RECENT RESEARCH between FFMI and mortality is lacking for patients with cancer . The objective of this study was to examine the association between FFMI and all-cause mortality in Chinese cancer patients .
Methods : This retrospective analysis included data on 1744 patients with cancer from a multicenter cohort study . The restricted cubic splines were used to flexibly model the association of FFMI with all-cause mortality . The association between low FFMI and overall survival was analyzed with the Kaplan – Meier method and a Cox model .
Results : Among all patients , there were 702 men ( 40.3 %) and 1042 women ( 59.7 %). The optimal cutoff point of low FFMI was 16.31 for men and 14.14 for women . The FFMI showed an inverse association with all-cause mortality for men ( per standard deviation [ SD ] increment ; hazard ratio [ HR ]: 0.72 ; 95 % confidence interval [ CI ], 0.60 – 0.87 ; P < 0.001 ) and a nonlinear relation for women ( per SD increment ; HR : 0.88 ; 95 % CI , 0.78 – 0.99 ; P = 0.048 ). After adjustment , a low FFMI score was independently associated with an increased risk of mortality for both men and women . In addition , FFMI showed a strong L-shape ( per SD increment ; HR : 0.59 ; 95 % CI , 0.46 – 0.76 ; P < 0.001 ) relation with allcause mortality in elderly patients with cancer . For specific tumor type , a low FFMI score was independently associated with worse prognosis in patients with lung and upper gastrointestinal cancer .
Conclusions : A low FFMI score was associated with all-cause mortality in patients with cancer , especially for elder adults with cancer . These results highlight the usefulness of the FFMI for routine clinical assessment and prognostic estimation in patients with cancer .
Chan L-C , Yang Y-C , Lin H-C , Wahlqvist ML , Hung Y-J , Lee M-S .
Nutrition counselling is associated with less sarcopenia in diabetes : A cross-sectional and retrospective cohort study . Nutrition , 2021 ; 91 – 92 . https :// doi . org / 10.1016 / j . nut . 2021.111269 .
Objectives : Muscle is crucial for blood glucose regulation . There is a need to prevent and treat sarcopenia in diabetes mellitus ( DM ). This study aimed to estimate the prevalence of sarcopenia and evaluate the association of nutritional counselling with the development of sarcopenia for people with DM .
Methods : In a cross-sectional and retrospective cohort study , people with type 2 DM were recruited from the Diabetes Shared Care Program of a teaching hospital . Muscle mass , muscle strength , and physical functional performance were evaluated using the Asian Working Group for Sarcopenia criteria . The skeletal muscle mass index was determined by dividing muscle mass by the square of the height . Clinical information , including the nutrition counselling record , was retrospectively obtained from medical records for a 2-y period .
Results : The prevalence of low skeletal muscle mass index ( presarcopenia ) and sarcopenia were , respectively , 20.4 % and 9.6 % ( including 3.1 % severe ) among 1292 participants . Specifically , 15.3 % of participants age ≥ 65 y were categorized as having sarcopenia . With more frequent nutritional counselling , there was a lesser risk of sarcopenia ; the adjusted odds ratio ( 95 % confidence interval ) was 0.51 ( 0.27 – 0.94 ) for ≥ 3 times / 2 y compared to no counselling . DM duration and age , glycemic status and medication , and body mass index and counselling frequency had no joint effects ; however , these variables ( except HbA1 c ) were independent risk factors for low skeletal muscle mass index and sarcopenia .
Conclusions : People with type 2 DM have a high risk of sarcopenia . Increased nutrition counselling in outpatients was associated with less sarcopenia . Education about sarcopenia-associated risk factors should be encouraged early in the onset of DM .
Current Topics in Medicine
FH , McMichael C , Hamilton I , Capon AG .
The 2021 report of the MJA – Lancet Countdown on health and climate change : Australia increasingly out on a limb ’. Med J Aust 2021 ; 215 ( 9 ): 390-392 . e22 . doi : 10.5694 / mja2.51302
Summary :
• The MJA – Lancet Countdown on health and climate change in Australia was established in 2017 , and produced its first national assessment in 2018 , its first annual update in 2019 , and its second annual update in 2020 . It examines indicators across five broad domains : climate change impacts , exposures and vulnerability ; adaptation , planning and resilience for health ; mitigation actions and health co‐benefits ; economics and finance ; and public and political engagement .
• Our special report in 2020 focused on the unprecedented and catastrophic 2019 – 20 Australian bushfire season , highlighting indicators that explore the relationships between health , climate change and bushfires . For 2021 , we return to reporting on the full suite of indicators across each of the five domains and have added some new indicators .
• We find that Australians are increasingly exposed to and vulnerable to excess heat and that this is already limiting our way of life , increasing the risk of heat stress during outdoor sports , and decreasing work productivity across a range of sectors . Other weather extremes are also on the rise , resulting in escalating social , economic and health impacts . Climate change disproportionately threatens Indigenous Australians ’ wellbeing in multiple and complex ways .
• In response to these threats , we find positive action at the individual , local , state and territory levels , with growing uptake of rooftop solar and electric vehicles , and the beginnings
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