One of the concepts I spend a lot of time talking to my patients about is the importance of maintaining muscle health. The reason for this is that virtually all people start to gradually lose muscle beginning somewhere in their 30s or 40s. At first these changes are barely noticeable, but by the time they are in their 70s many people will experience a huge degradation in their degree of fitness.
This matters for several reasons:
Muscle is one of the great “sinks” for fats and glucose in our bloodstream, meaning that healthy, vibrant muscle takes up a lot of these nutrients after we eat, resulting in better blood glucose and cholesterol numbers. The loss of muscle therefore plays a role in why many people become a lot less metabolically healthy as they age and start to develop problems in these areas.
For the same reason as above, as muscle deteriorates your body’s metabolism “slows down,” resulting in an easier tendency to gain weight.
Loss of muscle mass has been associated with a multitude of diseases other than cholesterol and diabetes, including increased risk for heart disease, cancer, and dementia. In fact, several studies have shown that simple strength tests, such as a measure of hand grip strength or the ability to get off the floor unassisted, are excellent predictors of all-cause mortality. Put another way, over any given time period studied, a stronger person is less likely to die than a weaker person.
Even ignoring disease and longevity, being strong is vital for quality of life. We take for granted when we are young that simple activities like taking a shower, getting off the toilet unassisted, or walking to the mailbox will always remain simple. But the sad fact is that for many elderly people these become strenuous and exhausting, resulting in the risk for falls and fractures, as well as the inability to live independently. Generalized frailty from a loss of muscle mass and overall fitness is the leading cause of having to spend one’s final years in a nursing home.
To some extent, the loss of muscle mass is inevitable. It’s just not possible for a 90 year old to be as strong as their 20 year old self was. But there is a lot of good news around this topic.
First off, studies have shown that even into their 90s, people retain the ability to become stronger and fitter with regular exercise.
Secondly, if you are in your 60s or younger, you can “bank” muscle now so that when you are older, you will be starting from a higher point and decline more slowly. This is very analogous to a savings fund, in which the earlier and more aggressively you save, the more money you will have when you retire, and hence the longer and more financially comfortable your retirement can be.
The specifics of how to build muscle can get into nuance, and I won’t cover this topic in detail, as I am not a fitness guru or personal trainer. But the basics are very, very, simple:
As early as you can in life (childhood is not too young to start) do some type of regular strength training. This can be with barbells, dumbbells, machines, your own body weight (e.g. exercises like pushups and air squats), kettlebells, resistance bands, or any other modality that you like. To your muscles, a weight is a weight, whether it comes from a fully loaded barbell, or just pushing yourself off the ground. So long as that weight is somewhat challenging to lift, you will send a signal to your body to make your muscle stronger.
You don’t need to become a professional bodybuilder to accomplish great results. Just two or three 20 minute sessions per week will bring huge benefits. More is better, but like a lot of things in life, you get the biggest bang for your buck by just going from doing nothing to doing something.
Make sure to eat adequate dietary protein (a topic that I’ve discussed before, and will have more to say on in the future). A reasonable goal for most people is something like three quarters of their body weight in grams per day, so a 100 pound person should aim for a minimum of 75g protein daily; a 200 pound person would aim for 150g; etc. The source of that protein (plant v. animal based) is not that important. More won’t hurt you (contrary to a very debunked popular belief that protein is bad for the kidneys) and being a bit short of this goal some days is not the end of the world so don’t stress about it. But aim to be in the ballpark of this goal more days than not.
For the best health results, pair the above with some other modalities of exercise, such as doing a few sessions per week of cardio training, doing some mobility work (for example stretching, or a weekly yoga class), and hitting your daily step goal.
These other types of exercise are also important and bring their own unique benefits, but don’t lose sight of the fact that healthy aging requires healthy muscle, and a little bit of investment now in building strong muscles can lead to massive dividends when you are older.
