Sarcopenia is an age-related event that affects everyone.
Sarcopenia is a condition characterized by the loss of muscle mass, strength, and function that occurs with age. While sarcopenia is a natural aging process, hormonal changes and reduced physical activity, impacts its time of onset and severity. Although age-related sarcopenia is difficult to prevent entirely, whether active or not, it can be mitigated with resistance training modifications and a focused diet. Athletic trainers should understand that sarcopenia in older adult athletes does occur regardless of training status. They should also develop strategies and understand how to prevent sarcopenia.
Recommended course: Exercise Over 55: Considerations and Special Needs of Older Clients
What is age-related sarcopenia?
Sarcopenia is an age-related event that affects everyone. However, the degree varies with physical activity type and levels, diet, and other factors like hormonal changes and disease. Characterized by a gradual decline in muscle mass starting around age 40, sarcopenia leads to muscle strength and power loss necessary to athletic performance. With many competitive athletes choosing to play after 40 and recreational athletes participating in sports at 40, 50, 60 and beyond, knowing how to prevent sarcopenia is paramount to success and injury prevention.
Hormone changes associated with sarcopenia
Hormonal changes that occur with age, such as a decrease in testosterone levels, contribute to sarcopenia. Decreased testosterone levels along with other hormonal changes that occur with age negatively affect muscle mass. This leads to decrements in strength and power and decreased sports performance.
Hormonal changes are particularly relevant in aging male athletes. However, these changes also affect female athletes. Hormones that influence sarcopenia also include human growth hormones, insulin-like growth factor, cortisol, and estrogen.
Testosterone
Testosterone plays a significant role in muscle protein synthesis. As athletes age, testosterone levels decrease, which contributes to the loss of muscle mass and strength. A decrease in endogenous testosterone also leads to the development of andropause in men which also contributes to decreased sports performance.
Human Growth Hormone (HGH)
Growth hormones are essential for the growth, maintenance, and repair of tissues, including muscles and supporting connective tissues. Growth hormone secretion declines during age, which impacts muscle protein synthesis making it harder to both build and maintain muscle mass.
Insulin-Like Growth Factor 1 (IGF-1)
IGF-1, a chemical stimulated by growth hormone, is important for muscle growth, development to maturity, and maintenance in adulthood. Aging results in reduced levels of IGF-1 and is a contributing factor to age-related muscle loss.
Cortisol
The stress hormone cortisol has catabolic effect on muscles. Elevated cortisol levels contribute to sarcopenia and an increase in difficulty building muscle. Regular resistance training decreases cortisol levels over time and promotes a better environment for muscle growth and maintenance.
Estrogen
In women, estrogen plays a key role in the development and maintenance of muscle mass. During menopause, estrogen levels decrease, contributing directly to age-related muscle loss and difficulty maintaining existing muscle.
How to prevent sarcopenia
Although age-related physical changes are inevitable, there are training and dietary strategies that lessen the effects of age-related sarcopenia in athletes. Sarcopenia gets worse when there is a decrease in the mechanical loading on muscles, defined as less activity, less intensity or frequency of resistance training.
Resistance Training Intensity
Squats and other large muscle compound lifts like deadlifts and bench presses are known to release testosterone and human growth hormone into the blood stream; therefore, any training program should include these foundation lifts and execute them at the highest intensity tolerated to naturally increase testosterone and HGH levels.
Resistance Training Volume
To prevent sarcopenia in women, training volume is the leading factor. One study showed that higher volume training programs versus lower volume, high-intensity programs were better to maintain muscle mass (Burrup, 2018). Subsequent data has shown comparable results, indicating that increased weekly frequency of resistance training decreases body fat and increases lean body mass (Magalhães, 2022).
Diet
Inadequate nutrition, particularly insufficient protein intake, can contribute to muscle loss. Athletes need to maintain an appropriate balance of macronutrients, including protein and vitamin D, to support muscle growth and maintenance.
Hormone Replacement Therapy (HRT)
Athletes can turn to HRT to reestablish hormones levels. These can lessen the severity of age-related changes like sarcopenia that affect sports performance. Under the guidance of healthcare professionals, HRT is a viable option to address hormonal imbalances that contribute to sarcopenia.
While sarcopenia is a natural aging process, athletes can take steps to prevent or minimize its effects. A comprehensive approach that includes resistance training, diet, and lifestyle modifications to build and maintain muscle is necessary. Consulting with medical professionals, nutritionists, and sports specialists, like athletic trainers, can help develop personalized strategies to address the unique needs of athletes experiencing sarcopenia.