory distress syndrome, critical illness myopathy, and post-viral fatigue syndrome. Patients with severe Covid-19 and PASC suffer from skeletal muscle weakness and exercise intolerance. Histological sections present muscle fibre atrophy, metabolic alterations, and immune cell infiltration. Contributing factors to weakness and fatigue in patients with severe Covid-19 include systemic inflammation, disuse, hypoxaemia, and malnutrition. These factors also contribute to post-intensive care unit (ICU) syndrome and ICU-acquired weakness and likely explain a substantial part of Covid-19-acquired weakness. The skeletal muscle weakness and exercise intolerance associated with PASC are more obscure. Direct severe acute respiratory syndrome coronavirus (SARS-CoV)-2 viral infiltration into skeletal muscle or an aberrant immune system likely contribute. Similarities between skeletal muscle alterations in PASC and chronic fatigue syndrome deserve further study. Both SARS-CoV-2-specific factors and generic consequences of acute disease likely underlie the observed skeletal muscle alterations in both acute Covid-19 and PASC.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35634380,

title = {Evaluation of a Fully Automatic Deep Learning-Based Method for the Measurement of Psoas Muscle Area},

author = {Dennis Van Erck and Pim Moeskops and Josje D Schoufour and Peter J M Weijs and Wilma J M Scholte Op Reimer and Martijn S Van Mourik and Yvonne C Janmaat and R Nils Planken and Marije Vis and Jan Baan and Robert Hemke and Ivana Išgum and José P Henriques and Bob D De Vos and Ronak Delewi},

doi = {10.3389/fnut.2022.781860},

issn = {2296-861X},

year  = {2022},

date = {2022-01-01},

journal = {Front Nutr},

volume = {9},

pages = {781860},

abstract = {BACKGROUND: Manual muscle mass assessment based on Computed Tomography (CT) scans is recognized as a good marker for malnutrition, sarcopenia, and adverse outcomes. However, manual muscle mass analysis is cumbersome and time consuming. An accurate fully automated method is needed. In this study, we evaluate if manual psoas annotation can be substituted by a fully automatic deep learning-based method.nnMETHODS: This study included a cohort of 583 patients with severe aortic valve stenosis planned to undergo Transcatheter Aortic Valve Replacement (TAVR). Psoas muscle area was annotated manually on the CT scan at the height of lumbar vertebra 3 (L3). The deep learning-based method mimics this approach by first determining the L3 level and subsequently segmenting the psoas at that level. The fully automatic approach was evaluated as well as segmentation and slice selection, using average bias 95% limits of agreement, Intraclass Correlation Coefficient (ICC) and within-subject Coefficient of Variation (CV). To evaluate performance of the slice selection visual inspection was performed. To evaluate segmentation Dice index was computed between the manual and automatic segmentations (0 = no overlap, 1 = perfect overlap).nnRESULTS: Included patients had a mean age of 81  6 and 45% was female. The fully automatic method showed a bias and limits of agreement of -0.69 [-6.60 to 5.23] cm, an ICC of 0.78 [95% CI: 0.74-0.82] and a within-subject CV of 11.2% [95% CI: 10.2-12.2]. For slice selection, 84% of the selections were on the same vertebra between methods, bias and limits of agreement was 3.4 [-24.5 to 31.4] mm. The Dice index for segmentation was 0.93  0.04, bias and limits of agreement was -0.55 [1.71-2.80] cm.nnCONCLUSION: Fully automatic assessment of psoas muscle area demonstrates accurate performance at the L3 level in CT images. It is a reliable tool that offers great opportunities for analysis in large scale studies and in clinical applications.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35719168,

title = {Bio-Electrical Impedance Analysis: A Valid Assessment Tool for Diagnosis of Low Appendicular Lean Mass in Older Adults?},

author = {Jantine van den Helder and Amely M Verreijen and Carliene van Dronkelaar and Robert G Memelink and Mariëlle F Engberink and Raoul H H Engelbert and Peter J M Weijs and Michael Tieland},

