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Sarcopenia (muscle loss) and Vitamin D

To gain muscle, many studies have found that you need some of the following:
Exercise - just even walking (Intermittent high intensity exercise is much better)
Vitamin D - at least 800 IU/day,
    Loading dose will show improvements in weeks instead of 4+ months
Protein - perhaps 1gm/kg/day in a form appropriate for existing stomach acid
Calcium - 300 mg?

See also Bone Health   reduce falls and fractures   Frailty and Vitamin D - many studies   Overview Muscles and Vitamin D

16 VitaminDWiki pages have SARCOPENIA in the title as of Oct 2021

Sarcopenis meta-analysis (most gave too Vitamin D to make a difference) March 2022

Effect of vitamin D monotherapy on indices of sarcopenia in community-dwelling older adults: a systematic review and meta-analysis
J Cachexia Sarcopenia Muscle . 2022 Mar 8. doi: 10.1002/jcsm.12976
Konstantinos Prokopidis 1 2, Panagiotis Giannos 2 3, Konstantinos Katsikas Triantafyllidis 2 4, Konstantinos S Kechagias 2 5, Jakub Mesinovic 6 7, Oliver C Witard 8, David Scott 6 7

Most trials used small doses

Summary image from examine.com

Background: Vitamin D supplementation is proposed as a potentially effective nutritional intervention to mitigate the risk of sarcopenia. The aim of this systematic review and meta-analysis was to investigate the impact of vitamin D supplementation monotherapy on indices of sarcopenia in community-dwelling older adults.

Methods: A comprehensive search of the literature was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Eligible randomized controlled trials (RCTs) compared the effect of vitamin D supplementation (as monotherapy) with placebo on indices of sarcopenia in older (>50 years) adults. Using the random effects inverse-variance model, we calculated the mean difference (MD) in handgrip strength (HGS), short physical performance battery (SPPB), timed up and go (TUG), and appendicular lean mass (ALM) between groups. We also calculated the standardized mean difference (SMD) in general muscle strength and general physical performance (composite plot of all muscle strength and physical performance outcomes, respectively) between groups.

Results: Ten RCTs were included in the meta-analysis. A significant decrease in SPPB scores was observed with vitamin D supplementation compared with placebo (MD: -0.23; 95% CI -0.40 to -0.06; I2 = 0%; P = 0.007). Vitamin D supplementation conferred no effect on HGS (MD: -0.07 kg; 95% CI -0.70 to 0.55; I2 = 51%, P = 0.82), TUG (MD: 0.07 s; 95% CI -0.08 to 0.22; I2 = 0%, P = 0.35), ALM (MD: 0.06 kg/m2 ; 95% CI: -0.32 to 0.44; I2 = 73%, P = 0.77), general muscle strength (SMD: -0.01; 95% CI -0.17 to 0.15; I2 = 42%, P = 0.90), or general physical performance (SMD: -0.02; 95% CI -0.23 to 0.18; I2 = 71%, P = 0.83).

Conclusions: Vitamin D supplementation did not improve any sarcopenia indices in community-dwelling older adults and may compromise some aspects of physical performance. Future studies are warranted to investigate the impact of vitamin D supplementation on individual indices of SPPB, including mobility and balance, in older adults.
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Vitamin D Deficiency and Sarcopenia in Older Persons - Nov 2019

Nutrients. 2019 Dec; 11(12): 2861 doi: 10.3390/nu11122861
Francesca Remelli, Aurora Vitali, Amedeo Zurlo, and Stefano Volpato*
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Vitamin D deficiency is a common health problem worldwide, in particular among older people. Vitamin D regulates and modulates the physiology and function of multiple human systems, including the skeletal muscle. The effect of vitamin D on the muscle has been widely investigated, suggesting that this hormone can stimulate the proliferation and differentiation of skeletal muscle fibers, maintaining and improving muscle strength and physical performance. Older persons have a higher prevalence of low Vitamin D levels as a consequence of low dietary intake and reduced ultraviolet irradiation of the skin. Therefore, older people with vitamin D deficiency might be at risk of sarcopenia, a geriatric syndrome characterized by the progressive loss of skeletal muscle mass and strength often complicated by adverse events, such as falls, disability hospitalization and death. Several randomized clinical trials have been conducted to investigate the effect of oral vitamin D supplementation in older patients to prevent or treat sarcopenia, but results are still controversial. In this narrative review we summarize the biological, clinical and epidemiological evidence supporting the hypothesis of a causal association between Vitamin D deficiency and an increased risk of sarcopenia in older people.
- - - - - -
RCTs considered generally shared one or more of the following problems

  1. Too short of time
  2. Too low of dose (often just 800 IU)
  3. No exercise (provide the body a reason to increase muscle)
  4. No protein needed to build muscle (In addition to Vitamin D

