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Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri

Yıl 2021, Cilt: 3 Sayı: 3, 208 - 221, 23.12.2021
https://doi.org/10.46413/boneyusbad.957116

Öz

Yaşlılık dönemi, hastalık yükünün ve hastalıklara karşı direncin azaldığı, engellenemeyen biyolojik bir dönemdir. Yaşlanmayla birlikte sindirim sisteminde çiğneme, yutma, sindirme ve bağırsak hareketliliği gibi birçok fonksiyondaki değişiklikler besin alımını olumsuz etkilemektedir. Herhangi bir beslenme sorunu olmasa bile yaşla beraber iskelet kas kütlesi azalırken; malnütrisyon varlığında iskelet kası yıkımıyla sarkopeni görülmektedir. Bu döngünün kırılmadığı durumlarda daha farklı hastalıkların da eklenmesiyle bireyin sağlığı olumsuz etkilenmektedir. İskelet kas fonksiyonunun zayıflamasıyla birlikte yaşlı bireylerin fiziksel aktivitesi ve enerji harcaması azalmaktadır. Buna eşlik eden abdominal yağlanma ile sarkopeninin yanında obezite de oluşabilmektedir. Sarkopenik obezite olarak adlandırılan bu durumda obezite kaynaklı ortaya çıkan inflamasyon, iskelet kası yıkımını daha da artırmaktadır. Bu nedenle sarkopenik obezite, sarkopeninin tek başına varlığından daha tehlikelidir. Yaşlı bireylerde kas kütlesindeki azalmayla birlikte yağ kütlesindeki artış, gözle görülür değişiklik oluşmaması halinde sarkopenik obezite tanısının konmasını zorlaştırmaktadır. Yaşlıların ihtiyaç duyduğu besin ve besin ögelerinin, yaşlılığın getirdiği nedenlerle oluşan iştahsızlık ve yeme güçlüklerine göre modifiye edilerek, yeterli ve dengeli bir diyetle verilmesi gerekmektedir. Bu şekilde yaşlıları hem sarkopeniden hem de sarkopenik obeziteden koruyabilmek mümkündür. Bu makalede, sarkopenik obezite görülen yaşlı bireylerde beslenme müdahalelerinin sağlık üzerine etkileri ve güncel beslenme önerileri literatürdeki kanıta dayalı son yayınlar incelenerek derlenmiştir.

Kaynakça

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Sarcopenic Obesity In The Elderly And Current Nutritional Recommendations

Yıl 2021, Cilt: 3 Sayı: 3, 208 - 221, 23.12.2021
https://doi.org/10.46413/boneyusbad.957116

Öz

The old age period is an inescapable biological era during which the burden of disease and disease resistance decreases as individuals gain more knowledge and experience. Many processes of the digestive system, such as chewing, swallowing, digestion, and intestinal motility, vary with age and have a negative impact on food intake. Skeletal muscle mass declines with age, even if there is no nutritional deficit, whereas sarcopenia is characterized by skeletal muscle degeneration in the presence of starvation. When this cycle is not disrupted, the individual's health suffers because of the accumulation of various diseases. Physical activity and energy expenditure in elderly people decline when skeletal muscle function deteriorates. Obesity may develop in conjunction with sarcopenia and abdominal adiposity. In this condition called sarcopenic obesity, obesity-induced inflammation further increases skeletal muscle destruction. As a result, sarcopenic obesity is more harmful than simply having sarcopenia. The fact that the net body weight does not change because of the loss of muscle mass and gain of fat mass in elderly people makes diagnosing sarcopenic obesity challenging. The nutrients and nutrients required by the elderly should be tailored to their loss of appetite and eating issues because of aging, and they should be supplemented with a nutritious and well-balanced diet. The elderly can be safeguarded from sarcopenia and sarcopenic obesity in this way. By reviewing the most recent evidence-based publications in the literature, the effects of dietary therapies on the health of elderly people with sarcopenic obesity and current nutritional recommendations are summarized in this article.

