Sarcopenia: Causes, Prevention, And Treatement. Part 1
01/06/2010
Sarcopenia: Causes, Prevention, And Treatement. Part 1
By Will Brink
Is a loss of strength, mobility, and functionality an
inevitable part of aging? No, it's not. It's a consequence of
disuse, suboptimal hormone levels, dietary and nutrient
considerations and other variables, all of which are compounded
by aging. One of the greatest threats to an aging adult's
ability to stay healthy and functional is the steady loss of
lean body mass - muscle and bone in particular.
The medical term for the loss of muscle is sarcopenia, and it's
starting to get the recognition it deserves by the medical and
scientific community. For decades, that community has focused on
the loss of bone mass (osteoporosis), but paid little attention
to the loss of muscle mass commonly seen in aging populations.
Sarcopenia is a serious healthcare and social problem that
affects millions of aging adults. This is no exaggeration. As
one researcher recently stated:
"Even before significant muscle wasting becomes apparent,
ageing is associated with a slowing of movement and a gradual
decline in muscle strength, factors that increase the risk of
injury from sudden falls and the reliance of the frail elderly
on assistance in accomplishing even basic tasks of independent
living. Sarcopenia is recognized as one of the major public
health problems now facing industrialized nations, and its
effects are expected to place increasing demands on public
healthcare systems worldwide" (Lynch, 2004)
Sarcopenia and osteoporosis are directly related conditions,
one often following the other. Muscles generate the mechanical
stress required to keep our bones healthy; when muscle activity
is reduced it exacerbates the osteoporosis problem and a vicious
circle is established, which accelerates the decline in health
and functionality.
What defines sarcopenia from a clinical perspective? Sarcopenia
is defined as the age-related loss of muscle mass, strength and
functionality. Sarcopenia generally appears after age 40 and
accelerates after the age of approximately 75. Although
sarcopenia is mostly seen in physically inactive individuals, it
is also commonly found in individuals who remain physically
active throughout their lives. Thus, it's clear that although
physical activity is essential, physical inactivity is not the
only contributing factor. Just as with osteoporosis, sarcopenia
is a multifactorial process that may involve decreased hormone
levels (in particular, GH, IGF-1, MGF, and testosterone), a lack
of adequate protein and calories in the diet, oxidative stress,
inflammatory processes, chronic, low level, diet-induced
metabolic acidosis, as well as a loss of motor nerve cells
A loss of muscle mass also has far ranging effects beyond the
obvious loss of strength and functionality. Muscle is a
metabolic reservoir. In times of emergency it produces the
proteins and metabolites required for survival after a traumatic
event. In practical terms, frail elderly people with decreased
muscle mass often do not survive major surgeries or traumatic
accidents, as they lack the metabolic reserves to supply their
immune systems and other systems critical for recovery.
There is no single cause of sarcopenia, as there is no single
cause for many human afflictions. To prevent and/or treat it, a
multi-faceted approach must be taken, which involve hormonal
factors, dietary factors, supplemental nutrients, and exercise.
Dietary considerations
The major dietary considerations that increase the risk of
sarcopenia are: a lack of adequate protein, inadequate calorie
intake, and low level, chronic, metabolic acidosis.
Although it's generally believed the "average" American gets
more protein then they require, the diets of older adults are
often deficient. Compounding that are possible reductions in
digestion and absorption of protein, with several studies
concluding protein requirements for older adults are higher than
for their younger counterparts (Young, 1990; Campbell et al.,
1994; Campbell et al., 1996). These studies indicate that most
older adults don't get enough high quality protein to support
and preserve their lean body mass.
There is an important caveat on increasing protein, which
brings us to the topic of low level, diet-induced, metabolic
acidosis. Typical Western diets are high in animal proteins and
cereal grains, and low in fruits and vegetables. It's been shown
that such diets cause a low grade metabolic acidosis, which
contributes to the decline in muscle and bone mass found in
aging adults (Frassetto et al., 2001). One study found that by
adding a buffering agent (potassium bicarbonate) to the diet of
post-menopausal women the muscle wasting effects of a "normal"
diet were prevented (Frassetto et al., 1997). The researchers
concluded the use of the buffering agent was "... potentially
sufficient to both prevent continuing age-related loss of muscle
mass and restore previously accrued deficits."
The take home lesson from this study is that - although older
adults require adequate intakes of high quality proteins to
maintain their muscle mass (as well as bone mass), it should
come from a variety of sources and be accompanied by an increase
in fruits and vegetables as well as a reduction of cereal
grain-based foods. The use of supplemental buffering agents such
as potassium bicarbonate, although effective, does not replace
fruits and vegetables for obvious reasons, but may be
incorporated into a supplement regimen.
