Inter-organ Crosstalk COMPLICATIONS AND ASSOCIATED RISKS MUSCLE FUNCTION Regulates Blood Glucose Stores Proteins & Glycogen Synthesizes & Stores Glutamine Structural Metabolic WHY MAINTAINING MUSCLE MATTERS Muscle plays structural and metabolic roles • Loss of lean body mass impacts patient outcomes YOU CAN’T ALWAYS SEE MUSCLE LOSS BMI doesn’t always tell you the full story: Same BMI, diﬀerent LBM by DXA Carneiro et al., reprinted with permission Fat mass Lean mass Strength & Power Mobility Posture & Balance MUSCLE LOSS Chronic Disease Aging Inﬂammation Malnutrition Acute Illness Injury Sedentary Lifestyle Hospitalization • Loss of strength and energy • Falls and fractures • Mobility-disability • Illness and infection IDENTIFY Patients at risk of muscle loss, especially those with recent weight loss and acute or chronic illness INTERVENE • Length of hospital stay • Hospital readmissions • Recovery time • Mortality Exercise & Physical Activity Nutrition • Nutrition counseling • High-protein foods and snacks • Oral nutritional supplementation Myogenesis SATELLITE CELL Apoptosis Synthesis PROTEIN Breakdown Oxidation LIPIDS Intracellular accumulation Glucose metabolism ENERGY Mitochondrial respiration BLOOD FLOW METABOLIC CONSIDERATIONS in SKELETAL MUSCLE References. Argilés JM et al. J Am Med Dir Assoc. 2016;17(9):789-796; JafariNasabian P et al. J Endocrinol. 2017;234(1):R37-R51; Paddon-Jones D et al. J Clin Endocrinol Metab. 2004;89(9):4351-4358; Kortebein P et al. JAMA. 2007;297(16):1772-1774; Puthucheary Z et al. JAMA. 2013;310(15):1591-1600; Hegerová P et al. Nutrition. 2015;31(1):166-170; Takeshima N et al. J Aging Phys Act. 2015;23(3):452-459; Beattie AH et al. Gut. 2000;46(6):813-818; Tappenden KA et al. JPEN J Parenter Enteral Nutr. 2013;37(4):482-497; Vigelsø A et al. J Rehabil Med. 2015;47(6):552-560; Prado CM et al. Curr Opin Clin Nutr Metab Care. 2015;18(6):535-551; Carneiro IP et al. Curr Oncol Rep. 2016;18(10):62; Martin L et al. J Clin Oncol. 2013;31(12):1539-1547. www.anhi.org ©2018 Abbott Laboratories 171391(1)/January 2018 LITHO IN USA

WHY MAINTAINING MUSCLE MATTERSInter-organ Crosstalk COMPLICATIONS AND ASSOCIATED RISKS MUSCLE FUNCTION Regulates Blood Glucose Stores Proteins & Glycogen Synthesizes & Stores Glutamine

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Inter-organ Crosstalk

COMPLICATIONS AND ASSOCIATED RISKS

MUSCLE FUNCTION

Regulates Blood Glucose

Stores Proteins & Glycogen

Synthesizes & Stores Glutamine

Structural Metabolic

WHY MAINTAINING MUSCLE MATTERSMuscle plays structural and metabolic roles • Loss of lean body mass impacts patient outcomes

YOU CAN’T ALWAYS SEEMUSCLE LOSS

BMI doesn’t always tell you the full story:Same BMI, di�erent LBM by DXA

Carneiro et al., reprinted with permission

Fat mass

Lean mass

Strength & Power

Mobility

Posture & Balance

MUSCLELOSS

Chronic Disease

Aging

Inflammation

Malnutrition

Acute Illness

Injury

Sedentary Lifestyle

Hospitalization

• Loss of strength and energy• Falls and fractures• Mobility-disability• Illness and infection

IDENTIFYPatients at risk of muscle loss, especially those with recent weight loss and acute or chronic illness

INTERVENE

• Length of hospital stay• Hospital readmissions• Recovery time• Mortality

Exercise & Physical ActivityNutrition• Nutrition counseling• High-protein foods and snacks• Oral nutritional supplementation

MyogenesisSATELLITE CELL

Apoptosis

SynthesisPROTEINBreakdown

OxidationLIPIDS

Intracellular accumulation

Glucose metabolismENERGY

Mitochondrial respiration

BLOOD FLOW

METABOLIC CONSIDERATIONSin SKELETAL MUSCLE

References. Argilés JM et al. J Am Med Dir Assoc. 2016;17(9):789-796; JafariNasabian P et al. J Endocrinol. 2017;234(1):R37-R51; Paddon-Jones D et al. J Clin Endocrinol Metab. 2004;89(9):4351-4358; Kortebein P et al. JAMA. 2007;297(16):1772-1774; Puthucheary Z et al. JAMA. 2013;310(15):1591-1600; Hegerová P et al. Nutrition. 2015;31(1):166-170; Takeshima N et al. J Aging Phys Act. 2015;23(3):452-459; Beattie AH et al. Gut. 2000;46(6):813-818; Tappenden KA et al. JPEN J Parenter Enteral Nutr. 2013;37(4):482-497; Vigelsø A et al. J Rehabil Med. 2015;47(6):552-560; Prado CM et al. Curr Opin Clin Nutr Metab Care. 2015;18(6):535-551; Carneiro IP et al. Curr Oncol Rep. 2016;18(10):62; Martin L et al. J Clin Oncol. 2013;31(12):1539-1547.

171391(1)/January 2018 LITHO IN USA