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Protein, Weight Lifting, Preservation of Muscle Mass, and Sarcopenia

A look at a recent publication:

Dickinson JM et. Leucine-Enriched Amino Acid Ingestion after Resistance Exercise Prolongs Myofibrillar Protein Synthesis and Amino Acid Transporter Expression in Older Men. J. Nutr. 144:1694-1702,2014

Aging is associated with a gradual and involuntary loss of skeletal muscle mass in both men and women, which leads at some point to a decline in muscle strength and function. Age -elated loss of muscle mass and function is known as sarcopenia.

On average, we loose about 1% of our muscle each year, beginning around age 30. Although there is some variability in the rate of sarcopenia, decline in muscle mass is pretty much inevitable.

Sarcopenia

Sarcopenia is a major contributor to loss of mobility, frailty, and independent living as we “mature.” Skeletal muscle is responsible for about 75% of our body’s control of blood sugar, and elevated blood sugar is a major risk factor for accelerated aging and premature death, primarily due to cardiovascular disease (preserving muscle mass as we age is a major longevity enhancing strategy. (NOTHING good happens to our body as fasting blood sugar rises.)

Resistance Exercise (RE)

It is estimated that there will be approximately 71 million Americans 65 and older by 2030, and sarcopenia will play a major role in rising health care costs, along with many people not having a “healthspan” anywhere near their lifespan. Resistance exercise (RE) or weight lifting is the primary strategy to enhance and preserve muscle mass and strength at ALL ages.

Tips for maximum strength creation, preservation, and muscle endurance:

  • Number of sets per exercise: one set
  • Speed of movement: slow, non-explosive
  • Number of repetitions: 8 to 12 with maximum 20 reps **
  • Frequency of training: twice per week for most muscle groups

**from Smith D and Bruce-Low S. Strength Training Methods and the Work of Arthur Jones. Journal of Exercise Physiology online. 2004;7(6): 52-68

A review of the published literature seems to indicate that varying the number of repetitions, higher or lower, does not produce differing effects on strength or muscular endurance. The exercises should be done to the point where it is hard to do more without help.

Additional material on Resistance Exercise: cdc.gov/physical activity/everyone/guidelines, and NutritionAction.com/ExerciseReport

Protein Ingestion Post RE

In ALL age groups essential amino acids have the ability to stimulate muscle protein synthesis, however, relative to younger individuals, older adults have an impaired muscle protein synthesis response to RE.

In ALL age groups the essential amino acid Leucine helps drive the production of muscle protein post- exercise, and this is especially important in older adults. In the above article by Dickinson, the important finding is the following (At least in older adults):

The ingestion of 10 grams of essential amino acids containing either 1.85 or 3.5 grams of Leucine, 1 hour after RE prolongs the anabolic response of aging muscle and facilities improved sensitivity of aging muscle to amino acids, and their muscle-building properties, up to 24 hours. This will help prevent sarcopenia and promotes muscle strength.

Whey Protein to the Rescue

Aging is associated with an inability for lower (< optimum) amounts of ingested protein to stimulate muscle protein synthesis. One scoop of whey protein contains >10 grams of essential amino acids and 1.63 G of Leucine.

Daily Protein Requirement

  • Adults age 18-59 need 0.36 grams of protein/pound of body weight daily
  • Adults age 60 years and older need 0.45 to 0.54 grams of protein/pound of body weight daily

Dr. Steve’s Favorite Protein Sources:

Jennie-O Ground Turkey Breast Extra Lean: 26 grams protein/3.5 ounces, 120 calories, 70 mg sodium www.switchtoturkey.com

Eating Right Boneless Skinless Chicken Breasts: 26 grams protein/3,5 ounces, 130 calories, 75 mg sodium www.vons.com/eatingright

Wild Pacific Salmon Fillet-King (Chinook flash-frozen fillet): 26 grams protein/3.5 ounces, 179 calories, 47 mg sodium www.vitalchoice.com

Wild Pacific Blue Mussels (flash-frozen): 24 grams protein/3.5 ounces, 172 calories, 369 mg sodium       www.vitalchoice.com

Wild & Pure Alaskan Sockeye Salmon (with skin and bones, BPA-free canned): 23 grams protein/3.75 ounces, 160 calories, 359 mg sodium (or 161 calories and 75 mg sodium in the “no salt added” variety) www.vitalchoice.com

