Sarcopenia Demystified: Why Muscle Loss Matters After 40

[7:07] joints and it’ll help the stem cells regenerate cartilage because they’re sitting next to cartilage, right? So stem cells are kind of versatile cells that can become other cells. Well, your stem cells decrease as you age as well. So you lose some of that capability to regenerate muscle. And also you have a decrease in your anabolic hormones. So anabolic means building up. So anabolic hormones are hormone that help you to build tissue. So as those go down, again, your ability to build muscle decreases. Okay? Um

[0:00] If you’re over 40 and not doing resistance training, your muscles are shrinking. And that’s not just aging. That’s sarcopenia. And it’s not just about looking soft. We’re talking about the kind of muscle loss that can wreck your balance. It slows your metabolism, and it can lead to early disability. Yeah. And most people don’t catch it until they’ve already lost strength they may never fully get back. But it is preventable and even reversible. Okay. So today we’re going to be breaking down what sarcopenia is, how to spot it, what actually works to stop

[0:31] it, and how to get stronger no matter what your age is. This episode can literally save your strength and independence. So let’s go. Let’s go. What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast? Chiropractors and physical therapists don’t like each other. Oh, think again. I’m Dr. Kathy Lynch, physical therapist who likes to help people move and get stronger. I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Welcome to the PTCH Podcast. Remember, there’s no I in

[1:02] PTCH. All righty, everybody. Welcome back to the PTCH Podcast. I’m Jason Young. I think I’m a chiropractor. Yeah, you’re not a chiropractor. Yeah. Okay. Physical therapist Kathy Lynch. Physical therapist Kathy Lynch. I like it. So, welcome back. Again, we start every episode the same way, which is by thanking you for your participation, for sharing the podcast with people that you care about and that you love. Today we have a really great

[1:33] topic because this one I think applies to absolutely everybody. If you’re growing up, if you’re getting older, this one applies to you. So listen up. Today, what are we talking about, Kathy? It’s called sarcopenia. That’s a fun word. It is a fun word. Sarcopenia. Yeah. So we’re going to talk about what it is, why it matters, and what you can do about it. Like, should we be stopping it? I think we should. We should definitely be stopping it.

[2:04] Absolutely. And especially if you’re a middle-aged listener, which I imagine is all of our listeners. Yeah. If you’re a middle-aged listener, this is a particularly important topic. Because what you do right now, what you do today about sarcopenia, it matters. So yeah. Yeah. So Kathy, you want to kick us off and tell us what is sarcopenia? So you may have heard of the word osteopenia.

[2:34] Yes. Yes, you have. Yes. I paid hundreds of thousands of dollars to learn what that word means. And a lot of our listeners are probably familiar with that. And that is basically bone loss, right? So sarcopenia means muscle loss. Yes. And osteopenia is a precursor to osteoporosis, which probably even more people have heard of — know what that is too. Yeah. So sarcopenia — you were talking about our middle-aged listeners, but really sarcopenia can sometimes start in

[3:04] the 30s. Oh, okay. Yeah. So even when you’re 30 years old, you can start to lose muscle mass. And the stats that I have seen is that you can lose as much as 3 to 5% of your muscle mass per decade. Whoops. Yeah. And so if you’re not actively trying to strengthen your muscle, you’re losing the battle. And so if it starts in your 30s, and in my practice I start to see people with more pains in their 50s, because now you’ve lost maybe 15% of

[3:34] your muscle mass by the time you’re 50. Yeah. And so that’s when a lot of the aches and pains come into our joints. So sarcopenia is a natural aging process. You’re going to get it. Yeah. Dang it. I think I might have it. No, I know I don’t have it. I’ve been working actively to stay away from it. But, you know, I think that you bring up a really good point about its association with aging because there’s certain conditions that are

[4:04] associated with aging. I have patients who come in all the time and they’re like, “I’ve got back pain and I think it’s just because I’m old,” right? And so there’s nothing that’s magical about just getting old that suddenly you have problems. There’s real processes — that sounds like multiple processes, whatever that word is and however you say it — there are real things at play that lead to these

[4:34] conditions, right? So you don’t just have to be like, “Oh, I’m old, I’m getting hurt now,” right? And sarcopenia, I think, is one of the major things that plays into why you might feel bad as you get older. Don’t surrender to the oldness. No. No. Don’t go quietly into the night. You don’t have to go quietly into the night. No, you don’t. You shouldn’t. You should go into the night screaming and lifting heavy things. Right. That’s right. Yeah.

[5:04] That’s right. So what causes sarcopenia then? Or is that my thing to talk about? Yeah, because we kind of game-planned this and I think I said that you were going to go through the key drivers. Let’s talk about some of the key drivers, shall we? Okay. So you mentioned it’s associated with aging and what happens as we age. I think there’s a few obvious things. Number one is we have changes in our hormones. Okay. So you start getting into your 40s, your 50s,

[5:36] 60s. Well, symptoms for sarcopenia show up in your 60s and 70s mostly, but you are really kind of feeling the burn when you’re in your 40s and 50s. Like, I still have patients who are like, “Oh man, I turned 40 and now everything is different,” and they’re right. You know, I didn’t believe them, right? And then I turned 40 and I was like, whoa. It’s like I hit a brick wall, right? And so it’s not that you can’t do things, but it’s like everything costs a little extra in terms of recovery. And so the changes in our

