The role of nutrition in the prevention of sarcopenia

Abstract

Sarcopenia is a common skeletal muscle disorder characterized by a loss of muscle mass and impaired muscle function that is associated with poor health outcomes. Although nutrition is considered an important factor in the etiology of sarcopenia, the preventive potential of diet, specifically the extent to which differences in habitual patterns of diet and/or nutrient intakes impact risk of its development, is poorly understood. This narrative review considered research evidence on dietary patterns and nutrient intakes in mid- (<60 y) and young-older (60-70 y) adulthood to evaluate how they relate to age-related changes in muscle mass and function. A key finding was that current evidence on adult diet and sarcopenia risk in older age is limited and fragmented, with different outcomes reported across studies (for example, lean mass, strength) and few reporting links to incident diagnosed sarcopenia. As these outcomes are not interchangeable, it challenges collation of the evidence, leaving many gaps in understanding. There is also limited information about adult (<70 y) diet and few longitudinal studies with repeated dietary assessments to enable definition of cumulative exposures across adulthood. However, despite these limitations, findings from studies of dietary patterns already provide reasonably consistent messages about the benefits of diets of higher quality in earlier adulthood for later physical performance, although whole-diet intervention trials are urgently needed to understand their potential. In comparison, there is little evidence of benefits of higher intakes of individual nutrients in earlier adulthood for later muscle mass and function. Although these gaps need to be addressed in future research, there may already be sufficient data to promote messages about diet quality more widely - that healthier diets of higher quality across adulthood, with known benefits for a range of health outcomes, are also linked to the effective preservation of muscle mass and function.

Keywords: aging; diet; lifecourse; prevention; sarcopenia.

FIGURE 1

Mechanisms implicated in the pathogenesis of sarcopenia. Mechanisms of sarcopenia are complex and include skeletal muscle fiber atrophy, imbalance of muscle protein synthesis and breakdown, mitochondrial dysfunction and accumulation of ROS, and neuromuscular changes. (Created with BioRender.com). ROS, reactive oxygen species.

FIGURE 2

HABCPPB decline over follow-up time, stratified by the MIND diet score tertile, adjusting for age, race, years since first diet visit, years of education, smoking status, physical activity, number of chronic diseases, BMI, and mean energy intake. Reproduced with permission from Talegawkar et al. [41]. HAPBCPPB, health, aging, and body composition physical performance battery; MIND, Mediterranean-dietary approaches to stop hypertension Intervention for Neurodegenerative Delay.

FIGURE 3

Summary of evidence from prospective studies and intervention trials for the effects of nutrition in mid- and young-older adulthood (<70 y) on later muscle mass, function, and physical performance.