Stronger for Longer: Prevent and Manage Sarcopenia

Did you know that as you age, your muscle mass tends to decline by about 3-8% with each passing decade, especially after you reach 30 years old? Over time, our muscles gradually become weaker and smaller. 

This condition of gradual involuntary loss of skeletal muscle mass, strength and function is known as sarcopenia and it becomes more pronounced after the age of 60,  affecting both genders equally. As part of the ageing process, our body goes through many changes such as decline in hormone levels, imbalance between muscle tissue breakdown and production, and changes in daily protein requirements. 

All of these natural changes can increase our risk of developing sarcopenia if we do not take early measures. We can prevent or delay sarcopenia by aiming to achieve and maintain a higher peak muscle mass and strength when we are still able to. This can help us to stay independent as we grow older and avoid costly healthcare expenses associated with sarcopenia-related hospitalizations.

What are the signs & symptoms?

Have you noticed some unusual changes in your body or behaviour? Symptoms are often the body's way of alerting us that something is not right.  

Muscle weakness is the most commonly reported symptom of sarcopenia. Other symptoms to look out for includes:

• Struggling with balance or coordination
• Reducing stamina or endurance
• Unintentional weight loss
• Feeling weak and less able to perform daily activities
• Losing muscle tone and definition

It's important to pay attention to these symptoms because detecting and treating sarcopenia early on can make a big difference in your quality of life. If you think you may have sarcopenia, talk to your doctor. 

Exercise & Diet Are Crucial To Stay Strong

Receiving diagnosis of sarcopenia can be daunting, but there are certainly ways to manage and live with the condition. Making healthy lifestyle choices such as eating the right foods paired with regular exercises could help in managing the symptoms and even slow down its progression.

You are encouraged to engage in progressive resistance-based strength training to enhance muscle mass and strength, alongside a nutritious diet. 

You don't need to be a bodybuilder to try out resistance training! This resistance typically comes from the usage of weights, resistance bands or your own bodyweight. The goal of progressive resistance training is to improve muscle mass and strength by gradually increasing the weight/external resistance, number of repetitions (reps), or sets of an exercise as you become stronger. 

Muscle strengthening exercises create resistance against your muscles, forcing them to work harder than they usually do in daily activities; and target different muscle groups of your body such as shoulders, arms, chest, hips, back and legs. 

With resistance training, your muscle fibres break down and then rebuild stronger during the recovery period. This process is called muscle hypertrophy, which results in bigger and stronger muscles. Over time, these exercises can also help to increase bone density and improve joint stability. 

Some examples of muscle strengthening exercises include weightlifting, resistance band exercises, bodyweight exercises such as push-ups, squats, and lunges, which can be done at home or gym. Taking this approach 2 - 3 times per week for a minimum of 8 to 12 weeks, helps to prevent plateaus and encourages continuous progress and improvement.

Here are a few examples of nearly no or minimal equipment resistance training you may try:

*The reps and routines may differ depending on your physical condition and abilities.

We all know that sedentary behaviour such as sitting for long periods of time at a desk or in front of a screen can contribute to muscle loss. Hence, it is important that we consciously move more and sit less throughout the day. By mixing up your workouts and finding activities that you enjoy, you can challenge your muscles in different ways and prevent sarcopenia. And remember, exercise doesn't have to be a chore - find activities that you enjoy and stick with them to make it a sustainable part of your routine!

Now, let’s talk about some dietary approaches you may try in your daily diet. 

Here are some of the essential nutrients you should know that can help with sarcopenia: 

1. Leucine 

You've probably heard of protein before, but have you heard of amino acids? Amino acids are the building blocks of protein that are necessary for muscle protein building. Leucine is an essential amino acid that cannot be produced by the body and can only be obtained through the diet. Surprisingly, it is also the only amino acid that has the ability to directly stimulate muscle protein production. Studies have shown that adequate leucine intake may help prevent age-related muscle loss or muscle wasting in older adults.

Examples of foods that are high in leucine: 

2. Vitamin D

Ageing gracefully requires strong muscles. But, did you know that as we age, the levels of 25(OH) vitamin D in our body tend to decline? Various studies have shown that there is a direct link between vitamin D deficiency in elderly causing reduced muscle strength and thus affecting stability. Having low levels of vitamin D predisposes and increases the risk of falls and fractures.

