Skip to main content Accessibility help
×
Home

Nutritional interventions in sarcopenia: a critical review

  • Mary Hickson (a1)

Abstract

The aim of the present paper is to critically review the details of the published nutrition intervention trials, with and without exercise, targeting sarcopenia. Sarcopenia is the loss of muscle mass, strength and/or performance with age. Since amino acids and energy are required for muscle synthesis it is possible that nutritional intake influences sarcopenia. Nutritional studies are challenging to carry out because of the complexity of modulating dietary intake. It is very difficult to change one nutrient without influencing many others, which means that many of the published studies are problematic to interpret. The studies included evaluate whole protein, essential amino acids and β-hydroxyl β-methylbutyrate (HMB). Whole-protein supplementation failed to show a consistent effect on muscle mass, strength or function. This can be explained by the variations in study design, composition of the protein supplement and the failure to monitor voluntary food intake, adherence and baseline nutritional status. Essential amino-acid supplements showed an inconsistent effect but there are only two trials that have significant differences in methodology and the supplement used. The HMB studies are suggestive of a beneficial effect on older adults, but larger well-controlled studies are required that measure outcomes relevant to sarcopenia, ideally in sarcopenic populations. The issues of timing and distribution of protein intake, and increased splanchnic amino-acid sequestration are discussed, and recommendations for future trials are made.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Nutritional interventions in sarcopenia: a critical review
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Nutritional interventions in sarcopenia: a critical review
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Nutritional interventions in sarcopenia: a critical review
      Available formats
      ×

