PROTEIN INTAKE PREDICTS CHANGES IN LEAN MASS IN ELDERLY AFTER A 12-WEEK RESISTANCE EXERCISE PROGRAM
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ABSTRACT Sarcopenia, the progressive deterioration of muscle mass, quality, and strength, is prevalent among older adults. Since the first Baby Boomers reached age 65 years in 2010, primary care providers have faced a challenge to address sarcopenia in this growing older population. Preventing sarcopenia is essential for reducing falls, preventing chronic disease, and improving longevity. This article reviews new dietary and exercise guidelines for sarcopenia prevention in older adults.
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Background: Early detection and prevention of sarcopenia are essential for maintaining the functional health of older adults. There is a close association between sarcopenia and physical activity levels. Possible sarcopenia is a precursor to sarcopenia, which can accurately predict sarcopenia
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Many people assume that resistance training has different effects on males and females with regard to muscle mass gain. The difference in serum testosterone is often cited as an explanation. However, studies examining relative muscle gain with resistance training have not been well established. The purpose of this study is to examine the relative muscle mass gain with resistance training between men and women. We examined lean mass gain in 201 men and women in three different studies. Subjects in these studies performed a standard progressive resistance training program for 10 or 12 weeks. Lean mass was measured before and after training. Both men and women in these 3 studies showed significant increases in muscle mass after resistance training. In the 18‐30 year old, 10 week study, men gained 2.9±0.4% (N=74) while women gained 2.6±0.5% (N=43, P=0.72). In the 60‐69 year old, 12 week study, men gained 1.9±0.6% (N=18) while women gained 1.9±0.5% (N=31, P=0.95). In the 50‐69 year old, 12 week study, men gained 3.6±0.8% (N=14) while women gained 4.0±0.6% (N=21, P=0.74). Across all studies percent change of lean mass did not show a significant difference between genders. These results suggest that lean mass gain with resistance training is more dependent of starting lean mass than gender.
Strength Training
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Sarcopenia is one of geriatric syndromes, characterized by decreased muscle mass accompanied by decreased muscle strength and/or performance. It is more prevalent with increase in age, and the prevalence depends on the criteria applied and the characteristic of the elderly. Sarcopenia has a higher risk of morbidity and mortality in elderly patients. The definition criteria of sarcopenia are still controversial, but diagnostic criteria from the Asian Working Group for Sarcopenia and the European Working Group on Sarcopenia in Older People (EWGSOP) are the most used criteria for clinical practice. Pathogenesis sarcopenia involved a multifactorial process and is divided into intrinsic and extrinsic factors. Risk factors for sarcopenia include constitutional factors, aging, lifestyle, changes in body condition, and chronic diseases. Based on that, sarcopenia is divided into primary and secondary sarcopenia. There are three stage of sarcopenia, which are pre-sarcopenia, sarcopenia, and severe sarcopenia. Nutrition and exercise are the two main pillars to manage sarcopenia.
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Background: Early detection and prevention of sarcopenia arecritical. There is a close association between sarcopenia and physical activity levels. Possible sarcopenia is a precursor to sarcopenia, which can accurately predict sarcopenia. According to the tertiary prevention system, the diagnosis of possible sarcopenia has significant implications for the early detection of sarcopenia and the reduction of its prevalence.
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Abstract Franco, CMC, Carneiro, MAS, de Sousa, JFR, Gomes, GK, and Orsatti, FL. Influence of high- and low-frequency resistance training on lean body mass and muscle strength gains in untrained men. J Strength Cond Res 35(8): 2089–2094, 2021—The aim of this study was to investigate whether high-frequency resistance training (HFRT) performs better in lean body mass (LBM) and muscle strength gains when compared with low-frequency resistance training (LFRT). Eighteen untrained males (height: 1.76 ± 0.05 m, body mass: 78.3 ± 13.5 kg, and age: 22.1 ± 2.2 years) were randomly allocated into HFRT ( n = 9) and LFRT ( n = 9). Muscle strength {1 repetition maximum (RM) (bench press [BP] and unilateral leg extension [LE])} and LBM (DXA) were assessed at before and after 8 weeks of training. Both groups performed 7 whole-body resistance exercises, standardized to 10 sets per week, 8–12 maximal repetitions, and 90–120 seconds of rest in a 5-day resistance training routine. The LFRT performed a split-body routine, training each specific muscle group once a week. The HFRT performed a total-body routine, training all muscle groups every session and progressed from a training frequency of once per week to a training frequency of 5 times per week. Lean body mass increased without differences between groups (HFRT = 1.0 kg vs. LFRT = 1.5 kg; p = 0.377). Similarly, 1RM increased without differences between groups (right LE, HFRT = 21.2 kg vs. LFRT = 19.7 kg, p = 0.782; BP, HFRT = 7.1 kg vs. LFRT = 4.5 kg, p = 0.293). These findings suggest that in young untrained men, progressing from a training frequency of once per week to a training frequency of 5 times per week with equated volume produces similar gains in LBM and muscle strength as a constant training frequency of once per week, over an 8-week training period.
