A study of 1048 participants without cardiovascular disease found that losing muscle and gaining fat increased the risk of heart disease. Compared with subjects with stable body fat, those who gained fat had a ≥ 2% increase in cardiovascular events. Loss of lean muscle mass was associated with a ≥ 8% increase in cardiovascular events.
LOSE FAT, GAIN LIFE | LOSE MUSCLE, LOSE LIFE SUMMARY
- A study of 1048 participants without cardiovascular disease found that losing muscle and gaining fat increased the risk of heart disease.
- Compared with subjects with stable body fat, those who gained fat had a ≥ 2% increase in cardiovascular events.
- Loss of lean muscle mass was associated with a ≥ 8% increase in cardiovascular events.
Obesity is a growing concern for medical practitioners worldwide. Obesity is associated with many comorbidities, such as cardiovascular disease and diabetes. (Kim et al., 2021) The most common assessment for obesity by medical practitioners is BMI, which is a measure of weight and height. However, the numbers on the scale are not as important for health as body fat percentage and amount of muscle tissue.
SIGNS OF LOSING MUSCLE MASS CAN PREDICT HEART DISEASE
Researchers commonly measure how much muscle a person has by measuring lean muscle mass (i.e., most researchers use a DEXA scan). What is lean muscle mass? Lean muscle mass comprises the combined weight of your bones, muscles, organs, ligaments, and tendons, plus all the water in your body. The measurement includes everything except fat.
Reducing muscle loss is critical for health. Lean muscle mass peaks at the age of 24 years. The loss of muscle loss begins at around 50 years, with mass loss at a rate of 0.5–1.2% per year. (Bell et al., 2016) Between the ages of 50 and 80 years, an additional loss of 30% occurs. (Dennison et al., 2017)
THE DOWNFALLS OF USING BMI
BMI does not differentiate between muscle and body fat. Studies show increases in body fat have been shown to be detrimental to cardiovascular health, whereas increases in muscle mass have a protective effect. (Medina-Inojosa et al., 2018) % body fat is commonly assessed with bodyfat calipers, but DEXA bodyfat measurements are much more accurate. Studies have found that people can have a normal BMI yet be at high risk for cardiovascular disease. (Held et al., 2022)
For example, in a study of 717 patients with heart disease, the risk of cardiovascular events for those with the highest fat percentage was nearly twice that of those with the lowest body fat. The risk of heart disease for those with the highest lean muscle mass was 47% lower than for those with the lowest lean muscle mass. Interestingly, no association was observed between BMI and cardiovascular events. (Medina-Inojosa et al., 2018)
Excessive gains in body fat promote fat cells to release pro-inflammatory factors and insulin resistance, which can lead to heart disease. (Castoldi et al., 2015) (Di Pino & DeFronzo, 2019)
STUDY OF GAINING FAT VERSUS LOSS OF MUSCLE MASS
In a new study, 1048 participants without cardiovascular disease were tracked with regular body fat and lean muscle mass assessments over several years. The researchers found that 2 years of fat gain increase or a loss of muscle mass was associated with an elevated risk of heart disease over the next 5.5 years. Interestingly, loss of lean mass was a higher predictor of future heart disease than gaining body fat.
Participants with 2% fat gain had a ≥ 1.07-fold higher risk of cardiovascular events than those who did not gain body fat. More importantly, muscle loss> 8% was related to a 2.83-fold higher risk of cardiovascular events compared with the stable group. Thus, in addition to changes in blood lipids, changes in body composition should be monitored as an early warning of cardiovascular disease. This mean losing muscle was associated with a greater risk of developing heart disease than gaining bodyfat.
Many adults focus on losing weight and burning fat but pay little attention to gaining muscle. Overweight adults commonly purchase fat burners to increase energy and burn more calories, but these supplements have little research to back their validity. (Clark & Welch, 2021) The benefits of lean muscle mass go beyond having big biceps that look good, as this study found it was predictive of cardiovascular disease risk.
PRESERVING MUSCLE MASS AS WE AGE
Preserving lean muscle mass with resistance exercise is essential for maintaining health and reducing the risk of all-cause mortality. In addition to regular resistance exercise and a high protein intake (i.e., foods and protein powders rich in branched-chain amino acids), there are several supplements for fat loss and muscle gain. A recent study found that whey protein taken in the morning, post-workout, and evening combined with resistance exercise increased lean mass more than a carbohydrate drink. (Kim et al., 2023) Studies have also shown that whey protein can enhance fat loss as well. (Frestedt et al., 2008)
Creatine monohydrate has been shown to improve mental function, increase lean muscle mass, and reduce body fat. (Avgerinos et al., 2018; Forbes et al., 2019; Wu et al., 2022) Creatine can be taken pre-workout or post-workout; creatine timing has no benefit.
