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dc.contributor.authorMustafa, Jabed
dc.date.accessioned2016-11-15T18:28:18Z
dc.date.available2016-11-15T18:28:18Z
dc.date.issued2016
dc.identifier.urihttps://hdl.handle.net/2144/19165
dc.description.abstractExercise and diet may preserve muscle mass and bone health, thereby preventing age-related functional decline among older community-dwelling subjects. We used data from two studies to examine effects of exercise administered through a home-based program for hip fracture patients and the effects of dietary protein, vitamin D, and calcium on physical functioning in older adults. In the Health and Independence Post-Rehabilitation (HIP) study, the effects of a home-based exercise program (vs. attention-based control) (n=232) on functional recovery following hip fracture was assessed using two standardized physical performance batteries. In a sub-analysis (n=56), we evaluated the effects of food frequency questionnaire-derived protein, calcium, and vitamin D intakes on these outcomes. In the Framingham Offspring Study (FOS), dietary protein, calcium, and vitamin D intakes were measured using two sets of 3-day diet records. Physical functioning over 12 years was measured using the Rosow-Breslau and Nagi scales. In the HIP study, the exercise intervention led to significant improvement in physical performance at 6 months for all primary endpoints [(SPPB (P<0.001), AMPAC Mobility Function (P=0.01) and Daily Activity (P=0.01). However, we found no beneficial effects of dietary protein, calcium, or vitamin D on physical functioning. In the FOS, Cox proportional hazard’s models were used to estimate risk of functional decline over 12 years, adjusting for potential confounding by age, sex, education, physical activity, cigarettes per day, height, and energy intake. Subjects consuming ≥ 1.2 gm/kg protein intake (vs <0.8 gm/kg) had a lower risk of becoming dependent the following tasks: heavy work at home; walking one-half mile; climbing stairs; stooping, kneeling, crouching; lifting >10 lbs, lifting <10 lbs. Subjects consuming ≥ 1.2 (vs <0.8) gm/kg/day of protein had a 41% lower risk of becoming dependent in ≥1 functional task over 12 years. The beneficial effect of higher protein intake was strengthened among subjects who were more active and had higher SMM. There was also evidence of a beneficial interaction of both vitamin D and calcium with physical activity and SMM. These results suggest that participation in home-based functional exercise in older post-hip fracture adults and higher intakes of dietary protein help to preserve functional capacity among community-dwelling older adults.en_US
dc.language.isoen_USen_US
dc.subjectMedicineen_US
dc.subjectCalciumen_US
dc.subjectDietary proteinen_US
dc.subjectExerciseen_US
dc.subjectVitamin Den_US
dc.titleEffects of exercise, dietary protein, vitamin D, and calcium on physical functioning among middle-aged and older adultsen_US
dc.typeThesis/Dissertation
dc.date.updated2016-11-03T01:07:09Z
etd.degree.nameDoctor of Philosophyen_US
etd.degree.leveldoctoralen_US
etd.degree.disciplineNutrition and Metabolismen_US
etd.degree.grantorBoston Universityen_US


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