Dominic Stone
Muscle retention is a topic that gains relevance as we age, as muscle atrophy, or the wasting and thinning of muscle tissue, is a natural part of the ageing process. Muscle atrophy can be caused by muscle disuse, malnutrition, age, genetics, lack of physical activity, nerve problems, or certain medical conditions. As muscle atrophy can make daily activities challenging, it is important to understand how to retain muscle mass. This can be achieved through regular exercise, a healthy diet, and progressive resistance training.
| Characteristics | Values |
|---|---|
| Definition | Muscle atrophy is the wasting, thinning, or loss of muscle mass or tissue. |
| Symptoms | Muscle weakness, numbness, tingling in limbs, difficulty in swallowing or speaking, trouble walking or <co: 1,5,6,16,20>balancing, decrease in muscle size. |
| Causes | Malnutrition, age, genetics, lack of physical activity, nerve problems, diseases, muscle immobility, certain medications, natural aging. |
| Diagnosis | Physical exam, blood test, muscle or nerve biopsy, electromyography (EMG), nerve conduction studies, CT scan, MRI scan, dual-energy X-ray absorptiometry (DEXA or DXA), bioelectrical impedance analysis (BIA). |
| Treatment | Exercise, healthy diet, progressive resistance-based strength training, anabolic agents, nutritional therapy, testosterone supplements, protein supplements. |
| Prevention | Regular exercise, aerobic exercise, resistance training, balance training, progressive resistance training (PRT), increasing protein intake. |
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What You'll Learn
Muscle atrophy types
Muscle atrophy refers to the wasting or thinning of muscle mass. It is characterised by a decrease in muscle mass, weakness, and numbness or tingling in the limbs. The condition can be caused by muscle disuse or neurogenic conditions.
There are several types of muscle atrophy, including:
Disuse (Physiologic) Atrophy
This type of atrophy occurs when muscles are not used enough, leading to a decrease in size and strength. Individuals with sedentary lifestyles, inadequate nutrition, or those who are on bed rest are at risk of developing disuse atrophy. It can also be caused by genetic disorders such as muscular dystrophy or Charcot-Marie-Tooth disease. Disuse atrophy can often be reversed through regular exercise, physical therapy, and improved nutrition.
Neurogenic Atrophy
Neurogenic atrophy is caused by injuries or diseases that affect the nerves connecting to the muscles. When these nerves are damaged, they cannot trigger the muscle contractions necessary for muscle activity. This type of atrophy can sometimes be treated with a specialised form of physical therapy called electrical stimulation, where electrodes are placed on the skin to send electrical impulses to the nerves and muscles.
Pathologic Atrophy
Pathologic atrophy is associated with aging, starvation, and diseases such as Cushing's disease, which can be caused by the overuse of corticosteroids or overactive adrenal glands.
Age-Related Atrophy (Sarcopenia)
Sarcopenia is the age-related progressive loss of muscle mass and strength. It is primarily caused by the natural aging process, including changes in hormones such as testosterone and insulin-like growth factor (IGF-1). Sarcopenia can be treated with lifestyle changes, including progressive resistance-based strength training and a healthy diet with adequate protein intake.
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Reversing muscle atrophy
Muscle atrophy is a condition that can affect anyone, especially those with spinal cord injuries or MS. It occurs when a muscle group isn't being used, so the body begins to break it down. This can happen due to injury, illness, disease, or age. Physiologic atrophy, or muscle wasting, is a slow process that can occur from prolonged illness, malnutrition, or neurological disease. It is a physical process that occurs gradually, and the rebuilding of muscles also takes time.
To reverse muscle atrophy, it is important to address the underlying causes. The most effective methods for reversing atrophy are similar to those used to prevent it, including staying active, physical therapy, passive movements, and maintaining good nutrition. Using the affected muscles can help prevent or reverse atrophy, and physical therapists can guide patients through safe exercises to keep muscles strong and maintain or gain mobility. Passive movement techniques involve the therapist manually moving the paralysed or stiff limb to teach the muscles how to move again, increasing mobility and promoting healing.