Kaynakça

  • Abd Aziz, N. A. S., Mohd Fahmi Teng, N. I., Kamarul Zaman, M. (2019). Geriatric Nutrition Risk Index is comparable to the mini nutritional assessment for assessing nutritional status in elderly hospitalized patients. Clincal Nutrition ESPEN, 29, 77-85. doi:10.1016/j.clnesp.2018.12.002
  • Artaza-Artabe, I., Sáez-López, P., Sánchez-Hernández, N., Fernández-Gutierrez, N., Malafarina, V. (2016). The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly: a systematic review. Maturitas, 93, 89-99. doi:10.1016/j.maturitas.2016.04.009
  • Atkins, J. L., Wannamathee, S. G. (2020). Sarcopenic obesity in ageing: cardiovascular outcomes and mortality. British Journal of Nutrition, 124(10), 1102-1113. doi:10.1017/s0007114520002172
  • Barkoukis, H. (2016). Nutrition recommendations in elderly and aging. The Medical Clinics of North America, 100(6), 1237-1250. doi:10.1016/j.mcna.2016.06.006
  • Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., MorleyI. E., ... Boirie, Y. (2013). Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. Journal of The American Medical Directors Association, 14(8), 542-559. doi: 10.1016/j.jamda.2013.05.021
  • Bauer, J. M., Kaiser, M. J., Anthony, P., Guigoz, Y., Sieber, C. C. (2008). The mini nutritional assessment®—its history, today's practice, and future perspectives. Nutrition in Clinical Practice, 23(4), 388-396. doi:10.1177/0884533608321132
  • Baum, J. I., Kim, I.-Y., Wolfe, R. R. (2016). Protein consumption and the elderly: What is the optimal level of intake? Nutrients, 8(6), 359. doi: 10.3390/nu8060359
  • Baumgartner, R. N. (2000). Body composition in healthy aging. Annals of the New York Academy of Sciences, 904(1), 437-448.
  • Besler, H., Rakıcıoğlu, N., Ayaz, A., Büyüktuncer Demirel, Z., Gökmen Özel, H., Samur, F., . . . Göktaş, Z. (2015). Türkiye'ye Özgü Besin ve Beslenme Rehberi. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Beslenme ve Diyetetik Bölümü, Ankara.
  • Beaudart, C., Locquet, M., Touvier, M., Reginster, J. Y., Bruyère, O. (2019). Association between dietary nutrient intake and sarcopenia in the SarcoPhAge study. Aging Clinical and Experimental Research, 31(6), 815-824. doi: 10.1007/s40520-019-01186-7
  • Björkman, M. P., Suominen, M. H., Kautiainen, H., Jyväkorpi, S. K., Finne-Soveri, H. U., Strandberg, T. E., . . . Tilvis, R. S. (2020). Effect of protein supplementation on physical performance in older people with sarcopenia–a randomized controlled trial. Journal of the American Medical Directors Association, 21(2), 226-232.e221. doi:10.1016/j.jamda.2019.09.006
  • Bo, Y., Liu, C., Ji, Z., Yang, R., An, Q., Zhang, X., . . . Lu, Q. (2019). A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: a double-blind randomized controlled trial. Clinical Nutrition, 38(1), 159-164. doi:10.1016/j.clnu.2017.12.020
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  • Dhillon, R. J., Hasni, S. (2017). Pathogenesis and management of sarcopenia. Clinics in Geriatric Medicine, 33(1), 17-26. doi:10.1016/j.cger.2016.08.002
  • Dodds, R. M., Syddall, H. E., Cooper, R., Benzeval, M., Deary, I. J., Dennison, E. M., ... Sayer, A. A. (2014). Grip strength across the life course: normative data from twelve British studies. PloS One, 9(12), e113637. doi: 10.1371/journal.pone.0113637
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  • European Food Safety Authority (2019). Interactive tool - Dietary reference values. Erişim tarihi: 02.09.2021, https://www.efsa.europa.eu/en/topics/topic/dietary-reference-values
  • El Hajj, C., Fares, S., Chardigny, J. M., Boirie, Y., Walrand, S. (2018). Vitamin D supplementation and muscle strength in pre-sarcopenic elderly Lebanese people: a randomized controlled trial. Archives of Osteoporosis, 14(1), 4. doi:10.1007/s11657-018-0553-2
  • Ganapathy, A., Nieves, J. W. (2020). Nutrition and sarcopenia—what do we know? Nutrients, 12(6), 1755. doi: 10.3390/nu12061755
  • Hayashi, A. P., de Capitani, M. D., Dias, S. F., de Souza Gonçalves, L., Fernandes, A. L., Jambassi-Filho, J. C., . . . Roschel, H. (2020). Number of high-protein containing meals correlates with muscle mass in pre-frail and frail elderly. European Journal of Clinical Nutrition, 74(7), 1047-1053. doi:10.1038/s41430-020-0618-3
  • Hsu, K. J., Liao, C. D., Tsai, M. W., Chen, C. N. (2019). Effects of exercise and nutritional intervention on body composition, metabolic health, and physical performance in adults with sarcopenic obesity: a meta-analysis. Nutrients, 11(9). doi:10.3390/nu11092163
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  • Juby, A. G., Mager, D. R. (2019). A review of nutrition screening tools used to assess the malnutrition-sarcopenia syndrome (MSS) in the older adult. Clinical Nutrition ESPEN, 32, 8-15. doi: 10.1016/j.clnesp.2019.04.003
  • Keller, U. (2019). Nutritional laboratory markers in malnutrition. Journal of Clinical Medicine, 8(6), 775. doi: 10.3390/jcm8060775
