Sarcopenia
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Grip Strength Is a Reliable Biomarker of Biological Age
Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2024/03/15/grip-strength-biological-age-biomarker.aspx
The original Mercola article may not remain on the original site, but I will endeavor to keep it on this site as long as I deem it to be appropriate.
Analysis by Dr. Joseph Mercola March 15, 2024
STORY AT-A-GLANCE
- Grip strength appears to be well correlated with epigenetic clocks used to estimate biological age based on DNA methylation patterns. Researchers concluded that age acceleration in men and women is associated with loss of strength over time
- Chronological age is the number of months or years that you have existed on Earth, while biological age describes the age at which your cells are functioning. As your cells grow older, they’re more susceptible to a variety of age-related diseases, many of which are in the top 10 leading causes of death
- There are similar associations between grip strength and endurance, balance, mobility, immune system function, heart health, cognitive function, an increase in psychiatric conditions and dementia
- Hand grip strength is measured with a dynamometer, which you can purchase or use at your local gym. Take three measurements following the instructions and average the measurements to find your grip strength
- While important, grip strength is an indicator of overall strength, so just improving hand strength doesn’t improve health or longevity. I highly encourage you to consider KAATSU, which is a specialized form of blood flow restriction training
Research1 published in the Journal of Cachexia, Sarcopenia and Muscle demonstrated once again that grip strength is a reliable biomarker of your biological age. In case you were not aware, your biological age can be a different number than your chronological age.
Biological Age, Health Span and Legal Implications
Chronological age is the number of years you have existed on Earth, while biological age describes the age at which your cells are functioning. For some people, these numbers are the same, and for others, they are vastly different. If you throw another measurement into the mix, your health span is the amount of time in life you are free from age-related disease.
Your health span is intimately related to your biological age. This means as your body’s cells decline in function, they’re more susceptible to a variety of age-related diseases, many of which are in the top 10 leading causes of death recorded by the Centers for Disease Control and Prevention.2 These conditions include heart disease, cancer, stroke, Alzheimer’s disease, diabetes and chronic liver disease.
Researchers believe that biological age is a combination of genetics, lifestyle choices, nutrition and comorbidities.3 You have control over two factors — lifestyle and nutrition — which together influence comorbidities. In other words, you have control over a vast majority of the factors that impact your biological age, and therefore your longevity.
When you consider the world around you, a lot has changed in the last five years. Bioethicists at Harvard University4 question if the distinction between biological and chronological age is significant, should that support a legal age change? While this is a question for another time, you can see how taking control of your health today may hold many benefits later in life, no matter what time in life you begin making changes.
The featured study indicates that grip strength is a reliable biomarker of your biological age, which would indicate that measuring your grip strength can help doctors predict your probability of developing chronic disease or all-cause mortality. One writer ponders5 about the growing number of individuals in their 20s and 30s who are no longer biologically young.
He writes that over the last eight years, a variety of studies have shown that the number of people with serious chronic diseases is growing, alongside a rising infertility rate, rising rate of mental illnesses in young women, and a roughly 70% decline in male testosterone since the 1970s.
He concludes that it is “obvious just how much the quality of human life has declined in just 1-2 decades.”6 Yet, information from the featured study and many others demonstrate that simple lifestyle changes can produce significant results.
Grip Strength Is a Reliable Biomarker for Biological Age
The researchers identified a growing body of evidence that has linked muscular weakness to a host of age-related health outcomes.7 Many researchers have looked at low grip strength as a biomarker of aging. This research team sought to identify the pathways that connect grip strength to negative health consequences by looking at DNA methylation (DNAm) age acceleration.
The researchers used data from the 2006 to 2008 data collection in the Health and Retirement Study in which there were eight to 10 years of follow-up. The researchers looked at longitudinal modeling that examined a potential association between the change in grip strength and DNAm age acceleration.
The data estimated age acceleration using DunedinPoAm, PhenoAge and GrimAge clocks, which are three epigenetic clocks used to estimate biological age based on DNAm patterns.8
At the conclusion of the study, the researchers wrote that there was “a robust and independent cross-sectional association between NGS (normalized grip strength) and DNAm age acceleration for men using the DunedinPoAm, PhenoAge and GrimAge clocks and for women using the DunedinPoAm and GrimAge clocks.”9
Based on the data, the researchers concluded that there is “some initial evidence of age acceleration among men and women with lower NGS and loss of strength over time.”10 They suggest that more research is needed to understand the extent to which DNAm age is associated with grip strength and chronic disease.
