1
|
Cho KH, Han EY, Jung MK, Kang CM, Shin JC, Im SH. Effects of protein-enriched nutritional support on skeletal muscle mass and rehabilitative outcomes in brain tumor patients: a randomized controlled trial. Sci Rep 2024; 14:12909. [PMID: 38839858 PMCID: PMC11153212 DOI: 10.1038/s41598-024-63551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
Patients with brain tumors require extensive and prolonged rehabilitation efforts as they suffer from lesion-induced motor weakness as well as treatment-related side effects, often leading to a significant decline in function. Protein supplements have shown positive effects on promoting muscle strength and physical performance in various tumor etiologies. However, reports on their effects specifically in brain tumor patients remain scarce. This study aims to investigate the feasibility and efficacy of protein supplements in enhancing rehabilitative outcomes via muscle strengthening and functional gain in brain tumor patients with neurological demise. Sixty brain tumor patients were randomly assigned to either a protein supplement or a control group, receiving either protein supplements or a placebo for 6 weeks, in conjunction with conventional rehabilitation therapy. Assessments before and after the intervention included laboratory tests, anthropometric measures using bioimpedance analysis, and functional assessments, which included the MMSE, the modified Barthel Index, the Beck Depression Inventory, the Brief Fatigue Inventory, the Timed Up and Go test, the 6-min walk test, the isokinetic quadriceps muscle strength test, and the handgrip power. After the intervention, the levels of serum hemoglobin, protein, albumin, and C-reactive protein were improved in both groups, however, the change was significant only in the protein group. The muscle strength was enhanced in both groups, however, the significant increase in pinch grasp power was only noted in the protein group (P < 0.05). The distance on 6MWT was also significantly extended at follow-up in the protein group (P < 0.01). In the subgroup analysis according to nutritional status, the moderate malnutrition group showed greater augmentation of muscle mass than those with adequate nutrition (P < 0.05). Interestingly, the amelioration of malnutrition was observed only the in protein group. This study using protein supplements to promote the rehabilitative potential of brain tumor patients revealed a significant effect on improving hemodynamic nutritional indices, muscle power reimbursement, and functional improvement, especially in malnourished patients. The safety and feasibility of protein supplements in brain tumor patients were affirmative in this study. Further studies with more patients may help confirm the secondary functional gain resulting from increased muscle power.Trial registration: This study was retrospectively registered in the Clinical Research Information Service, CRIS no. KCT0009113 on Jan 12, 2024.
Collapse
Affiliation(s)
- Kye Hee Cho
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University, Jeju, Republic of Korea
| | - Min Kyu Jung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Moo Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Cheol Shin
- Department and Research Institute of Rehabilitation Medicine, Severance Rehabilitation Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea
| | - Sang Hee Im
- Department and Research Institute of Rehabilitation Medicine, Severance Rehabilitation Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Hughes AK, Francis T, Rooney J, Pollock R, Witard OC. The effect of protein or amino acid provision on immobilization-induced muscle atrophy in healthy adults: A systematic review and meta-analysis. Exp Physiol 2024; 109:873-888. [PMID: 38424716 PMCID: PMC11140175 DOI: 10.1113/ep090434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
Bed rest and limb immobilization are models of muscle disuse associated with skeletal muscle atrophy and reduced strength. The purpose of this systematic review was to examine the impact of protein or amino acid provision before and/or during a period of muscle disuse on muscle atrophy (primary outcome), strength and muscle protein synthesis (secondary outcomes) following a disuse period. We performed a systematic review of Embase, MEDLINE, Web of Science, PubMed and Clinical Trials in December 2022. Eligible studies were randomized controlled trials that combined a dietary protein or amino acid intervention versus control during an experimental model of disuse (bed rest or unilateral limb immobilization) in healthy individuals aged ≥18 years. Nine articles from eight independent trials were identified and rated for risk of bias by two authors. A meta-analysis of muscle mass data revealed no effect (standardized mean difference: 0.2; 95% confidence interval: -0.18 to 0.57, P = 0.31) of protein/amino acid intervention in preventing disuse-induced muscle atrophy. Although the meta-analysis was not conducted on strength or muscle protein synthesis data, there was insufficient evidence in the reviewed articles to support the use of protein/amino acid provision in mitigating the disuse-induced decline in either outcome measurement. Additional high-quality studies, including the reporting of randomization procedures and blinding procedures and the provision of statistical analysis plans, might be required to determine whether protein or amino acid provision serves as an effective strategy to attenuate muscle atrophy during periods of disuse.
Collapse
Affiliation(s)
- Alix K. Hughes
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Thomas Francis
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Jessica Rooney
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Ross Pollock
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| | - Oliver C. Witard
- Centre for Human and Applied Physiological SciencesKing's College LondonLondonUK
| |
Collapse
|
3
|
Evans WJ, Guralnik J, Cawthon P, Appleby J, Landi F, Clarke L, Vellas B, Ferrucci L, Roubenoff R. Sarcopenia: no consensus, no diagnostic criteria, and no approved indication-How did we get here? GeroScience 2024; 46:183-190. [PMID: 37996722 PMCID: PMC10828356 DOI: 10.1007/s11357-023-01016-9] [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: 10/05/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
In addition to the role of skeletal muscle in movement and locomotion, muscle plays a critical role in a broad array of metabolic processes that can contribute to improved health or risk of disease. The age-associated loss of muscle has been termed sarcopenia. The muscle is the primary site of insulin-stimulated glucose disposal and the largest component of basal metabolic rate, directly and indirectly affects bone density, produces myokines with pleiotropic effect on muscle and other tissues including the brain, and stores essential amino acids essential for the maintenance of protein synthesis during periods of reduced food intake and stress. As such, not surprisingly deterioration of skeletal muscle health, typically operationalized as decline of muscle mass and muscle strength is both a powerful risk factor and main consequence of chronic diseases, disability, and loss of independence, and it is one of the strongest risk factors for mortality. However, skeletal muscle remains one of the most plastic of all tissues, with rapid changes in rates of protein synthesis and degradation in response to physical activity and inactivity, inflammation, and nutritional and hormonal status. This has made the development of pharmacological therapies to increase muscle mass (or prevent loss), an important goal for decades. However, while remarkable advances in the understanding of molecular and cellular regulation of muscle protein metabolism have occurred recently, there are no approved drugs for the treatment of sarcopenia, the loss of skeletal muscle affecting millions of older people. The goal of this paper is to describe the possible reasons for the lack of new and effective pharmacotherapies to treat one of the most important risk factors for age-associated disease and loss of independence.
Collapse
Affiliation(s)
| | - Jack Guralnik
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Peggy Cawthon
- California Pacific Medical Center, San Francisco, CA, USA
| | - James Appleby
- Gerontological Society of America, Washington, DC, USA
| | | | | | | | | | | |
Collapse
|
4
|
Cepková A, Zemková E, Šooš Ľ, Uvaček M, Muyor JM. Sedentary lifestyle of university students is detrimental to the thoracic spine in men and to the lumbar spine in women. PLoS One 2023; 18:e0288553. [PMID: 38051703 PMCID: PMC10697567 DOI: 10.1371/journal.pone.0288553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/29/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Sitting for long periods of time and lack of physical activity in young adults can cause postural deterioration leading to rapid onset of fatigue and increase the risk of back pain. We were interested in whether there are gender differences in spinal curvature among university students with a predominantly sedentary lifestyle. METHODS 20 sedentary female (age 20 ± 0.73 years) and 39 sedentary male university students (age 20 ± 1.08 years) participated in this study. Their thoracic and lumbar curvatures were assessed while standing and sitting using a Spinal Mouse. RESULTS In standing, 80.0% of the females and 69.2% of the males had a neutral position of the thoracic spine (33.25° and 35.33°, respectively). However, more males, 30.8%, than females, 10.0%, had hyperkyphosis (54.27° and 47.0°, respectively). Hypokyphosis was found in 10.0% of the females (18.50°) and none in the males. Similarly, 90.0% of the females and 97.4% of the males had neutral position of the lumbar spine (-33.11° and -29.76°, respectively). Increased hyperlordosis was found in 10.0% of the females and 2.6% of the males (-41.0° and -50.0°, respectively). Hypolordosis was not detected in either females or males. In sitting, on the other hand, 70.0% of the females and only 33.3% of the males had a neutral position of the thoracic spine (30.20° and 30.62°, respectively). Increased hyperkyphosis was found in 46.2% of the males (59.76°) and none of the females. 30.0% of the females and 23.1% of the males had light hypokyphosis (47.50° and 46.67°, respectively). Similarly, 70.0% of the females and only 38.5% of the males had a neutral position of the lumbar spine (7.0° and 6.6°, respectively). 35.9% of the males and only 5.0% of the females had a light hypokyphosis (16.14° and 16.0°, respectively). Slightly increased hyperkyphosis was identified in 25.6% of the males and 25.0% of the females (23.9° and 22.5°, respectively). CONCLUSION There are significant gender differences in spinal curvature. While in the thoracic spine it was to the detriment of the males when both standing and sitting, in the lumbar spine it is related to the females only when standing. It is therefore necessary to eliminate these spinal deviations in young adults induced by prolonged sitting during university courses by appropriate recovery modalities.
Collapse
Affiliation(s)
- Alena Cepková
- Faculty of Mechanical Engineering, Slovak University of Technology, Bratislava, Slovakia
| | - Erika Zemková
- Faculty of Physical Education and Sport, Comenius University in Bratislava, Bratislava, Slovakia
- Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia
| | - Ľubomír Šooš
- Faculty of Mechanical Engineering, Slovak University of Technology, Bratislava, Slovakia
| | - Marián Uvaček
- Faculty of Mechanical Engineering, Slovak University of Technology, Bratislava, Slovakia
| | - José M. Muyor
- Health Research Centre, University of Almería, Almería, Spain
| |
Collapse
|
5
|
Ferrando AA, Wolfe RR, Hirsch KR, Church DD, Kviatkovsky SA, Roberts MD, Stout JR, Gonzalez DE, Sowinski RJ, Kreider RB, Kerksick CM, Burd NA, Pasiakos SM, Ormsbee MJ, Arent SM, Arciero PJ, Campbell BI, VanDusseldorp TA, Jager R, Willoughby DS, Kalman DS, Antonio J. International Society of Sports Nutrition Position Stand: Effects of essential amino acid supplementation on exercise and performance. J Int Soc Sports Nutr 2023; 20:2263409. [PMID: 37800468 PMCID: PMC10561576 DOI: 10.1080/15502783.2023.2263409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
Position Statement: The International Society of Sports Nutrition (ISSN) presents this position based on a critical examination of literature surrounding the effects of essential amino acid (EAA) supplementation on skeletal muscle maintenance and performance. This position stand is intended to provide a scientific foundation to athletes, dietitians, trainers, and other practitioners as to the benefits of supplemental EAA in both healthy and resistant (aging/clinical) populations. EAAs are crucial components of protein intake in humans, as the body cannot synthesize them. The daily recommended intake (DRI) for protein was established to prevent deficiencies due to inadequate EAA consumption. The following conclusions represent the official position of the Society: 1. Initial studies on EAAs' effects on skeletal muscle highlight their primary role in stimulating muscle protein synthesis (MPS) and turnover. Protein turnover is critical for replacing degraded or damaged muscle proteins, laying the metabolic foundation for enhanced functional performance. Consequently, research has shifted to examine the effects of EAA supplementation - with and without the benefits of exercise - on skeletal muscle maintenance and performance. 2. Supplementation with free-form EAAs leads to a quick rise in peripheral EAA concentrations, which in turn stimulates MPS. 3. The safe upper limit of EAA intake (amount), without inborn metabolic disease, can easily accommodate additional supplementation. 4. At rest, stimulation of MPS occurs at relatively small dosages (1.5-3.0 g) and seems to plateau at around 15-18 g. 5. The MPS stimulation by EAAs does not require non-essential amino acids. 6. Free-form EAA ingestion stimulates MPS more than an equivalent amount of intact protein. 7. Repeated EAA-induced MPS stimulation throughout the day does not diminish the anabolic effect of meal intake. 8. Although direct comparisons of various formulas have yet to be investigated, aging requires a greater proportion of leucine to overcome the reduced muscle sensitivity known as "anabolic resistance." 9. Without exercise, EAA supplementation can enhance functional outcomes in anabolic-resistant populations. 10. EAA requirements rise in the face of caloric deficits. During caloric deficit, it's essential to meet whole-body EAA requirements to preserve anabolic sensitivity in skeletal muscle.
