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Review
. 2019 Mar 30;11(4):745.
doi: 10.3390/nu11040745.

Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults

Antoneta Granic  1   2   3 , Avan A Sayer  4   5   6 , Sian M Robinson  7   8   9
Affiliations
Review

Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults

Antoneta Granic et al. Nutrients. .

Abstract

In recent decades, the significance of diet and dietary patterns (DPs) for skeletal muscle health has been gaining attention in ageing and nutritional research. Sarcopenia, a muscle disease characterised by low muscle strength, mass, and function is associated with an increased risk of functional decline, frailty, hospitalization, and death. The prevalence of sarcopenia increases with age and leads to high personal, social, and economic costs. Finding adequate nutritional measures to maintain muscle health, preserve function, and independence for the growing population of older adults would have important scientific and societal implications. Two main approaches have been employed to study the role of diet/DPs as a modifiable lifestyle factor in sarcopenia. An a priori or hypothesis-driven approach examines the adherence to pre-defined dietary indices such as the Mediterranean diet (MED) and Healthy Eating Index (HEI)-measures of diet quality-in relation to muscle health outcomes. A posteriori or data-driven approaches have used statistical tools-dimension reduction methods or clustering-to study DP-muscle health relationships. Both approaches recognise the importance of the whole diet and potential cumulative, synergistic, and antagonistic effects of foods and nutrients on ageing muscle. In this review, we have aimed to (i) summarise nutritional epidemiology evidence from four recent systematic reviews with updates from new primary studies about the role of DPs in muscle health, sarcopenia, and its components; (ii) hypothesise about the potential mechanisms of 'myoprotective' diets, with the MED as an example, and (iii) discuss the challenges facing nutritional epidemiology to produce the higher level evidence needed to understand the relationships between whole diets and healthy muscle ageing.

Keywords: Mediterranean diet; dietary patterns; muscle function; muscle mass; muscle strength; nutrition; older adults; sarcopenia; ‘myoprotective’ diet.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Hypothesised ‘myoprotective’ effect of the Mediterranean diet (MED). Because of a higher (↑) intake of plant-based foods, olive oil as a main source of fat, moderate-to-high (→↑) intake of fatty fish, moderate-to-low (→↓) intake of poultry and eggs, moderate (→) intake of dairy (mostly from yoghurt and cheese), low (↓) intake of red meats and meat products, and moderate intake of red wine during meals, the MED is a potential source of bioactive nutrients that may act synergistically, antagonistically, and cumulatively on the ageing muscle and may be ‘myoprotective’. Potential ‘myoprotective’ effects of the MED may work through its higher anti-oxidative and anti-inflammatory capacities, its favourable acid-base load (directly), and by its reducing of the risk of age-related conditions related to sarcopenia (indirectly). MUFA, monounsaturated fatty acids; PUFA, polyunsaturated fatty acids. Skeletal muscle image adapted from: https://teaching.ncl.ac.uk/bms.
Figure 2
Figure 2
Dietary pattern-muscle health hypothesis investigation in nutritional epidemiology of muscle ageing faces several challenges to reach a higher level evidence. AHEI, Alternative Healthy Eating Index; DVS, Dietary Variety Score; DP, dietary pattern; HDI, Healthy Diet Indicator; HEI-2005, Healthy Eating Index 2005; DQI-I, Diet Quality Index-International; MED, Mediterranean diet; NDS, Nordic Diet Score.
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