Maintain aging muscles

  • Elmaze Joseph (left) works with therapist Jocelyne Denis doing foot exercises to maintain muscle strength. AP file

For the Monitor
Sunday, October 16, 2016

Have you ever noticed that you really slow down as you age? If you have, then you’re just like me! Even as I approach my late 40s, a mere rookie in the aging game, I can already notice a substantial decline in the speed in which I move and overall strength.

What gives rise to such an unfair reward to living a strong life? In a word, sarcopenia. Much in the same way osteoporosis (and its predecessor osteopenia) negatively impacts your bones, sarcopenia affects your muscles.

What is sarcopenia?

Sarcopenia is the age-associated loss of muscle mass and function. The term sarcopenia, derived from the Greek: sarx (flesh) and penia (poverty of), is a relatively new concept. It was first suggested in 1997 by Dr. Irwin Rosenberg. It has been implicated in the dramatic decline in mobility and overall function that is experienced with advancing age.

A national, population-based study estimates the prevalence of sarcopenia at 36.5 percent in people age 70 and older.

More recently, sarcopenia has been able to explain some of the decreased metabolic demand that occurs with aging. One common consequence of this shift is increased fat storage, and that can often result in weight gain. The term used to characterize this is not surprisingly called: sarcopenic obesity.

How is it diagnosed?

Unfortunately, because of unawareness, sarcopenia is rarely diagnosed. A DEXA scan (Dual-Energy X-ray Absorptiometry) is a reliable way to assess muscle mass in the body. It is often used to diagnose osteoporosis, and the same image may be used to diagnose sarcopenia.

However, the DEXA scan is also very expensive and despite its accuracy, does not represent a cost-effective way to diagnose the condition. More commonly, measuring walking speed and limb mass are more standard methods to diagnose sarcopenia.

Can it be prevented?

Currently, it appears that the age-associated loss of muscle mass is something that we must accept under the guise of “it stinks getting old.” However, the loss of function due to decreased muscle mass can be minimized with some common, non-invasive therapies.

What are the treatments for sarcopenia?

Exercise has been shown to be very effective in treating sarcopenia. In particular, resistance exercise, like weight training, has demonstrated great promise in treating the condition.

Even in situations where resistance exercise has not achieved increases in muscle mass, muscle strength and function often does improve with consistent exercise.

Daily walking has also been shown to offset the loss of mobility from aging sarcopenia.

One key message here is to keep moving. It promotes blood flow, nerve supply and nutrients to the muscle, all important requirements for muscle health.

Good nutrition also helps. When we think of muscle, most often the nutrient of interest is dietary protein. However, according to researchers, studies fail to consistently show that increasing dietary protein intake could reduce the risk of sarcopenia.

Many studies employ the use of supplements containing whey and casein, two primary proteins found in milk and some milk products. The amino acid leucine and its bi-product, HMB, has shown modest effects on preserving function in mobility-limited subjects, but more research is needed to achieve a consensus on this supplement.

With such uncertainty about the benefit of supplementation for this condition, a healthy diet, rich in fruits and vegetables as well as whole grains, combined with healthy fats, legumes, and lean meats is the standard recommendation at this point in time.

Does this dietary suggestion seem familiar to you? It characterizes the Mediterranean Dietary pattern, which has also shown to be protective against heart disease, stroke, and Type 2 diabetes.

Nothing about aging seems easy. However, by maintaining an active lifestyle and healthy diet, you can slow the effects of sarcopenia against muscle loss. Then, you can preserve one of life’s greatest gifts: movement.

(Jason Aziz is an exercise physiologist who has worked at Concord Hospital for more than 18 years. He is currently researching new methods of exercise that are designed to improve mobility in sarcopenic adults.)