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Nutrients Requirements and Muscle Mass in Older Persons

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Geriatric Nutrition".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 77789

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Special Issue Editors

Prof. Dr. Matteo Cesari

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Guest Editor

1. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
2. Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Interests: frailty; sarcopenia; geriatric medicine; integrated care; healthy ageing
Special Issues, Collections and Topics in MDPI journals

Dr. Beatrice Arosio

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Guest Editor

1. Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2. Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Interests: aging; longevity; cognitive decline; biomarkers; inflammation; cellular bioenergetics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

A large body of evidence has been developed over the years to demonstrate the crucial role played by nutrition on the health status of skeletal muscle (and, more generally, of the aging individual). Given this, successful interventions for preventing physical decline necessarily pass through the promotion of a healthy nutrition. This implies the need for (preclinical and clinical) research, specifically dedicated at better understanding the role that micro- and macro-nutrients play on the skeletal muscle.

This Special Issue of Nutrients, entitled “Nutrients Requirements and Muscle Mass in Older Persons”, welcomes the submission of manuscripts reporting the findings of original research or reviewing the existing literature on the subject. The topics of interest may be explored in various disciplines (e.g., nutritional sciences, geriatrics, internal medicine, sports medicine, public health, rheumatology, oncology, cardiology, orthopedics). Reports from basic science up to clinical and population research will be considered suitable for inclusion in the Special Issue. Articles presenting results (either positive or negative) from preclinical and clinical research will be given special consideration.

Potential topics include, but are not limited to:

The role that specific dietary patterns may play on skeletal muscle health
The effect of nutrition on sarcopenia, osteoporosis, and/or osteosarcopenia
Evaluating the relationship between nutrition and skeletal muscle in different settings and in the context of specific clinical conditions
Nutraceutical interventions for the improvement of the age-related skeletal muscle decline
Biological pathway at the basis of the effects that nutrients (alone or in associations) exert on skeletal muscle health
Role of gut microbiota in the metabolism of nutrients and skeletal muscle health

We therefore invite you to submit your latest original research or review articles that fall within the overarching theme of this Special Issue.

Dr. Matteo Cesari
Dr. Beatrice Arosio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Nutrition
Skeletal Muscle
Body composition
Sarcopenia
Proteins

Published Papers (13 papers)

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Editorial

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3 pages, 181 KiB

Open AccessEditorial

Nutrition and Muscle Health

by Beatrice Arosio and Matteo Cesari

Nutrients 2021, 13(3), 797; https://doi.org/10.3390/nu13030797 - 28 Feb 2021

Cited by 2 | Viewed by 3488

Abstract

The increase in human life expectancy at birth and the rapid aging of the population represent major social phenomena of this time [...] Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

Research

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14 pages, 322 KiB

Open AccessArticle

Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

by Laetitia Lengelé, Olivier Bruyère, Charlotte Beaudart, Jean-Yves Reginster and Médéa Locquet

Nutrients 2021, 13(2), 407; https://doi.org/10.3390/nu13020407 - 28 Jan 2021

Cited by 19 | Viewed by 2820

Abstract

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05). Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

22 pages, 1802 KiB

Open AccessArticle

An Increase in Fat-Free Mass is Associated with Higher Appetite and Energy Intake in Older Adults: A Randomised Control Trial

by Kelsie Olivia Johnson, Adrian Holliday, Nathan Mistry, Andrew Cunniffe, Kieran Howard, Nicholas Stanger, Lauren L. O’Mahoney, Jamie Matu and Theocharis Ispoglou

