Novel Insights on Nutrient Management of Sarcopenia in the Elderly

Abstract

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of muscle mass and strength. The more rationale approach to delay the progression of sarcopenia is based on the combination of proper nutrition, possibly associated with the use of dietary supplements and a regular exercise program. We performed a narrative literature review to evaluate the till-now evidence regarding (1) the metabolic and nutritional correlates of sarcopenia; (2) the optimum diet therapy for the treatment of these abnormalities. This review included 67 eligible studies. In addition to the well recognized link between adequate intake of proteins/amino acids and sarcopenia, the recent literature underlines that in sarcopenic elderly subjects there is an unbalance in vitamin D synthesis and in omega-6/omega-3 PUFA ratio. Given the detrimental effect of these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of sarcopenia. The optimum diet therapy for the sarcopenia treatment must aim at achieving specific metabolic goals, which must be reached through accession of the elderly to specific personalized dietary program aimed at achieving and/or maintaining muscle mass; increasing their intake of fish (4 times/week) or taking omega-3 PUFA supplements; taking vitamin D supplementation, if there are low serum levels.

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

“…It is widely thought that the most important influences associated with the aetiology include, but not limited to, a reduction of anabolic hormones (testosterone, growth hormone, insulin-like growth factor-I (IGF-I)), muscular disuse, increased circulating concentrations of pro-inflammatory cytokines (particularly TNF-α and IL-6), oxidative stress due to the accumulation of free radicals, mitochondrial dysregulation of muscle cells, a decline in the number of α-motoneurons and low vitamin-D status [100][101][102][103][104]. Although a number of dietary interventions have previously been investigated for their efficacy in the management and/or prevention of physical frailty and sarcopenia [45][46][47][48][49], the role of dietary protein often receives much attention. Dietary protein intake stimulates muscle protein synthesis (MPS) and facilitates postprandial muscle protein accretion [105].…”

“…Both aerobic and resistance training attenuates the loss of lean body mass, increases muscle strength and ameliorates frailty in older adults [42][43][44]. Numerous dietary interventions have been extensively investigated, though most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns [45][46][47][48][49]. However, it is plausible that many dietary factors, including individual nutrients and other non-nutrient bioactive constituents, individually and collectively, influence skeletal muscle functioning and body composition.…”

Estilo de vida e intervenções não farmacológicas no tratamento e na prevenção das síndromes geriátricas: uma revisão integrativa

“…Esse autor sugere que o consumo de 1-1,2g/kg de proteína por dia ou 25g-30g de proteína de alta qualidade em cada refeição é o adequado para a prevenção da sarcopenia. Rondanelli, et al (2015) aludem ainda a um possível benefício do uso de 800-1000 unidades por dia de vitamina D, de betahidroxmetilbutirato (HMB), 2g/dia por 12 semanas, e de creatina (5g/dia) na prevenção e no tratamento da sarcopenia.…”

An examination of the determinants of low muscle mass and low muscle strength in older adults in Ireland

“…The prevalence and determinants of loss of muscle mass and muscle strength have yet to be fully characterised in the context of an Irish population. Previous studies have implicated total energy, protein, vitamin D and omega 3 fatty acid intakes in the attenuation of these losses (2) . The objectives of this study were to examine the determinants of handgrip strength and skeletal muscle mass index (SMI) in a cohort of community-dwelling older adults living in Ireland.…”