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Cited by 106

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Defining anabolic resistance: implications for delivery of clinical care nutrition

Morton, Robert W., Traylor, Daniel A., Weijs, Peter J.M., Phillips, Stuart M.·2018·Current Opinion in Critical Care
DOI 10.1097/mcc.0000000000000488
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Abstract

Purpose of review: Skeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care. Recent findings: Anabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states. Anabolic resistance describes the reduced stimulation of muscle protein synthesis to a given dose of protein/amino acids and contributes to declines in skeletal muscle mass. Physical inactivity induces: anabolic resistance (that is likely exacerbated with aging), insulin resistance, systemic inflammation, decreased satellite cell content, and decreased capillary density. Critical illness results in rapid skeletal muscle atrophy that is a result of both anabolic resistance and enhanced skeletal muscle breakdown. Summary: Insofar as atrophic loss of skeletal muscle mass is concerned, anabolic resistance is a principal determinant of age-induced losses and appears to be a contributor to critical illness-induced skeletal muscle atrophy. Older individuals should perform exercise using both heavy and light loads three times per week, ingest at least 1.2 g of protein/kg/day, evenly distribute their meals into protein boluses of 0.40 g/kg, and consume protein within 2 h of retiring for sleep. During critical care, early, frequent, and multimodal physical therapies in combination with early, enteral, hypocaloric energy (∼10–15 kcal/kg/day), and high-protein (>1.2 g/kg/day) provision is recommended.

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Metadata

Authors
Morton, R. W., Traylor, D. A., Weijs, P. J. M., & Phillips, S. M.
Affiliations
  • Department of Kinesiology, McMaster University, Hamilton, Canada
  • Department of Nutrition and Dietetics, VU University
Venue
Current Opinion in Critical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-04
Volume
24
Issue
2
Pages
124-130
ISSN
  • 1070-5295
  • 1531-7072
DOI
10.1097/mcc.0000000000000488
Cited by
106
References
15
Language
en

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