Editor’s Note: This article is one of a three-part series. Part one discussed the interconnected relationships between muscles, joints and bones. Now is the time for the nutrition and dietary supplement industries to consider musculoskeletal health as one comprehensive category, particularly for formulations targeting the healthy aging community. The second part begins to examine the types of improvements that can be made to formulations to promote much superior wellness results.
Imagine the musculoskeletal category as a three-legged stool. Two of the legs are very well established: bone health and joint health. A significant glucosamine / chondroitin market is already in place for joint health. Many consumers are even aware of the different forms of calcium for their bones.
The weakest leg, making the entire stool (musculoskeletal system) unstable, is muscle health. The truth is, joint and bone health doesn’t exist without muscle health. Joint pain, for example, can lead to muscle weakness as people adapt the way they move or restrict their movement. Weight-bearing exercise is necessary for bone health, but even walking may not be possible or practical for people whose muscle weakness makes them unstable.
Many consumers believe this is covered through foods and drinks fortified with protein and readily available. But most people, including health professionals, are surprised to learn that consuming protein may have little impact on muscle health.
The enigma of proteins
People can overeat protein, but in three months the muscles may not improve. Although protein is necessary for building muscle, once it is consumed beyond the body’s demands the result is much more likely to be excess body fat, and not increased muscle.
Worse, studies recently published in reputable journals have shown that excessive protein intake precipitates metabolic syndrome and increases risk factors for cardiovascular disease (CVD) (Curr Opin Clin Nutr Metab Care. 2020; 23: 380-386).
Clearly, protein, while essential, is an incomplete solution.
Unavoidable age-related muscle loss
Until recently, people who don’t lift weights tended to ignore the entire muscle health category, but this population has more in common with the athletic community than they realize. Both groups will experience involuntary muscle loss with age.
Unlike joint or bone health problems, age-related muscle loss is inevitable. The body gradually becomes less efficient at rebuilding muscle tissue. As a result, the body needs more protein or exercise to get the same muscle growth responses.
The market for products that treat age-related muscle loss is poised to grow as consumers begin to realize that they cannot achieve their goals of healthy aging and mobility without also taking care of them. their muscle health.
Age-related muscle loss often begins to affect the quality of life of adults over the age of 60. But this decline can start in people as young as 30 years old and is often exacerbated by lifestyle. Some young people end up accelerating muscle loss by combining a poor diet with multiple aggressive attempts at weight loss without an exercise component. As they age, it can compromise their entire musculoskeletal system.
The clinical name for this acceleration of muscle loss and function is sarcopenia, a condition that is not fully understood by many people, including some doctors. But the symptoms are common: slower recovery from illness and injury, decreased strength and energy. The progression may seem too gradual to be noticed, until the simple act of getting up from a chair becomes a challenge.
Calcium β-hydroxy-β-methylbutyrate or HMB enters this scenario as an essential nutrient. It uniquely stimulates protein synthesis and reduces muscle breakdown. Research funded by the National Institutes of Health (NIH) has shown that adding HMB (like myHMB) and vitamin D3 to daily protein intake would improve muscle health in older people, even without exercise (J Gerontol A Biol Sci Med Sci. 2020; 75: 2089-2097). Vitamin D has also been correlated with muscle function. A 2021 review associated creatine supplementation with improved muscle strength, especially when combined with a resistance program (Med Sci Sports Exerc. 2021; 532388-2395).
Physicians need to work more closely with the dietary supplement industry to maximize synergies for their patients.
The hallmark of preventive medicine is to help consumers focus on areas of susceptibility rather than devoting their efforts to problems they are unlikely to encounter. For example, although not everyone is susceptible to osteoporosis or arthritis, everyone will be affected by age-related muscle loss.
Connect the three systems
As physicians, we believe that innovative opportunities in muscle health clearly fall within the realm of dietary supplements. Here’s why. The pharmaceutical industry in this country is focused on therapy (treatment) once a disease is diagnosed, while the dietary supplement industry is focused on maintaining health.
When drugs are a common course of action, say half a dozen or more drugs regularly prescribed for osteoporosis, the torch is not carried by the dietary supplement industry. Bone health supplements can and always should be part of a program, but innovation is on the back burner.
More than 20 years ago, no medicine was available for osteoarthritis (OA). It was the perfect time to step into a research-backed dietary supplement program. This is how the glucosamine / chondroitin categories were constructed. We now see similar circumstances with the muscle health category.
Going back to the three-legged stool analogy … strengthening the integrity of that third leg, muscle health, is greatly needed. Because HMB is a scientifically proven approach to maintaining healthy muscle mass, it’s time to consider including this ingredient in formulations for musculoskeletal health.
As people become more and more aware of the importance of maintaining muscle health and how best to achieve it, brands already in this space with well-researched ingredients are expected to gain an important part of a base. of global consumers.
Naji Abumrad, doctor of medicine, (“Dr. Naji”) is an award-winning educator, board-certified surgeon, National Institutes of Health (NIH) -funded researcher and member of the American Association for the Advancement of Science (AAAS).
Jason Theodosakis, MD, (“Dr. Theo”) is a certified physician, best-selling author, researcher, consultant, lecturer, and preventive medicine researcher. He has a second medical specialty (sports medicine), as well as a master’s degree in exercise physiology and public health. For more information, visit the Dr Théo’s website.