Role of Exercise and Nutrition in the Prevention of Sarcopenia

The age-associated loss of skeletal muscle mass and strength (sarcopenia) has been shown to increase the risk of injury due to falls and incidence of metabolic complications including insulin resistance and diabetes, which subsequently becomes a significant factor to disability among the elderly population. Nutrient intake is the most important anabolic stimulus for skeletal muscle. Specifically, the amino acid leucine and meal-induced insulin both independently stimulate muscle protein synthesis. However, age-specific changes in muscle anabolic responses to leucine become apparent when sub-maximal amounts of amino acids are administered in older subjects. Furthermore, insulin resistance of muscle protein metabolism with aging has been demonstrated in healthy non-diabetic older subjects. Resistance exercise is another anabolic stimulus which increases myofibrillar muscle protein synthesis in both young and older individuals. The increased muscle anabolism is apparent within 2-3 h after a single bout of heavy resistance exercise and remains elevated up to 2 d following the exercise. The mTOR signaling pathway in skeletal muscle is associated with an increased rate of muscle protein synthesis during the early recovery phase following a bout of resistance exercise. Finally, recent evidence on the cumulative effect of resistance exercise in combination with nutritional supplement on muscle protein metabolism will be discussed to propose a possible preventative measure against sarcopenia.