An Update on Protein, Leucine, Omega-3 Fatty Acids, and Vitamin D in the Prevention and Treatment of Sarcopenia and Functional Decline

Abstract

Aging is associated with sarcopenia and functional decline, leading to frailty and disability. As a modifiable risk factor, nutrition may represent a target for preventing or postponing the onset of these geriatric conditions. Among nutrients, high-quality protein, leucine, vitamin D, and omega-3 polyunsaturated fatty acids (n-3 PUFA) are of particular interest for their demonstrated effects on skeletal muscle health. This narrative review aims to examine the recent observational and interventional evidence on the associations and the role of these nutrients in the muscle mass, strength, mobility, and physical function of free-living older adults, who are either healthy or at risk of frailty. Recent evidence supports a higher protein intake recommendation of 1.0–1.2 g/kg/day in healthy older adults; an evenly distributed mealtime protein intake or minimal protein per meal may be beneficial. In addition, vitamin D supplementation of 800–1000 IU, particularly when vitamin D status is low, and doses of ~3 g/day of n-3 PUFA may be favorable for physical function, muscle mass, and strength. Reviewed studies are highly heterogenous, yet the quantity, quality, and timing of intakes should be considered when designing intervention studies. Combined protein, leucine, vitamin D, and n-3 PUFA supplements may convey added benefits and may represent an intervention strategy in the prevention of sarcopenia and functional decline.

Gut–Joint Axis: The Role of Physical Exercise on Gut Microbiota Modulation in Older People with Osteoarthritis

“…It is important to underline the role of an adequate diet and the use of dietary supplements in the 'active aging' population [45,46]. Indeed, these two interventions combined with vitamin D and amino acid supplementation and physical exercise could prevent several sequelae of the aging process including sarcopenia, as shown by several studies in the literature [47][48][49][50][51][52][53]. Finally, it has been demonstrated that there is a strong correlation between the adherence to a Mediterranean diet and a lower risk of OA manifestation, mediated by the well-known anti-inflammatory activity of fibers [54].…”

Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update

“…Further research is needed in order to establish the potential dose-dependent mechanism of PUFA when combined with other tailored strategies for the management of malnutrition, cachexia, sarcopenia and frailty in COPD. It has been suggested that medical nutrition interventions providing adequate protein, the amino acid leucine, vitamin D and PUFA may convey added benefits in the management of sarcopenia and functional decline (36).…”

Obesidade osteosarcopênica sob o olhar da nutrição funcional

“…Tessir et al 32 demonstraram que uma ingestão inadequada de proteína, ômega 3 e vitamina D pode promover sarcopenia, com redução da massa muscular, da força muscular ou da performance física, além de diminuir mobilidade e aumentar mortalidade ou morbidade. Além disso, outro estudo recente avaliou o impacto da nutrição e do exercício na massa muscular esquelética e demonstrou que proteína, aminoácidos essenciais, vitamina D e ômega 3 atuam no processo de contração muscular, produção de energia e estímulo mitocondrial, o que melhora a utilização de gordura pelo músculo como substrato energético 33 .…”