Sarcopenia

Sarcopenia

• Is the gradual loss of lean muscle mass
• No single reason is responsible but as is almost invariably the case with regard to health, the reasons are multifactorial.
• The factors contributing to muscle loss will be outlined below and possible strategies suggested:

Acid - Base Balance

• The effect of diet on body pH levels have been well known since Remer and Manz's studies in the 70's²⁰.
• They studied the effect of Potential Renal Acid Loads caused by various foods.
• Many foods are highly acidic such as grains, meat and dairy especially hard cheeses.
• Alcohol is also highly acidic
• Just think of the type of food most people consume in any given day --- carbohydrate [grain] rich meals, soft drinks, fries, pastries and alcohol.
• Endurance sports and high-intensity exercise also produces a significant acid load on the body through lactic acidosis and other metabolic processes. The Endurance Sports and High-Intensity Exercise Diet takes this into account and provides you with strategies to help offset this long-term damaging consequency of exercise.
• To neutralize this acid load on the body, you either have to consume a significant amount of vegetables [mainly] and fruit or your body will rob your bones and muscles of compounds that can neutralize these organic acids.
• The NutriDesk tutorial: Acid Alkali Foods will provide you with knowledge in greater depth as this is critical to know if you want to make it to old age healthy and strong.
• The Acid-Alkaline Food Guide book is a rich source of information on this important topic - simply click on the book graphic to learn more and to purchase this through NutriDesk.
• It is important to find strategies to neutralize the acid loads of modern day diets and vegetable juices and concentrates are an easy way to do this. Please click on the following link to find out more: NutriDesk QuickGuides: Vegetable Juice

Sleep and the loss of lean muscle mass: Waking up in a negative nitrogen balance state

• An excellent chapter in Ellengerg & Rifkins Diabetes Mellitus titled 'Integrated Fuel Metabolism' provides an excellent overview of the metabolic fuels used during sleep.
• A graphical representation can be found in NutriDesk's QuickGuide: Fueling Sleep
• You will see that the brain only wants to use glucose as a fuel source and the brain needs a great deal of fuel [glucose] to provide the energy it needs to function.
• Liver glycogen is available for only a few hours and beyond the point of depletion of liver glycogen stores, amino acids are then mobilized from skeletal muscle to convert glucogenic amino acids to glucose for brain function as well as for other organs. You thus wake up in a negative nitrogen balance with a net loss of lean muscle mass. This should be replenished with protein at breakfast but what do most individuals eat at breakfast, you guessed it, a carbohydrate-rich and protein-poor breakfast that provides a high acid load once again leading to even more loss of muscle. Consuming protein at breakfast is vital if you want to stop this cycle of lean muscle mass loss.
• The glycogen in muscle is unavailable for use by the brain or other organs as skeletal muscle lacks glucose-6-phosphatase to enable these muscle stores to break down glycogen to supply glucose for metabolism.
• Adding protein at breakfast is thus crucial if you want to maintain muscle mass --- an excellent whey protein with a very high biological value [BV] is suggested in the following link: Exercise Supplements. 
• This whey protein will taste delicous sprinkled on cereals in the morning especially the amazing NutriDesk Muesli outlined in all the diets. You can also make a berry - juice - whey protein smoothie for use in the morning.

Loss of anabolic signaling - the importance of L-Leucine and Protein

• There is a loss of anabolic signaling as we age and responses to insulin can become blunted with regard to protein synthesis.
• Numerous studies have shown the benefit of L-Leucine^{24, 25, 26}, an essential amino acid belonging to a group called the Branched Chain Amino Acids [BCAAs] as it possesses an aliphatic side-chain that is non-linear. See QuickGuides: Amino Acids.
• Adding protein to the diet is also critical.
  'There are compelling data to support the ability of dietary protein to acutely stimulate muscle protein synthesis in aging individuals²⁷.'
• For a suggested high level of L-Leucine in a mix of Branched Chain Amino Acids [BCAAs] please click on the following link: Exercise Supplements
• The whey protein product suggested has numerous peptides and fortified with BCAAs to help enhance protein synthesis for those involved in resistance training and those wanting to preserve and increase muscle mass.
• Ideally you will perform weight training exercises as suggested in the NutriDesk: Resistance Training: Once-a-Week program. This program is designed for ages from 18 years to 80 years and beyond. The beauty of this system is that everyone works within their limitations and progresses slowly building strength in a steady and safe way. Resistance training can also help to increase testosterone levels and testosterone is an important anabolic hormone important to increase levels of lean muscle mass.
• Post-exercise nutrition is critical to help decrease the catabolic [protein breakdown] hormones that are stimulated by exercise and to promote protein synthesis after weight training. The 1:1 calculator found in The Golden Hour will guide you in this regard.