Nutrients 2021, 13(1), 141; https://doi.org/10.3390/nu13010141 - 1 Jan 2021

Cited by 12 | Viewed by 5203

Abstract

Cross-sectional studies in younger adults have demonstrated a positive association between energy intake (EI) and fat-free mass (FFM), with this relationship seemingly mediated by resting metabolic rate (RMR). Establishing a causal effect longitudinally would be prudent in older adults suffering from loss of appetite. We investigated the effects of FFM on RMR, appetite and EI in 39 healthy older adults (age: 66 ± 4 years, BMI: 25.1 ± 3.5 kg∙m²) assigned to either 12-week resistance training + protein supplementation group (RT + PRO) or control group (CON). Body composition, subjective appetite, leptin, insulin, RMR and laboratory-measured ad libitum EI were measured at baseline, weeks 6 and 12 of the intervention, while daily EI at baseline and week 12. FFM (+1.2 kg; p = 0.002), postprandial subjective appetite (+8 mm; p = 0.027), ad libitum EI (+119 kcal; p = 0.012) and daily EI (+133 kcal; p = 0.010) increased from baseline to week 12 in the RT + PRO. RMR, fasted subjective appetite, leptin and insulin concentrations remained unchanged (all p > 0.05). The increases ad libitum EI correlated with increases in FFM (r = 0.527, p = 0.001), with 54% of the change in EI attributed to FFM changes. In conclusion, FFM increases were associated with an increased ad libitum EI and postprandial appetite in older adults. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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16 pages, 1099 KiB

Open AccessArticle

The Association between Major Dietary Pattern and Low Muscle Mass in Korean Middle-Aged and Elderly Populations: Based on the Korea National Health and Nutrition Examination Survey

by Seong-Ah Kim, Jinwoo Ha, Byeonghwi Lim, Jun-Mo Kim and Sangah Shin

Nutrients 2020, 12(11), 3543; https://doi.org/10.3390/nu12113543 - 19 Nov 2020

Cited by 6 | Viewed by 2562

Abstract

Reduced skeletal muscle mass in older populations is independently associated with functional impairment and disability, resulting in increased risk of mortality and various comorbidities. This study aimed to examine the association between major dietary pattern and low muscle mass among Korean middle-aged and elderly populations. A total of 8136 participants aged ≥50 years were included from a cross-sectional study based on the 2008–2011 Korea National Health and Nutrition Examination Survey. The following four distinct dietary patterns were derived using factor analysis: “Condiment, vegetables, and meats”; “wheat flour, bread, fruits, milk, and dairy products”; “white rice, fish, and seaweeds”; and “whole grain, bean products, and kimchi”. A higher “white rice, fish, and seaweeds” pattern score was associated with a lower prevalence of low muscle mass in both men and women, whereas a higher “condiment, vegetables, and meats” pattern score was associated with a higher prevalence of low muscle mass in men. A dietary pattern based on white rice, fish, and seaweeds can be helpful in protecting against loss of skeletal muscle mass in Korean middle-aged and elderly populations. Future research is paramount to confirm the causal association between dietary pattern and the risk of low muscle mass. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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10 pages, 459 KiB

Open AccessArticle

Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis

by Justin Chew, Audrey Yeo, Suzanne Yew, Cai Ning Tan, Jun Pei Lim, Noor Hafizah Ismail and Wee Shiong Lim