Sarcopenia 1.8X more likely if low vitamin D (Chinese males) June 2021

The Relationship between Sarcopenia and Vitamin D Levels in Adults of Different Ethnicities: ‰‰Findings from the West China Health and Aging Trend Study
The journal of nutrition, health & aging Published: 03 June 2021, https://doi.org/10.1007/s12603-021-1645-z
S. Luo, X. Chen, L. Hou, J. Yue, X. Liu, Y. Wang, X. Xia & Birong Dong

Sarcopenia is a condition associated with progressive loss of skeletal muscle mass and function resulting in substantial negative health outcomes and disability in older adults. It is thus important that sarcopenia-related risk factors be explored. The present study was based upon the Asian Working Group on Sarcopenia 2019 (AWGS2019) criteria to assess whether vitamin D levels are a risk factor associated with sarcopenia in various ethnic groups in western China.

Design: Cross-sectional study.

Setting: Communities in Yunnan, Guizhou, Sichuan, and Xinjiang provinces.

Participants: We included 4236 individuals that were 50 years of age or older from the West China Health and Aging Trend (WCHAT) study.

An InBody 770 instrument was used for bioimpedance-based analyses of muscle mass, while a digital grip strength dynamometer was used for handgrip strength-based measurements of muscle strength. Physical performance was assessed based upon gait speed over 4 m. Other secondary variables were additionally analyzed as potentially relevant risk factors.

Sarcopenia affected an estimated 22.45% of studied individuals who were 50 years of age or older, with respective prevalence rates in the < 60, 60–64, 65–79, and ≥80 age groups of 11.78%, 19.44%, 32.65%, and 67.97%.


Rates in males and females were 26.66% and 20.05%, respectively. In males, a significant difference in vitamin D levels was detected when comparing individuals with and without sarcopenia, although no such relationship was detected in females. Following adjustment for confounding variables, binary logistic regression analyses revealed that inadequate vitamin D was able to independently predict sarcopenia risk only in males (OR=1.875,95%CI: 1.109–3.169, P=0.019).

Among middle-aged and older adults of multiple ethnicities in western China, we found that inadequate vitamin D was an independent predictor of sarcopenia risk specifically in males.

Every trial found Scopenia to be associated with low vitamin D - Meta-analysis 2018

The association between blood concentration of 25- hydroxyvitamin D and sarcopenia: a meta-analysis.
Asia Pac J Clin Nutr. 2018;27(6):1258-1270. doi: 10.6133/apjcn.201811_27(6).0013.
Luo J1, Quan Z2, Lin S1, Cui L3.
1 Department of Public Health, Medical College of Qingdao University, Qingdao, Shandong Province, China.
2 Medical School of Yanbian University, Yanji City, Yanbian Korean Autonomous Prefecture, Jilin, China.
3 Department of Public Health, Medical College of Qingdao University, Qingdao, Shandong Province, China. qdlhcui at 163.com.
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Associations between blood 25-hydroxyvitamin D (25(OH)D) concentration and sarcopenia remain controversial; thus, this meta-analysis was conducted to explore the relationship between blood 25(OH)D concentration and sarcopenia.

We searched the PubMed and EMBASE databases for relevant published observational studies that investigated blood 25(OH)D concentration and sarcopenia up to June 2017.We then investigated data from these studies that compared blood 25(OH)D concentrations between the sarcopenia and healthy control groups. A random-effect model was used to calculate the pooled weighted mean difference (WMD) of blood 25(OH)D concentration with a 95% confidence interval (95% CI).

Twelve studies (eight cross-sectional, two matched case-control, and two prospective cohort studies) with a total of 22,590 individuals were included. Sarcopenic individuals had lower blood 25(OH)D concentrations than healthy controls (WMD=-2.14, 95% CI: -2.81- - 1.48; I2=74.6%). Subgroup analysis showed that the methods of assessing both blood 25(OH)D concentrations and sarcopenia might be sources of heterogeneity, and further showed that studies excluding obese individuals and different sarcopenia assessment criteria enhanced the relationship. Sensitivity analysis by one-study-removed confirmed the robustness of these results.

Our study shows that sarcopenic adults have lower blood 25(OH)D concentrations. Further high-quality large-scale prospective cohort studies are needed to confirm these findings.

