We are a country of elderly people. Indeed: many countries of elderly people. According to estimates by the World Health Organization, by 2050 the elderly population globally will exceed 2 billion people. While on the one hand the increase in life expectancy is good news, on the other hand it requires us to deal with the problems linked to aging and the management of people in advanced age. One of these problems – one of the most common and paradoxically one of the least diagnosed – is so-called sarcopenia, i.e. the gradual loss of skeletal muscle mass and reduction in muscle function.
It mainly affects people who are bedridden and/or hospitalized – it is estimated that a week of bedridden is enough to lose up to five kilos of lean mass – but it can also occur, less commonly, in young people. It is a particularly insidious disorder, as it increases the risk of disability, falls, injuries, hospitalization, limitation of independence and mortality.
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What are the risks associated with sarcopenia
A study conducted on almost 2 thousand people – average age 77 years – showed, for example, a strong association between sarcopenia and increased risk of disability (11.3%), hospitalization (11.2%) and mortality (31.9 %) compared to non-sarcopenic patients. A few other numbers to give the dimensions of the phenomenon: a meta-analysis (the combined study of different scientific works on the same topic), relating to 60 thousand patients over 60 years of age living in the community, estimated that one person in 10, in that age group suffers from sarcopenia.
There are also subjects who are more at risk, including diabetic patients, in which the prevalence stands at 18%, and especially oncological patients, in which it can reach up to 70% and for whom it has a particularly negative impact on the outcome of the treatments and side effects of chemotherapy.
Yet, despite all this, clinicians do not fail to underline that sarcopenia is too often underdiagnosed and, therefore, not addressed and combated as it should be done. The good news is that there is no shortage of tools to fight the disease, provided, precisely, that you know them and use them promptly, possibly before the problem manifests itself. Starting from prevention, the adoption of a healthy lifestyle and the regular practice of physical activity.
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The tone of the muscles: you need to move
Which must start as soon as possible because to feel good as an elderly person, one must act consciously as a young person. With the care not to underestimate how useful even mild physical activity is, which produces a slight fatigue greater than the activities carried out during the day, for example using small weights, dumbbells, bottles or grips, to produce the tension necessary for muscle so that it can increase in volume. In short, the message is: aerobic activities such as walking and jogging are good, but also be careful to take care of the tone of the muscles.
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Pay attention to physical activity, but also to nutrition
However, it is not just physical activity. Nutrition also and above all plays a crucial role in contributing to the prevention or treatment of sarcopenia: the disorder is notoriously associated with malnutrition caused by reduced food intake in the diet, inability to swallow, reduced bioavailability of nutrients (and unfortunately malnutrition is a common problem among hospitalized patients).
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“From the age of 50 onwards – he explains Mariangela Rondanelli, director of the Complex Metabolic Rehabilitation Structure at the Geriatric University Center of Pavia – a physiological loss of muscle mass is observed and a decisive change of pace in nutrition is therefore necessary, especially with regard to protein intake. If at the age of 30 10 grams of protein per day is enough to maintain and build muscle mass, at 50 (and beyond) this is no longer the case.”
Indeed, scientific evidence says that protein intake is too often neglected: a study published in the journal Hellion showed, for example, that up to 38% of men and up to 41% of women over 65 consume less protein than the recommended daily intake.
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The role of proteins
“You need to introduce rapidly absorbed proteins (for example those contained in milk and its derivatives) and take proteins at breakfast, lunch and dinner, preferring those with a high leucine content, the essential amino acid for maintaining adequate muscle mass The recommended dose for those over 50 is at least 25 grams of protein per meal (therefore, 75 per day) and at least 2.5 grams of leucine per meal (therefore, 7.5 per day)”.
And therefore: a portion of milk, yogurt or cottage cheese for breakfast, for example; pasta with legumes or ragù or vegetable proteins combined with cereals for lunch; and at least 3-4 portions of fish per week for dinner.
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“Fish is important – continues the expert – because it contains polyunsaturated fatty acids from the omega-3 series, considered a potential protective factor against muscle loss and activators of protein synthesis”. With these measures, within a balanced diet (i.e. which also includes the intake of at least five doses of fruit and vegetables and the right amount of carbohydrates) and associated physical activity, it is possible to prevent or slow down sarcopenia; patients in whom the disorder has already been diagnosed, however, must be even more careful.
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Additional nutrients
“If you suspect that you are suffering from sarcopenia, or if you have already received a diagnosis – continues Rondanelli – you need to contact a specialist centre, whose experts will create a targeted diet: generally the intake of 2.5 grams of protein is required per kilo of body weight. Sometimes, however, diet is not enough: in this case specialists can prescribe so-called foods for special medical purposes, which provide the necessary supplement of nutrients and which can be used, always under medical supervision, even for prevention purposes”.