Sarcopenia: 10 Keys to Keep Your Muscle Mass Up as You Age

June 13, 2017
Sarcopenia - Dr. Axe

Most adults achieve their peak muscle mass sometime during their late 30s to early 40s. After that point, a gradual loss of muscle mass begins and can continue a steady, downhill course into old age. This age-related loss of muscle mass, strength and function is known as sarcopenia, and it can happen quicker than you think. How quickly? People who are physically inactive can lose as much as 3 percent to 5 percent of their muscle mass per decade after age 30. (1)

Although there’s no specific level of lean body mass or muscle mass at which one can say sarcopenia is present, any loss of muscle mass is of concern since there’s a strong relationship between muscle mass and strength. Sarcopenia contributes significantly to the morbidity, decrease in quality of life and large health care costs experienced by the elderly. (2)

But wait, doesn’t 30- or 40-something seem way too young to start any kind of large-scale physical decline? Is there anything you can do to stop it? Absolutely. Research has even shown that a program of progressive resistance training exercises that build muscle fast can improve sarcopenia in as little as two weeks.

I’m about to tell you about all of the many very doable, easy and natural ways you can prevent, decrease and even reverse undesirable sarcopenia.

Natural Sarcopenia Treatment

While everyone loses some muscle mass with age, it’s possible to slow or even reverse that loss with regular exercise and many other easy, natural treatments. For the elderly, maintaining muscle mass and function is vital to having functional independence. Muscle deterioration can be prevented, decreased and reversed with the following methods:

1. Exercise

The adoption of a more sedentary lifestyle is the worst choice to make when it comes to warding off sarcopenia.

“Without question, exercise is the most powerful intervention to address muscle loss, whether it occurs in the context of advancing age or debilitating chronic or acute diseases,” said Nathan K. LeBrasseur, Ph.D., of the Department of Physical Medicine and Rehabilitation at Mayo Clinic in Rochester, Minn. (3) When it comes to sarcopenia, exercise has been shown to increase strength, aerobic capacity and muscle protein synthesis, as well as to increase muscle mitochondrial enzyme activity in both young and older people.

Resistance exercise, in particular, has been shown to decrease frailty and improve muscle strength in very elderly adults. Exercise is recommended on most days of the week, but a minimum of three times per week is recommended to slow muscle loss and prevent sarcopenia, which is one of the biggest benefits of exercise as we age.

2. Increase Overall Dietary Protein

Protein is the most valuable food for repairing and building muscle fibers. Studies show that 12 percent of men and 24 percent of women over age 70 eat significantly less than the recommended 0.8 gram of protein per kilogram of their body weight each day. Currently, the recommended dietary allowance for protein is generally 50 grams of protein per day or 0.8 gram per kilogram (g/kg) of body weight a day for men and women 19 years of age and older. However, recent research shows that higher levels of dietary protein are needed for adults 65 years and older. (4)

For healthy adults, between one and 1.2 g/kg is a good target for daily protein intake. For those with sarcopenia, protein needs are even higher at 1.2 to 1.5 g/kg a day.

To figure out how much protein you need, take your body weight in pounds and multiply it by 0.45. This gives you your body weight in kilograms. Next, multiply that number by 1.2 to reach the recommended grams of protein per day. For example, a person who weighs 150 pounds or 67.5 kilograms should aim for about 81 grams of protein per day. Most meat, poultry and fish have about 7 grams of protein in an ounce. One cup of milk or one egg has about 8 grams of protein. You can add high-protein snacks to your diet as well.

3. Choose Protein Wisely

When it comes to positively impacting sarcopenia, it’s not just how much protein you eat, but also what type of protein you consume. Not all protein is created equal, and the type of protein you eat also seems to play a role in preventing muscle loss.

Dietary protein is made up many types of amino acids. The body can make some amino acids on its own, but the rest it must obtain from protein-rich foods. Of the 20 total amino acids there are, certain ones are considered “essential” because these are the specific kinds we aren’t capable of making ourselves. Others are “nonessential” because the body can create them by synthesizing other amino acids.

The amino acid leucine has been shown to preserve body muscle. Leucine is an essential amino acid, which means our bodies cannot produce it, so we must get it from dietary sources.

A 2010 study showed that the ingestion of leucine-enriched essential amino acids stimulates muscle protein synthesis to a similar extent in both young and elderly individuals. (5) Leucine is found in higher amounts in animal foods, including beef, lamb, poultry, fish, eggs, milk and products made with milk. It’s also found in soybeans and, to a lesser extent, other beans, nuts and seeds. Of course, I always recommended choosing the best quality of these food items.

The best protein foods to include in your diet are the following:

  1. Grass-fed beef
  2. Whey protein (organic, ideally from raw goat milk)
  3. Lentils
  4. Wild-caught fish (salmon, mackerel, tuna, etc.)
  5. Organic chicken
  6. Black beans (or other beans)
  7. Natto
  8. Raw milk
  9. Kefir or yogurt
  10. Free-range eggs
  11. Raw cheese

Eating enough protein is necessary to build and maintain healthy muscle mass, while also supporting tendons, ligaments and other body tissue. When your diet lacks amino acids, “muscle wasting” (or muscle atrophy) can take place when your muscle fibers are broken down to support your body’s energy needs.

