Skip to main content
SpringerLink
Log in

Obesity, muscular strength, muscle composition and physical performance in an elderly population

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To evaluate the association between BMI levels, muscular strength, muscle composition and physical performance in the elderly.

Design

Italians subjects from the Progetto Veneto Anziani (ProVA) study were analyzed.

Setting

The ProVa was a population study focused on chronic diseases and functional limitations in Italian subjects aged ≥65 years living in two Northeast Italian cities.

Participants

The ProVa study included 3099 subjects. ProVa participants with unknown information on BMI or disability status were excluded. The final sample was thus represented by 1.188 men, and 1.723 women.

Measurements

Physical performance was measured with the Short Physical Performance Battery (SPPB) and leg muscular strength with dynamometry. Fat distribution and skeletal muscle composition were measured in an abdominal single-scan magnetic resonance (MRI) in a randomly selected sample of 348 subjects. Study population was stratified by BMI classes.

Results

An association between BMI levels and SPPB was observed. Normal weight subjects showed the best SPPB scores (8.29±0.03), with significant differences compared to underweight (7.50±0.15; p<0.001), overweight (8.12±0.02; p<0.001), class I (7.72±0.04; p<0.001), class II (6.67±0.09; p<0.001) and class III obesity (5.88±0.24; p<0.001). This pattern was not modified by adjustment for possible confounders. Compared to normal weight subjects (22.9±0.1 kg), leg muscular strength was higher in overweight (23.8±0.1; p<0.001) and in class I obesity (24.5±0.1; p<0.001), but it was reduced in class II (21.4±0.3; p<0.001) and class III (19.8±0.9; p<0.001). The association between BMI and impaired physical performance was not affected by adjustment for muscular strength. An inverse association between SPPB scores and fat infiltration in skeletal muscle was observed in patients with abdominal MRI.

Conclusion

A poor physical performance was observed in overweight and obese elderly subjects. Leg strength was reduced only in subjects with severe obesity. Physical performance was negatively influenced by the degree of fat infiltration in skeletal muscle.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys 1960 to 1991 JAMA 1994;272:205–11.

    CAS  PubMed  Google Scholar 

  2. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002;288:1728–32.

    Article  PubMed  Google Scholar 

  3. Condizioni di Salute, Fattori di Rischio e Ricorso ai Servizi Sanitari Anno 2005. Rome, Italy: Istituto Nazionale di Statistica, 2007.

    Google Scholar 

  4. Villareal DT, Apovian CM, Kushner RF et al. American Society for Nutrition; NAASO, The Obesity Society. Obesity in older adults: Technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res. 2005;13:1849–63.

    Article  PubMed  Google Scholar 

  5. LaCroix AZ, Guralnik JM, Berkman LF et al. Maintaining mobility in late life: smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol 1993;137:858–69.

    CAS  PubMed  Google Scholar 

  6. Alley DE, Chang VW. The changing relationship of obesity and disability, 1988–2004. JAMA 2007;298:2020–27.

    Article  CAS  PubMed  Google Scholar 

  7. Busetto L, Romanato G, Zambon S et al. The effects of weight changes after middle age on the rate of disability in an elderly population sample. J Am Geriatr Soc. 2009;57:1015–21.

    Article  PubMed  Google Scholar 

  8. Lang IA, Llewellyn DJ, Alexander K, Melzer D. Obesity, physical function, and mortality in older adults. J Am Geriatr Soc. 2008;56:1474–8.

    Article  PubMed  Google Scholar 

  9. Corti MC, Guralnik JM, Sartori L et al. The effect of cardiovascular and osteoarticular diseases on disability in older Italian men and women: Rationale, design, and sample characteristics of the Progetto Veneto Anziani (PRO.V.A.) study. J Am Geriatr Soc. 2002;50:1535–40.

    Article  PubMed  Google Scholar 

  10. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–61.

    Article  CAS  PubMed  Google Scholar 

  11. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Geneva: World Health Organization, 1998

    Google Scholar 

  12. Bandinelli S, Benvenuti E, Del Lungo I, et al. Measuring muscular strength of the lower limbs by hand-held dynamometer: a standard protocol. Aging 1999;11:287–93.

    CAS  PubMed  Google Scholar 

  13. Rossi A, Zoico E, Goodpaster BH et al. Quantification of intermuscular adipose tissue in the erector spinae muscle by MRI: Agreement with histological evaluation. Obesity 2010;18:2379–84.

    Article  PubMed  Google Scholar 

  14. Zamboni M, Turcato E, Santana H, et al. The relationship between body composition and physical performance in older women. J Am Geriatr Soc. 1999;47:1403–8.

