scholarly journals Relationship among Frailty, Muscle Volume, Protein Intake in Patients with Chronic Kidney Disease (CKD)

2020 ◽  
Vol 1 (2) ◽  
pp. 101-104
Author(s):  
Bando H ◽  
Kato Y
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Protein Intake ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
The Elderly ◽  
Protein Restriction ◽  
Restriction Diet ◽  
Meta Analyses

Maintenance of muscle mass and protein intake are closely related. Insufficient protein intake in each meal or a total of three meals causes a decrease in muscle mass. For the elderly, protein intake has been insufficient at breakfast and then a large amount of protein is necessary for stimulating muscle protein synthesis. Consequently, there is a need to more actively and consciously take protein in older age. There have been conflicting results concerning the effect of protein restriction diet on glomerular filtration rate (GFR) in patients with chronic kidney disease (CKD) from the data of various meta-analyses. A beneficial effect and also no significant effect was found. One of the perspectives suggested that protein restriction diet may make slower CKD progression in T1DM and non-DM subjects, but not for T2DM patients. However, further studies will be necessary in the future.

scholarly journals Optimal Protein Intake in Pre-Dialysis Chronic Kidney Disease Patients with Sarcopenia: An Overview

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1205
Author(s):  
Yoshitaka Isaka
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Exercise Therapy ◽  
Protein Intake ◽  
Renin Angiotensin System ◽  
Protein Restriction ◽  
Ckd Stage ◽  
End Stage

Multi-factors, such as anorexia, activation of renin-angiotensin system, inflammation, and metabolic acidosis, contribute to malnutrition in chronic kidney disease (CKD) patients. Most of these factors, contributing to the progression of malnutrition, worsen as CKD progresses. Protein restriction, used as a treatment for CKD, can reduce the risk of CKD progression, but may worsen the sarcopenia, a syndrome characterized by a progressive and systemic loss of muscle mass and strength. The concomitant rate of sarcopenia is higher in CKD patients than in the general population. Sarcopenia is also associated with mortality risk in CKD patients. Thus, it is important to determine whether protein restriction should be continued or loosened in CKD patients with sarcopenia. We may prioritize protein restriction in CKD patients with a high risk of end-stage kidney disease (ESKD), classified to stage G4 to G5, but may loosen protein restriction in ESKD-low risk CKD stage G3 patients with proteinuria <0.5 g/day, and rate of eGFR decline <3.0 mL/min/1.73 m2/year. However, the effect of increasing protein intake alone without exercise therapy may be limited in CKD patients with sarcopenia. The combination of exercise therapy and increased protein intake is effective in improving muscle mass and strength in CKD patients with sarcopenia. In the case of loosening protein restriction, it is safe to avoid protein intake of more than 1.5 g/kgBW/day. In CKD patients with high risk in ESKD, 0.8 g/kgBW/day may be a critical point of protein intake.

scholarly journals Egg Intake in Chronic Kidney Disease

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1945 ◽  
Author(s):  
Dina Tallman ◽  
Sharmela Sahathevan ◽  
Tilakavati Karupaiah ◽  
Pramod Khosla
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Dietary Cholesterol ◽  
Egg Yolk ◽  
Epidemiological Studies ◽  
Egg Consumption ◽  
Stage Renal Disease ◽  
The Impact

Patients with chronic kidney disease (CKD) are often instructed to adhere to a renal-specific diet depending on the severity and stage of their kidney disease. The prescribed diet may limit certain nutrients, such as phosphorus and potassium, or encourage the consumption of others, such as high biological value (HBV) proteins. Eggs are an inexpensive, easily available and high-quality source of protein, as well as a rich source of leucine, an essential amino acid that plays a role in muscle protein synthesis. However, egg yolk is a concentrated source of both phosphorus and the trimethylamine N-oxide precursor, choline, both of which may have potentially harmful effects in CKD. The yolk is also an abundant source of cholesterol which has been extensively studied for its effects on lipoprotein cholesterol and the risk of cardiovascular disease. Efforts to reduce dietary cholesterol to manage dyslipidemia in dialysis patients (already following a renal diet) have not been shown to offer additional benefit. There is a paucity of data regarding the impact of egg consumption on lipid profiles of CKD patients. Additionally, egg consumption has not been associated with the risk of developing CKD based on epidemiological studies. The egg yolk also contains bioactive compounds, including lutein, zeaxanthin, and vitamin D, which may confer health benefits in CKD patients. Here we review research on egg intake and CKD, discuss both potential contraindications and favorable effects of egg consumption, and describe the need for further research examining egg intake and outcomes in the CKD and end-stage renal disease population.

