Sarcopenia
Sarcopenia gets its name from the Greek words “sarx” meaning flesh and “penia” meaning poverty.
So Sarcopenia is the poverty of the flesh.
Sagging skin, wrinkles, poor posture and sunken ribs are due to sarcopenia.
Sarcopenia is actually the degenerative loss of skeletal muscle mass that occurs during aging and the corresponding increase in fat cells. It is similar to osteoporosis which is the gradual loss of bone.
Muscle loss is associated with reduced muscle strength and coordination that increases the risk of frailty and falls. Together with osteoporosis, sarcopenia is a major health problem for elderly people but one that does have treatments which I will outline later.
First, let’s look at Sarcopenia in more detail.
Causes of Sarcopenia
1. Aging process
The fibres that make up our muscles can be divided simply into slow twitch and fast twitch fibres. Slow twitch muscle fibres are used for aerobic activities like walking and running. Fast twitch muscle fibres are used for lifting, posture and other anaerobic activities. They are also the first to die and evidence suggests this process starts for all of us at about age 30.
2. Physical inactivity
Together with aging, inactivity is the main accelerator of sarcopenia. That is because without use, those fast twitch muscle fibres die faster.
Even active people of normal weight could be suffering from sarcopenia as they lose the fast twitch muscle fibres they haven’t been using.
The following chart shows the rates of muscle loss in inactive people.
Prevalence of Sarcopenia
Ages Percentage lost Women Men
Age 25-60 .5% per year
Age 60-70 1% per year 23% 13%
Age 70-80 2% per year 35% 25%
Age 80-90 4% per year 43% 52%
Age 90+ 8% per year
3. Decreased hormone production – testosterone and HGH
Testosterone and Human growth hormone levels fall as we age and these effect the ability of our bodies to synthesise protein.
4. Decreased protein synthesis
Decreased proteins means our muscles are actually starved (remember the Greek meaning of sarcopenia being “poverty of the flesh”).
Lack of adequate protein accelerates the death of muscle cells.
5. Decreased female oestrogen levels post menopause may be a factor.
Process of Sarcopenia.
Muscle cells die and are replaced by fat cells which swell. In fact it is actually quite possible to be obese and suffering from sarcopenia.
It is also possible for two people with the same BMI and thigh diameter but for one of them to have sarcopenia and the other not to. The one with sarcopenia would have a larger percentage of fat than the other and there are various tests that can be carried out to determine this.
What we can do to counteract the effects of Sarcopenia?
Bowen Therapy can help
Bowen Therapy rebalances the fascia that supports the muscles and that helps the muscles to receive the nutrients they need to function normally.
So it stands to reason that Bowen Therapy plays a part in preventing and reversing the effects of sarcopenia but it has best results when combined with activity.
Increase protein input
We need protein to build and maintain muscle mass. Protein comes from 2 sources. Essential proteins are absorbed from the foods we eat like meat, eggs and nuts. Synthesised proteins are produced in the body through the actions of hormones.
As we age our ability to absorb proteins from digestion reduces. Elderly people often lose their thirst and appetite reflexes which adds to this problem.
Hormone levels also drop as we age so our ability to synthesise proteins reduces. So we actually need more essential proteins to counteract that.
The process of sarcopenia speeds up if we starve ourselves of protein and this is often the case with the elderly but even middle-aged people can benefit from increasing their essential protein input.
Supplements
Research suggests hormone replacement therapy may help reduce the effects of sarcopenia but the benefits may be outweighed by the risks.
There are some supplements that may help and have fewer side effects.
These include:
Magnesium – the element well known for muscle health and function
Calcium – often prescribed with magnesium – also helps build bone
Fish oil – improves circulation, joint mobility and may help in the process of motor unit restructuring
Protein – we already talked about increasing essential proteins. Nuts, fish and tofu are all good sources of essential protein
Water – correct hydration is vital for muscle maintenance and muscle health. Alkaline water penetrates cells better so that would also be a recommendation.
