Build Muscle and Strength Over 40

Sarcopenia: Don’t Get Wasted!

By Joseph A. Miller, DC, MSCN, MA

Sarcopenia (sar-co-peen-ya). Even the sound of that word is frightening. And rightly so because if you’re over 40, nothing poses a greater risk to the muscle, strength and power you’ve developed than this. Sarcopenia is the unintentional loss of muscle, strength, power and function with aging. Although not a disease in the classic sense, sarcopenia can have a devastating effect on your health. It’s been linked to serious medical conditions including diabetes, cardiovascular disease, obesity, osteoporosis and arthritis. It increases the risk of falls, fractures, hospitalizations, loss of independence and in some instances may even result in premature death.

Because it’s a subtle atrophying process, sarcopenia is rarely detected early in life. Consequently it can cause appreciable loss of muscle mass, strength and power before you’re aware of it. Skeletal muscle loss, the hallmark of the condition, may begin as early as age 30 and if unchecked can result in a 40 percent loss of muscle by the sixth decade. Sarcopenia may also cause strength and power to decline by 2 to 3 percent per year during midlife.

Although sarcopenia is commonly associated with frail, elderly senior citizens it can negatively effect workout warriors in their 40s and 50s, just as significantly stripping them of their lean muscle mass, strength and power and leaving them less than they were.

If you’re a dedicated trainer and over 40, sarcopenia does not have to mean “game over.” With a sound training program, targeted nutrition and cutting-edge supplementation you may be able to prevent, slow or even reverse the muscle, strength and power losses associated with it.

Research has shown middle-aged and older trainers cannot eat, train or even supplement the way a 30-year-old does and expect to get results. In fact, doing so is likely to nullify progress, lead to injuries and open the door for sarcopenia. Fortunately, researchers have identified interventions that may be employed to maximize the training response during midlife, giving the 40, 50 and even 60-year-old their best shot at avoiding or mitigating the effects of sarcopenia.

Stages of Sarcopenia

The stages of sarcopenia have been described as follows:

Stage 1: Pre-Sarcopenia

Subtle loss of lean muscle mass but no loss of strength or function.

Stage 2: Sarcopenia

Measurable loss of muscle mass, strength and power OR functional loss (balance, agility).

Stage 3: Severe Sarcopenia

Extreme loss of muscle mass, strength, power AND functional loss.

With a well-conceived plan, sarcopenia can be overturned in all three stages. But the best shot at nullifying it occurs when it’s confronted during the initial stages before it’s had an opportunity to become entrenched. Studies do show even the individual in stage three can make headway against sarcopenia. But their response may not be as great, which is all the more reason to take a stand against sarcopenia during the early stages.

Causes of Sarcopenia

The following have been identified as potential causes of sarcopenia:

Anabolic Resistance. Many believe anabolic resistance is THE core issue of sarcopenia. Anabolic resistance (AR) is the suppression of muscle protein synthesis (MPS) to conventional stimuli such as essential amino acids, protein, insulin and contractile exercise. MPS is essential for the development AND retention of lean muscle mass, strength and power in anyone who trains, especially people over 40.

In young adults, a single bout of resistance training can ramp up MPS for several hours, setting the stage for gains in muscle hypertrophy, strength and function. However, in middle age, MPS may be diminished by 40 percent, making it difficult to preserve muscle and strength – much less add to it.

In a cruel twist of physiology, AR raises the threshold needed to trigger MPS as we age, making the benefits of training more difficult to secure. This may explain why, in your 40s, you’re not getting the results you once were, even though you’re doing the things that worked for you in the past. If you’re over 40 and feel like your body is fighting you, this may be where the battle is taking place.

Protein Consumption. Another common cause of sarcopenia for venerable trainers is poor protein management. If you are over 40 and training aggressively, you’re probably supplementing with protein. But are you getting the optimal amount, timing it correctly and consuming the right type? These are boxes that must be checked if you want to keep muscle erosion and sarcopenia at bay.

Unquestionably, protein is a potent activator of MPS, paving the way for strength, power and muscle mass gains in young people. But the response to the anabolic qualities of protein is reduced with age. Consequently, you may need more protein as you age, to optimize the muscle adaptation response,  especially if you’re still working out with intensity.

The Recommended Daily Allowance (RDA) of protein for middle aged and older individuals is 0.8 grams/kg/bodyweight. Research, however, suggests mature-aged individuals may need at least 1.0-1.2 grams/kg/bodyweight per day to ward off sarcopenia. And older individuals dedicated to their workouts may need up to 1.5 grams/kg/bodyweight of protein per day or nearly two times the RDA.

Two other issues of protein use the mature trainer needs to be smart about is the amount consumed at each “feeding opportunity” (meal, supplementation) and the timing of it. Studies with the young show MPS, the mechanism needed to trigger muscle change, maxes out with as little as 20 grams of protein. However, research with older adults shows maximum MPS only occurs when 35-40 grams of protein is consumed. In other words, the over-40 trainer needs a much larger dose of protein to optimize the lean muscle mass, strength and power gains they’re pursuing.

