human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study was design ed to evaluate the effects of enriching an essential amino acid ( EAA ) mixture with leucine on muscle protein metabolism in elderly and young individuals . Four ( 2 elderly and 2 young ) groups were studied before and after ingestion of 6.7 g of EAAs . EAAs were based on the composition of whey protein [ 26 % leucine ( 26 % Leu ) ] or were enriched in leucine [ 41 % leucine ( 41 % Leu ) ] . A primed , continuous infusion of L-[ring-2H5]phenylalanine was used together with vastus lateralis muscle biopsies and leg arteriovenous blood sample s for the determinations of fractional synthetic rate ( FSR ) and balance of muscle protein . FSR increased following amino acid ingestion in both the 26 % ( basal : 0.048 + /- 0.005%/h ; post-EAA : 0.063 + /- 0.007%/h ) and the 41 % ( basal : 0.036 + /- 0.004%/h ; post-EAA : 0.051 + /- 0.007%/h ) Leu young groups ( P < 0.05 ) . In contrast , in the elderly , FSR did not increase following ingestion of 26 % Leu EAA ( basal : 0.044 + /- 0.003%/h ; post-EAA : 0.049 + /- 0.006%/h ; P > 0.05 ) but did increase following ingestion of 41 % Leu EAA ( basal : 0.038 + /- 0.007%/h ; post-EAA : 0.056 + /- 0.008%/h ; P < 0.05 ) . Similar to the FSR responses , the mean response of muscle phenylalanine net balance , a reflection of muscle protein balance , was improved ( P < 0.05 ) in all groups , with the exception of the 26 % Leu elderly group . We conclude that increasing the proportion of leucine in a mixture of EAA can reverse an attenuated response of muscle protein synthesis in elderly but does not result in further stimulation of muscle protein synthesis in young subjects BACKGROUND & AIM Sarcopenia , the age-related decrease in muscle mass , strength , and function , is a main cause of reduced mobility , increased falls , fractures and nursing home admissions . Cross-sectional and prospect i ve studies indicate that sarcopenia may be influenced in part by reversible factors like nutritional intake . The aim of this study was to compare functional and nutritional status , body composition , and quality of life of older adults between age and sex-matched older adults with and without sarcopenia . METHODS In a multi-centre setting , non-sarcopenic older adults ( n = 66 , mean ± SD : 71 ± 4 y ) , i.e. Short Physical Performance Battery ( SPPB ) : 11 - 12 and normal skeletal muscle mass index , were recruited to match 1:1 by age and sex to previously recruited adults with sarcopenia : SPPB 4 - 9 and low skeletal muscle mass index . Health-related quality of life , self-reported physical activity levels and dietary intakes were measured using the EQ-5D scale and index , Physical Activity Scale for the Elderly ( PASE ) , and 3-day prospect i ve diet records , respectively . Concentrations of 25-OH-vitamin D , α-tocopherol ( adjusted for cholesterol ) , folate , and vitamin B-12 were assessed in serum sample s. RESULTS In addition to the defined components of sarcopenia , i.e. muscle mass , strength and function , reported physical activity levels and health-related quality of life were lower in the sarcopenic adults ( p < 0.001 ) . For similar energy intakes ( mean ± SD : sarcopenic , 1710 ± 418 ; non-sarcopenic , 1745 ± 513 , p = 0.50 ) , the sarcopenic group consumed less protein/kg ( -6 % ) , vitamin D ( -38 % ) , vitamin B-12 ( -22 % ) , magnesium ( -6 % ) , phosphorus ( -5 % ) , and selenium ( -2 % ) ( all p < 0.05 ) compared to the non-sarcopenic controls . The serum concentration of vitamin B-12 was 15 % lower in the sarcopenic group ( p = 0.015 ) , and all other nutrient concentrations were similar between groups . CONCLUSIONS In non-malnourished older adults with and without sarcopenia , we observed that sarcopenia substantially impacted self-reported quality of life and physical activity levels . Differences in nutrient concentrations and dietary intakes were identified , which might be related to the differences in muscle mass , strength and function between the two groups . This study provides information to help strengthen the characterization of this geriatric syndrome sarcopenia and indicates potential target areas for nutritional interventions BACKGROUND Poor nutrient intake is conceptualized to be a component of frailty , but this hypothesis has been little investigated . We examined the association between low energy and nutrient intake and frailty . METHODS We used data from 802 persons aged 65 years or older participating to the InCHIANTI ( Invecchiare in Chianti , aging in the Chianti area ) study . Frailty was defined by having at least two of the following criteria : low muscle strength , feeling of exhaustion , low walking speed , and reduced physical activity . The European Prospect i ve Investigation into Cancer and nutrition ( EPIC ) question naire was used to estimate the daily intake of energy and nutrients .  