• The Muscle Aging Process: Muscles break down faster than they repair as your body ages, making it difficult to carry out functional activities.
  • Strength Training: Engaging in strength training can allow you to regain some of the muscle loss due to aging/inactivity reduces the difficulty of performing daily tasks, enhances energy expenditure and body composition.
  • Vitamin D: Vitamin D supplementation slows down muscle loss, helps you regain muscle mass and strength, keeps blood sugar in check, and may prevent falls. 

Aging gracefully is not always easy. You may be picking up new health problems, dealing with new aches and pains, and suffering from a new-found fragility caused by muscle loss. How did this happen to you? And what steps can you take to slow down the aging process and stay healthy and fit? In this post, we will dive into the science of aging, and what you can do to age well and maintain your health in your golden years. 

What happens to your body as you age? 

You may not realize it, but your muscles are constantly being broken down and repaired. When you use your muscles, microscopic tears are caused by daily wear and tear. This necessitates rebuilding those tears with protein.

Here’s the problem: as you get older, your body stops rebuilding your muscles as efficiently as it used to. Over time, this leads to a reduction in overall muscle mass and strength. That loss can be from a combination of factors including hormone changes (ex.the level of hormone testosterone gradually decreases), physical inactivity, and comorbid conditions (cardiovascular disease, diabetes, cancer).

Now the kicker: this reduction in muscle mass doesn’t just occur in the elderly – unless you consider your 30s old. That’s right. Research has shown that strength and development peaks in the 20s and begins to plateau in your 30s.

For many people, decreased strength (whether consciously or not) translates to being less active, and previously routine activities become more difficult. Less activity means fewer calories burned, less muscle development, and over time, negative changes to your body composition – mainly muscle loss and an increase in percent body fat.

If left unchecked, at some point in your 30s, your body will start to progressively lose muscle year after year, and by the time you’re 50, you could have lost around 10% of your muscle area. Thereafter, you can lose an additional 15% of the remainder by the time you’re 60 and another 15% of that by 70. Eventually, you will lose enough functionality that you will be  unable to enjoy life to the fullest.  

Two Factors of Muscle Loss: Sarcopenia and Malnutrition

Sarcopenia

Sarcopenia refers to a clinically significant loss of muscle mass and strength resulting from “normal aging”. It is not solely the result of disease, but rather, is part of the natural aging process. Sarcopenia focuses on changes in nutrition and physical activity that causes a progressive loss of muscle mass. Historically, scientists and doctors believed that this muscle loss and its resulting consequences (balance issues, change in walking performance and a decreased ability to perform activities of daily living) were inevitable, but experts agree if we stay on top of our activity and body composition, we might just be able to fight this slow loss of muscle mass and strength.

Causes of sarcopenia are multifactorial and include age, inadequate nutrition (such as decreased protein intake), hormonal changes, increases in proinflammatory proteins (proteins that our body makes, not the ones that we eat), decreased physical activity, and vascular (circulatory) diseases.

Malnutrition

Malnutrition is a state of lack of uptake or intake of nutrition which can affect body composition negatively. These complications affect not only our diet/exercise but how our body responds to our diet and exercise.

An important nutrient that elderly people may not be getting enough of is protein. Trouble chewing, high food costs, and trouble cooking are all factors that limit elderly people’s access to protein. Inadequate protein intake can progress sarcopenia.

That is because protein requirements for the elderly population may even be higher than a younger population. This is due to age-related changes in the metabolism of protein, including a decreased response to protein intake. This means that an older population needs to consume more protein to get the same anabolic effect.

Micronutrient deficiency is a lack of nutrients, like minerals and vitamins, that support important bodily processes like cell regeneration, your immune system, and even eyesight. Some common examples are iron or calcium deficiencies. Micronutrient deficiency has the greatest impact on normal physiological functions/processes and can actually occur in conjunction with protein-energy deficiency since most micronutrients are obtained from food.

In short, sarcopenia, which can include malnutrition, results in loss of muscle mass. But, why should you care about muscle mass as you age? 

Why Body Composition is Important as You Age

It turns out that having lean muscle is not just important for the “beach body” you cared about in your younger years. Lack of adequate muscle results can cause:

  1. Difficulty moving:

All of a sudden, taking the elevator becomes a necessity, not a luxury. You get tired more easily. Even getting in and out of a car can become a challenge.  These are all possible experiences you may have as a result of losing muscle, as loss of function and independence is a pretty common consequence of muscle loss as you age.