115 pages with MUSCLE in title (as of Dec 2022)

This list is automatically updated

Items found: 113
Title Modified
More muscle strength 80 years after being born in warm season (no surprise) – Nov 2022 26 Nov, 2022
Exercise-induced muscle damage fought when enough vitamin D used for long enough – review Sept 2022 24 Sep, 2022
Frailty and low muscle mass both associated with low vitamin D – Aug 2013 14 Sep, 2022
Statin muscle problems decreased in 4 out of 5 patients when vitamin D was added – June 2022 30 Jun, 2022
Omega-3 improves elderly muscles – 2 meta-analyses 06 Jun, 2022
Overview Muscles and Vitamin D 20 May, 2022
High-Dose Vitamin D puts surplus calories into muscles instead of fat (mice) – May 2022 20 May, 2022
3X less muscle atrophy after ACL surgery if more than 40 ng of vitamin D – May 2022 14 May, 2022
Muscle Strength improved 1.4 to 19 percent by vitamin D3 (not D2) – systematic review June 2016 13 Feb, 2022
Role of Vitamin K in Bones and Muscles - Feb 2022 13 Feb, 2022
Some vitamin D is stored in skeletal muscles – multiple studies 27 Dec, 2021
Severe sarcopenia (loss of muscle) 6 X more likely in women with rheumatoid arthritis having low vitamin D – Oct 2021 16 Oct, 2021
Sarcopenia (muscle loss) and Vitamin D 16 Oct, 2021
Loss of muscle strength –sarcopenia – one of the suspects is vitamin D – Aug 2012 16 Oct, 2021
Less muscle inflammation after exercise if high level of Vitamin D (50 ng) -July 2021 08 Jul, 2021
Low muscle strength predicts low vitamin D level in elderly – March 2021 06 May, 2021
Adding just a little vitamin D does not help (muscle mass in this case) – meta-analysis Jan 2021 06 Feb, 2021
Low muscle mass at least 2X more likely if low Vitamin D (Korea, all ages) – Dec 2020 04 Jan, 2021
4,000 IU of vitamin D for 1 month does not help (muscles in this case) – RCT Jan 2020 21 Sep, 2020
Sarcopenia (muscle loss) is 1.6X more likely if poor Vitamin D receptor – July 2020 23 Jul, 2020
Less muscle loss associated with eating more fish (Omega-3, Vitamin D, Magnesium, etc) – Jan 2020 30 Jan, 2020
2X less muscle soreness after exercise if Omega-3 index higher than 4 – RCT 2014 23 Dec, 2019
Muscles not improved by just Vitamin D weekly (also need exercise) – Dec 2019 17 Dec, 2019
Low vitamin D resulted in reduced genes to make muscles (in rats) – Nov 2019 11 Nov, 2019
Active muscles store vitamin D in the winter - Oct 2019 11 Oct, 2019
Omega-3 helps muscles – Aug 2019 24 Aug, 2019
Muscles of senior women not helped by just vitamin D (also need exercise) – Aug 2019 10 Aug, 2019
8 Signs of Low Vitamin D - sweating, bones ache, muscle pain, poor immune, fatigue, slow healing etc. – YouTube Dec 2018 05 Aug, 2019
Vitamin D stored in muscle via Vitamin D Binding Protein – July 2019 30 Jul, 2019
Mechanisms of vitamin D action in skeletal muscle – June 2019 22 Jun, 2019
Vitamin D supplementation increases strength of lower muscles – Meta-analysis April 2019 01 May, 2019
Vitamin D does not help gain muscle mass (when only use small doses) – March 2019 03 Mar, 2019
Muscle loss (sarcopenia) may be both prevented and treated by Omega-3 – Feb 2019 23 Feb, 2019
Calcium supplements go to muscle, not bone, unless have enough Vitamin K – Feb 2019 12 Feb, 2019
Protein aids muscle gain – meta-analysis March 2018 02 Jan, 2019
Vitamin D and muscle – April 2019 07 Dec, 2018
Exercise plus vitamin D increases elderly muscles (Nordic walking in this case) – RCT Sept 2018 14 Sep, 2018
Postmenopausal women need Vitamin D, protein and exercise to prevent loss of muscle and bone – Aug 2018 21 Aug, 2018
Dietary Protein, Muscle and Physical Function in the Very Old – July 2018 17 Aug, 2018
