Building strong muscles isn’t just for 20-something gym buffs. Dietitian Brooke Delfino reveals how to stay strong and healthy, no matter what your age.
We all know our body changes as we age: our eyesight gets weaker, our hair turns grey and we slowly lose flexibility. But another profound change takes place from the relatively earlier age of 30. Called sarcopenia, this is the progressive loss of skeletal muscle mass, strength and function.
The good news is that people with sarcopenia can rebuild their muscle mass and strength with regular exercise and dietary changes. In fact, these are things we can all do to protect ourselves from weakening muscles. Read on to find out why it’s never too late to start building muscle — without stepping foot in a gym!
While some of us may have strived for prominent abs or biceps in our youth for aesthetic reasons, muscle mass actually plays a much more important role in maintaining good health, especially as we age. We use our skeletal muscles to stabilise ourselves as we stand tall and upright, as well as to move without falling. For much of our lives we probably take these actions for granted, even if we don’t do a lot of exercise. But older people know just how important good muscle strength is, and how much we rely on it.
Sarcopenia comes from the Greek words for ‘lack of flesh’ and is to our muscles what osteoporosis (or low bone mass) is to our bones. Affecting almost one third of older adults, it is a complex condition and we are only just starting to understand the serious implications low muscle mass has on our long-term health, quality of life and independence. For decades, the health focus had been on how much fat we have (or don’t have), but now how much muscle mass we have is becoming just as important.
Move it or lose it
After the age of 30, we start losing between three and eight per cent of our muscle mass per decade, and this rate of decline is even higher after the age of 60. From the age of 70, muscle loss accelerates to as high as 15 per cent for every decade.
This slow process has several causes. First of all, ageing disrupts the body’s ability to produce the proteins needed to grow and maintain muscles. Changes in testosterone and growth hormone levels also contribute. Other risk factors include inflammation, obesity and physical inactivity. If you don’t use your muscles, you end up losing them. Nutrition also plays a role, specifically a low-protein and/or low energy intake, or malnutrition (a classic cause of sarcopenia in the elderly).
And just because we lose muscle doesn’t mean it’s gone forever. While some loss is inevitable as we age, how rapid and significant that loss is can be partly mitigated by physical activity and diet.
The link between sarcopenia and type 2 diabetes
New research is highlighting another key muscle function that hasn’t received much attention previously. Skeletal muscle is essential for good metabolic function, including regulating blood glucose levels. Muscle is the body’s largest insulin-sensitive, metabolically active tissue. Put simply, muscles burn calories and ramp up the body’s metabolic rate, making it easier to maintain a healthy weight and reduce the risk of type 2 diabetes. Lower muscle mass usually means a higher percentage of body fat, which has a profound effect on metabolic health. Unfortunately, obesity often masks sarcopenia, which means people often go undiagnosed.
A 2019 review found sarcopenia affects 40 to 45 per cent of people who are overweight or obese. Furthermore, having both conditions increases the risk of type 2 diabetes by 38 per cent, compared to having only one. The exact reason is unclear, but sarcopenia may make a significant but under-appreciated contribution to increasing the risk of type 2 diabetes.
In your 40s… Work on your flexibility
Our 40s are when muscle mass and strength begin to decline. Without regular exercise, this loss accelerates with age, so now is the time to be proactive.
Flexibility means being able to move your joints through their full range of motion. Losing flexibility in your hip, knee and ankle joints affects your gait and increases your risk of falls as you get older. Along with the strength exercises shown on page 22, now is a good time to start incorporating regular stretching, tai chi and yoga into your exercise workouts.
In your 50s… Increase calcium and vitamin D intake
As we age, sarcopenia and osteoporosis (low bone mass) often develop side by side. From the age of 50 onwards, daily calcium requirements for women increase from 1000mg to 1300mg. For men, these requirements increase after the age of 70. While calcium alone doesn’t build muscle, it does help to strengthen bones, and there’s growing interest in the effects of simultaneous bone and muscle weakness, often described as ‘bone-muscle cross-talk’. Hormonal changes and inactivity also affect muscle and bone health.
As we lose muscle mass, we’re more prone to having falls and once we have a fall, we’re more likely to suffer a fracture and possibly lose our independence. To hit the daily calcium targets in this age group, eat three or four serves of calcium-rich dairy foods every day. One serve is a glass of milk, a small tub of yoghurt or 40g of cheese.
