Throwing Our Weight at Sarcopenia

    Throwing Our Weight at Sarcopenia

    Diminishing muscle mass muscle mass comes with age, but let’s not take that sitting down.

    Preventing Sarcopenia

    Doc, I’m losing weight.

    Not that I was gravely concerned. I felt good, my numbers were good, and I had plenty of energy and stamina.

    But still, I’d come to realize that I weighed seven or eight pounds less than my adult average. My clothes were hanging loosely. I thought my arms and legs looked a tad scrawnier. My wife and friends commented: Are you losing weight?

    Not intentionally. I hadn’t altered my eating or exercise habits. Nonetheless, I promised my worried beloved that I’d ask my doctor about the weight loss in the course of my annual physical.

    The doc asked me if I’d heard of sarcopenia. Well, kinda. It’s why some old geezers look so weak and their muscles appear withered. It’s an affliction of the elderly. Right?

    True. Sort of. Thomas Storer, director of the Exercise Physiology Laboratory at Harvard-affiliated Brigham and Women’s Hospital in Boston, defines sarcopenia as “the aging-related loss of lean muscle mass, which is often accompanied by an increase in fat mass and increasing loss of function.” (I’d seen Storer quoted in a Harvard health newsletter, and tracked him down for an interview, from which he is quoted below.)

    So is sarcopenia exclusively a geriatric concern? Nope. “It starts earlier in life than we’d like to accept,” Storer said. “As some of my colleagues say, ‘It’s all downhill after 25.’” In other words, it comes on slowly, and is easy to ignore—for a while. For years, in fact. We naturally lose about 3% to 5% of our lean muscle mass per decade as we advance (decline?) through our 30s, 40s, etc. That adds up. It’s typical to lose 30% of your muscle mass in a lifetime. If we allow sarcopenia to advance into our later years, we lose strength and the ability to fend for ourselves. We risk a host of ill effects, not the least of which are low-trauma fractures from falling, such as broken hips, collarbones, legs, arms, and wrists.

    “It’s sort of insidious,” Storer continued. “You may not notice much of a change in your 50s, but sarcopenia is cumulative. The less you do to prevent it, the more quickly it comes on.”

    By the way, my doctor wanted me to know about sarcopenia, but pretty much dismissed it as the main cause of my weight loss. It’s more likely that I’ve simply been more dutiful about diet and exercise than I’d given myself credit for. And even if I have some nascent sarcopenia, my doctor assured me that staying fit and active gives me a leg up on sedentary folks. In fact, the much more common pattern with sarcopenia is to gain weight. As Harvard’s Storer explained, the weight gain is “due to increased fat mass consequent to changing (the balance between) energy-in versus energy-out. This is why progressive sarcopenia is so insidious. You don’t know it’s happening until it’s later than you would like it to be.” It can create a double whammy: more mass to move, less muscle to move it with.

    Which brought me to another question for Storer: Is aging the main culprit, or is disuse?

    “To some extent it’s aging,” said Storer. “But in my opinion, it’s more disuse, though it is hard to separate one from the other. And partly it’s attitude. For some it’s I’m getting older, so I need to slow down. And, of course, it can be more difficult to get yourself going. There’s more soreness after exercise. Performance diminishes.”

    A 2011 study of masters athletes at the University of Pittsburgh bears out Storer’s opinion that disuse is quite possibly the main culprit behind sarcopenia. In “Chronic exercise preserves lean muscle mass in masters athletes,” the authors concluded that the common observation—that muscle mass and strength decline as a function of aging alone—was wrong. “Instead, these declines may signal the effect of chronic disuse rather than muscle aging.”

    Of course, as any masters athlete knows, disuse is not an obligatory part of aging. Plus, the good news is that losing muscle mass doesn’t mean it’s gone forever. Just as disuse contributes to sarcopenia, exercise helps stave it off.

    As the University of Pittsburgh study stated, “Maintenance of muscle mass and strength may decrease or eliminate the falls, functional decline, and loss of independence that are commonly seen in aging adults.”

    Ah, so we masters athletes are home free, right? Can we justify a bit of smugness, reckoning that merely by keeping active in our chosen sports we will stave off the ravages of sarcopenia?

    The answer is no. I put it to Storer directly: Many of us masters athletes like to think we’re doing all the right things to survive old age. But is that making me foolishly blasé about sarcopenia? If we’re mainly cardio focused, are we deceiving ourselves?

    Storer: “I think so. It’s my belief, and it’s shared among most doing what I do: There needs to be a more comprehensive approach.”

    By that Storer means resistance training. “My view is that particularly in older athletes, resistance training ought to be done at least at a minimal level—two days a week or more, one set of one exercise for each of the major muscle groups.”

    Storer concluded our interview by telling me about a physician friend of his whose take on training is “to be able to do anything physical with very little physical preparation.”

    He explained: “If you want to do a week of heliskiing in the Bugaboos you’d want to be in shape to do that. Or if you decide to run the Bay to Breakers, have a base of running. To live fully, you have to be aerobically fit and have strength and muscle power. Be ready. There’s a lot of life to live out there.”

    As a member of the gym-averse cohort, I can see I have some resistance to overcome and training to do. There is indeed a lot of life to live out there.

    Notes for the Gym-Averse

    Without getting into resistance-exercise specifics, Thomas Storer has some suggestions for us gym-averse cardio zealots:

    •      Choose your gym carefully. If one is intimidating and seems to cater exclusively to youthful muscleheads, seek out another. And consider hiring a trainer for at least a few sessions to set you on an informed course.
    •      Get a training partner.
    •      Make two days a week your goal. “Who can’t do two days?”
    •      Mix it up. “If you’re a runner, you probably vary your pace and duration. Same goes for resistance exercises. Instead of a seated chest press, do an incline dumbbell press. Instead of leg press, do a seated squat with dumbbells in your hands, and so on.”
    •      A simple home gym can serve you very well. Storer’s home gym consists of a rack of dumbbells, a bench, a pull-up bar, and a dozen or so elastic tubes (TheraBands) of various thicknesses.