Sarcopenia

Why muscle declines

MedlinePlus notes that people tend to lose lean tissue, including muscle, from around age 30, while fat tends to increase. The pace picks up later in life, especially with inactivity, illness, hospital stays, low protein intake and falling levels of hormones such as testosterone and estrogen.

The European Working Group on Sarcopenia in Older People notes that sarcopenia can begin earlier in life and has several contributors beyond aging, which is why midlife is a good time to build reserve.

How it is assessed

The group's 2019 update (EWGSOP2) uses a three-step approach:

• Probable sarcopenia: low muscle strength, measured with a hand-grip dynamometer or the time it takes to rise from a chair five times.
• Confirmed sarcopenia: low muscle quantity or quality, often estimated with DXA or bioelectrical impedance.
• Severe sarcopenia: also low physical performance, such as walking speed of 0.8 meters per second or slower.

Why it matters in midlife

Muscle is more than strength. It is a major site of glucose uptake, so losing it can worsen insulin resistance. It protects joints and bones, and it underpins balance, which falls depend on.

Rapid weight loss, including on GLP-1 medicines, can include a meaningful share of lean mass. Pairing weight loss with strength training and adequate protein helps protect muscle while fat comes off.

What helps

• Progressive resistance training: CDC advises muscle-strengthening activity at least two days a week, and balance work for older adults.
• Regular aerobic activity, about 150 minutes a week of moderate effort.
• Enough protein spread across meals, tailored to kidney health and your clinician's advice.
• Addressing contributors such as low vitamin D, untreated hormone deficiency, sleep problems and medications that sap energy.

Medication and evidence limits

No medicine is FDA-approved specifically to treat sarcopenia. Hormone therapy may help muscle in people with confirmed deficiency, and some peptides are marketed for body composition, but evidence in healthy aging adults is limited. Exercise remains the best-supported tool, and a HealifyMD clinician can help you combine it with any treatment you are considering.

Warning signs worth mentioning

Tell a clinician if you notice it is harder to open jars, climb stairs, get up from a low chair or carry groceries, or if you have had a fall or unplanned weight loss. These everyday changes are often the first clues, and they are easier to reverse when caught early.