What is Sarcopenia?
Sarcopenia, or age-related muscle loss, is an important topic I often discuss with my patients. It significantly affects health and well-being by weakening muscles, leading to more falls, injuries, and a reduced ability to perform daily tasks, ultimately lowering the quality of life. Additionally, sarcopenia is linked to higher mortality rates (death).
This condition typically begins around age 40 and accelerates after 60, making everyday activities more challenging and increasing the risk of falls and fractures. Addressing sarcopenia early is vital for maintaining muscle health and overall well-being.
Article Index:
How Common is Sarcopenia?
Sarcopenia affects about 10% of people over 60, nearly 30% of those in their 70s, and over 50% of those aged 80 and above. It is more prevalent in men and often accompanies conditions like obesity, diabetes, and heart disease. Beyond physical decline, sarcopenia also has significant mental health impacts. The loss of muscle strength and mobility can lead to decreased social interaction, as individuals are less likely to participate in activities they once enjoyed. This reduction in social engagement can contribute to feelings of isolation, depression, and a decreased quality of life.
How Sarcopenia Affects Your Muscles
Biomechanical Factors
Biochemical Pathways
Several biochemical changes contribute to sarcopenia. Anabolic resistance, where muscles become less responsive to protein, hampers muscle growth. Inflammatory cytokines like TNF-α and IL-6 increase, promoting muscle breakdown. Oxidative stress and mitochondrial dysfunction also play roles, damaging muscle cells and reducing their efficiency. Hormonal declines, including lower levels of growth hormone, testosterone, and IGF-1, further diminish muscle mass and strength.
By understanding these mechanisms, we can better target interventions to slow or reverse sarcopenia, improving health and quality of life as we age.
How to Prevent Sarcopenia
Addressing sarcopenia early is vital. Engaging in regular exercise, particularly strength training, and maintaining proper nutrition with sufficient protein can help preserve muscle health. Failing to address sarcopenia can lead to a significant loss of muscle strength, increasing the risk of falls and injuries, and ultimately, losing your independence. Taking action early can significantly enhance your quality of life and keep you stronger for longer.
Exercise Strategies
To prevent sarcopenia, it's crucial to keep your muscles active and strong. Here’s what you can do:
Resistance Exercises: Engage in weightlifting or use resistance bands at least 2 to 3 times a week. Focus on major muscle groups with exercises like squats, lunges, push-ups, and rows. Aim for 3 to 4 sets of 8 to 12 repetitions for each exercise. Resistance training activates muscle fibers, recruits satellite cells, and promotes muscle growth through the mTOR pathway.
Balance and Coordination Activities: Incorporate activities like yoga or tai chi into your routine at least twice a week. These practices improve balance, coordination, and flexibility, reducing the risk of falls and enhancing overall muscle function. They also support muscle energy and endurance through the AMPK and PGC-1α pathways.
Nutrition and Supplements
Proper nutrition is key to supporting muscle health. Here’s what you need:
Protein: Aim for 1.2 to 1.5 grams of protein per kilogram of body weight each day. For example, if you weigh 70 kg (about 154 pounds), you should consume between 84 to 105 grams of protein daily. Good sources include lean meats, fish, eggs, dairy products, legumes, and plant-based proteins like tofu and quinoa. Protein enhances muscle protein synthesis (MPS), crucial for muscle repair and growth.
Omega-3 Fatty Acids: Aim for about 1,000 mg of omega-3s daily. You can get this from fatty fish like salmon, mackerel, and sardines, or from plant sources such as flaxseeds, chia seeds, and walnuts. Omega-3 supplements, such as fish oil or algae oil, can also be beneficial. Omega-3s reduce inflammation and oxidative stress, protecting muscle cells.
Anti-inflammatory and Antioxidant Foods: Incorporate a variety of fruits and vegetables like berries, oranges, spinach, and kale. Nuts, seeds, and whole grains are also excellent choices. Spices such as turmeric and ginger have strong anti-inflammatory properties. These foods help combat inflammation and oxidative stress, which can damage muscles.
The Impact of Sleep on Sarcopenia
Sleep is critical for combating sarcopenia, as it significantly influences hormonal balance and muscle health:
Hormonal Balance and Muscle Repair: During deep sleep, the body releases growth hormone, essential for muscle repair and regeneration. This hormone stimulates protein synthesis, promoting muscle growth and maintenance. Inadequate sleep disrupts this process, leading to reduced muscle recovery and increased muscle loss.
Cortisol and Muscle Breakdown: Sleep deprivation raises cortisol levels, a stress hormone that promotes muscle breakdown. Chronic high cortisol levels contribute to muscle catabolism, exacerbating sarcopenia.
Insulin Sensitivity and Muscle Mass: Poor sleep affects insulin sensitivity, impairing glucose utilization, leading to increased fat storage and decreased muscle mass. Ensuring adequate, quality sleep is crucial for maintaining hormonal balance, supporting muscle repair, and preventing sarcopenia. Prioritizing sleep, along with regular exercise and proper nutrition, is vital for preserving muscle health and independence as we age.
