Muscle and Aging
What do you think is THE thing, the MOST important factor, the PRINCIPAL statistic most strongly linked with healthy aging?
Would you guess it might be heart health or alcohol consumption or lifelong cholesterol or blood sugar levels or smoking status... Nup, not any of those... IT IS quite simply… muscle... whether it be muscle mass or the strength it conveys.
In the context of aging and health, they are both closely linked. Now that we know this, it’d be wise to look at the problem, and there IS a problem. And also to ask, what can we do to make muscle work in our favour as we age? Do we all have to ‘bulk up or get jacked’ in order to enjoy healthy aging? Not at all. But we absolutely need to do something. So, let’s look at the main factors that affect our muscle composition and long-term strength and, in each case, what we can do to improve it far into the future.
“If you can build a muscle, you can build a mindset.”
- Jay Shetty
Firstly, the problems. As I said, there appears to be no question about the effect of the combination of muscle mass and strength on healthy aging. None whatsoever. It turns out that stronger adults with more muscle tissue on their bones, break bones less and enjoy better mobility. They fall less and enjoy better day-to-day health, and self-determination. It’s important to point out that it’s not necessarily easy to differentiate strong and weak adults by the way we look. Looks can be deceiving…
Here are some important facts. We experience peak strength and muscle mass in our mid-30s to early 40s. From that age on, we lose from 1-8% muscle mass per decade and from our 50s and 60s we lose from 1 to 5% of our muscle mass PER YEAR! That should be really scary to anyone over 40! In the face of these profound facts, we have 3 major problems.
Firstly, few mature aged people nowadays eat the appropriate foods to support continued muscle maintenance. Secondly, few older adults engage in the correct activities required to preserve strength and thirdly, anabolic resistance… That awesome, super scary complicated term. Let’s quickly and simply break down all 3 problems and explore a bunch of great tips for correcting these issues.
Problem 01: Protein Intake:
Doesn’t matter which way you slice or dice the situation; older people are not eating enough quality protein!
We tend to think it is inevitable to lose a lot of muscle as we age. That’s WRONG!
We tend to think it ‘makes sense’ to eat less protein as we age. That’s ALSO WRONG!
We tend to think it’s ok to have toast or bread or sugary cereal for breakfast. That’s WRONG TOO!
Up to date health professionals and promoters including vegans, carnivores and everyone in between know that the standard, suggested 0.8g of dietary protein per kilo of body weight per day is outdated and inadequate for the mature age body! Researchers such as Dr Brendan Egan have shown that not only do older people consume too little protein, but of the relatively little protein they DO eat, progressively less of it gets effectively assimilated in their metabolism due to factors like progressive reduction in stomach acid production. In fact, Dr Egan argues that older adults need to consume 50% more than the recommended daily amount of protein in order to achieve the same muscle synthesis as a younger person, when in fact older people are actually consuming 20% LESS than the recommended daily amount. Later in this article, I’ll cover good protein sources, how to judge your portion sizes and also protein digestion issues that are important for older people.
I’ll give you a hot tip here. Health coaches like myself get our clients to eat the majority of their protein in their first two meals each day. It sets them up for consistent energy throughout the day and reduces cravings right from the start. It’s almost like a magic trick.
Problem 2: Lack of Exercise:
Activity and the need for Resistance Training. You don’t need me to tell you that older people don’t move enough nor stimulate their muscle mass enough. The average person over 40 walks less than 4000 steps a day when we need it to be above 8000 steps. Adding one 30 minute walk every day would make a huge difference to this average. If we’re over 40 then it’s also very important to do some form of resistance training. We have to use our muscles or lift significantly heavy things regularly, otherwise our skeletal muscle gradually fades away. Regular resistance training has been shown to counteract age-related muscular decline[1], improve physical performance and improve delayed recall of memory in mature aged adults[2]. In terms of our brain health, it can enhance cerebral blood vessel function, improve cognition AND increase neuroplasticity, otherwise known as the ability of our brain to change through growth and reorganisation [3]. We’re not talking about confronting, arduous gym workouts either. Light kettlebell workouts are a good example of an activity that can be started at a light, low-stress concentration and then slowly built upon.
“To me, if life boils down to one thing, it's movement. To live is to keep moving.”
- Jerry Seinfeld
Problem 3: Anabolic Resistance:
Anabolic resistance is the reduced capacity to stimulate a sufficient increase in muscle protein production when we eat protein or exercise. This occurs with age, muscle disuse or extended illness. It’s connected to a reduction in protein digestion and absorption, and it slows recovery from resistance and endurance exercise. This means that if we keep our exercise level the same over the decades, we won’t even maintain our muscle mass and strength through time. Anabolic resistance is believed to run in parallel with insulin resistance, systemic inflammation, and smaller blood vessel issues, namely decreased capillary density.
The strategy to reverse anabolic resistance or just maintain existing muscle mass is to both increase dietary protein AND carry out some form of resistance training. Older adults should aim for 1.2g/kg/d of protein (or higher) as supported by this study [4]. Spread this protein across about 3 to 5 meals a day and increase free leucine-containing proteins to at least double the recommended daily amount, as supported by this study [5].
We’ve looked at the main problems. Let’s look at the solutions.
