Muscle matters: Dr Brendan Egan at TEDxUCD
Summary
TLDRThe video script discusses the importance of muscle in energy expenditure and its decline with age, a condition known as sarcopenia. It highlights the impact of modern sedentary lifestyles and medication on muscle health, emphasizing the rise of chronic diseases and muscle wasting in an aging population. The speaker advocates for strength training and bodyweight exercises to combat muscle loss, improve overall health, and enhance the quality of life in older adults, stressing the need for personalized exercise prescriptions similar to medical treatments.
Takeaways
- 💺 Sitting consumes about a calorie per minute, but exercise can increase this energy expenditure by 20 to 30 times.
- 🏋️ Muscles account for 30% of energy expenditure at rest and up to 90% during exercise, making them a key site for burning carbohydrates and fat.
- 🍽️ After eating, approximately 80% of the ingested energy is distributed to muscles, highlighting their importance in energy utilization.
- 🛋️ Prolonged sitting is an independent risk factor for many diseases, even if one exercises regularly.
- 🚶♂️ The term 'active couch potato' is used to describe those who exercise but spend most of their day sitting, which can still lead to health issues.
- 💊 Advances in medication have led to an aging population, but this longevity is often accompanied by chronic diseases.
- 👴 By 2050, the number of people over 65 is projected to exceed those under 15 for the first time in human history.
- 🦵 Sarcopenia, the age-related loss of muscle mass and strength, is inevitable and begins after the age of 30, with a loss of 3-8% of muscle mass per decade.
- 🏥 The prevalence of sarcopenia is about 20% in people over 65 and over 50% in those over 85, making it a significant concern for the aging population.
- 🤽♂️ Loss of muscle mass and strength increases the risk of falls, fractures, and frailty, impacting independence and overall health.
- 🏋️♀️ Resistance training, such as weight lifting, is essential for maintaining and improving muscle mass, unlike aerobic exercises which may not have the same effect.
Q & A
How much energy does the human body expend while sitting?
-The human body expends approximately one calorie per minute while sitting.
What happens to the energy expenditure when we exercise?
-When we exercise, our energy expenditure can increase by about 20 to 30 times compared to when we are sitting.
What percentage of energy is used by muscles during rest and exercise?
-At rest, muscles use about 30% of the body's energy, but during exercise, they contribute up to 90% of the energy.
What is the impact of muscle failure on health?
-When muscles begin to fail or develop problems, it can lead to a range of diseases associated with muscle dysfunction.
How does automation affect our physical activity?
-Automation in modern life predisposes us to being physically inactive, leading to a majority of our time being spent in a seated position.
What is the term used for the age-related loss of muscle mass and strength?
-The term used for the age-related loss of muscle mass and strength is 'sarcopenia'.
What is the prevalence of sarcopenia in the over-65 population in the US?
-In the US, the prevalence of sarcopenia in the over-65 population is about 20%.
How does sarcopenia affect balance and the risk of falls?
-Sarcopenia, which involves the loss of muscle strength and power, increases the risk of balance issues, falls, and fractures.
What is the impact of sarcopenia on the risk of frailty syndromes and loss of independence?
-Sarcopenia is a strong risk factor for frailty syndromes, loss of independence, and general ill health as we age.
How does muscle mass loss affect mortality rates in different age groups?
-As muscle mass decreases, particularly in the over-60s, the death rate increases significantly compared to younger individuals with stronger muscles.
What is the principle of specificity in exercise training?
-The principle of specificity in exercise training states that the body adapts specifically to the imposed demands, meaning that to improve strength and muscle mass, one needs to engage in weight lifting or similar activities.
What is the principle of progressive overload in exercise training?
-The principle of progressive overload in exercise training involves gradually increasing the intensity or volume of exercise to continually challenge the body and promote adaptation and improvement.
How can bodyweight exercises help in maintaining or improving muscle mass?
-Bodyweight exercises can help in maintaining or improving muscle mass by providing resistance against the body's own weight, which can be effective in both young and older adults.
What is the message conveyed about the importance of exercise in relation to muscle health?
-The message conveyed is that exercise should be prescribed like medicine, tailored to the individual and their condition, emphasizing the need for strength training and avoiding inactivity to maintain muscle health.
Outlines
💺 Inactivity and Muscle Function
This paragraph discusses the energy expenditure while sitting and how it contrasts with the energy used during exercise. It highlights the muscle's role in energy consumption, both at rest and during physical activity. The script points out the modern lifestyle's tendency towards automation, leading to prolonged periods of inactivity, which is a significant risk factor for various diseases. It also touches on the paradox of inactivity leading to muscle atrophy, despite the common association of a sedentary lifestyle with obesity. The paragraph concludes with a discussion on the aging population and the prevalence of chronic diseases, introducing sarcopenia as a significant concern in older adults.