Reversing Sarcopenia
Integrated and Holistic Approaches
Reversing sarcopenia is possible, especially with early intervention. Studies have shown that timely and comprehensive approaches can significantly improve muscle mass and function, reducing the progression of sarcopenia. Here’s how:
Exercise and Nutrition Synergy: Combining resistance training with nutritional supplementation has a profound impact on muscle mass and function. Regular physical activity, particularly strength training, stimulates muscle growth and enhances strength. Pairing this with a protein-rich diet and omega-3 fatty acids maximizes muscle protein synthesis and reduces inflammation, leading to significant improvements in muscle health.
Holistic Health: Maintaining mental health and cognitive function is crucial for muscle health. Stress management, mental stimulation, and social engagement keep individuals motivated and active, reducing the risk of muscle loss due to inactivity. Psychological support is also vital for overall well-being.
Quality Sleep: Adequate sleep is essential for muscle repair and growth. During deep sleep, the body releases growth hormone, which stimulates muscle protein synthesis. Poor sleep increases cortisol levels, a stress hormone that promotes muscle breakdown, and impairs insulin sensitivity, affecting muscle mass. Prioritizing quality sleep supports hormonal balance and muscle health.
Research supports the effectiveness of these integrated approaches. For instance, a study published in the Journal of Cachexia, Sarcopenia and Muscle found that older adults who engaged in resistance training combined with adequate protein intake experienced an increase in muscle mass by approximately 1.5 kg and a 30% improvement in muscle strength over a 12-week period. By embracing these strategies, individuals can effectively combat sarcopenia, enhancing their muscle health and overall quality of life.
Conclusion
Addressing muscle mass loss with age is critical for maintaining independence. In North America, while the average life expectancy is approximately 79.5 years, the average healthy life expectancy (HALE) is only 63.7 years, meaning people often spend over 15 years living with chronic illness or disability. Early action against sarcopenia can help close this gap, allowing more healthy, active living years. Regular exercise, a protein-rich diet, and quality sleep are essential to preserving muscle mass and strength, significantly improving health span and overall well-being. Even if you are suffering from an injury or arthritic changes and feel you cannot exercise, we can help you recover from those injuries. Remember, exercise, a good diet, and sleep all help increase your energy—they do not decrease it.
I believe in setting "non-negotiables" for health: daily exercise, a balanced diet, and sufficient sleep. At 67, I work out daily and lift weights thrice a week, keeping me strong and active. When patients say they lack time or energy, I emphasize the transformative benefits of prioritizing these habits. Making exercise, nutrition, and sleep priorities can lead to remarkable improvements in muscle health, helping you stay strong and independent as you age. Start today, and your future self will thank you!
References
Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., ... & Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and Ageing, 39(4), 412-423.
Fielding, R. A., Vellas, B., Evans, W. J., Bhasin, S., Morley, J. E., Newman, A. B., ... & Cummings, S. R. (2011). Sarcopenia: An undiagnosed condition in older adults. Current consensus definition: Prevalence, etiology, and consequences. Journal of the American Medical Directors Association, 12(4), 249-256.
Landi, F., Calvani, R., Tosato, M., Martone, A. M., Ortolani, E., Savera, G., ... & Bernabei, R. (2016). Anorexia of aging: Risk factors, consequences, and potential treatments. Nutrients, 8(2), 69.
Morley, J. E., Anker, S. D., & von Haehling, S. (2014). Prevalence, incidence, and clinical impact of sarcopenia: Facts, numbers, and epidemiology–Update 2014. Journal of Cachexia, Sarcopenia and Muscle, 5(4), 253-259.
Pahor, M., Guralnik, J. M., Ambrosius, W. T., Blair, S., Bonds, D. E., Church, T. S., ... & Kritchevsky, S. B. (2014). Effect of structured physical activity on prevention of major mobility disability in older adults: The LIFE study randomized clinical trial. JAMA, 311(23), 2387-2396.
Rolland, Y., Czerwinski, S., van Kan, G. A., Morley, J. E., Cesari, M., Onder, G., ... & Vellas, B. (2008). Sarcopenia: Its assessment, etiology, pathogenesis, consequences and future perspectives. Journal of Nutrition Health and Aging, 12(7), 433-450.
Rosenberg, I. H. (1997). Sarcopenia: Origins and clinical relevance. Journal of Nutrition, 127(5), 990S-991S.
Roubenoff, R. (2000). Sarcopenia and its implications for the elderly. European Journal of Clinical Nutrition, 54(S3), S40-S47.
Tieland, M., Trouwborst, I., & Clark, B. C. (2018). Skeletal muscle performance and ageing. Journal of Cachexia, Sarcopenia and Muscle, 9(1), 3-19.
Walston, J. D. (2012). Sarcopenia in older adults. Current Opinion in Rheumatology, 24(6), 623-627.
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DR. BRIAN ABELSON, DC. - The Author
Dr. Abelson is dedicated to using evidence-based practices to improve musculoskeletal health. At Kinetic Health in Calgary, Alberta, he combines the latest research with a compassionate, patient-focused approach. As the creator of the Motion Specific Release (MSR) Treatment Systems, he aims to educate and share techniques to benefit the broader healthcare community. His work continually emphasizes patient-centred care and advancing treatment methods.
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