Endocrine Factors in Sarcopenia: Lifestyle-Based Approaches with Nutrition, Exercise, and Circadian Health

Sarcopenia, the age-related skeletal muscle disorder characterized by declines in muscle mass, strength, and physical performance, has significant health consequences and represents a major global public health challenge. Age-related endocrine and peripheral anabolic-catabolic dysregulation plays a central role in sarcopenia development, and lifestyle factors interact with hormonal regulation to influence skeletal muscle homeostasis. In older adults, reduced hormone secretion capacity, receptor responsiveness, and peripheral metabolism impair hormonal systems, including the somatotropic, gonadal, adrenal, and thyroid axes, as well as insulin and peripheral mediators, such as adipokines, myokines, and inflammatory cytokines. These alterations promote anabolic resistance, a catabolic environment, and metabolic dysfunction, contributing to sarcopenia. Age-related changes in appetite, nutrient utilization, and food choice impair anabolic efficiency and metabolic homeostasis. Declines in physical activity and neuromuscular efficiency disrupt multiple signaling pathways required to maintain muscle mass, and psychosocial factors may increase the risk of a vicious cycle of inactivity. Alterations in the suprachiasmatic nucleus (SCN) and inconsistent behavioral zeitgebers disrupt physiological rhythms. These lifestyle domains influence skeletal muscle homeostasis independently and interact bidirectionally through shared endocrine pathways. Current pharmacological approaches remain adjunctive, limited to confirmed endocrine deficiencies. The coordinated optimization of nutrition, exercise, and circadian health, with attention to regularity and timing, may offer complementary benefits exceeding single-domain interventions. A stage-specific and individually tailored approach supported by multidimensional monitoring and digital technologies is recommended for effective sarcopenia prevention and management.