[6:06] bodies that happen — one of those is that you have a change in your hormones. Okay? So you have a decrease in testosterone, you have a decrease in estrogen. And so people are like, “Well, testosterone, that’s the muscle-building hormone.” Well, estrogen has a role in that too. So you need both of those, and as those decrease, it decreases your ability to add muscle mass. Okay. Other things are: you have a decrease in stem cells. So stem cells

[6:37] are really popular to talk about — people are like, “Oh, stem cells!” You rub this cream on your face and it’ll give you stem cells, right? So I’m going to tell you what a stem cell is. A stem cell is basically sort of like a blank cell. If you have a stem cell, it can become another type of cell, and usually what it will do is choose to become the type of cell that it is next to. So for example, they’ll do stem cell injections in

[7:07] joints and it’ll help the stem cells regenerate cartilage because they’re sitting next to cartilage, right? So stem cells are kind of versatile cells that can become other cells. Well, your stem cells decrease as you age as well. So you lose some of that capability to regenerate muscle. And also you have a decrease in your anabolic hormones. So anabolic means building up. Anabolic hormones are hormones that help you to build tissue. So as those go down, again, your ability to build muscle decreases. Okay.

[7:09] like tendons or muscles, and those stem cells will become new tendon cells or muscle cells — which is an oversimplification of the actual names. I was thinking about saying, but I was like, I don’t want people turning off the podcast yet. We’re going to wait probably another 10 minutes before we really lose you. So, yeah, that’s the simplified version of stem cells. And the older we get, the fewer stem cells we produce. Also, we get some change in the composition of our muscles, and so we start to get some fatty infiltration. I

[7:40] was talking about this with somebody and they said, “You mean marbling.” Yes. We become more of a — like a Wagyu beef than like an Angus beef. Right. The ribeye becomes more delicious. Okay. So yeah. So those are some of the things that come into play. You also have changes in habits, nutrition, lower levels of activity

[8:10] just in general, an accumulation of other problems, and a really, really big thing that feeds into this sarcopenia process is chronic inflammation. Okay. So chronic inflammatory conditions like rheumatoid arthritis — like all the other chronic inflammatory conditions that I now suddenly forgot about — like any of those types of things, just having a lot of inflammation, consuming things that you’re allergic or sensitive to,

[8:41] high intakes of things that cause inflammation. So, for example, sugar — sugar in high concentrations will cause inflammation — those types of things. When you have inflammation, you decrease the amount of muscle mass that you can make, and then that ends up leaving you in a situation where that’s just gradually declining over time. Did I do it? Did I tell you? Did I tell you where it comes from? Okay. All of the things. Yeah. Yeah. Okay.

[9:12] Kathy: So, can I ask you what you’ve noticed in terms of how sarcopenia shows up clinically? Like, what are you seeing with your people?

Jason: Yeah, I would say a lot of times what I’ll hear from my patients — one of the biggest ones is — I can’t get up and down off the floor anymore. And I want to play — “Help, I’ve fallen and I can’t get up.” Exactly. Call me Life Alert. Life Alert. You could be a sponsor for the PTCH Podcast. You could. They could. Yes. We still have space. We’re taking all sponsors.

[9:43] Exactly. We have a price. Yeah. And it’s not very high. Not right now. It’s not. Yeah. So, getting up and down off the floor is one of the biggest things that I usually see with people with sarcopenia. Also, people have trouble going up and down stairs. It’s like, oh, I got to hold the handrail, or going down hurts my knee. Those kind of things. And that — I don’t even have to suspect. I know.

[10:13] Yeah. It’s due to muscle loss. And people think that it’s, “Oh, my knee’s bone on bone, and that’s why it is.” Yeah. The reason is bone on bone. Yeah. Well, and they think it’s just joint problems, or “I’m just getting old and so stairs are harder,” but it is. Yes. You’re losing muscle mass, bro. Yeah. And that’s — in my practice, that’s what I tend to see. You know, as a high schooler, we weren’t taught — and this is me dating myself — but back in the

[10:44] ’80s and ’90s, we weren’t taught, at least especially the women, to strength train. We were told to get out and run and do cardio and be thin. And so I think that has manifested into a lot of the patients that I see now still focusing on walking and hiking, which is great, but they don’t focus on getting stronger. Yeah. This is why Generation X is so savage, right? Let’s go. Take that Gen Alpha, Gen Z, millennials. Yeah, we’ll take all of

[11:15] you. Bring it. Okay. So no, we’re trying to help you be better by not becoming sarcopenic. But yeah, you’re right. It was — you have to burn fat. Burn fat. Burn. Yes, that was the message we got. Yeah. The American Heart Association actually is like, “Get more cardio exercise because that’s good for your heart.” It is. It is. But what else is good for your heart? Yeah. Having a bunch of muscle. So, yeah. And I think it’s kind of a shortcut — and this is just

[11:46] telling people — the more muscle mass you have going into your later years, the happier, healthier, longer, and higher quality of life you’re going to have. Right. Oh, what about this one? Do you have patients who are like, “I don’t want to lift weights because I don’t want to look all bulky”? Yeah. Listen, lady — hey, why do you assume it’s a woman? It’s always a woman. I’ve never met

[12:16] a man that’s like, “These muscles are too big on me.” It’s always a woman. And it’s another cultural thing where we want you to look feminine, we want you to look small and skinny and everything like that. And the big bulky muscles — it just looks gross. But first of all, it is not easy for women to develop big bulky muscles. And so I alluded to testosterone and estrogen before, and those are the big differences, right?