Firstly, Protein Sources:
Because older people often don’t digest and assimilate protein as well as younger people, we really have to make an effort to obtain high-quality protein sources, several times a day. This has to start from the FIRST meal of the day. The most complete protein sources are ideally red meat, eggs, seafood and organ meats. Acceptable protein sources are also Greek yoghurt and quality cheese. Meats don’t need to be ‘grass-fed’. Although there are some measurable differences between grass fed and other meats, the more important thing is to get in the basic high-quality protein. Acceptable plant proteins are in the classic combos like beans and rice or lentils and almonds. With vegan/vegetarian sources, you need fairly large portions and you have to know and stick to the correct combinations. Eat your protein first. Top your food with some nuts. Replace cereal with eggs. Eggs are important because they are an ‘easy sell’. Mature-aged people are used to the idea that eggs are a typical part of a solid breakfast and fortunately, they’ve come back into favour recently. Getting older people, especially the elderly, to consume enough nutrition can be such a challenge that we often have to think creatively to find ways to sneak better quality foods into their diets. Older people remember days when sardines on toast for example, another quality protein meal, was a common breakfast. Also of concern is the current trend towards plant-based foods and subsequent reduction in quality protein foods consumed by older adults. It was already a struggle to get mature-aged adults to eat enough protein. Now it may be even more difficult. This is why one protein powder a day may be of serious benefit. High-leucine protein shakes are an acceptable inclusion about once a day.
This study published in the American Journal of Clinical Nutrition indicates that protein intake of 1.5 g per kg of body weight per day has the most beneficial effect in regard to preventing sarcopenia and frailty compared with protein intakes of 0.8 and 1.2 g per kg per day in prefrail or frail elderly subjects at risk of malnutrition.[6]
At any rate. Whatever you do, include a high-quality protein with every meal.
"Those who think they have no time for healthy eating will sooner or later have to find time for illness." – Edward Stanley.
Let’s talk Protein Portions:
Okay groovers, get your hand off your phone, mouse or toolbox (wink) and look at it. It’ll always be your easy guide. For older people we need to include enough high-quality protein 4 or 5 times a day that can cover the WHOLE palm of your hand to about the width of your index finger. Or for lower quality protein, like plant sources, cover the whole of your hand, to about thumb width. Let’s zoom in on the detail. For high-quality meat like red meat, oily fish and eggs (about 2 or 3) or lower quality meat like lamb, pork or chicken. The whole palm of your hand to index finger width. OR cheese, yoghurt, tofu or tempeh. Your whole hand at index finger width. OR classic plant protein combinations like lentils or beans mixed with nuts or rice covering your whole hand at thumb width. I think you get the idea. Plant sources equals larger serves. Also of value is a quality high leucine whey or plant protein powder portion. It’s not a whole food. Not ideal. But it’s convenient for people, adds some variety and does the job. So any of the above, 4 or 5 times a day. That’s the important message.
Now let’s look at Protein Digestion Issues:
Fortunately, protein digestion issues affect only a small percentage of middle-aged people and don’t typically get serious until after age 60. However, after our 40s, gastric acid and pepsin start to drop and eventually lead to digestive issues like reduced vitamin B12 and iron absorption. There is also evidence that the OVER 60s need their protein well cooked in order to absorb it effectively[7]. Key points are: Don’t overuse PPIs or acid-reducing medications, eat foods high in vitamin B6 which helps enzymes break down protein. Foods such as oily fish, chickpeas, dark leafy greens and organ meats.
Well, I gotta go see a man about a dog, so thank you for reading. If you found this information interesting, then please consider booping the like button and subscribing to the channel and have a tremendous day!
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To work with Andy, please schedule a consult at https://www.healthcoachandy.com
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References:
[1] Reeves, Neil D., Marco V. Narici, and Constantinos N. Maganaris. "Myotendinous plasticity to ageing and resistance exercise in humans." Experimental physiology 91, no. 3 (2006): 483-498.
[2] Marston, Kieran J., Jeremiah J. Peiffer, Stephanie R. Rainey-Smith, Nicole Gordon, Shaun Y. Teo, Simon M. Laws, Hamid R. Sohrabi, Ralph N. Martins, and Belinda M. Brown. "Resistance training enhances delayed memory in healthy middle-aged and older adults: A randomised controlled trial." Journal of Science and Medicine in Sport 22, no. 11 (2019): 1226-1231.
[3] Bliss, Edward S., Rachel HX Wong, Peter RC Howe, and Dean E. Mills. "Benefits of exercise training on cerebrovascular and cognitive function in ageing." Journal of Cerebral Blood Flow & Metabolism 41, no. 3 (2021): 447-470.
[4] Paulussen, Kevin Johannes Maria, Colleen F. McKenna, Joseph William Beals, and Nicholas A. Burd. "Anabolic resistance of muscle protein turnover comes in various shapes and sizes." Frontiers in Nutrition 8 (2021): 115.
[5] Szwiega, Sylwia, Paul B. Pencharz, Mahroukh Rafii, Mackenzie Lebarron, Jessica Chang, Ronald O. Ball, Dehan Kong, Libai Xu, Rajavel Elango, and Glenda Courtney-Martin. "Dietary leucine requirement of older men and women is higher than current recommendations." The American journal of clinical nutrition 113, no. 2 (2021): 410-419.
[6] Park, Yongsoon, Jeong-Eun Choi, and Hwan-Sik Hwang. "Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial." The American journal of clinical nutrition 108, no. 5 (2018): 1026-1033.
[7] Buffière, Caroline, Claire Gaudichon, Noureddine Hafnaoui, Carole Migné, Valérie Scislowsky, Nadezda Khodorova, Laurent Mosoni et al. "In the elderly, meat protein assimilation from rare meat is lower than that from meat that is well done." The American Journal of Clinical Nutrition 106, no. 5 (2017): 1257-1266.