By Sam Whitaker
Do your knees creak when you bend down? Do you feel the need to let out a slight groan every time you get out of a chair? Or do you just want to prevent these things from happening in later life? Then this is a post about Sarcopenia and healthy ageing is one for you.
How to age gracefully
Modern medicine and healthcare means we're liver longer lives than ever before. But are we living better lives? Considering the increased prevalence of chronic diseases including: hypertension, heart disease, diabetes, cancer, arthritis and impairments to mobility, I would say that many are not.
So that begs the question; is it worth it? Is it worth living an extra 10+ years if the quality of those years is greatly diminished?
It feels like there's so much emphasis on helping people live longer, with comparatively little emphasis on improving the quality of those extra years. As people age it becomes more and more difficult to do the things that were once routine. They lose mobility and their independence as their overall health deteriorates. This leads to lower quality of life and reliance on others.
Sarcopenia is an age related decline of muscle mass and strength. From the age of 25, there is a progressive decrease in the size and number of muscle fibres resulting in a loss of about 30% of muscle mass at the age of 80.
“The reduction in skeletal muscle mass and strength with advancing age is associated with diseased states including type 2 diabetes, cancer, metabolic syndrome, and rezduced mobility and disability, as well as mortality.”1
It's almost accepted that as you age you become frailer, less mobile and more accident prone. Obviously some physical deterioration is inevitable as we age. But that doesn't mean we can't do anything to slow it down and postpone the onset. Personally, I intend to fight the aging process and postpone it as much as I can. I've no interest in living a long time if my quality of life is reduced in those later years.
Mobility and Independence
This loss of muscle and strength is a big factor in the loss of mobility and independence, as I'm sure will be fairly obvious. It also increases the risk of injury from trips and falls.
I'm sure most of us will know of an elderly person who has hurt him or herself after a fall. If we can do anything to reduce the prevalence of these injuries, then clearly we need to do so. Not only to help individuals live healthier, happier lives, but also to help reduce the social and financial cost ageing has on society and the health care services.
It's been estimated that in the USA the direct cost of Sarcopenia, (in 2000), was $18.5 billion. These costs are represented by hospitalisation, nursing home admissions and home healthcare expenditure. (2)
What can we do about it?
Granted, we can't totally prevent muscle and strength loss as we age. However, we can certainly limit the amount we lose and postpone the onset. To do this, there are 2 main things to focus on.
- Participate in regular exercise, resistance exercise in particular
- Consume adequate protein
“Resistance training (RT) is a highly effective strategy to offset Sarcopenia and it has numerous beneficial ‘spill over’ effects” 1
Have you ever heard the phrase, 'use it or lose it'? It can be applied to many physical and mental attributes with muscle mass and strength among them.
So to maintain muscle mass you need to use it. You need to give your body a reason to keep it around.
While any exercise can be beneficial, resistance exercise has the biggest benefit when it comes to giving your body a reason to maintain its muscle mass.
This doesn't mean that you have to be lifting heavy weights into your twilight years. You can get similar benefits from lighter weight, high rep training as you can from heavy weight, low rep training. And considering the increased injury risk associated with the older population, the light weight, high rep protocol might be the best way to go.
If you're not really sure where to start with resistance exercise, drop me a message via the form at the bottom of the page and I'd be happy to send you a starter program for free.
"We don't stop playing because we grow old. We grow old because we stop playing"
The power of protein
High protein diets are heavily associated with young guys wanting to build muscle, bodybuilders and athletes. However, a higher protein diet can potentially benefit everyone, in various ways*.
Specific to the topic at hand, higher protein intakes "can help limit and treat age-related declines in muscle mass, strength, and functional abilities."(4)
The simplest advice to follow is to base each meal around a high quality protein source. What's a good quality protein source? Glad you asked...
