The Vital Sign Doctors Ignore (But Shouldn’t)

When you visit the doctor's office, the first thing your healthcare provider does is check your vital signs to get an overall picture of your health. Vital signs such as blood pressure, body temperature, heart rate, and weight provide immediate early warning of potential health conditions and risk levels.

However, one of the strongest predictors of reduced quality of life, poorer health outcomes, and increased risk of illness and premature death often goes unchecked: low muscle mass.

Fortunately, scientists have long advocated adding muscle mass to the list of basic vital signs. In this article, we'll look at the work of one group of researchers, the risks they identified, and the interventions they found effective for preventing and reversing low muscle mass.

Analyzing Low Muscle Mass And Health Outcomes

A review in the Annals of Medicine examined 140 studies on the effects of low muscle mass across inpatient, outpatient, and long-term care settings. The authors concluded that muscle mass was a significant predictor of adverse health outcomes, including mortality.

The included studies analyzed data from participants facing different medical conditions.

Among patients with breast cancer, those with the greatest muscle mass were 60 percent more likely to survive the disease than those with the least muscle.

In one hospital's intensive care unit, patients with greater muscle strength had higher survival rates, spent less time on ventilators, and were discharged sooner than those with lower muscle strength.

Patients undergoing surgery were more likely to experience intra- and postoperative complications if they had low muscle mass.

Other studies linked lower muscle mass to greater Alzheimer's disease severity in affected patients.

When low muscle mass is age-related, it is commonly called sarcopenia. This age-related muscle loss is associated with osteoporosis. With less muscle mass to exert force on bone, mechanoreceptive cells in bone tissue receive fewer signals to trigger new bone formation.

Synopsis

An analysis of 140 studies linked low muscle mass to worse outcomes across a variety of health conditions. Sarcopenia, which is age-related muscle loss, is closely linked to osteoporosis.

Potential Measures Of Muscle Mass

For doctors to adopt muscle mass as a vital sign, they will need a standardized, practical way to measure it.

BMI is widely used to assess body composition; however, there is a growing consensus that it is often ineffective and often misleading. It doesn't take into account how much of a person's weight is fat versus muscle. As a result, BMI can appear “healthy” even when muscle mass is unhealthily low.
The researchers discussed several alternatives.

CT scan images are widely used to assess muscle mass. The cross-sectional area of muscle at the third lumbar vertebra (L3) correlates strongly with whole-body muscle mass. However, accuracy may be limited in certain clinical conditions, and CT involves substantial radiation exposure.

Ultrasound has also been adopted to assess individual muscle groups; advocates note its handheld ease of use; however, standardized protocols for accurate assessment have not yet been established.

Simple physical tests of strength and muscle function, such as grip strength testing, are also viable options.

Some healthcare practitioners use the SARC-F questionnaire to screen for sarcopenia in older patients. It asks about f five tasks: lifting and carrying a ten pound weight (strength), walking across a room (assistance in walking), rising from a chair, climbing a flight of ten stairs, and a history of falls in the past year. By scoring each answer, the practitioner can quickly determine whether further assessment of strength and muscle mass is warranted.

Regardless of the tool, making muscle mass checks routine will require educating clinicians about the importance of muscle loss and implementing standardized screening and intervention protocols.

Synopsis

Several tools could support routine muscle-mass checks—CT, ultrasound, grip-strength testing, and the SARC-F questionnaire. Regardless of the tool, clinicians will need education on the importance of muscle mass alongside routine screening methods and interventions.

Interventions To Prevent And Reverse Low Muscle Mass

The researchers emphasized the need to counteract losses in muscle mass, strength, and physical function. They summarized interventions tested across the included studies.

Possible dietary interventions may include supplementation with protein or amino acid formulations, creatine, micronutrients, and other specialized compounds.

However, the principal intervention for building muscle is exercise. The exercise interventions typically involved strength or aerobic activity in a supervised or home-based setting.

The researchers stated that a recent systematic review concluded that exercise improves muscle mass, strength, and physical performance in adults 60 years and older. Nutrition played a role in a small proportion of those studies, but exercise was the consistent winner.

These findings demonstrate that it's critically important to build muscle mass, and that you're never too old to do so.

Exercise is also beneficial for building bone because, as per Wolff’s Law, the force your muscles exert on your bones triggers the production of strong, new bone tissue. As your muscle mass grows, so will your bone strength– increasing bone quality and density and reducing your risk of both falls and fractures.

Synopsis

The researchers noted that some studies utilized nutritional supplementation to support muscle growth, but exercise was the key driver of muscle gain. Even in participants 60 and older, exercise improved muscle mass, strength, and physical performance. The same exercise that builds muscle also builds bone.

What This Means To You

Unfortunately, medical professionals have not universally adopted muscle mass as a vital sign to be checked at every doctor's visit. Talk to your doctor about this and start a regular exercise routine to build muscle.

The Save Institute created SaveTrainer for this purpose. Savers need bone-targeted exercise routines that help prevent and reverse osteoporosis. SaveTrainer’s workouts help you reach that goal by building muscle.

Our professional trainers lead workout videos tailored to every ability level, so no matter where you're starting from, there is a comfortable and achievable workout ready for you. The wide variety of exercise formats ensures you'll find the program you need, at the level you need, available anyplace and anytime.

Exercise is foundational to building muscle and bone, staying healthy, and living the active, independent life you deserve.

References

¹ https://www.tandfonline.com/doi/full/10.1080/07853890.2018.1511918#infos-holder