In 30 seconds
- Sarcopenia is a muscle disease in which low strength is the main sign. It is common in older people, but it can start earlier.
- On average, men lose 4.7% of their peak muscle mass per decade and women 3.7%. At 75, strength falls 2 to 5 times faster than muscle.
- In 25 studies with people averaging 70 years of age, what built the most strength was training 2 days a week, with 2-3 sets of 7-9 repetitions at 70-79% of their maximum.
- From 65 onwards, European experts recommend at least 1.0-1.2 g of protein per kilo a day, and 1.2 g or more if you exercise.
Sarcopenia is the loss of strength and muscle mass that comes with age, to the point where it becomes a disease of the muscle 1. According to the studies, what slows it down most is strength training. In people aged 70 on average, the most effective approach was 2 sessions a week of 2-3 sets of 7-9 reps 3. Add enough protein at each meal, and the sooner you start, the better.
What sarcopenia is
The European consensus on sarcopenia, revised in 2019, defines it as a progressive and generalised skeletal muscle disorder 1. It describes a disease of the muscle, a “muscle failure”, and puts low strength, not a lack of muscle, as the main sign 1:
- Probable sarcopenia: low muscle strength.
- Confirmed sarcopenia: in addition, low muscle quantity or quality.
- Severe sarcopenia: in addition, low physical performance, such as walking at 0.8 metres per second or less.
It is common in older people, but it can appear earlier 1. If you notice that getting up from a chair, climbing stairs or carrying the shopping is getting harder, mention it to your doctor: the diagnosis is made with simple tests of strength and function.
Muscle and age
How much muscle and strength is lost over the years
How much muscle is lost and from what age
There is no exact age. According to one review, studies place the start of muscle loss between the ages of 27 and 60 2. From then on, the median across studies is 4.7% of peak muscle mass per decade in men and 3.7% in women 2. After 70, most people have around 80% of the muscle of a 20-30-year-old 2.
With age, the pace speeds up. This is how much is lost at around 75, in studies that followed the same people for years 2:
| Muscle mass | Strength | |
|---|---|---|
| Women | 0.64-0.70% a year | 2.5-3% a year |
| Men | 0.80-0.98% a year | 3-4% a year |
Source: Mitchell et al., 2012, review of studies that followed the same people for years.
The key figure: strength is lost 2 to 5 times faster than muscle mass 2. And it is the loss of strength that is most consistently linked to disability and mortality 2. That is why the goal is not just to have muscle, but to keep it strong.
Why it matters from a certain age
Sarcopenia is linked to more falls, fractures, physical disability and mortality 1. Put practically: muscle is what lets you get up off the floor, walk up a hill or carry your grandchild without depending on anyone.
In fact, the World Health Organization asks a little more of people over 65 than of other adults: activities that combine balance and strength on 3 or more days a week, to improve their functional capacity and prevent falls 4.
The good news is that muscle responds at any age.
Strength exercises: how much and how hard
It has the strongest backing for slowing the loss and turning the trend around. The WHO recommends that all adults do muscle-strengthening activities on 2 or more days a week, at moderate or greater intensity and working all the major muscle groups 4.
How much, and how hard? A meta-analysis brought together 25 studies with 819 people averaging 70 years of age. Strength training clearly improved strength, and these were the parameters that worked best 3:
| Variable | Most effective in the studies |
|---|---|
| Frequency | 2 sessions a week |
| Intensity | 70-79% of your one-repetition maximum |
| Sets | 2-3 per exercise |
| Repetitions | 7-9 per set |
| Programme length | 50-53 weeks: longer programmes gave more |
Source: Borde et al., 2015, meta-analysis of 25 studies with 819 people averaging 70 years of age.
In practice:
- 2-3 strength sessions a week, working legs, back, chest and shoulders.
- A weight that feels challenging: sets of 7-9 repetitions in which the last few take real effort. Increase the load gradually.
- Balance, especially from 65 onwards: standing on one leg, side steps, getting up from a chair without using your hands.
- Consistency: programmes lasting around a year built more strength than short ones 3.
If you are starting from scratch, you will find a step-by-step plan in our guide to training after 40.
Protein from 65 onwards
How much protein a day, per kilo of body weight
Protein: how much a day and at each meal
Training is the signal; protein is the building material. The PROT-AGE expert group recommends the following for people over 65 5:
- At least 1.0-1.2 g per kilo of body weight a day to maintain or regain muscle and function.
- 1.2 g or more if you exercise or are active.
- 1.2-1.5 g if you have an acute or chronic illness.
- Exception: with severe kidney disease not on dialysis, it may need to be limited. Always follow your doctor's advice.
How much you have in one go also matters. In men of about 71, muscle protein synthesis peaked with 0.40 g of protein per kilo in one meal, compared with 0.24 g in men of about 22 6. For a 75 kg person, that is about 30 g per meal.
| Your weight | Per day (1.0-1.2 g/kg) | If you exercise (1.2 g/kg or more) | Per meal (0.40 g/kg) |
|---|---|---|---|
| 60 kg | 60-72 g | 72 g or more | 24 g |
| 70 kg | 70-84 g | 84 g or more | 28 g |
| 80 kg | 80-96 g | 96 g or more | 32 g |
| 90 kg | 90-108 g | 108 g or more | 36 g |
Sources: PROT-AGE group, 2013 (daily total) and Moore et al., 2015 (each meal). If you have kidney disease, follow your doctor's advice.