Collapse
Affiliation(s)
- Arny A. Ferrando
- University of Arkansas for Medical Sciences, Center for Translational Research in Aging and Longevity, Department of Geriatrics, Little Rock, AR, USA
| | - Robert R. Wolfe
- University of Arkansas for Medical Sciences, Center for Translational Research in Aging and Longevity, Department of Geriatrics, Little Rock, AR, USA
| | - Katie R. Hirsch
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, Columbia, SC, USA
| | - David D. Church
- University of Arkansas for Medical Sciences, Center for Translational Research in Aging and Longevity, Department of Geriatrics, Little Rock, AR, USA
| | - Shiloah A. Kviatkovsky
- University of Arkansas for Medical Sciences, Center for Translational Research in Aging and Longevity, Department of Geriatrics, Little Rock, AR, USA
| | | | - Jeffrey R. Stout
- University of Central Florida, School of Kinesiology and Rehabilitation Sciences, Orlando, FL, USA
| | - Drew E. Gonzalez
- Texas A&M University, Exercise & Sport Nutrition Lab, Department of Kinesiology and Sports Management, College Station, TX, USA
| | - Ryan J. Sowinski
- Texas A&M University, Exercise & Sport Nutrition Lab, Department of Kinesiology and Sports Management, College Station, TX, USA
| | - Richard B. Kreider
- Texas A&M University, Exercise & Sport Nutrition Lab, Department of Kinesiology and Sports Management, College Station, TX, USA
| | - Chad M. Kerksick
- Lindenwood University, Exercise and Performance Nutrition Laboratory, College of Science, Technology, and Health, St Charles, MO, USA
| | - Nicholas A. Burd
- University of Illinois Urbana-Champaign, Department of Kinesiology and Community Health, Urbana, IL, USA
| | - Stefan M. Pasiakos
- National Institutes of Health, Office of Dietary Supplements, Bethesda, MD, USA
| | - Michael J. Ormsbee
- Florida State University, Institute of Sports Sciences and Medicine, Nutrition and Integrative Physiology, Tallahassee, FL, USA
| | - Shawn M. Arent
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, Columbia, SC, USA
| | - Paul J. Arciero
- University of Pittsburgh, Department of Sports Medicine and Nutrition, Pittsburgh, PA, USA
- Skidmore College, Health and Physiological Sciences, Saratoga Springs, NY, USA
| | - Bill I. Campbell
- University of South Florida, Performance & Physique Enhancement Laboratory, Tampa, FL, USA
| | - Trisha A. VanDusseldorp
- Bonafede Health, LLC, JDS Therapeutics, Harrison, NY, USA
- Jacksonville University, Department of Health and Exercise Sciences, Jacksonville, FL, USA
| | | | - Darryn S. Willoughby
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Douglas S. Kalman
- Nova Southeastern University, Dr. Kiran C Patel College of Osteopathic Medicine, Department of Nutrition, Davie, FL, USA
| | - Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| |
Collapse
|
6
|
Spiering BA, Weakley J, Mujika I. Effects of Bed Rest on Physical Performance in Athletes: A Systematic and Narrative Review. Sports Med 2023; 53:2135-2146. [PMID: 37495758 PMCID: PMC10587175 DOI: 10.1007/s40279-023-01889-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Athletes can face scenarios in which they are confined to bed rest (e.g., due to injury or illness). Existing research in otherwise healthy individuals indicates that those entering bed rest with the greatest physical performance level might experience the greatest performance decrements, which indirectly suggests that athletes might be more susceptible to the detrimental consequences of bed rest than general populations. Therefore, a comprehensive understanding of the effects of bed rest might help guide the medical care of athletes during and following bed rest. OBJECTIVE This systematic and narrative review aimed to (1) establish the evidence for the effects of bed rest on physical performance in athletes; (2) discuss potential countermeasures to offset these negative consequences; and (3) identify the time-course of recovery following bed rest to guide return-to-sport rehabilitation. METHODS This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases were searched (SPORTDiscus, Web of Science, Scopus, and MEDLINE/PubMed) in October of 2022, and studies were included if they were peer-reviewed investigations, written in English, and investigated the effects of horizontal bed rest on changes in physical capacities and qualities in athletes (defined as Tier 3-5 participants). The reporting quality of the research was assessed using a modified version of the Downs & Black checklist. Furthermore, findings from studies that involved participants in Tiers 1-2 were presented and synthesized using a narrative approach. RESULTS Our systematic review of the literature using a rigorous criterion of 'athletes' revealed zero scientific publications. Nevertheless, as a by-product of our search, seven studies were identified that involved apparently healthy individuals who performed specific exercise training prior to bed rest. CONCLUSIONS Based on the limited evidence from studies involving non-athletes who were otherwise healthy prior to bed rest, we generally conclude that (1) bed rest rapidly (within 3 days) decreases upright endurance exercise performance, likely due to a rapid loss in plasma volume; whereas strength is reduced within 5 days, likely due to neural factors as well as muscle atrophy; (2) fluid/salt supplementation may be an effective countermeasure to protect against decrements in endurance performance during bed rest; while a broader array of potentially effective countermeasures exists, the efficacy of these countermeasures for previously exercise-trained individuals requires further study; and (3) athletes likely require at least 2-4 weeks of progressive rehabilitation following bed rest of ≤ 28 days, although the timeline of recovery might need to be extended depending on the underlying reason for bed rest (e.g., injury or illness). Despite these general conclusions from studies involving non-athletes, our primary conclusion is that substantial effort and research is still required to quantify the effects of bed rest on physical performance, identify effective countermeasures, and provide return-to-sport timelines in bona fide athletes. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION Registration ID: osf.io/d3aew; Date: October 24, 2022.
Collapse
Affiliation(s)
- Barry A Spiering
- Sports Research Laboratory, New Balance Athletics, Inc., Boston, MA, USA
| | - Jonathon Weakley
- School of Behavioural and Health Sciences, Australian Catholic University, McAuley at Banyo, Brisbane, QLD, Australia.
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, QLD, Australia.
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds, UK.
| | - Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Basque Country, Spain
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| |
Collapse
|
7
|
Marijančić V, Grubić Kezele T, Peharec S, Dragaš-Zubalj N, Pavičić Žeželj S, Starčević-Klasan G. Relationship between Physical Activity and Sedentary Behavior, Spinal Curvatures, Endurance and Balance of the Trunk Muscles-Extended Physical Health Analysis in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6938. [PMID: 37887676 PMCID: PMC10606682 DOI: 10.3390/ijerph20206938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Physical inactivity and sedentary behavior are associated with poor well-being in young people with adverse effects extending into adulthood. To date, there are many studies investigating the relationship between physical activity (PA) and posture, but there are no data on the relationship between the type and intensity of PA and sedentary behavior, their association with thoracic and lumbar spine angles, and with endurance and balance of the trunk muscles, especially in healthy young adults aged 18-25 years. Moreover, there are no data on the relationship between PA and sedentary behavior and musculoskeletal and cardiopulmonary health, as well as quality of life (QoL) and sleep that would provide a more comprehensive picture of physical health status. AIM Therefore, the aim of this cross-sectional study was to investigate the extent to which PA and sedentary behavior are associated with each other and with changes in spinal curvatures, endurance and balance of trunk muscles in an extended analysis of physical health status in young adults aged 18-25 years by additionally including measures of body composition, cardiorespiratory capacity, and QoL and sleep. METHODS A total of 82 students (58% female, 42% male) aged 18-25 years completed all required tests. Primary outcome measures included the following: PA and sedentary behavior calculated from the long form of International PA Questionnaire (IPAQ-LF), spinal curvatures measured by a Spinal Mouse® device, endurance and balance of the trunk muscles measured using trunk endurance tests and their ratio. RESULTS Overall, 50% of students were classified as minimally active and 50% as health-enhancing PA (HEPA) active. The angles of thoracic kyphosis and lumbar lordosis showed no correlation with PA or time spent sitting. However, students with the lowest PA had significantly higher scores on the trunk extensor endurance test and trunk extensor/flexor endurance test ratio, indicating imbalanced trunk muscles. Moreover, these students spent the most their time sitting. Only PA of vigorous intensity and PA during recreation, leisure, and sports significantly correlated with QoL related to physical health. QoL related to physical and psychosocial health had significantly higher scores when students spent less time sitting. In addition, we found significantly better respiratory performance and SQ at higher PA values, i.e., PA during recreation, leisure, and sport. CONCLUSIONS Our results suggest that students with low PA levels and more time spent sitting have imbalanced trunk muscles, worse respiratory function, and poorer QoL and sleep. Moreover, these findings in college students may reflect their lifestyle and suggest that more PA needs to be promoted to prevent the development of chronic diseases including musculoskeletal disorders.
Collapse
Affiliation(s)
- Verner Marijančić
- Department of Physiotherapy, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia; (V.M.); (S.P.)
| | - Tanja Grubić Kezele
- Department of Physiology, Immunology and Pathophysiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
- Department of Clinical Microbiology, Clinical Hospital Rijeka, 51000 Rijeka, Croatia
| | - Stanislav Peharec
- Department of Physiotherapy, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia; (V.M.); (S.P.)
| | - Nataša Dragaš-Zubalj
- Department of School and University Medicine, Teaching Institute of Public Health of Primorje-Gorski Kotar County, 51000 Rijeka, Croatia;
| | - Sandra Pavičić Žeželj
- Department of Health Ecology, Teaching Institute of Public Health of Primorje-Gorski Kotar County, 51000 Rijeka, Croatia;
| | - Gordana Starčević-Klasan
- Department of Basic Medical Science, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia;
| |
Collapse
|
8
|
Li Z, Qian L, Chu J, Liu Y, Maitiniyazi G, Chen Y, Cheng X, He J, Cheng L, Ou M, Wang J, Xia S. Diet Is Associated with Frailty in Lung Cancer: A Possible Role of Gut Microbiota. Nutrients 2023; 15:4298. [PMID: 37836582 PMCID: PMC10574134 DOI: 10.3390/nu15194298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
This study investigated the associations between diet and frailty in lung cancer patients and the potential role of the gut microbiota involved. We assessed dietary intake and frailty status in 231 lung cancer patients by 3-day, 24-h dietary recalls and Fried frailty criteria, respectively, and collected 50 fecal samples for next-generation sequencing. A total of 75 (32.5%) patients were frail, which might be related to significantly lower intake of energy, protein, carbohydrate, dietary fiber, niacin, leucine, some minerals, and a poorer dietary quality as indicated by the Chinese Healthy Eating Index (p < 0.05). Among these, carbohydrate (OR = 0.98; 95% CI 0.96-0.99; p = 0.010), calcium (OR = 0.99; 95% CI 0.99-1.00; p = 0.025), and selenium (OR = 1.03; 95% CI 1.00-1.06; p = 0.022) were all significantly associated with frailty. A multivariate logistic regression analysis showed that the mean risk of frailty was 0.94 times lower (95% CI 0.90-0.99; p = 0.009) among participants with higher CHEI scores. Additionally, the frail patients demonstrated significantly lower gut microbiota β diversity (p = 0.001) and higher relative abundance of Actinobacteriota (p = 0.033). Frailty in lung cancer patients might be associated with insufficient nutrients intake and a poor dietary quality through gut microbiota regulation.
Collapse
Affiliation(s)
- Ziyuan Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Lei Qian
- Department of Rehabilitation, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi 214063, China;
| | - Jianghui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214125, China;
| | - Yuan Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | | | - Yue Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Xinxin Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Jianyun He
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Lan Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Minmin Ou
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Jun Wang
- Department of Rehabilitation, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi 214063, China;
| | - Shufang Xia
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| |
Collapse
|
9
|
Pavis GF, Abdelrahman DR, Murton AJ, Wall BT, Stephens FB, Dirks ML. Short-term disuse does not affect postabsorptive or postprandial muscle protein fractional breakdown rates. J Cachexia Sarcopenia Muscle 2023; 14:2064-2075. [PMID: 37431714 PMCID: PMC10570083 DOI: 10.1002/jcsm.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/28/2023] [Accepted: 05/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The decline in postabsorptive and postprandial muscle protein fractional synthesis rates (FSR) does not quantitatively account for muscle atrophy during uncomplicated, short-term disuse, when atrophy rates are the highest. We sought to determine whether 2 days of unilateral knee immobilization affects mixed muscle protein fractional breakdown rates (FBR) during postabsorptive and simulated postprandial conditions. METHODS Twenty-three healthy, male participants (age: 22 ± 1 year; height: 179 ± 1 cm; body mass: 73.4 ± 1.5 kg; body mass index 22.8 ± 0.5 kg·m-2 ) took part in this randomized, controlled study. After 48 h of unilateral knee immobilization, primed continuous intravenous l-[15 N]-phenylalanine and l-[ring-2 H5 ]-phenylalanine infusions were used for parallel determinations of FBR and FSR, respectively, in a postabsorptive (saline infusion; FAST) or simulated postprandial state (67.5 mg·kg body mass-1 ·h-1 amino acid infusion; FED). Bilateral m. vastus lateralis biopsies from the control (CON) and immobilized (IMM) legs, and arterialized-venous blood samples, were collected throughout. RESULTS Amino acid infusion rapidly increased plasma phenylalanine (59 ± 9%), leucine (76 ± 5%), isoleucine (109 ± 7%) and valine (42 ± 4%) concentrations in FED only (all P < 0.001), which was sustained for the remainder of infusion. Serum insulin concentrations peaked at 21.8 ± 2.2 mU·L-1 at 15 min in FED only (P < 0.001) and were 60% greater in FED than FAST (P < 0.01). Immobilization did not influence FBR in either FAST (CON: 0.150 ± 0.018; IMM: 0.143 ± 0.017%·h-1 ) or FED (CON: 0.134 ± 0.012; IMM: 0.160 ± 0.018%·h-1 ; all effects P > 0.05). However, immobilization decreased FSR (P < 0.05) in both FAST (0.071 ± 0.004 vs. 0.086 ± 0.007%·h-1 ; IMM vs CON, respectively) and FED (0.066 ± 0.016 vs. 0.119 ± 0.016%·h-1 ; IMM vs CON, respectively). Consequently, immobilization decreased net muscle protein balance (P < 0.05) and to a greater extent in FED (CON: -0.012 ± 0.025; IMM: -0.095 ± 0.023%·h-1 ; P < 0.05) than FAST (CON: -0.064 ± 0.020; IMM: -0.072 ± 0.017%·h-1 ). CONCLUSIONS We conclude that merely 2 days of leg immobilization does not modulate postabsorptive and simulated postprandial muscle protein breakdown rates. Instead, under these conditions the muscle negative muscle protein balance associated with brief periods of experimental disuse is driven near exclusively by reduced basal muscle protein synthesis rates and anabolic resistance to amino acid administration.
