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How Chemotherapy Impacts Your Body Composition

By Health, Medical, Recovery

As people continue to live longer and longer, cancer will only become more common. One of the essential treatments of cancer is called chemotherapy. For those who don’t know, chemotherapy refers to the use of chemical agents of substances in the treatment of cancer.

Chemotherapy treats cancer by using chemical substances to halt the division of cancerous cells. Unfortunately, these cancer-killing agents can also impact the patient’s metabolism and the absorption of calories. These therapies can also impact the patient’s body weight, which can affect his or her chances of survival.

In this article, we’ll discuss the body composition changes that occur when a person undergoes chemotherapy. We’ll also share practical ways to combat these changes to reduce the negative changes in body composition from treatment.

Weight Gain and Chemotherapy

There are many different types of chemotherapy treatments, however, all of them slow down the uncontrolled cancerous cell division that defines this condition. Examples of common chemotherapy agents include:

    • Alkylating agents: These attack cancer cells during the resting phase before they start the process of cell division.
    • Antimetabolites: These are agents that are absorbed by cancer cells and prevent them from dividing.
  • Topoisomerase inhibitors: Topoisomerases are enzymes that are required for DNA replication and cell division. These chemotherapy agents halt the action of these enzymes, making it impossible for cancer cells to divide.

Unfortunately, these chemotherapy agents also attack normal, healthy cells. These are where the side effects come from. Examples of common chemotherapy side effects include:

    • Nausea and vomiting
    • Hair loss
    • Puffy appearance of the face
    • Numbness and tingling
    • Weight gain
    • Urinary retention or incontinence
    • Acoustic damage leading to difficulty hearing
  • Pulmonary fibrosis and cardiotoxicity, in some cases

Researchers analyzed more than 200 women undergoing breast cancer treatment and found that the average patient gained around 4 kilograms (about 10 pounds).

Similar results, published in Clinical Oncology, showed that in a sample of over 100 women, the average weight change was a gain of 3.7 kilograms (about 9 pounds). These studies are in line with numerous others, indicating that many people with cancer gain weight while undergoing chemotherapy treatment.

There have been many different hypotheses proposed regarding why patients gain weight during treatment. Examples include:

    • Changes in the ability to process and absorb nutrients from food
    • Individuals feel sick and tired, leading to an inability to exercise
    • Fluid retention related to cancer and/or chemotherapy treatment
  • Steroid use to offset some of the complications related to cancer and treatment

Having excess fat (obesity) is clearly linked to an overall increased risk of cancer. However, just because you are gaining weight from treatment doesn’t mean that your chance of cancer recurring will increase, as weight gain does not always mean fat gain. The first study found no association between the amount of weight gained and the cancer recurrence. That said, these changes in body composition are highly linked to weight gain, often associated with increased risk for disease.

While these factors may contribute to weight gain, weight is not the best indicator of body composition change. While going through treatment because there are significant changes in body composition, it is imperative that you track these changes in order to understand how health risks can change over time.

Why is Body Composition Important?

For those who may not know,, body composition refers to the makeup of your body or, more commonly, your body weight. While other measures such as weight and BMI have been used as a measure of health for decades, body composition is a more accurate representation of your health and health risks. Body composition is typically divided into:

    • Total body water: Located in all components of the human body
    • Protein: Found in the muscles and organs
    • Minerals: Includes vitamins, calcium, iron, and other trace metals that are important for various functions
  • Fat: The primary way the body stores energy

Every aspect of body composition is important for a different reason. Your health isn’t just about gaining or losing weight, but about the fluctuation of the various components of your body composition. Cancer and chemotherapy can drastically impact your body composition, making it of vast importance to understand and track body composition in these patients.

What Effects does Chemotherapy Have on Body Composition?

Chemotherapy and Fat Mass

Chemotherapy, unfortunately, can cause unwanted body composition changes, as well as uncomfortable side effects.

study was published in Clinical Breast Cancer analyzing the body composition of women undergoing chemotherapy treatment for breast cancer. Body composition measurements were completed prior to starting chemotherapy and 12 months into chemotherapy. This helped analyze not only whether or not the participants gained weight but also where and how their body composition changed.

The results indicate that those who were of normal weight gained about 4 pounds and added fat in their torso and arms. On the other hand, those who were overweight or obese prior to starting chemotherapy lost between 3 and 4 pounds.

Another study published in the Journal of Clinical Endocrinology and Metabolism analyzed body composition and weight changes in women with breast cancer undergoing treatment. Conducted in a similar manner, this study found that their patients did not have any significant changes in their weight; however, they did have an increased amount of fat mass and decrease in fat-free mass.

Why do these changes occur?

These researchers also surveyed women on their lifestyle changes as a result of their chemotherapy treatment. The survey shows that many women reduce their levels of physical activity, reduce their work activity, and have a reduction in their appetite. All potentially contributed to the changes in their body composition discussed above.

Even though these studies demonstrated that women gained weight in the form of fat, as well as lost lean mass, these studies are important because they help patients anticipate what might happen as they start chemotherapy. If patients can anticipate that these changes might happen, they can take steps to avoid or decrease the extent of these changes in body composition.

Chemotherapy and Muscle Mass

study was completed to analyze the specific metabolic changes that happen in people who experience cancer-related cachexia. Researchers found as the patients approached death, they lost an average of 4 kg of muscle mass. These patients also lost fat mass and burned more calories, representing a major shift in metabolism.

A similar study found patients who lost more than 9 percent of their total muscle mass had significantly lower survival rates. While the average patient lost about 6.1 percent of their muscle mass, those who lost more than 9 percent were almost 3 times less likely to survive.

Since body composition and muscle mass play a major role in the survival of cancer patients, treatments should focus on proper nutrition to maintain muscle mass and prevent or minimize the effects of cachexia.

Novel Treatments and Maintenance of Body Composition

In addition to dietary changes, there are other interventions to help halt cachexia progression and increase survival. Novel treatments of cancer cachexia  include:

    • Exercise mimetics: Since many people are restricted to a sedentary lifestyle while undergoing chemotherapy treatment, drugs that help the body mimic exercise may stimulate muscle fibers and help retain muscle mass
    • Metabolic targets: An early study on the impact of AR-42 inhibitors (a type of cancer therapy) in animals with cancer showed that those who took the medication had less reduction in muscle fiber size and strength when compared to the control group.
  • Digestive targets: Probiotics are important for maintaining a healthy digestive tract while undergoing chemotherapy. Certain bacteria, such as Lactobacillus Reuteri and other probiotics, can help stimulate genetic targets and regulate inflammation, helping to reduce cachexia.

So, what does this mean for the cancer patient? People should think about incorporating various dietary changes and exercises to maintain muscle strength and slow muscle loss. It should be recommended to incorporate fish oils, amino acids, nutritional support, and exercises that focus on building muscle because, not only will this improve mood, it could also improve prognosis.


Chemotherapy can significantly impact a patient’s weight and body composition.

Studies have shown cancer patients gain weight, however, it’s primarily fat and body water stemming from inflammation. Because of this, body composition must be tracked to understand how the various physiological changes can influence health risk. This tracking can help healthcare professionals see fluctuations in fat, water, and even skeletal muscle mass, helping to prevent the negative changes in body composition in order to increase survival and quality of life.

Because of the changes discussed above, it is important for everyone to maintain a healthy diet and remain physically active during their cancer treatment. While this can be hard because of side effects such as nausea and vomiting, it will help people maintain their body composition and could increase survival.

There are inevitable changes to the body when cancer cells proliferate in the body. Performing treatment of the cancer is of utmost priority, but the next step is to manage the health of the body. Body composition can change, which will be associated with health risks, thus performing a mixture of diet and exercise can help offset these changes. Cancer exercise is a growing field due to the increased knowledge of the benefits of exercise.

The goal is not to become a bodybuilder, so weights aren’t always necessary. The goal is to stimulate the muscle fibers by using them, sending a signal to the body that these muscles are still needed. This will prevent muscle degradation and help the body incorporate ingested protein into new muscle fibers.

For those who do enter a cachectic state, there are treatment options available such as vitamins, minerals, and amino acids. Through education and collaboration with healthcare professionals, effects on body composition from cancer and subsequent chemotherapy treatment can be delayed and patient outcomes can improve.


David Randolph graduated from medical school at the University of North Carolina in Chapel Hill. He is currently completing his Residency in Pediatrics at the University of South Carolina.

Understanding Water Weight: What It Is and How It Affects Your Body

By Body Composition, Health, Medical

When you think about your weight, you probably see it as a semi-static measurement that, for the most part, accurately represents your overall fat and muscle mass. And while this is somewhat true, weight is actually a deeply complex metric!

Body weight is dynamic and ever-changing. It can be affected by a seemingly endless list of lifestyle and environmental factors. Stress, food and beverages you consume, and changes in your hormonal levels all play a role in creating the number you see on the scale, which fluctuates multiple times throughout the day.

In accordance with that, the number reported as your weight will increase or decrease as your body attempts to maintain a state of homeostasis (balance) as you move through daily routines.

One example of how your body maintains its balance lies in its ability to retain water during periods of metabolic need or stress. Commonly referred to as water weight or fluid retention, this phenomenon is incredibly common — and, in most cases, not something to be concerned about.

Throughout this article, we will dive into the science behind water weight — exploring what it is, why it occurs, and what you can do to prevent and treat any symptoms of water weight that may arise. This article also covers the difference between mild edema (which is another term for water weight) and its more insidious form, chronic edema — because the treatment needed for each of these conditions varies greatly.

Ready to learn more about your body and its fluctuating weight? Let’s get started!

Important note  water weight is different than chronic edema

Before we get too far into this article, we need to make an important distinction between water weight and mild water retention vs. chronic edema.

While both conditions involve excess fluids being held within the body, each condition’s severity and treatment options are vastly different. So, just for clarity’s sake, here are the definitions of each condition that will be utilized throughout the remainder of this article:

  • Water weight or mild edema — This is a low-grade condition that results in the retention of small amounts of additional fluid in the body. It is usually not a serious medical condition but rather a passing experience caused by certain lifestyle factors.
  • Chronic edema — Alternately, chronic edema is a much more serious condition, often seen as a complication of another medical comorbidity, such as heart or kidney failure. Symptoms of chronic edema are more apparent than symptoms of mild edema and can be debilitating. This form of edema requires medical attention to resolve.

What is water weight?

Water retention and water weight gain both refer to an increase in your overall body weight that results from an accumulation of fluids in your body tissues. On average, the human body is made up of about 60% water, divided between your organs, blood, and cells. Throughout the day, water moves through the membranes of your cells, on a mission to maintain your body’s balance and homeostasis.

