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Hettiarachchi J, Reijnierse EM, Kew N, Fetterplace K, Tan SY, Maier AB. The effect of dose, frequency, and timing of protein supplementation on muscle mass in older adults: A systematic review and meta-analysis. Ageing Res Rev 2024; 99:102325. [PMID: 38830547 DOI: 10.1016/j.arr.2024.102325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 06/05/2024]
Abstract
Protein supplementation has shown to improve muscle mass in older adults. However, its effect may be influenced by supplementation dose, frequency and timing. This systematic review aimed to assess the effect of dose, frequency and timing of protein supplementation on muscle mass in older adults. Five databases were systematically searched from inception to 14 March 2023, for randomised controlled trials investigating the effect of protein supplementation on muscle mass in adults aged ≥65 years. Random effects meta-analyses were performed, stratified by population. Subgroups were created for dose (≥30 g, <30 g/day), frequency (once, twice, three times/day) and timing of supplementation (at breakfast, breakfast and lunch, breakfast and dinner, all meals, between meals). Heterogeneity within and between subgroups was assessed using I2 and Cochran Q statistics respectively. Thirty-eight articles were included describing community-dwelling (28 articles, n=3204, 74.6±3.4 years, 62.8 % female), hospitalised (8 articles, n=590, 77.0±3.7 years, 50.3 % female) and institutionalised populations (2 articles, n=156, 85.7±1.2 years, 71.2 % female). Protein supplementation showed a positive effect on muscle mass in community-dwelling older adults (standardised mean difference 0.116; 95 % confidence interval 0.032-0.200 kg, p=0.007, I2=15.3 %) but the effect did not differ between subgroups of dose, frequency and timing (Q=0.056, 0.569 and 3.084 respectively, p>0.05). Data including hospitalised and institutionalised populations were limited. Protein supplementation improves muscle mass in community-dwelling older adults, but its dose, frequency or timing does not significantly influence the effect.
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Affiliation(s)
- Jeewanadee Hettiarachchi
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia; Institute of Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Natalie Kew
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Kate Fetterplace
- Department of Allied Health (Clinical Nutrition), The Royal Melbourne Hospital, Melbourne, VIC, Australia; The University of Melbourne, Department of Critical Care, Melbourne Medical School, Melbourne, VIC, Australia
| | - Sze-Yen Tan
- Institute of Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, @AgeSingapore, National University Health System, Singapore.
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McKendry J, Lowisz CV, Nanthakumar A, MacDonald M, Lim C, Currier BS, Phillips SM. The effects of whey, pea, and collagen protein supplementation beyond the recommended dietary allowance on integrated myofibrillar protein synthetic rates in older males: a randomized controlled trial. Am J Clin Nutr 2024; 120:34-46. [PMID: 38762187 PMCID: PMC11291473 DOI: 10.1016/j.ajcnut.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Skeletal muscle mass is determined predominantly by feeding-induced and activity-induced fluctuations in muscle protein synthesis (MPS). Older individuals display a diminished MPS response to protein ingestion, referred to as age-related anabolic resistance, which contributes to the progression of age-related muscle loss known as sarcopenia. OBJECTIVES We aimed to determine the impact of consuming higher-quality compared with lower-quality protein supplements above the recommended dietary allowance (RDA) on integrated MPS rates. We hypothesized that increasing total protein intake above the RDA, regardless of the source, would support higher integrated rates of myofibrillar protein synthesis. METHODS Thirty-one healthy older males (72 ± 4 y) consumed a controlled diet with protein intake set at the RDA: control phase (days 1-7). In a double-blind, randomized controlled fashion, participants were assigned to consume an additional 50 g (2 × 25g) of whey (n = 10), pea (n = 11), or collagen (n = 10) protein each day (25 g at breakfast and lunch) during the supplemental phase (days 8-15). Deuterated water ingestion and muscle biopsies assessed integrated MPS and acute anabolic signaling. Postprandial blood samples were collected to determine feeding-induced aminoacidemia. RESULTS Integrated MPS was increased during supplemental with whey (1.59 ± 0.11 %/d; P < 0.001) and pea (1.59 ± 0.14 %/d; P < 0.001) when compared with RDA (1.46 ± 0.09 %/d for the whey group; 1.46 ± 0.10 %/d for the pea group); however, it remained unchanged with collagen. Supplemental protein was sufficient to overcome anabolic signaling deficits (mTORC1 and rpS6), corroborating the greater postprandial aminoacidemia. CONCLUSIONS Our findings demonstrate that supplemental protein provided at breakfast and lunch over the current RDA enhanced anabolic signaling and integrated MPS in older males; however, the source of additional protein may be an important consideration in overcoming age-related anabolic resistance. This trial was registered clinicaltrials.gov as NCT04026607.
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Affiliation(s)
- James McKendry
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Caroline V Lowisz
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Arraksana Nanthakumar
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Meaghan MacDonald
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Changhyun Lim
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Brad S Currier
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology, Exercise Metabolism Research Group, McMaster University, Hamilton, Ontario, Canada.
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He W, Connolly ED, Cross HR, Wu G. Dietary protein and amino acid intakes for mitigating sarcopenia in humans. Crit Rev Food Sci Nutr 2024:1-24. [PMID: 38803274 DOI: 10.1080/10408398.2024.2348549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Adult humans generally experience a 0.5-1%/year loss in whole-body skeletal muscle mass and a reduction of muscle strength by 1.5-5%/year beginning at the age of 50 years. This results in sarcopenia (aging-related progressive losses of skeletal muscle mass and strength) that affects 10-16% of adults aged ≥ 60 years worldwide. Concentrations of some amino acids (AAs) such as branched-chain AAs, arginine, glutamine, glycine, and serine are reduced in the plasma of older than young adults likely due to insufficient protein intake, reduced protein digestibility, and increased AA catabolism by the portal-drained viscera. Acute, short-term, or long-term administration of some of these AAs or a mixture of proteinogenic AAs can enhance blood flow to skeletal muscle, activate the mechanistic target of rapamycin cell signaling pathway for the initiation of muscle protein synthesis, and modulate the metabolic activity of the muscle. In addition, some AA metabolites such as taurine, β-alanine, carnosine, and creatine have similar physiological effects on improving muscle mass and function in older adults. Long-term adequate intakes of protein and the AA metabolites can aid in mitigating sarcopenia in elderly adults. Appropriate combinations of animal- and plant-sourced foods are most desirable to maintain proper dietary AA balance.
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Affiliation(s)
- Wenliang He
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Erin D Connolly
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - H Russell Cross
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - Guoyao Wu
- Department of Animal Science, Texas A&M University, College Station, TX, USA
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Pagan JI, Bradshaw BA, Bejte B, Hart JN, Perez V, Knowles KS, Beausejour JP, Luzadder M, Menger R, Osorio C, Harmon KK, Hanney WJ, Wilson AT, Stout JR, Stock MS. Task-specific resistance training adaptations in older adults: comparing traditional and functional exercise interventions. FRONTIERS IN AGING 2024; 5:1335534. [PMID: 38746477 PMCID: PMC11091347 DOI: 10.3389/fragi.2024.1335534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024]
Abstract
Muscle strength declines ∼3% per year after the age of 70. Resistance training guidelines for older adults are often based on free-weight and machine exercises, which may be inaccessible and lack carryover to activities of daily living. We tested the hypothesis that resistance training adaptations in older adults are task-specific. Thirty adults (8 males, 22 females; mean age = 71 years) were randomly assigned to participate in 6 weeks of supervised, high-intensity resistance training (twice per week) utilizing free-weight and machine exercises (traditional) versus functional activities that were overloaded with a weighted vest (functional). Participants were thoroughly familiarized with the exercises and testing prior to beginning the study. Major outcome measures included assessments of functional performance, five-repetition maximum strength, isometric knee extensor force, and quadriceps muscle size. Physical activity and nutrition were monitored. The study results demonstrate that the magnitude of improvement within a given outcome was largely dependent on group assignment, with greater improvements in gait speed and the timed-up-and-go in the functional group, but 2-3× greater five repetition maximum strength improvements for the trap bar deadlift, leg press, and leg extension following traditional resistance training. Both groups showed improvements in isometric knee extensor force and muscle size, suggesting that some aspects of the observed adaptations were generic, rather than specific. Overall, these novel findings suggest that, among older adults, 1) resistance training adaptations exhibit a high degree of task specificity and 2) significant improvements in functional outcomes can be achieved with the use of a weighted vest.
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Affiliation(s)
- Jason I. Pagan
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Bethany A. Bradshaw
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Brisilda Bejte
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jordan N. Hart
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Vanjeliz Perez
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Kevan S. Knowles
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jonathan P. Beausejour
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Marc Luzadder
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Reed Menger
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Carlos Osorio
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Kylie K. Harmon
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
| | - William J. Hanney
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Abigail T. Wilson
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R. Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Matt S. Stock
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
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Khaing IK, Tahara Y, Chimed-Ochir O, Shibata S, Kubo T. Effect of breakfast protein intake on muscle mass and strength in adults: a scoping review. Nutr Rev 2024:nuad167. [PMID: 38219154 DOI: 10.1093/nutrit/nuad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The distribution of protein intake throughout the day is frequently skewed, with breakfast having the lowest protein intake across all age groups. There is no review that addresses the association between breakfast protein intake and muscle mass and strength. OBJECTIVE This scoping review aims to summarize the literature on the relationship between protein intake during breakfast and muscle mass and strength in adults. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Two independent reviewers screened and appraised the articles identified from 3 electronic databases (Medline, Web of Science, and Scopus) that focused on protein intake per meal and its impact on muscle-related outcomes. RESULTS A total of 14 763 articles were retrieved from 3 databases, and after the screening process, 15 articles were included for analysis. Approximately 58.8% of findings from 11 studies examining the association between high protein intake during breakfast and muscle mass indicated an increase in muscle mass among participants. Half of 6 studies (50.0%) exploring the relationship between high protein intake at breakfast and muscle strength demonstrated an increase in muscle strength. Consuming high amounts of protein at breakfast or more protein in the morning than in the evening was associated with an increase in the skeletal muscle index and lean body mass. CONCLUSION Protein consumption at breakfast revealed potential benefits in increasing muscle mass across 5 studies involving an elderly population and 2 studies encompassing middle-aged women and young men in our review. However, the relationship between protein intake at breakfast and muscle strength remains unclear. Further high-quality randomized controlled trials are required to examine whether adults can preserve skeletal muscle health outcomes by consuming higher amounts of protein at breakfast.
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Affiliation(s)
- Inn-Kynn Khaing
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yu Tahara
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigenobu Shibata
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Geny A, Petitjean M, Van Wymelbeke-Delannoy V, Sulmont-Rossé C. Impact of food-based fortification on nutritional outcomes and acceptability in older adults: systematic literature review. Front Nutr 2023; 10:1232502. [PMID: 37964932 PMCID: PMC10641731 DOI: 10.3389/fnut.2023.1232502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/02/2023] [Indexed: 11/16/2023] Open
Abstract
Background "Do it yourself" (DIY) food-based fortification involves adding fortificants into everyday foods. It is a flexible solution that allows older people with reduced appetite to meet their nutritional needs. Objectives The aims of the systematic review are (a) to describe DIY fortified recipes, (b) to evaluate their acceptability, and (c) to evaluate whether they are effective levers to improve nutritional outcomes in older people. Methods A systematic search of 3 databases (Web of Science, PubMed, Scopus, last searched on January 2022) was undertaken. Main eligibility criteria include older adults aged ≥60 years living at home, in an institution or in hospital. Studies carried out for a specific medical condition or targeting only micronutrient fortification were excluded. After reviewing all titles/abstracts then full-text papers, key data were extracted and synthesized narratively. The quality of included studies was assessed using Kmet et al. Results Of 21,493 papers extracted, 44 original studies were included (3,384 participants), with 31 reporting nutritional outcomes, 3 reporting acceptability outcomes and 10 reporting both nutritional and acceptability outcomes. The review highlighted a wide variety of DIY fortified recipes, with additional energy ranging from 23 to 850 kcal/d (M = 403; SE = 62) and/or protein ranging from 4 to 40 g/d (M = 19; SE = 2). Compared to a standard diet, DIY fortification seems to be a valuable strategy for increasing energy and protein intake in older people. However, no strong evidence was observed on the nutritional status. Implication for future Further acceptability studies are crucial to ensure that DIY fortified foods are palatable and thus have a significant impact on the nutritional status. In addition, it would be useful for studies to better describe DIY recipes. This information would result in a better understanding of the factors that maximize the impact of DIY fortification on nutritional outcomes. Study registration: PROSPERO no. CRD42021244689.Systematic review registration: PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021244689.
