Essential Amino Acids and Polyphenol (Wine) Prophylaxis against Sarcopenia and Gradual Protein Depletion of the Elderly Günter Valet

Summary: It is accepted that muscle mass decreases with age (sarcopenia) causing a significant diminution of physical strength. Individuals become weaker, collapse more easily and may suffer bone fractures. This frequently limits their activities and requires costly nursing care.
The regular prophylactic intake of essential amino acids at higher age is a simple, efficient, side effect free and cost effective measure to stop gradual muscle protein depletion, provided it is accompanied by regular polyphenol intake (apple wine, cider, red wine, prefentially dealcoholized) to counteract blood capillary rarefication as an important tissue ageing process that gradually reduces tissue blood supply, leading to an increasing loss of functional organ cells. Effects of essential amino acids on muscle strenght of older people are usually investigated under standardized conditions in retirement and nursing homes (1, 2, 3). It seems, however, more important to investigate elderly humans prior to their entry into these institutions to keep them mobile on their own as long as possible.
Continuous intake of essential amino acids does not generate impressive changes during the first weeks except smoothing and revitalization of the skin combined with diminution of superficial keratoses, skin dryness and some fadeing of age spots. General frailness diminishes while general tonicity and physical performance increase within 3-4 months without particular supplementary exercise due to increasing muscle strength. Important functions like intellectual capacity, motivation, hearing, ocular fundus, blood sugar, blood pressure, bile system and kidney regulation as well as mobility and musculosceletal system remain surprisingly well conserved for longer time periods (years).

Protein Metabolism: Muscle and other body proteins consist of 20 different amino acids, eight of them, the "essential amino acids" cannot be synthesized by the organism. Essential and other amino acids are eaten as animal or vegetal protein at a daily requirement of approximately 1g protein/kg body weight, cleaved into amino acids in the intestinal tract, resorbed via the intestinal wall followed by protein synthesis in the body tissues. This functions well until the age of 60-70 years. Protein synthesis decreases afterwards despite continuation of usual food intake. Vital functions like blood and immune cell production, regeneration of intestinal and skin epithelium continues, nevertheless immune defense decreases, digestive problems may arise and the skin is less well regenerated than before. It becomes thinner (cigarette paper skin) with a tedency of keratosis formation and the emergence of age spots. Required, but missing essential amino acids are either taken from muscle protein degradation or less new muscle protein is snthesized, leading to a gradual protein depletion of the organism with the consequences described above.

Nutritional Protein Increase: Increase of protein intake to 100% of the recommended amount of around 1g protein/kg body weight is typically accompanied by increased fat uptake like in meat, ham, sausage, fish, cheese, yoghurt, eggs or nuts resulting in an unwanted increase of body weight. Continuous eating of low fat quark is not tasty and sometimes not well tolerated (digestive problems). Commercial protein drinks or shakes (soja, whey) do not necessarily correspond in their amino acid composition to the individual requirements, they may strain kidney metabolism and are not always well tolerated (allergies, additives).

Deficit Compensation (Sponge like): Body protein synthesis can alternatively be stimulated in the elderly by providing sufficient quantities of essential amino acids, corresponding to approximately 30-40% of the daily requirements in addition to the eating of typically between 50-70% of the daily protein requirements of approximately 1g/kg body weight in the remaining nutrition. Essential amino acids may stimulate in this way the reutilization (4) of amino acids produced by internal protein degradation. In case of excess essential amino acids, they may be transformed into other molecules, used for energy generation or excreted in small quantities in the urine.