    Article  CAS  PubMed  Google Scholar 

  15. Himes CL. Obesity, disease, and functional limitation in later life. Demography 2000;37:73–82.

    Article  CAS  PubMed  Google Scholar 

  16. Jensen GL, Friedmann JM. Obesity is associated with functional decline in community-dwelling rural older persons. J Am Geriatr Soc. 2002;50:918–23.

    Article  PubMed  Google Scholar 

  17. Peeters A, Bonneux L, Nusselder WJ, De Laet C, Barendregt JJ. Adult obesity and the burden of disability throughout life. Obes Res. 2004;12:1145–51.

    Article  PubMed  Google Scholar 

  18. Reynolds SL, Saito Y, Crimmins EM. The impact of obesity on active life expectancy in older American men and women. Gerontologist 2005;45:438–44.

    Article  PubMed  Google Scholar 

  19. Visser M, Harris TB, Langlois J et al. Body fat and skeletal muscle mass in relation to physical disability in very old men and women of the Framingham heart study. J Gerontol A Biol Sci Med Sci. 1998;53:M214–21.

    Article  CAS  PubMed  Google Scholar 

  20. Baumgartner RN, Wayne SJ, Waters DL et al. Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obes Res 2004;12:1995–2004.

    Article  PubMed  Google Scholar 

  21. Stenholm S, Alley D, Bandinelli S et al. The effect of obesity combined with low muscle strength on decline in mobility in older persons: results from the InCHIANTI Study. Int J Obes 2009;33:635–44.

    Article  CAS  Google Scholar 

  22. Sallinen J, Stenholm S, Rantanen T, et al. Effect of age on the association between body fat percentage and maximal walking speed. J Nutr Health Aging 2011;15:427–32.

    Article  CAS  PubMed  Google Scholar 

  23. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412–23.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Stenholm S, Rantanen T, Heliövaara M, Koskinen S. The mediating role of C-reactive protein and handgrip strength between obesity and walking limitation. J Am Geriatr Soc. 2008;56:462–9.

    Article  PubMed  Google Scholar 

  25. Strugnell C, Dunstan DW, Magliano DJ, Zimmet PZ, Shaw JE, Daly RM. Influence of age and gender on fat mass, fat-free mass and skeletal muscle mass among Australian adults: the Australian diabetes, obesity and lifestyle study (AusDiab). J Nutr Health Aging 2014;18:540–6.

    Article  CAS  PubMed  Google Scholar 

  26. Frontera WR, Hughes VA, Lutz KJ, Evans WJ. A cross-sectional study of muscle strength and mass in 45- to 78-yr-old men and women. J Appl Physiol. 1991;71:644–50.

    CAS  PubMed  Google Scholar 

  27. Marcus RL, Addison O, Kidde JP, Dibble LE, Lastayo PC. Skeletal muscle fat infiltration: impact of age, inactivity, and exercise. J Nutr Health Aging 2010;14:362–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Goodpaster BH, Krishnaswami S, Harris TB et al. Obesity, regional body fat distribution, and the metabolic syndrome in older men and women. Arch Intern Med. 2005;165:777–83.

    Article  PubMed  Google Scholar 

  29. Hardin BJ, Campbell KS, Smith JD et al. TNF-alpha acts via TNFR1 and muscle-derived oxidants to depress myofibrillar force in murine skeletal muscle. J Appl Physiol. 2008;104:694–9.

    Article  CAS  PubMed  Google Scholar 

  30. Visser M, Kritchevsky SB, Goodpaster BH et al. Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70 to 79: the health, aging and body composition study. J Am Geriatr Soc. 2002;50:897–904.

    Article  PubMed  Google Scholar 

  31. Marcus RL, Addison O, Dibble LE et al. Intramuscular adipose tissue, sarcopenia, and mobility function in older individuals. J Aging Res. 2012;2012:629637.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Sattler F, Bhasin S, He J et al. Testosterone threshold levels and lean tissue mass targets needed to enhance skeletal muscle strength and function: the HORMA trial. J Gerontol A Biol Sci Med Sci. 2011;66:122–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, University of Padova, Padova, Italy

    Fabio De Stefano, S. Zambon, L. Giacometti, G. Sergi, M. C. Corti, E. Manzato & L. Busetto

  2. Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Padova, Clinica Medica I, Policlinico Universitario, Via Giustiniani 2, 35128, Padova, Italy

    Fabio De Stefano

Authors
  1. Fabio De Stefano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Zambon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Giacometti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Sergi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. C. Corti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Manzato
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Busetto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fabio De Stefano.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

De Stefano, F., Zambon, S., Giacometti, L. et al. Obesity, muscular strength, muscle composition and physical performance in an elderly population. J Nutr Health Aging 19, 785–791 (2015). https://doi.org/10.1007/s12603-015-0482-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-015-0482-3

Key words

Search

Navigation