[12:46] Testosterone is going to allow you to put on more muscle than estrogen. Estrogen is going to allow you to put on a good, appropriate amount of muscle. So yeah. Culturally, I think that kind of feeds into our sarcopenia problems. Mhm. And you were kind of alluding to it as you were talking about what drives sarcopenia. And the thing I like to tell people about it too is — the less muscle mass you have, you usually have

[13:17] more fat cells. And fat cells are more inflammatory than lean muscle mass. And you were kind of talking about that when you were talking about steak. I mean, you weren’t talking about steak. The marbling. Yeah. And so it’s kind of a never-ending cycle. The more fat tissue you have, it creates more inflammation within your body. Yes. And then in my line of work — well, both of our lines of work — that low-grade chronic inflammation actually

[13:48] leads to osteoarthritis. It does. Yes. Yeah. Wait, you mean it’s not wear and tear? It is not. I mean, that’s part of it, but — we used to think that’s all it was: wear and tear. Yeah. But really, what science is finding out is that osteoarthritis is driven a lot by low-grade chronic systemic inflammation. Yes. Yeah. And there’s something called sarcopenic obesity. Heard of that?

[14:18] No. Sarcopenic obesity is wonderful to say, first of all. Yeah. Try it. Go ahead. Sarcopenic obesity. Yes. Okay. The other term that we use for this sometimes — this gets thrown around — is being what’s called skinny fat. Oh yeah. Okay. And so there are people out there who have a healthy BMI. So BMI, if you don’t know, is body mass index, and it’s a ratio of your height to weight. Now it is by no means perfect. Right,

[14:48] it’s useful though for a few reasons. Number one, well, first of all, let me talk about why it’s not perfect. If I have 200 lb of muscle on me and I have 7% body fat, my body mass index is going to be high. Oh, I got to tell you how tall I am. Let’s say I’m 5’3”. Okay? So I am just — I got tons of muscle, very little fat, and I’m short, and my body mass index is going to be like high 30s or 40 maybe. And that’s not

[15:19] necessarily unhealthy, right? And body mass index is used to kind of determine — or help us to identify — who has increased risk factors because of their ratio of height to weight. But it doesn’t do anything to tell us about our body composition. Okay. At the same time, you could have somebody who’s in a healthy range for body mass index. And the range is different for men and women. For men, it’s a little bit lower of a range. For women, it’s a little bit higher. But you can have somebody who’s smack dab in the middle of that range, maybe on the low end,

[15:50] but they’re still not healthy. And the reason is because they can have what’s called sarcopenic obesity. So that is when somebody has a normal body weight or a low body weight, but a significant amount of body fat percentage. And so maybe they’re 35–40% body fat, but they are in that healthy BMI range, right? And so that’s why BMI isn’t always

[16:21] really useful. But you know, people like to bag on it. And I used to — I used to really think, oh, this is stupid. We need something else. But the good thing — bit my tongue. Ouch. It’s sarcopenia. It is. That’s one of the signs, isn’t it? Like you lose control of your tongue and — Oh, that really hurts. You need to get in the gym, man. Okay, Scott’s laughing. Mhm. Thank you. All right, so this is going to be like a trivia question one day. In which episode of the PTCH Podcast did host Jason Young permanently end his

[16:52] podcasting career by biting off the tip of his tongue? All right, what was I talking about? Sarcopenic obesity. Yeah. Oh, and BMI. So I used to really think that BMI is stupid. We should get rid of it. But it’s free. It doesn’t cost anything to do BMI. It is much cheaper than, like, more gold standard tests of where we are in terms of body composition, like a DEXA scan and things like that. So BMI definitely has a place, but you shouldn’t just hang your hat on that

[17:23] because if you don’t have enough muscle mass and you have a high amount of fat, you’re in trouble. Yeah, you’re definitely going to have a hard time getting off the floor. Yes, absolutely. Mhm. I have a patient who’s 100 years old and the first thing she does every morning is she gets out of bed and she gets down on the floor. Yes. And she gets down on the floor because she wants to get up off them. Yes. So she trains every single day in case she has a fall. Isn’t that awesome? That is. Yeah. It’s part of the reason she’s — That’s right.

[17:53] So good habits. What happens whenever people have — like, why are falls a big deal? Because that’s also one of the symptoms of sarcopenia: people have trouble with balance and gait. They start walking slower. They have more falls. Why do falls matter? Well — I hope you edit this out. Sorry. I’ll edit this out. Yeah. Uh huh. Okay. Ask me that again.

[18:23] Okay. So why do falls matter? So falls, especially in our elderly population, can lead to fractures, and fractures can lead to more inactivity, which leads to more sarcopenia. So it’s kind of a never-ending cycle. Yeah. Mhm. Yeah. Not a good one. It is not a good — Yeah. I’d like a never-ending cycle of like going to the gym or, you know, eating ice cream or something. No, don’t

[18:53] want that. But yeah, you’re right. When you start having falls, well, there’s the obvious risks, which are like if you fall down, you can hit your head, get a concussion. You can break a bone. If you’re like into your sixth, seventh, eighth decade of life and you have a fall, it can be catastrophic. Yeah. There are many, many people who die every year because of falls. Yes. And did you know that a lot

[19:24] of times when people have the — oh, I fell and broke my hip — it’s that they actually broke their hip and then they fell. I did know that. Which is crazy, right? It’s like you’re standing there and your bones have become so weak that they break and then you fall. That’s right. Is it preventable though? Sarcopenia. Well, any of that — like, what do we do to kind of — I shouldn’t say aging-proof our bodies because we’re all going to age. There’s

[19:54] nothing wrong with aging, but like what do we do to kind of age more gracefully — to age more fiercely, I guess — which are two opposites. Like, yeah. Be harder to kill. Be harder to kill. I love that. That’s the Helix Training thing. It is. Right. And you put that on shirts. We do. And — I want one of those shirts. But I don’t think that I’d ever wear it. Because I don’t — I don’t want people being like, “Oh yeah, challenge accepted.