Nutrients 2020, 12(10), 2957; https://doi.org/10.3390/nu12102957 - 27 Sep 2020

Cited by 14 | Viewed by 4150

Abstract

Osteosarcopenia is associated with increased risk of adverse outcomes such as falls and fractures. Its association with frailty is less well-described, particularly in independent community-dwelling older adults. Although nutrition plays a crucial role in maintaining bone and muscle health, the complex relationship between osteosarcopenia and nutrition in the pathogenesis of frailty remains to be elucidated. In this cross-sectional analysis of 230 independent, community-dwelling individuals (mean age 67.2 ± 7.4 years), we examined the associations between osteosarcopenia with nutritional status and frailty, and the mediating role of nutrition in the association between osteosarcopenia and frailty. Osteosarcopenia was defined as fulfilling both the Asian Working Group for Sarcopenia 2019 consensus definition (low relative appendicular skeletal muscle mass adjusted for height, in the presence of either of either low handgrip strength or slow gait speed) and T-score ≤ −2.5 SD on bone mineral densitometry. We assessed frailty using the modified Fried criteria and nutrition using the Mini-Nutritional Assessment. We performed multiple linear regression, followed by pathway analysis to ascertain whether nutrition mediates the relationship between osteosarcopenia and frailty. Our study population comprised: 27 (11.7%) osteosarcopenic, 35 (15.2%) sarcopenic, 36 (15.7%) osteoporotic and 132 (57.4%) normal (neither osteosarcopenic, sarcopenic nor osteoporotic). Osteosarcopenia (β = 1.1, 95% CI 0.86–1.4) and sarcopenia (β = 1.1, 95% CI 0.90–1.4) were significantly associated with frailty, but not osteoporosis. Nutrition mediated the association between osteosarcopenia and frailty (indirect effect estimate 0.09, bootstrap 95% CI 0.01–0.22). In conclusion, osteosarcopenia is associated with frailty and poorer nutritional status, with nutrition mediating the association between osteosarcopenia and frailty. Our findings support early nutritional assessment and intervention in osteosarcopenia to mitigate the risk of frailty. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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17 pages, 557 KiB

Open AccessArticle

The Simplified Nutritional Appetite Questionnaire (SNAQ) as a Screening Tool for Risk of Malnutrition: Optimal Cutoff, Factor Structure, and Validation in Healthy Community-Dwelling Older Adults

by Sabrina Lau, Kalene Pek, Justin Chew, Jun Pei Lim, Noor Hafizah Ismail, Yew Yoong Ding, Matteo Cesari and Wee Shiong Lim

Nutrients 2020, 12(9), 2885; https://doi.org/10.3390/nu12092885 - 21 Sep 2020

Cited by 38 | Viewed by 9137

Abstract

Malnutrition is an independent marker of adverse outcomes in older adults. While the Simplified Nutritional Appetite Questionnaire (SNAQ) for anorexia has been validated as a nutritional screening tool, its optimal cutoff and validity in healthy older adults is unclear. This study aims to determine the optimal cutoff for SNAQ in healthy community-dwelling older adults, and to examine its factor structure and validity. We studied 230 community-dwelling older adults (mean age 67.2 years) who were nonfrail (defined by Fatigue, Resistance, Ambulation, Illnesses & Loss (FRAIL) criteria). When compared against the risk of malnutrition using the Mini Nutritional Assessment (MNA), the optimal cutoff for SNAQ was ≤15 (area under receiver operating characteristic (ROC) curve: 0.706, sensitivity: 69.2%, specificity: 61.3%). Using exploratory factor analysis, we found a two-factor structure (Factor 1: Appetite Perception; Factor 2: Satiety and Intake) which accounted for 61.5% variance. SNAQ showed good convergent, discriminant and concurrent validity. In logistic regression adjusted for age, gender, education and MNA, SNAQ ≤15 was significantly associated with social frailty, unlike SNAQ ≤4 (odds ratio (OR) 1.99, p = 0.025 vs. OR 1.05, p = 0.890). Our study validates a higher cutoff of ≤15 to increase sensitivity of SNAQ for anorexia detection as a marker of malnutrition risk in healthy community-dwelling older adults, and explicates a novel two-factor structure which warrants further research. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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16 pages, 1787 KiB

Open AccessArticle

Daily Protein and Energy Intake Are Not Associated with Muscle Mass and Physical Function in Healthy Older Individuals—A Cross-Sectional Study

by Grith Højfeldt, Yusuke Nishimura, Kenneth Mertz, Simon R. Schacht, Jonas Lindberg, Mikkel Jensen, Morten Hjulmand, Mads Vendelbo Lind, Tenna Jensen, Astrid Pernille Jespersen, Soren Reitelseder, Inge Tetens and Lars Holm

