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Manifestation of Novel Social Challenges of the European Union in the Teaching Material of Medical Biotechnology Master’s Programmes at the University of Pécs and at the University of Debrecen Identification number: TÁMOP-4.1.2-08/1/A-2009-0011.

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slide1

Manifestation of Novel Social Challenges of the European Unionin the Teaching Material ofMedical Biotechnology Master’s Programmesat the University of Pécs and at the University of Debrecen

Identification number: TÁMOP-4.1.2-08/1/A-2009-0011

nutrition physical status body composition sarcopenia part 1

Manifestation of Novel Social Challenges of the European Unionin the Teaching Material ofMedical Biotechnology Master’s Programmesat the University of Pécs and at the University of Debrecen

Identification number: TÁMOP-4.1.2-08/1/A-2009-0011

Erika Pétervári and Miklós Székely

Molecular and Clinical Basics of Gerontology – Lecture 3

Nutrition,physical status,body composition, sarcopeniaPart 1
body composition energy stores
Body composition – energy stores

In a healthy young human being:

  • Adipose tissue: circa 15 kg (130–140,000 kcal)
  • Protein: around 10-12 kg (35–40,000 kcal)
  • Carbohydrates: circa 0.3 kg (1,100 kcal)
  • Water: around 42 kg
  • Minerals: about 4 kg
slide4

Lean body mass (LBM)and

  • fat mass (FM)
    • LBMFM
  • 20-y60+13=73 kg
  • 70-y48+26=74 kg
  • Excess weight (if any) = mainly fat(NOT only in fat tissue)
  • Age-related obesity:fat accumulation in parenchymal cells (muscle, liver)  LIPOTOXICITY
slide5

Shakespeare: As you like it

All the world's a stage,

And all the men and women merely players;

They have their exits and their entrances;

And one man in his time plays many parts,

His acts being seven ages. At first the infant,

Mewling and puking in the nurse's arms;

Then the whining school-boy, with his satchel

And shining morning face, creeping like snail

Unwittingly to school. And then the lover,

Sighing like furnace, with a woeful ballad

Made to his mistress' eyebrow. Then a soldier,

Full of strange oaths, and bearded like a pard,

Jealous in honour, sudden and quick in quarrel,

Seeking the bubble reputation.

Even in the cannon's mouth. And then the justice,

In fair round belly with good capon lin'd,

With eyes severe and beard of formal cut,

Full of wise saws and modern instances;

And so he plays his part. The sixth age shifts

Into the lean and slipper'd pantaloon,

With spectacles on nose and pouch on side;

His youthful hose, well sav'd, a world too wide

For his shrunk shank; and his big manly voice,

Turning again childish treble, pipes

And whistles in his sound. Last scene of all,

That ends this strange eventful history,

Is second childishness and mere oblivion;

Sansteeth, sanseyes, sanstaste, Sanseverything.

body composition energy stores1
Body composition – energy stores

Body Fat Ranges for Standard Adults 1

Underfat

Healthy

Overfat

Obese

Female 20-39

Age 40-59

60-79

40%

30%

20%

10%

0%

Male 20-39

Age 40-59

60-79

Underfat

Healthy

Overfat

Obese

Based on NIH/WHO BMI Guidelines.

changes in body composition with age
Changes in body compositionwith age

Body weight increases until 60-65, then it starts to decrease

18-55 years 55-65 years 65-80 years

    • 8-9 kg/decade 1-2 kg/decade -1,-2 kg/decade

The body weight of active athletes does not increase.

  • The fat content of the body increases with age

25 years 75 years

16 – 25 % 28 – 41 % males – females

12 – 15 kg 22 – 25 kg

In active athletes the increase is blunted (~young, lean, sedentary). Intensive training decreases abdominal fat.

Males have a tendency for visceral fat accumulation, after menopause females too.

