Sarcopenia Part 2

Dear Friends:
 
Sarcopenia, as discussed in Part One, means a decline in muscle mass, strength, and physical performance that tend to most typically be associated with aging, but also can happen with disturbances in metabolism, disease, and conditions of malnutrition that centers around mitochondrial dysfunction.

 As mentioned in Part One, along with exercise, which is mandatory both for better prevention and rehabilitation, nutritional and even supplements as interventions are crucially important in helping contribute to preventing its development as well as its reversal, especially for less complicated age-related sarcopenia. 

However, in more complex syndromes, not necessarily age-related, the management and treatment for underlying disease and a health condition, such as diabetes or even interestingly obesity in rare cases, is crucial. 
 
Therefore, part of the nutritional armamentarium in managing sarcopenia, absolutely nothing can substitute for a good foundational diet that is rich in fruits and vegetables, plenty of hydration since muscle about 90% water, good protein as I will discuss in a moment, and key nutrients such as Vitamin D3, Vitamin K2, Zinc, B-Complex, Vitamin E,.
 
Also could well include the role of several or more super-nutrients that are proving to offer additional efficacy as “epigenetic” facilitators in protecting the mitochondrial genes in our muscle DNA. 
 
Keep in mind, the list of epigenetic facilitators continues to grow with more surprises as we learn and research more natural substances, so what is provided in this article is just a start.
 
This is important because, as with osteoporosis and osteopenia, as well as sarcopenia, there can be an inflammatory component that is part of the disease syndrome, and mitochondrial dysfunction has a monumental role in the etiology of lean-tissue deterioration because of the down-regulation of key mitochondrial genes in our DNA that can be controlled and largely influenced by its “epigene” ( Epigenetics).

That means. a particular substance, in this case, a “positive-enhancing” nutrient, nutraceutical, or a specifically designed pharmaceutical sits on top of the gene and is a “switch” that will turn off or on that gene let’s say for the better, but there are a number of other means, from toxins, disturbed metabolism, harmful drugs or drug interactions, alcohol, bad dietary decisions, even from lack of exercise, etc, that can provide an “adverse” epigene that can get control and switch on the gene to create a more negative manifestation of that specific gene expression.

Several very specific powerful epigene dietary supplement facilitators are noted below: There are many not mentioned and many still in discovery, but this is a start. 

1.Astaxanthin with zinc supplementation noted in the research study:

Effect of long-term dietary astaxanthin intake on sarcopenia

Abstract Conclusions: The AX formulation improved muscle strength and CSA in healthy elderly in addition to the elevation in endurance and walking distance found with exercise training alone. Thus, the AX formulation in combination with a functional training program uniquely improved muscle strength, endurance, and mobility in the elderly.           

October 2008

Tairyoku Kagaku. Japanese journal of physical fitness and sports medicine 57(5):541-552

2. PQQ Inhibiting muscle atrophy and help protect against neuromuscular denervation in muscle wasting syndromes ( and upregulated mitochondrial function)

 PLoS One. 2015; 10(12): e0143600.

Published online 2015 Dec 8. doi: 10.1371/journal.pone.0143600

3. NAD+ Precursors and Possible NMN in Epi-genetic facilitation in preventing muscle wasting:

Nestle-EpiGen joint sarcopenia study: Mitochondria dysfunction in muscles a key cause of sarcopenia

11-Mar-2020 By Tingmin Koe
A joint study found that mitochondria bioenergetics dysfunction is key in the development of sarcopenia and that the condition could be managed by improving mitochondria function and repair.
 
4. Quercetin protects against obesity-induced skeletal muscle inflammation and atrophy

PM: 2014;2014:834294.

Ngoc Hoan Le  1 , Chu-Sook Kim  1 , Taesun Park  2 , Jung Han Yoon Park  3 , Mi-Kyung Sung  4 , Dong Gun Lee  5 , Sun-Myung Hong  1 , Suck-Young Choe  1 , Tsuyoshi Goto  6 , Teruo Kawada  6 , Rina Yu  1

 

5. Selenium:

Another potential nutrient that may positively affect sarcopenia outcomes is selenium. In our review, we included 4 studies that showed a positive association of selenium and muscle mass, physical performance, and sarcopenia. Association of low plasma selenium concentrations with poor muscle strength in older community-dwelling adults: 

Am J Clin Nutr. 2007 Aug; 86(2): 347–352.

doi: 10.1093/ajcn/86.2.347

Circling back to protein and exercise, protein intake and physical activity are the main anabolic stimuli for muscle protein synthesis thus significant for sarcopenia and general health. 

As optimal dietary protein intake, 1.0 – 1.2 g/kg (body weight)/day with an optimal repartition over each daily meal or 25 – 30 g of high-quality protein per meal were recommended to prevent sarcopenia, which was supported by many studies. 

Protein supplementation, protein foods, containing key amino acid in protein,  leucine, with vitamin D3 and zinc has been amply investigated to improve muscle quality in sarcopenic people in the  must context of a good foundation diet.

In summary, to outline a  possible  overall additional supplement program inclusive of  one or more of the  following may prove beneficial to consider with  or under professional advisement:

1.   Protein sources beyond an essential good and balanced diet: Whey, Pea, Various balanced plant and microbiological proteins such as algae, mushroom, etc,  Collagen, HMB, Advanced deodorized agglomerated fish protein

2.   Extra Nutrients: Vitamin D3, Vitamin K2, Natural tocopherols, zinc, calcium, phosphorus, magnesium as magnesium glycinate, trace minerals. B-complex, Vitamin C, and E, 

3.   Super antioxidants and mitochondrial facilitators: Astaxanthin, PQQ, NAD precursors, Quercetin, selenium ( especially effective as found in a natural grown cruciferous vegetable complex).

 

Thank you, Dr. Koz