Muscle mass and longevity. Why is it worth protecting?

Muscle mass is mostly associated with physical activity, physique and fitness. Yet its importance goes well beyond the ability to exercise. Muscles help regulate glucose metabolism, shape everyday functioning and help you stay independent as you age.

Research shows that low muscle mass and reduced muscle strength are linked to a higher risk of functional limitations, chronic disease and premature death. That is why preventive healthcare pays increasing attention to maintaining muscle throughout life.

Muscle mass and lifespan. What does the research show?

A meta-analysis published in 2023 examined 49 prospective studies with more than 878,000 participants in total. People with low muscle mass had, on average, a 36% higher relative risk of death from any cause than people without it. An association with the risk of cardiovascular death was also observed [1].

These results come from observational studies, so the possible influence of chronic disease, malnutrition and other factors has to be taken into account. Low muscle mass can be both a factor affecting health and a consequence of existing health problems.

Research on muscle-strengthening activity adds important information. A meta-analysis published in the British Journal of Sports Medicine in 2022 found that such activity was associated with an approximately 10–17% lower risk of death and of selected chronic diseases. Favourable associations were seen with as little as 30–60 minutes of muscle-strengthening exercise per week [2].

These associations point to the importance of muscular activity for health. They do not, however, allow us to say by how many years a given person will extend their life by increasing their muscle mass.

Muscle mass and muscle strength are two different measures

Assessing muscle health requires looking at both the quantity of muscle and its ability to generate force.

Muscle mass describes the amount of muscle tissue in the body. Muscle strength refers to the ability to do work and overcome resistance. The two are related, but they do not always change at the same pace.

A person with relatively large muscle mass may have limited physical function, while someone with less muscle mass may maintain very good strength and functional capacity.

In the current European consensus, EWGSOP2, low muscle strength is the primary indicator suggesting sarcopenia. Reduced muscle quantity or quality confirms the diagnosis, and additionally impaired physical performance indicates severe sarcopenia [3].

From a health perspective, what matters is keeping muscles that can work effectively, not reaching the highest possible muscle mass.

Sarcopenia. Why do muscles weaken with age?

Sarcopenia is a skeletal muscle disease characterised by a progressive decline in muscle strength and in the quantity or quality of muscle tissue.

Ageing brings changes in muscle structure, in nervous system function and in the response to training stimuli. Lower physical activity, insufficient protein intake, chronic disease and periods of immobilisation also play a role.

Muscle loss can accelerate during hospitalisation, prolonged bed rest or inadequate nutrition. In older adults, rebuilding lost muscle tissue tends to be harder, especially with coexisting conditions.

Sarcopenia increases the risk of falls, reduced mobility and loss of independence. It can also develop in people with overweight or obesity, so body weight and BMI alone are not enough to rule it out [3].

It is worth starting to prevent significant muscle loss well before old age.

Why do muscles matter for metabolic health?

Skeletal muscles are one of the main sites of glucose use in the body. Under the influence of insulin, muscle cells increase their uptake of glucose from the blood, which can then be used for energy or stored as glycogen.

Regular physical activity improves the muscles' ability to use glucose and supports insulin sensitivity. This is particularly important in the prevention of type 2 diabetes and for people with metabolic disorders.

Muscles are also an important reserve of body protein. During serious illness, injury or inflammation, the body can increase the breakdown of muscle proteins and use the released amino acids in metabolic and repair processes.

Maintaining good nutritional status and muscle function therefore also matters for tolerating illness and for recovery. The size of these benefits depends on age, clinical status and the type of condition.

How to protect muscle mass effectively?

1. Regular resistance training

Resistance training means doing exercises in which muscles work against a given resistance. This can be weights, resistance bands or your own body weight.

According to WHO guidelines, adults should do muscle-strengthening exercises involving the major muscle groups at least twice a week. This recommendation also applies to older adults, adjusted to their abilities and health [4].

A sample workout may include:

• Squats or standing up from a chair.
• Pulling exercises with a resistance band.
• Wall push-ups or push-ups on a raised surface.
• Calf raises.
• Core-strengthening exercises.

Beginners can start with two short sessions a week, gradually increasing the number of repetitions and the level of difficulty. We describe how to return to movement safely in our article on how to start exercising after a long break, and the benefits of strength work in our piece on strength training for women.

Aerobic activity is worth including as well. WHO recommends that adults get 150–300 minutes of moderate activity a week or 75–150 minutes of vigorous activity [4]. For older adults, balance exercises are also particularly important.

2. Adequate protein intake

Protein supplies the amino acids used to build and repair muscle proteins. Getting enough of it matters especially during regular training, weight loss and in older age.

The 2022 ESPEN guidelines recommend that older adults consume at least 1.0 g of protein per kilogram of body weight per day. For healthy older adults a range of 1.0–1.2 g/kg is often suggested, while in selected medical conditions requirements may reach 1.2–1.5 g/kg [5].

