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The journal of nutrition, health & aging

, Volume 17, Issue 4, pp 315–321 | Cite as

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

  • R. M. Alfonso-Rosa
  • Borja del Pozo-CruzEmail author
  • J. Del Pozo-Cruz
  • J. T. Del Pozo-Cruz
  • B. Sañudo
Article

Abstract

Objective

To explore the relationship between nutritional status, functional capacity and health-related quality of life (HRQoL) in older adults with type 2 diabetes (T2DM).

Design

Cross-sectional study.

Setting and participants

Forty two non-insulin dependent older adults from a primary care center in Seville, Spain.

Measurements

Function was assessed with a battery of standardized physical fitness tests. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and the European Quality of Life Questionnaire (EQ-5D-3L) was used to assess HRQoL.

Results

There was an association between MNA-nutritional status and lower body strength as assessed by the chair sit-stand test (rho=.451; p=.037) and between MNA-nutritional status and EQ-5D-3L-HRQoL (EQ-5D-3Lutility, rho=.553; p<.001 and EQ-5D-3LVAS rho=.402; p<.001). An MNA item by item correlation analysis with HRQoL and lower limb strength demonstrated that HRQoL appears to be related to functional capacity (principally lower body strength, motor agility and cardiorespiratory fitness) among participants. These results were maintained when correlations were adjusted for co-morbidity.

Conclusion

Our results demonstrated that nutritional status is moderately associated with HRQoL and lower limb strength in patients with T2DM. Our data suggest that more emphasis should be placed on interventions to encourage a correct diet and stress the needed to improve lower body strength to reinforce better mobility in T2DM population

