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Understanding Sarcopenia: The Battle Against Age-Related Muscle Loss

As we age, maintaining our physical strength and functional abilities becomes increasingly important. One of the crucial aspects of this is understanding sarcopenia, which is the age-related loss of muscle mass and function. In this article, we will explore what sarcopenia is, its implications for longevity, and practical strategies to combat its effects. I had the pleasure of sitting down with Justin Keogh who is the Associate Dean of Research for the Faculty of Health Science and Medicine at Bond University, with a special interest in geriatric exercise prescription who helped me understand this area better and write this guide to help you maintain muscle health as you age.

What is Sarcopenia?

Sarcopenia is defined as the progressive loss of muscle mass, strength, and function associated with aging. It is not merely a consequence of getting older; rather, it significantly impacts independence and quality of life. As muscle mass decreases, older adults often find everyday activities more challenging. Tasks like standing up from a chair, walking, or climbing stairs become increasingly difficult.

Contemporary definitions of sarcopenia encompass not only muscle mass but also muscle strength and physical performance. Physical performance can be gauged through assessments such as gait speed and the ability to perform sit-to-stand activities. These metrics are used because the movements offer a proxy for fundamental movements for maintaining independence and functionality in daily life.

The Importance of Muscle Health in Aging

Taking steps to maintain and enhance muscle strength as we age is important for several reasons. Loss of muscle mass can lead to:

  • Increased risk of falls
  • Reduced mobility
  • Decreased overall strength
  • Lower metabolic health

How Does Muscle Loss Affect Longevity?

One of the key questions surrounding sarcopenia is its relationship with longevity. Studies have shown that individuals who lose muscle as they age may not only experience functional decline but may also have a higher risk of premature death. For instance, walking speed has been identified as a significant biomarker of longevity. A gait speed of less than 0.8 meters per second is associated with increased negative health outcomes aka not living as long as you might. 

As walking speed decreases, the risk of severe health consequences and mortality increases. Therefore, maintaining muscle strength along with function is paramount for promoting longevity.

Factors Contributing to Sarcopenia

Sarcopenia can result from various factors, including:

  • Reduced physical activity
  • Hormonal changes
  • Chronic diseases
  • Malnutrition

These factors can compound over time, leading to significant muscle loss. It is crucial to address these elements proactively to mitigate the effects of sarcopenia.  You might do this with your doctor, nutritionist, chiropractor or osteopath, but whomever you work with make sure they have skills in working with an elderly population. 

Strategies to Combat Sarcopenia

To effectively combat sarcopenia, a multifaceted approach is required. Here are some practical strategies:

1. Engage in Resistance Training

Resistance training is one of the most effective ways to maintain and build muscle mass. Engaging in strength training exercises at least twice a week can help counteract muscle loss. Focus on exercises that target major muscle groups, which can start with things like getting up and down from a chair and progress to:

  • Squats
  • Lunges
  • Push-ups
  • Rowing

2. Incorporate Balance and Flexibility Exercises

Improving balance and flexibility is crucial for functional mobility. Incorporate exercises such as:

  • Tai Chi
  • Yoga
  • Dynamic stretching

These activities can enhance stability and coordination which increase the brain’s control of your muscles.  This can reduce the risk of falls.

3. Optimize Nutrition

A well-balanced diet rich in protein is essential for muscle repair and growth.  For most people as they age their protein requirement actually goes up.  This is due to difficulty absorbing some proteins as the intestines age. So, aim to include for following foods in your diet. 

  • Lean meats
  • Dairy products
  • Legumes
  • Nuts and seeds

Consuming adequate amounts of protein can help maintain muscle mass as you age.

4. Maintain an Active Lifestyle

Incorporating physical activity into your daily routine is vital. Consider activities such as:

  • Walking
  • Gardening
  • Dancing
  • Swimming

These activities can help sustain muscle health and improve overall fitness levels.  In some communities they have exercise classes specifically for an elderly population.  For example my mother, who is currently 86 regularly attended a group exercise class for the elderly in the UK.  She does this with friends and finds it a really good way to socialize as well as exercise. 

