Sarcopenia is the atrophy of skeletal muscle that increases with advancing age. Older adults, especially the elderly, are at a much higher risk of sarcopenia, as muscle mass and strength begin to steadily decline in our 30s. Nearly 50% of an individual’s muscle mass may be lost by age 70, unless it’s sustained by regular exercise and resistance training. Muscle loss leads to functional decline and loss of independence, and it’s associated with increased risk of falls, fractures, immobility, acute and chronic illness, frailty, and even mortality.

Skeletal Muscle Mass and Diabetes 

Skeletal muscle plays a critical role in regulating blood sugar, as it is the largest insulin-sensitive tissue in the human body. Thus, a major loss in skeletal muscle (sarcopenia) may lead to older adults developing type 2 diabetes. According to a new study from the Journal of the Endocrine Society, “relatively lower lean body mass with aging was related to a higher incidence of diabetes in men but not women, and partially related to body size.”

Sarcopenia and Obesity

Sarcopenic obesity (SO) is a condition “characterized by a mismatch between muscle mass and fat mass” that involves multiple underlying biological pathways responsible for its development, primarily age-related changes in metabolism and body composition, along with the simultaneous development of physical illnesses and environmental obesogenic factors. “Incremental metabolic changes over time promote fat deposition with a pro-inflammatory cascade of events … and loss of lean mass and muscle strength,” suggesting that inflammation and inactivity may be the target for treating SO.

These studies suggest that maintaining healthy body weight is a crucial factor in helping prevent sarcopenia in older adulthood. Regulating blood sugar is also critical in maintaining healthy body composition, specifically lean body mass.

Nutritional Support for Helping to Prevent Muscle Loss

In addition to weight management, our diet, lifestyle, and specific nutritional components may help prevent age-related muscle loss and metabolic disorders, including type 2 diabetes and obesity. Regular strength training, increasing protein intake, and reducing simple carbohydrates (i.e., adopting a low-glycemic diet) may help older adults maintain muscle mass and healthy blood sugar levels well into their 80s and 90s. Protein-energy malnutrition is a major risk factor for the development of sarcopenia in older populations; increasing protein consumption may counteract sarcopenia and obesity development. In addition, increasing dietary fiber intake may improve body composition, as it has been shown to be linked with significantly higher skeletal muscle mass compared with those whose intake was below the recommended average intake. Regularly monitoring blood sugar and insulin levels in your patients is important through testing of the Homeostatic Model Assessment of Insulin Resistance, fasting glucose, hemoglobin A1c (HbA1c), and oral glucose tolerance.

Important supplemental considerations include:

• Glutathione — helps preserve the muscle protein synthesis pathway, and therefore, it is a key component in building muscle mass and strength

• Protein powders and branched–chain amino acids (BCAAs) — (e.g., whey, pea, or bone broth) may improve mobility by increasing lean body mass, strength, and walking capability in elderly populations

• Collagen peptides — may increase fat-free muscle mass when combined with exercise

• Fish oil rich in eicosapentaenoic acid (EPA) and dehydroepiandrosterone (DHA) — have been shown to have anti-inflammatory properties, and may help to support normal insulin sensitivity and stimulate muscle protein synthesis

• Vitamin D — may help increase muscle strength and may reduce the loss of muscle in postmenopausal women

• Resveratrol — may enhance the growth of muscle fibers by addressing metabolic changes that contribute to sarcopenia

• Herbs and nutrients that support healthy blood sugar levels:

  • Gymnema Sylvestre — is a potent botanical shown to support diabetes management

  • Berberine — may support normal blood glucose metabolism for type 2 diabetes

  • Alpha-lipoic acid — has antioxidant properties that are shown to possess beneficial properties in the prevention and treatment of diabetes with insulin-mimetic and anti-inflammatory actions

  • Chromium, vanadium, and selenium — support metabolic health

  • Myo-inositol and D-chiro inositol — the most predominant isomers of inositol that are involved in supporting normal insulin function

  • Ginkgo biloba — has been shown to significantly reduce HbA1c, fasting glucose, insulin, and waist circumference in patients with type 2 diabetes

By Caitlin Higgins, MS, CNS, LDN