Muscle Matters: Let’s talk about Muscle Loss and Importance of Muscle Strength for Longevity?

Case Study

Background:

Raj (name changed), a 52-year-old marketing-professional, sought assistance from Ever+ to enhance his overall health and well-being

Blood Results Snapshot:

Triglyceride Levels: Elevated (221 mg/dL)

Fasting Insulin Levels: Higher than optimal (28 μIU/mL)

CGM Findings: Irregular patterns, indicating unstable blood sugar levels

ApoB - 105 mg/dL

Lp(a) - Within normal range

LFTs: Slightly elevated

Uric Acid - 7.5 mg/dL(sub-optimal)?

Testosterone - 290 (lower than normal)?

Body Composition and Fat Percentage:

Raj faced challenges associated with low muscle mass (22%), impacting his overall health and fitness.

Scientific Analysis for Low Muscle Mass:

Body Composition?

1. BMI (18.75 kg/m2): The BMI suggests that the individual is underweight for their height, indicating a potential concern for low muscle mass.
2. Skeletal Muscle Mass (30.0 kg): The skeletal muscle mass is lower compared to the previous example, indicating reduced muscle development. This might suggest lower strength, potentially impacting metabolism and overall health.
3. Protein Content (12.0 kg): The protein content is on the lower side, potentially indicating insufficient protein for optimal muscle maintenance and overall physiological functions.
4. Fat Mass (18.0 kg): The fat mass is relatively high, and interpretation may vary based on individual health goals. In some cases, it could be associated with a higher percentage of body fat.
5. Bone Mass (3.8 kg): Similar to the previous example, bone mass is considered in the context of bone health, and further assessments may be needed

Comparison:

• The individual with low muscle mass may have concerns related to strength, metabolism, and overall health.
• The BMI and muscle mass indicate a potential need for muscle-building exercises and dietary adjustments to support healthy weight gain, particularly in terms of muscle.

Let’s understand what contributed to his low muscle mass and ways in which we can address this concern.

What is Muscle Loss?

When we think of muscles, most of our minds can't help but envision marvel superheroes flexing their might and conquering the world, one bicep curl at a time! But the truth is muscles are more than just bulging bulges, they play an integral role in? movement and maintain balance of our body. Muscle accounts for 47-60% of lean body mass in men and women and is one of the most important contributors to total body energy expenditure. As a result, maintaining skeletal muscle health is essential for overall health and lifespan. Skeletal muscles' mass, size, shape, and arrangement can vary greatly depending on their location and physical role in the body. Increased physical activity, such as exercise, leads to an increase in muscle mass. Reduced or limited usage of skeletal muscle, on the other hand, is one of the most significant contributors to muscular atrophy.?

How does it occur? Muscle mass loss with ageing is connected with decreased muscle fibre quantity and size, which is primarily due to the gradual loss of motoneurons. Muscle function deteriorates with time because motoneuron loss is inadequately compensated by reinnervation of muscle fibres by the remaining motoneurons.

Processes underlying anabolic resistance and muscular loss in the elderly.

Source : https://www.sciencedirect.com/science/article/pii/S156816371830134X

Males and females are undoubtedly distinct in many aspects of muscular health and physiology, including muscle fibre composition, anabolic and catabolic pathways, hormonal connections, and mitochondrial content and function, according to several research findings . These distinctions can have a significant impact on the development and evolution of different muscular atrophy, including disuse atrophy. It’s also suggested that Females and males may have varied mitochondrial responses to cellular stress, emphasising the necessity of further understanding how female muscle varies from male muscle, both at rest and under stress.?

