For far too many people, aging brings increasing frailty, weakness, tiredness and difficulties performing the most basic of tasks needed to live independently. Finally, five years ago, this plight was recognised as a medical condition: sarcopenia, “the new disease on the block”.
Simply, this debilitating condition results from accelerated muscle wasting, with a cascade of deleterious impacts on health including greater risk of falls and fractures, chronic disease, infection, hospitalisation, poor lung function, cancer, depression, diabetes and premature death.
Although muscle tissue naturally declines with age, sarcopenia is not inevitable. A recent Swedish study followed 3200 people aged 60 or more over 12 years and showed that not all of those with sarcopenia deteriorated – some improved. The researchers concluded that early intervention holds promise.
In fact, it’s increasingly recognised that sarcopenia can be prevented and even reversed through exercise and diet – especially protein.
(This is not new – back in 44 BC, Cicero argued in his Essay on Old Age that “it is our duty … to resist old age, to compensate for its defects, to fight against it as we would fight a disease; to adopt a regimen of health; to practice moderate exercise, and to take just enough food and drink to restore our health”.)
Physical activity is king when it comes to healthy aging – it has even been called the “miracle cure” by the Academy of Medical Royal Colleges and a “wonder drug” by the Centres for Disease Control. It’s very concerning then that activity levels have declined alarmingly.
To maintain and build muscle mass (and help prevent bone wasting, or osteoporosis), resistance or strength training is paramount. This includes any activity or exercise that strengthens muscles, and although it’s ideal to start when young, a 1990 study showed that even institutionalised people aged 90 to 99 increased their muscle strength by a whopping 174% with high intensity, progressive resistance exercise training.
It was later shown that older adults could incorporate new nuclei into muscle fibres. Exploring the body of evidence, Timothy Law, from Ohio University, Athens, concluded that “these adaptations are comparable to what is observed in younger individuals suggesting that the muscle of older adults is not limited in its ability to adapt”.
In his team’s review, they recommend two to four days a week of resistance exercise training over 30-60 minutes with rest intervals of 30-60 seconds, focussing on multi-joint exercises and ensuring all the major muscle groups are targeted. Resistance machines are recommended for beginners over free weights as they require less skill and are thus safter.
For an individually tailored program it is recommended to seek professional advice.
If activity is king, then diet is the queen of muscles, in turn preventing or delaying sarcopenia. In particular, protein intake is vital.
Protein has numerous important roles in the body including hormone and enzyme production, wound healing and immunity. When combined with exercise protein helps maintain lean muscle mass as well as healthy bone density.
While it’s commonly thought that meat and other animal proteins are the best source, research suggests that plant protein could be just as good at building and maintaining lean muscle mass. Bearing in mind other myriad health benefits of these foods, good protein sources include fish, eggs, legumes, nuts, dairy, quinoa and even hemp.
The recommended protein intake for older adults is at least 1 to 1.2 grams per kilogram of body weight per day, ideally spread across each meal.
More broadly, healthy muscles need a good quality diet with an array of healthy nutrients. And we’re still learning just how important this is. A lesser-known nutrient, called beta-hydroxy-beta-methyl butyrate or HMB for short, has been found to help prevent muscle loss as well as building muscle. While the body can produce it naturally, small amounts of HMB are also found in foods like avocado, grapefruit and cauliflower.