Understanding sarcopenia: the silent muscle loss that could affects us all

The surprising reality: it’s not just about ageing

While sarcopenia is traditionally associated with older adults, recent research reveals alarming trends among younger populations. NHS doctor Dr Rupy Aujla wrote in an article in the Telegraph that muscle loss can begin as early as our 20s, with increasing numbers of 20 to 30-year-olds in the US showing signs of sarcopenia. This trend is largely attributable to sedentary lifestyles and poor dietary habits, particularly inadequate protein consumption.

The implications extend far beyond muscle appearance. Sarcopenia is actually more concerning than osteoporosis in many ways. While osteoporosis primarily increases fall risk, sarcopenia not only affects quality of life but also contributes to metabolic issues, including high blood sugar levels due to reduced muscle mass.

Understanding the causes

Sarcopenia results from a combination of factors working together beyond simple ageing:

Age-related changes: natural hormonal fluctuations, including declining testosterone and oestrogen levels, affect muscle mass maintenance. Additionally, motor neuron function decreases with age, impacting muscle control and strength.

Lifestyle factors: physical inactivity is perhaps the most significant modifiable risk factor. The saying “use it or lose it” is particularly relevant here; muscles deteriorate rapidly when not regularly engaged. Sitting or lying down for extended periods limits leg movement, leading to rapid muscle weakening.

Nutritional deficiencies: poor dietary nutrition, particularly low protein intake and inadequate caloric consumption, contributes significantly to muscle loss. The body requires a constant supply of amino acids to maintain muscle tissue, and when dietary protein is insufficient, the body begins breaking down muscle for its protein needs.

Medical conditions: chronic inflammation, including persistent infection states, accelerates muscle breakdown. Excessive use of steroid hormones and alcohol consumption are also linked to muscular atrophy.

Anabolic resistance: as we age, our bodies become less responsive to protein intake, requiring higher amounts to achieve the same muscle-building effects. This phenomenon, combined with decreased appetite and changes in digestive function, creates a perfect storm for muscle loss.

The protein connection

Protein plays a crucial role in preventing and treating sarcopenia. Our bodies require a continuous supply of essential amino acids, which include isoleucine, histidine, and lysine.  These essential amino acids cannot be produced internally and must be obtained through diet. Additionally, non-essential amino acids, such as arginine, glutamine, serine, and asparagine must be adequately produced and stored, though production may decrease during periods of significant stress.

The importance of protein becomes even more critical when we consider how quickly muscle loss can occur. For example, during a 48-hour water fast, the body still requires approximately 300 grams of protein for essential functions. When dietary protein isn’t available, the body turns to muscle tissue as its protein source, highlighting the constant need for adequate protein intake.

The mobility factor: why your legs matter most

One of the most striking aspects of sarcopenia is how quickly leg muscles deteriorate when not used. This rapid deterioration occurs because leg muscles are among the largest in the body and require constant engagement to maintain their mass and strength.

The feet and legs are particularly critical because they support the entire body’s weight and are essential for mobility. This is why the phrase “ageing starts from the feet up” holds particular relevance. Activities such as walking, running and cycling are excellent ways to build and maintain muscle mass, particularly in the lower body.

Common comorbidities

Sarcopenia rarely occurs in isolation. Many individuals with sarcopenia also experience osteoporosis, arthritis and abdominal complaints, such as irritable bowel syndrome (IBS). This clustering of conditions suggests shared underlying mechanisms and emphasises the importance of comprehensive health management.

Diagnosis & assessment

Currently, there are no standardised tests or specific muscle mass levels that definitively diagnose sarcopenia. However, healthcare providers look for several key indicators, such as:

• thin or weak muscles
• slow walking speed
• difficulty with standard grip tests
• history of long-term steroid use
• frequent falls or balance issues

These assessments help identify individuals who may benefit from sarcopenia treatment, even in the absence of formal diagnostic criteria.

Treatment approaches

Managing sarcopenia requires a multifaceted approach focusing on three key areas:

Dietary interventions: working with a qualified nutritional therapist or our environmental naturopath can help ensure adequate protein intake through both food sources and supplements when necessary. The approach must be personalised, taking into account individual preferences, dietary restrictions, allergies and specific health conditions. High-quality protein powders, nutritional supplements, and specific herbs may be recommended to support muscle maintenance and growth.

Exercise programs: exercise represents one of the most important approaches to prevent and alleviate sarcopenia. Regular physical activity helps build muscle, strengthen bones and support immune system function. The emphasis should be on both resistance training and aerobic activities, with particular attention to exercises that engage the large muscle groups of the legs.

Complementary therapies: depending on individual needs, breathing exercises may be beneficial to ensure optimal oxygen and carbon dioxide levels are maintained, supporting overall metabolic function and muscle health.  Our environmental naturopath has been teaching breathing techniques and for chronic pain, sometimes uses a technique called neuromuscular taping, which has been shown to be successful in management of pain.

Prevention: the best medicine

The most effective approach to sarcopenia is prevention. This involves:

• Maintaining regular physical activity throughout life, with particular emphasis on strength training and activities that engage leg muscles.
• Ensuring adequate protein intake at all life stages.
• Addressing underlying health conditions that may contribute to muscle loss.
• Avoiding prolonged periods of inactivity.
• Regular health assessments to identify early signs of muscle loss.

The path forward

Sarcopenia represents a significant health challenge that requires increased awareness and proactive management. By understanding the condition’s causes, recognising its early signs and implementing comprehensive treatment approaches, we can significantly improve outcomes for those affected.

The key message is that sarcopenia is largely preventable and treatable through lifestyle modifications, particularly adequate protein intake and regular exercise. The earlier these factors are addressed, the better our chances of maintaining muscle mass, strength and independence throughout our lives.

Remember, every step you take, every protein-rich meal you consume and every resistance exercise you perform is an investment in your future mobility and quality of life. Don’t wait until muscle loss becomes noticeable; start protecting your muscle mass today.