Physical Activity and Nutrition as Modifiable Lifestyle Factors for Healthy Aging in Older Adults

200 Pages·2013·1.95 MB·English

Physical Activity and Nutrition as Modifiable Lifestyle Factors
for Healthy Aging in Older Adults

by
Samantha Louise Logan

A Thesis
presented to
The University of Guelph

In partial fulfillment of requirements
for the degree of
Doctor of Philosophy
in
Human Health and Nutritional Sciences

Guelph, Ontario, Canada
© Samantha Louise Logan, December, 2013
ABSTRACT
PHYSICAL ACTIVITY AND NUTRITION AS MODIFIABLE LIFESTYLE
FACTORS FOR HEALTY AGING IN OLDER ADULTS

Samantha L. Logan Advisor:
University of Guelph, 2013 Professor L. L. Spriet

Physical activity and nutrition are important modifiable lifestyle factors that are
important for healthy aging. This thesis contains three studies in community-dwelling older
adults (≥60 years) aimed to: (1) evaluate the use of a physical activity questionnaire to predict
physical health; (2) compare dietary intake with physical health parameters in an affluent
population, and; (3) improve metabolic and physical health parameters.
The first study investigated whether relationships existed between a person's score on the
Physical Activity Scale for the Elderly (PASE) questionnaire and health-related body
composition, cardiovascular and blood, strength, and flexibility measurements. The only
significant relationship was waist circumference (WC), where a minimum PASE score of ~140
predicted a favourable WC for males and ~120 predicted a favourable WC for females. This
relationship may be used encourage older adults to become more physically active by increasing
their PASE score to move their WC into a favorable range.
The second study investigated the relationships between physical health parameters and
nutrient intake from food and supplement use in a population with high socioeconomic status
(SES), typically recruited for research at the University of Guelph. Results demonstrated that
adults with high SES have a similar risk of nutrient inadequacies to Canadian population data,
and supplement users do not have higher nutrient intake from food than non-users. Finally,
adding vitamin D intake to a predictive model which included age, sex, and body mass index,
improved the model’s capacity to predict a participant’s lean body mass.
The final study investigated the effect of 12 weeks of omega-3 fish oil (O3FA; FO) and
olive oil (placebo, PL) supplementation on metabolic and physical health parameters at rest and
during exercise. Results demonstrated that O3FA, and not PL, intake increased metabolic rate
and fat oxidation at rest (24% males, 16% females) and exercise (11%). The FO group also
experienced a lowering of triglyceride levels, and diastolic blood pressure for the males. Finally,
females had an increase in lean mass and functional capacity.
Therefore, this thesis demonstrates that modifiable life factors, such as physical activity
and diet, influence the healthy aging of older community-dwelling adults.
SUBMITTED MANUSCRIPTS & PUBLICATIONS

This thesis is based on the following publications:

Logan, S.L., Gottlieb, B.H., Maitland, S.B., Meegan, D., & Spriet, L.L. (2013a). The Physical
Activity Scale for the Elderly (PASE) Questionnaire; Does It Predict Physical Health?
International Journal of Environmental Research and Public Health, 10(9), 3967-3986.
Doi:10.3390/ijerph10093967

Logan, S.L., McIntosh, E.I., Vallis, L.A., & Spriet, L.L. (2013b). Nutrient and dietary
supplement intake and measures of lean mass, fat free mass index and strength in community-
dwelling adults 70 years and older with high socioeconomic status. Journal of Human Nutrition
& Food Science, 1(1), 1-11.

Logan, S.L., & Spriet, L.L. (2013c). The effect of 12 weeks of omega-3 fatty acid
supplementation on metabolic and physical health parameters in community-dwelling older
adults. (Submitted to The Nutrition Journal).

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ACKNOWLEDGEMENTS

I would like to thank my advisor Dr. Lawrence Spriet for giving me the opportunity to
continue my desire to learn and helping me expand my knowledge and skill set. Thank you for
teaching me to think like a scientist; to question everything and not merely accept things as
truths.
I am also thankful to my advisory committee; Dr. Alison Duncan, Dr. Scott Maitland, and
Dr. Lori Vallis, for their availability, wisdom, support, and direction in this thesis. I am thankful
for having this rich experience.
Finally, to my wonderful family (Mom, Pops, Angie, Heather, & Greg), this dissertation
is dedicated to you. Thank you for encouraging hard work and learning for the sake of learning,
and fostering curiosity. I don’t know anyone else who loves and accepts others to the extent you
all do. The world is a much richer place with you all in it.