Disability was 1.9 X more likely if weak muscles and low vitamin D two years before – Aug 2018 06 Aug, 2018
Muscle fatigue 4X less likely in rugby players getting Omega-3 and protein – July 2018 14 Jul, 2018
Seniors can restore lost muscle (Sarcopenia) – first restore vitamin D, then exercise – July 2018 13 Jul, 2018
Muscle problems are both treated and avoided by Vitamin D – April 2018 03 Jul, 2018
Seniors getting Vitamin D (but no exercise) for 3 months failed to increase muscle strength – RCT June 2018 03 Jul, 2018
Muscle, etc. problems if consume little vitamin D (mice) – June 2018 27 Jun, 2018
Muscle pain (Low Magnesium) plus Low Vitamin D associated with 10X more Cancer, etc (San Francisco) – Aug 2017 13 Apr, 2018
Widespread pain, arthritis pain and muscle pain are associated with low vitamin D – meta-analysis March 2018 08 Apr, 2018
Fewer Breast Cancer deaths if more muscle (probably due to less fat, more Vitamin D) – April 2018 07 Apr, 2018
Omega-3 helps muscles and reduces inflammation, lipids, and insulin – Nov 2015 03 Mar, 2018
Headaches (chronic tension) 3X more likely to have low vitamin D – also muscle weakness and bone tenderness – May 2017 25 Jan, 2018
Seniors gained 0.3 kg of muscle in 6 weeks with 800 IU and Leucine protein – Aug 2017 29 Aug, 2017
Vitamin D improves muscle strength, reduces falling, and reduces frailty – review March 2015 27 Jul, 2017
Muscle strength not increased by Vitamin D - 96 percent were not deficient – RCT April 2017 20 Jul, 2017
Infant muscle development best with 400 IU of vitamin D (not 800) – Sept 2015 13 Jul, 2017
Fast twitch muscles increased by Vitamin D in athletes and seniors (reduce falling) – Oct 2016 08 Jun, 2017
Muscle strength not increased by Vitamin D when 96 percent already had enough – RCT April 2017 30 Apr, 2017
Muscle strength of senior women increased 25 percent with vitamin D, decreased 6 percent with placebo – Oct 2016 08 Mar, 2017
More fast twitch muscles (IIA) are associated with higher levels of Vitamin D – Feb 2017 02 Mar, 2017
Severely burned children recovered muscle capability much faster with daily 1000 IU of vitamin D – RCT March 2017 01 Mar, 2017
Hypothesis: Less severe muscle damage if vitamin D level had been normalized – July 2013 21 Feb, 2017
Large single-dose of Omega-3 reduced expected muscle damage – Feb 2017 21 Feb, 2017
Added 1 lb of muscle to sarcopenia adults in 13 weeks with just 800 IU vitamin D and protein – RCT Jan 2017 31 Jan, 2017
Sarcopenic added 1 lb of muscle in 13 weeks with just 800 IU vitamin D and protein – RCT Jan 2017 31 Jan, 2017
Osteosarcopenic obesity (obese with low bone and muscle mass) twice as likely if low vitamin D – Oct 2016 31 Jan, 2017
More muscle torque associated with higher vitamin D – Jan 2017 05 Jan, 2017
Vitamin D increased muscle strength by 1% to 19% (varied with dose and duration) – review June 2016 22 Nov, 2016
Vitamin D increased muscle strength by 1 to 19 percent – review June 2016 22 Nov, 2016
Vitamin D increasing muscle strength may reduce knee pain – Feb 2016 22 Nov, 2016
Myotonic dystrophy a (rare genetic muscle problem) associated with low vitamin D – Nov 2016 18 Nov, 2016
Myotonic dystrophy (a rare genetic muscle problem) associated with low vitamin D – Nov 2016 18 Nov, 2016
Muscle strength is associated with vitamin D receptor gene variants – March 2016 12 Nov, 2016
Improved muscle function in postmenopausal women with just 1,000 IU of vitamin D daily – RCT May 2015 31 Oct, 2016
Vitamin D supplementation improves muscle strength in healthy adults – meta-analysis of 6 RCT Aug 2014 31 Oct, 2016
Vitamin D improved child muscle mass even without varying dose with weight – RCT Feb 2016 06 May, 2016