Nutrients 2020, 12(9), 2794; https://doi.org/10.3390/nu12092794 - 12 Sep 2020

Cited by 12 | Viewed by 4875

Abstract

Dietary protein has a pivotal role in muscle mass maintenance with advancing age. However, an optimal dose and distribution of protein intake across the day as well as the interaction with energy intake for the maintenance of muscle mass and physical function in healthy older adults remain to be fully elucidated. The purpose of this study was to examine the association between muscle mass, strength, and physical function, and the total amount and distribution of protein and energy intake across the day in healthy older individuals. The research question was addressed in a cross-sectional study including 184 Danish men and woman (age: 70.2 ± 3.9 years, body mass: 74.9 ± 12.1 kg, Body Mass Index (BMI): 25.4 ± 3.7 kg/m²) where a 3-day dietary registration, muscle mass, strength, and functional measurements were collected. We found that neither daily total protein intake nor distribution throughout the day were associated with muscle mass, strength, or physical function. Consequently, we do not provide an incentive for healthy older Danish individuals who already adhere to the current internationally accepted recommended dietary protein intake (0.83 g/kg/day) to change dietary protein intake or its distribution pattern throughout the day. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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8 pages, 224 KiB

Open AccessArticle

Vitamin D Receptor Polymorphisms in Sex-Frailty Paradox

by Beatrice Arosio, Franca Rosa Guerini, Andrea Saul Costa, Alessandra Dicitore, Evelyn Ferri, Daniela Mari, Erminio Torresani, Mario Clerici, Matteo Cesari and Giovanni Vitale

Nutrients 2020, 12(9), 2714; https://doi.org/10.3390/nu12092714 - 5 Sep 2020

Cited by 9 | Viewed by 2610

Abstract

The “male-female health-survival paradox” evidences that the survival advantage observed in women is linked to higher rates of disability and poor health status compared to men, a phenomenon also called the “sex-frailty paradox”. The depletion of vitamin D seems to play a role in the fragilization of old persons, and genetic polymorphisms of the vitamin D receptor (VDR) gene seem to be involved in regulating the vitamin D pathway. This study correlated the VDR gene polymorphisms (FokI, ApaI, BsmiI, and TaqI) with frailty, computed by frailty index (FI), in 202 persons (127 women and 75 men, aged from 60 to 116 years), aiming to capture the involvement of vitamin D in the sex-frailty paradox. The results showed slightly higher FI (p = 0.05), lower levels of 25(OH)D (p = 0.04), and higher levels of parathyroid hormone PTH (p = 0.002) and phosphorus (p < 0.001) in women than in men. Interestingly, the ApaI minor allele (Aa + aa) showed a significant positive association with FI (p = 0.03) and a negative association with inorganic phosphorus values (p = 0.04) compared to AA genotype only in women, regardless of age. The exact mechanism and the causal role that, in old women, links ApaI polymorphism with frailty are still unclear. However, we could speculate that a specific genetic profiling, other than 25(OH)D levels, play a role in the sex-frailty paradox. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

14 pages, 551 KiB

Open AccessArticle

Hip Fracture Patients in Geriatric Rehabilitation Show Poor Nutritional Status, Dietary Intake and Muscle Health

by Inge Groenendijk, Charlotte S. Kramer, Laura M. den Boeft, Hans S. M. Hobbelen, Gert-Jan van der Putten and Lisette C. P. G. M. de Groot

Nutrients 2020, 12(9), 2528; https://doi.org/10.3390/nu12092528 - 20 Aug 2020

Cited by 14 | Viewed by 5055

Abstract

The aim of this study was to gain insight into the nutritional status, dietary intake and muscle health of older Dutch hip fracture patients to prevent recurrent fractures and to underpin rehabilitation programs. This cross-sectional study enrolled 40 hip fracture patients (mean ± SD age 82 ± 8.0 years) from geriatric rehabilitation wards of two nursing homes in the Netherlands. Assessments included nutritional status (Mini Nutritional Assessment), dietary intake on three non-consecutive days which were compared with Dietary Reference Intake values, and handgrip strength. Muscle mass was measured using Bioelectrical Impedance Analysis and ultrasound scans of the rectus femoris. Malnutrition or risk of malnutrition was present in 73% of participants. Mean energy, protein, fibre and polyunsaturated fat intakes were significantly below the recommendations, while saturated fat was significantly above the UL. Protein intake was <0.8 in 46% and <1.2 g/(kg·day) in 92%. Regarding micronutrients, mean intakes of calcium, vitamin D, potassium, magnesium and selenium were significantly below the recommendations. The prevalence of low muscle mass, low handgrip strength and sarcopenia were 35%, 27% and 10%, respectively. In conclusion, a poor nutritional status, dietary intake and muscle health are common in older hip fracture patients in geriatric rehabilitation wards. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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16 pages, 699 KiB