Copyright

Corresponding author

* Corresponding author: M. Hickson, email mary.hickson@imperial.nhs.uk

References

Hide All
1. Chen, L-K, Liu, L-K, Woo, J et al. (2014) Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 15, 95101.
2. Cruz-Jentoft, AJ, Baeyens, JP, Bauer, JM et al. (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in older People. Age Ageing 39, 412423.
3. Fielding, RA, Vellas, B, Evans, WJ et al. (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12, 249256.
4. Muscaritoli, M, Anker, SD, Argilés, J et al. (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr 29, 154159.
5. Dam, T-T, Peters, KW, Fragala, M et al. (2014) An evidence-based comparison of operational criteria for the presence of sarcopenia. J Gerontol A Biol Sci Med Sci 69, 584590.
6. Morley, JE, Abbatecola, AM, Argiles, JM et al. (2011) Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc 12, 403409.
7. Welch, A (2014) Nutritional influences on age-related skeletal muscle loss. Proc Nutr Soc 73, 1633.
8. Schiaffino, S, Dyar, KA, Ciciliot, S et al. (2013) Mechanisms regulating skeletal muscle growth and atrophy. FEBS J 280, 42944314.
9. Volpi, E, Kobayashi, H, Sheffield-moore, M et al. (2003) Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr 78, 250258.
10. Cruz-Jentoft, AJ, Landi, F, Schneider, SM et al. (2014) Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the Int. Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 43, 748759.
11. Bonnefoy, M, Cornu, C, Normand, S et al. (2003) The effects of exercise and protein-energy supplements on body composition and muscle function in frail elderly individuals: a long-term controlled randomised study. Br J Nutr 89, 731739.
12. Bunout, D, Barrera, G, de la Maza, P et al. (2001) The impact of nutritional supplementation and resistance training on the health functioning of free-living Chilean Elders: results of 18 months of follow-up. J Nutr 131 Suppl., 24412446.
13. Chalé, A, Cloutier, GJ, Hau, C et al. (2013) Efficacy of whey protein supplementation on resistance exercise-induced changes in lean mass, muscle strength, and physical function in mobility-limited older adults. J Gerontol A Biol Sci Med Sci 68, 682690.
14. Tieland, M, Dirks, ML, van der Zwaluw, N et al. (2012) Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 13, 713719.
15. Tieland, M, van de Rest, O, Dirks, ML et al. (2012) Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 13, 720726.
16. Maher, CG, Sherrington, C, Herbert, RD et al. (2003) Research report reliability of the PEDro scale for rating quality of randomized. Phys Ther 83, 713721.
17. Galloway, DH (1975) Nitrogen balance of men with marginal intakes of protein and energy. J Nutr 105, 914923.
18. Bauer, J, Biolo, G, Cederholm, T et al. (2013) Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 14, 542559.
19. Deutz, NEP, Bauer, JM, Barazzoni, R et al. (2014) Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 33, 929936.
20. Fukagawa, NK (2014) Protein requirements: methodologic controversy amid a call for change. Am J Clin Nutr 99, 761762.
21. Hubbard, GP, Elia, M, Holdoway, A et al. (2012) A systematic review of compliance to oral nutritional supplements. Clin Nutr 31, 293312.
22. Dillon, EL, Sheffield-Moore, M, Paddon-Jones, D et al. (2009) Amino acid supplementation increases lean body mass, basal muscle protein synthesis, and insulin-like growth factor-I expression in older women. J Clin Endocrinol Metab 94, 16301637.
23. Kim, HK, Suzuki, T, Saito, K et al. (2012) Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. J Am Geriatr Soc 60, 1623.
24. Eley, HL, Russell, ST, Tisdale, MJ (2008) Attenuation of depression of muscle protein synthesis induced by lipopolysaccharide, tumor necrosis factor, and angiotensin II by beta-hydroxy-beta-methylbutyrate. Am J Physiol Endocrinol Metab 295, E1409E1416.
25. Eley, HL, Russell, ST, Baxter, JH et al. (2007) Signaling pathways initiated by β-hydroxy-β-methylbutyrate to attenuate the depression of protein synthesis in skeletal muscle in response to cachectic stimuli. Am J Physiol 293, 923931.
26. Stancliffe, RA & Zemel, MB (2012) Role of β-hydroxy-β-methylbutyrate (HMB) in leucine stimulation of muscle mitochondrial biogenesis. FASEB J 26, 251256.
27. Nissen, S, Sharp, R, Ray, M et al. (1996) Effect of leucine metabolite β-hydroxy-β-methylbutyrate on muscle metabolism during resistance-exercise training Effect of leucine metabolite β-hydroxy-β-methylbutyrate on muscle metabolism during resistance-exercise training. J Appl Physiol 20952104.
28. Gallagher, PM, Carrithers, JA, Godard, MP et al. (2000) Beta-hydroxy-beta-methylbutyrate ingestion, Part I: effects on strength and fat free mass. Med Sci Sports Exerc 32, 21092115.
29. Fitschen, PJ, Wilson, GJ, Wilson, JM et al. (2013) Efficacy of β-hydroxy-β-methylbutyrate supplementation in elderly and clinical populations. Nutrition 29, 2936.
30. Wilson, GJ, Wilson, JM, Manninen, AH (2008) Effects of beta-hydroxy-beta-methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: a review. Nutr Metab 5, 1.
31. Vukovich, MD, Stubbs, NB, Bohlken, RM (2001) Body composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methylbutyrate similarly to that of young adults. J Nutr 131, 20492052.
32. Flakoll, P, Sharp, R, Baier, S et al. (2004) Effect of beta-hydroxy-beta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition 20, 445451.
33. Deutz, NEP, Pereira, SL, Hays, NP et al. (2013) Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clin Nutr 32, 704712.
34. Stout, JR, Smith-Ryan, AE, Fukuda, DH et al. (2013) Effect of calcium β-hydroxy-β-methylbutyrate (CaHMB) with and without resistance training in men and women 65+yrs: a randomized, double-blind pilot trial. Exp Gerontol 48, 13031310.
35. Baier, S, Johannsen, D, Abumrad, N et al. (2009) Year-long changes in protein metabolism in elderly men and women supplemented β-hydroxy-β-methylbutyrate (HMB), L-arginine, and L-lysine. Nutrition 33, 7182.
36. Wilson, JM, Grant, SC, Lee, S-R et al. (2012) Beta-hydroxy-beta-methyl-butyrate blunts negative age-related changes in body composition, functionality and myofiber dimensions in rats. J Int Soc Sports Nutr 9, 18.
37. Reeds, PJ (2000) Criteria and significance of dietary protein sources in humans dispensable and indispensable amino acids for humans. J Nutr 18351840.
38. Rand, WM & Young, VR (1999) Statistical analysis of nitrogen balance data with reference to the lysine requirement in adults. J Nutr 129, 19201926.
39. Beaumier, L, Castillo, L, Yu, YM et al. (1996) Arginine: new and exciting developments for an “old” amino acid. Biomed Environ Sci 9, 296315.
40. Beaudart, C, Buckinx, F, Rabenda, V et al. (2014) The effects of vitamin D on skeletal muscle strength, muscle mass and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 99, 43364345.
41. Simpson, RU, Thomas, GA, Arnold, AJ (1985) Identification of 1, 25-dihydroxyvitamin D3 receptors and activities in muscle. J Biol Chem 260, 88828891.
42. Visser, M, Deeg, DJH, Lips, P (2003) Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (Sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab 88, 57665772.
43. Fuller, JC, Baier, S, Flakoll, P et al. (2011) Vitamin D status affects strength gains in older adults supplemented with a combination of β-hydroxy-β-methylbutyrate, arginine, and lysine: a cohort study. JPEN 35, 757762.
44. Hsieh, LC, Chow, CJ, Chang, WC et al. (2010) Effect of beta-hydroxy-beta-methylbutyrate on protein metabolism in bed-ridden elderly receiving tube feeding. Asia Pac J Clin Nutr 19, 200208.
45. Walrand, S, Short, KR, Bigelow, ML et al. (2008) Functional impact of high protein intake on healthy elderly people. Am J Physiol Endocrinol Metab 295, E921E928.
46. Symons, TB, Schutzler, SE, Cocke, TL et al. (2007) Aging does not impair the anabolic response to a protein-rich meal. Am J Clin Nutr 86, 451456.
47. Mamerow, MM, Mettler, J, English, KL et al. (2014) Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. J Nutr 876880.
48. Bollwein, J, Diekmann, R, Kaiser, MJ et al. (2013) Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg. Nutr J 12, 109.
49. Deutz, NEP & Wolfe, RR (2013) Is there a maximal anabolic response to protein intake with a meal? Clin Nutr 32, 309313.
50. Arnal, MA, Mosoni, L, Boirie, Y et al. (1999) Protein pulse feeding improves protein retention in elderly women. Am J Clin Nutr 69, 12021208.
51. Bouillanne, O, Curis, E, Hamon-Vilcot, B et al. (2013) Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: a randomized controlled trial. Clin Nutr 32, 186192.
52. Stoll, B, Burrin, DG (2006) Measuring splanchnic amino acid metabolism in vivo using stable isotopic tracers. J Anim Sci 84, 6072.
53. Boirie, Y, Gachon, P, Beaufrere, B (1997) Splanchnic and whole-body elderly men13 leucine kinetics in young and elderly men. Am J Clin Nutr 65, 489495.

Keywords

Related content

Powered by UNSILO

Nutritional interventions in sarcopenia: a critical review

  • Mary Hickson (a1)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.