A systematic set of nutritional, exercise, and often pharmacological or nutraceutical interventions specifically engineered to promote the net synthesis and accumulation of skeletal muscle mass and bone mineral density. These strategies are critical for combating age-related sarcopenia and frailty, representing a deliberate effort to shift the body’s nitrogen balance toward anabolism. Successful accretion is quantified by measurable increases in lean body mass.
Origin
This term draws from exercise science, clinical nutrition, and endocrinology, focusing on the processes of tissue growth and repair. ‘Accretion’ emphasizes the gradual, measurable buildup of tissue over time, while ‘lean tissue’ specifies the desired outcome of muscle and bone rather than adipose gain. The formulation of these strategies is guided by principles of protein metabolism and anabolic hormone responsiveness.
Mechanism
Effective strategies operate by maximizing the anabolic stimuli necessary for muscle protein synthesis (MPS) while minimizing catabolic signals. This involves optimizing the timing and quantity of essential amino acid intake, particularly leucine, to trigger the mTOR pathway, the master regulator of MPS. Simultaneously, resistance exercise provides the mechanical tension signal, and optimized hormonal support, such as sufficient testosterone and IGF-1 levels, provides the systemic endocrine environment required to sustain a positive nitrogen balance and drive myocyte hypertrophy.
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