Low intake was defined using the value corresponding to the lowest sex-specific intake quintile of energy and specific nutrients . Adjusted logistic regression analyses were used to study the association of frailty and frailty criteria with low intakes of energy and nutrients . RESULTS Daily energy intake < or = 21 kcal/kg was significantly associated with frailty ( odds ratio [ OR ] : 1.24 ; 95 % CI : 1.02 - 1.5 ) . After adjusting for energy intake , a low intake of protein ( OR : 1.98 ; 95 % CI : 1.18 - 3.31 ) ; vitamins D ( OR : 2.35 ; 95 % CI : 1.48 - 3.73 ) , E ( OR : 2.06 ; 95 % CI : 1.28 - 3.33 ) , C ( OR : 2.15 ; 95 % CI : 1.34 - 3.45 ) , and folate ( OR : 1.84 ; 95 % CI : 1.14 - 2.98 ) ; and having a low intake of more than three nutrients ( OR : 2.12 ; 95 % CI : 1.29 - 3.50 ) were significantly and independently related to frailty . CONCLUSIONS This study provides evidence that low intakes of energy and selected nutrients are independently associated with frailty OBJECTIVES To evaluate the association between protein intake and incident frailty . DESIGN Prospect i ve cohort study . SETTING Subset of the Women 's Health Initiative Observational Study conducted at 40 clinical centers . PARTICIPANTS Twenty-four thous and four hundred seventeen women aged 65 to 79 who were free of frailty at baseline with plausible self-reported energy intakes ( 600 - 5,000 kcal/day ) according to the Food Frequency Question naire ( FFQ ) . MEASUREMENTS Baseline protein intake was estimated from the FFQ . Calibrated estimates of energy and protein intake were corrected for measurement error using regression calibration equations estimated from objective measures of total energy expenditure ( doubly labeled water ) and dietary protein ( 24-hour urinary nitrogen ) . After 3 years of follow-up , frailty was defined as having at least three of the following components : low physical function ( measured using the R and -36 question naire ) , exhaustion , low physical activity , and unintended weight loss . Multinomial logistic regression models estimated associations for uncalibrated and calibrated protein intake . RESULTS Of the 24,417 eligible women , 3,298 ( 13.5 % ) developed frailty over 3 years . After adjustment for confounders , a 20 % increase in uncalibrated protein intake ( % kcal ) was associated with a 12 % ( 95 % confidence interval (CI)=8 - 16 % ) lower risk of frailty , and a 20 % increase in  calibrated protein intake  was associated with a 32 % ( 95 % CI=23 - 50 % ) lower risk of frailty . CONCLUSION Higher protein consumption , as a fraction of energy , is associated with a strong , independent , dose-responsive lower risk of incident frailty in older women . Using uncalibrated measures underestimated the strength of the association . Incorporating more protein into the diet may be an intervention target for frailty prevention Dietary protein intake might be beneficial to physical function ( PF ) in the elderly . We examined the cross-sectional and prospect i ve associations of protein intake of g/kg body weight ( BW ) , fat mass ( FM ) and lean mass ( LM ) with PF in 554 women aged 65·3 - 71·6 years belonging to the Osteoporosis Risk Factor and Prevention Fracture Prevention Study . Participants filled a question naire on lifestyle factors and 3-d food record in 2002 . Body composition was measured by dual-energy X-ray absorptiometry , and PF measures were performed at baseline and at 3-year follow-up . Sarcopaenia was defined using European Working Group on Sarcopenia in Older People criteria . At the baseline , women with higher protein intake ( ≥ 1·2 g/kg BW ) had better performance in h and -grip strength/body mass ( GS/BM ) ( P=0·001 ) , knee extension/BM ( P=0·003 ) , one-leg stance ( P=0·047 ) , chair rise ( P=0·043 ) , squat ( P=0·019 ) , squat to the ground ( P=0·001 ) , faster walking speed for 10 m ( P=0·005 ) and higher short physical performance battery score ( P=0·004 ) compared with those with moderate and lower intakes ( 0·81 - 1·19 and ≤ 0·8 g/kg BW , respectively ) . In follow-up results , higher protein intake was associated with less decline in GS/BM , one-leg stance and t and em walk for 6 m over 3 years . Overall , results were no longer significant after controlling for FM . Associations were detected between protein intake and PF in non-sarcopaenic women but not in sarcopaenic women , except for change of GS ( P=0·037 ) . Further , FM but not LM was negatively associated with PF measures ( P<0·050 ) . This study suggests that higher protein intake and lower FM might be positively associated with PF in elderly women Objective To examine the association of dietary protein intake with 4-year change in physical performance measures and muscle mass in Chinese