{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:03:29Z","timestamp":1789135409938,"version":"build-2803163510"},"reference-count":46,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Older adults with sarcopenic obesity (SO) are at increased risk of adverse health outcomes. It has not been identified which pattern of macronutrient intake is appropriate in relation to SO. We aimed to compare the patterns of macronutrient intake for predicting SO in older adults. Data from a total of 3828 older adults who participated in the 2008\u20132011 Korea National Health and Nutrition Examination Survey were analyzed. The one-day 24 h dietary recall method was used to assess macronutrient intake. SO was defined by a combination of body mass index (BMI) \u2265 25 kg\/m2 and BMI adjusted-appendicular skeletal muscle mass &lt;0.789 for men and &lt;0.512 for women. Weighted logistic regression analysis revealed the odds ratio (95% confidence interval) for SO of total calorie intake per 100 increments and carbohydrate (CHO) intake (g\/kg\/day) per 1 increment to be 0.95 (0.91\u20130.99) and 0.83 (0.74\u20130.94), respectively, after adjusting for confounding variables in women. The predictive power for SO of CHO intake (g\/kg\/day) was higher compared with the other patterns of macronutrient intake both in men and women. In conclusion, total calorie intake and CHO intake (g\/kg\/day) are inversely related to SO in women. CHO intake (g\/kg\/day) could be the best index for determining SO.<\/jats:p>","DOI":"10.3390\/nu13114031","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T23:04:46Z","timestamp":1636671886000},"page":"4031","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Using Dietary Macronutrient Patterns to Predict Sarcopenic Obesity in Older Adults: A Representative Korean Nationwide Population-Based Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1007-1633","authenticated-orcid":false,"given":"Jun-Hyuk","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye-Min","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Chaum Medical Checkup Center Samseongdong Branch, Cha University, Seoul 06125, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-476X","authenticated-orcid":false,"given":"Yong-Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"ref_1","unstructured":"(2021, September 18). Population Ageing and Development 2012. Available online: https:\/\/www.un.org\/en\/development\/desa\/population\/publications\/ageing\/population-ageing-development-2012.asp."},{"key":"ref_2","unstructured":"(2021, September 18). Population Projections for Korea (2017\u20132067). Available online: http:\/\/kostat.go.kr\/portal\/eng\/pressReleases\/8\/8\/index.board?bmode=download&bSeq=&aSeq=375684&ord=2."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.clnu.2005.10.013","article-title":"A 3-year longitudinal study on body composition changes in the elderly: Role of physical exercise","volume":"25","author":"Raguso","year":"2006","journal-title":"Clin. Nutr."},{"key":"ref_4","first-page":"513","article-title":"Body composition remodeling and mortality: The health aging and body composition study","volume":"72","author":"Santanasto","year":"2017","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"861","DOI":"10.3389\/fendo.2019.00861","article-title":"Aging and imaging assessment of body composition: From fat to facts","volume":"10","author":"Ponti","year":"2019","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.3904\/kjim.2016.193","article-title":"Sarcopenia and sarcopenic obesity","volume":"31","author":"Choi","year":"2016","journal-title":"Korean J. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s12603-020-1474-5","article-title":"Sarcopenia as a risk factor for future hip fracture: A Meta-analysis of prospective cohort studies","volume":"25","author":"Huang","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.injury.2020.02.072","article-title":"The association between sarcopenia and fracture in middle-aged and elderly people: A systematic review and meta-analysis of cohort studies","volume":"51","author":"Chen","year":"2020","journal-title":"Injury"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s11886-020-1273-y","article-title":"Association between obesity and cardiovascular outcomes: Updated evidence from meta-analysis studies","volume":"22","author":"Dwivedi","year":"2020","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"697264","DOI":"10.1155\/2014\/697264","article-title":"Abdominal adiposity distribution in diabetic\/prediabetic and nondiabetic populations: A meta-analysis","volume":"2014","author":"Lee","year":"2014","journal-title":"J. Obes."