PPARγ agonists prevent sarcopenia by regulating glucose metabolism
Activation of PPARγ receptors (Peroxisome proliferator-activated receptor gamma) allows increasing sensitivity to insulin, a hormone that regulates blood glucose levels, which helps reduce intermuscular fat. And intermuscular fat is one of the reasons for decreased muscle mass. PPARγ receptor agonists are promising agents for the treatment of sarcopenia.
Source link:
- https://it.wikipedia.org/wiki/PPAR-γ
Telmisartan is one of the drugs in the sartan group, which, in addition to lowering blood pressure, has an additional property - agonism to PPARγ receptors . Of all the sartans, telmisartan is the most potent PPAR-γ activator and is approximately 20 times more potent than losartan. In wild-type mice, long-term administration of telmisartan results in increased running endurance, decreased body fat, and an increased proportion of Type I muscle fibers. Type I fibers are rich in mitochondria and are resistant to fatigue. It is because of these properties that there was a proposal in 2016 to add telmisartan to the list of doping agents for athletes. Therefore, for people with high blood pressure to protect against sarcopenia, telmisartan is the drug of choice.
Link(s) to study(s):
- https://onlinelibrary.wiley.com/doi/10.1111/j.1582-4934.2010.01085.x/full
- it.wikipedia.org/wiki/PPAR-γ
A 2008 study from the University of Florida in the US examined the effects of a low-calorie diet on glucose metabolism and associated protection against sarcopenia. Preliminary observations suggest that small (up to 8%) reductions in food intake may have a protective effect against sarcopenia in aging. This means that you need to get into the habit of leaving the table with a slight feeling of hunger.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/18191752
- www.ncbi.nlm.nih.gov/pubmed/16677097
Fenofibrate is a medicine to treat high blood cholesterol. Fenofibrate activates peroxisome proliferator-activated receptors alpha (PPAR alpha). In this regard, scientists at Anhui University in China studied fenofibrate from the point of view of its effect on muscle aging. A study was published in 2020 and found that fenofibrate reduced inflammation in skeletal muscle and thereby protected it from sarcopenia. A 2020 study from the Norwegian University of Science and Technology found that fenofibrate protected muscle against aging during menopause, an estrogen-deficient condition in female rats. Rats were treated with fenofibrate for 8 weeks. After treatment, the rats jumped higher than before treatment. It is worth noting that people are prescribed statins to lower cholesterol, which, on the contrary, worsen the condition of muscle mass. And if a person needs to reduce cholesterol and treat sarcopenia, then fenofibrate is preferable to use. But you cannot combine fenofibrate with statins at the same time - this is dangerous. Fenofibrate should not be used by people with elevated creatinine in blood tests or with a reduced glomerular filtration rate. And of course it cannot be used without a doctor’s prescription.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/27297630
- www.ncbi.nlm.nih.gov/pubmed/27526032
Metformin, a medicine for the treatment of type 2 diabetes mellitus, is also a PPAR-gamma receptor agonist. A 2014 human study conducted by the University of Texas Health Science Center (see figure left) in San Antonio, USA, found that the main mortality-reducing effect of metformin was due to a reduced risk of frailty due to loss of muscle mass and other causes of frailty. . Researchers studied 2,415 patients with type 2 diabetes aged 65 to 89 years from 1999 to 2006. We considered patients who were prescribed only metformin (without other glucose-lowering drugs) for the treatment of diabetes mellitus for at least 180 days. Patients with kidney disease, liver disease, and oncology were also excluded. It turned out that a 23% reduction in mortality among those taking metformin was associated precisely with the prevention of the onset of frailty. So for people who were already frail when metformin was prescribed, this medicine did not reduce mortality. This means that the prolongation of life with metformin was mainly associated with the prevention of the development of frailty.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/27978584
- www.ncbi.nlm.nih.gov/pubmed/25506599
Following these promising results from metformin, a clinical trial of metformin was initiated to prevent muscle loss in diabetic patients. The clinical trial is being conducted by the University of Kentucky in the USA (see picture on the left). The fact is that in a number of diabetic patients in old age, training muscle mass does not produce results, and sometimes even on the contrary, the size of muscle mass decreases. But it has been hypothesized that metformin may block muscle insensitivity to exercise in some diabetic patients. Older patients are given 1700 mg of metformin per day or placebo. At the same time, patients train on simulators. According to scientists, metformin should increase the effectiveness of training. The results will be ready in 2017-2018.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/28441958
A 2016 study from the Catholic University of the Sacred Heart in Italy examined the effects of a ketogenic diet with amino acid supplementation in a clinical trial on sarcopenia. The amino acid ketogenic diet was highly effective for weight loss without losing muscle mass.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/27383313
Yes. Anyone who uses a ketogenic diet should definitely drink BCAA amino acids (which can be bought at a sports store or ordered here ) so that on a ketogenic diet there is no sarcopenia, but on the contrary, the muscles are better.
