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Sarcopenia: Age-Related Loss Of Muscle Mass, Strength, & Function

5 months, 1 week ago

4118  1
Posted on Mar 17, 2019, 4 p.m.

Peak muscle mass is typically achieved in adults during their 30s to early 40s, after that gradual muscle loss beings and continues into old age; this age-related loss of muscle mass, strength, and function is called sarcopenia and it can happen quicker than one thinks contributing to morbidity, decreased quality of life, and high healthcare costs.

Those who are not very physically active or lead sedentary lifestyles can lose as much as 5% of their muscle mass per decade after reaching 30 years old. There is not a specific level of lean body mass at which point it can be said sarcopenia is present, but any loss of muscle mass is a concern at any age.

30-40 seems way too young to start any scale of physical decline, yet sadly it can happen if the body remains sedentary. With age everyone loses muscle mass, however it is possible to naturally slow and/or reverse this loss with regular exercise and healthy nutrition.

Research has shown that exercise including a program of progressive resistance/strength training can help to improve sarcopenia in as little as two weeks to rebuild muscle mass and help slow, and stave off sarcopenia. Exercise is without question the most powerful intervention to address muscle loss, when it comes to sarcopenia exercise has been shown to increase strength, aerobic capacity, muscle protein synthesis, and increase muscle mitochondrial enzyme activity in young and older individuals. Resistance/strength training has been shown to decrease frailty and improve muscle strength in very elderly adults. To prevent and/or reverse sarcopenia some exercise is recommended daily, but a minimum of 3 times per week is needed.

Protein is needed for repairing and building muscle fibers, however studies show 12% of men and 25% of women aged 70+ consume significantly less than the recommended 50 grams of protein per day or 0.8 grams of protein per kilogram of body weight each day; higher levels of dietary protein may be needed for those aged 65+. Most meat, poultry and fish have about 7 grams of protein per ounce; one cup of milk or one egg has about 8 grams of protein.

Not all protein is created equal, when it comes to sarcopenia it’s not about how much you eat rather what type of protein is consumed. Dietary protein is made up of amino acids, the body can make some amino acids the rest must be obtained from food. Leucine is an essential amino acid, and has been shown to help preserve body muscle, it is found in highest amounts within animal food sources and to a lesser extent in beans, nuts, and seeds. When the body is lacking sufficient levels of amino acids, muscle wasting can occur when muscle fibers are broken down to support the body’s energy needs. Intake of protein before and after exercise has been shown to help increase muscle recovery, promote muscle synthesis, and serves as an effective muscle ache treatment.

Omega-3 fatty acids have been shown to influence protein metabolism and mitochondrial physiology in human aging. Dietary omega-3 fatty acid supplementation has been found to increase the rate of muscle synthesis in older adults. EPA has been found to preserve muscle mass under various physiological conditions, DHA similarly has anti-inflammatory effects which are believed to be of value in managing sarcopenia. Fish oil derived omega-3 fatty acid supplementation has been found to slow the normal decline in muscle mass and function in older adults, and should be considered as a therapeutic approach for preventing sarcopenia according to the study published in The American Journal of Clinical Nutrition.

If you are 40+ it may be a good idea to get blood work done annually to track hormone levels as they can significantly affect muscle mass. Deficiencies in DHEA, testosterone, growth hormone, and estradiol may impair muscle performance as well as play roles in sarcopenia.

Lower levels of vitamin D in the blood is associated with lower muscle strength, increased body instability, falls, disability, and sarcopenia; supplementation may help to improve muscle function and muscle mass. Regardless of ethnicity or race vitamin D deficiency is most common among older adults, as much as 90% of adults in the USA are believed to be vitamin D deficient.

Much like any condition chronic inflammation is a silent contributor to sarcopenia, consuming a more anti-inflammatory diet can help to improve sarcopenia as overall health. Increase intake of green leafy vegetables, pineapple, salmon, walnuts, and blueberries just to name a few. Avoid processed foods, simple refined sugars, excess carbohydrates, refined grains, and meals from fast food restaurants.

Muscles can be weakened over time by alcohol, which is important to keep in mind for older adults. Abuse of alcohol appears to affect skeletal muscle severely promoting wasting and damage. Alcoholics often suffer from low muscle mass, low strength, cramps, muscle pain, difficulties in gail, and falls, according to a study published in the Rambam Maimonides Medical Journal. Alcoholic drinks are more than just empty calories, they can also remove critical nutrients from the body, and contribute to inflammation.

Smoking is another lifestyle habit with a long list of reasons as to why you should avoid it, and when it comes to sarcopenia it is no exception. Studies have shown those who smoke were more likely to have sarcopenia; those who smoke have been reported to have lower relative appendicular skeletal muscle according to the same report in the Rambam Maimonides Medical Journal.

Around 45% of Americans are estimated to have sarcopenia, which can cost roughly $900 per person per year; 43% of women and 53% of men aged 80+ are sarcopenic; neither race, gender, or ethnicity is protected from sarcopenia. Disability caused by sarcopenia is estimated to account for $18.5 billion in direct medical costs or the equivalent of 1.5% of the nation’s healthcare expenditure.

Someone who is 80 could have 30% less muscle mass than a 20 year old, strength declines even more than mass. Lean muscle mass contributes to about 50% of total body weight in young adults which declines with age to be around 25% by 75 years of age. Those who are sedentary can lose 5% of their muscle mass per decade after reaching 30 years of age. One in four adults are either completely inactive during leisure time, are never active at all, or engage in very low levels of physical activity daily.

Muscle wasting of sarcopenia typically begins to appear near the fourth decade in life and accelerates near the seventh decade in life. The main symptoms include but are not limited to decreased muscle mass, decreased strength, frailty, problems with mobility, falls, fractures, decreased activity levels, loss of independence, weak bones, weight gain, problems with coordination, slower movement, and taking longer to do things/loss of being able to do things. Metabolic effects can include but are not limited to decreased resting metabolic rate, higher prevalence of insulin resistance, type 2 diabetes, mellitus, hypertension, and dyslipidemia.

Factors that are believed to play roles in the development of sarcopenia include: Age related reduction in nerve cells responsible for sending signals from the brain to muscles to initiate movement; Inadequate intake of nutrients/calories/protein to sustain muscle mass; Decrease of the ability to synthesis protein; Decrease in hormone concentrations; As well as smoking, alcohol and other conditions such as cancer, heart failure, diabetes, and inflammation contributing to an increased likelihood of sarcopenia.

“Health care professionals can measure muscle coordination via some of the some of the tests of functional biomarkers of aging with the Agemeter. A muscle coordination test is done by moving a finger back and forth between two touch screen buttons. Also, muscle movement ability is involved in the tests of auditory reaction time, visual reaction time, decision reaction time, and decision movement time. An estimated function age is provided after the tests are completed  as well as a percentile ranking for each test result. Determining how young or old a person functions is the way to validate the results of biochemical and genetic biological age tests and whether aging intervention therapies are working.” ~ Elliott Small, President and Founder of Centers For Age Control Inc.

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