Comparison of maximal muscle strength of elbow flexors and knee extensors between younger and older men with the same level of daily activity Background: Aging promotes neuromuscular loss, significantly reducing muscle strength. The magnitude of loss of strength seems to be different between the limbs, probably because of differences in activities of daily living (ADL). Therefore, the present study compared the muscle strength of the elbow flexors and knee extensors in younger (n = 7, mean age 23.3 ± 1.2 years) and older (n = 5, mean age 61.8 ± 2.6 years) men matched by ADL level. contractions of the elbow flexors and knee extensors using an isokinetic dynamometer following a crossover study design. Changes in the dependent variables were compared using mixed model analysis (limb versus age). Results: The main results demonstrated that concentric, eccentric, and mean contraction torques for knee extensors were significantly (P , 0.05) higher for younger men than for elderly men. On the other hand, no statistically significant difference (P. 0.05) was found in concentric, isometric, eccentric, and mean torques for elbow flexors between younger and older individuals. Conclusion: These results show that elbow flexors maintain better strength than knee extensors through aging, even when comparing individuals with similar ADL levels.

Inappropriate prescribing in the hospitalized elderly patient: Defining the problem, evaluation tools, and possible solutions

High Calorie Diet and the Human Brain

Background Conflicting evidence associates diet acidity with the incidence of chronic diseases such as hypertension, diabetes, kidney disease, and bone-mineral disorders. It is currently unknown whether dietary acidity is associated with death. Objective We investigated the association of dietary acid load with the risk of all-cause and cardiovascular disease (CVD) mortality. Methods We used data from 2 prospective cohorts, the Swedish Mammography Cohort and the Cohort of Swedish Men, which included 36,740 women and 44,957 men aged 45-84 y at the start of a 15-y follow-up period (1998-2012). Acid load was estimated from food-frequency questionnaires by use of the validated potential renal acid load (PRAL) algorithm. Deaths were ascertained via record linkage. Associations of PRAL with mortality were modeled by use of restricted cubic splines. Results The median PRAL was 0.65 mEq/d (range: -109 to 81.5 mEq/d) in women and 12.3 mEq/d (-111 to 121 mEq/d) in men. During a mean of 13.5 ± 3.3 y of follow-up, there were 8576 and 13,332 deaths, of which 3203 and 5427 were attributed to cardiovascular causes in woman and men, respectively. In both sexes, a nonlinear U-shaped relation was observed, with higher mortality rates for both dietary acid and alkali excess. Compared with neutral PRAL (0 mEq/d), the HRs for all-cause mortality for the 10th and 90th percentiles of PRAL were 1.05 (95% CI: 1.01, 1.10) and 1.03 (95% CI: 0.98, 1.08), respectively, in women. The corresponding results for men were HRs 1.01 (95% CI: 1.00, 1.02) and 1.04 (95% CI: 1.00, 1.08) respectively. This relation was slightly stronger for CVD mortality. Conclusions Excess diet alkalinity and acidity both showed weak associations with higher mortality in Swedish adults. An acid-base balanced diet was associated with the lowest mortality, but the magnitude of mortality reduction was modest. The Swedish Mammography Cohort was registered at clinicaltrials.gov as NCT01127698 The Cohort of Swedish Men was registered at clinicaltrials.gov as NCT01127711.

/pdf/modest-u-shaped-association-between-dietary-acid-load-and-36vm16zyq4.pdf

Modest U-Shaped Association between Dietary Acid Load and Risk of All-Cause and Cardiovascular Mortality in Adults

