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Sarcopenia (muscle loss) and Vitamin D

To gain muscle many studies have found that you need some of the following:
Exercise - just even walking
Vitamin D - a minimum of 800 IU/day,
  Loading dose will show improvements in weeks instead of 4+ months
Protein - perhaps 1gm/kg/day in a form appropriate for existing stomach acid
Calcium - 300 mg?
Creatine

These also increase Bone Health and reduce falls and fractures

See also VitaminDWiki


Sarcopenia statistics - 2014

Sample statistics from http://sarcopeniacure.com/statistics/ Note- protein and vitamin D are among their cures

  • >50 % loss of muscle mass by 90 years
  • Healthcare expenditures due to sarcopenia cost roughly $900 per person per year
  • In the United States, an estimated 53 % of men and 43 % of women over 80 are sarcopenic.
  • People who are physically inactive can lose as much as 3 to 5 % of their muscle mass per decade after age 30

Added 1 lb of muscle mass with 800 IU Vitamin D - RCT 2017

Added 1 lb of muscle to sarcopenia adults in 13 weeks with just 800 IU vitamin D and protein – RCT Jan 2017


Pedometer + reminder to increase steps 10%/month - RCT with Vitamin D Aug 2015

J Am Med Dir Assoc. 2015 Aug 1;16(8):654-60. doi: 10.1016/j.jamda.2015.02.017. Epub 2015 Apr 7.
Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.
Yamada M1, Nishiguchi S2, Fukutani N2, Aoyama T2, Arai H3.

VitaminDWiki Summary
  • The trial arm which added 10 gram Protein + 500 IU Vitamn D + 300 mg Calcium did NOT do as well as the trial atm of only walking
  • Note that just walking got 3/4 as much increase in Vitamin D levels as walking + 500 IU of vitamin D (outdoors in the sun more?)
  • Note: A different successful trial used 1gram/kg of protein, which could be 50 grams per day (5X as much)


 Download the PDF from VitaminDWiki



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OBJECTIVE: The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults.
DESIGN: A cluster-randomized controlled trial.
SETTING AND PARTICIPANTS: This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy.
INTERVENTION: Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation).
MEASUREMENTS: The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25OHD), as well as frailty, were assessed by the Cardiovascular Health Study criteria.
RESULTS: Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults.
CONCLUSION: These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail.

PMID: 25858281 DOI: 10.1016/j.jamda.2015.02.017


Hypothesis: Sarcopenia and other senior problems are related to low gastric acid


From muscle wasting to sarcopenia and myopenia: update 2012.

J Cachexia Sarcopenia Muscle. 2012 Nov 17
von Haehling S, Morley JE, Anker SD.
Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany, stephan.von.haehling at charite.de.

Human muscle undergoes constant changes.
After about age 50, muscle mass decreases at an annual rate of 1-2 %.
Muscle strength declines by 1.5 % between ages 50 and 60 and by 3 % thereafter.

The reasons for these changes include denervation of motor units and a net conversion of fast type II muscle fibers into slow type I fibers with resulting loss in muscle power necessary for activities of daily living. In addition, lipids are deposited in the muscle, but these changes do not usually lead to a loss in body weight.

Once muscle mass in elderly subjects falls below 2 standard deviations of the mean of a young control cohort and the gait speed falls below 0.8 m/s, a clinical diagnosis of sarcopenia can be reached. Assessment of muscle strength using tests such as the short physical performance battery test, the timed get-up-and-go test, or the stair climb power test may also be helpful in establishing the diagnosis. Serum markers may be useful when sarcopenia presence is suspected and may prompt further investigations.

Indeed, sarcopenia is one of the four main reasons for loss of muscle mass.

On average, it is estimated that 5-13 % of elderly people aged 60-70 years are affected by
sarcopenia. The numbers increase to 11-50 % for those aged 80 or above.

Sarcopenia may lead to frailty, but not all patients with sarcopenia are frail-sarcopenia is about twice as common as frailty. Several studies have shown that the risk of falls is significantly elevated in subjects with reduced muscle strength.