Less muscle and insulin resistance for children of vitamin D deficient mothers – Jan 2011 05 May, 2016
Sunshine is a cure for “weak and soft muscles” – 425 BC 22 Apr, 2016
Senior muscles increased somewhat with Omega-3 – RCT July 2015 18 Jan, 2016
Muscle strength of Judo athletes increased 13 percent following single dose of 150,000 IU vitamin D – RCT Nov 2015 05 Nov, 2015
More muscle response when have adequate vitamin D 27 Jul, 2015
Pelvic floor muscle strength is low after giving birth if vitamin D deficient – March 2015 20 Mar, 2015
Weight loss includes muscle loss unless add vitamin D, whey and leucine – RCT Feb 2015 07 Feb, 2015
Elderly lost extra half pound of leg and arm muscle mass if low vitamin D (6 years) – Oct 2014 27 Jan, 2015
Vitamin D and bicarbonate perhaps synergistically reduce muscle loss – June 2013 27 Jan, 2015
Muscle increased 17 percent in vitamin D insufficient elderly getting 4,000 IU for 4 months – RCT Oct 2013 27 Jan, 2015
Low Vitamin D breaks down muscle by interferring with protein - Editorial Nov 2013 27 Jan, 2015
People with old burns improved muscle strength with 2200 IU average vitamin D – RCT Sept 2014 20 Dec, 2014
Vitamin D supplementation help muscles of seniors who are vitamin D deficient – meta-analysis July 2014 18 Jul, 2014
Muscle fatigue reduced with 10,000 IU of vitamin D – March 2013 05 May, 2014
MRI of elderly skeletal muscle lacking vitamin D – April 2014 30 Apr, 2014
Muscle cells differentiate into fat cells if there is low vitamin D in petrie dish – April 2013 30 Apr, 2014
Skeletal muscles helped by vitamin D – Review Feb 2014 08 Feb, 2014
Elderly lower limb muscle strength improved with Vitamin D supplementation - Meta-analysis Oct 2013 23 Dec, 2013
Vitamin D improves muscle strength if deficient – meta-analysis - Oct 2010 19 Dec, 2013
Muscle strength not increased by raising vitamin D to only 30 ng – RCT Aug 2012 19 Dec, 2013
Vitamin D provides faster recovery after muscle overuse – April 2013 18 Dec, 2013
Type 2 muscles, not all muscles, get benefit from Vitamin D - Dec 2012 23 Oct, 2013
Evidence that vitamin D is also stored in muscle cells – Sept 2013 26 Sep, 2013
Muscle strength in youth increased with 60,000 IU vitamin D per week and 1 g Calcium – April 2010 10 Aug, 2013
Hypothesis: Low vitamin D is one of the causes of muscle weakness in alcoholics – Dec 2012 31 Jul, 2013
More muscle injuries in NFL players who were low on vitamin D – July 2011 13 Jul, 2013
Muscle inflammation 17X more probable if vitamin D deficient – Feb 2013 13 Jul, 2013
Muscle improved by increasing vitamin D if previously less than 24 ng – June 2013 02 Jul, 2013
Most immigrant women in Sweden had little vitamin D and lots of muscle pain – May 2013 22 May, 2013
Deadly amount of vitamin D speeds up recovery of crushed muscles in rats – Dec 2012 19 Apr, 2013
Relevance of Vitamin D in Bone and Muscle Health of Cancer Patients - Jan 2013 06 Dec, 2012
Vitamin D2 intervention increased elderly muscle strength – Nov 2010 10 Nov, 2012
Higher vitamin D helps regain muscle strength after knee surgery – July 2011 01 Sep, 2011
Meta-analysis of RCT – vitamin D might increase senior muscle function – Sept 2010 14 Sep, 2010
Skeletal Muscle weakness from lack of vitamin D fixed by adding Calcium and phosphorus – Aug 2010 11 Aug, 2010
Vitamin D, Muscle Function, and Exercise Performance in kids – June 2010 09 Jun, 2010
Vitamin D improving muscles may be due to improving phosphate levels – June 2010 03 Jun, 2010
Vit D associated with less muscle fat 11 Apr, 2010
Reduced muscle function in mice lacking Vitamin D Receptors in muscles – June 2019 No value for &#039;modification_date_major&#039;