In your 60s… Find your balance
One in four people over the age of 60 have a fall every year, and this increases to one in three people over the age of 65. Having good balance helps maintain stability and prevent falls when we undertake daily activities. As with flexibility, we probably take our balance for granted but if we don’t train ourselves to maintain it, we can lose our balance as we age.
You will need to have maintained muscle strength to do balance exercises, so it’s all interlinked. Practise your balance by standing up on a moving bus or train without holding onto handles or poles. Or try walking backwards or standing on one leg. Taking up slow-moving tai chi will also improve your balance.
Low vitamin D levels have also been linked to muscle weakness and falls. Sunlight exposure is the main way to boost vitamin D, but if you can’t get outdoors for long periods, speak to your GP who may recommend a vitamin D supplement.
In your 70s… Focus on protein
As we get older, the body becomes resistant to building muscle, so we need more protein from our diet to help stimulate muscle growth.
Men and women over the age of 70 require approximately 20 per cent more protein every day than those aged between the ages of 19 and 70. A US study of more than 2000 men and women between the ages of 70 and 79 compared their diets and muscle mass over a three-year period. The 20 per cent who had the highest protein diets lost around 40 per cent less muscle mass over this period of time, compared to the 20 per cent who had the lowest protein diets.
Current guidelines advise a daily protein intake of between 57 and 81g, however, there’s growing research to suggest protein intake in the elderly should be even higher to moderate the loss of lean muscle mass. As we get older, we may also be more prone to illness, which can hinder muscle building. When we’re unwell or recovering from sickness, getting plenty of protein is essential for a speedy recovery.
Aim to include a variety of high-protein foods in every meal and snack. Refer to the chart below for some suggestions.
|120g portion of beef, pork, lamb or chicken||23g–26g|
|120g fillet of fish||18g–24g|
|100g of tofu or tempeh||12g–19g|
|Small can of tuna or salmon||12g–22g|
|Small can of baked beans with 1 slice of grainy bread||13g|
|40g of hard cheese||9g–12g|
|½ cup of thick Greek-style or high-protein yoghurt||11g|
|1 egg with 1 slice of grainy bread||11g|
|¼ cup of rolled oats with ½ cup of calcium-fortified milk||10g|
|¼ cup of nuts||6g–7g|
Download these strengthening exercises to do at home
Article sources and references
- Batsis J & Villareal D. 2018. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endorcrinol. 14(9): 513-537. https://pubmed.ncbi.nlm.nih.gov/30065268/
- Beaudart et al. 2017. Nutrition and physical activity in the prevention and treatment of sarcopenia: Systematic review. Osteoporosis Intl. 6: 1817-33. Granic et al. 2019. Dietary patterns, skeletal muscle health, and sarcopenia in older adults. Nutr. 11: 745.https://pubmed.ncbi.nlm.nih.gov/28251287/
- Khadra et al. 2019. Association between sarcopenic obesity and higher risk of type 2 diabetes in adults: A systematic review and meta-analysis. World J Diabetes. 10(5): 311-23.https://pubmed.ncbi.nlm.nih.gov/31139318/
- Krok-Schoen et al. 2019. Low dietary protein intakes and associated dietary patterns and functional limitations in an aging population: A NHANES analysis. J Nutr, Health & Aging. 23: 338-47.https://pubmed.ncbi.nlm.nih.gov/30932132/
- NHMRC. 2013. Nutrient Reference Values for Australia and New Zealand – Protein. Accessed march 2021https://www.nrv.gov.au/
- Peterson et al. 2011. Resistance exercise for the aging adult: Clinical implications and prescription guidelines. Am J Med. 124: 194-8.https://www.amjmed.com/article/S0002-9343(10)00927-7/abstract
- Scott et al. 2016. Sarcopenia: a potential cause and consequence of type 2 diabetes in Australia’s ageing population? Med J Aust. 205(7): 329-333. https://www.mja.com.au/journal/2016/205/7/sarcopenia-potential-cause-and-consequence-type-2-diabetes-australias-ageing
- Stay on Your Feet. 2021. Falls. Accessed March 2021https://www.stayonyourfeet.com.au/2021/
- Yoo et al. 2018. Role of exercise in age-related sarcopenia. J Exerc Rehabil. 14(4): 551-58.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165967/