doi = {10.3389/fnut.2022.874980},

issn = {2296-861X},

year  = {2022},

date = {2022-01-01},

journal = {Front Nutr},

volume = {9},

pages = {874980},

abstract = {BACKGROUND: The diagnosis of sarcopenia is essential for early treatment of sarcopenia in older adults, for which assessment of appendicular lean mass (ALM) is needed. Multi-frequency bio-electrical impedance analysis (MF-BIA) may be a valid assessment tool to assess ALM in older adults, but the evidences are limited. Therefore, we validated the BIA to diagnose low ALM in older adults.nnMETHODS: ALM was assessed by a standing-posture 8 electrode MF-BIA (Tanita MC-780) in 202 community-dwelling older adults (age ≥ 55 years), and compared with dual-energy X-ray absorptiometry (DXA) (Hologic Inc., Marlborough, MA, United States; DXA). The validity for assessing the absolute values of ALM was evaluated by: (1) bias (mean difference), (2) percentage of accurate predictions (within 5% of DXA values), (3) the mean absolute error (MAE), and (4) limits of agreement (Bland-Altman analysis). The lowest quintile of ALM by DXA was used as proxy for low ALM (< 22.8 kg for men, < 16.1 kg for women). Sensitivity and specificity of diagnosing low ALM by BIA were assessed.nnRESULTS: The mean age of the subjects was 72.1 ± 6.4 years, with a BMI of 25.4 ± 3.6 kg/m, and 71% were women. BIA slightly underestimated ALM compared to DXA with a mean bias of -0.6 ± 1.2 kg. The percentage of accurate predictions was 54% with a MAE of 1.1 kg, and limits of agreement were -3.0 to + 1.8 kg. The sensitivity for ALM was 80%, indicating that 80% of subjects who were diagnosed as low ALM according to DXA were also diagnosed low ALM by BIA. The specificity was 90%, indicating that 90% of subjects who were diagnosed as normal ALM by DXA were also diagnosed as normal ALM by the BIA.nnCONCLUSION: This comparison showed a poor validity of MF-BIA to assess the absolute values of ALM, but a reasonable sensitivity and specificity to recognize the community-dwelling older adults with the lowest muscle mass.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35669447,

title = {Interprofessional Treatment of Malnutrition and Sarcopenia by Dietitians and Physiotherapists: Exploring Attitudes, Interprofessional Identity, Facilitators, Barriers, and Occurrence},

author = {Jan-Jaap Reinders and Johannes S M Hobbelen and Michael Tieland and Peter J M Weijs and Harriët Jager-Wittenaar},

doi = {10.2147/JMDH.S358237},

issn = {1178-2390},

year  = {2022},

date = {2022-01-01},

journal = {J Multidiscip Healthc},

volume = {15},

pages = {1247--1260},

abstract = {PURPOSE: Malnutrition and sarcopenia require dietetic and physiotherapy interventions. In this study, we aimed to compare interprofessional identity of dietitians and physiotherapists, as well as attitudes towards, facilitators and barriers for, and occurrence of interprofessional treatment of malnutrition and sarcopenia by both professions.nnMETHODS: A cross-sectional online survey was distributed from December 4, 2021 until January 31, 2022 through an international online network platform for professionals (LinkedIn). Practitioners working as dietitian or physiotherapist in a healthcare setting were eligible for participation. Outcome measures concerned perceptions regarding shared problem domains, interprofessional treatment, attitudes towards interprofessional treatment, interprofessional identity, facilitators, and barriers. A Chi-test, Mann-Whitney -test, and Spearman's Rho correlation were calculated.nnRESULTS: Data from 53 physiotherapists and 48 dietitians were included. Malnutrition is considered a shared problem domain by both professions ( = 1248.000;  = 0.858). While sarcopenia is treated by both professions ( = 1260.000;  = 0.927), physiotherapists consider sarcopenia more often a shared problem domain compared to dietitians ( = 1003.000;  = 0.044). Attitudes towards interprofessional treatment were mostly positive (73%, n = 35 and 87%, n = 46 respectively). Interprofessional identity of dietitians was lower compared to physiotherapists (median = 4.0 versus median = 4.3 respectively;  = 875.000,  = 0.007). This was explained by lower interprofessional belonging (median = 4.0 versus median = 4.8 respectively;  = 771.000,  < 0.001) and lower interprofessional commitment (median = 4.0 versus median = 4.3 respectively;  = 942.500,  = 0.023). Interprofessional identity was correlated with efficient means of communication ( = 0.30,  = 0.003) and bureaucracy ( = -0.21,  = 0.034). Other barriers reported included available time, financial compensation, interprofessional knowledge, and obtaining extra care. Most reported facilitators concerned role clarity, clarity of expertise, and willingness of others to collaborate.nnCONCLUSION: Dietitians and physiotherapists have different interprofessional identities, but both are advocates of interprofessional treatment. Both professions mostly treat malnutrition and sarcopenia individually and have different perceptions regarding sarcopenia as shared problem domain. Facilitators were mainly related to clarity and commitment while barriers were mainly related to resources.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34373999,

