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
Identification number: TÁMOP-4.1.2-08/1/A-2009-0011
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
Identification number: TÁMOP-4.1.2-08/1/A-2009-0011
Erika Pétervári and Miklós Székely
Molecular and Clinical Basics of Gerontology – Lecture 3
NUTRITION,
PHYSICAL STATUS,
BODY COMPOSITION,
SARCOPENIA
PART 1
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
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Lean body mass (LBM) and
fat mass (FM)
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
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Shakespeare: As you like it
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.
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Body composition – energy stores
Body Fat Ranges for Standard Adults 1
Underfat
Healthy
Overfat Obese
Female 20-39
Age 40-59
60-79
0%
10%
20%
30%
40%
Male 20-39
Age 40-59
60-79
Underfat
1 Based on NIH/WHO BMI Guidelines.
Healthy
Overfat
Obese
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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.
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Adipogenesis and aging
Does aging make fat go MAD?
(During aging certain cell types
degenerate and lipids accumulate in
non-adipose tissues.)
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Impaired adipogenesis and fat tissue
function with aging
Fundamental aging processes
(reactive oxygen species,
telomeres, other)
 fatty acid
handling,
glucose
metabolism
 cytokines,
cellular stress
 LIP
 CHOP
 C/EBP
 PPAR
 DifferentiationDependent Genes
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Fat distribution with aging
Preadipocytes
Osteoblast
s
Muscle satellite
cells
Macrophages
Fat in fat
depots
Mesenchymal
adipocyte-like
default
(MAD)
cells
Other mesenchymal cells
AGING
Fat outside
fat depots
Insulin
sensitivity
Cytokines
(TNFα, IL-6)
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Peroxisome proliferator-activating
receptor  (PPAR )
Adipose
 FA storage (FABP)
 FA oxidation
(UCP3)
FFA
Liver
 gluconeogenesis
(PEPCK)
UCP
uncoupling protein
PPAR
FFA
FABP
fatty acid binding
protein
LXR
liver-X-receptor-
Muscle
Macrophage
 glucose oxidation
(PDK4)
 FA oxidation (UCP3)
 oxLDL uptake(CD36)
 CH efflux (LXR and
ABCA1)
insulin sensitization
glucose lowering
triglyceride lowering
antiatherosclerotic
antihypertensive
ABCA1
ATP-binding cassette
A1
PDK4
pyruvatdehydrogenase
kinase, isoenzyme 4
PEPCK
phosphoenolpyruvatcarboxykinase
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Fat metabolism
LEPTIN
FA
OXIDATION
cAMP
activated
prot.kinase
FA transfer
to mitoch.
ac CoA
carboxylase
inhibition
carnitin
palmitoyl
acyl
transferas
e
activation
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Fat, muscle and aging
Fat mass
Male
Female
18-y
18%
33%
85-y
36%
44%
Muscle mass
20-40% loss  SARCOPENIA
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Body weight and
adiposity index in rats
Body Weight or Adiposity Index
600
500
400
300
Body Weight
Adiposity Index
200
100
3
12
18
Age (mo)
24
30
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“Optimal” and real rise of body weight
in a 30-y period
“Optimal”
Reality White male
4.5 kg rise (<6%) (30-y period)
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
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Body Mass Index
Body Weight (kg)
=
20Height (m)2
25
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Bodyweight change (course of 9y)
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%
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Men’s mortality ratio (× 100)
U-shaped relationship between
BMI and mortality ratio
>210
190
170
150
130
110
90
70
50
15 18 21 24 27 30 33 36 39
>210
190
BMI associated with
170
lowest mortality
150
(nadir of curve)
130
Age group
BMI
110
20-29
21.4
90
30-39
21.6
70
40-49
22.9
50
50-59
25.8
15 18 21 24 27 30 33 36 39 15 18 21 24 27 30 33 36 39
Body Mass Index (kg/m2)
60-69
26.6
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The effect of age on the BMI
associated with the lowest mortality
28
The regression lines
were computed
separately for men
and for women.
Body Mass Index (wt/ht2)
26
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.
24
22
20
18
20
30
40
Age (yrs)
50
60
70
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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?)