Scientists just identified the 3 best ways to prevent muscle loss as you age

 

More reasons for your competent? doctor to have EXACT 100% RECOVERY PROTOCOLS! You don't want sarcopenia or muscle atrophy to occur. 

Ask your doctor if 'Exercise-in-a-pill' (9 posts to May 2017) will also produce this benefit.

Scientists just identified the 3 best ways to prevent muscle loss as you age

• A meta-analysis of 96 randomized controlled trials found that strength and balance training, along with protein intake, led to the biggest improvements in walking speed, grip strength, lean muscle mass, overall performance, and balance.
• The holistic approach is key, since longevity depends on multiple areas of health—your diet, balance training, and exercise, experts say.
• The bottom line is that it is possible to fight against muscle loss—at any age.

Muscle loss is common as people get older, but it’s not inevitable. A combination of strength training, protein, and other healthy lifestyle habits can help to combat what's known more scientifically as sarcopenia. Still, those are pretty vague recommendations, making it hard to know exactly how to approach this. Now, new research is laying out a clear formula.

The meta-analysis, which was published in the Journal of Nutrition, Health & Aging, analyzed data from thousands of people and came up with straightforward guidance that everyone can use.

Here’s what the researchers discovered when it comes to preventing muscle loss as you age, plus why it makes sense.

Meet the experts: Scott Keatley, RD,is the co-owner of Keatley Medical Nutrition Therapy. Bert Mandelbaum, MD, is a sports medicine specialist and orthopedic surgeon at Cedars-Sinai Orthopaedics and co-director of the Regenerative Orthobiologic Center at Cedars-Sinai Medical Center in Los Angeles.

What did the study find?

For the study, researchers analyzed data from 96 randomized controlled trials in order to understand the effectiveness of different types of exercise on muscle strength, physical function, and muscle mass in people with sarcopenia.

Related video

: The five muscle groups doctors say to train hardest as you age (Talking With Docs)People who ate protein but didn’t exercise only had small changes in their muscle mass, and didn’t see meaningful improvements in their strength or mobility.

Why is this combination important for preventing muscle loss?

A big element is that these factors will help to support your playspan, which is the ability to stay physically active as you age, says Bert Mandelbaum, MD, sports medicine specialist and orthopedic surgeon at Cedars-Sinai Orthopaedics and co-director of the Regenerative Orthobiologic Center at Cedars-Sinai Medical Center in Los Angeles.

Approaching playspan from multiple areas of health—your diet, balance training, and exercise—can come together to support longevity. “It’s important to be comprehensive,” he says.

While exercising to combat muscle loss makes sense, protein is crucial, too, according to Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy. “As we age, muscles become less responsive to protein, a process known as anabolic resistance,” he explains. “Higher protein intakes help overcome this by repeatedly triggering muscle protein synthesis throughout the day.” While the Recommended Daily Allowance (RDA) is for 0.8 grams per kilogram of body weight, active women looking to gain muscle may want to aim for 1.2 g/kg or slightly above.

Protein provides the building blocks for muscle, but resistance exercise provides the signal that tells the body to actually build it, according to Keatley. “Without mechanical loading, amino acids are more likely to be used for energy or general maintenance rather than new muscle tissue,” he says. “This disconnect is even stronger in older adults.”

The national guidelines suggest a minimum of two days per week of muscle-strengthening activity, although upping that to three (and even up to five) sessions a week can help support muscle-building. (Always talk to your healthcare provider or a trainer before drastically changing your exercise routine or diet.)

As for balance, some experts suggest incorporating balance moves, like single-leg stands, marching in place, and alternating reverse lunges, into your strength workouts, or doing them alone for 10- to 15-minutes a few times a week.

What’s the takeaway here?

The researchers provide a concrete formula to follow to combat muscle loss, but maintaining muscle mass requires a multi-faceted approach. “The impact isn’t going to be significant enough just by choosing one of these drivers,” Dr. Mandelbaum says. “You need all three to make a difference.”

Beyond that, Keatley stresses that it is possible to fight against muscle loss with age. “Meaningful improvements are possible at any age with the right inputs,” he says.

A Dietitian Says This Is the Best Protein for Aging Muscles

 I add this to my KA'chava drink but it doesn't dissolve very well. Probably not getting enough.

A Dietitian Says This Is the Best Protein for Aging Muscles

Muscle loss is hard to avoid as you age, but eating enough high-quality protein can help you stay strong, mobile, and independent.