This data seeks to explain what other researchers have documented, that grip strength provides evidence of your overall strength and upper limb function, as well as information about bone mineral density, nutrition, cognition, sleep and quality of life.11

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Relationship Between Strength and Overall Health
Other researchers have also identified a similar relationship with grip strength, overall health and specific health conditions. According to geriatric medicine specialist Ardeshir Hashmi from the Cleveland Clinic, “Grip strength naturally begins to decline around age 50, and maybe even earlier. People who maintain their grip strength age more slowly. They stay healthier longer and are stronger throughout their bodies.”12
The consensus is that the stronger your grip strength, the better your health and the lower your grip strength the poorer your health. However, there is no consensus on the exact low and high measurements, and they are different based on your chronological age, weight and other factors.13
It’s estimated that grip strength is an indication of general muscle strength, which is crucial for endurance, balance and mobility. The association between hand grip strength and the strength of your immune system was the focus of a 2022 study14 that concluded measuring hand strength allows for “preliminary predictions on the current level of immunity and inflammation in the body.”
Data has also found that hand grip strength is correlated with heart health and can help predict cardiovascular problems alongside family history, blood pressure and other indicators.15 Low grip strength increases the risk of osteoporosis in postmenopausal women and a stronger grip is associated with increased functional independence.16 Grip strength can also affect your stability and increase the risk of accidents when you can’t catch yourself from falling.
Several studies have also found an association between a weaker grip, a reduction in cognitive functioning, an increase in the risk of psychiatric conditions and an increase in dementia.17 A large study published in 2022 associated poor hand grip strength in midlife with cognitive decline roughly 10 years later.18
The study19 published in JAMA Neurology used data from the U.K. Biobank Cohort Study. The researchers concluded that hand grip strength is associated with neurocognitive brain health. They believe this adds to a growing body of research indicating that increasing muscle strength in middle-aged adults may help maintain neurocognitive brain health as you age.
Another 2022 study20 published in BMC Medicine analyzed cross-sectional and longitudinal data from over 40,000 participants. The number in the cohort varied depending on the measurement being analyzed.
The researchers looked at the association between grip strength, behavioral outcomes and brain structure, finding an association between grip strength and increased gray matter volume in regional areas of the brain, as well as several measures of cognition and mental health.
How to Measure Hand Grip Strength
I have known of the correlation between grip strength and longevity for some time now, but was surprised that the instrument to measure it is inexpensive, So, I purchased one for $25 on Amazon and was delighted that my grip strength was off the charts at 129 pounds. I sincerely believe it is largely due to hanging for 90 seconds to two minutes twice a day for the last few years, a practice that I encourage nearly anyone to consider to increase their grip strength.
Researchers in the featured study used a Smedley spring-type hand dynamometer to measure grip strength.21 Grip strength measures muscle strength exerted in your hand and forearm muscles. A dynamometer is typically the tool that’s used to measure grip strength but not what’s used to improve your grip strength.
The measurement is typically given in kilograms or pounds. A digital hand dynamometer is the easiest and most reliable way of measuring your hand strength. Owning a hand dynamometer helps you keep track of your grip strength over time. To use a dynamometer be sure to follow the instructions that come with the device. Generally:22
- The grip handle should be positioned to fit your hand
- Bend your elbow at a 90-degree angle
- Apply maximum effort to squeeze the dynamometer
- Repeat a total of three times and average the three results
A 2018 study23 used data from 1,232 participants aged 18 to 85 years to extract normative reference values for hand grip strength in that age range. The researchers established ranges based on gender and dominant or non-dominant hands.
