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episode #269

Systematic Review: Which Intervention Will Help Improve Muscle Mass?

July 17, 2023 in Podcast


This week I discuss a systematic review and meta analysis looking at 10 pharmacological interventions to help with sarcopenia (muscle loss) as we age.

The 10 interventions were: Vitamin D, combined estrogen-progesterone, dehydroepiandrosterone, growth hormone, growth hormone-releasing hormone, combined testosterone-growth hormone, insulin-like growth factor-1, pioglitazone, testosterone and angiotensin-converting enzyme inhibitors.

The two winners were: Vitamin D had a significant effect on muscle strength and physical performance, especially in women with low baseline values (< 25 nmol/l). Testosterone had a strong effect on muscle mass and a modest to minimal effect on muscle strength and physical performance, respectively, when supplementing men with low serum levels (< 200-300 ng/dl). 

So to conclude: Vitamin D, especially in older women, and testosterone in older men with clinical muscle weakness and low testosterone serum levels can be justified in daily clinical practice to improve muscle mass, muscle strength and/or physical performance.

Make sure to get your levels checked and make sure you are in optimal range:

- Optimal values for Vitamin D are between 50 and 70 ng/mL.
- Sufficient Values for Testosterone are between 300 - 1000 ng/dL

Brian (1s):

Hello and welcome to the GETLEAN and Eat Clean podcast. My name is Brian Gryn. I'm a certified health coach, trainer and author, and this podcast is for middle aged men and women looking to optimize their health and get their bodies back to what it once was 10 to 15 years ago. I will give you simple, actionable items to get long term sustainable results. Thanks for listening and enjoy the show. All, right Welcome to the Get Lean Eat Clean podcast. My name is Brian Gryn. I hope you had a great weekend and happy Tuesday if you're listening to this on Tuesday. Hopefully you listen to my interview with Brian St Pierre.

Brian (43s):

He's the director of performance and nutrition at Precision Nutrition, and we touched all about his deep health framework, his things that he's learned from working with professional athletes like Sloan Stevens and the San Antonio Spurs and Cleveland Browns. So lots of great info to unpack there and hopefully you'll listen to that. He's got some great principles around just, you know, general health and, and sleep, stress recovery, things like that. So if you haven't already, definitely listened to my interview with Brian St. Pierre, episode 2 68. And so on today's micro podcast, I actually wanted to bring up a, a paper on, I know how much you like studies.

Brian (1m 27s):

This one's a Systematic Review of meta-analysis on Pharmacological Interventions to Improve muscle mass, Muscle Strength, and Physical Performance in Older People. So I thought it was fairly relevant. I'm gonna share the screen real quick so you can just see this paper if you're watching on YouTube and you wanna read more, I'm just gonna give you sort of the high level, not gonna go through the depth of it, but we're gonna talk about what pharmacological interventions they did and which ones sort of proved best when it comes to building muscle mass and strength as we, as we age.

Brian (2m 8s):

So this, I found this really interesting and something that I think we can all maybe look at and apply to our lives. I'm gonna read the abstract and the background talked about sarcopenia and sarcopenia. If we, and we've talked about this on my podcast before, is a pathological De decline in muscle mass, muscle strength, and physical performance. And it comes with Aging, they, the Belgian Society of Gerontology and Geriatrics is currently developing evidence-based Guidelines for the prevention and the therapy of sarcopenia for use in broad clinical practice.

Brian (2m 50s):

And so that's sort of brought on this Systematic Review, which summarizes the results of the working group on pharmac pharmacological pharmacology, excuse me. So the objective was to provide an evidence-based overview of the possible pharma pharmacological interventions for sarcopenia with a focus on interventions that have already been studied in Systematic Reviews or meta-analysis. So pretty much what what this, what this review did was it looked at these interventions on subjects aged greater than 65 and study selection, quality assessment and data extraction were performed by two independent reviewers.

Brian (3m 34s):

They looked at 10 pharmacological interventions, Vitamin D combined estrogen, progesterone growth hormone combined testosterone and growth hormone insulin like growth factor one, so on and so forth. So, they looked at these 10 pharmacological interventions and they said, well, which ones had the most impact? And this was obviously based on individuals that are greater than 65 years old, but I think could really apply for people, probably perhaps at any age and definitely 40 years and older. So the recommendations were looking at, you know, what was most effective and healthy pre sarcopenic or sarcopenic older people and Vitamin D came out on top, Vitamin D and testosterone Vitamin D had a significant effect on Muscle strength, physical performance, especially in women with low baseline valleys adv.

Brian (4m 38s):

Adverse adverse events were rare. And then testosterone had a strong effect on muscle mass and modest to minimal effect on muscle strength and physical performance with men, with men's supplementing them with low serum testosterone levels, less than 200 to 300 nanograms per deme. So the conclusion of this paper and this meta-analysis was that only Vitamin D, especially in older women and testosterone in older men with clinical Muscle Muscle weakness and low testosterone ster levels can be justified in a daily clinical practice to improve muscle mass, muscle strength and or physical performance.

Brian (5m 22s):

So it just shows to, you know, everyone talks about Vitamin b Vitamin D as like this sunshine Vitamin, right? It's actually ahor, it's actually technically a hormone I believe. But either way, it's something to keep in mind, especially because if you're not getting your Vitamin D levels checked, maybe you should be. And way best ways to get Vitamin D spend time in the sun doesn't need to be all day 15 to 20 minutes of direct sunlight every day can definitely help. And I would do this with obviously without putting any sunscreen on, I'm not a huge sunscreen advocate. Obviously if you're gonna be out there for a while, you don't wanna burn. And so if that's a way for you not to burn use, you know, you, you can use a quality sunscreen, but spending time in the sun is a big one.

Brian (6m 11s):

You can eat some Vitamin, D rich foods. It's a little more difficult to get from food, but things like wild salmon or tuna or eggs, even mushrooms or some type of fortified milk has some Vitamin D in it. Who's to say how much you absorb from that? I know with the sun, you know, just getting it on your faces, you know, you wanna get it on sort of the, the bigger organs like your back or your chest. And then three would be considering maybe some type of supplement. I can put a link in the show notes for a Vitamin D supplement that I think is really quality. But either way you might, this might have to be something you add in. I think first and foremost you should get your levels checked and, and that goes for Vitamin, D and testosterone.

Brian (6m 59s):

I'm not gonna get into testosterone today, but maybe that'll be something I'll do for some of the micro Podcasts is talking about, you know, the effects And, you know, positive or negative effects of, you know, getting this something, you know, testosterone replacement therapy, which I know is becoming more and more popular. So I would say that from this paper, it's definitely worth looking into your Vitamin D levels, your testosterone levels, and making sure those are in line, not just with the general population, but for optimization. There's a big difference there. So that's all I wanted to touch on today, and if you have any questions, feel free to email me, Brian Gryn I dot com.

Brian (7m 44s):

And yeah, if you haven't already, love, check out my book, the Stepladder System. You can get it on Amazon now, so you can get it in paperback. You can also go to this Stepladder system.com and get the ebook as well from there. So that's all I wanna touch on today. I hope you have a great week and look out for another great interview coming up on Friday. Thanks so much. Thanks for listening to the GETLEAN E Clean podcast. I understand there are millions of other Podcasts out there and you've chosen to listen to mine and I appreciate that. Check out the show notes at Brian Gryn dot com for everything that was mentioned in this episode.

Brian (8m 24s):

Feel free to subscribe to the podcast and share it with a friend or family member who's looking to get their body back to what it once was. Thanks again, and Have a great day.

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