Sarcopenia if total of the following is >4

Strength How much difficulty do you have
in lifting and carrying 10 pounds?
None = 0
Some = 1
A lot or unable = 2
Assistance in walking How much difficulty do you have
walking across a room?
None = 0
Some = 1
A lot, use aids, or unable = 2
Rise from a chair How much difficulty do you have
transferring from a chair or bed?
None = 0
Some = 1
A lot or unable without help = 2
Climb stairs How much difficulty do you have
climbing a flight of 10 stairs?
None = 0
Some = 1
A lot or unable = 2
Falls How many times have you fallen
in the past year?
None = 0
1-3 falls = 1
4 or more falls = 2

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See also VitaminDWiki

VitaminDWiki pages containing SARCOPENIA in title (16 as of Oct 2021)

This list is automatically updated

Items found: 17
Title Modified
Sarcopenia with obesity is more likely if dark skin, diabetes, OR COPD (all associated with low vitamin D) 16 Oct, 2021
Severe sarcopenia (loss of muscle) 6 X more likely in women with rheumatoid arthritis having low vitamin D – Oct 2021 16 Oct, 2021
Sarcopenia (muscle loss) and Vitamin D 16 Oct, 2021
Loss of muscle strength –sarcopenia – one of the suspects is vitamin D – Aug 2012 16 Oct, 2021
Sarcopenia (muscle loss) is 1.6X more likely if poor Vitamin D receptor – July 2020 23 Jul, 2020
Sarcopenia reduction: Protein, Leucine, Omega-3, Vitamin D, and exercise - hypothesis Aug 2018 30 Jan, 2020
Muscle loss (sarcopenia) may be both prevented and treated by Omega-3 – Feb 2019 23 Feb, 2019
Seniors can restore lost muscle (Sarcopenia) – first restore vitamin D, then exercise – July 2018 13 Jul, 2018
Sarcopenia does not officially exist in Australia, but 1 in 3 of their seniors have it - July 2018 03 Jul, 2018
Sarcopenia: Nutrition and physical activity – systematic review – Jan 2017 10 Mar, 2017
Added 1 lb of muscle to sarcopenia adults in 13 weeks with just 800 IU vitamin D and protein – RCT Jan 2017 31 Jan, 2017
Hypothesis: Sarcopenia and other senior problems are related to low gastic acid 12 May, 2015
Sarcopenia and non-alcoholic fatty liver disease (vitamin D not mentioned) – Sept 2013 07 Mar, 2015
Hypothesis: Sarcopenia and other senior problems are related to low gastric acid 01 Feb, 2015
Vitamin D is one of the treatments for sarcopenia – Nov 2012 31 Jan, 2015
No correlation found between vitamin D and sarcopenia – German dissertation Jan 2013 22 Jan, 2013
Novel treatment approaches to cachexia and sarcopenia: 13 Apr, 2010

Sarcopenia statistics - 2014

Sample statistics from http://sarcopeniacure.com/statistics/ Note- protein and vitamin D are among their cures

  • >50 % loss of muscle mass by 90 years
  • Healthcare expenditures due to sarcopenia cost roughly $900 per person per year
  • In the United States, an estimated 53 % of men and 43 % of women over 80 are sarcopenic.
  • People who are physically inactive can lose as much as 3 to 5 % of their muscle mass per decade after age 30

Added 1 lb of muscle mass with 800 IU Vitamin D - RCT 2017

Added 1 lb of muscle to sarcopenia adults in 13 weeks with just 800 IU vitamin D and protein – RCT Jan 2017

Pedometer + reminder to increase steps 10%/month - RCT with Vitamin D Aug 2015

J Am Med Dir Assoc. 2015 Aug 1;16(8):654-60. doi: 10.1016/j.jamda.2015.02.017. Epub 2015 Apr 7.
Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.
Yamada M1, Nishiguchi S2, Fukutani N2, Aoyama T2, Arai H3.

VitaminDWiki Summary
  • The trial arm which added 10 gram Protein + 500 IU Vitamn D + 300 mg Calcium did NOT do as well as the trial atm of only walking
  • Note that just walking got 3/4 as much increase in Vitamin D levels as walking + 500 IU of vitamin D (outdoors in the sun more?)
  • Note: A different successful trial used 1gram/kg of protein, which could be 50 grams per day (5X as much)

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Image Image

OBJECTIVE: The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults.
DESIGN: A cluster-randomized controlled trial.
SETTING AND PARTICIPANTS: This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy.
INTERVENTION: Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation).
MEASUREMENTS: The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25OHD), as well as frailty, were assessed by the Cardiovascular Health Study criteria.
RESULTS: Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults.
CONCLUSION: These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail.

PMID: 25858281 DOI: 10.1016/j.jamda.2015.02.017

Hypothesis: Sarcopenia and other senior problems are related to low gastric acid
   Hypothesis by VitaminDWiki Feb 2015

From muscle wasting to sarcopenia and myopenia: update 2012.

J Cachexia Sarcopenia Muscle. 2012 Nov 17
von Haehling S, Morley JE, Anker SD.
Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany, stephan.von.haehling at charite.de.

Human muscle undergoes constant changes.
After about age 50, muscle mass decreases at an annual rate of 1-2 %.
Muscle strength declines by 1.5 % between ages 50 and 60 and by 3 % thereafter.

The reasons for these changes include denervation of motor units and a net conversion of fast type II muscle fibers into slow type I fibers with resulting loss in muscle power necessary for activities of daily living. In addition, lipids are deposited in the muscle, but these changes do not usually lead to a loss in body weight.

Once muscle mass in elderly subjects falls below 2 standard deviations of the mean of a young control cohort and the gait speed falls below 0.8 m/s, a clinical diagnosis of sarcopenia can be reached. Assessment of muscle strength using tests such as the short physical performance battery test, the timed get-up-and-go test, or the stair climb power test may also be helpful in establishing the diagnosis. Serum markers may be useful when sarcopenia presence is suspected and may prompt further investigations.

Indeed, sarcopenia is one of the four main reasons for loss of muscle mass.

On average, it is estimated that 5-13 % of elderly people aged 60-70 years are affected by
sarcopenia. The numbers increase to 11-50 % for those aged 80 or above.

Sarcopenia may lead to frailty, but not all patients with sarcopenia are frail-sarcopenia is about twice as common as frailty. Several studies have shown that the risk of falls is significantly elevated in subjects with reduced muscle strength.