Diet: proper and balanced diet for muscle growth
Another way to stop weight loss in adulthood is to eat a healthy and balanced diet. A healthy diet doesn't have to be overly complicated, just make sure your diet includes foods rich in all the essential micro and macronutrients.
Proper nutrition can multiply the positive effect of your workouts. Carbohydrates and fats will fill you with the necessary energy, and protein will provide your body with building material for muscles. In addition, by consuming key vitamins and minerals, you can restart many important processes in the body.
Let's look at the most important components of proper nutrition that can help prevent weight loss. Below are four nutrients that have been found to be most effective in combating sarcopenia.
No. 1. Protein, aka protein
If you thought that protein was a substance that only bodybuilders used, then you were wrong. Protein is one of the most important macroelements that absolutely all mammals need for life.
Protein molecules are made up of tiny amino acids, which are the building blocks for all the tissues of our body. All cells in our body are made of protein, which is why it is extremely important for our life.
Remember we talked about the process of cell destruction and anabolism? So, if we consume enough protein, then protein synthesis starts in our body, stimulating cell growth. Therefore, the protein you just received with food plays a vital role in the restoration and maintenance of muscle volume.
If there is a shortage of this essential macronutrient in the body, then the condition of your muscles will begin to deteriorate. As you may already understand, protein deficiency in the body accelerates the onset of sarcopenia.
The body's need for protein changes with age.
Throughout our lives, the amount of protein we need changes. The older a man is, the more proteins should enter his body. This is because as we age, muscles become more resistant to growth signals.
Each amino acid plays an essential role in the growth process of muscle cells. However, scientists believe that leucine is the most important element in the process of cell growth.
You can find this essential amino acid in foods such as meat, fish, soy, milk and its derivatives.
Current research shows that men over the age of 50 should consume 25-30 g of protein with each meal.
No. 2. Vitamin D
It is also often called “sunny”. This vitamin got its name for a reason, because your body naturally produces it when sunlight touches your skin. However, in modern realities, not everyone can get enough sun during the day. And as we get older, the risk of vitamin D deficiency increases.
Scientists say there is a link between low vitamin D levels and sarcopenia. However, the reasons for this dependence have not yet been identified.
Men suffering from vitamin D deficiency can obtain it by taking special dietary supplements. It will also help increase testosterone levels, an important androgenic hormone that is involved in muscle growth.
Currently, the amount of vitamin D required to slow sarcopenia is unknown. However, if you are older and spend long periods of time indoors, you are likely getting less than the recommended daily intake of this vitamin.
No. 3. Creatine
Creatine is a nitrogen-containing carboxylic acid that is found in vertebrates. It is mainly synthesized in the liver and kidneys from various amino acids. This creatine is called endogenous. The creatine that enters our body with foods is called exogenous. It can be obtained together with protein products such as meat, eggs, milk and its derivatives. In addition, to saturate your body with creatine, you can use special creatine-containing nutritional supplements.
Creatine is an extremely important element for muscle function. As creatine phosphate, it is involved in high-energy communications between muscle cells during both high- and low-intensity physical activity. This is why creatine is so important for maintaining good physical shape.
Creatine supplements
Many athletes enjoy creatine supplements because of its specific properties that stimulate muscle growth and improve endurance. However, creatine-containing supplements can be used not only by professional athletes. If dosage recommendations are followed, this dietary supplement will be beneficial to all people, even those over 50.
Recent research suggests that supplementing your diet with creatine and strength training improved your physique more effectively than training without supplements. This means that the weight of the subjects increased, and body fat, on the contrary, decreased.
It is worth noting that this study did not involve 20-year-old athletes, but older people, including those over 50 years old.
Creatine will help you strengthen your muscles and protect them from sarcopenia. Additionally, creatine supplements are the cheapest and most common of all supplements available.
For men over 50 years of age, experts recommend consuming 5 grams of creatine per day along with a small amount of carbohydrates. In addition, taking this dietary supplement should be combined with progressive resistance training.
