How to tame sarcopenia; the scourge of old age

    Old age is synonymous with fragility, weakness and disability. As we grow older, there is a gradual decline in body strength and metabolic functions. By age of 75, an individual literally functions at  25% of its capacity of young age.

    Sarcopenia is gradual loss of muscles with advancing age and one of the key reasons for fragility in old age. This phenomenal is considered a hallmark of ageing.  Actually muscle loss starts as early as thirty, but it accelerates after age of fifty with an annual loss of 2-3% of muscle mass. It occurs even among athletes and weight lifters who remain fit throughout their lives. The performance declines after forty and dropping to half by 80 years. Approximately by late sixties around 25% people will suffer from sarcopenia and by eighty this rate increases to 40%. 70% people living in nursing homes may suffer from sarcopenia.

What accelerates sarcopenia

     Inactivity or even drop in activity among elderly accelerate sarcopenia. Older adults lying in bed rest tend to loose muscle mass six times faster than younger  people. In younger adults the recovery is full, but elderly patients are likely to lose some independence in basic activities of daily life in the course of a single hospitalization.

How to counter Sarcopenia

    To counter sarcopenia we have two major weapons; diet and exercise. Sound application of these two can slow down or even reverse or correct sarcopenia.

Diet

    Sarcopenia is a result of chronic protein and micronutrient deficiency since adulthood. As such our food has become poorer in micronutrients. As per scientific data, there has been a gradual decline in quantity of micronutrients globally, thanks to our modern agricultural practices. High consumption of processed foods have aggravated this dietary deficiency.

   Our diet must be rich in proteins. Present guidelines of proteins and micronutrients are grossly inadequate to address the issue of sarcopenia. RDA for protein is 0.83 gm/kg body weight/day, which is ok for diseases prevention in adults, but cannot counter the effects of sarcopenia. At least 25-30 gm of protein must be ingested per meal. More the better. To know about proteins, you can read my article “Are you getting enough Proteins”

    Unfortunately, most of Indian adults do not even reach the 50% of the daily requirement of 80-90 gm per day. Average Indian diet is high in carbs and low in proteins. This protein deficiency accumulates over time resulting in aggravating sarcopenia effects. Our medical setup has also contributed to protein deficiency. Experts discourage intake of foods like milk, eggs and meat with the erroneous belief that these foods, high in saturated fats,  will increase cholesterol and subsequent heart attacks. Discarding egg yellow makes an egg an incomplete protein. Better not to eat the egg, if you believe in this practice. Egg with the yolk is a complete food. Large number of Indians, specially Indian women avoid eggs and meat for religious reasons. No doubt, women suffer more from sarcopenia, due to their inadequate protein intake and longer lifespan than males.

    Second important consideration is micronutrients ie vitamins and minerals. The RDAs are minimal amounts to prevent the clinical diseases and cannot satisfy the old age requirements. Our intake of micronutrients should be at least 5-10 times than the RDAs for optimal health. An elderly must take 25000 IU of vit A, 250-500 mg of vit C, 10,000 IU of vitamin D/week, and B complex group vitamins at least 5-10 times of RDA. When you check multivitamins tab, please check whether it contains all vitamins in adequate dosages. Most of nutraceuticals advertised as supplements do not even satisfy the RDA. 

    Third important arsenal to combat sarcopenia is exercise. Walking, a popular form of exercise among elderly, cannot counter the affects of sarcopenia. In walking, Type 2 muscle fibers are activated which are least affected by sarcopenia. Sarcopenia mainly affects Type 1 muscles fibers which are required for strength related activities eg getting up, lifting loads and other weight bearing activities. Due to sarcopenia, capacity to perform these activity suffer grossly resulting in fragility. 

  Regular exercise is a must to prevent or tackle sarcopenia. Elders must do those exercises, which put pressure on joints and muscles. Balancing exercises like one leg stand, toe stand etc must be done. Weight training is essential for sarcopenia control. Push ups, crunches, squats etc are good exercises. These exercises should form a part of daily routine. One should start gradually and increase exercise intensity and duration with increase in body strength.

    There are thousands of videos dealing with exercises in the YouTube. One can see them and select few exercises. You may consult me also through poshanshiksha@gmail.com

    For those who want to make their old age healthy and disability free, Poshan Shiksha is the destination. You may subscribe to Premium Poshan Shiksha WhatsApp group and join the community of the people, who want to remain healthy till end stage of their life & and not burden their children to look after them in old age. Premium Poshan Shiksa is a paid group with annual fee of Rs 300/- only. By joining the group you will have free access to all webinars, courses and live sessions. If you are interested to join you can fill the google form and submit. 

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