In elderly, muscle mass, energy expenditure and insulin sensitivity are decreased.•A Mediterranean-like energy supply of approximately 30kcal/kg/day is recommended.•Endurance plus resistance exercise improves muscle mass and oxidative capacity.•A protein intake of 1.0–1.5g protein/kg/day is recommended.•An integrated approach of protein-energy homeostasis is needed.
Protein-energy homeostasis is a major determinant of healthy aging. Inadequate nutritional intakes and physical activity, together with endocrine disturbances are associated with of sarcopenia and frailty. Guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition in elderly. Besides these quantitative aspects of protein load, perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding, the use of fast proteins and the addition of leucine or citrulline to dietary protein. An integrated management of sarcopenia, taking into account the determinants of muscle wasting, i.e. nutrition, physical activity, anabolic factors such as androgens, vitamin D and n-3 polyunsaturated fatty acids status, needs to be tested in the prevention and treatment of sarcopenia. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition. According to present data, healthy nutrition in elderly should respect the guidelines for protein and energy requirement, privilege a Mediterranean way of alimentation, and be associated with a regular physical activity. Further issues relate to the identification of the genetics determinants of protein energy wasting in elderly.
ในผู้สูงอายุ มวลกล้ามเนื้อ ลดความไวต่ออินซูลินและจ่ายพลังงาน •A เมดิเตอร์เรเนียนเช่นพลังงานประมาณ 30kcal/กก./วัน แนะนำ •Endurance และความต้านทานออกกำลังกายเพิ่มกล้ามเนื้อโดยรวม และ oxidative กำลัง •A โปรตีนบริโภคของ 1.0 – 1.5 กรัมโปรตีน/กก/วันแนะนำ. •An รวมวิธีพลังงานโปรตีน จำเป็นสำหรับภาวะธำรงดุล Protein-energy homeostasis is a major determinant of healthy aging. Inadequate nutritional intakes and physical activity, together with endocrine disturbances are associated with of sarcopenia and frailty. Guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition in elderly. Besides these quantitative aspects of protein load, perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding, the use of fast proteins and the addition of leucine or citrulline to dietary protein. An integrated management of sarcopenia, taking into account the determinants of muscle wasting, i.e. nutrition, physical activity, anabolic factors such as androgens, vitamin D and n-3 polyunsaturated fatty acids status, needs to be tested in the prevention and treatment of sarcopenia. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition. According to present data, healthy nutrition in elderly should respect the guidelines for protein and energy requirement, privilege a Mediterranean way of alimentation, and be associated with a regular physical activity. Further issues relate to the identification of the genetics determinants of protein energy wasting in elderly.
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