Collapse
Affiliation(s)
- George F. Pavis
- Nutritional Physiology Research Group, Public Health & Sport Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Doaa R. Abdelrahman
- Department of SurgeryUniversity of Texas Medical BranchGalvestonTXUSA
- Sealy Center of AgingUniversity of Texas Medical BranchGalvestonTXUSA
| | - Andrew J. Murton
- Department of SurgeryUniversity of Texas Medical BranchGalvestonTXUSA
- Sealy Center of AgingUniversity of Texas Medical BranchGalvestonTXUSA
| | - Benjamin T. Wall
- Nutritional Physiology Research Group, Public Health & Sport Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Francis B. Stephens
- Nutritional Physiology Research Group, Public Health & Sport Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Marlou L. Dirks
- Nutritional Physiology Research Group, Public Health & Sport Sciences, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
- Human and Animal PhysiologyWageningen UniversityWageningenThe Netherlands
| |
Collapse
|
10
|
Ely IA, Phillips BE, Smith K, Wilkinson DJ, Piasecki M, Breen L, Larsen MS, Atherton PJ. A focus on leucine in the nutritional regulation of human skeletal muscle metabolism in ageing, exercise and unloading states. Clin Nutr 2023; 42:1849-1865. [PMID: 37625315 DOI: 10.1016/j.clnu.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/23/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Muscle protein synthesis (MPS) and muscle protein breakdown (MPB) are influenced through dietary protein intake and physical (in)activity, which it follows, regulate skeletal muscle (SKM) mass across the lifespan. Following consumption of dietary protein, the bio-availability of essential amino acids (EAA), and primarily leucine (LEU), drive a transient increase in MPS with an ensuing refractory period before the next MPS stimulation is possible (due to the "muscle full" state). At the same time, MPB is periodically constrained via reflex insulin actions. Layering exercise on top of protein intake increases the sensitivity of SKM to EAA, therefore extending the muscle full set-point (∼48 h), to permit long-term remodelling (e.g., hypertrophy). In contrast, ageing and physical inactivity are associated with a premature muscle full set-point in response to dietary protein/EAA and contractile activity. Of all the EAA, LEU is the most potent stimulator of the mechanistic target of rapamycin complex 1 (mTORC1)-signalling pathway, with the phosphorylation of mTORC1 substrates increasing ∼3-fold more than with all other EAA. Furthermore, maximal MPS stimulation is also achieved following low doses of LEU-enriched protein/EAA, negating the need for larger protein doses. As a result, LEU supplementation has been of long term interest to maximise muscle anabolism and subsequent net protein accretion, especially when in tandem with resistance exercise. This review highlights current knowledge vis-à-vis the anabolic effects of LEU supplementation in isolation, and in enriched protein/EAA sources (i.e., EAA and/or protein sources with added LEU), in the context of ageing, exercise and unloading states.
Collapse
Affiliation(s)
- Isabel A Ely
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Bethan E Phillips
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Kenneth Smith
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Daniel J Wilkinson
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Mathew Piasecki
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | - Philip J Atherton
- Centre of Metabolism, Ageing & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and Nottingham NIHR Biomedical Research Centre, Derby, DE22 3DT, UK.
| |
Collapse
|
11
|
Hu X, Ma Y, Jiang X, Tang W, Xia Y, Song P. Neurosurgical perioperative management of frail elderly patients. Biosci Trends 2023; 17:271-282. [PMID: 37635083 DOI: 10.5582/bst.2023.01208] [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] [Indexed: 08/29/2023]
Abstract
With the rapid increase in global aging, the prevalence of frailty is increasing and frailty has emerged as an emerging public health burden. Frail elderly patients suffer from reduced homeostatic reserve capacity, which is associated with a disproportionate decline in physical status after exposure to stress and an increased risk of adverse events. Frailty is closely associated with changes in the volume of the white and gray matter of the brain. Sarcopenia has been suggested to be an important component of frailty, and reductions in muscle strength and muscle mass lead to reductions in physical function and independence, which are critical factors contributing to poor prognosis. Approximately 10-32% of patients undergoing neurological surgery are frail, and the risk of frailty increases with age, which is significantly associated with the occurrence of adverse postoperative events (major complications, total duration of hospitalization, and need for discharge to a nursing facility). The postoperative mortality rate in severely frail patients is 9-11 times higher than that in non-frail individuals. Therefore, due attention must be paid to neurosurgical frailty and muscle assessment in elderly patients. Specialized interventions in the perioperative period of neurosurgery in frail elderly patients may improve their postoperative prognosis.
Collapse
Affiliation(s)
- Xiqi Hu
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine Haikou, China
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yanan Ma
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Gastroenterology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Xuemei Jiang
- Department of Gastroenterology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Wei Tang
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ying Xia
- Department of Neurosurgery, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine Haikou, China
| | - Peipei Song
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
12
|
Park JB. Effects of 12 weeks of low molecular collagen peptide supplementation on body composition in overweight Korean adults aged 50 years and older.. [DOI: 10.21203/rs.3.rs-3016558/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
After the age of 50, their muscle mass gradually declines each year, and the lost muscle is often replaced by fat mass. Insufficient protein intake after middle age further accelerates this process. Previous studies that have used collagen as a supplementation, which accounts for about 30% of the body's protein, have combined it with resistance exercise. This study investigated the effects of collagen supplementation on body composition in individuals over the age of 50 (23≤BMI≤32), while maintaining their daily activity levels constant. Participants were assigned to either the collagen group (n=42) or the placebo group(n=42). Collagen supplementation (15g of collagen) and placebo product (xanthan gum) were offered. Bioactive Collagen Peptides, which is a type of low molecular weight collagen extracted from porcine raw materials, was used. Body composition was measured by bioelectrical impedance analysis and dual-energy X-ray absorptiometry. Blood samples were taken for analysis. Physical activities and dietary intake were measured by international physical activity questionnaire and a 3-day food record, respectively. 74 participants in the collagen group (n=37) and placebo group (n=37) were used in the final analysis. Physical activity and dietary intake showed no significant difference between the two groups. The collagen group showed a significant reduction in total body fat mass compared to the placebo group, as evidenced by both BIA (P=0.021) and DEXA (P=0.041) measurements. There were no significant differences in blood measurements between the two groups. Therefore, the intake of collagen supplementation after middle age may be used for preventing age related fat mass accumulation.
Collapse
|
13
|
Rittel CM, Borg BA, Hanessian AV, Kuhar A, Fain MJ, Bime C. Longitudinal Assessment of Mobility and Self-care Among Critically Ill Older Adults. An Age-Friendly Health Systems Initiative Quality Improvement Study. Dimens Crit Care Nurs 2023; 42:234-239. [PMID: 37219478 PMCID: PMC10208591 DOI: 10.1097/dcc.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Early mobility in the intensive care unit (ICU) is vital to maintaining an older adult patient's performance of activities of daily living, functional mobility, and overall quality of life. Prior studies have shown reduced length of inpatient stay and onset of delirium in patients with early mobilization. Despite these benefits, many ICU patients are often labeled as too sick to participate in therapy and frequently do not receive physical (PT) or occupational therapy (OT) consults until they are considered floor status. This delay in therapy can negatively affect a patient's capacity to participate in his/her self-care, add to the burden on caregivers, and limit disposition options. OBJECTIVES Our goals were to perform a longitudinal assessment of mobility and self-care among older patients through their medical ICU (MICU) stays and to quantify visits by therapy services to identify areas for improvement in achieving early intervention in this at-risk population. METHOD This was a retrospective quality improvement analysis of a cohort of admissions to the MICU at a large tertiary academic medical center between November 2018 and May 2019. Admission information, PT and OT consult information, Perme Intensive Care Unit Mobility Score, and Modified Barthel Index scores were entered into a quality improvement registry. Inclusion criteria consisted of age older than 65 years and at least 2 distinct visits by PT and/or OT for evaluation. Patients without consults and patients with weekend-only MICU stays were not assessed. RESULTS There were 302 MICU patients 65 years or older admitted during the study period. Forty-four percent (132) of these patients received PT/OT consults, and among these, 32% (42) had at least 2 visits to allow comparison of objective scores. Seventy-five percent of patients had improved Perme scores (median, 9.4%; interquartile range, 2.3%-15.6%), and 58% of patients had improved Modified Barthel Index scores (median, 3%; interquartile range, -2% to 13.5%). However, 17% of potential therapy days were missed because of inadequate staffing/time, and 14% were missed because of being sedated or unable to participate. CONCLUSIONS In our cohort of patients older than 65 years, receipt of therapy in the MICU led to modest improvements in score-assessed mobility and self-care before transfer to floor. Staffing, time constraints, and patient sedation or encephalopathy appeared to interfere most with further potential benefits. In the next phase, we plan to implement strategies to increase PT/OT availability in the MICU and implement a protocol to increase identification and referral of candidates for whom early therapy can prevent loss of mobility and ability to perform self-care.
Collapse
|
14
|
Park JB. Effects of collagen supplementation on body composition and muscle strength in Korean adults aged 50 years and older.. [DOI: 10.21203/rs.3.rs-3016558/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
BACKGROUND: Insufficient protein intake can accelerate the loss of muscle mass as one ages. A decrease in muscle mass leads to an increase in fat mass, creating a vicious cycle that can result in sarcopenic obesity. Previous studies that have used collagen as a supplementation, which accounts for about 30% of the body's protein, have combined it with resistance exercise.
OBJECTIVE: This study investigated the effects of collagen supplementation on body composition in individuals over the age of 50, while maintaining their daily activity levels constant.
DESIGN: Double-blind randomized controlled trial
PARTICIPANTS: Participants were assigned to either the collagen group (n=42) or the placebo group(n=42).
MEASUREMENTS: Collagen supplementation (14g of collagen) and placebo product (xanthan gum) were offered to collagen group and placebo group respectively, once a day. Body composition was measured by bioelectrical impedance analysis and dual-energy X-ray absorptiometry. Participants were instructed to maintain their dietary intake and physical activity levels, which were evaluated through a 3-day food record analysis and an international physical activity questionnaire (IPAQ) analysis, respectively.
RESULTS: 74 participants in the collagen group (n=37) and placebo group (n=37) completed the follow-up, and there was no significant difference between the two groups in terms of physical activity levels. The collagen group showed a significant reduction in total body fat mass compared to the placebo group, as evidenced by both BIA (P=0.021) and DEXA (P=0.041) measurements. However, there was no significant difference between the two groups in terms of muscle mass.
Conclusion: From this study, the consumption of collagen supplementation is effective in reducing fat mass, which is significant in preventing sarcopenic obesity after middle age.
Collapse
|
15
|
Ye H, Yang JM, Luo Y, Long Y, Zhang JH, Zhong YB, Gao F, Wang MY. Do dietary supplements prevent loss of muscle mass and strength during muscle disuse? A systematic review and meta-analysis of randomized controlled trials. Front Nutr 2023; 10:1093988. [PMID: 37252241 PMCID: PMC10210142 DOI: 10.3389/fnut.2023.1093988] [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: 11/09/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Objective We performed a systematic review and meta-analysis of existing randomized controlled trials (RCTs) to assess whether dietary supplements can prevent loss of muscle mass and strength during muscle disuse. Methods We searched the following databases: PubMed, Embase, Cochrane, Scopus, Web of Science, and CINAHL for RCTs assessing the effect of dietary supplements on disuse muscular atrophy without language and time restrictions. Muscle strength and leg lean mass were used as the primary outcome indicators. Muscle cross-sectional area (CSA), muscle fiber type distribution, peak aerobic capacity and muscle volume were used as secondary outcome indicators. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Heterogeneity was tested using the I2 statistic index. Mean and standard deviation of outcome indicators were extracted from the intervention and control groups to calculate effect sizes and 95% confidence intervals, with the significance level set at P < 0.05. Results Twenty RCTs were included with a total of 339 subjects. The results showed that dietary supplements had no effect on muscle strength, CSA, muscle fiber type distribution, peak aerobic capacity or muscle volume. But dietary supplements have a protective effect on the lean mass of the legs. Conclusion Dietary supplements can improve lean leg mass, but did not show a tendency to have an effect on muscle strength, CSA, muscle fiber type distribution, peak aerobic capacity or muscle volume during muscle disuse. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42022370230.
