Vitamin D as a Modulator of Sarcopenia in Women: Interactions with Dietary Patterns and Physical Exercise

Women are particularly vulnerable to sarcopenia- a progressive, age-related condition characterized by the loss of skeletal muscle mass, strength, and physical performance- due to sex-specific hormonal and physiological changes, most notably the decline in estrogen levels after menopause. This increased risk highlights the critical importance of developing tailored, sex-specific strategies for prevention, diagnosis, and management. Among nutritional factors, vitamin D is increasingly recognized as a key regulator of skeletal muscle physiology, exerting direct effects on muscle tissue via vitamin D receptors and modulating the gene expression involved in muscle cell proliferation, protein synthesis, and mitochondrial function. This review aims to evaluate the synergistic roles of vitamin D, nutrition, and exercise in improving skeletal muscle function in women, with a specific focus on the prevention and management of sarcopenia. Vitamin D can contribute to skeletal muscle integrity by influencing fiber composition, preserving type II fibers, and preventing mass loss. Additionally, it promotes satellite cell activation, thereby supporting muscle repair and regeneration. Consequently, vitamin D supplementation can improve muscle strength, balance, and physical performance, while reducing the risk of falls, frailty, osteoporosis and sarcopenia. Recent studies suggest that vitamin D acts synergistically with diets enriched with whey protein and leucine, as well as with structured exercise programs, predominantly resistance training, to further enhance muscle function and bone health. This review critically examines the current evidence regarding these combined interventions in preserving and optimizing skeletal muscle function in older women, while also addressing the major limitations and inconsistencies in available studies. Understanding the collective impact of these strategies is crucial for developing personalized and effective strategies aimed at maintaining musculoskeletal health, physical performance, and functional independence throughout the female aging process.