Treatment of sarcopenia remains challenging, but promising results have been obtained using

  • progressive resistance training,
  • testosterone,
  • estrogens,
  • growth hormone,
  • vitamin D, and
  • angiotensin-converting enzyme inhibitors.

Interesting nutritional interventions include

  • high-caloric nutritional supplements and
  • essential amino acids that support muscle fiber synthesis.
    (= protein: note by VitaminDWiki)

PMID: 23160774


Elderly need >1 grams of protein /kg of weight and correction of vitamin D deficiency - Jan 2015

Treating Sarcopenia In Older And Oldest Old.
Curr Pharm Des. 2015 Jan 30. [Epub ahead of print]
Martone AM, Lattanzio F, Abbatecola AM, La Carpia D, Tosato M, Marzetti E, Calvani R, Onder G, Landi F1.

The presence of sarcopenia is not only rapidly rising in geriatric clinical practice and research, but is also becoming a significant concept in numerous medical specialties. This rapidly rising concept has encouraged the need to identify methods on how to treat sarcopenia. For example, physical activity measures using resistance training exercise, combined with nutritional interventions (protein and amino acid supplementation) have shown to significantly improve muscle mass and strength in older persons. Resistance training may improve muscle strength and mass by improving protein synthesis in skeletal muscle cells. Aerobic exercise has also shown to hold beneficial impacts on sarcopenia by improving insulin sensitivity. At the moment, the literature indicates that most significant improvement on sarcopenia is based on exercise programs. Thus, this type of intervention should be implemented in a persistent manner over time in elders, with or at risk of muscle loss. At the same time, physical training exercise should include correcting nutritional deficits with supplementation methods.
For example, in older sarcopenic patients with adequate renal function, daily protein intake should be increased to >1. 0 grams of protein per kilogram of body weight. In particular, leucine, β-hydroxy β-methylbutyrate (HMB), creatine and some milk-based proteins have been have shown to improve skeletal muscle protein balance.
In addition, it is also recommended to correct for vitamin D deficiency, if present, considering the crucial role of vitamin D in skeletal muscle. In this present paper, we will provide evidence regarding the effects of different physical exercise protocols, specific nutritional intervention, and some new metabolic agents (HMB, citrulline malate, ornithine, and others) on clinical outcomes related to sarcopenia in older adults.

PMID: 2563311  Download the ResearchGate PDF from VitaminDWiki


Interventions against sarcopenia in older persons - Dec 2014

Curr Pharm Des. 2014;20(38):5983-6006.
Valeria Z, Renato G, Luisa C, Bruno V, Mauro Z, Matteo C1.

The term "sarcopenia" describes the age-related loss of skeletal muscle mass and function. It represents a major risk factor for functional loss and disability in older persons. Multiple underlying pathophysiological mechanisms have been posed at the basis of the sarcopenia phenomenon, including intrinsic (e.g., age-related modifications of the skeletal muscle, the central nervous system, and hormones) and extrinsic (e.g., sedentariness, poor protein dietary intake) factors.
Several interventions have been explored in the last years to counteract the age-related muscle decline.
These include

  • protein supplementations,
  • physical exercise,
  • testosterone replacement (as well as other anabolic androgens) in men,
  • estrogen replacement in women,
  • growth hormone replacement, and
  • treatment of vitamin D deficiency.

To date, adequate protein intake and resistance training are the most promising interventions able to prevent and/or delay the decline of muscle mass and function. An intense debate is currently ongoing about the best operational definition able to capture the complexity of this aging condition. In the context of identifying the optimal treatment for a specific condition, this is not a trivial issue because it sets the target of the intervention as well as the population at risk. Nevertheless, despite the current methodological issues, it is important to preliminarily test the possible strategies that might be implemented in the future, when the sarcopenia condition will finally be more univocally defined and its clinical relevance recognized. Aim of the present review is to describe and discuss available evidence about the possible interventions potentially serving at acting against sarcopenia. Pharmacological as well as non-pharmacological interventions are presented.