The timing of protein is another situation where the needs of young people and older trainers differ. It’s well established that youthful trainers may dramatically benefit by consuming protein in the immediate period after training. This is the well-known “window of opportunity” scientists tell us we can take advantage of to push muscle gains forward.

Unfortunately, the “window of opportunity” is not universal. As studies show, individuals over 40 don’t experience the bump in MPS with an infusion of protein immediately after training that their younger counterparts do. Which makes the consumption of a large dose of protein immediately after exercise of questionable value if you are over 40. Studies with mature, aged trainers show that “spreading” protein intake throughout the day every two to three hours keeps MPS elevated and is more supportive to the positive changes one is seeking at the muscle level.

The last issue standing between optimal protein use with aging is the type of protein you’re consuming. Protein effectiveness is driven by its digestion and absorption kinetics. In young trainers, studies show casein, a slow-digesting protein, may stimulate more lean muscle mass development. But in older individuals whose digestion may be diminished, whey protein may produce more MPS and better skeletal muscle mass gain. Making whey a better fit for the aging trainer.

Leucine

No discussion about tempering sarcopenia would be complete without discussing the essential amino acid leucine. Adequate dietary protein is vital to overcoming anabolic resistance and maintaining muscle mass, strength and function as we age, however LEUCINE is THE master regulator of MPS – making it indispensable for overcoming sarcopenia.

Leucine is a versatile nutrient that provides a number of different benefits. It can be added to protein drinks to stimulate MPS to an optimal level. It may be consumed between meals to ensure MPS stays elevated. It has been found to be helpful with recovery, particularly in older individuals who find they don’t bounce back as they once did. By replicating protein’s role of stimulating the mTor pathway, it provides another, lower caloric option for stimulating hypertrophy. There’s also evidence it may enhance explosive ability. A study of trained cyclists found power and sprint performance significantly improved after a trial of leucine supplementation.

Given leucine’s crucial roles, it’s vital for the 40 and over trainer seeking to optimize their results and mitigate the effects of sarcopenia. How much leucine do you need to reap its benefits? Between 2.8 and 3.5 grams per serving. In a study by Katasano, a protein drink consisting of 15 grams of whey and 2.8 grams of leucine increased MPS in older adults, while a lesser content of leucine didn’t.  Another study found that optimal stimulation occurs at 3.5 grams.

A number of amino acids contribute to protein synthesis, but the predominate role in stimulating that process is leucine. The essential role leucine plays in helping  to fend off sarcopenia with aging cannot be overemphasized. And with optimal protein use, it forms the backbone of an effective sarcopenia strategy.

Vitamin D

Vitamin D also plays a crucial role in managing sarcopenia. Studies show older individuals with low levels of vitamin D are twice as likely to experience the impairments associated with sarcopenia. Research also shows the loss of lean muscle mass and strength and vitamin D deficiency to be correlated. Inadequate levels of vitamin D also reduce the ability of type 2 muscle fibers to perform.  When we’re youthful, type 2 fibers allow us to bang out max bench presses. As we age, they make it possible to train with enough intensity to retain, if not all, at least a reasonable portion of the muscle, strength and function we’ve built. Unfortunately, sarcopenia targets type 2 muscle fibers as studies show they may be diminished by 50 percent with aging.

Clearly, vitamin D is another ally in the battle against sarcopenia. In conjunction with leucine, it may dramatically increase MPS, assist in overcoming anabolic resistance and help keep type 2 muscle fibers healthier and more functional with aging.

Resistance Training

In conjunction with an optimal nutrition approach WEIGHT TRAINING is THE GOLD STANDARD for preserving skeletal muscle mass, strength and power as you age. By sensitizing skeletal muscle to the anabolic properties of amino acids and elevating MPS, resistance training provides those over 40 with a legitimate vehicle to ameliorate sarcopenia. So if you’re over 40 and consistently weight training, continue to do so. You’re on the right track. And if you’re not and are physically capable of doing so, I’d advise you to start, as resistance training is essential for opposing sarcopenia.

So if you’re no longer a kid and you can’t lift heavy iron as you once did, how should you go about it? In a study assessing the intensity and load of exercise needed to trigger MPS with aging trainers, the following was established:

• Resistance training performed at 20 percent to 40 percent of one’s one-repetition maximum (1RM) produced only a small, insignificant increase in MPS.

• Resistance training performed at 60 percent of one’s 1RM significantly increased MPS.

• Resistance training performed at 90 percent of one’s 1RM increased MPS nearly identically as the 60 percent intensity.

The results of this study is welcome news for more mature trainers because it means you don’t have to lift the heaviest weights to stimulate positive responses in muscle physiology. You can get what you need from weight-training sessions without overextending yourself, risking injury or putting your health and well-being at risk.