Collapse
Affiliation(s)
- Hua Ye
- Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Jia-Ming Yang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Yun Luo
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Yi Long
- Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Jia-Hong Zhang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
| | - Yan-Biao Zhong
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
- Ganzhou Intelligent Rehabilitation Technology Innovation Center, Ganzhou, Jiangxi, China
| | - Feng Gao
- School of Rehabilitation, Capital Medical University, Beijing, China
- Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Mao-Yuan Wang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi, China
- Ganzhou Key Laboratory of Rehabilitation Medicine, Ganzhou City, Jiangxi, China
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Hardy EJO, Inns TB, Hatt J, Doleman B, Bass JJ, Atherton PJ, Lund JN, Phillips BE. The time course of disuse muscle atrophy of the lower limb in health and disease. J Cachexia Sarcopenia Muscle 2022; 13:2616-2629. [PMID: 36104842 PMCID: PMC9745468 DOI: 10.1002/jcsm.13067] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 07/01/2022] [Accepted: 07/20/2022] [Indexed: 12/15/2022] Open
Abstract
Short, intermittent episodes of disuse muscle atrophy (DMA) may have negative impact on age related muscle loss. There is evidence of variability in rate of DMA between muscles and over the duration of immobilization. As yet, this is poorly characterized. This review aims to establish and compare the time-course of DMA in immobilized human lower limb muscles in both healthy and critically ill individuals, exploring evidence for an acute phase of DMA and differential rates of atrophy between and muscle groups. MEDLINE, Embase, CINHAL and CENTRAL databases were searched from inception to April 2021 for any study of human lower limb immobilization reporting muscle volume, cross-sectional area (CSA), architecture or lean leg mass over multiple post-immobilization timepoints. Risk of bias was assessed using ROBINS-I. Where possible meta-analysis was performed using a DerSimonian and Laird random effects model with effect sizes reported as mean differences (MD) with 95% confidence intervals (95% CI) at various time-points and a narrative review when meta-analysis was not possible. Twenty-nine studies were included, 12 in healthy volunteers (total n = 140), 18 in patients on an Intensive Therapy Unit (ITU) (total n = 516) and 3 in patients with ankle fracture (total n = 39). The majority of included studies are at moderate risk of bias. Rate of quadriceps atrophy over the first 14 days was significantly greater in the ITU patients (MD -1.01 95% CI -1.32, -0.69), than healthy cohorts (MD -0.12 95% CI -0.49, 0.24) (P < 0.001). Rates of atrophy appeared to vary between muscle groups (greatest in triceps surae (-11.2% day 28), followed by quadriceps (-9.2% day 28), then hamstrings (-6.5% day 28), then foot dorsiflexors (-3.2% day 28)). Rates of atrophy appear to decrease over time in healthy quadriceps (-6.5% day 14 vs. -9.1% day 28) and triceps surae (-7.8% day 14 vs. -11.2% day 28), and ITU quadriceps (-13.2% day 7 vs. -28.2% day 14). There appears to be variability in the rate of DMA between muscle groups, and more rapid atrophy during the earliest period of immobilization, indicating different mechanisms being dominant at different timepoints. Rates of atrophy are greater amongst critically unwell patients. Overall evidence is limited, and existing data has wide variability in the measures reported. Further work is required to fully characterize the time course of DMA in both health and disease.
Collapse
Affiliation(s)
- Edward J O Hardy
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Thomas B Inns
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jacob Hatt
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Brett Doleman
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,Department of Anaesthetics, Royal Derby Hospital, Derby, UK
| | - Joseph J Bass
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Philip J Atherton
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jonathan N Lund
- Department of General Surgery, Royal Derby Hospital, Derby, UK.,Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
| | - Bethan E Phillips
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.,MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research (CMAR) and NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| |
Collapse
|
18
|
Vinci P, Di Girolamo FG, Mangogna A, Mearelli F, Nunnari A, Fiotti N, Giordano M, Bareille MP, Biolo G. Early lean mass sparing effect of high-protein diet with excess leucine during long-term bed rest in women. Front Nutr 2022; 9:976818. [PMID: 36505255 PMCID: PMC9729546 DOI: 10.3389/fnut.2022.976818] [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: 06/23/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
Muscle inactivity leads to muscle atrophy. Leucine is known to inhibit protein degradation and to promote protein synthesis in skeletal muscle. We tested the ability of a high-protein diet enriched with branched-chain amino acids (BCAAs) to prevent muscle atrophy during long-term bed rest (BR). We determined body composition (using dual energy x-ray absorptiometry) at baseline and every 2-weeks during 60 days of BR in 16 healthy young women. Nitrogen (N) balance was assessed daily as the difference between N intake and N urinary excretion. The subjects were randomized into two groups: one received a conventional diet (1.1 ± 0.03 g protein/kg, 4.9 ± 0.3 g leucine per day) and the other a high protein, BCAA-enriched regimen (1.6 ± 0.03 g protein-amino acid/kg, 11.4 ± 0.6 g leucine per day). There were significant BR and BR × diet interaction effects on changes in lean body mass (LBM) and N balance throughout the experimental period (repeated measures ANCOVA). During the first 15 days of BR, lean mass decreased by 4.1 ± 0.9 and 2.4 ± 2.1% (p < 0.05) in the conventional and high protein-BCAA diet groups, respectively, while at the end of the 60-day BR, LBM decreased similarly in the two groups by 7.4 ± 0.7 and 6.8 ± 2.4%. During the first 15 days of BR, mean N balance was 2.5 times greater (p < 0.05) in subjects on the high protein-BCAA diet than in those on the conventional diet, while we did not find significant differences during the following time intervals. In conclusion, during 60 days of BR in females, a high protein-BCAA diet was associated with an early protein-LBM sparing effect, which ceased in the medium and long term.
Collapse
Affiliation(s)
- Pierandrea Vinci
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Filippo Giorgio Di Girolamo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy,Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Alessandro Mangogna
- Institute for Maternal and Child Health, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofolo, Trieste, Italy
| | - Filippo Mearelli
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Alessio Nunnari
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Nicola Fiotti
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Mauro Giordano
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | | | - Gianni Biolo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy,*Correspondence: Gianni Biolo,
| |
Collapse
|
19
|
Daniele A, Lucas SJE, Rendeiro C. Detrimental effects of physical inactivity on peripheral and brain vasculature in humans: Insights into mechanisms, long-term health consequences and protective strategies. Front Physiol 2022; 13:998380. [PMID: 36237532 PMCID: PMC9553009 DOI: 10.3389/fphys.2022.998380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
The growing prevalence of physical inactivity in the population highlights the urgent need for a more comprehensive understanding of how sedentary behaviour affects health, the mechanisms involved and what strategies are effective in counteracting its negative effects. Physical inactivity is an independent risk factor for different pathologies including atherosclerosis, hypertension and cardiovascular disease. It is known to progressively lead to reduced life expectancy and quality of life, and it is the fourth leading risk factor for mortality worldwide. Recent evidence indicates that uninterrupted prolonged sitting and short-term inactivity periods impair endothelial function (measured by flow-mediated dilation) and induce arterial structural alterations, predominantly in the lower body vasculature. Similar effects may occur in the cerebral vasculature, with recent evidence showing impairments in cerebral blood flow following prolonged sitting. The precise molecular and physiological mechanisms underlying inactivity-induced vascular dysfunction in humans are yet to be fully established, although evidence to date indicates that it may involve modulation of shear stress, inflammatory and vascular biomarkers. Despite the steady increase in sedentarism in our societies, only a few intervention strategies have been investigated for their efficacy in counteracting the associated vascular impairments. The current review provides a comprehensive overview of the evidence linking acute and short-term physical inactivity to detrimental effects on peripheral, central and cerebral vascular health in humans. We further examine the underlying molecular and physiological mechanisms and attempt to link these to long-term consequences for cardiovascular health. Finally, we summarize and discuss the efficacy of lifestyle interventions in offsetting the negative consequences of physical inactivity.
Collapse
Affiliation(s)
- Alessio Daniele
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Catarina Rendeiro,
| |
Collapse
|
20
|
Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals. Clin Nutr 2022; 41:2244-2263. [DOI: 10.1016/j.clnu.2022.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 11/03/2022]
|
21
|
Beaudry KM, Binet ER, Collao N, De Lisio M. Nutritional Regulation of Muscle Stem Cells in Exercise and Disease: The Role of Protein and Amino Acid Dietary Supplementation. Front Physiol 2022; 13:915390. [PMID: 35874517 PMCID: PMC9301335 DOI: 10.3389/fphys.2022.915390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Human skeletal muscle is a remarkedly plastic tissue that has a high capacity to adapt in response to various stimuli. These adaptations are due in part to the function of muscle-resident stem/progenitor cells. Skeletal muscle regeneration and adaptation is facilitated by the activation and expansion of muscle stem cells (MuSCs). MuSC fate is regulated by signals released from cells in their niche, such as fibro-adipogenic progenitors (FAPs), as well as a variety of non-cellular niche components. Sufficient dietary protein consumption is critical for maximizing skeletal muscle adaptation to exercise and maintaining skeletal muscle in disease; however, the role of dietary protein in altering MuSC and FAP responses to exercise in healthy populations and skeletal muscle disease states requires more research. The present review provides an overview of this emerging field and suggestions for future directions. The current literature suggests that in response to resistance exercise, protein supplementation has been shown to increase MuSC content and the MuSC response to acute exercise. Similarly, protein supplementation augments the increase in MuSC content following resistance training. Endurance exercise, conversely, is an area of research that is sparse with respect to the interaction of protein supplementation and exercise on muscle stem/progenitor cell fate. Initial evidence suggests that protein supplementation augments the early myogenic response to acute endurance exercise but does not enhance the MuSC response to endurance training. Resistance training increases the number of proliferating FAPs with no additional effect of protein supplementation. Future research should continue to focus on the nutritional regulation of skeletal muscle stem/progenitor cell fate paired with studies examining the effects of exercise on a variety of human populations.
Collapse
Affiliation(s)
| | | | - Nicolás Collao
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Michael De Lisio
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Michael De Lisio,
| |
Collapse
|
22
|
Association between protein intake and lean body mass in a group of Masters Athletes. J Nutr Sci 2022; 11:e30. [PMID: 35573464 PMCID: PMC9066312 DOI: 10.1017/jns.2022.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/30/2022] Open
Abstract
Recommendations for protein intake are based on total body weight; however, these recommendations do not consider lean body mass (LBM). The purpose of the present study was to identify the average protein intake in g/kg LBM in a group of healthy Masters Athletes (≥26 years of age, exercising ≥2 d/week). Data were obtained from a cross-sectional study. Body weight (kg), height (cm) and LBM via dual-energy X-ray absorptiometry were measured. Dietary intake was measured using a 2005 Block Food Frequency Questionnaire. The average energy intake, the percent energy from protein and the average protein intake in g/kg LBM were calculated. Differences between protein intake and the US Recommended Dietary Allowance (US RDA) (0⋅8 g/kg body weight) were determined. Alpha levels were set a priori to P < 0⋅05. A total of 176 participants (94 women, 82 men; 39 ± 11 years of age; body mass index: 24⋅6 ± 3⋅4 kg/m2) were analysed. The average energy intake, the percent protein energy and the average protein intake were 7996⋅9 ± 110⋅9 kilojoules (kJ)/d (1,910⋅4 ± 26⋅5 kcal), 15⋅5 ± 2⋅6 % and 1⋅43 ± 0⋅53 g/kg LBM, respectively. No differences existed between women and men for protein intake/kg LBM. Both sexes had significantly higher protein intakes than the US RDA (P < 0⋅001). We identified the average protein intake (g/kg LBM) in healthy Masters Athletes that may contribute to evolving perspectives on the determination of protein needs. The present study helps establish the relationship between protein intake and LBM so that we may further increase our accuracy when developing future protein recommendations.
Collapse
|
23
|
Nunes EA, Stokes T, McKendry J, Currier BS, Phillips SM. Disuse-induced skeletal muscle atrophy in disease and non-disease states in humans: mechanisms, prevention, and recovery strategies. Am J Physiol Cell Physiol 2022; 322:C1068-C1084. [PMID: 35476500 DOI: 10.1152/ajpcell.00425.2021] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Decreased skeletal muscle contractile activity (disuse) or unloading leads to muscle mass loss, also known as muscle atrophy. The balance between muscle protein synthesis (MPS) and muscle protein breakdown (MPB) is the primary determinant of skeletal muscle mass. A reduced mechanical load on skeletal muscle is one of the main external factors leading to muscle atrophy. However, endocrine and inflammatory factors can act synergistically in catabolic states, amplifying the atrophy process and accelerating its progression. Additionally, older individuals display aging-induced anabolic resistance, which can predispose this population to more pronounced effects when exposed to periods of reduced physical activity or mechanical unloading. Different cellular mechanisms contribute to the regulation of muscle protein balance during skeletal muscle atrophy. This review summarizes the effects of muscle disuse on muscle protein balance and the molecular mechanisms involved in muscle atrophy in the absence or presence of disease. Finally, a discussion of the current literature describing efficient strategies to prevent or improve the recovery from muscle atrophy is also presented.
