6 Dec 2018

Muscle wasting and 'skinny fat' in old age

From Our Changing World, 9:07 pm on 6 December 2018

Lifting weights and doing resistance training should be part of the recipe for a healthy old age, according to a gerontology expert at the University of Otago.

Debra Waters says that sarcopenia or muscle wasting is a major contributor to frailty as we get older.

She also says that sarcopenic obesity, or ‘skinny fat’ is a growing but under-recognised health risk for the elderly.

As we get older, we lose muscle mass and power in our arms and legs - but there are things we can do to keep our strength and have a healthier old age.

As we get older, we lose muscle mass and power in our arms and legs - but there are things we can do to keep our strength and have a healthier old age. Photo: CC0 Public Domain

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Sarcopenia is to muscle what osteoporosis is to bone.  It is a progressive loss of lean muscles as you get older, particularly in your arms and legs.

Loss of muscle mass is an inevitable part of ageing, but the loss of too much muscle results in a condition known as sarcopenia, which literally means ‘poverty of the flesh.’

It is one of the main reasons we become frail as we age and it puts us at greater risk from falls.

Associate Professor Debra Waters is Director of Gerontology Research in the Department of Medicine at the University of Otago.

Associate Professor Debra Waters is Director of Gerontology Research in the Department of Medicine at the University of Otago. Photo: Alan Dove Photography

Associate Professor Debra Waters, Director of Gerontology Research in the Department of Medicine at the University of Otago, says that sarcopenia is as relevant to young people as it is to old people. That is because how much muscle mass you have when you are younger, in your 20s and early 30s, helps determines how much you’ll have when you’re old.

Start on resistance training in your youth, she says, and you will enjoy the dividends with a healthy old age.

Poor grip strength is one of the symptoms of sarcopenia, or muscle wasting.

Poor grip strength is one of the symptoms of sarcopenia, or muscle wasting. Photo: Cristian Newman CC0 Public Domain

Debra says that there is debate in the scientific community about how to exactly clinically define sarcopenia. It is generally diagnosed from a DEXA muscle scan, as well as a combination of simple strength indicators such as grip strength or how strong your hands are, walking speed and sit-to-stand, or the ability to rise from a chair without using your arms.

The good news is that sarcopenia is not inevitable.

Debra says it is possible to slow muscle loss, with resistance training and “getting adequate amounts of protein in your diet.”

“Progressive resistance exercise is the best,” says Debra. “And the weight-bearing exercises that we’ve always said are so important are still important, but it generally is not enough [on its own].”

So walking is good, but weight lifting as well as walking is better. Debra says this might not have to be a regular visit to the gym. It might just be walking up a steep hill, rather than on the flat.

Sarcopenic obesity is a combination of getting fatter and losing lean muscle mass, and is a growing health issue amongst the elderly.

Sarcopenic obesity is a combination of getting fatter and losing lean muscle mass, and is a growing health issue amongst the elderly. Photo: Elien Dumon CC0 Public Domain

‘Skinny fat’

Sarcopenic obesity is a growing problem. Debra describes it as being ‘skinny fat.’

Your weight and even your BMI might seem to stay the same as you age, but an increasing amount of fat is masking the fact that you are also losing both muscle and bone mass.

Debra says that sarcopenic obesity is “a tricky beast because it is hard to identify.”

“That combination of high fat and low muscle is really detrimental to function” and to health.

She says that managing sarcopenic obesity is a combination of weight loss and a protein-rich diet, while slowly increasing amounts of exercise to build muscle mass.

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