Insights of sports nutrition science to support active aging in healthy older adults

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Abstract

Skeletal muscle mass losses with age are associated with negative health consequences, including an increased risk of developing metabolic disease and the loss of independence. Athletes adopt numerous nutritional strategies to maximize the benefits of exercise training and enhance recovery in pursuit of improving skeletal muscle quality, mass, or function. Importantly, many of the principles applied to enhance skeletal muscle health in athletes may be applicable to support active aging and prevent sarcopenia in the healthy (non-clinical) aging population. Here, we discuss the anabolic properties of protein supplementation in addition to ingredients that may enhance the anabolic effects of protein (e.g. omega 3 s, creatine, inorganic nitrate) in older persons. We conclude that nutritional strategies used in pursuit of performance enhancement in athletes are often applicable to improve skeletal muscle health in the healthy older population when implemented as part of a healthy active lifestyle. Further research is required to elucidate the mechanisms by which these nutrients may induce favorable changes in skeletal muscle and to determine the appropriate dosing and timing of nutrient intakes to support active aging.




Introduction

Population aging is a global phenomenon. It is estimated that 1 in every 6 individuals will be over the age of 65 by the year 2050, an increase of 45% from 2019 [1]. Aging is associated with the loss of skeletal muscle mass and strength, termed sarcopenia. Sarcopenia is measurable within the 5th decade of life and is associated with loss of muscle mass at a rate of~1% per year [2], loss of muscle strength (e.g. 1-repetition maximum) at~3% per year [3], and loss of muscle power (e.g. force and speed of movement) at~8% per year [4]. Importantly, these decrements in muscle function are associated with the loss of independence, and a decline in the ability to perform activities of daily living [5], and are linked with several negative metabolic health outcomes [6]. Thus, strategies to augment or maintain skeletal muscle mass and its functional capacity are a primary consideration in preserving the quality of life of aging adults.

The enhancement of skeletal muscle mass and function are also the primary objective for many athletes. In this population, specific exercise and nutrition regimens are utilized to optimize skeletal muscle remodeling and often to stimulate muscle hypertrophy. Despite athletic intervention strategies being performance-focused, many principles are directly applicable to skeletal muscle health in older adults. Both athletic and older populations can accumulate training hours to achieve competitive goals [7]. However, for the general healthy older population, physical activity provides benefits beyond athletic achievements, such as maintaining independence, reducing the risk of falls, and establishing/continuing social interaction [8]. Consequently, the nutrition intervention strategies discussed in this review should be applied in the context of supporting the completion of and maximizing the benefits of, physical activity and, as such, supporting more active aging.

To this end, this review will discuss sports nutrition strategies used by athletes and discuss their potential application to the healthy aging population with a focus on skeletal muscle mass and function. For the purpose of this review, healthy older adults are classified as those people free of health conditions





*Dietary protein

*Creatine

*Omega-3/n-3 polyunsaturated fatty acids (n-3 PUFA)

*Inorganic nitrate (NO3 −)

*Carbohydrate periodization





Summary

In summary, nutritional strategies used by athletes in pursuit of performance enhancements are applicable to improve skeletal muscle health in healthy older people. Importantly, nutritional interventions such as those discussed as part of this review are not sufficient to counteract sarcopenia alone. Along with dietary interventions, increasing physical activity and reducing sedentary behavior is of significant importance in the pursuit of healthy aging. More research is required to elucidate the mechanisms by which various nutrients may induce favorable changes in skeletal muscle and determine the quantities and timing of nutrient intake to support active aging.
 

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Fig. 1 Impact of protein, creatine, omega-3 s (n-3PUFAs), inorganic nitrate/beetroot juice, and carbohydrate periodization on skeletal muscle in athletes (pink) and older people (red). Proposed daily protein consumption layout and dosage for both athletes (light) and older people (dark). For older people, we present both a practical protein dose (similar to athletes) and an optimal protein dose. Optimal protein intake following exercise is body mass-dependent and can be calculated by 0.24–0.3 g/ kg of body mass for young people (<30 years of age), and 0.4 g/kg of body mass for adults (>60 years of age) [21]. BM, body mass
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Table 1 Examples of protein sources for athletes (or practical meals for older adults) at~20 g and optimal meals for older adults at~35 g at each eating occasion
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Table 2 Daily carbohydrate intake guidelines based on physical activity level. Suggested ranges accommodate likely variations in individual goals specifically related to body composition. Lower intakes should be targeted to accommodate the weight loss and fat loss, whereas upper targets should be considered for weight maintenance or gain
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Key points:

•Adults lose skeletal muscle with advancing age, which contributes to the decline in mobility and loss of independence.

•Exercise is a potent stimulator of muscle growth, and older adults respond effectively to resistance-type exercise training through increases in muscle mass and strength.

•Both athletes and older people require a greater total protein intake to support skeletal muscle health.

•Other nutritional strategies used by athletes to augment performance, including optimizing protein intake throughout the day, periodization of carbohydrate intake, and supplementation of creatine, n-3 PUFAs, or inorganic nitrate, also have the potential to improve muscle health in older adults.
 
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5-6 g/kg carbo/day I find a lot, considering that fat is also an energy source, and by the way much more abundant. Carbohydrate is only required for intense activity
 
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