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This study examines whether meeting World Health Organization physical activity guidelines, combined with higher versus lower than the recommended daily allowance protein intake, is associated with greater appendicular lean soft tissue index (ALSTI) in adults aged 40–59 years with cancer using data from the National Health and Nutrition Examination Survey. Participants were grouped by activity level and protein intake assessed via two interviewer-administered 24-hour dietary recalls. Results show no significant association for meeting vigorous or moderate guidelines with higher protein, but a positive association when both vigorous and moderate guidelines were met. Conclusions emphasize the need for longitudinal and interventional work to clarify activity and adequate protein’s role in preserving muscle health.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/meeting-physical-activity-guidelines-in-conjunction-with-higher-protein-intake-associations-with-appendicular-lean-soft-tissue-index-in-middle-aged-adults-with-cancer/443351/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/meeting-physical-activity-guidelines-in-conjunction-with-higher-protein-intake-associations-with-appendicular-lean-soft-tissue-index-in-middle-aged-adults-with-cancer/443351.png","ImageObject",300,407,{"name":92,"@type":93},"Ezra","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s main aim?","Question",{"text":112,"@type":113},"To test whether meeting World Health Organization physical activity guidelines together with higher versus lower-than-RDA protein intake is associated with higher appendicular lean soft tissue index (ALSTI) in adults with cancer aged 40–59 years.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were physical activity and protein intake measured?",{"text":117,"@type":113},"Physical activity was categorized as moderate (≥150 min/week) or vigorous (≥75 min/week), and protein intake was classified as >0.8 versus ≤0.8 g/kg/day using two interviewer-administered 24-hour dietary recalls.",{"name":119,"@type":110,"acceptedAnswer":120},"Did meeting activity guidelines plus higher protein improve ALSTI?",{"text":121,"@type":113},"In fully adjusted models, meeting either vigorous or moderate guidelines with higher protein intake was not significantly associated with ALSTI. A significantly positive association was found when both vigorous and moderate activity criteria were met.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},443351,1790768795,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Supportive Care in Cancer (2026) 34:66  \n[https://doi.org/10.1007/s00520-025-10290-6](https://doi.org/10.1007/s00520-025-10290-6)  \nMeeting physical activity guidelines in conjunction with higher protein intake: associations with appendicular lean soft tissue index in middle aged adults with cancer  \nKonstantinos Prokopidis1 · Stefano Cacciatore2,11 · Nicola Veronese3,4 · Brendon Stubbs5 · Paolo Piaggi6 ·  \nJohn A. Batsis7,8 · Carla M. Prado9 · Mathias Schlögl10  \nReceived: 14 September 2025 / Accepted: 19 December 2025 / Published online: 6 January 2026 © The Author(s) 2026  \nAbstract  \nBackground Loss of muscle mass is a common concern among patients with cancer. The aim of this study was to examine whether meeting the World Health Organization physical activity guidelines in combination with a higher vs. lower than the recommended daily allowance (RDA) protein intake is associated with greater appendicular lean soft tissue index (ALSTI) in adults aged 40–59 years with cancer from the National Health and Nutrition Examination Survey.  \nMethods Participants were categorized by physical activity levels (moderate ≥ 150 min/week or vigorous ≥ 75 min/week) and protein intake (> 0.8 vs. ≤ 0.8 g/kg/day) assessed via two interviewer-administered 24-h dietary recalls. ALSTI was calculated using dual-energy X-ray absorptiometry (kg/m2) . Linear regression models estimated associations, adjusting for demographic, clinical, and dietary covariates.  \nResults Among 169 participants (mean age 51.0 ± 5.6 years; 69% women, mean ALSTI 7.74 ± 1.66 kg/m2), those meeting vigorous or moderate physical activity guidelines with higher protein intake did not show a significant association with ALSTI in the fully adjusted models (vigorous: β = 0.08, standard error (SE) 0.12, p = 0.53; moderate: β = -0.05, SE 0.15, p = 0.76) . However, a significantly positive link was found in those meeting both vigorous and moderate physical activity (β = 0.40, b SE 0.02, p \u003C 0.01) .  \nConclusions Meeting vigorous or moderate physical activity guidelines in combination with higher vs. lower protein intake was not associated with ALSTI in adults with cancer. However, meeting both was positively linked to ALSTI. Longitudinal and interventional studies using objective measures and longitudinal designs are needed to clarify the role of physical activity with adequate protein intake in preserving muscle health in this clinical population.  \nKeywords Cancer · Sarcopenia · Muscle wasting · Protein intake · Nutrition  \n* Konstantinos Prokopidis[k.prokopidis@liverpool.ac.uk](k.prokopidis@liverpool.ac.uk)  \n1 Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK  \n2 Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.Go F. Vito 1,  \n00168 Rome, Italy  \n3 Geriatric Unit, Department of Medicine, University of Palermo, Palermo, Italy  \n4 Saint Camillus International University of Health Sciences, Rome, Italy  \n5 Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK  \n6 Department of Information Engineering, University of Pisa, Pisa, Italy  \n7 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA  \n8 Division of Geriatric Medicine, UNC School of Medicine, Chapel Hill, NC, USA  \n9 Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada  \n10 Clinic Barmelweid, Department for Geriatric Medicine, Erlinsbach, Switzerland  \n11 Fondazione Policlinico Universitario “Agostino Gemelli”IRCCS, L.Go A. Gemelli 8, 00168 Rome, Italy  \nIntroduction  \nDuring ageing, the maintenance of muscle mass and strength is essential for preserving functional independence and mitigating the risk and consequences of sarcopenia, a condition characterized by the progressive loss of skel","cbCaikGo7h1QUxcI","https://ap.wps.com/l/cbCaikGo7h1QUxcI","pdf",870473,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Keywords\n# Introduction","[{\"question\":\"What was the study’s main aim?\",\"answer\":\"To test whether meeting World Health Organization physical activity guidelines together with higher versus lower-than-RDA protein intake is associated with higher appendicular lean soft tissue index (ALSTI) in adults with cancer aged 40–59 years.\"},{\"question\":\"How were physical activity and protein intake measured?\",\"answer\":\"Physical activity was categorized as moderate (≥150 min/week) or vigorous (≥75 min/week), and protein intake was classified as \\u003e0.8 versus ≤0.8 g/kg/day using two interviewer-administered 24-hour dietary recalls.\"},{\"question\":\"Did meeting activity guidelines plus higher protein improve ALSTI?\",\"answer\":\"In fully adjusted models, meeting either vigorous or moderate guidelines with higher protein intake was not significantly associated with ALSTI. A significantly positive association was found when both vigorous and moderate activity criteria were met.\"}]","Meeting physical activity guidelines in conjunction with higher protein intake - associations with appendicular lean soft tissue index in middle aged adults with cancer | PDF",1790703758,23]