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改善老年人肌少症结局的营养策略:叙述性综述。

Nutritional strategies for improving sarcopenia outcomes in older adults: A narrative review.

机构信息

School of Physical Education, State University of Campinas (FEF-UNICAMP), Campinas, São Paulo, Brazil.

Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.

出版信息

Pharmacol Res Perspect. 2024 Oct;12(5):e70019. doi: 10.1002/prp2.70019.

Abstract

Sarcopenia is characterized by a decline in muscle strength, generalized loss of skeletal muscle mass, and impaired physical performance, which are common outcomes used to screen, diagnose, and determine severity of sarcopenia in older adults. These outcomes are associated with poor quality of life, increased risk of falls, hospitalization, and mortality in this population. The development of sarcopenia is underpinned by aging, but other factors can lead to sarcopenia, such as chronic diseases, physical inactivity, inadequate dietary energy intake, and reduced protein intake (nutrition-related sarcopenia), leading to an imbalance between muscle protein synthesis and muscle protein breakdown. Protein digestion and absorption are also modified with age, as well as the reduced capacity of metabolizing protein, hindering older adults from achieving ideal protein consumption (i.e., 1-1.5 g/kg/day). Nutritional supplement strategies, like animal (i.e., whey protein) and plant-based protein, leucine, and creatine have been shown to play a significant role in improving outcomes related to sarcopenia. However, the impact of other supplements (e.g., branched-chain amino acids, isolated amino acids, and omega-3) on sarcopenia and related outcomes remain unclear. This narrative review will discuss the evidence of the impact of these nutritional strategies on sarcopenia outcomes in older adults.

摘要

肌肉减少症的特征是肌肉力量下降、全身骨骼肌量减少和身体机能受损,这些是用于筛查、诊断和确定老年人肌肉减少症严重程度的常见结果。这些结果与生活质量下降、跌倒风险增加、住院和死亡风险增加有关。肌肉减少症的发展是由衰老引起的,但其他因素也会导致肌肉减少症,如慢性疾病、身体活动不足、膳食能量摄入不足和蛋白质摄入减少(与营养相关的肌肉减少症),导致肌肉蛋白合成和肌肉蛋白分解之间的失衡。随着年龄的增长,蛋白质的消化和吸收能力也会发生变化,以及代谢蛋白质的能力下降,这使得老年人难以达到理想的蛋白质摄入量(即 1-1.5g/kg/天)。营养补充策略,如动物(如乳清蛋白)和植物性蛋白、亮氨酸和肌酸,已被证明在改善与肌肉减少症相关的结果方面发挥着重要作用。然而,其他补充剂(例如支链氨基酸、分离氨基酸和欧米伽-3)对肌肉减少症和相关结果的影响仍不清楚。本综述将讨论这些营养策略对老年人肌肉减少症结果的影响证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f930/11472304/61d4af304b9e/PRP2-12-e70019-g001.jpg

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