Frailty…The Need for Muscle Nurturance

Frailty, sadly because usually so unnecessary, is a leading cause of death. Frailty is usually referred to as a comorbidity…but if we start looking at it as a cause of disease and death, maybe prevention of frailty will explicitly be addressed and valued just as prevention of heart disease, cancer, obesity, diabetes and all of our other chronic illnesses.

The first answer that comes to mind when asked the #1 cause of death is always cancer, heart disease, some kind of chronic illness.

I am asking you to dig a little deeper understanding frailty as a cause of disease and death.

What leads to a number of the causes of cancer and heart disease……..If we focus on prevention of frailty, how many other illnesses could we prevent?

We have to connect dots here.  Remember, according to the CDC 80% of chronic illness is lifestyle – not genetic.

A 2014 study by the Japanese Geriatric Society concluded:

“Frailty is strongly associated with higher mortality, especially among women. Among men, the association was explained by baseline functional capacity, comorbidity and lifestyle factors. Changes in frailty status should also be taken into consideration when planning geriatric care, as such changes could indicate a more rapid decline in health.”

We all know what frailty looks like and have an idea of what it is – but from a systemic perspective, frailty is a consequence of cumulative decline in multiple physiological systems over a lifespan.

According to Johns Hopkins, frailty increases the risk of infections, illnesses that have to be treated in the hospital, falls and  disabilities, doubles the risk of surgical complications, lengthens hospital stays, and increases the odds of leaving forfeiting independence (moving to a nursing home or assisted-living facility) after a surgical procedure twentyfold.

So then, the next logical step is to ask ourselves, what caused the multiple physiological systems to break down. Please don’t say “old age”.

The brain, endocrine system, immune system and skeletal muscle are intrinsically inter-related and are currently the organ systems best studied in the development of frailty. While frailty is most often associated with the elderly, some old people never get frail. Experts now regard it as a medical syndrome.

Diagnosing frailty:

• unintentional weight loss (10 or more pounds within the past year, muscle loss)
• muscle loss and weakness
• a feeling of fatigue
• slow walking speed
• low levels of physical activity

Imagine if we lived in a world where people nurtured their muscle mass as much as they nurtured other aspects of their life: finances, cars, wardrobes……

Muscle is the ultimate example in life of use it or lose it.  At the ripe old age of 30 we start losing muscle mass if it is not worked…age related loss of muscle is called sarcopenia. However, many studies prove to us, and many people I personally know, we can build muscles at any age. People over 90 can build muscle.

Muscles deserve far more respect than they receive. For that reason, in every wellness program I include what I call “muscle nurturance”. Muscles are to be cherished through

• food choices
• exercise (yes we can destroy muscle tissue with incorrect exercise or overtraining)
• Getting quality sleep
• alcohol control
• smoking – stop
• certain medications

The misconceptions, lack of appreciation for our muscles is rampant, causing an avalanche of psychological and  physiological demise. Just naming a few consequences of muscle loss, and yes, please excuse my brevity here!

• Our metabolism:  muscle  burns more calories — even at rest — than body fat. Average: 10 pounds of muscle  burns 50 calories in a day spent at rest, while 10 pounds of fat would burn 20 calories
• Imperative for diabetes control: Muscle pulls sugar out of the blood to be used as fuel, lowering blood glucose levels.
• For each 10% increase in the ratio of muscle mass to total body weight, there is an 11% reduction in insulin resistance and a 12% reduction in prediabetes. Prediabetes is a condition in which a person’s blood sugar is higher than normal, but not high enough to be diabetes. Ultimately, our muscles can help prevent diabetes.
• Glucose control is imperative in prevention of all of our chronic diseases, including cancer and obesity
• Control of oxidative stress
• Uncontrolled blood glucose levels can cause us to make poor food choices
• Lowering sugar intake, muscles will burn fat as a source of fuel
• Strength training muscle does not have to be in a gym – it can be done in home or office, even with a desk job
• There are numerous forms of activity that build muscle, not just weight lifting
• Numerous studies prove strength training is critical in prevention and recovery from depression. Studies from Harvard & Duke concurred depressed people who follow a structured strength training protocol were able to overcome depression without medication, and for every 50 minutes of exercise per week the rate of depression decreased by half. This has been attributed to many physiological mechanisms triggered by strength training.
• Strength training provides better quality sleep, and quality sleep is vital for muscle mass
• Our lymphatic system (immune) is dependent on our pumping muscles to move the lymph throughout the body
• Our heart is a muscle that needs to be trained, through exercise
• strength training strengthens bones as well – drastic reduction in osteoporosis
• studies from numerous institutions concur our focus and productivity our greatly improved with strength training and a higher lean mass ratio. This is attributed again to many benefits including glucose metabolism and hormonal balance, reduction of stress responses…….
• Hundreds of studies on strength training and physiologically reducing stress
• Muscles are one of our greatest regulators of hormonal balance…..this itself has hundreds of health benefits….
• Of course the obvious: our physical strength, mobility…all dependent on muscle
• Musculoskeletal injuries and depression cost millions in workplace absenteeism. Muscle work has a very strong role in the prevention and recovery of both
• Alcohol can destroy muscle mass, in a number of ways
• Harvard School of Public Health study: followed 10,500 US men aged over 40 for 12 years and found that of all the activities they did, weight training for 20 minutes three times a week had the greatest effect on preventing age-related abdominal fat.
• Strong muscles help us breathe, oxygenate our body.

Muscle is far more than looking good. Going for walks is great – however, it does not replace muscle work. Muscle training is often called the “new running for the over 40s.

Frailty occurs with loss of muscle. When we look at this partial list, no wonder frailty is associated with cumulative decline of physiological & psychological systems, and death. Our muscles are front and center to every aspect of our health and wellness.

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