Our muscles do so much for us—from carrying a suitcase through the airport to lifting a gallon of milk at the store. Without strong muscles, these seemingly simple everyday tasks would be incredibly difficult or even impossible. As we age, maintaining adequate muscle mass becomes imperative to stay independent, mobile, and functional in our daily lives. In addition, should a major injury or illness occur, those with more muscle mass tend to have better outcomes and healing.
Being under muscled – a condition known as sarcopenia – comes with both short-term and long-term health risks and consequences that can significantly impact quality of life. Let’s look at what sarcopenia really is, sarcopenia treatment, and why building and preserving muscle mass matters so much as we age.
What is Sarcopenia?
Sarcopenia is characterized by a significant reduction in muscle mass and a decline in muscle function. It primarily affects older adults as they age and has significant consequences like mobility limitations, decreased quality of life, and an increased fall risk and related injuries. It’s reported that the prevalence of sarcopenia in the population over 80 years old is up to 29%.
You may be asking yourself – don’t we all naturally lose some muscle as we age? While yes, our muscles undergo significant and notable changes with the aging process – a 3-8% decrease in muscle mass each decade after 30 if we do nothing about it – sarcopenia represents much more than just the typical muscle loss with age that occurs naturally over time. Research has demonstrated that other factors also play an important role, including obesity and physical inactivity. Furthermore, muscle weakness observed in middle-aged and older adults is strongly linked to limitations in daily functioning and the development of physical disability—both of which can create a cycle that further accelerates muscle loss.
Associated Health Risks With Sarcopenia
Sarcopenia is associated with various short-term and long-term health risks, including:
- Poor balance
- Increased risk of falls or fractures
- Loss of functional mobility and independence
- Longer hospitalization due to falls, injuries, or fractures
- Postoperative complications including delayed or poor healing
- Mortality (increased risk of dying)
- Poor metabolic health, such as high blood pressure, cholesterol levels, and insulin resistance/blood sugar dysregulation
Some conditions, like physical inactivity, smoking, diabetes, and malnutrition, are associated with an increased risk of sarcopenia.
Why Does Muscle Mass Matter as We Age?
Maintaining muscle mass as we age is essential for helping us stay active and function better in our daily lives. The ultimate goal is to preserve enough muscle to remain independent and capable of performing everyday tasks without assistance—such as carrying groceries from the car to the house, squatting to pick something up from the floor, or lifting luggage into an overhead compartment. These everyday tasks are what define our autonomy and self-sufficiency. Without the physical strength to do them ourselves, we gradually lose our independence and may need to rely on others for help.
Muscle mass also plays a crucial role in helping us recover from illness and injury, especially as we get older. Someone with more muscle mass will typically bounce back faster from sickness or physical setbacks than someone with less muscle mass – making maintaining muscle mass even more essential as we age.
How to Gain Healthy Muscle Mass: Sarcopenia Treatment
Engaging in regular weight-lifting exercise, ensuring adequate dietary protein intake, and incorporating some specific nutritional supplements into our routine can all contribute significantly to building and sustaining muscle mass throughout the aging process.
Weightlifting
Resistance exercise in the form of weightlifting, is the standard non-pharmacological sarcopenia treatment. When performed consistently, weightlifting effectively builds muscle mass and improves muscular function, leading to better overall health outcomes and quality of life as we age.
But we’re not just referring to simple bicep curls with 3–5 pound dumbbells. The most effective and beneficial exercises are those that engage large muscle groups — like squats, lunges, deadlifts, pull-ups, and push-ups for example. If you’re new to weightlifting or haven’t done it for a while, it is often recommended that you work with a qualified professional or certified trainer who can make sure you’re using proper form during these exercises to avoid injury and also to get the best benefit.
When you lift weights, make sure to focus on big muscle groups, like your legs, back, and chest for example. Ideally, you should work your way up gradually to lifting weights at least three times per week. Maintaining this consistent weight-lifting routine as you age is ideal. But from a sarcopenia treatment perspective, most will need to commit to at least three months of regular training before you begin to see meaningful and measurable results.