As we age, our strength and muscle mass inevitably decline — by approximately three percent and one percent per year, respectively, according to one review published in 2019. You may think muscle is mainly for gym bros chasing bigger pecs, but muscle tissue does far more than fill out a T-shirt. It moves and supports your joints, helps keep you steady and able-bodied, and may even be a relatively strong predictor of longevity.

In other words, holding on to your muscle as you age should be a priority. Doing that requires regular strength training and enough protein. That’s the macronutrient your body uses to build and repair muscle, along with your cells, hair, nails, and other tissues. But not all protein sources affect muscle in exactly the same way. Complete proteins provide all nine essential amino acids, including the ones most directly involved in stimulating muscle growth. And according to one dietitian, a familiar supplement may be especially useful for maintaining muscle as you age.

What You Should Know About Protein and Aging Muscle

Registered dietitian Jillian Kubala points to whey protein as one of the best options for maintaining muscle with age. Whey is a complete protein, meaning it contains all nine essential amino acids. Those are the building blocks of protein that your body cannot produce on its own. It also delivers a substantial amount of protein for relatively few calories and is easy to mix into a shake, smoothie, or meal.

That combination of nutritional value and convenience can make whey especially useful for older adults who have a smaller appetite or little desire to prepare protein-heavy meals from scratch. Protein provides the raw material your body needs to repair and build muscle, while strength training gives it a reason to do so.

Muscle loss with age is not caused by one factor alone. People often eat less protein and become less active over time, while age-related changes also make the body somewhat less responsive to both protein and exercise. Eating enough high-quality protein and continuing to resistance train can help counter those effects at nearly any age.

Going Deeper: Why Whey, and How Much You Need

Amino acids are organic molecules that create the protein your body needs to build muscle, sure, but also perform hundreds of other bodily processes. Your body needs 20 amino acids to function, and of those 20, nine are considered “essential,” meaning your body needs them but can’t create them on its own. You can obtain these amino acids only from food or supplements.

Almost any whey protein supplement you purchase will contain all nine essential amino acids. Whey is also particularly rich in the three branched-chain amino acids, or BCAAs: leucine, isoleucine, and valine. The body burns through BCAAs right in the muscle, and their distinctive branched structure makes them especially important for building new muscle and repairing it after a workout.

Whey’s amino acid profile isn’t its only advantage. It’s also digested relatively quickly, meaning those amino acids enter your bloodstream and become available to your muscles faster than they would with many other protein sources. Leucine is especially important here because it helps flip the switch on muscle protein synthesis — the process your body uses to repair and build new muscle tissue. Research supports this.

• A 2020 review found that whey protein may promote muscle protein synthesis, improve muscle performance, protect against age-related muscle loss, and even reduce fall risk in adults over 65. 
• A 2024 review found that combining whey protein with resistance training improved muscle mass and strength in older adults with sarcopenia. 
• And a 2026 review found that pairing whey with resistance training produced some of the most meaningful improvements in muscle and strength. 

As for how much protein you need, the old recommended daily allowance (RDA) of 0.8 grams per kilogram (about 0.36 per pound) is really just the floor to prevent deficiency — most adults benefit from more. The 2025-2030 Dietary Guidelines for Americans now put the healthy range at 1.2 to 1.6 grams per kilogram (0.54 to 0.73 per pound); for a 150-pound person, that’s about 81 to 110 grams a day, and anyone trying to hold onto muscle or living an active life should aim toward the top of that range.

Older adults have specific targets. Experts recommend at least 1.0 to 1.2 grams per kilogram (about 0.45 to 0.54 grams per pound) — well above the RDA — just to preserve muscle. Those actively building, recovering from illness, or at risk of malnutrition may need 1.5 to 2 grams per kilogram (about 0.68 to 0.91 per pound) — about 102 to 136 grams a day for that same 150-pound person.

The Takeaway

Whey protein is a convenient, easy-to-absorb supplement that can help older adults reach higher protein targets, especially when appetite or meal preparation becomes a barrier. But the supplement works best when it’s paired with resistance training. Protein provides the raw materials, and the workout puts them to use to build muscle mass. Whole-food and plant proteins still count, too; whey is simply one convenient option.

Bottom Line

Whey is a complete, leucine-rich, and research-backed supplement for helping older adults preserve muscle, particularly when combined with strength training. Still, it’s not magic, and it’s not the only quality protein that works. Total daily protein intake and consistent resistance training are the real drivers of muscle retention, which matters for staying strong, mobile, balanced, and independent as you age.

