Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlínico San Matteo, Pavia.
Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Curr Opin Clin Nutr Metab Care. 2022 May 1;25(3):142-153. doi: 10.1097/MCO.0000000000000822. Epub 2022 Feb 18.
To provide an updated overview of recent efficacy data on the use of muscle-targeted nutritional therapy, which should consider the optimization of protein and essential amino acids intakes, possibly in combination with supplementation with vitamin D (correction of deficiency/insufficiency status) and v-3 fatty acids.
Intervention studies conducted in the last years in different healthcare settings and heterogeneous patient populations support the use of muscle-targeted oral nutritional supplementation to improve muscle mass, function and physical performance in patients with sarcopenia. Higher efficacy is likely to be achieved in combination with individually tailored resistance exercise training programs and when nutritional therapy and the provision of specific nutrients result in an adequate protein-calorie balance. However, not only a reactive but also a pro-active application of this therapy could be proposed as evidence exists on the maintenance of or improvement in the same outcome variables in patients at risk of losing skeletal muscle mass.
Based on available efficacy data, both a reactive and pro-active use of muscle-targeted nutritional therapy are promising and should be proposed. However, future research should be directed toward the management of patient populations characterized by substantial muscle wasting, as these have been frequently excluded from previous trials, perhaps to avoid confounding.
提供肌肉靶向营养治疗近期疗效数据的最新概述,这应考虑优化蛋白质和必需氨基酸的摄入,可能与维生素 D(纠正缺乏/不足状态)和 v-3 脂肪酸补充相结合。
近年来在不同医疗环境和异质患者人群中进行的干预研究支持使用肌肉靶向口服营养补充剂来改善肌少症患者的肌肉量、功能和身体表现。当营养治疗和特定营养素的提供导致足够的蛋白质-热量平衡时,与个体化量身定制的抗阻运动训练计划相结合可能会取得更高的疗效。然而,不仅可以进行反应性治疗,还可以进行前瞻性治疗,因为有证据表明,在有骨骼肌丢失风险的患者中,这种治疗可以维持或改善相同的结局变量。
基于现有疗效数据,肌肉靶向营养治疗的反应性和前瞻性应用都很有前景,应该被提出。然而,未来的研究应该针对肌肉大量流失的患者人群进行管理,因为这些患者经常被以前的试验排除在外,也许是为了避免混杂因素。