The Importance and Uncertainties About Preserving Muscle
The attention that goes daily to the subject of preserving muscle and its importance is off the chart. Just this week a call to action about muscle loss in diabetes and a new systematic review on the effects of resistance exercise on cognitive function are demanding our attention.
It is clear that preserving muscle as we age or try to cope with obesity is important. It has big effects on long-term health. But it is also clear that we have a great deal to learn about it.
Sarcopenic Diabetes
A new paper in Clinical Nutrition tells us one in four patients with type 2 diabetes will have sarcopenic diabetes. That is the combination of diabetes with the loss of muscle mass and function. Sarcopenia typically occurs with aging, but but the pathophysiology of diabetes adds to the risk of it.
So leaders from ESPEN and EASD tell are calling for action. They say that sarcopenic diabetes is neglected, much to the detriment of patient health:
“Diabetes and adiposity are mechanistically related to sarcopenia, defined as reduction of skeletal muscle strength and mass, through complex muscle-catabolic derangements, conferring additional risk for negative outcomes. Awareness of diabetes-induced muscle abnormalities remains low among healthcare professionals, patients and policymakers, contributing to research, knowledge and practice gaps. Lifestyle recommendations and treatments centered on nutritional care and physical activity to preserve and improve muscle mass and function remain poorly implemented.”
Resistance Exercise and Cognitive Function
A new systematic review and meta-analysis published by Frontiers in Psychiatry tells us pretty definitively that preserving muscle function with resistance exercise can help with preserving cognitive function:
“Resistance exercise exerts selective benefits on cognitive domains in older adults, particularly enhancing overall cognition, working memory, verbal learning, and spatial memory. The magnitude of improvement appears to depend on age and exercise parameters, suggesting a potential dose–response relationship. These findings provide evidence-based guidance for resistance training into cognitive health promotion and rehabilitation programs for ageing populations.”
Uncertainties
Sensational reporting about this subject – especially in the context of obesity care – is rampant. It is not, however, very helpful. For example, Vox writes this week that “people taking Ozempic are losing muscle mass and it’s freaking them out.” That was their clickbait. Read the article and you will find no evidence of “freaking.”
What is clear, though, is that we have much to learn. John Jakicic and Renee Rogers explain this in a recent review paper. They describe an assumption that physical activity and structured exercise will prevent muscle loss when people lose weight with new obesity medicines:
“Physical activity and structured exercise have been suggested as potential strategies for attenuating these reductions, yet there is a paucity of research to support that these benefits will be realized.”
Of course they call for more research to fill the gaps. But they also call for a focus on what is known – the health benefits of exercise itself and the health needs of individual patients. Sweeping generalizations and sensationalism are not so helpful.
Click here for the call to action in Clinical Nutrition, here for the paper on cognition in Frontiers, and here for the paper by Jakicic and Rogers.
The Athlete’s Muscular Flexion, painting by Osmar Schindler / Wikimedia Commons
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December 5, 2025
December 07, 2025 at 10:25 am, John DiTraglia said:
The increase in insulin sensitivity by exercise is probably the mechanistic underpinning of all the other correlates.