Hormonal considerations
As most are aware, with aging comes a general decline in many
hormones, in particular, anabolic hormones such as Growth
Hormone (GH), DHEA, and testosterone. In addition, researchers
are looking at Insulin-like Growth factor one (IGF-1) and
Mechano Growth factor (MGF) which are essential players in the
hormonal milieu responsible for maintaining muscle mass as well
as bone mass. Without adequate levels of these hormones, it's
essentially impossible to maintain lean body mass, regardless of
diet or exercise.
It's been shown, for example, that circulating GH declines
dramatically with age. In old age, GH levels are only one-third
of that in our teenage years. In addition, aging adults have a
blunted GH response to exercise as well as reduced output of MGF
(Hameed et al., 2003), which explains why older adults have a
much more difficult time building muscle compared to their
younger counterparts. However, when older adults are given GH,
and then exposed to resistance exercise, their MGF response is
markedly improved, as is their muscle mass (Hameed et al.,
2004).
Another hormone essential for maintaining lean body mass is
testosterone. Testosterone, especially when given to men low in
this essential hormone, has a wide range of positive effects.
One review looking at the use of testosterone in older men
(Gruenewald et al., 2003) concluded:
"In healthy older men with low-normal to mildly decreased
testosterone levels, testosterone supplementation increased lean
body mass and decreased fat mass. Upper and lower body strength,
functional performance, sexual functioning, and mood were
improved or unchanged with testosterone replacement"
Contrary to popular belief, women also need testosterone!
Although women produce less testosterone, it's as essential to
the health and well being of women as it is for men.
The above is a highly generalized summary and only the tip of
the proverbial iceberg regarding various hormonal influences on
sarcopenia. A full discussion on the role of hormones in
sarcopenia is well beyond the scope of this article. Needless to
state, yearly blood work after the age of 40 is essential to
track your hormone levels, and if needed, to treat deficiencies
via Hormone Replacement Therapy (HRT). Private organizations
like the Life Extension Foundation offer comprehensive hormone
testing packages, or your doctor can order the tests. However,
HRT is not for everyone and may be contraindicated in some
cases. Regular monitoring is required, so it's essential to
consult with a medical professional versed in the use of HRT,
such as an endocrinologist.
End Part 1
About the Author: Want to gain muscle, strength, and save time
and money while doing it? Find out more at:
http://www.bodybuildingrevealed.com See The Number One Science
Based Web Site On All Things Health, Bodybuilding, Fitness,
Weight loss: http://WWW.BRINKZONE.COM
Source: http://www.isnare.com
Permanent Link:
By Will Brink
Is a loss of strength, mobility, and functionality an
inevitable part of aging? No, it's not. It's a consequence of
disuse, suboptimal hormone levels, dietary and nutrient
considerations and other variables, all of which are compounded
by aging. One of the greatest threats to an aging adult's
ability to stay healthy and functional is the steady loss of
lean body mass - muscle and bone in particular.
The medical term for the loss of muscle is sarcopenia, and it's
starting to get the recognition it deserves by the medical and
scientific community. For decades, that community has focused on
the loss of bone mass (osteoporosis), but paid little attention
to the loss of muscle mass commonly seen in aging populations.
Sarcopenia is a serious healthcare and social problem that
affects millions of aging adults. This is no exaggeration. As
one researcher recently stated:
"Even before significant muscle wasting becomes apparent,
ageing is associated with a slowing of movement and a gradual
decline in muscle strength, factors that increase the risk of
injury from sudden falls and the reliance of the frail elderly
on assistance in accomplishing even basic tasks of independent
living. Sarcopenia is recognized as one of the major public
health problems now facing industrialized nations, and its
effects are expected to place increasing demands on public
healthcare systems worldwide" (Lynch, 2004)
Sarcopenia and osteoporosis are directly related conditions,
one often following the other. Muscles generate the mechanical
stress required to keep our bones healthy; when muscle activity
is reduced it exacerbates the osteoporosis problem and a vicious
circle is established, which accelerates the decline in health
and functionality.
What defines sarcopenia from a clinical perspective? Sarcopenia
is defined as the age-related loss of muscle mass, strength and
functionality. Sarcopenia generally appears after age 40 and
accelerates after the age of approximately 75. Although
sarcopenia is mostly seen in physically inactive individuals, it
is also commonly found in individuals who remain physically
active throughout their lives. Thus, it's clear that although
physical activity is essential, physical inactivity is not the
only contributing factor. Just as with osteoporosis, sarcopenia
is a multifactorial process that may involve decreased hormone
levels (in particular, GH, IGF-1, MGF, and testosterone), a lack
of adequate protein and calories in the diet, oxidative stress,
inflammatory processes, chronic, low level, diet-induced
metabolic acidosis, as well as a loss of motor nerve cells
A loss of muscle mass also has far ranging effects beyond the
obvious loss of strength and functionality. Muscle is a
metabolic reservoir. In times of emergency it produces the
proteins and metabolites required for survival after a traumatic
event. In practical terms, frail elderly people with decreased
muscle mass often do not survive major surgeries or traumatic
accidents, as they lack the metabolic reserves to supply their
immune systems and other systems critical for recovery.