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Affiliation(s)
- Alexia Geny
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, France
| | - Maité Petitjean
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, France
| | - Virginie Van Wymelbeke-Delannoy
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, France
- CHU Dijon Bourgogne, Unité de recherche Pôle Personnes Âgées, Dijon, France
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, France
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Nishimura Y, Højfeldt G, Breen L, Tetens I, Holm L. Dietary protein requirements and recommendations for healthy older adults: a critical narrative review of the scientific evidence. Nutr Res Rev 2023; 36:69-85. [PMID: 34666855 DOI: 10.1017/s0954422421000329] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Adequate protein intake is essential for the maintenance of whole-body protein mass. Different methodological approaches are used to substantiate the evidence for the current protein recommendations, and it is continuously debated whether older adults require more protein to counteract the age-dependent loss of muscle mass, sarcopenia. Thus, the purpose of this critical narrative review is to outline and discuss differences in the approaches and methodologies assessing the protein requirements and, hence, resulting in controversies in current protein recommendations for healthy older adults. Through a literature search, this narrative review first summarises the historical development of the Food and Agriculture Organization/World Health Organization/United Nations University setting of protein requirements and recommendations for healthy older adults. Hereafter, we describe the various types of studies (epidemiological studies and protein turnover kinetic measurements) and applied methodological approaches founding the basis and the different recommendations with focus on healthy older adults. Finally, we discuss important factors to be considered in future studies to obtain evidence for international agreement on protein requirements and recommendations for healthy older adults. We conclude by proposing future directions to determine 'true' protein requirements and recommendations for healthy older adults.
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Affiliation(s)
- Yusuke Nishimura
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Grith Højfeldt
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Inge Tetens
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Holm
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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Aragon AA, Tipton KD, Schoenfeld BJ. Age-related muscle anabolic resistance: inevitable or preventable? Nutr Rev 2023; 81:441-454. [PMID: 36018750 DOI: 10.1093/nutrit/nuac062] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Age-related loss of muscle mass, strength, and performance, commonly referred to as sarcopenia, has wide-ranging detrimental effects on human health, the ramifications of which can have serious implications for both morbidity and mortality. Various interventional strategies have been proposed to counteract sarcopenia, with a particular emphasis on those employing a combination of exercise and nutrition. However, the efficacy of these interventions can be confounded by an age-related blunting of the muscle protein synthesis response to a given dose of protein/amino acids, which has been termed "anabolic resistance." While the pathophysiology of sarcopenia is undoubtedly complex, anabolic resistance is implicated in the progression of age-related muscle loss and its underlying complications. Several mechanisms have been proposed as underlying age-related impairments in the anabolic response to protein consumption. These include decreased anabolic molecular signaling activity, reduced insulin-mediated capillary recruitment (thus, reduced amino acid delivery), and increased splanchnic retention of amino acids (thus, reduced availability for muscular uptake). Obesity and sedentarism can exacerbate, or at least facilitate, anabolic resistance, mediated in part by insulin resistance and systemic inflammation. This narrative review addresses the key factors and contextual elements involved in reduction of the acute muscle protein synthesis response associated with aging and its varied consequences. Practical interventions focused on dietary protein manipulation are proposed to prevent the onset of anabolic resistance and mitigate its progression.
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Affiliation(s)
- Alan A Aragon
- is with the Department of Family and Consumer Sciences, California State University, Northridge, California, USA
| | - Kevin D Tipton
- is with the Institute of Performance Nutrition, Edinburgh, Scotland
| | - Brad J Schoenfeld
- is with the Department of Health Sciences, CUNY Lehman College, Bronx, New York, USA
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Arentson-Lantz EJ, Layman DK, Leidy HJ, Campbell WW, Phillips SM. Important Concepts in Protein Nutrition, Aging, and Skeletal Muscle: Honoring Dr Douglas Paddon-Jones (1969-2021) by Highlighting His Research Contributions. J Nutr 2023; 153:615-621. [PMID: 36931744 PMCID: PMC10196581 DOI: 10.1016/j.tjnut.2023.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
This review is a tribute to honor Dr Douglas Paddon-Jones by highlighting his career research contributions. Dr Paddon-Jones was a leader in recognizing the importance of muscle health and the interactions of physical activity and dietary protein for optimizing the health span. Aging is characterized by loss of muscle mass and strength associated with reduced rates of muscle protein synthesis (MPS) and the ability to repair and replace muscle proteins. Research from the team at the University of Texas Medical Branch in Galveston discovered that the age-related decline in MPS could be overcome by increasing the quantity or quality of dietary protein at each meal. Dr Paddon-Jones was instrumental in proposing and testing a "protein threshold" of ∼30 g protein/meal to optimize MPS in older adults. Dr Paddon-Jones demonstrated that physical inactivity greatly accelerates the loss of muscle mass and function in older adults. His work in physical activity led him to propose the "Catabolic Crisis Model" of muscle size and function losses, suggesting that age-related muscle loss is not a linear process, but the result of acute periods of disuse associated with injuries, illnesses, and bed rest. This model creates the opportunity to provide targeted interventions via protein supplementation and/or increased dietary protein through consuming high-quality animal-source foods. He illustrated that nutritional support, particularly enhanced protein quantity, quality, and meal distribution, can help preserve muscle health during periods of inactivity and promote health across the life course.
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Affiliation(s)
- Emily J Arentson-Lantz
- Department of Nutrition, Metabolism and Rehabilitation Science, University of Texas Medical Branch, Galveston, TX, USA.
| | - Donald K Layman
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Heather J Leidy
- Department of Nutritional Sciences, Department of Pediatrics-Dell Medical, University of Texas at Austin, Austin, TX, USA
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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10
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Is It Time to Reconsider the U.S. Recommendations for Dietary Protein and Amino Acid Intake? Nutrients 2023; 15:nu15040838. [PMID: 36839196 PMCID: PMC9963165 DOI: 10.3390/nu15040838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/06/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
Since the U.S. Institute of Medicine's recommendations on protein and amino acid intake in 2005, new information supports the need to re-evaluate these recommendations. New lines of evidence include: (1) re-analysis/re-interpretation of nitrogen balance data; (2) results from indicator amino acid oxidation studies; (3) studies of positive functional outcomes associated with protein intakes higher than recommended; (4) dietary guidance and protein recommendations from some professional nutrition societies; and (5) recognition that the synthesis of certain dispensable amino acids may be insufficient to meet physiological requirements more often than previously understood. The empirical estimates, theoretical calculations and clinical functional outcomes converge on a similar theme, that recommendations for intake of protein and some amino acids may be too low in several populations, including for older adults (≥65 years), pregnant and lactating women, and healthy children older than 3 years. Additional influential factors that should be considered are protein quality that meets operational sufficiency (adequate intake to support healthy functional outcomes), interactions between protein and energy intake, and functional roles of amino acids which could impact the pool of available amino acids for use in protein synthesis. Going forward, the definition of "adequacy" as it pertains to protein and amino acid intake recommendations must take into consideration these critical factors.
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11
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Effect of 24-Week, Late-Evening Ingestion of a Calcium-Fortified, Milk-Based Protein Matrix on Biomarkers of Bone Metabolism and Site-Specific Bone Mineral Density in Postmenopausal Women with Osteopenia. Nutrients 2022; 14:nu14173486. [PMID: 36079744 PMCID: PMC9460355 DOI: 10.3390/nu14173486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022] Open
Abstract
Dietary calcium intake is a modifiable, lifestyle factor that can affect bone health and the risk of fracture. The diurnal rhythm of bone remodelling suggests nocturnal dietary intervention to be most effective. This study investigated the effect of daily, bed-time ingestion of a calcium-fortified, milk-derived protein matrix (MBPM) or control (CON), for 24 weeks, on serum biomarkers of bone resorption (C-terminal telopeptide of type I collagen, CTX) and formation (serum pro-collagen type 1 N-terminal propeptide, P1NP), and site-specific aerial bone mineral density (BMD), trabecular bone score (TBS), in postmenopausal women with osteopenia. The MBPM supplement increased mean daily energy, protein, and calcium intake, by 11, 30, and 107%, respectively. 24-week supplementation with MBPM decreased CTX by 23%, from 0.547 (0.107) to 0.416 (0.087) ng/mL (p < 0.001) and P1NP by 17%, from 60.6 (9.1) to 49.7 (7.2) μg/L (p < 0.001). Compared to CON, MBPM induced a significantly greater reduction in serum CTX (mean (CI95%); −9 (8.6) vs. −23 (8.5)%, p = 0.025 but not P1NP −19 (8.8) vs. −17 (5.2)%, p = 0.802). No significant change in TBS, AP spine or dual femur aerial BMD was observed for CON or MBPM. This study demonstrates the potential benefit of bed-time ingestion of a calcium-fortified, milk-based protein matrix on homeostatic bone remodelling but no resultant treatment effect on site-specific BMD in postmenopausal women with osteopenia.
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12
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Shinto T, Makino S, Tahara Y, Nitta L, Kuwahara M, Tada A, Abe N, Michie M, Shibata S. Relationship Between Protein Intake in Each Traditional Meal and Physical Activity: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e35898. [PMID: 35819831 PMCID: PMC9328787 DOI: 10.2196/35898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/23/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background Protein intake plays an important role in the synthesis and maintenance of skeletal muscles for the prevention of health risks. It is also widely known that physical activity influences muscle function. However, no large-scale studies have examined the relationship between daily dietary habits, especially the timing of protein intake, and daily physical activity. Objective The purpose of this cross-sectional study was to investigate how protein intake and composition (involving the 3 major nutrients protein, fat, and carbohydrate) in the 3 traditional meals (breakfast, lunch, and dinner) are associated with physical activity. Methods Using daily dietary data accumulated in the smartphone food log app “Asken” and a web-based cross-sectional survey involving Asken users (N=8458), we analyzed nutrient intake and composition, as well as daily activity levels. As very few individuals skipped breakfast (1102/19,319 responses, 5.7%), we analyzed data for 3 meals per day. Results Spearman rank correlation analysis revealed that breakfast and lunch protein intakes had higher positive correlations with daily physical activity among the 3 major macronutrients (P<.001). These findings were confirmed by multivariate logistic regression analysis with confounding factors. Moreover, participants with higher protein intake and composition at breakfast or lunch tended to exhibit significantly greater physical activity than those with higher protein intake at dinner (P<.001). Conclusions Among the 3 macronutrients, protein intake during breakfast and lunch was closely associated with daily physical activity.
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Affiliation(s)
- Takae Shinto
- Department of Bioscience and Engineering, Waseda University, Tokyo, Japan
| | - Saneyuki Makino
- Department of Bioscience and Engineering, Waseda University, Tokyo, Japan
| | - Yu Tahara
- Department of Bioscience and Engineering, Waseda University, Tokyo, Japan
| | - Lie Nitta
- Department of Bioscience and Engineering, Waseda University, Tokyo, Japan
| | - Mai Kuwahara
- Department of Bioscience and Engineering, Waseda University, Tokyo, Japan
| | | | | | | | - Shigenobu Shibata
- Department of Bioscience and Engineering, Waseda University, Tokyo, Japan
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13
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Hawley AL, Liang X, Børsheim E, Wolfe RR, Salisbury L, Hendy E, Wu H, Walker S, Tacinelli AM, Baum JI. The potential role of beef and nutrients found in beef on outcomes of wellbeing in healthy adults 50 years of age and older: A systematic review of randomized controlled trials. Meat Sci 2022; 189:108830. [PMID: 35483315 DOI: 10.1016/j.meatsci.2022.108830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/25/2022] [Accepted: 04/18/2022] [Indexed: 12/19/2022]
Abstract
Shifts in wellbeing and health occur as we age. As life expectancy increases, maintenance of wellbeing and health becomes increasingly important. Nutrients found in beef are associated with outcomes of wellbeing such as physical and cognitive function, lean body mass, and mood in older adults and individuals with chronic disease. However, it is unclear how beef and nutrients found in beef impact wellbeing in healthy adults ≥50 years of age. This study systematically reviewed evidence linking the intake of beef and nutrients found in beef to markers of wellbeing in healthy adults. PubMed, CINAHL, and Web of Science were searched up to August 31, 2021 for eligible randomized controlled trials (RCTs). Nutrients included in the analysis were beef, red meat, dietary protein, essential amino acids, branched chain amino acids, tryptophan, arginine, cysteine, glycine, glutamate, vitamin B6, vitamin B12, choline, zinc, and iron. We identified nine RCTs with results from 55 measurements of markers of wellbeing. An overall positive effect was found of beef and beef's nutrients on wellbeing. There was an overall positive effect of amino acids and protein on wellbeing, with no effect of arginine, vitamin B-12, leucine, and zinc. Physical function was also influenced by beef and nutrients found in beef. Eight of the studies found focused on specific nutrients found in beef, and not beef itself in older adults with one or more chronic diseases. This study identified a need for further research regarding the effect of beef and nutrients found in beef on defined functional outcomes of wellbeing in healthy adults ≥50 years of age.