Open AccessArticle

Leucine-Enriched Protein Supplementation Increases Lean Body Mass in Healthy Korean Adults Aged 50 Years and Older: A Randomized, Double-Blind, Placebo-Controlled Trial

by Yeji Kang, Namhee Kim, Yong Jun Choi, Yunhwan Lee, Jihye Yun, Seok Jun Park, Hyoung Su Park, Yoon-Sok Chung and Yoo Kyoung Park

Nutrients 2020, 12(6), 1816; https://doi.org/10.3390/nu12061816 - 18 Jun 2020

Cited by 19 | Viewed by 5327

Abstract

Early prevention of sarcopenia could be an important strategy for muscle retention, but most studies have focused on subjects aged 65 or older. Therefore, in this study we investigated the effects of leucine-enriched protein supplementation on muscle condition in a sample including late middle-aged adults. A 12-week intervention was performed for 120 healthy community-dwelling adults by providing either leucine-enriched protein supplement [protein 20g(casein 50%+ whey 40%+ soy 10%, total leucine 3000 mg), vitamin D 800IU(20 ug), calcium 300 mg, fat 1.1 g, carbohydrate 2.5 g] or isocaloric carbohydrate supplement twice per day. Appendicular skeletal muscle mass (ASM) and lean body mass (LBM) were measured by dual-energy X-ray absorptiometry. A total of 111 participants completed the study, with a dropout rate of 9.2%. LBM normalized by body weight (LBM/Wt) was significantly increased (p < 0.001) in the intervention group (0 wk: 63.38 ± 0.85 vs. 12 wk 63.68 ± 0.83 in the intervention group; 0 wk: 63.85 ± 0.82 vs. 12 wk: 63.29 ± 0.81 in the control group). In subgroup analyses, significant differences remained only in subjects between 50 and 64 years of age. We concluded that leucine-enriched protein supplementation can have beneficial effects by preventing muscle loss, mainly for late middle-aged adults. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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10 pages, 600 KiB

Open AccessArticle

Dietary Fibre May Mitigate Sarcopenia Risk: Findings from the NU-AGE Cohort of Older European Adults

by Diego Montiel-Rojas, Andreas Nilsson, Aurelia Santoro, Claudio Franceschi, Alberto Bazzocchi, Giuseppe Battista, Lisette C. P. G. M. de Groot, Edith J. M. Feskens, Agnes Berendsen, Barbara Pietruszka, Olga Januszko, Susan Fairweather-Tait, Amy Jennings, Claudio Nicoletti and Fawzi Kadi