Due to a variety of factors, there are times when it is advantageous for the body to hold on to, or retain, excess water. This is an example of water weight or mild edema — a short-lived period of time when the amount of fluid in your body is greater than usual. When this occurs, you may notice that you feel slightly bloated or that your hands, feet, and ankles feel a bit puffier than normal. In most cases, this mild form of fluid retention resolves itself without treatment, often in a matter of hours.

How does my body gain water weight?

To better understand fluid retention, you first need to understand that there are two primary locations where water can be stored in the body — the intracellular and extracellular spaces.

  • Intracellular space — The intracellular compartment refers to all fluid stored within the membranous walls of an organism’s cells. Under healthy and balanced conditions, about ⅔ of your body water (or 28 liters of fluid) is stored within your cells at any given time. This fluid can flow into and out of the cells as needed to maintain balance during periods of dehydration or overhydration.
  • Extracellular space — The extracellular compartment is composed of two smaller components: your blood plasma (which is the fluid part of your blood) and interstitial fluids (which can be found between individual cells). Making up the other ⅓ of your body’s water, neural and hormonal sensors throughout the body are very sensitive to changes in the volumes of these fluid compartments.

Body Water Balance

When it comes to maintaining this delicate fluid balance between the compartments, the renal system (primarily the kidneys) is heavily involved. Acting as a filter for your blood, your kidneys are made up of small filtering units called nephrons. As your blood passes through the nephron, essential nutrients and water are reabsorbed into the bloodstream, based on the body’s metabolic needs.

As a result of dietary changes, activity levels, or hormonal imbalances, the amount of water retained during this process can increase, resulting in a higher level of extracellular fluid and the development of water weight symptoms.

The most common symptoms of water weight

Because fluid retention is a systemic condition that impacts multiple tissues and organs, it is common to experience water weight symptoms throughout your entire body. Examples of some of the most common water weight symptoms include:

  • Bloating of the abdominal area
  • Joint stiffness and pain
  • A swelling feeling in the feet, ankles, and calves
  • Puffiness in the face, hips, and feet
  • Fluctuations in your baseline weight

Usually, the symptoms you experience due to water weight gain will disappear within a few hours or days as your body returns to a state of homeostasis.

But, if you notice that your symptoms persist for multiple weeks or feel that your symptoms are worsening, it may be a sign that they are being caused by more serious health issues that should be addressed by a healthcare provider. Examples of symptoms to look out for include:

  • Profound swelling and puffiness of the feet, ankles, and legs
  • Stretched and shiny skin
  • Difficulty moving joints
  • A heavy or full feeling in the affected limbs
  • Areas of skin that temporarily hold the shape of a thumbprint when pressure is applied (also known as pitting edema)
  • Shortness of breath and difficulty breathing as the condition progresses

Why you gain water weight

As mentioned above, most cases of water weight gain are not the result of a serious medical condition. Instead, when you notice that your body is holding onto more water than normal, it may be a result of some of the following environmental and lifestyle factors:

  • You ate more sodium than normal — While sodium is an essential nutrient that you need to get from your foods, eating a meal with a large amount of sodium can cause the body to retain excess water for a short period of time afterward.
  • You changed your exercise level — Prolonged periods of sitting or standing in one place can cause fluid to pool in the extracellular spaces of your feet and ankles. Regular movement can help to reduce these symptoms.
  • You are taking a new medication — When starting a new medication, it is very important to speak to your primary care provider about the possible side effects you may experience. In some cases, mild fluid retention and water weight gain may be something you should look out for during the early stages of treatment.
  • Your hormones are fluctuating — Your hormones play an essential role in regulating your body during periods of change and stress. At times of high anxiety, you may experience water weight gain as your body produces higher levels of the stress hormone cortisol.

Diagnosing water weight gain

In most cases, water weight is often not an officially diagnosed health condition, due to its short-lived and mild symptoms. This being said, that doesn’t mean you should completely brush off any symptoms you are experiencing. If you notice symptoms of water weight that are persistent or recurring over longer periods of time, be sure to speak to your primary care provider.

Additionally, if you want to learn more about the amount of water your body carries at a baseline level, body composition testing may be helpful. By recording your average body water percentage to get a better understanding of your baseline values, you will be able to track changes in these measurements over time that may be signs of early-stage fluid retention.

Most cases of water weight do not require treatment

Treating your water weight gain may be as simple as letting some time pass — yes, really! Because mild fluid retention is often a short-term response to a lifestyle or environmental situation, your body will likely be able to resolve this issue on its own over time. Additionally, paying closer attention to your diet, participating in regular exercise, and getting a good night’s sleep can also help to treat any mild forms of fluid retention.

However, treating chronic edema is a much more advanced and involved process. Because chronic edema most commonly presents as a complication of another poorly managed medical condition, treating the underlying disease is often the first-line therapy for edema symptoms. Other treatment options for chronic edema that may be explored include:

  • Elevating the affected tissue above heart level for 30 minutes at a time
  • Reducing sodium intake from dietary sources
  • Taking diuretic (water pill) medications

How to prevent water weight gain

As a result of living in a modern world full of stress, it is impossible to completely remove any risk that your body will experience periods of mild fluid retention from time to time.

But there are lifestyle changes you can make to better manage fluid retention and reduce your susceptibility to frequent bouts of water weight gain. Some of our top tips for preventing water weight gain include:

  • Reducing the amount of sodium you consume
  • Ensuring that your body is adequately hydrated throughout the day
  • Elevating your legs after long periods of standing
  • Participating in regular physical activity
  • Wearing supportive compression stockings on the feet and calves

Putting it all together

So, what have we learned?

While it is completely normal for your body weight to fluctuate, sudden increases in your weight and the development of mild puffiness and swelling may signify that you are carrying some extra water weight. And this isn’t always a bad thing!

As a mild and non-life-threatening condition that will likely resolve within a day, water weight symptoms can be a helpful sign that you may want to adjust your current lifestyle habits.

Just because your scale shows a weight increase, that doesn’t necessarily mean that you have gained muscle or fat mass — it can mean that your body is merely holding on to a little extra water for a while. However, if you notice your water weight symptoms persisting, it’s advised that you consider contacting your healthcare provider.

We hope this article has been a helpful resource for dispelling some of the most common misconceptions about weight gain and fluid retention. Maybe it will also act as a reminder to show your body some extra compassion and TLC the next time water weight gain happens to you!

Reducing Chronic Disease Risk: 5 Ways Improving Body Composition Helps

By Body Composition, Health, Medical

Chronic conditions are extremely prevalent in the United States. According to a 2019 survey conducted by the CDC, more than half of American adults ages 18 to 34 years old are dealing with at least one chronic condition!

Unfortunately, some of the most common chronic conditions, such as heart disease, diabetes, depression, and cancer, can have a huge negative impact on your quality of life.

Conversations about preventing chronic conditions tend to focus on maintaining a certain weight or BMI. But another proactive way that you can potentially reduce your vulnerability to these diseases is by managing your body composition!

Your body composition can be a factor in whether or not you develop some chronic conditions.

In this article, you’ll learn how improving your body composition can lessen your risk of developing several common chronic diseases.

5 Ways That Improving Your Body Composition Can Decrease Your Risk For Chronic Conditions

1. Improves insulin sensitivity

The first way that improving your body composition can decrease your risk for chronic conditions is through its positive effects on your insulin sensitivity.

Glucose is a broken-down carbohydrate molecule that your cells use for energy, and insulin is an important hormone because it is responsible for shuttling glucose to your cells.

Unfortunately, high levels of body fat have been linked to insulin resistance, which means that your cells allow less glucose into your cells.

As a result, glucose remains in your bloodstream, leading to elevated blood sugar levels. If this goes on for too long, you may acquire Type 2 diabetes or metabolic syndrome.

As you can see, your body fat percentage definitely plays a role here. But perhaps even more interestingly, there is evidence that the place where you accumulate your fat tissue may be more important than your total fat levels!

Abdominal obesity, or the fat tissue that accumulates around your midsection, is especially pertinent when it comes to your risk of insulin resistance.

Researchers have found that high levels of abdominal fat may increase the release of free fatty acids and signal molecules called adipokines, which can increase your risk for chronic conditions like Type 2 diabetes and cardiovascular disease. 

The good news is, there’s plenty of evidence that improving your body composition can help you manage your blood sugar levels. A more balanced body composition can even contribute to a healthier metabolism!  

Some of the most obvious body composition-related improvements to your health come from losing fat. Take this study that evaluated how body composition improvements (from exercise or a reduced-calorie diet) could impact participants’ insulin resistance.

The researchers found that either exercise or reduced calorie intake could be comparably effective for improving insulin resistance. These improvements were linked to changes in body weight, total fat mass, and visceral fat volume.

Your muscle mass can play an important role in your health as well, which is why looking at your body composition instead of your weight or BMI alone can be beneficial.

A study that evaluated the insulin resistance of 132 healthy adults found that, in male subjects, having more lean muscle mass was associated with greater insulin sensitivity, independent of the subjects’ fat tissue.

Another study on Korean adults found that participants with higher muscle and lower fat body compositions had significantly lower insulin resistance than those with low muscle and low fat levels.

So in order to manage your insulin resistance, you may need to focus on both your body fat and your muscle mass — or in other words, focus on body recomposition.

2. Decreases chronic inflammation

Another important way that your body composition can affect your risk of chronic conditions is through inflammation.

Inflammation is a normal response that your immune system conducts to keep you healthy. When it detects an unfamiliar and potentially dangerous invader like a bacteria or virus, your immune system increases blood flow to the infection site.

Your white blood cells then release chemicals that “attack” the invader, ultimately keeping you healthy and safe from harm.

Unfortunately, under certain conditions, inflammation can also become chronic. In these cases, your body may have inappropriate inflammatory reactions even in the absence of an actual threat, which means that your immune system can begin attacking your body’s own tissues.

Chronic inflammation is linked to a wide array of serious health issues, including diabetes, heart disease, inflammatory arthritis cancer, gastrointestinal disorders, and metabolic syndrome.

A high body weight tends to be one of the most prevalent risk factors talked about when it comes to inflammatory diseases, but another promising method for lowering inflammation is through managing your body composition.

Consider the “BMI paradox.” It’s been observed that overweight people are more likely to develop cancer but also have lower mortality rates. Researchers have found that this phenomenon may have more to do with their body composition than their weight alone.

