Sarcopenia Among Seniors can be Prevented

A senior doing push-ups at a gym. (iStockphoto/Thinkstock)
A senior doing push-ups at a gym. (iStockphoto/Thinkstock)

Sarcopenia is not a disease. But it may kill you. It makes you frail because there is incremental loss of strength, increasing the risk of hospitalization and death. Sarcopenia is a Greek word which means “poverty of flesh.” It is part of aging. The skeletal muscles degenerate 0.5 to one per cent per year after the age of 25. Older adults lose about three per cent of their lean body mass each decade.

In the United States, an estimated 53 percent of men and 43 percent of women over 80 are sarcopenic, says an article in the New York Times.

The European Working Group on Sarcopenia in Older People (EWGSOP) says that for the diagnosis of sarcopenia, there should be presence of low muscle mass and low muscle function (strength or performance). The exact reason for sarcopenia is not known. Lack of exercise increases the likelihood of sarcopenia. Muscle fibres are replaced with fat and there is an increase in fibrous tissue – akin to scar tissue.

As the aging process keeps marching on, there is a tendency to be less physically active. That should be avoided if you want your muscles to maintain bulk and strength. Studies have shown exercise in the very old can increase strength and muscle function and improve balance. This will reduce the risk of falling and breaking bones. Your capacity to live independently will increase.

It has been shown sarcopenia is an important independent predictor of disability, linked to poor balance, gait speed, falls, and fractures. Sarcopenia is very similar to osteoporosis where there is loss of bone caused by inactivity. Osteoporosis can be prevented with regular exercise just like sarcopenia. Combination of sarcopenia and osteoporosis in old age causes significant frailty and risk of falling.

There are two ways to prevent and treat sarcopenia. One is regular exercise and second one is intake of adequate amount of dietary protein.

Regular exercise increases the ability and capacity of skeletal muscle to synthesize proteins in response to short term resistance exercise. Thirty minutes of walking three times a week and light resistance exercise three times a week can do wonders for physical strength in frail individuals. For an elderly person who is not able to lift light weights, should try water aerobics.

Having a good high protein diet is important. In the elderly, it should be more than the amount recommended to prevent deficiency disease, says the Times article quoting one of the experts interviewed by the paper. For older adults, four ounces of fish, chicken or turkey a day, and an additional protein snack in the afternoons to combat a dip in energy will help. Also include vegetarian protein sources like soy or quinoa, to provide variety without dietary fat, says the expert.

Other strategies include: use of testosterone or anabolic steroids, agents such as DHEA and human growth hormone, selective androgen receptor modulators (SARMs), and the fatty acids EPA and DHA contribute to increased muscle strength. Some of these treatments have side effects and some have not proven to be of benefit. So, high protein intake (if there is no kidney disease) and regular exercise to build strength remains the main therapy to prevent and treat sarcopenia.

Remember, November is Seniors’ Falls Prevention Month.

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Sugar… Sugar… You Are Not My Honey Anymore

Ice cream and fried bananas. (Dr. Bharwani)
Ice cream and fried bananas. (Dr. Bharwani)

Many experts believe sugar is a poison. So does the Mayor of New York city, Michael R. Bloomberg. The mayor has been trying to improve the health habits of New Yorkers for some time, with actions like bans on smoking in bars and city parks and the posting of calorie counts on menus in chain restaurants.

Bloomberg’s recent project was to reduce the obesity rates of his citizens by restricting the amount of sugary drinks they can buy. So, last week, the New York City Board of Health approved a ban on the sale of large sodas and other sugary drinks at restaurants, street carts and movie theaters, the first restriction of its kind in the U.S. Now sugary drinks cannot be sold in containers larger than 16 ounces – some exceptions apply.

Dietary sugar is not good for your health. There are nine reasons why you should quit on sweetie sugar. It may cause hyperactivity, raise blood sugar level, suppress immune system, lead to obesity and diabetes, cause cardiovascular disease, Alzheimer’s disease, dental decay and macular degeneration.

Like many things in science, you can dig out statistics which have contradictory conclusions. This leads to confusion. The World Health Organization and others have said there are contrasting impacts of sugar in refined and unrefined forms. So there are at time no comparable studies to draw conclusions from.

Some experts believe hyperactivity is due to sugar consumption. Others have refuted the idea. Until we get a final word on it, you can stop feeding sugar to kids and adults – especially if they get sugar-high. Your blood sugar level goes up as soon as you eat sugary stuff. Consuming too much sugar suppresses the immune system. The white blood cells that attack bacteria are less effective. Immune system is also suppressed if a person is obese.

Consuming large amount of dietary sugar does not cause diabetes but it does cause obesity which is a risk factor in diabetics. A meta-analysis of several studies found sugar-sweetened beverages may increase the risk of metabolic syndrome and type 2 diabetes not only through obesity but also by increasing dietary glycemic load, leading to insulin resistance, β-cell dysfunction, and inflammation. Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. It is estimated the syndrome is present in 25 per cent of the the U.S. population.

