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Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery.
Hirsch, KR, Wolfe, RR, Ferrando, AA
Nutrients. 2021;(5)
Abstract
Nutritional status is a strong predictor of postoperative outcomes and is recognized as an important component of surgical recovery programs. Adequate nutritional consumption is essential for addressing the surgical stress response and mitigating the loss of muscle mass, strength, and functionality. Especially in older patients, inadequate protein can lead to significant muscle atrophy, leading to a loss of independence and increased mortality risk. Current nutritional recommendations for surgery primarily focus on screening and prevention of malnutrition, pre-surgical fasting protocols, and combating post-surgical insulin resistance, while recommendations regarding macronutrient composition and timing around surgery are less established. The goal of this review is to highlight oral nutrition strategies that can be implemented leading up to and following major surgery to minimize atrophy and the resultant loss of functionality. The role of carbohydrate and especially protein/essential amino acids in combating the surgical stress cascade and supporting recovery are discussed. Practical considerations for nutrient timing to maximize oral nutritional intake, especially during the immediate pre- and post- surgical periods, are also be discussed.
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2.
Vitamin D, muscle recovery, sarcopenia, cachexia, and muscle atrophy.
Garcia, M, Seelaender, M, Sotiropoulos, A, Coletti, D, Lancha, AH
Nutrition (Burbank, Los Angeles County, Calif.). 2019;:66-69
Abstract
The relevance of vitamin D to skeletal muscle metabolism has been highlighted in recent years. The interest arises from the important findings of studies demonstrating multiple effects of vitamin D on this tissue, which can be divided into genomic (direct effects) and non-genomic effects (indirect effects). Another important aspect to be considered in the study of vitamin D and muscle fiber metabolism is related to different expression of vitamin D receptor (VDR), which varies in muscle tissue depending on age, sex, and pathology. The correlation between low circulating levels of vitamin D and muscle metabolism disorders is documented in various contexts, including muscle recovery, atrophy, sarcopenia, and cachexia. The aim of this review was to analyze recent results of both in vitro and in vivo studies to address the relationship between vitamin D and skeletal muscle biology. The words muscle atrophy, muscle hypertrophy, sarcopenia, and cachexia were crossed over with vitamin D in a Pubmed search. All original contributions, along with reviews on the topic, were included, and no publications in the past 10 y were discarded. The papers retrieved different topics such as vitamin D in skeletal muscle; vitamin D in circulation; vitamin D, sarcopenia, and muscle atrophy; vitamin D and cachexia; and vitamin D and muscle recovery.
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3.
Supplements with purported effects on muscle mass and strength.
Valenzuela, PL, Morales, JS, Emanuele, E, Pareja-Galeano, H, Lucia, A
European journal of nutrition. 2019;(8):2983-3008
Abstract
PURPOSE Several supplements are purported to promote muscle hypertrophy and strength gains in healthy subjects, or to prevent muscle wasting in atrophying situations (e.g., ageing or disuse periods). However, their effectiveness remains unclear. METHODS This review summarizes the available evidence on the beneficial impacts of several popular supplements on muscle mass or strength. RESULTS Among the supplements tested, nitrate and caffeine returned sufficient evidence supporting their acute beneficial effects on muscle strength, whereas the long-term consumption of creatine, protein and polyunsaturated fatty acids seems to consistently increase or preserve muscle mass and strength (evidence level A). On the other hand, mixed or unclear evidence was found for several popular supplements including branched-chain amino acids, adenosine triphosphate, citrulline, β-Hydroxy-β-methylbutyrate, minerals, most vitamins, phosphatidic acid or arginine (evidence level B), weak or scarce evidence was found for conjugated linoleic acid, glutamine, resveratrol, tribulus terrestris or ursolic acid (evidence level C), and no evidence was found for other supplements such as ornithine or α-ketoglutarate (evidence D). Of note, although most supplements appear to be safe when consumed at typical doses, some adverse events have been reported for some of them (e.g., caffeine, vitamins, α-ketoglutarate, tribulus terrestris, arginine) after large intakes, and there is insufficient evidence to determine the safety of many frequently used supplements (e.g., ornithine, conjugated linoleic acid, ursolic acid). CONCLUSION In summary, despite their popularity, there is little evidence supporting the use of most supplements, and some of them have been even proven ineffective or potentially associated with adverse effects.