Having more muscle mass seems to offer more protection than fat tissue, which is linked to higher inflammation (as well as other chronic disease risk factors, such as insulin resistance and higher cholesterol levels).

Why? There is some evidence that fat tissue, especially the visceral fat tissue found deep in your abdomen, can be inflammatory.

In fact, the state of obesity itself is considered chronic low-grade inflammation, since it is associated with several inflammatory markers, likely due to excess fat tissue.

In addition to metabolic and cancer-related chronic illnesses, your body composition can also play a role in other chronic conditions.

For example, inflammation is associated with chronic obstructive pulmonary disease (COPD), a chronic inflammatory lung disease that can block your airways and make it hard to breathe.

Researchers have found that low muscle mass is linked with systemic inflammation.

Ultimately, having a lower body fat mass and a higher muscle mass may protect you from chronic inflammation, which can give you better protection from a huge array of chronic conditions.

3. Improves cholesterol levels and blood pressure

Did you know that your body composition can heavily influence your heart health, through its effects on your cholesterol levels and blood pressure?

Cholesterols are fatty substances that are produced in your liver and travel through your bloodstream. They perform various roles in your body, like helping you to digest fat-soluble vitamins and building important hormones.

There are several kinds of cholesterol. Two of the most important are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL is sometimes considered the “bad” kind of cholesterol, because it sticks to the sides of your arteries as it travels through your bloodstream. HDL, on the other hand, can carry excess cholesterol away from your organs, which is why it’s known as the “good” kind of cholesterol.

When someone has high cholesterol levels (especially high levels of LDL and lower levels of HDL), cholesterol may adhere to the sides of your arteries and develop into plaque. This plaque can then harden, making it more difficult for your heart to pump blood to all the places it needs to be delivered to. Eventually, this can contribute to high blood pressure (hypertension), which increases your risk of cardiac events like heart attacks and strokes, ultimately affecting your heart health for the worse.

Your body composition may play a major role in how cholesterol impacts you.

Research has found that obesity can actually change the way that your body metabolizes fats, which is linked to its promotion of insulin resistance. This can cause your body to produce more LDL and less HDL, contributing to issues with your heart health.

However, you can lower your risk or reduce the severity of your current heart issues by improving your body composition.

For example, a study on older adults found that reductions in fat mass of approximately 1 kg predicted a reduction in triglyceride levels, which are another type of fat that can be found in your bloodstream and fat tissue.

Similarly, the study also found that gaining lean muscle mass led to improved triglyceride levels.

4. Strengthens bones

Because your muscle tissue and bone mass are so closely interlinked, increasing your muscle mass can protect your bones, which is great for reducing your risk of chronic bone conditions like osteoporosis and osteoarthritis.

This link between your bone health and muscle mass seems to start in childhood, with studies finding that the body composition of children and adolescents significantly influences their development of bone mineral density early in life, and that higher body fat percentages seem to negatively affect bone acquisition.

This finding may be especially relevant to older adults, as your bone density tends to decrease as you get older.

Because bone mass and muscle mass are so closely linked, there’s evidence that older populations that are prone to bone diseases like osteoporosis may benefit from resistance training programs that improve these body composition metrics.

5. Better mental health

Finally, improving your body composition may also do a world of good for your mental health! In addition to physical health issues, mental illnesses like depression are among some of the most prevalent chronic conditions.

This may in part be due to an association between higher-risk body composition metrics and lower physical activity levels. For example, a 2020 study found that less physical activity, higher body fat mass, and lower muscle mass all were associated with stronger depression severity

There may also be a link between behavior and the gut microbiome, or the microbes that live in your gut, since they play a variety of roles in your body, including regulating your moods and behavior via the microbiota-gut-brain axis.

In the same vein, some researchers believe that improving your gut microbiome diversity can influence factors that play a role in your body composition, such as insulin sensitivity!

However, more research needs to be done to determine the exact links between body composition, the gut microbiome, and mental health. 

The bottom line: it’s important to note that body composition hasn’t been proven to be a cause of chronic mood and mental disorders like depression.

Instead, there’s some evidence that points to the idea that the actions you take to improve your body composition, such as exercising more frequently, can help reduce your mental illness risks and/or severity.


Chronic conditions are serious health concerns that can alter one’s quality of life and even shorten your lifespan.

While there are several factors that can contribute to your risk for chronic conditions, such as genetics and age, one proactive way that you can manage your risk is to improve your body composition, by focusing on gaining lean muscle mass and reducing your body fat.

Enhancing Your Immune System: 7 Proven Methods for Better Health

By Health, Nutrition

There are very few things in the world worse than being stuck in bed because you’re sick. The CDC estimates that seasonal influenza caused U.S. employees to miss approximately 17 million workdays. That’s a staggering $7 billion in sick days and lost productivity! For some people, the symptoms of the common cold seems to linger for weeks. While other people never get sick. All things being equal, the difference usually comes down to a strong immune system.

Once a virus enters your system, your body goes into defense mode, with your immune system in the front line. What’s amazing is that, unless something is wrong with your body’s system of defense, you don’t notice it working day and night to keep you safe. It has evolved over many years to protect you and keep you strong and healthy, which is a rather comforting feeling. Beyond gratitude, there are things you can do to help boost your immune system. After all, as strong as he was, Batman wouldn’t be able to save Gotham City without the help of Robin.

The Human Immune System

The Immune System is very complex and essential in maintaining health. Its main tasks are to neutralize pathogenic microorganisms like bacteria that enter the body and threaten its normal homeostasis, eliminate harmful substances from the environment, and fight against the body’s own cells that rebel and cause illnesses like cancer.

Your body’s defense system consists of the innate and adaptive immune processes. Elements of the innate system include exterior defenses, such as the skin, serum proteins, and phagocytic leukocytes. Any pathogenic organisms that manage to escape the first line of defense, come face to face with the adaptive system, which is made up of T and B cells. The adaptive immune system serves as a learned defense, constantly adapting and evolving in order to be able to identify changes in pathogens that, too, change over time. It’s an evolutionary arms race between host and pathogen. Together, the innate and adaptive systems work closely to provide a formidable resistance to any long-term survival of infectious agents in the body.

Mighty as it may be on its own, there are simple adjustments you can do in your everyday life to help strengthen and boost this magnificent, genius system that’s working to keep you safe.

Ways to boost your immune system

1. Quit Smoking

You don’t need anyone to tell you that smoking is bad for your health.  Smoking impairs the immune system and is associated with a long list of cardiovascular, autoimmune, respiratory and neurological diseases. The list of common symptoms of tobacco-related diseases includes shortness of breath, persistent cough, and frequent colds or upper respiratory infections.

Specifically, the substances you ingest while smoking a cigarette have a direct effect on both the innate and adaptive immunity, suppressing the normal development and function of the cells that are responsible for driving immunity in the body. Nicotine, in particular, has been shown to be a potent immunosuppressive agent by affecting the immunosurveillance properties of dendritic cells, highly-specialized cells of the immune system.

Imagine this; your body fights for your survival every single day of your life, and in the meantime, you can be counteracting these efforts every time you decide to smoke. Is that cigarette worth your health?

2. Drink Alcohol in Moderation

Alcohol is often associated with celebrations and anniversaries, but if you abuse it, your immune system suffers.  Alcohol consumption is a contributing factor to organ damage, specifically the liver, and is known to slow down recovery from tissue injuries. The “Dietary Guidelines for Americans” defines moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men.  Alcohol intake exceeding the recommended intake disrupts essential immune pathways and, in turn, impairs the body’s ability to defend itself against infections.

It is worth stating that alcohol-related immune system disturbances have been implicated in the development of certain types of cancer, including but not limited to head and neck cancers among alcohol users. Before you start thinking that this is a problem isolated to chronic alcohol users, keep in mind that acute binge drinking, also known as a Saturday night, has the ability to severely impair the body’s defense system.

3. Keep the Stress Away

Chronic stress is like poison for your body; it has a negative impact on every aspect of your health, and it’s even more dangerous due to its ability to creep up without you consciously acknowledging it.  One of the many systems responsible in the body for handling difficult situations is the immune system. Specifically, cells of the immune systems are equipped with receptors that recognize stress hormones, such as cortisol.

Even acute stress can mess up your immune system by increasing the release of inflammatory-promoting cytokines in the blood, a special type of immune cell that signals other cells and affect their function. Stress, immunity, and disease can affect each other in reciprocal ways, but these relationships can be moderated by life stage, other environmental pressures and goals, stressor duration, and protective factors, such as good sleep. Make sure you have a healthy strategy to help you relieve the symptoms of stress like exercising or spending time with friends and family.

4. Get More Sleep

Speaking of sleep, it is a strong regulator of immunological processes and works to enhance the memory of the adaptive immune system. When you deprive your body of adequate sleep, you simultaneously make it more susceptible to many infectious agents. Sleep deprivation not only makes you more susceptible to infections like the common cold or the flu, but it also makes it so much harder to recover from the bacteria or virus infection that eventually manages to enter your system.

While you are sleeping every night, your body uses this time to strengthen the immune system and move T cells to the lymph nodes, the vessels of the immune system responsible for filtering harmful substances. These T cells produce cytokines which are called to action when there is inflammation in your body or when you’re under stress. During periods of inadequate sleep, cytokine production is diminished, further hurting your immune system.  So feel free to hit that snooze button, and in case you come down with the flu, feel free to hibernate for a few days.

5. Exercise Regularly – But Don’t Skip Rest Days

Most people have a love-hate relationship with exercise.  This particular argument will only add to your love towards exercise. Studies have proved that regular physical activity may enhance the immune system and provide protection against infection.

Furthermore, regular resistance exercise increases your muscle mass, which acts as a protein reserve when the immune system is working to stave off disease. Simply put, the more muscle mass you build through a healthy diet and regular exercise, the more equipped your body is to fight off infection and keep you strong and healthy. Conversely, getting rid of bacteria or virus infection will be a lot harder if you have been neglecting the gym.

But don’t forget to take your workouts outside. Exercising outside is a great way to both destress and reap the benefits of Vitamin D. Vitamin D deficiency has also been linked to an increased susceptibility to infection, so when the weather permits try to go outside and enjoy the sun.

Unfortunately, no one can stay young forever, and as the body ages, its natural defenses begin to waiver.  The good news is that regular physical activity in the elderly may counteract the actions of time and boost the immune system so that it can protect the body from infection and disease.

Nonetheless, like everything else in life, too much of a good thing can be bad.  Being a couch potato suppresses the immune system, but the opposite extreme can be equally detrimental. Repeated bouts of strenuous exercise, also known as overtraining syndrome, can lead to symptoms like immune dysfunction, so make sure to maintain a healthy balance between regular physical activity and exhaustion.

