Dominic Stone
Muscle atrophy is the wasting or thinning of muscle mass. It can be caused by not using muscles enough, nerve problems, or certain medical conditions. Malnutrition, defined as an imbalance between the nutrients the body needs and the nutrients it receives, can lead to muscle atrophy. Malnutrition can cause a negative skeletal muscle protein balance, resulting in muscle loss. This is especially prevalent in older hospitalized patients, where malnutrition is associated with low muscle strength and mass.
| Characteristics | Values |
|---|---|
| What is muscle atrophy? | Muscle atrophy is the wasting or thinning of muscle mass. |
| What causes muscle atrophy? | Muscle atrophy can be caused by disuse of muscles, neurogenic conditions, malnutrition, age, genetics, and lack of physical activity. |
| How does malnutrition cause muscle atrophy? | Malnutrition leads to a negative skeletal muscle protein balance, resulting in muscle loss. |
| What are the symptoms of malnutrition-related muscle atrophy? | Symptoms include decreased muscle strength, decreased handgrip strength, decreased knee extension strength, and wasting of fat and muscle. |
| Who is at risk for malnutrition-related muscle atrophy? | Older hospitalized patients are at a high risk for malnutrition-related muscle atrophy. |
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What You'll Learn
Malnutrition and muscle wasting in older patients
Malnutrition is frequently observed in older patients and can lead to changes in body composition, resulting in functional impairment and poor clinical outcomes. It is a risk factor for developing low muscle mass and strength, which can increase the risk of falls and fractures, lower quality of life, and higher morbidity and mortality.
Several studies have investigated the association between malnutrition and muscle wasting in older patients during hospitalization. One study found that malnutrition, according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, and weight loss were the only independent risk factors for a significant decrease in mid-thigh muscle cross-sectional area (CSA) during two weeks of hospitalization. Malnourished patients experienced an average loss of 9% of thigh muscle mass within 14 days, comparable to the average decline during nine years of aging.
Another study, the EMPOWER study, included 378 patients aged seventy years or older who were admitted to four different wards of an academic teaching hospital in Amsterdam. Patients were grouped into low and high risk of malnutrition based on the Short Nutritional Assessment Questionnaire (SNAQ) score. At admission, a high risk of malnutrition was significantly associated with lower muscle mass but not muscle strength.
The impact of malnutrition on muscle wasting in older patients has also been observed in other studies. Van Ancum et al. found that patients with lower muscle strength and mass at admission were at risk of a higher number of geriatric conditions, including malnutrition, falls, and functional disability. It is speculated that malnutrition, combined with physical inactivity, causes muscle wasting and adversely affects muscle strength and physical functioning.
Overall, these findings highlight the need for routine nutritional assessment and early recognition of malnutrition in older hospitalized patients. Minimizing muscle mass loss and preserving muscle strength should be integral to the treatment and management of malnutrition in this population.
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Muscle atrophy due to disuse
Muscle atrophy is the wasting or thinning of muscle mass. It can be caused by several factors, including malnutrition, age, genetics, lack of physical activity, and certain medical conditions. Disuse atrophy, also known as physiologic atrophy, occurs when muscles are not used enough. This can be due to various reasons, such as leading a sedentary lifestyle, malnutrition, lack of exercise, or certain medical conditions that impair mobility.
When muscles are not contracted through use, the body starts to break them down, leading to a decrease in muscle size and strength. This process can begin within two to three weeks of muscle disuse. The rate of atrophy may vary between different muscle groups, with some muscles being more susceptible to atrophy than others. For example, the triceps surae muscle group may atrophy at a faster rate than the quadriceps or hamstrings.
Disuse atrophy can have a significant impact on an individual's health and quality of life. It can lead to a decrease in overall muscle mass and strength, making individuals more susceptible to injuries. Additionally, disuse atrophy can affect mobility and functional ability, further contributing to a sedentary lifestyle and progression of muscle wasting. This can become a vicious cycle, where the loss of muscle function leads to a further reduction in activity levels.
The effects of disuse atrophy are not limited to physical health. In older adults, low muscle strength has been associated with a higher risk of falls and other geriatric conditions. Additionally, conditions such as penile disuse atrophy can have psychological impacts, affecting sexual function and relationships.
