Does nutrition play a role in the prevention and management of sarcopenia?

Abstract

There is a growing body of evidence that links nutrition to muscle mass, strength and function in older adults, suggesting that it has an important role to play both in the prevention and management of sarcopenia. This review summarises the discussions of a working group [ESCEO working group meeting 8th September 2016] that met to review current evidence and to consider its implications for preventive and treatment strategies. The review points to the importance of 'healthier' dietary patterns that are adequate in quality in older age, to ensure sufficient intakes of protein, vitamin D, antioxidant nutrients and long-chain polyunsaturated fatty acids. In particular, there is substantial evidence to support the roles of dietary protein and physical activity as key anabolic stimuli for muscle protein synthesis. However, much of the evidence is observational and from high-income countries. Further high-quality trials, particularly from more diverse populations, are needed to enable an understanding of dose and duration effects of individual nutrients on function, to elucidate mechanistic links, and to define optimal profiles and patterns of nutrient intake for older adults.

Keywords: Muscle mass; Muscle strength; Nutrition; Physical performance; Sarcopenia; Supplementation.

Figure 1

Estimated linear changes in energy intake (kcal/day) in 922 men and 879 women over a 12-year follow-up period, according to (4-year) age group at baseline [9].

Figure 2

Fractional mixed muscle protein synthesis rates (FSR) in healthy young and older men in the post-absorptive state (n = 34 young, n = 72 older) and post-prandial (n = 35 young, n = 40 older) state, following ingestion of 20 g protein. Significantly different comparing post-absorptive and post-prandial values for each group: ** (P<0.01), *** (P<0.001); significantly different comparison of older and young men: †† (P<0.01) [24].

Figure 3

Mean mixed-muscle protein fractional synthetic rates (FSR) after protein ingestion in young (n = 24) and older (n = 24) men at rest and after exercise based on L-[1-13C]phenylalanine (ingested tracer) enrichment. Data were analysed by ANOVA (age · exercise): age effect, P = 0.62; exercise effect, P=0.05; age x exercise effect, P = 0.52. [42]

Figure 4

Proposed model of age-related muscle loss punctuated by episodes of acute illness or injury[57]

Figure 5

Mean (±SEM) mixed skeletal muscle protein fractional synthesis rate (FSR) during postabsorptive conditions and hyperaminoacidemic-hyperinsulinemic clamp, before and after 8 weeks of supplementation with corn oil or n3 fatty acids (a:significant effect of clamp,P<0.01; b:significant effect of clamp P<0.01; c: significantly different from the corresponding value before omega-3 fatty acid supplementation, P<0.01) [120]