News | 20 December 2018

Protein and physical activity stimulate night-time muscle build-up

Five-day hospitalisation results in considerable loss of muscle mass

A protein-rich diet combined with physical effort before sleeping can help prevent patients losing muscle mass during a period of hospitalisation. This is one of the primary conclusions drawn by Imre Kouw from her PhD study at Maastricht UMC+. The PhD candidate investigated a series of strategies for countering the loss of muscle mass due to ageing and illness, in particular during a period of hospitalisation.

iStockiStockAs we become older, people lose muscle mass and muscle strength in a phenomenon known as sarcopenia. During a period of hospitalisation people are even more vulnerable. Moreover, the mental and physical stress that often accompanies hospitalisation in many cases leads to reduced appetite. One outcome from Kouw's study is that patients who were hospitalised for a hip operation lost between three and four percent of their muscle mass in just five days. That easily equates to between five hundred grams and a full kilogram.

Diet strategy
Muscle tissue is constantly built up and broken down. Crucial to muscle building is the intake of sufficient protein in the diet. "However, elderly patients undergoing a hip operation, for example, often leave up to thirty percent of their food uneaten," explained Kouw. "As a result they take in insufficient protein and lose even more muscle mass and strength. This in turn slows down their recovery." In response, the PhD candidate went in search of smart strategies to increase the protein intake and to ensure that patients were up and about sooner.

Night-time muscle build-up
In the end, taking a protein-rich drink (with 40 grams of protein) shortly before settling down for the night proved an effective method. It in fact stimulates the night-time build-up of new muscle by 33 percent. Combining this with physical effort led to a further 30 percent increase in night-time muscle build-up. Since we need more protein to counter ageing and illness, this is a relatively simple dietary strategy aimed at satisfying this additional need. This dietary intervention can for example be initiated a few days before an operation, or during the period in hospital itself. "We also recommend patients to always combine the consumption of a protein-rich meal (at least 25-30 grams of protein) during the course of the day with some form of physical exercise," explained Kouw. "Before, during and after hospitalisation."

Imre Kouw was awarded her PhD at the University of Maastricht on 5 December, with her thesis 'Nutritional strategies to support muscle maintenance in clinical populations.' In two recent publications, Kouw has described her study into loss of muscle mass in patients following hospitalisation and the positive effect of protein intake shortly before sleeping.