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Affiliation(s)
- Aubree L Hawley
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, United States of America; Department of Food Science, Bumpers College for Agricultural and Life Sciences, University of Arkansas, Fayetteville, AR 72704, United States of America
| | - Xinya Liang
- Department of Rehabilitation, Human Resources, and Communication Disorders, College of Education and Health Professions, University of Arkansas, Fayetteville, AR 72701, United States of America
| | - Elisabet Børsheim
- Department of Pediatrics, Arkansas Children's Nutrition Center, Arkansas Children's Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America; Department of Geriatrics, Donald W. Reynold's Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of America
| | - Robert R Wolfe
- Department of Geriatrics, Donald W. Reynold's Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States of America
| | - Lutishoor Salisbury
- University of Arkansas Libraries, Fayetteville, AR 72701, United States of America
| | - Emma Hendy
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, United States of America; Department of Food Science, Bumpers College for Agricultural and Life Sciences, University of Arkansas, Fayetteville, AR 72704, United States of America
| | - Hexirui Wu
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, United States of America; Department of Food Science, Bumpers College for Agricultural and Life Sciences, University of Arkansas, Fayetteville, AR 72704, United States of America
| | - Sam Walker
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, United States of America; Department of Food Science, Bumpers College for Agricultural and Life Sciences, University of Arkansas, Fayetteville, AR 72704, United States of America
| | - Angela M Tacinelli
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, United States of America; Department of Food Science, Bumpers College for Agricultural and Life Sciences, University of Arkansas, Fayetteville, AR 72704, United States of America
| | - Jamie I Baum
- Center for Human Nutrition, University of Arkansas System Division of Agriculture, Fayetteville, AR 72704, United States of America; Department of Food Science, Bumpers College for Agricultural and Life Sciences, University of Arkansas, Fayetteville, AR 72704, United States of America.
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14
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Griffen C, Renshaw D, Duncan M, Weickert MO, Hattersley J. Changes in 24-h energy expenditure, substrate oxidation, and body composition following resistance exercise and a high protein diet via whey protein supplementation in healthy older men. Physiol Rep 2022; 10:e15268. [PMID: 37815091 PMCID: PMC9332127 DOI: 10.14814/phy2.15268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/01/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate changes in 24-h energy expenditure (EE), substrate oxidation, and body composition following resistance exercise (RE) and a high protein diet via whey protein supplementation (alone and combined) in healthy older men. METHODS In a pooled groups analysis, 33 healthy older men [(mean ± SE) age: 67 ± 1 years; BMI: 25.4 ± 0.4 kg/m2] were randomized to either RE (2×/week; n = 17) or non-exercise (n = 16) and either a high protein diet via whey protein supplementation (PRO, 2 × 25 g whey protein isolate/d; n = 17) or control (CON, 2 × 23.75 g maltodextrin/d; n = 16). An exploratory sub-analysis was also conducted between RE+CON (n = 8) and RE+PRO (n = 9). At baseline and 12 weeks, participants resided in respiration chambers for measurement of 24-h EE and substrate oxidation and wore an accelerometer for 7 days for estimation of free-living EE. RESULTS Resistance exercise resulted in greater increases in fat-free mass (1.0 ± 0.3 kg), resting metabolic rate [(RMR) 36 ± 14 kcal/d], sedentary EE (60 ± 33 kcal/d), and sleeping metabolic rate [(SMR) 45 ± 7 kcal/d] compared to non-exercise (p < 0.05); however, RE decreased activity energy expenditure in free-living (-90 ± 25 kcal/d; p = 0.049) and non-exercise activity inside the respiration chamber (-1.9 ± 1.1%; p = 0.049). PRO decreased fat mass [(FM) -0.5 ± 0.3 kg], increased overnight protein oxidation (30 ± 6 g/d), and decreased 24-h protein balance (-20 ± 4 g/d) greater than CON (p < 0.05). RE+PRO decreased FM (-1.0 ± 0.5 kg) greater than RE+CON (p = 0.04). CONCLUSION Resistance exercise significantly increased RMR, SMR, and sedentary EE in healthy older men, but not total EE. PRO alone and combined with RE decreased FM and aided body weight maintenance. This study was registered at clinicaltrials.gov as NCT03299972.
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Affiliation(s)
- Corbin Griffen
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- Human Metabolism Research UnitUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Derek Renshaw
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
| | - Michael Duncan
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- School of Life SciencesFaculty of Health and Life SciencesCoventry UniversityCoventryUK
| | - Martin O. Weickert
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of Endocrinology and DiabetesUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - John Hattersley
- Centre for Sport, Exercise and Life SciencesResearch Institute for Health and WellbeingCoventry UniversityCoventryUK
- Human Metabolism Research UnitUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
- School of EngineeringUniversity of WarwickCoventryUK
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15
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Nunes EA, Colenso‐Semple L, McKellar SR, Yau T, Ali MU, Fitzpatrick‐Lewis D, Sherifali D, Gaudichon C, Tomé D, Atherton PJ, Robles MC, Naranjo‐Modad S, Braun M, Landi F, Phillips SM. Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults. J Cachexia Sarcopenia Muscle 2022; 13:795-810. [PMID: 35187864 PMCID: PMC8978023 DOI: 10.1002/jcsm.12922] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/14/2022] Open
Abstract
We performed a systematic review, meta-analysis, and meta-regression to determine if increasing daily protein ingestion contributes to gaining lean body mass (LBM), muscle strength, and physical/functional test performance in healthy subjects. A protocol for the present study was registered (PROSPERO, CRD42020159001), and a systematic search of Medline, Embase, CINAHL, and Web of Sciences databases was undertaken. Only randomized controlled trials (RCT) where participants increased their daily protein intake and were healthy and non-obese adults were included. Research questions focused on the main effects on the outcomes of interest and subgroup analysis, splitting the studies by participation in a resistance exercise (RE), age (<65 or ≥65 years old), and levels of daily protein ingestion. Three-level random-effects meta-analyses and meta-regressions were conducted on data from 74 RCT. Most of the selected studies tested the effects of additional protein ingestion during RE training. The evidence suggests that increasing daily protein ingestion may enhance gains in LBM in studies enrolling subjects in RE (SMD [standardized mean difference] = 0.22, 95% CI [95% confidence interval] 0.14:0.30, P < 0.01, 62 studies, moderate level of evidence). The effect on LBM was significant in subjects ≥65 years old ingesting 1.2-1.59 g of protein/kg/day and for younger subjects (<65 years old) ingesting ≥1.6 g of protein/kg/day submitted to RE. Lower-body strength gain was slightly higher by additional protein ingestion at ≥1.6 g of protein/kg/day during RE training (SMD = 0.40, 95% CI 0.09:0.35, P < 0.01, 19 studies, low level of evidence). Bench press strength is slightly increased by ingesting more protein in <65 years old subjects during RE training (SMD = 0.18, 95% CI 0.03:0.33, P = 0.01, 32 studies, low level of evidence). The effects of ingesting more protein are unclear when assessing handgrip strength and only marginal for performance in physical function tests. In conclusion, increasing daily protein ingestion results in small additional gains in LBM and lower body muscle strength gains in healthy adults enrolled in resistance exercise training. There is a slight effect on bench press strength and minimal effect performance in physical function tests. The effect on handgrip strength is unclear.
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Affiliation(s)
- Everson A. Nunes
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
- Laboratory of Investigation of Chronic Diseases, Department of Physiological SciencesFederal University of Santa CatarinaFlorianópolisBrazil
| | - Lauren Colenso‐Semple
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Sean R. McKellar
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Thomas Yau
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
| | - Muhammad Usman Ali
- McMaster Evidence Review and Synthesis CentreMcMaster UniversityHamiltonOntarioCanada
| | | | - Diana Sherifali
- School of Nursing, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Claire Gaudichon
- Université Paris‐SaclayAgroParisTech, INRAE, UMR PNCAParisFrance
| | - Daniel Tomé
- Université Paris‐SaclayAgroParisTech, INRAE, UMR PNCAParisFrance
| | - Philip J. Atherton
- MRC Versus Arthritis Centre of Excellence for Musculoskeletal Ageing Research (CMAR), NIHR Biomedical Research Centre, School of MedicineUniversity of NottinghamNottinghamUK
| | | | | | - Michelle Braun
- International Flavors & FragrancesResearch and DevelopmentSt. LouisMOUSA
| | - Francesco Landi
- Fondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
| | - Stuart M. Phillips
- Exercise Metabolism Research Group, Department of KinesiologyMcMaster UniversityHamiltonOntarioCanada
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16
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Jackson KL, Gropper SS, Hunt D, D’Avolio D, Newman D. Effectiveness of a Per-Meal Protein Prescription and Nutrition Education with versus without Diet Coaching on Dietary Protein Intake and Muscle Health in Middle-Aged Women. Nutrients 2022; 14:375. [PMID: 35057556 PMCID: PMC8781460 DOI: 10.3390/nu14020375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 01/25/2023] Open
Abstract
Sufficient dietary protein intake is vital to maintaining muscle health with aging. Yet protein intake among adults is often inadequate. This study's main objective was to examine the impact of nutrition education (NE) and a per-meal protein prescription (PRx) with versus without diet coaching on protein intake. A secondary objective examined its effects on muscle health. Participants included 53 women, age 45-64 years. All participants received NE and PRx; those randomized to coached-group received 10-weeks of diet coaching. Assessments included: protein intake at baseline, weeks 4 and 12 and muscle health (muscle mass, grip strength, five-chair rise test, 4 mgait speed test). The Chi-square test examined percentages of participants meeting PRx between groups. Repeated measures analysis of variance assessed within group and intervention effects on protein intake and muscle health parameters. Protein intake (g/kg body weight) increased (p < 0.001): not-coached (n = 28) 0.8 ± 0.2 to 1.2 ± 0.3 and coached (n = 25) 1.0 ± 0.2 to 1.4 ± 0.3 with no significant difference between groups. A greater percentage of coached-group participants met (p = 0.04) breakfast (72%) and met (p < 0.001) three-meal (76%) PRx versus not-coached participants (25% and 53%, respectively). Participants in both groups exhibited significantly (p < 0.001) improved times for the five-chair rise test and 4 mgait speed test. Diet coaching in conjunction with a PRx and NE should be considered to assist individuals in improving protein intake through self-selection of protein-rich foods.
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Affiliation(s)
- Kelley L. Jackson
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| | - Sareen S. Gropper
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| | - Dennis Hunt
- Department of Rehabilitation Sciences, Florida Gulf Coast University, 10501 FGCU Blvd S, Fort Myers, FL 33965, USA;
| | - Deborah D’Avolio
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA; (K.L.J.); (D.D.); (D.N.)
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17
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Griffen C, Duncan M, Hattersley J, Weickert MO, Dallaway A, Renshaw D. Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial. Exp Gerontol 2021; 158:111651. [PMID: 34896568 DOI: 10.1016/j.exger.2021.111651] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To determine the individual and combined effects of 12 weeks of resistance exercise (RE) and whey protein supplementation on skeletal muscle strength (primary outcome), mass and physical function, and hormonal and inflammatory biomarkers in older adults. METHODS Thirty-six healthy older men [(mean±SE) age: 67±1 y; BMI: 25.5±0.4 kg/m2] were randomised to either control (CON; n=9), whey protein (PRO; n=9), RE+control (EX+CON; n=9), or RE+whey protein (EX+PRO; n=9) in a double-blinded fashion. Whole-body RE (2 sets of 8 repetitions and 1 set to volitional failure at 80% 1RM) was performed twice weekly. Supplements (PRO, 25 g whey protein isolate; CON, 23.75 g maltodextrin) were consumed twice daily. RESULTS EX+CON and EX+PRO increased leg extension (+19±3 kg and +20±3 kg, respectively) and leg press 1RM (+27±3 kg and +39±2 kg, respectively) greater than the CON and PRO groups (P<0.001, Cohen's d=1.50-1.90). RE (EX+CON and EX+PRO groups pooled) also increased fat-free mass (FFM) (+0.9±0.3 kg) and 6-min walk test distance (+21±5 m) and decreased fat mass (-0.4±0.4 kg), and interleukin-6 (-1.0±0.4 pg/mL) and tumor necrosis factor-alpha concentration (-0.7±0.3 pg/mL) greater than non-exercise (CON and PRO groups pooled; P<0.05, Cohen's f=0.37-0.45). Whey protein supplementation (PRO and EX+PRO groups pooled) increased 4-m gait speed greater than control (CON and EX+CON groups pooled) (+0.08±0.03 m/s; P=0.007, f=0.51). CONCLUSION RE increased muscle strength, FFM and physical function, and decreased markers of systemic inflammation in healthy active older men. Whey protein supplementation alone increased gait speed. No synergistic effects were observed. This study was registered at clinicaltrials.gov as NCT03299972.
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Affiliation(s)
- Corbin Griffen
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom.
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 2DS, United Kingdom
| | - John Hattersley
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; School of Engineering, University of Warwick, Coventry, CV4 7HL, United Kingdom
| | - Martin O Weickert
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Department of Endocrinology and Diabetes, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Alexander Dallaway
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom
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18
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Abstract
PURPOSE OF REVIEW The practice of time-restricted feeding (TRF) has received fervent interest in recent years as a strategy to mitigate obesity and metabolic disease. We sought to review the implications of TRF for skeletal muscle health and function in aging. RECENT FINDINGS TRF has high adherence and can promote body weight loss in older populations. Body weight reductions favor fat mass in the young, however, there is also the potential for undesirable losses in lean mass. There is currently no evidence to support TRF for skeletal muscle function and metabolism in older persons, and only tentative findings in the young. With a narrow eating window of 6-8 h and a prolonged fasting period to minimize daily insulin exposure, TRF may contradict recommended dietary practices for optimizing skeletal muscle anabolism in older people. SUMMARY TRF might represent a promising intervention to address obesity and its associated metabolic diseases, however, at present there is insufficient evidence for optimizing skeletal muscle mass or health in older individuals. Further research is needed to: (1) ascertain the impact of TRF on body composition, skeletal muscle anabolism, and autophagy in aging, and; (2) delineate the potentially myoprotective roles of dietary protein and exercise within the framework of TRF in older persons.