In fact, 19% of women and 10% of men enrolled in Medicare-aged 65 years or older are unable to kneel. So what? You may have never thought of kneeling as a challenge, but that’s the type of motion that is useful when you need to pick up something that you’ve dropped on the floor. So if you don’t have the balance to kneel and pick something up, you’re in trouble.

It’s not just kneeling, either. Below is a graph showing, by percentages, other physical movements that Medicare enrollees aged 65 years or older cannot perform, such as walk two to three blocks or lift 10 pounds.

Source: CDC

  1. Weight gain:

Your muscles are linked with your metabolism, so as soon your muscles start to diminish, so does your metabolism.

When this happens, many people describe it as their “metabolism slowing down.” That’s only partially true; the majority of what’s actually happening is muscle loss, which means your body needs fewer calories to operate. If your body needs fewer calories but you continue to eat the same number of calories as you did before, you’ll start gaining body fat.  What’s more: this entire process can occur with no drastic changes to your weight.

As muscle loss progresses and is replaced by fat (two separate processes, mind you), your body weight can remain largely unchanged – masking significant changes in body composition and potentially leading to a wide array of health problems associated with obesity.

  1. New health problems: 

Studies have shown that steady weight gain throughout life can lead to adult onset diabetes.  This is due in part to not only more body fat but also muscle loss. Loss of skeletal muscle mass has been linked with insulin resistance: the less muscle you have, the less insulin sensitive you become – as your insulin sensitivity decreases and you become more resistant, your risk factor for type II diabetes increases (to review: insulin sensitivity is good, while insulin resistance is bad for your health).   

But don’t forget, the loss of muscle can cause other problems as you age.  A particularly damaging condition, especially for women, is the onset of osteoporosis. Osteoporosis occurs when more old bone is reabsorbed than new bone is created. The number of published studies in both men and women have linked decreased muscle mass with thinner, weaker bones, increasing the risk of osteoporosis and the risk of serious injury from falls.

As we lose muscle, all the above starts to happen, but what can you do? 

    • Eat sufficient protein throughout the day. It is often best to space out your protein across meals rather than consuming it all at once to ensure you’re getting a good amount on a daily basis.
    • Monitor your body composition regularly. You should make sure you minimize muscle mass loss and fat mass gain as you age.
  • Establish a strength training routine. Although some muscle mass loss can be stopped later in life with exercise, it’s better to start out with muscle mass than try to play catch-up.

Eating enough protein and watching your body composition are both important, but is strength training really necessary? 

Why You Should Focus on Building Muscle as You Age

Research has shown that muscle loss and weakness is not actually a part of aging, but rather a result of chronic disuse. That’s right: although people tend to lose muscle mass as they get older, it’s not because of the aging process itself that causes muscle atrophy, but because people tend to become inactive as they age. Inactivity is the true culprit behind muscle loss and weakness.

Why is this great news? Because unlike aging, you can actually do something about inactivity.

For example, a study on postmenopausal women, revealed that consistent resistance training resulted to increased muscle strength by upwards of 19% after one year. The researchers attributed this to increased bone mineral density (BMD), which defends against brittle bones – another hallmark of aging.

A review of related studies on the same subject also confirmed that frailty can be reduced.  Muscle quality (strength relative to muscle mass) can indeed be improved with resistance training.

A running theme throughout these studies is the idea that physical aging can be slowed down with regular physical activity — specifically exercise to keep those muscles from thinking that they don’t have a purpose anymore.

You’re probably curious about what kind of exercise intensity is required to receive these benefits.  To get closer to answering this question, we need to meet a second major player in the conversation about muscle mass and aging: telomeres.

Longer Telomeres, Longer Life

What are telomeres? An article published in Nature – Telomeres and Adversity: Too Toxic to Ignore wonderfully describes the nature and function of telomeres (emphasis added):

Telomeres are the caps at the end of each strand of DNA that protect our chromosomes, like the plastic tips at the end of shoelaces. Without the coating, shoelaces become frayed until they can no longer do their job, just as without telomeres, DNA strands become damaged and our cells can’t do their job.

