Last Updated: August 16, 2022

Sarcopenia is a condition characterized by a progressive loss of muscle mass and strength. It arises as a consequence of aging or is caused by factors like disease, physical inactivity, or inadequate nutrition. Resistance training and a high-protein diet are the primary treatments for sarcopenia.

research-feedResearch feed
What is sarcopenia?

Sarcopenia is a progressive and generalized skeletal muscle disorder characterized by a loss of muscle mass and strength and is associated with an increased risk of adverse outcomes, including falls, bone fractures, postoperative complications, physical disability, and mortality.[1][2]

There are two types of sarcopenia — primary and secondary. Sarcopenia is considered primary when it results from no other underlying cause except for age.[1] It is considered secondary when causal factors other than age are present, such as disease (e.g., cancer, advanced organ failure), malnutrition, or physical inactivity.

What are the main signs and symptoms of sarcopenia?
  • History of recurrent falls
  • Feeling weak
  • Slow walking speed
  • Difficulty rising from a chair
  • Recent unintentional weight loss (> 5%)
How is sarcopenia diagnosed?

Muscle mass, strength, and physical performance are assessed to diagnose sarcopenia.[1] Diagnosis starts with muscle strength, usually grip strength measured using a calibrated handheld dynamometer, but lower body strength may also be assessed using the chair stand test, which measures the amount of time it takes the individual to rise five times from a seated position without using their arms. If low muscle strength is determined, muscle quantity is assessed to confirm the presence of sarcopenia. Lastly, physical performance is assessed using scores on the gait speed test, the Short Physical Performance Battery, the Timed-Up and Go test, or the 400-meter walk test to determine the severity of sarcopenia.

What are some of the main medical treatments for sarcopenia?

No specific drugs have been approved for the treatment of sarcopenia. Testosterone treatment may increase muscle mass and strength in older men with low serum testosterone levels (<200–300 ng/mL) and muscle weakness.[3] In addition, preliminary evidence suggests that myostatin inhibitors, which block the actions of myostatin — a protein secreted by muscle cells that inhibits protein synthesis and hypertrophy — may increase muscle mass and some measures of physical performance.[4][5] However, the medical use of myostatin inhibitors as a treatment of sarcopenia is currently limited to clinical trials.

Have any supplements been studied for sarcopenia?

The following supplements have been studied for the treatment of sarcopenia and have shown some efficacy in different scenarios (e.g., when combined with resistance exercise, in people with inadequate dietary intake):[6]

How could diet affect sarcopenia?

Protein is crucial for skeletal muscle growth and maintenance, and older adults display an impaired muscle protein synthesis response to the ingestion of protein,[7] so a large portion of the evidence base revolves around optimizing protein intake for the prevention and treatment of sarcopenia.

Total protein intake should ideally be 1.2–1.6 grams per kilogram of body weight per day, evenly distributed between 3–4 meals containing ≥ 0.4 grams of protein per kilogram of body weight.[6]

With respect to dietary patterns, largely consistent evidence from observational studies demonstrates that higher adherence to a Mediterranean diet is associated with better physical functioning, including lower extremity functioning, mobility, and walking speed.[8][9]

Are there any other treatments for sarcopenia?

Resistance exercise is the most potent non-medical treatment for combatting skeletal muscle deterioration and improving health-related quality of life.[10] It’s traditionally recommended that people perform 2–3 resistance training sessions per week using relatively heavy loads (i.e., 80% of 1-repetition maximum), but more recent evidence suggests that low-load resistance training (i.e., 35–50% of 1-repetition maximum) is similarly effective for increasing muscle mass and strength when performed to volitional fatigue.[6] A combined resistance training and high-protein diet intervention seems to be more effective than either intervention alone.[11]

What causes sarcopenia?

In the case of primary sarcopenia, there is a wide range of factors that contribute to the development of the condition, which are not entirely understood and largely thought to be natural consequences of aging.[2] These include decreased type II muscle fiber size, loss of motor units (i.e., a motor neuron and the muscle fibers it innervates), hormonal changes (i.e., a decline in serum levels of anabolic hormones like testosterone and insulin-like growth factor 1), anorexia (i.e., decreased or loss of appetite), decreased physical activity, anabolic resistance (i.e., a blunted muscle protein synthesis response to dietary protein and resistance exercise), systemic inflammation, insulin resistance, and increased body fat.[12]

Supplements Demystified: Get Our Unbiased, Evidence-Based Guide

Looking for a Supplement guide?