Protein is especially important after exercise, since physical activity like strength training purposefully damages muscle tissues so they can repair and grow back stronger. For the process to happen effectively, you need some extra protein to help repair the damage. While protein alone won’t enhance athletic performance, research shows that eating protein before and after exercise helps increase muscle recovery, promotes muscle synthesis and serves as effective muscle ache treatment. (6)

4. Up Omega-3s

Omega-3 fatty acids have been found to influence muscle protein metabolism and mitochondrial physiology in the context of human aging. A 2011 randomized and controlled study’s objective was to evaluate the effect of omega-3 fatty acid supplementation on the rate of muscle protein synthesis in older adults. Supplementation of omega-3 fatty acids versus corn oil were compared. The study found that dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults. (7)

The omega-3 fatty acid EPA has been found to preserve muscle mass under various physiological conditions. Like EPA, the omega-3 fatty acid DHA has anti-inflammatory effects, which scientists believe may be of value in managing sarcopenia.

A 2015 study published intThe American Journal of Clinical Nutrition found that fish oil-derived omega-3 fatty acid supplementation slowed the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults. (8)

You can consider supplementing with fish oil or flaxseed oil to increase your omega-3 acid intake.

5. Hormone Balance

Hormonal factors can significantly affect muscle mass. If you’re 40 years of age or older, you can have annual blood work done to track your hormone levels. If necessary, deficiencies of essential hormones, such as growth hormone, DHEA and testosterone, can be addressed using natural supplementation under a doctor’s supervision. There are also many ways to balance hormones naturally, which is important to prevent muscle loss.

For women in particular, hormonal balance can have a direct effect on sarcopenia. Menopause is linked to reduced concentrations of a hormone called estradiol in middle-aged and older women. There appears to be impaired muscle performance during the postmenopausal period when ovarian hormone production has decreased. It’s believed that hormonal changes and balance may play a role in sarcopenia in older women. (9)


Sarcopenia statistics - Dr. Axe


6. Vitamin D

Many studies have shown that low blood levels of vitamin D are associated with lower muscle strength, increased body instability, falls and disability in older subjects. (10) Vitamin D deficiency is the most common nutritional deficiency for older adults regardless of race or ethnicity. Up to 90 percent of adults in the U.s. are believed to have a vitamin D deficiency.

Low vitamin D levels have been associated with sarcopenia. Supplementation of vitamin D in individuals with low levels can help improve muscle function and muscle mass. (11)

7.  Increase Anti-Inflammatory Foods

Chronic inflammation has received attention as a potential contributor to sarcopenia. (12) To move toward an anti-inflammatory diet and anti-inflammatory foods, we must primarily move away from the abundance of overly processed, unbalanced diets of the West and toward the ancient eating patterns of the Mediterranean diet.

For the sake of improving sarcopenia as well as your overall health, you should increase your intake of anti-inflammatory foods like green leafy vegetables, blueberries, pineapple, walnuts and salmon, to name a few.

8. Decrease Pro-Inflammatory Foods

With lots of anti-inflammatory foods filling your diet, you’ll naturally begin to eliminate pro-inflammatory foods and substances. Two pro-inflammatory suspects you definitely want to avoid are high fructose corn syrup and trans fats. Found in processed foods, these bad guys cause inflammation that contributes to sarcopenia. 

Processed foods are also likely to be higher in omega-6 fatty acids, which are necessary but only to an extent. In excess and without the balance of omega-3s, omega-6 fats actually create inflammation in the body. The typical American diet tends to contain 14–25 times more omega-6 fatty acids than omega-3 fatty acids.

Simple, refined sugars and carbohydrates are more inflammation-causing culprits. Limiting refined grains is another important component of an anti-inflammatory diet. 

9. Watch Alcohol Intake

Drinking too much alcohol over time can weaken the muscles, which is a good reason for all adults to consider their alcohol consumption. If you know you already have sarcopenia, then you want to consider your alcohol consumption even more seriously.

Alcohol abuse appears to affect skeletal muscle severely, promoting its damage and wasting. Alcohol misusers also frequently suffer from low muscle mass and strength, muscle pain, cramps, difficulties in gait, and falls, according to research published in the Rambam Maimonides Medical Journal. (13)

Most alcoholic beverages aren’t just empty calories, but they can also remove critical nutrients from your body. Alcohol, especially in excess, can also contribute to inflammation. With sarcopenia, you want to increase your nutrient intake significantly and decrease bodily inflammation. By reducing your alcohol intake or avoiding alcohol all together, it’s easier to reach your goal of increasing beneficial nutrients and decreasing pro-inflammatory substances.

