Summary: Muscle loss and bone demineralization are significant concerns for both NASA’s astronauts and patients undergoing surgical intervention requiring prolonged immobilization. This also means that these patients can benefit from nutrition therapy used by NASA’s astronauts. Studies suggest that boosting intake of specific amino acids like leucine and HMB is particularly helpful.
What is the biggest health concern for NASA’s astronauts? Well, it is muscle wasting and bone demineralization. This primary health issue occurs even after spending a short time in outer space. This means that NASA has done a massive amount of research over decades to prevent this issue.
Figure 1 Nutrition therapy to prevent muscle and bone loss
Similarly, for many doctors, especially surgeons, one of the biggest concerns is ensuring faster patient recovery post-surgery. However, prolonged bed rest leads to muscle wasting and bone demineralization, similar to that occurs in astronauts. Unlike astronauts, patients are of older age and feeble, and thus, many take quite a long time to recover, and some fail to recover.
All this means that medicine can learn a lot from NASA about preventing muscle loss associated with surgical procedures or prolonged periods of immobility.
Studies by NASA show that just one month of time spent in microgravity causes 20% muscle loss and about 30% strength loss. Thus, most astronauts should not be living in microgravity for more than 6-12 months.
Similarly, studies in hospitals show that muscle atrophy begins within 48 hours of inactivity. Yes, that is quite a short period. In bedridden individuals, loss of muscles like quadriceps is ~0.5% per day for young adults and as much as 1% per day for older adults. Further, it appears that muscle loss is most extensive during the first two weeks.
So, one of the good strategies may be to learn from NASA and their studies. NASA’s experience shows that muscle wasting can be prevented in many ways. Nutrition therapy must begin much before the intervention, which may include correcting nutritional deficiencies. It must also include stopping the intake of junk food, sodas, high-sugar foods, and alcohol. Further, nutrition must be optimized for muscle growth, which essentially means increasing the intake of proteins and complex carbs and supplementing the diet with protein supplements or amino acids.
Special attention must be given to immediate post-operative interventions, as this is the period of stress and when much muscle loss occurs. During this period, boosting the intake of amino acids is critical.
Finally, there must be a long-term post-discharge strategy in place. This must include nutrition therapy to prevent bone loss and boost muscle growth.
Studies show that coming up with the right kind of nutrition therapy is not that easy. It is insufficient to increase the intake of proteins or carbs. Further, studies show that though taking vitamins like vitamin D and K may be good, but these measures also have an insufficient role in preventing post-surgical sarcopenia or muscle loss.
Interestingly, studies show that amino acids, especially leucine and HMB (β-hydroxy-β-methylbutyrate), along with cofactors and antioxidants, may be quite good. It appears that these amino acids are not just needed for building muscles but can also influence certain metabolic pathways, thus boosting muscle growth and recovery.
Further, more studies are needed on the topic. For example, science needs to understand what amino acids and at what doses are the best for preventing muscle loss. Similarly, it is unclear why some fail to benefit from a high-protein diet or what impact a low-glycemic index can have on recovery.
To sum up, medicine can learn a lot from NASA, which focuses mainly on nutrition therapy for preventing muscle loss, an issue that is significant in post-operative patients, too. Efforts to prevent weakness and muscle loss must begin with nutrition therapy initiation much before the intervention, with special care taken during the immediate phase after the intervention. Finally, it is also vital to have a long-term nutrition therapy strategy in place. If implemented correctly, it may make a significant difference for older adults, many of whom might not fully recover after surgical procedures without such an approach.
