How (and why it’s important) to build muscle in old age

Who like Popeye, a sailor who only needs a pot of spinach to turn his weak muscles into a wrecking machine. But things are not as simple as the comic strip created by Elzie Crisler Segar in the second decade of the 20th century suggests.

Although spinach is a food rich in nutrients—such as vitamins K, A, C, B2, folic acid, manganese, magnesium, and iron—it benefits bones and helps fight diabetes , among other things, it is not enough on its own to contain the progressive loss of muscle mass that affects a large part of the population, especially during old age, due to the inevitable physical and physiological changes that occur with age.

This condition is known as sarcopenia, and although it is associated with aging, it can begin to manifest at age 40 – in some cases even at age 30 – with the loss of 3-8% of muscle mass. every ten years. The percentage, yes, increases considerably after the barrier of six decades of life, which is also linked to a series of factors such as lifestyle and the pre-existence of comorbidities, among others.

“From the age of 75, it can increase even more, reaching approximate losses of 15% of muscle mass per year”, explains Fernando Rivero Diez, kinesiologist and manager of the residence for the elderly. Acali Florida . It is “undoubtedly a big problem, capable of sending the elderly person into a dead end spiral of frailty, functional dependence and ultimately death”.

The loss of muscle mass has a significant impact on quality of life: it involves a risk of physical disability, an increase in falls – one of the main causes of fractures and injuries in the elderly – and is associated with the development cardiovascular diseases, respiratory and cognitive disorders, in addition to mobility disorders. In fact, the death rate for people with sarcopenia is 3.6 times higher than for people without it.

Although it has different classifications —which can put the global figures into perspective—it is estimated that sarcopenia affects more than 50 million people and that in 40 years this figure will quadruple worldwide.

How much effort and work do you need to get up from the chair? Can you do it without using your hands? Do you have just one or do you need both? Or maybe you need someone to help you up? Your answer could give indications of possible sarcopenia.

The loss of muscle mass affects functional abilities and “activities of daily living, such as getting up from a chair”, explains Alberto Mercado, geronto-kinesiologist at the Hospital’s Falls Unit. MEDS Clinic .

Greater loss of muscle mass, yes, does not necessarily imply greater loss of strength. “There is no direct relationship,” says Mercado, also an academic at Finis Terrae University’s School of Kinesiology. “There are elderly people who suffer from sarcopenia but who have a lot of muscular power”, proof of one of the characteristics of aging: “it is extremely heterogeneous”.

The geronto-kinesiologist explains that there is a chronological age, a biological age and a functional age. And the health of an elderly person is measured particularly on the latter. “A person can be 80 years old and be able to get up quickly from a chair, walk quickly and travel the world. Another 65-year-old but sedentary person may struggle to get up from a chair to stand up, walk slowly, and have trouble getting out of the house. Therefore, the first individual is much more “functional” than the second.

Something similar can be projected with respect to young and old muscle. It is likely that someone associates the qualifiers with the chronological age of people. However, this would fall into ageism, the main form of discrimination, according to Mercado, behind sexism and racism. In fact, a young person can have older muscles than an older person.

“I have 72-year-old patients who are able to do the chair climb test quickly and efficiently, with one limb. They train a lot and have a balanced diet, so they are able to function with young muscle. In On the other hand, an obese forty-year-old will have more difficulty passing the test, because their muscles are not very functional and are old,” explains the specialist.

In all cases, in the elderly the risk of sarcopenia is greater. One of them concerns falls. “In general, people who fall tend to have less muscle mass and strength in the flexor-extensor muscles, especially in the hips and knees,” Rivero says. Added to this is the possibility of contracting chronic diseases such as osteoporosis and diabetes.

And sarcopenia threatens not only the muscle structure, but also the control of the central nervous system, where muscle movements are initiated, coordinated and controlled. “This is why treatments for sarcopenia cannot only focus on the mass, but also on neurocognitive functions”, argues the gerontokinesiologist.