There is indirect evidence to suggest consuming a diet with a high glycemic load is strongly associated with an increased risk of developing coronary heart disease. The glycemic index ranks foods on how they affect our blood glucose levels.

It is suggested that Alzheimer’s disease is linked with the western diet. Animal studies suggest controlling the consumption of sugar-sweetened beverages may be an effective way to curtail the risk of developing the disease. There are links between free sugar consumption and macular degeneration in older age. There is convincing evidence from human studies to show an association between the amount and frequency of free sugars intake and dental decay.

Bloomberg’s next project should be to do what Japan did in 2008. A law in Japan requires overweight individuals or individuals who show signs of weight – related illnesses to go to dieting classes. If they fail to attend the classes then the company and/or the local government would be fined.

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Eat Fruits and Vegetables to Produce Healthier Sperm

A sperm fertilizing an egg. (iStockphoto/Thinkstock)
A sperm fertilizing an egg. (iStockphoto/Thinkstock)

A study published in Fertility and Sterility reported men who consume a high amount of certain nutrients may produce healthier sperm than men who do not. The study also found this effect to be more pronounced in older men.

Dr. Andrew Wyrobeck and his colleagues from Lawrence Berkeley National Laboratory, Berkeley, California determined dietary micronutrient intake among 80 individuals aged 22 to 80 years. Examples of micronutrients are vitamin C, vitamin E, and zinc. These nutrients are required by the body in small quantities for a whole range of physiological functions. The human body does not produce these micronutrients. Sperms from these individuals were also analysed.

The study found men with a higher intake of vitamin C, vitamin E, folate, and zinc produced sperm that had significantly less DNA damage than men who consumed lower amounts. Analysis showed that older men with an intake below that of the population’s median levels for vitamin C, vitamin E, and zinc (but not β-carotene or folate) had significantly more sperm DNA damage compared with all other groups, including older men with above median intakes.

What does this mean? It means older men who are planning to father a child in the near future should start eating a healthy diet if they are not doing so already. Older fathers, with DNA-damaged sperm, may be contributing to the increasing rates of autism, schizophrenia and other diseases among children and adolescents.

Researchers say consuming micronutrients such as vitamin C, E, folate and zinc helps turn back the clock for older men. The analysis revealed that men older than 44 who consumed the most vitamins and micronutrients had 20 per cent less sperm DNA damage compared to men their own age who consumed the fewest nutrients.

In younger men, a higher intake of micronutrients didn’t improve the quality of the DNA in their sperm. The benefit was observed solely among the older men. But, of course, they are the ones most vulnerable to sperm DNA damage – and therefore have the most to gain from an improved diet.

Future studies are needed to determine whether increased antioxidant intake in older fathers will improve fertility, reduce risks for genetically defective pregnancies, and result in healthier children, concludes the team.

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A Pinch of Salt – The Rest of the Story

An overweight man getting his blood pressure checked. (Digital Vision/Thinkstock)
An overweight man getting his blood pressure checked. (Digital Vision/Thinkstock)

In my column last week, I discussed the adverse effects of dietary salt on your health. The conclusion was that if you want to stay healthy and have your blood pressure under control then you need to eat less than one teaspoon table salt a day.

After that, a reader sent me a link to a Scientific American article, “It’s Time to End the War on Salt,” written by Melinda Wenner Moyer.

Moyer says, “The zealous drive by politicians to limit our salt intake has little basis in science.”

Moyer’s argument is based on a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure.

Moyer goes on to quote several more studies from all over the world. She goes on to say, “These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.” She concludes the article by saying there is little evidence for long-term benefit from reducing salt intake.

Point well taken. However, there is evidence that shows too much or too little salt in the diet can lead to muscle cramps, dizziness, or electrolyte disturbance, which can cause neurological problems or death. Generally, more emphasis is given to the evidence showing an association between salt intake and blood pressure among adults. We also know reduced salt intake results in a small reduction in blood pressure. Evidence suggests that high salt intake causes enlargement of the heart and swelling of the legs. The evidence may be tenuous but it is there.

Like many things in science and particularly in medicine, strong evidence is lacking in many of the things doctors advise their patients about good health. Some advice is based on “tenuous” evidence as there is nothing better to suggest. When we have strong evidence that certain habits can lead to bad health and even cancer (e.g. smoking, sun worshipping) generally people ignore the advice.

The story of salt intake is a just a small pinch in the overall story of healthy eating and exercise in maintaining good cardiovascular system and good health. The message is, eat in moderation, it is not what you do and eat, it is how much you do and eat to stay healthy and happy.

Less salt won’t hurt you. Too much salt is not good for you.

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