Ageing-related muscle function loss is characterised by quantitative and qualitative changes in skeletal muscle structure and function. This process is normally gradual, and functional loss varies greatly between individuals, but it is documented in all humans [even healthy, well-nourished, and physically active people]. The ageing-related denervation/reinnervation process has a significant influence on quantitative muscle changes such as muscle fibre loss and atrophy, leading to complete muscle wasting and loss of muscular function in old age. However, qualitative changes in skeletal muscle affecting protein function, repair processes, loss of coordinated expression of contractile, SR, and mitochondrial proteins, and overall decreased resilience to stress in old age are likely to play an even greater role in the impaired muscle function associated with old age.The reduction in muscle mass and function is most likely the most severe and significant of all changes that occur during the ageing process, a condition known as sarcopenia

Symptoms of Sarcopenia Sarcopenia, or age-related muscle loss, is a normal aspect of ageing. It is influenced by two factors: the quantity of muscle mass present initially and the rate at which it falls with age.Sarcopenia results in reduced strength, metabolic rate, and maximum oxygen consumption. Muscle weakness is the most typical symptom of sarcopenia. Other symptoms may include fatigue, difficulty completing everyday tasks, sluggish walking, difficulty climbing stairs, poor balance, and falls as well as decrease in muscle size.

Why is Sarcopenia a concern? Sarcopenia is estimated to affect 10%-16% of the elderly worldwide. It is an unavoidable consequence of the world's rapidly ageing population. Individuals with dementia, diabetes, and pulmonary illness have a much greater prevalence of sarcopenia than those without these conditions, regardless of the criteria of sarcopenia used. According to a meta-analysis of? 17,206 unhealthy individuals? (mean age: 65.31.6 years, 49.9% females) and 22,375 healthy individuals to determine the prevalence of sarcopenia as a comorbid disease, individuals with cardiovascular disease (CVD) had the greatest frequency of sarcopenia when compared to those with dementia, diabetes, and respiratory illness. Sarcopenia has numerous risk factors with CVD, dementia, diabetes, and respiratory illness, such as sedentary behaviour, poor physical activity, inflammation, malnutrition, and several other processes, which may explain why sarcopenia is more common in people with these age-related disorders.

After the age of 30, you should expect to lose 3% to 5% of your body weight every decade. During their lifetimes, most men? lose roughly 30% of their muscular mass. Even if you are physically active, you will experience some muscle loss.There is no precise test or degree of muscle mass that may be used to diagnose sarcopenia. Muscle loss is important since it reduces strength and movement.

Muscle mass and strength decrease in the elderly (particularly after the age of 65-70) is a public health issue. Longitudinal studies indicate that muscle mass declines at a rate of 0.64-0.7%/y in women and 0.8-0.98%/y in men over the age of 75. Muscle function? is lost more rapidly, with longitudinal studies revealing that at the age of 75 years, males lose strength at a rate of 3-4% per year and women at a rate of 2.5-3% per year.Physically inactive individuals might lose up to 5% of their muscle mass every decade after the age of 30.?

What can be done? to avoid this ? Muscle growth is primarily dependent on? three things :hormonal environment, substrates and progressive resistance.?

Skeletal muscle growth is dependent on the metabolic processes that drive protein synthesis, particularly the Akt/mTOR pathway, and the hormonal influences that alter them (insulin and IGF-1).It has been demonstrated that testosterone has a more direct influence on muscular building. This hormone stimulates the growth of satellite cells at the cellular level.It increases the synthesis of muscle proteins while decreasing their degradation at the metabolic level. Testosterone stimulates the local synthesis of IGF-1 in muscle as well as the intracellular utilisation of amino acids during muscle protein formation.

Carbohydrates, proteins, and lipids are the three macronutrients essential for muscle building. Each macronutrient is essential for muscular growth.Nutrition is critical when it comes to promoting muscle growth. It's critical to have enough calories and protein, but it's also critical to get the right combination of carbohydrates and fats. Eating too little or too much of one of these macronutrients may impede your ability to grow muscle.?

The concept of increasing overload is crucial to good resistance training. According to this notion, in order for muscles to develop, they must be exposed to a continual, constantly increasing exertion. A popular progressive overload training technique involves choosing a goal, working out at a comfortable but difficult level, and gradually increasing the intensity of the sessions over time.?

Here are few steps we can follow to avoid overall muscle loss

Resistance Training:

• Engage in regular resistance or strength training exercises. Focus on compound movements like squats, deadlifts, and bench presses.
• Include both concentric and eccentric movements for a comprehensive muscle workout.
• Sedentary behaviour can contribute to muscle loss. Incorporate movement into your daily routine and avoid prolonged periods of sitting.