Experts Who Contributed

• Andrew Gutman, NASM-CPT, wrote this article.
• Lauren Keary, NASM-CNC, reviewed this article for accuracy.

Adults lose muscle with age—researchers found an unexpected health risk

 More reasons for your doctor to get you 100% recovered! 

DOES YOUR DOCTOR HAVE THE EXACT PROTOCOLS TO DO THAT?

Adults lose muscle with age—researchers found an unexpected health risk

The gradual loss of muscle that often comes with aging may do more than make everyday tasks harder.  

Known as sarcopenia, the condition is already linked to frailty and a higher risk of death. 

Now, a new study suggests it could also leave people more vulnerable to serious infections. 

people with sarcopenia faced a significantly higher long-term risk of infections than those with healthy muscle function. 

The elevated risk extended to respiratory infections, urinary tract infections, skin and soft tissue infections, and sepsis.  

The study, published in MedScience, followed participants for a median of more than 12 years, making it one of the largest investigations yet into the relationship between muscle health and infection risk.  

Researchers found a graded pattern: people with low muscle mass were at increased risk of infection, while those with more advanced sarcopenia faced an even greater risk. 

Professor Arshad Rather, a consultant geriatrician at Medical Express Clinic who was not involved in the research, said many people mistakenly assume significant muscle loss is simply an unavoidable part of getting older. 

“Losing some muscle with age is common, but becoming weak enough to affect daily life is not inevitable,” Rather told Newsweek. 

He said the earliest warning signs are often subtle. 

“Getting out of a chair without using your arms becomes harder,” Rather said. “Stairs take longer. You struggle with jars, luggage or heavy shopping bags. You may walk more slowly, feel more tired, or notice clothes fitting differently even though your weight has not changed much.” 

According to Rather, sarcopenia can affect people who appear to have a healthy weight, as muscle tissue can gradually be replaced by fat. 

The study’s findings add weight to a growing body of evidence suggesting that muscle plays an important role in immune health.  

While muscles are best known for movement, they also function as an endocrine organ, releasing signaling molecules called myokines that help regulate immune responses and inflammation.  

Muscle also acts as a reserve of amino acids that the body can draw upon during periods of illness or physiological stress. 

Researchers proposed several mechanisms that might explain the association.  

Reduced muscle mass could impair the production of immune-regulating myokines, limit the availability of amino acids needed by immune cells, and contribute to chronic low-grade inflammation that weakens the body’s defenses. 

Rather said the biological explanation is plausible.  

“Muscle is not just for movement,” he said. “It helps regulate inflammation and acts as a reserve of amino acids the body uses when fighting infection. When muscle mass and strength fall, that reserve shrinks.” 

He noted that the new findings showed people with sarcopenia faced a substantially higher risk of infections over time, including respiratory infections and sepsis. 

However, he cautioned that the research demonstrates an association rather than proving that muscle loss directly causes infections. 

Still, experts said there are good reasons to protect muscle health as people age.  

Rather pointed to resistance training and adequate protein intake as the most effective evidence-based strategies. 

“The best evidence for slowing it is still practical: regular resistance exercise two to three times a week, using weights, bands or supervised strength training, plus enough protein spread across the day,” he said. 

He added that maintaining strength earlier in life may provide a valuable buffer against future illness. 

“The key message is to start before a crisis,” Rather said. “Maintaining strength in your 50s and 60s gives you more reserve for illness, surgery, and recovery later in life.” 

Reference  

Meng Gao, Bolong Liu, Hequn Chen, Zewu Zhu, Juliet Matsika, Minghui Liu, Jiao Hu, Xiaogen Kuang, Jinbo Chen. Association of sarcopenia with the long-term risk of overall infections and infectious diseases: a prospective cohort study of 458 332 participants. MedScience, 2026, 20 (2) : 345-357 DOI:10.1007/s11684-026-1224-0. 

Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang

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5 morning exercises to help adults over 60 restore muscle mass, according to a trainer

 Did your competent? doctor get you recovered enough to do all these? NO? So, PURE INCOMPETENCE THEN!

Knowing since medical school that stroke was a complete failed shitshow and doing nothing is par for the course of your stroke medical 'professionals'!

5 morning exercises to help adults over 60 restore muscle mass, according to a trainer

1. Sit-to-Stands 

I can do this from a standard kitchen chair, couches and Adirondack chairs, not!