10. Quit Smoking

If you smoke, here is just another item on the laundry list of reasons why you want to quit stat. Cigarette smoking is associated with poor lifestyle habits, such as low levels of physical activity and impaired nutrition. In addition, smoking itself is another lifestyle habit that has been found to be associated with sarcopenia.

Studies have found that men and women who were smokers were more likely to have sarcopenia. It’s also been reported that smokers had lower relative appendicular skeletal muscle mass than subjects who never smoked and that men with sarcopenia smoked significantly more, according to the same Rambam Maimonides Medical Journal research that connected alcohol abuse to sarcopenia.

Tobacco smoking is definitely a risk factor for sarcopenia that you can and should avoid, and that include electronic cigarettes.

Sarcopenia Statistics

Why is it so important to do the 10 things mentioned above? The following are some very interesting and alarming statistics on sarcopenia that show exactly the reasons you want to stave off this condition as much as possible: (14)

  • Roughly 45 percent of the U.S. population is sarcopenic.
  • Health care expenditures due to sarcopenia cost roughly $900 per person per year.
  • No race or ethnicity is protected from sarcopenia.
  • In the U.S., an estimated 53 percent of men and 43 percent of women over 80 are sarcopenic.
  • One study estimated that disability caused by sarcopenia accounted for $18.5 billion in direct medical costs in 2000, equivalent to 1.5 percent of the nation’s health care spending that year.
  • An 80-year-old might have 30 percent less muscle mass than a 20-year-old. And strength declines even more than mass. Weight-lifting records for 60-year-old men are 30 percent lower than for 30-year-olds; for women the drop-off is 50 percent.
  • Lean muscle mass generally contributes up to approximately 50 percent of total body weight in young adults but declines with aging to be 25 percent at 75–80 years old.
  • People who are physically inactive can lose as much as 3 percent to 5 percent of their muscle mass per decade after age 30.
  • One in four adults either engage in a low level of activity (i.e., moderately active during usual daily activities and completely inactive during leisure time) or are never active at all.

Sarcopenia Symptoms & Effects

Sarcopenia’s muscle wasting generally begins to appear in the fourth decade of life and accelerates after the age of about 75 years old.

The main symptoms of sarcopenia are decreased muscle mass and strength. As a result, other symptoms and effects of sarcopenia include frailty, problems with mobility, falls and fractures, decreased activity levels (which only makes sarcopenia worse), loss of independence, weak bones, and weight gain from lack of activity.

The metabolic effects of sarcopenia include a decrease in resting metabolic rate, which leads to a higher prevalence of insulin resistance, type 2 diabetes mellitus, dyslipidemia (an elevation of plasma cholesterol, triglycerides or both) and hypertension.

Root Causes of Sarcopenia

Estimates of how much of our muscle is lost with age varies from 8 percent to about 50 percent, with men seeming to lose muscle faster than women. In general, strength is lost more rapidly than muscle mass for both sexes.

A lack of exercise and inactivity combined is by far the No. 1 cause of sarcopenia. However, since even lifelong physically active people can experience sarcopenia, there are some other things that play a role in its development.

Researchers think the following four factors also play a role in developing sarcopenia:

  • Age-related reduction in nerve cells responsible for sending signals from the brain to the muscles to initiate movement.
  • Inadequate intake of calories and/or protein to sustain muscle mass.
  • A decrease in the body’s ability to synthesize protein.
  • A decrease in the concentrations of some hormones, including growth hormone, testosterone and insulin-like growth factor.

Nutritional deficiencies, smoking, excessive alcohol consumption and inflammation, as well as other conditions like heart failure, cancer and diabetes, also contribute to an increased likelihood of sarcopenia.

Sarcopenia Takeaways

  • Most adults achieve their peak muscle mass sometime during their late 30s to early 40s, at which point sarcopenia kicks in. People who are physically inactive can lose as much as 3 percent to 5 percent of their muscle mass per decade after age 30.
  • Sarcopenia treatment and prevention includes exercise, increasing overall dietary protein, choosing protein wisely, upping your intake of omega-3s, balancing hormones, upping your vitamin D intake, consuming more anti-inflammatory foods, decreasing your inflammatory foods intake, limiting alcohol consumption or avoiding alcohol, and quitting smoking.
  • The main symptoms of sarcopenia are decreased muscle mass and strength. As a result, other symptoms and effects of sarcopenia include frailty, problems with mobility, falls and fractures, decreased activity levels (which only makes sarcopenia worse), loss of independence, weak bones, and weight gain from lack of activity.
  • In addition to inactivity and lack of exercise, researchers believe the following four factors also play a role in developing sarcopenia: age-related reduction in nerve cells responsible for sending signals from the brain to the muscles to initiate movement; inadequate intake of calories and/or protein to sustain muscle mass; a decrease in the body’s ability to synthesize protein; and a decrease in the concentrations of some hormones, including growth hormone, testosterone and insulin-like growth factor.

Read Next: How to Eat to Gain Muscle

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