What is sarcopenia?
In 2024, the Global Leadership Initiative in Sarcopenia (GLIS) published an international definition. Sarcopenia is defined by:
- loss of muscle mass;
- loss of muscle strength;
- reduced muscle-specific strength (how strong your muscle is for its size).
Poorer physical performance, such as walking speed, is treated as a consequence of sarcopenia rather than part of the definition. Sarcopenia is linked to falls, fractures, disability, loss of independence and earlier death.
Why muscle matters for metabolic health
- Blood sugar: muscle is the main place your body stores and uses glucose after meals. More muscle, and active muscle, helps keep blood sugar stable.
- Weight loss: when you lose weight, some of what's lost is muscle. Protecting it helps you keep strength and function.
- Bones and balance: strong muscles support joints and reduce the risk of falls.
- Independence: grip strength, getting up from a chair and climbing stairs all depend on muscle.
Who is at higher risk?
- Older adults, especially from their 60s onwards.
- People who are inactive, or recovering from illness or a hospital stay.
- People losing weight quickly, including with weight-loss medicines or surgery.
- Women after menopause.
- People with long-term conditions such as diabetes, kidney disease or heart failure.
- People with obesity, who can have low muscle relative to their size (sometimes called sarcopenic obesity).
How much protein do you need?
Protein needs vary by age, health and activity. As a general guide from expert groups:
| Group | Suggested daily protein (per kg of body weight) |
|---|---|
| Healthy adults (minimum) | About 0.8 g |
| Healthy older adults | About 1.0 to 1.2 g |
| Older adults with acute or chronic illness | About 1.2 to 1.5 g |
For a 70 kg older adult, 1.0 to 1.2 g per kg is roughly 70 to 85 g a day.
Tips:
- Spread protein across meals, rather than having most of it at dinner.
- Include a protein source at each meal: eggs, dairy or maas, fish, chicken, lean meat, beans, lentils, chickpeas, soya or tofu.
- Food first. Most people can meet their needs without supplements.
Important: if you have kidney disease, protein needs are different. Ask your doctor before increasing protein.
Strength training: the most powerful tool
The World Health Organization recommends that adults do muscle-strengthening activities on at least two days a week. Adults aged 65 and over should also do varied activities that include balance and strength on at least three days a week to prevent falls.
Getting started:
- Use body weight (sit-to-stands from a chair, wall push-ups, step-ups), resistance bands or weights.
- Work the major muscle groups: legs, hips, back, chest, shoulders and arms.
- Aim for an effort where the last few repetitions feel challenging.
- Progress gradually by adding repetitions, resistance or sets.
- Consider guidance from a biokineticist or physiotherapist, especially if you have joint problems, a heart condition or have been inactive.
When to see a doctor
- You've noticed unintended weight loss, weakness or difficulty with everyday tasks.
- You've had a fall, or feel unsteady.
- You're losing weight quickly, including with medicines.
- You have a heart, lung, joint or kidney condition and want to start strength training.
Frequently asked questions
Am I too old to build muscle?
No. Studies show that people well into their 80s and 90s can gain strength with appropriate training.
Do I need protein shakes?
Not usually. They can be convenient if you struggle to eat enough, but food sources work well for most people.
Is walking enough?
Walking is excellent for heart health, but it doesn't build much muscle strength on its own. Add strength training.
Will lifting weights make me bulky?
Rarely. For most people, strength training improves strength, function and body composition without large gains in size.
References
- Kirk B et al. The conceptual definition of sarcopenia: Delphi consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age and Ageing. 2024. Executive summary: Aging Clinical and Experimental Research. 2024;36:153.
- Deutz NEP et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clinical Nutrition. 2014.
- Bauer J et al. Evidence-based recommendations for optimal dietary protein intake in older people (PROT-AGE). Journal of the American Medical Directors Association. 2013.
- World Health Organization. Guidelines on physical activity and sedentary behaviour. 2020.
This article is for general educational purposes only, like a health newsletter. It is not medical advice, diagnosis or treatment, and reading it does not create a doctor and patient relationship. Please speak to your own doctor about your situation. In an emergency, call 10177 or 112, or go to your nearest emergency unit.