Growth Hormone - don't blunt this important hormone of youth

• Growth hormone [GH] is released in the few hours after you go to sleep
• If you have had a carbohydrate rich meal of pasta, bread, rice or potato, then your insulin and sugar levels before going to bed will be very high.
• This will certainly blunt the GH surge which is important for you to blast away fat and increase protein synthesis.
• We know that low glucose levels and high levels of amino acids can stimulate GH secretion. See NutriDesk QuickGuides: Growth Hormone
• All the NutriDesk diets have been designed to take advantage of this important circadian rhythm of growth hormone secretion by limiting starchy carbohydrates at night to keep insulin levels down. Some great recipes are given so that you won't miss your starchy food at all.
• A small amount [1 heaped teaspoon] of quality whey protein [see Exercise Supplements] mixed in a small amount [say 1/3 glass] of low-fat milk and taken 1/2 hour before sleep can help to stimulate GH levels due to the elevated amino acids in your blood stream.
• If you are overweight or obese, then this may also interfere with growth hormone secretion and the NutriDesk Weight Management Diet will be of great help to you.

Testosterone deficiency in aging men and women

• Diminishing testosterone levels in aging men and women is a well documented process.
• The acidosis caused by dietary habits as described above and the loss of skeletal muscle during sleep occurs throughout life.
• However, in men there is a gradual loss of testosterone and this will manifest in many ways such as a diminished libido, decreased strength, osteoporosis, anaemia and a gradual loss of muscle mass as testosterone is a vital anabolic hormone that stimulates protein synthesis and increased muscle mass and bone strength.  
• The use of hormones to maintain optimal health and strength is still in the dark ages as hormone use is limited due to the side-effect profiles of artificial hormones produced by pharmaceutical companies and even hormones from a different species that have been used in hormone replacement therapies [HRT] for women in the past. No wonder so many side-effects occur.
• The truth is that bioidentical hormones exist but this is not to say these hormones are natural. They are synthetic but they look and act like human hormones and the metabolic machinery to metabolize these efficiently in cells already exist. Compare this with artificial hormones or the hormones used from other species, the cells and the human body just doesn't know how to handle these and many dangerous intermediate metabolites are produced as the body tries to work out how to get rid of these chemicals.
• Many 'experts' blur the science and many pharmaceutical companies are now producing bioidentical hormones such as Testogel^® a popular testosterone replacement in the US. 
• Please view the NutriDesk QuickGuide: Testosterone

An enlightened statement about testosterone use in adults comes from the American Association of Clinical Endocrinologists:

• The reason for such a statement is that loss of muscle mass in men and women can lead to a decreased basal metabolic rate [BMR] and increasing adiposity [fat gain] putting an individual at significant risk for diabetes as this fat is most likely going to accumulate in the abdomen area. The dangerous area for fat accumulation.
• In men there is an approximate 15% increased risk of aggressive prostate cancer with low testosterone levels.
• Click on the testosterone link above to read about the important testosterone research by Professor Abraham Morgentaler a urologist at Harvard University. He proved that the thinking on testosterone and prostate cancer was totally wrong.
• The other critical reason that warrants a clinical trial of testosterone is the findings of the Rotterdam study that has shown conclusively that men that suffer from low testosterone levels have a higher risk of cardiovascular disease.
• Our views on hormone replacement to provide optimal health in aging is truly backward and no doubt this will change as the pharmaceutical industry produces more and more bioidentical hormones as public and professional perceptions change.

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