scholarly journals Association of Protein Intake in Three Meals with Muscle Mass in Healthy Young Subjects: A Cross-Sectional Study

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 612 ◽  
Author(s):  
Jun Yasuda ◽  
Mai Asako ◽  
Takuma Arimitsu ◽  
Satoshi Fujita
Keyword(s):  
Muscle Mass ◽  
Protein Intake ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Cross Sectional Study ◽  
Fat Free Mass ◽  
Intake Rate ◽  
Young Population ◽  
Cross Sectional ◽  
Young Subjects

Protein intake of >0.24 g/kg of body weight (BW) at a single meal is necessary to maximize muscle protein synthesis in a young population. However, the association between the protein intake rate for three meals and muscle mass in the young population has not been evaluated. We hypothesized that a protein intake of >0.24 g/kg BW at all three meals is effective for maintaining muscle mass. Therefore, we cross-sectionally examined the association between protein intake at all three meals with muscle mass in 266 healthy young subjects (aged 21.4 ± 2.4 years). Subjects were divided into the AP group, which achieved protein intake >0.24 g/kg BW at all three meals; and the NP group, which did not. We calculated total fat-free mass (FFM) and appendicular fat-free mass (AppFFM) with dual-energy X-ray absorptiometry, and the percentage of total FFM (TotalFFM%) and appendicular FFM (AppFFM%) were calculated as the percentage of BW (%BW). We demonstrated that TotalFFM% (77.0 ± 0.5 vs. 75.2 ± 0.4%, p = 0.008) and AppFFM% (34.7 ± 0.3 vs. 34.1 ± 0.2%, p = 0.058) were higher in the AP than in the NP group. This finding suggests that achieving protein intake of >0.24 g/kg BW at all three meals is important for muscle mass maintenance in young populations.

Aging, exercise, and muscle protein metabolism

2009 ◽  
Vol 106 (6) ◽  
pp. 2040-2048 ◽  
Author(s):  
René Koopman ◽  
Luc J. C. van Loon
Keyword(s):  
Physical Activity ◽  
Skeletal Muscle ◽  
Protein Synthesis ◽  
Food Intake ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
The Elderly ◽  
Age Related

Aging is accompanied by a progressive loss of skeletal muscle mass and strength, leading to the loss of functional capacity and an increased risk of developing chronic metabolic disease. The age-related loss of skeletal muscle mass is attributed to a disruption in the regulation of skeletal muscle protein turnover, resulting in an imbalance between muscle protein synthesis and degradation. As basal (fasting) muscle protein synthesis rates do not seem to differ substantially between the young and elderly, many research groups have started to focus on the muscle protein synthetic response to the main anabolic stimuli, i.e., food intake and physical activity. Recent studies suggest that the muscle protein synthetic response to food intake is blunted in the elderly. The latter is now believed to represent a key factor responsible for the age-related decline in skeletal muscle mass. Physical activity and/or exercise stimulate postexercise muscle protein accretion in both the young and elderly. However, the latter largely depends on the timed administration of amino acids and/or protein before, during, and/or after exercise. Prolonged resistance type exercise training represents an effective therapeutic strategy to augment skeletal muscle mass and improve functional performance in the elderly. The latter shows that the ability of the muscle protein synthetic machinery to respond to anabolic stimuli is preserved up to very old age. Research is warranted to elucidate the interaction between nutrition, exercise, and the skeletal muscle adaptive response. The latter is needed to define more effective strategies that will maximize the therapeutic benefits of lifestyle intervention in the elderly.