Collapse
Affiliation(s)
- Everson A Nunes
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada.,Laboratory of Investigation of Chronic Diseases, Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Tanner Stokes
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - James McKendry
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Brad S Currier
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
24
|
Association between dietary intake of branched-chain amino acids and sarcopenia and its components: a cross-sectional study. Sci Rep 2022; 12:5666. [PMID: 35383191 PMCID: PMC8983668 DOI: 10.1038/s41598-022-07605-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 02/10/2022] [Indexed: 01/06/2023] Open
Abstract
There is no previous study that investigated the association between dietary intake of total and individual branched-chain amino acids (BCAAs) and odds of sarcopenia. The present study aimed to examine the association between dietary intake of BCAAs and sarcopenia and its components among Iranian adults. The data for this cross-sectional study was collected in 2011 among 300 older people (150 men and 150 female) with aged ≥ 55 years. We used a Block-format 117-item food frequency questionnaire (FFQ) to evaluate usual dietary intakes. BCAAs intake was calculated by summing up the amount of valine, leucine and isoleucine intake from all food items in the FFQ. The European Sarcopenia Working Group (EWGSOP) definition was used to determine sarcopenia and its components. Mean age of study participants was 66.8 years and 51% were female. Average intake of BCAAs was 12.8 ± 5.1 g/day. Prevalence of sarcopenia and its components was not significantly different across tertile categories of total and individual BCAAs intake. We found no significant association between total BCAAs intake and odds of sarcopenia (OR for comparison of extreme tertiles 0.48, 95% CI 0.19–1.19, P-trend = 0.10) and its components (For muscle mass 0.83, 95% CI 0.39–1.77, P-trend = 0.63; for hand grip strength 0.81, 95% CI 0.37–1.75, P-trend: 0.59; for gait speed 1.22, 95% CI 0.58–2.57, P-trend = 0.56). After adjusting for potential confounders, this non-significant relationship did not alter. In addition, we did not find any significant association between individual BCAAs intake and odds of sarcopenia or its components. We found no significant association between dietary intakes of BCAAs and sarcopenia in crude model (OR 0.60; 95% CI 0.29–1.26). After controlling for several potential confounders, the result remained insignificant (OR 0.48; 95% CI 0.19–1.19). In this cross-sectional study, no significant association was observed between dietary intakes of total and individual BCAAs and odds of sarcopenia and its components.
Collapse
|
25
|
The Inverse Association of Sarcopenia and Protein-Source Food and Vegetable Intakes in the Korean Elderly: The Korean Frailty and Aging Cohort Study. Nutrients 2022; 14:nu14071375. [PMID: 35405986 PMCID: PMC9002384 DOI: 10.3390/nu14071375] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/11/2022] Open
Abstract
The aging population contributes to increasing economic and social burden worldwide. Sarcopenia, an age-related degenerative disease and progressive disorder, is characterized by a reduction in skeletal muscle mass and function. This study aims to assess the association between dietary factors and sarcopenia in the Korean elderly using nationwide data. A total of 801 subjects aged 70–84 years were included in this analysis. Subjects were divided into two groups: sarcopenic and nonsarcopenic groups according to the sarcopenia criteria established by the Asian Working Group for Sarcopenia. Nutrient and food intakes were assessed using a 24-h recall method. Logistic regression analysis was used to assess the association between sarcopenia and food group and nutrient intakes. In the multivariable models, the meat/fish/egg/legume food group, vegetable group, and total food intake were inversely associated with the prevalence of sarcopenia. The high intakes of energy, carbohydrate, protein, fiber, zinc, carotene, and vitamin B6 were associated with the lower prevalence of sarcopenia. Therefore, consuming sufficient nutrients through various protein source foods and vegetables will help prevent sarcopenia in the Korean elderly.
Collapse
|
26
|
Trinity JD, Drummond MJ, Fermoyle CC, McKenzie AI, Supiano MA, Richardson RS. Cardiovasomobility: an integrative understanding of how disuse impacts cardiovascular and skeletal muscle health. J Appl Physiol (1985) 2022; 132:835-861. [PMID: 35112929 PMCID: PMC8934676 DOI: 10.1152/japplphysiol.00607.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Cardiovasomobility is a novel concept that encompasses the integration of cardiovascular and skeletal muscle function in health and disease with critical modification by physical activity, or lack thereof. Compelling evidence indicates that physical activity improves health while a sedentary, or inactive, lifestyle accelerates cardiovascular and skeletal muscle dysfunction and hastens disease progression. Identifying causative factors for vascular and skeletal muscle dysfunction, especially in humans, has proven difficult due to the limitations associated with cross-sectional investigations. Therefore, experimental models of physical inactivity and disuse, which mimic hospitalization, injury, and illness, provide important insight into the mechanisms and consequences of vascular and skeletal muscle dysfunction. This review provides an overview of the experimental models of disuse and inactivity and focuses on the integrated responses of the vasculature and skeletal muscle in response to disuse/inactivity. The time course and magnitude of dysfunction evoked by various models of disuse/inactivity are discussed in detail, and evidence in support of the critical roles of mitochondrial function and oxidative stress are presented. Lastly, strategies aimed at preserving vascular and skeletal muscle dysfunction during disuse/inactivity are reviewed. Within the context of cardiovasomobility, experimental manipulation of physical activity provides valuable insight into the mechanisms responsible for vascular and skeletal muscle dysfunction that limit mobility, degrade quality of life, and hasten the onset of disease.
Collapse
Affiliation(s)
- Joel D Trinity
- Salt Lake City Veteran Affairs Medical Center Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Micah J Drummond
- Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.,Department of Physical Therapy, University of Utah, Salt Lake City, Utah
| | - Caitlin C Fermoyle
- Salt Lake City Veteran Affairs Medical Center Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah
| | - Alec I McKenzie
- Salt Lake City Veteran Affairs Medical Center Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah
| | - Mark A Supiano
- Salt Lake City Veteran Affairs Medical Center Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah
| | - Russell S Richardson
- Salt Lake City Veteran Affairs Medical Center Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah.,Department of Internal Medicine, Division of Geriatrics, University of Utah, Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| |
Collapse
|
27
|
Eugenio FA, van Milgen J, Duperray J, Sergheraert R, Le Floc'h N. Feeding intact proteins, peptides, or free amino acids to monogastric farm animals. Amino Acids 2022; 54:157-168. [PMID: 35106634 DOI: 10.1007/s00726-021-03118-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/09/2021] [Indexed: 12/13/2022]
Abstract
For terrestrial farm animals, intact protein sources like soybean meal have been the main ingredients providing the required amino acids (AA) to sustain life. However, in recent years, the availability of hydrolysed protein sources and free AA has led to the use of other forms of AA to feed farm animals. The advent of using these new forms is especially important to reduce the negative environmental impacts of animal production because these new forms allow reducing the dietary crude protein content and provide more digestible materials. However, the form in which dietary AA are provided can have an effect on the dynamics of nutrient availability for protein deposition and tissue growth including the efficiency of nutrient utilization. In this literature review, the use of different forms of AA in animal diets is explored, and their differences in digestion and absorption rates are focused on. These differences affect the postprandial plasma appearance of AA, which can have metabolic consequences, like greater insulin response when free AA or hydrolysates instead of intact proteins are fed, which can have a profound effect on metabolism and growth performance. Nevertheless, the use and application of the different AA forms in animal diets are important to achieve a more sustainable and efficient animal production system in the future, as they allow for a more precise diet formulation and reduced negative environmental impact. It is, therefore, important to differentiate the physiological and metabolic effects of different forms of AA to maximize their nutritional value in animal diets.
Collapse
Affiliation(s)
- F A Eugenio
- PEGASE, INRAE, Institut Agro, 35590, Saint Gilles, France
- BCF Life Sciences, Boisel, 56140, Pleucadeuc, France
| | - J van Milgen
- PEGASE, INRAE, Institut Agro, 35590, Saint Gilles, France
| | - J Duperray
- BCF Life Sciences, Boisel, 56140, Pleucadeuc, France
| | - R Sergheraert
- BCF Life Sciences, Boisel, 56140, Pleucadeuc, France
| | - N Le Floc'h
- PEGASE, INRAE, Institut Agro, 35590, Saint Gilles, France.
| |
Collapse
|
28
|
Effect of High-Protein Diets on Integrated Myofibrillar Protein Synthesis before Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Pilot Study. Nutrients 2022; 14:nu14030563. [PMID: 35276922 PMCID: PMC8840691 DOI: 10.3390/nu14030563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Increasing dietary protein intake during periods of muscle disuse may mitigate the resulting decline in muscle protein synthesis (MPS). The purpose of this randomized pilot study was to determine the effect of increased protein intake during periods of disuse before anterior cruciate ligament (ACL) reconstruction on myofibrillar protein synthesis (MyoPS), and proteolytic and myogenic gene expression. Six healthy, young males (30 ± 9 y) were randomized to consume a high-quality, optimal protein diet (OP; 1.9 g·kg−1·d−1) or adequate protein diet (AP; 1.2 g·kg−1·d−1) for two weeks before ACL reconstruction. Muscle biopsies collected during surgery were used to measure integrated MyoPS during the intervention (via daily deuterium oxide ingestion) and gene expression at the time of surgery. MyoPS tended to be higher, with a large effect size in OP compared to AP (0.71 ± 0.1 and 0.54 ± 0.1%·d−1; p = 0.076; g = 1.56). Markers of proteolysis and myogenesis were not different between groups (p > 0.05); however, participants with greater MyoPS exhibited lower levels of MuRF1 gene expression compared to those with lower MyoPS (r = −0.82, p = 0.047). The data from this pilot study reveal a potential stimulatory effect of increased daily protein intake on MyoPS during injury-mediated disuse conditions that warrants further investigation.
Collapse
|
29
|
Nutritional Considerations for Injury Prevention and Recovery in Combat Sports. Nutrients 2021; 14:nu14010053. [PMID: 35010929 PMCID: PMC8746600 DOI: 10.3390/nu14010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.
Collapse
|
30
|
Strategies to Prevent Sarcopenia in the Aging Process: Role of Protein Intake and Exercise. Nutrients 2021; 14:nu14010052. [PMID: 35010928 PMCID: PMC8746908 DOI: 10.3390/nu14010052] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 12/24/2022] Open
Abstract
Sarcopenia is one of the main issues associated with the process of aging. Characterized by muscle mass loss, it is triggered by several conditions, including sedentary habits and negative net protein balance. According to World Health Organization, it is expected a 38% increase in older individuals by 2025. Therefore, it is noteworthy to establish recommendations to prevent sarcopenia and several events and comorbidities associated with this health issue condition. In this review, we discuss the role of these factors, prevention strategies, and recommendations, with a focus on protein intake and exercise.
Collapse
|
31
|
Shiau MH, Lee MC, Lin FL, Hurng BS, Yeh CJ. Cross-Sectional, Short-, Medium-, and Long-Term Effects of Dietary Pattern on Frailty in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189717. [PMID: 34574637 PMCID: PMC8470872 DOI: 10.3390/ijerph18189717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 12/31/2022]
Abstract
This study examined the association between dietary patterns and the development of frailty during 4-, 8-, 12-year follow-up periods in the population-based Taiwan Study. We used the data of an elderly population aged 53 years and over (n = 3486) from four waves of the Taiwan Longitudinal Study on Aging. Frailty was identified by using the modified Fried criteria and the values were summed to derive a frailty score. We applied reduced rank regression to determine dietary patterns, which were divided into tertiles (healthy, general, and unhealthy dietary pattern). We used multinomial logistic regression models to assess the association between dietary patterns and the risk of frailty. The healthy dietary pattern was characterized by a higher intake of antioxidant drinks (tea), energy-rich foods (carbohydrates, e.g., rice, noodles), protein-rich foods (fish, meat, seafood, and eggs), and phytonutrient-rich foods (fruit and dark green vegetables). Compared with the healthy pattern, the unhealthy dietary pattern showed significant cross-sectional, short-term, medium-term, and long-term associations with a higher prevalence of frailty (odds ratios (OR) 2.74; 95% confidence interval (CI) 1.94–3.87, OR 2.55; 95% CI 1.67–3.88, OR 1.66; 95% CI 1.07–2.57, and OR 2.35; 95% CI 1.27–4.34, respectively). Our findings support recommendations to increase the intake of antioxidant drinks, energy-rich foods, protein-rich foods, and phytonutrient-rich foods, which were associated with a non-frail status. This healthy dietary pattern can help prevent frailty over time in elderly people.
Collapse
Affiliation(s)
- Mei-Huey Shiau
- Health Promotion Administration, Ministry of Health and Welfare, Taipei 103205, Taiwan;
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan; (F.-L.L.); (B.-S.H.)
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 40343, Taiwan;
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
| | - Fang-Ling Lin
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan; (F.-L.L.); (B.-S.H.)
| | - Baai-Shyun Hurng
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan; (F.-L.L.); (B.-S.H.)
| | - Chih-Jung Yeh
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan; (F.-L.L.); (B.-S.H.)
