Nutrient Intake and Muscle Measures in Geriatric Outpatients

Figures & data

Table 1. Characteristics of geriatric outpatients (n = 58).

	N	Total (n = 58)	Male (n = 20)	Female (n = 38)
Sociodemographics
Age, years	58	77.2 ± 9.0	76.7 ± 10.8	77.5 ± 8.0
Married/living with partner, n (%)	58	24 (41.4)	8 (40.0)	16 (42.1)
Living at home, n (%)	58	55 (94.8)	18 (90.0)	37 (97.4)
Highly educated^(a), n (%)	49	5 (10.2)	0	5 (13.2)
Current smoking, n (%)	52	2 (3.8)	1 (5.6)	1 (2.9)
Physically active^(b), n (%)	48	26 (54.2)	8 (50.0)	18 (56.2)
Health characteristics
Multimorbidity^(c), n (%)	58	58 (100)	20 (100)	38 (100)
Polypharmacy^(d), n (%)	58	44 (75.9)	18 (90.0)	26 (68.4)
MMSE, score, median [IQR]	57	29.0 [26.0–30.0]	28.0 [26.0–29.0]	29.0 [26.0–30.0]
MNA, score, median [IQR]	58	25.0 [22.5–28.0]	24.0 [22.5–25.0]	26.0 [22.5–28.0]
Normal nutritional status^(e), n (%)		39 (67.2)	14 (70.0)	25 (65.8)
Risk of malnutrition^(e), n (%)		18 (31.0)	5 (25.0)	13 (34.2)
Malnourished^(e), n (%)		1 (1.7)	1 (5.0)	0
Anthropometry
Body weight, kg	58	72.9 ± 15.3	83.2 ± 15.1	67.4 ± 12.5
Height, cm	57	161.7 ± 9.2	169.9 ± 7.8	157.1 ± 6.4
Body mass index, kg/m^2	57	27.9 ± 5.1	28.7 ± 3.8	27.5 ± 5.7
BMI groups^(f)	57
Underweight, n (%)		5 (8.8)	0	5 (13.5)
Normal weight, n (%)		20 (35.1)	7 (35.0)	13 (35.1)
Overweight, n (%)		32 (56.1)	13 (65.0)	19 (51.4)
Fat mass, %	49	36.8 ± 9.1	33.1 ± 7.3	38.8 ± 9.5
Muscle measures
SMM, kg	49	24.4 ± 5.8	30.4 ± 4.7	21.2 ± 3.2
SMI, kg/m^2	49	9.26 ± 1.34	10.41 ± 0.95	8.65 ± 1.09
SMM/BMI	49	0.88 ± 0.20	1.06 ± 0.14	0.79 ± 0.16
Handgrip strength, kg	45	22.7 ± 8.3	28.7 ± 7.6	18.7 ± 6.1
CST, seconds, median [IQR]	57	21.3 [16.3–38.7]	20.4 [14.9–28.6]	21.9 [17.8–100.0]

All values are presented as mean ± standard deviation, unless otherwise indicated.

^(a)Postgraduate education or above.

^(b)At least 2.5 hours of physical activity per week (self-reported).

^(c)Defined as ≥ 2 diseases.

^(d)Defined as ≥ 5 medications.

^(e)MNA score was categorized into normal nutrition status (24.0–30.0), at risk of malnutrition (17.0–23.5), and malnourished (<17.0).

^(f)BMI was categorized into underweight (< 22.0), normal weight (22.0–27.0), and overweight (>27.0).

BMI = body mass index; IQR = interquartile range; MMSE = Mini-Mental State Examination; MNA = Mini-Nutritional Assessment; SMI = skeletal muscle mass index; SMM = skeletal muscle mass; CST = chair-stand test.

Table 2. Daily energy-adjusted nutrient intake of geriatric outpatients.

