The Joyful Life Guide for Silver Hair Generation - Stay Away from the Threat of Myopia

        The proportion of elderly people aged 65 and above in Taiwan is increasing, and it is estimated to reach 35.5% by 2050. As they grow older, muscle loss in their elders becomes more severe, and cases of sarcopenia are heard from time to time, such as slower walking speed, inability to open bottle caps, difficulty wringing out towels, weight loss, and thin calves like bird feet, all of which may be caused by sarcopenia. This issue of 'Health Column' introduces the causes and improvement methods of sarcopenia, helping you and your family stay away from the risk of injury in old age.

                According to statistics from the United States, the annual medical expenses caused by sarcopenia are as high as USD 18 billion, including poor lower limb function leading to weakness, fatigue, or gait instability in the elderly, which increases the risk of falls, fractures, and disability. Additionally, sarcopenia also increases metabolic syndrome, cardiovascular risk, hospitalization rates, morbidity, disability, and mortality rates. In addition, patients with sarcopenia have an increased risk of iatrogenic infections after hospitalization, indicating that sarcopenia can cause many adverse effects on the elderly.

        Generally speaking, if the muscle mass of elderly people is only below the standard, it still belongs to the "pre muscular dystrophy" stage; If it is low muscle mass, combined with low muscle strength or low physical function, it is called 'sarcopenia'; If all three are present, it is' severe sarcopenia '. Preventing sarcopenia or slowing down its deterioration rate can not only reduce the serious consequences caused by the disease, but also save huge medical care expenses.

        Causes of sarcopenia

        In addition to natural muscle loss caused by aging, the causes of sarcopenia also include:

        Neuromuscular changes caused by aging: including a decrease in motor neurons, damage to peripheral nerve myelin sheaths, and a reduction in synapses at the neuromuscular junction, resulting in a decrease in the number of muscle fibers.

        Changes in hormone concentration and sensitivity related to aging, including growth hormone, insulin-like growth factor, androgen, estrogen, decreased insulin, and increased insulin resistance. In addition, a decrease in vitamin D is also associated with decreased muscle strength.

        Produce inflammatory substances such as tumor necrosis factor, interleukin-1, interleukin-6, and C-reactive protein.

        Nutritional related changes: Insufficient protein and energy intake or poor absorption.

        Lack of physical activity: reduced activity, even bedridden or inactive.

        From this, it can be concluded that the preferred methods for preventing and treating sarcopenia are "nutritional supplementation" and "impedance exercise".

        Improving sarcopenia

        1. Nutrition

        The daily protein intake should reach 1.2-1.5g per kilogram of body weight, and be evenly distributed among breakfast, lunch, and dinner. It is recommended to consume 25-30g of high-quality protein (high biological value protein, HBV protein) per meal. Do not consume a large amount of protein at once, as consuming more than 30g of protein at a time is not beneficial for muscle growth.

        High biological value proteins contain nine essential amino acids, which can provide sufficient nutrients for the body after consumption. Most tofu, fish, meat, eggs, dairy products, and their dairy products contain high biological value proteins. It is recommended to supplement them in sufficient amounts to help muscles and proteins achieve optimal synthesis results.

        In addition, whey protein is also a high biological value protein that can cause a significant and transient increase in plasma amino acid concentration, promoting postprandial protein synthesis. The white amino acids contained in it can stimulate mTOR (mechanical target of rapamycin) phosphorylation and increase activity, thereby increasing the phosphorylation levels of the two main target proteins, S6K1 (S6 kinase 1) and 4EBP-1 (4E binding protein-1), and producing muscle protein. In other words, it can enhance protein production and reduce degradation.

        Vegetarians can eat legumes, including soybean milk, tofu, dried tofu and other soy products. Although the whole grain rhizomes also contain protein, they are mainly low biological value proteins, lacking specific essential amino acids, which cannot meet the body's needs. In addition, 1/4 bowl of rice contains only about 2 grams of low price protein, but there are 15 grams of carbohydrates. If the elderly only use this kind of food to obtain enough protein, they will ingest too many carbohydrates, which will lead to the fatter they eat, but not get better quality and quantity of protein. Muscle protein is not easy to synthesize, so it is not recommended to use low biological value proteins as the main diet against sarcopenia.

        It is worth noting that vitamin D supplements have been proven to improve muscle strength and gait, especially in the elderly. As they age, the skin is unable to effectively synthesize vitamin D, and the kidneys are also less likely to convert vitamin D into active hormones, leading to a decreasing amount of vitamin D. Supplementing with vitamin D can promote muscle protein synthesis and improve sarcopenia by binding to the vitamin D receptor (VDR) in the nucleus of muscle cells.

        2. Exercise

        Aerobic exercise and progressive resistance training are the most effective ways to increase muscle mass and strengthen muscle strength. Among them, for impedance sports, those with good physical fitness can receive guidance from gym coaches or seek appropriate training from physical therapists; At home, you can also use an elastic ball, place your toes on it when standing, or take a bottle filled with water as a small dumbbell for training. You can also use an elastic band as a resistance exercise aid to enhance muscle strength.

        Finally, a small reminder

        Sarcopenia can cause many complications, even leading to disability and increasing the risk of death in the elderly. Therefore, it is important not to ignore the initial symptoms of weakened hand and foot strength, increasing walking speed, or mistakenly believe in the idea that "as we age, we should eat less", which can cause weight loss and trigger sarcopenia. It is recommended that the public undergo testing at medical institutions equipped with bioelectrical impedance analyzers, dual energy X-ray absorptiometers, and grip strength machines. Currently, the Family Medicine Department of Far Eastern Memorial Hospital also provides this screening service. If you are already suffering from sarcopenia, it is also recommended to seek advice from nutritionists and physical therapists on treatment guidelines.

        From "preserving muscle mass" and "maintaining muscle mass" to "reducing muscle loss" in old age, these are important concepts for preventing and treating sarcopenia. Through early screening, diagnosis, prevention, and improvement, we can stay away from the threat of sarcopenia and achieve the goal of a happy life until old age.

        Dr. Lin Zhijian's expertise includes preventive healthcare diagnosis and treatment, chronic disease control, acute disease diagnosis and treatment, tourism medicine, and palliative care.

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