For those unable to perform intense exercise, any amount of movement can help. Mild or moderate activities, such as walking a few steps with assistance or bathing, are important for regaining strength and rebuilding muscle. Good nutrition is also key, as malnutrition and lack of nutrients and protein can contribute to atrophy. A high-protein diet of 25 to 40 grams per meal can help muscles maintain their mass.
In addition to diet and exercise, there are tools such as the MyoCycle that can help retain or build muscle mass. Electrical stimulation can also be incorporated into active or passive exercises to encourage muscle contraction. Progressive loading can stimulate muscle growth and help reverse atrophy, but regaining muscle strength and control requires a high number of repetitions.
There are also therapeutic strategies for skeletal muscle atrophy caused by injury, denervation, diabetes, cancer, or sepsis. For example, torbafylline reduces inflammatory cytokine levels, while pentoxifylline administration inhibits protein degradation. Natural substances such as salidroside, baicalin, atractylenolide I, isoquercetin, and N-acetyl-L-cysteine have been shown to alleviate skeletal muscle atrophy in animal models and cell cultures.
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Sarcopenia
The main symptom of sarcopenia is muscle weakness, with other symptoms including loss of stamina, difficulty performing daily activities, walking slowly, trouble climbing stairs, poor balance, and a decrease in muscle size. The rate of muscle loss depends on exercise level, co-morbidities, nutrition, and other factors. Sarcopenia is diagnosed when a patient has muscle mass that is at least two standard deviations below the relevant population mean and has a slow walking speed. The degree of sarcopenia is determined by two factors: the initial amount of muscle mass and the rate at which muscle mass declines.
The pathologic changes of sarcopenia include a reduction in muscle tissue quality, an increase in fibrosis, changes in muscle metabolism, oxidative stress, and degeneration of the neuromuscular junction. These changes are believed to be caused by a combination of factors, including decreased type II muscle fibre size and number, inactivity, obesity, insulin resistance, reduced androgen and growth factor serum concentrations, inadequate protein intake, and a blunted muscle protein synthesis (MPS) response to protein meals or resistance exercise. Sarcopenia is also associated with several chronic diseases that negatively affect the musculoskeletal system and physical activity, including chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), chronic kidney disease (CKD), diabetes mellitus (DM), human immunodeficiency virus (HIV), and cancer.
Treatment for sarcopenia typically includes lifestyle changes such as progressive resistance-based strength training and a healthy diet with increased protein intake through food or supplements.
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Preventing muscle atrophy
Muscle retention refers to the preservation of muscle mass. Muscle atrophy, on the other hand, is the wasting or thinning of muscle mass. It can be caused by various factors, including disuse of muscles, neurogenic conditions, malnutrition, age, genetics, and certain medical conditions. Here are some detailed tips to prevent muscle atrophy:
Exercise and Physical Activity
Regular exercise is crucial for preventing muscle atrophy. Aim for a combination of resistance exercises, weightlifting, and stair climbing. Progressive resistance training (PRT) is particularly effective, as it involves gradually increasing the intensity of your workouts as your strength and endurance improve. This continuous challenge helps build muscle and prevents plateaus. It is recommended to exercise seven days a week for optimal results, rather than sporadically.
Healthy Diet
A well-balanced diet that includes sufficient protein is essential for muscle retention. Protein is crucial for muscle building, as the body breaks it down into amino acids, which are then used to build muscle. Animal sources such as meat, eggs, and milk provide the ideal ratios of essential amino acids. For older adults, a daily protein intake of 1 to 1.3 grams per kilogram of body weight is recommended, especially if engaging in resistance training. Consuming a meal or drink with a carbohydrate-to-protein ratio of 3:1 or 4:1 within 30 minutes after your workout can also maximize muscle growth and improve recovery.
