From Sarcopenia To Frailty: A Road Less Traveled
J Cachexia Sarcopenia Muscle. 2014 Mar 5:5-8. doi: 10.1007/s13539-014-0132-3. Epub 2014 Feb 14.Morley JE1, von Haehling S, Anker SD, Vellas B.
The physical frailty phenotype consists of fatigue, weight loss, and loss of muscle power. Sarcopenia has been shown to be a major cause of frailty. Six societies including SCWD published a consensus suggesting that all persons older than 70 years of age should be screened for frailty when seeing health professionals.Simple screening tests such as the FRAIL scale can be used.It is felt that frailty can be treated by
Nutritional Strategies For Optimizing Muscle Mass
Several nutrients, including creatine, vitamin D, and whey protein, have shown great promise in combating sarcopenia.
Creatine. The muscle atrophy commonly seen in older adults comes mainly from a loss of fast-twitch muscle fibers that are recruited during high-intensity movements, such as weight lifting and sprinting. These are the fibers most profoundly affected by the dietary supplement creatine. Various studies have found that when creatine is given to older adults who are participating in resistance exercise training, it helps increase strength and lean body mass.13-15 According to one research group, creatine supplementation in older adults may help attenuate age-related loss of muscle strength as well as improve ones ability to perform functional living tasks.14
Vitamin D. While scientists have long known that vitamin D plays an important role in bone health, recent studies suggest that it is also essential for maintaining muscle mass in aging people. Vitamin D helps preserve the Type II muscle fibers that are prone to atrophy in the elderly. Scientists recently noted that vitamin D helps support both muscle and bone tissue, and that low vitamin D levels seen in older adults may be associated with poor bone formation and muscle function. Thus, ensuring adequate vitamin D intake may help reduce the incidence of both osteoporosis and sarcopenia in aging people.16
Sarcopenia: What You Need to Know
And Dont Forget About Exercise
The best way to limit the extent of loss of muscle strength is by staying physically active all through life, says Calabrese. But if youve been sedentary and have lost strength, the answer is still exercise.
A combination of aerobic and strength-training exercises will improve muscle health, as well as overall health. If you havent been very active and are just beginning to exercise, go slow. Dont do too much too soon, says Calabrese.
Start by consulting an expert, such as a physical therapist or exercise physiologist. This professional will not only teach you the correct exercises but will put together a program with the right sequence and progression of exercises to get the best results.
You need a well-rounded program that will strengthen all of your muscles, starting with the large muscle groups. Calabrese emphasizes that its important to be patient. It can take six to eight weeks to see results.
This article originally appeared in Cleveland Clinic Arthritis Advisor.
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Exactly How To Train To Reduce Risk Of Age
Schoenfeld recommends regimented resistance exercises to stave off sarcopenia, and he suggests aiming for two to three strength sessions per week, working for 30 to 45 minutes. You just have to lift hard, he says, suggesting you lift close to failure.
Most importantly, you want to focus on progressive overloadgradually increasing the amount of weight you lift overtime. For beginners to master this technique, Schoenfeld suggests lifting about 65 to 75 percent of your one-rep max for 10 to 15 reps each set. That means that if your one-rep max is 100 pounds, then you should start out lifting anywhere between 65 to 75 pounds and progress the load from there.
Melissa Boyd, NASM-certified personal trainer, and Tempo coach says, As you progress, the focus should be on slowly adding more weight while doing fewer reps and building full-body strength instead of just exhausting the body, which will affect your running.
If you dont know where to start, then try this basic workout designed by Boyd to help you build strength. Complete each move for the number of reps and sets listed below, resting for one to two minutes in between each set.
Every Trial Found Scopenia To Be Associated With Low Vitamin D
The association between blood concentration of 25- hydroxyvitamin D and sarcopenia: a meta-analysis.Asia Pac J Clin Nutr. 2018 27:1258-1270. doi: 10.6133/apjcn.201811_27.0013.Luo J1, Quan Z2, Lin S1, Cui L3.1 Department of Public Health, Medical College of Qingdao University, Qingdao, Shandong Province, China.2 Medical School of Yanbian University, Yanji City, Yanbian Korean Autonomous Prefecture, Jilin, China.3 Department of Public Health, Medical College of Qingdao University, Qingdao, Shandong Province, China. .
BACKGROUND AND OBJECTIVES:Associations between blood 25-hydroxyvitamin D D) concentration and sarcopenia remain controversial thus, this meta-analysis was conducted to explore the relationship between blood 25D concentration and sarcopenia.
