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How to Approach Sarcopenia As You Age by Archana Gogna

 

How to Approach Sarcopenia As You Age

By Archana Gogna, MS, CNS, MBA

Maintaining strong and toned muscles are very important; not just for the sake of vanity and for attracting admiring looks, but the health of muscles translates to real health and vitality. While a great deal has been made of strong bones, not enough attention is paid to the health of muscles mass other than for ‘decorative’ purposes. Just as there is a name given to the condition of loss of bone mass (osteoporosis) so is there a name for the loss of muscle mass (sarcopenia).

Sarcopenia (from Greek, sarx, “flesh” and penia, “poverty”) is the degenerative loss of skeletal muscle mass, quality, and strength associated with aging. It starts to become apparent after the age of 40 and progresses annually (0.5 to 1% loss per year after the age of 50), generally accelerating after the age of about 75. Progressive sarcopenia is a good predictor of many illnesses, physical and mental, as well as premature mortality. Sarcopenia and osteoporosis are directly related conditions, one often following the other. Muscles generate the mechanical stress to keep our bones healthy. When muscles are used less frequently, as in the elderly and in 'couch potatoes', it can exacerbate the problem of osteoporosis and lead to a decline in health. It is evident that the top priority to maintain good health involves maintaining muscle health.

There is no single cause of sarcopenia. Sarcopenia can be a result of many different factors that arise as a natural part of aging, like:

  • inadequate dietary protein
  • nutritional imbalances
  • lack of exercise (especially strength training like weights and resistance)
  • sub-optimal hormone levels
  • inflammation
  • oxidative stress

A multi-pronged approach is thus the best way to address the prevention and/or the treatment of this condition. 

One of the major factors for sarcopenia is inadequate dietary protein as well as inadequate calorie intake, especially in the elderly. It is often thought that Americans consume too much protein in their diet and that may be true for the average American, but the diets of older Americans are often deficient in protein.  With age there is also a decline in digestive functionality due to a decrease in the production of digestive enzymes and stomach acids that are crucial for protein digestion and absorption. One of the best-absorbed sources of protein is whey protein that has been found to be beneficial in increasing muscle and tendon size and strength. Whey protein from a high quality natural source can be a good source of protein intake in the form of 'smoothies', which are all the rage today.

The best way to incorporate protein in your diet is to get it through a variety of healthy sources. Meat from grass-fed animals provides lean protein, as do pasture-raised eggs, free-range poultry, 'safe' seafood, beans and legumes, as well as nuts. Along with this, eating a variety of rainbow colored vegetables and fruits is also important to get the fiber and micronutrients necessary for proper muscle functioning.

An optimal vitamin D level (between 50 and 80 ng/dL) is critical for maintaining muscle health in that it helps to preserve type 2 muscle fibers (these are the fibers that atrophy most in aging people). Most people are found to be deficient in vitamin D. Thus, vitamin D levels should be frequently and normally tested and supplementation recommended for both healthy muscles as well as bones. Creatine, a dietary supplement, also seems to have a positive effect on these muscle fibers in studies in older adults (50 to 71 years) and in helping improve age-related loss of muscle strength as well as in improving their ability to perform functional living tasks.

Other nutrients such as omega-3 fatty acids (EPA/DHA from fish oils), l-glutamine (may be helpful in increasing muscle mass in combination with resistance training), l-carnitine (may help promote healthy muscle mass in older adults), and buffering agents such as potassium bicarbonate might also benefit muscle health. The omega-3 fatty acids can be helpful for reducing inflammation, which can quite often go hand-in-hand with muscle deterioration. 

One thing that goes without saying is the critical importance of exercise in preventing and managing sarcopenia. Exercise stimulates the release of various hormones such as GH (growth hormone), as well as MGF (mechano growth factor). Aerobic training is important for overall health but without strength and resistance training, there does not seem to be any benefit for bone and muscle. A minimum of three times a week of resistance and strength training is recommended by most healthcare professionals.

A decrease with age in hormones such as testosterone, DHEA, as well as IGF-1 (insulin growth factor-1) can also impact the health of bone and muscle. It is important to have a discussion with a healthcare professional about your hormone levels and have them tested to keep abreast of these changes and consider any suggestions they might have to offer.

Increased inflammation may also need to be addressed. Aging creates a certain amount of oxidative stress that can in turn create an increased level of inflammation. Eating an anti-inflammatory diet is highly recommended. Adding a variety of fresh vegetables and fruits may help to get you there, with a minimum of four servings daily and anywhere up to eight or nine servings. Also, bicarbonate and citrate buffering agents containing minerals such as potassium, magnesium, and calcium may be able to reverse metabolic acidosis caused by highly acidic western diets.

Adopting and incorporating these recommendations should begin as early as possible for maximum benefit.  Following many of the suggestions made here, like dietary changes, exercise, targeted nutraceuticals, keeping track of hormonal changes, and keeping inflammation in check, you may be able to ease into your golden years with relative ease and be able to lead active and independent lives.

References:

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  • Goldspink G. Mechanical signals, IGF-1 gene splicing, and muscle adaptation.  Physiology (Bethesda.). 2005 Aug;20_232-8.
  • Campbell WW, Crim MC, Dallal GE, Young VR, Evans WJ.  Increased protein requirements in elderly people: new data and retrospective reassessments.  Am J Clin Nutr. 1994 Oct;60(4):501-9.
  • Frassetto L, Morris RC, Jr., Sebastian A.  Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women.  J Clin Endocrinol Metab.  1997 Jan;82(1):254-9.
  • Gomes MR, Tirapegui J. Relation of some nutritional supplements and physical performance.  Arch Latinoam Nutr. 2000 Dec;50(4):317-29.
  • Bass SL, Eser P, Daly R.  The effect of exercise and nutrition on the mechanostat. J Musculoskeletal Neuronal Interact.  2005 Jul;5(3):239-54.
  • Chrusch MJ, Chillibeck PD, Chad KE, Davison KS, Burke DG.  Creatine supplementation combined with resistance training in older men.  Med Sci Sports Exerc.  2001 Dec;33(12):2111-7.
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