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Biomedical subjects

M Bonnefoy

Publications and source records attributed to M Bonnefoy.

At least 19 recordsLinked to original sources
PubMed2003

The effects of exercise and protein-energy supplements on body composition and muscle function in frail elderly individuals: a long-term controlled randomised study.

Fighting against inactivity and inadequate nutritional intake are of utmost importance in the elderly. To our knowledge, the few studies which have been performed were conducted for only a short period and the results do not permit formal conclusions to be drawn. We therefore tried to fill this gap in our knowledge by determining whether an intervention combining an acceptable progressive exercise programme and nutritional supplements would be feasible for a long-term period in the very frail elderly, and would bring about concomitant benefits in body composition and muscle power. Accordingly, this exercise and nutritional combination was assessed in the frail elderly in a 9-month randomised trial with a factorial design. Fifty-seven elderly volunteers over 72 years, from sixteen retirement homes in Lyon, France participated in the study. Dietary supplements were compared with placebo, and physical exercise was compared with memory training. Main outcome measures were fat-free mass (FFM) and muscle power. FFM was determined by labelled water, and muscle power was measured by a leg-extensor machine. At 9 months, the compliance was 63 % for exercise sessions, and 54 % for nutritional supplements. In patients with dietary supplements, muscle power increased by 57 % at 3 months (P=0.03), and showed only a tendency at 9 months; although FFM increased by 2.7 % at 9 months, the difference was not significant (P=0.10). Exercise did not improve muscle power at 9 months, but improved functional tests (five-time-chair rise, P=0.01). BMI increased with supplements (+3.65 %), but decreased with placebo (-0.5 %) at 9 months (P=0.007). A long-term combined intervention is feasible in frail elderly individuals with a good rate of compliance. Nutritional supplements and exercise may improve muscle function. Despite no significant results on FFM, due to the limited number of volunteers, combined intervention should be suggested to counteract muscle weakness in the frail elderly.

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PubMed2002

[Relation between physical activity, muscle function and IGF-1, testosterone and DHEAS concentrations in the elderly].

OBJECTIVE: Lower amounts of circulating anabolic hormones are thought to accelerate the age related decline in muscle mass and function. Replacement therapies are promising interventions but there are problems with these therapies. Thus alternative strategies should be developed. The age related changes in hormonal status may be probably influenced by exercise. The purpose of this study was: a) to confirm with other methods, more adapted for elderly people, the results of a previous study that has shown relationship between physical activity (PA) and quadriceps muscle function with dehydroepiandrosterone sulphate (DHEAS), insulin like growth factor-1 (IGF-1). Quadriceps muscle power (Pmax) is measured in this new work with a recently developed leg extensor machine and, b) to complete the results of the first study examining simultaneously the relationship between PA, Pmax and cardiorespiratory fitness (VO2max) with DHEAS, IGF-1 and testosterone in a group of healthy elderly people. METHODS: Fifty independent, community dwelling elderly subjects (25 mens and 25 womens) aged from 66 to 84 volunteered to participate in the study. PA was evaluated by the questionnaire and expressed using two activity indices: mean habitual daily energy expenditure (MHDEE) and the daily energy expenditure corresponding to leisure time sports activities (Sports Activity). Pmax and optimal shortening velocity (vopt) were measured on a Ergopower dynamometer. The Pmax was expressed relative to body mass, Pmax/kg (W kg-1), and relative to the mass of the two quadriceps muscles, Pmax/Quadr (W.kgQuadr-1). VO2max has been measured during a maximal treadmill exercise. RESULTS: In women, IGF-1 correlated significantly with MHDEE (r = 0.54, P = 0.004), Pmax/kg (r = 0.54, P = 0.004) and Pmax/Quadr (r = 0.46, P = 0.02), whereas DHEAS with MHDEE (r = 0.54, P = 0.004), Sports Activity (r = 0.65, P < 0.001), VO2max (r = 0.46, P = 0.02), Pmax/kg (r = 0.46, P = 0.02) and Pmax/Quadr (r = 0.55, P = 0.004). No such correlation was found in men. CONCLUSION: These findings confirm that in healthy elderly women physical activity, cardiorespiratory fitness and quadriceps muscle function are similarly related to levels of circulating DHEAS and IGF-1 suggesting a favourable influence of exercise on anabolic hormonal production in the elderly.

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PubMed2002

[Hypocholesterolemia in hospitalized elderly: relations with inflammatory and nutritional status].