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Affiliation(s)
- Matthew J Lees
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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19
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Mathewson SL, Gordon AL, Smith K, Atherton PJ, Greig CA, Phillips BE. Determining the Influence of Habitual Dietary Protein Intake on Physiological Muscle Parameters in Youth and Older Age. Nutrients 2021; 13:nu13103560. [PMID: 34684561 PMCID: PMC8539198 DOI: 10.3390/nu13103560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Protein ingestion is a potent stimulator of skeletal muscle protein synthesis (MPS). However, older adults demonstrate resistance to anabolic stimuli. Some evidence has demonstrated that a larger acute protein dose is required in older compared to younger adults to elicit the same synthetic response, suggesting that older adults should be consuming higher habitual dietary protein to optimise muscle mass. However, limited research has explored dietary habits in different age groups or the relationship between habitual dietary intake and mechanistic physiological parameters associated with muscle mass and function. This work investigated the effect of habitual dietary intake in young (n = 10, 25.9 (3.2y)) and older (n = 16, 70.2 (3.2y)) community-dwelling adults (16:10 male: female) on physiological muscle parameters. Dietary intake was assessed using four-day diet diaries. Post-absorptive MPS and MPS responses to feeding (4.25x basal metabolic rate; 16% protein) were determined in muscle biopsies of the m. vastus lateralis via stable isotope tracer ([1, 2-13C2]-leucine) infusions with mass-spectrometric analyses. Body composition was measured by dual-energy x-ray absorptiometry. Whole body strength was assessed via 1-repetition maximum assessments. No significant differences in habitual dietary intake (protein, fat, carbohydrate and leucine as g.kgWBLM-1.day-1) were observed between age groups. Whole-body lean mass (61.8 ± 9.9 vs. 49.8 ± 11.9 kg, p = 0.01) and knee-extensor strength (87.7 ± 28.3 vs. 56.8 ± 16.4 kg, p = 0.002) were significantly higher in young adults. Habitual protein intake (g.kg-1.day-1) was not associated with whole-body lean mass, upper-leg lean mass, whole-body strength, knee-extensor strength, basal MPS or fed-state MPS across both age groups. These findings suggest that differences in muscle mass and strength parameters between youth and older age are not explained by differences in habitual dietary protein intake. Further research with a larger sample size is needed to fully explore these relationships and inform on interventions to mitigate sarcopenia development.
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Affiliation(s)
- Sophie L. Mathewson
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston B15 2TT, UK; (S.L.M.); (C.A.G.)
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing, University of Birmingham, Edgbaston B15 2TT, UK
| | - Adam L. Gordon
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Derby DE22 3DT, UK; (A.L.G.); (K.S.); (P.J.A.)
- Department of Medicine for the Elderly, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
| | - Kenneth Smith
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Derby DE22 3DT, UK; (A.L.G.); (K.S.); (P.J.A.)
| | - Philip J. Atherton
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Derby DE22 3DT, UK; (A.L.G.); (K.S.); (P.J.A.)
| | - Carolyn A. Greig
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Edgbaston B15 2TT, UK; (S.L.M.); (C.A.G.)
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing, University of Birmingham, Edgbaston B15 2TT, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Edgbaston B15 2TT, UK
| | - Bethan E. Phillips
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Derby DE22 3DT, UK; (A.L.G.); (K.S.); (P.J.A.)
- Correspondence:
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20
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Gaspareto N, Previdelli ÁN, Laurentino GC, de Aquino RDC. Protein Consumption: Inadequacy in Amount, Food Sources, and Mealtime Distribution in Community-Dwelling Older Adults. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09465-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Aoyama S, Kim HK, Hirooka R, Tanaka M, Shimoda T, Chijiki H, Kojima S, Sasaki K, Takahashi K, Makino S, Takizawa M, Takahashi M, Tahara Y, Shimba S, Shinohara K, Shibata S. Distribution of dietary protein intake in daily meals influences skeletal muscle hypertrophy via the muscle clock. Cell Rep 2021; 36:109336. [PMID: 34233179 DOI: 10.1016/j.celrep.2021.109336] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/20/2021] [Accepted: 06/11/2021] [Indexed: 01/25/2023] Open
Abstract
The meal distribution of proteins throughout the day is usually skewed. However, its physiological implications and the effects of better protein distribution on muscle volume are largely unknown. Here, using the two-meals-per-day feeding model, we find that protein intake at the early active phase promotes overloading-induced muscle hypertrophy, in a manner dependent on the local muscle clock. Mice fed branched-chain amino acid (BCAA)-supplemented diets at the early active phase demonstrate skeletal muscle hypertrophy. However, distribution-dependent effects are not observed in ClockΔ19 or muscle-specific Bmal1 knockout mice. Additionally, we examined the relationship between the distribution of proteins in meals and muscle functions, such as skeletal muscle index and grip strength in humans. Higher muscle functions were observed in subjects who ingested dietary proteins mainly at breakfast than at dinner. These data suggest that protein intake at breakfast may be better for the maintenance of skeletal muscle mass.
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Affiliation(s)
- Shinya Aoyama
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan; Organization for University Research Initiatives, Waseda University, Tokyo 162-8480, Japan; Department of Neurobiology & Behavior, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Hyeon-Ki Kim
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan; Organization for University Research Initiatives, Waseda University, Tokyo 162-8480, Japan
| | - Rina Hirooka
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Mizuho Tanaka
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Takeru Shimoda
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Hanako Chijiki
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Shuichi Kojima
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Keisuke Sasaki
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Kengo Takahashi
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Saneyuki Makino
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Miku Takizawa
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - Yu Tahara
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan
| | - Shigeki Shimba
- Department of Health Science, School of Pharmacy, Nihon University, Chiba 274-8555, Japan
| | - Kazuyuki Shinohara
- Department of Neurobiology & Behavior, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan
| | - Shigenobu Shibata
- Laboratory of Physiology and Pharmacology, School of Advanced Science and Engineering, Waseda University, Tokyo 162-8480, Japan.
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22
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Abstract
The growing consumer awareness regarding health and fitness has been leading to a huge rise in the consumption of nutritional supplements and, consequently, to an increase in concerns about their quality. In this sense, one of the most consumed products is protein supplements and, despite being safer than other types of supplements, there are several studies showing incompatibilities between what is present on the labels and their actual content. Therefore, this review is focused on gathering information about the problems arising from poor manufacturing practices and inadequate quality control of sport protein supplements. These issues are mainly related to three aspects: reduction of the supplements’ nutritional value, the presence of pharmacological substances, and contamination with microorganisms or toxic metals. Regarding the first aspect, reports about the “classic” addition of nitrogen-rich compounds to mask the protein content measured by the Kjeldahl method were discussed, as well as recent topics such as the addition of cheaper proteins to produce an “undetectable” adulteration in whey protein supplements. With respect to the presence of pharmacological compounds, it is a finding that is not very common in protein supplements; however, even trace amounts of foreign substances in this type of product may cause adverse effects to consumers, and, in the case of an elite athlete, may result in doping. Finally, we discuss about the contamination with microorganisms and toxic metals, this latter being a subject that should be further explored due to few studies in the literature.
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23
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Aoyama S, Nakahata Y, Shinohara K. Chrono-Nutrition Has Potential in Preventing Age-Related Muscle Loss and Dysfunction. Front Neurosci 2021; 15:659883. [PMID: 33935640 PMCID: PMC8085298 DOI: 10.3389/fnins.2021.659883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/26/2021] [Indexed: 01/25/2023] Open
Abstract
The mammalian circadian clock systems regulate the day-night variation of several physiological functions such as the sleep/wake cycle and core body temperature. Disturbance in the circadian clock due to shiftwork and chronic jetlag is related to the risk of several disorders such as metabolic syndrome and cancer. Recently, it has been thought that shiftwork increases the risk of sarcopenia which is characterized by age-related decline of muscle mass and its dysfunctions including muscle strength and/or physical performance. First, we summarize the association between circadian rhythm and the occurrence of sarcopenia and discuss its mechanistic insight by focusing on the muscle function and molecular clock gene in knockout or mutant mice. The clock gene knockout or mutant mice showed early aging phenotypes, including low survival rate and muscle loss. It suggests that improvement in the disturbance of the circadian clock plays an important role in the aging process of healthy muscles. Nutritional intake has the potential to augment muscle growth and entrain the peripheral clock. Second, we discuss the potential of chrono-nutrition in preventing aging-related muscle loss and dysfunction. We also focus on the effects of time-restricted feeding (TRF) and the distribution of protein intake across three meals.
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Affiliation(s)
- Shinya Aoyama
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yasukazu Nakahata
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kazuyuki Shinohara
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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24
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Mertz KH, Reitelseder S, Bechshoeft R, Bulow J, Højfeldt G, Jensen M, Schacht SR, Lind MV, Rasmussen MA, Mikkelsen UR, Tetens I, Engelsen SB, Nielsen DS, Jespersen AP, Holm L. The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults: A randomized controlled trial. Am J Clin Nutr 2021; 113:790-800. [PMID: 33564844 DOI: 10.1093/ajcn/nqaa372] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 11/16/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Protein supplementation alone or combined with resistance training has been proposed to be effective in counteracting age-related losses of muscle mass and strength. OBJECTIVES To investigate the effect of protein supplementation alone or combined with light-intensity or heavy-load resistance exercise on muscle size, strength, and function in older adults. METHODS In a 1-y randomized controlled trial, 208 healthy older adults (>65 y) were randomly assigned to 1 of 5 interventions: 1) carbohydrate supplementation (CARB); 2) collagen protein supplementation (COLL); 3) whey protein supplementation (WHEY); 4) light-intensity resistance training 3-5 times/wk with whey protein supplementation (LITW); and 5) heavy resistance training 3 times weekly with whey protein supplementation (HRTW). Protein supplements contained 20 g protein + 10 g carbohydrate, whereas CARB contained 30 g of carbohydrates. All intervention groups received the supplement twice daily. The primary outcome was change in the quadriceps cross-sectional area (qCSA). Secondary outcomes included measures of lower extremity strength and power, functional capabilities, and body composition. RESULTS There were 184 participants who completed the study. COLL and WHEY did not affect any measured parameter compared to CARB. Compared to WHEY, HRTW improved the qCSA size (between-group difference, +1.68 cm2; 95% CI, +0.41 to +2.95 cm2; P = 0.03), as well as dynamic (+18.4 Nm; 95% CI, +10.1 to +26.6 Nm; P < 10-4) and isometric knee extensor strength (+23.9 Nm; 95% CI, +14.2 to +33.6 Nm; P < 10-5). LITW did not improve the qCSA size, but increased dynamic knee extensor strength compared to WHEY (+13.7 Nm; 95% CI, +5.3 and +22.1 Nm; P = 0.01). CONCLUSIONS Recommending protein supplementation as a stand-alone intervention for healthy older individuals seems ineffective in improving muscle mass and strength. Only HRTW was effective in both preserving muscle mass and increasing strength. Thus, we recommend that future studies investigate strategies to increase long-term compliance to heavy resistance exercise in healthy older adults. This trial was registered at clinicaltrials.gov as NCT02034760.
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Affiliation(s)
- Kenneth H Mertz
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
| | - Søren Reitelseder
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Bechshoeft
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jacob Bulow
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
| | - Grith Højfeldt
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
| | - Mikkel Jensen
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
| | - Simon R Schacht
- Vitality Centre for Good Older Lives, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mads Vendelbo Lind
- Vitality Centre for Good Older Lives, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Morten A Rasmussen
- Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Inge Tetens
- Vitality Centre for Good Older Lives, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Søren B Engelsen
- Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Dennis S Nielsen
- Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Astrid P Jespersen
- Copenhagen Center for Health Research in the Humanities, Saxo-Institute, University of Copenhagen, Copenhagen, Denmark
| | - Lars Holm
- Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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25
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Verreijen AM, van den Helder J, Streppel MT, Rotteveel I, Heman D, van Dronkelaar C, Memelink RG, Engberink MF, Visser M, Tieland M, Weijs PJM. A higher protein intake at breakfast and lunch is associated with a higher total daily protein intake in older adults: a post-hoc cross-sectional analysis of four randomised controlled trials. J Hum Nutr Diet 2021; 34:384-394. [PMID: 33190355 PMCID: PMC8048646 DOI: 10.1111/jhn.12838] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/22/2020] [Accepted: 10/20/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND A protein intake of 30-40 g per meal is suggested to maximally stimulate muscle protein synthesis in older adults and could therefore contribute to the prevention of sarcopenia. Protein intake at breakfast and lunch is often low and offers a great opportunity to improve daily protein intake. Protein, however, is known for its satiating effects. Therefore, we explored the association between the amount of protein intake at breakfast and lunch and total daily protein intake in older adults. METHODS Protein intake was assessed by a 3-day food record in 498 community dwelling older adults (≥55 years) participating different lifestyle interventions. Linear mixed model analysis was used to examine the association between protein intake at breakfast or lunch and total daily protein intake, adjusted for sex, age, body mass index, smoking status, study and total energy intake. RESULTS After adjustment for potential confounders, a 10 g higher protein intake at breakfast was associated with a 3.2 g higher total daily protein intake (P = 0.008) for males and a 4.9 g (P < 0.001) higher total daily protein intake for females. A 10 g higher protein intake at lunch was associated with a 3.7 g higher total daily protein intake (P < 0.001) for males, and a 5.8 g higher total daily protein intake (P < 0.001) for females. CONCLUSIONS A higher protein intake at breakfast and lunch is associated with a higher total daily protein intake in community dwelling older adults. Stimulating a higher protein intake at breakfast and lunch might represent a promising nutritional strategy to optimise the amount of protein per meal without compromising total daily protein intake.
