"Aging and Healthy: Maintain healthy muscle mass."

Muscle lean mass (Sarcopenia) It refers to the loss of muscle mass, muscle strength, and body function, which is common in up to 1/3 of the general elderly. Muscle mass loss occurs more with age. As a result, most of the elderly have reduced physical strength and are not as active as before.

Although aging is the main factor in muscle mass loss, other risk factors such as sedentary behavior and lack of movement Improper nutrition Hormonal changes Other comorbidities such as diabetes, thyroid dysfunction. Illness and inflammation of the body, as well as the use of certain medications, are all catalysts for the elderly to experience greater muscle mass loss.

Elderly people with low muscle mass may feel weak and do not want to move their bodies. It is an endless cycle. Increased risk of falls Broken bonesAbility to perform daily routines and help oneself regresses (Functional decline) Increase the chance of hospitalization and death.

To prevent loss of muscle mass Older adults should focus on exercise and proper diet. If there is continuous appropriate behavior, It can restore the muscles to be good. Even if you start doing it at an advanced age.

Diet and exercise are important for maintaining muscle mass.

1. Exercise regularly

Resistance and Strength Exercises (Resistance and strength training) It is the most effective way to prevent muscle mass loss. Elderly people should exert themselves in all parts of the body, including the legs, hips, chest, and the body. Abdomen Arms and shoulders  You don't need to go to the gym or have a lot of equipment. Just use your body weight or equipment that you can find at home, such as a water bottle that is fully filled, and you can start exercising at home.

Older people may start by using light weights and not very long periods of time, and then gradually increase the weight and duration. When the strength of the musclesDo 2 to 3 sets of 8-12 reps in each part to maximize the benefits.

According to the recommendations of the US Centers for Disease Control and Prevention (Centers for Disease Control and Prevention, CDC) Seniors should do at least 150 minutes of moderate-intensity exercise per week, such as 30 minutes of brisk walking exercise 5 days a week, or 75 minutes of vigorous exercise per week such as running, swimming, speed cycling, etc., along with exercises that train muscle strength at least 2 days a week, such as push-ups on the wall (Wall Push-up) Front thigh muscle exercises (Quadriceps exercise) or do activities that train muscle strength, such as digging the soil for gardening, etc. If you have exercises that help you balance (Balance Exercise)  For example, Tai Chi will help prevent falls even better.

Physical activity is very important in increasing physical strength, but if the elderly are still unable to exercise, physical activity can be increased. (Physical Activity) By doing household chores such as gardening. Because the most important thing is to try to keep your body moving and sit less because there is research that confirms that people who move their bodies regularly can maintain their strength and physical fitness.

2. Eat properly and adequately.

Nutrition plays a very important role in maintaining muscle mass. Most often elderly people suffer from anorexia. Problems with gums and teeth, or even not being able to buy food on their own. This makes them eat less, especially protein, an important nutrient used to build muscle. Research shows that the consumption of foods containing proteinIt has a positive effect on the maintenance of muscle mass by the elderly without chronic kidney disease. Protein should be consumed about 1-1.2 For example, an elderly person weighing 50 kg should eat 50-60 grams of protein per day by choosing easily digestible protein sources such as fish, tofu, grains, milk, and nuts.

In addition to consuming enough protein each day. A large amount of protein should not be consumed in one meal. By protein content per meal A 2009 study compared muscle building between 30 grams of protein for 220 kcal and 90 grams of protein for 660 kcal.Ree in 1 It was found that muscle building did not increase in the protein consumption group. 90 g

Amino acids with a branched structure, or Branched chain amino acids (BCAA) Leucine (Leucine) Isoleucine (Isoleucine) and valine (Valine) and beta-hydroxybeta-methylbutyrate (Beta-Hydroxy-Beta-Methylbutyrate; ß-HMB) It can contribute to increasing muscle protein synthesis and increasing muscle strength. Seniors may choose to take supplements containing these nutrients in addition to their regular meals.

Eat enough protein.

• Older people need more protein. To compensate for the reduced muscle building process, including many underlying medical conditions.
• Older people may experience age-related problems that cause a decrease in their diet, such as loss of appetite. Underlying medical conditions or financial problems
• It is recommended that the elderly eat at least protein. 1 – 1.2 The amount varies depending on the nutritional status of each individual.

Exercise

• Regular exercise helps maintain muscle mass, muscle strength, and working capacity.
• Resistance exercises It has a positive effect on muscle recovery in the elderly and should be done in conjunction with eating an adequate amount of protein.

‘Prevention is key.'

Preventing or slowing muscle mass loss reduces the risk of potential health problems in the elderly. Maintaining muscle mass is like saving money for retirement. The elderly, including the children and grandchildren in the house, should pay attention to it. Regarding diet and nutrition, exercise, you may consult a doctor and a specialist to take care of the elderly body to maintain the strength as much as possible.

By Medical Team BDMS Wellness Clinic Institute and the Association of Physicians for Health Rehabilitation and Promotion of Obesity Education, Bangkok (BARSO)

References:

1. Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clinical nutrition. 2014;33(6):929-36.
2. Meier NF, Lee DC. Physical activity and sarcopenia in older adults. Aging Clin Exp Res. 2020;32(9):1675-87.
3. Symons, T.B.; Sheffield-Moore, M.; Wolfe, R.R.; Paddon-Jones, D. A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J. Am. Diet. Assoc. 2009, 109, 1582–86.
4. Centers for Disease Control and Prevention (2023) How much physical activity do older adults need?, Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm#:~:text=Adults% 20aged%2065%20 and%20older,of%20activities%20that%20strengthen%20muscles. (Accessed: 16 May 2024).