title = {Physical activity, dietary intake and quality of life during COVID-19 lockdown in patients awaiting transcatheter aortic valve implantation},

author = {D van Erck and C D Dolman and M Snaterse and M Tieland and A H G Driessen and P J M Weijs and W J M Scholte Op Reimer and J P Henriques and J D Schoufour},

doi = {10.1007/s12471-021-01609-z},

issn = {1568-5888},

year  = {2021},

date = {2021-09-01},

journal = {Neth Heart J},

volume = {29},

number = {9},

pages = {460--467},

abstract = {BACKGROUND: The COVID-19 pandemic has led to a national lockdown in the Netherlands, which also affected transcatheter aortic valve implantation (TAVI) patients. The objective of the study was to describe physical activity, dietary intake and quality of life (QoL) in patients on the waiting list for TAVI pre-lockdown and during lockdown.nnMETHODS: Consecutive patients awaiting TAVI at the Amsterdam University Medical Centers, the Netherlands were included. Measurements were self-reported effect of lockdown, physical activity, dietary intake and QoL.nnRESULTS: In total, 58 patients (median age 80, interquartile range (IQR) 76-84, 45% female) were observed pre-lockdown and 16 patients (median age 78, IQR 76-82, 25% female) during lockdown. Ten of the 16 patients during lockdown reported a decline in physical activity. However, we observed a median number of 5861 steps a day (IQR 4579-7074) pre-lockdown and 8404 steps a day (IQR 7653-10,829) during lockdown. Median daily protein intake was 69 g (IQR 59-82) pre-lockdown and 90 g (IQR 68-107) during lockdown. Self-rated health on a visual analogue scale was 63 points (IQR 51-74) pre-lockdown and 73 points (IQR 65-86) during lockdown.nnCONCLUSIONS: More than half of the patients during lockdown reported less physical activity, while we observed a higher number of steps a day, a similar dietary intake and a higher QoL. Therefore, patients on the TAVI waiting list appeared to be able to cope with the lockdown measures.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33973896,

title = {Monitoring muscle mass using ultrasound: a key role in critical care},

author = {Isabel M van Ruijven and Sandra N Stapel and Jeroen Molinger and Peter J M Weijs},

doi = {10.1097/MCC.0000000000000846},

issn = {1531-7072},

year  = {2021},

date = {2021-08-01},

journal = {Curr Opin Crit Care},

volume = {27},

number = {4},

pages = {354--360},

abstract = {PURPOSE OF REVIEW: The loss of muscle mass in critically ill patients contributes to morbidity and mortality, and results in impaired recovery of physical functioning. The number of publications on the topic is increasing. However, there is a lack of consistent methodology and the most optimal methodology remains unclear, hampering its broad use in clinical practice.nnRECENT FINDINGS: There is a large variety of studies recently published on the use of ultrasound for assessment of muscle mass. A selection of studies has been made, focusing on monitoring of muscle mass (repeated measurements), practical aspects, feasibility and possible nutrition and physical therapy interventions. In this review, 14 new small (n = 19-121) studies are categorized and reviewed as individual studies.nnSUMMARY: The use of ultrasound in clinical practice is feasible for monitoring muscle mass in critically ill patients. Assessment of muscle mass by ultrasound is clinically relevant and adds value for guiding therapeutic interventions, such as nutritional and physical therapy interventions to maintain muscle mass and promote recovery in critically ill patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34330471,

