Function Promoting Anabolic Interventions' Diet and Exercise

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Function Promoting Anabolic Interventions.Diet
and Exercise
Carmen Castaneda Sceppa, MD, PhD
NMRI
Annual Meeting
2007
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Loss of Lean Body MassMuscle Mass and Function

• Aging
• Disease
• Disuse

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Sarcopenia15 to 35 of Older Adult Population
Baumgartner R, Am J Epidemiol 1998
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Muscle Anabolic/Catabolic Signals
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Prevalence of Inactivity
65
51
42
Prevalence ()
34
31
CDC Adults participating in NO leisure-time
physical activity Current average 40
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Lean Body Mass Matters

• Function
• Muscle ? strength, independence
• Viscera ? resting energy expenditure
• Immune system ? infection/inflammation
• Morbidity demonstrable at a 5 loss
• Mortality fatal at a 40 loss

BCM
Body Cell Mass ? bodys metabolically active
tissue
Kotler J, AmJ Clin Nutr 1989
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Dietary Protein Intake
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Protein Intake and Nitrogen Balance
½ DRI DRI



10-wk Change, g N/d
p lt 0.02
Castaneda-Sceppa C, AmJ Clin Nutr 1995
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Protein Intake and Muscle Size
Castaneda-Sceppa C, J Nutr Health Aging 2000
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Protein Intake and Anabolism
DRI ½ RDA
p lt 0.02
Castaneda-Sceppa C, J Nutr Health Aging 2000
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Reduced Anabolism and Muscle Atrophy
DRI, r 0.36 P lt 0.005
½ DRI, r 0.45
Castaneda-Sceppa C, J Nutr Health Aging 2000
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Resistance Exercise Training a
non-pharmachologic anabolic therapy
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Muscle Mass and Function with Resistance Training
Hughes V, J Gerontol 2001
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Resistance Training, Lean Body Mass and Type 2
Diabetes
Castaneda-Sceppa C, Diabetes Care 2002
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Glycemic Control and Muscle Hypertrophy
Brooks N, Int J Med Sciences 2006
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Insulin Sensitivity and Muscle Hypertrophy
Brooks N, Int J Med Sciences 2006
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Resistance Training, Muscle Wasting and CKD
Castaneda-Sceppa C, Ann Int Med 2001
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Muscle Wasting and Inflammation in CKD
Castaneda-Sceppa C, Am J Kidney Dis 2004
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Evidence-Based Research into Practice
Diabetes Care Technical Review 2004 Position
Statement 2006
Evidence Level A from well-conducted
adequately powered generalizable randomized
controlled trials (RCT)
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Summary Future Work

• The structural and functional consequences of the
  loss of muscle mass and function with aging have
  been characterized to some extent.
• Less is known about these in the setting of
  chronic disease conditions leading to muscle
  wasting.
• The mechanisms of such losses require further
  investigation.
• Currently, diet and exercise are the most
  beneficial lifestyle interventions to counteract
  sarcopenia and muscle wasting.