If you use a device running an Android version prior to 7.1.1, beginning January 11 your access from that device to this site and many others will be impaired. For details and solutions, see this topic.

'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Insights and discussion from the cutting edge with reference to journal articles and other research papers.
Orangeblossom
Senior Contributor
Senior Contributor
Posts: 802
Joined: Tue Nov 07, 2017 10:11 am

'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby Orangeblossom » Thu Jul 05, 2018 2:17 pm

A first-of-its-kind study has found that 'skinny fat' -- the combination of low muscle mass and strength in the context of high fat mass -- may be an important predictor of cognitive performance in older adults. Using data from a series of community-based aging and memory studies, researchers assessed the relationship of sarcopenic obesity or 'skinny fat' with performance on various cognition tests. Results show that sarcopenic obesity was associated with the lowest performance on global cognition.

https://www.sciencedaily.com/releases/2 ... 084218.htm

NF52
Support Team
Support Team
Posts: 1413
Joined: Tue Oct 25, 2016 9:41 am
Location: Eastern U.S.

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby NF52 » Fri Jul 06, 2018 6:26 am

Orangeblossom wrote:A first-of-its-kind study has found that 'skinny fat' -- the combination of low muscle mass and strength in the context of high fat mass -- may be an important predictor of cognitive performance in older adults.
Hi Orangeblossom,

Just thought I'd add to the "first-of-its-kind", the 8-year long study below, which also claims to be the first to look at sarcopenia/obesity with changes Independent Activities of Daily Living (IADL) in seniors. They found that people with sarcopenia and obesity tended to lose 2 points on IADL within 1.5 years. The average participant was followed for about 4.5 years. The study was based in Albuquerque, New Mexico with 450 community-dwelling adults. The average age was early 70's at baseline. This article provides specific definitions of both sarcopenia and obesity differentiated in males and females. While those with sarcopenia and obesity were significantly older at baseline (78 vs 71 years). their increased risk was still evident after adjusting for age. Being obese without sarcopenia was not associated with a significant difference in IADL or death vs. being non-obese. (This seems to be consistent with research you've cited that being overweight may be less of a risk in the elderly.) Here's an excerpt from the summary, including one hypothesis on the underlying causes of the condition, that suggests that obesity may not be as benign as the evidence from those without sarcopenia suggests.
This is the first study, to our knowledge, to report that sarcopenic obesity precedes and predicts the onset of IADL disability in a sample of community-dwelling elderly. Our data suggest that nondisabled elderly with sarcopenic obesity are 2.5 times more likely to report subsequent IADL disability over a 7-year follow-up than individuals without sarcopenic obesity, regardless of age, sex, level of habitual physical activity, and morbidity. “Pure” sarcopenia— or sarcopenic nonobesity—and obesity without sarcopenia were not significantly associated with the onset of IADL disability in this study, which contrasts somewhat with reports from previous cross-sectional studies for significant positive associations.
There are several limitations of this study that should be recognized. First, the study cohort was small, and sarcopenic obesity was rare, limiting the statistical power to detect associations. The small sample size also limited our ability to analyze potentially confounding associations with incident morbidity. Although our data suggest that the association of sarcopenic obesity with incident IADL disability is independent of major prevalent comorbidities, it remains possible that this association is confounded by underlying, “preclinical” morbidity... It has long been recognized that proinflammatory cytokines, tumor necrosis factor  and IL-6 in particular, are associated with muscle wasting in cachexia through stimulation of protein degradation through the ubiquitin–proteosome pathway. Roubenoff has proposed that chronic low levels of these cytokines caused by age-associated increases in adiposity may result in an enhancement of the more subtle, gradual loss of muscle that characterizes sarcopenia (37). Thus, sarcopenia may be accelerated in individuals with long-standing obesity and its associated chronic inflammatory status, resulting in sarcopenic obesity in old age.
Sarcopenic Obesity Predicts Instrumental Activities of Daily Living Disability in the Elderly
Last edited by NF52 on Sun Jul 08, 2018 12:58 pm, edited 1 time in total.
4/4 and still an optimist!

