Once people hit a “certain” age, they become aware of a few things changing with their bodies. Beyond the wrinkles, increasing number of gray hairs, and the more frequent use of those “cheaters”, many begin to notice they may not be quite as strong as they used to be. Somehow, the jar lids have become tighter, the grocery bags heavier, and the thought of moving furniture around to vacuum elicits images of two days in bed with a sore back.
Sarcopenia is the gradual, continuous loss of muscle mass that begins around 4th decade of life and tends to accelerate around the age of 75. This loss of muscle mass results in decreased strength, contributing to an increased risk of falls and fractures, reduced mobility and functional decline. Sarcopenia is one of the main causes of the loss of independence in older adults and is a strong predictor of disability and the need for nursing care.
Though sarcopenia is most often recognized in older adults, the signs and symptoms can appear as early as age 50 or 60, depending on a person’s health and lifestyle. A steady, progressive decline tends to begin around the age of 40, resulting in a 3-5% loss of muscle mass per decade. Some studies indicate that the loss could be as high as 8% per decade. Approximately 1/3 of adults over the age of 60 suffer from sarcopenia and its negative effects.
Sarcopenia is associated with many health issues, including chronic disease. However, a major concern associated with sarcopenia is the reduced quality of life resulting from the physical decline. Fatigue, weakness, and reduced strength often prevent individuals from participating in favorite hobbies, can make daily tasks such as minor cleaning or shopping exhausting, and may limit a person’s overall level of physical activity. As the level of physical activity decreases, sarcopenia increases, and the cycle continues.
“With normal aging and accumulation of chronic diseases, the risks for functional decline and loss of independence increase. Decline is especially marked in individuals with multiple chronic illnesses who experience multiple exacerbations of chronic illness or acute illnesses. Typically, these individuals tend to be less physically active. Lean muscle mass declines as a result of inactivity. This leads to a reduction in resting energy expenditure, reduction in caloric intake, and weight loss (lean muscle mass along with fat). Sarcopenia increases, tolerance of physical activity decreases, and the cycle repeats itself. “ http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/preventive-medicine/aging-preventive-health/
Loss of strength is just one of the inevitable consequences of aging – or is it?
Many factors seem to contribute to sarcopenia including hormonal changes and changes in our body’s ability to build and repair tissue. Age and gender are two risk factors that cannot be controlled, yet sarcopenia is not inevitable and can be prevented and/or managed through proper lifestyle choices.
Physical inactivity and poor diet play primary roles in the development and progression of sarcopenia. Currently, physical training, along with adequate nutrition, is the most effective way to prevent and/or manage sarcopenia.
“The identification of cost-effective interventions that improve the health status and prevent disability in old age is one of the most important public health challenges. Regular physical activity is the only intervention that has consistently been shown to improve functional health and energy balance and to reduce the risk of cardiovascular disease, stroke, diabetes, several cancers, depression and falls. In advanced age, physical activity is also effective at mitigating sarcopenia, restoring robustness, and preventing/delaying the development of disability.” https://www.medscape.com/medline/abstract/28181204
Walking is an important and necessary part of an effective exercise program for many older adults, but it is not enough to maintain and/or restore strength, balance, and mobility. When I ask new clients about their current fitness program, they will often tell me “I walk a lot”. Though I do not want to minimize this important component of their program, most walk at a pace that offers little health benefits. Those who exhibit poor posture, reduced mobility, and decreased strength, may actually be exacerbating those issues by changing their gait pattern to accommodate their posture, mobility, and weakness.
Resistance training, or strength training, is the only effective physical countermeasure proven to help combat the development/progression of sarcopenia. Research has shown that even those who require nursing home care can improve their strength through an effective, progressive workout program. In my many years of working with seniors, I have witnessed this first hand.
I have worked with individuals in their 90’s and even 100’s who were able to increase their strength enough to better perform some of the necessary tasks of daily living. Through a post-rehab exercise program, I have experienced the progression of clients from wheel-chair bound to using a walker and regaining their mobility. I am always truly inspired and energized by those who are seemingly bedridden yet remain persistent and positive as they work to reach their goals of regaining some strength and independence.
To be effective, a strength training program should include enough resistance to build muscle while safely moving the joints through a full range of motion. This program should focus on all major muscle groups and be completed three times per week. A well-developed program will strengthen the muscles and trigger the body’s muscle building activity as the muscle cells grow and repair themselves. This activity will shift the body from a state of muscle-wasting to muscle-building and the process will continue helping maintain and build muscular strength.
