Bones! Sarcopenia and Osteoporosis

I am excited to share on this topic of Sarcopenia and Osteoporosis. Sarcopenia affects many millions of elderly people each year, but by combating it with good diet, exercise, and lifestyle habits, you can maintain confidence and strength. It is a syndrome that actually affects 50 million people in the world today, and more than 50 percent of people over 80. Sarcopenia is the term used for age-related loss of our skeletal muscle mass. As we age, the major muscles in our body gradually become smaller and less powerful. Over time, this reduced muscle strength can lead to other serious health issues. Women in particular are vulnerable to this condition due to fluctuating and declining hormone levels. We also generally have a lower proportion of type II (i.e. fast power-producing) muscle fibers than men (though we typically have a greater proportion of type I endurance fibers). So including some form of weight resistance training into your routine to build and maintain as much strength, power, and force is important. We start losing muscle around age 40 (maybe even earlier). That loss, especially of those powerful type II fibers becomes more pronounced during the menopause transition, as hormonal changes accelerate the loss of lean muscle mass independent of aging. Without intervention, you can lose up to 50 percent of your lean skeletal muscle mass by your 80th birthday. Although worrisome, good news is that there are things we can do now to help prevent sarcopenia from developing later on in our lives, and even reverse it if we are already seeing its effects. Research shows that resistance training is just as, if not more effective than aerobic exercise at reducing the risk for chronic diseases like type 2 diabetes, cardiovascular disease, and cancer, as well as general disability. As we get older and hit the menopause transition where our growth hormone production decreases and declining estrogen causes us to lose a signal for myosin, which is a muscle fiber that helps us generate strong contractions, performing heavy strength training can boost our growth hormone and anabolic signaling and help stimulate myosin to keep our contractions strong. The Two Types of Sarcopenia Sarcopenia is actually classified into two types: primary and secondary. Primary sarcopenia is the normal loss of muscle mass that happens as we age; it happens whether we want it to or not. As we approach middle age, we start to lose around 3 percent of our muscle mass per year, unless we take steps to counteract it (see below). Secondary sarcopenia occurs when there are other co-morbidities present. This kind of sarcopenia isn’t just losing some of the strength that we had when we were young. It’s the drastic loss of muscle mass and strength that, combined with other health issues, can severely limit our mobility and keep us from performing routine tasks. It’s this latter type of the disease that is more worrisome because it is more prevalent, more dangerous to our overall health and well-being, and requires more attention to treat. Muscle Loss and Poor Diet Poor diet can have a major effect on developing sarcopenia. In his book Clinical Nutrition and Ageing: Sarcopenia and Muscle Metabolism, Chad Cox, Ph.D., talks about the link between diet and muscle loss. He writes, “Regrettably, poor diet is one of the most common problems practitioners encounter when treating older adults. Many individuals in this population have low nutrient intakes, for a variety of reasons." Women in particular perform best in a fuelled state, this means eating carbohydrates. Sadly, due to the diet craze and misinformation, women experiment with all types of unhealthy eating strategies. Carbs are the preferred fuel source for our brain; they’re necessary to fuel high intensity efforts, and they improve exercise performance for any efforts lasting longer than 45 minutes. When our brain perceives that we’re not getting enough nutrition, especially carbohydrate, we have a marked reduction in the production of kisspeptin, a neuropeptide that’s responsible for sex hormones and endocrine and reproductive function, which also plays a significant role in maintaining healthy glucose levels, appetite regulation, and body composition. Less kisspeptin stimulation can increase our appetite and reduce our sensitivity to insulin. So think about including some complex carbohydrates into your diet. Things you can do to support your muscle and bone health:

1. Incorporate resistance training (RT) into your workout regimen. Resistance exercise in particular has been shown to be effective at slowing age-related muscle loss. RT puts stress on your muscles; your body responds by telling those muscles to grow bigger and stronger, which, of course, is the exact opposite of what sarcopenia does. That’s why RT is one of the best ways to counteract age-related muscle loss.

2. Osteoporosis. When we look at Osteoporosis and consider that nearly 20 percent of U.S. women 50 years and older have osteoporosis of the femur, neck, or lumbar spine, including RT is super important. Weight training helps build and preserve that bone, no matter what your age. Research on premenopausal women shows that even just six months of heavy resistance training improves bone mineral density of the femoral neck and lumbar vertebrae. Strength training also helps maintain bone mineral density in postmenopausal women and increase bone mineral density of the spine and hip in women with low bone mineral density and osteoporosis. A study where postmenopausal women did back strengthening exercises for two years showed that their risk for spinal compression fractures was 2.7 times lower than their peers who did no back strengthening exercise. And a study of high intensity resistance and impact (like plyometric) training improved markers of bone strength in postmenopausal women with low to very low bone mass with no adverse affects.

3. Go on walks. Walking is absolutely the most underrated form of movement ever. Walking studies have shown that people who walk regularly are less likely to develop sarcopenia—not to mention have a better overall quality of life.

4. Eat more protein. Protein is the building block of muscle tissue, and if you’re losing muscle mass, that can indicate you’re not getting enough protein in your diet. Pasture-raised and grass-fed meat is the obvious way to increase protein consumption, but there are plenty of other protein-rich foods too: nuts, seeds, beans, eggs, and tofu, just to name a few.

5. Make sure you’re getting plenty of antioxidants in your diet - complex carbohydrates. Antioxidants help reduce the number of free radicals in your body, which reduces inflammation and prevents oxidative stress, both of which can lower your chances of developing sarcopenia. Be sure to eat plenty of foods high in antioxidants and especially carotenoids (like spinach, carrots, and bell peppers) and flavonoids (blackberries, kale, and citrus fruits, for example).

6. Get outside in the sun! Your body needs vitamin D for maintaining bone density and absorbing calcium. But it also plays an important metabolic role in muscle health, and increased vitamin D has been linked to increases in muscle mass. It’s even anti-inflammatory. The great news here is that the absolute best way to increase your vitamin D intake is to get outside and enjoy the sun for 20 minutes in the early mornings or late afternoons.

Lastly, Resistance training is also good for your mental health. A meta-analysis that included more than 1,800 participants found that resistance training significantly reduced depression symptoms in women and men. In a Harvard study of older adults ages 60 to 84 with depression, 10 weeks of resistance training worked as an effective antidepressant. The more intensely they trained, the better they felt.