We thank Li and colleagues for their comments on our article,1 and for sharing their interesting data on associations of lean mass and muscle strength with incident type 2 diabetes mellitus in middle-aged Australian men. The low observed prevalence of sarcopenia according to the Foundation for the National Institutes of Health (FNIH) definition2 is likely attributable in part to the relatively young age of their cohort (mean age 54 years).3 However, the finding also highlights that the FNIH cut-points for low lean mass and hand grip strength may be overly conservative. Indeed, a United Kingdom study including over 1500 adults aged 60–64 years revealed a similarly low prevalence of sarcopenia according to the FNIH definition (1.1% in men and 2.0% in women).4 It has been recently noted that the low prevalence associated with current multicomponent definitions of sarcopenia may limit opportunities for its early identification and treatment.5 This is particularly relevant in the middle-aged adult population, who potentially should be the primary target for sarcopenia prevention.
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