Key words

Type 2 diabetes management exercise physical fitness 

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References

  1. 1.
    Maritim AC, Sanders RA, Watkins JB, 3rd. Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol. 2003;17(1):24–38.PubMedCrossRefGoogle Scholar
  2. 2.
    Sundaram M, Kavookjian J, Patrick JH, Miller LA, Madhavan SS, Scott VG. Quality of life, health status and clinical outcomes in Type 2 diabetes patients. Qual Life Res. 2007 Mar;16(2):165–177.PubMedCrossRefGoogle Scholar
  3. 3.
    Gough SC, Kragh N, Ploug UJ, Hammer M. Impact of obesity and type 2 diabetes on health-related quality of life in the general population in England. Diabetes Metab Syndr Obes. 2009;2:179–184.PubMedCrossRefGoogle Scholar
  4. 4.
    Egede LE, Ellis C. Diabetes and depression: global perspectives. Diabetes Res Clin Pract. 2010 Mar;87(3):302–312.PubMedCrossRefGoogle Scholar
  5. 5.
    Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts. Diabetes Care. 2003 Jan;26(1):61–69.Google Scholar
  6. 6.
    Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 May 3;344(18):1343–1350.PubMedCrossRefGoogle Scholar
  7. 7.
    Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393–403.PubMedCrossRefGoogle Scholar
  8. 8.
    Pinget M. [Epidemiology of type 2 diabetes, is it a problem of bad nutrition or malnutrition?]. Soins. 2008 Apr(724 Suppl):S4–S8.Google Scholar
  9. 9.
    Kujala UM. Evidence on the effects of exercise therapy in the treatment of chronic disease. Br J Sports Med. 2009 Aug;43(8):550–555.PubMedCrossRefGoogle Scholar
  10. 10.
    Rolland Y, Czerwinski S, Abellan Van Kan G, Morley JE, Cesari M, Onder G, et al. Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging. 2008 Aug–Sep;12(7):433–450.PubMedCrossRefGoogle Scholar
  11. 11.
    Srikanthan P, Karlamangla AS. Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey. J Clin Endocrinol Metab. 2011 Sep;96(9):2898–2903.PubMedCrossRefGoogle Scholar
  12. 12.
    Turnbull PJ, Sinclair AJ. Evaluation of nutritional status and its relationship with functional status in older citizens with diabetes mellitus using the mini nutritional assessment (MNA) tool—a preliminary investigation. J Nutr Health Aging. 2002 May;6(3):185–189.PubMedGoogle Scholar
  13. 13.
    Bennett WL, Ouyang P, Wu AW, Barone BB, Stewart KJ. Fatness and fitness: how do they influence health-related quality of life in type 2 diabetes mellitus? Health Qual Life Outcomes. 2008;6:110.PubMedCrossRefGoogle Scholar
  14. 14.
    Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci. 1992 Dec;17(4):338–345.PubMedGoogle Scholar
  15. 15.
    Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381–1395.PubMedCrossRefGoogle Scholar
  16. 16.
    Deurenberg P, Andreoli A, Borg P, Kukkonen-Harjula K, de Lorenzo A, van Marken Lichtenbelt WD, et al. The validity of predicted body fat percentage from body mass index and from impedance in samples of five European populations. Eur J Clin Nutr. 2001 Nov;55(11):973–979.PubMedCrossRefGoogle Scholar
  17. 17.
    Gusi N, Prieto J, Olivares PR, Delgado S, Quesada F, Cebrián C. Normative Fitness Performance Scores of Community-Dwelling Older Adults in Spain. J Aging Phys Act. 2011;In press.Google Scholar
  18. 18.
    EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy. 1990 Dec;16(3):199–208.Google Scholar
  19. 19.
    Brooks R. EuroQol: the current state of play. Health Policy. 1996 Jul;37(1):53–72.PubMedCrossRefGoogle Scholar
  20. 20.
    Guigoz Y, Vellas BJ. [Malnutrition in the elderly: the Mini Nutritional Assessment (MNA)]. Ther Umsch. 1997 Jun;54(6):345–350.PubMedGoogle Scholar
  21. 21.
    Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996 Jan;54(1 Pt 2):S59–S65.PubMedGoogle Scholar
  22. 22.
    Cohen J. Statistical power analysis for the behavioural sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Publishers; 1988.Google Scholar
  23. 23.
    Hughes S. Diabetes: support for those at risk of malnutrition in the community. Br J Community Nurs. 2012 Nov;17(11):529–630, 32–4.PubMedGoogle Scholar
  24. 24.
    Forster S, Gariballa S. Age as a determinant of nutritional status: a cross sectional study. Nutr J. 2005;4:28.PubMedCrossRefGoogle Scholar
  25. 25.
    Sanchez-Garcia S, Garcia-Pena C, Duque-Lopez MX, Juarez-Cedillo T, Cortes-Nunez AR, Reyes-Beaman S. Anthropometric measures and nutritional status in a healthy elderly population. BMC Public Health. 2007;7:2.PubMedCrossRefGoogle Scholar
  26. 26.
    Ozdirenc M, Biberoglu S, Ozcan A. Evaluation of physical fitness in patients with Type 2 diabetes mellitus. Diabetes Res Clin Pract. 2003 Jun;60(3):171–176.PubMedCrossRefGoogle Scholar
  27. 27.
