Do Omega-3s Prevent Age-Related Muscle Loss?

Written by Dr. Steve Chaney on . Posted in Exercise, Supplements and Health

Does Fish Oil Build Muscle?

Author: Dr. Stephen Chaney

 

omega-3Omega-3-rich fish oil supplements have attracted their share of controversy in recent years, but there appear to be lots of reasons to make sure that you get enough omega-3s from your diet.

There is actually pretty good evidence that omega-3s offer a natural approach for people who wish to lower their blood pressure (https://healthtipsfromtheprofessor.com/do-omega-3s-lower-blood-pressure/) or heart attack risk (https://healthtipsfromtheprofessor.com/fish-oil-really-snake-oil/). There is also some evidence that omega-3s may be important for brain development in infants (J Protzko et al, Perspectives on Psychological Science, 8: 25-40, 2013), for mental performance in children (https://healthtipsfromtheprofessor.com/omega-3s-improve-reading-skills/) and for preventing cognitive decline in the elderly (https://healthtipsfromtheprofessor.com/omega-3s-slow-cognitive-decline/).

If the latest headlines are to be believed, we can add preventing age-related muscle loss to the benefits of an omega-3-rich diet.

Why Is Age-Related Loss of Muscle Mass a Problem?

The term for age-related muscle loss is sarcopenia, and it is a big problem for older adults. After age 50 we lose 1-2% of our muscle mass each year. As you might expect, our strength declines as well. Each 1% loss of muscle mass translates into about 1.5% loss in strength. That means after age 50 we lose 1.5% of our muscle strength each year, and once we hit 60 the rate of loss increases to around 3% per year.

That may not sound like much on an annual basis, but it adds up over time. With a little bit of higher math you can calculate that you could easily have lost 45% of your muscle strength by the age of 70 and a whopping 75% by the age of 80. At that point even the simplest physical activities – lifting a grandchild or a bag of groceries – can become challenging. That loss of strength also contributes to a loss of balance that can lead to debilitating falls.

The most effective way of preventing age-related muscle loss is regular resistance training, especially when coupled with adequate intake of protein and leucine (https://healthtipsfromtheprofessor.com/protein-needs-for-older-adults/). However, resistance training is hard work, so many older adults gravitate to quick fixes like testosterone, growth hormone, or DHEA – even though each of those treatment regimens have significant side effects and risks.

That’s why the recent headlines suggesting that a risk-free approach like omega-3 supplementation might increase muscle mass and strength in older adults is so enticing.

Do Omega-3s Prevent Age-Related Muscle Loss?

A previous study had suggested that omega-3 supplementation enhanced the effect of strength training in elderly women (Rodacki et al, AJCN, 95: 428-436, 2012). Although the mechanism of that effect is unclear, the authors of this study decided to go one step further. They asked if omega-3 fatty acids might prevent loss of muscle mass even in the elderly in the absence of a structured exercise program (Smith et al, AJCN, doi: 10.3945/ajcn.114.105833, 2015).

age-related muscle lossThe study consisted of 44 men and women age 60-85 (average age 69) who were not exercising on a regular basis. They were given either 4 gm of fish oil (containing 1.86 gm of EPA and 1.5 gm of DHA) or a placebo containing corn oil each day for 6 months. Muscle mass and four measures of muscle strength were performed at the beginning of the study and again at 6 months. The measures used were thigh muscle volume (a measure of muscle mass), hand grip strength, overall muscle strength (the maximum weight that the subject could lift in a single repetition for leg press, chest press, knee extension, and knee flexion) and isokinetic power (the power attained in knee extension and flexion exercises). The results were pretty impressive for the omega-3 group compared with the control group:

  • Thigh muscle volume (muscle mass) increased by 3.6%
  • Handgrip strength increased by 6%.
  • Overall muscle strength increased by 4%.
  • Isokinetic power increased by 5.6%.
  • Other than complaints about fishy breath, there were no adverse effects in the omega-3 group.
  • The authors calculated that the increase in muscle mass and strength during 6 months of omega-3 supplementation was sufficient to offset 2-3 years of normal age-related muscle loss and strength loss.
  • The increase in muscle mass and strength associated with omega-3 supplementation was less than can be attained from regular resistance exercise coupled with adequate protein intake. However, it was the same or greater than could be obtained from testosterone, growth hormone or DHEA – and didn’t have the risks associated with those treatments.