	Total (n = 58)	Male (n = 20)	Female (n = 38)
Energy, kcal	1591 ± 504	1647 ± 532	1561 ± 494
Macronutrients
Carbohydrate, g	178.2 ± 29.4	177.1 ± 32.2	178.7 ± 28.2
Carbohydrate, en%	43.9 ± 7.4	43.2 ± 8.2	44.2 ± 7.0
Protein, g	72.9 ± 14.1	75.8 ± 15.9	71.4 ± 13.1
Protein, en%	20.6 ± 4.0	20.0 ± 4.0	19.3 ± 3.9
Protein, g/kg body weight	1.0 ± 0.2	0.9 ± 0.2	1.1 ± 0.2
Fat, g	56.4 ± 11.0	53.3 ± 11.1	58.0 ± 10.8
Fat, en%	31.0 ± 6.3	29.5 ± 6.2	31.7 ± 6.3
Saturated fat, g	21.9 ± 5.4	20.8 ± 4.1	22.4 ± 5.9
Saturated fat, en%	12.0 ± 3.1	11.4 ± 2.2	12.3 ± 3.5
Fibers, g	21.9 ± 7.0	20.1 ± 8.0	22.9 ± 6.4
Micronutrients
Sodium, mg	1802 [1444–2129]	1903 [1488–2312]	1769 [1382–2051]
Calcium, mg	807 ± 283	748 ± 261	838 ± 293
Iron, mg	9.8 ± 2.2	9.7 ± 2.5	9.8 ± 2.0
Zinc, mg	8.4 [7.6–9.9]	8.7 [7.6–11.1]	8.3 [7.5–9.7]
Potassium, mg	2686 ± 521	2681 ± 658	2689 ± 442
Magnesium, mg	295 ± 68	282 ± 67	302 ± 68
Selenium, µg	68 ± 17	69 ± 14	67 ± 18
Iodine, µg	167 [134–198]	170 [125–188]	166 [135–206]
Vitamin A, µg	657 [483–987]	561 [373–768]	748 [532–994]
Vitamin E, mg	8.4 [6.2–11.0]	7.2 [5.0–8.5]	8.8 [7.5–11.5]
Riboflavin, mg	1.8 [1.4–2.3]	1.6 [1.4–2.5]	1.8 [1.5–2.1]
Folate, µg	477 [388–590]	481 [383–567]	467 [389–614]
Thiamin, mg	1.2 [0.9–1.9]	1.3 [0.9–2.1]	1.2 [0.9–1.7]
Niacin, mg	18.2 [15.1–21.2]	20.5 [16.0–25.8]	16.8 [14.8–20.3]
Vitamin B6, mg	1.1 [0.9–1.3]	1.1 [0.9–1.3]	1.1 [0.9–1.4]
Vitamin B12, µg	3.8 [3.1–5.2]	4.0 [3.1–5.3]	3.7 [3.0–4.8]
Vitamin C, mg	81 [51–119]	63 [30–84]	87 [69–121]

Values are presented as mean ± standard deviation or median [interquartile range]. Energy-adjusted nutrient intake was used except for energy intake and the percentage of energy from carbohydrate, protein, fat, and saturated fat.

en% = energy percentage; g = gram; Kcal = kilocalorie; mg = milligram; µg = microgram.

Table 3. Associations between energy-adjusted nutrient intake and muscle mass in geriatric outpatients (n = 49).