"I recommend these as my number one because they build strength in the quads, glutes, and core through a movement people need every day," says Kraft. "Being able to stand up from a chair with control is one of the clearest signs of functional lower-body strength. It sounds easy to do but as we age, doing this is vital to maintaining functional movement."

1. Begin seated at the front of a sturdy chair, feet under your knees.
2. Lean forward just a bit.
3. Try to stand up without using your knees, hands, or additional support.
4. Use control to slowly sit back down.

RELATED: If You Can Do These 8 Lower-Body Moves, Your Leg Strength Is Elite

2. Step-Ups

My stepping is only going to get better since I bought a 4 level condo, 7 steps between levels.

"Step-ups help rebuild lower-body strength while also training balance, coordination, and single-leg control," Kraft says. "After 60, that combination matters because people are often dealing with both muscle loss and reduced stability."

1. Begin by standing tall, facing a low step, holding a lightweight dumbbell in each hand.
2. Place your left foot firmly onto the surface, keeping your core engaged and chest tall.
3. Press through your left heel to lift your body until your left leg is straight and you're standing on the surface.
4. Use control to lower back to the start position.
5. Repeat on the other side.

RELATED: 5 Easy Bodyweight Tests That Show Your Real Fitness After 45

3. Incline Pushups

Not possible since my doctor completely failed at curing my spasticity and thus can't flatten my left hand at all.

"One of my favorite ways to train upper-body pushing strength safely. It works the chest, shoulders, arms, and core without requiring someone to get down on the floor, and it's easy to scale based on ability," Kraft tells us.

1. Use a stable surface like a wall, countertop, plyometric box, or workout bench, and place your hands on it, shoulder-width apart.
2. Walk your legs back so you're at a straight incline from your head to your heels.
3. Keep your legs together and rise onto the balls of your feet. Engage your core and keep your gaze forward.
4. Bend your elbows to lower your body until your chest lines up with your elbows.
5. Return back to straight arms.

RELATED: These 5 Daily Moves Reverse Muscle Loss Faster Than Gym Workouts After 45

4. Farmer's Carry

"Farmer carries are one of the most practical strength exercises I use. They challenge grip, posture, core stability, and full-body tension in a way that translates directly to real life, like carrying groceries, laundry, or bags," Kraft explains. "So many folks I meet past 60 really start losing grip strength and posture while walking quickly. This keeps those muscles firing and you mobile."

1. Hold a dumbbell in each hand at your sides.
2. Start walking forward, keeping your torso still and maintaining a tall posture.

RELATED: 5 No-Equipment Exercises That Strengthen Your Core Faster Than Planks After 40

5. Glute Bridges

"The glutes are the largest muscle in the body and the first to weaken after 60," Siwicki tells us.

1. Lie flat on your back with bent knees and feet hip-width apart on the floor, arms at your sides with palms pressing into the ground.
2. Press through your heels to lift your hips until your body forms a straight line from head to heels.
3. Squeeze your buttocks, holding at the top for 2 seconds.
4. Lower your hips back to the start position.

Read the original article on Eat This Not That.

Researchers Discover Biological Mechanism Behind Exercise and Healthier Aging Muscles

 More reasons for your competent? doctor to have EXACT 100% RECOVERY PROTOCOLS! You don't want sarcopenia or muscle atrophy to occur. 

Ask your doctor if 'Exercise-in-a-pill' (9 posts to May 2017) will also produce this benefit.

Researchers Discover Biological Mechanism Behind Exercise and Healthier Aging Muscles

And another article here:

Scientists discover why exercise reverses muscle aging

Pharmacological Effects of Urolithin A and Its Role in Muscle Health and Performance: Current Knowledge and Prospects

 

Ask your competent? doctor if this would prevent muscle atrophy post stroke. Doesn't know! You DON'T have a functioning stroke doctor if your doctor doesn't have a protocol to prevent muscle atrophy/sarcopenia!

muscle atrophy (31 posts to July 2013)

sarcopenia (17 posts to March 2016)

Pharmacological Effects of Urolithin A and Its Role in Muscle Health and Performance: Current Knowledge and Prospects

Haotian Zhao ^1,2,†, Ge Song ^3,†, Hongkang Zhu ^2,†, He Qian ², Xinliang Pan ³, Xiaoneng Song ^1,*, Yijie Xie ^4,*, Chang Liu ^3,*