🏋️♂️ The Impact of Muscle Loss on Health and Aging
The second paragraph delves into the consequences of muscle loss, particularly sarcopenia, which is characterized by the age-related decline in muscle mass and strength. It emphasizes the importance of muscle strength for maintaining balance and independence, and how muscle loss can lead to frailty and increased risk of falls and fractures. The script also addresses the issue of disease-related malnutrition in Ireland, highlighting its significant economic impact. Furthermore, it discusses the correlation between strength and longevity, indicating that maintaining muscle mass can improve life expectancy. The paragraph also explores the rapid muscle loss that can occur due to inactivity or bed rest, underscoring the importance of regular physical activity.
🏋️♀️ Combating Muscle Loss Through Exercise
The final paragraph focuses on the potential of exercise to combat muscle loss, even in the elderly. It presents evidence of significant muscle mass and strength improvements in individuals over 85 years old through targeted training. The script advocates for the use of bodyweight exercises as an accessible and effective way to increase muscle mass and strength, citing studies that show positive results in both young and older adults. It also emphasizes the importance of exercises that mimic daily activities to improve functional capacity and maintain independence in older age. The paragraph concludes with a call to action, urging the prescription of exercise as a critical component of health care, tailored to individual needs and conditions.
Mindmap
Keywords
💡Calorie expenditure
💡Muscle atrophy
💡Sarcopenia
💡Inactivity
💡Exercise
💡Strength training
💡Progressive overload
💡Bodyweight exercises
💡Frailty syndromes
💡Disease-related malnutrition
Highlights
Sitting expends about a calorie per minute, but exercise can increase this energy expenditure by 20 to 30 times.
Muscles contribute about 30% of energy expenditure at rest and 90% during exercise, making them a major site for burning carbohydrates and fat.
Muscle failure can lead to a range of diseases, highlighting the importance of muscle health.
Automation and a sedentary lifestyle are major factors contributing to physical inactivity and associated health risks.
Even with exercise, spending most of the day sitting can still be detrimental to health, labeling such individuals as 'active couch potatoes'.
Muscles of inactive individuals, like those depicted as 'couch potatoes', actually shrink over time, contrary to the common misconception of inactivity leading to increased size.
The aging population and advancements in medication are leading to longer lifespans but also an increase in chronic diseases.
By 2050, the number of people over 65 is projected to exceed those under 15 for the first time in human history.
Sarcopenia, the age-related loss of muscle mass and strength, is an inescapable fact affecting individuals after the age of 30.
Every decade after the age of 30, individuals lose between 3 to 8% of their muscle mass.
Sarcopenia is prevalent, with about 20% of people over 65 and over 50% of those over 85 affected in the US.
Loss of muscle mass and strength is a strong risk factor for frailty, loss of independence, and general ill health in older adults.
Disease-related malnutrition is a significant issue in Ireland, affecting 140,000 people and costing 1.5 billion euros.
Strength is crucial as it is associated with a lower death rate; the stronger individuals have half the death rate of the weakest.
Sarcopenia is related to various diseases, and muscle wasting is a common factor in these conditions.
Reduced activity, such as making individuals take fewer steps, can lead to a rapid loss of muscle mass, even in young healthy individuals.
Elderly individuals can still make significant improvements in muscle mass and strength through targeted exercise training.
Bodyweight exercises are an effective way to improve muscle mass and strength, and can be done without expensive equipment.
Maintaining muscle mass through exercise can delay the aging process and improve overall health and functional capacity in older adults.
Exercise should be prescribed like medicine, tailored to the individual and their condition, to effectively combat age-related muscle wasting.