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One-repetition maximum
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The aging of society is coming up in Japan and it is one of the most important issues for us to prevent or reduce frailty and sarcopenia, two major causes of disability in older adults. In centenarians, the frailty and sarcopenia could be key factors to determine the prognosis. Maintaining both physical and cognitive functions influences the improvement of QOL and the independence of ADL. Recent studies have demonstrated pathogenic roles of age-related inflammatory activation(inflammaging), and some of circulation biomarkers for frailty are developed. It is important to prevent frailty and sarcopenia by caring a lifestyle from the earlier ages in life, preparing for the aging society with healthy status.
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Population Ageing
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Sarcopenia can be classified as age-, activity-, nutrition-, and disease-related. Hospital-associated sarcopenia, acute sarcopenia, and iatrogenic sarcopenia are activity-, nutrition-, and disease-related, not age-related. There is considerable overlap between hospital-associated sarcopenia and acute sarcopenia; however, they are distinct concepts. Some causes of hospital-associated sarcopenia and acute sarcopenia are iatrogenic. Sarcopenia is important in primary care because it is a loss of skeletal muscle mass and function that causes bedridden, dysphagia, and respiratory dysfunction. However, the percentage of primary care physicians who are familiar with sarcopenia is quite low at 18.8%.1 The causes of sarcopenia can be classified into age, activity, nutrition, and disease. Therefore, sarcopenia can occur in people who are not old due to activity, nutrition, or disease. Sarcopenia often occurs during hospitalization in acute care hospitals. Hospital-associated sarcopenia refers to sarcopenia resulting from hospitalization and is related to hospital-associated deconditioning and hospital-associated disability. Hospital-associated sarcopenia occurs not only in acute care hospitals but also in rehabilitation and long-term care hospitals. Acute sarcopenia refers to sarcopenia that occurs primarily during an acute hospitalization.2 However, acute sarcopenia can occur in institutional and home medical care. Hospital-associated sarcopenia and acute sarcopenia are distinct concepts, although there is considerable overlap. The causes of hospital-associated sarcopenia and acute sarcopenia are activity, nutrition, and disease, not age. In addition, the causes of hospital-associated sarcopenia and acute sarcopenia are classified into non-iatrogenic and iatrogenic (Figure 1). Iatrogenic sarcopenia refers to sarcopenia caused by the activities of medical staff including doctors, nurses, or other healthcare professionals in healthcare facilities.3 Activity-related sarcopenia occurs in bed rest required for medical treatment. For example, if the patient is hemodynamically unstable and sitting causes arrhythmias and dyspnea, bed rest is required. Nutrition-related sarcopenia occurs when the patient's food intake is inadequate despite medically appropriate nutritional care management. Disease-related sarcopenia occurs with trauma, fractures, cancer, chronic organ failure, and chronic inflammatory diseases and medically necessary surgery. Activity-related sarcopenia occurs during medically unnecessary bed rest. For example, when the patient is hospitalized for aspiration pneumonia, the physician orders tentative bed rest without appropriate assessment. Nutrition-related sarcopenia results from medically inappropriate nutritional care management. For example, nutritional care management is often inadequate in hospitalized patients with aspiration pneumonia who do not take oral nutrition. Disease-related sarcopenia occurs with iatrogenic diseases or drug-related adverse events. Rehabilitation nutrition4 and rehabilitation pharmacotherapy5 can be useful in the prevention of hospital-associated sarcopenia and acute sarcopenia, both non-iatrogenic and iatrogenic. Rehabilitation nutrition and rehabilitation pharmacotherapy are defined as helping people with disabilities and frail older people to achieve the highest possible body functions, activities, participation, and quality of life (QOL), using holistic evaluation by the International Classification of Functioning, Disability and Health (ICF), rehabilitation nutrition care process, and rehabilitation pharmacotherapy management. The combination of rehabilitation, appropriate nutritional care management, and medication review from the day of admission can prevent sarcopenia during hospitalization to some extent. Prevention of iatrogenic sarcopenia is possible and should be done at all costs. However, prevention of sarcopenia due to non-iatrogenic disease is difficult. Primary care physicians working in acute care hospitals should be responsible for managing not only diseases causing hospitalization but also hospital-associated sarcopenia and acute sarcopenia and should provide rehabilitation nutrition and rehabilitation pharmacotherapy. Clinical practice guidelines for sarcopenia and rehabilitation nutrition are available for primary care physicians. The Global Leadership Initiative in Sarcopenia (GLIS) will develop new consensus papers for sarcopenia.6 For prevention of sarcopenia, it is desirable to include hospital-associated sarcopenia and acute sarcopenia, as well as age-related sarcopenia in the GLIS. The author has stated explicitly that there are no conflicts of interest in connection with this article.
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