Experts Urge Doctors to Track Muscle Quality Alongside Blood Pressure

Doctors should measure muscle health with the same rigor they apply to blood pressure, according to an international team of kinesiologists and nutrition experts. The group issued a review urging a shift in clinical focus toward skeletal muscle quality and the ratio of muscle to fat. They argue these factors drive metabolic regulation, immune function, and overall vitality.

Dr. Nicolaas Deutz, a professor in the Department of Kinesiology and Sport Management at Texas A&M University, co-authored the review. He stated that estimating muscle health could be as important as measuring a patient’s blood pressure. The team emphasizes that muscle serves as the body’s primary storage system for blood sugar. This function maintains an active metabolism and lowers systemic inflammation.

Current medical assessments often rely on muscle size, but that metric loses accuracy with age. Dr. Deutz noted that healthy muscles are not defined by bicep size or weight alone. Mass is only one component of overall muscle health. For example, women typically have lower overall muscle mass than men, yet their muscle health is generally comparable. A complete picture includes strength, balance, physical function, activity levels, and the amount of fat stored within the muscle tissue itself.

Dr. Fatima Cody Stanford, an obesity medicine physician-scientist at Mass General Brigham and associate professor at Harvard Medical School, emphasized the role of muscle in metabolic diseases. She highlighted the impact of GLP-1 medications such as Ozempic and Zepbound. These drugs improve blood sugar, blood pressure, and cardiovascular risk, but they also cause a loss of lean mass. Stanford said people taking these medications require adequate nutrition to preserve muscle function.

Stanford explained that as people lose substantial body weight, the body requires less muscle to carry that weight. Reducing fat within muscle can improve quality and function. However, older adults, individuals with frailty, or those with low baseline muscle mass need close monitoring. She recommended tracking strength, function, protein intake, and resistance exercise for these groups.

To prevent muscle loss, experts recommend a sufficient amount of high-quality daily protein. Sources include fish, poultry, eggs, dairy, tofu, beans, lentils, nuts, and seeds. The U.S. dietary guidelines advise prioritizing protein from minimally processed foods at every meal. The recommendation is 1.2 to 1.6 grams of protein per kilogram of body weight.

Stephen J. Carter, Ph.D., an associate professor in the Department of Kinesiology at Indiana University, identified muscle power as a critical but overlooked metric. Muscle power is the ability to produce force quickly. Carter noted that this ability declines earlier and more rapidly with aging than muscle strength. He said muscle power is more relevant to daily life than simple strength.

Grip strength offers a simple way to measure this power. A large analysis of over 20,000 older men and women defined low strength as less than 57 pounds for men and 35 pounds for women. Targeted resistance training can improve these numbers. Carter recommended free weights, weight machines, resistance bands, or body-weight exercises two to three times weekly. He advised progressing gradually to higher intensity to build muscle.

Other functional tests evaluate endurance, power, and mobility. The 6-Minute Walk Test measures distance covered in six minutes to gauge lung and cardiovascular fitness. The Timed Up and Go Test assesses fall risk and mobility at home. The 30-Second Chair Stand Test counts how many times a person stands from a chair in 30 seconds without using arms. The 5-Repetition Sit-to-Stand Test times five repetitions from sitting to standing to measure balance, strength, and flexibility.