MSK Matters

Nutrition and Physical Activity

Dr. Ali Rendely and Guests Season 3 Episode 1

Welcome to Season 3!  Three new residents will be co-hosting this season alongside Dr. Ali Rendely.

PGY1: Dr. Chris Wavell

PGY4: Dr. Melissa Weidman

PGY4: Dr. Natalie Daly

 Episode one focuses on nutrition and physical activity through the decades.

How do patients optimize nutrition and physical activity as they age? 
It’s hard to “out nutrition” inactivity, but exercise is the forgiver of many sins!  

The recommended dietary allowance (RDA) is 0.8 g protein per kg of body weight per day. For older adults, that may not be enough and 1-1.2g/kg/day may be more optimal, to a max of 1.6g/kg/day. This max dose may be less for those that are less active and those with kidney disease.

All movement is good and more is better, in addition to dietary protein. 

A dietary history should include what they eat, how much, and when they are eating. This should include screening for Vitamin D intake, calcium intake and protein intake. 

Protein assists as a bone builder and can be helpful in minimizing morbidity and mortality associated with fractures. High energy density proteins help build and maintain muscle mass i.e. yogurt, eggs.

Anabolic resistance is analogous to insulin resistance, but relating to protein and muscle mass. The key active amino acid is leucine. This can be obtained from whey protein supplements and whole foods.

Prevention (re: bone loss, muscle loss) is key. Patients should build up a reserve and prevent decline instead of trying to reverse it once it’s started.

 Recovery: 3 R’s: rehydration, refuel, repair!

Additional Resources: 

https://blogs.bmj.com/bjsm/2021/09/26/physical-activity-in-young-adulthood-pays-dividends-decades-later/

Nutritional Supplements in Support of Resistance Exercise to Counter Age-Related Sarcopenia

Skeletal muscle protein metabolism in the elderly: Interventions to counteract the 'anabolic resistance' of ageing

Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group

Does nutrition play a role in the prevention and management of sarcopenia?

Additional research from Dr. Stuart Phillip @mackinprof

Feedback, thoughts, questions? Tweet us @MSKMatters @alirendely