Treatment of sarcopenia remains challenging, but promising results have been obtained using

  • progressive resistance training,
  • testosterone,
  • estrogens,
  • growth hormone,
  • vitamin D, and
  • angiotensin-converting enzyme inhibitors.

Interesting nutritional interventions include

  • high-caloric nutritional supplements and
  • essential amino acids that support muscle fiber synthesis.
    (= protein: note by VitaminDWiki)

PMID: 23160774

Elderly need >1 grams of protein /kg of weight and correction of vitamin D deficiency - Jan 2015

Treating Sarcopenia In Older And Oldest Old.
Curr Pharm Des. 2015 Jan 30. [Epub ahead of print]
Martone AM, Lattanzio F, Abbatecola AM, La Carpia D, Tosato M, Marzetti E, Calvani R, Onder G, Landi F1.

The presence of sarcopenia is not only rapidly rising in geriatric clinical practice and research, but is also becoming a significant concept in numerous medical specialties. This rapidly rising concept has encouraged the need to identify methods on how to treat sarcopenia. For example, physical activity measures using resistance training exercise, combined with nutritional interventions (protein and amino acid supplementation) have shown to significantly improve muscle mass and strength in older persons. Resistance training may improve muscle strength and mass by improving protein synthesis in skeletal muscle cells. Aerobic exercise has also shown to hold beneficial impacts on sarcopenia by improving insulin sensitivity. At the moment, the literature indicates that most significant improvement on sarcopenia is based on exercise programs. Thus, this type of intervention should be implemented in a persistent manner over time in elders, with or at risk of muscle loss. At the same time, physical training exercise should include correcting nutritional deficits with supplementation methods.
For example, in older sarcopenic patients with adequate renal function, daily protein intake should be increased to >1. 0 grams of protein per kilogram of body weight. In particular, leucine, β-hydroxy β-methylbutyrate (HMB), creatine and some milk-based proteins have been have shown to improve skeletal muscle protein balance.
In addition, it is also recommended to correct for vitamin D deficiency, if present, considering the crucial role of vitamin D in skeletal muscle. In this present paper, we will provide evidence regarding the effects of different physical exercise protocols, specific nutritional intervention, and some new metabolic agents (HMB, citrulline malate, ornithine, and others) on clinical outcomes related to sarcopenia in older adults.

PMID: 2563311  Download the ResearchGate PDF from VitaminDWiki

Interventions against sarcopenia in older persons - Dec 2014

Curr Pharm Des. 2014;20(38):5983-6006.
Valeria Z, Renato G, Luisa C, Bruno V, Mauro Z, Matteo C1.

The term "sarcopenia" describes the age-related loss of skeletal muscle mass and function. It represents a major risk factor for functional loss and disability in older persons. Multiple underlying pathophysiological mechanisms have been posed at the basis of the sarcopenia phenomenon, including intrinsic (e.g., age-related modifications of the skeletal muscle, the central nervous system, and hormones) and extrinsic (e.g., sedentariness, poor protein dietary intake) factors.
Several interventions have been explored in the last years to counteract the age-related muscle decline.
These include

  • protein supplementations,
  • physical exercise,
  • testosterone replacement (as well as other anabolic androgens) in men,
  • estrogen replacement in women,
  • growth hormone replacement, and
  • treatment of vitamin D deficiency.

To date, adequate protein intake and resistance training are the most promising interventions able to prevent and/or delay the decline of muscle mass and function. An intense debate is currently ongoing about the best operational definition able to capture the complexity of this aging condition. In the context of identifying the optimal treatment for a specific condition, this is not a trivial issue because it sets the target of the intervention as well as the population at risk. Nevertheless, despite the current methodological issues, it is important to preliminarily test the possible strategies that might be implemented in the future, when the sarcopenia condition will finally be more univocally defined and its clinical relevance recognized. Aim of the present review is to describe and discuss available evidence about the possible interventions potentially serving at acting against sarcopenia. Pharmacological as well as non-pharmacological interventions are presented.

PMID: 24641222

From sarcopenia to frailty: a road less traveled - March 2014

J Cachexia Sarcopenia Muscle. 2014 Mar;5(1):5-8. doi: 10.1007/s13539-014-0132-3. Epub 2014 Feb 14.
Morley JE1, von Haehling S, Anker SD, Vellas B.

The physical frailty phenotype consists of fatigue, weight loss, and loss of muscle power. Sarcopenia has been shown to be a major cause of frailty. Six societies including SCWD published a consensus suggesting that all persons older than 70 years of age should be screened for frailty when seeing health professionals.
Simple screening tests such as the FRAIL (fatigue, resistance, aerobic, illness, and loss of weight) scale can be used.
It is felt that frailty can be treated by

  • exercise (resistance and aerobic),
  • high quality protein,
  • vitamin D, and
  • treatment of the common causes of fatigue.