Mind-Muscle Connection:

• Practice mindfulness during workouts. Focus on the muscle groups you are targeting to enhance the mind-muscle connection.

Protein Intake:

• Ensure an adequate protein intake. Protein is crucial for muscle repair and synthesis.
• Consider consuming protein-rich foods such as lean meats, fish, eggs, dairy, and plant-based protein sources.
• Leucine is an essential amino acid that plays a key role in muscle protein synthesis. Consider leucine supplements or consume foods rich in leucine.

Vitamin Supplementation:

• Vitamin D is essential for bone health and may contribute to muscle function. Get regular sunlight exposure and consider vitamin D supplements if needed.
• Calcium and Vitamin K are nutrients that are crucial for bone health, which indirectly supports muscle health. Include dairy, leafy greens, and other calcium-rich foods in your diet.

?Biohacks? for Muscle Growth?

Do 3 sets of plank jacks every day? to improve your core strength and endurance

The plank jack is a body weight exercise that targets the core muscles, including the rectus abdominis, transverse abdominis, obliques, shoulders, chest, and legs. This dynamic exercise can help boost overall core stability, strength, and endurance, while increasing your heart rate and burning calories. It also helps improve your posture while working your glutes and legs, helping to tone and strengthen these muscles.

Here's how to do plank jacks:

• Step 1: Begin in a high plank position, with your shoulders stacked over your wrists and your body forming a straight line from your head to your heels.
• Step 2: Engage your core and glutes to maintain a stable plank position.
• Step 3: Keeping your core tight and your upper body steady, jump your feet apart to the sides, as if you are doing a jumping jack.
• Step 4: Keep your hips low and your back flat as you jump your feet out.
• Step 5: Quickly jump your feet back together, returning to the starting plank position.
• Step 6: Repeat the movement, jumping your feet in and out, for the desired number of repetitions or time duration.

Take 3 g of leucine supplement? to lower the risk of losing muscle mass and strength with age Leucine supplementation may help reduce the risk of sarcopenia, which is the loss of muscle mass and strength with age. Leucine is an essential amino acid that plays an important role in muscle protein synthesis. Leucine when combined with Vitamin D has a significant impact on handgrip strength and gait speed—markers of strength and agility during old age. A dosage of 3 g of leucine along with 800 IU of vitamin D for 13 weeks shows a promising impact on strength. Here’s how to incorporate leucine supplementation into your life:

1. Stick to the recommended dosage: It is recommended to take 3 g of leucine via dietary sources, along with 25-30 g of protein across 3 meals a day.
2. You may also take leucine as a separate supplement instead of incorporating it into your diet. In that case, you may either consume 2 doses per day of 1.5 g each, or a single 3 g dose per day.
3. Consult your physician/nutritionist. As with any supplement, it's best to check with a licensed healthcare professional before getting started.
4. Alternative: Leucine is found in most protein sources. High biological value proteins like lean meats, eggs, cheese, dairy products, and whey protein are good sources of leucine.

Add 2 eggs to a breakfast meal to increase your protein intake Eggs are among the best dietary sources of protein. They are loaded with 9 essential amino acids that the body can’t produce, vitamins, minerals, antioxidants, high-quality protein, and good fats. On average, a large egg (50 g) contains 71.5 kcal, 6.3 grams of protein, 5 g of fat and trace amounts of other nutrients.Include eggs in your breakfast most mornings. You can have them anyway you like. Avoid using seed oils to cook your eggs as these oils lead to increased body inflammation. Instead use healthy fats such as olive oil, avocado oil, or coconut oil.

The probability of muscle wasting relative to age will rise as the world population ages.? Malnutrition and a lack of physical exercise appear to be the two key risk factors for sarcopenia. Individualised therapy like supplements and nutrition may be highly effective for sarcopenic people. However, no medicinal therapy for the treatment of sarcopenia is currently authorised. Increased knowledge and understanding of this condition is critical for the continuous development of standardised treatment and diagnostic options, which will lead to better care and quality of life for our ageing populations.Muscular health, endurance, and lifespan are all intertwined. Understanding the effects of muscle loss, also known as sarcopenia, on our general health has never been more important.

