Suplementacija kod starih ljudi ili - KUPI BABI PROTEIN!
Svi znate one meme sa Slavoruma, "baba zna najbolje"?
Evo i ja da napravim jednu:
Kako sarma ne valja, a tamo neki prašak valja?! Tužiću te babi!
Na žalost, istina je vrlo jednostavna i posledično tužna. Znate svi već kako ide, stari deluju zdravo, kao da im "nije ništa". Počnu da slabe, "padnu na postelju" - i kraj.
Ako malo vratite vreme, setićete se da im je ishrana uglavnom bila slaba i jednolična. Mnogi kod nas olako izgube zube. Ne naročito shvatljivo u dobrano načetom XXI veku, ali tako je. Hrana im se svede na hleb, mleko i "nešto na kašiku".
U jako starom radu, iz pedesetih, možemo naći koje aminokiseline uaze u sastav brašna i hleba. Zanimljivo je da korica sadrži manje aminokiselina. Logično, pošto je više ispečena - više se uništi.
Kao što možete videti iz tabele, nedostajaće im Metionin i Lizin, sve i ako unose 2 ili 3x veću količinu hleba od preporučene. Triptofan je na granici prihvatljivog.
Obe navedene aminokisleine su esencijalne, drugim rečima, telo ne može da ih sintetiše, mora da ih unese.
Generalno govoreći, obe navedene aminokiseline se retko nalaze u hrani biljnog porekla.
Lizin se relativno lako može nadomestiti iz omiljene ali zapostavljene namirnice - pasulja.
Soja ima jako malo Triptofana, ali dosta Metionina, tako da bi kombinacija sve tri namirnice napravila neki prihvatljiv balans.
Dodavanje mleka ne rešava problem, pošto i u njemu ima malo triptofana.
Za kraj, rešenje za Metionin su jaja.
Ali zapravo... Pitanje je da li su stari u stanju da svakodnevno unose optimalnu preporučenu količinu proteina, koja je nekih pedesetak grama. Prevedeno na hranu, to je oko 150-200 gr mesa ili pola kila hleba?! ili 1.5-2 l mleka, 7-8 jaja. Kao što vidite, gotovo je nemoguće da prosečna stara osoba kod nas uspe da unese dovoljnu količinu proteina ako smanji unos mesa. I sve i ako u tome uspe, mora da napravi balans tako da unese neophodne (esencijalne) aminokiseline, a da pritom ostane na prihvatljivoj kilaži. Ovo napominjem zato što bi optimalni unos proteina preko navedenih namirnica u kombinaciji sa slabom aktivnošću lako doveo do toga da osoba unosi previše kalorija koje neće imati kuda da odu osim u masniću.
Rešenje - KUPI BABI PROTEIN
Na tržištu postoje dva osnovna tipa proteina "za bildere": proteini soje i proteini surutke. Među proizvođačima i nema neke razlike, tako da nema potrebe da reklamiram bilo koga.
Kako proteini surutke sadrže više problemaičnih aminokiselina u odnosu na proteine soje - predlažem da nabavite taj tip proteina.
U praksi, za proteine surutke (eng. whey), oko 80% mase je čist protein. Sa 30 gr praška, unosi se oko 25 gr proteina ili polovina potrebnog dnevnog unosa. Cena je oko 100 dinara dnevno.
Navedene tvrdnje mogu da potkrepim dvema novim referencama.
U prvom radu, praćena je sarkopenija, gubitak telesnih mišića. Do nje dolazi upravo zbog loše ishrane i slabe fizičke aktivnosti. Mada ne deluje opasno, zapravo je češći uzrok smrtnosti kod starih u poređenju sa previsokom telesnom težinom. Valjda otuda logika naših starih da gojazno znači zdravo. Kako bi im smanjuli telesnu masu za 7%, istraživači su im menjali jedan obrok mešavinom esencijalnih sastojaka (samo 170 Cal, 4 ili 3 gr masti, 17 grama šećera u obe ispitivane formule i 13 ili 14 gr proteina). Za 8 nedelja koliko je trajao eksperiment, ispitanici su izgubili oko 5 kg masnoće, bez da su značajno ugrozili svoje mišiće.
U drugom radu, cilj je bio da se ispita da li je moguće povećati mišićnu masu kod starih ljudi pojačanom suplementacijom proteinima i treningom. Suplementacija je podrazumevala 2 x 15 gr proteina dnevno. Razlika u količini mišićne mase posle 12 nedelja iznosila je oko 1.5 kg između grupe koja je dobijala protein i grupe koja je bila placebo (misle da unose protein). U oba slučaja, snaga im se značajno poboljšala (oko 15-20 kg znažnije noge, oko 2,5 kg snažniji stisak). Grupa koja je bila na suplmentaciji proteinima se pokazala nešto bolje.
