Understanding Muscle Wasting: Causes And Triggers

what causes muscle waste

Muscle wasting, or atrophy, is the decrease in muscle size and tissue, resulting in a loss of strength and movement. There are several causes of muscle wasting, including physiologic atrophy, which is caused by not using muscles enough, and neurogenic atrophy, which is caused by nerve injuries or diseases. Age-related muscle loss, or sarcopenia, is another common cause of muscle wasting, as the body goes through changes such as decreased protein production and hormone level changes, leading to a faster loss of muscle mass. Additionally, certain medical conditions, such as amyotrophic lateral sclerosis (ALS), muscular dystrophy, and multiple sclerosis, can contribute to muscle wasting. Malnutrition, chronic illnesses, and prolonged inactivity due to bed rest or injuries can also lead to muscle atrophy. Treatment for muscle wasting depends on the underlying cause and may include exercise, physical therapy, ultrasound therapy, and nutritional interventions.

Characteristics Values
Type Physiologic (Disuse), Pathologic, Neurogenic
Causes Sedentary lifestyle, malnutrition, inadequate protein intake, nerve injuries, aging, stroke, osteoarthritis, muscular dystrophy, Charcot-Marie-Tooth disease, dermatomyositis, genetic disorders, chronic illnesses
Symptoms Loss of movement, weakness, numbness, tingling in limbs, decrease in muscle mass and strength
Treatment Exercise, physical therapy, ultrasound therapy, surgery, healthy diet, nutritional supplements, electrical stimulation therapy

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Sedentary lifestyle and lack of exercise

A sedentary lifestyle and lack of exercise can lead to muscle wastage, also known as muscle atrophy. This is a condition where muscles waste away due to disuse, resulting in a decrease in muscle mass, strength, and endurance.

Our muscles are made up of bundles of fibres that grow and strengthen when exposed to activity and resistance training. When we engage in physical activity, these fibres sustain tiny amounts of damage and then repair themselves, increasing in thickness and size over time. This leads to boosted muscle mass and improved power and endurance. However, when we lead sedentary lifestyles and don't get enough exercise, our muscles remain inactive and contracted for prolonged periods.

As a result, underused muscles start to waste away. The protein structures and fibres in the muscles break down faster than they can rebuild, leading to muscle atrophy. Research has shown that adults with desk jobs can lose up to 3.8% of their muscle mass per day from sitting too long. This diminished muscle growth translates into reduced strength for daily movements. Staying in seated postures with hunched shoulders and rounded backs for extended periods can cause muscles to stiffen, shortening and tightening them, which constrains our range of motion for basic functions like bending down or getting up from a chair.

To counteract the effects of a sedentary lifestyle and promote muscle health, it is essential to incorporate movement and exercise into your daily routine. Aim for at least 7,000 to 10,000 steps per day and include activities such as walking, pacing while on the phone, or taking the stairs. Incorporate bodyweight exercises, resistance bands, weights, or weight machines to challenge your muscles and promote adaptation and strength gains. Focus on major muscle groups such as hips, legs, back, core, chest, shoulders, and arms.

Additionally, reduce sitting time during leisure activities by standing whenever possible, such as when watching TV or during social gatherings. Interval sitting can also help muscles recover during periods when sitting is necessary. Schedule seated tasks in intervals of 20 to 30 minutes with short breaks in between to walk around and stretch. Getting upright hourly prevents muscles from remaining stagnantly contracted and helps prevent muscle atrophy.

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Malnutrition and inadequate nutrition

Muscle wasting due to malnutrition can occur in people who are overweight or underweight. In developed countries, poorer communities often have easier access to fast food, which is high in calories but low in nutritional value. This can lead to a deficiency of macronutrients like proteins, carbohydrates, and fats, which are essential for the body to produce energy. Micronutrient deficiencies, such as a lack of vitamins and minerals, can also contribute to muscle wasting.

Undernutrition, a form of malnutrition, occurs when an individual does not consume an adequate diet or when the body has difficulty absorbing nutrients. Certain medical conditions, such as nausea or difficulty swallowing, can make it challenging for the body to absorb sufficient nutrients, leading to undernutrition and muscle wasting. Additionally, financial constraints and limited access to nutritious foods can be factors in undernutrition.

To prevent and treat muscle wasting caused by malnutrition, proper nutrition is crucial. A diet that provides sufficient calories, protein, and other nutrients that promote muscle development is essential. Working with a dietitian to improve nutritional intake and incorporating nutritional supplements may be recommended.

In addition to nutritional interventions, physical activity plays a vital role in combating muscle wasting. Regular exercise helps stimulate muscle contraction and promotes muscle growth. Even individuals with limited mobility can benefit from exercises performed with the assistance of braces or splints. Physical therapy, including focused ultrasound therapy, can also be employed to prevent and treat muscle atrophy.

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Genetic disorders

Muscle atrophy or wasting can be caused by various factors, including genetics. Genetic disorders such as muscular dystrophy and Charcot-Marie-Tooth disease can lead to muscle wasting.