Nutrients 2020, 12(4), 1075; https://doi.org/10.3390/nu12041075 - 13 Apr 2020

Cited by 19 | Viewed by 5709

Abstract

Sarcopenia is characterised by a progressive loss of skeletal muscle mass and physical function as well as related metabolic disturbances. While fibre-rich diets can influence metabolic health outcomes, the impact on skeletal muscle mass and function is yet to be determined, and the moderating effects by physical activity (PA) need to be considered. The aim of the present study was to examine links between fibre intake, skeletal muscle mass and physical function in a cohort of older adults from the NU-AGE study. In 981 older adults (71 ± 4 years, 58% female), physical function was assessed using the short-physical performance battery test and handgrip strength. Skeletal muscle mass index (SMI) was derived using dual-energy X-ray absorptiometry (DXA). Dietary fibre intake (FI) was assessed by 7-day food record and PA was objectively determined by accelerometery. General linear models accounting for covariates including PA level, protein intake and metabolic syndrome (MetS) were used. Women above the median FI had significantly higher SMI compared to those below, which remained in fully adjusted models (24.7 ± 0.2% vs. 24.2 ± 0.1%, p = 0.011, η²p = 0.012). In men, the same association was only evident in those without MetS (above median FI: 32.4 ± 0.3% vs. below median FI: 31.3 ± 0.3%, p = 0.005, η²p = 0.035). There was no significant impact of FI on physical function outcomes. The findings from this study suggest a beneficial impact of FI on skeletal muscle mass in older adults. Importantly, this impact is independent of adherence to guidelines for protein intake and PA, which further strengthens the potential role of dietary fibre in preventing sarcopenia. Further experimental work is warranted in order to elucidate the mechanisms underpinning the action of dietary fibre on the regulation of muscle mass. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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Review

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20 pages, 1714 KiB

Open AccessReview

Protein Intake and Frailty: A Matter of Quantity, Quality, and Timing

by Hélio J. Coelho-Junior, Emanuele Marzetti, Anna Picca, Matteo Cesari, Marco C. Uchida and Riccardo Calvani

Nutrients 2020, 12(10), 2915; https://doi.org/10.3390/nu12102915 - 23 Sep 2020

Cited by 75 | Viewed by 11598

Abstract

Frailty is a geriatric syndrome that refers to a state of reduced resiliency to stressful events that occurs in response to physiological and/or psychosocial detriments. Frailty is a predictor of poor prognosis, given that frail older adults are at higher risk of many adverse health-related events. Hence, the identification of potential strategies to prevent the development and progression of frailty is of extreme importance for avoiding its negative outcomes. An adequate protein consumption is advocated as a possible intervention for the management of frailty in older adults due to its effects on muscle mass and physical function. However, empirical evidence is still needed to support this proposition. On the other hand, substantial evidence from observational studies has provided important information on the association between frailty and dietary protein-related parameters. Here, we provide a narrative review of the current literature regarding the association between protein intake (amount (how much?), quality (what type?), and distribution across meals (when?)) and frailty-related parameters. The ultimate aim of this work is to offer practical, evidence-based indications to healthcare professionals responsible for the care of frail older adults. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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24 pages, 1684 KiB

Open AccessReview

Impact of Protein Intake in Older Adults with Sarcopenia and Obesity: A Gut Microbiota Perspective

by Konstantinos Prokopidis, Mavil May Cervo, Anoohya Gandham and David Scott

Nutrients 2020, 12(8), 2285; https://doi.org/10.3390/nu12082285 - 30 Jul 2020

Cited by 48 | Viewed by 14114

Abstract

The continuous population increase of older adults with metabolic diseases may contribute to increased prevalence of sarcopenia and obesity and requires advocacy of optimal nutrition treatments to combat their deleterious outcomes. Sarcopenic obesity, characterized by age-induced skeletal-muscle atrophy and increased adiposity, may accelerate functional decline and increase the risk of disability and mortality. In this review, we explore the influence of dietary protein on the gut microbiome and its impact on sarcopenia and obesity. Given the associations between red meat proteins and altered gut microbiota, a combination of plant and animal-based proteins are deemed favorable for gut microbiota eubiosis and muscle-protein synthesis. Additionally, high-protein diets with elevated essential amino-acid concentrations, alongside increased dietary fiber intake, may promote gut microbiota eubiosis, given the metabolic effects derived from short-chain fatty-acid and branched-chain fatty-acid production. In conclusion, a greater abundance of specific gut bacteria associated with increased satiation, protein synthesis, and overall metabolic health may be driven by protein and fiber consumption. This could counteract the development of sarcopenia and obesity and, therefore, represent a novel approach for dietary recommendations based on the gut microbiota profile. However, more human trials utilizing advanced metabolomic techniques to investigate the microbiome and its relationship with macronutrient intake, especially protein, are warranted. Full article

(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)

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