Protein, supplements, and strength training reduce age-related loss of muscle mass

Age-related loss of muscle mass is a natural process and may result in increased feebleness and even disability. Strength training and diet play a major role, and older people need more protein, especially an essential amino acid called leucine. In addition, supplements of vitamin D, omega-3 fatty acids, and probiotics can have a positive impact on muscle mass and muscle strength, according to a review article that is published in Frontiers in Nutrition.

From the age of around 50 years, the body loses approximately one percent of muscle mass every year. The process, which is quite natural, starts to speed up around the age of 65-70 years. If the loss of muscle mass and strength is too great, it may cause what is known as sarcopenia, which is a muscle disease with a harmful impact on health and quality of life. In severe cases, it can also increase the risk of disease and fall accidents, nursing home placement, hospitalization, and early death.
Sarcopenia is particularly dangerous if it occurs in combination with severe overweight.
Besides being associated with ageing, sarcopenia is linked to chronic inflammation, oxidative stress, hormonal changes, poor diets, and physical inactivity. Although it is well-known that sarcopenia has such a detrimental impact on people’s health and comes with a huge socioeconomic price tag, there is far too little focus on how to prevent and treat the problem. In their new review article, the authors have looked at how proper diet and the use of relevant supplements can support both muscle mass and muscle function.

Protein and the amino acid leucine

Protein is important for the building of muscle mass, for the energy turnover, and for the production of hormones, antibodies, and neurotransmitters. Apparently, the official guidelines for protein intake among seniors are too conservative. This is because the muscle building (anabolic) processes slow down and are far less effective in old age, which increases the need for protein.
According to the review article, people aged 65 years and older should have a daily protein intake of at least 1 to 1.2 grams per kilogram of body weight. In the case of chronic inflammation, which is very common in most chronic diseases and in overweight, the daily protein intake should be around 1.2 – 1.5 grams for each kilogram of body weight.
Each main meal should therefore contain around 25-30 grams of protein from high-quality animal and plant sources. Proteins are made of amino acids, and the authors stress the importance of getting plenty of leucine, which is essential for muscle function due to its role in the building of muscle mass and muscle strength. The best source of leucine is animal protein such as meat, fish, eggs, and dairy products. The authors recommend a leucine intake of around 2.8 – 3.0 grams twice daily.

Protein content in food (per 100 grams)
Meat and fish: 20-24 grams
Eggs: 12 grams
Nuts: 10-14 grams
Cooked beans: 6-7 grams
Bread and past: 5-6 grams
Various fruits and vegetables: 0.5 – 1.5 grams

Vitamin D’s effect on muscles

Most of the body’s cells, muscle cells included, have vitamin D receptors (VDR). Vitamin D supports the building of muscle mass together with protein synthesis and leucine. Vitamin D also affects insulin sensitivity and cellular calcium intake, which are crucial for the muscles and their ability to contract.
There are widespread problems with vitamin D deficiency, and the authors behind the review article advise seniors to supplement with at least 20-25 micrograms of vitamin D daily, in some cases even more. What is important is to optimize blood levels of the nutrient. High-dosed supplements are available on the market. The upper intake level for adults is 100 micrograms of vitamin D daily. Make sure to get plenty of magnesium also, as this nutrient helps with the activation of vitamin D.

Omega-3 fatty acids and their effect on muscle mass

Oily fish and fish oil supplements contain the two omega-3 fatty acids, EPA and DHA, which are structural components of cell membranes and have a variety of physiological functions.
Animal and human studies have demonstrated that supplementation with omega-3 fatty acids can reduce the loss of muscle mass and support the body’s muscle synthesis. Omega-3 fatty acids also have anti-inflammatory properties. This is highly relevant because inflammation typically occurs in old age and in connection with chronic diseases. The anti-inflammatory effect of omega-3 is important because inflammation contributes to oxidative stress and cell damage caused by free radicals.
In one study, researchers supplemented 126 people aged 65 years and older with 1.2 grams of fish oil daily for six months. This increased the walking speed of the participants but did not affect their muscle strength. Other studies suggest that it takes as much as three grams of fish oil daily to improve muscle strength. This dose is also able to counteract inflammation and aching joints, which are problems that affect many older people with sarcopenia.

Probiotics and their effect on muscles

Our gut microflora consists of billions of bacteria that have numerous physiological functions. Poor diets, overuse of medicine, and ageing, however, can have a negative impact on the intestinal microflora and disrupt its delicate balance. Supplementation with probiotics has been seen to have a positive effect on muscle health by regulating the host’s immune defense, metabolism, insulin sensitivity, and gene activation. Several studies have shown a link between older people’s gut flora and their physical capacity. Probiotics may therefore be highly relevant for those suffering from sarcopenia.

Selenium’s impact on muscles

Selenium and Q10 are also important for muscle health, according to earlier studies. Selenium supports a host of selenium-containing proteins that are important for many body functions. Selenium is also a crucial antioxidant that protects cells (also muscle cells) against damage caused by free radicals and oxidative stress.
Older people with low selenium intake often have reduced muscle strength in their hips, knees, and hands, and that increases their risk of being injured if they fall. This was demonstrated in an Italian study published in American Journal of Clinical Nutrition. The selenium-containing selenoproteins are also involved in muscle tissue activity, and they even prevent the breakdown of muscle tissue caused by free radicals and oxidative stress. Moreover, selenium enhances Q10’s effect in the body’s energy turnover.
The daily need for selenium, according to the New Nordic Nutrient Recommendations, is 75 micrograms for women and 90 micrograms for men. European farmland is low in selenium, which is reflected in the entire food chain, and this makes it challenging for people to get enough selenium, even if they eat a balanced diet. In most studies of selenium, researchers have used a daily dose of 100-200 micrograms.

Q10’s effect on muscles

Q10 is a coenzyme that is highly important for the energy turnover in all cells, including muscle cells. According to a study that is published in Free Radical Research, Q10 supplementation has a rejuvenating effect on older people’s muscle fibers. This is believed to be because of its role as an antioxidant that counteracts oxidative damage in muscle cells.
The human body can synthesize most of the Q10 needed for various functions, but our endogenous Q10 synthesis decreases with age. The use of cholesterol-lowering statins also reduces the body’s Q10 synthesis. This can be compensated for with a daily Q10 supplement. Make sure to choose a preparation with documented bioavailability. Q10 is a molecule that is difficult for the body to absorb. In most studies of Q10, a daily dose of 100 mg twice daily has been given.

• The effect of the different supplements is improved if you are physically active and train your muscles.

References:

Attilio Giacosa et al. The nutritional support to prevent sarcopenia in the elderly. Frontiers in Nutrition. 2024

Van Dronkelaar et al. Minerals and Sarcopenia. The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass Muscle Strength, and Physical Performance in Older adults: A systematic review. J Am Med Dir Assoc Jan 2018

Nordic Council of Ministers. Nordic Nutrition Recommendations 2023

Linnane et al. Cellular redox activity of coenzyme Q10: effect of coQ10 supplementation on human skeletal muscle. Free Radical Research. 2002