Just as iron sharpens iron, so one man’s countenance sharpens another (Proverbs 27:17).

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TABLE OF CONTENTS

ACKNOWLEDGEMENTS…………………………………………………………....................v
TABLE OF CONTENTS..……………………………...……………………………………......vi
LIST OF TABLES....……..……………………………………………………….………….… xii
LIST OF FIGURES…………………………………………………………………...................xv
LIST OF ABBREVIATIONS………………………..………………………………...............xvii

CHAPTER 1
REVIEW OF LITERATURE
1.1. HEALTHY AGING ……………..……………………………….…………….................1
1.1.1. Healthy Aging Overview………..………………………………....……………..................2
1.1.2. Theories of Aging……………………………………………………………...............................3
1.1.3. Physiological Changes with Aging and Modifiable Lifestyle Factors……..........................6
1.2. HEALTHY AGING AND PHYSICAL ACTIVITY….……………………………..….8
1.2.1. Benefits of Physical Activity…………………………………...…………………..…….....8
1.2.2. Physical Activity and Physical Fitness……………………………………………….……9
1.2.3. Increased Interest on Musculoskeletal Fitness...……………………... ………….……...10
1.2.4. Physical Activity Guidelines and Canadian Older Adults……………………..….……...12
1.2.5. Monitoring Physical Activity……………………………………………………………..15
1.3. NUTRITION AND HEALTHY AGING……………………………………………..…18
1.3.1. Benefits of Healthy Eating and Risks Related to Poor Nutrition………………................18
1.3.2. Contributors to Changes in Food Intake……………………………………….…….…..22
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1.3.3. Assessment of Dietary Intake……………………………………………..…..…..............24
1.3.4. Nutrition in Canadian Older Adults…………………….………………….….................26
1.3.5. Healthy Aging and Long-Chain Omega-3 Fatty Acid Intake…..…………………….…..28
1.3.6. Omega-3 Intake in Canadian Older Adults…………………………………………........30
1.3.7. Health Benefits of Omega-3 Fatty Acid Intake in Aging…………………………….…...31
1.4. CONCLUSIONS…………………………………………………………. ……………....35

CHAPTER 2
2.1 AIMS OF THESIS…………………………………………………………….……………37

CHAPTER 3
THE PHYSICAL ACTIVITY SCALE FOR THE ELDERLY (PASE) QUESTIONNAIRE;
DOES IT PREDICT PHYSICAL HEALTH?
3.1. ABSTRACT………………………………………………………..………….………….43
3.2. INTRODUCTION…………………………………………………….…………………44
3.3. METHODS………………………………………………………………………….…....47
3.3.1. Participants ……. ………………….………………………………………….................47
3.3.2. Recruitment & Inclusion…..………………………………………………………….…..47
3.3.3. Body Composition Measures……………………………………………………………..48
3.3.4. Cardiovascular Measures………………………………..……………………….…........49
3.3.5. Blood Measures……………….……………………………………..……………...........49
3.3.6. Flexibility and Strength Measures…………….……………………..……………...........50
3.3.7. Questionnaires……………….……………………………………..…...…………..........50
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3.3.8. Data Analysis………………….……………………………………..….…………..........51
3.4. RESULTS………………..……………………………………………………….……....52
3.4.1. Participant Characteristics………………..…... …………………………..…….……...52
3.4.2. Correlation of Physical Measures with PASE Score ………….……………...….………55
3.4.3. Prediction of Health Measures from PASE Score ……………………….….……...…....59
3.4.4. Use of a Cut-Point for PASE Score Based on Prediction Models and Scatterplot Data ..59
3.5. DISCUSSION……………………………………………………………………….….....62
3.5.1. Waist Circumference and PASE Score ………………….…………………………….....63
3.5.2. PASE and Chronic Health Conditions……………………………...……….………...….64
3.5.3. Comparison of PASE and SCREEN Scores with Other Research …………………….....65
3.5.4. How Healthy is Our Cohort? Comparison of Our Physical Measures with Population
Data ……………………….………………………...……………………...…………….66
3.5.5. The Importance of Moderate and Intense Activity in Older Adults …………………..….67
3.5.6. Limitations and Next Steps ……………………………………….……………………....68
3.6. CONCLUSIONS…………………………………………………………………………..69
3.7. ACKNOWLEDGEMENTS……………………………………………............................69

