Implications of low muscle mass across the continuum of care: a narrative review
Open accessAbstract
Abnormalities in body composition can occur at any body weight. Low muscle mass is a predictor of poor morbidity and mortality and occurs in several populations. This narrative review provides an overview of the importance of low muscle mass on health outcomes for patients in inpatient, outpatient and long-term care clinical settings. A one-year glimpse at publications that showcases the rapidly growing research of body composition in clinical settings is included. Low muscle mass is associated with outcomes such as higher surgical and post-operative complications, longer length of hospital stay, lower physical function, poorer quality of life and shorter survival. As such, the potential clinical benefits of preventing and reversing this condition are likely to impact patient outcomes and resource utilization/health care costs. Clinically viable tools to measure body composition are needed for routine screening and intervention. Future research studies should elucidate the effectiveness of multimodal interventions to counteract low muscle mass for optimal patient outcomes across the healthcare continuum. Key messages Low muscle mass is associated with several negative outcomes across the healthcare continuum. Techniques to identify and counteract low muscle mass in clinical settings are needed.
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Decreased and/or low muscle and bone mass negatively impact health, including physical impairment or disability, falls and fractures, surgical complications, reduced quality of life, and decreased survival.
“Decreased and/or low muscle and bone mass negatively impact health, including physical impairment or disability, falls and fractures, surgical complications, reduced quality of life, and decreased survival [159, 160].”
From Nutritional priorities to support <scp>GLP</scp> ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society (2025) · cites this paper as [160]
The Primary Care and Population section links low muscle mass to falls, fractures, poorer physical function and shorter survival. The Surgery section links it to postoperative complications and lower quality of life. The review associates sarcopenia with lower bone mineral density, but does not establish that low bone mass itself accounts for the listed outcomes; it generally reports associations rather than causal impacts. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredLosses of skeletal muscle mass and function can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes.
“such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes.”
From Strategies for minimizing muscle loss during use of incretin‐mimetic drugs for treatment of obesity (2025) · cites this paper as [3]
The Primary Care and Population section (page unavailable) links higher muscle mass with better physical function, quality of life, and fewer cardiovascular risk factors; the Surgery section also reports associations between low muscle mass and poorer function, quality of life, and other adverse outcomes. The paper does not establish that muscle loss causes these outcomes, and the searched passages do not support weight cycling as an outcome or the broader claim of reduced metabolic health. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLoss of skeletal muscle mass and function can accompany rapid substantial weight reduction.
“Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction”
From Strategies for minimizing muscle loss during use of incretin‐mimetic drugs for treatment of obesity (2025) · cites this paper as [3]
The Inpatient Settings > COPD section says that fat-free mass accounts for a large portion of weight loss in people with COPD and associates low fat-free mass with poor physical performance. It does not establish that rapid, substantial weight reduction is accompanied by loss of skeletal muscle mass and function generally; the speed and extent of weight reduction are unsupported. (LLM, conf=0.78)
Experimental — accuracy not yet measuredLow muscle mass is often unrecognized and is independently associated with increased risk of mortality and morbidity, reduced quality of life, increased risk of type 2 diabetes, and other adverse health outcomes.
“Low muscle mass is often unrecognized and is independently associated with increased risk of mortality and morbidity, reduced quality of life, increased risk of T2D, and other adverse health outcomes.”
From Strategies for minimizing muscle loss during use of incretin‐mimetic drugs for treatment of obesity (2025) · cites this paper as [3]
The Introduction (page not provided) calls low muscle mass a predictor of morbidity and mortality, while Outpatient Settings > Primary Care and Population links it to poorer quality of life and other adverse outcomes. Low Muscle Mass: A New Face of an Old Problem explains how reliance on BMI can obscure it. The reviewed passages do not establish an independent association with increased risk of developing type 2 diabetes; the type 2 diabetes reference concerns outcomes in people who already have it. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLoss of muscle mass accompanying restricted caloric intake can be detrimental.
“and that such loss can be detrimental.”
From Strategies for minimizing muscle loss during use of incretin‐mimetic drugs for treatment of obesity (2025) · cites this paper as [3]
Decreased and/or low muscle and bone mass negatively impact health, including physical impairment or disability, falls and fractures, surgical complications, reduced quality of life, and decreased survival.
“Decreased and/or low muscle and bone mass negatively impact health, including physical impairment or disability, falls and fractures, surgical complications, reduced quality of life, and decreased survival [150,151].”
Decreased and/or low muscle and bone mass negatively impact health, including physical impairment or disability, falls and fractures, surgical complications, reduced quality of life, and decreased survival.
“Decreased and/or low muscle and bone mass negatively impact health, including physical impairment or disability, falls and fractures, surgical complications, reduced quality of life, and decreased survival [159,160].”
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References 221 · Cited by 286
Research works printed but not linked: 2
- [109]Prado CMM, Mourtzakis M, Baracos V, Reiman T, Sawyer MB, McCargar LJ. Overweight and obese patients with solid tumors may have sarcopenia, poor prognosis and early features of cachexia. Int J Body Compos Res. 2010; 8(1): 7– 15.
- [198]Du K, Goates S, Arensberg MB, Pereira S, Gaillard T, Hegazi R. Impact of sarcopenia on falls and hospitalization in community dwelling adults. International Conference on Frailty and Sarcopenia Research 2017.
- Authors
- Prado, C. M., Purcell, S. A., Alish, C., Pereira, S. L., Deutz, N. E., Heyland, D. K., Goodpaster, B. H., Tappenden, K. A., & Heymsfield, S. B.
- Affiliations
- University of Alberta (CA)
- Abbott Nutrition (United States) (US)
- Texas A&M University (US)
- Kingston General Hospital (CA)
- Sanford Burnham Prebys Medical Discovery Institute (US)
- University of Illinois Urbana-Champaign (US)
- Pennington Biomedical Research Center (US)
- Corresponding author
- Prado, Carla M.
- ORCID
- Venue
- Annals of Medicine
- Publisher
- Informa UK Limited
- Published
- 2018-09-12
- Volume
- 50
- Issue
- 8
- Pages
- 675-693
- ISSN
- 0785-3890 (ISSN-L)
- 1365-2060
- PMC
- PMC6370503
- OpenAlex
- W2889388367
- Semantic Scholar
- a21f17e49a6096eb375bf832a5dce9e4655f6a4f
- Cited by
- 286
- References
- 221
- Citations by year
- 2026: 48 · 2025: 43 · 2024: 28 · 2023: 34 · 2022: 42 · 2021: 33 · 2020: 33 · 2019: 20 · 2018: 2 · 2016: 1
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Annals of Medicine (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Environmental Health Sciences (12)
- National Heart, Lung, and Blood Institute (87)
- Canadian Institutes of Health Research
- Campus Alberta Innovates
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- low muscle mass, sarcopenia, body composition, inpatient care, outpatient care, long-term care, surgical complications, postoperative complications, length of hospital stay, physical function, quality of life, survival, multimodal intervention, health care costs
- MeSH terms
- Body Composition, Body Weight, Continuity of Patient Care, Humans, Length of Stay, Muscular Atrophy, Quality of Life, Muscle, Skeletal, Wasting Syndrome
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