PURPOSE: Hypocholesterolemia is a common finding in hospitalized elderly people and is associated with increased mortality. Changes in plasma lipid levels are well known in the acute phase response. It has also been suggested that malnutrition is a cause of hypocholesterolemia. However, malnutrition is the reflect of general condition, and the respective roles of malnutrition and inflammation have not yet been clearly established. This research project was undertaken to examine the impact of nutritional and inflammatory status on the hypocholesterolemia. METHODS: In a prospective study, 597 elderly patients (83 +/- 7 years) consecutively admitted in a geriatric acute care unit were included. Clinical and anthropometric data: Body Mass Index (BMI), Tricipital Skinfold Thickness (TSF), Sub-Scapular Skinfold Thickness (SSF), Mid Arm Circumference (MAC) have been collected. The blood samples were obtained within the 72 hours following the admission. Nutritional proteins (albumin, prealbumin, transferrin, retinol binding protein); inflammatory proteins (CRP, alpha-1 acid glycoprotein), and blood lipids (cholesterol, LDL, HDL cholesterol, triglycerides, apoproteins A1 and B) were dosed. RESULTS: The anthropometric and biologic parameters have been compared on the two sexes, significant differences were observed only for blood lipids. The analyses are thus realized and presented by sex separately. Four groups of patients are generated according to the quartile of total cholesterol. Means and standard deviation for all factors are calculated within each group. Both, the trend of means and analyses of correlation show associations with cholesterol in the two sexes. The analysis of variance showed that the cholesterolemia is associated with 1/ decrease in the values of the anthropometrics, and nutritional proteins and 2/ upward trends of the inflammatory parameters. Significant correlations were observed for all transport proteins and CRP with total cholesterol in men and women. The multiple linear regression of the total cholesterol retained albumin, APO A1, APO B and RBP as predictor factors of cholesterolemia for women and APO A1, APO B and tryglicerid for men. When patients with infectious diseases were compared to the others, significant differences have been observed for total cholesterol and all blood lipids, as well as for nutritional and inflammatory proteins. CONCLUSION: The results confirm an association between nutritional status and hypocholesterolemia, and suggest also the responsability of inflammation as a cause of hypocholesterolemia.

Age Factors↗
PubMed2002

Malnourished elderly people and lipid status.

UNLABELLED: Protein-energy malnutrition is common in the elderly. The relationship between protein-energy malnutrition and lipid status remains uncertain and few studies are available. The aim of this study was to evaluate the lipid status of malnourished elderly subjects recently hospitalized in a geriatric medical care unit. Classical parameters such as total cholesterol, HDL cholesterol, apoproteins A1 et B, vitamins A and E were measured. Particular attention was given to other parameters such as fatty acids. The studied population included 86 elderly subjects. They were divided into two groups, according to serum albumin (alb) and Body Mass Index (BMI). Fifty patients aged 81.5 7.3 years were considered to be well-nourished (WN) with albumin 35 g/l and BMI 21 kg/m2. Thirty six patients aged 84.1 6.6 years were considered to be malnourished (MN) with albumin < 35 g/l and BMI < 21 kg/m2. Our main findings shown significant decrease in all classical lipid parameters : total cholesterol (p< 0.001), HDL cholesterol (p< 0.005), apoproteins A1 (p< 0.001) and B (p< 0.001) in the malnourished group. We found an increase in the rate of v9 fatty acids (p< 0.001 for the oleic acid; p< 0.05 for the eicosatrienoic acid) and also an increase in the triene/tetraene ratio (p< 0.05) as a result of malnutrition. CONCLUSION: Protein-energy malnutrition is accompanied by lipid status alterations.

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PubMed2001

Simultaneous validation of ten physical activity questionnaires in older men: a doubly labeled water study.

OBJECTIVE: The purpose of this study was to simultaneously validate 10 physical activity (PA) questionnaires in a homogenous population of healthy elderly men against the reference method: doubly labeled water (DLW). DESIGN: Cross-sectional study. SETTING: Community-based sample from Lyon, France. PARTICIPANTS: Nineteen healthy old men (age 73.4 +/- 4.1 years), recruited from various associations for elderly people in Lyon, agreed to participate in the study. MEASUREMENTS: The questionnaire-derived measures (scores) were compared with two validation measures: DLW and maximal oxygen uptake (VO2max). With the DLW method three parameters were calculated: (1) total energy expenditure (TEE), (2) physical activity level (PAL), i.e., the ratio of TEE to resting metabolic rate, (3) energy expenditure of PA. RESULTS: Relative validity. Correlation between the questionnaires and TEE ranged from 0.11 for the Yale Physical Activity Survey (YPAS) total index to 0.63 for the Stanford usual activity questionnaire. This questionnaire also gave the best correlation coefficients with PAL (0.75), and with VO2max (0.62). Significant results with TEE measured by the DLW method were also obtained for college alumni sports score, Seven Day Recall moderate activity, and Questionnaire d'Activité Physique Saint-Etienne sports activity (r = 0.54, r = 0.52, and r = 0.54, respectively). Absolute validity. No difference was found between PA measured by the Seven Day Recall or by the YPAS and DLW, on a group basis. The limits of agreement were wide for all the questionnaires. CONCLUSIONS: Only a few questionnaires demonstrated a reasonable degree of reliability and could be used to rank healthy older men according to PA. Correlation coefficients were best when the Stanford Usual Activity Questionnaire was compared with all the validation measures. The two questionnaires reporting recent PA, the Seven Day Recall, and YPAS accurately assessed energy expenditure for the group. The individual variability was high for all the questionnaires, suggesting that their use as a proxy measure of individual energy expenditure may be limited.

