Targeting Inflammation and Downstream Protein Metabolism in Sarcopenia: A Brief Up-Dated Description of Concurrent Exercise and Leucine-Based Multimodal Intervention

Abstract

Sarcopenia is defined as the progressive loss of muscle mass with age, and poses a serious threat to the physiological and psychological health of the elderly population with consequential economic and social burdens. Chronic low-grade inflammation plays a central role in the development of sarcopenia such that it alters cellular protein metabolism to favor proteolysis over synthesis, and thereby accelerates muscular atrophy. The purpose of this review is to highlight how exercise and nutrition intervention strategies can attenuate or treat sarcopenia. Resistance exercise increases not only muscle mass but also muscle strength, while aerobic exercise is able to ameliorate the age-related metabolic disorders. Concurrent exercise training integrates the advantages of both aerobic and resistance exercise, and may exert a significant synergistic effect in the aging organism. Higher protein intakes rich in the amino acid leucine appear to restore skeletal muscle protein metabolism balance by rescuing protein synthesis in older adults. There is good reason to believe that a multimodal treatment, a combination of exercise and increased leucine consumption in the diet, can combat some of the muscle loss associated with aging. Future research is needed to consolidate these findings to humans, and to further clarify to what extent and by which mechanisms protein metabolism might be directly involved in sarcopenia pathogenesis and the multimodal treatment responses.

Systemic Inflammation in the Recovery Stage of Stroke: Its Association with Sarcopenia and Poor Functional Rehabilitation Outcomes

“…49) This finding can be largely explained by the mechanism of muscle protein breakdown, i.e., the progression of sarcopenia. 47) We hypothesize that pre-existing sarcopenia caused partly by systemic inflammation might have meaningful effects on rehabilitation outcomes, even though a causal relationship between systemic inflammation and sarcopenia was not clear in the current study because of its design. We believe that it is important to be aware of the influence of systemic inflammation on functional outcomes in the relevant study fields.…”

“…It has also been shown that depletion of muscle mass with aging is caused by inflammatory cytokines produced by chronic low-grade inflammation. 47) Inflammatory cytokines suppress protein synthesis pathways including that of the mammalian target of rapamycin. Inflammatory cytokines also activate the ubiquitin / proteasome pathway (UPP) which promotes the breakdown of muscle proteins.…”

“…Inflammatory cytokines also activate the ubiquitin / proteasome pathway (UPP) which promotes the breakdown of muscle proteins. 47) This inflammation-driven mechanism is believed to partly explain the age-related decrease in muscle mass. Decreases in growth hormones, indirectly caused by inflammation, are also negatively associated with skeletal muscle metabolism.…”

One-year Mediterranean diet promotes epigenetic rejuvenation with country- and sex-specific effects: a pilot study from the NU-AGE project

“…As the population continues to age within Europe, an increase in the incidence of age-related diseases is observed (WHO 2017). Indeed, the increasing lifespan is not associated with an increase in health span, and this issue represents a great challenge for our societies.…”

“…A possible strategy to impact on aging is to intervene on lifestyle factors, such as diet or physical activity. Nutritional interventions seem to be one of the most promising approaches to promote healthy aging, and growing amount of data indicates that they can influence the health status of subjects (Longo et al 2015;Dato et al 2016;Wahl et al 2016;Shlisky et al 2017;Xia et al 2017;Heiss et al 2017).…”