It is expected that this approach will decrease disability in older persons.

PMID: 24526568
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Improved muscle function in postmenopausal women with just 1,000 IU of vitamin D daily – RCT May 2015

Improved muscle function in postmenopausal women with just 1,000 IU of vitamin D daily – RCT May 2015
postmenopausal women with a history of falls (associated with low vitamin D)
1,000 IU daily for 9 months

Vitamin DPlacebo
Vitamin D at start15 ng17 ng
Vitamin D after 9 months28 ng 14 ng
Muscle strength lower limbs +25 %
Loss of lean muscle mass -7 %

Vitamin D is one of 3 basic options to treat Sarcopenia - June 2015

Pharmacologic Options for the Treatment of Sarcopenia
Calcified Tissue International, June 2015 Publisher wants $40 for PDF
John E. Morley

Sarcopenia is now clinically defined as a loss of muscle mass coupled with functional deterioration (either walking speed or distance or grip strength). Based on the FRAX studies suggesting that the questions without bone mineral density can be used to screen for osteoporosis, there is now a valid simple questionnaire to screen for sarcopenia, i.e., the SARC-F. Numerous factors have been implicated in the pathophysiology of sarcopenia. These include genetic factors, mitochondrial defects, decreased anabolic hormones (e.g., testosterone, vitamin D, growth hormone and insulin growth hormone-1), inflammatory cytokine excess, insulin resistance, decreased protein intake and activity, poor blood flow to muscle and deficiency of growth derived factor-11. Over the last decade, there has been a remarkable increase in our understanding of the molecular biology of muscle, resulting in a marked increase in potential future targets for the treatment of sarcopenia.
At present,

  • resistance exercise,
  • protein supplementation, and
  • vitamin D

have been established as the basic treatment of sarcopenia. High-dose testosterone increases muscle power and function, but has a number of potentially limiting side effects. Other drugs in clinical development include selective androgen receptor molecules, ghrelin agonists, myostatin antibodies, activin IIR antagonists, angiotensin converting enzyme inhibitors, beta antagonists, and fast skeletal muscle troponin activators. As sarcopenia is a major predictor of frailty, hip fracture, disability, and mortality in older persons, the development of drugs to treat it is eagerly awaited.

Sarcopenia overview including Vitamin D - Life Extension Foundation - Nov 2018

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Sarcopenia (muscle loss) and Vitamin D        
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17354 Apr22_Vitamin D supplementation for sarcopenia_01.png admin 07 Apr, 2022 21:13 130.32 Kb 374
17353 Sarcopenia meta.pdf PDF 2022 admin 07 Apr, 2022 21:12 1.14 Mb 108
13628 Sarcopenia 2019 Fig 3.jpg admin 14 Mar, 2020 11:34 86.55 Kb 6608
13627 Vitamin D Deficiency and Sarcopenia in Older Persons.pdf PDF 2019 admin 14 Mar, 2020 11:16 840.34 Kb 742
12654 Sarco meta.jpg admin 17 Sep, 2019 16:05 40.99 Kb 2095
12652 Sarcopenia meta-analysis.pdf PDF 2018 admin 17 Sep, 2019 16:00 1.30 Mb 892
10725 Sacropenia LEF Nov 2018.pdf PDF 2018 admin 22 Oct, 2018 00:43 1.46 Mb 1034
10470 Questionnaire Sarcopenia.pdf admin 03 Sep, 2018 13:07 257.46 Kb 1710
7813 Treating Sarcopenia In Older And Oldest Old.pdf PDF 2015 admin 08 Mar, 2017 15:00 1.03 Mb 1619
7812 Walk T3.jpg admin 08 Mar, 2017 14:44 57.99 Kb 3924
7811 Walk RCT.jpg admin 08 Mar, 2017 14:43 54.78 Kb 5092
7810 Mail-based Sarcopenia Intervention trial.pdf PDF 2015 admin 08 Mar, 2017 14:11 577.27 Kb 1198
4993 sarcopenia 1998.jpg admin 31 Jan, 2015 13:35 45.85 Kb 2036
4992 sarcopenia to frailty.pdf PDF 2014 admin 31 Jan, 2015 13:34 116.17 Kb 1790
4991 Update F2.jpg admin 31 Jan, 2015 12:59 63.53 Kb 9506
4990 Update PubMed.jpg admin 31 Jan, 2015 12:58 31.74 Kb 5376
4989 sarcopenia update 2014.pdf PDF 2014 admin 31 Jan, 2015 12:57 271.61 Kb 1863
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