Summary: Muscle loss and bone demineralization (bones losing minerals) are big concerns for NASA’s astronauts. They are also big concerns for surgery patients stuck in bed for long stretches. So these patients can gain from the nutrition therapy NASA uses. Studies suggest that more of certain amino acids, like leucine and HMB, is especially helpful.
What is the biggest health concern for NASA’s astronauts? It is muscle wasting and bone loss. It happens even after a short time in space. So NASA has spent decades on research to prevent it.
Figure 1 Nutrition therapy to prevent muscle and bone loss
Surgeons have a similar worry: getting patients back on their feet faster after surgery. But long bed rest causes muscle wasting and bone loss, just like in astronauts. Unlike astronauts, patients are older and frail. Many take a long time to recover. Some never do.
So medicine can learn a lot from NASA about preventing muscle loss after surgery or long periods in bed.
NASA studies show that just one month in microgravity (near-zero gravity) causes 20% muscle loss and about 30% strength loss. So most astronauts should not live in microgravity for more than 6-12 months.
Hospital studies show the same thing. Muscle starts to shrink within 48 hours of not moving. Yes, that fast. In people stuck in bed, thigh muscles like the quadriceps lose ~0.5% per day in young adults. Older adults lose as much as 1% per day. It appears the worst loss comes in the first two weeks.
So a smart plan is to learn from NASA. Its experience shows muscle wasting can be prevented in many ways. Nutrition therapy must start well before the procedure. That may mean fixing gaps in the diet. It also means cutting out junk food, sodas, sugary foods, and alcohol. Then the diet must be built for muscle growth. That means more protein and complex carbs, plus protein supplements or amino acids.
The days right after surgery need special care. This is when stress peaks and much of the muscle is lost. During this time, more amino acids are critical.
Last, there must be a long-term plan for after the patient goes home. It must include nutrition therapy to prevent bone loss and build muscle.
Studies show that getting nutrition therapy right is not easy. Just eating more protein or carbs is not enough. Vitamins like vitamin D and K may be good. But studies show they do not do enough to prevent sarcopenia (muscle loss) after surgery.
Studies show that amino acids, mainly leucine and HMB (β-hydroxy-β-methylbutyrate), along with cofactors and antioxidants, may work well. These amino acids appear to do more than build muscle. They can also act on certain metabolic pathways. That boosts muscle growth and recovery.
More studies are needed. Science still needs to learn which amino acids, and what doses, work best to prevent muscle loss. It is also unclear why some people gain nothing from a high-protein diet. And no one knows yet what a low-glycemic index diet does for recovery.
To sum up, medicine can learn a lot from NASA. NASA relies mainly on nutrition therapy to prevent muscle loss. Surgery patients face the same problem. The fight against weakness and muscle loss must start with nutrition well before the procedure. The days right after it need special care. Then a long-term nutrition plan must be in place. Done right, it may make a significant difference for older adults. Without it, many of them may never fully recover after surgery.
Frequently asked questions
How fast do you lose muscle when you are on bed rest?
Fast. Hospital studies show muscle starts to shrink within 48 hours of not moving. In people stuck in bed, thigh muscles such as the quadriceps lose about 0.5% a day in young adults. Older adults lose as much as 1% a day. The heaviest loss comes in the first two weeks. That is why prevention has to start early.
How can you prevent muscle loss after surgery?
Start before the procedure. Fix any gaps in your diet, and stop junk food, sodas, sugary foods and alcohol. Eat more protein and complex carbs, and add protein supplements or amino acids. Right after surgery, stress and muscle loss peak. That is when more amino acids are critical. After you go home, keep a long-term nutrition plan to protect bone and rebuild muscle.
Do leucine and HMB help prevent muscle wasting?
Studies show that the amino acid leucine and HMB (beta-hydroxy-beta-methylbutyrate), taken with cofactors and antioxidants, may work well. They do more than supply building blocks for muscle. They act on metabolic pathways that boost muscle growth and recovery. Just eating more protein or carbs is not enough. Vitamins D and K play only a small role.
What can surgery patients learn from NASA about muscle loss?
Muscle wasting and bone loss are the biggest health concerns for astronauts. One month in microgravity causes about 20% muscle loss and 30% strength loss. Long bed rest after surgery causes the same kind of loss. And older patients recover more slowly than astronauts do. NASA’s decades of research point to nutrition therapy, mainly amino acids, as a core part of prevention.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