For example, for a healthy older person weighing 70 kg, a range of 1.0–1.2 g/kg corresponds to roughly 70–84 g of protein a day.

Protein can come from both animal and plant foods. We write more about spreading it across the day in our article on protein in women's diet.

Protein content depends on the product and how it is prepared.

In practice it helps to include a protein source in every main meal. With a reduced appetite, foods with a higher protein concentration, such as skyr, quark or tofu, can be useful.

For chronic kidney disease and other conditions that require a modified protein intake, recommendations should be set individually.

3. Protein supplements. When do they make sense?

Protein supplements can make it easier to meet requirements, especially for people who struggle to get enough protein from their everyday diet.

A 2022 review of systematic reviews found that combining protein supplementation with resistance training in older adults led to greater gains in lean and muscle mass than training alone. Additional benefits for muscle strength were less clear [6].

Supplementation remains a supporting tool. Whether it makes sense depends on actual protein intake, nutritional status and the type of physical activity.

Weight loss and muscle loss

During weight loss the body can lose both fat tissue and part of its lean body mass. The latter includes muscle, water and organs, among other things.

A meta-analysis published in 2025 examined 25 randomised trials in adults with overweight or obesity. Adding resistance training to a dietary intervention limited the loss of lean body mass, led to greater fat loss and improved muscle strength compared with diet alone [7].

These results matter when planning weight loss. A change in the number on the scale alone does not show which tissues have decreased.

During weight loss, pay attention to adequate protein intake, a moderate energy deficit, regular activity and maintaining muscle strength.

In older adults, restrictive weight-loss diets call for particular caution, because excessive muscle loss can impair physical function and increase the risk of malnutrition [5].

How to assess muscle health?

Dietetic practices often use body composition analysis by bioelectrical impedance (BIA). It can estimate lean body mass, among other things, but the result depends on hydration, the device used and the measurement conditions.

That is why a body composition result on its own is not enough to diagnose sarcopenia.

Clinical assessment also uses handgrip strength and the five-times chair stand test. According to the EWGSOP2 criteria, a grip strength below 27 kg in men and below 16 kg in women may indicate reduced muscle strength [3].

Interpreting the results requires taking into account the patient's age, health and physical function. Assessing muscle mass, strength and function gives a fuller picture than watching body weight alone.

Maintaining muscle function is an important part of healthy ageing. Regular resistance training, adequate protein intake and limiting prolonged inactivity help protect muscles from excessive loss. What matters most is the ability to function independently, carry out everyday activities and keep a good quality of life in the decades ahead.

Frequently asked questions

Does more muscle mass mean a longer life?

Observational studies show that low muscle mass is associated with a higher risk of premature death. That does not mean every extra amount of muscle automatically extends life. Muscle strength, physical function and overall health also matter.

At what age do we start losing muscle mass?

Changes in muscle mass and strength can appear as early as middle age, and they often speed up in older age. Regular training and good nutrition help slow this process.

Is walking enough to protect your muscles?

Walking supports health and fitness, but resistance exercise is also recommended to maintain or increase muscle strength. It can be done at home using your own body weight or resistance bands.

How much protein should a person over 60 eat?

ESPEN guidelines recommend at least 1.0 g/kg of body weight per day. For healthy older adults a range of 1.0–1.2 g/kg is often used, and a higher intake may be justified in certain clinical situations. Protein intake should be tailored individually.

Do you always lose muscle when losing weight?

Weight loss can involve losing part of your lean body mass. Well-planned resistance training and adequate protein intake help limit the loss of muscle tissue.

References

1. Zhou HH, Liao Y, Peng Z, Liu F, Wang Q, Yang W. Association of muscle wasting with mortality risk among adults: A systematic review and meta-analysis of prospective studies. J Cachexia Sarcopenia Muscle. 2023;14(4):1596–1612. doi:10.1002/jcsm.13263.
2. Momma H, Kawakami R, Honda T, Sawada SS. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. Br J Sports Med. 2022;56(13):755–763. doi:10.1136/bjsports-2021-105061.
3. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. doi:10.1093/ageing/afy169.
4. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451–1462. doi:10.1136/bjsports-2020-102955.
5. Volkert D, Beck AM, Cederholm T, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958–989. doi:10.1016/j.clnu.2022.01.024.
6. Vieira AF, Santos JS, Costa RR, Cadore EL, Macedo RCO. Effects of Protein Supplementation Associated with Resistance Training on Body Composition and Muscle Strength in Older Adults: A Systematic Review of Systematic Reviews with Meta-analyses. Sports Med. 2022;52(10):2511–2522. doi:10.1007/s40279-022-01704-0.
7. Binmahfoz A, Dighriri A, Gray C, Gray SR. Effect of resistance exercise on body composition, muscle strength and cardiometabolic health during dietary weight loss in people living with overweight or obesity: a systematic review and meta-analysis. BMJ Open Sport Exerc Med. 2025;11(3):e002363. doi:10.1136/bmjsem-2024-002363.