- Lean meat
- Greek Yoghurt
- Whey Protein
"Recent recommendations suggest that older adults should consume 25–30 g of high-quality protein at each meal to attenuate age-associated muscle mass loss". (1)
What does 30g of high quality protein look like when it comes to actual food? Well, glad you asked… again…
- 150g chicken breast
- 150g lean steak mince
- A tin of tuna
- 3 medium eggs and 30g low fat cheese, (like in an omelette)
- 1 scoop of whey protein
Obviously these are just a few examples, there are many more.
An easy way to find out how much protein you're consuming is to enter a couple typical days worth of food into My Fitness Pal. If you're not hitting the 25-30g per meal, at least 3 times a day, you should look to include more high protein foods in your meals.
In fact, another study suggests 35g+ per meal might be needed for maximum benefit. (5)
*"A growing body of research indicates that protein intakes well above the current Recommended Dietary Allowance help to promote healthy ageing, appetite regulation, weight management, and goals aligned with athletic performance.
Higher protein intakes may help prevent age-related Sarcopenia, the loss of muscle mass, and strength that predisposes older adults to frailty, disability, and loss of autonomy.
Higher protein diets also improve satiety and lead to greater reductions in body weight and fat mass compared with standard protein diets, and may therefore serve as a successful strategy to help prevent and/or treat obesity." (4)
While both can give benefits on their own, they have a synergistic effect. Meaning, resistance training has a bigger effect when combined with a higher protein intake. And a higher protein intake has a bigger effect when combined with resistance training. So it's important to pay attention to both.
“In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function” 3
Prevention is better than the cure
If you're reading this, thinking you're too young to worry about ageing gracefully, you might want to think again. As the saying goes, the prevention is better than the cure. We don't run our cars until they break down. We get them serviced regularly; change the oil etc. to reduce the chances of things going wrong.
This is how you should think about your body. You want to take care of it from an early age to prevent, or at least attenuate, the negative effects of ageing.
It's never too late to start
On the other hand, it's never too late to start. It's never too late to start benefiting from increasing protein intake and performing resistance training.
Granted, for someone with a lot of miles on the clock, it's not realistic for him or her to charge into the weight room at the gym and start lifting heavy stuff. But that doesn't mean they can't start with simple body weight exercises, or light resistance machine work.
Why am I telling you this?
I want to help people live healthier, happier lives well into old age. It's heart breaking to see how so many of the older generation lose mobility and independence in their later years. The benefits that can be gained from paying attention to diet and exercise are so large that I feel passionate about sharing such information.
"Most people don't know how good their body is designed to feel"
I want to help people realise that they shouldn't just accept that immobility and frailty come with old age. And that you can do something to fight it. Or at least postpone and attenuate its affect to live better for longer.
I don't want to sound like I'm touting a proper diet and exercise routine as a cure all. Obviously there are things that they can't help prevent. You should still listen to your Doctor - take any prescribed medication etc. But even if some conditions/disease states can't be prevented by a proper diet and exercise, they might help lessen the effects, in many cases.
Take home points
- We should focus on increasing quality of life instead of just thinking about living longer.
- The reduction in skeletal muscle mass and strength with advancing age, (Sarcopenia), is associated with diseased states including type 2 diabetes, cancer, metabolic syndrome, and reduced mobility and disability, as well as mortality.
- Resistance exercise and a high protein intake have been shown attenuate muscle and strength loss.
- Resistance training (RT) is a highly effective strategy to offset Sarcopenia and it has numerous beneficial “spill over” effects.
- Higher protein intakes can help limit and treat age-related declines in muscle mass, strength, and functional abilities.
- Prevention is better than the cure.
- It's never too late to start.
This Iraki Nutrition Podcast episode with Dr. Stu Phillips on Sarcopenia.
December 16 issue of Alan Aragon's Research Review (AARR) - (requires subscription)
Studies - For the nutrition geeks out there
29-year-old Sam Whitaker is a Fitness & Nutrition Consultant and Co-Founder & Director of Body Target Ltd.
Over the past 5-6 years, he has been self-educating on all things health and fitness by reading textbooks, online articles and books by people such as Lyle McDonald and Alan Aragon. He has also just started The SBS Academy - an evidence based online training and nutrition course.