Transcripts
as you sit there in your chair you
expend in a rough amount of energy
somewhere around a calorie per minute
when we exercise we can increase this by
about 20 or 30 fold as you sit there
your muscle country's about 30 percent
of your energy during exercise a
contributor of 90 percent of your energy
so it becomes the major site where we
burn carbohydrate and fat and when we
eat a meal about 80 percent of the
energy that's ingested in that meal is
distributed to the muscle in other words
when muscle begins to fail or when we
develop problems with a muscle is it's
not surprising then that we develop a
range of diseases associated with that
there's two things that have happened in
modern science that have unintended
consequences in terms of the way that
muscle functions the first is automation
so in modern life now we're predisposed
to being physically inactive we spend a
large amount of our time in a sitting
position so even if we do or half-hour
of purposeful exercise first thing in
the morning we spend it about 90 percent
of the next 15 and a half hours of
waking we spend our time in a seated
position
so one of the problems with sitting is
that it's an independent risk factor for
a majority of diseases in other words
even if you do exercise first thing in
the morning or last thing at night or
whenever you exercise you're in the day
if you do in a single bout and you spend
the rest of your day sitting you might
be called what's classified as an act
active couch potato
so potatoes are much used for muscles
and so if you look at someone like this
and we tend to associate inactivity and
inappropriate diet with that with the
increase in size in actual fact the
muscles of individuals such as this guy
on the couch are actually getting
smaller and smaller and working less and
less the second major thing that modern
science has delivered us is medication
and as a result we're living longer and
longer so we have a worldwide aging or
grain population and if you look at the
yellow segment on those pie charts
that represents the numbers of people
who are over 65 so a current projections
sometime after the year 2050 the numbers
of people who are greater than 65 years
of age will exceed the numbers of people
who are less than 15 years of age for
the first time in human history however
with the aging and with extended
lifespans
due to this improvements in our
medication unfortunately that's
associated with chronic diseases so in
data from the US adults aged over 65
years the current numbers would suggest
that ninety two point two percent of
those individuals have one or more
chronic diseases so although we're
living longer we might not necessarily
be living healthier in this case chronic
diseases were defined as the usual ones
we tend to hear about hypertension
coronary heart disease stroke cancer and
so forth but as one disease that's not
mentioned here that I want to talk a bit
more about today in that sarcopenia so
sarcopenia is defined as the edge
related wasting of muscle and the in the
word comes from greek which means a
poverty of flesh but it also means a
poverty of strength so we lose muscle
mass and we lose strength as we age and
there's no way it's inescapable it's a
fact that happens after about the age of
30 we lose it 3 to 8% of our muscle
every decade keep that number in mind
because I'm going to come back to it so
every decade we lose somewhere between 3
and 8 percent of our muscle on the right
hand side and in the second figure there
you see the appearance of the time
muscle of an individual cross section of
their tie and what you can see there is
at an elderly individual they've lost a
large proportion of the muscle mass so
the white color there indicates adipose
tissue or fat so muscle is shrunk
we've lost muscle as we age beneath that
is a 74 year old athlete who has trained
their whole life and it's managed
maintained their muscle mass and despite
what I said was the inescapable fact we
would lose muscle throughout our life so
you might wonder what is the prevalence
of sarcopenia is it just some disease
that this guy is really interested
you know it's not really that relevant
well at the moment in over 65s it's
about twenty verse this is data from the
US it's about twenty percent prevalence
in people over the age of 85 greater
than half of the individuals have
sarcopenia now when you lose strength
and you lose power in your muscles you
lose these are these are things that are
greatly associated with balance if you
lose your capacity to balance
you're more predisposed to Falls and
fractures so this loss of muscle mass is
a is a strong risk factor for frailty
syndromes for loss of Independence and
for general ill health as we age we
don't have any figures for Ireland but
what we do know in Ireland is that this
there's another pair to this story which
is disease related malnutrition and this
might surprise you but in Ireland at any
one time there's 140,000 people who are
suffering from disease related
malnutrition that cost about indirect
costs about 1.5 billion euro to the
Exchequer and you might think well how
much does that mean you know is what
kind of disease is this again that's
more than the direct cost of obesity so
this is a this is a an invisible type of
disease disease related malnutrition
very strongly associated with
age-related muscle wasting so why is
strength important
I mentioned the incidence of frailty and
loss of Independence if we look at
individuals who are either over 60 or
under 60 and we look at their strength
so their whole body strikes three colors
here represent weak individuals the
average individuals to strong
individuals if you look at the two red
bars what you see there is that as we
age so the over-60s day over four and
four times elevated death rate compared
to the under 60s so that makes sense if
we're a little older we're more likely
to die however on the right-hand side if
you compare the green to the red the
stronger that you are so the strongest
heart of the population have half the
death rate of those who are weakest in
other words if you preserve your muscle
mass you have a greater chance of living
that little bit longer now
why would that effect be so obvious and
why would it be of relevance to