CHAPTER 4
NUTRIENT AND DIETARY SUPPLEMENT INTAKE AND MEASURES OF LEAN
MASS, FAT FREE MASS INDEX AND STRENGTH IN COMMUNITY-DWELLING
ADULTS 70 YEARS AND OLDER WITH HIGH SOCIOECONOMIC STATUS
4.1. ABSTRACT…………………………………………………………………..………..….71
4.2. INTRODUCTION………………………………………………………………..….…....73
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4.3. METHODS………………………………………………………………………..…….....75
4.3.1. Recruitment and Inclusion ………………………………………….………………........75
4.3.2. Physical Measures and Determining FFMI……….……………..…………………........75
4.3.3. Questionnaires ……………………………..……………………………...……………..76
4.3.4. Assessment of Energy and Nutrient Intake………………………….………………........77
4.3.5. Estimating Prevalence of Inadequacy …………..………………….…………………....77
4.3.6. Statistical Analysis…………..…………………………...………….………………........78
4.4. RESULTS………………………………………………..…………………………….......78
4.4.1. Participant Characteristics ……………………………………………………...……....78
4.4.2. Prevalence of Supplement Use …………………………………………………….….…81
4.4.3. Nutrient Adequacy ………………………………………………….………………...…81
4.4.4. Correlation of FFMI and Strength to Dietary Intake…………………………………….88
4.4.5. Predictive Capacity of Dietary Intake and FFMI and LM…………………………….…88
4.5. DISCUSSION……………………………………………………………………………...90
4.5.1. Nutrient intake and Comparison to Other Research …………………………..……...…90
4.5.2. Dietary Supplement Use ……………………………………..………………………......91
4.5.3. Nutrient Intake and LM, FFMI, and CGS ………………………………….………..…...93
4.5.4. Future Studies ……………………………..……………………………….………..…...94
4.6. CONCLUSION ……………….…………..……………………………….………...…....95
4.7. ACKNOWLEDGEMENTS ……………….…………..……………………………........96

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CHAPTER 5
THE EFFECTS OF 12 WEEKS OF OMEGA-3 FATTY ACID SUPPLEMENTATION ON
METABOLIC AND PHYSICAL HEALTH PARAMETERS IN COMMUNITY-
DWELLING OLDER ADULTS
5.1. ABSTRACT……………………………………………………………………………......98
5.2. INTRODUCTION………………………………………………….…………………....100
5.3. METHODS……………………………………………………………………………….104
5.3.1. Recruitment and Inclusion……………………….……………………………………...104
5.3.2. Experimental Protocol…………………………………………………...…...…………104
5.3.3. Physical Measures………………………………….……………….…………………..107
5.3.4. Cardiovascular and Blood Measures ….………….……………………………………109
5.3.5. Metabolic Calculations………………………………………………………….………109
5.3.6. Questionnaires ………….……………………………………………………….……...110
5.3.7. Assessment of Dietary Intake……………………………………………………….…...110
5.3.8. Statistical Analysis……………………………………………………………….……...111
5.4. RESULTS………………….……………………………………………………………..111
5.4.1. Participant Characteristics…………………………………………………..………….111
5.4.2. Influence of Supplementation on Physical and Blood Measures ………………...……..112
5.4.3. Influence of Supplementation on Resting Metabolic Measures ………………………...114
5.4.4. Influence of Supplementation on Exercise Metabolic Measures ……………………….116
5.5. DISCUSSION…………………….……………………………………………………....121
5.5.1. Influence of Supplementation on Metabolism……………………………………...…...…122
5.5.2. Influence of the Supplementation on Physical Measures………………………….…....124
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