5. Use Movement Snacks

For those struggling to find time for formal exercise, “movement snacks” can be an effective solution. This concept involves integrating short bursts of physical activity into your day. Examples of movement snacks include:

  • Doing calf raises while cooking
  • Performing squats while watching TV
  • Taking the stairs instead of the elevator
  • Standing on tiptoe while brushing your teeth.

These small actions can accumulate significant benefits for muscle health.

Addressing Common Concerns

Many individuals may question whether they can still gain muscle mass as they age. Dr. Keogh says that while it is more challenging, it is certainly possible, especially for those who are new to resistance training. Older adults can experience significant strength gains and improvements in functional capacity.

It is essential to start with a manageable routine and gradually increase the intensity. Consulting with a fitness professional can help tailor a program that meets individual needs and goals.

Understanding and addressing sarcopenia is critical for promoting longevity and maintaining a high quality of life as we age. By engaging in resistance training, optimizing nutrition, and incorporating physical activity into our daily routines, we can combat the effects of muscle loss. Remember, it is never too late to start prioritizing your muscle health—every effort counts towards enhancing your health span and lifespan.

For more information on muscle health and effective strategies to combat sarcopenia, reach out to me via the Contact Page and we’ll see if we can start making Your Lifestyle Your Medicine.

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Podcasts

Episode 42: Aging Strong – Insights on Sarcopenia and Longevity with Justin Keogh

Can losing muscle mass determine how long we live independently? Join me, Ed Padgett, as I explore this critical question with Justin Keogh, the Associate Dean of Research at Bond University and a seasoned expert in sports science and geriatric exercise. We’ll dissect the phenomenon of sarcopenia, the age-related loss of muscle mass, and its profound effects on our daily lives and longevity. Justin shares his extensive knowledge on maintaining muscle strength and physical performance as we grow older, providing invaluable insights into overcoming the challenges of aging.

One muscle often overlooked but vital for preventing falls and maintaining balance is the tibialis anterior. We’ll discuss the significance of strengthening this muscle and how tailored exercises can boost muscle strength and endurance in older adults. Justin also highlights the potential risks of overly accommodating environments that can hasten physical decline and underscores the benefits of an active lifestyle. Drawing lessons from communities known for their longevity, we touch on the importance of incorporating resistance training and cognitive challenges into daily routines to sustain muscle mass and overall function.

Ever heard of “movement snacks”? We’ll introduce this practical concept, perfect for those struggling to find time or motivation for traditional gym sessions. Justin offers creative ideas to seamlessly integrate resistance training into everyday activities, making fitness an achievable goal for everyone. Additionally, we emphasize the importance of varying exercise routines to keep engagement high and prevent monotony. From changing sets and repetitions to using different equipment, these minor adjustments can significantly enhance physical fitness. Join us for a holistic discussion on health and wellness, blending physical activity with mental well-being, and learn strategies to live a longer, healthier, and more independent life.

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Blog

Navigating Scoliosis: Understanding Your Options Beyond Surgery

The shock of discovering scoliosis can be very sudden.  Adolescent Idiopathic Scoliosis can feel like it comes on overnight, one day it isn’t there then the next day it is.  Or course it doesn’t happen like this but when parents notice it for the first time it seems like it does.   If you are like most people, you’ve gone home and googled it. And what do you read?

Most likely you start by reading the definition:

Scoliosis is a condition that causes the spine to curve to the side. It can affect any part of the spine, but the most common regions are the chest area (thoracic scoliosis) and the lower section of the back (lumbar scoliosis). Idiopathic scoliosis has no known cause.

That doesn’t tell you much, so you dig a little further and see something like this from the Mayo Clinic:

“If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side.

Problems with Appearance. — including unlevel shoulders, prominent ribs, uneven hips, and a shift of the waist and trunk to the side


“Complications can involve lung and heart damage, back problems.”

This doesn’t sound good…you don’t know if you or your child’s spine will get worse, get better, or just stay the same.