For example, a recent study has concluded that testosterone injections are associated with a significant risk of stroke, acute coronary syndromes, hospitalization and death (Layton et al, JAMA Internal Medicine, doi: 10.1001/jamainternmed.2015.1573).

The authors concluded ”Fish oil-derived omega-3 therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults.”

Limitations of the Study

Before you all run out and stock up on fish oil supplements, I should point out that this study has several limitations.

  • It is a very small study. It needs to be replicated by future studies.
  • It used a very high dose of fish oil (4 gm/day). High doses are often used in an initial study like this one just to establish whether there is an effect worth further study. However, this study needs to be repeated at lower doses to see if this benefit of omega-3 supplementation is also seen at more physiological doses (500 – 1,000 mg) of omega-3s.

Because of these limitations, I am not yet ready to agree with the authors that omega-3 supplementation “…should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults.” This is an interesting finding that holds the promise of an inexpensive, risk-free, natural approach for maintaining muscle mass in older adults, but it needs to be verified by future studies before it can be widely recommended.

There are many reasons to supplement with omega-3s, but at this point in time I would definitely not recommend fish oil supplementation as an alternative to resistance exercise and adequate protein intake for older adults who wish to prevent age-related loss of muscle mass and strength.

However, the health risks of testosterone, growth hormone, and DHEA supplementation are significant. For someone who is absolutely set on pursuing an exercise-free solution to maintaining muscle mass and strength as they age, I would recommend omega-3 supplementation first rather one of the riskier alternatives.

 

The Bottom Line

  • A recent study has suggested that omega-3 supplementation may prevent age-related loss of muscle mass and strength. The study was performed in both men and women age 60-85 who were not exercising on a regular basis.
  • Omega-3 supplementation was less effective than regular resistance exercise coupled with adequate protein intake, but equal to or greater in effectiveness than testosterone, growth hormone, or DHEA treatment.
  • This was a very small study and it used a very high dose of omega-3s. It is a promising finding because it represents an inexpensive, risk-free, natural approach for maintaining muscle mass in older adults, but it needs to be verified by future studies before it can be widely recommended.
  • There are many good reasons to supplement with omega-3s, but at this point in time I would definitely not recommend fish oil supplementation as an alternative to resistance exercise and adequate protein intake for older adults who wish to prevent age-related loss of muscle mass and strength. Resistance training combined with adequate protein is a proven intervention. Omega-3 supplementation is not.
  • However, the health risks of testosterone, growth hormone, and DHEA supplementation are significant. For someone who is absolutely set on pursuing an exercise-free solution to maintaining muscle mass and strength as they age, I would recommend omega-3 supplementation first rather one of the riskier alternatives. It might just work, and it is a lot less risky.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (2)

  • Joanne Larson

    |

    You mentioned possible risks using dhea What are those risks?

    Reply

    • Dr. Steve Chaney

      |

      Dear Joanne,

      DHEA is an immediate precursor to both estrogen and testosterone, so the potential side effects are the same as for those hormones. I would be most concerned about cancer.

      Dr. Chaney

      Reply

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Latest Article

Does Magnesium Optimize Vitamin D Levels?

Posted February 12, 2019 by Dr. Steve Chaney

The Case For Holistic Supplementation

Author: Dr. Stephen Chaney

 

Does magnesium optimize vitamin D levels?

magnesium optimize vitamin dOne of the great mysteries about vitamin D is the lack of correlation between vitamin D intake and blood levels of its active metabolite, 25-hydroxyvitamin D. Many people who consume RDA levels of vitamin D from foods and/or supplements end up with low blood levels of 25-hydroxyvitamin D. The reason(s) for this discrepancy between intake of vitamin D and blood levels of its active metabolite are not currently understood.