  • Fat free mass (FFM) is stable until 40, then it decreases

25 years 75 years

62 – 46 kg - 3.5 kg decrease/decade, (-3 – -4 %/decade)

FFM values and changes are relatively stable with small individual differences. The rate of decrease is similar in athletes.

slide8

Adipogenesis and aging

Does aging make fat go MAD?(Duringagingcertaincelltypesdegenerate and lipidsaccumulateinnon-adiposetissues.)
impaired adipogenesis and fat tissue function with aging
Impaired adipogenesis and fat tissue function with aging

Fundamental aging processes(reactive oxygen species, telomeres, other)

 fatty acid handling, glucose metabolism

cytokines,

cellular stress

LIP

CHOP

C/EBP

PPAR

Differentiation-Dependent Genes

fat distribution with aging
Fat distribution with aging

Preadipocytes

Fat in fat

depots

Osteoblasts

Fat outside fat depots

Mesenchymal

adipocyte-like

default

(MAD)

cells

Muscle satellite cells

Insulin

sensitivity

Macrophages

Cytokines

(TNFα, IL-6)

Other mesenchymal cells

AGING

peroxisome proliferator activating receptor g ppar g
Peroxisomeproliferator-activating receptor g (PPAR g)

FABPfatty acid binding protein

UCPuncoupling protein

LXRaliver-X-receptor-a

ABCA1ATP-binding cassette A1

PDK4pyruvat-dehydrogenasekinase,isoenzyme 4

PEPCKphosphoenolpyruvat-carboxykinase

Adipose

FA storage (FABP)

FA oxidation (UCP3)

FFA

Liver

gluconeogenesis (PEPCK)

PPAR

FFA

Muscle

glucoseoxidation (PDK4)

 FA oxidation (UCP3)

Macrophage

oxLDLuptake(CD36)

CH efflux (LXR and ABCA1)

insulin sensitization

glucose lowering

triglyceride lowering

antiatherosclerotic

antihypertensive

fat metabolism
Fat metabolism

cAMP activated prot.kinase

ac CoAcarboxylase inhibition

LEPTIN

carnitin

palmitoyl

acyl

transferase

activation

FA OXIDATION

FA transfer

to mitoch.

slide13

Fat, muscle and aging

Fat mass

Male Female

18-y 18% 33%

85-y 36% 44%

Muscle mass

20-40% loss  SARCOPENIA

body weight and adiposity index in rats
Body weight andadiposity index in rats

600

500

400

Body Weight or Adiposity Index

300

Body Weight

Adiposity Index

200

100

3

12

18

24

30

Age (mo)

slide15

“Optimal” and real rise of bodyweightin a 30-y period

“Optimal”4.5 kg rise (<6%) (30-y period)

RealityWhite male9.7 kg

mean BMI ~30 or >30

Black male 10.1 kg

(n = 16,000)

White female 12.0 kg

Black female 20.8 kg

body mass index
Body Mass Index

Body Weight (kg)

Height (m)2

= 20-25

slide17

Bodyweight change (course of 9y)

AGE at start BW-change

MALE FEMALE

25–45-y + 3.4% + 5.2%

45–65-y no ch. no ch.

65–75-y - 4.1% - 6.3%

u shaped relationship between bmi and mortality ratio
U-shaped relationship betweenBMI and mortality ratio

>210

190

170

150

130

110

90

70

Men’s mortality ratio (× 100)

50

15

18

21

24

27

30

33

36

39

>210

190

BMI associated with lowest mortality(nadir of curve)

Age group BMI

20-29 21.4

30-39 21.6

40-49 22.9

50-59 25.8

60-69 26.6

170

150

130

110

90

70

50

15

18

21

24

27

30

33

36

39

15

18

21

24

27

30

33

36

39

Body Mass Index (kg/m2)

the effect of age on the bmi associated with the lowest mortality
The effect of age on the BMI associated with the lowest mortality

28

The regression lines were computed separately for men and for women.

Note that there is a strong effect of age on the BMI associated with the lowest mortality and that the regression lines for men and women are nearly identical.

26

24

Body Mass Index (wt/ht2)

22

20

18

20

30

40

50

60

70

Age (yrs)

bmi associated with the lowest mortality
BMI associated with the lowest mortality

Increased proportion of fat (♂ 36%, ♀ 44%)

Height !

Normal values may be different (calculations?)