title = {Are we overfeeding hemodialysis patients with protein? Exploring an alternative method to estimate protein needs},

author = {Manouk Dam and Eva Anne Hartman and Hinke Kruizenga and Brigit C van Jaarsveld and Peter J M Weijs},

doi = {10.1016/j.clnesp.2021.06.012},

issn = {2405-4577},

year  = {2021},

date = {2021-08-01},

journal = {Clin Nutr ESPEN},

volume = {44},

pages = {230--235},

abstract = {BACKGROUND & AIMS: Sufficient protein intake is of great importance in hemodialysis (HD) patients, especially for maintaining muscle mass. Daily protein needs are generally estimated using bodyweight (BW), in which individual differences in body composition are not accounted for. As body protein mass is best represented by fat free mass (FFM), there is a rationale to apply FFM instead of BW. The agreement between both estimations is unclear. Therefore, the aim of this study is to compare protein needs based on either FFM or BW in HD patients.nnMETHODS: Protein needs were estimated in 115 HD patients by three different equations; FFM, BW and BW adjusted for low or high BMI. FFM was measured by multi-frequency bioelectrical impedance spectroscopy and considered the reference method. Estimations of FFM x 1.5 g/kg and FFM x 1.9 g/kg were compared with (adjusted)BW x 1.2 and x 1.5, respectively. Differences were assessed with repeated measures ANOVA and Bland-Altman plots.nnRESULTS: Mean protein needs estimated by (adjusted)BW were higher compared to those based on FFM, across all BMI categories (P < 0.01) and most explicitly in obese patients. In females with BMI >30, protein needs were 69 ± 17.4 g/day higher based on BW and 45 ± 9.3 g/day higher based on BMI adjusted BW, compared to FFM. In males with BMI >30, protein needs were 51 ± 20.4 g/day and 23 ± 20.9 g/day higher compared to FFM, respectively.nnCONCLUSIONS: Our data show large differences and possible overestimations of protein needs when comparing BW to FFM. We emphasize the importance of more research and discussion on this topic.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34024542,

title = {Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission},

author = {Nicolette J Wierdsma and Hinke M Kruizenga and Lotte Aml Konings and Daphne Krebbers and Jolein Rmc Jorissen and Marie-Helene I Joosten and Loes H van Aken and Flora M Tan and Ad A van Bodegraven and Maarten R Soeters and Peter Jm Weijs},

doi = {10.1016/j.clnesp.2021.03.021},

issn = {2405-4577},

year  = {2021},

date = {2021-06-01},

journal = {Clin Nutr ESPEN},

volume = {43},

pages = {369--376},

abstract = {BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.nnMETHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.nnRESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.nnCONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33190355,

title = {A higher protein intake at breakfast and lunch is associated with a higher total daily protein intake in older adults: a post-hoc cross-sectional analysis of four randomised controlled trials},

author = {A M Verreijen and J van den Helder and M T Streppel and I Rotteveel and D Heman and C van Dronkelaar and R G Memelink and M F Engberink and M Visser and M Tieland and P J M Weijs},