Another great mystery is why it has been so difficult to demonstrate benefits of vitamin D supplementation. Association studies show a strong correlation between optimal 25-hydroxyvitamin D levels and reduced risk of heart disease, cancer, and other diseases. However, placebo-controlled clinical trials of vitamin D supplementation have often come up empty. Until recently, many of those studies did not measure 25-hydroxyvitamin D levels. Could it be that optimal levels of 25-hydroxyvitamin D were not achieved?

The authors of the current study hypothesized that optimal magnesium status might be required for vitamin D conversion to its active form. You are probably wondering why magnesium would influence vitamin D metabolism. I had the same question.

The authors pointed out that:

  • Magnesium status affects the activities of enzymes involved in both the synthesis and degradation of 25-hydroxyvitamin D.
  • Some clinical studies have suggested that magnesium intake interacts with vitamin D intake in affecting health outcomes.
  • If the author’s hypothesis is correct, it is a concern because magnesium deficiency is prevalent in this country. In their “Fact Sheet For Health Professionals,” the NIH states that “…a majority of Americans of all ages ingest less magnesium from food than their respective EARs [Estimated Average Requirement]; adult men aged 71 years and older and adolescent females are most likely to have low intakes.” Other sources have indicated that magnesium deficiency may approach 70-80% for adults over 70.

If the author’s hypothesis that magnesium is required for vitamin D activation is correct and most Americans are deficient in magnesium, this raises some troubling questions.

  • Most vitamin D supplements do not contain magnesium. If people aren’t getting supplemental magnesium from another source, they may not be optimally utilizing the vitamin D in the supplements.
  • Most clinical studies involving vitamin D do not also include magnesium. If most of the study participants are deficient in magnesium, it might explain why it has been so difficult to show benefits from vitamin D supplementation.

Thus the authors devised a study (Q Dai et al, American Journal of Clinical Nutrition, 108: 1249-1258, 2018 ) to directly test their hypothesis.

 

How Was The Study Designed?

magnesium optimize vitamin d studyThe authors recruited 180 volunteers, aged 40-85, from an ongoing study on the prevention of colon cancer being conducted at Vanderbilt University. The duration of the study was 12 weeks. Blood was drawn at the beginning of the study to measure baseline 25-hydroxyvitamin D levels. Three additional blood draws to determine 25-hydroxyvitamin D levels were performed at weeks 1, 6, and 12.

Because high blood calcium levels increase excretion of magnesium, the authors individualized magnesium intake based on “optimizing” the calcium to magnesium ratio in the diet rather than giving everyone the same amount of magnesium. The dietary calcium to magnesium ratio for most Americans is 2.6 to 1 or higher. Based on their previous work, they considered an “ideal” calcium to magnesium ratio to be 2.3 to 1. The mean daily dose of magnesium supplementation in this study was 205 mg, with a range from 77 to 390 mg to achieve the “ideal” calcium to magnesium ratio. The placebo was an identical gel capsule containing microcrystalline cellulose.

Two 24-hour dietary recalls were conducted at baseline to determine baseline dietary intake of calcium and magnesium. Four additional 24-hour dietary recalls were performed during the 12-week study to assure that calcium intake was unchanged and the calcium to magnesium ratio of 2.3 to 1 was achieved.

In short this was a small study, but it was very well designed to test the author’s hypothesis.

 

Does Magnesium Optimize Vitamin D Levels?

 

does magnesium optimize vitamin d levelsThis was a very complex study, so I am simplifying it for this discussion. For full details, I refer you to the journal article (Q Dai et al, American Journal of Clinical Nutrition, 108: 1249-1258, 2018).

The most significant finding was that magnesium supplementation did affect blood levels of 25-hydroxyvitamin D. However, the effect of magnesium supplementation varied depending on the baseline 25-hydroxyvitamin D level at the beginning of the study.

  • When the baseline 25-hydroxyvitamin D was 20 ng/ml or less (which the NIH considers inadequate), magnesium supplementation had no effect on 25-hydroxyvitamin D levels.
  • When the baseline 25-hydroxyvitamin D was 20-30 ng/ml (which the NIH considers the lower end of the adequate range), magnesium supplementation increased 25-hydroxyvitamin D levels.
  • When the baseline 25-hydroxyvitamin D level approached 50 ng/ml (which the NIH says may be “associated with adverse effects”), magnesium supplementation lowered 25-hydroxyvitamin D levels.

