Sarcopenia (sarco=muscle)(penia=poverty) is the gradual loss of muscle mass, strength and function with age. We often see elderly folks who appear to be shrunken and practically skin and bones. Sarcopenia is closely linked with a greater incidence of falls and fractures, and higher risk of postoperative complications, longer hospital stays, type 2 diabetes, cardiovascular disease, metabolic disorders, osteoporosis and cognitive decline (dementia).

Though it is usually associated with the elderly, it has recently been found to start in midlife, even as early as the thirties.

Although it occurs as a natural part of aging, affecting 5-13 percent of people ages 60 to 70, and up to 50 percent of people 80 years old and over, sarcopenia can be combatted by a combination of exercise and diet.

The good news is, you can do something in your 40s or 50s to prevent sarcopenia in later life. This is especially important if you have diabetes or are genetically prone to it, since muscle is a metabolic powerhouse, and plays an important role in glucose metabolism, fat storage and energy regulation.

Preserving muscle doesn’t just mean preserving mass, it’s about supporting muscle quality. Without regular exercise, muscle becomes infiltrated with fat and connective tissue over time, reducing its functional capacity even if muscle mass is preserved.

Experts advise building muscle through resistance (strength) training. Sorry, cardio or yoga alone is not enough to prevent sarcopenia. I started resistance training when I hit 50, thinking with my lean frame, I’d be looking like a walking skeleton 20 years hence. Twenty five years later I’m still working out with weights at least two hours a week. Originally, I went to the gym to have a trainer help with my form and avoid injury. But the pandemic put a hold on that, so I asked my trainer to put together a set of whole-body exercises with just dumbbells and a bench to work out at home. Since then, I’ve been sticking to this routine.

Another great insight of the study was the essential connection of gut health to muscle health. There appears to be a gut-muscle axis which plays a vital role in maintaining muscle health. Our gut contains a microbiome of trillions of bacteria, in balance with our gastrointestinal system.

A healthy, diverse gut microbiome supports protein absorption, reduces inflammation (which breaks down muscle), and promotes mitochondrial (cell powerhouses) function inside muscle cells. Thus, it is essential that we maintain our intestinal flora by supplying it with good quality, diverse food sources. Any disruption that disturbs the intestinal flora diversity will also affect muscle health. Over half of the protective effect of a gut-friendly diet is through reducing systemic inflammation, which also affects many other organs adversely.

Another important factor is the intake of high quality protein, such as chicken, eggs, milk, yoghurt, whey-based protein powders, which helps build muscle. But protein intake or supplementation alone is not enough. There must be an integrated formula of protein intake timed around the strength training. The aim is to create a continuous low-grade anabolic environment supporting stronger, more resilient muscles over the long haul.

Here is the formula for building and keeping quality muscle to prevent sarcopenia:

1. Progressive resistance training two to three times a week.

2. Incorporate exercises that move multiple joints and muscle groups like jumping.

3. Use fast-paced bodyweight squats to maintain speed and agility.

4. Eat at least 25-30 grams of protein each meal with a variety of high-quality proteins rich in essential amino acids.

5. Time protein intake around workouts to maximize muscle recovery and growth.

The latter is very important for maximum utilization of proteins for building muscle and keeping it. A study found that high protein diets alone had limited effects on muscle mass and strength even in physically active adults.

Nowadays, we talk about quality of life. When a person has sarcopenia, his/her quality of life deteriorates greatly. With loss of muscle mass and strength, one will experience poor balance which may lead to falls and fractures, often the precipitating cause of deaths in the elderly. Weakness will make everyday activities like walking, climbing stairs, or just getting out of a chair difficult. It reduces independence such that persons suffering from sarcopenia need to have assistance in most daily activities and with it, a loss of self-esteem.

But even at advanced age, resistance training can still help build muscle and reduce the complications that come with sarcopenia. A gradual increase in weights for training will greatly improve one’s strength, balance and general well-being. It is never too late to begin.

Maintaining muscle mass as one ages is crucial to staying strong, balanced and independent. It also helps control blood sugar, improve cholesterol levels and keep weight within a healthy range. Best of all, it gives you good quality of life.