DESIGN:We searched the PubMed and EMBASE databases for relevant published observational studies that investigated blood 25D concentration and sarcopenia up to June 2017.We then investigated data from these studies that compared blood 25D concentrations between the sarcopenia and healthy control groups. A random-effect model was used to calculate the pooled weighted mean difference of blood 25D concentration with a 95% confidence interval .
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Sarcopenia: Symptoms To Watch For
People who suffer from sarcopenia experience a loss of muscle mass. This loss of strength also results in increased weakness and less mobility. This, in return, can increase the risk of injury, such as fractures from falls .
If you experience one or more of these symptoms or just have the feeling that you might suffer from sarcopenia, please talk to your doctor.
Resistance Training Slows Age
Supplements only work when you get moving and exercise regularly. In every study showing improved muscle strength with protein and collagen supplementation, the participants in the study and control groups were completing resistance training.
This doesnt have to mean heavy weights at the gym: Resistance band exercises, smaller weights and body-weight exercises all count as resistance training. Doing your favourite activity, whether its gardening, tennis or walking, is fantastic, but its not enough to slow sarcopenia. Add some specific resistance workouts to your week, and youll find your strength, muscle tone and overall fitness improves drastically.
Most cities and towns have fantastic community classes like yoga, tai chi and gym classes available to seniors for free, so check them out. Theyre also a great way to meet people, while preserving your strength and independence. During social distancing, many of these classes are still operating online.
Causes Of Ageing Muscle Loss
Ageing muscles is a condition that often affects older adults. Some of the symptoms include reduced muscle strength and endurance, weakness in your bones, and reduced flexibility. Age related muscle loss can also lead to reduced mobility. Researchers think that vitamin D might be one of the reasons that elderly people lose muscle mass and strength. In a study involving nearly 900 people, it was found that elderly women who had higher levels of vitamin D were less likely to have reduced muscle mass. Another study found that elderly women who took supplements of vitamin D had greater muscle strength compared to those who didnt. This might be because vitamin D can help with muscle strength. However, there is not much evidence to support this claim, and some studies have found no association between vitamin D and muscle strength. Additionally, there is also conflicting evidence on whether vitamin D can help prevent age related muscle loss. Vitamin D can also play a role in regulating the immune system. This means that taking vitamin D might have beneficial health effects on the elderly.
What Runners Should Know About Sarcopenia
Naturally, Jentoft says, older adults are at higher risk for developing sarcopenia. Those who are physically inactive, do not exercise, or do not eat wellespecially those who do not eat enough proteinare at the highest risk. Jentoft defines enough protein as 1 to 1.2 grams per kilogram of bodyweight a day for older adults and 1.5 grams for older adults living with sarcopenia.
While exercise is smart for the aging population at risk for sarcopenia, running wont necessarily stave off the condition. Aerobic-type exercise, like running, does not do much for counteracting sarcopenia and depending on your nutrition intake, it can actually exacerbate it, if youre in a caloric deficit, says Brad Schoenfeld, Ph.D., C.S.C.S., professor of exercise science at Lehman College and director of the graduate program in human performance and fitness. Long-distance runners who dont strength train, he says, are just as prone to developing the sarcopenia as a sedentary individual.
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Epidemiological Association Between Vitamin D And Muscle Strength And Physical Performance
Although many prospective studies have examined the vitamin D role in muscle strength and physical performance in older adults , there is high heterogeneity in term of participants characteristics and type of muscle strength assessment, and only a few projects included very old people , despite this subgroup being at the greatest risk of low vitamin D status, muscle mass and strength loss, and functional decline .
What Is Sarcopenia And How Does It Differ From Age
To be considered sarcopenic, Mark Peterson, Ph.D., C.S.C.S., associate professor at the University of Michigan says someone must have declines in not only muscle mass, but also strength and function to the point that it is detrimental to ones health. In fact, sarcopenia can be so detrimental that it can increase your risk of falls and fractures, and even can lead to functional decline, frailty, and mortality. All of us will not experience sarcopenia, but we will experience a deceleration of muscle mass and strength with age, Peterson adds.
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How To Prevent Sarcopenia: What To Try First
If youre worried about losing muscle mass and strength as you age, remember that good nutrition, plenty of protein, and a regular strength training program are essential therapies. Theyll not only help to prevent sarcopenia, but will help keep you healthier, leaner, and free from chronic disease. Your take-away:
These simple steps will provide the foundation for keeping you strong, mobile, and independent. Extra supplementation with protein powder such as whey protein , leucine , and vitamin D can be added for even more powerful sarcopenia support.