Editors: David C Nieman, JohnA Rathmacher

PMCID: PMC10609777  PMID: 37892516

Abstract

Urolithin A (UA) is a naturally occurring compound derived from the metabolism of gut microbiota, which has attracted considerable research attention due to its pharmacological effects and potential implications in muscle health and performance. Recent studies have demonstrated that Urolithin A exhibits diverse biological activities, encompassing anti-inflammatory, antioxidant, anti-tumor, and anti-aging properties. In terms of muscle health, accumulating evidence suggests that Urolithin A may promote muscle protein synthesis and muscle growth through various pathways, offering promise in mitigating muscle atrophy. Moreover, Urolithin A exhibits the potential to enhance muscle health and performance by improving mitochondrial function and regulating autophagy. Nonetheless, further comprehensive investigations are still warranted to elucidate the underlying mechanisms of Urolithin A and to assess its feasibility and safety in human subjects, thereby advancing its potential applications in the realms of muscle health and performance.

More at link.

5 bed exercises adults over 55 can use to rebuild leg strength

 In case your incompetent? doctor didn't get your legs fully recovered!

5 bed exercises adults over 55 can use to rebuild leg strength

The 8-Minute Bed Routine That Restores Leg Muscle Faster Than Weight Training After 55

As you age, muscle strength becomes increasingly important. Without it, daily activities can become more and more challenging. You count on your leg muscles more than you'd think, and they keep you balanced and independent. Just consider how often you run errands, lift things up off the floor, and walk up and down stairs each day.

It's important to keep your leg muscles strong, because as early as your 30s and 40s, you lose muscle by a natural process known as sarcopenia. The loss even revs up after 65. That means your body repairs your muscles less, and they can even decrease in size.

Getting in the right amount of exercise is essential to keep your leg muscles in check, so we spoke with Jaqueline Gavino, MPH, CHES® & Director of Fitness at Pritikin to help you out.

"The goal of a bed-based routine is to activate muscle groups without joint stress or equipment," Gavino tells us. "What makes bed-based routines especially effective for this age group is the consistency factor. By removing every barrier, no commute, no equipment, no balance risk, people are far more likely to follow through daily. In older adults, adherence and frequency are ultimately what convert muscle stimulus into lasting strength gains."

Try this eight-minute bed routine that can help get the job faster than classic weight training after 55.

1. Supine Glute Bridges

"Electromyographic (EMG) research shows the supine bridge produces strong gluteus maximus activation at approximately 33.8% of maximal voluntary isometric contraction (MVIC), with a favorable glute-to-hamstring ratio, making it highly efficient for glute recruitment while lying down," Gavino explains.

1. Begin by lying flat on your back with bent knees and feet hip-width apart on the mattress.
2. Place your arms at your sides with palms pressing into the surface.
3. Press through your heels to lift your hips until your body forms a straight line from head to heels.
4. Squeeze your buttocks, holding at the top for a moment.
5. Lower your hips back to the start position.
6. Perform 3 sets of 10 reps.

RELATED: The 6-Minute Chair Routine That Builds Leg Muscle Faster Than Squats After 60

2. Straight-Leg Raise

"Age-related strength decline tends to be more pronounced in the quads than hamstrings, and quadriceps strength is a key predictor of functional ability in older adults. The straight-leg raise loads the quads safely in a fully supine position. This is one of my favorites because it also mimics the correct way of walking, using so many functional muscles and improving posture," Gavino says.

1. Start by lying flat on your back with your arms extended overhead.
2. Keep one leg extended on the mattress and the other bent.
3. Activate your core as you lift the extended leg off the mattress, keeping your lower back pressed into the surface.
4. Hold for 3 seconds at the top.
5. Use control to lower your leg.
6. Repeat on the other side.
7. Perform 2 sets of 10 reps on each leg.

RELATED: 5 Chair Exercises That Restore Leg Strength Faster Than Squats After 60

3. Lying Leg Curl

(Interesting that lying face down I can engage my left hamstring fully, no other position works! Ask your doctor to explain.)  

"Research confirms the lying leg curl produces the greatest hamstring activation and the highest hamstring-to-quadriceps EMG ratio compared to squats, deadlifts, and hip thrusts, making it uniquely effective for hamstring isolation horizontally," Gavino explains.

1. Begin by lying flat on your stomach on the mattress with legs extended behind you.
2. Place your forehead on a pillow or your hands for support.
3. Bend one knee and bring your heel toward your glute.
4. Curl it as far as you're comfortably able to while pressing your thigh into the mattress.
5. Hold briefly at the top, squeezing your hamstring.
6. Return to the start position.
7. Perform 2 sets of 12 reps on each leg.

