MUSCLE LOSS AND AGEING: Use it or Lose it!

WHAT IS SARCOPENIA?

Sarcopenia is the medical term for muscle wasting (taken from the Ancient Greek for ‘sarx’- meaning ‘flesh’ and ‘penia’ –meaning ‘loss’). Physical activity is essential to preventing illness as we reach our advanced years, but more emphasis needs to be given to resistance (strength) as well as balance training which is often neglected with ageing. Keeping muscles active is the strongest way to fight sarcopenia.

The importance of sarcopenia is heavily underestimated given that 10-20% of the UK population over the age of 65 years and 50% over the age of 80 years of age suffer with sarcopenia. The process of muscle wasting can be seen in some individuals to take place from as early as 30 years old. For this reason, resistance training from this age onwards is highly recommended.

The current adult guidelines suggest incorporating resistance training into our weekly exercise schedule at least 2 days per week. Strength exercises which work all major muscle groups (legs, hips, shoulders, back, abdomen, chest and arms) are recommended. This recommendation is in addition to or by incorporating it into the minimum 150 minutes of moderate intensity aerobic physical activity recommended per week.

HOW IS RESISTANCE TRAINING AND SARCOPENIA RELEVANT TO MY OWN HEALTH?

The loss of skeletal muscle mass in older age is strongly related to frailty, osteoporosis, disability, and death. It is a major factor in fall risk and affects one’s ability to perform day to day activities. Skeletal muscle also has a key role to play in glucose regulation. It is one of the most important sites of glucose disposal in the body. Studies have shown that those individuals with higher amounts of muscle relative to their body weight were more insulin sensitive and less likely to be pre-diabetic.

In addition to lack of exercise, it is also worth considering other risk factors for sarcopenia. Poor nutrition and associated chronic illnesses such as type 2 diabetes have been proven to have a negative effect. In addition, natural age-related changes may also cause loss of muscle strength too due to reduced hormone levels, which can accelerate muscle fibre loss.

SHOULD I JOIN A GYM THEN?

You do not need to spend hours in the gym pumping iron, have your own dumbbells or need any other special equipment for resistance training. For older adults a 10-minute workout twice a week using your own body weight and some household objects is a great first step. Exercises to start off with can include body-weight squats, lunges, push-ups against a wall or knees, triceps dips on a kitchen work top, shoulder press using water bottles and step-ups. All these can be done in the comfort of your own home. Various studies have shown this simple step to be a successful intervention in the prevention and treatment of sarcopenia.

DIET AND SARCOPENIA

Recent studies have also shown the critical role of dietary protein (typically legumes and beans, nuts, seeds, high quality lean meats, eggs and dairy) in preventing sarcopenia. A protein intake of at least 1.2g per kg of body weight should help mitigate against muscle loss. In addition, there is also some evidence of the benefit of vitamin D, Selenium, Magnesium and Omega 3 Fatty Acids. A Mediterranean diet with higher consumption of fruit and vegetables has also been associated with improved physical performance, protection against muscle wasting and frailty.

IT’S NOT TOO LATE TO START

No matter your age, for prevention of chronic disease and frailty it is essential to incorporate resistance training into your workout. It is never too late, and you do not necessarily need any equipment to start. It will certainly pay dividends for your health in years to come.

References

Failure to expand the motor unit size to compensate for declining motor unit numbers distinguishes sarcopenic from non-sarcopenic older men – Piasecki, Ireland et al. The Journal of Physiology 2018

Sarcopenia Is Recognized as an Independent Condition by an International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) Code – Cao and Morley 2016

European Working Group on Sarcopenia in Older People Updated Guidelines 2018 – Cruz-Jentoft, Bahat et al, Age Ageing 2019

Nutrition and Sarcopenia, what do we Know? – Ganapathy and Nieves, Nutrients 2020

Pathogenesis and Management of Sarcopenia – Robinder J S Dhillon, Sarfraz Hasni, Clinical Journal of Geriatrics 2017