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Nutritional Factors to Preserve Muscle Mass, Strength and Performance in Senior Citizens

Review by International Osteoporosis Foundation (IOF) Nutrition Working Group examines role of nutrition in sarcopenia, with focus on protein, vitamins D and B, and acid-based diet.

Jan. 18, 2013 - Sarcopenia - the decrease in the amount and quality of muscle -  is a common consequence of aging, and poses a significant risk factor for disability in older adults. Falling, which can lead to fractures and other injuries for seniors, is often caused by poor muscle strength resulting from sarcopena.

The International Osteoporosis Foundation (IOF) Nutrition Working Group has published a new review which identifies nutritional factors that contribute to loss of muscle mass, or conversely, are beneficial to the maintenance of muscle mass. 

The Group reviewed evidence from worldwide studies on the role of nutrition in sarcopenia, specifically looking at protein, acid–base balance, vitamin D/calcium, and other minor nutrients like B vitamins.


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“The most obvious intervention against sarcopenia is exercise in the form of resistance training,” said Professor Jean-Philippe Bonjour, co-author and Professor of Medicine at the Service of Bone Diseases, University of Geneva.

“However, adequate nutritional intake and an optimal dietary acid-base balance are also very important elements of any strategy to preserve muscle mass and strength during ageing.”

The review discusses and identifies the following important nutritional factors that have been shown to be beneficial to the maintenance of muscle mass and the treatment and prevention of sarcopenia:

Protein: Protein intake plays an integral part in muscle health. The authors propose an intake of 1.0–1.2 grams per kilo (1 kilo equals 2.2046 pounds) of body weight per day as optimal for skeletal muscle and bone health in elderly people without severely impaired renal function.

Vitamin D:  As many studies indicate a role for vitamin D in the development and preservation of muscle mass and function, adequate vitamin D should be ensured through exposure to sunlight and/or supplementation if required. Vitamin D supplementation in seniors, and especially in institutionalized elderly, is recommended for optimal musculoskeletal health.

Avoiding dietary acid loads: Excess intake of acid-producing nutrients (meat and cereal grains) in combination with low intake of alkalizing fruits and vegetables may have negative effects on musculoskeletal health. Modifying the diet to include more fruits and vegetables is likely to benefit both bones and muscles.

Emerging evidence also suggests that vitamin B12 and/or folic acid play a role in improving muscle function and strength.

As well, the Review discusses non-nutritional interventions such as hormones, and calls for more studies to identify the potential of antioxidants and anti-inflammatory compounds in the prevention of sarcopenia.

Dr. Ambrish Mithal, co-author and Chair and Head of Endocrinology and Diabetes division at Medanta, New Delhi underlined the need for further research in the field. “Strategies to reduce the numbers of falls and fractures within our ageing populations must include measures to prevent sarcopenia. At present, the available evidence suggests that combining resistance training with optimal nutritional status has a synergistic affect in preventing and treating sarcopenia," said Mithal. 

“We hope that further studies will shed light on other effective ways of preventing and treating this condition.”

More About Sarcopenia

Physical Therapist's Guide to Sarcopenia and Frailty

Frailty is a common syndrome among older people. It's associated with an increased risk of falling and increased hospitalization, disability, and death. The risk of becoming frail increases in the oldest-old, especially those aged 80 or older. Most older adults in nursing homes are frail. Sarcopenia, which is a decrease in the amount and quality of muscle, is a major contributor to frailty.

The 5 factors for frailty are:

o    Unintended weight loss (more than 10 pounds in the past year)

o    General feeling of exhaustion 3 or more days per week

o    Muscle weakness

o    Slow walking speed

o    Low levels of physical activity

Key points:

o    Keep moving! The more you sit or lie down, the more strength and energy you'll lose, and your heart health will be affected, too.

o    You might feel overwhelmed by thought of moving around, but you can start slow and make small changes.

o    Your physical therapist can work with your health care team or with you individually or in a group to safely improve your strength, speed, and balance—so you can get back to the activities you want to do!

o    Having an exercise partner increases your chances of success.

Click Here for more information, including –

o    What Is Frailty, and How Does Sarcopenia Contribute to It?

o    How Can a Physical Therapist Help?

o    Can this Injury or Condition be Prevented?

o    Real Life Experiences

o    What Kind of Physical Therapist Do I Need?

o    Further Reading

Impact of nutrition on muscle mass, strength, and performance in older adults. A. Mithal & J.-P. Bonjour & S. Boonen & P. Burckhardt & H. Degens & G. El Hajj Fuleihan & R. Josse & P. Lips & J. Morales Torres & R. Rizzoli & N. Yoshimura & D. A. Wahl & C. Cooper & B. Dawson-Hughes & for the IOF CSA Nutrition Working Group. Osteoporos Int DOI 10.1007/s00198-012-2236-y


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