How to Prevent and Reverse Sarcopenia (Muscle Loss) - Doctor Q&A

Start young: Sarcopenia (muscle loss) starts earlier than you think

Sarcopenia is the progressive loss of muscle mass, strength and function that occurs with ageing. The terms derived from Greek - sarx (flesh) and penia (loss). In Singapore, sarcopenia is estimated to affect approximately 1 in 3 adults aged 60 years and above*. 

While muscle loss is a natural part of aging, sarcopenia develops when this loss becomes significant enough to affect mobility, independence and quality of life. The gradual decline in muscle health can begin as early as the 30s and accelerates after the age of 60. 

Who is at risk of sarcopenia (muscle loss)?

While anyone can develop sarcopenia with age, certain factors increase the risk. These include:

• Sedentary lifestyle or low levels of physical activity
• Poor nutritional intake, particularly inadequate protein
• Chronic medical conditions such as diabetes, heart disease or kidney disease
• Prolonged bed rest or repeated hospitalisation
• Excessive alcohol consumption

Individuals with one or more of these risk factors should pay closer attention to maintaining muscle health. 

Recognising the early signs of sarcopenia (muscle loss)

Early signs of sarcopenia are often subtle and may be mistaken for “normal aging”.

However, it is not normal to become weaker as we age! Recognising these warning signs early allows intervention before significant muscle loss occurs:

• Feeling weaker or more easily tired than before
• Difficulty climbing stairs, carrying groceries or rising from a chair
• Walking more slowly than usual
• Reduced balance or more frequent falls

As sarcopenia progresses to its later stages, visible muscle wasting may occur, particularly in the arms, legs and shoulders. 

How is sarcopenia (muscle loss) diagnosed?

Based on the Asian Working Group for Sarcopenia (AWGS) 2025 recommendations, healthcare professionals assess sarcopenia by evaluating:

1) Handgrip strength test to measure muscle strength.

2) Body composition assessment such as Bioelectrical Impedance Analysis (BIA) to estimate muscle mass

Additional assessment including physical performance tests such as 6-minute walk test may also be performed to determine the severity of the condition and guide treatment.

Protecting your muscle health

The good news is that sarcopenia can be prevented, delayed or even reversed, especially if detected early. The earlier healthy habits are adopted, the better the long-term outcomes. 

Key strategies include:

• Perform regular resistance and strength-training exercise
• Consume adequate protein throughout the day to support muscle maintenance
• Maintain a healthy, balance diet
• Stay physically active and avoid prolonged inactivity.

Vitamin D also plays an important role in muscle health. Low vitamin D levels have been associated with muscle weakness. It can be obtained through sunlight exposure and foods such as salmon, sardines, eggs and vitamin D-fortified milk. 

If you have questions about sarcopenia or muscle health, submit them through the forum. A/Prof Frederick Koh is here to help you better understand the condition and what you can do about it. 

*Source: Prevalence and Associated Factors of Sarcopenia in Singaporean Adults – The Yishun Study 2021 

1. Tan LF, Koh FH, Lim WS, Wang Y, Woo J, Arai H, Merchant RA. Sarcopenia: Current evidence, advances in assessment, clinical implementation and future directions. Ann Acad Med Singap. 2026 Jan 15;55(1):26-37. doi: 10.47102/annals-acadmedsg.2025287. PMID: 41601290.

2. Wang JJ, Quak GS, Lee HB, Foo LX, Tay P, Mah SM, Tong C, Koh FH. The Role of Vitamin D Supplementation in Enhancing Muscle Strength Post-Surgery: A Systemic Review. Nutrients. 2025 Apr 29;17(9):1512. doi: 10.3390/nu17091512. PMID: 40362819; PMCID: PMC12073290.

3. Maier AB, Chew STH, Goh J, Koh FHX, Tan NC. Strengthening Muscle Health of Community-Dwelling Older Adults in Singapore: Evidence Towards Clinical Implementation. J Frailty Aging. 2023;12(4):258-266. doi: 10.14283/jfa.2023.31. PMID: 38008975.)[YL1]  [YL1]Can we add a hyperlink for readers who want to learn more?

Clin Assoc Prof Frederick Koh is a Consultant in the Department of Colorectal Surgery, Division of Surgery, at Sengkang General Hospital (SKH). He is also an NMRC-funded Surgeon-Scientist and Principal Investigator at the SKH Musculoskeletal Regenerative Laboratories and leads the SingHealth Duke-NUS Muscle Health Programme. In addition, he serves as Deputy Vice Chair (Research) for the Surgery Academic Clinical Programme (ACP) and Deputy Director, Research at SKH.

Clin Assoc Prof Koh is a strong advocate for academic surgery and is widely published in peer-reviewed journals. His clinical and research interests span general and colorectal surgery, sarcopenia, and the use of artificial intelligence in endoscopy. He holds a PhD focusing on the impact of sarcopenia in surgical patients and continues to lead research in this area, including serving as Clinical Lead for the Mechanistic Investigation and Clinical Innovation for Sarcopenia Diagnosis and Therapy (MAGNET) programme, funded by NMRC OF-LCG in 2025.

His contributions to research and clinical innovation have led to recognition as a key opinion leader with global industry partners such as Abbott, Hyphens Pharma, Pharmacosmo, and Medtronic. In recognition of his academic contributions, he was awarded the 28th Yahya Cohen Memorial Lectureship in 2025 by the College of Surgeons, Academy of Medicine, Singapore.

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