Dietary acid load from Western diets may be a risk factor for osteoporosis. It can be estimated by net endogenous acid production (NEAP). No data currently exists for NEAP estimates and bone indices in the very elderly (i.e. > or = 75 y). The aim of this study was to determine the association between NEAP estimates by using the potential renal acid load (PRAL) equation and quantitative bone ultrasound (QUS) measurements at the heel [broadband ultrasound attenuation (BUA)] in Caucasian women. We assessed NEAP and QUS in 401 very elderly Swiss ambulatory women. We evaluated dietary intake and NEAP estimates with a validated FFQ. QUS was measured using Achilles (Lunar). We identified 2 subgroups: 256 women (80.6 y +/- 3; BUA, 96.8 dB/MHz) with a fracture history and the remaining 145 (79.9 y SD 2.9; BUA, 101.7 dB/MHz) without. Women who reported having suffered a fracture had lower BUA (P < 0.001) than nonfractured women but did not differ in nutrient intakes and NEAP. Lower NEAP (P = 0.023) and higher potassium intake (P = 0.033) were correlated with higher BUA, which remained significant even after adjustment for age, BMI, and osteoporosis treatment. BUA was positively correlated with calcium (P = 0.016) and BMI (P < 0.001). Women who reported no fractures had no significant correlations between nutrient intake, NEAP, and BUA. Low nutritional acid load was correlated with higher BUA in very elderly women with a fracture history. Although relatively weak compared with age and BMI, this association was significant and may be an important additional risk factor that might be particularly relevant in frail patients with an already high fracture risk.

/pdf/low-estimates-of-dietary-acid-load-are-positively-associated-1rp3dxerxn.pdf

Low Estimates of Dietary Acid Load Are Positively Associated with Bone Ultrasound in Women Older Than 75 Years of Age with a Lifetime Fracture

There is growing evidence that consumption of a Western diet is a risk factor for osteoporosis through excess acid supply, while fruits and vegetables balance the excess acidity, mostly by providing K-rich bicarbonate-rich foods. Western diets consumed by adults generate approximately 50-100 mEq acid/d; therefore, healthy adults consuming such a diet are at risk of chronic low-grade metabolic acidosis, which worsens with age as a result of declining kidney function. Bone buffers the excess acid by delivering cations and it is considered that with time an overstimulation of this process will lead to the dissolution of the bone mineral content and hence to reduced bone mass. Intakes of K, Mg and fruit and vegetables have been associated with a higher alkaline status and a subsequent beneficial effect on bone health. In healthy male volunteers an acid-forming diet increases urinary Ca excretion by 74% and urinary C-terminal telopeptide of type I collagen (C-telopeptide) excretion by 19% when compared with an alkali (base-forming) diet. Cross-sectional studies have shown that there is a correlation between the nutritional acid load and bone health measured by bone ultrasound or dual-energy X-ray absorptiometry. Few studies have been undertaken in very elderly women (>75 years), whose osteoporosis risk is very pertinent. The EVAluation of Nutrients Intakes and Bone Ultra Sound Study has developed and validated (n 51) an FFQ for use in a very elderly Swiss population (mean age 80.4 (sd 2.99) years), which has shown intakes of key nutrients (energy, fat, carbohydrate, Ca, Mg, vitamin C, D and E) to be low in 401 subjects. A subsequent study to assess net endogenous acid production (NEAP) and bone ultrasound results in 256 women aged > or = 75 years has shown that lower NEAP (P=0.023) and higher K intake (P=0.033) are correlated with higher bone ultrasound results. High acid load may be an important additional risk factor that may be particularly relevant in very elderly patients with an already-high fracture risk. The latter study adds to knowledge by confirming a positive link between dietary alkalinity and bone health indices in the very elderly. In a further study to complement these findings it has also been shown in a group of thirty young women that in Ca sufficiency an acid Ca-rich water has no effect on bone resorption, while an alkaline bicarbonate-rich water leads to a decrease in both serum parathyroid hormone and serum C-telopeptide. Further investigations need to be undertaken to study whether these positive effects on bone loss are maintained over long-term treatment. Mineral-water consumption could be an easy and inexpensive way of helping to prevent osteoporosis and could be of major interest for long-term prevention of bone loss.

