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A few years later, an American initiative led by the Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium used a different approach, mostly based on the pooled analysis of epidemiological studies, to define sarcopenia [16]. This initiative compiled data from nine studies in community‐dwelling older persons, with a pooled sample of 26 625 participants, to identify sex‐specific cut‐off points for low muscle mass (estimated by the appendicular lean mass adjusted for body mass index) and low muscle strength (measured as grip strength). These cut‐off points were shown to be associated with functional limitations (including slow gait speed, used as a component of other definitions).

Both the AWGS and the FNIH tried to overcome a major limitation of the EWGSOP definition – it did not recommend explicit cut‐off points for the parameters included in the definition – by proposing precise references to define normality for each variable. However, all definitions at this time agreed on the overall concept of sarcopenia as a compound of low muscle mass and reduced muscle function, defined by muscle strength, reduced physical performance, or both. The role of muscle quality, although mentioned in some initiatives, was still quite unclear.

Some important milestones derived from these definitions have been, among others, the recognition of sarcopenia as an independent condition with an ICD‐10‐CM code in 2016 [17], the development of the first clinical guideline for the condition [18], and the involvement of the European Medicines Agency in initiatives to develop a framework for drug development [19].