RELATED: If You Can Do These 8 Lower-Body Moves, Your Leg Strength Is Elite

4. Side-Lying Hip Abduction

"The gluteus medius is critical for gait stability and fall prevention, a top concern for this age group. This movement targets those lateral hip muscles with zero joint loading," Gavino points out.

1. Start by lying on one side of your body with your legs stacked.
2. Lift your top leg slightly back and up.
3. Perform 2 sets of 12 reps on each leg.

RELATED: This 5-Minute Morning Routine Builds More Strength Than Hour-Long Workouts After 50

5. Ankle Pumps

"This exercise activates the calf muscles and supports venous return, especially important first thing in the morning, and serves as a warm-up before progressing to more demanding movements," explains Gavino.

1. Start by lying flat on your back in bed.
2. Keep your body relaxed and your legs extended or slightly bent.
3. Pull your toes back toward your shins, flexing at the ankles.
4. Continue to switch between pointing and flexing.
5. Perform 2 sets of 20 reps.

Read the original article on Eat This Not That.

Accuracy of sarcopenia screening tools among older adults with stroke undergoing inpatient rehabilitation

 You doctor doesn't need screening tools if they WERE COMPETENT AT ALL! Competence would be having EXACT PROTOCOLS THAT PREVENT THIS! I guess you are that blitheringly stupid you understand nothing about stroke recovery!

Accuracy of sarcopenia screening tools among older adults with stroke undergoing inpatient rehabilitation

• Kanokphol Supasirimontri,
• Vilai Kuptniratsaikul ,
• Metita Wiwitkul

• 
  
• 
  
• Published: May 28, 2026
• https://doi.org/10.1371/journal.pone.0346732

3 Physical Markers Beyond Blood Pressure That Can Predict Stroke Risk by mindbodygreen

 Prior to my stroke I was high in all three.

3 Physical Markers Beyond Blood Pressure That Can Predict Stroke Risk

• Walking pace: Can you comfortably maintain a brisk pace (roughly 3 mph or faster) for 10 to 15 minutes? If you find yourself naturally slowing down or feeling winded quickly, it may be worth paying attention.(I can still do this)
• Grip strength: Notice if everyday tasks, like carrying groceries, opening bottles, and holding a bag, feel harder than they used to. Clinical assessments of grip strength use a special tool called a dynamometer, but functional changes in daily life are a reasonable signal.(My right hand has gotten even stronger, left hand, complete failure of my doctor and therapists to get any recovery there.)
• Muscle mass: Look for signs of sarcopenia like difficulty rising from a chair without using your arms, reduced stamina, or visible muscle loss in your legs and arms over time.(Getting out of couches and Adirondack chairs requires scooting to the edge to get my feet under me so when I push off with my right hand my weight is over my feet and I can easily stand. Stamina still pretty good, was able to keep up with a healthy tour group on the 9 days in Italy even being sick with bronchitis.)

Sleep Apnea Is Linked To A Surprising Change In Muscle Health by mindbodygreen

 The one takeaway from this is your doctor doing a skeletal muscle index study so you get an objective view of your muscle atrophy/sarcopenia. Then your competent? doctor will have THE EXACT REHAB PROTOCOLS TO FIX THAT! Oh NO, you instead have an incompetent? doctor who has nothing! Fire them!

Sleep Apnea Is Linked To A Surprising Change In Muscle Health

Daily Peanut Butter Intake Linked to Improved Muscle Strength in Older Adults: Study

 You're already at an elevated risk for sarcopenia. Will your competent? doctor determine if plain peanuts are better? The "bad" components in many commercial peanut butters include added sugars (like corn syrup), hydrogenated vegetable oils (trans fats), palm oil, and high sodium levels.

muscle atrophy (38 posts to July 2013) or the deadly 

sarcopenia (32 posts to March 2016) 

peanuts (7 posts to May 2017)

peanut butter (8 posts to October 2013)

Daily Peanut Butter Intake Linked to Improved Muscle Strength in Older Adults: Study

Sarcopenia and ischemic stroke outcomes after endovascular revascularization: results of a retrospective, cohort study

What is your competent? doctors EXACT PROTOCOL to prevent sarcopenia(muscle loss)! NOTHING?

Let's see how long everyone related to stroke has been incompetent!

sarcopenia (31 posts to March 2016) (Almost a decade and managed not to get fired? Your board of directors is woefully incompetent!)