No. 4. Omega-3
Omega-3 fatty acids are known to be very beneficial for joints. But could these tiny oil capsules be even more beneficial?
Studies have shown that consuming omega-3 fatty acids helps increase muscle mass in people over 50 years of age.
Again, this result was shown not by young athletes, but by healthy older people. According to the scientists who conducted this study, omega-3 supplementation may even directly affect protein synthesis.
Omega-3 fatty acid supplements may help prevent muscle loss by improving protein synthesis.
Suppressing muscle inflammation prevents sarcopenia
A 2002 study conducted by the University Medical Center in the Netherlands examined vitamin D3 in terms of the effects of vitamin D deficiency in the blood on muscle mass. With a deficiency of vitamin D in the blood, muscle atrophy occurs (mainly in type II fibers) due to inflammation.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/11916748
A 2008 study from the University of Southampton (UK) found in 2,983 patients aged 59 to 73 that eating fatty fish (or fish oil ) may be essential for restoring skeletal muscle strength by modulating inflammation. Similar results were shown in a 2012 randomized controlled trial conducted by the Federal University of Parana (Brazil), as well as in a 2020 study conducted by McMaster University in Canada.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/9467429
- www.ncbi.nlm.nih.gov/pubmed/18005355
- www.ncbi.nlm.nih.gov/pubmed/21159787
- www.ncbi.nlm.nih.gov/pubmed/21501117
- www.ncbi.nlm.nih.gov/pubmed/22218156
- www.ncbi.nlm.nih.gov/pmc/articles/PMC4496741
Get enough protein
Dutch researchers have found that adequate protein intake can help preserve muscle during an extended break from exercise (protein provides the body with amino acids, the building blocks of muscle).
Quality protein sources such as animal protein (poultry, eggs, fish, beef, low-fat dairy) and plant protein (soy, legumes, vegetables, nuts and seeds) should be included in every meal.
How much protein is needed to maintain muscle? Aim to consume 100 to 150 grams of protein at each meal and 50 to 100 grams of protein at snack time.
Other ways to prevent sarcopenia
HMB (β-hydroxy-β-methylbutyrate) is a metabolite of the amino acid leucine. This basically means that our body produces HMB from leucine. In addition to affecting muscle growth signaling elements, HMB also reduces the activity of protein breakdown in muscle. A 2016 study from the University of Montpellier in France examined β-hydroxy-β-methylbutyrate ( HMB ) and its role in reducing intermuscular adipose tissue to prevent muscle atrophy. As you can see in the graph on the left, consuming of HMB per day for 4 weeks increases muscle mass. But after 4 weeks, this effect begins to decrease - it makes sense to use HMB for no more than 4 weeks, and then take a break for 1 month . A 2015 study from Tianjin University in China and McMaster University in Canada also found β-hydroxy-β-methylbutyrate ( HMB ) supplementation to be effective in treating sarcopenia in people aged 65 years and older. But given that β-hydroxy-β-methylbutyrate ( HMB ) activates mTOR and suppresses autophagy, it makes sense to use this supplement in courses rather than constantly.
Link(s) to study(s):
- www.ncbi.nlm.nih.gov/pubmed/27106402
- www.ncbi.nlm.nih.gov/pubmed/26169182
- www.ncbi.nlm.nih.gov/pubmed/26178029
Hydroxymethylbutyrate ( HMB ) can be purchased at sporting goods stores or ordered online - link Now Foods, Sports Nutrition, Hydroxymethylbutyrate Powder, 3.2 oz (90 g).
Workouts: how to dry off after gaining weight
There is one training system for both home training and the gym. After gaining mass, endurance work begins. This involves losing subcutaneous fat through more repetitions. The optimal number of repetitions for cutting is 15-20 (depending on the fat tissue). If during the period of mass gain the adipose tissue has not increased much, train 15 times per approach. This amount will prevent muscle breakdown, but will also speed up metabolism for effective fat burning.
Train 4-5 times a week, combining strength and cardio training. Divide the main muscle groups by day. An excellent method for cutting is training with supersets. For example, after squats, immediately move on to lunges, 30 seconds of rest and 3 more circles. Thus, the two exercises are performed as one. Perform 3 of these supersets per workout. Do not exceed the duration of the workout more than one hour.
Cardio training can be done on a separate day, or on a strength training day. Don't exceed 40 minutes, but don't exercise for less than 20 minutes. Choose the optimal heart rate when running or on the orbit track.
The heart rate zone for fat burning includes 120 – 160 beats per minute.