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4.
Nutritional Considerations in Preventing Muscle Atrophy.
Cretoiu, SM, Zugravu, CA
Advances in experimental medicine and biology. 2018;:497-528
Abstract
Muscle atrophy may occur under different circumstances throughout a person's life. These conditions include periods of immobilization of a limb or of the whole body and aging accompanied by the onset of sarcopenia. Muscle mass is reduced as a result of decreased protein synthesis or increased protein degradation. Most studies aim to prevent the degradation of muscle proteins, but the way in which protein synthesis can be stimulated is often neglected. This study will provide an up-to-date review regarding nutritional considerations and resistance exercise countermeasures in the prevention of muscle mass loss and recovery of muscle mass in muscle atrophy secondary to immobilization or in sarcopenic obesity. We do not address muscle atrophy in disease states associated with inflammation (rheumatoid arthritis, COPD, cancer cachexia, AIDS, burns, sepsis, and uremia) which are governed by particular mechanisms of muscle loss.
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5.
Nutritional Support to Counteract Muscle Atrophy.
Owens, DJ
Advances in experimental medicine and biology. 2018;:483-495
Abstract
Malnutrition is an important factor contributing to muscle atrophy. Both underfeeding and obesity have negative consequences for the preservation of muscle mass and function. In addition, adequate nutrition on an exercise background is an efficacious strategy to counteract the severity of muscle loss associated with numerous clinical muscle wasting conditions. As such, significant research efforts have been dedicated to identifying optimal calorie control and the requirements of particular macro- and micronutrients in attenuating muscle atrophy. This chapter will explore current nutrition strategies with robust evidence to counteract muscle atrophy with a particular focus on protein, as well presenting evidence for other promising emergent strategies.
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6.
The Role of Mitochondrial Stress in Muscle Wasting Following Severe Burn Trauma.
Ogunbileje, JO, Herndon, DN, Murton, AJ, Porter, C
Journal of burn care & research : official publication of the American Burn Association. 2018;(1):100-108
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Abstract
Increased resting metabolic rate and skeletal muscle wasting are hallmarks of the pathophysiological stress response to severe burn trauma. However, whether these two responses occur independently in burn patients or are in fact related remains unclear. In light of recent evidence demonstrating that increased proteolysis in skeletal muscle of burned patients is accompanied by mitochondrial hypermetabolism, oxidative stress, and protein damage; in this article, we discuss the evidence for a role for the mitochondrion in skeletal muscle wasting following severe burn trauma. In particular, we focus on the role of mitochondrial superoxide production in oxidative stress and subsequent proteolysis, and discuss the role of the mitochondrion as a signaling organelle resulting in protein catabolism in other cellular compartments following severe burn trauma.
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7.
Disturbed Ca2+ Homeostasis in Muscle-Wasting Disorders.
Avila, G
Advances in experimental medicine and biology. 2018;:307-326
Abstract
Ca2+ is essential for proper structure and function of skeletal muscle. It not only activates contraction and force development but also participates in multiple signaling pathways. Low levels of Ca2+ restrain muscle regeneration by limiting the fusion of satellite cells. Ironically, sustained elevations of Ca2+ also result in muscle degeneration as this ion promotes high rates of protein breakdown. Moreover, transforming growth factors (TGFs) which are well known for controlling muscle growth also regulate Ca2+ channels. Thus, therapies focused on changing levels of Ca2+ and TGFs are promising for treating muscle-wasting disorders. Three principal systems govern the homeostasis of Ca2+, namely, excitation-contraction (EC) coupling, excitation-coupled Ca2+ entry (ECCE), and store-operated Ca2+ entry (SOCE). Accordingly, alterations in these systems can lead to weakness and atrophy in many hereditary diseases, such as Brody disease, central core disease (CCD), tubular aggregate myopathy (TAM), myotonic dystrophy type 1 (MD1), oculopharyngeal muscular dystrophy (OPMD), and Duchenne muscular dystrophy (DMD). Here, the interrelationship between all these molecules and processes is reviewed.
