Quantifying muscle mass accurately, on the other hand, is a more complicated operation: it would require methods such as nuclear magnetic resonance imaging and computed axial tomography, which can hardly be included into the evaluation process. However, simpler methods can be used, such as double energy X-ray absorbimetry (DXA) or bioimpedance measurement (BIA), which provide an overall estimate of lean mass within the body.
How to measure muscles
Several expert groups met between 2009 and 2012 to better define and measure sarcopenia, including the European Working Group on Sarcopenia in Older People (EWSGOP), which published its model in 2010 and updated it in 2018.
However, there are two parameters that best describe the quality and quantity of muscle: handgrip strength and appendicular lean mass.
Equally important was the work of the Sarcopenia Project carried out by the Biomarkers Consortium of the Foundation for the National Institutes of Health (FNIH). Thanks to the analysis of data from more than 26,000 people collected in nine international cohort studies, the researchers identified two parameters of strength and muscle mass that currently best predict the onset of functional limitations: handgrip strength and appendicular lean mass.
Sarcopenia: how to prevent and slow it down
Having said that, sarcopenia is a complex phenomenon, difficult to isolate from the physiological process of aging that generates it. Moreover, it can hide behind the excess of adipose tissue and, therefore, potentially affect even people with normal body mass.
Physical exercise is the best medicine: “use it or lose it”, as the Anglo-Saxons say.
Many factors influence the loss of muscle, from hormonal and inflammatory ones to some diseases, but a great weight has the lifestyle. Exercise is the best medicine: “use it or lose it”, as the Anglo-Saxons say. Even better if conducted in the open air so that the sun’s rays trigger the production of vitamin D, a hormone probably also involved in maintaining muscle fitness.
The starting conditions make the difference: building a good “biological capital” during the first 30 years of life means being able to count on an insurance for the future.
A balanced diet, like the Mediterranean diet, also plays its part, guaranteeing a sufficient supply of protein, which must be distributed over the different meals of the day.
However, the starting conditions make the difference: building a good biological capital during the first 30 years of life, both from a qualitative and quantitative point of view, means being able to count on insurance for the future, because it is in the later years that the muscle decline will start. Following a healthy lifestyle from an early age therefore allows us to delay functional loss while aging.
There are no drugs for sarcopenia to date, but preliminary studies suggest that correcting some hormonal imbalances – such as testosterone deficiency in men – or intervening on particular mechanisms that regulate muscle functions – such as myostatin inhibitors – could lead to the development of drugs and offer benefits especially to those who, for health or social reasons, are unable to lead an optimal lifestyle.