Infuse Issue 14 October 2021 - Page 14

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Muscle and bone tissue both come from the same precursor , and they remain connected throughout life . Muscle cells and bone cells are constantly communicating via hormones or different growth factors . Together , strong bones and strong muscles reduce your risk of fractures .

How do you identify someone with sarcopenia ?
There are the three good , practical tests :
1 . Gait speed . If gait speed is below 0.8 metres per second , that is suggestive of sarcopenia .
2 . Ask the patient to sit down in a chair and calculate the time it takes the person to sit and stand up five times .
3 . Grip strength using a dynamometer . This is much more sensitive than gait speed .
If patients do an exercise programme , have appropriate nutrition support and correct their vitamin D levels , muscle strength and function will improve , but not necessarily muscle mass .
What are the general recommendations you have in terms of protein for older adults ?
There are two categories for indicating protein supplementation :
1 . For healthy older adults who are functional and have relatively good access to food , the recommendation is 1.0-1.2g protein per kilogram of their body weight per day .
2 . For frail , older adults who have higher nutritional requirements , we go up to 1.5g protein per kilogram of their body weight per day .
Leucine is a particularly important amino acid for older people . It provides a structural base to form muscle and improve or maintain muscle mass . Beta-hydroxy-betamethylbutyrate ( HMB ) is a metabolite from leucine and it helps to increase muscle mass , function and strength . The optimal dose of HMB for muscle health benefits is 3g per day , but you would need to eat a lot of protein to get that amount because only around 5 % of leucine in the diet is converted into HMB .
Has there been research into supplementation with HMB on outcomes ?
Yes . There have been good , well-designed studies looking at the effect of a high protein multi-nutrient oral nutritional supplement drink enriched with HMB on muscle ,
© Dietitian Connection 14 Infuse | October 2021