What is Sarcopenia?
Natural muscle loss is very common as we get older. On average, adults lose 3% of their muscle strength every year, which can begin as early as the age of 30. Continuous inactivity over the years can lead to a condition called sarcopenia, the age-related loss of muscle mass, strength, and function.1 Approximately 10% of the population over 50 years old are affected by sarcopenia.
Causes of Sarcopenia:
- Decline in hormones
- Increased inflammation
- Inactivity
- Poor nutrition
These factors are commonly correlated with obesity, diabetes, and low levels of vitamin D. The most common factors that contribute to the loss of muscle mass include an inactive lifestyle (immobile/ sedentary), unbalanced diet, inflammation from chronic or long-term illnesses, and stress.2
How Sarcopenia Impacts Dialysis Patients:
Ability to perform routine activities and live independently
Although it sounds simple, in order to perform the routine activities of daily living (personal hygiene, ability to use the bathroom, dressing, feeding, ambulating etc.), you need strength. Prevention of the onset of sarcopenia amongst older adults is extremely important for healthy aging, and ultimately reduces the need for long-term care.
Overall survival
Sarcopenia is commonly associated with frailty, thus leading to greater risk of falls in the elderly population and higher risk for disability and mortality.3
Lifestyle Changes to Highlight for Seniors:
- Turning daily routine activities into strength building activities! Strength training can include: cleaning the house, carrying groceries, playing with the kids, taking the stairs, parking further away during errands, gardening etc.
- Performing light aerobic and strength training exercises 3 days/week. Combine aerobic activity (walking, jogging, biking, swimming) with strength training (i.e. push-ups, pull-ups, sit-ups, lifting weights and using resistance bands) a few days a week to keep your muscles active.2 Bonus! Not only does exercise help with cardiovascular health, but it can also help reduce stress and improve sleep.
- Ensuring a diet that includes these 3 nutrients: protein, vitamin D, and omega-3 fatty acids.
The Building Blocks of Muscle Growth:
Protein: In order to account for changes in older adult’s metabolism and frailty status, it has been suggested to increase protein intake to 1.2 to 1.6 g/kg/day.4 Simple ways to meet your protein needs include having protein at each meal of the day, and eating your protein food first before filling up on anything else.
Grocery list: Eggs, peanut butter, cottage cheese, greek yogurt, nuts, tuna, chicken or other animal protein choice. Plant protein sources include: tofu, lentils, quinoa, chickpeas, nutritional yeast, and edamame.
Protein supplementation: Especially for older adults, appetite loss, poor dentition and digestive and metabolic changes make it difficult to achieve the recommended protein intake with regular meals alone. Utilizing a high-quality protein supplement that contains all of the essential amino acids often helps to bridge the gap in a person’s ability to consume enough protein. It is important to consume a protein drink that is palatable, as well as easy to digest and absorb.
Protein sources: Whey/ casein (milk proteins), collagen protein, egg protein, soy protein and rice/pea protein.1 Whey protein contains high levels of leucine, which plays an important role in muscle protein synthesis. As we age, our bodies produce less natural collagen, which promotes the synthesis of muscle protein like creatine, and stimulates muscle growth and repair after exercise.
If you are looking for a protein resource to share with your patients, our dietitians created a free printable protein guide that explains the role of protein in the body and effective ways for patients to get more of it in their diets.
Vitamin D: A key factor in the prevention of sarcopenia, Vitamin D is fat-soluble vitamin that aids in the absorption of calcium in the gut, assists with bone formation, reduces inflammation, helps with immune cell growth, and helps maintain and improve muscle strength, function and physical performance in older adults.5 Ultimately, Vitamin D is a key factor in the prevention of sarcopenia.
Omega-3 fatty acids: Research suggests that Omega 3 may help with muscle growth and increased muscular strength. This is likely due to the anti-inflammatory benefits and its ability to signal muscle growth directly.2
Grocery list: Nuts and seeds (flaxseed, chia seeds, walnuts, peanut nutter), dairy and juices fortified with omega-3’s (eggs, margarine, milk, juice, soy milk, yogurt), breads and pastas that contain omega-3’s (cereal, oatmeal, flour tortillas), fresh produce with alpha-linolenic acid omega-3s such as brussel sprouts, kale, spinach, broccoli, cauliflower. Omega-3 supplements such as fish oil, krill oil, cod liver oil and algal oil may be appropriate if unable to get enough omega-3’s through diet alone.
References:
1. Wellman, Nancy S & Kamp, Barbara J. Nutrition in Aging. In: Mahan & Stump, ed Krause’s Food & Nutrition Therapy. 12th edition. St Lois, MO. Saunders Elsevier. 2008: 286-291
2. How to Fight Sarcopenia (Muscle Loss Due to Aging). Healthline Media Website. Accessed January 5, 2021. Updated 2020. https://www.healthline.com/nutrition/sarcopenia
3. Santilli V, Bernetti A, Mangone M, Paoloni M. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab. 2014;11(3):177-180.
4. Oikawa, S. Y., MSc, & Torres-Gonzalez, M., PhD. (2020, January). The Impact of Protein Quality on Muscle Recovery. Retrieved January 08, 2021, from https://www.todaysgeriatricmedicine.com/archive/JF20p14.shtml
5. Remelli F, Vitali A, Zurlo A, Volpato S. Vitamin D Deficiency and Sarcopenia in Older Persons. Nutrients. 2019;11(12):2861. Published 2019 Nov 21. doi:10.3390/nu11122861
6. Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care. 2004;7(4):405-410. doi:10.1097/01.mco.0000134362.76653.b2