6. Eat Enough Nutritious Foods

Every system in the body requires energy to function properly. This energy is provided by food sources in the form of calories. Indeed, insufficient intake of calories may lead to micronutrient deficiencies and suppress the immune system and its vital functions. In fact, malnutrition is the most prevalent cause of immunodeficiency around the world.

Food is powerful; it has the potential to make or break every chemical pathway in the body that sustains you. Because of that, it makes sense that the healthier your food choices are, the stronger your immune system and, subsequently, your health will be.

Certain nutrient deficiencies have the potential to alter immune responses and damage the way your immune response to infections. Vitamins and nutrients with antioxidant properties can provide protection against free radicals. Adding an abundance of foods high in naturally occurring antioxidants like citrus fruits in your diet is the key to maintaining a healthy immune system. Exposure to environmental conditions such as UV light, cigarette smoke can ultimately take its toll on the immune system and drive the production of free radicals in the body. Antioxidants fight the free radicals and restore the structural integrity of cells and membranes in the body. Examples of such antioxidants include zinc, selenium, iron, copper, vitamin C, A, and E. Foods high in vitamin C, A, and E, in particular, may also increase the activation of cells involved in tumor immunity.

Plant-derived bioactive compounds, known as phytonutrients, also play an important role in strengthening the immune system.  Polyphenols, flavonoids, isoflavonoids, carotenoids, and phytoestrogens, are some of the few phytonutrients that have the ability to enhance the immune system with their immunity-boosting superpowers. Dietary intake of phytochemicals promotes health benefits and protects against chronic disorders, such as cancer, cardiovascular and neurodegenerative diseases, diabetes, and inflammation. Also, their natural origin poses lower side effects when compared to chemotherapy or radiotherapy, and promises a brilliant future for their use in treating specific types of cancer.

Finally, there is emerging research linking gut health to the immune system and there is promising research highlighting the benefits of probiotics supplementation in improving the body’s response to bacterial infections.

Balanced nutrition, especially in terms of adequate vitamin, mineral and protein intake (for those essential amino acids), enhances the resistance against infections. If you are not sure that you can provide everything your body needs through your diet alone, it might be worth investing in a quality multivitamin to help cover any inconsistencies from your diet.

7. Maintain a healthy body fat percentage

It has been observed that overnutrition can potentially increase the risk of inflammatory and autoimmune diseases.  A healthy body fat percentage ranges between 10-20% of the total body weight for men and 18-28% for women. Therefore, a percent body fat higher than this may impair the immune response.

Studies have shown that the link between obesity, insulin resistance, and diabetes could be explained through the subsequent activation of the innate immune system.  The same system that is implicated in the pathophysiology of obesity-related liver damage.  A healthy immune system does an excellent job in protecting you from disease, but permanent activation causes the release of immune cells that promote inflammation in the body, making it a lot harder for the immune system to concentrate on its primary goal; to keep you healthy.

The solution is simple in this case. You can reverse the negative effects of a high body percentage by improving your body composition. Less body fat, specifically visceral fat, equals less immune cells circulating in the bloodstream, promoting inflammation and wreaking havoc on the natural processes of the body.

In addition to losing fat, gaining more muscle mass, as we spoke about before, can further improve body composition and reset a dysfunctioning immune system, laying the foundations towards long term health.

Putting it All Together

Your immune system works day and night to keep you healthy and often has to fight you in its efforts to maintain normal homeostasis. You can become its best friend by applying these 7 small changes in your everyday life:

  1. Quit smoking
  2. Drink alcohol in moderation
  3. Try to keep the stress away
  4. Get enough sleep
  5. Exercise regularly, but avoid overtraining
  6. Eat enough calories and include foods rich in antioxidants in your diet
  7. Maintain a healthy body fat percentage through diet and exercise

You may read this article and think that all these are just too much change for you. Small changes are still a step in the right direction. Change your habits one at a time to help support your immune system, and it will help you bounce back quickly next time you catch a common cold. After all, a strong, healthy body depends on your daily decisions.

Take care of your body, so that it can take care of you.


Rafaela Michailidou is a Biomedical scientist, and a freelance health and wellness content writer. Aspiring to help people achieve their goals, she is currently studying to be a Health Coach. 

How Glycogen Impacts Your Body Composition

By Diet, Health
  • There are three classes of carbohydrates: monosaccharides, disaccharides, and polysaccharides.
  • Replenishing glycogen stores by consuming carbohydrates is beneficial for recovery after exercise, as well as sustaining activity for an extended amount of time.
  • If you follow a low-carbohydrate eating pattern, ensure that you consume enough protein each day.

There’s a lot of conflicting information about carbs and its role in your nutrition. We want to help clear up some of the confusion. Read on to learn about carbs and its role in energy production i.e glycogen, why you should consider healthy carbohydrates, and what you want to be aware of if you are following a low-carb diet.

Glucose, Carbs, and Sugar

Glucose, carbohydrates, sugar – all words that we’ve heard of when it comes to our body and diet. What about glycogen? What is it?

Glycogen is a branched polymer of glucose, or in simpler terms, made of many connected glucose molecules.

Glucose is the body’s primary source of energy, and when all of the glucose isn’t needed, it gets stored in the liver and muscles in the form of glycogen. On the other hand, when you are not consuming enough glucose or you need more energy, glycogen is released into the bloodstream to the muscles and used as fuel.

Let’s dive into a bit of chemistry. Glucose is a form of carbohydrate (also called saccharides), which has three main classes. They are:

  • Monosaccharides – contain one sugar unit
  • Disaccharides – contain two sugar units
  • Polysaccharides – contain multiple sugar units

A lesser-known group called oligosaccharides also exists, but to avoid confusion, let’s focus on the three.

Monosaccharides are often called single sugars and are the building blocks for the bigger carbohydrates. Examples of monosaccharides include:

  • Glucose
  • Fructose
  • Galactose

These three monosaccharides combine to form many of the different types of sugars found naturally in food. Carbohydrates or sugars are converted to glucose during digestion, and the body uses the glucose for energy.

Fructose, also known as fruit sugar, is found in fruits, berries, honey, root vegetables, and some grains. Galactose is a sugar that can be found in milk and yogurt.

When two monosaccharides are joined together, they create a disaccharide. Disaccharides include:

  • Sucrose
  • Lactose
  • Maltose

Sucrose is one glucose and one fructose combined and is commonly known as table sugar. Lactose is the combination of one glucose and one galactose. Lactose, also called milk sugar, is found in all dairy products and mammals’ milk. Maltose contains two glucose molecules and can be found in germinating grains such as barley, as well as in malt.

Polysaccharides are very complex and made up of long chains of monosaccharides and disaccharides. They could contain anywhere from ten to several thousand monosaccharide chains. Polysaccharides include:

  • Starch
  • Glycogen
  • Cellulose

You may have heard of the term “starchy carbohydrates,” and that’s where you can find starch. Starchy carbohydrates include food such as potatoes, corn, and rice. Foods that contain cellulose include fruits and vegetables (along with skin such as apples and pears), wheat bran, and spinach.

As previously mentioned, when there is too much glucose in the body, it gets stored as glycogen in the muscles or liver. This is a process called glycogenesis. Insulin (a hormone in our body) will recognize that glucose and energy are present in high amounts and will help convert glucose into glycogen.

Glycogen and Muscles

Most glycogen in the body is stored in the skeletal muscles and is an important source for muscle contraction. Once the glycogen is used in the skeletal muscles, your body will then begin to utilize the glycogen in the liver.

However, the storage capacity of carbohydrates in the body are not as high as fats or proteins. It’s essential, especially with active individuals, to refuel these stores but specific carbohydrate intake needs can vary from person to person.

When it comes to long-term endurance, your body is reliant on pre-exercise glycogen availability. Replenishing that glycogen after exercise will shorten the time needed for recovery.

study was done on ten endurance-trained individuals to examine whether muscle glycogen availability correlated with fatigue in repeated exercise. Participants were involved in two different runs: An initial run until exhaustion (70% of VO2max), followed by 4 hours of recovery, then another run until exhaustion. Participants received either a low-carbohydrate or high-carbohydrate beverage at 30-minute intervals during the 4-hour recovery.

Results of the test showed that increasing carbohydrate intake during short-term recovery increased glycogen repletion. In turn, this enhanced the participant’s ability for repeated exercise, and they experienced less fatigue.

Dietary Guidelines For Carbohydrates

According to the Dietary Guidelines for Americanscarbohydrates should make up 45 to 65 percent of your total daily calories. So, if you are eating around 2,000 calories per day, your calories from carbohydrates would be between 900 and 1,300. This also translates to between 225 and 325 grams of carbohydrates.

Carbohydrate content can be found on food packaging nutrition labels. The label will show total carbohydrates, which includes starches, fiber, naturally occurring sugar, as well as added sugar.

If you’re curious about carbohydrate content for foods that do not have a label, such as fruits and vegetables, U.S. Department of Agriculture FoodData Central makes it easy to search for specific foods to see their nutrient breakdown.


Glycogen and Fat Mass

You may have talked with a family member, friend, or coworker who decided to follow a low-carbohydrate diet to lower their fat mass and improve their body composition. Low-fat diets were well-known toward the end of the 20th century, but now low-carbohydrates are taking over in popularity.  The rise of the ketogenic diet has created a negative reputation for carbohydrates, but it’s the type of carbohydrate that makes the difference. Choosing healthier, complex carbohydrates such as whole grains, starchy vegetables, and legumes can actually make you feel full longer compared to simple carbohydrates due to the fiber content and slower digestion. Simple sugars are digested quickly and also spike blood sugar shortly after consumption. Simple sugars are found in refined sugar, such as white sugar, and don’t provide fiber, vitamins, and minerals like complex carbohydrates.

So is reducing the intake of carbohydrates the way to go when you’re seeking fat loss?

One study compared the effects of a restricted carb vs fat diet on fat loss. Participants first started with a 5-day baseline diet that consisted of 50% carbohydrates, 35% fat, and 15% protein. Then they were randomly assigned to either a 60% reduction of dietary carbohydrate (low-carb diet) or an 85% reduction of dietary fat (low-fat diet) for six days. The results showed that, calorie for calorie, restriction of dietary fat led to more fat loss than the limitation of carbohydrates.

When comparing the baseline diet and low-carb diet, participants showed an increase in body fat loss and fat oxidation, as well as a decrease in insulin secretion when following the low-carb diet.