doi = {10.1111/jhn.12838},

issn = {1365-277X},

year  = {2021},

date = {2021-04-01},

journal = {J Hum Nutr Diet},

volume = {34},

number = {2},

pages = {384--394},

abstract = {BACKGROUND: A protein intake of 30-40 g per meal is suggested to maximally stimulate muscle protein synthesis in older adults and could therefore contribute to the prevention of sarcopenia. Protein intake at breakfast and lunch is often low and offers a great opportunity to improve daily protein intake. Protein, however, is known for its satiating effects. Therefore, we explored the association between the amount of protein intake at breakfast and lunch and total daily protein intake in older adults.nnMETHODS: Protein intake was assessed by a 3-day food record in 498 community dwelling older adults (≥55 years) participating different lifestyle interventions. Linear mixed model analysis was used to examine the association between protein intake at breakfast or lunch and total daily protein intake, adjusted for sex, age, body mass index, smoking status, study and total energy intake.nnRESULTS: After adjustment for potential confounders, a 10 g higher protein intake at breakfast was associated with a 3.2 g higher total daily protein intake (P = 0.008) for males and a 4.9 g (P < 0.001) higher total daily protein intake for females. A 10 g higher protein intake at lunch was associated with a 3.7 g higher total daily protein intake (P < 0.001) for males, and a 5.8 g higher total daily protein intake (P < 0.001) for females.nnCONCLUSIONS: A higher protein intake at breakfast and lunch is associated with a higher total daily protein intake in community dwelling older adults. Stimulating a higher protein intake at breakfast and lunch might represent a promising nutritional strategy to optimise the amount of protein per meal without compromising total daily protein intake.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33546451,

title = {Digitally Supported Dietary Protein Counseling Changes Dietary Protein Intake, Sources and Distribution in Community-Dwelling Older Adults},

author = {Jantine van den Helder and Sjors Verlaan and Michael Tieland and Jorinde Scholten and Sumit Mehra and Bart Visser and Ben J A Kröse and Raoul H H Engelbert and Peter J M Weijs},

doi = {10.3390/nu13020502},

issn = {2072-6643},

year  = {2021},

date = {2021-02-01},

journal = {Nutrients},

volume = {13},

number = {2},

abstract = {Digitally supported dietary counselling may be helpful in increasing the protein intake in combined exercise and nutritional interventions in community-dwelling older adults. To study the effect of this approach, 212 older adults (72.2 ± 6.3 years) were randomised in three groups: control, exercise, or exercise plus dietary counselling. The dietary counselling during the 6-month intervention was a blended approach of face-to-face contacts and videoconferencing, and it was discontinued for a 6-month follow-up. Dietary protein intake, sources, product groups, resulting amino acid intake, and intake per eating occasion were assessed by a 3-day dietary record. The dietary counselling group was able to increase the protein intake by 32% at 6 months, and the intake remained 16% increased at 12 months. Protein intake mainly consisted of animal protein sources: dairy products, followed by fish and meat. This resulted in significantly more intake of essential amino acids, including leucine. The protein intake was distributed evenly over the day, resulting in more meals that reached the protein and leucine targets. Digitally supported dietary counselling was effective in increasing protein intake both per meal and per day in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34298547,

title = {The effects of a preschool-based intervention for Early Childhood Education and Care teachers in promoting healthy eating and physical activity in young children: A cluster randomised controlled trial},

author = {Nicole Toussaint and Martinette T Streppel and Sandra Mul and Marielle Balledux and Karen van Drongelen and Mirka Janssen and Ruben G Fukkink and Peter J M Weijs},