The simplest interpretation of these results is:

  • When vitamin D intake is inadequate, magnesium cannot magically create 25-hydroxyvitamin D from thin air.
  • When vitamin D intake is adequate, magnesium can enhance the conversion of vitamin D to 25-hydroxyvitamin D.
  • When vitamin D intake is too high, magnesium can help protect you by lowering 25-hydroxyvitamin D levels.

The authors concluded: “Our findings suggest that optimal magnesium status may be important for optimizing 25-hydroxyvitamin D status. Further dosing studies are warranted…”

 

What Does This Study Mean For You?

magnesium optimize vitamin d for youThis was a groundbreaking study that has provided novel and interesting results.

  • It provides the first evidence that optimal magnesium status may be required for optimizing the conversion of vitamin D to 25-hydroxyvitamin D.
  • It suggests that optimal magnesium status can help normalize 25-hydroxyvitamin D levels by increasing low levels and decreasing high levels.

However, this was a small study and, like any groundbreaking study, has significant limitations. For a complete discussion of the limitations and strengths of this study I refer you to the editorial (S Lin and Q Liu, American Journal of Clinical Nutrition, 108: 1159-1161, 2018) that accompanied the study.

In summary, this study needs to be replicated by larger clinical studies with a more diverse study population. In order to provide meaningful results, those studies would need to carefully control and monitor calcium, magnesium, and vitamin D intake. There is also a need for mechanistic studies to better understand how magnesium can both increase low 25-hydroxyvitamin D levels and decrease high 25-hydroxyvitamin D levels.

However, assuming the conclusions of this study to be true, it has some interesting implications:

  • If you are taking a vitamin D supplement, you should probably make sure that you are also getting the DV (400 mg) of magnesium from diet plus supplementation.
  • If you are taking a calcium supplement, you should check that it also provides a significant amount of magnesium. If not, change supplements or make sure that you get the DV for magnesium elsewhere.
  • I am suggesting that you shoot for the DV (400 mg) of magnesium rather than reading every label and calculating the calcium to magnesium ratio. The “ideal” ratio of 2.3 to 1 is hypothetical at this point. A supplement providing the DV of both calcium and magnesium would have a calcium to magnesium ratio of 2.5, and I would not fault any manufacturer for providing you with the DV of both nutrients.
  • If you are taking high amounts of calcium, I would recommend a supplement that has a calcium to magnesium ratio of 2.5 or less.
  • If you are considering a magnesium supplement to optimize your magnesium status, you should be aware that magnesium can cause gas, bloating, and diarrhea. I would recommend a sustained release magnesium supplement.
  • Finally, whole grains and legumes are among your best dietary sources of magnesium. Forget those diets that tell you to eliminate whole food groups. They are likely to leave you magnesium-deficient.

Even if the conclusions of this study are not confirmed by subsequent studies, we need to remember that magnesium is an essential nutrient with many health benefits and that most Americans do not get enough magnesium in their diet. The recommendations I have made for optimizing magnesium status are common-sense recommendations that apply to all of us.

 

The Case For Holistic Supplementation

 

magnesium optimize vitamin d case for holistic supplementationThis study is one of many examples showing that a holistic approach to supplementation is superior to a “magic bullet” approach where you take individual nutrients to solve individual problems. For example, in the case of magnesium and vitamin D:

  • If you asked most nutrition experts and supplement manufacturers whether it is important to provide magnesium along with vitamin D, their answer would likely be “No”. Even if they are focused on bone health, they would be more likely to recommend calcium along with vitamin D than magnesium along with vitamin D.
  • If your doctor has tested your 25-hydroxyvitamin D levels and recommended a vitamin D supplement, chances are they didn’t also recommend that you optimize your magnesium status.
  • Clinical studies investigating the benefits of vitamin D supplementation never ask whether magnesium intake is optimal.