Activities of Daily Living↗
PubMed2001

Response of Blood Lipids to Physical Exercise in Elderly Subjects.

Regular physical activity plays an important role in nonpharmacologic management of hyperlipidemia, in both the primary and secondary prevention of coronary heart disease. Training intensity and duration, health status (especially the presence of cardiovascular disease), and concomitant changes in body mass and dietary habits are the most important factors that can modify the physical activity-blood lipid profile relationship in the elderly. The benefit of regular exercise goes beyond direct influence on blood lipids; it aids in reducing weight, decreasing fat mass, increasing lean body mass, reducing elevated blood pressure, and increasing insulin sensitivity. Regular physical activity has become widely recommended as an important element of healthy and successful aging and should be encouraged in individuals without contraindications. (c)2001 CHF, Inc.

Journal Article↗
PubMed2001

Lack of correlation between 6-month fluctuations in habitual physical activity and testosterone. Concentrations in elderly subjects.

BACKGROUND: To examine the influence of long-term modifications in habitual physical activity (PA) on resting total testosterone (TT) concentrations in a group of healthy elderly subjects. METHODS EXPERIMENTAL DESIGN: 6-month prospective study. SETTING: University research departments of exercise physiology and geriatric medicine. PARTICIPANTS: thirty-one independent, community dwelling elderly subjects (16 men and 15 women) aged > 65 who volunteered to participate. INTERVENTIONS: correlational study. MEASURES: PA was evaluated by a questionnaire QAPSE (Questionnaire d Activité Physique Saint-Etienne) and expressed by two activity indices: mean habitual daily energy expenditure (MHDEE) and daily energy expenditure corresponding to leisure time sports activities (Sports activity index). RESULTS: Changes in resting TT concentrations were not related to changes in MHDEE (r = -0.28; p = 0.30 and r = -0.001; p=0.99) and Sports activity (r = -0.30; p = 0.26 and r = -0.05; p = 0.85) in men and women, respectively. Similarly, relative (%) changes in TT were not related to relative changes in MHDEE (r = -0.16; p=0.55 and r = 0.17; p=0.55) and Sports activity (r = -0.11; p=0.68 and r = 0.02; p = 0.92). CONCLUSIONS: The levels of habitual PA undertaken by an average senior do not appear to affect TT levels in healthy active elderly men and women.

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PubMed2000

[Influence of nutrition and physical activity on muscle in the very elderly].

AGE-RELATED LOSS IN MUSCLE MASS: Aging is associated with a progressive decline in muscle mass (sarcopenia). Age-related sarcopenia results in a 50% decrease in muscle fiber area, especially type II fiber area. There are many consequences related to this reduction in muscle mass including decline in muscle strength and function and impaired functional capacity. PROTEIN INTAKE: Sarcopenia also results in a reduction in the body's major protein pool. Adequate dietary protein to replace obligatory nitrogen loss and to support protein turnover is essential for maintaining muscle mass. It is usually suggested that protein requirements in older subjects are above 1 g/kg/d. PHYSICAL EXERCISE: Sedentary lifestyle may contribute to loss of skeletal mass in elderly people. Exercise can help reverse this deficit and may improve the regeneration potential of muscle fibers.

Activities of Daily Living↗
PubMed2000

Leg extensor power and dehydroepiandrosterone sulfate, insulin-like growth factor-I and testosterone in healthy active elderly people.