doi = {10.1371/journal.pone.0255023},

issn = {1932-6203},

year  = {2021},

date = {2021-01-01},

journal = {PLoS One},

volume = {16},

number = {7},

pages = {e0255023},

abstract = {The need for excess weight gain prevention in disadvantaged young children is widely recognised. Early Childhood Education and Care teachers are potential key actors in early interventions to prevent overweight and obesity. This study examines the effects of a preschool-based intervention for teachers in promoting healthy eating and physical activity in young children. A cluster randomised controlled trial was conducted at 41 preschools in a deprived area of Amsterdam, The Netherlands. The intervention consisted of 2 programmes that were applied in succession: A Healthy Start and PLAYgrounds for TODdlers. The study period was 9 months. Primary outcomes were assessed via questionnaires and included teachers' knowledge, attitude, food/activity-related practices, and level of confidence in promoting healthy behaviours. Secondary outcomes in this study were teachers' and children's BMI (z-score), body composition, dietary intake and physical activity level. Intention-to-treat analyses were performed using linear mixed models. In total, 115 teachers and 249 children (mean age 3.0 (0.2) years) were included. A positive effect on teachers' knowledge about the Dutch dietary guidelines was found after the programme A Healthy Start (difference = 1.38; 1-sided 95% CL = 0.29; p = 0.02). This effect was not sustained at 9 months (difference = 0.34; 1-sided 95% CL = -0.76; p = 0.31). The overall intervention had a positive effect on 3 of the 5 attitude statements regarding a healthy lifestyle (difference ranged from 0.34 to 0.55) and on the practice scale Activity-related-Modelling (difference = 0.16; 1-sided 95% CL = 0.06; p = 0.01). No intervention effects were observed on food-related practice scales and the level of confidence in promoting healthy behaviours. At this stage, no effects were seen on teachers' and children's BMI (z-score). This study contributes to the professional development of Early Childhood Education and Care teachers and addresses the call for interventions to prevent overweight/obesity and to minimise health inequalities in young children.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33435317,

title = {Dietary Protein Intake in Older Adults from Ethnic Minorities in the Netherlands, a Mixed Methods Approach},

author = {Elvera Overdevest and Berber G Dorhout and Mary Nicolaou and Irene G M van Valkengoed and Annemien Haveman-Nies and Halime Oztürk and Lisette C P G M de Groot and Michael Tieland and Peter J M Weijs},

doi = {10.3390/nu13010184},

issn = {2072-6643},

year  = {2021},

date = {2021-01-01},

journal = {Nutrients},

volume = {13},

number = {1},

abstract = {Optimizing protein intake is a novel strategy to prevent age associated loss of muscle mass and strength in older adults. Such a strategy is still missing for older adults from ethnic minority populations. Protein intake in these populations is expected to be different in comparison to the majority of the population due to several socio-cultural factors. Therefore, the present study examined the dietary protein intake and underlying behavioral and environmental factors affecting protein intake among older adults from ethnic minorities in the Netherlands. We analyzed frequency questionnaire (FFQ) data from the Healthy Life in an Urban Setting (HELIUS) cohort using ANCOVA to describe dietary protein intake in older adults from ethnic minorities in the Netherlands (N = 1415, aged >55 years, African Surinamese, South Asian Surinamese, Moroccan, and Turkish). Additionally, we performed focus groups among older adults from the same ethnic minority populations (N = 69) to discover behavioral and environmental factors affecting protein intake; 40-60% of the subjects did not reach minimal dietary protein recommendations needed to maintain muscle mass (1.0 g/kg bodyweight per day (BW/day)), except for Turkish men (where it was 91%). The major sources of protein originated from animal products and were ethnic specific. Participants in the focus groups showed little knowledge and awareness about protein and its role in aging. The amount of dietary protein and irregular eating patterns seemed to be the major concern in these populations. Optimizing protein intake in these groups requires a culturally sensitive approach, which accounts for specific protein product types and sociocultural factors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34109204,

title = {The Relevance of Diet, Physical Activity, Exercise, and Persuasive Technology in the Prevention and Treatment of Sarcopenic Obesity in Older Adults},

author = {Josje D Schoufour and Michael Tieland and Rocco Barazzoni and Somaya Ben Allouch and Joey van der Bie and Yves Boirie and Alfonso J Cruz-Jentoft and Doris Eglseer and Eva Topinková and Bart Visser and Trudy Voortman and Amalia Tsagari and Peter J M Weijs},