[20:25] Let’s do this right now.” Oh my gosh. Yeah. But I think that’s just like the coolest slogan, harder to kill. Yeah. We like to train people so that they live longer. I always tell a lot of my patients too — the reason I do squats is so that when I’m 90, nobody’s picking me up off the toilet. No, that is a boundary for me. Okay. I might not know who I am, where I am, what country I live in, but I’m getting myself up and down off the toilet.

[20:55] Yeah. Well, it’s a huge deal. Squats are like a super exercise because it’s quality of life, right? Everybody squats every single day. Every day. Pooping is a great equalizer, as I’ve heard it said. Right. I don’t care who you are, right? You can be Hitler. You can be Gandhi. Yeah. Eventually, you got to squat down and take a — True. Do a number two. This is — How did we get to pooping? I don’t know. What are we talking about?

dial it back. But um the biggest one is what’s your recovery like? Yeah. So if I go out and I run, um let’s say I run a 5K, I’m not really sore the next day. Um that’s fine. If I go out and I run a 5K and I can’t walk for the rest of the week, that’s probably too much for me right now. Right. And so it’s just learning your own body through experience. Yes. Through safe testing of it. Yes. Exactly.

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[21:25] Kathy: Sarcopenia. Sarcopenia, right? Anyway, but yeah, let’s — let’s circle back around. I’m just trying to bring in some of the younger crowd. Yeah, they never started watching. Okay. But yeah, so quality of life thing. You can’t squat. Yeah. Like you can’t get in and out of your car. So now you don’t drive. Right. Right. You have difficulty using the restroom. So now you are in danger of being taken out of your home. You can’t be independent. Right. And so you can train for these

[21:56] things though. Yeah. Mhm. Do you want to know my suggestion on training for these things? Not — hey, Scott, let me tell you, Scott, the best way to prevent sarcopenia. Yeah. Kathy, would you — would you also include me? Could you tell me like what are — what are some of the best ways? Like, and I’ll edit that. No, I think that was good. You do? What about this? Should I edit this? Oh, dang it. Okay, here we go.

[22:31] Jason: What are some of the things that you are telling patients to — first of all, help them avoid sarcopenia, or if they’re starting to see the signs of it, like what are you doing with people to help them get out of that?

Kathy: Yeah. A lot of times when I’m discharging patients from PT, they say, “Well, how long do I have to do my exercise?” And I say, “For life.” Yeah. Just until you die. Just, you know, that’s it. And then when you’re dead. Yeah. After your funeral, you can just do whatever. Yeah. Mhm. Yeah. Yeah.

[23:01] Jason: That’s like — how long do you want to be healthy? That’s a really good question.

Kathy: Yeah. So, you know, if they’re beginners, I tell them to start small, you know. Body weight exercises can be really valuable to start with, like we just talked about. Yeah — the squat, a lunge, heel raises, step-ups. Moving your body against gravity can help strengthen muscles. Yeah, cuz that’s what you’ll be moving

[23:32] most of the time anyway, right?

Jason: Absolutely. But then I like to put 5 lbs in their hand because I like to think, okay, now you can stand up with 5 lbs heavier than your body weight. So that guarantees that you can lift more than your body weight. But let’s talk about people in their 40s and 50s. Yeah. What should they be doing? That’s a great question. Yeah. You should be lifting heavy stuff now. Right now. Now. And I — so I see a lot of people who have back pain and things like that. And that

[24:03] is probably one of the biggest apprehensions that people have. They’re like, “Oh, well, I have back pain, so I’m not going to do weight training because — you know — I don’t want to hurt myself.” Right? Well, you’re already hurt. Yep. Right. And doing a good, controlled, supervised, safe, intermediate to mild level weight training program is fantastic for back pain, knee pain, hip pain, any of those kinds of things. So a lot of the things that scare people away from doing resistance exercise

[24:35] are exactly the things that they need resistance exercise for. People will say, “I’m afraid to go to the gym. I think I’m going to get hurt,” or, “I get hurt when I go to the gym.” The risk of not strength training is much higher than the risk of actually strength training.

Kathy: Absolutely. And getting your body ready. Do you remember 2020? There was an illness that went around. What was that? I think it was — was that the murder hornets?

Jason: It was the murder hornets. That’s what I

[25:05] was thinking of. Yeah. The Australia fires. No. So when COVID happened, we saw people — well, did you have Helix then?

Kathy: I did. Yeah. So that was a tough time for gyms. Yeah. That’s a terrible time. Good. Yeah. So you had all kinds of people leaving gyms because you couldn’t go in and nobody wants to work out in a mask. So lots of home gyms popping up and things like that. Also, you had people coming out of the workplace or setting up their home offices,

[25:35] which is really like your laptop on a stack of empty pizza boxes, right? Cuz it’s like the only food you could get. So, and then whenever all those restrictions started getting lifted, I’d have patients coming back and they’re like, “Now that people are getting back in the gym, are you starting to see a lot more injuries? Is it good for business?” And I’m like, “It’s actually the opposite.” Right? Now that people were getting to the gym, I was seeing fewer patients because people were getting themselves healthy. Yes. Rather than hurting themselves standing

[26:06] in front of a bunch of pizza boxes with a MacBook on it. Right. Exactly. Yeah. And so it just can’t be overstated how healthy exercise is for you, even if it hurts a little bit. Yeah. Yeah. Yeah. Strength training is going to hurt a little bit. You’re going to feel the muscle burn. Yeah, totally. Yeah.