We examined the association between quadriceps muscle function and serum levels of dehydroepiandrosterone sulphate (DHEAS), insulin-like growth factor I (IGF-I) and testosterone in a group of healthy elderly people. Fifty-three independent, community-dwelling elderly subjects (26 men and 27 women) aged from 66 to 84 years volunteered to participate in the study. Physical activity (PA) was evaluated by a questionnaire. Quadriceps maximal muscle power (Wmax) and optimal shortening velocity (v(opt)) were measured on a friction-loaded non-isokinetic cycle ergometer. The Wmax is expressed in relation to body mass (W(max/kg), W x kg(-1)), and in relation to the mass of the two quadriceps muscles (W(max/Quadr), W x kg(Quadr(-1))). In women, when adjusted for age, anthropometric measurements and PA indices, IGF-I correlated significantly with W(max/kg) (partial correlation: r = 0.59; P = 0.001), W(max/Quadr) (r = 0.58; P = 0.002) and v(opt) (r = 0.53; P = 0.004), whereas DHEAS was correlated significantly with W(max/kg) (r = 0.54; P = 0.003) and W(max/Quadr) (r = 0.58; P = 0.002). No such correlation was found in men. These findings indicate that in healthy elderly women lower values for quadriceps muscle Wmax and v(opt) are related, independently of age, anthropometric measurements and PA indices, to lower circulating levels of DHEAS and IGF-I.

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PubMed2000

Physical activity, aerobic capacity and selected markers of oxidative stress and the anti-oxidant defence system in healthy active elderly men.

The relationship of oxidative stress and the anti-oxidant defence system to maximal oxygen consumption (VO2max) and habitual physical activity was assessed in 26 elderly men (71.0 +/- 4.2 years) and compared to that of 12 young men (22.1 +/- 5.1 years). Physical activity was assessed by a questionnaire. Malondialdehyde (MDA), plasma total anti-oxidant status (TAS), the levels of red blood cell (RBC) superoxide dismutase (SOD) and glutathione peroxidase (GPX), as well as serum GPX activities were determined under resting conditions. The older and young men had similar TAS and RBC SOD, while MDA, RBC GPX and plasma GPX were higher, and RBC SOD/GPX ratio was significantly lower in the older men. Neither MDA nor anti-oxidants were associated with any of the physical activity/aerobic capacity measures in the elderly men. We conclude that in healthy elderly men with a good nutritional status, indicators of the anti-oxidant defence system are not lower in comparison with young men. Increased RBC and plasma GPX coupled with a high level of lipid peroxidation marker may indicate an adaptation of anti-oxidant defences to sustained oxidative stress. Furthermore, the results of the present study suggest that the level of habitual physical activity and aerobic capacity have no major influence on the resting balance between radical generation and blood anti-oxidant potential in healthy older men.

Adolescent↗
PubMed2000

Quadriceps muscle function in relation to habitual physical activity and VO2max in men and women aged more than 65 years.

The relationship of quadriceps maximal muscle power (Pmax), corresponding optimal shortening velocity (v(opt)), and relative fatigability (Pmax%D) to maximal oxygen uptake (VO2max) and habitual physical activity (PA) was examined in healthy community-dwelling subjects (29 women and 25 men) aged more than 65 years old. PA was evaluated by a questionnaire and expressed using two activity indices: mean habitual daily energy expenditure (MHDEE) and the daily energy expenditure corresponding to leisure time sports activities (Sports Activity). In women, Pmax correlated positively with VO2max (r = .56) and with Sports Activity (rho = .41). Both Sports Activity and Pmax were significant independent predictors of VO2max and accounted for 62% of variance in VO2max. In men, v(opt) was significantly negatively related to MHDEE (r = -.59) and to Sports Activity (rho = -.40). Neither in women nor in men was Pmax%D correlated with VO2max or PA indices. The different relationship of Pmax and v(opt) with VO2max and PA indices suggests that habitual PA may be sufficient in active older women, but not in men, to positively influence quadriceps muscle function. These gender differences may suggest different approaches in exercise programming for elderly women and men.

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PubMed2000

The symptomatology of upper respiratory tract infections and exercise in elderly people.

PURPOSE: To analyze, both by a retrospective and prospective study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to upper respiratory tract infections (URTI) symptomatology in elderly subjects. METHODS: 61 (33 men and 28 women) healthy and weight-stable active elderly volunteers aged 66-84 yr participated in the study. PA was evaluated by a questionnaire QAPSE (Questionnaire d'Activite Physique Saint-Etienne) and expressed by two QAPSE activity indices: MHDEE (mean habitual daily energy expenditure) and sports activity (daily energy expenditure corresponding to leisure time sports activities). Log books for daily recording of URTI symptomatology were used in prospective design. RESULTS: In a 1-yr retrospective study a significant correlation was found between number of weeks with URTI per year and Sports activity index (r = -0.27, P = 0.037). In a prospective 12-month follow-up, the number of episodes per year and number of days with URTI per year were significantly negatively associated with sports activity index (r = -0.29, P = 0.022 and r = -0.26, P = 0.041, respectively). CONCLUSIONS: In healthy active elderly subjects the symptomatology of URTI over long periods of time is inversly related to energy expenditure utilized during moderately intensive physical exercise.