Sarcopenia and ischemic stroke outcomes after endovascular revascularization: results of a retrospective, cohort study

Lea Maria Bumann¹Bijan Zendeh Zartoshti¹Ulrike Voßmann¹Daniel Cantré²Artem Rafaelian³Daniel Dubinski³Alexander Storch¹Matthias Wittstock^1*†

• ¹Department of Neurology, University Medical Center Rostock, Rostock, Germany
• ²Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
• ³Department of Neurosurgery, University Medical Center Rostock, Rostock, Germany

Stroke is a major cause of disability and mortality, with its incidence increasing with age. Despite advances in acute stroke treatment, functional outcomes in elderly patients are not always as favorable as expected. Therefore, additional efforts are required to identify reliable prognostic markers and improve patient outcomes. Sarcopenia has been recognized as a negative factor influencing functional outcomes after ischemic stroke. Temporalis muscle thickness (TMT), assessed on routine imaging, has emerged as a potential surrogate marker for sarcopenia; however, its prognostic value in stroke patients has not yet been conclusively established. This study aimed to evaluate the association between TMT and functional outcome, assessed using the modified Rankin Scale (mRS) at hospital discharge, and in-hospital death. In this retrospective cohort study, we included 152 consecutive patients (median age, 74 years [IQR, 63–83]; 53% male) admitted to the Department of Neurology at the University of Medicine Rostock who underwent endovascular revascularization (EVT) for acute ischemic stroke. TMT was determined from initial cranial CT scans. Due to the small sample size, we used a uniform TMT cutoff value (5.78 mm) for sarcopenia. The primary endpoint was the mRS at discharge. Sarcopenic patients were older (p < 0.001), more often female (p < 0.001), and had a lower BMI (p = 0.045). They also had significantly worse functional outcomes (p = 0.006) and higher comorbidity burdens (atrial fibrillation, p = 0.023; arterial hypertension, p = 0.024; smoking, p = 0.020). Poor outcome was significantly associated with sarcopenia, but this association lost significance after adjustment. In the group comparison regarding mortality, deceased patients had lower TMT and were more frequently sarcopenic. However, these associations also lost significance in the multivariate model.

Introduction

Stroke is a major cause of disability and mortality worldwide (1). Its incidence increases with age (2). Despite improvements in care and treatment, the functional outcome in elderly stroke patients is not always as favorable as expected. Sarcopenia has been discussed as a contributing factor in this context (3, 4). Sarcopenia—defined as the loss of skeletal muscle mass—has been shown to increase after stroke. Both sarcopenia and stroke have been associated with worse functional outcomes (3, 4). This highlights the importance of measuring skeletal muscle mass as a measure of sarcopenia in older stroke patients with respect to functional outcomes.

Diagnostic tools for assessing sarcopenia rely on methods that estimate muscle quantity, including magnetic resonance imaging (MRI) and computed tomography (CT) scans of the lumbar muscles obtained during abdominal scans (5–7). More recently, estimation of temporalis muscle thickness (TMT) has become a favorable approach for sarcopenia measurement, as it can be easily, quickly, and reliably performed during routine imaging. This has been demonstrated in cerebellar ischemia and traumatic brain injury (8, 9). Evidence of the prognostic value of TMT in EVT for ischemic stroke is limited, and the relevance of TMT measurements is not fully clarified (10, 11). The current study aimed to investigate the association between TMT, as a measure of sarcopenia, and functional outcomes and to assess mortality in elderly patients undergoing EVT for acute ischemic stroke at hospital discharge.

Methods

Study design

In this retrospective cross-sectional cohort study, we screened the hospital charts of 220 consecutive patients admitted to the Department of Neurology of the University Medicine Rostock between January 2022 and December 2023 undergoing revascularization procedures (thrombolysis, endovascular thrombectomy, or both) for acute ischemic stroke. After exclusion of patients with insufficient clinical data due to wrong coding or duplicate records, a total of 152 patients were included in the final analysis (see Figure 1 for study flowchart). This study was conducted in accordance with the amended Declaration of Helsinki and was approved by the local ethics committee (A 2024–0039).

Figure 1

Figure 1. Study flowchart.

Patients

All patients received standard-of-care treatment according to the European Stroke Organization Guidelines for ischemic stroke (12). Basic characteristics such as age, sex, body mass index (BMI), pre-morbid disability measured by the individual’s category in the Clinical Frailty Scale (CFS) from the Canadian Study of Health and Aging (CSHA) (13), cardiovascular risk factors, presence of advance directive, and imaging data, as well as therapeutic procedures of the acute phase and length of hospitalization were obtained. Clinical severity of stroke was assessed using the National Institutes of Health Stroke Scale (NIHSS) and the ASPECTS score (14).