Wild Pacific Silver Coho Salmon Fillet (flash frozen): 22 grams protein/3.5 ounces, 146 calories, 46 mg sodium www.vitalchoice.com

Wild Pacific Red Sockeye Salmon Fillet (flash frozen): 21 grams protein/3.5 ounces, 168 calories, 47 mg sodium www.vitalchoice.com

Alaskan Halibut Fillet (flash frozen): 21 grams protein/3.5 ounces, 110 calories, 54 mg sodium     www.vitalchoice.com

Solgar Whey to Go Whey Protein Powder Natural Vanilla (rBGH free): 20 grams protein/scoop, 90 calories, 40 mg sodium  www.solgar.com

Wild and Pure Alaskan Sockeye Salmon (skinless and boneless, BPA-free caned); 19 grams protein/3.75 ounces, 133 calories, 359 mg sodium (or 134 calories and 67 mg sodium in the “no salt added” variety)   www.vitalchoice.com

Kirkland Solid White Albacore Tuna (packed in water): 16 grams protein/ 2 oz., 70 calories, 180 mg sodium www.costco.com

Voskos Greek Nonfat Yogurt: 15 grams protein/5.3 ounce container, 90 calories, 55 mg sodium www.voskos.com

King Oscar Sardines in extra-virgin olive oil: 14 grams protein/ 3.75 ounces, 240 calories, 300 mg sodium     www.kingoscar.com

Kirkland Wild Alaskan Sockeye Salmon (BPA-free canned): 12 grams protein/ ¼ cup, 60 calories, 230 mg sodium www.costco.com

Once Again Organic Crunchy Peanut Butter (no salt added): 9 grams protein/2 Tbsp., 210 calories, 0 mg sodium   www.onceagainnutbutter.com

Soy nuts: 9 grams protein ¼ cup, 70 calories, sodium variable, multiple sources

Cascade Fresh Nonfat Yogurt: 10 grams protein/6 ounces, 80 calories, 110 mg sodium www.cascadefresh.com

Horizon Organic Fat-Free Milk: 9 grams protein/cup, 90 calories, 120 mg sodium   www.horizonorgainic.com

Haagen-Dazs Vanilla All Natural Low-Fat Frozen Yogurt: 9 grams protein/ ¼ cup, 180 calories, 45 mg sodium  www.haagendazs.com

Horizon Organic DHA Omega-3 Fat-Free Milk: 9 grams protein/cup, 100 calories, 160 mg sodium www.horizonorganic.com

Pumpkin Seeds; 9 grams protein/ ¼ cup, 180 calories, 5 mg sodium, multiple brands (organic, when possible)

Westbrae Natural Vegetarian Organic Lentil Beans: 8 grams protein/ ½ cup, 100 calories, 150 mg sodium www.westbrae.com/

MaraNatha Organic Roasted Peanut Butter: 8 grams protein/2 tablespoons, 180 calories, 0 mg sodium www.maranathafoods.com

Edamame (shelled): 8 grams protein/ ½ cup cooked, 100 calories, sodium variable, multiple brands

Quinoa, cooked: 8 grams protein/ cup, 220 calories, sodium variable, multiple brands

MaraNatha Natural Almond Butter: 7 grams protein/2 tablespoons, 190 calories, 0 mg sodium www.maranathafoods.com

Stonyfield Organic 0% Fat Yogurt: 7 grams protein/cup, 100 calories, 120 mg sodium www.stonyfield.com

Almonds: 7 grams protein/ ¼ cup, 130 calories, 0 mg sodium, multiple sources

Lactaid Lactose-Free Nonfat Yogurt: 7 grams protein/cup, 140 calories, 120 mg sodium www.lactaid.com

Egg (large): 6 grams protein/1 large egg, 70 calories, 55 mg sodium, multiple brands

 

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Calcium and Obesity

A look at a recent publication:

Villarroel P et al. Calcium, obesity, and the role of the calcium-sensing receptor. Nutrition Reviews Volume 72 Issue 10, pages 627-637; October, 2014

 

