The loss of muscle mass that happens with aging, sarcopenia, is not good news. First of all it represents a significant risk factor for falls and fractures in elderly people, and moreover, as the muscle mass decreases, so does strength, physical performance, mobility and in the most advanced cases independence.
Nutrition and lifestyle have a critical impact on muscle mass, and can be tailored to sustain muscle health and performance in the long term.
First of all, adequate amounts of high-quality protein are important for optimal stimulation of muscle protein synthesis.
There is some evidence that the synthesis of new muscle in response of protein intake may be blunted in older people, particularly at low intakes, and when protein is consumed together with carbohydrate, which suggests that protein intake may, therefore, need to be increased with age to protect from sarcopenic muscle loss. However, as the production of digestive juices may decrease with age, it is also important to check that the protein eaten are being properly digested and absorbed.
Recommended protein intakes may, need to be raised in older people. One study proposes an intake of 1.0-1.2g of protein per kg of body weight per day as optimal for skeletal muscle health in elderly people (the normal RDA for protein is 0.8 g/kg). This would be equivalent to two eggs, 30g of hard cheese and 200g of cooked fish, for a person weighing around 65kg.
When increasing the amount of protein in a diet is important to provide adequate intake of alkalizing foods such as fruits and vegetables, as chronic ingestion of acid-producing diets (such as those rich in protein) may adversely impact bone health as well as have a negative impact on muscle performance.
Several studies also demonstrate the role of vitamin D in the development and preservation of muscle. It is important therefore to ensure adequate exposure to the sun. As the ability to produce vitamin D from sun exposure may decrease with age, vitamin D supplementation may be also considered.
There is increasing interest in the role of oxidative stress as a causative factor for sarcopenia. In older age, an accumulation of free radicals may lead to oxidative damage and contribute to losses of muscle mass and strength. It is therefore important to ensure an adequate intake of antioxidant nutrients such as selenium, carotenoids, vitamin E, flavonoids, and other plant polyphenols. A diet rich in fresh, colorful vegetables and fruit is a basic requirement, and supplementation should be also considered.
As sarcopenia is increasingly recognised as an inflammatory state, an anti-inflammatory diet may be of importance in relation to preservation of muscle health. In particular, long chain ω 3-polyunsaturated fatty acids (found especially in oily fish) may be of particular value as they not only have the potential to be potent anti-inflammatory agents, but may also contribute to the preservation of muscle function by directly stimulating muscle protein synthesis.
A low intake of vitamin B12 and folic acid may also impair muscle function through their action on homocysteine. A diet containing fish and leafy green, and supplementation (especially for those patients on medications that cause B12 depletion, such as antacids and hormone replacement therapy), is therefore recommended.
Resistance exercise training has been shown to be effective in increasing muscle strength and improving physical function in older adults. Whilst consumption of a high protein meal has been shown to increase muscle protein synthesis in older adults by 50%, combining a high protein meal with resistance exercise may increase synthesis >100%.
All these nutritional considerations are not only important for the silver haired amongst us. Optimizing diet and nutrition throughout life may be key to preventing sarcopenia and promoting physical capability in older age – it is never too early to look after your muscles.
Nutrition and lifestyle have a critical impact on muscle mass, and can be tailored to sustain muscle health and performance in the long term.
First of all, adequate amounts of high-quality protein are important for optimal stimulation of muscle protein synthesis.
There is some evidence that the synthesis of new muscle in response of protein intake may be blunted in older people, particularly at low intakes, and when protein is consumed together with carbohydrate, which suggests that protein intake may, therefore, need to be increased with age to protect from sarcopenic muscle loss. However, as the production of digestive juices may decrease with age, it is also important to check that the protein eaten are being properly digested and absorbed.
Recommended protein intakes may, need to be raised in older people. One study proposes an intake of 1.0-1.2g of protein per kg of body weight per day as optimal for skeletal muscle health in elderly people (the normal RDA for protein is 0.8 g/kg). This would be equivalent to two eggs, 30g of hard cheese and 200g of cooked fish, for a person weighing around 65kg.
When increasing the amount of protein in a diet is important to provide adequate intake of alkalizing foods such as fruits and vegetables, as chronic ingestion of acid-producing diets (such as those rich in protein) may adversely impact bone health as well as have a negative impact on muscle performance.
Several studies also demonstrate the role of vitamin D in the development and preservation of muscle. It is important therefore to ensure adequate exposure to the sun. As the ability to produce vitamin D from sun exposure may decrease with age, vitamin D supplementation may be also considered.
There is increasing interest in the role of oxidative stress as a causative factor for sarcopenia. In older age, an accumulation of free radicals may lead to oxidative damage and contribute to losses of muscle mass and strength. It is therefore important to ensure an adequate intake of antioxidant nutrients such as selenium, carotenoids, vitamin E, flavonoids, and other plant polyphenols. A diet rich in fresh, colorful vegetables and fruit is a basic requirement, and supplementation should be also considered.
As sarcopenia is increasingly recognised as an inflammatory state, an anti-inflammatory diet may be of importance in relation to preservation of muscle health. In particular, long chain ω 3-polyunsaturated fatty acids (found especially in oily fish) may be of particular value as they not only have the potential to be potent anti-inflammatory agents, but may also contribute to the preservation of muscle function by directly stimulating muscle protein synthesis.
A low intake of vitamin B12 and folic acid may also impair muscle function through their action on homocysteine. A diet containing fish and leafy green, and supplementation (especially for those patients on medications that cause B12 depletion, such as antacids and hormone replacement therapy), is therefore recommended.
Resistance exercise training has been shown to be effective in increasing muscle strength and improving physical function in older adults. Whilst consumption of a high protein meal has been shown to increase muscle protein synthesis in older adults by 50%, combining a high protein meal with resistance exercise may increase synthesis >100%.
All these nutritional considerations are not only important for the silver haired amongst us. Optimizing diet and nutrition throughout life may be key to preventing sarcopenia and promoting physical capability in older age – it is never too early to look after your muscles.
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