community-dwelling older people aged 65 and older in Hong Kong . Design Prospect i ve cohort study design . Setting Hong Kong , People ’s of Republic of China . Participants There were 2,726 ( 1411 male , 1315 female ) community-dwelling older people aged 65 and older . Measurements Baseline total , animal and vegetable protein intakes  were collected using a vali date d food frequency question naire . Relative protein intake expressed as g/kg body weight was calculated and divided into quartiles for data analysis . Baseline and 4-year physical performance measures ( normal and narrow 6-meters walking speed and step length in a 6-meters walk ) were measured and 4-year change in appendicular skeletal muscle mass ( ASM ) from baseline was assessed by dual-energy X-ray absorptiometry . Univariate analysis identified age and sex as significant factors associated with change in physical performance measures or ASM , thus adjustments for these factors were made for subsequent analysis of covariance . Results  Median relative total protein intake  was 1.3 g/kg body weight in men and 1.1 g/kg body weight in women . After adjustment for age and sex , relative total protein intake and animal protein intake were not associated with change in physical performance measures and ASM . In contrast , participants in the highest quartile ( > 0.72 g/kg body weight ) of relative vegetable protein intake lost significantly less ASM over 4-year than those in the lowest quartile of relative vegetable protein intake ( < = 0.40 g/kg body weight ) ( adjusted mean ± SE : 0.270 ± 0.029 vs. 0.349 ± 0.030 kg , ptrend=0.025 ) . There was no association between relative vegetable protein intake and change in physical performance measures .  Conclusions Higher protein intake from vegetable source was associated with reduced muscle loss in Chinese community-dwelling older people in Hong Kong whereas no association between total and animal protein intake and subsequent decline in muscle mass or physical performance measures was observed in this sample OBJECTIVES To examine the association between consumption of dairy products and risk of frailty  in community-dwelling older adults . DESIGN Prospect i ve cohort study . SETTING General population from the older cohort of the Study on Nutrition and Cardiovascular Risk in Spain . PARTICIPANTS Community-dwelling adults aged 60 and older free of frailty at baseline ( N = 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study was design ed to evaluate the effects of enriching an essential amino acid ( EAA ) mixture with leucine on muscle protein metabolism in elderly and young individuals . Four ( 2 elderly and 2 young ) groups were studied before and after ingestion of 6.7 g of EAAs . EAAs were based on the composition of whey protein [ 26 % leucine ( 26 % Leu ) ] or were enriched in leucine [ 41 % leucine ( 41 % Leu ) ] . A primed , continuous infusion of L-[ring-2H5]phenylalanine was used together with vastus lateralis muscle biopsies and leg arteriovenous blood sample s for the determinations of fractional synthetic rate ( FSR ) and balance of muscle protein . FSR increased following amino acid ingestion in both the 26 % ( basal : 0.048 + /- 0.005%/h ; post-EAA : 0.063 + /- 0.007%/h ) and the 41 % ( basal : 0.036 + /- 0.004%/h ; post-EAA : 0.051 + /- 0.007%/h ) Leu young groups ( P < 0.05 ) . In contrast , in the elderly , FSR did not increase following ingestion of 26 % Leu EAA ( basal : 0.044 + /- 0.003%/h ; post-EAA : 0.049 + /- 0.006%/h ; P > 0.05 ) but did increase following ingestion of 41 % Leu EAA ( basal : 0.038 + /- 0.007%/h ; post-EAA : 0.056 + /- 0.008%/h ; P < 0.05 ) . Similar to the FSR responses , the mean response of muscle phenylalanine net balance , a reflection of muscle protein balance , was improved ( P < 0.05 ) in all groups , with the exception of the 26 % Leu elderly group . We conclude that increasing the proportion of leucine in a mixture of EAA can reverse an attenuated response of muscle protein synthesis in elderly but does not result in further stimulation of muscle protein synthesis in young subjects BACKGROUND & AIM Sarcopenia , the age-related decrease in muscle mass , strength , and function , is a main cause of reduced mobility , increased falls , fractures and nursing home admissions . Cross-sectional and prospect i ve studies indicate that sarcopenia may be influenced in part by reversible factors like nutritional intake . The aim of this study was to compare functional and nutritional status , body composition , and quality of life of older adults between age and sex-matched older adults with and without sarcopenia . METHODS In a multi-centre setting , non-sarcopenic older adults ( n = 66 , mean ± SD : 71 ± 4 y ) , i.e. Short Physical Performance Battery ( SPPB ) : 11 - 12 and normal skeletal muscle mass index , were recruited to match 1:1 by age and sex to previously recruited adults with sarcopenia : SPPB 4 - 9 and low skeletal muscle mass index . Health-related quality of life , self-reported physical activity levels and dietary intakes were measured using the EQ-5D scale and index , Physical Activity Scale for the Elderly ( PASE ) , and 3-day prospect i ve diet records , respectively . Concentrations of 25-OH-vitamin D , α-tocopherol ( adjusted for cholesterol ) , folate , and vitamin B-12 were assessed in serum sample s. RESULTS In addition to the defined components of sarcopenia , i.e. muscle mass , strength and function , reported physical activity levels and health-related quality of life were lower in the sarcopenic adults ( p < 0.001 ) . For similar energy intakes ( mean ± SD : sarcopenic , 1710 ± 418 ; non-sarcopenic , 1745 ± 513 , p = 0.50 ) , the sarcopenic group consumed less protein/kg ( -6 % ) , vitamin D ( -38 % ) , vitamin B-12 ( -22 % ) , magnesium ( -6 % ) , phosphorus ( -5 % ) , and selenium ( -2 % ) ( all p < 0.05 ) compared to the non-sarcopenic controls . The serum concentration of vitamin B-12 was 15 % lower in the sarcopenic group ( p = 0.015 ) , and all other nutrient concentrations were similar between groups . CONCLUSIONS In non-malnourished older adults with and without sarcopenia , we observed that sarcopenia substantially impacted self-reported quality of life and physical activity levels . Differences in nutrient concentrations and dietary intakes were identified , which might be related to the differences in muscle mass , strength and function between the two groups . This study provides information to help strengthen the characterization of this geriatric syndrome sarcopenia and indicates potential target areas for nutritional interventions BACKGROUND Poor nutrient intake is conceptualized to be a component of frailty , but this hypothesis has been little investigated . We examined the association between low energy and nutrient intake and frailty . METHODS We used data from 802 persons aged 65 years or older participating to the InCHIANTI ( Invecchiare in Chianti , aging in the Chianti area ) study . Frailty was defined by having at least two of the following criteria : low muscle strength , feeling of exhaustion , low walking speed , and reduced physical activity . The European Prospect i ve Investigation into Cancer and nutrition ( EPIC ) question naire was used to estimate the daily intake of energy and nutrients .  Low intake was defined using the value corresponding to the lowest sex-specific intake quintile of energy and specific nutrients . Adjusted logistic regression analyses were used to study the association of frailty and frailty criteria with low intakes of energy and nutrients . RESULTS Daily energy intake < or = 21 kcal/kg was significantly associated with frailty ( odds ratio [ OR ] : 1.24 ; 95 % CI : 1.02 - 1.5 ) . After adjusting for energy intake , a low intake of protein ( OR : 1.98 ; 95 % CI : 1.18 - 3.31 ) ; vitamins D ( OR : 2.35 ; 95 % CI : 1.48 - 3.73 ) , E ( OR : 2.06 ; 95 % CI : 1.28 - 3.33 ) , C ( OR : 2.15 ; 95 % CI : 1.34 - 3.45 ) , and folate ( OR : 1.84 ; 95 % CI : 1.14 - 2.98 ) ; and having a low intake of more than three nutrients ( OR : 2.12 ; 95 % CI : 1.29 - 3.50 ) were significantly and independently related to frailty . CONCLUSIONS This study provides evidence that low intakes of energy and selected nutrients are independently associated with frailty OBJECTIVES To evaluate the association between protein intake and incident frailty . DESIGN Prospect i ve cohort study . SETTING Subset of the Women 's Health Initiative Observational Study conducted at 40 clinical centers . PARTICIPANTS Twenty-four thous and four hundred seventeen women aged 65 to 79 who were free of frailty at baseline with plausible self-reported energy intakes ( 600 - 5,000 kcal/day ) according to the Food Frequency Question naire ( FFQ ) . MEASUREMENTS Baseline protein intake was estimated from the FFQ . Calibrated estimates of energy and protein intake were corrected for measurement error using regression calibration equations estimated from objective measures of total energy expenditure ( doubly labeled water ) and dietary protein ( 24-hour urinary nitrogen ) . After 3 years of follow-up , frailty was defined as having at least three of the following components : low physical function ( measured using the R and -36 question naire ) , exhaustion , low physical activity , and unintended weight loss . Multinomial logistic regression models estimated associations for uncalibrated and calibrated protein intake . RESULTS Of the 24,417 eligible women , 3,298 ( 13.5 % ) developed frailty over 3 years . After adjustment for confounders , a 20 % increase in uncalibrated protein intake ( % kcal ) was associated with a 12 % ( 95 % confidence