Muscle Wasting in Lung Disease: A Comprehensive Review of Secondary Sarcopenia Prevention Strategies

Abstract

Sarcopenia, defined as the progressive loss of skeletal muscle mass and function, represents a critical but frequently underestimated complication in patients with chronic lung diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and lung cancer. The intersection of systemic inflammation, hypoxia, physical inactivity, and nutritional deficiency in these conditions creates a pathophysiological environment uniquely predisposed to accelerated muscle deterioration. Secondary prevention—aimed at halting or reversing sarcopenia in patients already at risk or in early stages—has emerged as a cornerstone of comprehensive pulmonary care. This review synthesizes current evidence on multimodal secondary prevention strategies including structured exercise programs, protein and nutritional supplementation, pulmonary rehabilitation, vitamin D therapy, and emerging pharmacological approaches. A comparative analysis of these interventions across different lung disease populations is provided. Findings indicate that integrated, multidisciplinary approaches combining resistance training with nutritional support and pulmonary rehabilitation yield the most robust outcomes, significantly improving muscle mass, physical performance, and quality of life in this vulnerable population.