Osteoporosis International

, Volume 24, Issue 5, pp 1555-1566

First online:

Impact of nutrition on muscle mass, strength, and performance in older adults

  • A. MithalAffiliated withMedanta Medicity Email author 
  • , J.-P. BonjourAffiliated withDivision of Bone Diseases, University Hospitals and Faculty of Medicine
  • , S. BoonenAffiliated withCentre for Metabolic Bone Diseases and Division of Geriatric Medicine, University of Leuven
  • , P. BurckhardtAffiliated withClinique Bois Cerf/Hirslanden
  • , H. DegensAffiliated withInstitute for Biomedical Research into Human Movement and Health, Manchester Metropolitan UniversityDivision Space Physiology, Institute of Aerospace Medicine, German Aerospace Center
  • , G. El Hajj FuleihanAffiliated withCalcium Metabolism & Osteoporosis Program, American University of Beirut Medical Center
  • , R. JosseAffiliated withDivision of Endocrinology and Metabolism, University of Toronto, St. Michael’s Hospital Health Centre
  • , P. LipsAffiliated withDivision of Internal Medicine, Endocrine Section, VU University Medical Center
  • , J. Morales TorresAffiliated withHospital Aranda de la Parra
    • , R. RizzoliAffiliated withDivision of Bone Diseases, University Hospitals and Faculty of Medicine
    • , N. YoshimuraAffiliated withDepartment of Joint Disease Research, 22nd Century Medical and Research Center, The University of Tokyo
    • , D. A. WahlAffiliated withInternational Osteoporosis Foundation
    • , C. CooperAffiliated withMRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General HospitalNIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford
    • , B. Dawson-HughesAffiliated withJean Mayer USDA Human Nutrition Research Center on Aging, Tufts University
    • , for the IOF CSA Nutrition Working Group

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Muscle strength plays an important role in determining risk for falls, which result in fractures and other injuries. While bone loss has long been recognized as an inevitable consequence of aging, sarcopenia—the gradual loss of skeletal muscle mass and strength that occurs with advancing age—has recently received increased attention. A review of the literature was undertaken to identify nutritional factors that contribute to loss of muscle mass. The role of protein, acid–base balance, vitamin D/calcium, and other minor nutrients like B vitamins was reviewed. Muscle wasting is a multifactorial process involving intrinsic and extrinsic alterations. A loss of fast twitch fibers, glycation of proteins, and insulin resistance may play an important role in the loss of muscle strength and development of sarcopenia. Protein intake plays an integral part in muscle health and an intake of 1.0–1.2 g/kg of body weight per day is probably optimal for older adults. There is a moderate inverse relationship between vitamin D status and muscle strength. Chronic ingestion of acid-producing diets appears to have a negative impact on muscle performance, and decreases in vitamin B12 and folic acid intake may also impair muscle function through their action on homocysteine. An adequate nutritional intake and an optimal dietary acid–base balance are important elements of any strategy to preserve muscle mass and strength during aging.


Aging IOF Malnutrition Muscle strength loss Nutritional Recommendations Sarcopenia