Jason: So, how much exercise is too much? I know I have an answer that I tell patients. I’m wondering like what are you telling people if they’re worried about exercise? Like how much is

[26:37] too much?

Kathy: That’s a good question. So, usually — how do I answer that? Because sometimes what I like to tell them is they have to listen to their body, just like in yoga. Yes. Oh, yes. Did we do an episode about yoga? I think we did. It’ll come out. Everybody should go back and watch that. Yeah. They can hear about my horrible P90X experience. Yeah. Golly. All right. Yeah. But at the same time, you

[27:09] got to listen to your body, but at the same time, lifting weights and getting stronger — what you’re doing is you are actually injuring your muscle. You’re — you have micro tears. Yeah. Right. So it’s going to hurt. It might hurt in the moment and it’s probably going to hurt for a couple days. Yeah. I think another way to refer to that is you’re straining yourself, right? You’re straining your body and it’s that process of repair that then makes it better.

Jason: What I tell people is — whenever it comes to pain, and it’s not just with lifting weights or anything like that, but it’s

[27:40] any activity — it depends upon how quickly you can recover from an activity. Yes. So I tell them if you’re going out and you’re doing something like an exercise, or lifting weights, or riding a bike, or whatever, if you’re getting sharp — like over seven or eight out of 10 pain — you might want to dial it back, right? Especially if that is something that is sustained. If you’re finding that you can’t function, so like you have a joint that gives out or something like that, you should dial it back. If you’re getting numbness or tingling, you should

[28:10] definitely stop, right? But then after that, it’s just about how much discomfort you can handle and how quickly you recover. So if it’s taking you between like half an hour to two hours to make a reasonable recovery to where it’s like, okay, now I’m just kind of sore, I think that that’s an acceptable range. If you’re wrecked for the rest of the day, that’s a problem. Too much, right? It’s taking you a week or two weeks to recover. You just did too much. It’s pretty simple. You just dial it back, right? You do less weight, fewer reps, less distance, whatever it is, and

[28:41] you just keep going. And I think that it’s totally normal and natural to mess up and do too much. Definitely. And that’s how you find out where you are. Yeah. Right. So the body’s forgiving, though. It is. It’s very forgiving. Heals itself. It’s made to heal. It is made to heal. And I think that that’s the interesting thing, too, about people who want to blame age for their problems, because all healing happens in the future. It does, right? It is the truth, right? People are like, “Oh, I’m just getting

[29:11] older.” And it’s like, “Okay, so what was different when you were 20?” Well, I could heal from these things. So when you were 20 and you got injured, you could heal — when you were older, that’s the only way this thing works, right? That’s true. And so we have diminished capacity to heal as we get older, but it’s not like it completely disappears. And so when we’re active and we’re exercising, we actually maintain that capacity to make a quicker

[29:41] recovery. So how much exercise, how much resistance exercise do you think that it takes? Like, let’s go in a week. Okay. How many days a week would you say that somebody needs to be doing resistance exercise in order to avoid or decrease their chances of sarcopenia? Yeah. Well, one’s better than none. Yes, that’s a great way to start. Yeah, literally start with one day a week. Start with one day a week bodyweight exercises. Get your body conditioned to

[30:11] it. Two is great and two to three is optimal. Yeah, because you need those days in between. That’s the other thing. You need the days in between because that’s actually when your body’s healing and you’re getting stronger. Yeah. I’ve actually seen some data that says that for people who are in like their 50s and 60s, training over like four days a week typically is not going to get you further gains. You’re not going to get more out of that. And so you might actually be better off

[30:42] taking that time for the rest, which is like cool. You’re like, “Oh, what? I’m getting old. I have to work out less.” And so that’s good. Can you work out six days a week? Heck yes, you totally can. But like, are you going to be getting those gains? Not necessarily. And that’s fine. And that’s one of the things that’s cool about being older. I saw a study that — they took geriatric populations, and we’re talking like old people, call them old. It’s actually reminds me of my grandpa.

[31:13] So my grandpa passed away a few years ago, and let’s see, he was 90. No. Well, he was in his 90s, right? Very old. Okay. And so you call him up and you’re like, “Popa, what are you doing?” He’s like, “Oh, you know, I’m just taking my time. I’m taking care of the old ladies at church.” I’m like, “Really? What do you mean?” “Oh, I drive around, check on them, make sure they have — ” “Popa, who’s older than you at church?” And it’s like, it’s the young ladies to you. So anyway, love you,

[31:45] Pop. So yeah, they looked at these geriatric populations. These are people like in their 90s, and they set them up with resistance training exercises, some using light weights, some using bands. They had them work out three days a week, and they did this for 13 weeks. And what they found was that some of these people who were previously untrained — like they weren’t doing this already — their strength actually doubled. Wow. Right. So even in your 90s, you still

[32:16] have the ability to gain muscle mass. It’s not like that just completely turns off. And so there’s never a point at which we should be saying, “Well, I’m jumping off the muscle train because it’s already gone.” So till the day you die, you can build muscle. Yeah. And you know, people get obsessed with calories in, calories out, or with the idea of burning calories. Like, I ate a hamburger, so now I’m going to get on this bike and I’m going to bike until I burn those calories. And that’s not how our bodies work. The main thing in your body that burns calories is muscle mass. Muscle mass. It’s muscle mass, right? And so if you want to lose weight, one of the best things that you could do is put on muscle. That’s right,

[32:46] because every single day your body has to maintain that muscle mass and it takes a certain amount of calories. So do you give people nutritional advice at all whenever it comes to

[33:16] sarcopenia? So it’s not necessarily in my scope of practice. I do give some advice and I think the things that I do talk about mostly is protein. Yeah. Right. Protein intake. Most people are not eating enough protein to build muscle. Mm-hmm. So what we’ll usually say, for older adults — and this is where we get into the metric system. Yeah. Are you ready for this? I love it. Yeah. Mm-hmm.

