We are constantly besieged by media reports about how overweight we are as a population and the detrimental effects that this has on our health. However, little spotlight, if any, is shed on the importance of maintaining muscle mass as we age. More often than not, concern regarding muscle is overshadowed by the “battle of the bulge” narrative that we have become so familiar with. Muscle mass and strength decrease naturally with age and by the age of 40, an average person will lose their muscle mass at a rate of roughly 1% annually. This sounds like a relatively small amount, but by the age of 70, cumulatively, this could mean the loss of up to one third of the body’s muscle mass.
But losing weight is good, right?
No, not necessarily. A loss of body weight due to a loss of muscle can have serious adverse effects. Muscle is vital for strength, function and mobility, and it also serves as the epicentre for many of the body’s cellular processes. In other words, the more muscle you have, the more capacity your body has for processing nutrients and maintaining important processes.
Muscle, like bone, is in a constant state of remodelling, or “turnover”, the simultaneous processes of protein production and breakdown. Although there are several factors that cause the loss of muscle with ageing, it is ultimately rooted in an imbalance in protein production and breakdown in the body. Muscle breakdown can occur at a modest rate, thus, even a slight disturbance in this production-breakdown cycle can result in meaningful differences in remaining stores. Over time this could contribute to the loss of large volumes of muscle.
Sarcopenia
As we age, insufficient calorie and protein intake from the diet can lead to a more rapid, unintentional loss of body weight and muscle. This loss of muscle is called sarcopenia. Pronounced ‘sar-co-pee-nee-a,’ a Greek term meaning “poverty of the flesh,” this condition is the age-related progressive loss of muscle mass, function, quality, and strength. Sarcopenia can contribute to mobility issues, osteoporosis, frailty, falls and fractures, decreased physical activity levels and can threaten independent living. Despite this, little is known about how prevalent sarcopenia is globally, but research suggests it may occur in up to 33% of people over 50 living in the community, with higher prevalence in long-term and acute care settings (Cruz-Jentoft et al, 2014). Some have suggested that this may increase to more than half of those aged over 80 years (Baumgartner et al, 1998).
Sarcopenia can very quickly affect our physical capabilities and quality of life: in real terms, it can lead to frailty and increase the risk of falls and fractures in older adults. Worryingly, when coupled with other common conditions associated with ageing, the effects of sarcopenia can be even more pronounced. For example, in those with osteoporosis, sarcopenia dramatically increases the existing risk of injurious falls and fractures. Therefore, preventing sarcopenia can, in turn, lessen the potential burden on other health issues that are commonly associated with ageing.
How can I avoid sarcopenia?
You can’t avoid the loss of muscle mass altogether as it is a natural component of the ageing process. However, with regular resistance exercise or ‘strength training’ and appropriate dietary considerations, you can help to ward-off or slow the progression of sarcopenia.
1. Start strength training
Strength training is essential. It can slow down the natural loss of muscle that comes with ageing, build strength in muscles and connective tissues, and improve flexibility and coordination. Encouragingly, strength training can be done anywhere: at home, in the garden, at a park or at a gym facility and should be carried out a minimum of three times per week to have a beneficial effect on muscle mass and strength. The three major regions of the body involved with strength include the trunk and back, the upper body and the lower body.
It is more effective to prevent or slow the progression of sarcopenia, than it is to treat the existing condition. Strength training programmes for those with sarcopenia can successfully improve functionality, but the reversal of the condition once established, can be very difficult. Strength training in older adults is often less effective than in their younger counterparts partly because they, particularly older women, are often already too weak to perform the intensity of exercise required to build muscle. Therefore, the best strategy is to start your strength training as earlier as possible. In in other words, use it or lose it. Incorporating a strength training programme into your routine can offset the potentially harmful effects of loss of muscle mass in old age. That being said, it is never too late to get started. Research has shown that a programme of progressive strength training can increase protein production rates in older adults in as little as two weeks
Strength training can have a significant effect on your overall health too, reducing blood pressure, improving cholesterol levels and reducing risk of diabetes. In addition, the “everyday” benefits are obvious too, such as increased ability for lifting or moving objects at home, gardening and playing with children (or grandchildren), as strength, co-ordination and flexibility improve. Click on the final link in the resources section (below) for additional information on strength training, including activities to help you build strength, maintain bone density, improve balance, and test coordination.
2. Eat more quality protein
In addition to beginning a strength training programme, the foods we consume play an essential role in maintaining muscle and slowing the development of sarcopenia. Several nutrients have been identified as beneficial to the maintenance of muscle mass, including protein, vitamin D, vitamin B12 and folic acid, among others. However, it is the protein in particular, that proves crucial to muscle maintenance as we age.
On a cellular level, protein instructs the body to build muscle and to provide the necessary building blocks (amino acids) for this new muscle tissue. With age, there is a gradual decrease in sensitivity to the signal that initiates this process, therefore older adults need to increase protein intake from food to offset the decrease in its uptake. When accompanied by an increased protein intake, the effect of strength training on muscle production is significantly increased.
The ideal amount of protein intake necessary to prevent or slow down the progression of sarcopenia has yet to be determined. However, some suggest that intakes need to be higher than the present recommendation (0.8g protein per kg body weight, per day) to see improvements in older adults. Therefore, it is suggested that older adults should aim to consume between 1.0–1.2g protein per kg body weight, per day)(Dreyer & Volpi, 2005). The timing of meals or snacks can play an important role also. Immediately after training, muscle is more sensitive to the effects of the protein, therefore eating shortly after training can make improve protein uptake by the body.
Adding some extra protein to everyday foods, as part of a healthy balanced diet, can be simple to do.
Warning: Increasing protein intake is not advisable for people with renal dysfunction, kidney disease and those taking certain medications. Always consult your General Practitioner before altering your diet.
Warning: Before commencing a new exercise routine, always consult your General Practitioner or a Chartered Physiotherapist to guide you with an age- and intensity- appropriate strength training programme.
10 tips for adding extra protein
to your diet
Protein is the building block from which muscle is made and is essential for both
growth and repair. To stay fit and strong eat a variety of protein-rich foods each
day. Great sources include lean meat, poultry and fish. Oily fish like salmon,
sardines and kippers are packed with protein and heart-healthy omega-3 fats,
and should be eaten twice a week. Milk, yoghurt and cheese are also excellent
sources of protein and are rich in calcium too. Eating beans, eggs and nuts is a
simple way of boosting protein in your diet.
Here are some simple ideas for boosting the protein content of some everyday
meals and snacks:
1. Add hard-boiled eggs to salads.
2. Add tinned tuna or tinned salmon to salads or pasta dishes.
3. Eat Greek or low-calorie unsweetened yoghurt alone as a snack or add
to fruit and cereal, at breakfast.
4. Add milk or yoghurt to a fruit smoothie.
5. Add nut butter to sandwiches, toast, crackers, or muffins, or use as a dip
for vegetables and fruit.
6. Add skimmed milk powder to cream soups, mashed potatoes,
casseroles, puddings, and milk-based desserts.
7. Add skimmed milk powder to regular milk for use in drinks, hot porridge,
breakfast cereals, custard and milk puddings.
8. Add nuts, seeds, or wheat germ to casseroles, breads, muffins and
pancakes, or use nuts, seeds, or wheat germ to top fruit, cereal, ice
cream, and yogurt or in place of breadcrumbs.
9. Add high quality vegetable protein sources like soy, quinoa and pulses
(e.g., chickpeas, kidney beans, butter beans and lentils) to soups,
casseroles, or salads.
10. Add cheese to sauces, vegetables, salads, mashed potatoes, scrambled
eggs and omelettes and casseroles
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