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1038\/s41371-018-0046-1","article-title":"Body mass index, abdominal fatness, and hypertension incidence: A dose-response meta-analysis of prospective studies","volume":"32","author":"Zhou","year":"2018","journal-title":"J. Hum. Hypertens."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.numecd.2007.10.002","article-title":"Sarcopenic obesity: A new category of obesity in the elderly","volume":"18","author":"Zamboni","year":"2008","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s12603-018-1088-3","article-title":"Associations between sarcopenic obesity and cognitive impairment in elderly chinese community-dwelling individuals","volume":"23","author":"Wang","year":"2019","journal-title":"J. Nutr. Health Aging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1002\/gps.5121","article-title":"Sarcopenic obesity predicts nonremission of late-life depression","volume":"34","author":"Kokkeler","year":"2019","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_15","unstructured":"Atkinson, R.L., Butterfield, G., Dietz, W., Fernstrom, J., Frank, A., Hansen, B., and Moore, B. (2004). Weight management: State of the science and opportunities for military programs. Institute of Medicine (US) Subcommittee on Military Weight Management, National Academies Press."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/MCO.0b013e32831cef8b","article-title":"Dietary protein recommendations and the prevention of sarcopenia","volume":"12","author":"Rasmussen","year":"2009","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"60","DOI":"10.11124\/jbisrir-2015-2363","article-title":"Intermittent fasting interventions for the treatment of overweight and obesity in adults aged 18 years and over: A systematic review protocol","volume":"13","author":"Jane","year":"2015","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.trsl.2014.05.013","article-title":"Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: A review of human findings","volume":"164","author":"Barnosky","year":"2014","journal-title":"Transl. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1038\/s41366-018-0284-x","article-title":"Meal timing and obesity: Interactions with macronutrient intake and chronotype","volume":"43","author":"Xiao","year":"2019","journal-title":"Int. J. Obes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1753-4887.2009.00189.x","article-title":"Health benefits of dietary fiber","volume":"67","author":"Anderson","year":"2009","journal-title":"Nutr. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e018449","DOI":"10.1136\/bmjopen-2017-018449","article-title":"Does high-carbohydrate intake lead to increased risk of obesity? A systematic review and meta-analysis","volume":"8","author":"Sartorius","year":"2018","journal-title":"BMJ Open"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"167","DOI":"10.4235\/agmr.18.0046","article-title":"Protein intake recommendation for korean older adults to prevent sarcopenia: Expert consensus by the Korean Geriatric Society and the Korean Nutrition Society","volume":"22","author":"Jung","year":"2018","journal-title":"Ann. Geriatr. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1093\/gerona\/glv210","article-title":"Improved function with enhanced protein intake per meal: A pilot study of weight reduction in frail, obese older adults","volume":"71","author":"Pieper","year":"2016","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Petroni, M.L., Caletti, M.T., Dalle Grave, R., Bazzocchi, A., Aparisi G\u00f3mez, M.P., and Marchesini, G. (2019). Prevention and treatment of sarcopenic obesity in women. Nutrients, 11.","DOI":"10.3390\/nu11061302"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1093\/ajcn\/nqy214","article-title":"Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: A randomized, double-blind, placebo-controlled trial","volume":"108","author":"Park","year":"2018","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"81","DOI":"10.7570\/jomes21022","article-title":"2020 Korean society for the study of obesity guidelines for the management of obesity in Korea","volume":"30","author":"Kim","year":"2021","journal-title":"J. Obes. Metab. Syndr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/ije\/dyt228","article-title":"Data resource profile: The Korea National Health and Nutrition Examination Survey (KNHANES)","volume":"43","author":"Kweon","year":"2014","journal-title":"Int. J. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e2014002","DOI":"10.4178\/epih\/e2014002","article-title":"The Korea National Health and Nutrition Examination Survey (KNHANES): Current status and challenges","volume":"36","author":"Kim","year":"2014","journal-title":"Epidemiol. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jand.2013.09.002","article-title":"Diet quality of urban older adults age 60 to 99 years: The cardiovascular health of seniors and built environment study","volume":"114","author":"Deierlein","year":"2014","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_30","first-page":"143","article-title":"Validity of the 24-hr. recall. Analysis of data obtained from elderly subjects","volume":"68","author":"Madden","year":"1976","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kwon, Y.-J., Lee, H.S., Park, J.-Y., and Lee, J.-W. (2020). Associating intake proportion of carbohydrate, fat, and protein with all-cause mortality in Korean adults. Nutrients, 12.","DOI":"10.3390\/nu12103208"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"40","DOI":"10.7570\/jomes.2019.28.1.40","article-title":"2018 Korean society for the study of obesity guideline for the management of obesity in Korea","volume":"28","author":"Seo","year":"2019","journal-title":"J. Obes. Metab. Syndr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/gerona\/glu010","article-title":"The FNIH sarcopenia project: Rationale, study description, conference recommendations, and final estimates","volume":"69","author":"Studenski","year":"2014","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.diabres.2006.04.013","article-title":"Appropriate waist circumference cutoff points for central obesity in Korean adults","volume":"75","author":"Lee","year":"2007","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/01.CSMR.0000306206.72186.00","article-title":"Exercise and the Institute of Medicine recommendations for nutrition","volume":"4","author":"Manore","year":"2005","journal-title":"Curr. Sports Med. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1152\/physiol.00024.2014","article-title":"Sex-based differences in skeletal muscle kinetics and fiber-type composition","volume":"30","author":"Haizlip","year":"2015","journal-title":"Physiology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1152\/japplphysiol.90812.2008","article-title":"Greater systemic lipolysis in women compared with men during moderate-dose infusion of epinephrine and\/or norepinephrine","volume":"107","author":"Horton","year":"2009","journal-title":"J. Appl. Physiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/2042-6410-3-13","article-title":"Sex differences in human adipose tissues\u2014The biology of pear shape","volume":"3","author":"Karastergiou","year":"2012","journal-title":"Biol. Sex Differ."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/1753-0407.12874","article-title":"Shortage of energy intake rather than protein intake is associated with sarcopenia in elderly patients with type 2 diabetes: A cross-sectional study of the KAMOGAWA-DM cohort","volume":"11","author":"Okamura","year":"2019","journal-title":"J Diabetes"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.phrp.2014.02.002","article-title":"Under-reporting of energy intake from 24-hour dietary recalls in the Korean National Health and Nutrition Examination Survey","volume":"5","author":"Kye","year":"2014","journal-title":"Osong Public Health Res. Perspect."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1093\/cdn\/nzaa061_055","article-title":"Accuracy of 24-hour diet recalls in older Korean women","volume":"4","author":"Kim","year":"2020","journal-title":"Curr. Dev. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/obr.12791","article-title":"Low glycaemic index diets as an intervention for obesity: A systematic review and meta-analysis","volume":"20","author":"Zafar","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.numecd.2013.04.008","article-title":"Long-term effects of low glycemic index\/load vs. high glycemic index\/load diets on parameters of obesity and obesity-associated risks: A systematic review and meta-analysis","volume":"23","author":"Schwingshackl","year":"2013","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Lim, M.T., Pan, B.J., Toh, D.W.K., Sutanto, C.N., and Kim, J.E. (2021). Animal protein versus plant protein in supporting lean mass and muscle strength: A systematic review and meta-analysis of randomized controlled trials. Nutrients, 13.","DOI":"10.3390\/nu13020661"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/11\/4031\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:28:53Z","timestamp":1760167733000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/11\/4031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,11]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["nu13114031"],"URL":"https:\/\/doi.org\/10.3390\/nu13114031","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,11]]}}}