Im Krankenhaus Muskeln schützen: Eiweiß, Energie und Bewegung

<h4>Purpose of review</h4>Muscle loss during hospitalization is a major clinical concern, as it has been associated with reduced physical function, quality of life, and increased mortality. This review outlines the key causes of muscle wasting and highlights practical strategies to support muscle mass preservation during hospitalization.<h4>Recent findings</h4>Physical inactivity, along with reduced energy and protein intake, are the primary drivers of muscle atrophy during hospitalization by suppressing muscle protein synthesis (MPS). Maintaining energy balance is critical to prevent declines in MPS rates and attenuate muscle loss. Preserving habitual protein intake is essential and, when total energy intake is reduced, should be achieved through a more protein-dense diet. Preventing disuse atrophy requires at least some level of daily physical activity. Physical activity sensitizes skeletal muscle to the anabolic properties of protein ingestion, enabling greater use of protein-derived amino acids for MPS. Therefore, frequent in-hospital movements, such as bed-to-chair transfers and walking, should be encouraged. When voluntary activity or muscle contractions are impossible, exercise mimetics, like neuromuscular electrical stimulation, may be applied to stimulate muscle activity and limit muscle mass loss.<h4>Summary</h4>Preserving muscle mass during hospitalization requires a multimodal approach: achieving energy balance, maintaining protein intake, minimizing muscle disuse

Dietary protein is crucial in preserving muscle mass and promoting long-term bone health, particularly in aging populations. The novelty of this study lies in evaluating the impact of varying protein intake levels (0.8 vs. 1.2 g/kg b.w/d) on muscle mass composition in elderly females suffering from sarcopenia. For this purpose, in this research trial, a total of 126 participants (60-75 years) were enrolled and equally divided into two groups: normal protein intake (0.8 g/kg b.w/d) and moderately high protein intake (1.2 g/kg b.w/d) for 12 weeks. The effects of dietary protein were assessed using anthropometric measurements, magnetic resonance imaging (MRI), handgrip, and knee flexion tests with baseline and post-intervention comparisons. Statistical analysis was conducted using SPSS, employing paired sample t-test at a significance level of <i>p</i> < 0.05. Results indicated a significant improvement in muscle mass composition with moderately high protein intake. Anthropometric parameters, including body mass (83.51 ± 4.23 kg) and waist circumference (113.90 ± 10.82 cm), showed notable enhancement in the moderately higher protein group. Muscle function and imaging assessments, such as handgrip strength and knee flexion, demonstrated improved functionality. MRI-derived measurements of the muscle composition of the calf (141.23 ± 4.87 MCSA, mm² × 10⁴) and thigh (258.04 ± 7.26 MCSA, mm² × 10⁴) further confirmed the positive impact of i

<h4>Background</h4>Multimorbidity is the most common chronic condition experienced among older adults. It is unknown which amount and source of protein influences the development of frailty and mortality in patients with multimorbidity. We aimed to examine the association of plant and animal sources of protein intake with frailty and mortality among this type of patients.<h4>Methods</h4>This longitudinal study included 1868 participants aged ≥ 60 years from the Seniors-ENRICA cohort in Spain with multimorbidity, defined as having 2 or more clinician-diagnosed chronic diseases. Habitual diet was assessed at baseline (2008-2010) with a validated computerized diet history. Participants underwent repeated physical examinations (in 2013, 2015 and 2017) for assessment of frailty (≥ 3 criteria from the frailty phenotype: low physical activity, slow walking speed, muscle weakness, weight loss and exhaustion). All-cause mortality was assessed up to January 2022. Analyses were conducted using Cox proportional hazard models and multistate models adjusted for sociodemographic, lifestyle and other dietary factors.<h4>Results</h4>Mean consumption of protein was 90.2 (standard deviation [SD]: 26.8) g/day, which represents 18.7% of the total energy intake and 1.23 (0.39) g per kg of body weight per day. Plant protein represented 6.16% of the energy intake, while animal protein represented 12.5%. During a median follow-up of 12.9 (range: 11.7-13.9) years, we documented 196 incident cases of f

<h4>Objectives</h4>Due to variations in the standards for optimal protein intake and conflicting results across studies for Korean older adults, this study aimed to quantitatively integrate existing research on the association of protein intake with sarcopenia and related indicators in Koreans aged 65 and older through meta-analysis.<h4>Methods</h4>A total of 23 studies were selected according to the study selection criteria (PICOS). Sixteen cross-sectional studies, 5 randomized controlled trials (RCTs), and 2 non-RCTs were included in the review, with 9 out of 23 studies included in the meta-analysis. We used fixed-effects models and performed subgroup and sensitivity analyses.<h4>Results</h4>A meta-analysis found that the risk of sarcopenia was significantly higher in the <0.8 g/kg/day protein intake group compared to the 0.8-1.2 g/kg/day and ≥1.2 g/kg/day groups, with odds ratios (ORs) of 1.25 (95% confidence interval (CI), 1.10 to 1.42; <i>I</i>² = 55%) and 1.79 (95% CI, 1.53 to 2.10; <i>I</i>² = 71%), respectively. For low hand grip strength (HGS), the risk was higher in the <0.8 g/kg/day group compared to the 0.8-1.2 g/kg/day or ≥1.2 g/kg/day groups (OR 1.31; 95% CI, 1.03 to 1.65; <i>I</i>² = 28%). No significant associations were found with other sarcopenia indicators, such as skeletal muscle mass, short physical performance battery score, balance test, gait speed, and timed up-and-go test.<h4>Conclusions</h4>Lower protein intake is ass

<h4>Background</h4>Metabolic and bariatric surgery (MBS) is a proven treatment for obesity. Yet weight loss is accompanied by loss of muscle which may predispose to sarcopenia. The prevalence of low muscle mass in older adults after MBS remains unexplored, even though this group is more vulnerable to sarcopenia.<h4>Methods</h4>This cross-sectional study investigated sarcopenia and low muscle mass by comparing adults older than 65 years with previous MBS (BAR) to patients following nonsurgical obesity management (CON). A sample size of 100 was estimated from appendicular lean mass (ALM) in a similar study in younger adults. Patients were recruited from the University Hospitals Leuven Obesity Clinic, Belgium. Study assessments included dual-energy X-ray absorptiometry, handgrip, short battery of physical performance, blood sampling and self-reported dietary intake. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People (EWGSOP1) criteria using obesity-specific cut-off points and sarcopenic obesity by the European Society for Enteral and Parenteral Nutrition (ESPEN) and the European Association of the Study of Obesity (EASO) consensus definition. Main endpoints were sarcopenia and ALM normalized to body mass index (%ALM/BMI). A multiple linear regression model was fitted to predict ALM.<h4>Results</h4>We included 50 participants per group (male, BAR 40%, CON 35%). BAR participants were older (68.3 ± 3.2 years vs. 70.7 ± 3.9, p < 0.01), and m