No known Side Effects and Inexpensive: No side effects are observed upon ingestion of physiologic amounts (30-40% of total requirement) of essential amino acids. The intestinal mucosa cannot differentiate between supplemented amino acids and amino acids obtained from intestinal protein degradation. The therapy is comparatively economic with 14-18Euro/20 days that is less than 1 Euro/day. Essential amino acids are nutrition supplements and no medication. They can be obtained in stationary or on-line pharmacies ( z.B.) and are of vegetal origin. The effects of 3x2 capsules prior to breakfast, supper and dinner for the author as well as his wife, both aged above 80 years was unexpectedly positive, with observable effects beginning at 8-14 days after start (Doppelherz Essential Amino Acids with vitamins B1/B12 and His for children: His 252/ILeu 504/Leu 983/Lys 756/Met 262/Phe 630/Thr 378/Try 101/Val 655mg/day *) corresponding to 36% of the daily requirement (World Health Organisation, WHO) for a 70kg person). Nutrition continued to be diversified and self prepared, with 40-50g protein/day at body mass indices (BMI) of 25.7 and 21.5. No home, fitness or eldery gymnastic training was performed and no anabolica or protein preparations were taken. Skin converted after approximately 14days from thin, pale and dry to well perfused with "vital" aspect. keratoses diminished after several weeks and age spots faded significantly.

Increase of Muscle Strength without Training: Concerning muscle strength, one may think that personal estimation represents imagination rather than reality. Regarding the images of either the split logs work (fig.1) at the end of April 2022 or of the fence rebuilding activities in August 2022 (fig.2) makes this, however, unlikely. 17-25 stere of split beech and needle wood logs are prepared at similar living conditions since 13 years (1 stere (=1m3) equaling approximately 1.000kg for fresh beech and 900kg for needle wood, resulting in a total weight between 15-20tons) by two persons without outside or family help. Wood is worked up in daily quantities of around 1,4 stere, loaded, driven home, unloaded and piled up. One day of rest was typically required during the past few years after one or two consecutive days of work, while this year 8,5 stere (8.5tons) beech trees were prepared and brought home on a trailer during 3 consecutive days before and 3 consecutive days after the easter holidays. The tree trunks in the left image were converted into the split logs pile in the right image. The image in the middle shows 50cm long trunk sections of up to 75cm diameter weighing close to 200kg per piece. They were split by metal wedges and a chopper into six logs. The meter (2m length) in the right image serves as reference for the wood pile. Taking four month 30-40% of the daily requirement of essential amino acids has clearly increased physical performance (tonicity) as compared to earlier years.

Conclusions & Outlook: The potential for the generalization of the presented results could be investigated with self supporting elderly people or in retirement homes by providing prophylactic essential amino acids while determining their physical capacities without unusual training efforts. This may turn into an important focus for geriatry in the effort of mobility conservation for the elderly. The increased protein synthesis may furthermore concern bone structure proteins and thus act against osteoporosis. The prophylactic taking of essential amino acids could also increase protein synthesis in people affected by protein malnutrion in developping countries and may help to reduce meat consumption in industrialized countries.

   

fig.1 Work up of around 8,5m3 freshly cut beech trunks corresponding to about 8.500kg wood within six working days (click images to enlarge)

   
fig.2 Storms broke several trees in March 2022. They flattened parts of the meadow fence (left). It was not possible to excavate the 20 holes for new fence posts with a motor drill due to a concrete like hardened clay underground with numerous embedded stones of over feast size. Digging (middle) with a 2m digging steel rod (right in image) or a long chisel (adjacent left) did not give enough progress. Several pilot holes were finally drilled with an electric drill hammer. The earth was then broken either by inserting the chisel into the pilot holes or by hammering it into the earth with a sledge hammer (middle of image). This took about 2h/post for 70cm depth in contrast to around 30min/post by motor drilling. The new fence measures 60m (Click images to enlarge).

References:
1. Kobayashi H. Age-related sarcopenia and amino acid nutrition.
J Phys Fitness Sports Med. (2013) 2: 401-407.
2. Barnes K, Masud T.. Sarcopenia and amino acids
Geratric Medicine (2016)
3. Kobayashi H. Amino Acid Nutrition in the Prevention and Treatment of Sarcopenia
J Pharmaceut Soc Japan, (2018) 138:1277-1283
4. https://www.fao.org/3/AA040E/AA040E05.htm#ch5.

*) Abbreviations: His= l-Histidine, ILeu=l-Isoleucine, Leu=l-Leucine, Lys=l-Lysine, Met=l-Methionine, Phe=l-Phenylalanine, Thr=l-Threonine, Try=l-Tryptophan, Val=l-Valine