Eat Enough Dietary Protein
Studies show that older adults who eat more protein lose less lean muscle mass than those who eat less. Getting enough protein—paired with weight training—is the most effective non-pharmacological way to combat muscle loss as we age. Aim for at least 90 grams of protein each day, which is above the recommended daily value of protein because older adults need even more protein to maintain muscle as they age. This suggests an age-related resistance to protein because the aging body is less responsive to low doses of amino acids. Getting at least 90 grams of protein is key and provides significant health benefits for maintaining muscle mass and function in older adults.
Focus on high-quality protein sources like organic and grass-fed sources of meats, and wild caught sources of fish. Plant-based proteins are good as well, just know they don’t have as complete of a distribution of amino acids as the animal proteins do. If you are on a vegan diet, keep in mind when eating plant-based protein, pairing it with non-processed whole grains or nuts and seeds for a complete amino acid profile. For more information on protein and the best sources, check out this blog post.
Supplements for Muscle Mass Improvement: Sarcopenia Supplements
Supplements like creatine and branched chain amino acids (BCAAs), can help build muscle mass. Creatine is a compound made of 3 specific amino acids, glycine, arginine and methionine. It offers proven benefits for both younger and older adults. In younger adults, it increases lean body mass and supports athletic performance. In older adults, it helps build and maintain muscle mass while improving function. It’s especially effective when combined with weightlifting. Typical dosing is around 5g of creatine daily, however some more recent studies have looked at dosing of up to 20 grams per day, especially when it pertains to brain health.
- Meta-analyses demonstrate that creatine supplementation combined with resistance training increases lean tissue mass, upper-body muscle strength, handgrip strength, and sit-to-stand performance compared to training alone.
- Systematic reviews indicate that creatine may improve memory and attention in generally healthy older adults, with some studies showing enhanced cognitive processing under metabolic stress (sleep deprivation, mental fatigue).
- Indirect benefits include improved functional ability, reduced fall risk, and enhanced general well-being.
Leucine, an essential amino acid, also one of the BCAAs, is a valuable supplement for building muscle mass and improving muscular function. Leucine is the most potent amino acid stimulator of muscle protein synthesis, primarily through activation of the mechanistic target of rapamycin complex 1 (mTORC1) signaling pathway, which regulates muscle mass by promoting protein accretion when combined with adequate protein intake and resistance exercise. Studies demonstrate that adding leucine (6.25 g protein supplemented with 5.0 g total leucine) produces similar muscle protein synthesis responses to higher protein doses (25 g). What does this mean? It means that adding supplemental leucine can be especially helpful with those not able to eat enough dietary protein.
You can usually find leucine in BCAA supplements, as well as essential amino acid or a full amino acid complex supplement. Since the body can’t produce leucine on its own, it must be obtained through diet. Found naturally in meat, poultry, fish, eggs, milk, and some plant-based sources, leucine stimulates muscle synthesis – a process that becomes increasingly important as we age. Older adults require a higher proportion of leucine to build and maintain muscle. In the case of sarcopenia, a leucine supplement is generally recommended. Whey protein supplements, which are high in leucine, offer an easy way to increase protein intake in those who can tolerate dairy.
The Functional Medicine Approach to Sarcopenia Treatment
Being under muscled has both short-term and long-term health effects—which is why staying active and strong is so important, especially as we age. Maintaining muscle mass is one of the best ways to preserve long-term health. Functional medicine takes a holistic approach to aging and health, recognizing the vital role muscle mass plays in our well-being. The goal is to maintain independence as we age, and muscle mass is key to achieving this.
At Arizona Wellness Medicine, we take a preventative approach and integrate this knowledge into our care plans. We believe optimal health comes from a whole-person approach and examining health through a comprehensive lens. Through lifestyle integration—including movement, physical therapy, strength training, and proper nutrition—functional medicine can help address symptoms. If you’re looking to partner with functional medicine professionals to develop a personalized treatment plan, Arizona Wellness Medicine may be right for you. Contact us here to book your first appointment.
Resources:
- Epidemiology of sarcopenia: Prevalence, risk factors, and consequences
- Sarcopenia definition, diagnosis and treatment: consensus is growing
- A Review of Sarcopenia Pathophysiology, Diagnosis, Treatment and Future Direction
- Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults
- Nutritional Supplements to Support Resistance Exercise in Countering the Sarcopenia of Aging
- Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia
- Protein intake and exercise for optimal muscle function with aging: Recommendations from the ESPEN Expert Group
- Role of Dietary Protein and Muscular Fitness on Longevity and Aging