There is no single cause of sarcopenia, as there is no single
cause for many human afflictions. To prevent and/or treat it, a
multi-faceted approach must be taken, which involve hormonal
factors, dietary factors, supplemental nutrients, and exercise.
Dietary considerations
The major dietary considerations that increase the risk of
sarcopenia are: a lack of adequate protein, inadequate calorie
intake, and low level, chronic, metabolic acidosis.
Although it's generally believed the "average" American gets
more protein then they require, the diets of older adults are
often deficient. Compounding that are possible reductions in
digestion and absorption of protein, with several studies
concluding protein requirements for older adults are higher than
for their younger counterparts (Young, 1990; Campbell et al.,
1994; Campbell et al., 1996). These studies indicate that most
older adults don't get enough high quality protein to support
and preserve their lean body mass.
There is an important caveat on increasing protein, which
brings us to the topic of low level, diet-induced, metabolic
acidosis. Typical Western diets are high in animal proteins and
cereal grains, and low in fruits and vegetables. It's been shown
that such diets cause a low grade metabolic acidosis, which
contributes to the decline in muscle and bone mass found in
aging adults (Frassetto et al., 2001). One study found that by
adding a buffering agent (potassium bicarbonate) to the diet of
post-menopausal women the muscle wasting effects of a "normal"
diet were prevented (Frassetto et al., 1997). The researchers
concluded the use of the buffering agent was "... potentially
sufficient to both prevent continuing age-related loss of muscle
mass and restore previously accrued deficits."
The take home lesson from this study is that - although older
adults require adequate intakes of high quality proteins to
maintain their muscle mass (as well as bone mass), it should
come from a variety of sources and be accompanied by an increase
in fruits and vegetables as well as a reduction of cereal
grain-based foods. The use of supplemental buffering agents such
as potassium bicarbonate, although effective, does not replace
fruits and vegetables for obvious reasons, but may be
incorporated into a supplement regimen.
Hormonal considerations
As most are aware, with aging comes a general decline in many
hormones, in particular, anabolic hormones such as Growth
Hormone (GH), DHEA, and testosterone. In addition, researchers
are looking at Insulin-like Growth factor one (IGF-1) and
Mechano Growth factor (MGF) which are essential players in the
hormonal milieu responsible for maintaining muscle mass as well
as bone mass. Without adequate levels of these hormones, it's
essentially impossible to maintain lean body mass, regardless of
diet or exercise.
It's been shown, for example, that circulating GH declines
dramatically with age. In old age, GH levels are only one-third
of that in our teenage years. In addition, aging adults have a
blunted GH response to exercise as well as reduced output of MGF
(Hameed et al., 2003), which explains why older adults have a
much more difficult time building muscle compared to their
younger counterparts. However, when older adults are given GH,
and then exposed to resistance exercise, their MGF response is
markedly improved, as is their muscle mass (Hameed et al.,
2004).
Another hormone essential for maintaining lean body mass is
testosterone. Testosterone, especially when given to men low in
this essential hormone, has a wide range of positive effects.
One review looking at the use of testosterone in older men
(Gruenewald et al., 2003) concluded:
"In healthy older men with low-normal to mildly decreased
testosterone levels, testosterone supplementation increased lean
body mass and decreased fat mass. Upper and lower body strength,
functional performance, sexual functioning, and mood were
improved or unchanged with testosterone replacement"
Contrary to popular belief, women also need testosterone!
Although women produce less testosterone, it's as essential to
the health and well being of women as it is for men.
The above is a highly generalized summary and only the tip of
the proverbial iceberg regarding various hormonal influences on
sarcopenia. A full discussion on the role of hormones in
sarcopenia is well beyond the scope of this article. Needless to
state, yearly blood work after the age of 40 is essential to
track your hormone levels, and if needed, to treat deficiencies
via Hormone Replacement Therapy (HRT). Private organizations
like the Life Extension Foundation offer comprehensive hormone
testing packages, or your doctor can order the tests. However,
HRT is not for everyone and may be contraindicated in some
cases. Regular monitoring is required, so it's essential to
consult with a medical professional versed in the use of HRT,
such as an endocrinologist.
End Part 1
About the Author: Want to gain muscle, strength, and save time
and money while doing it? Find out more at:
http://www.bodybuildingrevealed.com See The Number One Science
Based Web Site On All Things Health, Bodybuilding, Fitness,
Weight loss: http://WWW.BRINKZONE.COM
Source: http://www.isnare.com
Permanent Link:
http://www.isnare.com/?aid=466639&ca=Wellness%2C+Fitness+and+Diet
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