CHU Clermont-Ferrand, Service de Nutrition Clinique, F-63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, 58 rue Montalembert, BP 321, F-63009 Clermont-Ferrand cedex 01, France.
Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, 58 rue Montalembert, BP 321, F-63009 Clermont-Ferrand cedex 01, France.
Mech Ageing Dev. 2014 Mar-Apr;136-137:76-84. doi: 10.1016/j.mad.2014.01.008. Epub 2014 Jan 31.
Protein-energy homeostasis is a major determinant of healthy aging. Inadequate nutritional intakes and physical activity, together with endocrine disturbances are associated with of sarcopenia and frailty. Guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition in elderly. Besides these quantitative aspects of protein load, perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding, the use of fast proteins and the addition of leucine or citrulline to dietary protein. An integrated management of sarcopenia, taking into account the determinants of muscle wasting, i.e. nutrition, physical activity, anabolic factors such as androgens, vitamin D and n-3 polyunsaturated fatty acids status, needs to be tested in the prevention and treatment of sarcopenia. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition. According to present data, healthy nutrition in elderly should respect the guidelines for protein and energy requirement, privilege a Mediterranean way of alimentation, and be associated with a regular physical activity. Further issues relate to the identification of the genetics determinants of protein energy wasting in elderly.
蛋白质-能量平衡是健康老龄化的主要决定因素。营养摄入不足、体力活动不足以及内分泌紊乱与肌肉减少症和虚弱有关。科学学会的指南主要针对老年人蛋白质和能量营养的定量方面。除了蛋白质负荷的这些定量方面外，促进肌肉蛋白质合成和预防肌肉减少症的策略还包括脉冲喂养、使用快速蛋白质以及在膳食蛋白质中添加亮氨酸或瓜氨酸。需要综合管理肌肉减少症，考虑到肌肉消耗的决定因素，即营养、体力活动、雄激素等合成代谢因素、维生素 D 和 n-3 多不饱和脂肪酸状况，以预防和治疗肌肉减少症。强调体力活动的重要性，特别是抗阻训练，不仅是为了促进肌肉蛋白质合成，还可以增加有营养不良风险的老年人的食欲和食物摄入。根据目前的数据，老年人的健康营养应尊重蛋白质和能量需求的指南，优先考虑地中海式饮食，并与定期的体力活动相结合。进一步的问题涉及确定老年人蛋白质-能量消耗的遗传决定因素。