Nutrients	Z SMM, kg								Z SMI, kg/m^2								Z SMM/BMI
	Model 1				Model 2				Model 1				Model 2				Model 1
	β	SE	p		β	SE	p		β	SE	p		β	SE	p		β	SE	p
Energy, kcal	0.00	0.00	0.006*		0.00	0.00	0.033*		0.00	0.00	0.054		0.00	0.00	0.288		0.00	0.00	0.028*
Macronutrients
Carbohydrate, g	0.00	0.01	0.840		0.00	0.00	0.535		0.00	0.01	0.825		0.00	0.00	0.908		0.00	0.01	0.494
Carbohydrate, en% kcal	0.02	0.02	0.433		0.02	0.02	0.179		0.01	0.02	0.757		0.01	0.02	0.424		0.02	0.02	0.250
Protein, g	0.02	0.01	0.153		0.00	0.01	0.938		0.01	0.01	0.290		−0.01	0.01	0.565		0.00	0.01	0.983
Protein, en%	0.01	0.04	0.799		−0.01	0.03	0.752		0.00	0.04	0.974		−0.02	0.03	0.440		0.00	0.04	0.928
Protein, 0.1g/kg BW	−0.17	0.06	0.004*		−0.01	0.06	0.935		−0.21	0.05	<0.001		−0.05	0.06	0.443		0.01	0.06	0.087
Fat, g	−0.02	0.01	0.183		−0.01	0.01	0.361		−0.02	0.01	0.233		−0.01	0.01	0.472		−0.01	0.01	0.312
Fat, en%	−0.03	0.02	0.271		−0.02	0.02	0.389		−0.03	0.02	0.305		−0.01	0.02	0.446		−0.02	0.02	0.312
Saturated fat, g	−0.02	0.03	0.558		−0.01	0.02	0.733		−0.02	0.03	0.498		−0.01	0.02	0.653		−0.01	0.03	0.824
Saturated fat, en%	−0.02	0.05	0.609		−0.01	0.04	0.764		−0.03	0.05	0.516		−0.02	0.04	0.636		−0.01	0.04	0.862
Fibers, g	−0.01	0.02	0.758		0.02	0.02	0.233		−0.01	0.02	0.631		0.02	0.02	0.254		0.01	0.02	0.803
Micronutrients
Sodium, mg	0.00	0.00	0.020*		0.00	0.00	0.538		0.00	0.00	0.003*		0.00	0.00	0.219		0.00	0.00	0.036*
Calcium, mg	0.00	0.00	0.939		0.00	0.00	0.538		0.00	0.00	0.414		0.00	0.00	0.772		0.00	0.00	0.272
Iron, mg	0.03	0.08	0.703		0.01	0.06	0.834		0.05	0.08	0.570		0.03	0.06	0.654		−0.12	0.07	0.114
Zinc, mg	0.07	0.05	0.151		0.00	0.04	0.944		0.05	0.05	0.302		−0.03	0.04	0.529		0.01	0.05	0.850
Potassium, mg	0.00	0.00	0.240		0.00	0.00	0.433		0.00	0.00	0.204		0.00	0.00	0.371		0.00	0.00	0.715
Magnesium, mg	0.00	0.00	0.884		0.00	0.00	0.383		0.00	0.00	0.450		0.00	0.00	0.863		0.00	0.00	0.676
Selenium, µg	0.01	0.001	0.139		0.01	0.01	0.330		0.01	0.01	0.332		0.00	0.01	0.782		0.00	0.00	0.762
Iodine, µg	0.01	0.00	0.025*		0.00	0.00	0.017*		0.00	0.00	0.037*		0.00	0.00	0.025*		0.00	0.00	0.869
Vitamin A, µg	0.00	0.00	0.378		0.00	0.00	0.731		0.00	0.00	0.099		0.00	0.00	0.185		0.00	0.00	0.599
Vitamin E, mg	−0.05	0.04	0.197		−0.02	0.03	0.638		−0.04	0.04	0.325		0.00	0.03	0.995		−0.03	0.04	0.423
Riboflavin, mg	−0.22	0.27	0.426		−0.11	0.22	0.605		−0.31	0.28	0.264		−0.20	0.21	0.350		−0.04	0.27	0.876
Folate, µg	0.00	0.00	0.008*		0.00	0.00	0.003*		0.00	0.00	0.021*		0.00	0.00	0.010*		0.00	0.00	0.469
Thiamin, mg	0.44	0.20	0.037*		0.19	0.17	0.293		0.52	0.21	0.015*		0.25	0.17	0.147		−0.15	0.21	0.483
Niacin, mg	0.02	0.02	0.330		−0.01	0.01	0.642		0.02	0.02	0.162		0.00	0.01	0.963		−0.02	0.02	0.302
Vitamin B6, mg	0.07	0.32	0.821		0.14	0.26	0.596		−0.01	0.33	0.965		0.05	0.25	0.828		0.29	0.31	0.352
Vitamin B12, µg	0.06	0.08	0.454		−0.01	0.07	0.946		0.03	0.08	0.734		−0.05	0.06	0.478		0.00	0.08	0.978
Vitamin C, mg	0.00	0.00	0.177		0.00	0.00	0.897		0.00	0.00	0.119		0.00	0.00	0.998		0.00	0.00	0.393

Model 1: adjusted for age, Model 2: As Model 1 + body weight. p < 0.001 were considered statistically significant after Bonferroni correction and indicated in bold. p < 0.05 are indicated with an asterisk. Energy-adjusted nutrient intake was used except for energy intake and the percentage of energy from carbohydrate, protein, fat and saturated fat. Muscle mass was analyzed with sex-specific z scores.

BW = body weight; BMI = body mass index, en% = energy percentage; SE = standard error; SMI = skeletal muscle mass index; SMM = skeletal muscle mass.

Table 4. Associations between energy-adjusted nutrient intake and muscle strength (n = 45) and muscle power (n = 57) in geriatric outpatients.