Zaključak
Stari ljudi ne mogu da unesu dovoljno proteina, a da ne naruše količinu masnog tkiva. Osim toga, imaju veliki problem kako da unesu neophodne aminokiseline u željenoj proporciji. Suplementacija proteinima pomaže u redukciji masnog tkiva ako se koristi kao zamena za obrok i uz vežbanje omogućava porast mišićne mase.
Za kraj, pogledajte Mladena Todorović iz Vrnjačke Banje i poslušajte kako se hrani.
Reference:
- McDermott, E. E., and J. Pace. "The content of amino-acids in white flour and bread." British Journal of Nutrition 11.4 (1957): 446-452.
- Blanco, A., and Ricardo Bressani. "Bioavailability of amino acids in beans (Phaseolus vulgaris)." Archivos latinoamericanos de nutricion 41.1 (1991): 38-52.
- Rayaprolu, Srinivas, et al. "Amino acid profiles of 44 soybean lines and ACE‐I inhibitory activities of peptide fractions from selected lines." Journal of the American Oil Chemists' Society 92.7 (2015): 1023-1033.
- Payne-Botha, Sheila, and E. J. Bigwood. "Amino-acid content of raw and heat-sterilized cow's milk." British Journal of Nutrition 13.4 (1959): 385-389.
- Shafer, D. J., et al. "Dietary methionine intake effects on egg component yield, composition, functionality, and texture profile analysis." Poultry science 77.7 (1998): 1056-1062.
- Whey protein and essential amino acids promote the reduction of adipose tissue and increased muscle protein synthesis during caloric restriction-induced weight loss in elderly, obese individuals
- Tieland, Michael, et al. "Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial." Journal of the American Medical Directors Association 13.8 (2012): 713-719.
The last time I translated one of your blogs (Google translate works but it is not eloquent) I began to read up on the Balkan Wars. What a tragic tale of International intrigue (not just the Balkans), betrayal and waste. With this blog, the picture of the elderly lady got me. I expected a folksy, maybe ethnically colorful essay. Not what I found. Very useful information more people need. I don't think gerontologists incorporate this information into practice. I know it's widely suggested in the US that resistance training may be helpful, but I haven't come across anything that addresses protein content in the diet.
I think there might be market-based disincentives to giving out the proper information. Understanding of protein and its relationship to physical stability in the elderly would mean changing purchasing patterns, which would not suit farmers and food manufacturers.
I do have a question though. As people grow older their kidneys become less efficient. High-protein diets tend to stress kidneys. Would this be an issue for many people or only for those diagnosed with kidney insufficiency?
Good blog--once again worth the translation effort.
You are absolutely right about the supplementation of the western people. Yes, it will be probably pointless, because they are eating well. If they need to lose some weight, it's ok to replace the meal with some proteins to avoid losing the lean mass.
However, in South-Eastern Europe, we have a special sort of problem.
Our basics healthcare is fine and free. (parameters such as child mortality, TBC and so on)
Our genetics is ok (normal amount of cancer cases, very long lifespan in Western Slavs)
Our advanced medicine is bad (high amount of people who die from cancer, low number of transplantations).
Deaths in young populations are low (accidents, overdose...)
And surprisingly - our average lifespan is short?!
And the answer is trivial, it's the strange norm of non-exercising in older age, overweight that is leading to cardiovascular diseases, and the lack of teeth. For some strange reason, it's normal to lose all the teeth, never visit a dentist, never get prostatic teeth. They also, never visit a gynaecologist, never do a routine cancer screening and the results are simply sad.
While an average 60-70 years old Western man is travelling across the World, has active life and is considered to be an honoured member of the society, 60-70 years in the East means to be in the grave with one leg.
It's just the lack of education.
That is sad...years of life lost. Amazing how people overlook the importance of teeth. I never thought of that as an element in longevity, but of course.
Ne pije baba ovaj veiiiij, imaš neki sooooj za vegune???
Pogrešan odnos aminokiselina i za nijansu jeftiniji.
Ali svakako vredi razmisliti o tržištu ostarelih milenijalca za jedno 50 godina
I cannot believe serbian is a real language :P
XD In its written form, it can be awkward, especially for French people, because we have the letter "lj", and they are trying to pronounce it as "lzh". Write the word "ljuljashka", and give it to your French friend to read. It will be amazing.
Let's write something in Cyrillic:
Nice new avatar :)
Take that back :P
Well, it looks better than Dutch and I suspect that it sounds better than Dutch. But I am not sure if that is a complement : P
Well, to people not familiar with Slavic languages, it probably sounds like any other Slavic language, because I had people asking me whether I'm Russian, Polish, etc. :D
Hopefully I'll make my DaVinci application soon, so you will have a chance to satisfy your curiosity ;)
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