Abstract:
PURPOSE OF REVIEW:The loss of skeletal muscle with injury or critical illness can be dramatic. This review emphasizes the importance of skeletal muscle as a metabolic reserve. Changes in protein metabolism with bed rest alone and during physiological stress are discussed. Nutritional and hormonal interventions that ameliorate the loss of skeletal muscle are highlighted. RECENT FINDINGS:The loss of skeletal muscle that occurs with inactivity alone can be prevented by nutritional supplementation with an essential amino acid formula. Bed rest with accompanying hypercortisolemia produces a threefold greater loss of skeletal muscle than bed rest alone. Essential amino acids stimulate muscle anabolism during acute hypercortisolemia; however, their effects during chronic hypercortisolemia must be explored. SUMMARY:Skeletal muscle loss with trauma or critical illness is due in great part to the interaction of bed rest (muscular inactivity) and stress (hypercortisolemia). Younger individuals respond to nutritional and pharmacological interventions during bed rest alone. Given a lower relative lean mass in the elderly and the importance of skeletal muscle as a metabolic reserve during stress, it is understandable that clinical outcomes are worse in older patients. Countermeasures to the loss of skeletal muscle, especially in the stressed patient, must be developed.
journal_name
Curr Opin Clin Nutr Metab Carejournal_title
Current opinion in clinical nutrition and metabolic careauthors
Ferrando AA,Paddon-Jones D,Wolfe RRdoi
10.1097/01.mco.0000232901.59168.e9subject
Has Abstractpub_date
2006-07-01 00:00:00pages
410-5issue
4eissn
1363-1950issn
1473-6519pii
00075197-200607000-00012journal_volume
9pub_type
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