Let s discuss active aging networking and matchmaking between research and businesses How muscular activity and protein intake promote muscle regrowth in elderly people Lars Holm Associate Professor Faculty of Health and Medical Sciences Dept. of Biomedical Sciences University of Copenhagen Institute of Sports Medicine, Bispebjerg Hospital Slide 1 Disclosure I declare no conflicts of interest! Funding sources: Danish Research Council Otsuka Pharmaceuticals Arla Foods Ingredients Group P/S Danish Dairy Research Foundation Danish Cattle Research Foundation University of Copenhagen, Excellence Program Innovation Foundation Denmark Slide 2 1
Muscle size and strength Lexell et al 1988 J Neurol Sci Janssen et al 2000 J Appl Physiol Slide 3 Institute of Sports Medicine, Copenhagen Factors involved in elderly s natural without injury/disease - loss of skeletal muscle mass Morley JE et al 2011 JAMDA Cruz-Jentoft AJ et al 2010 Age & Ageing NUTRITION/PROTEIN & EXERCISE Dias 4 2
Is RDA of dietary protein enough? Bauer J et al 2013 JAMDA Dias 5 Institute of Sports Medicine, Copenhagen Biomedicinsk Institut QVANTITY: Required protein intake 0.8 g/kg/d Adult individuals: 98% reach null N-balance at 0.83 g/kg/d. Dias 6 Rand et al., 2003 AJCN 3
Protein intake among elderly +65 yrs in European countries Dias 7 Institute of Sports Medicine, Copenhagen Muscle protein kinetics & signaling Ways to assess the muscle-anabolic potential of interventions Changes in muscle fibre or whole muscle area OR regional/whole body mass Phillips et al., JAP 2009. Slide 8 4
Protein synthesis Amino acids Proteins mrna Protein synthesis measured with tracers Amino acids Proteins 13 C 15 N 2 H 13 C Labelled AA Unlabelled AA 5
Hyper-aminoacidemia in the RESTING muscle Bohé J et al., 2001, J Physiol Amount of protein does make a difference with an upper limit 20-25 g Institute of Sports Medicine, Bispebjerg Hospital Dias 12 Moore DR et al., Am J Clin Nutr 2009. 6
Quantity of protein stimulating MPS maximally Institute of Sports Medicine, Copenhagen Moore DR et al 2015 J Gerontol Dias 13 Institute of Sports Medicine, Copenhagen 30-50 g protein/serving (meal) Dias 14 Deutz NEP et al 2014 Clin Nutr 7
Experimental settings - over night fasting - single protein-only serving BUT WHAT ABOUT REAL MEALS - mixed nutrients - energy Slide 15 Biomedicinsk Institut Take home protein requirement Protein intake- quantity Adults needs 0.8 (-1.0) g/kg/d The larger intake the larger use for energy metabolism BUT the requirement in elderly subjects is probablyas highas 1.5 g/kg/d. NEXT beyondbasicscience to implementation: From experimental settings and single protein servings to whole day meals and every day life practices Dias 16 8
Adequate protein intake and muscle growth (Semi)-frail(Fried et al, 2001): 1) Unintensional weight loss 2) Weakness 3) Self-reported exhaustion 4) Slow walking speed 5) Low physical activity Protein supplement: 1) 15 g Milk Protein Concentrate 7.1 g carbohydrate 2) PLACEBO 2 x daily at BREAKFAST & LUNCH Slide 17 Tieland et al 2012 JAMDA Adequate protein intake IS required to grow muscle Resistance training: 2 x per week 5-min warm up 4 set leg press 4 set knee extension + upper body 10-15 reps @ 50% 1RM 8-10 reps @ 75% 1RM RM tests @ pre, 4, 8, 12, 16, 20 wks Tieland et al 2012 JAMDA Slide 18 9
Enhedens navn Elderly people above the age of 83 years DAILY PROTEIN/ENERGY SUPPL HRT (n=15) CONTROL (n=15) 3x/week 2x/day Progressive supervised 20g of milk protein heavy resistance 1260kJ training 5 3 sets of 15RM 6RM Dias 19 Bechshoeft, Holm et al., unpublished Elderly people above the age of 83 years DAILY PROTEIN/ENERGY SUPPL Slide 20 10
Setting and Intensity of RESISTANCE EXERICSE Institute of Sports Medicine, Copenhagen Dias 21 Institute of Sports Medicine, Copenhagen Interventions 1. Protein quality vs. non-protein 2. Home-based low-intensity (3-5 x /wk) 3. Centre-based heavy load (2-3 x /wk) Breakfast Lunch Dinner Dias 22 11
Thank you I m looking forward to a fruitful discussion Slide 23 12