    TH IJ, Schaper NC, Melai T, Meijer K, Willems PJ, Savelberg HH. Lower extremity muscle strength is reduced in people with type 2 diabetes, with and without polyneuropathy, and is associated with impaired mobility and reduced quality of life. Diabetes Res Clin Pract. 2012 Mar;95(3):345–351.CrossRefGoogle Scholar
  28. 28.
    Krishnan S, Rosenberg L, Singer M, Hu FB, Djousse L, Cupples LA, et al. Glycemic index, glycemic load, and cereal fiber intake and risk of type 2 diabetes in US black women. Arch Intern Med. 2007 Nov 26;167(21):2304–2309.PubMedCrossRefGoogle Scholar
  29. 29.
    Willett W, Manson J, Liu S. Glycemic index, glycemic load, and risk of type 2 diabetes. Am J Clin Nutr. 2002 Jul;76(1):274S–280S.PubMedGoogle Scholar
  30. 30.
    Reed RL, Mooradian AD. Nutritional status and dietary management of elderly diabetic patients. Clin Geriatr Med. 1990 Nov;6(4):883–901.PubMedGoogle Scholar
  31. 31.
    Cesari M, Pahor M, Bartali B, Cherubini A, Penninx BW, Williams GR, et al. Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J Clin Nutr. 2004 Feb;79(2):289–294.PubMedGoogle Scholar
  32. 32.
    Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, et al. Higher 25-hydroxyvitamin D concentrations are associated with better lowerextremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr. 2004 Sep;80(3):752–758.PubMedGoogle Scholar
  33. 33.
    Cruz-Jentoft AJ, Landi F, Topinkova E, Michael JP. Understanding sarcopenia as a geriatric syndrome. Current Opinion in Clinical Nutrition and Metabolic Care. 2010;13(1):1–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Zanuso S, Jimenez A, Pugliese G, Corigliano G, Balducci S. Exercise for the management of type 2 diabetes: a review of the evidence. Acta Diabetol. 2010 Mar;47(1):15–22.PubMedCrossRefGoogle Scholar
  35. 35.
    Castaneda C, Layne JE, Munoz-Orians L, Gordon PL, Walsmith J, Foldvari M, et al. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care. 2002 Dec;25(12):2335–2341.PubMedCrossRefGoogle Scholar
  36. 36.
    Baldi JC, Snowling N. Resistance training improves glycaemic control in obese type 2 diabetic men. Int J Sports Med. 2003 Aug;24(6):419–423.PubMedCrossRefGoogle Scholar
  37. 37.
    Eriksson BG, Dey DK, Hessler RM, Steen G, Steen B. Relationship between MNA and SF-36 in a free-living elderly population aged 70 to 75. J Nutr Health Aging. 2005 Jul–Aug;9(4):212–220.PubMedGoogle Scholar
  38. 38.
    Doumit J, Nasser R. Quality of life and wellbeing of the elderly in Lebanese nursing homes. Int J Health Care Qual Assur. 2010;23(1):72–93.PubMedCrossRefGoogle Scholar
  39. 39.
    Kvamme JM, Olsen JA, Florholmen J, Jacobsen BK. Risk of malnutrition and health-related quality of life in community-living elderly men and women: the Tromso study. Qual Life Res. 2011 May;20(4):575–582.PubMedCrossRefGoogle Scholar
  40. 40.
    Mastaglia SR, Seijo M, Muzio D, Somoza J, Nunez M, Oliveri B. Effect of vitamin D nutritional status on muscle function and strength in healthy women aged over sixty-five years. J Nutr Health Aging. 2011 May;15(5):349–354.PubMedCrossRefGoogle Scholar
  41. 41.
    Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E, Delahanty L, et al. Correlates of health-related quality of life in type 2 diabetes. Diabetologia. 2006 Jul;49(7):1489–1497.PubMedCrossRefGoogle Scholar
  42. 42.
    Ose D, Miksch A, Urban E, Natanzon I, Szecsenyi J, Kunz CU, et al. Health related quality of life and comorbidity. A descriptive analysis comparing EQ-5D dimensions of patients in the German disease management program for type 2 diabetes and patients in routine care. BMC Health Serv Res. 2011;11:179.PubMedCrossRefGoogle Scholar
  43. 43.
    Herder C, Peltonen M, Koenig W, Sutfels K, Lindstrom J, Martin S, et al. Antiinflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study. Diabetologia. 2009 Mar;52(3):433–442.PubMedCrossRefGoogle Scholar
  44. 44.
    Fodor JG, Adamo KB. Prevention of type 2 diabetes mellitus by changes in lifestyle. N Engl J Med. 2001 Aug 30;345(9):696; author reply-7.PubMedCrossRefGoogle Scholar
  45. 45.
    Scheen AJ. [Clinical study of the month. Prevention of type 2 diabetes in overweight patients with impaired glucose tolerance: efficiency of lifestyle changes]. Rev Med Liege. 2001 Jun;56(6):463–465.PubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2013

Authors and Affiliations

  • R. M. Alfonso-Rosa
    • 1
  • Borja del Pozo-Cruz
    • 1
    • 3
    Email author
  • J. Del Pozo-Cruz
    • 1
  • J. T. Del Pozo-Cruz
    • 2
  • B. Sañudo
    • 1
  1. 1.Department of Physical Education and SportsUniversity of SevilleSevilleSpain
  2. 2.Department of CommunicationUniversity of SevilleSevilleSpain
  3. 3.Seville, SevilleSpain

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