SIGNS YOU ARE LOSING MUSCLE MASS
Regular body composition assessments are the best way to determine if you are losing muscle mass. Muscle loss is extremely common when on a calorie-restricted diet, and you feel sluggish. Weight loss, muscle weakness, fatigue, etc., are all common symptoms of excessive muscle loss.
Avgerinos, K. I., Spyrou, N., Bougioukas, K. I., & Kapogiannis, D. (2018). Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Experimental gerontology, 108, 166-173. https://doi.org/10.1016/j.exger.2018.04.013
Bell, K. E., von Allmen, M. T., Devries, M. C., & Phillips, S. M. (2016). Muscle Disuse as a Pivotal Problem in Sarcopenia-related Muscle Loss and Dysfunction. J Frailty Aging, 5(1), 33-41. https://doi.org/10.14283/jfa.2016.78
Castoldi, A., Naffah de Souza, C., Câmara, N. O., & Moraes-Vieira, P. M. (2015). The Macrophage Switch in Obesity Development. Front Immunol, 6, 637. https://doi.org/10.3389/fimmu.2015.00637
Clark, J. E., & Welch, S. (2021). Comparing effectiveness of fat burners and thermogenic supplements to diet and exercise for weight loss and cardiometabolic health: Systematic review and meta-analysis. Nutr Health, 27(4), 445-459. https://doi.org/10.1177/0260106020982362
Dennison, E. M., Sayer, A. A., & Cooper, C. (2017). Epidemiology of sarcopenia and insight into possible therapeutic targets. Nat Rev Rheumatol, 13(6), 340-347. https://doi.org/10.1038/nrrheum.2017.60
Di Pino, A., & DeFronzo, R. A. (2019). Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents. Endocr Rev, 40(6), 1447-1467. https://doi.org/10.1210/er.2018-00141
Forbes, S. C., Candow, D. G., Krentz, J. R., Roberts, M. D., & Young, K. C. (2019). Changes in Fat Mass Following Creatine Supplementation and Resistance Training in Adults ≥50 Years of Age: A Meta-Analysis. Journal of Functional Morphology and Kinesiology, 4(3), 62. https://doi.org/10.3390/jfmk4030062
Frestedt, J. L., Zenk, J. L., Kuskowski, M. A., Ward, L. S., & Bastian, E. D. (2008). A whey-protein supplement increases fat loss and spares lean muscle in obese subjects: a randomized human clinical study. Nutrition & Metabolism, 5, 8-8. https://doi.org/10.1186/1743-7075-5-8
Held, C., Hadziosmanovic, N., Aylward, P. E., Hagström, E., Hochman, J. S., Stewart, R. A. H., White, H. D., & Wallentin, L. (2022). Body Mass Index and Association With Cardiovascular Outcomes in Patients With Stable Coronary Heart Disease – A STABILITY Substudy. J Am Heart Assoc, 11(3), e023667. https://doi.org/10.1161/jaha.121.023667
Kim, C.-B., Park, J.-H., Park, H.-S., Kim, H.-J., & Park, J.-J. (2023). Effects of Whey Protein Supplement on 4-Week Resistance Exercise-Induced Improvements in Muscle Mass and Isokinetic Muscular Function under Dietary Control. Nutrients, 15(4), 1003. https://www.mdpi.com/2072-6643/15/4/1003
Kim, M. S., Kim, W. J., Khera, A. V., Kim, J. Y., Yon, D. K., Lee, S. W., Shin, J. I., & Won, H. H. (2021). Association between adiposity and cardiovascular outcomes: an umbrella review and meta-analysis of observational and Mendelian randomization studies. Eur Heart J, 42(34), 3388-3403. https://doi.org/10.1093/eurheartj/ehab454
Medina-Inojosa, J. R., Somers, V. K., Thomas, R. J., Jean, N., Jenkins, S. M., Gomez-Ibarra, M. A., Supervia, M., & Lopez-Jimenez, F. (2018). Association Between Adiposity and Lean Mass With Long-Term Cardiovascular Events in Patients With Coronary Artery Disease: No Paradox. J Am Heart Assoc, 7(10). https://doi.org/10.1161/jaha.117.007505
Wu, S.-H., Chen, K.-L., Hsu, C., Chen, H.-C., Chen, J.-Y., Yu, S.-Y., & Shiu, Y.-J. (2022). Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021. Nutrients, 14(6), 1255. https://doi.org/10.3390/nu14061255