Another study showed similar results after participants followed a plant-based diet for 16 weeks. The intervention group (prescribed the plant-based diet) were limited to 20 to 30 grams of fat per day but had no limit on energy or carbohydrate intake. The control group was asked to maintain their current diet for the 16 weeks, which included dairy and meat products.

Results found that increased consumption of carbohydrates and dietary fiber, as well as decreased amounts of fat in the plant-based diet, showed reduced body weight, fat mass, and insulin resistance in overweight individuals.

These studies utilize carbohydrates coming from fruit, vegetables, and whole grains. Very few studies show that a diet rich in healthy carbohydrates will result in weight gain. The bulk and fiber that comes from these foods can help you feel full longer, and on fewer calories.

What If I’m Following A Low-Carbohydrate Diet?

ketogenic-type, or low-carbohydrate diet, has been a popular eating pattern among individuals for some time. If it’s going well for you, keep doing what you’re doing! 

When it comes to following these kind of eating patterns, most of your calories will come from fat at about 50% for the day. You are also typically consuming 20% of your daily calories from carbohydrates, and eating various amounts of protein. Even though your brain and muscles prefer glucose as its primary energy source, if that depletes, then it will rely on other sources for fuel.

Ketosis occurs when glycogen stores have entirely run out and are not being replenished. During ketosis, your liver oxidizes fatty acids into ketones. Your body can then use ketone bodies as an alternative energy source.

It’s crucial during this time to ensure that you are consuming an adequate amount of protein. Amino acids in protein assist with continued fat oxidation once glucose availability is limited. It’s recommended to consume between 1.3 to 2.5 g/kg of protein if you are following a low-carbohydrate diet.

You may find yourself getting tired quicker during exercises compared to someone who is not following a low-carbohydrate diet. During exercise, since you are limited on carbohydrates, your body has increased fat oxidation for fuel. This increases the brains uptake of free tryptophan. Tryptophan is an amino acid and is the precursor to serotonin, a brain neurotransmitter that makes you feel tired.

Your body also has elevated ammonia production due to the higher consumption of protein. Ammonia is another factor that promotes feelings of exhaustion.

If you are active and follow a low-carbohydrate diet, consider saving your daily carbohydrates for before, during, and after an exercise so your body can utilize them as your energy source.

Wrapping Up

A lot of information has been discussed and studies broken down, but overall you’re in charge of how you eat so that it aligns with your goals. Glucose may be the body’s preferred source of energy, but it can utilize fat and protein as energy if needed. It’s also important to note that a specific eating pattern that works for someone else may not be the best fit for you, and vice versa. Eat in a way that feels right for yourself and your body!


Lauren Armstrong is a Registered Dietitian with several years of experience counseling and educating individuals seeking chronic disease prevention and a healthier lifestyle. She is a graduate of Western Michigan University and completed her dietetic internship at Michigan State University.

The Connection Between Diabetes and Hypertension

By Blood Pressure, Health

Living with the chronic disease requires ongoing medical attention and is the leading cause of death and disability in the United States. Diabetes and hypertension are two of these chronic diseases that impact millions of people worldwide. 


Hypertension, which is also known as high blood pressure, is when your average or resting blood pressure is higher than the normal range established by the American Heart Association. Your blood pressure is the amount of pressure that pushes against your artery walls which typically comes from the heart pumping blood. To have hypertension, your blood pressure should be at or higher than 130/80 mmHg per the CDC. 

Common type of diabetes

There are two forms of diabetes, type 1 and type 2 diabetes, which both cause your blood glucose (or blood sugar) to be too high. Type 1 diabetes is usually diagnosed in children and young adults and is a result of your body being unable to make insulin (the hormone needed to allow blood glucose into cells for fuel). Type 2 diabetes is more common and typically diagnosed in middle-aged and older individuals. With type 2 diabetes, your body has the capability of producing insulin but it does not make or use it well. 

The American Diabetes Association provides information about some common methods for diagnosis, including an A1C of greater or equal to 6.5% or a fasting blood sugar level at 126 mg/dl or higher.

If you’ve been diagnosed with or are worried about either of these conditions, in this blog we’re breaking down how they are connected and ways to prevent them. 

How diabetes and blood pressure are connected 

According to a 2012 review published in the Current Atherosclerosis Reports, hypertension occurs in about 30% of individuals who have type 1 diabetes and approximately 50% to 80% in those with type 2 diabetes. Studies have also indicated that only 42% of people with diabetes had normal blood pressure, and only 56% of those with hypertension had normal glucose tolerance (which indicates how your body processes sugar). 

There are several reasons behind why these two conditions are often seen together. Researchers of a 2018 study published in Hypertension concluded that the “development of hypertension and diabetes mellitus track each other over time.” A common feature they notice in both prediabetes and prehypertension is insulin resistance. As we previously mentioned, insulin helps to keep the amount of sugar or glucose in the blood under control. When someone is insulin resistant, which occurs in type 2 diabetes, your body isn’t responding to or making enough insulin to allow glucose to enter the cells. 

Insulin resistance often does not have any symptoms which leads to a gradual increase in blood sugar levels if it’s not being treated. This can cause damage to the blood vessels, eventually making them become thick and stiff (a condition called atherosclerosis). The hardening of these blood vessels increases the pressure that blood is being pumped through. , AKA high blood pressure. The combination of these effects left untreated can lead to serious conditions such as heart attack and stroke.

Diabetes and blood pressure share many risk factors. These include:

  • Family history of these conditions 
  • Having excess weight and body fat 
  • An inactive lifestyle 
  • Stress and poor sleep
  • Tobacco use 
  • Older age 

Can one cause the other? 

The short answer is yes, diabetes can cause hypertension and hypertension can cause diabetes. 

There seem to be two factors that link these conditions together — genetics and environment. According to the same 2012 review, certain DNA sequences that can be used to predict the potential occurrence of diabetes were also linked with predicting the onset of hypertension. However, our lifestyle plays the biggest role in controlling environmental factors impacting our health, which includes diet and physical activity. 

Factors such as inflammation and oxidative stress also occur in both hypertension and diabetes. A 2018 study published in the Journal of Inflammation Research states that as diabetes and hypertension progress, it decreases antioxidant and anti-inflammatory biomarkers which leads to an imbalance in oxidative stress and inflammation.  

Prevention of high blood pressure and diabetes 

Maintaining a healthy lifestyle is key to reducing the risk of chronic diseases, including diabetes and hypertension. High intakes of sodium, alcohol, and saturated fat combined with smoking, lack of physical activity, and mental stress, are all factors that can affect our overall health and longevity. 

The American Heart Association recommends getting at least 150 minutes per week of moderate-intense aerobic activity or 75 minutes per week of vigorous aerobic activity. Moderate-intense activities include: 

  • Brisk walking (at least 2.5 miles per hour) 
  • Water aerobics 
  • Dancing 
  • Gardening 
  • Tennis
  • Biking 

Along with aerobic activity, it’s recommended to add in 2 days of moderate- to high-intensity muscle-strengthening activity like resistance bands or weights. 

When it comes to healthy eating, the Dietary Approaches to Stop Hypertension (DASH) diet, was created specifically to prevent and treat hypertension. An analysis published by the American Heart Association found that the DASH diet is also effective against diabetes. According to the article, the DASH diet significantly improved fasting insulin levels when followed for more than 16 weeks. 

The DASH diet doesn’t require special foods, but it is geared towards a heart-healthy eating style. The plan recommends:

  • Eating vegetables, fruits, and whole grains 
  • Choosing fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils 
  • Limiting foods high in saturated fat including fatty meals, full-fat dairy products, and tropical oils (coconut and palm oils) 
  • Limiting sugar-sweetened beverages and foods 

The diet highly recommends consuming no more than 2,300 milligrams of sodium per day, which is no more than 1 teaspoon. If sodium intake is cut back to 1,500 milligrams, blood pressure could be lowered even more. 

Medication options 

Lifestyle changes are important, but some situations may call for the treatment of medication, as well. According to a 2017 article, published in the Journal of Hypertension, individuals that have a blood pressure that is 160/100 mmHg or higher, should be treated with medication along with lifestyle therapy. It’s also believed that the management of hypertension should be aggressive in those that have diabetes. The treatment for hypertension should include prescriptions that reduce cardiovascular events in those with diabetes. Medications might include: 

  • ACE inhibitors: relax blood vessels and decreasing blood volume 
  • Angiotensin receptor blockers: these block angiotensin, which is a chemical that narrows blood vessels 
  • Thiazide-like diuretics: reduce the fluid that accumulates in the body 
  • Dihydropyridine calcium channel blockers: reduce the entry of calcium into muscle cells 

It’s also not uncommon to be prescribed multiple drugs simultaneously; however, if lifestyle therapy is consistentin some cases, medications can eventually be discontinued. 

The takeaway 

Since diabetes and hypertension have many shared risk factors, those that are diagnosed with one will have a higher chance of developing the other. Prevention and management of these conditions come with lifestyle adjustments which include diet and exercise, but treatment will often include medication(s) based on the severity. If left untreated, the combination of diabetes and hypertension can lead to serious health complications including heart attack, or stroke. 


Lauren Armstrong is a Registered Dietitian with several years of experience counseling and educating individuals seeking chronic disease prevention and a healthier lifestyle. She is a graduate of Western Michigan University and completed her dietetic internship at Michigan State University.

The Relationship Between Body Composition and Liver Function

By Body Composition, Health, Medical

Your liver is a true powerhouse of an organ. It has a hand in some of your body’s most crucial regulatory processes, from the digestion and metabolizing of various nutrients to the detoxification of your blood. So, when there’s something wrong with your liver, the consequences can be serious. And unfortunately, a damaged liver may not always emit any overt or obvious signals that something is wrong. That means that major liver issues may go undetected for a long time.

But, as it turns out, one of the most telling indicators of your liver function is actually your body composition, which makes it much easier to keep tabs on your own health! Read on to find out how your body composition impacts your liver function, and how you can use this information to proactively protect your wellbeing.

The liver: what it is and why it matters

Your liver is a large organ that sits in your abdominal cavity, near your stomach, intestines, and kidneys. As a part of the digestive system, your liver plays a huge variety of roles in your body, including:

  • Producing bile for digestion
  • Metabolizing fat-soluble vitamins
  • Processing drugs
  • Producing cholesterol
  • Regulating carbohydrates and proteins
  • Detoxifying blood by removing drugs and other potential toxins

Liver issues

Because it’s an integral factor in so many different bodily processes, your liver’s health directly impacts your overall health. Unfortunately, under certain circumstances, your liver can become prone to conditions and diseases that lessen its ability to function normally, such as nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD)

As you might be able to guess from the name, nonalcoholic fatty liver disease (or NAFLD for short) is a set of conditions in which excess fat accumulates in your liver. This type of fat accumulation can also occur from excess alcohol consumption, in a disease aptly named “alcohol-related liver disease” (ARLD). But, unlike ARLD, NAFLD can occur in the absence of excessive alcohol consumption, influenced instead by factors like your lifestyle and genetics.