The power of Resistance Training
Remember those fast and slow twitch muscle fibres?
Fast twitch fibres are like an agile tightrope walker. The neurones that power fast twitch fibres are fast and have great precision.
Slow twitch muscle fibres are more like a lumbering bull in a china shop. They have less speed but live longer than fast twitch muscle fibres and the neurones that power them have less precise innervation.
When we are actively using our muscles for anaerobic activities – such as weight lifting - our fast twitch muscle fibres are engaged so are less likely to die from lack of use. Unfortunately some still die due to aging but a process known as motor unit restructuring occurs that replaces them with slow twitch fibres. It’s similar to the recircuiting that occurs after a brain injury.
Slow twitch fibres are not as precise as fast twitch fibres so balance and speed are reduced slightly which is why older athletes can never compete with younger ones, but some strength is maintained.
Why resistance training?
Keeping aerobically fit such as walking, running or biking is important for health but does little to help stave off sarcopenia. That is because those activities only use the slow twitch muscle fibres.
We need resistance training to force the body (anaerobically) to maintain the connections with the fast twitch fibres (or carry our motor unit restructuring with slow twitch fibres) in order to maintain (or increase) muscle mass.
Studies have shown that even moderate resistance training of two 20-minute sessions per week can significantly increase muscle mass in elderly people.
Resistance training has also shown to have positive effects on other conditions like osteoporosis, osteoarthritis, coronary heart disease, diabetes and depression.
Types of resistance training
Weight training machines – these are the usual machines found in most gyms and should never be used without a qualified instructor advising clients on how to use them, how many reps and sets and what weights are appropriate.
Elastic bands – these are the large bands that can be used safely by most folk as each person can only use them to his or her ability.
Objects around the home – people can do simple resistance training with simple free weights or objects like soup cans. These also need to be demonstrated and you should never try to overtrain or lift weights that are too heavy. Elderly people can tear muscles or break a bone if they lift something too heavy.
Body weight – push-ups are the obvious example and there are many more that can be suggested. Once again, caution is needed in selecting and carrying out these exercises.
Why should we start resistance training?
One study of people aged 78-84 who went on a resistance-training program increased their protein synthesis by an average of 182%.
Another study showed elderly people who did resistance therapy for 45 minutes 3 times per week for 12 weeks had an increase in muscle mass and strength of over 30%.
It appears that resistance training can increase hormone concentrations, which in turn improves protein synthesis rates, motor neuron firing rates, muscle fibre growth and creates a more efficient motor unit. This all causes faster muscle contractions and greater force production.
It’s like your muscles are growing younger!
Suggested Exercises
Reps of 10-15 at a weight the client finds “somewhat hard” for all major muscle groups – pectorals, latissimus dorsi, deltoids, abdominals, gluteals, quadriceps and hamstrings.
A selection of multi-joint exercises is recommended as apposed to single-joint movements.
Allow the weights to increase progressively
Include a variety of moderate to intensive cycles within the exercise plan
Resistance training should be done two or three times per week and each session should be at least 48 hours apart – one session may be enough for maintenance.
Elderly people need to be taught correct lifting techniques and breathing – personal trainers can help
You should take on a minimum workload for the first 8 weeks to allow joint connective tissue to adjust to resistance training.
Workout sessions should be kept to 20-30 minutes for elderly clients.
Do not use any joints that are inflamed due to arthritis or other joint or bone disorders.
Seek medical advice if you have diabetes or dementia as resistance training could exacerbate their condition.
Conclusion
In the ideal world we would all take the supplements recommended to us by health professionals and attend gyms where suitably qualified instructors would guide us through carefully planned programs to maximise our fitness and muscle health. But ours is not an ideal world.
We each need to make the decisions that we are happy with regarding our future health and combating sarcopenia is one of those areas where a little preventative work can make a huge difference.
No comments:
Post a Comment