- Correspondence: ; Tel.: +886-24730022 (ext. 11837)
| |
Collapse
|
32
|
Zemková E, Cepková A, Muyor JM. The association of reactive balance control and spinal curvature under lumbar muscle fatigue. PeerJ 2021; 9:e11969. [PMID: 34434668 PMCID: PMC8362667 DOI: 10.7717/peerj.11969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/23/2021] [Indexed: 11/30/2022] Open
Abstract
Background Although low back fatigue is an important intervening factor for physical functioning among sedentary people, little is known about its possible significance in relation to the spinal posture and compensatory postural responses to unpredictable stimuli. This study investigates the effect of lumbar muscle fatigue on spinal curvature and reactive balance control in response to externally induced perturbations. Methods A group of 38 young sedentary individuals underwent a perturbation-based balance test by applying a 2 kg load release. Sagittal spinal curvature and pelvic tilt was measured in both a normal and Matthiass standing posture both with and without a hand-held 2 kg load, and before and after the Sørensen fatigue test. Results Both the peak anterior and peak posterior center of pressure (CoP) displacements and the corresponding time to peak anterior and peak posterior CoP displacements significantly increased after the Sørensen fatigue test (all at p < 0.001). A lumbar muscle fatigue led to a decrease of the lumbar lordosis in the Matthiass posture while holding a 2 kg load in front of the body when compared to pre-fatigue conditions both without a load (p = 0.011, d = 0.35) and with a 2 kg load (p = 0.000, d = 0.51). Also the sacral inclination in the Matthiass posture with a 2 kg additional load significantly decreased under fatigue when compared to all postures in pre-fatigue conditions (p = 0.01, d = 0.48). Contrary to pre-fatigue conditions, variables of the perturbation-based balance test were closely associated with those of lumbar curvature while standing in the Matthiass posture with a 2 kg additional load after the Sørensen fatigue test (r values in range from −0.520 to −0.631, all at p < 0.05). Conclusion These findings indicate that lumbar muscle fatigue causes changes in the lumbar spinal curvature and this is functionally relevant in explaining the impaired ability to maintain balance after externally induced perturbations. This emphasizes the importance for assessing both spinal posture and reactive balance control under fatigue in order to reveal their interrelations in young sedentary adults and predict any significant deterioration in later years.
Collapse
Affiliation(s)
- Erika Zemková
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University Bratislava, Bratislava, Slovakia.,Sports Technology Institute, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Bratislava, Slovakia
| | - Alena Cepková
- Centre of Languages and Sports, Faculty of Mechanical Engineering, Slovak University of Technology, Bratislava, Slovakia
| | - José M Muyor
- Laboratory of Kinesiology, Biomechanics and Ergonomics, Health Research Centre, University of Almería, Almería, Spain
| |
Collapse
|
33
|
Juhl OJ, Buettmann EG, Friedman MA, DeNapoli RC, Hoppock GA, Donahue HJ. Update on the effects of microgravity on the musculoskeletal system. NPJ Microgravity 2021; 7:28. [PMID: 34301942 PMCID: PMC8302614 DOI: 10.1038/s41526-021-00158-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
With the reignited push for manned spaceflight and the development of companies focused on commercializing spaceflight, increased human ventures into space are inevitable. However, this venture would not be without risk. The lower gravitational force, known as microgravity, that would be experienced during spaceflight significantly disrupts many physiological systems. One of the most notably affected systems is the musculoskeletal system, where exposure to microgravity causes both bone and skeletal muscle loss, both of which have significant clinical implications. In this review, we focus on recent advancements in our understanding of how exposure to microgravity affects the musculoskeletal system. We will focus on the catabolic effects microgravity exposure has on both bone and skeletal muscle cells, as well as their respective progenitor stem cells. Additionally, we report on the mechanisms that underlie bone and muscle tissue loss resulting from exposure to microgravity and then discuss current countermeasures being evaluated. We reveal the gaps in the current knowledge and expound upon how current research is filling these gaps while also identifying new avenues of study as we continue to pursue manned spaceflight.
Collapse
Affiliation(s)
- Otto J Juhl
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Evan G Buettmann
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael A Friedman
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Rachel C DeNapoli
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabriel A Hoppock
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Henry J Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
34
|
Hirsch KR, Wolfe RR, Ferrando AA. Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery. Nutrients 2021; 13:nu13051675. [PMID: 34063333 PMCID: PMC8156786 DOI: 10.3390/nu13051675] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022] Open
Abstract
Nutritional status is a strong predictor of postoperative outcomes and is recognized as an important component of surgical recovery programs. Adequate nutritional consumption is essential for addressing the surgical stress response and mitigating the loss of muscle mass, strength, and functionality. Especially in older patients, inadequate protein can lead to significant muscle atrophy, leading to a loss of independence and increased mortality risk. Current nutritional recommendations for surgery primarily focus on screening and prevention of malnutrition, pre-surgical fasting protocols, and combating post-surgical insulin resistance, while recommendations regarding macronutrient composition and timing around surgery are less established. The goal of this review is to highlight oral nutrition strategies that can be implemented leading up to and following major surgery to minimize atrophy and the resultant loss of functionality. The role of carbohydrate and especially protein/essential amino acids in combating the surgical stress cascade and supporting recovery are discussed. Practical considerations for nutrient timing to maximize oral nutritional intake, especially during the immediate pre- and post- surgical periods, are also be discussed.
Collapse
|
35
|
Arentson-Lantz EJ, Kilroe S. Practical applications of whey protein in supporting skeletal muscle maintenance, recovery, and reconditioning. J Anim Sci 2021; 99:6149525. [PMID: 33630061 DOI: 10.1093/jas/skab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
Like humans, many companion animals experience a gradual decline in skeletal muscle mass and function during later years of life. This process, analogous to sarcopenia in humans, increases risk for morbidity and mortality. Periods of reduced activity due to injury or illness, followed by an incomplete recovery, can accelerate the loss of muscle mass and function. Emerging research from human studies suggests that moderate amounts of high-quality protein may attenuate the loss of muscle, while preventing accumulation of fat during periods of disuse. Whey protein is a consumer-friendly and readily available source of high-quality protein. It supports skeletal muscle maintenance during normal aging and may also provide anabolic support during periods of illness, injury, and recovery. Ongoing research efforts continue to refine our understanding of how protein quality, quantity, and meal timing can be optimized to support retention of muscle mass and function during aging. Priority research areas include supplementation with high-quality protein during illness/injury to stimulate anabolism by targeting molecular mechanisms that regulate skeletal muscle metabolism.
Collapse
Affiliation(s)
- Emily J Arentson-Lantz
- Department of Nutrition and Metabolism, Center for Recovery, Physical Activity and Nutrition, University of Texas Medical Branch, Galveston, TX 77555-1028, USA
| | - Sean Kilroe
- Department of Nutrition and Metabolism, Center for Recovery, Physical Activity and Nutrition, University of Texas Medical Branch, Galveston, TX 77555-1028, USA.,Department of Sports and Health Sciences, College of Life and Environmental Science, University of Exeter, Exeter, UK
| |
Collapse
|
36
|
IJmker-Hemink V, Moolhuijzen N, Wanten G, van den Berg M. High Frequency Protein-Rich Meal Service to Promote Protein Distribution to Stimulate Muscle Function in Preoperative Patients. Nutrients 2021; 13:nu13041232. [PMID: 33917987 PMCID: PMC8068324 DOI: 10.3390/nu13041232] [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: 03/15/2021] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 12/02/2022] Open
Abstract
Apart from meeting daily protein requirements, an even distribution of protein consumption is proposed instrumental to optimizing protein muscle synthesis and preserving muscle mass. We assessed whether a high frequency protein-rich meal service for three weeks contributes to an even daily protein distribution and a higher muscle function in pre-operative patients. This study was a post-hoc analysis of a randomized controlled trial (RCT) in 102 patients. The intervention comprised six protein-rich dishes per day. Daily protein distribution was evaluated by a three-day food diary and muscle function by handgrip strength before and after the intervention. Protein intake was significantly higher in the intervention group at the in-between meals in the morning (7 ± 2 grams (g) vs. 2 ± 3 g, p < 0.05) and afternoon (8 ± 3 g vs. 2 ± 3 g, p < 0.05). Participants who consumed 20 g protein for at least two meals had a significantly higher handgrip strength compared to participants who did not. A high frequency protein-rich meal service is an effective strategy to optimize an even protein distribution across meals throughout the day. Home-delivered meal services can be optimized by offering more protein-rich options such as dairy or protein supplementation at breakfast, lunch and prior to sleep for a better protein distribution.
Collapse
Affiliation(s)
- Vera IJmker-Hemink
- Department of Gastroenterology and Hepatology, Dietetics and Intestinal Failure, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands;
- Correspondence: ; Tel.: +31-243-614-760
| | - Nicky Moolhuijzen
- Department of Gastroenterology and Hepatology, Dietetics and Intestinal Failure, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands;
| | - Geert Wanten
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (G.W.); (M.v.d.B.)
| | - Manon van den Berg
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands; (G.W.); (M.v.d.B.)
| |
Collapse
|
37
|
Kilroe SP, Fulford J, Jackman S, Holwerda A, Gijsen A, van Loon L, Wall BT. Dietary protein intake does not modulate daily myofibrillar protein synthesis rates or loss of muscle mass and function during short-term immobilization in young men: a randomized controlled trial. Am J Clin Nutr 2021; 113:548-561. [PMID: 32469388 DOI: 10.1093/ajcn/nqaa136] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/12/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Short-term (<1 wk) muscle disuse lowers daily myofibrillar protein synthesis (MyoPS) rates resulting in muscle mass loss. The understanding of how daily dietary protein intake influences such muscle deconditioning requires further investigation. OBJECTIVES To assess the influence of graded dietary protein intakes on daily MyoPS rates and the loss of muscle mass during 3 d of disuse. METHODS Thirty-three healthy young men (aged 22 ± 1 y; BMI = 23 ± 1 kg/m2) initially consumed the same standardized diet for 5 d, providing 1.6 g protein/kg body mass/d. Thereafter, participants underwent a 3-d period of unilateral leg immobilization during which they were randomly assigned to 1 of 3 eucaloric diets containing relatively high, low, or no protein (HIGH: 1.6, LOW: 0.5, NO: 0.15 g protein/kg/d; n = 11 per group). One day prior to immobilization participants ingested 400 mL deuterated water (D2O) with 50-mL doses consumed daily thereafter. Prior to and immediately after immobilization upper leg bilateral MRI scans and vastus lateralis muscle biopsies were performed to measure quadriceps muscle volume and daily MyoPS rates, respectively. RESULTS Quadriceps muscle volume of the control legs remained unchanged throughout the experiment (P > 0.05). Immobilization led to 2.3 ± 0.4%, 2.7 ± 0.2%, and 2.0 ± 0.4% decreases in quadriceps muscle volume (P < 0.05) of the immobilized leg in the HIGH, LOW, and NO groups (P < 0.05), respectively, with no significant differences between groups (P > 0.05). D2O ingestion resulted in comparable plasma free [2H]-alanine enrichments during immobilization (∼2.5 mole percentage excess) across groups (P > 0.05). Daily MyoPS rates during immobilization were 30 ± 2% (HIGH), 26 ± 3% (LOW), and 27 ± 2% (NO) lower in the immobilized compared with the control leg, with no significant differences between groups (P > 0.05). CONCLUSIONS Three days of muscle disuse induces considerable declines in muscle mass and daily MyoPS rates. However, daily protein intake does not modulate any of these muscle deconditioning responses.Clinical trial registry number: NCT03797781.
Collapse
Affiliation(s)
- Sean Paul Kilroe
- Department of Sport and Health Sciences, College of Life and Environmental Science, University of Exeter, Exeter, UK
| | - Jonathan Fulford
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Sarah Jackman
- Department of Sport and Health Sciences, College of Life and Environmental Science, University of Exeter, Exeter, UK
| | - Andrew Holwerda
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Annemie Gijsen
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Luc van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Benjamin Toby Wall
- Department of Sport and Health Sciences, College of Life and Environmental Science, University of Exeter, Exeter, UK
| |
Collapse
|
38
|
Nozawa Y, Wagatsuma Y. Protein Intake and Physical Performance Following Long-Term Stay on the International Space Station. Aerosp Med Hum Perform 2021; 92:153-159. [PMID: 33754972 DOI: 10.3357/amhp.5640.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: Exposure to microgravity reduces muscle mass, volume, and performance. The ingestion of protein, especially combined with carbohydrate intake and exercise after ingestion, improves net muscle protein synthesis and increases muscle mass. However, there are few studies on this relationship during and after a long-term spaceflight. The objective of this study was to investigate the influence of protein and the combined effects of carbohydrate intake on muscle performance following long-term spaceflight.METHODS: This study is a retrospective cohort study involving secondary analysis of data stored in the NASA Lifetime Surveillance of Astronaut Health Repository. Multivariable analysis was performed to evaluate the impact of protein intake on physical performance by considering covariates potentially associated with each model.RESULTS: After adjusting for sex, age, flight week, energy intake, and preflight physical performance, protein intake was found to be significantly associated with concentric measurements for knee extension ( 51.66), ankle plantar flexion ( 32.86), and eccentric measurements for ankle plantar flexion ( 79.85) at 5 d after landing. Significant associations remained after controlling for exercise effect. No significant interaction between protein and carbohydrate intake was observed in either model.DISCUSSION: Protein intake during spaceflight was related to physical performance for knee extension and ankle plantar flexion, even after taking exercise effect into consideration. However, protein and carbohydrate intake provided no synergetic benefit. This suggests that high protein intake, about twice the current average intake, may serve as a countermeasure to offset the negative effects of long-duration spaceflights.Nozawa Y, Wagatsuma Y. Protein intake and physical performance following long-term stay on the International Space Station. Aerosp Med Hum Perform. 2021; 92(3):153159.