[33:46] So protein intake should be about 1.2 to 1.6 grams per kilogram. Yes. Per day. Yes. So let’s do the math on this. If you weigh 150 pounds, you weigh 75 kg. Oh, I’m so glad you did that math, ‘cause I thought you were going to put me on the spot. I was — woo. Okay. Yeah. You know, divide it by two-ish, right? So you’re at 75 kg. So that means you should be eating more than 75 grams of protein per day.

[34:16] Yes, because if you’re going to hit the 1.2 to 1.6. Yep. Yeah. And I think that’s good. And that’s a good formula. You go on Instagram and stuff like that, you see influencers and they’re telling people it’s one gram per pound of body weight, which is an insane amount of protein. I mean, you can, but then the protein becomes a chore. Yeah. And it’s very expensive, too. Yeah. But yeah, so that’s a key thing —

[34:46] so protein is the building blocks of muscle. Yeah. So a protein molecule, you break it down, you have amino acids, and amino acids are the building blocks for muscle tissue. So that’s a key recommendation. And the other — because this is in my scope, and it’s in my wheelhouse, too, because that was part of my master’s, which was nutrition, right? So other things that people don’t think about besides protein is vitamin D.

[35:17] Okay. Virtually every cell in your body has a vitamin D receptor in it. And so we need vitamin D in order for just about everything to work correctly. So if you are low in vitamin D, you’re going to have a difficult time with anabolic, which means growth, processes like gaining muscle mass. You also want to be making sure that you’re getting enough calcium. A lot of people do. A lot of people are like, “Oh, I need to supplement calcium.” Most people actually probably don’t need to supplement calcium. If

[35:47] you’re getting like a multivitamin or something like that, that’s fine. But a lot of people can get enough calcium in food. So, eat some vegetables and things like that. Eat some eggshells. Don’t — don’t — don’t eat eggshells. Don’t eat eggshells. Yeah. So, those things are important. Making sure that you’re getting like magnesium, which is used for metabolizing hundreds of chemical reactions in your body. So if you don’t want to write all these down, just get yourself a good multivitamin,

[36:18] multi-mineral supplement. And don’t do like the cheapest one that you can find. You want to find a good quality supplement, so that you can make sure that this process of making muscle, which becomes less and less efficient the older you get — so, it’s more and more important to kind of clean up the nutrition as you age. You want to make sure that that’s firing on all cylinders. Also hydrating well. If you’re hydrating well, then you’re

[36:49] reducing some of the effects of inflammation in your body. And kind of a hybrid recommendation with this is creatine.

Kathy: I was just going to ask you about creatine.

Jason: You were going to ask me about creatine. I was — I can see it in your eye.

Kathy: You see it?

Jason: Yeah. The creatine look. Okay. Think about creatine. Yeah. So creatine — that is becoming the big hip supplement, right? So a few years ago was vitamin D and then it was magnesium. Oh, I’ve already mentioned those — and now the big thing is creatine for several reasons. Creatine used to

[37:19] be associated with 14-year-old boys who wanted to get a spot on their high school football or basketball team. And I was in that wave of adolescence where it’s like, “Bro, you got to get some creatine.” Remember that. It’s like they’ll tell you, “I’m taking creatine.” It’s steroids, right? It’s not steroids. Your body makes creatine. And what happens when you’re taking creatine? Oh, and it used to be miserable to take creatine because it was like these crystally powders that didn’t break down. So it’s like you’re drinking like

[37:50] pop rocks. It was not user friendly. Pop rocks. Yeah. It was gross and it was a little bit bitter, and you had to — like there was a loading phase. You had to get like 20 grams of creatine a day. So just hadn’t been enough research done, and the technology to make good creatine supplements wasn’t great. But what creatine does from a muscle standpoint — it basically makes more space in your muscles for water in between the muscle cells. So

[38:20] it gives you some bulk and mass. It swells you up. You get swoll. Literally, you get swoll. You literally swell up. Yeah. And there’s a few things to that. Like, having bigger muscles is good — you get some mechanical advantage. And creatine also helps you to create more energy, and it’s not just energy for the muscle. So like, it allows you to lift more and longer, but it also gives you some mental energy. Yeah. So it is a good, fairly

[38:51] natural way to increase your attention and everything like that. So if you enjoy a good cup of coffee, you might just enjoy taking creatine instead. The coffee. Yeah. So like four to five grams of creatine every day, especially as people are getting into middle age and older age — they found that it’s very beneficial. Very few side effects, as long as you’re also consuming a healthy diet. I hesitate to say this because I know that there are some people that are just going to be like, “Oh, well then that’s all I’ll do.”

[39:21] Kathy: Yep. No.

