Are Canadian protein and physical activity guidelines optimal for sarcopenia prevention in older adults?

Abstract

Aging is characterized by physiological and morphological changes that affect body composition, strength, and function, ultimately leading to sarcopenia. This condition results in physical disability, falls, fractures, poor quality of life, and increased health care costs. Evidence suggests that increased consumption of dietary protein and physical activity levels, especially resistance exercise, can counteract the trajectory of sarcopenia. Canadian guidelines for protein intake and physical activity were last updated in 2005 and 2011, respectively, and new evidence on sarcopenia diagnosis, prevention, and treatment is rapidly evolving. Protein recommendations are set as "one-size-fits-all" for both young and older adults. Recent evidence demonstrates that current recommendations are insufficient to meet the minimum protein requirement to counteract muscle loss and to stimulate hypertrophy in healthy older adults. Beyond quantity, protein quality is also essential to benefit muscle anabolism in older adults. In terms of physical activity, resistance exercise training is a potential strategy to counteract age-related effects, as it can elicit muscle hypertrophic response in addition to increases in muscle strength and function in older adults. Canadian physical activity guidelines lack details on how this modality of training should be performed. Current guidelines for protein intake and physical activity do not reflect recent knowledge on sarcopenia prevention. The gap between guidelines and the latest evidence on the maintenance and promotion of older adult's health highlight the need for updated protein and physical activity recommendations.

Study of the Older Adults’ Motivators and Barriers Engaging in a Nutrition and Resistance Exercise Intervention for Sarcopenia: An Embedded Qualitative Project in the MIlkMAN Pilot Study

“…Current recommendations for the treatment and prevention of sarcopenia include adequate protein intake and RE (Cruz-Jentoft et al, 2014; Deutz et al, 2014; Oliveira et al, 2018); however, encouraging older adults to change their dietary habits and engage in RE is challenging (Burton et al, 2017; Chao et al, 2000; Cohen-Mansfield et al, 2003; Crombie et al, 2004; Moran et al, 2014).…”

Associations of accelerometer-determined physical activity and sedentary behavior with sarcopenia and incident falls over 12 months in community-dwelling Swedish older adults

“… 10 While strength training is recommended in current PA guidelines, they focus primarily on general PA rather than targeted exercise. 11 It is therefore important to understand associations of general PA with sarcopenia and falls. The aim of this study was to determine associations of accelerometer-determined total duration and number of bouts of sedentary behavior, LPA, and MVPA with EWGSOP2-defined sarcopenia and its components, as well as their associations with incidence of falls over 12 months.…”

Dietary Protein Intake Dynamics in Elderly Chinese from 1991 to 2018

“…Hence, almost half of the elderly Chinese population did not meet the individual protein intake requirement, which may result in serious adverse consequences for healthy aging. Furthermore, epidemiological studies have suggested that current dietary protein intake recommendations may be insufficient for maintaining muscle mass and strength for the elderly and for improving their health [20,21]. The requirement for a larger dose of protein to generate responses in elderly adults similar to those in younger adults provides the support for a beneficial effect of increased protein intake in older populations [22].…”