Maintain Muscle to Maintain Health
From about 25 years of age we begin to lose muscle mass. We may lose up to 40% of muscle mass between our 20s and our 80s. This gradual loss of muscle mass, muscle strength and physical performance as we age is known as sarcopenia. Lower levels of testosterone, progesterone and oestrogen, increasing insulin resistance and higher levels of inflammation all contribute to the loss of muscle as we age. This muscle loss speeds up once we are in our 60s when it is often accompanied by fat gain.
There is a growing recognition of the importance of both muscle strength and muscle mass relative to body size in contributing to functional decline and overall health. Sarcopenia, especially if combined with fat gain, is associated with a wide range of chronic health conditions including heart disease, diabetes, dementia, osteoporosis and frailty. Staving off frailty is important if we want to live independently into old age. The prevalence of sarcopenia increases with age and leads to high personal, social, and economic costs.
The good news is that muscle loss, and its associated health problems, can be slowed through diet and lifestyle measures.
The Importance of Diet for Muscle Mass
Finding nutritional measures to maintain muscle health, preserve function, and independence for the growing population of older adults has important scientific and societal implications. Here are a few findings:
Physical activity – muscle loss is accelerated by inactivity. Physical activity is vital for keeping muscles strong. Jogging, walking, cycling, dancing, skipping, aerobics and rebounding are all recommended.
Resistance exercise – helps keep muscles strong. Good options include lifting weights, using elastic resistance bands and exercises that use your own body weight such as planks and press ups.
Protein – eating sufficient protein is vital for building and maintaining muscle. Good sources of protein include lean meat, fish, eggs, beans, peas, lentils, nuts, seeds, tofu, tempeh and green vegetables. Aim for 25-40g of protein with each meal. Protein supplementation may improve functional and/or strength outcomes (1).
Protein supplementation combined with exercise – protein supplementation combined with muscle strengthening exercises or resistance training leads to significant improvements in whole-body lean mass, leg strength, and walking capability in elderly patients (1,2,3).
The Mediterranean Diet
Following the Mediterranean diet and higher consumption of fruits and vegetables have been associated with improved physical performance and protection against muscle wasting, sarcopenia, and frailty (4,5,6).
The Mediterranean Diet includes 3-9 servings of vegetables a day, 1 or 2 servings of fruit a day along with plenty of whole grains and olive oil (7). Protein comes from nuts, seeds, pulses and fish.
A Japanese study found that a dietary pattern characterised by high intakes of fish, soybean products such as tofu, tempeh and miso, potatoes, most vegetables, mushrooms, seaweeds, and fruits and low rice intake was inversely associated with sarcopenia in older people (8).
As well as certain dietary patterns aiding muscle maintenance, some nutrients also offer protective effects against declines in strength and function associated with ageing. Here are a few suggestions:
Vitamin D – may have a protective effect against sarcopenia (4).
Minerals – several minerals may be important in the prevention and treatment of sarcopenia, particularly, magnesium, selenium, and calcium. Additionally iron and zinc may improve physical performance in older adults (4,9).
Omega-3 fatty acids – supplementing with more than 2 g/day of fish oils may contribute to muscle mass gain and improved walking speed, especially if taken for more than 6 months (10).
Creatine – has anabolic and anti-catabolic functions, and enhances muscle regeneration (11).
1. Curr Protein Pept Sci. 2018;19(7):649-667. Nutrition and Exercise in Sarcopenia. Anton SD et al.
2. 2019 Jul 25;11(8):1713. The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials. Chun-De Liao et al.
3. Am J Clin Nutr. 2017 Oct;106(4):1078-1091. Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: a systematic review and meta-analysis. Chun-De Liao et al.
4. 2020 Jun 11;12(6):1755. Nutrition and Sarcopenia-What Do We Know? Ganapathy A et al.
5. 2019 Mar 30;11(4):745. Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults. Granic A et al.
6. 2020 Jul 28;12(8):2257. Myoprotective Whole Foods, Muscle Health and Sarcopenia: A Systematic Review of Observational and Intervention Studies in Older Adults. Granic A et al
7. 2015 Nov 5;7(11):9139-53. Definition of the Mediterranean Diet; a Literature Review. Davis C et al.
8. Nutr J. 2021 Jan 18;20(1):7. Association of nutrient-derived dietary patterns with sarcopenia and its components in community-dwelling older Japanese: a cross-sectional study. Yokoyama Y.
9. J Am Med Dir Assoc. 2018 Jan;19(1):6-11.e3. Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review. Van Dronkelaar C et al.
10. 2020 Dec 4;12(12):3739. Effects of Omega-3 Fatty Acids on Muscle Mass, Muscle Strength and Muscle Performance among the Elderly: A Meta-Analysis. Ya-Hui Huang et al.
11. 2019 Oct 23;9(11):642. Muscular Atrophy and Sarcopenia in the Elderly: Is There a Role for Creatine Supplementation? Dolan E et al.