What about leucine? The International Society of Sports Nutrition recommends that each serving of good-quality protein provides 700-3,000 mg of this essential amino acid, with servings spread every 3-4 hours 7. In practice: 3-4 meals a day, each with a good portion of protein.
If you find it hard to get enough from food, a shake helps. “Protein contributes to the maintenance of muscle mass.” “Protein contributes to a growth in muscle mass.” 9 A varied and balanced diet and a healthy lifestyle are important. We summarise the studies in protein in older adults.
Creatine from 55 onwards
The conditions of its authorised claim
Creatine alongside your training, from 55
If you are over 55 and do strength training regularly, creatine has a specific authorised claim in the EU 8:
Daily creatine consumption can enhance the effect of resistance training on muscle strength in adults over the age of 55.
Its conditions: 3 g of creatine a day, together with resistance training that lets you increase the load over time, at least three times a week for several weeks and at an intensity of at least 65-75% of your one-repetition maximum 8. Creatine adds to training; it does not replace it. You will find the studies in creatine in older adults.
Vitamin D, magnesium and omega-3
Three nutrients that are also linked to muscle:
- Vitamin D. It has this authorised claim in the EU: “Vitamin D contributes to the maintenance of normal muscle function.” 9 If you are worried you are not getting enough, ask your doctor to check your levels. We explain it in vitamin D and muscle.
- Magnesium. Magnesium contributes to normal muscle function 9.
- Omega-3. This is an active line of research. A meta-analysis of 10 trials with 552 people aged 60 or over found a small increase in muscle mass, clearer with more than 2 g a day. Time on the test of standing up, walking and sitting back down also improved, but grip strength did not 10. You will find the detail in omega-3 and muscle.
Why start earlier
Sarcopenia builds up over a lifetime and can appear before old age 1. Every year of training adds to your reserves for later, and at 70 muscle still responds 3.
Strength does not only protect you from falls: it is also linked to living longer. We explain it in longevity and strength. And if you want to see everything that helps you look after your muscle, we have brought it together in Strength & Muscle.
Safety
- Kidney disease: before increasing your protein or taking creatine, check with your doctor 5.
- Medication or pregnancy: if you take medication regularly or are pregnant, check with your doctor before adding a supplement.
- Omega-3: if you are pregnant or breastfeeding, choose the product and the dose with your doctor or midwife.
Frequently asked questions
What is sarcopenia?
It is a progressive and generalised muscle disorder, which the European consensus considers a disease. Its main sign is low strength, and the diagnosis is confirmed by measuring the quantity or quality of muscle.
At what age do you start losing muscle mass?
There is no fixed age: according to the studies, the loss begins between the ages of 27 and 60. On average, men lose 4.7% of their peak muscle mass per decade and women 3.7%.
Which exercise works best to slow down muscle loss?
Strength training. In a meta-analysis of 25 studies with people averaging 70 years of age, the most effective approach was training 2 days a week, with 2-3 sets of 7-9 repetitions at 70-79% of their maximum.
How much protein does an older person need a day?
The PROT-AGE expert group recommends at least 1.0-1.2 g per kilo of body weight a day for people over 65, and 1.2 g or more for those who exercise. If you have kidney disease, check with your doctor.
Is creatine good for people over 55?
The EU authorises this claim: “Daily creatine consumption can enhance the effect of resistance training on muscle strength in adults over the age of 55.” The effect is obtained with 3 g a day and strength training at least three times a week.
Sources
- Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. View publication
- Mitchell WK, Williams J, Atherton P, Larvin M, Lund J, Narici M. Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength; a quantitative review. Front Physiol. 2012;3:260. View publication
- Borde R, Hortobágyi T, Granacher U. Dose-response relationships of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med. 2015;45(12):1693-1720. View publication
- Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. View publication
- Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542-559. View publication
- Moore DR, Churchward-Venne TA, Witard O, et al. Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intakes in healthy older versus younger men. J Gerontol A Biol Sci Med Sci. 2015;70(1):57-62. View publication
- Jäger R, Kerksick CM, Campbell BI, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2017;14:20. View publication
- Commission Implementing Regulation (EU) 2017/672 of 7 April 2017 authorising a health claim relating to creatine. View publication
- Commission Regulation (EU) No 432/2012 establishing a list of permitted health claims made on foods. View publication
- Huang YH, Chiu WC, Hsu YP, Lo YL, Wang YH. Effects of omega-3 fatty acids on muscle mass, muscle strength and muscle performance among the elderly: a meta-analysis. Nutrients. 2020;12(12):3739. View publication
Information based on published studies. It does not replace the advice of a doctor or registered dietitian. The results describe what was measured in each study, not the properties of any specific product.