Muscle Protein Metabolism in the Elderly: Influence of Exercise and Nutrition

2001 ◽  
Vol 26 (6) ◽  
pp. 588-606 ◽  
Author(s):  
Kevin D. Tipton
Keyword(s):  
Protein Synthesis ◽  
Muscle Mass ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Effective Means ◽  
The Elderly ◽  
Protein Breakdown ◽  
Small Magnitude ◽  
Muscle Protein Breakdown ◽  
Metabolic Basis

Although the causes of sarcopenia are multi-factorial, at least some, such as poor nutrition and inactivity, may be preventable. Changes in muscle mass must be a result of net muscle protein breakdown over that particular time period. Stable isotope methodology has been used to examine the metabolic basis of muscle loss. Net muscle protein breakdown may occur due to a decrease in the basal level of muscle protein synthesis. However, changes of this type would likely be of small magnitude and undetectable by current methodology. Hormonal mediators may also be important, especially in association with forced inactivity. Net muscle protein breakdown may be also attributed to alterations in the periods of net muscle protein synthesis and breakdown each day. Reduced activity, combined with ineffectual nutrient intake, could lead to decreased net muscle protein balance. Chronic resistance exercise training clearly is an effective means of increasing muscle mass and strength in elderly individuals. Although sometimes limited, acute metabolic studies provide valuable information for maintenance of muscle mass with age. Key words: sarcopenia, inactivity, strength training, muscle protein synthesis, muscle hypertrophy

scholarly journals The anabolic role of plant-based proteins in response to chronic resistance exercise

2021 ◽  
Vol 11 (3) ◽  
pp. 14-23
Author(s):  
Carina Sousa Santos ◽  
Eudes Souza Oliveira Júnior ◽  
Marcus James Lopes de Sá ◽  
Elizabethe Adriana Esteves
Keyword(s):  
Skeletal Muscle ◽  
Protein Synthesis ◽  
Resistance Exercise ◽  
Muscle Mass ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
The Elderly ◽  
Food Sources ◽  
Dietary Adequacy ◽  
The Face

Proper maintenance of skeletal muscle mass is essential to prevent sarcopenia and ensure health and quality of life as aging progress. The two determinants of muscle protein synthesis are the increased load on skeletal muscle through resistance exercise and protein intake. For an effective result of maintaining or increasing muscle mass, it is relevant to consider the quantitative and adequate intake of protein, and the dietary source of protein since the plant-based protein has differences in comparison to animals that limit its anabolic capacity. Given the increase in vegetarianism and the elderly population, which consumes fewer food sources of animal protein, the importance of understanding how protein of plant-based protein can sustain muscle protein synthesis in the long term when associated with resistance exercise is justified, as well as the possibilities of dietary adequacy in the face of this demand.

Dietary protein considerations for muscle protein synthesis and muscle mass preservation in older adults

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Eunice T. Olaniyan ◽  
Fiona O’Halloran ◽  
Aoife L. McCarthy
Keyword(s):  
Older Adults ◽  
Protein Synthesis ◽  
Amino Acid ◽  
Muscle Mass ◽  
Protein Intake ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Adult Population ◽  
Anabolic Resistance

Abstract Amino acid bioavailability is critical for muscle protein synthesis (MPS) and preservation of skeletal muscle mass (SMM). Ageing is associated with reduced responsiveness of MPS to essential amino acids (EAA). Further, the older adult population experiences anabolic resistance, leading to increased frailty, functional decline and depleted muscle mass preservation, which facilitates the need for increased protein intake to increase their SMM. This review focuses on the role of proteins in muscle mass preservation and examines the contribution of EAA and protein intake patterns to MPS. Leucine is the most widely studied amino acid for its role as a potent stimulator of MPS, though due to inadequate data little is yet known about the role of other EAA. Reaching a conclusion on the best pattern of protein intake has proven difficult due to conflicting studies. A mixture of animal and plant proteins can contribute to increased MPS and potentially attenuate muscle wasting conditions; however, there is limited research on the biological impact of protein blends in older adults. While there is some evidence to suggest that liquid protein foods with higher than the RDA of protein may be the best strategy for achieving high MPS rates in older adults, clinical trials are warranted to confirm an association between food form and SMM preservation. Further research is warranted before adequate recommendations and strategies for optimising SMM in the elderly population can be proposed.