While NAFLD does not always cause symptoms on its own, having it can increase your risk for other serious health issues, such as cardiovascular disease and Type 2 diabetes.

There are two different kinds of NAFLD: 

  • Nonalcoholic fatty liver (NAFL): People with NAFL have an enlarged liver with excess fat accumulation, but this type of NAFLD comes with minimal inflammation or damage to the liver itself.
  • Nonalcoholic steatohepatitis (NASH): People who have this kind of NAFLD can experience inflamed livers. Twenty percent of these patients will progress to cirrhosis (scarring), which can damage the liver itself. These devastating impacts mean that NASH has even been linked to liver cancer and liver failure, and it is highly associated with the necessity for liver transplants.

Generally, people with nonalcoholic fatty liver disease will develop either NAFL or NASH. However, some people with one form of NAFLD may later be diagnosed with the other form.

So, how does fatty liver disease develop in the first place? As it turns out, your body composition plays a big part in it.

How your body composition affects your liver function

Your body is primarily composed of four components: body water, minerals, skeletal muscle mass, and body fat. While all of these factors can have a major impact on your overall metabolic health Two of these factors, your skeletal muscle mass, and your body fat mass, can have a huge impact on your overall metabolic health. In this case, they can also influence how much fat is accumulating in your liver.

Some specific body composition risk factors that can affect your liver function include excess body fat, uneven body fat distribution, and low skeletal muscle mass.

Excess body fat mass

Obesity is one of the biggest body composition risk factors for developing nonalcoholic fatty liver disease and other liver issues.

Under typical circumstances, the dietary fat that you consume breaks down into fatty acids which are then stored primarily in your fat tissue, although small amounts are also stored in your liver. But it’s thought that the high amounts of fat tissue present in obese patients increase the rate at which fatty acids are released into circulation, which then goes on to increase the rate at which the liver accumulates fat. More specifically, researchers have found that increased risk for NAFLD occurs if the total percent body fat exceeds 32.23% in women and 26.73% in men.

Body fat distribution

You don’t necessarily even need to be obese for your body fat to impact your liver health either, because the location in your body that your fat tends to accumulate also matters.

High levels of visceral fat, aka “central adiposity” (or, even more simply, belly fat), seem to play a key role in how your liver is affected by your body composition when compared to other kinds of fat accumulation. For example, one study discovered that, after averaging the weight of its subjects, higher levels of central adiposity were associated with increased instances of fatty liver. Meanwhile, subjects who had more fat stored in lower extremities, such as their legs, were found to have fewer instances of fatty liver.

Low skeletal muscle mass

Your body composition can contribute to liver complications beyond a NAFLD diagnosis. In conjunction with high levels of body fat mass and central adiposity, low levels of skeletal muscle mass can also cause further complications like fibrosis, or scarring of your liver, which can lead to more serious issues like cirrhosis. A cross-sectional 2021 study found that, among 149 participants being treated for nonalcoholic fatty liver disease, instances of liver fibrosis were significantly and inversely associated with skeletal muscle mass, and significantly and positively associated with fat mass, waist-hip ratio, and visceral fat.

Other considerations

There are also some other common risk factors that you could use to predict the health of your liver and its subsequent functioning. While these factors might not necessarily be body composition measurements, they tend to be positively correlated with both metabolic conditions and nonalcoholic fatty liver disease — and both of these can be influenced by body composition.

Take metabolic syndrome, for example. Metabolic syndrome is a cluster of metabolic conditions like high blood sugar, high cholesterol, and abdominal obesity that can increase your risk for developing serious chronic conditions, including heart disease and Type 2 diabetes. Because metabolic syndrome and nonalcoholic fatty liver are both heavily influenced by obesity and other body composition factors, scientists often find an association between the two. For example, one global epidemiological review found that there was a 42.54% association between NAFLD and metabolic syndrome. Interestingly, a fatty liver overproduces both blood sugar and triglycerides, two of the key components found in metabolic syndrome. So, while having metabolic syndrome might not cause fatty liver, or vice versa, having high triglyceride levels and/or blood sugar levels might indicate that it’s time to have your liver checked by a doctor.

Triglyceride levels

In addition to the amount of stored fat tissue in your body, there’s also the fat in your blood to consider, otherwise known as your “triglyceride levels.”

One of your liver’s jobs is to create triglycerides, a form of fat that it releases when your body needs energy. These triglycerides are then delivered to your cells via your bloodstream, where they can provide energy. But, under certain conditions, such as obesity, your body’s ability to process its fats can change, contributing to the accumulation of fat on your liver. In fact, a 2014 study found that, among 168 NAFLD patients, elevated triglyceride levels were the strongest predictor of NAFLD compared to other metabolic issues, including cholesterol and blood glucose levels.

Insulin resistance

Another risk factor for the fatty liver disease has to do with insulin resistance, which is also associated with obesity and high body fat percentages.

Under typical circumstances, the hormone insulin helps your body store glucose, which is what carbohydrates are broken down into upon digestion in your body. Insulin also suppresses lipolysis, which is the process by which your body breaks down its stored fat for energy. But your cells can become insulin-resistant for a variety of metabolic-related reasons, including regular overconsumption of calories. Unfortunately, some scientists believe that insulin resistance can impact your ability to suppress lipolysis, leading to increased fat storage in your liver instead. Insulin resistance can also promote inflammation, which may further contribute to liver damage.

Assessing your risk

Regular visits with your primary care provider are critical for diagnosing diseases like nonalcoholic fatty liver disease. But, short of ultrasounds, CT scans, and invasive liver biopsies, you can also keep an eye on your risk factors for fatty liver diseases simply by keeping track of your body composition and taking regular blood tests.


  • Body composition testing is an easy, non-invasive way to keep an eye on those body composition factors that have been linked to liver function, such as your body fat percentage, skeletal muscle mass, and visceral fat. While body composition testing can’t help you diagnose diseases or conditions, it can certainly help you keep track of your risk for fatty liver and other metabolic conditions — and help you be proactive about monitoring your liver function without involving more expensive or invasive testing methods. The great news here is that if you do experience NAFLD or other liver issues, dietary changes and weight management may be able to help. Researchers have found that high-calorie diets and excessive fructose consumption are often associated with instances of NAFLD, but losing just 5-10% of your total body weight can lead to improvements.


  • Blood tests are an invaluable tool for taking a closer look at other risk factors that could be affecting your liver function. For example, triglyceride tests/cholesterol panels and blood sugar tests can provide key insights into your metabolic health and indicate if something more serious is going on that needs to be addressed.


If you do find that either your body composition tests or your blood tests indicate that you may be at a higher risk for developing NAFLD or other liver complications, you can check in with your doctor to ensure that any potential issues are detected in a timely manner.


A healthy liver is critical for an overall healthy body, but you may not always be able to tell that there’s something wrong with this important organ until it is too late. But by monitoring key body composition measurements, you can take a proactive role in managing your risk factors.

Body Composition Change after Recovery from COVID-19

By Body Composition, Health, Nutrition

COVID‐19 patients are prone to develop significant weight loss, malnutrition, and deterioration of body composition which are caused by many different factors. According to research, 81% of patients on the rehab wards post COVID-19 required dietetic input.

The main factors are as follows.

  1. COVID-19 infection can cause major inflammation, particularly pronounced in patients with severe and critical diseases.
  2. Malnutrition is frequently seen in COVID‐19 patients. Disease‐associated reductions in food intake and malnutrition can contribute to tissue wasting.
  3. Immobilization can also significantly contribute to muscle wasting and sarcopenia in COVID‐19. Ultimately, the negative ‘synergy’ of all these factors together can cause significant body wasting in COVID‐19 patients as clinically often observed.

Then how does the body composition change after COVID-19 infection and during the recovery? 


Body Composition Change After Infection

Through the actual case of a patient who recovered from COVID-19, we will see how body composition changed after being infected with COVID-19 and in the recovery, and how the InBody results can help COVID-19 patients.

On December 19th of 2020, this person was infected with COVID-19 and hospitalized from the 4th to the 9th of January. This 50-year-old male used to maintain good body composition status (with an InBody score over 80).

Below is his InBody result before & after COVID-19.

If you see the change of his body composition before and after the COVID-19 infection, you can see :
1) The weight decreased from 90.3kg to 85.5kg
2) Muscle mass decreased from 40.2kg to 37.2kg
3) ECW Ratio increased from 0.369 to 0.374
4) Phase Angle decreased, especially the trunk Phase Angle from 9.5 to 5.7.


After the infection, not only the patients’ body composition changes but also their lungs might become inflamed, making it tough for them to breathe. For some people, the infection becomes more serious and the lung tissue itself becomes swollen and filled with fluid and debris from dead cells.

This man had similar symptoms as above. COVID-19 made him difficult to have proper breathing. After the treatment, the function of the lung, immunity system, and breathing ability got slowly well with the effort of doctors and nurses, but he also tried some exercises to accelerate the recovery process and get back to the condition before the infection.


His Efforts for the Recovery

In the beginning, he started doing exercise as usual. He tried running, swimming, and other exercises. However, his heart rate dramatically went up as soon as he tried those exercises. Even when he tried to climb the stairs in his home, his heart rate increased up to 130bpm with SvO2 dropping to 88%. Then it took more than 5 mins to get his breath back. This is because hard/strong exercise for someone who has respiratory diseases makes the condition worse. It is proved by several research studies conducted about how hard exercise negatively affects lung function.

Then how did he manage it? He started to exercise in a controlled condition. Starting with slowly walking between the kitchen and room. Then he tried several exercises with monitoring his SvO2 and HR rate to find the best exercise which does not affect his body condition. He found that indoor cycling at zero effort can maintain his SvO2 between 88-92% and HR between 78-90. He exercised his lung systematically to breathe deeper and deeper. He also monitored blood glucose levels as COVID-19 gave the pancreas beating.


Body Composition Change during the Recovery

As shown above, after the exercise,

  1. His weight increased from 85.5kg to 89.4kg,
  2. His muscle mass, which had been reduced to 37.2kg, increased to 39kg.

