Nutritional strategies to counteract muscle atrophy caused by disuse and to improve recovery

Abstract

Periods of immobilisation are often associated with pathologies and/or ageing. These periods of muscle disuse induce muscle atrophy which could worsen the pathology or elderly frailty. If muscle mass loss has positive effects in the short term, a sustained/uncontrolled muscle mass loss is deleterious for health. Muscle mass recovery following immobilisation-induced atrophy could be critical, particularly when it is uncompleted as observed during ageing. Exercise, the best way to recover muscle mass, is not always applicable. So, other approaches such as nutritional strategies are needed to limit muscle wasting and to improve muscle mass recovery in such situations. The present review discusses mechanisms involved in muscle atrophy following disuse and during recovery and emphasises the effect of age in these mechanisms. In addition, the efficiency of nutritional strategies proposed to limit muscle mass loss during disuse and to improve protein gain during recovery (leucine supplementation, whey proteins, antioxidants and anti-inflammatory compounds, energy intake) is also discussed.

Frailty and nutrition: Searching for evidence

“…Dietary strategies should be developed to compensate such anabolic resistance, and to counteract muscle atrophy caused by periods of immobilisation that are frequently observed in the elderly (94). The muscle's anabolic response also depends on the digestion and absorption kinetics and amino acid composition of proteins.…”

Glutamine metabolism in advanced age

“…For this reason, protein and amino acids, notably glutamine, as dietary supplementation may have potential usefulness in fighting against muscle atrophy during aging. Thus far, however, dietary supplementation with proteins or amino acids seems inefficient in limiting the atrophy processes, and neither leucine [100][101][102] (or essential amino acids 103,104 ) nor glutamine 105 fights against the loss of skeletal muscle. Protein supplementation increased muscle mass gain only during resistance-type exercise training in elderly people.…”

Leucine as a treatment for muscle wasting: A critical review

“…During immobilization and bed rest muscle wasting results from both increased protein breakdown, which is upregulated within the first 24 h, and decreased protein synthesis [34]. While reduced basal protein synthesis may or may not contribute to the loss of muscle mass during the early stages of inactivity, after the first 10 d of immobilization nearly all of the muscle loss is thought to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 1...…”

“…Ultimately, the inability of leucine to stimulate muscle protein synthesis during inflammation could also be the result of any number of alterations to mTOR, its binding partners or the proteins responsible for its cellular localization that prevents the interaction of mTOR and Rheb [47]. Anabolic resistance to amino acids is considered a major contributor to muscle wasting, and strategies to address anabolic resistance are a focus for many researchers [20,25,34,37].…”

“…The first involves providing a greater anabolic stimulus, which forms the major rationale for increasing dietary leucine intake during muscle wasting conditions. The second involves attenuation of the factors causing the reduction in normal anabolic signaling; for example using anti-inflammatory approaches and antioxidants [34]. While both make rational arguments, current evidence suggests the latter approach is more effective than the former.…”