DIETARY PROTEIN TO MAINTAIN MUSCLE MASS IN AGING: A CASE FOR PER-MEAL PROTEIN RECOMMENDATIONS

2016 ◽  
pp. 1-10
Author(s):  
C.H. MURPHY ◽  
S.Y. OIKAWA ◽  
S.M. PHILLIPS
Keyword(s):  
Muscle Mass ◽  
Dietary Protein ◽  
Protein Intake ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Dietary Advice ◽  
Age Related ◽  
Meal Protein ◽  
Single Meal ◽  
And Function

It is well accepted that daily protein intake is an important dietary consideration to limit and treat age-related declines in muscle mass, strength, and function. Furthermore, we propose that there is a growing appreciation for the need to consider protein intake on a per-meal basis rather than simply focusing on the total daily protein intake. The existence of a saturable dose-response relationship between muscle protein synthesis (MPS) and the quantity of protein consumed in a single meal/bolus provides the rationale for promoting an even/balanced pattern of daily protein intake. We hypothesize that a balanced/even protein intake pattern with the ingestion a quantity of protein shown to optimally stimulate MPS at each meal may be an effective strategy to alleviate sarcopenic muscle loss. In this review we examine the available evidence supporting the influence of dietary protein intake pattern on muscle protein turnover, muscle mass, and muscle function. We present several practical considerations that, it is proposed, should be taken into account when translating a per-meal protein recommendation into dietary advice for older adults.

scholarly journals Dietary protein and exercise training in ageing

2010 ◽  
Vol 70 (1) ◽  
pp. 104-113 ◽  
Author(s):  
René Koopman
Keyword(s):  
Skeletal Muscle ◽  
Protein Synthesis ◽  
Exercise Training ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Human Subjects ◽  
The Elderly ◽  
Age Related

Ageing is accompanied by a progressive loss of skeletal muscle mass and strength, leading to the loss of functional capacity and an increased risk for developing chronic metabolic diseases such as diabetes. The age-related loss of skeletal muscle mass results from a chronic disruption in the balance between muscle protein synthesis and degradation. As basal muscle protein synthesis rates are likely not different between healthy young and elderly human subjects, it was proposed that muscles from older adults lack the ability to regulate the protein synthetic response to anabolic stimuli, such as food intake and physical activity. Indeed, the dose–response relationship between myofibrillar protein synthesis and the availability of essential amino acids and/or resistance exercise intensity is shifted down and to the right in elderly human subjects. This so-called ‘anabolic resistance’ represents a key factor responsible for the age-related decline in skeletal muscle mass. Interestingly, long-term resistance exercise training is effective as a therapeutic intervention to augment skeletal muscle mass, and improves functional performance in the elderly. The consumption of different types of proteins, i.e. protein hydrolysates, can have different stimulatory effects on muscle protein synthesis in the elderly, which may be due to their higher rate of digestion and absorption. Current research aims to elucidate the interactions between nutrition, exercise and the skeletal muscle adaptive response that will define more effective strategies to maximise the therapeutic benefits of lifestyle interventions in the elderly.

scholarly journals The role of dietary protein in optimizing muscle mass, function and health outcomes in older individuals

2012 ◽  
Vol 108 (S2) ◽  
pp. S88-S93 ◽  
Author(s):  
Robert R. Wolfe
Keyword(s):  
Protein Synthesis ◽  
Health Outcomes ◽  
Muscle Mass ◽  
Dietary Protein ◽  
Protein Intake ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Dietary Protein Intake ◽  
Older Individuals ◽  
And Function

The determination of whether increased dietary protein can positively affect health outcomes is hindered by the absence of prospective, randomized trials directly addressing this issue in which all pertinent variables are controlled. Consequently, we can only address the question deductively by considering the support for the rationale underlying the notion of a beneficial effect of increased dietary protein intake. With regard to health outcomes, we have focused on older individuals. Muscle mass and function are progressively lost with aging, so that by the age of 60 many individuals have reached a threshold where function begins to be affected. An association between reduced muscle mass and strength and unfavourable health outcomes is more likely to be revealed in individuals who have significant decrements in muscle mass and strength. In this article support for the rationale underlying the notion of a beneficial effect of increased dietary protein intake is considered. Dietary protein intake, and the resulting increased availability of plasma amino acids, stimulates muscle protein synthesis. If all other variables are controlled, increased muscle protein synthesis leads to improved muscle mass, strength and function over time. Increased muscle mass, strength and function are related to improved health outcomes in older individuals. Since adverse effects of reasonable increases in protein intake above the recommended dietary allowance (RDA) of 0·8 g protein/kg/day have not been reported, it is reasonable to conclude that the optimal protein intake for an older individual is greater than the RDA.

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