I have heard many “reasons” why adults of a certain age fail to include strength training in their exercise program. “I don’t have time”, “I don’t want to join a gym”, “I don’t have any equipment”, and, my favorite, “I don’t want to bulk up” are among the top reasons for avoiding strength training.
Strength training requires very little equipment; in fact, if you cannot properly perform pushups and/or lunges, all you need to begin with is your own body weight. Resistance bands offer a portable, light-weight, budget-friendly way to add strength training without going to a gym. An efficient strength training workout using resistance bands can be completed in 20-30 minutes, all in the comfort of your own home.
It seems ironic to me that getting “middle-aged” adults to add strengthening exercises is so difficult; yet, older adults come to me asking me to help them get stronger! Unfortunately, those middle-aged adults will wait until they notice a marked decline in strength before they decide to do something about it.
Resistance training is imperative to prevent/manage sarcopenia, but without a proper and adequate diet, the muscles will be unable to repair and strengthen. The American diet today is filled with saturated fat, sodium, added sugars, and simple carbohydrates and tends to lack in lean protein, vegetables, fruits, and fiber. Our reliance on take-out, fast food, microwave meals, processed foods has left much of our population overweight, obese, and, at the same time, malnourished.
How can we, as a population, be overweight/obese, yet malnourished? As our diets have shifted to prepared/processed/restaurant meals, we tend, as a whole, to be missing out on many important nutrients as we fill our bodies with unhealthy fats, sugars, and sodium. The vitamins, minerals, antioxidants, and fiber found in vegetables, fruits, and whole grains have been replaced with chemicals, colorings, and additives. Important amino acids and nutrients found in lean sources of protein have been replaced by artificial flavorings and saturated fat.
We rely on the doughnut and coffee breakfast rather than eggs and oatmeal. A trip to the vending machine might be lunch (or we might just go without), and the drive-thru hands us dinner. “I don’t have time”, “I don’t know how”, “it costs too much” to eat healthy validates our trip to the restaurant for an over-sized, over-priced, nutrient-poor meal.
Though resistance training is considered the first form of therapy to prevent/manage sarcopenia, dietary changes are necessary to provide the body with the nutrients necessary for muscular growth. Research is beginning to uncover the need for proper amounts of calories and protein, as well as adequate amounts of nutrients such as Omega-3 fatty acids and Vitamin D.
Middle-aged adults tend to consume too many calories, yet older adults often fall below their recommended calorie consumption. Older adults tend to eat less for a variety of reasons; cooking for 1 seems a waste of time, decreased appetite (often due to lack of physical activity), changes in taste and smell, and the effects of illness and medications often leave older adults undernourished and in a calorie-deficit. As food is fuel for the human body, improper intake coupled with a lack of nutrient-dense foods leaves the body unable to run properly and efficiently. The undernourished body just simply cannot operate optimally.
Many studies confirm the correlation between protein intake and muscle mass. Protein is necessary to stimulate muscle growth and repair. Amino acids, the building blocks of proteins, are responsible for support and nourishment to cells, tissues, and organs and play an important role in almost all of the body’s metabolic processes. The amino acid leucine is particularly important for regulating muscle growth and can be found in whey protein, meat, fish and eggs.
The current Recommended Daily Allowance for protein is 0.8g/kg body weight. To determine your requirements, simply multiply your weight by 0.36. Following these guidelines, a 140-pound woman requires approximately 53 grams of protein/day. However, these guidelines are being challenged and new studies are indicating the need for more protein to boost the immune system, aid in healing, and to maintain muscle mass. In fact, most research is suggesting that those who suffer from sarcopenia may need as much as twice the recommended amount of protein. Remember, the guidelines just provide a minimum amount to maintain health for the general population, but for many, the minimum may be too low.
Sarcopenia may be caused by a variety of factors including chronic inflammation, stress, and hormonal changes that occur as we age. Though sarcopenia is not fully understood, we know that physical inactivity and poor diet are major determinants.
Don't let sarcopenia steal your strength. Begin a strength training program that you follow consistently and fuel your body with healthy, nutrient-dense foods.
Add Life to Your Years through simple Healthy Aging strategies. Your future self will thank you!
You are never too old or too young to take steps to improve your strength, health, and overall well-being. Today is a great day to start!