Telomere shortening is one of the hallmarks of cellular aging and has been a reliable predictor of mortality. Often, cells with shortened telomeres tend to become malfunction and secrete hormone factors that trigger inflammatory processes and tumor formation.

So, unlike muscle wasting, telomere shortening is directly associated with aging. However, just like muscle wasting, you can do something about it.

A 2015 study found out that people who regularly exercise have longer telomeres, but what was especially interesting was that these benefits are achievable for everyone. You don’t have to spend the entire day at the gym; in fact, moderate, not heavy strength training exercise was found to be effective.

Focusing on muscle health as you age is one of the best ways to slow down physical aging. But how should you go about it? Can an old dog learn new tricks? 

How You Can Maintain Muscle Through Strength Training

Despite the consequences of muscle mass loss, older people are still reluctant to try to improve their fitness level through resistance workouts. There’s a false belief that after years of inactivity, they are too old to pick up a dumbbell. But with the right mindset, anyone can set goals to improve your body composition that’ll improve your energy level and keep you active long into your golden years.

Functional fitness, the ability to move about comfortably in our daily lives, not only benefits you in terms of activity but also contributes to improved body composition. In fact, working to reach a certain level of functional fitness and improving body composition go hand in hand.

The aging process has been shown to reduce our metabolic rate, which often leads to an increase in body fat. That’s largely due to the fact that people tend to lose Lean Body Mass as they age due to inactivity. Lean Body Mass contributes to your overall Basal Metabolic Rate (BMR), also known as your metabolism, which is the number of calories your body needs to support its essential functions.

By engaging in strength training or resistance exercises, older adults – as well as anyone at any age — can regain some of the muscle loss due to aging/inactivity, which in turn can lead to an increase in their lean body mass. That increased Lean Body Mass increases BMR, which helps stave off fat gain if diet remains consistent.

Why do we care about improving our body composition as we age? For important reasons like preventing bone loss, heart disease, obesity, and age-related falling, to name a few. As we age and lose lean muscle mass, balance and agility often go with it. Our tendency to fall increases and the injuries sustained from those falls can be detrimental to our overall health and quality of life.

Fractures caused by falling are higher in elderly women than men. Despite the fact that women can greatly benefit from resistance training, the number of women who lift regularly is still low. Fortunately for women, joining the ranks of the bench press/deadlift brigade isn’t necessary for results to come. In an all-women study involving 20 women over the age of 50, the subjects spent 12 weeks using bands as the chosen form of resistance training (as opposed to dumbbells or seated machines) and saw increases in strength. Also worth noting, none of the participants reported injuries. That’s important information for those who are worried that exercise may be too strenuous for their body.

It’s never too late to start lifting

Frankly, the numbers are pretty bleak. A shockingly low 6% of adults in the United States engage in resistance training or any type of weight training at least twice a week, the minimum criteria set forth in the 2008 Physical Activity Guidelines for Americans (2008 Guidelines) and by the American College of Sports Medicine.

No doubt, misconceptions that weight training exercises have an age limit plays a large role. Part of the beauty of the benefits received from lifting weights, whether they be dumbbells, bodyweight exercises, bands, machines or otherwise, is that you don’t have to be young to reap the benefits.

You don’t have to train at a high-intensity. You don’t have to be a beacon of health. It seems odd that we still have to clarify this, but it’s important to reiterate that both men and women can benefit from lifting weights.

For older adults interested in increasing their energy levels and decreasing their body fat, look to resistance training. A study published in Sports Medicine on the effects of strength training on the elderly stated,

Resistance training in older adults also increases power, reduces the difficulty of performing daily tasks, enhances energy expenditure and body composition, and promotes participation in spontaneous physical activity. In light of this information, take comfort in knowing that it’s never too late in life to start lifting. 

But strength training isn’t the only thing you should be doing to maintain your health as you age. As we mentioned earlier, the key changes older adults can make to increase their health are eating sufficient nutrients, monitoring body composition, and engaging in strength training. Both strength training and eating sufficient nutrients are vital for maintaining or achieving your ideal body composition. Did you know that there is a vitamin that can not only help you gain muscles and increase your functional fitness but also help regulate your blood sugar? 