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PubMed1999

Influence of acute and chronic exercise on insulin-like growth factor-I in healthy active elderly men and women.

We examined the influence of physical activity (PA) and acute resistance exercise on insulin-like growth factor I (IGF-I) in 39 healthy, independent, community-dwelling elderly volunteers (14 men and 25 women) aged from 66 to 84. In a longitudinal non-interventional study, we compared the fluctuations in IGF-I levels and changes in habitual PA over a 6-month period. PA was evaluated by a questionnaire QAPSE (Questionnaire d'Activité Physique Saint-Etienne), and expressed by two activity indices: mean habitual daily energy expenditure (MHDEE), and daily energy expenditure corresponding to leisure time sports activities (sports activity index). In an experimental design we compared IGF-I levels before, at 1 and 15 minutes after short quadriceps muscle exertion (10 consecutive repetitions) carried out with optimal muscle power development. Changes in IGF-I levels over a 6-month period were positively related to changes in MHDEE (r = 0.41; p<0.01), and sports activity (r = 0.40; p<0.02). When analyzed by gender, these correlations were still statistically significant in women (r = 0.39; p = 0.05 and r = 0.41; p<0.05), but not in men (r = 0.36; p = 0.21 and r = 0.20; p = 0.50). No changes (p = 0.17) were observed in serum IGF-I concentrations after the acute exercise protocol. These findings indicate that IGF-I levels are positively related to fluctuations in habitual PA, at least in women. Further research is needed to establish the best intensity and duration of exercise training to induce these changes.

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PubMed1999

Relationship of physical activity and fitness to lipid and lipoprotein (a) in elderly subjects.

PURPOSE: To determine, both by a cross-sectional and longitudinal study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to blood lipids and lipoprotein(a) [Lp(a)] in a population of healthy and weight-stable elderly volunteers aged 66-84 yr. METHODS: In a cross-sectional study in 52 subjects (23 men and 29 women), all independent variables (age, anthropometric, VO2max, and PA indices) were used in a multiple stepwise regression analysis to select variables influencing lipid and lipoprotein parameters. In a prospective nonintervention study, 38 subjects (17 men and 21 women) were reexamined after 6 months. RESULTS: In a cross-sectional study, sports activity index contributed significantly to total cholesterol (TC), low density lipoprotein (LDL) cholesterol (LDL-C), TC/high density lipoprotein (HDL) cholesterol (HDL-C) ratio, and LDL-C/HDL-C ratio variance in men, whereas VO2max accounted for 23% variance of apolipoprotein A-I in women. In a prospective study, there was no indication that any measured variable was correlated with absolute or relative changes in PA indices in the total group or when analyzed by gender. CONCLUSIONS: These data confirm that favorable relationship between PA/fitness and blood lipid profile is visible in elderly people but spontaneous changes in habitual PA are not a sufficient stimulus to alter serum lipid and lipoprotein levels in this population. Furthermore, there is no direct association between Lp(a) levels and PA, fitness, or body composition in the elderly men and women.

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PubMed1998

Determination of ceftazidime in plasma using high-performance liquid chromatography and electrochemical detection. Application for individualizing dosage regimens in elderly patients.

This study describes a sensitive HPLC-electrochemical detection method for the analysis of ceftazidime, a third-generation cephalosporin, in human plasma. The extraction procedure involved protein precipitation with 30% trichloroacetic acid. The separation was achieved on a reversed-phase column (250X4.6 mm I.D., 5 microm) packed with C18 Kromasil with isocratic elution and a mobile phase consisting of acetonitrile-25 mM KH2PO4-Na2HPO4 buffer, pH 7.4 (10:90, v/v). The proposed analytical method is selective, reproducible and reliable. The assay has a precision of 0.2-15.1% (C.V.) in the range of 5-200 microg mil(-1). (corresponding to 0.5 to 20 ng of ceftazidime injected onto the column), and is optimised for assaying 50 microl of plasma. The extraction recovery from plasma was approximately 100%. The method was highly specific for ceftazidime and there was no interference from either commonly administered drugs or endogenous compounds. This assay was used to measure ceftazidime in elderly patients for therapeutic drug monitoring.

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