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Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts and Tupper Research Institute and Division of Clinical Nutrition, Department of Medicine, Tufts University School of Medicine and New England Medical Center, Boston, Massachusetts
Aging is associated with changes in body composition and energy and protein metabolism that are due both to the direct effects of aging and to the effect of age-related diseases. We have recently differentiated these changes under three categories: wasting, cachexia, and sarcopenia. We have defined wasting as unintentional loss of weight, including both fat and fat-free compartments. Experience in the HIV epidemic suggests that wasting is driven largely by inadequate dietary intake. Cachexia, on the other hand, refers to loss of fat-free mass, and especially body cell mass, but with little or no weight loss. The metabolic hallmarks of cachexia are hypermetabolism and hypercatabolism, driven by inflammatory cytokine-mediated acute phase responses. Finally, sarcopenia refers to loss of muscle mass specifically, and seems to be an intrinsic age-related condition. In the elderly, wasting as defined here is at the extreme end of the spectrum, but generally develops in the setting of pre-existing sarcopenia and cachexia. The challenges before us now are to better define these conditions, establish guidelines for their recognition, and develop better methods for intervening when appropriate.
Key words: wasting, elderly, sarcupenia, body composition.
The Journal of Nutrition Vol. 129 No. 1 January 1999,
pp. 256S-259S
Copyright ©1999 by the American Society for Nutritional Sciences
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