Osteoporosis International

, Volume 24, Issue 5, pp 1555–1566 | Cite as

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

  • A. MithalEmail author
  • J.-P. Bonjour
  • S. Boonen
  • P. Burckhardt
  • H. Degens
  • G. El Hajj Fuleihan
  • R. Josse
  • P. Lips
  • J. Morales Torres
  • R. Rizzoli
  • N. Yoshimura
  • D. A. Wahl
  • C. Cooper
  • B. Dawson-Hughes
  • for the IOF CSA Nutrition Working Group


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 



The Nutrition Working Group of the IOF Committee of Scientific Advisors was supported by the International Osteoporosis Foundation. The help received from Maria Beloyartseva and Parjeet Kaur in the referencing is gratefully acknowledged.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • A. Mithal
    • 1
    Email author
  • J.-P. Bonjour
    • 2
  • S. Boonen
    • 3
  • P. Burckhardt
    • 4
  • H. Degens
    • 5
    • 6
  • G. El Hajj Fuleihan
    • 7
  • R. Josse
    • 8
  • P. Lips
    • 9
  • J. Morales Torres
    • 10
  • R. Rizzoli
    • 2
  • N. Yoshimura
    • 11
  • D. A. Wahl
    • 12
  • C. Cooper
    • 13
    • 14
  • B. Dawson-Hughes
    • 15
  • for the IOF CSA Nutrition Working Group
  1. 1.Medanta MedicityGurgaonIndia
  2. 2.Division of Bone DiseasesUniversity Hospitals and Faculty of MedicineGenevaSwitzerland
  3. 3.Centre for Metabolic Bone Diseases and Division of Geriatric MedicineUniversity of LeuvenLeuvenBelgium
  4. 4.Clinique Bois Cerf/HirslandenLausanneSwitzerland
  5. 5.Institute for Biomedical Research into Human Movement and HealthManchester Metropolitan UniversityManchesterUK
  6. 6.Division Space Physiology, Institute of Aerospace MedicineGerman Aerospace CenterCologneGermany
  7. 7.Calcium Metabolism & Osteoporosis ProgramAmerican University of Beirut Medical CenterBeirutLebanon
  8. 8.Division of Endocrinology and MetabolismUniversity of Toronto, St. Michael’s Hospital Health CentreTorontoCanada
  9. 9.Division of Internal Medicine, Endocrine SectionVU University Medical CenterAmsterdamNetherlands
  10. 10.Hospital Aranda de la ParraHidalgoMexico
  11. 11.Department of Joint Disease Research, 22nd Century Medical and Research CenterThe University of TokyoTokyoJapan
  12. 12.International Osteoporosis FoundationNyonSwitzerland
  13. 13.MRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
  14. 14.NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal SciencesUniversity of OxfordOxfordUK
  15. 15.Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonUSA

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