A claim you hear on longevity podcasts

Can exercise prevent muscle loss with age?

The claim checked: Exercise helps protect against the muscle and strength you lose with age Hear it at 1:51

What do the studies say?

Strong consensus for

All ten studies found that exercise, resistance training most of all, built or kept muscle, strength or everyday function in older adults. That held for people with sarcopenia (age-related muscle loss) and for frail adults aged 85 or older.

Computed from 10 studies that test this point, each judged by two readers, in full. 10 more studies are waiting for a full read and do not count yet.

What was said on the podcast?

“exercise can help protect against age related loss of muscle mass, strength and function.”
Mark Hyman, The Dr. Hyman Show · 5 Things You Think Are Extending Your Life (That Are Actually Doing Nothing) · 1:51 on YouTube
Episode check Fasting can cost you muscle, the episode says. In six of ten studies, it didn't. 5 claims checked against 79 studies · 1 chapter not checked yet See the whole episode →
Point 1 of 2 Strong consensus for

In older adults, exercise, especially resistance training, helps protect against age-related loss of muscle mass, strength and function

Agree 10

other primary study · 2018 · landmark

“Recommendation 3: Physical Activity (Resistance-Based Training) In patients with sarcopenia, prescription of resistancebased training can be effective to improve muscle strength, skeletal muscle mass and physical function.”

International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management. J Nutr Health Aging
Who: Older adults with sarcopenia (clinical practice guideline; evidence from background meta-analyses of RCTs in older adults with sarcopenia and frailty)
PMID 30498820

pooled analysis · 2009 · landmark

“This review provides evidence that PRT is an effective intervention for improving physical functioning in older people, including improving strength and the performance of some simple and complex activities.”

Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev
Who: Older people (aged 60 years and older) in randomised controlled trials of progressive resistance training, healthy and with a range of health conditions
PMID 19588334

controlled trial · 2017 · landmark

“Lean mass decreased less in the combination group (56.5 kg to 54.8 kg; a change of −1.7±0.3 kg [3% decrease]) and in the resistance group (58.1 to 57.1 kg; a change of −1.0±0.3 kg [2% decrease]) than in the aerobic group (55.0 to 52.3 kg; a change of −2.7±0.3 kg [5% decrease]) (Table 2 and Fig. 2D).”

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults. N Engl J Med
Who: Obese (BMI 30 or more), sedentary adults aged 65 years or older with mild-to-moderate frailty, mean age 70, mostly women and white, New Mexico, USA
PMID 28514618

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pooled analysis · 2015 · landmark

“This systematic literature review and meta-analysis confirmed the effectiveness of RT on specific measures of upper and lower extremity muscle strength and muscle morphology in healthy old adults.”

Dose-Response Relationships of Resistance Training in Healthy Old Adults: A Systematic Review and Meta-Analysis. Sports Med
Who: Healthy adults aged 60-90 (study mean age 65 or older; mean 70.4 years) in RCTs of machine-based resistance training versus non-active controls
PMID 26420238

systematic review · 2017 · landmark

“In conclusion, physical exercise has a beneficial impact on muscle mass, muscle strength, or physical performance in healthy subjects aged 60 years and older.”

Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporos Int
Who: Systematic review of RCTs in men and women aged 60 and older (mostly healthy community-dwelling; some frail, nursing home or mobility-limited), comparing exercise alone with exercise plus a nutritional supplement
PMID 28251287

systematic review · 2023 · landmark

“Moderate certainty evidence showed that adding balance training to resistance exercise was the most effective intervention for improving physical function measures.”

Exercise for sarcopenia in older people: A systematic review and network meta-analysis. J Cachexia Sarcopenia Muscle
Who: Older adults (age ≥60 years, median 72.9) with sarcopenia in randomized controlled trials of exercise vs nutrition, placebo or usual care
PMID 37057640

controlled trial · 2014 · landmark

“In summary, the multicomponent exercise intervention used in the present study resulted in improvements in strength and power performance, muscle hypertrophy, intramuscular fat infiltration, and functional outcomes (i.e., TUG, rise from a chair, balance, and dual-task performance) and reduced the incidence of falls in institutionalized frail nonagenarians.”

Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age (Dordr)
Who: Institutionalized frail men and women aged 85 years or older (mean 91.9 ± 4.1 years) meeting Fried frailty criteria, Pamplona, Spain
PMID 24030238

pooled analysis · 2019 · landmark

“There is high quality evidence for a positive and significant effect of resistance training on muscle mass (five studies of which four meta-analyses ( 20 , 21 , 27 , 28 , 29 )), muscle strength (seven studies of which five meta-analyses ( 19 , 20 , 21 , 24 , 26 , 28 , 29 )) and physical performance (three studies of which one meta-analysis ( 25 , 28 , 29 )).”

Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review. J Nutr Health Aging
Who: Umbrella review of systematic reviews and meta-analyses of exercise interventions in older adults (healthy and frail; disease-specific populations excluded)
PMID 31233069

controlled trial · 2019 · landmark

“The main finding of this intervention study is that an easy-to-use, functional resistance training program was effective in maintaining functional strength and increasing muscle mass in older adults with pre-sarcopenia.”

Effects of Resistance Training on Functional Strength and Muscle Mass in 70-Year-Old Individuals With Pre-sarcopenia: A Randomized Controlled Trial. J Am Med Dir Assoc
Who: Men and women aged 70 years with pre-sarcopenia (low appendicular lean mass index by EWGSOP criteria) from the Healthy Ageing Initiative, Umeå, Sweden
PMID 30414822

controlled trial · 2025 · landmark

“This study found that after 12 weeks of exercise intervention, KES was significantly higher in both groups compared to before intervention.”