That’s because most doctors and nutrition experts still think of nutrients as “magic bullets.” I cover holistic supplementation in detail in my book “Slaying The Supplement Myths.”  Other examples that make a case for holistic supplementation that I cover in my book include:

  • A study showing that omega-3 fatty acids and B vitamins may work together to prevent cognitive decline. Unfortunately, most studies looking at the effect of B vitamins on cognitive decline have not considered omega-3 status and vice versa. No wonder those studies have produced inconsistent results.
  • Studies looking at the effect of calcium supplementation on loss of bone density in the elderly have often failed to include vitamin D, magnesium, and other nutrients that are needed for building healthy bone. They have also failed to include exercise, which is essential for building healthy bone. No wonder some of those studies have failed to find an effect of calcium supplementation on bone density.
  • A study reported that selenium and vitamin E by themselves might increase prostate cancer risk. Those were the headlines you might have seen. The same study showed Vitamin E and selenium together did not increase prostate cancer risk. Somehow that part of the study was never mentioned.
  • A study reported that high levels of individual B vitamins increased mortality slightly. Those were the headlines you might have seen. The same study showed that when the same B vitamins were combined in a B complex supplement, mortality decreased. Somehow that observation never made the headlines.
  • A 20-year study reported that a holistic approach to supplementation produced significantly better health outcomes.

In summary, vitamins and minerals interact with each other to produce health benefits in our bodies. Some of those interactions we know about. Others we are still learning about. When we take high doses of individual vitamins and minerals, we create potential problems.

  • We may not get the full benefit of the vitamin or mineral we are taking because some other important nutrient(s) may be missing from our diet.
  • Even worse, high doses of one vitamin or mineral may interfere with the absorption or enhance the excretion of another vitamin or mineral. That can create deficiencies.

The same principles apply to our diet. I mentioned earlier that whole grains and legumes are among the best dietary sources of magnesium. Eliminating those two foods from the diet increases our risk of becoming magnesium deficient. And, that’s just the tip of the iceberg. Any time you eliminate foods or food groups from the diet, you run the risk of creating deficiencies of nutrients, phytonutrients, specific types of fiber, and the healthy gut bacteria that use that fiber as their preferred food source.

The Bottom Line

 

A recent study suggests that optimal magnesium status may be important for optimizing 25-hydroxyvitamin D status. This is one of many examples showing that a holistic approach to supplementation is superior to a “magic bullet” approach where you take individual nutrients to solve individual problems. For example, in the case of magnesium and vitamin D:

  • If you asked most nutrition experts and supplement manufacturers whether it is important to provide magnesium along with vitamin D, their answer would likely be “No.”  Even if they are focused on bone health, they would be more likely to recommend calcium along with vitamin D than magnesium along with vitamin D.
  • If your doctor has tested your 25-hydroxyvitamin D levels and recommended a vitamin D supplement, chances are he or she did not also recommend that you optimize your magnesium status.
  • Clinical studies investigating the benefits of vitamin D supplementation never ask whether magnesium intake is optimal. That may be why so many of those studies have failed to find any benefit of vitamin D supplementation.

I cover holistic supplementation in detail in my book “Slaying The Supplement Myths” and provide several other examples where a holistic approach to supplementation is superior to taking individual supplements.

In summary, vitamins and minerals interact with each other to produce health benefits in our bodies. Some of those interactions we know about. Others we are still learning about. Whenever we take high doses of individual vitamins and minerals, we create potential problems.

  • We may not get the full benefit of the vitamin or mineral we are taking because some other important nutrient(s) may be missing from our diet.
  • Even worse, high doses of one vitamin or mineral may interfere with the absorption or enhance the excretion of another vitamin or mineral. That can create deficiencies.

The same principles apply to what we eat. For example, whole grains and legumes are among the best dietary sources of magnesium. Eliminating those two foods from the diet increases our risk of becoming magnesium deficient. And, that’s just the tip of the iceberg. Any time you eliminate foods or food groups from the diet, you run the risk of creating deficiencies.

For more details about the current study and what it means to you read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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