Nutrients	Z HGS, kg								Z CST, seconds
	Model 1				Model 2				Model 1				Model 2
	β	SE	p		β	SE	p		β	SE	p		β	SE	p
Energy, kcal	0.00	0.00	0.299		0.00	0.00	0.363		0.00	0.00	0.372		0.00	0.00	0.303
Macronutrients
Carbohydrate, g	−0.01	0.00	0.143		−0.01	0.00	0.173		0.00	0.00	0.438		0.00	0.01	0.457
Carbohydrate, en%	−0.01	0.02	0.471		−0.01	0.02	0.535		−0.03	0.02	0.118		−0.03	0.02	0.126
Protein, g	0.01	0.01	0.347		0.01	0.01	0.575		−0.01	0.01	0.183		−0.02	0.01	0.116
Protein, en%	0.04	0.04	0.243		0.04	0.04	0.362		−0.04	0.03	0.227		−0.04	0.03	0.201
Protein, 0.1g/kg BW	−0.01	0.07	0.848		0.04	0.09	0.660		−0.06	0.06	0.284		−0.08	0.07	0.295
Fat, g	−0.01	0.01	0.561		−0.01	0.01	0.643		0.02	0.01	0.150		0.02	0.01	0.134
Fat, en%	−0.02	0.02	0.428		−0.02	0.02	0.495		0.03	0.02	0.102		0.04	0.02	0.095
Saturated fat, g	−0.04	0.03	0.163		−0.04	0.03	0.160		0.03	0.03	0.263		0.03	0.03	0.246
Saturated fat, en%	−0.07	0.05	0.126		−0.07	0.05	0.120		0.07	0.04	0.114		0.07	0.04	0.106
Fibers, g	0.01	0.02	0.564		0.02	0.02	0.373		0.00	0.02	0.949		0.00	0.02	0.894
Micronutrients
Sodium, mg	0.00	0.00	0.450		0.00	0.00	0.680		0.00	0.00	0.282		0.00	0.00	0.316
Calcium, mg	0.00	0.00	0.847		0.00	0.00	0.889		0.00	0.00	0.531		0.00	0.00	0.567
Iron, mg	0.05	0.06	0.429		0.04	0.06	0.513		−0.04	0.06	0.470		−0.05	0.06	0.441
Zinc, mg	0.04	0.06	0.499		0.02	0.06	0.749		−0.08	0.05	0.095		−0.09	0.05	0.060
Potassium, mg	0.00	0.00	0.698		0.00	0.00	0.711		0.00	0.00	0.433		0.00	0.00	0.447
Magnesium, mg	0.00	0.00	0.196		0.00	0.00	0.191		0.00	0.00	0.344		0.00	0.00	0.369
Selenium, µg	0.00	0.01	0.718		0.00	0.01	0.852		0.00	0.01	0.577		−0.01	0.01	0.514
Iodine, µg	0.00	0.00	0.251		0.00	0.00	0.309		0.00	0.00	0.987		0.00	0.00	0.970
Vitamin A, µg	0.00	0.00	0.097		0.00	0.00	0.126		0.00	0.00	0.154		0.00	0.00	0.166
Vitamin E, mg	0.01	0.04	0.698		0.03	0.04	0.454		0.01	0.04	0.761		0.02	0.04	0.696
Riboflavin, mg	−0.03	0.23	0.894		−0.03	0.23	0.914		−0.10	0.22	0.647		−0.09	0.22	0.685
Folate, µg	0.00	0.00	0.014*		0.00	0.00	0.017*		0.00	0.00	0.395		0.00	0.00	0.380
Thiamin, mg	0.17	0.18	0.364		0.13	0.19	0.486		−0.02	0.18	0.920		−0.03	0.19	0.855
Niacin, mg	0.02	0.02	0.213		0.02	0.02	0.354		−0.01	0.02	0.655		−0.01	0.02	0.553
Vitamin B6, mg	0.07	0.33	0.827		0.05	0.33	0.888		0.52	0.31	0.092		0.52	0.31	0.095
Vitamin B12, µg	0.01	0.08	0.896		−0.01	0.09	0.916		−0.07	0.08	0.395		−0.07	0.08	0.362
Vitamin C, mg	0.00	0.00	0.993		0.00	0.00	0.888		0.00	0.00	0.837		0.00	0.00	0.797

Model 1: adjusted for age, Model 2: As Model 1 + body weight. p < 0.001 were considered statistically significant after Bonferroni correction and indicated in bold. p < 0.05 are indicated with an asterisk. Energy-adjusted nutrient intake was used except for energy intake and the percentage of energy from carbohydrate, protein, fat, and saturated fat. Muscle strength and muscle power were analyzed with sex-specific z scores.

BW = body weight; CST = chair-stand test; en% = energy percentage; HGS = handgrip strength; SE = standard error.