/pdf/postgraduate-symposium-positive-influence-of-nutritional-5dijjda255.pdf

Postgraduate Symposium: Positive influence of nutritional alkalinity on bone health.

Simple Summary Magnesium is an essential nutrient, also called an essential mineral or element. Magnesium is vastly important in all life, with vital roles for the healthy functioning of the human immune, metabolic, neurological, psychological, and heart and circulatory systems. Our bodies cannot “make” magnesium; rather, we must get it from outside the body—from our environment, usually through food and water. In most modern cultures, magnesium intake has been low for decades. When the COVID-19 pandemic began, a group of international magnesium researchers were profoundly struck by the strong similarities between low magnesium status and the many risk factors for COVID-19, including older age, obesity, diabetes, kidney disease, cardiovascular disease, hypertension, and ailments that affect breathing. They began Zoom meetings to share ideas, data, and study plans and formed the MaGNet Global Magnesium Project. This review, written by several MaGNet members, discusses several peer-reviewed studies demonstrating the following: (1) low magnesium status is associated with the severity of COVID-19 outcomes, including mortality, and with several disease-related neurological symptoms, including loss of memory, taste, and/or smell; (2) inhaled magnesium as a therapy may improve oxygen status; and (3) magnesium therapy, alone or in combination with zinc, may increase the effectiveness of anti-COVID-19 medications. Abstract A large amount of published research points to the interesting concept (hypothesis) that magnesium (Mg) status may have relevance for the outcome of COVID-19 and that Mg could be protective during the COVID disease course. As an essential element, Mg plays basic biochemical, cellular, and physiological roles required for cardiovascular, immunological, respiratory, and neurological functions. Both low serum and dietary Mg have been associated with the severity of COVID-19 outcomes, including mortality; both are also associated with COVID-19 risk factors such as older age, obesity, type 2 diabetes, kidney disease, cardiovascular disease, hypertension, and asthma. In addition, populations with high rates of COVID-19 mortality and hospitalization tend to consume diets high in modern processed foods, which are generally low in Mg. In this review, we review the research to describe and consider the possible impact of Mg and Mg status on COVID-19 showing that (1) serum Mg between 2.19 and 2.26 mg/dL and dietary Mg intakes > 329 mg/day could be protective during the disease course and (2) inhaled Mg may improve oxygenation of hypoxic COVID-19 patients. In spite of such promise, oral Mg for COVID-19 has thus far been studied only in combination with other nutrients. Mg deficiency is involved in the occurrence and aggravation of neuropsychiatric complications of COVID-19, including memory loss, cognition, loss of taste and smell, ataxia, confusion, dizziness, and headache. Potential of zinc and/or Mg as useful for increasing drug therapy effectiveness or reducing adverse effect of anti-COVID-19 drugs is reviewed. Oral Mg trials of patients with COVID-19 are warranted.

https://www.mdpi.com/2079-7737/12/5/735/pdf?version=1684490217

Importance of Magnesium Status in COVID-19

The role of nutrition in human acid-base homeostasis has gained increasing attention in recent years. Although in healthy humans, homeostatic mechanisms and the kidneys' capacity to excrete acid equivalents can prevent strong diet-induced alterations in blood pH, even moderate increases in blood hydrogen ion levels as a result of unfavorable diet composition can have long-term consequences for the occurrence and progression of a number of diseases. The Second International Acid-Base Symposium, Nutrition-Health-Disease, provided deeper insight and updates in the scientific basis of the relation among diet, acid-base homeostasis, physiology, and pathophysiological consequences.

Dietary, Metabolic, Physiologic, and Disease-Related Aspects of Acid-Base Balance: Foreword to the Contributions of the Second International Acid-Base Symposium

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Importance of Magnesium Status in COVID-19

Dietary, Metabolic, Physiologic, and Disease-Related Aspects of Acid-Base Balance: Foreword to the Contributions of the Second International Acid-Base Symposium