The cohort was broken into five-year age ranges and an overall range was established for each group as well as identifying those in the 10th, 25th, 50th, 75th and 90th percentiles. Examples of the measurement ranges in the dominant hand include:
| Years | Pounds |
|---|---|
| Men | |
| 18-24 | 103.6 +/- 17.9 |
| 35-39 | 103.8 +/- 26.2 |
| 50-54 | 97.0 +/- 22.7 |
| 60-64 | 84.7 +/- 22.7 |
| 70-74 | 76.5 +/- 19.8 |
| Women | |
| 18-24 | 61.9 +/- 15.7 |
| 35-39 | 64.4 +/- 13.7 |
| 50-54 | 62.2 +/- 13.9 |
| 60-64 | 52.0 +/- 14.3 |
| 70-74 | 47.4 +/- 11.2 |
Pay Close Attention to Overall Strength
As the lead researcher of the featured study, Mark D. Peterson said, “Grip strength is a proxy indicator of overall muscle strength, meaning that it is highly correlated to other measures of strength. Thus, simply increasing grip strength would not render any changes to health or longevity.”24
While grip strength is just an indicator of your overall strength, you still may want to spend some time improving your grip strength to make everyday tasks easier. Hashmi recommends25 using a racquetball or squash ball as a squeeze ball.
He notes that the size and the material of the ball are important so that you have the right resistance. A tennis ball is too large and may cause an injury while exercising. Other options can include resistance bands and grip and squeeze handles that come in different sizes and levels of resistance. He recommends using a low resistance and working your way up to higher strengths.
While you might think that traditional weightlifting is the only way to build muscle, there are several other options. If you’ve never done any strength training, it may help to begin with resistance bands that come in a variety of different strengths. These allow you to build muscle while you learn the correct form to reduce your risk of injury.
As you get stronger, I highly encourage you to consider my favorite way of strength training — KAATSU, also known as blood flow restriction training. It can help radically improve muscle growth and strength without risking injury. This makes an ideal for people who have never done strength training and for the elderly.
Strength training is vital to prevent age-related muscle loss that leads to frailty and premature death. KAATSU is not only effective in building muscle, even when you’re older, but it also generates some highly beneficial metabolic byproducts, including insulin growth factor 1, growth hormones and brain-derived neurotrophic factor (BDNF).
You can learn more about the benefits of KAATSU in “How to Optimize Health and Strength — Even if You’re Over 60,” which features my interview with Dr. Marcos de Andrade, a research physician and CEO of BIOHAXS. We met at Dave Asprey’s Biohacking Conference in June 2023, where we ended up arm wrestling. De Andrade was 38 years old and an extreme fitness buff, and I was 69. But I still beat him. So, age doesn’t have to be a determining factor or excuse for poor fitness.
- 1 Journal of Cachexia, Sarcopenia and Muscle, November 9, 2022
- 2 Centers for Disease Control and Prevention, Leading Causes of Death
- 3 Translational Oncology, 2022; 15(1) Bullet 3
- 4 Center for Bioethics, April 1, 2021
- 5, 6 Haidut, February 27, 2024 (Archived)
- 7 Journal of Cachexia, Sarcopenia and Muscle, November 9, 2022, Sentence 1 and background last sentence
- 8 Haidut, February 27, 2024, last para (Archived)
- 9 Journal of Cachexia, Sarcopenia and Muscle, November 9, 2022, Results; Conclusion for next para
- 10 Journal of Cachexia, Sarcopenia and Muscle, November 9, 2022, Conclusion
- 11 Clinical Interventions in Aging, 2019; 14
- 12 Cleveland Clinic, March 13, 2023, para 5
- 13 Cleveland Clinic, March 13, 2023, Subhead 1 para 2; Muscle strength para 1
- 14 International Journal of Environmental Research and Public Health, 2022; 19(20) quote is from last sentence abstract
- 15 British Heart Foundation, March 14, 2018
- 16 Joan Pagano, November 7, 2023
- 17 BMC Medicine, 2022;20(286) 5% down the page, Background para 1
- 18 Harvard Health Publishing, September 1, 2022 top of para 1
- 19 JAMA Neurology, 2022; 5(6) Abstract/Concl and Relevance
- 20 BMC Medicine, 2022;20(286) 45% down the page, Discussion, para 1 GMV=grey matter volume – abbreviations at the end of the article
- 21 Journal of Cachexia, Sarcopenia and Muscle, November 9, 2022, Methods/Exposures/Grip Strength para 1 15-30% Down the page
- 22 Cathe, How Strong Is Your Grip? Para 7
- 23 Journal of Orthopaedic & Sports Physical Therapy, 2018;48(9) Pop up appendix A 80% down the page
- 24 Atlanta Journal Constitution, April 17, 2023
- 25 Cleveland Clinic, March 13, 2023, Hand exercises 60% down the page
Can These Nutrients Help Prevent Muscle Wasting?
Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2022/11/25/how-to-prevent-sarcopenia.aspx
The original Mercola article may not remain on the original site, but I will endeavor to keep it on this site as long as I deem it to be appropriate.
Analysis by Dr. Joseph Mercola Fact Checked November 25, 2022<

STORY AT-A-GLANCE
- Age-related muscle loss, also called sarcopenia, begins at age 30 and affects at least half of the people over age 80; omega-3 fatty acids, the amino acid leucine, and the probiotic Lactobacillus paracasei PS23 help counteract sarcopenia
- Whey protein is high in leucine and has long been known as an excellent source of protein that is easily digested and absorbed. Leucine may regulate muscle protein turnover and is an effective way to optimize muscle growth when combined with resistance training
- Nicotinamide adenine dinucleotide (NAD+) is a substrate for important enzymes and impacts age-related amyloid protein aggregates in the muscle that affects muscle aging. Boost your levels through exercise, sauna bathing, fasting, and minimizing EMF exposure
- A Harvard study showed consuming protein is not enough to protect muscle mass, participants must also include strength training, which also improves basal blood flow in the lower extremities. This helps protect against functional impairment and metabolic syndrome
As you age, your body naturally tends to lose muscle. This condition is known as sarcopenia or muscle wasting. A 2022 study published in the journal Nutrients1 found increasing certain nutrients could lower your risk of sarcopenia as you age.
If you are not proactive, you can expect to lose approximately 15% of your muscle mass between your 30s and your 80s.2 An estimated3 10% to 25% of older adults under age 70 and half of those over age 80 have sarcopenia.
Even when you’re younger, if you are forced to stay in bed it can have a dramatic impact on your muscle mass. In one 2015 review,4 researchers found you could lose 5.2% of your muscle mass in the first two weeks of bed rest and by Day 23, you could have lost up to 10% of your quadriceps muscle mass. Strong muscles are required for mobility, balance and the ability to live independently.
Sarcopenia5 can increase the risk of falls and fractures, which ultimately can lead to hospitalization and surgery. It is important to know that sarcopenia is not related to your body mass. In other words, individuals who are obese can also lose muscle mass, which increases their risk for complications.
One meta-analysis6 of 35 studies and 58,404 people demonstrated the global prevalence of sarcopenia is 10% in men and women. Scientists understand the importance of muscle wasting as it relates to longevity and health. This led the Centers for Disease Control and Prevention7 to recognize it as an independently reportable medical condition.
When you have a reserve of muscle mass, it minimizes the challenges that result from muscle wasting8 if you become sick or hospitalized. Because muscle is lost far more easily and quickly than it’s built, it’s crucial to find ways to continuously promote and maintain muscle mass.
Nutritional Treatment Helps Counteract Sarcopenia
Researchers in the featured study9 knew that a variety of nutrients have shown effectiveness in supporting muscle. The randomized clinical trial was developed to analyze how effective two months of food high in omega-3 fats, leucine and probiotic Lactobacillus paracasei PS23 (LPPS23) would be on appendicular lean mass, inflammatory status, amino acid profile and muscle performance in people who were diagnosed with sarcopenia.
The researchers enrolled 60 participants who were within 4.8 years of 79.7 years and split them into an intervention or placebo group. The researchers prepared a customized diet schedule for both groups that provided 1.5 grams of protein per kilogram of body weight each day.10 Each group also received a dietary plan that consisted of approximately 30% lipids and 55% carbohydrates.
The researchers measured weight loss as compared to the individual’s weight history in the six months before their baseline visit. The subjects were questioned about how well they had followed their diet plan and physical activity recommendations. They also filled out a 24-hour dietary recall once a month.
The group that received the intervention took a supplement containing 500 mg of omega-3 fatty acid, 2.5 g of leucine and an LPPS23 probiotic. The control group received an isocaloric placebo. At the end of the study, the researchers measured body composition, physical performance, mood, blood pressure, muscle strength and functional status.