Our Supplement Guides give you unbiased research-based recommendations that you can immediately apply to improve your health. Sarcopenia is related to the following Supplement Guide:

Don't miss out on the latest research

  1. ^Alfonso J Cruz-Jentoft, Gülistan Bahat, Jürgen Bauer, Yves Boirie, Olivier Bruyère, Tommy Cederholm, Cyrus Cooper, Francesco Landi, Yves Rolland, Avan Aihie Sayer, Stéphane M Schneider, Cornel C Sieber, Eva Topinkova, Maurits Vandewoude, Marjolein Visser, Mauro Zamboni, Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2Sarcopenia: revised European consensus on definition and diagnosisAge Ageing.(2019 Jan 1)
  2. ^Andrew D. Ardeljan, Razvan HurezeanuSarcopenia
  3. ^Anton De Spiegeleer, David Beckwée, Ivan Bautmans, Mirko Petrovic, Sarcopenia Guidelines Development group of the Belgian Society of Gerontology and Geriatrics (BSGG)Pharmacological Interventions to Improve Muscle Mass, Muscle Strength and Physical Performance in Older People: An Umbrella Review of Systematic Reviews and Meta-analysesDrugs Aging.(2018 Aug)
  4. ^Clemens Becker, Stephen R Lord, Stephanie A Studenski, Stuart J Warden, Roger A Fielding, Christopher P Recknor, Marc C Hochberg, Serge L Ferrari, Hubert Blain, Ellen F Binder, Yves Rolland, Serge Poiraudeau, Charles T Benson, Stephen L Myers, Leijun Hu, Qasim I Ahmad, Kelli R Pacuch, Elisa V Gomez, Olivier Benichou, STEADY GroupMyostatin antibody (LY2495655) in older weak fallers: a proof-of-concept, randomised, phase 2 trialLancet Diabetes Endocrinol.(2015 Dec)
  5. ^Daniel Rooks, Jens Praestgaard, Sam Hariry, Didier Laurent, Olivier Petricoul, Robert G Perry, Estelle Lach-Trifilieff, Ronenn RoubenoffTreatment of Sarcopenia with Bimagrumab: Results from a Phase II, Randomized, Controlled, Proof-of-Concept StudyJ Am Geriatr Soc.(2017 Sep)
  6. ^James McKendry, Brad S Currier, Changhyun Lim, Jonathan C Mcleod, Aaron C Q Thomas, Stuart M PhillipsNutritional Supplements to Support Resistance Exercise in Countering the Sarcopenia of AgingNutrients.(2020 Jul 10)
  7. ^Traylor DA, Gorissen SHM, Phillips SMPerspective: Protein Requirements and Optimal Intakes in Aging: Are We Ready to Recommend More Than the Recommended Daily Allowance?Adv Nutr.(2018 May 1)
  8. ^Antoneta Granic, Avan A Sayer, Sian M RobinsonDietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older AdultsNutrients.(2019 Mar 30)
  9. ^S M Robinson, J Y Reginster, R Rizzoli, S C Shaw, J A Kanis, I Bautmans, H Bischoff-Ferrari, O Bruyère, M Cesari, B Dawson-Hughes, R A Fielding, J M Kaufman, F Landi, V Malafarina, Y Rolland, L J van Loon, B Vellas, M Visser, C Cooper, ESCEO working groupDoes nutrition play a role in the prevention and management of sarcopenia?Clin Nutr.(2018 Aug)
  10. ^D Beckwée, A Delaere, S Aelbrecht, V Baert, C Beaudart, O Bruyere, M de Saint-Hubert, I BautmansExercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella ReviewJ Nutr Health Aging.(2019)
  11. ^E Dent, J E Morley, A J Cruz-Jentoft, H Arai, S B Kritchevsky, J Guralnik, J M Bauer, M Pahor, B C Clark, M Cesari, J Ruiz, C C Sieber, M Aubertin-Leheudre, D L Waters, R Visvanathan, F Landi, D T Villareal, R Fielding, C W Won, O Theou, F C Martin, B Dong, J Woo, L Flicker, L Ferrucci, R A Merchant, L Cao, T Cederholm, S M L Ribeiro, L Rodríguez-Mañas, S D Anker, J Lundy, L M Gutiérrez Robledo, I Bautmans, I Aprahamian, J M G A Schols, M Izquierdo, B VellasInternational Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and ManagementJ Nutr Health Aging.(2018)