To maintain adequate levels of Vitamin D, try to include foods that are high in vitamin D in your diet such as:

An interesting fact to note is that besides food, sun is the natural source of vitamin D. In fact, soaking some morning sun for about 10-30 minutes, two to three times in a week is recommended to produce vitamin D naturally in the body.

3. Omega-3 fatty acid

Omega-3s are the superheroes of the fat world! They're like the cool, calm, and collected defenders of your body, fighting off inflammation due to their anti-inflammatory properties and helping keep your heart, brain, and joints healthy. In addition, they are key nutrients for preserving strong muscles and preventing age-related muscle loss such as sarcopenia. 

Hence, don't forget to include these muscle-saving champs in your diet such as:

4. Iron

Are you feeling easily tired and less energetic as you get older? It is possible that low iron levels are to be blamed. Iron is an essential nutrient that our bodies need, but as we age, we may not get enough of it in our diets. Studies have shown that eating foods rich in iron can help to improve muscle strength, physical performance, and overall muscle mass in older adults. Iron also helps reduce oxidative stress which can damage muscles and make them weaker. 

It is important to make sure you are getting enough iron in your diet to keep your muscles strong and healthy as you age. The good news is that there are many delicious foods, both animal and plant-based sources that are high in iron. 

So, start adding these foods to your plate today and watch your energy and strength improve:

It is also important to pair iron-rich foods with foods high in vitamin C (like citrus fruits, tomatoes, and bell peppers); as vitamin C helps your body to absorb iron better.  

Note from DOC2US

Losing muscle mass and overall strength can be scary, but do not worry because with the right combination of exercise and nutrition, you can slow down and in fact reverse the effect of muscle loss. It is never too late to take care of your muscles and combat sarcopenia. With every little bit of effort and dedication, you can keep your muscles strong and healthy and enjoy all the benefits of leading a healthy and active lifestyle.

Now that you have read the information about the right nutrients needed for preventing sarcopenia, you may be wondering how to combine them into one meal. Don't worry, we've got you covered! Here's a recipe that you can easily try at home:

It is important to understand that proper nutrition varies for each individual based on factors such as their unique physiology and exercise routine. Therefore, it's best to seek personalised dietary advice from a dietitian or nutritionist to optimise your overall health and fitness. 

To consult with a dietitian/nutritionist online, simply scan the QR code below and book your appointment today!

* This service will be provided until 5th May 2023. 

This article is written by Jeff Fang (DOC2US) & Queenie Liu (DOC2US),
reviewed by Ashwini Nair, MB BCh BAO​ (DOC2US)​

References: 

1. Kang Y, Kim N, Choi YJ, et al. Leucine-Enriched Protein Supplementation Increases Lean Body Mass in Healthy Korean Adults Aged 50 Years and Older: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2020 Jun 18;12(6):1816. doi: 10.3390/nu12061816. PMID: 32570811; PMCID: PMC7353448.
2. Supriya R, Singh KP, Gao Y, et al. Effect of Exercise on Secondary Sarcopenia: A Comprehensive Literature Review. Biology (Basel). 2021 Dec 30;11(1):51. doi: 10.3390/biology11010051. PMID: 35053049; PMCID: PMC8773430.
3. Uchitomi R, Oyabu M, Kamei Y. Vitamin D and Sarcopenia: Potential of Vitamin D Supplementation in Sarcopenia Prevention and Treatment. Nutrients. 2020 Oct 19;12(10):3189. doi: 10.3390/nu12103189. PMID: 33086536; PMCID: PMC7603112.
4. Dupont J, Dedeyne L, Dalle S, et al. The role of omega-3 in the prevention and treatment of sarcopenia. Aging Clin Exp Res. 2019 Jun;31(6):825-836. doi: 10.1007/s40520-019-01146-1. Epub 2019 Feb 19. PMID: 30784011; PMCID: PMC6583677.
5. van Dronkelaar C, van Velzen A, Abdelrazek M, et al. Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review. J Am Med Dir Assoc. 2018 Jan;19(1):6-11.e3. doi: 10.1016/j.jamda.2017.05.026. Epub 2017 Jul 12. PMID: 28711425.

Written By

Jeff Fang (DOC2US) & Queenie Liu (DOC2US)

Reviewed By

Doc2us Medical Board