something like cancer so are there are
other diseases that that sarcopenia or
muscle-wasting relate to and there are
so all of these diseases listed on this
slide and cone coincide with muscle
wasting so in each one of those when the
disease manifests itself it's also
associated with the loss of muscle mass
and therefore a loss of Independence
what I want to focus on is a
mobilization and bed rest so if you take
young healthy males in the twenties
student aged student population and
you've probably heard of this ten
thousand steps that you need to do in
any given day in order to be to be
healthy if you take people who were
making those ten thousand steps and you
reduce their activity by making them
take elevators and make them take
escalators pushing around in wheelchairs
making them sit a lot more we reduce
their number of steps to two thousand
they lose about five percent of the
muscle mass in the space of 14 days so I
said that usually we lose about three to
eight percent per decade over the age of
thirty these guys lose 5% of their
muscle mass within 14 days if an elderly
person over the age of 70 is bedridden
for ten days they lose 10% to the most
of us
in other words depending on the
situation in as little as two weeks you
can lose the equivalent muscle mass of
what would take a decade to lose so we
want to avoid these things we want to
avoid mobilization we want to stay
active we want to avoid bed rest where
possible so how should we do this and
typically what we're told is that we
need to get out and walk more we need to
do half an hour of activity accumulated
on five different days of the week well
I'm going to tell you that that's
probably not enough so the principle of
specificity in terms of exercise
training is that the body adapts
specifically to the the imposed demands
so if we want to get bigger if we want
to improve our strength and improve our
muscles we have to lift weight going out
for a walk isn't going to make you
stronger and in fact there's some
evidence to say that like people who are
lifelong in
aerobic or querida sports to losing
muscle mass compared to those
individuals who do strength training
the other interesting thing is that when
it comes to diseases like diabetes and
obesity the most recent evidence would
suggest that it's combined endurance and
robic exercise that works you shouldn't
just be doing one or the other there
should be a combination within there a
second principle in an exercise training
is the principle of progressive overload
and this is Milo the wrestler
two and a half thousand years ago famous
Greek wrestler and the story goes that
in order to develop his strength as he
as he grew he used to carry a bull a
calf around from a young age so he
carried it every day and as the bull got
bigger he got stronger I don't know if
this is true but the point is that each
day he pushed himself a little bit
harder and his body adapted accordingly
and that's what an important principle
of the way we exercise so then the
question is if an adult is old around
this case they're over there over 85
years of age if we exercise train them
can they actually make improvements so
on the left hand side what you're seeing
there it's pre-imposed too much you're
looking at the cross-section area and in
this particular individual that person's
muscle in the quad again they're in
their time muscle has increased by about
44% on the right hand side you're
looking at their improvement in strength
it's improved by about 50%
that was after 12 weeks of training that
focused on anti-partisan muscles in 85
year old individuals so in this case the
muscle wasting could be reversed in
other words we've reversed the aging
process so how should we exercise then
does it have to have to go to a gym do
we have to do to have to invest in
expensive equipment something we're
excited about aucd at the moment is
using bodyweight exercises so these are
exercises that you use your own
bodyweight in space to provide a
resistance against your against your
against your muscles so I'll give you
two little studies that we've done right
now
we took young college age males again
obese and overweight and we trained them
for six weeks three days a week half an
hour each day and all they did were
these body which type exercises no
equipment
after six weeks we saw about a three
percent improvement in muscle mass
particularly in the legs and we have
that holy grail that lasts a small bit
of fat as well there were young
individuals in older adults starting at
the age of 55 would have a mean age of
about 63 we see the same thing after 12
weeks body weight on the exercises three
times a week we see about a three
percent improvement in in their muscle
mass so improving muscle mass is one
thing but these exercises are very
similar to things that we do and not in
everyday activities so we lift things
above our head we get up off the ground
we get up out of chairs so these are
what we call activities of daily living
and one of the major predictors of loss
of Independence is when an older adult
can no longer do these activities of
daily living so we're excited now to
begin to look at these bodyweight
exercises and how they might improve the
overall health and function functional
capacity of older adults so I suppose
the last thing I'll say is that in the
case of sarcopenia or muscle wasting you
don't just wake up one day and have this
situation it's a continuum progresses
over time and so I was talking about
those bodyweight exercises being able to
increase muscle mass but if we can just
delay the aging process so if we if we
just maintain muscle mass rather than
actually having to improve it in that in
itself would have benefits to their
overall health so my simple message is
this
we need to prescribe exercise like we
prescribed medicine so we shouldn't just
give everyone to say a medicine we
should treat the individual and we
should treat the condition so going out
and doing 30 minutes of walking every
day might not call it when it comes to
people who have age related muscle
wasting so in other words what I'd say
is usage or lose it because muscle
matters and only the strong survive
thank you
you
you
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