Muscular Dystrophy

Muscular dystrophy is a group of more than 30 genetic disorders that cause progressive weakness and degeneration of skeletal muscles. The condition is caused by changes or mutations in the genes responsible for producing proteins necessary for healthy muscle structure and function. These mutations prevent cells from maintaining muscles, leading to progressive muscle weakness and wasting. Muscular dystrophy can affect people of all ages, from infancy to adulthood, with symptoms worsening over time. It can impact various muscle groups, including the face, shoulders, upper arms, calves, neck, and tongue. Some types of muscular dystrophy also affect organs such as the heart, lungs, and brain.

There are several types of muscular dystrophy, including:

  • Emery-Dreifuss: This type typically starts by age 10 and causes stiffness in certain joints, making it difficult for children to bend their elbows or walk flat on their feet. It leads to the wasting and weakening of muscles in the upper arms and lower legs.
  • Facioscapulohumeral (FSHD): FSHD initially affects the muscles of the face, shoulders, and upper arms, causing progressive weakness. It can cause asymmetric weakness, with one side of the body being more affected than the other.
  • Congenital: Congenital muscular dystrophy presents at birth or before age 2 and causes muscle weakness that worsens over time. Some forms progress slowly, while others rapidly lead to serious health challenges.
  • Myotonic: This type of muscular dystrophy affects the ability to relax muscles voluntarily. It often starts between ages 20 and 30, impacting facial and neck muscles first. As the disease progresses, it can affect the heart muscle and cause an irregular heartbeat.
  • Oculopharyngeal: Oculopharyngeal muscular dystrophy usually begins in a person's 40s or 50s and affects the muscles of the face, tongue, and throat, leading to swallowing difficulties.

Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth disease is a neuromuscular disorder that affects the nerves controlling voluntary muscles and those communicating sensory information back to the brain. When these neurons become unhealthy or die, it leads to muscle weakness and atrophy.

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Neurological conditions

In addition to these conditions, intensive care unit (ICU)-induced skeletal muscle wasting is a complex issue that can arise from prolonged bed rest, even in healthy patients. Limb muscle wasting is particularly common in critical illnesses such as sepsis, organ failure, hyperglycemia, and diseases associated with systemic inflammation or oxidative stress. Certain treatments, such as neuromuscular blockers, can further increase the risk of muscle wasting in ICU patients.

Neurogenic atrophy can sometimes be treated with a specialized form of physical therapy called electrical stimulation. This involves placing electrodes on the skin over the affected muscles to send electrical impulses that stimulate muscle contractions and help maintain muscle mass and strength.

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Ageing

The onset of sarcopenia typically begins in one's 30s, with muscle mass decreasing by about 3-5% per decade. However, the rate of muscle loss can vary, and some individuals may experience a more rapid decline starting around age 60. The loss of muscle mass and strength associated with sarcopenia can significantly impact an individual's ability to perform daily tasks, such as getting out of chairs, opening jars, or carrying groceries.

The underlying causes of sarcopenia are multifaceted and not fully understood. One contributing factor is a decrease in the number and size of muscle fibres, leading to muscle thinning. Additionally, age-related hormonal changes, such as reduced levels of testosterone and insulin-like growth factor (IGF-1), can affect muscle fibres and contribute to sarcopenia. Furthermore, the body's ability to convert protein into energy decreases with age, which may also play a role in muscle wasting.

Physical inactivity and a poor diet are also considered risk factors for sarcopenia. A sedentary lifestyle can lead to faster muscle loss and increasing weakness. Additionally, a diet lacking sufficient calories, protein, and other essential nutrients can contribute to muscle wasting. Chronic diseases, such as COPD, kidney disease, diabetes, cancer, and HIV, are also associated with an increased risk of sarcopenia.

While sarcopenia is a natural consequence of ageing, it is not an inevitable process. Studies suggest that staying active and incorporating progressive resistance training into one's routine can effectively prevent and even reverse sarcopenia. Additionally, ensuring adequate calorie and protein intake, as well as considering supplements like omega-3 fatty acids and creatine, may help slow down muscle loss associated with ageing.

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Frequently asked questions

There are three types of muscle atrophy: physiologic, pathologic, and neurogenic. Physiologic atrophy is caused by not using muscles enough, and can be reversed with exercise and better nutrition. Pathologic atrophy is associated with aging, starvation, and diseases such as Cushing disease. Neurogenic atrophy is the most severe type and is caused by an injury to, or disease of, a nerve that connects to the muscle.

Medical conditions that cause muscle wasting include amyotrophic lateral sclerosis (ALS), muscular dystrophy, multiple sclerosis (MS), and spinal muscular atrophy. ALS is a progressive disease that affects nerve cells throughout the body. Muscular dystrophy is a genetic condition that leads to progressive muscle weakness and wasting. MS is an autoimmune disease that affects the myelin surrounding nerve fibres, causing damage to the nerves and in turn, the muscles.

Non-medical causes of muscle wasting include prolonged inactivity, bed rest, and malnutrition. Research shows that muscle wasting can develop within 10 days in healthy older adults on bed rest. Malnutrition, caused by conditions such as anorexia nervosa, cancer, or persistent nausea, can also lead to muscle wasting.

Sarcopenia is a type of muscle atrophy that is caused by the natural aging process. It is characterised by a progressive loss of muscle mass and strength, leading to muscle weakness, loss of stamina, and difficulty performing daily activities. The risk factors for sarcopenia include physical inactivity, chronic diseases such as diabetes and cancer, and malnutrition.

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