  • Khor, E. Q., Lim, J. P., Tay, L., Yeo, A., Yew, S., Ding, Y. Y., Lim, W. S. (2020). Obesity definitions in sarcopenic obesity: differences in prevalence, agreement and association with muscle function. Journal of Frailty & Aging, 9(1), 37-43. doi:10.14283/jfa.2019.28
  • Kiesswetter, E., Sieber, C. C., Volkert, D. (2020). Protein intake in older people : why, how much and how? Zeitschrift für Gerontologie und Geriatrie, 53(4), 285-289. doi:10.1007/s00391-020-01723-4
  • Kim, T. N. (2018). Elderly obesity: is it harmful or beneficial? Journal of Obesity & Metabolic Syndrome, 27(2), 84-92. doi:10.7570/jomes.2018.27.2.84
  • Leij-Halfwerk, S., Verwijs, M. H., van Houdt, S., Borkent, J. W., Guaitoli, P., Pelgrim, T., . . . Corish, C. A. (2019). Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults≥ 65 years: a systematic review and meta-analysis. Maturitas, 126, 80-89. doi: 10.1016/j.maturitas.2019.05.006
  • Liao, C. D., Chen, H. C., Huang, S. W., Liou, T. H. (2019). The role of muscle mass gain following protein supplementation plus exercise therapy in older adults with sarcopenia and frailty risks: a systematic review and meta-regression analysis of randomized trials. Nutrients, 11(8). doi:10.3390/nu11081713
  • Liao, C. D., Tsauo, J. Y., Wu, Y. T., Cheng, C. P., Chen, H. C., Huang, Y. C., . . . Liou, T. H. (2017). Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: a systematic review and meta-analysis. American Journal of Clinical Nutrition, 106(4), 1078-1091. doi:10.3945/ajcn.116.143594
  • Lim, H. S., Park, Y. H., Suh, K., Yoo, M. H., Park, H. K., Kim, H. J., . . . Byun, D. W. (2018). Association between sarcopenia, sarcopenic obesity, and chronic disease in korean elderly. Journal of Bone Metabolism, 25(3), 187-193. doi:10.11005/jbm.2018.25.3.187
  • Lonnie, M., Hooker, E., Brunstrom, J. M., Corfe, B. M., Green, M. A., Watson, A. W., . . . Johnstone, A. M. (2018). Protein for life: review of optimal protein intake, sustainable dietary sources and the effect on appetite in ageing adults. Nutrients, 10(3), 360. doi: 10.3390/nu10030360
  • Maeda, K., Akagi, J. (2016). Treatment of sarcopenic dysphagia with rehabilitation and nutritional support: a comprehensive approach. Journal of the Academy of Nutrition and Dietetics, 116(4), 573-577. doi: 10.1016/j.jand.2015.09.019
  • Martin, H., Aihie Sayer, A., Jameson, K., Syddall, H., Dennison, E. M., Cooper, C., Robinson, S. (2011). Does diet influence physical performance in community-dwelling older people? Findings from the Hertfordshire Cohort Study. Age and Ageing, 40(2), 181-186. doi: 10.1093/ageing/afq175
  • Montiel-Rojas, D., Nilsson, A., Santoro, A., Franceschi, C., Bazzocchi, A., Battista, G., . . . Kadi, F. (2020). Dietary fibre may mitigate sarcopenia risk: findings from the NU-AGE cohort of older European adults. Nutrients, 12(4), 1075. doi: 10.3390/nu12041075
  • Morley, J. E. (2016). Frailty and sarcopenia in elderly. Wiener Klinische Wochenschrift, 128(Suppl 7), 439-445. doi:10.1007/s00508-016-1087-5
  • Nie, C., He, T., Zhang, W., Zhang, G., ve Ma, X. (2018). Branched chain amino acids: beyond nutrition metabolism. International Journal of Molecular Sciences, 19(4), 954. doi: 10.3390/ijms19040954
  • Öztürk, Z. A., Türkbeyler İ, H., Abiyev, A., Kul, S., Edizer, B., Yakaryılmaz, F. D., Soylu, G. (2018). Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity. Internal Medicine Journal, 48(8), 973-981. doi:10.1111/imj.13935
  • Park, Y., Choi, J. E., Hwang, H. S. (2018). Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial. The American Journal of Clinical Nutrition, 108(5), 1026-1033. doi: 10.1093/ajcn/nqy214
  • Picetti, D., Foster, S., Pangle, A. K., Schrader, A., George, M., Wei, J. Y., Azhar, G. (2017). Hydration health literacy in the elderly. Nutrition and Healthy Aging, 4, 227-237. doi:10.3233/NHA-170026
  • Prokopidis, K., Cervo, M. M., Gandham, A., Scott, D. (2020). Impact of protein intake in older adults with sarcopenia and obesity: a gut microbiota perspective. Nutrients, 12(8), 2285. doi: 10.3390/nu12082285
  • Rath, P. (2019). Nutrition for elderly. In P. C. Rath (Ed.), Models, Molecules and Mechanisms in Biogerontology: Physiological Abnormalities, Diseases and Interventions (pp. 411-426). Singapore: Springer Singapore.
  • Reinders, I., Wijnhoven, H. A., Jyväkorpi, S. K., Suominen, M. H., Niskanen, R., Bosmans, J. E., ... Visser, M. (2020). Effectiveness and cost-effectiveness of personalised dietary advice aiming at increasing protein intake on physical functioning in community-dwelling older adults with lower habitual protein intake: rationale and design of the PROMISS randomised controlled trial. British Medical of Journal Open, 10(11), e040637. doi: 10.1136/bmjopen-2020-040637.