Jason: But they’ve done studies where they’ve had people supplement creatine and they’ve measured their muscle mass, and they find that people will gain muscle mass just by taking creatine. Yeah. You don’t have to work out any extra. Now it’s a modest increase. So it’s not like life-changing or anything like that, but that is what a difference maker it can be — is if you’re taking some creatine, you’re going to gain muscle mass, which if you’re fighting sarcopenia, super helpful. So four to five grams per day. I would

[39:53] love it if we had like a creatine company that sponsored the show.

Kathy: Yeah, that would be nice. Like, I enjoy consuming a creatine gummy, and it makes it so easy. I’ve had those. They taste really good.

Jason: Yeah, they taste really good. I think the one I gave you was super sour.

Kathy: It was really good. Yeah. Woo. So, but just to emphasize that you can’t just take creatine. So, I work with a dietitian — shout out to Amanda. And I asked her about creatine. She said, you know, creatine is for people who are already, first of all, getting enough protein.

Jason: Yes.

Kathy: And you can’t get something from nothing.

Jason: Correct.

Kathy: And then number two, you are actively strength training.

Jason: Yes.

Kathy: So you have to add those two things into it.

Jason: Yes. And that’s why I hesitated to bring up what that study said, because it’s not going to be a big enough effect where you notice it. But I just wanted to highlight that — like, it’s going to work for you all. So just imagine you’re picking up those weights, right? You’re doing a burpee or two.

Kathy: No burpees. No burpees. Okay.

[40:56] Sorry, Royal. Yeah. Well, we’ve been talking a long time. And I really want to play a game with you.

Jason: Let’s go.

Kathy: Yes. Yes. Let’s get to — let’s get to this game. Oh goodness. Let me find it here first of all. Yes. Tada. All right. So, a little callback to, I think, our very first episode — you had me play a game called start, bench, or cut,

[41:28] right? And you made me do it with some of my Oregon State Beaver heroes. Yeah, I cut you up. Yeah. So, it’s okay. That was fun. So, I want to do this with you today. And I think you should be able to do really well on this just because you already know a lot. And I think that we’ve talked about just about all of these things. Okay? So, we’re going to do a few rounds of this. I’m going to give you three kind of strategies for avoiding or fixing sarcopenia. And I want you to tell me for each of these strategies,

[41:58] what do you start, what do you bench, and what do you cut? Okay. Ready for the first one? I’m ready. Round one. For strength training, bodyweight squats, resistance bands, or biceps curls with dumbbells? Oh man, that’s easy. I’m definitely starting bicep curls with dumbbells. Okay. I will bench the resistance bands. Okay. I’ll cut bodyweight. Oh, really? Okay. I think it’s great,

[42:29] but I think you got to challenge yourself. I see what you’re saying. Okay. Is that how you intended it? No, there’s no right answer. I mean, this is your answer. I would have flipped the bodyweight squats actually with dumbbells. And the reason I was thinking is because of the size of muscle group. But I think your reason is good too, because — and here’s why I had an epiphany while you were saying this. Here’s why I like that: because some people are just really afraid to strength train, right? And they’re intimidated by the equipment

[43:00] and so then they will just opt for a bodyweight exercise, which you can get a great workout with bodyweight. You can, but you can also really cut yourself a break when you’re doing bodyweight, and so that’s an issue. Well, now I feel bad because the squat is my favorite exercise. It is. Yeah. I can’t believe I just cut it. Yeah. Yeah. It’s literally my favorite. But you want to put it on the bench now? Yeah. Yeah. Okay. It’s on the bench. Resistance bands. I think it’s challenging, because really in reality they’re all resistance exercises and they’re all going to be effective. So I just wanted to make you

[43:31] I’m not going to sleep tonight. No, that’s good. All right. Here we go. Protein sources. Round two. Greek yogurt. Okay. Chicken thighs or plant-based protein powder? Those are all good, though. See, that’s why the game is hard. That’s why it’s hard. Okay. I’m going to start with — I’m going to start chicken. Okay.

[44:01] And then what was the other one? I got Greek yogurt, plant-based protein powder. Personally, I’m going to bench — I’m going to bench the plant-based protein powder. Okay. And then I’m going to have to cut Greek yogurt. But I love Greek yogurt, I eat it every day. Okay. This is hurting my heart. So why are you cutting the yogurt? I like it. I feel like you can get more protein in a cup of protein

[44:34] powder than in a cup of Greek yogurt. Okay. I don’t know. I get 10, 12 grams. Yeah. Yeah. That’s the only reason. Well, we definitely agree on the chicken thighs — it’s delicious. All right. And I would have flipped them. And the only reason is because — well, I think number one, it depends. How do you deal with lactose? Yeah, you know, so there’s some people that are sensitive to the Greek yogurt. But then my reasons for keeping the Greek yogurt is that you get the benefits of the probiotics in there,

[45:05] too. And then plant-based protein, you don’t always get a full amino acid profile. So there’s some of them that you might not get. So I was thinking — like I said, though, no wrong answers. I’m making you choose between three things that are actually all good strategies. Okay. Yeah. So, start, bench, or cut: supplements. Creatine, vitamin D, branched-chain amino acids. Whoa. I’m gonna start omega-3s.