It's clear that maintaining muscle mass and increasing endurance aren't only fitness goals, but also essential components of living a longer, healthier life. The importance of regular exercise, a well-balanced diet, and a proactive approach to muscle health cannot be stressed.

Let us empower ourselves and others as we traverse the path to good ageing. Let us commit to including a lifestyle that values and prioritises our muscular health.

Boost Your Healthspan NOW

If a fitter, healthier you is on your mind–then it’s time to meet MITO. A personalised wellbeing app ? from Human Edge that simplifies health, MITO can help you be the best version of yourself. Want to try it out for yourself? Register on www.humanedge.co/mito/ for early access.?

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This newsletter is part of our ongoing series.

?Tune in to episode of SparX, @Mukesh (Founder Myntra and Cult.Fit) where I talk about how ‘Living well beyond 100” is now a reality.?????

Watch the episode here :? https://www.youtube.com/watch?v=Z2jiWQBOqFY&t=10s

Click here ?to check out my audiobook, “The Human Edge”,where I talk in depth about the inner workings of our muscles (Chapter 2). This book unravels the amazing adaptive physiological responses that our bodies undergo as we push ourselves to the physical limits in human performance.

You can also buy the paperback version using this link : https://www.amazon.in/Human-Edge-Dr-Marcus-Ranney/dp/0000989835/ref=sr_1_1?crid=CJ2OHV7BUBS5&keywords=human+edge&qid=1695007578&s=books&sprefix=human+edge%2Cstripbooks%2C193&sr=1

Sources?

1. Larsson, L., Degens, H., Li, M., Salviati, L., Lee, Y. I., Thompson, W., ... & Sandri, M. (2019). Sarcopenia: aging-related loss of muscle mass and function. Physiological reviews, 99(1), 427-511.https://journals.physiology.org/doi/full/10.1152/physrev.00061.2017
2. Cannataro, R., Cione, E., Bonilla, D. A., Cerullo, G., Angelini, F., & D'Antona, G. (2022). Strength training in elderly: An useful tool against sarcopenia. Frontiers in Sports and Active Living, 287.https://www.frontiersin.org/articles/10.3389/fspor.2022.950949/full
3. Mitchell, W. K., Williams, J., Atherton, P., Larvin, M., Lund, J., & Narici, M. (2012). Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Frontiers in physiology, 3, 260.https://www.frontiersin.org/articles/10.3389/fphys.2012.00260/full
4. Rosa-Caldwell, M.E., Greene, N.P. Muscle metabolism and atrophy: let’s talk about sex. Biol Sex Differ 10, 43 (2019). https://doi.org/10.1186/s13293-019-0257-3
5. Gao, Y., Arfat, Y., Wang, H., & Goswami, N. (2018). Muscle atrophy induced by mechanical unloading: mechanisms and potential countermeasures. Frontiers in physiology, 9, 235.https://www.frontiersin.org/articles/10.3389/fphys.2018.00235/full
6. https://www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass
7. Taylor J. Marcell, Review Article: Sarcopenia: Causes, Consequences, and Preventions, The Journals of Gerontology: Series A, Volume 58, Issue 10, October 2003, Pages M911–M916, https://doi.org/10.1093/gerona/58.10.M911
8. Papadopoulou SK. Sarcopenia: A Contemporary Health Problem among Older Adult Populations. Nutrients. 2020; 12(5):1293. https://doi.org/10.3390/nu12051293
9. https://www.sciencedirect.com/science/article/pii/S0531556519307417
10. Pacifico, J., Geerlings, M. A., Reijnierse, E. M., Phassouliotis, C., Lim, W. K., & Maier, A. B. (2020). Prevalence of sarcopenia as a comorbid disease: A systematic review and meta-analysis. Experimental gerontology, 131, 110801.https://www.sciencedirect.com/science/article/pii/S0531556519307417
11. https://www.webmd.com/healthy-aging/sarcopenia-with-aging
12. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/muscle-growth