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Muscular Atrophy in Cardiovascular Disease.
Sisto, IR, Hauck, M, Plentz, RDM
Advances in experimental medicine and biology. 2018;:369-391
Abstract
Currently, the number of chronic diseases has increased due to increasing in life expectancy of population. Among them, cardiovascular diseases (CVD) are the most prevalent and responsible for the high mortality and morbidity rates. Patients with CVD have metabolic, hemodynamic, and musculoskeletal changes. There is a debate regarding the correct term for musculoskeletal changes that affect this group of patients; therefore, we found in literature myopia, muscular atrophy, cardiac cachexia, and sarcopenia. However, although there is no standardization in relation to correct term, these musculoskeletal consequences directly affect the quality of life and are associated with a poor prognosis. In this way, the importance of prevention of muscular atrophy, but also of treatment for those patients with progressive muscle decline, is proven. We also emphasize the importance of a multi-professional team, because therapeutic strategies are needed that are capable of delaying the onset or minimizing the consequences of skeletal muscle loss, from pharmacological management and nutrition to physical exercise.
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9.
Muscle Mass, Quality, and Composition Changes During Atrophy and Sarcopenia.
Yamada, Y
Advances in experimental medicine and biology. 2018;:47-72
Abstract
Skeletal muscle mass (SMM) and muscle strengh reach their peak in 20s to 40s of age in human life and then decrease with advancing age. The decrease rate of muscle strength or power was twice to four times as large as that of the SMM. Thus, the normalized muscle force (muscle strength divided by SMM) also decreases in aging. It depends on the number of factors in skeletal muscle tissues and neuromuscular system. In human study, SMM cannot be measured directly without dissection so that all of the methodologies are indirect methods to assess SMM, even computing tomography or magnetic resonance imaging. Dual-energy X-ray absorptiometry, ultrasonography, anthropometry, and bioelectrical impedance analysis (BIA) are used as secondary indirect methods to estimate SMM. Recent researches show muscle composition changes in aging, and in particular, the ratio of muscle cell mass (MCM) against SMM decrease and relative expansion of extracellular water (ECW) and extracellular space is observed with advancing age and/or decrease of physical function. The intracellular water (ICW) and ECW estimated by segmental bioelectrical impedance spectroscopy or multifrequency BIA are good biomarkers of the ratio of MCM against SMM in limbs. The BIS and other state-of-the-art technology for assessment of muscle mass, quality, and composition are useful to fully understand the muscle atrophy in a living organism.
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10.
To Contrast and Reverse Skeletal Muscle Atrophy by Full-Body In-Bed Gym, a Mandatory Lifestyle for Older Olds and Borderline Mobility-Impaired Persons.
Carraro, U, Gava, K, Baba, A, Marcante, A, Piccione, F
Advances in experimental medicine and biology. 2018;:549-560
Abstract
Older olds, that is octogenarians, spend small amounts of time for daily physical activity, contributing to aggravate their independence limitations up to force them to bed and to more and more frequent hospitalizations. All progressive muscle contractile impairments, including advanced age-related muscle power decline, need permanent management. Inspired by the proven capability to recover skeletal muscle contractility and strength by home-based functional electrical stimulation and guided by common sense, we suggested to older olds a 15-30 min daily routine of 12 easy and safe physical exercises. Since persons can do many of them in bed (full-body in-bed gym), hospitalized elderly can continue this kind of light training that is an extension of the well-established cardiovascular-ventilation rehabilitation before and after admission. Monitoring arterial blood pressure before and after the daily routine demonstrates that peripheral resistance decreases in a few minutes by the functional hyperemia of the trained body muscles. Continued regularly, full-body in-bed gym helps to maintain the independence of frail older people and may reduce the risks of serious consequences of accidental falls.