[45:35] That’s not one of them. Oh, I thought you said that’s what it was. What was it? Creatine. Vitamin D. Oh, I’m going to start — you need to start taking some creatine. I’m going to start — okay. Let’s say vitamin D. Okay. Creatine. And then I got to bench. I got to cut

[46:05] the branched-chain amino acids. Okay. What are you going to do? I like that. I’m going to agree with you. Okay. Yeah. If you don’t have enough vitamin D, it just — the other things don’t even really matter, right? Mhm. And the branched-chain amino acids, you can just get a steak — like a nice Wagyu steak. All right. Let’s do like two more of these. Okay. Let me see. We already did one of those. Oh, okay. Here we go. Exercise tracking tools: a smartwatch

[46:35] with a heart rate monitor, a written workout journal, or an Instagram accountability post. Yeah, guys. This is the year I’m going to do it. This is it, dude. Yeah, I’m going to lose all this weight. Follow my health journey, my fitness journey. Because it’s easy, I’m going to start with — God, what was the first one? Okay. Smartwatch with heart rate monitor, written workout journal,

[47:05] Instagram account. Starting with the smartwatch because it’s easy. Okay. And then I’ll bench the journal. Okay. And then I’m going to cut the Insta — same page. Okay. All right, good. And one more. Okay. We’re going to do movement habits. All right. Walking daily 10,000 steps, lifting weights three times a week, or a 20-minute yoga stretch session. What? They’re all good. We got to cut one of those. They’re all good. Yeah, but remember, we’re talking sarcopenia. Okay. Sarcopenia. All right. We got to

[47:36] cut yoga. I hope Jen and Nicole aren’t listening to this episode. Sorry. But you said stretching. Yoga. Stretching. Yoga slash stretch sessions, 20 minutes. Yeah, we still got to cut that. For sarcopenia. Oh, no, no, no, no. Sorry. I’m cutting walking. Okay. My bad. My bad. Okay. I’m cutting walking and I’m starting resistance training three days a week. Okay. We’re on the same page there, too.

[48:06] Yeah. Yeah. So what’s wrong with the walking? Nothing’s wrong with it, but you’re not challenging your muscles, you’re not putting your muscles under tension. It’s not resistance exercise. It’s great — all exercise is resistance exercise. Right. But if you’re trying to avoid sarcopenia, nothing’s going to beat the weights. Right. Right. And we learned previously that yoga is a good strength workout. It really is a good strength — it’s a lot

[48:36] of isometrics. Absolutely. Absolutely. Okay. Well, good. I would give you a solid A. Yeah. Well, because there’s not really any — it’s just hard decisions, not wrong answers. That’s true. No, it’s very good. Okay, so wow, our longest episode ever. I feel like we say that every week, you know. We’ll see after all the stuff we have to edit out, right? So yeah. Just to recap, we talked about sarcopenia. It is the gradual loss of muscle mass over time

[49:07] and it is something that we can beat. Yes. Right. We could do this together. Hand in hand throughout the world. Yes, we are stronger together. Uh-huh. We are — we can be stronger together and harder to kill. Yeah, definitely harder to kill. That is the goal. Yes. So, yeah, what are your key takeaways from this episode? So, this is kind of the soapbox I

[49:37] live on. Yes. Every day. Do it, girl. Yeah. I think I mentioned it earlier. My favorite thing to tell people is that when I’m 90, I’m going to be able to get up and down off the toilet because I squat. That’s why I squat. Mhm. You know, and at my gym, Helix Training. Yes. You know, we do programming blocks where we will — and this could be another episode we could talk about — where we program for hypertrophy, making the muscles bigger, and then we program for strength. Mhm.

[50:08] Which is the ability to move weight against, you know, gravity. Yes. Things like that. So I would say find yourself a professional, not a YouTuber. Okay. That can at least give you a workout plan that works for you to start with. Yes. Yeah. I think that’s great advice. My takeaways — I need to talk about this more with the people that I see. I need to be reminding people more about the reality of this. It is really

[50:38] easy to just kind of put your finger on the boo-boo, right? Which is really common — like when you’re seeing a lot of people, we just want to work where it hurts. But this is an important thing. One of the things that I should have mentioned earlier that we offer to people is we do body composition scanning. So if you are interested in knowing exactly how much muscle mass you have, how much is in each arm, each leg, in your trunk, where the body fat is, and everything like that, we do $15 body composition

[51:08] scans. They take about a minute and a half. And it’s quick and easy and it’s accurate and it can help you to know where you are. I had somebody who came in today and she did it, and the thing that she was most concerned about was “I have to lose 24 pounds of fat,” but what she should have been looking at was the fact that, compared to other women her age and height, she had 80% of the muscle mass that the average woman has in her legs. So,

[51:40] it was a great opportunity to have a conversation about the fact that if she doesn’t fix that, she’s going to start becoming prone to falls, injuries, and it increases what’s called all-cause mortality. All-cause mortality is your chances of dying from anything — being hit by a bus, cancer, diabetes, stroke, heart disease, anything like that. All-cause mortality is increased 21% whenever you have sarcopenia, and so it’s something that

[52:11] people need to know about and we need to be giving them the tools to fix it. So yeah. Oh, Kathy, great episode. Yeah, it’s my favorite one. Well, no. Yeah, we don’t say that every time. I think we do say that. Favorite topic. This is getting better and better every time. Yeah. And I mean it’s just like — I think we’re passionate about this and it makes a big difference. So, but what’s important to you? So, yeah, we want to talk about the things that are important to you. So please leave us comments.

[52:41] Whether you’re on YouTube, Spotify, Apple Podcast, leave us a comment. Let us know what you would like to learn about. And also let us know what was important to you in this episode. What did you learn? Like, what is this going to change for you? Share this information with a friend. Share it with a parent. Because I guarantee your parents — they’re needing this. They are definitely needing this. But yeah, so that is — I think that’s gonna wrap it up for us. Except I do believe there’s one more very important item of business.

[53:11] That’s right. You know what it is? I do. There’s no “I” in pitch.