  • Rusu, A., Randriambelonoro, M., Perrin, C., Valk, C., Álvarez, B., Schwarze, A.-K. (2020). Aspects influencing food intake and approaches towards personalising nutrition in the elderly. Journal of Population Ageing, 1-18. doi: 10.1007/s12062-019-09259-1
  • Sağlık Bakanlığı (2016). Türkiye Beslenme Rehberi TÜBER 2015. TC Sağlık Bakanlığı Yayını No:1031, Ankara
  • Santos, V. R. D., Christofaro, D. G. D., Gomes, I. C., Júnior, I. F. F., Gobbo, L. A. (2018). Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over. Revista Brasileira de Ortopedia, 53(3), 300-305. doi:10.1016/j.rboe.2017.09.002
  • Seino, S., Sumi, K., Narita, M., Yokoyama, Y., Ashida, K., Kitamura, A., Shinkai, S. (2018). Effects of low-dose dairy protein plus micronutrient supplementation during resistance exercise on muscle mass and physical performance in older adults: a randomized, controlled trial. The Journal of Nutrition Health and Aging, 22(1), 59-67. doi:10.1007/s12603-017-0904-5
  • Siddique, N., O'Donoghue, M., Casey, M. C., Walsh, J. B. (2017). Malnutrition in the elderly and its effects on bone health – A review. Clinical Nutrition ESPEN, 21, 31-39. doi:10.1016/j.clnesp.2017.06.001
  • Son, J., Yu, Q., Seo, J. S. (2019). Sarcopenic obesity can be negatively associated with active physical activity and adequate intake of some nutrients in Korean elderly: findings from the Korea National Health and Nutrition Examination Survey (2008-2011). Nutrition Research and Practice, 13(1), 47-57. doi:10.4162/nrp.2019.13.1.47
  • Studenski, S. A., Peters, K. W., Alley, D. E., Cawthon, P. M., McLean, R. R., Harris, T. B., . . . Kenny, A. M. (2014). The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 69(5), 547-558. doi: 10.1093/gerona/glu010
  • Sulmont-Rossé, C. (2020). Eating in the elderly. Handbook of Eating and Drinking: Interdisciplinary Perspectives, 433-457.
  • Türkiye İstatistik Kurumu. (2020). İstatistiklerle Yaşlılar. Erişim tarihi: 28.04.2021, https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2020-37227
  • US Department of Agriculture (2020). US Department of Health and Human Services-Dietary Guidelines for Americans, 2020-2025. Erişim tarihi: 02.09.2021, https://dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf
  • US Department of Agriculture (2021). Erişim tarihi: 04.09.2021, https://www.myplate.gov/myplate-plan Verlaan, S., Aspray, T. J., Bauer, J. M., Cederholm, T., Hemsworth, J., Hill, T. R., ... Brandt, K. (2017). Nutritional status, body composition, and quality of life in community-dwelling sarcopenic and non-sarcopenic older adults: A case-control study. Clinical Nutrition, 36(1), 267-274. doi: 10.1016/j.clnu.2015.11.013
  • Verlaan, S., Maier, A. B., Bauer, J. M., Bautmans, I., Brandt, K., Donini, L. M., ... Cederholm, T. (2018). Sufficient levels of 25-hydroxyvitamin D and protein intake required to increase muscle mass in sarcopenic older adults–The PROVIDE study. Clinical Nutrition, 37(2), 551-557. doi: 10.1016/j.clnu.2017.01.005
  • Veronese, N., Berton, L., Carraro, S., Bolzetta, F., De Rui, M., Perissinotto, E., ... Sergi, G. (2014). Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program: a randomized controlled trial. The American Journal of Clinical Nutrition, 100(3), 974-981. doi: 10.3945/ajcn.113.080168
  • Wakabayashi, H., Kishima, M., Itoda, M., Fujishima, I., Kunieda, K., Ohno, T., . . . D. (2021). The Japanese working group on sarcopenic, diagnosis and treatment of sarcopenic dysphagia: a scoping review. Dysphagia, 36(3), 523-531. doi:10.1007/s00455-021-10266-8
  • Welch, A. A., Jennings, A., Kelaiditi, E., Skinner, J., Steves, C. J. (2020). Cross-sectional associations between dietary antioxidant vitamins C, E and carotenoid intakes and sarcopenic indices in women aged 18–79 years. Calcified Tissue International, 106(4), 331-342. doi: 10.1007/s00223-019-00641-x
  • World Health Organisation. (2017). World health statistics. Life expectancy and healthy life expectancy. Erişim tarihi: 19.04.2021 https://apps.who.int/gho/data/node.main.SDG2016LEX?lang=en
  • World Health Organization. (‎2015)‎. World report on ageing and health. Erişim tarihi: 04.09.2021 https://apps.who.int/iris/handle/10665/186463
  • Yang, L.-J., Wu, G.-H., Yang, Y.-L., Wu, Y.-H., Zhang, L., Wang, M.-H., . . . Weng, X.-F. (2019). Nutrition, physical exercise, and the prevalence of sarcopenia in elderly residents in nursing homes in China. Medical Science Monitor : International Medical Journal Of Experimental And Clinical Research, 25, 4390-4399. doi:10.12659/MSM.914031
  • Zhang, X., Xie, X., Dou, Q., Liu, C., Zhang, W., Yang, Y., . . . Cheng, A. S. (2019). Association of sarcopenic obesity with the risk of all-cause mortality among adults over a broad range of different settings: a updated meta-analysis. BMC Geriatrics, 19(1), 1-14. doi: 10.1186/s12877-019-1195-y
Toplam 67 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm DERLEME MAKALE
Yazarlar

