An Important Key to Unlocking Longevity:
Sarcopenia Awareness
As I delve into the exciting arena of longevity and wrestle with methods to arrest the disease of aging, I realize the squeaky wheels of obesity, insulin resistance, and cardiovascular disease have been stealing the front row seats while an equally important cofactor in aging sits quietly, and disturbingly, unnoticed: sarcopenia.
What is sarcopenia?
The word sarcopenia is derived from the Greek words “sarco” meaning muscle or flesh and “penia” meaning deficiency or loss. It is medically defined as a loss of muscle mass and function that reduces mobility, diminishes quality of life, and can lead to fall- related injuries in the elderly, usually requiring costly hospitalization and rehabilitation efforts. Herein lies the problem; until relatively recently, sarcopenia was relegated to the ‘elderly’ population, when in truth the loss of muscle mass, unchecked, can begin its slow, undetected decline as early as your third decade of life, increasing its toll more and more with each ensuing decade. It’s not hard to see why it has taken a back seat to chronic diseases easily visible like obesity, easily tested as in type 2 diabetes, and the very scary and sometimes dramatic, cardiovascular disease.
Who needs to pay attention to sarcopenia?
Everyone! The loss of muscle mass takes place incrementally over time and is sometimes labeled as an ‘expected part of aging,’ and is therefore easily relegated to ‘something that happens to us later.’ But now, thanks to the study of longevity, sarcopenia is in the limelight where it belongs and for very good reason. Your muscle is
the largest organ in your body, serving many roles for all body systems beyond the obvious duty of skeletal movement. It supports a strong metabolism and is the largest site for glucose absorption. It is one of the antidotes to inflammation, thanks to the production of anti-inflammatory cytokines whose antidotal properties directly correlate to the the amount of muscle mass present. Our muscles can even contribute to regulation of our hormones. Many diseases are affected by the amount of muscle mass we have; more muscle equals better quality of life and less overall mortality. As I mentioned earlier, lean body mass and strength begin their slow decline in your 30’s and accelerate after the age of 50. Disease can also manifest much earlier if sarcopenia is present. The methods to keep sarcopenia at bay are now front and center as we signal their importance in the pursuit of longevity.
What are some of the biological mechanisms of sarcopenia?
Our muscle cells are called myocytes and their job is to contract and release muscles, utilizing large amounts of cellular energy called ATP. Our cells make ATP in cell parts called mitochondria via the electron transport chain process. The fact that each and every mitochondrion is double-membraned, just like the nucleus of our cells which protect our DNA, is indicative of their importance. And mitochondria contain their very own set of DNA for replicating themselves, independent of cell division. How convenient that our cells have a method for reproducing more tiny energy factories! More mitochondria equal stronger muscle, which equates to better overall health. I often speak of ways to improve our mitochondrial function and hopefully now the pieces are falling into place; mitochondrial function is directly related to better muscle function, which is the underpinning of how we stave off sarcopenia and many other chronic illnesses. Understanding the importance of muscle health is most certainly one of the longevity keys.
How is sarcopenia diagnosed?
Tests for lean body mass, grip strength, and gait speed are used to diagnose sarcopenia. Muscle mass can be measured by your practitioner using a CT scan or an MRI, however they are cost prohibitive and radiation exposure is always a concern. A DXA scan, the gold standard in the analysis of body composition at a molecular level, is less expensive and has minimal radiation exposure. Grip strength can be easily measured with a tool called a dynamometer, whereby you squeeze the handle as hard as you can for 10-15 seconds and then record your highest number. You can buy these relatively inexpensively, however it might be worth checking with your doctor’s office or fitness center, as many of these locations have them on hand. Gait speed is simply evaluated by measuring out a 20-foot course and then measuring the time it takes you to walk it at your usual pace; a speed of less than 3 feet per second is associated with mobility impairment.
So what exactly should I do to prevent sarcopenia?
The good news is sarcopenia is not only preventable, but in many cases, reversible. There are several avenues of attack we can use in order to combat sarcopenia: diet, exercise, supplements, and most importantly, resistance weight training. As usual in functional medicine, a good place to start is our diet. A clean, whole foods diet is always recommended and in the case of sarcopenia, protein is highlighted. Without adequate protein intake or protein supplementation, we cannot see improved muscle function and strength outcomes. So exactly how much protein do we need? The recommendation now stands at 0.8 grams per kilogram of body weight, per day. However, newer studies show 1.2 to 1.5 grams would be more advantageous for our muscles, especially as we age. The addition of vitamin D and omega-3 fatty acids are also strongly recommended. Proper electrolyte balance and additional minerals such as magnesium, selenium, and calcium, may also prove beneficial. Under consideration, too, are newer supplements such as NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) which are NAD boosters. NAD is a necessary coenzyme your mitochondria need to produce ATP, and it tends to diminish as we age. As always, your exact approach to nutrition and supplementation will be individual and should be discussed with your practitioner.
The next, and possibly most important, big ticket behavior to add to your sarcopenia prevention protocol is resistance weight training. Although all movement is beneficial and finding everyday activities to keep your body in motion are requisite, resistance weight training provides some very specific advantages in avoiding or reversing sarcopenia. Resistance training increases muscle strength, lean body mass, muscle fiber size, and physical function by making your muscles work against a weight or force. Examples of tools you can use are resistance bands, free weights, weight machines, and your own body weight via exercises like squats, push-ups, and sit-ups. You can even get creative and use items from home such as water bottles or jugs of sand as training tools. Adding a twice weekly yoga practice into your routine is another avenue for combating sarcopenia. In addition to adding strength to your body, there is the added benefit of stress reduction and mind-body awareness. Training at least twice per week, via the strength training option that fits best into your life, will lead to an increase in muscle mass, strength, and endurance as well as strengthen tendons, which attach muscle to bone.
How do I get started on my goal to prevent or reverse sarcopenia?
Below is a condensed version of the actions you can take to prevent or reverse sarcopenia:
• Ensure you are getting sufficient protein every day.
• Supplement with omega-3 fatty acids and vitamin D.
• Consider adding electrolytes to your daily regimen.
• Take a multivitamin to ensure vitamin and mineral requirements.
• Engage in cardiovascular exercise several days each week.
• Practice resistance training 2-3 times per week.
• Eat a clean, whole foods diet.
It’s exciting to realize we are capable of delaying or preventing sarcopenia, one of our biggest nemeses in our longevity quest. But many of the methods I have shared with you require behavioral change which is sometimes easier said than done. If you find it challenging to implement these changes in your life, please discuss with your care provider and consider enlisting the help of a health coach. Incorporating the above practices into your routine will help you reap the many benefits of stronger muscles and a healthier, more youthful body. Here’s to good health and staying younger, longer!
Works cited:
Chen, N., He, X., Feng, Y., Ainsworth, B. E., & Liu, Y. (2021). Effects of resistance training in healthy older people with sarcopenia: a systematic review and meta-analysis of randomized controlled trials. European Reviews of Aging & Physical Activity, 18(1), 1–19. https://uws.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=s3h&AN=153553102&site=eds-live&scope=site
Negm, A. M., Lee, J., Hamidian, R., Jones, C. A., & Khadaroo, R. G. (2022).
Management of Sarcopenia: A Network Meta-Analysis of Randomized
Controlled Trials. Journal of the American Medical Directors
Association, 23(5), 707–714.
Charlette Plinneke lives on the Central Coast of California and enjoys tennis, writing, yoga, wine tasting, and anything happening in the great outdoors.