  12. ^Roger A Fielding, Bruno Vellas, William J Evans, Shalender Bhasin, John E Morley, Anne B Newman, Gabor Abellan van Kan, Sandrine Andrieu, Juergen Bauer, Denis Breuille, Tommy Cederholm, Julie Chandler, Capucine De Meynard, Lorenzo Donini, Tamara Harris, Aimo Kannt, Florence Keime Guibert, Graziano Onder, Dimitris Papanicolaou, Yves Rolland, Daniel Rooks, Cornel Sieber, Elisabeth Souhami, Sjors Verlaan, Mauro ZamboniSarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopeniaJ Am Med Dir Assoc.(2011 May)
  13. ^Malmstrom TK, Morley JESARC-F: a simple questionnaire to rapidly diagnose sarcopenia.J Am Med Dir Assoc.(2013-Aug)
  14. ^Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L, Morley JESARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes.J Cachexia Sarcopenia Muscle.(2016-03)
  15. ^Ferrucci L, de Cabo R, Knuth ND, Studenski SOf Greek heroes, wiggling worms, mighty mice, and old body builders.J Gerontol A Biol Sci Med Sci.(2012-Jan)
  16. ^Dodds RM, Syddall HE, Cooper R, Benzeval M, Deary IJ, Dennison EM, Der G, Gale CR, Inskip HM, Jagger C, Kirkwood TB, Lawlor DA, Robinson SM, Starr JM, Steptoe A, Tilling K, Kuh D, Cooper C, Sayer AAGrip strength across the life course: normative data from twelve British studies.PLoS One.(2014)
  17. ^Keller K, Engelhardt MStrength and muscle mass loss with aging process. Age and strength lossMuscles Ligaments Tendons J.(2014 Feb 24)
  18. ^Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood KFrailty in elderly people.Lancet.(2013-Mar-02)
  19. ^Langlois F, Vu TT, Kergoat MJ, Chassé K, Dupuis G, Bherer LThe multiple dimensions of frailty: physical capacity, cognition, and quality of life.Int Psychogeriatr.(2012-Sep)
  20. ^Douglas E, McMillan DCTowards a simple objective framework for the investigation and treatment of cancer cachexia: the Glasgow Prognostic Score.Cancer Treat Rev.(2014-Jul)
  21. ^Domić J, Grootswagers P, van Loon LJC, de Groot LCPGMPerspective: Vegan Diets for Older Adults? A Perspective On the Potential Impact On Muscle Mass and Strength.Adv Nutr.(2022-06-01)
  22. ^Philippe J M Pinckaers, Jorn Trommelen, Tim Snijders, Luc J C van LoonThe Anabolic Response to Plant-Based Protein IngestionSports Med.(2021 Sep)
  23. ^Stefan Hm Gorissen, Astrid Mh Horstman, Rinske Franssen, Julie Jr Crombag, Henning Langer, Jörgen Bierau, Frederique Respondek, Luc Jc van LoonIngestion of Wheat Protein Increases In Vivo Muscle Protein Synthesis Rates in Healthy Older Men in a Randomized TrialJ Nutr.(2016 Sep)
  24. ^Yang Y, Churchward-Venne TA, Burd NA, Breen L, Tarnopolsky MA, Phillips SMMyofibrillar protein synthesis following ingestion of soy protein isolate at rest and after resistance exercise in elderly menNutr Metab (Lond).(2012 Jun 14)
  25. ^Alistair J Monteyne, Mandy V Dunlop, David J Machin, Mariana Oc Coelho, George F Pavis, Craig Porter, Andrew J Murton, Doaa R Abdelrahman, Marlou L Dirks, Francis B Stephens, Benjamin T WallA mycoprotein based high-protein vegan diet supports equivalent daily myofibrillar protein synthesis rates compared with an isonitrogenous omnivorous diet in older adults: a randomized controlled trialBr J Nutr.(2020 Nov 11)
  26. ^Herreman L, Nommensen P, Pennings B, Laus MCComprehensive overview of the quality of plant- And animal-sourced proteins based on the digestible indispensable amino acid score.Food Sci Nutr.(2020-Oct)