They concluded from the measurements that the intervention appeared to be a “valid strategy to counteract the progression of sarcopenia and sarcopenic-defining parameters in older adults.”11
Whey Protein Another Tool to Prevent Sarcopenia
As the featured study demonstrated, your diet plays a significant role in muscle development since your muscles need enough protein to stay viable. A 2011 paper12 published in the American Journal of Nutrition noted that the differences in digestion and absorption of dietary protein can modulate muscle growth.
So, while you need protein to build and maintain muscle, some proteins are more easily digested and absorbed than others. When you eat the right kind of protein it can make a difference in the potential risk for sarcopenia. The researchers in the featured study13 included the amino acid leucine in the intervention, which is also found in high concentrations in whey protein.14
Whey is a byproduct of cheese production and has long been acknowledged as an excellent source of protein. In the 2011 study, whey protein was compared to casein and casein hydrolysate, and was found to stimulate muscle protein growth the best, likely because of the leucine content.
One of the reasons that leucine is so important to prevent sarcopenia is that it helps regulate the turnover of protein in your muscle. A 1975 paper15 in the Journal of Clinical Investigation said leucine may also “play a pivotal role in the protein-sparing effect of amino acids.”
A more recent 2017 study16 explained the most effective way to optimize muscle building is to use a combination of resistance training followed by a protein meal, with leucine-rich whey being one of the most efficient proteins that can be used. However, a Harvard study demonstrated that simply taking leucine will likely be ineffective.17
Two groups of men over age 65 consumed either 0.8 grams of protein per kilo per day or 1.3 g of protein per kilo per day. The researchers found the high protein group did not experience an increase in lean muscle mass, or improve physical function or muscle strength, greater than the low protein group, most likely because they were not exercising.
Whey protein also contains glutathione, another important component in promoting and protecting muscle mass. It is thought to play an important role in muscle wasting, specifically in helping to modulate higher levels of oxidative stress18 often found in patients with sarcopenia. As noted in a 2012 review:19
“It has been suggested that oral antioxidant supplementation may contribute at reducing indices of oxidative stress both in animal and human models by reinforcing the natural endogenous defenses …
Antioxidants are substances able to inhibit the rate of oxidation. Mainly, antioxidant enzymes (e.g., catalase, superoxide dismutase (SOD), glutathione peroxidase, glutathione reductase) work to maintain a state of balance preventing the transformation of ROS and to convert them into more stable molecules (like water and molecular oxygen).”
NAD+ Combats Age-Related Muscle Deterioration
Studies have also proposed that mitochondrial dysfunction in the motor neurons may drive the development of sarcopenia. A 2021 paper20 published in Cell Reports compared the similarities between muscle aging and degenerative muscle diseases. The data revealed that protein aggregates deposit in skeletal muscle, which is a feature of muscle aging.
The researchers identified an amyloid-like protein that impairs mitochondrial function. While researchers have known that aggregated proteins could contribute to brain aging, this was the first time that data had shown it could contribute to muscle aging and directly damage the mitochondria.
The researchers first used a substance in worms and found it could reduce age-related amyloid protein aggregates.21 They found the same results in human muscle tissue from older subjects. They then went on to test nicotinamide adenine dinucleotide (NAD+) boosting nicotinamide riboside in aged mice and found it reduced the number and size of the amyloid aggregates within the skeletal muscle tissue.
NAD+ is a substrate for several important enzymes and is essential in metabolic processes, such as creating ATP in the mitochondria. A 2020 paper22 published in Endocrinology and Metabolism demonstrated that when the NAD+ salvage pathways in muscle are impaired, mitochondrial dysfunction and decreased muscle mass ensue.
If your NAD+ level is low, some simple lifestyle strategies can help. For example, exercise, fasting, minimizing electromagnetic field (EMF) exposure and sauna bathing can help improve your NAD+ levels. Exercise, heat exposure and fasting address low NAD+ because they are catabolic stressors that activate AMP protein kinase (AMPK).
This in turn activates an enzyme called NAMPT, which governs the NAD+ salvage pathway. Oxidative stress and inflammation can also deplete NAD+. Exercise, sauna and fasting can help reduce oxidative stress and inflammation, and as a result, less NAD+ is depleted.