Collapse
|
39
|
Smith-Ryan AE, Hirsch KR, Saylor HE, Gould LM, Blue MNM. Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation. J Athl Train 2021; 55:918-930. [PMID: 32991705 DOI: 10.4085/1062-6050-550-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nutritional interventions are not commonly a standard of care in rehabilitation interventions. A nutritional approach has the potential to be a low-cost, high-volume strategy that complements the existing standard of care. In this commentary, our aim is to provide an evidence-based, practical guide for athletes with injuries treated surgically or conservatively, along with healing and rehabilitation considerations. Injuries are a normal and expected part of exercise participation. Regardless of severity, an injury typically results in the athlete's short- or long-term removal from participation. Nutritional interventions may augment the recovery process and support optimal healing; therefore, incorporating nutritional strategies is important at each stage of the healing process. Preoperative nutrition and nutritional demands during rehabilitation are key factors to consider. The physiological response to wounds, immobilization, and traumatic brain injuries may be improved by optimizing macronutrient composition, caloric consumption, and nutrient timing and using select dietary supplements. Previous research supports practical nutrition recommendations to reduce surgical complications, minimize deficits after immobilization, and maximize the chance of safe return to play. These recommendations include identifying the individual's caloric requirements to ensure that energy needs are being met. A higher protein intake, with special attention to evenly distributed consumption throughout the day, will help to minimize loss of muscle and strength during immobilization. Dietary-supplement strategies may be useful when navigating the challenges of appropriate caloric intake and timing and a reduced appetite. The rehabilitation process also requires a strong nutritional plan to enhance recovery from injury. Athletic trainers, physical therapists, and other health care professionals should provide basic nutritional recommendations during rehabilitation, discuss the timing of meals with respect to therapy, and refer the patient to a registered dietitian if warranted. Because nutrition plays an essential role in injury recovery and rehabilitation, nutritional interventions should become a component of standard-of-care practice after injury. In this article, we address best practices for implementing nutritional strategies among patients with athletic injuries.
Collapse
Affiliation(s)
- Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill.,Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill
| | - Katie R Hirsch
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill
| | - Hannah E Saylor
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill
| | - Lacey M Gould
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Malia N M Blue
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill
| |
Collapse
|
40
|
Khalooeifard R, Shariatpanahi ZAHRAVAHDAT, Ahani A, Keykhaee M, Oraee-Yazdani M, Zali A, Oraee-Yazdani S. Effect of Protein Supplement on Paraspinal Muscles in Spine Fusion Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial. Int J Spine Surg 2021; 15:47-54. [PMID: 33900956 PMCID: PMC7931746 DOI: 10.14444/8005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Dysfunction and weakness due to atrophy of the paraspinal muscles is a major issue after posterior spinal fusion (PSF) surgery, resulting in pain and disability. Considering the role of protein in muscle regeneration, it seems that protein supplements after surgery may prevent muscle atrophy. To date, to our knowledge, no intervention study has investigated the effect of protein supplementation on the volume of paraspinal muscles, pain, or disability after PSF. METHODS In this randomized, double-blind, placebo-controlled clinical trial, patients were randomly assigned to a control (placebo + diet with 1.2 g/kg body weight of protein, n = 40) or a protein supplementation (36 g/day + a diet with 1.2 g/kg body weight of protein, n = 40) group, which received intervention from 48 hours before to 1 month after surgery. The cross-sectional area (CSA) of the paraspinal muscles was measured by thin-slice computed tomography, and pain and disability were assessed using the visual analog scale and Oswestry Disability Index. RESULTS After 4 weeks of protein supplementation, the CSAs of multifidus and psoas muscles on both sides were significantly higher in the supplementation group than the placebo group (P <.001). Less atrophy was seen in the right erector spinae and quadratus lumborum muscles in the group receiving protein supplements than the placebo group (P < .001). In addition, protein supplementation was significantly negatively correlated with both pain (P < .001) and disability (P < .001). CONCLUSIONS In conclusion, we demonstrated that 36 g/day protein supplementation significantly increased the CSA of muscles and reduced the atrophy, pain, and disability after PSF surgery. LEVEL OF EVIDENCE 2.
Collapse
Affiliation(s)
- Razieh Khalooeifard
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - ZAHRA VAHDAT Shariatpanahi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirahmad Ahani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Keykhaee
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Oraee-Yazdani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Oraee-Yazdani
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
41
|
Smeuninx B, Elhassan YS, Manolopoulos KN, Sapey E, Rushton AB, Edwards SJ, Morgan PT, Philp A, Brook MS, Gharahdaghi N, Smith K, Atherton PJ, Breen L. The effect of short-term exercise prehabilitation on skeletal muscle protein synthesis and atrophy during bed rest in older men. J Cachexia Sarcopenia Muscle 2021; 12:52-69. [PMID: 33347733 PMCID: PMC7890266 DOI: 10.1002/jcsm.12661] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/19/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Poor recovery from periods of disuse accelerates age-related muscle loss, predisposing individuals to the development of secondary adverse health outcomes. Exercise prior to disuse (prehabilitation) may prevent muscle deterioration during subsequent unloading. The present study aimed to investigate the effect of short-term resistance exercise training (RET) prehabilitation on muscle morphology and regulatory mechanisms during 5 days of bed rest in older men. METHODS Ten healthy older men aged 65-80 years underwent four bouts of high-volume unilateral leg RET over 7 days prior to 5 days of inpatient bed rest. Physical activity and step-count were monitored over the course of RET prehabilitation and bed rest, whilst dietary intake was recorded throughout. Prior to and following bed rest, quadriceps cross-sectional area (CSA), and hormone/lipid profiles were determined. Serial muscle biopsies and dual-stable isotope tracers were used to determine integrated myofibrillar protein synthesis (iMyoPS) over RET prehabilitation and bed rest phases, and acute postabsorptive and postprandial myofibrillar protein synthesis (aMyoPS) rates at the end of bed rest. RESULTS During bed rest, daily step-count and light and moderate physical activity time decreased, whilst sedentary time increased when compared with habitual levels (P < 0.001 for all). Dietary protein and fibre intake during bed rest were lower than habitual values (P < 0.01 for both). iMyoPS rates were significantly greater in the exercised leg (EX) compared with the non-exercised control leg (CTL) over prehabilitation (1.76 ± 0.37%/day vs. 1.36 ± 0.18%/day, respectively; P = 0.007). iMyoPS rates decreased similarly in EX and CTL during bed rest (CTL, 1.07 ± 0.22%/day; EX, 1.30 ± 0.38%/day; P = 0.037 and 0.002, respectively). Postprandial aMyoPS rates increased above postabsorptive values in EX only (P = 0.018), with no difference in delta postprandial aMyoPS stimulation between legs. Quadriceps CSA at 40%, 60%, and 80% of muscle length decreased significantly in EX and CTL over bed rest (0.69%, 3.5%, and 2.8%, respectively; P < 0.01 for all), with no differences between legs. No differences in fibre-type CSA were observed between legs or with bed rest. Plasma insulin and serum lipids did not change with bed rest. CONCLUSIONS Short-term resistance exercise prehabilitation augmented iMyoPS rates in older men but did not offset the relative decline in iMyoPS and muscle mass during bed rest.
Collapse
Affiliation(s)
- Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Yasir S. Elhassan
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Centre for Endocrinology, Diabetes and MetabolismBirmingham Health PartnersBirminghamUK
| | - Konstantinos N. Manolopoulos
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Centre for Endocrinology, Diabetes and MetabolismBirmingham Health PartnersBirminghamUK
| | - Elizabeth Sapey
- NIHR Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust and Institute of Inflammation and AgeingUniversity of BirminghamBirminghamUK
| | - Alison B. Rushton
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Sophie J. Edwards
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Paul T. Morgan
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Andrew Philp
- Garvan Institute of Medical ResearchSydneyNSWAustralia
- St Vincents Medical School, UNSW MedicineUNSW SydneySydneyNSWAustralia
| | - Matthew S. Brook
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Nima Gharahdaghi
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Kenneth Smith
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Philip J. Atherton
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
- MRC‐Arthritis Research UK Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamUK
| |
Collapse
|
42
|
Zeng N, D'Souza RF, MacRae CL, Figueiredo VC, Pileggi CA, Markworth JF, Merry TL, Cameron-Smith D, Mitchell CJ. Daily protein supplementation attenuates immobilization-induced blunting of postabsorptive muscle mTORC1 activation in middle-aged men. Am J Physiol Cell Physiol 2021; 320:C591-C601. [PMID: 33471625 DOI: 10.1152/ajpcell.00284.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Disuse-induced muscle atrophy is accompanied by a blunted postprandial response of the mammalian target of rapamycin complex 1 (mTORC1) pathway. Conflicting observations exist as to whether postabsorptive mTORC1 pathway activation is also blunted by disuse and plays a role in atrophy. It is unknown whether changes in habitual protein intake alter mTORC1 regulatory proteins and how they may contribute to the development of anabolic resistance. The primary objective of this study was to characterize the downstream responsiveness of skeletal muscle mTORC1 activation and its upstream regulatory factors, following 14 days of lower limb disuse in middle-aged men (45-60 yr). The participants were further randomized to receive daily supplementation of 20 g/d of protein (n = 12; milk protein concentrate) or isocaloric carbohydrate placebo (n = 13). Immobilization reduced postabsorptive skeletal muscle phosphorylation of the mTORC1 downstream targets, 4E-BP1, P70S6K, and ribosomal protein S6 (RPS6), with phosphorylation of the latter two decreasing to a greater extent in the placebo, compared with the protein supplementation groups (37% ± 13% vs. 14% ± 11% and 38% ± 20% vs. 25% ± 8%, respectively). Sestrin2 protein was also downregulated following immobilization irrespective of supplement group, despite a corresponding increase in its mRNA content. This decrease in Sestrin2 protein was negatively correlated with the immobilization-induced change in the in silico-predicted regulator miR-23b-3p. No other measured upstream proteins were altered by immobilization or supplementation. Immobilization downregulated postabsorptive mTORC1 pathway activation, and 20 g/day of protein supplementation attenuated the decrease in phosphorylation of targets regulating muscle protein synthesis.
Collapse
Affiliation(s)
- Nina Zeng
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Randall F D'Souza
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Caitlin L MacRae
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Vandre C Figueiredo
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Centre for Muscle Biology, College of Health Sciences, University of Kentucky, Lexington, Kentucky
| | - Chantal A Pileggi
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - James F Markworth
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan
| | - Troy L Merry
- Discipline of Nutrition, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - David Cameron-Smith
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cameron J Mitchell
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,School of Kinesiology, University of British Colombia, Vancouver, British Columbia, Canada
| |
Collapse
|
43
|
|
44
|
Feenstra F. Reactivating Hospital, Active Patients Through Special Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 14:87-105. [PMID: 33161751 DOI: 10.1177/1937586720966757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE With the reactivating hospital concept, it is our goal to provide a more active stay in a hospital for patients by diverting the focus away from "lying in bed." We want to achieve this by changing the spatial environment of the nursing ward. These new spatial interventions are aimed toward helping the patients to be healthier during and after their admission to the hospital. BACKGROUND When it comes to hospitals, we tend to have a mindset that is basically focused on disease, not on health. The whole hospital is geared toward illness, waiting, lying in bed: a passive attitude of the patient in this medical stronghold. Staying in a hospital has a negative influence on the body, especially for vulnerable patients. However, when patients remain active during their hospital stay, fewer negative effects occur. The risk of complications reduces, and patients recover better and faster. Research shows that only 15% of patients actually need to stay in bed. In order to enable hospitals and their patients to benefit from these insights, Gortemaker Algra Feenstra Architects introduces the reactivating hospital concept: a set of scientifically based practical interventions intended for a change in organization and spatial design of hospitals. DESIGN HYPOTHESIS How can spatial interventions to a geriatric department contribute positively to activating elderly patients during their stay in the hospital? RESEARCH QUESTION What impact does providing areas for activation away from a patient's bed have on the quality of the patient's experience? METHOD The reactivating hospital concept no longer revolves around "lying in bed," but around the notion of "making patients stronger." We are introducing a new rhythm of 8 hr of activation, 8 hr of relaxation, and 8 hr of sleep. This requires a different mindset of patients and personnel and involves a totally different interpretation of space. To tackle the problem at its roots, the bed will be solely reserved for sleeping and all other activities will take place elsewhere in the nursing ward. To encourage patients to remain active, we soften the transition from bed to room, from room to corridor, from corridor to department, and from department to the rest of the hospital. These subtle transitions invite patients to move around, thus remaining active. To test these methods, we use qualitative and quantitative research methods such as observation, conversations with focus groups, and questionnaires during the research. RESULTS Reactivating hospital concept is a concept and a design research in progress in collaboration with the existing Diakonessenhuis hospital and the Netherlands Organisation for Applied Scientific Research (TNO). In this setting, there are different scales of innovation. In the first phase, we have been working on a completely new bed department with a new typology. In the second phase, we are currently testing significant changes in a room, corridor, and department level, within the context of the existing department, and we are measuring and monitoring the results. The first research results show a positive effect on the state of mind of patients as well as the nurses. At this moment, we are researching the positive effect on the exercise and health of patients, and we are expecting the first concrete results to come in at the end of the year. CONCLUSION The initial feedback we have received from the Diakonessenhuis hospital has been positive. Furthermore, we have noticed that the reactivating hospital concept is receiving more and more support. Lying in bed has a negative effect on patients, and a lot of hospitals are aware of this and are therefore looking for alternatives.