Sarcopenia Protocol

If you’re over 40 and wishing to prevent, minimize or even reverse the backsliding effects of sarcopenia, here are guidelines you may want to follow:

*Nutrition

• 1.0-1.5 grams/kg/bodyweight of protein per day

• 25-40 grams of high-quality protein per feeding opportunity (meal; supplementation)

• 2.5-3.5 grams of leucine, 1-2 times per day

• 800 IU of vitamin D3 per day

*Resistance Training

Frequency: 3 times per week

Intensity: 60% of 1RM (one-repetition maximum)

Load: 10-15 reps per set

Sets: 2-3 per exercise depending on your conditioning level

Warm up well with at least one set at a lighter load.

Perform one exercise for each muscle group (chest, back, shoulders, arms, legs).

*Prior to making dietary changes or engaging in a new resistance-training program please discuss this with your physician.

Conclusion

Sarcopenia is the unintentional loss of muscle, strength, power and function. It’s a major clinical problem for older adults, as it’s closely associated with health consequences including obesity, cardiovascular disease, diabetes, osteoporosis and arthritis. And it’s an important predictor of morbidity and mortality in middle-aged and older adults.

Physiologically, sarcopenia is marked by a muted response to anabolic stimuli and changes at the muscle level that may lead to unchecked loses of muscle mass, strength, power and function as you age. Happily, there’s evidence demonstrating that sarcopenia can be slowed, mitigated and in some instances even reversed with a solid resistance-training program, optimal nutrition and smart supplementation. So if you’re over 40 and you are not training or managing your nutrition and supplementation in a way that may act as an antidote to sarcopenia, I encourage you to start. You can stop the waste. Game on!

Dr. Joseph A. Miller is a mature trainer dedicated to fighting off sarcopenia. He has been a health care provider and leader in the fitness, exercise and human performance fields for over 30 years. As president and CEO of Finger Lakes Progressive Nutrition, Dr. Miller has been sought out by exercise enthusiasts and competitive athletes seeking optimal results and health and wellness outcomes. By combining his experience with an education that includes masters degrees in clinical nutrition and exercise science and a doctorate degree in chiropractic care, Dr. Miller has helped countless people maximize their performance, manage their weight more effectively and improve their health so they may feel and be the best they can be. Dr. Miller welcomes your questions and comments. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.

References:

Breen L (2011). Skeletal muscle protein metabolism in elderly and intervention to counteract the anabolic resistance of aging. Nutrition and Metabolism, 8;68.

Cramer J (2016). Impact of high protein oral nutritional supplement among malnourished men and women with sarcopenia. Journal of American Medical Diretors Association, Vol. 17, 11, Nov. 1044-1055.

Denison H (2015). Prevention and optimal management of sarcopenia. A review of combined exercise and nutritional interventions to improve muscle outcomes in older people. Clinical Interventions in Aging, 10: 859-869.

Dreyer H (2005). Role of protein and amino acids in the patho-physiology and treatment of sarcopenia. Journal of American College of Nutrition, Vol. 24 No.2; 140-145.

Katsanos CS (2006). A high proportion of leucine is required for optimal stimulation of muscle protein synthesis. Endocrinology Metabolism, 291: 381-387.

Kumar V (2009). Age-related differences in dose response relationship of muscle protein synthesis to resistance exercise in young and old men. Journal of Physiology, 587: 211-217.

Landi F (2016). Protein intake and muscle health in old age. Nutrients, 8: 295-304.

Lexall J (1998). What is the cause of aging atrophy. Neurological Science, 84 (2-3) 275-294.

Lolascon G (2014). Physical exercise and sarcopenia in older people. Clinical Cases in Mineral and Bone Metabolism, Sept-Dec. 11(3): 215-221.

Robinson SM (2018). Does nutrition play a role in preventing and managing sarcopenia. Clinical Nutrition, 37: 1121-1132.

Verlaan S (2018). The Provide Study. Clinical Nutrition, 37; 2, 551-557.

Viser M (2003). Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and mass in sarcopenia. Journal of Clinical Endocrinology Metabolism, 88: 5766-5672.

Wilkinson DJ (2017). Effects of leucine enriched essential amino acids and whey protein bolus dosing on skeletal muscle protein synthesis.  Clinical Nutrition 36: 1-11.

Wilkinson DJ (2018). The age-related loss of skeletal muscle mass and function of muscle fiber atrophy and loss in humans. Aging Research Review, Nov. 47:123-132.

DISCUSS ON OUR FORUMS
SUBSCRIBE TO MD TODAY
GET OFFICIAL MD STUFF
VISIT OUR STORE  

ALSO MAKE SURE FOLLOW US ON:

FACEBOOK
TWITTER
INSTAGRAM 
YOUTUBE