The topology of stroke was assessed by an experienced board-certified neuroradiologist (D.C.) who was blinded to the hypothesis investigated in this study using cerebral CT or MRI. The occurrence of large vessel occlusion (LVO) was determined. Stroke volumes were measured on CT or MRI scans using Brainlab software (Brainlab AG), and the ASPECTS score was determined (14). After EVT, flow restoration at the end of each procedure was graded using the modified Treatment In Cerebral Infarction (mTICI) scale, with optimal recanalization corresponding to a score of 2b-3 (15).

The mRS score at discharge from the hospital represents the primary outcome measure. An mRS score between 0 and 3 was considered a good functional outcome, scores between 4 and 6 represented a bad outcome, and a score of 6 represented in-hospital death, which was assessed separately (16). A 24-h follow-up CT scan was assessed to identify complications such as brain bleeding events (secondary intracranial hemorrhage ICH), defined according to the European Cooperative Acute Stroke Study (ECASS II) classification (17).

TMT measurement

TMT was assessed on CT or MRI scans at admission according to the method presented previously by Ravera et al. and Steindl et al. (18, 19). In detail, TMT was manually measured on the patient’s baseline brain CT scan using the method introduced by Katsuki et al. (20). Slice thickness was set at 5 mm, and the CT axial image was manually adjusted to obtain a symmetric cross-section. TMT was measured bilaterally, perpendicular to the long axis of the temporal muscle. Three determinations were taken for each side: one at the level of the orbital roof, identified by comparing a sagittal view, another 5 mm above the orbital roof, and the last at 5 mm below the orbital roof. The arithmetic mean of the three measurements was calculated for both the left and right sides. Once the right and left means were obtained, the final TMT, expressed in millimeters, was measured by calculating the arithmetic mean between the two values. Based on the mean TMT values, patients were further divided into two groups: sarcopenic (TMT < 5.78 mm) and non-sarcopenic (TMT ≥ 5.78 mm). Because of the small sample size, female and male patients were analyzed together in each group. An analysis of sex-specific differences according to sex-specific TMT cutoffs was performed according to Steindl et al. The results are provided in Supplementary Tables S1, S2.

Statistical analysis

For statistical comparisons between groups, the Mann–Whitney U-test or Kruskal–Wallis test was used for comparison of parametric data, and the Pearson’s chi-squared test or Fisher’s exact test for comparison of non-parametric data, as appropriate. For ordinal data, the Jonckheere–Terpstra test was applied. To test whether there was an association between categorical clinical variables and the outcome of interest, univariate and multivariate binary logistic (for in-hospital death as the dependent outcome variable) or ordinal regression analyses (for mRS as the dependent outcome measure) were performed. To select relevant covariates, we performed the Mann–Whitney U-test and the chi-squared/Fisher’s exact test in combination with univariate regression models to determine the predictive values and odds ratios (ORs) with 95% confidence intervals (95% CIs) of the candidate covariates age, sex, NIHSS at admission, stroke volume, intracerebral hemorrhage, length of hospital stay, aspiration pneumonia, and atrial fibrillation (for detailed information, see Supplementary Tables S3, S4). Before calculating multivariate regressions, assumptions of normality, homoscedasticity, independence of errors, and absence of multicollinearity were checked. The results (variance inflation factor values) are shown in the Supplementary Tables S5, S6.

Analyses were conducted using R software, version 4.4.1 (R Foundation for Statistical Computing, Vienna, Austria) via RStudio version 2024.09.0 (Posit Software, PBC), and all p-values were two-sided, and values of P less than 0.05 were considered statistically significant. Due to the limited sample size in our retrospective study, adjustment of p-values was not carried out to preserve statistical power.

Results

Demographic and clinical characteristics

A total of 220 consecutive patients treated by EVT for LVO in ischemic stroke were screened; 68 were excluded due to wrong coding or unavailable clinical data (Figure 1). At admission, all patients except one received CT imaging (1 patient underwent MR imaging, 0.7%). A total of 152 ischemic stroke patients with LVO were included (median age 74 years [IQR 63–83 years]; 53.0% men). The median value of NIHSS at admission was 16 (IQR 10–19). Detailed demographic and clinical characteristics are illustrated in Table 1.