doi = {10.3389/fnut.2021.661449},

issn = {2296-861X},

year  = {2021},

date = {2021-01-01},

journal = {Front Nutr},

volume = {8},

pages = {661449},

abstract = {The aging population faces two conditions that threaten healthy aging: high fat mass (obesity) and low muscle mass and function (sarcopenia). The combination of both-referred to as sarcopenic obesity-synergistically increases the risk of adverse health outcomes. The two conditions often co-occur because they reinforce each other and share common etiologies, including poor nutrition and inactivity. All aging people are at risk of gaining weight and losing muscle mass and could benefit from improvements in physical activity, exercise and dietary intake. one specific window of opportunity is during the transient time of retirement, as older adults already need to restructure their daily activities. It is key to change lifestyle behavior in a sustainable manner, providing scientifically proven, personalized, and acceptable principles that can be integrated in daily life. Health technologies (e.g., applications) can provide promising tools to deliver personalized and appealing lifestyle interventions to a large group of people while keeping health care costs low. Several studies show that health technologies have a strong positive effect on physical activity, exercise and dietary intake. Specifically, health technology is increasingly applied to older people, although strong evidence for long term effects in changing lifestyle behavior is generally lacking. Concluding, technology could play an important role in the highly warranted prevention of sarcopenic obesity in older adults. Although health technology seems to be a promising tool to stimulate changes in physical activity, exercise and dietary intake, studies on long lasting effects and specifically targeted on older people around the time of retirement are warranted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33103379,

title = {Blended home-based exercise and dietary protein in community-dwelling older adults: a cluster randomized controlled trial},

author = {Jantine van den Helder and Sumit Mehra and Carliene van Dronkelaar and Gerben Ter Riet and Michael Tieland and Bart Visser and Ben J A Kröse and Raoul H H Engelbert and Peter J M Weijs},

doi = {10.1002/jcsm.12634},

issn = {2190-6009},

year  = {2020},

date = {2020-12-01},

journal = {J Cachexia Sarcopenia Muscle},

volume = {11},

number = {6},

pages = {1590--1602},

abstract = {BACKGROUND: Effective and sustainable interventions are needed to counteract the decline in physical function and sarcopenia in the growing aging population. The aim of this study was to determine the 6 and 12 month effectiveness of blended (e-health + coaching) home-based exercise and a dietary protein intervention on physical performance in community-dwelling older adults.nnMETHODS: This cluster randomized controlled trial allocated 45 clusters of older adults already engaged in a weekly community-based exercise programme. The clusters were randomized to three groups with ratio of 16:15:14; (i) no intervention, control (CON); (ii) blended home-based exercise intervention (HBex); and (iii) HBex with dietary protein counselling (HBex-Pro). Both interventions used a tablet PC with app and personalized coaching and were targeting on behaviour change. The study comprised coached 6 month interventions with a 6 month follow-up. The primary outcome physical performance was assessed by modified Physical Performance Test (m-PPT). Secondary outcomes were gait speed, physical activity level (PAL), handgrip muscle strength, protein intake, skeletal muscle mass, health status, and executive functioning. Linear mixed models of repeated measured were used to assess intervention effects at 6 and 12 months.nnRESULTS: The population included 245 older adults (mean age 72 ± 6.5 (SD) years), 71% female, and 54% co-morbidities observed. Dropout of the intervention was 18% at 6 months and 26% at 12 months. Participants were well functioning, based on an m-PPT score of 33.9 (2.8) out of 36. For the primary outcome m-PPT, no significant intervention effects (HBex, +0.03, P = 0.933; HBex-Pro, -0.13, P = 0.730) were found. Gait speed (+0.20 m/s, P = 0.001), PAL (+0.06, P = 0.008), muscle strength (+2.32 kg, P = 0.001), protein intake (+0.32 g/kg/day, P < 0.001), and muscle mass (+0.33 kg, P = 0.017) improved significantly in the HBex-Pro group compared with control group after 6 month intervention. The protein intake, muscle mass, and strength remained significantly improved after 12 months as compared with those of control. Health change and executive functioning improved significantly in both intervention groups after 6 months.nnCONCLUSIONS: This HBex and dietary protein interventions did not change the physical performance (m-PPT) in community-dwelling older adults. Changes were observed in gait speed, PAL, muscle mass, strength, and dietary protein intake, in response to this combined intervention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}