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Affiliation(s)
- A. M. Verreijen
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - J. van den Helder
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - M. T. Streppel
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - I. Rotteveel
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - D. Heman
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - C. van Dronkelaar
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - R. G. Memelink
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - M. F. Engberink
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - M. Visser
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- Department of Health SciencesFaculty of ScienceVrije UniversiteitAmsterdamThe Netherlands
| | - M. Tieland
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
| | - P. J. M. Weijs
- Faculty of Sports and NutritionCenter of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamThe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
- Department of Nutrition and DieteticsAmsterdam University Medical CentersVrije UniversiteitAmsterdamThe Netherlands
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26
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Timmons JF, Hone M, Cogan KE, Duffy O, Egan B. Increased Leg Strength After Concurrent Aerobic and Resistance Exercise Training in Older Adults Is Augmented by a Whole Food-Based High Protein Diet Intervention. Front Sports Act Living 2021; 3:653962. [PMID: 33842881 PMCID: PMC8034230 DOI: 10.3389/fspor.2021.653962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Most studies in older adults have utilized powdered protein supplements or oral nutrition solutions as a source of additional dietary protein, but whole foods may provide a greater anabolic stimulus than protein isolated from food matrices. Therefore, the present study investigated a concurrent aerobic and resistance exercise training program in older adults, in the absence or presence of a high protein whole food-based dietary intervention, for effects on strength, physical function, and body composition. Community-dwelling older adults (n = 56; M/F, 28/28; age, 69.3 ± 4.0 years; BMI, 26.6 ± 3.7 kg m−2) participated in a 12-week intervention after randomization to either nutrition only (NUTR; n = 16), exercise only (EX, n = 19), or nutrition plus exercise (NUTR + EX, n = 21) groups. NUTR and NUTR + EX followed a dietary intervention targeting an increase in protein-rich meals at breakfast, lunch, and dinner. Exercise training in EX and NUTR + EX consisted of 24 min sessions of concurrent aerobic and resistance exercise performed three times per week. Daily protein intake increased in NUTR and NUTR + EX, but not EX. The increase in 1RM leg press strength was greater (Interaction effect, P = 0.012) in NUTR + EX [29.6 (18.1, 41.0) kg] than increases observed in NUTR [11.1 (−1.3, 23.6) kg] and EX [12.3 (0.9, 23.8) kg]. The increase in 1RM chest press strength was greater (interaction effect, P = 0.031) in NUTR + EX [6.3 (4.0, 8.6) kg] than the increase observed in NUTR [2.9 (0.3, 5.5) kg], but not EX [6.3 (3.9, 8.7) kg]. Hand-grip strength and sit-to-stand performance were each improved in all three groups, with no differences observed between groups (interaction effect, P = 0.382 and P = 0.671, respectively). An increase in percentage body fat was observed in NUTR, but not in EX or NUTR + EX (interaction effect, P = 0.018). No between-group differences were observed for change in lean body mass (interaction effect, P = 0.402). Concurrent aerobic and resistance exercise training improves strength and physical function in older adults, but combining this training with an increase in daily protein intake through whole foods may be advantageous to increase lower limb strength.
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Affiliation(s)
- James F Timmons
- Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Michelle Hone
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Karl E Cogan
- Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Orlaith Duffy
- Medfit Proactive Healthcare, Blackrock Co., Dublin, Ireland
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.,National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.,Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
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27
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Dietary protein considerations for muscle protein synthesis and muscle mass preservation in older adults. Nutr Res Rev 2020; 34:147-157. [PMID: 32883378 DOI: 10.1017/s0954422420000219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Amino acid bioavailability is critical for muscle protein synthesis (MPS) and preservation of skeletal muscle mass (SMM). Ageing is associated with reduced responsiveness of MPS to essential amino acids (EAA). Further, the older adult population experiences anabolic resistance, leading to increased frailty, functional decline and depleted muscle mass preservation, which facilitates the need for increased protein intake to increase their SMM. This review focuses on the role of proteins in muscle mass preservation and examines the contribution of EAA and protein intake patterns to MPS. Leucine is the most widely studied amino acid for its role as a potent stimulator of MPS, though due to inadequate data little is yet known about the role of other EAA. Reaching a conclusion on the best pattern of protein intake has proven difficult due to conflicting studies. A mixture of animal and plant proteins can contribute to increased MPS and potentially attenuate muscle wasting conditions; however, there is limited research on the biological impact of protein blends in older adults. While there is some evidence to suggest that liquid protein foods with higher than the RDA of protein may be the best strategy for achieving high MPS rates in older adults, clinical trials are warranted to confirm an association between food form and SMM preservation. Further research is warranted before adequate recommendations and strategies for optimising SMM in the elderly population can be proposed.
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28
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The Potential Role of Fish-Derived Protein Hydrolysates on Metabolic Health, Skeletal Muscle Mass and Function in Ageing. Nutrients 2020; 12:nu12082434. [PMID: 32823615 PMCID: PMC7468851 DOI: 10.3390/nu12082434] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 02/07/2023] Open
Abstract
Fish protein represents one of the most widely consumed dietary protein sources by humans. The processing of material from the fishing industry generates substantial unexploited waste products, many of which possess high biological value. Protein hydrolysates, such as fish protein hydrolysates (FPH), containing predominantly di- and tripeptides, are more readily absorbed than free amino acids and intact protein. Furthermore, in animal models, FPH have been shown to possess numerous beneficial properties for cardiovascular, neurological, intestinal, renal, and immune health. Ageing is associated with the loss of skeletal muscle mass and function, as well as increased oxidative stress, compromised vascularisation, neurological derangements, and immunosenescence. Thus, there appears to be a potential application for FPH in older persons as a high-quality protein source that may also confer additional health benefits. Despite this, there remains a dearth of information concerning the impact of FPH on health outcomes in humans. The limited evidence from human interventional trials suggests that FPH may hold promise for supporting optimal body composition and maintaining gut integrity. FPH also provide a high-quality source of dietary protein without negatively impacting on subjective appetite perceptions or regulatory hormones. Further studies are needed to assess the impact and utility of FPH on skeletal muscle health in older persons, ideally comparing FPH to ‘established’ protein sources or a non-bioactive, nitrogen-matched control. In particular, the effects of acute and chronic FPH consumption on post-exercise aminoacidaemia, skeletal muscle protein synthesis, and intramyocellular anabolic signalling in older adults are worthy of investigation. FPH may represent beneficial and sustainable alternative sources of high-quality protein to support skeletal muscle health and anabolism in ageing, without compromising appetite and subsequent energy intake.
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29
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Weijzen MEG, Kouw IWK, Geerlings P, Verdijk LB, van Loon LJC. During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein per Kilogram Body Weight per Day. Nutr Clin Pract 2020; 35:655-663. [PMID: 32578906 PMCID: PMC7384011 DOI: 10.1002/ncp.10542] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Malnutrition is prevalent in hospitalized patients. To support muscle maintenance in older and chronically ill patients, a protein intake of 1.2-1.5 g/kg/d has been recommended during hospitalization. We assessed daily protein intake levels and distribution in older patients at risk for malnutrition during hospitalization. METHODS In this prospective, observational study, we measured actual food and food supplement consumption in patients (n = 102; age, 68 ± 14 years; hospital stay, 14 [8-28] days) at risk of malnutrition during hospitalization. Food provided by hospital meals, ONS, and snacks and the actual amount of food (not) consumed were weighed and recorded for all patients. RESULTS Hospital meals provided 1.03 [0.77-1.26] protein, whereas actual protein consumption was only 0.65 [0.37-0.93] g/kg/d. Protein intake at breakfast, lunch, and dinner was 10 [6-15], 9 [5-14], and 13 [9-18] g, respectively. The use of ONS (n = 62) resulted in greater energy (1.26 [0.40-1.79] MJ/d, 300 [100-430] kcal/d) and protein intake levels (11 [4-16] g/d), without changing the macronutrient composition of the diet. CONCLUSION Despite protein provision of ∼1.0 g/kg/d, protein intake remains well below these values (∼0.65 g/kg/d), as 30%-40% of the provided food and supplements is not consumed. Provision of ONS may increase energy and protein intake but does not change the macronutrient composition of the diet. Current nutrition strategies to achieve the recommended daily protein intake in older patients during their hospitalization are not as effective as generally assumed.
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Affiliation(s)
- Michelle E. G. Weijzen
- Department of Human BiologySchool of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+Maastrichtthe Netherlands
| | - Imre W. K. Kouw
- Department of Human BiologySchool of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+Maastrichtthe Netherlands
| | - Phil Geerlings
- Department of DieteticsMaastricht University Medical Centre+Maastrichtthe Netherlands
| | - Lex B. Verdijk
- Department of Human BiologySchool of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+Maastrichtthe Netherlands
| | - Luc J. C. van Loon
- Department of Human BiologySchool of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+Maastrichtthe Netherlands
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30
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Analysis of Anabolic Agents in Whey Protein by Gas Chromatography Coupled to Triple Quadrupole Mass Spectrometry. FOOD ANAL METHOD 2020. [DOI: 10.1007/s12161-020-01813-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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31
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McKendry J, Currier BS, Lim C, Mcleod JC, Thomas AC, Phillips SM. Nutritional Supplements to Support Resistance Exercise in Countering the Sarcopenia of Aging. Nutrients 2020; 12:E2057. [PMID: 32664408 PMCID: PMC7399875 DOI: 10.3390/nu12072057] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022] Open
Abstract
Skeletal muscle plays an indispensable role in metabolic health and physical function. A decrease in muscle mass and function with advancing age exacerbates the likelihood of mobility impairments, disease development, and early mortality. Therefore, the development of non-pharmacological interventions to counteract sarcopenia warrant significant attention. Currently, resistance training provides the most effective, low cost means by which to prevent sarcopenia progression and improve multiple aspects of overall health. Importantly, the impact of resistance training on skeletal muscle mass may be augmented by specific dietary components (i.e., protein), feeding strategies (i.e., timing, per-meal doses of specific macronutrients) and nutritional supplements (e.g., creatine, vitamin-D, omega-3 polyunsaturated fatty acids etc.). The purpose of this review is to provide an up-to-date, evidence-based account of nutritional strategies to enhance resistance training-induced adaptations in an attempt to combat age-related muscle mass loss. In addition, we provide insight on how to incorporate the aforementioned nutritional strategies that may support the growth or maintenance of skeletal muscle and subsequently extend the healthspan of older individuals.
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Affiliation(s)
| | | | | | | | | | - Stuart M. Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada; (J.M.); (B.S.C.); (C.L.); (J.C.M.); (A.C.Q.T.)
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32
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Effects of low-dose milk protein supplementation following low-to-moderate intensity exercise training on muscle mass in healthy older adults: a randomized placebo-controlled trial. Eur J Nutr 2020; 60:917-928. [PMID: 32524231 PMCID: PMC7900046 DOI: 10.1007/s00394-020-02302-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE The purpose of this study was to examine whether long-term ingestion of low-dose milk protein supplementation causes a greater increase in muscle mass and strength of older adults during low-to-moderate intensity exercise training intervention than isocaloric carbohydrate. METHODS In a randomized, double-blind, and placebo-controlled design, 122 healthy older adults (60-84 year) received either an acidified milk protein drink containing 10 g of milk protein (MILK; n = 61) or an isocaloric placebo drink (PLA; n = 61) daily throughout 6 months of body weight and medicine ball exercise training. Measurements before and after the intervention included body composition, physical performance and blood biochemistry. RESULTS Lean body mass significantly increased in the MILK group (+ 0.54 kg, p < 0.001), but did not change in the PLA group (- 0.10 kg, p = 0.534). The increases in the MILK group were significantly greater than in the PLA group (p = 0.004). Fat mass (- 0.77 kg) and plasma uric acid levels (- 0.3 mg/dL) significantly decreased only in the MILK group (p < 0.001), with a significant group difference (p = 0.002 and p < 0.001, respectively). Most of the physical performance tests significantly improved in both groups, but no group differences were found. CONCLUSION We conclude that low-dose milk protein supplementation (10 g of protein/day) combined with low-to-moderate intensity exercise training is associated with increased muscle mass, but not improved physical performance compared to carbohydrate combined with exercise in healthy older adults. This study was registered in the UMIN Clinical Trials Registry (UMIN000032189).