The best way to increase NAD+ levels is to optimize your circadian rhythm by going to bed around 9 and getting up around 5 AM. The further you veer from these hours the more you challenge your circadian rhythm. It is also important to avoid blue light from screens and home lights after sunset and before sunrise.
Then you want to make sure you are doing regular strength training exercises. The best time to do them would be in the AM while you are fasting. You can also take niacinamide 50 mg powder three times a day. More is not better and will be counterproductive by inhibiting your longevity proteins (sirtuins). You can see my interview with Nichola Conlon for more details.
Strength Training Helps Preserve Muscle Mass and Heart Health
As the Harvard study23 demonstrated, consuming protein is not enough to protect your muscle mass. One study24 from the University of Michigan School of Public Health found those with lower muscle strength did not live as long as their peers with stronger muscles. After adjusting for confounding factors, the data continue to show those with low muscle strength had a 50% greater risk of dying early.
The data was pulled from a study of 8,326 men and women aged 65 and older. A loss of muscle in older adults may also be a primary driver of insulin resistance25 and declining strength may impact a reduction in daily physical activity, which also contributes to metabolic dysfunction.26
Researchers from the National Institute of Health and Nutrition in Tokyo, Japan,27 tested the hypothesis that a reduction in leg blood flow would be absent or minimal in people who regularly perform strength training exercises. They engaged a group of 104 men ages of 20 to 34 and 35 to 65 to compare whole-leg blood flow and vascular conductance between the groups.
The data showed no notable differences in the two age groups in those who used resistance training. However, there was a significant difference in the sedentary middle-aged group leading the team to conclude that a reduction in basal whole leg blood flow may be absent in men who routinely engage in resistance training.
The researchers suggested that resistance training could favorably influence leg perfusion. Lower levels of basal leg blood flow are associated with developing metabolic syndrome and functional impairment.28
I have been exercising for over 50 years. In the first 43 years, I exclusively used aerobic exercise. I didn’t realize that while it lowered the risk of heart disease, it is highly catabolic and eventually lowers the ability to build muscle. At the height of my running career, my upper arm circumference was 10.5 in.
However, contrast that with my arm circumference in December 2020 when it measured 15 inches. I stopped long-distance running and started resistance training. The results didn’t happen overnight, and I was well over 50 when I first began using resistance training.
The key to my success has been allowing time for significant recovery so the connective tissue and muscle can rebuild. I work with a trainer, but if you cannot afford a trainer, there are many great videos.
When you use resistance training and add the nutritional elements your body needs to grow muscles, you’ll reap the benefits. Remember to avoid doing the same exercise every day to allow the body to recover and repair so you get the benefits and avoid injuries.
- 1, 13 Nutrients, 2022;14(21)
- 2 Journals of Gerontology, 1995;50(5-8)
- 3 Journals of Gerontology, 2003; 58(10)
- 4 Extreme Physiology & Medicine 2015;4:16
- 5 Aging in Motion, What Is Sarcopenia?
- 6 Journal of Diabetes and Metabolic Disorders, 2017; 16
- 7 Federal Practitioner, 2017;34(7)
- 8 Current Opinions in Clinical Nutrition and Metabolic Care 2012; 15(1)
- 9 Nutrients, 2022;14(21) Abstract
- 10 Nutra-Ingredients, November 2, 2022
- 11 Nutrients, 2022;14(21) 5
- 12, 14 American Journal of Nutrition, 2011; 93(5): 997-1005
- 15 Journal of Clinical Investigation, 1975;56(5)
- 16 Journal of the International Society of Sports Nutrition, 2017, 43(14)
- 17, 23 JAMA Internal Medicine, 2018; 178(4)
- 18 Maturitas 2018;109
- 19 Journal of Aging Research, 2012;2012(316943)
- 20 Cell Reports, 2021;34(3)
- 21 Science Daily, January 20, 2021
- 22 Endocrinology and Metabolism, 2020;35(4) Section Mitochondrial dysfunction
- 24 University of Michigan School of Public Health, August 22, 2018
- 25 Diabetes Care, 2009;32(2)
- 26 Journals of Gerontology, 2018;73(8)
- 27, 28 Journal of Applied Physiology, October 1, 2005; doi.org/10.1152/japplphysiol.00061.2005