It has been estimated that 42 percent of people over the age of 65 years have limitations in performing one or more daily tasks that are essential for independence, such as transferring from sitting to standing, grocery shopping, or housekeeping.(1) Age-related muscle atrophy begins in the third decade of life and accelerates with advancing age; it really speeds up after a person’s 75th birthday.(1) Sarcopenia, from the Greek meaning "poverty of flesh," is the age related loss of muscle mass and function associated with aging. It is a component of the frailty syndrome and can be debilitating and even fatal for the elderly, especially in the face of other co-morbidities.(1)
At the root of the problem with sarcopenia is the issue of body composition. For simplicity, lean body mass (LBM) is defined as “the mass of the body minus the fat.” LBM is crucial for wound healing, immunity, organ function, and muscle strength. Loss of LBM occurs with aging, immobilization, acute injury or surgery, poor diet, lack of activity, and chronic health conditions. If a person who already has a deficiency of muscle mass suffers an additional insult from trauma or a chronic disease process, recovery of normal independent function is very difficult if not unlikely but proper nutrition can help, particularly protein intake. It is recommended that protein be spread evenly throughout the day as opposed to eating the vast majority of protein at a single meal. Simply put, a breakfast of tea and toast is not going to maximize protein synthesis. Protein should be included at every meal. Encourage your patients to consume protein throughout the day as shown in the sample menu below. For patients who have a poor appetite, oral nutrition supplements can fill in the gaps and generally provide 9-13 grams of protein per serving but some high protein supplements contain more protein. For example, Ensure® contains 9 grams of protein, Ensure Complete™ with Revigor® contains 13 grams of protein, and Ensure® High Protein Shakes contain 25 grams of protein.
1. Russ DW, Gregg-Cornell K, Conaway MJ, Clark BC. Evolving concepts on the age-related changes in “muscle quality.” J Cachexia Sarcopenia Muscle [serial online]. 2012; 3:95-109. Available at: http://www.springerlink.com/content/u400w8658h7711j7/fulltext.pdf?MUD=MP. Accessed June 25, 2012.