Why is ALMI important for your Healthspan?
Musculoskeletal Health — Longevity
Skeletal muscle is one of the strongest predictors of healthy aging. ALMI focuses specifically on appendicular lean mass—the muscle in your arms and legs—which plays a central role in mobility, glucose regulation, bone density, and independence as we age. A higher ALMI is associated with improved strength, greater metabolic flexibility, and reduced risk of frailty, falls, and disability later in life. Maintaining muscle mass is essential not only for movement and stability, but also for supporting hormonal balance, mitochondrial efficiency, and long-term energy metabolism.
Low ALMI can signal poor muscle retention, sarcopenia risk, inadequate protein intake, low physical activity, or chronic illness. Over time, decreased appendicular muscle mass contributes to slower metabolism, insulin resistance, lower physical capacity, and increased risk of hospitalization and mortality in older adulthood. Conversely, improving or maintaining ALMI supports lifelong function and resilience—extending the number of years we can move, think, and live well.
What is ALMI?
Appendicular Lean Mass Index is calculated by dividing the total lean mass of the arms and legs by height squared, similar to the way BMI is scaled. This measurement is typically obtained via DEXA scan and gives a more meaningful picture of body composition than weight alone. Muscle tissue in the limbs contains the majority of active skeletal muscle used for movement, resistance exercise, and functional daily activities. It also serves as a reservoir for amino acids, glucose storage, and immune-modulating proteins.
ALMI reflects the balance between muscle synthesis (building) and muscle breakdown (catabolism). With aging, inactivity, or insufficient protein, the rate of muscle loss accelerates—a process known as sarcopenia. A strong ALMI score suggests robust muscle maintenance, better glucose uptake, improved metabolic health, and protection against age-related decline. Monitoring ALMI over time is particularly valuable for assessing interventions like exercise training, nutrition strategies, or hormone-related changes that influence muscle mass.
How do we take action?
Exercise Improvement — Diet Enhancement — Weight Management
The most effective way to improve ALMI is through consistent resistance training paired with adequate protein intake. Strength-focused exercise (2–4 sessions per week) stimulates muscle growth and maintenance, particularly when using progressive overload—gradually increasing weight, reps, or intensity. Aim for sufficient high-quality protein distributed evenly across meals (typically 1.2–1.6 g/kg/day for most adults), along with amino-acid–rich foods like eggs, lean meats, dairy, legumes, and soy. Prioritizing recovery, sleep, and whole-food nutrition further supports muscle synthesis and reduces muscle breakdown. Maintaining a healthy weight and addressing chronic inflammation or hormonal imbalances can also positively impact lean mass retention. Tracking ALMI over time helps measure progress and refine strategies for long-term strength and functional independence.
Additional resources
- Cruz-Jentoft, A. J., et al. (2019). Sarcopenia: Revised European Consensus on Definition and Diagnosis. Age and Ageing, 48(1), 16–31. https://doi.org/10.1093/ageing/afy169
- Chen, L. K., et al. (2020). Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. Journal of the American Medical Directors Association, 21(3), 300–307.e2. https://doi.org/10.1016/j.jamda.2019.12.012
Author
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