The Role Of Nutrition
To build muscle, you need 0.45 gram of protein per pound of body weight, Calabrese says. For example, a person weighing 140 pounds should eat 63 grams of protein a day . Good sources are milk, cheese, eggs, poultry, fish, peanuts and beans.
Protein is critical, but you also need carbohydrates, which is the energy source your body uses to be able to exercise. Middle- and older-age adults should not be on a low-carbohydrate diet. But be sure to choose healthy carbohydrates. Vegetables, fruits and whole grains are preferable to highly processed foods. Whole, fresh foods also have vitamins and other nutrients your body needs.
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Effects Vitamin D On Muscle Cell Types
Muscle cells can be divided in two main types: type I and type II .
- -Type I muscle cells are considered slow twitch, characterized by aerobic metabolism with low power production and high endurance capacity. They present a thick network of capillaries, important for carrying more oxygen, and a large quantity of myoglobin and mitochondria, for fat and carbohydrates oxidative phosphorylation. For these reasons, they have red color. Because of their lower strength and slow speed of contraction, they are essential for endurance exercise.
- -Type II muscle cells are defined as fast twitch, characterized by anaerobic metabolism with high speed and strength contraction, important for sprinting exercises. There are two major subtypes, divided according to speed and force generated: IIA identified as fast twitch oxidative with intermediate characteristics between type I and II and IIB defined as fast twitch glicolytic characterized by high power and low endurance. Only the latter have a pale color, due to a low number of mitochondria, lower amount of myoglobin and fewer capillaries.
What Makes This Nutrient Unique
For starters, it is both a fat-soluble vitamin and a hormone made by the body from sun exposure. Thus, it is commonly called the sunshine vitamin. Vitamin D is generally associated with bone health. However, it serves many important roles and functions throughout the body. In addition to helping build and maintain healthy, strong bones, it helps regulate inflammation and has been shown to reduce the risk of certain cancers such as breast, colon, and prostate. Additionally, vitamin D plays a vital in the function of the immune system and nerve and muscle function.
Research has shown vitamin D plays an essential role in the health of our skeletal muscles. In fact, low serum levels of vitamin D are associated with reduced muscle strength and function, leading to muscle loss, and decreased production of cells needed to build muscle. When there is a loss of muscle strength, function, and ability to build muscle cells, individuals are at increased risk of falls due to muscle weakness. This makes sense if your body is not making and maintaining its muscles’ stores you will not have the strength and endurance to move around and do the things you love most.
What does all this mean?
Food rich in Vitamin D
Vitamin D is not naturally present in many foods. Thus, food manufacturers have added or fortified foods with vitamin D for many years.
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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 bodys 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.
What Vitamins Stops Age Related Muscle Loss
Vitamins are the essential components of the human diet and play a major role in the preventing the muscle loss.
Vitamin D is a very powerful element that affects the major systems of the body. All the cells in the human body have the receptors for Vitamin D. It plays an important role like a hormone. Vitamin D gets activated in the skin when exposed to the sunlight however, it can also be taken externally by diet and vitamin supplements.
Regular intake of Vitamin D plays a major role in neuromuscular functions. It reduces the muscle loss and improves the muscle strength by increasing the rate of protein synthesis by enlarging the muscle cell fibers. It reduces the risk of falls and fracture and optimizes the bone density. Vitamin D can be obtained from food like fish, Salmon, Tuna or as supplementation. The dosage needs to be decided based on your blood vitamin D levels. The normal Vitamin D levels in your blood must be between 50 80 ng/mL for staying healthy. To attain this, one must consume 2000 5000 IU of vitamin D per day.
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Pathophysiology And Muscle Wasting
Sarcopenia is a geriatric syndrome with multiples causes, which can include genetic influence, immobility or disuse, endocrine factors, inflammation and nutritional deficiencies . These disorders involve an imbalance between anabolic and catabolic pathways that rules muscle mass. The major anabolic pathway involves activation of the Akt mammalian target of rapamycin , which leads to increased muscle protein synthesis . Insulin-like growth factor 1 , branched-chain aminoacids, exercise, testosterone and B2-adrenergics agents upregulate this pathway and are known to promote muscle growth . During the aging process, there is a decline of anabolic hormones such as testosterone, growth hormone and IGF-1, leading to decreased protein synthesis . Insulin resistance, which occurs with aging and obesity, plays an important role in decreasing available glucose and protein for muscle anabolism .
Most important causes associated to sarcopenia.
In figure 2, we summarized the most important pathways and causes contributing to loss of muscle mass that can lead to sarcopenia.
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