Sarcopenia is a degenerative process that affects muscle mass and it is therefore of vital importance to know what we can do to combat it
«Our muscle mass should be considered a new vital sign», says Carla Prado, doctor and professor of Nutrition, Food and Health at the University of Alberta.
Muscle mass as a predictor of health
Cardiorespiratory capacity has been considered for years as a powerful predictor of future morbidity and mortality. In addition to the classic markers to be controlled in any clinical intervention aimed at improving health.
However, muscle mass is one of the most neglected factors when it comes to muscle management
Atrophy or Loss of Muscle Mass
This loss of muscle mass is known as atrophy, the aetiology of which is multifactorial and may involve several points:
- Sedentarianism and inactivity
- Metabolic diseases
- Loss of mass associated with age.
What is Sarcopenia?
“Sarcopenia represents a loss of strength and muscle mass in older individuals and is the major determinant of risk of fall and loss of ability to perform activities of daily living, often linked to disability, loss of independence and death” (Dhillon & Hasni, 2018).
Causes of Sarcopenia
The physiopathology of sarcopenia is varied and not all the underlying mechanisms of pathogenesis are yet fully understood
However, taking into account that age is the major trigger for sarcopenia, associated factors seem to be the main processes that trigger this condition, such as:
- Increased oxidative stress,
- Decreased release of myocines,
- Proliferation of inflammatory cytokines that generate a state of low chronic inflammation,
Figure I. Physiopathogenesis of sarcopenia (Kim & Choi, 2013)
Symptoms of Sarcopenia
If we approach this condition from a socio-behavioural approach, its development generates weakness, loss of muscle mass and reduced mobility, which makes practising the main strategy for the management of the pathology, physical activity, diminished.
Figure II. Cause/consequence feedback cycle of sarcopenia (Fuggle et al., 2018)
How can you combat Sarcopenia?
Multiple therapies are available to address the progression of the disease, thus mitigating the adverse health effects of this condition
The following image shows the anabolic and catabolic factors and the therapies to correct this development, proposed by Fuggle et al. (2017).
Figura III. Factors and interventions for controlling sarcopenia (Fuggle et al. 2017)
Doing physical exercise, both endurance as well as strength training
Especially the latter, in a controlled way to encourage the development of muscular-skeletal hypertrophy without generating excessive muscle damage that could accentuate a pre-existing pro-inflammatory environment.
Adequate nutrition, as it is very common for the elderly to suffer from malnutrition caused by a loss of appetite
It is therefore important that they are fed correctly and their nutrition is supervised by a registered dietitian-nutritionist, with special emphasis on protein nutrition, which is structurally necessary to produce hypertrophy (and reverse sarcopenia) and is usually deficient in the elderly.
For this, the consumption of Whey Protein shakes is a useful strategy, as it is a way to consume protein that does not require large capacity and is easily consumable.
Reduce oxidative stress
Reduce age-related oxidative stress, and the production of inflammatory molecules
To this end, the inclusion of Multivitamins high quality multivitamin can be a useful strategy, especially for older people with malnutrition.
The use of antioxidants EROS capturers; and the addiction of flavonols and turmeric in the diet, should be one of the aspects implemented to control the markets of inflammation (such as SSV) and specific (such as CRP) in the elderly, where a doctor should assess the best way to treat them before pharmacological therapy.
Hormone replacement therapy
Finally, the analysis of the serum concentrations of anabolic hormones, being able to assess the possibility of starting a hormone replacement therapy (HRT), which is prescribed and controlled by an endocrinologist, will improve the quality of life of those elderly people with alterations in the production of androgens or other hormones.
Leucine and its help against Sarcopenia
In this field, the amino acid plays an extraordinary role leucine, behaving as a fuel for muscle metabolism by intensifying the recycling of amino acids as raw material in protein synthesis.
Leucine is also a stimulant of insulin synthesis in the pancreas, an irreplaceable hormone for the normal supply of amino acids to the interior of muscle cells so that they can maintain their protein metabolism at the desired level.
Recent scientific reports suggest the real possibility of balancing the rate of protein synthesis after meals, and thus curbing sarcopenia, by means of a daily leucine supplement at reduced doses.
- Dhillon, R. J. S., & Hasni, S. (2017). Pathogenesis and Management of Sarcopenia. Clinics in Geriatric Medicine, 33(1), 17–26. https://doi.org/10.1016/j.cger.2016.08.002
- Fuggle, N., Shaw, S., Dennison, E., & Cooper, C. (2017). Sarcopenia. Best Practice & Research. Clinical Rheumatology, 31(2), 218–242. https://doi.org/10.1016/j.berh.2017.11.007
- Kim, T. N., & Choi, K. M. (2013). Sarcopenia: definition, epidemiology, and pathophysiology. Journal of Bone Metabolism, 20(1), 1–10. https://doi.org/10.11005/jbm.2013.20.1.1
- Moon, A., Heywood, L., Rutherford, S., Cobbold, C., A, C. M., Heywood, L., … Creatine, C. C. (2015). Creatine Supplementation in the Elderly : is Resistance Training Really Needed ?, 2(2).
- Leucine supplementation improves muscle protein synthesis in elderly men independently of hyperaminoacidaemia J Physiol August 15, 2006 575 (1) 305-315; published ahead of print June 15, 2006, doi:10.1113/jphysiol.2006.110742
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