Effects of 12-week whole-body vibration training versus resistance training in older people with sarcopenia. Sci Rep
Who: 27 physically inactive older people aged >= 65 years with sarcopenia (AWGS-2019 criteria), Sanxing Town, Chongming District, Shanghai, China; mean age 73.6 years, 13 men and 14 women
PMID 40011687

Partly agree 0

None.

Disagree 0

None.

Point 2 of 2 Leaning for

In older adults, low muscle strength or mass is linked to worse mobility, balance and loss of independence

Four studies linked low strength or muscle loss to more falls, mobility problems or disability. Six found mixed results: weak grip often predicted trouble, but low muscle mass on its own often did not.

Computed from 10 studies that test this point, each judged by two readers, in full. 10 more studies are waiting for a full read and do not count yet.

Agree 4

pooled analysis · 2017 · landmark

“The pooled results indicated a higher risk of functional disability for sarcopenic subjects compared with non-sarcopenic ones (pooled OR 3.03 (95% CI 1.80–5.12)).”

Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis. PLoS One
Who: Adults aged 60 years or older (community-dwelling, hospitalized and nursing home residents) in prospective cohorts with sarcopenia defined by EWGSOP (low muscle mass plus low strength or low physical performance)
PMID 28095426

trial or observed group · 2020 · landmark

“We found that low grip strength (either the absolute value or the ratio of grip strength to body size or composition) was associated with incident outcomes of falls, mobility limitation, hip fracture, and mortality in both men and women.”

Putative Cut-Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis. J Am Geriatr Soc
Who: Community-dwelling men and women aged 65 and older in eight prospective cohort studies (largely white, US) with DXA, grip strength and walking speed data
PMID 32633824

other primary study · 2020

“Candidate definitions based on grip strength variables were associated with increased risk of mortality, falls, mobility disability, and instrumental activities of daily living disability.”

Establishing the Link Between Lean Mass and Grip Strength Cut Points With Mobility Disability and Other Health Outcomes: Proceedings of the Sarcopenia Definition and Outcomes Consortium Conference. J Gerontol A Biol Sci Med Sci
Who: Older adults from eight epidemiological cohorts (mean age 75, mostly community-dwelling, aged 65+), plus 10 clinical populations and 2 nationally representative US cohorts
PMID 30869772

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systematic review · 2021

“It found evidence of cross-sectional associations between of handgrip and motor outcomes measuring mobility, balance and ADL ability.”

The clinical usefulness of muscle mass and strength measures in older people: a systematic review. Age Ageing
Who: Systematic review of older patients (aged 65+ or mean 70+) in clinical settings: inpatient wards, geriatric outpatients, rehabilitation, care homes and hip fracture patients
PMID 32706848

Partly agree 6

other primary study · 2020 · landmark

“Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size.”

Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc
Who: Community-dwelling older adults from eight observational cohorts, plus clinical populations (randomized trials, hip fracture and HIV cohorts) and two nationally representative surveys (HRS, NHATS)
PMID 32150289

other primary study · 2015

“Those with sarcopenia as defined by the IWGS reported significantly higher falls in the last year and prevalent fractures (falls in the last year: OR 2.51 CI 1.09, 5.81 p=0.03; fractures OR 2.50 CI 1.05, 5.92 p=0.04) but these significant associations were not seen when the EWGSOP definition was applied.”

Definitions of Sarcopenia: Associations with Previous Falls and Fracture in a Population Sample. Calcif Tissue Int
Who: Community-dwelling men and women aged ~70-82 (mean age 76) from the Hertfordshire Cohort Study, UK
PMID 26223791

other primary study · 2014

“On the other hand, sarcopenia and dynapenia were not associated with the transition from independence to more complex levels of disability (IADL and ADL).”

Sarcopenia according to the european working group on sarcopenia in older people (EWGSOP) versus Dynapenia as a risk factor for disability in the elderly. J Nutr Health Aging
Who: Community-dwelling adults aged 60 and older in Sao Paulo, Brazil (SABE Study) with no mobility, ADL or IADL disability in 2006
PMID 24886743

Show 3 more Show fewer

trial or observed group · 2018

“Sarcopenia was associated with having lower mobility at one year and a greater risk of becoming a resident of a nursing home or death.”

Does sarcopenia predict change in mobility after hip fracture? a multicenter observational study with one-year follow-up. BMC Geriatr
Who: Community-dwelling, previously ambulatory patients aged 65 and older hospitalized for hip fracture at three Norwegian hospitals, 2011-2013 (mean age 79.4, 76% female)
PMID 29506481

other primary study · 2018

“In model 2 the same risk factors were found. However, dynapenia was not associated with disability.”

Dynapenia and Sarcopenia as a Risk Factor for Disability in a Falls and Fractures Clinic in Older Persons. Open Access Maced J Med Sci
Who: Adults aged 60 and older (mean 74, 75% women) attending a falls, dizziness and fractures clinic in Manizales, Colombia
PMID 29531601

other primary study · 2015

“In line with those findings our results illustrate that ASM/h 2 was neither associated with self-reported falls nor with impairment in the activities of daily living indicating that muscle power output might be more relevant for functional ability in older adults than muscle mass alone.”

Mechanography performance tests and their association with sarcopenia, falls and impairment in the activities of daily living - a pilot cross-sectional study in 293 older adults. J Musculoskelet Neuronal Interact
Who: Community-dwelling men and women aged 60-85 years randomly sampled from Berlin, Germany, able to walk without a walking aid (cross-sectional)
PMID 26350943

Disagree 0

None.

What else was said but not tested?

  • Muscle is the key organ of longevity

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