  27. ^Meng Thiam Lim, Bernice Jiaqi Pan, Darel Wee Kiat Toh, Clarinda Nataria Sutanto, Jung Eun KimAnimal Protein versus Plant Protein in Supporting Lean Mass and Muscle Strength: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsNutrients.(2021 Feb 18)
  28. ^Victoria Hevia-Larraín, Bruno Gualano, Igor Longobardi, Saulo Gil, Alan L Fernandes, Luiz A R Costa, Rosa M R Pereira, Guilherme G Artioli, Stuart M Phillips, Hamilton RoschelHigh-Protein Plant-Based Diet Versus a Protein-Matched Omnivorous Diet to Support Resistance Training Adaptations: A Comparison Between Habitual Vegans and OmnivoresSports Med.(2021 Feb 18)
  29. ^Thomas DRSarcopeniaClin Geriatr Med.(2010 May)
  30. ^Sundell JResistance Training Is an Effective Tool against Metabolic and Frailty SyndromesAdv Prev Med.(2011)
  31. ^Johnston AP, De Lisio M, Parise GResistance training, sarcopenia, and the mitochondrial theory of agingAppl Physiol Nutr Metab.(2008 Feb)
  32. ^Pillard F, Laoudj-Chenivesse D, Carnac G, Mercier J, Rami J, Rivière D, Rolland YPhysical activity and sarcopeniaClin Geriatr Med.(2011 Aug)
  33. ^Bautmans I, Van Puyvelde K, Mets TSarcopenia and functional decline: pathophysiology, prevention and therapyActa Clin Belg.(2009 Jul-Aug)
  34. ^Kemmler W, von Stengel S, Engelke K, Häberle L, Kalender WAExercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: the randomized controlled senior fitness and prevention (SEFIP) studyArch Intern Med.(2010 Jan 25)
  35. ^Taaffe DR, Robinson TL, Snow CM, Marcus RHigh-impact exercise promotes bone gain in well-trained female athletesJ Bone Miner Res.(1997 Feb)
  36. ^Martyn-St James M, Carroll SEffects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysisJ Bone Miner Metab.(2010 May)
  37. ^Hourigan SR, Nitz JC, Brauer SG, O'Neill S, Wong J, Richardson CAPositive effects of exercise on falls and fracture risk in osteopenic womenOsteoporos Int.(2008 Jul)
  38. ^Kronhed AC, Möller MEffects of physical exercise on bone mass, balance skill and aerobic capacity in women and men with low bone mineral density, after one year of training--a prospective studyScand J Med Sci Sports.(1998 Oct)
  39. ^Asikainen TM, Kukkonen-Harjula K, Miilunpalo SExercise for health for early postmenopausal women: a systematic review of randomised controlled trialsSports Med.(2004)
  40. ^de Matos O, Lopes da Silva DJ, Martinez de Oliveira J, Castelo-Branco CEffect of specific exercise training on bone mineral density in women with postmenopausal osteopenia or osteoporosisGynecol Endocrinol.(2009 Sep)
  41. ^Yamazaki S, Ichimura S, Iwamoto J, Takeda T, Toyama YEffect of walking exercise on bone metabolism in postmenopausal women with osteopenia/osteoporosisJ Bone Miner Metab.(2004)
  42. ^Wilks DC, Winwood K, Gilliver SF, Kwiet A, Chatfield M, Michaelis I, Sun LW, Ferretti JL, Sargeant AJ, Felsenberg D, Rittweger JBone mass and geometry of the tibia and the radius of master sprinters, middle and long distance runners, race-walkers and sedentary control participants: a pQCT studyBone.(2009 Jul)
  43. ^Kontulainen S, Sievänen H, Kannus P, Pasanen M, Vuori IEffect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controlsJ Bone Miner Res.(2003 Feb)
  44. ^Derman O, Cinemre A, Kanbur N, Doğan M, Kiliç M, Karaduman EEffect of swimming on bone metabolism in adolescentsTurk J Pediatr.(2008 Mar-Apr)
  45. ^Taaffe DR, Snow-Harter C, Connolly DA, Robinson TL, Brown MD, Marcus RDifferential effects of swimming versus weight-bearing activity on bone mineral status of eumenorrheic athletesJ Bone Miner Res.(1995 Apr)
  46. ^A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men