Obesity is a world-wide problem that not only dramatically increases health costs but also causes a significant reduction in healthy life years or what I have called “healthspan”.  The World Health Organization (WHO) estimates that by 2015, 2.3 billion adults will be overweight and more than 700 million will be obese.  For many years there have been numerous published studies suggesting that there is an inverse relationship between calcium intake and obesity (weight gain and or percent fat, and body weight itself).  Obesity is a multifactorial disease and itself is associated with other conditions including dyslipidemia, metabolic syndrome (having 3 of the following 5 conditions—“large waist”, hypertension, elevated blood sugar, low HDL cholesterol, elevated triglycerides), insulin resistance and or type 2 diabetes mellitus, orthopedic “issues”, arthritis, cancer, macular degeneration (AMD), cataracts, infertility, and asthma.   All but AMD, cataracts, and asthma are also associated with low dietary calcium.  Daily calcium intake also plays a major role in preventing osteoporosis in both men and women.  In the United States, a 2012 publication reported that only 1 in 4 women older than 50 years meets the Institute of Medicine (IOM) recommendations for 1200 mg of calcium daily for adults over age 50.  The IOM recommends 1000 mg of daily calcium for adults 19-50.  And in fact, all age groups and both sexes have a significant percentage of men and women not meeting daily calcium intake recommendations.

  • In my opinion, the following statements are significant in the discussion of calcium and weight:
  • We should focus on dietary calcium > supplemental calcium when considering this relationship (this does not mean we should not take calcium supplements, and in fact my wife and I take  ½ pill daily of Nature Made Calcium, giving us 375 mg of calcium, 250 IU vitamin D3, and 20 mcg’s of vitamin K).
  • Of the 4 intervention studies that provided calcium as supplements, only 1 showed calcium to have an effect of decreasing body weight and fat mass
  • Of the 6 studies reviewed in this review article that used dairy products, 4 showed an effect of reducing fat or waist circumference
  • “Dairy calcium”, due to the food matrix in which it is found, may play some role in controlling appetite
  • High, sustained calcium consumption may play a role in the rate of fat oxidation (a good thing when considering weight control)
  • A dairy-based high calcium diet (with adequate vitamin D-adequate in my opinion results in a 25(OH) vitamin D3 level of 50-80 nanograms/ml) seems to lower oxidative stress (occurs when free radicals overwhelm our antioxidant defense mechanisms) and inflammatory biomarkers in overweight and obese subjects, as well as those in a “non-obesity” status.  Remember, excess body fat emits a number of pro-inflammatory cytokines (chemicals) and in almost all cases, inflammation occurs prior to the diagnosis of a “health issue”.  The inflammation causes by our excess “fat”, is the link between obesity and its comorbid conditions (e.g. metabolic and cardiovascular consequences of obesity).
  • At the cellular level, we have calcium-sensing receptors that seem to be involved in mechanisms related to dietary calcium and elevated body weight as well as obesity-related adipose tissue inflammation, thus offering an additional mechanism by which calcium plays a role in maintaining a healthy weight
Food Size Calcium % Calcium Absorbed
Sesame seeds 1/4 cup 351 mg unknown
Cheddar cheese 1.5 oz 303 mg 32%
Milk 8 oz 300 mg 32%
Soymilk 8 oz 300 mg 32%
Yogurt 8 oz 300 mg 32%
Tofu 1/2 cup cubed 258 mg 31 %
Rhubarb 1/2 cup chopped 174 mg 9%
Spinach 1/2 cup cooked 115 mg 5%
White beans 1/2 cup cooked 115 mg 22%
Collard greens 1/2 cup cooked 113 mg unknown
Bok choy 1/2 cup cooked 79 mg 54%
Kale 1/2 cup cooked 61 mg 49%
Orange 1 52 mg unknown
Broccoli 1/2 cup cooked 35 mg 61%

* Adapted from S Pratt SuperFoods Rx for Pregnancy (2013) and J Higdon An Evidence-Based Approach to Vitamins and Minerals (2003)

Finally, although dietary calcium will not, in the absence of many other weight “control” strategies, prevent healthspan-lowering weight gain, this article states that “with the exception of 1 study with a conclusion that was later questioned, there are NO studies with negative effects (i.e. studies that showed weight gain with calcium intake).   Instead, even though not all studies showed a significant effect, many of the outcomes were in accordance with the hypothesis (there is an inverse relationship between calcium intake and obesity), which further reinforces the conclusion that higher calcium intake is related to lower body weight and or fat”.

  • Use the table above as a guide to achieving adequate daily intakes of calcium
  • Aim for at least 2/3 of your daily intake of calcium from food