What is Sarcopenia and How to Fight It?

What is Sarcopenia and How to Fight It?

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.Atrophy

However, muscle mass is one of the most neglected factors when it comes to muscle management

Muscle mass is a “living” tissue of the organism, which performs regulatory functions, in which a large number of enzymatic reactions take place, and whose degeneration entails great risks for the health of the individual

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
  • Malnutrition
  • Metabolic diseases
  • Loss of mass associated with age.
The latter is the one we are going to deal with in this article, and is known as sarcopenia

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,
  • Malabsorption,
  • Neurodegeneration

Sarcopenia causes

Figure I. Physiopathogenesis of sarcopenia (Kim & Choi, 2013)

There are also a number of causes linked to the development of “secondary” sarcopenia, the most common of which is obesity. Therefore, both the elderly and the obese constitute a population at risk for the development of this pathogenic condition

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. Sarcopenia factors

Figure II. Cause/consequence feedback cycle of sarcopenia (Fuggle et al., 2018)

It is therefore important for elderly people suffering from sarcopenia to remain physically active, despite the difficulties this may entail, as generalised immobilisation accelerates muscle atrophy and therefore loss of strength and muscle mass

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).Sarcopenia treatment

Figura III. Factors and interventions for controlling sarcopenia (Fuggle et al. 2017)

Many of the interventions proposed in the literature, such as the use of myostatin inhibitors, activin receptor therapies or the use of troponin activators, are theories, future therapies with a potential yet to be determined
What we know for now is that for the management of sarcopenia we must incorporate:

Physical exercise

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.

An elderly person should undergo strength training, adapted and monitored by a professional in physical activity and sport sciences

Nutrition

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.

Supplementing with Creatine can also be an effective strategy in elderly people who do not have kidney problems since “creatine supplementation in the elderly can produce an increase in muscle mass, endurance and performance” (Moon et al. 2015)

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.

An essential fact is that it also alters with age and is a causal factor in this loss of muscle mass, which can be as much as 8% in the worst case
With well-studied dietary guidelines, the contribution of leucine can be notably improved, since it is an amino acid present in appreciable quantities in red meat, eggs, fish, dairy products and foods of vegetable origin such as legumes, wholemeal cereals, nuts and potatoes, without the intention of exhausting the catalogue.

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.

In the context of avoiding or at least delaying the onset of this problem, the regular use of a dietary supplement must be able to improve protein anabolism beyond the targets covered by the routine diet, without at any time impairing the rhythm of daily meals

Bibliography Sources

  1. 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
  2. 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
  3. 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
  4. 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).
  5. 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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Assessment Combating Sarcopenia

Physical exercise - 100%

Adequate nutrition - 100%

Antioxidants - 100%

Supplements - 100%

100%

HSN Evaluation: 5 /5
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About Alfredo Valdés
Alfredo Valdés
A specialist in Pathophysiology and biomolecular effects on nutrition and sportive activity who will show you the elaborate world of sports nutrition in his articles, employing a simple and critical writing.
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