Baseline Nutritional Status and In-Hospital Step Count are Associated with Muscle Quantity, Quality, and Function: Results of an Exploratory Study

Abstract

This exploratory study aimed to assess associations of baseline nutritional status and in-hospital step count with muscle quantity, quality, and function. Seventy-nine participants aged ≥70 years (mean age 79.1 years, 44.3% female) were recruited (elective colorectal surgery, emergency abdominal surgery, and general medical patients with infections). Baseline nutrition (Mini Nutritional Assessment) and in-hospital step count (Fitbit Inspire devices) were assessed. Ultrasound quadriceps, bioelectrical impedance analysis, and physical function were assessed at baseline and 7 (±2) days and 13 (±1) weeks post-admission/post-operatively. Baseline nutritional status was associated with baseline rectus femoris ultrasound echogenicity (normal: 58.5, at risk: 68.5, malnourished: 81.2; p = 0.025), bilateral anterior thigh thickness (normal: 5.07 cm, at risk: 4.03 cm, malnourished: 3.05 cm; p = 0.021), and skeletal muscle mass (Sergi equation) (normal: 21.6 kg, at risk: 18.2 kg, malnourished: 12.0 kg; p = 0.007). Step count was associated with baseline patient-reported physical function (<900 37.1, ≥900 44.5; p = 0.010). There was a significant interaction between nutrition, step count, and time for skeletal muscle mass (Janssen equation) (p = 0.022).

Keywords:

• Sarcopenia
• accelerometry
• ultrasound

Acknowledgments

No further acknowledgments.

Ethical approval

This research has been sponsored by and reviewed by the University of Birmingham research governance team. Ethical approval has been obtained from Wales Research Ethics Committee 4 (19/WA/0036), the Health Research Authority, and the University Hospitals Birmingham NHS Trust Research and Development department. Written informed consent was obtained from all participants who were considered to have capacity to consent for themselves. Written personal or professional consultee declaration was obtained if the participant was considered to lack capacity to consent to participation. The use of both informed consent and consultee declaration was approved by the ethics committee. All methods were performed in accordance with the relevant guidelines and regulations.

Author contributions

CW designed the research question and study protocol. TJ, CG, TM, and TP all contributed toward design of the study protocol. CW, ZM, and HM all significantly contributed toward recruitment and follow-up assessments of participants in the study. DL and BS contributed toward data collection. CW analyzed and interpreted the results and was responsible for manuscript preparation. All authors significantly contributed toward the writing of the manuscript and approved the final submitted version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The anonymized dataset is available from the corresponding author upon reasonable request.

Additional information

Funding

This research was funded by a project grant from the Dowager Countess Eleanor Peel Trust and the Medical Research Council – Versus Arthritis Center for Musculoskeletal Aging Research awarded to Dr Carly Welch in the form of a PhD studentship. Dr Thomas Jackson is funded by the West Midlands National Institute for Health Research (NIHR) Clinical Research Network Research Scholar programme. The views in this manuscript are those of the authors and not necessarily those of the NIHR, the National Health Service, or the Department of Health. The funding bodies were not involved in the design of the study, collection, analysis, or interpretation of the data, or in writing the manuscript.