PeteWilliams
Contributor
Contributor
Posts: 25
Joined: Fri Jul 06, 2018 10:04 am
Location: London, England
Contact:

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby PeteWilliams » Fri Jul 06, 2018 10:23 am

This is something we look to measure in all our patients.

We do this in two ways HT to waist ratio...

And for those who can afford it, we use Dexa Scanning to get more gold standard measures. This does prove an enlightening experience for most! In fact, all patients perceive to be at least 15% lower than they are. It's a great tool and motivator when they realise how much body fat they have.

PeteWilliams
Contributor
Contributor
Posts: 25
Joined: Fri Jul 06, 2018 10:04 am
Location: London, England
Contact:

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby PeteWilliams » Fri Jul 06, 2018 10:56 am

Also, basic physical exam and strength testing within that exam can give you basic ideas of this issue. I look for functional capacity, in other words, some can be sarcopenic but have high functionality and strength. A term called dynapenia. The more functional they are the more likely they move and that has huge positive implications for Cognition.

Orangeblossom
Senior Contributor
Senior Contributor
Posts: 802
Joined: Tue Nov 07, 2017 10:11 am

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby Orangeblossom » Fri Jul 06, 2018 11:52 am

Juts been having a look at the causes of sarcopenia and found this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/

User avatar
Karengo
Contributor
Contributor
Posts: 71
Joined: Sun Jan 14, 2018 10:30 pm
Location: Bay Area, California
Contact:

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby Karengo » Sat Jul 07, 2018 1:53 pm

PeteWilliams wrote:This is something we look to measure in all our patients.

We do this in two ways HT to waist ratio...

And for those who can afford it, we use Dexa Scanning to get more gold standard measures. This does prove an enlightening experience for most! In fact, all patients perceive to be at least 15% lower than they are. It's a great tool and motivator when they realise how much body fat they have.


Hello Pete: Welcome to our community! Thank you for your comments and insights. Sounds like you know what you're talking about :D I understand you're an exercise scientist? How interesting! Movement is an important part of a healthy lifestyle practice.

I see you're in the UK (I'm a Brit living in California) so I'm not sure if we have this in the US. Does anyone else know? Even so, I'm fascinated that most of your patients perceive themselves to be at least 15% lower in the body fat department than they actually are. I find that's pretty shocking! At the same time I can understand the way we perceive ourselves (and the world) has a lot to do with how our minds work. As a health coach, I find conversations with my clients are centred around perception and belief. Once these shift then real change can happen. I recognise that's what you're saying about the Dexa Scanning being a great tool - to raise awareness - and then a great motivator - once we are aware then we can become motivated to create change!

Please feel free to explore the site adding your insights - taking the time to share your wisdom and experience is much appreciated.

I think you'll find there a number of resources on the site such as the Primer written by our physician member, Stavia. Also if you're looking for certain topics you can use the magnifying glass icon which you'll find up in the top right hand corner or you can use Wiki

Thanks again for your contribution. We look forward to hearing more from you. And if you would like to tell us more about your and the work you're doing, please do so OurStories

Wishing you good health,
~Karengo
ApoE4 Support Team
FMCA certified Health Coach
"For whatever we lose like a you or a me, it's always ourselves we find in the sea"

circular
Senior Contributor
Senior Contributor
Posts: 5164
Joined: Sun Nov 03, 2013 10:43 am

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby circular » Sat Jul 07, 2018 8:21 pm

PeteWilliams wrote:I look for functional capacity, in other words, some can be sarcopenic but have high functionality and strength. A term called dynapenia. The more functional they are the more likely they move and that has huge positive implications for Cognition.

Wow, I've never heard of dynapenia! That is interesting. Will look it up.