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Wirth J, Hillesheim E, Brennan L. The Role of Protein Intake and its Timing on Body Composition and Muscle Function in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr 2020; 150:1443-1460. [PMID: 32232404 DOI: 10.1093/jn/nxaa049] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/16/2020] [Accepted: 02/12/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Increased protein intake has been suggested to improve gains in muscle mass and strength in adults. Furthermore, the timing of protein intake has been discussed as a margin of opportunity for improved prevention measures. OBJECTIVE This systematic review investigated the effect of protein supplementation on body composition and muscle function (strength and synthesis) in healthy adults, with an emphasis on the timing of protein intake. METHODS Randomized controlled trials were identified using PubMed, Web of Science, CINAHL, and Embase, up to March 2019. For meta-analyses, data on lean body mass (LBM), handgrip strength, and leg press strength were pooled by age group (mean age 18-55 or >55 y) and timing of protein intake. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS Data from 65 studies with 2907 participants (1514 men and 1380 women, 13 unknown sex) were included in the review. Twenty-six, 8, and 24 studies were used for meta-analysis on LBM, handgrip strength, and leg press strength, respectively. The protein supplementation was effective in improving (mean difference; 95% CI) LBM in adults (0.62 kg; 0.36, 0.88) and older adults (0.46 kg; 0.23, 0.70), but not handgrip strength (older adults: 0.26 kg; -0.51, 1.04) and leg press strength (adults: 5.80 kg; -0.33, 11.93; older adults: 1.97 kg; -2.78, 6.72). Sensitivity analyses removing studies without exercise training had no impact on the outcomes. Data regarding muscle synthesis were scarce and inconclusive. Subgroup analyses showed no beneficial effect of a specific timing of protein intake on LBM, handgrip strength, and leg press strength. CONCLUSION Overall, the results support the positive impact of protein supplementation on LBM of adults and older adults, independently of intake timing. Effects on muscle strength and synthesis are less clear and need further investigation. This systematic review was registered on PROSPERO as CRD42019126742.
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Affiliation(s)
- Janine Wirth
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Elaine Hillesheim
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Lorraine Brennan
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland.,Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
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Chen LH, Huang SY, Huang KC, Hsu CC, Yang KC, Li LA, Chan CH, Huang HY. Lactobacillus paracasei PS23 decelerated age-related muscle loss by ensuring mitochondrial function in SAMP8 mice. Aging (Albany NY) 2020; 11:756-770. [PMID: 30696799 PMCID: PMC6366975 DOI: 10.18632/aging.101782] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/15/2019] [Indexed: 12/18/2022]
Abstract
Sarcopenia is a common impairment in the elderly population responsible for poor outcomes later in life; it can be caused by age-related alternations. Only a few strategies have been reported to reduce sarcopenia. Lactobacillus paracasei PS23 (LPPS23) has been reported to delay some age-related disorders. Therefore, here we investigated whether LPPS23 decelerates age-related muscle loss and its underlying mechanism. Female senescence-accelerated mouse prone-8 (SAMP8) mice were divided into three groups (n=6 each): non-aging (16-week-old), control (28-week-old), and PS23 (28-week-old) groups. The control and PS23 groups were given saline and LPPS23, respectively. We evaluated the effects of LPPS23 by analyzing body weight and composition, muscle strength, protein uptake, mitochondrial function, reactive oxygen species (ROS), antioxidant enzymes, and inflammation-related cytokines. LPPS23 significantly attenuated age-related decreases of muscle mass and strength. Compared to the control group, the non-aging and PS23 groups exhibited higher mitochondrial function, IL10, antioxidant enzymes, and protein uptake. Moreover, inflammatory cytokines and ROS were lower in the non-aging and PS23 groups than the control group. Taken together, LPPS23 extenuated sarcopenia progression during aging; this effect might have been enacted by preserving the mitochondrial function via reducing age-related inflammation and ROS and by retaining protein uptake in the SAMP8 mice.
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Affiliation(s)
- Li-Han Chen
- Department of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei, Taiwan
| | - Shih-Yi Huang
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Family Medicine, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
| | - Chih-Chieh Hsu
- Research and Development Department, Bened Biomedical Co., Ltd., Taipei, Taiwan
| | - Kuen-Cheh Yang
- Department of Family Medicine, National Taiwan University Hospital Beihu Branch, Taipei, Taiwan
| | - Lin-Ai Li
- Department of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei, Taiwan
| | - Ching-Hung Chan
- Department of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei, Taiwan
| | - Hui-Yu Huang
- Department of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei, Taiwan.,Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
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Phillips SM, Martinson W. Nutrient-rich, high-quality, protein-containing dairy foods in combination with exercise in aging persons to mitigate sarcopenia. Nutr Rev 2020; 77:216-229. [PMID: 30561677 DOI: 10.1093/nutrit/nuy062] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Sarcopenic declines in muscle mass and function contribute to the risk of falls, reduced mobility, and progression to frailty in older persons. Mitigation of sarcopenia can be achieved by consumption of higher quality protein in sufficient quantities, which current research suggests are greater than the recommended intakes of approximately 0.8 g/kg bodyweight/d. In addition, higher levels of physical activity and participation in exercise to support cardiovascular fitness and musculoskeletal function work additively with protein in attenuating sarcopenia. This narrative review provides evidence to support a recommendation for per-meal protein targets in older persons that are underpinned by knowledge of muscle protein turnover. Based on work examining acute dose-responses of muscle protein synthesis (MPS) to protein, a proposed per-meal target for protein intakes is set at approximately 0.4-0.6 g protein/kg bodyweight/meal for older persons. Habitual patterns of dietary protein intake tend to emphasize a skewed protein distribution, which would not maximize muscle anabolism. Observational studies show that more even patterns of protein intake are associated with increased muscle mass and improved muscle function. A food-based approach to achieving these protein targets would be advantageous, and the nutrient density of the protein-containing foods would be particularly important for older persons. Dairy foods provide high-quality protein and contain several nutrients of concern for older persons. This brief review provides an overview of the science underpinning why dairy foods should be a point of nutritional emphasis for older persons. Practical suggestions are provided for implementation of dairy foods into dietary patterns to meet the protein and other nutrient targets for older persons.
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Affiliation(s)
- Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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Hone M, Nugent AP, Walton J, McNulty BA, Egan B. Habitual protein intake, protein distribution patterns and dietary sources in Irish adults with stratification by sex and age. J Hum Nutr Diet 2020; 33:465-476. [PMID: 31997529 DOI: 10.1111/jhn.12736] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/21/2019] [Accepted: 12/24/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Given the importance of habitual dietary protein intake, distribution patterns and dietary sources in the aetiology of age-related declines of muscle mass and function, the present study examined these factors as a function of sex and age in Irish adults aged 18-90 years comprising The National Adult Nutrition Survey (NANS). METHODS In total, 1051 (males, n = 523; females, n = 528) undertook a 4-day semi-weighed food diary. Total, body mass relative intake and percentage contribution to total energy intake of dietary protein were determined in addition to protein distribution scores (PDS), as well as the contribution of food groups, animal- and plant-based foods to total protein intake. RESULTS Total and relative protein intake [mean (SD)] were highest in those aged 18-35 years [96 (3) g day-1 , 1.32 (0.40) g kg-1 day-1 ], with lower protein intakes with increasing age (i.e. in adults aged ≥65 years [82 (22) g, 1.15 (0.34) g kg-1 day-1 , P < 0.001 for both]. Differences in protein intake between age groups were more pronounced in males compared to females. Protein distribution followed a skewed pattern for all age groups [breakfast, 15 (10) g; lunch, 30 (15) g; dinner, 44 (17) g]. Animal-based foods were the dominant protein source within the diet [63% (11%) versus 37% (11%) plant protein, P < 0.001]. CONCLUSIONS Protein intake and the number of meals reaching the purported threshold for maximising post-prandial anabolism were highest in young adults, and lower with increasing age. For main meals, breakfast provided the lowest quantity of protein across all age categories and may represent an opportunity for improving protein distribution, whereas, in older adults, increasing the number of meals reaching the anabolic threshold regardless of distribution pattern may be more appropriate.
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Affiliation(s)
- M Hone
- School of Health and Human Performance, Dublin City University, Glasnevin, Ireland
| | - A P Nugent
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Ireland.,School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland
| | - J Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,Department of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - B A McNulty
- School of Agriculture and Food Science, Institute of Food and Health, University College Dublin, Belfield, Ireland
| | - B Egan
- School of Health and Human Performance, Dublin City University, Glasnevin, Ireland.,National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, Ireland
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Francis P, Mc Cormack W, Lyons M, Jakeman P. Age-Group Differences in the Performance of Selected Tests of Physical Function and Association With Lower Extremity Strength. J Geriatr Phys Ther 2020; 42:1-8. [PMID: 29494377 DOI: 10.1519/jpt.0000000000000152] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE It is not known whether short functional performance tests used in aging research are appropriate for use in healthy older adults. The purpose of this study was to investigate age-group differences (sixth decade vs seventh decade) in selected functional performance tests and the association between lower extremity strength and functional performance. METHODS One hundred fifty-nine (18.2% [n = 29] male) healthy older adults (mean (standard deviation) age 60.4 (5.3) years), adults were recruited from the University of Limerick Campus Community. Knee extensor (KE) peak torque (PT) was assessed from a maximal voluntary isometric contraction. Subsequently, participants completed 10-m maximal and habitual gait speed tests, 5 repetition and 30-second chair rise tests, and a 900-m gait speed test. RESULTS AND DISCUSSION There was no difference in 10-m gait speed between those in the sixth and seventh decades (P > .05). Compared with the sixth decade, those in the seventh decade required an extra 39 seconds to complete 900 m, an extra 0.6 seconds to complete 5 chair rises and performed 2 fewer chair rises in a 30-second time period (P < .05). All tests had a weak association with KE strength (r = 0.226-0.360; P < .05), except for 900-m gait speed that had a moderate association (r = -0.537; P < .001). Our findings suggest that gait speed tests of 10 m or less cannot detect age-related difference in functional capacity when used in healthy older adults. CONCLUSION Extended physical performance tests should be used in aging research on healthy older adults.
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Affiliation(s)
- Peter Francis
- Musculoskeletal Health Research Group, School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom.,Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
| | - William Mc Cormack
- Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
| | - Mark Lyons
- Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
| | - Philip Jakeman
- Human Science Research Unit, Center for Intervention in Inflammation, Infection and Immunity, University of Limerick, Limerick, Ireland
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Blair M, Kellow NJ, Dordevic AL, Evans S, Caissutti J, McCaffrey TA. Health Benefits of Whey or Colostrum Supplementation in Adults ≥35 Years; a Systematic Review. Nutrients 2020; 12:E299. [PMID: 31979025 PMCID: PMC7070284 DOI: 10.3390/nu12020299] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 01/20/2023] Open
Abstract
Food-health claims are an important method of translating nutrition research to consumers. Whey and colostrum are thought to exert health benefits to adults, but it is unclear what measurable, objective health benefits they impart. This review aimed to identify the objective health benefits of bovine whey or colostrum-based beverages to healthy adults aged ≥35 years to substantiate a food-health claim. Seven databases were systematically searched. Eligible articles were RCTs that involved healthy adults aged ≥35 years, consuming whey or colostrum in beverage form and measuring objective health markers. Quality assessment and data extraction was conducted in duplicate. The searches identified 9943 papers and 16 were included in this review; 13 studies, reported across 15 papers, related to whey, one study to colostrum. The outcomes identified were body composition, bone mineral density, biochemical markers, such as blood glucose and lipids, and muscle strength and synthesis. Heterogeneous outcomes, high risk of bias and inconsistent findings resulted in inconclusive evidence to substantiate a food-health claim. Clearer reporting and consensus on a minimum set of objective measures would allow for more robust recommendations regarding food-health claims. Protecting consumers from misleading health claims will require collaboration between regulators, researchers, and the food industry.
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Affiliation(s)
| | | | | | | | | | - Tracy A. McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Level 1 264 Ferntree Gully Road, Melbourne, VIC 3168, Australia; (M.B.); (N.J.K.); (A.L.D.); (S.E.); (J.C.)
