Nutritional Factors to Preserve Muscle Mass,
Strength and Performance in Senior Citizens
Review by International Osteoporosis Foundation (IOF)
Nutrition Working Group examines role of nutrition in sarcopenia,
with focus on protein, vitamins D and B, and acid-based diet.
Jan. 18, 2013 - Sarcopenia - the
decrease in the amount and quality of muscle
- is a common consequence of aging, and poses a
significant risk factor for disability in older adults. Falling,
which can lead to fractures and other injuries for seniors, is often caused by
poor muscle strength resulting from sarcopena.
The International Osteoporosis Foundation (IOF)
Nutrition Working Group has published a new review which identifies
nutritional factors that contribute to loss of muscle mass, or
conversely, are beneficial to the maintenance of muscle mass.
The Group reviewed evidence from worldwide
studies on the role of nutrition in sarcopenia, specifically looking
at protein, acidbase balance, vitamin D/calcium, and other minor
nutrients like B vitamins.
The most obvious intervention against
sarcopenia is exercise in the form of resistance training, said
Professor Jean-Philippe Bonjour, co-author and Professor of Medicine
at the Service of Bone Diseases, University of Geneva.
However, adequate nutritional intake and an
optimal dietary acid-base balance are also very important elements
of any strategy to preserve muscle mass and strength during ageing.
The review discusses and identifies the
following important nutritional factors that have been shown to be
beneficial to the maintenance of muscle mass and the treatment and
prevention of sarcopenia:
Protein: Protein intake plays an
integral part in muscle health. The authors propose an intake of
1.01.2 grams per kilo (1 kilo equals 2.2046 pounds) of body weight
per day as optimal for skeletal muscle and bone health in elderly
people without severely impaired renal function.
Vitamin D: As many studies indicate a
role for vitamin D in the development and preservation of muscle
mass and function, adequate vitamin D should be ensured through
exposure to sunlight and/or supplementation if required. Vitamin D
supplementation in seniors, and especially in institutionalized
elderly, is recommended for optimal musculoskeletal health.
Avoiding dietary acid loads: Excess
intake of acid-producing nutrients (meat and cereal grains) in
combination with low intake of alkalizing fruits and vegetables may
have negative effects on musculoskeletal health. Modifying the diet
to include more fruits and vegetables is likely to benefit both
bones and muscles.
Emerging evidence also suggests that vitamin
B12 and/or folic acid play a role in improving muscle function and
As well, the Review discusses non-nutritional
interventions such as hormones, and calls for more studies to
identify the potential of antioxidants and anti-inflammatory
compounds in the prevention of sarcopenia.
Dr. Ambrish Mithal, co-author and Chair and
Head of Endocrinology and Diabetes division at Medanta, New Delhi
underlined the need for further research in the field. Strategies
to reduce the numbers of falls and fractures within our ageing
populations must include measures to prevent sarcopenia. At present,
the available evidence suggests that combining resistance training
with optimal nutritional status has a synergistic affect in
preventing and treating sarcopenia," said Mithal.
We hope that further studies will shed light
on other effective ways of preventing and treating this condition.
More About Sarcopenia
Physical Therapist's Guide to Sarcopenia and Frailty
Frailty is a common syndrome among older people. It's associated
with an increased risk of
falling and increased hospitalization, disability, and death.
The risk of becoming frail increases in the oldest-old, especially
those aged 80 or older. Most older adults in nursing homes are
frail. Sarcopenia, which is a decrease in the amount and quality of
muscle, is a major contributor to frailty.
The 5 factors for frailty are:
Unintended weight loss (more than 10 pounds in the past year)
General feeling of exhaustion 3 or more days per week
Slow walking speed
Low levels of physical activity
Keep moving! The more you sit or lie down, the more strength and
energy you'll lose, and your heart health will be affected, too.
You might feel overwhelmed by thought of moving around, but you can
start slow and make small changes.
Your physical therapist can work with your health care team or with
you individually or in a group to safely improve your strength,
speed, and balanceso you can get back to the activities you want to
Having an exercise partner increases your chances of success.
Click Here for more information, including
What Is Frailty, and How Does Sarcopenia Contribute to It?
How Can a Physical Therapist Help?
Can this Injury or Condition be Prevented?
Real Life Experiences
What Kind of Physical Therapist Do I Need?
Impact of nutrition on muscle mass, strength, and performance in
older adults. A. Mithal & J.-P. Bonjour & S. Boonen & P. Burckhardt
& H. Degens & G. El Hajj Fuleihan & R. Josse & P. Lips & J. Morales
Torres & R. Rizzoli & N. Yoshimura & D. A. Wahl & C. Cooper & B.
Dawson-Hughes & for the IOF CSA Nutrition Working Group. Osteoporos
Int DOI 10.1007/s00198-012-2236-y