What Is Vitamin D?

a woman holding a fork to eat roasted salmon with asparagusVitamin D is a fat-soluble nutrient that can be acquired in several ways and supports normal physiologic functions including absorption of minerals such as calcium and zinc. Nature provides this nutrient in two ways: consuming food or supplements and sun exposure

With the exception of fatty fish, most foods in a regular diet provide a relatively small amount. Examples of natural food sources include:

  • Salmon
  • Swordfish
  • Egg yolk
  • Fortified foods, including some milk, orange juices, and yogurts

After Vitamin D enters your body, it goes through your liver and kidney and gets converted into its active form,  known as a prohormone, which is then circulated in your blood. Prohormone is essential to normal physiological function and supports the skeletal muscle system.

Building Muscle – The Vitamin D Approach

Vitamin D has long been known to play an important role in bone health, but more recently it has been reported to influence muscle quality. This could have important implications for adults as they age.

As we mentioned earlier, skeletal Muscle Mass tends to decrease as we age, primarily as a result of decreasing activity. Treatments that include proper nutrition, exercise, and yes, vitamin D supplementation were found to not only slow down muscle loss but help regain muscle mass and strength.

Can Vitamin D Keep You on Your Feet?

Falls are the number-one cause of fatal and nonfatal injury among older adults, and low vitamin D levels may be partly to blame.

Although it may not be directly linked, there is a strong correlation that vitamin D deficiency may increase fall risk in older adults.

The connection likely has to do with the effects on muscle strength and function. A trial involving nearly 250 older adults found that a daily vitamin D (plus calcium) supplementation improved quadriceps strength, postural control, and daily functions, like standing up and walking, after one year.

Most impressively, falls decreased by over 25% after 12 months compared with patients who only received calcium, and by almost 40% after 20 months. Not only did the supplements help these people counter the effects of aging and inactivity on their muscle, but it was important in the prevention of a potentially disastrous fall that could result in injury.

The benefit of supplementing may be especially noticeable in people who have a history of falls. One study showed that recurrent falls were significantly lower in people taking a supplement with vitamin D and calcium, compared with calcium alone. Improvements in muscle strength and function seem to be especially important for this group, since improving vitamin D status resulted in an increase in strength and functional performance and a decrease in fall risk.

But does all this mean older adults can just rely on vitamin D to reduce their fall risk and forget about regular strength training sessions?

Absolutely not.

It is probably best to think of getting enough vitamin D as an extra step you can take to supplement your exercise and strength training routine that will keep you upright and your muscles healthy.

Keeping Your Blood Sugar in Check

With the tremendous benefits that Vitamin D has on your muscle health, it’s no surprise that researchers have a link connecting muscle mass, vitamin D status, and blood sugar. Insulin, the hormone that allows blood sugar into your muscles, tends to be better in people with greater muscle mass. People with blood vitamin D levels over 26 ng/dL had a significantly lower risk of hyperglycemia than those below recommended levels.

That association does not necessarily mean this is the only thing you need to do to keep your blood sugar low. But research shows daily vitamin D supplements in combination with calcium slowed the long-term rise in blood sugar in people with prediabetes.

Although adequate vitamin D levels may prevent the progression of hyperglycemia, the jury is still out on the effectiveness of supplementation for people with diabetes. It could be worthwhile to monitor blood for vitamin D levels and look out for any deficiency. Research indicates that supplementation is beneficial in people who are classified as having a deficiency, although not for people who have an insufficiency or normal levels.

Should You Take Vitamin D Supplements? 

Vitamin D deficiency becomes a concern as you age. For individuals with deficiency, vitamin supplementation helps prevent loss of muscle and strength, elderly falling, and the progression of hyperglycemia. Vitamin D can be a part of aging well when it is combined with strength training, aerobic exercise, a healthy diet, and the regular monitoring of body composition. 

Conclusion: Aging Well Is Possible 

You’re not alone in your concerns about maintaining your health as you age, and with this insight, you can maintain your health and age gracefully! 

As you get older, it does become harder to maintain your ideal body composition. Your muscles have a harder time rebuilding, and you may experience sarcopenia and malnutrition. But, that doesn’t mean it’s impossible, or even exceedingly difficult to age well. Remember, it’s not about getting your flawless physique, it’s about being able to participate in activities and maintain a healthy lifestyle as you age. 

You can achieve functional fitness by observing and evaluating your diet, dietary supplementation needs, and starting a twice per week strength training and five times per week moderate cardiovascular fitness routine (at any age) may be all you need to age healthily. 

It is never too late to start on your journey towards health!

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