Department of Physical Therapy, Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, Texas 77555-1144, USA.
Curr Opin Clin Nutr Metab Care. 2010 Jan;13(1):34-9. doi: 10.1097/MCO.0b013e328333aa66.
To highlight the losses in muscle mass, strength, power, and functional capacity incurred in older adults during bed rest-mediated inactivity and to provide practical recommendations for both the prevention and rehabilitation of these losses.
In addition to sarcopenic muscle loss, older adults lose lean tissue more rapidly than the young during prolonged periods of physical inactivity. Amino acid or protein supplementation has the potential to maintain muscle protein synthesis and may reduce inactivity-induced muscle loss, but should ideally be part of an integrated countermeasure regimen consisting of nutrition, exercise, and, when appropriate, pharmacologic interventions.
In accordance with recent mechanistic advances, we recommend an applied, broad-based two-phase approach to limit inactivity-mediated losses of muscle mass and function in older adults: (i) Lifestyle: consume a moderate amount (25-30 g) of high-quality protein with each meal and incorporate habitual exercise in close temporal proximity to protein-containing meals; (ii) Crises: react aggressively to combat the accelerated loss of muscle mass and function during acute catabolic crises and periods of reduced physical activity. As a base strategy, this should include nutritional support such as targeted protein or amino acid supplementation and integrated physical therapy.
强调在卧床休息引起的活动减少期间老年人肌肉质量、力量、功率和功能能力的丧失，并为这些丧失的预防和康复提供实用建议。
除了肌肉减少症外，老年人在长时间的身体不活动期间比年轻人更快地失去瘦组织。氨基酸或蛋白质补充剂有可能维持肌肉蛋白质合成，并可能减少不活动引起的肌肉损失，但理想情况下应作为营养、运动以及在适当情况下的药物干预的综合对策方案的一部分。
总之，根据最近的机制进展，我们建议采用一种实用的、广泛的两阶段方法来限制老年人因活动减少而导致的肌肉质量和功能丧失：（i）生活方式：每餐摄入适量（25-30 克）高质量蛋白质，并在接近含有蛋白质的膳食时进行习惯性运动；（ii）危机：积极应对急性分解代谢危机和体力活动减少期间肌肉质量和功能的加速丧失。作为基础策略，这应包括营养支持，如靶向蛋白质或氨基酸补充剂和综合物理治疗。
