title: The combined effects of diet quality and physical activity on maintenance of muscle strength among diabetic older adults from the NuAge cohort.
abstract: Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabetic counterparts. Adequate protein and energy intakes and physical activity (PA) may preserve MS during aging. However, the role of diet quality (DQ) in MS maintenance is still unknown. This study aimed to determine the association between DQ - alone or combined with PA - and changes in MS over 3 years in diabetic participants aged 67 to 84 years at recruitment in a secondary analysis of the longitudinal observational NuAge study. Changes in handgrip, knee extensor and elbow flexor strengths were calculated as the difference between recruitment (T1) and after 3 years (T4) in 156 diabetic older adults. Baseline DQ was calculated from 3 non-consecutive 24-hour dietary recalls collected at T1 using the validated Canadian Healthy Eating Index (C-HEI). Change in PA was calculated from Physical Activity Scale for the Elderly (PASE) as PASE T4-PASE T1. Four combinations of variables were created: C-HEI<70 with PASE change either < or > median and C-HEI ≥ 70 with PASE change either < or > median. The association between these four categories and MS maintenance was evaluated using General Linear Modeling (GLM). Analyses were stratified by sex and controlled for covariates. Baseline DQ alone was not associated with MS maintenance. Baseline DQ combined with PASE change showed associations with crude and baseline adjusted handgrip strength (p=0.031, p=0.018) and crude and baseline adjusted elbow flexor change (p=0.028, p=0.017) in males only; no significant results were found for knee extensor strength in either males or females. While findings for females were inconclusive, results demonstrate that better adherence to dietary guidelines combined with a more active lifestyle may prevent MS decline among diabetic older males. Additional research is needed on a larger sample since generalization of these results is limited by the small sample size.
authors.affiliation: Département de Nutrition, Université de Montréal, Canada.
authors.forename: Berna
authors.initials: B
authors.lastname: Rahi
authors.affiliation: Division of Geriatric Medicine, McGill University, Canada.
authors.forename: José A
authors.initials: JA
authors.lastname: Morais
authors.affiliation: Faculté d'Éducation Physique et Sportive, Université de Sherbrooke, Canada; Centre de Recherche sur le Vieillissement, CSSS-IUGS, Canada.
authors.forename: Isabelle J
authors.initials: IJ
authors.lastname: Dionne
authors.affiliation: Centre Hospitalier de l'Université de Montréal Research Center, Canada; Département de Médecine, Université de Montréal, Canada.
authors.forename: Pierrette
authors.initials: P
authors.lastname: Gaudreau
authors.affiliation: Centre de Recherche sur le Vieillissement, CSSS-IUGS, Canada; Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Canada.
authors.forename: Hélène
authors.initials: H
authors.lastname: Payette
authors.affiliation: Département de Nutrition, Université de Montréal, Canada; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Canada. Electronic address: bryna.shatenstein@umontreal.ca.
authors.forename: Bryna
authors.initials: B
authors.lastname: Shatenstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000503:physiopathology / Q000534:rehabilitation; D003927:Diet, Diabetic / Q000592:standards*; D004551:Elbow Joint / Q000503:physiopathology; D058620:Elder Nutritional Physiological Phenomena / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D012959:Socioeconomic Factors
keywords: 24-HR; 24-h dietary recalls; DQ; Diet quality; HDQ–DPA; HDQ–ISPA; LDQ–DPA; LDQ–ISPA; Muscle strength; NuAge; Older adults; PA; Physical activity; Québec Longitudinal Study on Nutrition and Successful Aging; Type 2 diabetes; diet quality; high diet quality–decreased physical activity; high diet quality–stable physical activity; low diet quality–decreased physical activity; low diet quality–stable physical activity; physical activity