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Effects of exercise and whey protein on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life in older adults: a secondary analysis of the Liverpool Hope University-Sarcopenia Ageing Trial (LHU-SAT). Eur J Appl Physiol 2020; 120:493-503. [PMID: 31894414 DOI: 10.1007/s00421-019-04293-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/21/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the effects of exercise in combination with, or without, a leucine-enriched whey protein supplement on muscle mass, fat mass, myoelectrical muscle fatigue and health-related quality of life (HR-QOL) in older adults. METHODS 100 community-dwelling older adults [52% women, age: 69 ± 6 years (mean ± SD)] were randomised to four [Control (C); Exercise (E); Exercise + Protein (EP); Protein (P)] independent groups. E and EP groups completed 16 weeks of exercise [resistance (2 times/week) and functional (1 time/week]. EP and P groups were also administered a leucine-enriched whey protein supplement (3 times/day) based on body weight (1.5 g/kg/day). Muscle and fat mass (bioelectrical impedance analysis), myoelectrical muscle fatigue (surface electromyography) and HR-QOL (WHOQOL-BREF) were measured pre- and post-intervention. RESULTS At post-intervention, the rectus femoris (E: - 4.8%/min, p = 0.007, ES = 0.86; EP: - 3.3%/min, p = 0.045, ES = 0.58) and bicep femoris (E: - 3.9%/min, p < 0.001, ES = 1.46; EP: - 4.3%/min, p < 0.001, ES = 1.58) muscles became more resistant to fatigue in the E and EP groups, respectively (p < 0.05 versus C). HR-QOL improved in the E group only. Muscle and fat mass did not change (p > 0.05). CONCLUSION Physical exercise is a potent method to improve myoelectrical muscle fatigue and HR-QOL in older adults. However, leucine-enriched whey protein did not augment this response in those already consuming sufficient quantities of protein at trial enrolment.
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de Sousa MV, da Silva Soares DB, Caraça ER, Cardoso R. Dietary protein and exercise for preservation of lean mass and perspectives on type 2 diabetes prevention. Exp Biol Med (Maywood) 2019; 244:992-1004. [PMID: 31307203 PMCID: PMC6879776 DOI: 10.1177/1535370219861910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Sedentary lifestyle and aging favor the increasing prevalence of obesity and type 2 diabetes and their comorbidities. The loss of lean body mass reduces muscle strength, resulting in impaired functional capacity and leading to increased risks of chronic diseases with advancing age. Besides aging, conditions such as inappetence, social isolation, and inadequate dietary intake cause the loss of lean body mass and increased abdominal fatty mass, resulting in sarcopenic obesity and predisposition to type 2 diabetes. Compared to younger people, this condition is more common in the elderly owing to natural changes in body composition associated with aging. Lifestyle changes such as increased physical activity and improved dietary behaviors are effective for preventing the occurrence of comorbidities. Regarding muscle nutrition, besides caloric adequacy, meeting the requirements for the consumption of dietary amino acids and proteins is important for treating sarcopenia and sarcopenic obesity because muscle tissue mainly consists of proteins and is, therefore, the largest reservoir of amino acids in the body. Thus, this review discusses the effects of dietary protein on the preservation of lean body mass, improvements in the functional capacity of muscle tissue, and prevention of chronic diseases such as type 2 diabetes. In addition, we address the effects of regular physical training associated with dietary protein strategies on lean body mass, body fat loss, and muscle strength in the elderly at a risk for type 2 diabetes development.
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Affiliation(s)
- Maysa Vieira de Sousa
- Endocrinology Division, School of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | | | - Elaine Reis Caraça
- Organização Social de Saúde, Santa Marcelina de Itaquaquecetuba, SP 08599-280, Brazil
| | - Ronaldo Cardoso
- Endocrinology Division, School of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
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Nutrient Intakes from Meals and Snacks Differ with Age in Middle-Aged and Older Americans. Nutrients 2019; 11:nu11061301. [PMID: 31181765 PMCID: PMC6627320 DOI: 10.3390/nu11061301] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/30/2019] [Accepted: 06/06/2019] [Indexed: 12/13/2022] Open
Abstract
The present study investigated the meal patterns across demographic characteristics in middle-aged and older US adults. Study participants were noninstitutionalized participants from the 2005–2016 National Health and Nutrition Examination Survey, an observational cross-sectional study. Data from 17,361 adults were categorized into 45–59 years (n = 7366), 60–70 years (n = 5348), and 71+ years (n = 4647) to compare demographics, nutrient intakes, and meal patterns. Dietary recalls were collected using the multiple-pass method. Data analyses were weighted to create a nationally representative sample. Two-thirds of adults reported consuming three meals on the day of intake. Lunch was the most often skipped meal across all age groups. A greater proportion of adults over 70 years reported consuming breakfast, while a smaller proportion reported consuming snacks. Significant differences were observed in total energy and nutrient intakes and proportion of the day’s intakes by meal. Grain, milk, and dairy food group intakes were highest at breakfast, while the protein food group intakes were highest at lunch and dinner. Age-related differences in meal consumption and composition provide valuable formative data to support targeted nutritional education and intervention opportunities to promote and encourage healthy food choices.
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Kirk B, Mooney K, Amirabdollahian F, Khaiyat O. Exercise and Dietary-Protein as a Countermeasure to Skeletal Muscle Weakness: Liverpool Hope University - Sarcopenia Aging Trial (LHU-SAT). Front Physiol 2019; 10:445. [PMID: 31133863 PMCID: PMC6524700 DOI: 10.3389/fphys.2019.00445] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/01/2019] [Indexed: 01/06/2023] Open
Abstract
Objective To investigate the effects of a 16-week concurrent exercise regimen [resistance exercise (RE) + functional exercise (FE)] in combination with, or without, a leucine-enriched whey protein isolate supplement on muscle strength, physical functioning, aerobic capacity, and cardiometabolic health in older adults (≥60 years). Physical activity levels were also evaluated 6 months post-cessation of the intervention. Methods Forty-six, community-dwelling, previously untrained males, and females [age: 68 ± 5 years (mean ± SD); BMI: 27.8 ± 6.2 kg/m2] who completed the trial were initially randomized to one of two independent arms [Exercise n = 24 (E); Exercise+Protein n = 22 (EP)]. Both arms completed 16 weeks of RE (performed to fatigue) (2 times/week) with FE (1 time/week) on non-consecutive days. Additionally, EP were administered a leucine-enriched whey protein supplement (3 times/day) for 16 weeks based on individual body-weight (1.5 g/kg/day). Results As a result of dietary supplementation, protein intake increased in EP (∼1.2 ± 0.4 to 1.5 ± 0.7 g/kg/day) during the intervention. Maximal strength (1RM) values for leg press (E: +39 ± 7 kg, p = 0.006; EP: +63 ± 7 kg, p < 0.001), chest press (E: +22 ± 4 kg, p < 0.001; EP: +21 ± 6 kg, p < 0.001), and bicep curl (E: +7 ± 0 kg, p = 0.002; EP: +6 ± 1 kg, p = 0.008) significantly increased in E and EP respectively, with no differences between arms (p > 0.05). Physical functioning in the obstacle course (E: -5.1 ± 6.8 s, p < 0.001; EP: -2.8 ± 0.8 s, p < 0.001) and short-physical performance battery scores (E: +0.5 ± 0.5, p = <0.001; EP: +0.4 ± 0.5, p = 0.038), and aerobic capacity in the 6-min walk test (E: +37 ± 24 m, p = 0.014; EP: +36 ± 3 m, p = 0.005) improved in E and EP respectively, with no differences between arms (p > 0.05). No significant change was observed for markers of cardiometabolic health (glycaemic control or blood pressure) (p > 0.05). At follow-up, 86% of older adults reported to performing physical activity ≥1 per week. Of those, 61% were still participating in strength- and cardiovascular- based exercise. Conclusion Concurrent exercise (RE + FE) offers a potent method to combat age-related muscle weakness, and our results suggest a high proportion of older adults may continue to exercise unsupervised. However, leucine-enriched whey protein isolate supplementation did not confer any additional benefit in those already consuming ample amounts of dietary protein at trial enrolment. Future trials should utilize a whole-foods approach and investigate the effects in frail and non-frail older adults habitually consuming the RDA of protein, to assess if a higher intake of protein is needed to delay the onset of muscle weakness. Trial Registration Clinicaltrials.gov Identifier: NCT02912130.
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Affiliation(s)
- Ben Kirk
- School of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
| | - Kate Mooney
- School of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
| | | | - Omid Khaiyat
- School of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
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Ten Haaf DSM, Eijsvogels TMH, Bongers CCWG, Horstman AMH, Timmers S, de Groot LCPGM, Hopman MTE. Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial. J Cachexia Sarcopenia Muscle 2019; 10:298-310. [PMID: 30848096 PMCID: PMC6463466 DOI: 10.1002/jcsm.12394] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 12/18/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND An inadequate protein intake may offset the muscle protein synthetic response after physical activity, reducing the possible benefits of an active lifestyle for muscle mass. We examined the effects of 12 weeks of daily protein supplementation on lean body mass, muscle strength, and physical performance in physically active older adults with a low habitual protein intake (<1.0 g/kg/day). METHODS A randomized double-blinded controlled trial was performed among 116 physically active older adults [age 69 (interquartile range: 67-73) years, 82% male] who were training for a 4 day walking event of 30, 40, or 50 km/day. Participants were randomly allocated to either 31 g of milk protein or iso-caloric placebo supplementation for 12 weeks. Body composition (dual-energy X-ray absorptiometry), strength (isometric leg extension and grip strength), quadriceps contractile function, and physical performance [Short Physical Performance Battery, Timed Up-and-Go test, and cardiorespiratory fitness (Åstrand-Rhyming submaximal exercise test)] were measured at baseline and after 12 weeks. We assessed vitamin D status and markers of muscle damage and renal function in blood and urine samples before and after intervention. RESULTS A larger increase in relative lean body mass was observed in the protein vs. placebo group (∆0.93 ± 1.22% vs. ∆0.44 ± 1.40%, PInteraction = 0.046). Absolute and relative fat mass decreased more in the protein group than in the placebo group (∆-0.90 ± 1.22 kg vs. ∆-0.31 ± 1.28 kg, PInteraction = 0.013 and ∆-0.92 ± 1.19% vs. ∆-0.39 ± 1.36%, PInteraction = 0.029, respectively). Strength and contractile function did not change in both groups. Gait speed, chair-rise ability, Timed Up-and-Go, and cardiorespiratory fitness improved in both groups (P < 0.001), but no between-group differences were observed. Serum urea increased in the protein group, whereas no changes were observed in the placebo group (PInteraction < 0.001). No between-group differences were observed for vitamin D status, muscle damage, and renal function markers. CONCLUSIONS In physically active older adults with relatively low habitual dietary protein consumption, an improvement in physical performance, an increase in lean body mass, and a decrease in fat mass were observed after walking exercise training. A larger increase in relative lean body mass and larger reduction in fat mass were observed in participants receiving 12 weeks of daily protein supplementation compared with controls, whereas this was not accompanied by differences in improvements between groups in muscle strength and physical performance.
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Affiliation(s)
- Dominique S M Ten Haaf
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen, The Netherlands
| | - Coen C W G Bongers
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen, The Netherlands
| | | | - Silvie Timmers
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen, The Netherlands.,Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | | | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, Nijmegen, The Netherlands.,Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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Hanach NI, McCullough F, Avery A. The Impact of Dairy Protein Intake on Muscle Mass, Muscle Strength, and Physical Performance in Middle-Aged to Older Adults with or without Existing Sarcopenia: A Systematic Review and Meta-Analysis. Adv Nutr 2019; 10:59-69. [PMID: 30624580 PMCID: PMC6370271 DOI: 10.1093/advances/nmy065] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/31/2018] [Indexed: 12/23/2022] Open
Abstract
Sarcopenia is an age-related condition associated with a progressive loss of muscle mass and strength. Insufficient protein intake is a risk factor for sarcopenia. Protein supplementation is suggested to improve muscle anabolism and function in younger and older adults. Dairy products are a good source of high-quality proteins. This review evaluates the effectiveness of dairy proteins on functions associated with sarcopenia in middle-aged and older adults. Randomized controlled trials were identified using PubMed, CINAHL/EBSCO, and Web of Science databases (last search: 10 May 2017) and were quality assessed. The results of appendicular muscle mass and muscle strength of handgrip and leg press were pooled using a random-effects model. The analysis of the Short Physical Performance Battery is presented in narrative form. Adverse events and tolerability of dairy protein supplementation were considered as secondary outcomes. Fourteen studies involving 1424 participants aged between 61 and 81 y met the inclusion criteria. Dairy protein significantly increased appendicular muscle mass (0.13 kg; 95% CI: 0.01, 0.26 kg; P = 0.04); however, it had no effect on improvement in handgrip (0.84 kg; 95% CI: -0.24, 1.93 kg; P = 0.13) or leg press (0.37 kg; 95% CI: -4.79, 5.53 kg; P = 0.89). The effect of dairy protein on the Short Physical Performance Battery was inconclusive. Nine studies reported the dairy protein to be well tolerated with no serious adverse events. Although future high-quality research is required to establish the optimal type of dairy protein, the present systematic review provides evidence of the beneficial effect of dairy protein as a potential nutrition strategy to improve appendicular muscle mass in middle-aged and older adults.
