Commentary: Why S’poreans need to bone up on muscle wellness, as more become caregivers to loved ones

Commentary: Why S'poreans need to bone up on muscle wellness, as more become caregivers to loved ones

As Singaporeans live longer, millennials and older adults are having to adjust to a role reversal: becoming caregivers to their aging parents and family members.

The saying often goes, “To Take Care of Others, Start by Taking Care of Yourself”. This holds true especially for those of us who have to juggle providing care for aged parents and loved ones with other responsibilities. Caregivers need to be advocates for their own health, so as to provide quality care in turn.

While mental and financial wellness of caregivers tend to receive great concern, cultivating physical wellness is just as important.

Personal strength is crucial in caregiving, and this involves keeping muscles strong. For caregivers whose daily responsibilities involve continual energy and strength to constantly lift and transfer patients or loved ones, prioritizing muscle health can be an essential part of their caregiving.


Healthy muscles matter. Muscle strength is a key indicator of overall health and plays an integral role in strength, energy, immunity and bone health which enables us to move, lift things, pump blood through the body and even help us breathe.

However, as some can experience muscle loss that comes with age, it is important to pay attention to our muscles and take care to maintain our strength as we get older.

While we Singaporeans enjoy one of the longest living spans globally at about 83 years old, the years gained may not be enjoyed to the fullest as more time is spent coping with age-related health problems, musculoskeletal problems being the amongst the most frequent.

Sarcopenia, or age-related muscle mass loss and function, can start as early as 40 years old, with up to eight per cent of muscle loss each decade onwards.

In Singapore, four in five older adults who are at risk of malnutrition have low muscle mass, as revealed in the SHIELD (Strengthening Health In Elderly Through Nutrition) research that Abbott has been conducting in collaboration with Changi General Hospital and SingHealth Polyclinics.


Age-related muscle loss can be prevented with the right intervention through what we eat and how we use our muscles.

Consuming a balanced diet with protein-rich foods helps build muscle health. As we age, more dietary protein is necessary to help preserve muscle mass. About 25-30 grams of protein per meal is recommended, including protein-rich foods like chicken, seafood, eggs, nuts, beans, tofu or dairy.

An adequate intake of vitamin D can also help maintain and improve muscle function and strength. To increase vitamin D intake, spend some time outdoors in the sun and add foods like fatty fish, mushrooms, eggs or fortified food with vitamin D like orange juice and soy milk.

Meeting daily requirements with adequate nutrient intake can help you stay strong for longer and keep up your strength when caring for loved ones throughout the day. For older caregivers who are not eating well, consuming specialized nutrition supplements can support their muscle health.


Oral nutritional supplements with HMB (beta-hydroxy-beta-methylbutyrate), a naturally-occurring compound has been shown effective in preserving muscle mass in the elderly. HMB is naturally found in small quantities in some foods but it is difficult to get amounts found to support muscle health just by diet alone.

In the SHIELD study, it was found that older adults who consumed an oral nutritional supplement containing HMB were clinically shown to have improved strength. They experienced significant improvement in their nutritional status, physical function and health outcomes.

To avoid weakening of muscle strength, caregivers should also engage in regular exercise. An ideal exercise plan includes both aerobics, like walking, biking or swimming, and resistance or strength training such as lunges, squats, push-ups, and one-leg stands.

Simple everyday activities like walking, taking the stairs and lifting things, can also help to keep muscles active. The next time you shop at the supermarket, consider carrying a grocery bag or basket instead of using a trolley.


Pay attention to how your muscles are doing, so you can take prompt action to improve your strength.

How can you tell if you are at risk of poor muscle health? A quick and effective way is to use the five-times sit-to-stand test, which you can do at home to assess functional lower extremity strength, transitional movements, balance, and fall risk.

To perform the test, fold your arms across your chest and transfer from a seated to a standing position and back to sitting five times as fast as possible, using a timer to time yourself. helps.

After doing the test, uncover your muscle age by using the muscle age calculator which matches sit-to-stand test time to the average test time of biological age groups.

Someone in their 40s may have a muscle age in their 50s if they take longer than average to complete the test, and this could be due to poorer muscle health.

Busy individuals, especially caregivers who often need to provide round-the-clock care, can consider trying this simple assessment as an easy way to determine risk of muscle mass loss.


To provide quality care for others, do not neglect your own health.

Good nutrition, along with regular exercise, can be beneficial for building and maintaining muscle strength, and for you to live fuller and healthier in the long run.

Take the first step today to check your muscle health and make improvements to your diet and exercise routines. As you care for your loved ones, keep in mind that this includes yourself too.

Making yourself a priority is not a selfish act, especially when it comes to caregiving.


Andrea B. Maier is Oon Chiew Seng Professor in Medicine and Co-Director at the Center for Healthy Longevity, National University of Singapore



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