Most of the COVID patients suffer from weight loss/muscle loss (about 61% decreases by more than 5% of the total body weight), and it is difficult for them to increase their muscle and weight, but it is very important.


Use of Body Composition for COVID-19 Patient

In order to return to a healthy status same as before the COVID-19, close body composition monitoring is necessary. During the recovery process, if you only focus on the weight gain, important nutritional indicators (ECW ratio, Phase Angle) and fat/muscle management are not able to be achieved. Without management of key factors, the nutritional status may not return to normal.

If we take a look at the results of the 50-year-old man, some of the parameters were recovered, but the ECW Ratio or Phase angle did not return to the previous status, and at the same time he thought that the body condition is not the same as before.

In many cases of COVID-19 patients, they tend to focus on the weight only to monitor the recovery, but in fact, the perfect recovery can be achieved when we monitor and manage the body composition.

• Muscle Loss (Sarcopenia)

1) While the patients are suffering from disease, physical activity decreases.
2) One of the most common post-COVID symptoms is fatigue, which refrains post-COVID patients from physical exercises.

The above two can lead to muscle loss. To prevent sarcopenia, it is important to monitor the muscle mass and have some proper treatments not to lose muscle.

• ECW ratio (Inflammation)

ECW ratio, the ratio of Extracellular Water to Total Body Water is an important indicator to check the balance of body water. Acute systematic inflammation that can occur during the disease can raise the ECW ratio.
Moreover, since the ECW ratio sensitively reflects your body condition, it can be used to track the recovery of the patient.

• Phase Angle (Nutrition)

Phase Angle is a clinically important bioimpedance parameter used for nutritional assessment and evaluating the severity of various diseases.
Low Phase Angle tends to be consistent in individuals with malnutrition, infection, cancer, and old age.

Phase Angle can be also used to monitor the recovery of the post- COVID patients.


If you want to know more about the body composition analyzer which shows ECW ratio, Phase Angle, please contact us.


Your Metabolism and Your Body Composition

By Fitness, Health, InBody Blog
Editor’s Note: This post was updated on October 5, 2018for accuracy and comprehensiveness. It was originally published on February 10, 2016

You probably don’t think about your body composition when you’re thinking about your metabolism. But you should.

You probably think about it in terms of speed: “My metabolism is fast” or “my metabolism is slowing down.”  If that sounds like you, you’re not alone: simply googling the word “metabolism” yields 4 articles in the top 10 all based around boosting/increasing your metabolism for weight loss.

People are naturally afraid of their metabolism slowing and the weight gain they know comes with it. To some extent, those worries are well-founded.

Metabolism is linked with weight gain and loss because of its a biological process involved with energy and calories.  

The Mayo Clinic defines metabolism as:

…the process by which your body converts what you eat and drink into energy. During this complex biochemical process, calories in food and beverages are combined with oxygen to release the energy your body needs to function.

Notice how it doesn’t mention anything about the speed you process your food. That would be digestion.

In medical terminology, metabolism is known as your Basal Metabolic Rate (BMR), which is the minimum number of calories your body needs to perform basic bodily functions. BMR is usually expressed in terms of calories.  Your Basal Metabolic Rate also has another interesting quality: the more Lean Body Mass (which includes muscle, water, and minerals) you have, the greater your BMR will be.

When we talk about metabolism, we should always start the conversation with how many calories your body needs. But because your BMR and Lean Body Mass are linked, that means any conversation about metabolism becomes a conversation about your body composition.

Your Body Composition Is Linked To Your Metabolism

Why is it that some people seem to be able to eat whatever they want and never experience any weight gain, while other people – even skinny people – feel like whenever they have one bite of dessert it instantly goes to their waistline?

The reason is that metabolism can vary in size.

Take a look at these two body composition profiles, and see if you can spot the difference.

Beyond the obvious differences in weight, the Person A has a much smaller Basal Metabolic Rate than the second.  This means Person B needs more calories than Person A in order to provide their body with the necessary energy to function without losing weight.  Because the BMR is bigger, the metabolism is “bigger.”

Greater than height and gender, the most important factor playing into BMR is the amount Lean Body Mass each person has.  That’s because, as research in the American Journal of Clinical Nutrition states, the more Lean Body Mass you have, the greater your Basal Metabolic Rate will be. That is why strength training for muscle gain, which in turn will increase your lean body mass, is recommended as a way to increase your metabolism.

This is why people who are big or above average in weight can eat more than people who are smaller.  Their body literally requires them to eat more to maintain their weight, and specifically – their Lean Body Mass.

OK, you say, but these two people are very different in body weight – of course, the second person will have a bigger metabolism.  Take a look at the two people below, who we’ll call “Jane” and “Sarah”, two individuals who are similar body in age, height, weight, and gender.

Despite being similar in age, height, weight, and gender, these two people have very different body composition profiles.  As a result, they have different Basal Metabolic Rates. Although Jane has a body weight within the normal range (identified by being near the 100% mark), her body composition is defined by having more fat mass and less lean body mass and skeletal muscle than Sarah.

The person below has a lower body fat percentage and more Lean Body Mass – which is why when looking at this person, you’d describe them as “lean.”  Again, because this person has more than 10 pounds more Lean Body Mass, her Basal Metabolic Rate comes out over a hundred calories greater than the person above.

Metabolism and Weight Gain Over Time

Image Source: Flickr

Let’s take a deeper look at what you might call a “slow” metabolism. Far from being an issue of fastness or slowness, weight gain is almost always the result of a caloric imbalance that goes unchecked over a long period of time.

But first, something needs to be clarified – your Basal Metabolic Rate is not the only factor that plays into your overall caloric needs, and it’s not the total amount of calories you need in a day.  There are two other major influencers, which are:

  • Your energy level – how active you are
  • The thermic effect of food – the energy your body uses to digest your food

These taken together with your Basal Metabolic Rate provide your Total Daily Energy Expenditure (TDEE). This is the number of calories your body burns in a day.

BMR is a necessary piece of information to estimate TDEE. Although they’re not exact, equations exist for estimating your TDEE based on your activity level and BMR. These are based on multiplying your BMR with an “activity factor” – a number between 1 and 2 – that increases the more active you are (and decreases when you are less active, regardless of your appetite).

To take a closer look into metabolism and weight gain, let’s take the two people whose body compositions we’ve looked at above, Jane and Sarah, and see what could happen in a real world example and accounting for diet and exercise.

For this exercise, we first need to estimate TDEE for Jane and Sarah, using their BMRs as a guide.  Based on Jane and Sarah’s compositions, it would be fair to assume that Jane does less exercise/is less active than Sarah, so we’ll assign an activity level of “Sedentary” for Jane and assign “Lightly Active” for Sarah.

Using these numbers and multiplying it by the appropriate activity factor, we can estimate Jane’s TDEE to be 1573 calories and Sarah’s to be 1953 calories, a difference of 380 calories.

Notice how although the difference in BMR was a little over 100 calories when activity levels are factored in, the difference in actual caloric needs becomes magnified.

Now that we have an estimate of the calories Jane and Sarah will need/burn in a day, let’s give them calories to take in. Let’s put them both on a diet of 1,800 calories a day – the estimated caloric intake suggested by the USDA for sedentary women between the ages of 26-30.

Assuming that Jane and Sarah both follow the 1,800 calorie diet perfectly without any extra, high caloric snacks or treats, Jane would end each day with a calorie surplus of 227 calories/day. Sarah would end each day in a slight calorie deficit of 153 calories a day.

When you are in a caloric surplus – taking in more calories than you use – and live a mostly sedentary lifestyle, you will experience weight gain, specifically, fat. An extra 227 calories a day might not seem like a lot at first – that’s about a single soda -, but over time, a surplus of 227 calories a day becomes 1589 extra calories a week and a surplus of 7037 extra calorie a month: roughly 2 pounds of fat gain per month.

calorie surplus

Bottom line: despite being the same height, same gender, similar weight, and similar ages, because of the difference between Jane and Sarah’s body compositions, Jane will experience weight gain over time while Sarah might experience some weight loss (because of her calorie deficit), even though their diets are the same.  That’s because the differences in their caloric needs, although seemingly small at first, increase to significant differences when allowed to persist over time.

It’s not about their age or anything else; it’s about their body compositions determining their metabolism/caloric needs.

Making Your Metabolism Work For You

Because your metabolism isn’t something that slows down or speeds up depending on things like age, this actually gives you some control over it.  With the correct exercise and dietary plan, you can make your metabolism work for you

  • Improve and increase your metabolism

It all goes back to improving and maintaining a healthy body composition.

Because your body needs more energy to support itself when it has more Lean Body Mass, working to increase your Lean Body Mass can actually increase your Basal Metabolic Rate, which can have a huge impact on your TDEE once you factor in your activity level.

  • Avoid a decrease in your metabolism

For many people, simply maintaining their metabolism or avoiding a “slowdown” (which as we’ve seen, is a myth right up there with muscle turning into fat) is an important goal.

How can you avoid a decrease of your metabolism?

In short: by maintaining the Lean Body Mass that you already have.  That means maintaining your Skeletal Muscle Mass.

Your Skeletal Muscle Mass isn’t the same as your Lean Body Mass, but it is the overall biggest contributor to it. It’s the muscle that you can actually grow and develop through exercise, and increases/decreases in SMM have a strong influence on increases/decreases in Lean Body Mass.

Skeletal Muscle Mass is best developed through strength training and resistance exercise along with a proper diet.  A regular exercise plan that includes strength training and resistance exercise will help you maintain your Skeletal Muscle Mass.

This can be especially important as you age.  As people become older and busier, activity levels tend to drop and a proper diet can become harder to maintain as responsibilities increase.  Poor diet and nutrition can lead to loss of Lean Body Mass over time, which leads to a decrease in overall metabolism – not a slowdown.

  • Balance your diet and with your metabolism

The example of Jane is a good example of a well-intentioned dietary plan that doesn’t match the metabolism of the person practicing it.

Even though Jane has been led to believe that 1,800 calories is right for her based on age and gender, her metabolism doesn’t require that caloric intake, and she will end up gaining weight despite her efforts to eat a healthy diet. In the end, she will probably end up blaming her “slowing metabolism.”

It’s examples like Jane’s that show how important understanding the link between metabolism and body composition is.

How much Lean Body Mass do you have?  What might your Basal Metabolic Rate be?  These questions should be answered first before starting any weight loss or diet program, as well as conversations about metabolism.

The first step is always to get the information you need to get the answers to these questions by getting your body composition accurately tested.  Your metabolism and your body composition are strongly linked, so in order to truly understand your metabolism and weight, you must get your body composition tested.