Büşra Çolak 0000-0002-8546-8248

Seda Çiftçi 0000-0002-4103-1618

Yayımlanma Tarihi 23 Aralık 2021
Gönderilme Tarihi 24 Haziran 2021
Kabul Tarihi 10 Kasım 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 3 Sayı: 3

Kaynak Göster

APA Çolak, B., & Çiftçi, S. (2021). Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi, 3(3), 208-221. https://doi.org/10.46413/boneyusbad.957116
AMA Çolak B, Çiftçi S. Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. Aralık 2021;3(3):208-221. doi:10.46413/boneyusbad.957116
Chicago Çolak, Büşra, ve Seda Çiftçi. “Yaşlılarda Sarkopenik Obezite Ve Güncel Beslenme Önerileri”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi 3, sy. 3 (Aralık 2021): 208-21. https://doi.org/10.46413/boneyusbad.957116.
EndNote Çolak B, Çiftçi S (01 Aralık 2021) Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 3 3 208–221.
IEEE B. Çolak ve S. Çiftçi, “Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri”, Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi, c. 3, sy. 3, ss. 208–221, 2021, doi: 10.46413/boneyusbad.957116.
ISNAD Çolak, Büşra - Çiftçi, Seda. “Yaşlılarda Sarkopenik Obezite Ve Güncel Beslenme Önerileri”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 3/3 (Aralık 2021), 208-221. https://doi.org/10.46413/boneyusbad.957116.
JAMA Çolak B, Çiftçi S. Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. 2021;3:208–221.
MLA Çolak, Büşra ve Seda Çiftçi. “Yaşlılarda Sarkopenik Obezite Ve Güncel Beslenme Önerileri”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi, c. 3, sy. 3, 2021, ss. 208-21, doi:10.46413/boneyusbad.957116.
Vancouver Çolak B, Çiftçi S. Yaşlılarda Sarkopenik Obezite ve Güncel Beslenme Önerileri. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. 2021;3(3):208-21.

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