PMID: 24641222


From sarcopenia to frailty: a road less traveled - March 2014

J Cachexia Sarcopenia Muscle. 2014 Mar;5(1):5-8. doi: 10.1007/s13539-014-0132-3. Epub 2014 Feb 14.
Morley JE1, von Haehling S, Anker SD, Vellas B.

The physical frailty phenotype consists of fatigue, weight loss, and loss of muscle power. Sarcopenia has been shown to be a major cause of frailty. Six societies including SCWD published a consensus suggesting that all persons older than 70 years of age should be screened for frailty when seeing health professionals.
Simple screening tests such as the FRAIL (fatigue, resistance, aerobic, illness, and loss of weight) scale can be used.
It is felt that frailty can be treated by

  • exercise (resistance and aerobic),
  • high quality protein,
  • vitamin D, and
  • treatment of the common causes of fatigue.

It is expected that this approach will decrease disability in older persons.

PMID: 24526568
 Download the PDF from VitaminDWiki.


Improved muscle function in postmenopausal women with just 1,000 IU of vitamin D daily – RCT May 2015

Improved muscle function in postmenopausal women with just 1,000 IU of vitamin D daily – RCT May 2015
postmenopausal women with a history of falls (associated with low vitamin D)
1,000 IU daily for 9 months

Vitamin DPlacebo
Vitamin D at start15 ng17 ng
Vitamin D after 9 months28 ng 14 ng
Muscle strength lower limbs +25 %
Loss of lean muscle mass -7 %

Vitamin D is one of 3 basic options to treat Sarcopenia - June 2015

Pharmacologic Options for the Treatment of Sarcopenia
Calcified Tissue International, June 2015 Publisher wants $40 for PDF
John E. Morley

Sarcopenia is now clinically defined as a loss of muscle mass coupled with functional deterioration (either walking speed or distance or grip strength). Based on the FRAX studies suggesting that the questions without bone mineral density can be used to screen for osteoporosis, there is now a valid simple questionnaire to screen for sarcopenia, i.e., the SARC-F. Numerous factors have been implicated in the pathophysiology of sarcopenia. These include genetic factors, mitochondrial defects, decreased anabolic hormones (e.g., testosterone, vitamin D, growth hormone and insulin growth hormone-1), inflammatory cytokine excess, insulin resistance, decreased protein intake and activity, poor blood flow to muscle and deficiency of growth derived factor-11. Over the last decade, there has been a remarkable increase in our understanding of the molecular biology of muscle, resulting in a marked increase in potential future targets for the treatment of sarcopenia.
At present,

  • resistance exercise,
  • protein supplementation, and
  • vitamin D

have been established as the basic treatment of sarcopenia. High-dose testosterone increases muscle power and function, but has a number of potentially limiting side effects. Other drugs in clinical development include selective androgen receptor molecules, ghrelin agonists, myostatin antibodies, activin IIR antagonists, angiotensin converting enzyme inhibitors, beta antagonists, and fast skeletal muscle troponin activators. As sarcopenia is a major predictor of frailty, hip fracture, disability, and mortality in older persons, the development of drugs to treat it is eagerly awaited.


See also web



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7813 Treating Sarcopenia In Older And Oldest Old.pdf PDF 2015 admin 08 Mar, 2017 15:00 1.03 Mb 112
7812 Walk T3.jpg admin 08 Mar, 2017 14:44 57.99 Kb 223
7811 Walk RCT.jpg admin 08 Mar, 2017 14:43 54.78 Kb 254
7810 Mail-based Sarcopenia Intervention trial.pdf PDF 2015 admin 08 Mar, 2017 14:11 577.27 Kb 62
4993 sarcopenia 1998.jpg admin 31 Jan, 2015 13:35 45.85 Kb 1074
4992 sarcopenia to frailty.pdf PDF 2014 admin 31 Jan, 2015 13:34 116.17 Kb 666
4991 Update F2.jpg admin 31 Jan, 2015 12:59 63.53 Kb 2372
4990 Update PubMed.jpg admin 31 Jan, 2015 12:58 31.74 Kb 1742
4989 sarcopenia update 2014.pdf PDF 2014 admin 31 Jan, 2015 12:57 271.61 Kb 716
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