Collapse
Affiliation(s)
- Femke Feenstra
- Gortemaker Algra Feenstra Architects, Board Architect of Gortemaker Algra Feenstra Architects, Rotterdam, The Netherlands
| |
Collapse
|
45
|
Lobo DN, Gianotti L, Adiamah A, Barazzoni R, Deutz NEP, Dhatariya K, Greenhaff PL, Hiesmayr M, Hjort Jakobsen D, Klek S, Krznaric Z, Ljungqvist O, McMillan DC, Rollins KE, Panisic Sekeljic M, Skipworth RJE, Stanga Z, Stockley A, Stockley R, Weimann A. Perioperative nutrition: Recommendations from the ESPEN expert group. Clin Nutr 2020; 39:3211-3227. [PMID: 32362485 DOI: 10.1016/j.clnu.2020.03.038] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Malnutrition has been recognized as a major risk factor for adverse postoperative outcomes. The ESPEN Symposium on perioperative nutrition was held in Nottingham, UK, on 14-15 October 2018 and the aims of this document were to highlight the scientific basis for the nutritional and metabolic management of surgical patients. METHODS This paper represents the opinion of experts in this multidisciplinary field and those of a patient and caregiver, based on current evidence. It highlights the current state of the art. RESULTS Surgical patients may present with varying degrees of malnutrition, sarcopenia, cachexia, obesity and myosteatosis. Preoperative optimization can help improve outcomes. Perioperative fluid therapy should aim at keeping the patient in as near zero fluid and electrolyte balance as possible. Similarly, glycemic control is especially important in those patients with poorly controlled diabetes, with a stepwise increase in the risk of infectious complications and mortality per increasing HbA1c. Immobilization can induce a decline in basal energy expenditure, reduced insulin sensitivity, anabolic resistance to protein nutrition and muscle strength, all of which impair clinical outcomes. There is a role for pharmaconutrition, pre-, pro- and syn-biotics, with the evidence being stronger in those undergoing surgery for gastrointestinal cancer. CONCLUSIONS Nutritional assessment of the surgical patient together with the appropriate interventions to restore the energy deficit, avoid weight loss, preserve the gut microbiome and improve functional performance are all necessary components of the nutritional, metabolic and functional conditioning of the surgical patient.
Collapse
Affiliation(s)
- Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| | - Luca Gianotti
- School of Medicine and Surgery, University of Milano-Bicocca, Department of Surgery, San Gerardo Hospital, Monza, Italy
| | - Alfred Adiamah
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicolaas E P Deutz
- Center for Translational Research in Aging & Longevity, Department of Health & Kinesiology, Texas A&M University, College Station, TX, 77843-4253, USA
| | - Ketan Dhatariya
- Department of Diabetes, Endocrinology and General Medicine, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust and University of East Anglia, Colney Lane, Norwich, NR4 7UY, UK
| | - Paul L Greenhaff
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Michael Hiesmayr
- Division of Cardio-Thoracic-Vascular Surgical Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Stanislaw Klek
- General and Oncology Surgery Unit, Stanley Dudrick's Memorial Hospital, Skawina, Poland
| | - Zeljko Krznaric
- University Hospital Centre Zagreb and Zagreb School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Olle Ljungqvist
- Faculty of Medicine and Health, School of Health and Medical Sciences, Department of Surgery, Örebro University, Örebro, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Katie E Rollins
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Marina Panisic Sekeljic
- Military Medical Academy, Clinic for General Surgery, Department for Perioperative Nutrition, Crnostravska Street 17, Belgrade, Serbia
| | - Richard J E Skipworth
- Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Zeno Stanga
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Audrey Stockley
- Patient Public Involvement Group, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Ralph Stockley
- Patient Public Involvement Group, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Arved Weimann
- Klinik für Allgemein-, Viszeral- und Onkologische Chirurgie, Klinikum St. Georg gGmbH, Delitzscher Straße 141, 04129, Leipzig, Germany
| |
Collapse
|
46
|
Machado CLF, Pinto RS, Brusco CM, Cadore EL, Radaelli R. COVID-19 pandemic is an urgent time for older people to practice resistance exercise at home. Exp Gerontol 2020; 141:111101. [PMID: 33049354 PMCID: PMC7547324 DOI: 10.1016/j.exger.2020.111101] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/24/2020] [Accepted: 09/26/2020] [Indexed: 12/16/2022]
Abstract
Social distancing measures have been used to contain the COVID-19 pandemic; nevertheless, it causes unintended greater time at home and consequently a reduction in general physical activity and an increase in sedentary time, which is harmful to older people. A decrease in daily physical activities and an increase in sedentary time culminates in an impactful skeletal muscle disuse period and reduction in neuromuscular abilities related to functional capacity. Home-based resistance training is a strategy to mitigate physical inactivity and improve or retain muscle function and functional performance. Therefore, it is an urgent time to encourage older people to perform resistance exercises at home to avoid a harmful functional decline and promote physical health.
Collapse
Affiliation(s)
- Carlos Leonardo Figueiredo Machado
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Ronei Silveira Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Clarissa Muller Brusco
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Régis Radaelli
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
47
|
Collins J, Maughan RJ, Gleeson M, Bilsborough J, Jeukendrup A, Morton JP, Phillips SM, Armstrong L, Burke LM, Close GL, Duffield R, Larson-Meyer E, Louis J, Medina D, Meyer F, Rollo I, Sundgot-Borgen J, Wall BT, Boullosa B, Dupont G, Lizarraga A, Res P, Bizzini M, Castagna C, Cowie CM, D'Hooghe M, Geyer H, Meyer T, Papadimitriou N, Vouillamoz M, McCall A. UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research. Br J Sports Med 2020; 55:416. [PMID: 33097528 DOI: 10.1136/bjsports-2019-101961] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/09/2023]
Abstract
Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.
Collapse
Affiliation(s)
- James Collins
- Intra Performance Group, London, UK.,Performance and Research Team, Arsenal Football Club, London, UK
| | | | - Michael Gleeson
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Johann Bilsborough
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,New England Patriots, Foxboro, MA, USA
| | - Asker Jeukendrup
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,MySport Science, Birmingham, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - S M Phillips
- Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Armstrong
- Human Performance Laboratory, University of Connecticut, Storrs, CT, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Rob Duffield
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia
| | - Enette Larson-Meyer
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel Medina
- Athlete Care and Performance, Monumental Sports & Entertainment, Washington, DC, USA
| | - Flavia Meyer
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ian Rollo
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,PepsiCo Life Sciences, Global R&D, Gatorade Sports Science Institute, Birmingham, UK
| | | | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Gregory Dupont
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Peter Res
- Dutch Olympic Team, Amsterdam, Netherlands
| | - Mario Bizzini
- Research and Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Carlo Castagna
- University of Rome Tor Vergata, Rome, Italy.,Technical Department, Italian Football Federation (FIGC), Florence, Italy.,Italian Football Referees Association, Bologna, Italy
| | - Charlotte M Cowie
- Technical Directorate, Football Association, Burton upon Trent, UK.,Medical Committee, UEFA, Nyon, Switzerland
| | - Michel D'Hooghe
- Medical Committee, UEFA, Nyon, Switzerland.,Medical Centre of Excelence, Schulthess Clinic, Zurich, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Tim Meyer
- Medical Committee, UEFA, Nyon, Switzerland.,Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | | | | | - Alan McCall
- Performance and Research Team, Arsenal Football Club, London, UK .,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia.,Sport, Exercise and Health Sciences, School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| |
Collapse
|
48
|
Dietary protein, exercise, ageing and physical inactivity: interactive influences on skeletal muscle proteostasis. Proc Nutr Soc 2020; 80:106-117. [PMID: 33023679 DOI: 10.1017/s0029665120007879] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Dietary protein is a pre-requisite for the maintenance of skeletal muscle mass; stimulating increases in muscle protein synthesis (MPS), via essential amino acids (EAA), and attenuating muscle protein breakdown, via insulin. Muscles are receptive to the anabolic effects of dietary protein, and in particular the EAA leucine, for only a short period (i.e. about 2-3 h) in the rested state. Thereafter, MPS exhibits tachyphylaxis despite continued EAA availability and sustained mechanistic target of rapamycin complex 1 signalling. Other notable characteristics of this 'muscle full' phenomenon include: (i) it cannot be overcome by proximal intake of additional nutrient signals/substrates regulating MPS; meaning a refractory period exists before a next stimulation is possible, (ii) it is refractory to pharmacological/nutraceutical enhancement of muscle blood flow and thus is not induced by muscle hypo-perfusion, (iii) it manifests independently of whether protein intake occurs in a bolus or intermittent feeding pattern, and (iv) it does not appear to be dependent on protein dose per se. Instead, the main factor associated with altering muscle full is physical activity. For instance, when coupled to protein intake, resistance exercise delays the muscle full set-point to permit additional use of available EAA for MPS to promote muscle remodelling/growth. In contrast, ageing is associated with blunted MPS responses to protein/exercise (anabolic resistance), while physical inactivity (e.g. immobilisation) induces a premature muscle full, promoting muscle atrophy. It is crucial that in catabolic scenarios, anabolic strategies are sought to mitigate muscle decline. This review highlights regulatory protein turnover interactions by dietary protein, exercise, ageing and physical inactivity.
Collapse
|
49
|
Mekjavic IB, Eiken O, Mekjavic PJ, McDonnell AC. Do females and males exhibit a similar sarcopenic response as a consequence of normoxic and hypoxic bed rest? Exp Physiol 2020; 106:37-51. [PMID: 33016528 DOI: 10.1113/ep087834] [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] [Received: 02/13/2020] [Accepted: 08/20/2020] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do females and males exhibit a similar sarcopenic response as a consequence of normoxic and hypoxic bed rest? What is the main finding and its importance? During 10-day bed rest, exposure to a simulated (normobaric hypoxia) altitude of ∼4000 m does not exert additional significant structural or functional effect on the weight-bearing muscles in females compared to those noted under normoxic conditions. Whereas males and females exhibit decrements in muscle cross-sectional area and mass during normoxic and hypoxic bed rest, a concomitant strength decrement was only observed in males. ABSTRACT This study investigated the effects of hypoxia on the known processes of adaptation of body composition and muscle function to normoxic inactivity. Females (n = 12) and males (n = 11) took part in the following interventions: hypoxic ambulation (HAMB; ∼4000 m); hypoxic bed rest (HBR; ∼4000 m) and normoxic bed rest (NBR). Prior to and immediately following each intervention, body composition, thigh and lower leg cross-sectional area (CSA) and isometric muscular strength were recorded. Participants lost body mass (HAMB: male -1.5 ± 0.9 kg, female -1.9 ± 0.7 kg; HBR: male -2.0 ± 1.8 kg, female -2.4 ± 0.8 kg; NBR: male -1.4 ± 1.3 kg, female -1.4 ± 0.9 kg) and lean mass (HAMB: male -3.9 ± 3.0%, female -3.4 ± 2.0%; HBR: male -4.0 ± 4.4%, female -4.1 ± 2.0%; NBR: male -4.0 ± 3.4%, female -2.2 ± 2.7%) with no between-condition or sex differences. Knee extension decreased for males in NBR compared to HAMB (HAMB: male -0.2 ± 9.1%, female 1.3 ± 4.9%; HBR: male -7.8 ± 10.3%, female -3.3 ± 10.9%; NBR: male -14.5 ± 11%, female -3.4 ± 6.9%). Loss of force during maximal voluntary contraction (MVC) in the knee extensors was significantly different between males and females following NBR. There were no other significant changes noted following the experimental interventions. There were no differences recorded between sexes in maximal MVC for elbow or ankle joints. Female lower leg CSA decreased following bed rest (HAMB: -4.5 ± 2.0%; HBR: -9.9 ± 2.6%; NBR: -8.0 ± 1.6%). These findings indicate that a 10-day hypoxic bed rest does not exert any significant additional effect on muscle atrophy when compared to NBR, except for female thigh CSA. In contrast to males, who exhibited a significant loss of muscle strength, no such decrement in strength was observed in the female participants.
Collapse
Affiliation(s)
- Igor B Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia.,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ola Eiken
- Department of Environmental Physiology, Swedish Aerospace Centre, Royal Institute of Echnology, Stockholm, Sweden
| | | | - Adam C McDonnell
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| |
Collapse
|
50
|
Millward DJ. Limiting deconditioned muscle atrophy and strength loss with appropriate nutrition: can it be done? Am J Clin Nutr 2020; 112:499-500. [PMID: 32559274 DOI: 10.1093/ajcn/nqaa150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Joe Millward
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| |
Collapse
|