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

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

NUTRITION,

PHYSICAL STATUS,

BODY COMPOSITION, SARCOPENIA

PART 1

Erika Pétervári and Miklós Székely

Molecular and Clinical Basics of Gerontology – Lecture 3

at the University of Pécs and at the University of Debrecen

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

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

LBM FM

20-y 60 + 13 = 73 kg

70-y 48 + 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

fat mass (FM)

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.

Shakespeare: As you like it

Body composition – energy stores

Body Fat Ranges for Standard Adults ¹

1 Based on NIH/WHO BMI Guidelines.

Underfat Healthy Overfat Obese

Underfat Healthy Overfat Obese

0% 10% 20% 30% 40%

Female 20-39 Age 40-59 60-79

Male 20-39

Age 40-59

60-79

Changes in body composition with 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.

Does aging make fat go MAD?

(During aging certain cell types

degenerate and lipids accumulate in non-adipose tissues.)

Adipogenesis and aging

Impaired adipogenesis and fat tissue function with aging

 cytokines, cellular stress

 C/EBP

 PPAR

 LIP

 CHOP

 fatty acid handling,

glucose metabolism Fundamental aging processes

(reactive oxygen species, telomeres, other)

 Differentiation-

Dependent Genes

Fat distribution with aging

Mesenchymal adipocyte-like

default (MAD)

cells

Fat in fat depots

Fat outside fat depots

Insulin sensitivity

Cytokines (TNFα, IL-6) Preadipocytes

Osteoblast s

Muscle satellite cells

Macrophages

Other mesenchymal cells

AGING

Peroxisome proliferator-activating receptor  (PPAR )

FABP

fatty acid binding protein

UCP

uncoupling protein LXR 

liver-X-receptor-  ABCA1

ATP-binding cassette A1

PDK4 pyruvat-

dehydrogenase

kinase, isoenzyme 4 PEPCK

phosphoenolpyruvat- carboxykinase

PPAR

insulin sensitization glucose lowering triglyceride lowering

antiatherosclerotic antihypertensive Adipose

 FA storage (FABP)

 FA oxidation (UCP3)

Macrophage

 oxLDL uptake(CD36)

 CH efflux (LXR and ABCA1)

Muscle

 glucose oxidation (PDK4)

 FA oxidation (UCP3)

Liver

 gluconeogenesis (PEPCK)

FFA

FF A

Fat metabolism

LEPTIN

cAMP activated prot.kinase

ac CoA carboxylase

inhibition

FA

OXIDATION

FA transfer to mitoch.

carnitin palmitoyl

acyl transferas

e

activation

Fat mass

Male Female 18-y 18% 33%

85-y 36% 44%

Muscle mass

20-40% loss  SARCOPENIA

Fat, muscle and aging

adiposity index in rats

Body W eight or Adiposity I ndex

Age (mo)

3 12 18 24 30

100 200 300 400 500 600

Adiposity Index

Body Weight

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

Reality White male 9.7 kg

mean BMI ~30 or

>30

Black male 10.1 kg

(n = 16,000) White female 12.0 kg

Black female 20.8 kg

“Optimal” and real rise of body weight

in a 30-y period

Body Mass Index

Body Weight (kg)

Height (m) ² = 20-

25

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%

Bodyweight change (course of 9y)

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

BMI and mortality ratio

Men’ s mortality ra tio ( × 100)

50

>210 190 170 150 130 110 90 70

Body Mass Index (kg/m

)

15 18 21 24 27 30 33 36 39

15 18 21 24 27 30 33 36 39

39

>210 190 170 150 130 110 90 70

50 15 18 21 24 27 30 33 36

The effect of age on the BMI

associated with the lowest mortality

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

22

20

18 30 40 50 60

Age (yrs) Body Mas s Index (wt /ht

)

20 70

28

BMI associated with the lowest mortality

Age (years) Male Female

20-29 21.4 19.5

30-39 21.6 23.4

40-49 22.9 23.2

50-59 25.8 25.2

60-69 26.6 27.3

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

Normal values may be different (calculations?)