Sarcopenia is a syndrome whose origin is linked to various factors. “This can be explained by age-related changes at the cellular level (since the number of muscle cells decreases), biochemical, metabolic and endocrine,” explains Fernando Rivero. This is called primary sarcopenia.

The secondary, on the other hand, is linked to factors other than age, “such as prolonged periods of bed rest, such as long hospital stays, excessive rest periods or catabolic processes”, illustrates t -he. This is why sedentary behaviors carry so many risks.

Mercado says that we are “anti-gravity mammals”, since after six or eight hours of sleep, we must “defy gravity” to get up on our feet. And for that, the muscles – especially those in the lower body, such as the glutes, quadriceps or triceps surae – need to be kept active and with potential.

“When you abuse an antigravity state, such as spending a lot of time lying down, the ones that suffer the most are that antigravity muscle group,” Mercado says. A warning that is mainly aimed at those who work eight hours straight without getting up from their chair, especially if they are also overweight.

On the other hand, as muscle fiber is lost, the body begins to accumulate fatty tissue, an imbalance that can become a real problem if it occurs with a sedentary lifestyle. Mercado says that a few years ago people started talking about “sarcopenic obesity.”

For the academic of the U. No more Terrae, this is a worrying problem, given the high rates of obesity that exist in the country: according to the latest National Health Survey, from 2016-2017, 31.4% of the population is obese ; 3.4% are morbidly obese and more than 40% are overweight, figures which have hardly decreased in recent years.

Considering that sarcopenia can begin to appear as early as age 30, the best recommendation is to lead an active and balanced life much earlier. “Chile has a high rate of childhood obesity. So what awaits these generations? It has to start with the basics, with more hours of physical activity in schools and healthy eating.

“For an elderly person, who practices little or no physical activity, the proportion of maximum effort necessary to carry out daily activities increases”, explains Alberto Mercado. Getting up from a chair, getting out of bed, climbing stairs or walking can become undeniable challenges.

And if it’s “never too late to start exercising”, as the specialist says, those who are not used to physical activity should take certain precautions before doing so. venture. “If a sedentary person, who has never had a cardiological evaluation, starts an exercise program, of course they are at risk.”

Nicolás Fontecilla, traumatologist at the Indisa clinic, agrees and completes: “at the beginning there is a greater risk of other injuries due to overloading, falls or lack of balance”. Therefore, the first thing is ideally to undergo an interdisciplinary medical evaluation – geriatrics, neurology, otolaryngology, kinesiology, occupational therapy, among others – to determine the state of health, if treatment for sarcopenia is necessary , and propose a physical training program according to their needs and abilities.

In general, the exercises that are recommended are those of resistance. “They can be done with light weights or even using the patient’s own weight. For example, doing push-ups while standing against the wall. Or sit with your feet dangling and straighten your knees completely,” says Fontecilla.

Fernando Rivero says that elastic bands and other similar items also serve these purposes. And that physical activity programs with two or three sessions per week “showed changes in muscle strength and power parameters in just two months.” For this, he adds, it is also very important to accompany the exercises with an adequate nutritional plan, which “ensures an adequate protein intake for the person”.

If it is possible to walk, do it daily – between 10 and 30 minutes, depending on the possibilities – because this also counts as physical activity and is beneficial for the body. And always have good hydration. “High temperatures start and dehydration is very common in older people,” says Mercado. This can lead to states of confusion that limit daily life.

Mercado also highly recommends tai chi, a very popular martial art around the world that doesn’t necessarily involve contact, and is often recommended as part of treatment for stress and anxiety.

“It’s not an exercise, it’s a discipline. People who practice tai chi twice a week benefit greatly, not only in fighting sarcopenia, but also in improving their cognitive levels. and their attention. There is enormous evidence that it is a feasible, practical and cost-effective tool,” says Mercado.

Although it can be practiced alone, it is also generally done in a group, which is strongly recommended for the elderly: maintaining active socialization reduces, among other things, the risk of generating dementia. Another thing Popeye spinach can’t fight on its own.