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Affiliation(s)
- Nivine I Hanach
- Division of Nutritional Sciences, University of Nottingham, Leicestershire, United Kingdom
| | - Fiona McCullough
- Division of Nutritional Sciences, University of Nottingham, Leicestershire, United Kingdom
| | - Amanda Avery
- Division of Nutritional Sciences, University of Nottingham, Leicestershire, United Kingdom,Address correspondence to AA (e-mail: )
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45
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Weijzen MEG, Kouw IWK, Verschuren AAJ, Muyters R, Geurts JA, Emans PJ, Geerlings P, Verdijk LB, van Loon LJC. Protein Intake Falls below 0.6 g•kg-1•d-1 in Healthy, Older Patients Admitted for Elective Hip or Knee Arthroplasty. J Nutr Health Aging 2019; 23:299-305. [PMID: 30820520 PMCID: PMC6399806 DOI: 10.1007/s12603-019-1157-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 11/07/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Hospitalization is generally accompanied by changes in food intake. Patients typically receive hospital meals upon personal preference within the framework of the food administration services of the hospital. In the present study, we assessed food provision and actual food and snack consumption in older patients admitted for elective hip or knee arthroplasty. DESIGN A prospective observational study. SETTING Orthopedic nursing ward of the Maastricht University Medical Centre+. PARTICIPANTS In the present study, n=101 patients (age: 67±10 y; hospital stay: 6.1±1.8 d) were monitored during hospitalization following elective hip or knee arthroplasty. MEASUREMENTS Energy and protein provided by self-selected hospital meals and snacks, and actual energy and protein (amount, distribution, and source) consumed by patients was weighed and recorded throughout 1-6 days. RESULTS Self-selected meals provided 6.5±1.5 MJ•d-1, with 16, 48, and 34 En% provided as protein, carbohydrate, and fat, respectively. Self-selected hospital meals provided 0.75±0.16 and 0.79±0.21 g•kg-1•d-1 protein in males and females, respectively. Actual protein consumption averaged merely 0.59±0.18 and 0.50±0.21 g•kg-1•d-1, respectively. Protein consumption at breakfast, lunch, and dinner averaged 16±8, 18±9, and 20±6 g per meal, respectively. CONCLUSIONS Though self-selected hospital meals provide patients with ~0.8 g•kg-1•d-1 protein during short-term hospitalization, actual protein consumption falls well below 0.6 g•kg-1•d-1 with a large proportion (~32%) of the provided food being discarded. Alternative strategies are required to ensure maintenance of habitual protein intake in older patients admitted for elective orthopedic surgery.
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Affiliation(s)
- M E G Weijzen
- Prof. L.J.C. van Loon, Ph.D., Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, PO Box 616, 6200 MD Maastricht, the Netherlands, E-mail: , Tel: +31 43 388 1397, Fax: +31 43 367 0976
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Krause M, Crognale D, Cogan K, Contarelli S, Egan B, Newsholme P, De Vito G. The effects of a combined bodyweight-based and elastic bands resistance training, with or without protein supplementation, on muscle mass, signaling and heat shock response in healthy older people. Exp Gerontol 2018; 115:104-113. [PMID: 30529477 DOI: 10.1016/j.exger.2018.12.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/28/2018] [Accepted: 12/04/2018] [Indexed: 12/12/2022]
Abstract
This investigation sought to determine the effects of twelve weeks of resistance exercise training in addition to protein supplementation on body composition, markers of muscle atrophy/hypertrophy and heat shock response (HSR) in healthy older adults. Thirty-eight healthy sedentary participants (M/F, 18/20; age, 63.5 ± 4.4 y) were randomly assigned to four groups: I) PLACEBO: no training, receiving placebo sachets; II) NUTRITION: no training, receiving protein supplementation sachets; III) EXERCISE PLACEBO: training, placebo sachets and IV) EXERCISE NUTRITION: training, receiving protein sachets. The resistance training (using bodyweight and elastic bands) consisted of 45 min supervised training sessions, 3×/week. Participants from both exercise groups increased their total lean body mass (from 48.4 ± 8.7 to 49.2 ± 8.7 kg and from 44.9 ± 7.8 to 45.9 ± 8.1 kg, average of gain ~0.8 and 1 kg, placebo and nutrition respectively) and improved results in physical tests. Exercise nutrition group also reduced their body fat (from 34.8 ± 7.3 to 32.9 ± 7.4%), increased the expression of proteins/gene involved on the HSR, S6 and eEF2, while FOXO3 and Murf1 were reduced. Expression of MHC-I was reduced in both exercise groups while MHC-IIa increased, with no effect of protein supplementation alone. Body-weight and elastic bands based resistance exercise prompted, in healthy older people, improvements in body composition and muscle function. When protein supplementation was added to the people engaged in resistance training, improvements in fat mass and changes in skeletal muscle signaling were detected, favoring protein synthesis pathways and the protective heat shock response.
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Affiliation(s)
- Mauricio Krause
- Institute for Sport & Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland; Laboratory of Inflammation, Metabolism and Exercise Research (LAPIMEX) and Laboratory of Cellular Physiology, Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Food for Health Ireland, University College Dublin, Ireland.
| | - Domenico Crognale
- Institute for Sport & Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland; Food for Health Ireland, University College Dublin, Ireland
| | - Karl Cogan
- Institute for Sport & Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland
| | - Serena Contarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Brendan Egan
- Institute for Sport & Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland; School of Health & Human Performance, Dublin City University, Ireland
| | - Philip Newsholme
- CHIRI Biosciences Research Precinct, School of Biomedical Sciences, Curtin University, Australia
| | - Giuseppe De Vito
- Institute for Sport & Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland; Food for Health Ireland, University College Dublin, Ireland.
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47
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Ten Haaf DSM, Nuijten MAH, Maessen MFH, Horstman AMH, Eijsvogels TMH, Hopman MTE. Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults: a systematic review and meta-analysis. Am J Clin Nutr 2018; 108:1043-1059. [PMID: 30475963 DOI: 10.1093/ajcn/nqy192] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/16/2018] [Indexed: 12/18/2022] Open
Abstract
Background Increasing protein intake has been suggested as an effective strategy to ameliorate age-related loss of muscle mass and strength. Current reviews assessing the effect of protein supplementation are strongly influenced by the inclusion of studies with frail older adults. Objectives We assessed the effect of protein supplementation on lean body mass, muscle strength, and physical performance in exclusively nonfrail community-dwelling older adults. Moreover, we assessed the superior effects of protein supplementation during concomitant resistance exercise training on muscle characteristics. Design A systematic literature search was conducted on PubMed, Embase, and Web of Science up to 15 May 2018. We included randomized controlled trials that assessed the effect of protein supplementation on lean body mass, muscle thigh cross-sectional area, muscle strength, gait speed, and chair-rise ability and performed random-effects meta-analyses. Results Data from 36 studies with 1682 participants showed no significant effects of protein supplementation on changes in lean body mass [standardized mean difference (SMD): 0.11; 95% CI: -0.06, 0.28], handgrip strength (SMD: 0.58; 95% CI: -0.08, 1.24), lower extremity muscle strength (SMD: 0.03; 95% CI: -0.20, 0.27), gait speed (SMD: 0.41; 95% CI: -0.04, 0.85), or chair-rise ability (SMD: 0.10; 95%: CI -0.08, 0.28) compared with a control condition in nonfrail community-dwelling older adults. Moreover, no superior effects of protein supplementation were found during concomitant resistance exercise training on muscle characteristics. Conclusions Protein supplementation in nonfrail community-dwelling older adults does not lead to increases in lean body mass, muscle cross-sectional area, muscle strength, or physical performance compared with control conditions; nor does it exert superior effects when added to resistance exercise training. Habitual protein intakes of most study participants were already sufficient, and protein interventions differed in terms of type of protein, amount, and timing. Future research should clarify what specific protein supplementation protocol is beneficial for nonfrail community-dwelling older adults with low habitual protein intake.
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Affiliation(s)
- Dominique S M Ten Haaf
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Malou A H Nuijten
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martijn F H Maessen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
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48
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McCormick R, Vasilaki A. Age-related changes in skeletal muscle: changes to life-style as a therapy. Biogerontology 2018; 19:519-536. [PMID: 30259289 PMCID: PMC6223729 DOI: 10.1007/s10522-018-9775-3] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022]
Abstract
As we age, there is an age-related loss in skeletal muscle mass and strength, known as sarcopenia. Sarcopenia results in a decrease in mobility and independence, as well as an increase in the risk of other morbidities and mortality. Sarcopenia is therefore a major socio-economical problem. The mechanisms behind sarcopenia are unclear and it is likely that it is a multifactorial condition with changes in numerous important mechanisms all contributing to the structural and functional deterioration. Here, we review the major proposed changes which occur in skeletal muscle during ageing and highlight evidence for changes in physical activity and nutrition as therapeutic approaches to combat age-related skeletal muscle wasting.
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Affiliation(s)
- Rachel McCormick
- Musculoskeletal Biology II, Institute of Ageing and Chronic Disease, Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.
| | - Aphrodite Vasilaki
- Musculoskeletal Biology II, Institute of Ageing and Chronic Disease, Centre for Integrated Research into Musculoskeletal Ageing, University of Liverpool, William Duncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK
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49
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Agostini D, Zeppa Donati S, Lucertini F, Annibalini G, Gervasi M, Ferri Marini C, Piccoli G, Stocchi V, Barbieri E, Sestili P. Muscle and Bone Health in Postmenopausal Women: Role of Protein and Vitamin D Supplementation Combined with Exercise Training. Nutrients 2018; 10:nu10081103. [PMID: 30115856 PMCID: PMC6116194 DOI: 10.3390/nu10081103] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/11/2018] [Accepted: 08/13/2018] [Indexed: 12/25/2022] Open
Abstract
Menopause is an age-dependent physiological condition associated with a natural decline in oestrogen levels, which causes a progressive decrease of muscle mass and strength and bone density. Sarcopenia and osteoporosis often coexist in elderly people, with a prevalence of the latter in elderly women. The profound interaction between muscle and bone induces a negative resonance between the two tissues affected by these disorders worsening the quality of life in the postmenopausal period. It has been estimated that at least 1 in 3 women over age 50 will experience osteoporotic fractures, often requiring hospitalisation and long-term care, causing a large financial burden to health insurance systems. Hormonal replacement therapy is effective in osteoporosis prevention, but concerns have been raised with regard to its safety. On the whole, the increase in life expectancy for postmenopausal women along with the need to improve their quality of life makes it necessary to develop specific and safe therapeutic strategies, alternative to hormonal replacement therapy, targeting both sarcopenia and osteoporosis progression. This review will examine the rationale and the effects of dietary protein, vitamin D and calcium supplementation combined with a specifically-designed exercise training prescription as a strategy to counteract these postmenopausal-associated disorders.
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Affiliation(s)
- Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Sabrina Zeppa Donati
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Marco Gervasi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Giovanni Piccoli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Vilberto Stocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
- Interuniversity Institute of Myology (IIM), University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
| | - Piero Sestili
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino 61029 (PU), Italy.
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50
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Kouw IWK, Groen BBL, Smeets JSJ, Kramer IF, van Kranenburg JMX, Nilwik R, Geurts JAP, Ten Broeke RHM, Poeze M, van Loon LJC, Verdijk LB. One Week of Hospitalization Following Elective Hip Surgery Induces Substantial Muscle Atrophy in Older Patients. J Am Med Dir Assoc 2018; 20:35-42. [PMID: 30108034 DOI: 10.1016/j.jamda.2018.06.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/14/2018] [Accepted: 06/25/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Short successive periods of skeletal muscle disuse have been suggested to substantially contribute to the observed loss of skeletal muscle mass over the life span. Hospitalization of older individuals due to acute illness, injury, or major surgery generally results in a mean hospital stay of 5 to 7 days, during which the level of physical activity is strongly reduced. We hypothesized that hospitalization following elective total hip arthroplasty is accompanied by substantial leg muscle atrophy in older men and women. DESIGN AND PARTICIPANTS Twenty-six older patients (75 ± 1 years) undergoing elective total hip arthroplasty participated in this observational study. MEASUREMENTS On hospital admission and on the day of discharge, computed tomographic (CT) scans were performed to assess muscle cross-sectional area (CSA) of both legs. During surgery and on the day of hospital discharge, a skeletal muscle biopsy was taken from the m. vastus lateralis of the operated leg to assess muscle fiber type-specific CSA. RESULTS An average of 5.6 ± 0.3 days of hospitalization resulted in a significant decline in quadriceps (-3.4% ± 1.0%) and thigh muscle CSA (-4.2% ± 1.1%) in the nonoperated leg (P < .05). Edema resulted in a 10.3% ± 1.7% increase in leg CSA in the operated leg (P < .05). At hospital admission, muscle fiber CSA was smaller in the type II vs type I fibers (3326 ± 253 μm2 vs 4075 ± 279 μm2, respectively; P < .05). During hospitalization, type I and II muscle fiber CSA tended to increase, likely due to edema in the operated leg (P = .10). CONCLUSIONS Six days of hospitalization following elective total hip arthroplasty leads to substantial leg muscle atrophy in older patients. Effective intervention strategies are warranted to prevent the loss of muscle mass induced by short periods of muscle disuse during hospitalization.
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Affiliation(s)
- Imre W K Kouw
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Bart B L Groen
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Joey S J Smeets
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Irene Fleur Kramer
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands; Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Janneau M X van Kranenburg
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Rachél Nilwik
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Jan A P Geurts
- Department of Orthopedic Surgery, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, The Netherlands
| | - René H M Ten Broeke
- Department of Orthopedic Surgery, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+, The Netherlands
| | - Martijn Poeze
- Department of Surgery, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Luc J C van Loon
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands
| | - Lex B Verdijk
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, The Netherlands.
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