Yes, glad to have an exercise scientist on board!
ApoE 3/4 > Thanks in advance for any responses made to my posts.

PeteWilliams
Contributor
Contributor
Posts: 25
Joined: Fri Jul 06, 2018 10:04 am
Location: London, England
Contact:

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby PeteWilliams » Sun Jul 08, 2018 8:12 am

I suppose normal is definitely not normal anymore. And so people look normal compared to others, except others are not normal. We are finding many patients 40-50% Bf on Dexa and they are super shocked with the realisation. And when they are after a sophisticated programme such as Bredesen's we go no further than work on bringing the body fat down, which covers many of the bases.

Thanks for the welcome.

PeteWilliams
Contributor
Contributor
Posts: 25
Joined: Fri Jul 06, 2018 10:04 am
Location: London, England
Contact:

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby PeteWilliams » Sun Jul 08, 2018 8:14 am

Karengo, Dexa should be all over the place and cheap to do.

circular
Senior Contributor
Senior Contributor
Posts: 5164
Joined: Sun Nov 03, 2013 10:43 am

Re: 'Skinny fat' in older adults may predict dementia, Alzheimer's risk

Postby circular » Sun Jul 08, 2018 11:39 am

PeteWilliams wrote:Karengo, Dexa should be all over the place and cheap to do.

Is this the same DEXA as used for BMD scans?

There seems to be a lot of nuance in this area that's not always acknowledged, so I appreciate this discussion. I offer myself up as a case study :ugeek:

I'm conflicted. Stavia says no belly fat at all. I have a small amount of belly fat and still very proportional. Some might say I have the beginning of skinny fat. I found a height/weight chart here. Using this chart, despite the fact that I have a small amount of belly fat, I am at the low end of acceptable weight for my height at 120 of 117 - 143 lb (5'6"). Meanwhile, I asked my GP to evaluate my small amount of belly fat and she said it's subcutaneous, not visceral, and not much of a worry and encouraged me to exercise. Well that's been the challenging issue for both physical and time reasons. Even when I do get more exercise, I lose what I think is too much weight.

This means I need to restore my muscle mass (lost due to chronic health issues that are improving, but I'll always have connective tissue disorder limitations). Restoring muscle mass should increase metabolic rate and thereby enable me to burn more calories while keeping lean mass, weight and BMI up. But I can't easily get to no belly fat through exercise-induced increase in muscle mass, so I'm working to get 2500 leucine per meal, especially after exercise, but at least 30 mg protein per meal independent of leucine value. I've begun to see that my protein/leucine intake has been woefully insufficient in the context of my exercise limitations.

Dr. Lyon indicates that one doesn't have to worry a lot about the spike in mTOR and insulin following animal protein ingestion, as long as you fast 3-4 hours between meals so they go back to baseline. She indicates that it's spiking it constantly that's the problem with excess growth factors.

While working with PT and walking when I can, I'm trying to find the dietary sweet spot, balancing 1) animal protein, 2) plant protein with high resistant starch, and 3) supplemental hemp protein powder when my protein is fish or eggs (low in leucine) to hit the leucine requirement. I'm also aiming for continuing to spend some time in mild ketosis, but I'm no longer sure it's necessary or good for me to spend all my time in ketosis. I actually gained this extra weight while eating a higher fat, lower protein, low carb ketogenic diet, probably due to the exercise limitations.

Since I'm just learning more about some of the newer research suggesting a need for higher protein requirements, I'd be interested in your thoughts? Here's a thread I started not too long ago about higher protein, but it's not getting a lot of traction. Many here are worried about spiking mTOR and insulin, while I'm beginning to think that fear can go too far, unless one has the time and ability do a lot of exercise to be really lean and muscular without it.
ApoE 3/4 > Thanks in advance for any responses made to my posts.


Return to “Science and Research”

Who is online

Users browsing this forum: No registered users and 9 guests