interval (CI)=8 - 16 % ) lower risk of frailty , and a 20 % increase in  calibrated protein intake  was associated with a 32 % ( 95 % CI=23 - 50 % ) lower risk of frailty . CONCLUSION Higher protein consumption , as a fraction of energy , is associated with a strong , independent , dose-responsive lower risk of incident frailty in older women . Using uncalibrated measures underestimated the strength of the association . Incorporating more protein into the diet may be an intervention target for frailty prevention Dietary protein intake might be beneficial to physical function ( PF ) in the elderly . We examined the cross-sectional and prospect i ve associations of protein intake of g/kg body weight ( BW ) , fat mass ( FM ) and lean mass ( LM ) with PF in 554 women aged 65·3 - 71·6 years belonging to the Osteoporosis Risk Factor and Prevention Fracture Prevention Study . Participants filled a question naire on lifestyle factors and 3-d food record in 2002 . Body composition was measured by dual-energy X-ray absorptiometry , and PF measures were performed at baseline and at 3-year follow-up . Sarcopaenia was defined using European Working Group on Sarcopenia in Older People criteria . At the baseline , women with higher protein intake ( ≥ 1·2 g/kg BW ) had better performance in h and -grip strength/body mass ( GS/BM ) ( P=0·001 ) , knee extension/BM ( P=0·003 ) , one-leg stance ( P=0·047 ) , chair rise ( P=0·043 ) , squat ( P=0·019 ) , squat to the ground ( P=0·001 ) , faster walking speed for 10 m ( P=0·005 ) and higher short physical performance battery score ( P=0·004 ) compared with those with moderate and lower intakes ( 0·81 - 1·19 and ≤ 0·8 g/kg BW , respectively ) . In follow-up results , higher protein intake was associated with less decline in GS/BM , one-leg stance and t and em walk for 6 m over 3 years . Overall , results were no longer significant after controlling for FM . Associations were detected between protein intake and PF in non-sarcopaenic women but not in sarcopaenic women , except for change of GS ( P=0·037 ) . Further , FM but not LM was negatively associated with PF measures ( P<0·050 ) . This study suggests that higher protein intake and lower FM might be positively associated with PF in elderly women Objective To examine the association of dietary protein intake with 4-year change in physical performance measures and muscle mass in Chinese community-dwelling older people aged 65 and older in Hong Kong . Design Prospect i ve cohort study design . Setting Hong Kong , People ’s of Republic of China . Participants There were 2,726 ( 1411 male , 1315 female ) community-dwelling older people aged 65 and older . Measurements Baseline total , animal and vegetable protein intakes  were collected using a vali date d food frequency question naire . Relative protein intake expressed as g/kg body weight was calculated and divided into quartiles for data analysis . Baseline and 4-year physical performance measures ( normal and narrow 6-meters walking speed and step length in a 6-meters walk ) were measured and 4-year change in appendicular skeletal muscle mass ( ASM ) from baseline was assessed by dual-energy X-ray absorptiometry . Univariate analysis identified age and sex as significant factors associated with change in physical performance measures or ASM , thus adjustments for these factors were made for subsequent analysis of covariance . Results  Median relative total protein intake  was 1.3 g/kg body weight in men and 1.1 g/kg body weight in women . After adjustment for age and sex , relative total protein intake and animal protein intake were not associated with change in physical performance measures and ASM . In contrast , participants in the highest quartile ( > 0.72 g/kg body weight ) of relative vegetable protein intake lost significantly less ASM over 4-year than those in the lowest quartile of relative vegetable protein intake ( < = 0.40 g/kg body weight ) ( adjusted mean ± SE : 0.270 ± 0.029 vs. 0.349 ± 0.030 kg , ptrend=0.025 ) . There was no association between relative vegetable protein intake and change in physical performance measures .  Conclusions Higher protein intake from vegetable source was associated with reduced muscle loss in Chinese community-dwelling older people in Hong Kong whereas no association between total and animal protein intake and subsequent decline in muscle mass or physical performance measures was observed in this sample OBJECTIVES To examine the association between consumption of dairy products and risk of frailty  in community-dwelling older adults . DESIGN Prospect i ve cohort study . SETTING General population from the older cohort of the Study on Nutrition and Cardiovascular Risk in Spain . PARTICIPANTS Community-dwelling adults aged 60 and older free of frailty at baseline ( N = 
    Output:
    