Sarcopenia and Healthy Aging: How to avoid muscle loss with age

Both sarcopenia and healthy aging theme are extremely relevant when we approach geriatric medicine, and are highly interconnected and have a great impact on the quality of life of the elderly as a whole.

But first, do you know what sarcopenia is? Sarcopenia is the progressive loss of mass and muscle function, which occurs with aging. It involves not only the decrease in muscle amount, but also loss of strength and muscle resistance. This process can be accelerated by factors such as physical inactivity, chronic diseases (such as cardiovascular disease, diabetes and osteoporosis), malnutrition and inflammation. Having sarcopenia is associated with many negative impacts on the health of the elderly, such as difficulty in performing daily activities – for example, climbing stairs or getting up from a chair – as well as raising the risk of falls, fractures and increasing dependence of third parties.

Now, when we talk about healthy aging, this is already a much broader concept that goes beyond the simple absence of disease. It is a continuous process of physical, mental and social adaptation throughout life, with the aim of ensuring that the elderly have an active, independent and good quality life.
However, these two concepts are directly interconnected, as the preservation of muscle mass is one of the keys to achieve healthy aging, allowing the elderly to maintain their independence and functionality longer.

Current guidelines for sarcopenia prevention emphasize a multifactorial approach, which includes physical activities, adequate nutrition and general health monitoring.

The importance of physical activity and food in the prevention of sarcopenia

Exercise is known to be one of the most effective ways to prevent sarcopenia and promote healthy aging. The overall recommendation includes muscle strength exercises such as bodybuilding, with an average of 2 to 3 times a week, regular walks of about 30 minutes, as well as balance and strength exercises, such as yoga and pilates, which help prevent falls and injuries, and improve mobility as a whole.

Associated with regular physical activity, we must not forget a proper and balanced diet, especially with regard to adequate intake of proteins and micronutrients. Among the main sources of protein we can cite lean meats, fish, eggs, legumes and dairy products. Protein intake is essential for muscle synthesis.

We should also be aware of the regular monitoring of vitamins such as calcium and vitamin D, which, when disabled, are associated with the highest risk of muscle mass loss. We should not forget the proper intake of liquids, fundamental for proper muscle functioning and the hydration of the body as a whole.
Regular medical evaluations are important because, through bioimpedance and dexa examination, we are able to monitor the patient’s muscle mass.

As a form of sarcopenia prevention and aiming at healthy aging, we should also avoid risk behaviors such as smoking and excessive alcohol consumption.

Supplementation and new technologies in combating muscle loss

Although the focus is on preventive measures, based above all in lifestyle, in some cases medical interventions may be necessary. In these cases, anabolic hormones, such as testosterone, or vitamin D and protein supplements, depend on the degree of sarcopenia and risk of complications. And we should not forget the control of chronic diseases such as diabetes, hypertension and heart disease, which can aggravate sarcopenia.

Nutrition and supplementation play a key role in preserving muscle mass and preventing sarcopenia in the elderly, contributing significantly to healthy aging. One of the most effective ways to prevent or slow the development of sarcopenia is through nutrition and supplementation optimization, mainly addressing key nutrients that favor muscle maintenance.

Proteins are essential for the maintenance and synthesis of new muscle fibers. In the elderly, the ability of muscle protein synthesis decreases, which requires greater protein intake to ensure mass maintenance. The recommendation of 1.2 to 1.5 g of protein per kg body weight per day has been effective for the elderly (provided that after a proper medical evaluation, removing situations that contraindicate this amount, such as in the cases of kidney and transplanted patients).

Another supplement that has gained increasingly prominent in the media and fighting sarcopenia is creatine, usually in doses of 3 to 5 grams per day. It is well tolerated and has shown to improve strength, muscle function and physical performance in the elderly. It can improve muscle resistance, the ability to perform daily activities and reduce the feeling of fatigue, which is critical to maintaining active and healthy aging.

Vitamin D plays a crucial role in regulating calcium metabolism and maintaining bone health, but is also vital to muscle function. Daily vitamin D intake should be at least 800 to 1000 IU for most elderly, and may vary depending on serum levels and sun exposure, being adjusted by the doctor individually.

In addition to the cited nutrients, other nutritional factors also play a relevant role in muscle preservation, such as omega-3 fatty acids, which can help reduce inflammation and improve muscle function. Vitamins C and E help protect the muscles from oxidative stress, which increases with aging.

Now, speaking a little more about personalized exercises to maintain mobility, a subject that has generated controversy is muscle electrostimulation, which involves the application of electrical impulses to stimulate muscles, helping to increase strength and muscle mass. This tool can be effective for the elderly, especially those who cannot conventional resistance exercises due to physical limitations – such as fragile and fully bedridden elderly.

This technique can be used for both prevention and rehabilitation, helping to prevent sarcopenia progression and even contributing to the recovery of muscle loss. Remembering that exercise programs should be individualized, taking into account the physical conditions, the level of mobility and the patient’s comorbidities.

The combination of electrostimulation with a personalized exercise program can have synergistic effects. While electrostimulation helps recruit muscle fibers that are harder to activate in conventional exercise, adequate exercise further strengthens muscles, improving function and mobility.

Conclusion

Promoting a healthy aging, focusing on sarcopenia prevention, requires a multifactorial approach in which nutrition plays a central role. Protein adequacy, creatine and vitamin D supplementation, along with a regular exercise regime, are key interventions to preserve muscle mass, improve functionality and provide a more active and independent quality of life for the elderly. The implementation of these strategies should be adapted to the individual needs of each patient, taking into account pre -existing health conditions and food preferences.

*Text written by Geriatrician Julianne Pessequilo (CRM 160834 / RQE – 71895), member of Brazil Heath

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This content was originally published in sarcopenia and healthy aging: how to avoid muscle loss with age on CNN Brazil.

Source: CNN Brasil