Table III.
Available recommendations regarding nutraceutical support in muscle wasting
| Author | Year | Recommendations | Reference |
|---|---|---|---|
| PROT-AGE Study Group | 2013 | “To maintain physical function, older people need more dietary protein than do younger people; older people should consume an average daily intake at least in the range of 1.0 to 1.2 g/kg BW/d”. “Most older adults who have an acute or chronic disease need even more dietary protein (i.e., 1.2–1.5 g/kg BW/d); people with severe illness or injury may need as much as 2.0 g/kg BW/d”. “Older people with severe kidney disease who are not on dialysis (i.e. estimated GFR < 30 ml/min/1.73 m2) are an exception to the high-protein rule; these individuals need to limit protein intake”. “Protein quality, timing of intake, and amino acid supplementation may be considered so as to achieve the greatest benefits from protein intake, but further studies are needed to make explicit recommendations”. “In combination with increased protein intake, exercise is recommended at individualized levels that are safe and tolerated”. |
44 |
| Report of the International Sarcopenia Initiative – European Working Group on Sarcopenia in Older People (EWGSOP) and International Working Group on Sarcopenia (IWGS) | 2014 | “Some nutrition interventions such as EAAs (with ∼2.5 g of leucine) and HMB may improve muscle parameters. Although our findings did not appear to support this approach, increasing protein intake to 1.2 g/kg body weight/day, either by improving diet or adding protein supplements, has been recommended for adults and older people by an expert group [44]. Evidence to recommend specific interventions is yet to be established”. | 45 |
| The Belgian Society of Gerontology and Geriatrics | 2021 | “The umbrella review provided sufficient evidence to recommend leucine supplementation for sarcopenic older people to increase muscle mass, but not for muscle strength or physical performance”. | 54 |
| The Society on Sarcopenia, Cachexia and Wasting Disorders | 2010 | “It is recommended that the total protein intake should be 1 to 1.5 g/kg/day.” “It is suggested that a leucine-enriched balanced essential amino acid mix may be added to the diet.” “A trial of balanced amino acid supplementation alone and with exercise in sarcopenia is recommended.” “Creatine may enhance the effects of exercise in sarcopenic patients.” “25(OH) vitamin D levels should be measured in all sarcopenic patients.” “Vitamin D supplementation in doses sufficient to raise levels above 100 nmol/l should be given as an adjunctive therapy.”; “Either vitamin D2 or D3 is an acceptable replacement.”; “Doses of 50,000 IU of vitamin D a week are safe.” “Short-term resistance exercise improves strength and gait speed.”; “Aerobic exercise improves quality of life years (QALY) and is cost effective.”; “Epidemiology studies suggest positive effects of physical fitness on health.”; “We recommend resistance and aerobic exercise for 20 to 30 minutes, 3 times a week.” |
161 |
| The Society on Sarcopenia, Cachexia and Wasting Disorders | 2019 | “A protein intake of 1 to 1.5 g/kg/day in conjunction with physical exercise seems reasonable for a person with sarcopenia.” “Vitamin D supplementation specifically for sarcopenia was found to have insufficient evidence, though there is evidence that persons with low vitamin D levels may improve their strength with vitamin D supplementation.” “At present, there is insufficient evidence that vitamin D, anabolic steroids, or newer pharmacological agents should be used to treat sarcopenia.” “β-hydroxy β-methylbutyrate (HMB) has been shown to improve muscle mass and to preserve muscle strength and function in older people with sarcopenia or frailty.” |
83 |
| The Asian Working Group for Sarcopenia (AWGS) | 2019 | “Available evidence suggests that exercise plus nutrition improves muscle strength and function, with variable effects on muscle mass.” “AWGS 2019 highlights the impact of sarcopenia in all health care settings and recommends individualized lifestyle intervention that may be implemented across the health care spectrum.” |
162 |
| International Conference on Sarcopenia and Frailty Research (ICSFR) | 2018 | “We recommend clinicians consider protein supplementation/a protein-rich diet for older adults with sarcopenia.” “Clinicians may also consider discussing with patients the importance of adequate calorie and protein intake.” “Nutritional (protein) intervention should be combined with a physical activity intervention.” “Insufficient evidence exists to determine whether a Vitamin D supplementation regime by itself is effective in older adults with sarcopenia.” |
160 |
| The Korean Geriatric Society and the Korean Nutrition Society | 2018 | “Based on the currently available evidence, we recommend a dietary protein intake of > 1.2 g/kg and > 20 g essential amino acids per day in healthy older adults.” “Leucine or BCAAs and β-HMB enrichment may be beneficial, although the clinical evidence is insufficient. Fast protein (for example, whey protein) may be beneficial compared to slow protein (for example, casein protein), and protein of animal origin may be better than plant-based protein in promoting muscle mass.” “Evidence indicates that the combination of timely exercises with protein intake may synergistically stimulate muscle protein synthesis, leading to improved muscle mass and strength in older people.” |
163 |