Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne.
Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St. Albans, Melbourne, Victoria, Australia.
Curr Opin Clin Nutr Metab Care. 2021 Jan;24(1):25-32. doi: 10.1097/MCO.0000000000000711.
Osteosarcopenia (the joint loss of bone density and muscle mass and function) is an emerging geriatric syndrome, which associates with poor health outcomes. Several nutrients including protein, vitamin D and calcium interact (directly or through absorption properties) to regulate muscle and bone metabolism. We provided an update on the efficacy of these nutrients on musculoskeletal outcomes in older adults with, or at risk of, osteosarcopenia.
Randomized trials show that correcting vitamin D and calcium deficiencies to meet the recommended dietary allowance (RDA) increases bone density and reduces fracture (but not falls) risk. Supplementing above the RDA with protein supports gains in lean mass and lumbar-spine bone density; however, there is inconclusive evidence for muscle strength, physical function or other bone density sites. A likely explanation for this relates to the significant heterogeneity between trials regarding protein dose, type and timing, as well as baseline protein intake. Further high-quality trials are needed in older osteosarcopenic adults to investigate the effects of protein (while correcting vitamin D and calcium deficiencies) on clinically meaningful outcomes such as activities of daily living, falls and fractures.
An adequate intake of protein (1.2-1.5 g/kg/day), vitamin D (800 IU/day) and calcium (1000-1200 mg/day), is well tolerated and effective at mitigating some aspects of osteosarcopenia such as lean mass, bone density and fracture risk.
骨质疏松-肌少症（骨密度和肌肉量及功能的联合丧失）是一种新兴的老年综合征，与不良健康结局相关。一些营养素，包括蛋白质、维生素 D 和钙，通过相互作用（直接或通过吸收特性）来调节肌肉和骨骼代谢。我们就这些营养素对存在或有骨质疏松-肌少症风险的老年人的肌肉骨骼结局的疗效提供了最新信息。
随机试验表明，纠正维生素 D 和钙缺乏以达到推荐膳食允许量（RDA）可增加骨密度并降低骨折（而非跌倒）风险。在 RDA 基础上补充蛋白质可增加瘦体重和腰椎骨密度；然而，对于肌肉力量、身体功能或其他骨密度部位，证据并不确定。这一结果可能与试验之间在蛋白质剂量、类型和时间以及基线蛋白质摄入量方面存在显著异质性有关。需要进一步开展高质量的临床试验，以研究在纠正维生素 D 和钙缺乏的同时补充蛋白质对日常生活活动、跌倒和骨折等有临床意义的结局的影响。
充足摄入蛋白质（1.2-1.5g/kg/天）、维生素 D（800IU/天）和钙（1000-1200mg/天）耐受良好且有效，可以减轻骨质疏松-肌少症的某些方面，如瘦体重、骨密度和骨折风险。