Your doctor will probably ask for some x-rays. Once they come back, they will measure the change in degrees of your spine from straight to bent, called the Cobb Angle and depending on how severe the curve is, they will give you three options:

  1. Wait and see what happens to the angle of the curve.
  2. Bracing
  3. Surgery

This is pretty typical of modern medicine. They have to draw a line in the sand somewhere, but it doesn’t take into account all the other types of therapy you could try. 

Viewing scoliosis simply as an unwanted curvature in the spine means it seems logical that correction is the only solution. For example, if I’m a surgeon trained to fix physical issues through surgery, how would I want to fix a curve? Most likely, I would recommend surgery.

A review of the history of surgery for scoliosis by Carol Hasler in the Journal of Children’s Orthopaedics (1) points out that when the methods used in scoliosis surgery are compared to other orthopedic surgeries such as hip and knee replacements, it is stigmatized by the medical world as ‘a rather archaic way of sacrificing function in young and otherwise healthy individuals.’ However, it’s come a long way from the way Galen and Hippocrates used to treat scoliosis.

In the 1950s, a surgeon named Paul Harrington pioneered a procedure that corrected the side bending of the spine by cutting people along the length of their back and inserting metal rods. It’s been estimated that between 1960 and 1990, about one million people had this surgery. However, it’s no longer used in the original format because it came with numerous problems. 

For example, the rods had a tendency to  break resulting in more operations.   Historically, surgeons didn’t consider the spine as a three-dimensional structure, meaning it moves forward and backward, side to side, and rotates both ways. This resulted in the areas on either end of the rod being overworked, wearing out, and developing arthritis.

Modern Surgical Techniques

During the 1970s and 80s, surgery was developed to work with the three-dimensional nature of the spine by using wires, hooks, screws, and rods. These procedures were refined during the 90s, but still, new surgeries were created due to the shortcomings of the wires, hooks, and rods.

More recently, surgeons offer osteotomies (removal of parts of the bone), vertebral body resection (removal of the vertebra), and most recently, vertebral tethering, in which a surgeon essentially takes some cord and tacks it between two vertebrae on the the long side of the curve. As the person grows, it creates tension and straightens the spine.

Some of these modern surgeries aim to preserve the ability of the spine to function or express movement in young people which is a huge leap forward from the rods. 

Before You Commit to Surgery

Don’t get me wrong, I’m not against surgery. But before we commit to a procedure from which there is no turning back at such a young age, we need to ask some pretty deep questions.

  • At what point do you need surgery, and what happens if you don’t have it?

Ask your doctor 

  • At what curve angle is surgery medically necessary due to heart or lung problems? 

You’ll be surprised by the answer.

  • Ask them what happens if you don’t have surgery?
  • Ask them what problems can be caused by the long term loss of motion in the spinal joints after surgery?

If you are not considering surgery then you should look into bracing and exercise.

Bracing has been shown to be effective(2) in halting curve progression and exercise can be used in combination with bracing or by itself to slow down, stop or reduce curves. Exercise, in some but not all cases,  is also a great way to reverse the curve. For example, Charlotte, at 12 years old, had a curve of 25 degrees, and in just 3 months reduced it by 10 degrees by following the Scoliosis Protocol.  

Scoliosis specific exercises can be done in water, with a kinesiologist, physiotherapist, osteopath or chiropractor. 

Depending on your age you may also want to consider dietary changes or supplements and more passive therapies like massage and foam rolling.  These can help the symptoms of scoliosis which are pain and fatigue and are more common in adults than teens. 

The takeaway here is that your doctor might not even mention other approaches and instead just focus on the angle of the curve and surgery, when specific exercises in adolescence and adulthood can slow down, stop or even reverse the progression of scoliosis.

If you would like to receive my FREE E-book on the 7 Secrets of Scoliosis join the Public Scoliosis Correction Protocol Group here and download it once you join: https://www.facebook.com/groups/351414238781617/

Sources:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566253/
  2. https://www.nejm.org/doi/full/10.1056/NEJMoa1307337