Sarcopenia: What You Need To Know

By Health, InBody Blog
Editor’s Note: This post was updated on November 4, 2018for accuracy and comprehensiveness. It was originally published on September 12, 2017.

It’s no secret that we’re living longer now than ever before. The average life expectancy in the United States was 78.8 years of age in 2015, up from 76.8 in 2000.

While living a longer life sounds great in theory, its only great as far as your health and body allow it.

We often focus on proper nutrition and physical activity as a way to prevent chronic diseases such as Cardiovascular Disease or Diabetes, but we sometimes neglect the importance of nutrition and exercise on our body composition and how that impacts our long-term health and functional ability.

As we age, our body composition begins to shift, physical activity tends to decrease, and this leads to a change in our body composition. Coupled with a change in diet (or a change in our nutrition status as a result of a medical condition), muscle mass begins to decline, and we become susceptible to accidental injuries, chronic joint pain and decreased tolerance to surgery.

After the age of 50, there is a 1-2% annual decrease in muscle mass. An average 5-13% of elderly people aged 60-70 years will be affected by clinically significant muscle loss. Once you hit 80 years old, that number increases to 11-50%.

Why do we care? Because loss of muscle leads to decreased functional capacity in adults and is associated with numerous amounts of health risks and a decrease in quality of life decreases.

Let’s take a closer look at why being aware of the risk of sarcopenia is so important, and how you can combat it.


What does Sarcopenia even mean?

Sarcopenia refers to a clinically significant loss of muscle mass and strength resulting from “normal aging”. It is not solely the result of disease, but rather, is part of the natural aging process. This is not to be confused with cachexia, which describes the uncontrolled loss of muscle mass and/or body fat mass. While cachexia is most often thought of as a case of malnutrition due to health conditions such as cancer, sarcopenia focuses on changes in nutrition and physical activity that causes a progressive loss of muscle mass. This is important because sarcopenic individuals can maintain their fat mass, which can also lead to a “skinny fat” body composition. The condition of sarcopenic obesity has greater health consequences, as we will describe later.

Historically, scientists and doctors believed that this muscle loss and its resulting consequences (balance issues, change in walking performance and a decreased ability to perform activities of daily living) were inevitable, but experts agree if we stay on top of our activity and body composition, we might just be able to fight this slow loss of muscle mass and strength.

It’s no secret that as we age, not only do we tend to gain more fat, but we also begin to lose muscle mass.

Studies have shown that older adults between the ages of 60-69 years old have 14 and 13 pounds less lean body mass respectively than men and women 20-29 years old, despite being more than 8 to 12 pounds heavier.

So what’s going on?

What causes sarcopenia?

To reiterate, sarcopenia is thought to be part of the normal aging process but the process is more complex than that.

Causes seem to be multifactorial and include age, inadequate nutrition (such as decreased protein intake), hormonal changes, increases in pro-inflammatory proteins (proteins that our body makes, not the ones that we eat), decreased physical activity, vascular (circulatory) diseases, etc.

Let’s break this down further.

While we do know that sarcopenia is often related to aging, we also know that there are many other factors that contribute to the progressive muscle loss that characterizes sarcopenia. Some of these factors are not directly related to our diet but may exacerbate the muscle loss or cause it to progress more quickly.


One study found that the prevalence of sarcopenia increased from 4% of men and 3% of women aged 70-75 years old to 16% of men and 13% of women age 85 and older. This may be related to the changes in activity, so we are still learning if we are able to prevent this “aging-related” muscle loss.

Hormonal Changes

Hormones are chemicals produced by the endocrine system that help control major bodily function. As we age, hormone production changes which play a huge part in the aging process, as they are involved in the development of muscle mass and strength.

Testosterone is the primary male sex hormone but affects the health of both men women. The production of this hormone plays a central role in the risk of sarcopenia. Testosterone helps to increase muscle gain and also activates satellite cells, which support increased function. When testosterone begins to decline with age, we not only get a decrease in protein synthesis but also decreasing ability to produce  satellite precursor cells which are essential for muscle repair.

Diminished intake of protein and creatine

Many seniors are at risk of malnutrition because a variety of external factors that affect their ability maintain good nutrition. Malnutrition is defined as a state of lack of uptake or intake of nutrition which can affect body composition negatively. These complications affect not only our diet/exercise but how our body responds to our diet and exercise.

An important nutrient that elderly people may not be getting enough of is protein. Trouble chewing, high food costs, are trouble cooking are all factors that limit elderly people access to protein. Inadequate protein intake can progress sarcopenia.

That because protein requirements for the elderly population may even be higher than a younger population. This is due to age-related changes in the metabolism of protein, including a decreased response to protein intake. This means that an older population needs to consume more protein to get the same anabolic effect.

Decreased physical activity

Physical inactivity is one of the primary factors in the progression of sarcopenia. Regular resistance exercise can help to maintain muscle mass and also build muscular strength. Elderly people tend to be more sedentary than younger populations which can exacerbate the effects of sarcopenia.

Decrease in motor neurons

Aging is accompanied by a loss of motor neurons due to cell death, which leads to a parallel decrease in muscle fiber number and size. This decrease in muscle fibers leads to impaired performance, a reduction in the functional capacity and a decreased ability to perform everyday tasks.

Increase in Pro-inflammatory Cytokines

Poor diet and exercise are also known to promote the storage of visceral fat. This type of fat tissue produces proinflammatory cytokines which can accelerate muscle breakdown and thus, worsen risk. Obesity and muscle weakness are both associated with high levels of these pro-inflammatory cytokines. Central obesity, made worse by decreased muscle mass seems to play a role in the progression of sarcopenia.

Disease-related malnutrition

Disease-related malnutrition is different than the previously related malnutrition because this type of malnutrition is directly triggered by sickness or illness.

When an individual suffers from a health-related disease or is provided long-term hospital care increases their risk of malnutrition. A few of the conditions are provided here as an example.

Cardiovascular and respiratory diseases such as Congestive Heart Failure (CHF), Peripheral Arterial Disease (PAD) and Chronic Obstructive Pulmonary Disease (COPD) tend to have onset during middle age, but the elderly population is most negatively affected. Elderly patients with these conditions undergo significantly greater wasting than those who are younger.

A decline in insulin-like growth factor or the development of insulin resistance also seems to accelerate the development of sarcopenia. Thus, both common health conditions such as diabetes and more severe conditions such as heart failure all contribute to larger losses in muscle.

What does this all mean?

While some of these changes that occur within the body are expected with older age, the importance of proper diet and physical activity cannot be underscored enough; the better you treat your body, the more likely you are to prevent progressive muscle loss. Additionally, a healthy diet can prevent the storage of harmful fat mass, which may increase health risks.

Sarcopenic Obesity

You may not have heard the term sarcopenic obese, but you’ve likely heard the term skinny fat. A person who is “skinny fat” may be a normal weight but has a metabolic composition similar to someone who is overweight or obese.

A person who is “skinny fat” has lost muscle mass and gained or maintained fat mass. This can be the result of an improper diet coupled with physical inactivity.

Because sarcopenia is most commonly the result of improper diet/exercise, a person of any age can be sarcopenic obese, especially if they neglect their nutrition and exercise. This is why it’s so important to focus on body composition and not just weight.

How do you know if you’re sarcopenic? You’ll want to determine your body composition using a medical body composition analyzer and keep an eye on how it changes over time. If you find that your lean body mass is decreasing while your fat mass is increasing, you may be experiencing increasing your risk for sarcopenia or sarcopenic obesity.

How can you fight Sarcopenia?

While there is currently no cure for sarcopenia, there are multiple things you can do to ensure to preserve muscle. Similar to wearing sunscreen, it’s important to take these preventative measures. If you are already experiencing muscle breakdown, these factors might help delay its progression.

1) Strength Training

While we know it is important to exercise for your physical health, it is important to begin strength training( such as resistance training, bodyweight exercises, etc) at a young age to keep muscle mass high and decrease the likelihood that muscle will begin to break down prematurely

Resistance training has been shown to be effective at preventing or delaying sarcopenia, even in a very elderly population. Research has shown that resistance training elicits muscle hypertrophy as well as changes in neuromuscular function. These changes in muscle mass and nervous system function lead to an improved ability to perform those functional activities that may become more difficult with older age. If you are worried that your body is too old to cope with resistance training, remember that there is no age limit. If you are worried about injury, train under the supervision of a accredited fitness professional and stay within your ability level.  

2) Increase Protein Intake

Protein is essential for building and repairing muscle tissue. The current Acceptable Macronutrient Distribution Range (AMDR) for protein is set at 10-35% of your daily energy needs. For those who already have signs of impaired muscle size or function, adequate protein intake is even more important to allow for optimal protein synthesis in the body.

The good news is that protein supplementation alone may slow muscle mass decline, but when coupled with theproper amino acid balance and creatine, it can also enhance muscle strength.


3) Increased Amino Acid Intake

Studies suggest that amino acid supplementation may improve outcomes for people with sarcopenia.. A popular supplement is essential amino acids, which are amino acids that the body cannot make on its own and can only be obtained from dietary sources. Leucine, an essential branched-chain amino acid (BCAA) has been shown to preserve lean body mass. Leucine seems to stimulate muscle protein synthesis in a similar way in both young and elderly populations.

4) Monitor Your Hormone Levels

As mentioned earlier, hormones can play a significant role in the progression of sarcopenia. Stay on top of your hormones by having your doctor check your levels during your annual visit.

As it currently stands, Hormone Replacement Therapy is not yet recommended for the treatment of sarcopenia but may become a feasible treatment option in the future.

5) Watch Your Vitamin D Levels

Vitamin D deficiency has been shown to be correlated with muscle loss in women regardless of body composition, diet and hormonal status. The research suggests that avoiding Vitamin D deficiency is not just important for bone health, but also in the avoidance of aging-related muscle loss.


Wrapping It Up

There are so many changes that come with aging, but decreasing quality of life doesn’t have to one of them. By focusing on resistance training, consuming adequate protein, and amino acid supplementation, you can improve the quality of life and functional ability by lowering your risk for developing sarcopenia. Regular body composition checks will create a more accurate picture of what is really going on with your muscle mass. By focusing on body composition rather than weight, you can better understand the changes that are taking place in your body.



For more information on InBody products which show the index for sarcopenia, please click here.


Alix Turoff MS, RD, CDN, CPT is a Registered Dietitian and NASM Certified Personal Trainer. She sees patients privately and also works as a freelance consultant and writer.