{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:07:13Z","timestamp":1792112833846,"version":"4.4.0"},"reference-count":157,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SingHealth Duke-NUS Academic Medicine Research Grant","award":["AM\/RM010\/2024"],"award-info":[{"award-number":["AM\/RM010\/2024"]}]},{"name":"Sengkang General Hospital Center Grant Seed","award":["003"],"award-info":[{"award-number":["003"]}]},{"award":["003"],"award-info":[{"award-number":["003"]}],"id":[{"id":"https:\/\/ror.org\/05cqp3018","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Sarcopenia is a progressive and multifactorial muscle disorder associated with diminished strength, reduced functional capacity, and increased risk of adverse health outcomes including frailty, falls, and mortality. Despite its clinical burden, the molecular pathogenesis of sarcopenia remains poorly understood, which hinders the development of precise therapeutic strategies. This review examines emerging evidence linking anabolic resistance, mitochondrial dysfunction, neuromuscular instability, and chronic inflammation to impaired regeneration and disrupted proteostasis. While nutritional interventions such as high-quality protein, leucine metabolites, and vitamin D supplementation preserve lean mass, they fail to consistently restore function independently. Although exercise remains the cornerstone therapy, its benefits are often constrained in patients with multimorbidity or reduced mobility. Given the biological heterogeneity of sarcopenia, there is a need to shift from generic supportive care to stratified, mechanism-based therapy. Emerging omics technologies including transcriptomic, proteomic, and metabolic profiling offer a promising avenue to define molecular endotypes. This will guide the development of precision-based management strategies.<\/jats:p>","DOI":"10.3390\/nu18071161","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:19:32Z","timestamp":1775434772000},"page":"1161","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Molecular Mechanisms and Nutritional Modulation in Sarcopenia: A Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"given":"Hui San","family":"Chin","sequence":"first","affiliation":[{"name":"Research Office, Sengkang General Hospital, Singapore 544886, Singapore"},{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"},{"name":"Surgery Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8902-6001","authenticated-orcid":false,"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Research Office, Sengkang General Hospital, Singapore 544886, Singapore"},{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"},{"name":"Surgery Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6201-1301","authenticated-orcid":false,"given":"Pei-Ju","family":"Liao","sequence":"additional","affiliation":[{"name":"Research Office, Sengkang General Hospital, Singapore 544886, Singapore"},{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra L. 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M.","family":"Wee","sequence":"additional","affiliation":[{"name":"Research Office, Sengkang General Hospital, Singapore 544886, Singapore"},{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu-Yi","family":"Kwek","sequence":"additional","affiliation":[{"name":"Research Office, Sengkang General Hospital, Singapore 544886, Singapore"},{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin Tean","family":"Teh","sequence":"additional","affiliation":[{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"},{"name":"Surgery Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"},{"name":"Genome Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore 138672, Singapore"},{"name":"Laboratory of Cancer Epigenome, Division of Medical Science, National Cancer Center Singapore, Singapore 168583, Singapore"},{"name":"Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore 138673, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-4480","authenticated-orcid":false,"given":"Frederick H.","family":"Koh","sequence":"additional","affiliation":[{"name":"Research Office, Sengkang General Hospital, Singapore 544886, Singapore"},{"name":"SingHealth Duke-NUS Muscle Health Program, SingHealth, Singapore 168582, Singapore"},{"name":"Surgery Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, Singapore 169857, Singapore"},{"name":"Department of General Surgery, Colorectal Service, Sengkang General Hospital, Singapore 544886, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101883","DOI":"10.1016\/j.arr.2023.101883","article-title":"An elusive consensus definition of sarcopenia impedes research and clinical treatment: A narrative review","volume":"86","author":"Coletta","year":"2023","journal-title":"Ageing Res. 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