Addressing Malnutrition and Nutritional Deficiency
Malnutrition and nutritional deficiencies can contribute to muscle atrophy. Ensuring adequate intake of lean protein sources and optimizing your diet with nutritional support can help prevent muscle wasting.
Hormonal Factors
Changes in hormones, such as testosterone and insulin-like growth factor (IGF-1), can affect muscle fibers and contribute to muscle loss. While testosterone supplements have shown potential in building muscle mass, they are not FDA-approved for this purpose, and adverse effects may occur. Hormonal replacement therapy for combating muscle loss has had limited success due to the multifactorial nature of the problem.
Neurogenic Conditions
Neurogenic atrophy occurs due to nerve problems or diseases that affect the nerves connecting to the muscles. While this type of atrophy is more complex, certain treatments, such as gene therapy, stem cell therapy, cytokine therapy, and physical therapy, can help address neurogenic muscle atrophy.
Surgery-Related Atrophy
Surgery can induce muscle atrophy due to the release of cortisol, a major stress hormone. While research is ongoing, specific types of testosterone injections before surgery may help prevent this type of atrophy.
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Muscle-building diet
Muscle retention refers to preventing muscle atrophy, or the wasting and thinning of muscle mass. This can be caused by muscle disuse, neurogenic conditions, malnutrition, age, genetics, or certain medical conditions. Muscle atrophy can be reversed with exercise and a healthy, muscle-building diet.
Protein
Protein is essential for muscle growth, as it is broken down into amino acids, which are used to build muscle. Animal sources such as meat, eggs, and milk provide the proper ratios of all the essential amino acids. However, older men may experience anabolic resistance, which lowers their bodies' ability to break down and synthesize protein, so they may require more protein in their diets. A daily intake of 1 to 1.3 grams of protein per kilogram of body weight is recommended for older adults who do resistance training. For example, a 175-pound man should aim for about 79 to 103 grams of protein per day.
Carbohydrates
Consuming a meal or drink with a carbohydrate-to-protein ratio of about 3:1 or 4:1 within 30 minutes after a workout can maximize muscle growth and improve recovery. For example, chocolate milk, which contains about 22 grams of carbohydrates and 8 grams of protein, is a good choice.
Micronutrients
In addition to protein and carbohydrates, certain micronutrients are important for muscle growth. Iron, for example, plays a role in storing and transporting oxygen in the blood and muscles, and vitamin B12 is important for nerve and blood cell health, which can help with exercise performance.
Calories
For those looking to build muscle mass, a caloric surplus is generally recommended. During the bulking phase, bodybuilders typically eat a high-calorie, protein-rich diet and lift weights intensely to maximize muscle growth. This is followed by a cutting phase, during which the focus shifts to losing body fat while maintaining muscle mass.
Resistance Training
Progressive resistance training (PRT) is a key component of muscle growth, as it involves gradually increasing workout volume, weight, reps, and sets as strength and endurance improve. This constant challenge helps build muscle and prevent plateaus.
Variety
It is important to incorporate a variety of foods into your diet to ensure your nutritional needs are met, especially during periods of caloric restriction. This can include nuts, eggs, cheese, beans, legumes, and various sources of meat.
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Frequently asked questions
Muscle retention is the ability to maintain muscle mass. Muscle atrophy, or muscle loss, can occur due to various factors such as age, lack of physical activity, malnutrition, nerve damage, or certain medical conditions.
To prevent muscle atrophy, it is important to stay physically active and maintain a healthy diet. Progressive resistance training (PRT) is particularly effective in building and retaining muscle mass. A high-protein diet is also recommended, with a daily intake of 1 to 1.3 grams of protein per kilogram of body weight suggested for older adults doing resistance training.
Yes, muscle atrophy can often be reversed through exercise and improved nutrition. Treatment depends on the underlying cause of the atrophy, but it often includes physical activity and adequate nutrition.