The treatment for disuse atrophy aims to reverse the muscle wasting and improve muscle strength. This can be achieved through exercise programs, including pool-based exercises, and by adopting a healthy diet. In some cases, targeted therapies such as functional electric stimulation or surgical procedures may be recommended. Early intervention is crucial to counter the adverse effects of muscle disuse and prevent further atrophy.
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Neurogenic atrophy
The symptoms of neurogenic atrophy include reduced muscle mass, with one arm or leg being noticeably smaller than the other. Other symptoms may include weakness, numbness, or tingling sensations in the limbs, trouble walking or balancing, difficulty swallowing or speaking, and gradual memory loss.
While malnutrition can contribute to muscle atrophy, it is not the direct cause of neurogenic atrophy. However, malnutrition can exacerbate the condition by impairing muscle growth and maintenance. Diets low in lean protein, fruits, and vegetables can contribute to malnutrition-related muscle atrophy. Additionally, certain medical conditions associated with malnutrition, such as cachexia, can lead to extreme weight loss and muscle atrophy.
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Micronutrient deficiencies
Vitamin D deficiency is a common micronutrient deficiency that can cause muscle weakness, bone loss, and an increased risk of fractures. It can also lead to softening of the bones and muscle aches. In children, vitamin D deficiency can cause rickets, a condition characterised by soft and bent bones.
Calcium deficiency is another common micronutrient deficiency that can lead to osteoporosis, a condition marked by brittle bones. Calcium is important for maintaining strong bones and controlling muscle and nerve function. While there may be no short-term symptoms of calcium deficiency, severely low calcium levels can cause numbness, tingling fingers, and abnormal heart rhythms.
Magnesium deficiency is another common micronutrient deficiency, especially in Western countries. It can cause muscle cramps, restless leg syndrome, fatigue, and migraines. In more severe cases, it can also lead to numbness, tingling, seizures, irregular heart rhythms, personality changes, and coronary spasms.
Iron deficiency is also widespread, especially among young women, children, and vegetarians. It can cause anemia, fatigue, weakened immune system, and impaired brain function.
Vitamin B12 deficiency is common among vegetarians, vegans, and older adults. It can lead to blood disorders, impaired brain function, and elevated homocysteine levels.
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Macronutrient deficiencies
Malnutrition is an imbalance between the nutrients your body needs and the nutrients it receives. It can manifest as undernutrition or overnutrition. Undernutrition, the more commonly understood form of malnutrition, is a deficiency of nutrients. It can cause muscle wasting, or muscle atrophy, and is associated with adverse health outcomes.
Protein, a macronutrient, is essential for health and well-being at all ages. It is a building block of our diet and helps the body produce energy. Protein malnutrition can lead to muscle wasting and other serious health issues. Worldwide, it is estimated that over 1 billion people suffer from insufficient protein intake.
Protein-calorie malnutrition, or marasmus, is characterised by extreme muscle wasting, loss of subcutaneous fat, and atrophy of internal organs. This is a severe form of malnutrition that can have life-threatening consequences.
Micronutrient undernutrition often accompanies macronutrient undernutrition. Calcium, a micronutrient, is essential for muscle function. Calcium deficiency can lead to osteoporosis, which is characterised by softer and more fragile bones. Vitamin D deficiency is also associated with muscle weakness and bone loss.
Magnesium deficiency is another common micronutrient deficiency in Western countries, and it can cause muscle cramps, restless leg syndrome, and fatigue.
Therefore, macronutrient deficiencies, particularly of protein, can cause muscle atrophy, and they are often accompanied by micronutrient deficiencies that can further contribute to muscle weakness and atrophy.
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Frequently asked questions
Muscle atrophy is the wasting or thinning of muscle mass.
Muscle atrophy can be caused by malnutrition, age, genetics, lack of physical activity, or certain medical conditions.
Malnutrition is a deficiency of nutrients. Undernutrition can cause visible wasting of fat and muscle. Malnutrition can lead to a negative skeletal muscle protein balance, resulting in muscle loss.
Symptoms of malnutrition include low body weight, low heart rate, low blood pressure, low body temperature, weakness, faintness, fatigue, and irritability.
Treatment options for muscle atrophy include physical therapy, functional electric stimulation, and surgery. Focused ultrasound can stimulate muscles and aid in recovery.
