God, Hope & Helping Others
By Dr. Mercola
Staying active and maintaining strong muscles becomes increasingly important as you get older to prevent chronic health problems and injuries from falls. The good news is that even frail seniors of advanced age can improve strength, agility, and balance through a personalized strength training program.
Examples of muscle-strengthening exercises include yoga, body-weight exercises, and resistance training using elastic bands and/or free weights or weight machines.
The American College of Sports Medicine, the American Heart Association, and the US Department of Health and Human Services (DHHS) recommend engaging in muscle strengthening activities targeting all major muscle groups at least two days per week.1
Gaining more muscle through resistance training has many benefits, and is an essential element if you want to prevent weakening of your bones (osteoporosis), age-related muscle loss (sarcopenia), limited range of motion, aches, and pains.
Strength training can in fact be more important for older adults and seniors than aerobic exercise. Besides, strength training is an excellent form of aerobic exercise, because in order to actually access your cardiovascular system, you have to perform mechanical work with your muscle. This is a fact that many still are not familiar with.
It’s important to realize that by the time you’re in your 70s, your muscle strength and tone will have declined by roughly 25 percent from what you had in your mid-30s. You’ll lose up to 50 percent once you approach your 90s.
Light walking workouts will not suffice if you want to preserve muscle tone, bone health, balance, and posture as you age. If you’re not engaging in strength or resistance training, chances are you’ll become increasingly less functional with age, which can take a toll on your quality of life.
Interestingly, strength training even has a beneficial impact on your gene expression. Not only has it been shown to slow cellular aging but it can actually return gene expression to youthful levels. In seniors who take up strength training, the genes’ clocks can be turned back by as much as a decade!
While diet accounts for the majority, about 80 percent, of the health benefits you reap from a healthy lifestyle, exercise is a crucial component and adjunct. Strength training in particular, from this point of view, acts as a force multiplier, and is the great leveraging agent...
Unfortunately, less than 25 percent of Americans over the age of 45 engage in strength training exercises, according to a recent survey.2 This is actually a decrease from last year’s survey,3 in which 29 percent of adults reported meeting the government’s strength training recommendations. As noted by the authors of the study:
“Muscle strengthening activities are essential in the maintenance of health and physical function. This fact is of particular importance in the aging population, given the high association of aging with decreases in skeletal muscle size and function...
Continuing to develop interventions to target adults throughout their lifespan, including well beyond the age of 65, may offer a strategy to attenuate the effects of sarcopenia and increase physical function in advancing age while also helping to control other cardiometabolic risk factors.
Given what is known about the health-related benefits of physical activity and about muscle strengthening activities, it is important to increase understanding of the correlates and determinates of strength training participation in older adults.”
Those least likely to meet government strength training recommendations included the following, and the authors recommended interventions be designed to specifically target these high-risk groups:
- Women, especially widows
- Seniors over the age of 85
- High school drop-outs
A number of different factors can lead to muscle atrophy, including the following:
- Age: The older you get, the faster your muscles atrophy if you're not regularly engaging in appropriate exercise. Age-related muscle loss, also known as sarcopenia, can actually begin far sooner than you might think—starting as early as in your 20s if you’re sedentary.4 After the age of 50, you tend to lose about 0.4 pounds of muscle with each passing year.5
- Diet: A low carbohydrate diet is essential to prevent obesity and diabetes and to promote longevity in general. But it’s important to avoid replacing lost carbs with too much protein. Ideally, you’ll want to replace them with healthy fats instead.
Also, while conventional thought says you need lots of protein to build and maintain muscle, most Americans actually eat far too much low-quality protein as it is. Excess dietary protein can lead to elevated blood sugar, weight gain, kidney stress, leaching of bone minerals, and may stimulate cancer cell growth. Most people will probably not need more than one-half gram of protein per pound of lean body mass, which for most is somewhere from 40 to 70 grams of protein per day.
That said, after strength training exercises, it is very important to provide the proper fuel (protein) within a crucial window, typically within an hour after exercise. Otherwise you’re not going to be able to build muscle. Whey protein, which is often referred to as the gold standard of protein, is one of the finest post-exercise meals for increasing muscle growth.
One of the reasons whey protein concentrate works so well is that it has the highest concentration of any food of the amino acid leucine, which is typically the rate limiting protein element for muscle building. Avoid whey protein isolates as they are highly processed and full of putrid health damaging proteins. A study published in the journal Medicine and Science in Sports & Exercise6 showed that leucine and other amino acids found in high-quality whey protein activate cellular pathways, including a mechanism called mTORC-1, which in turn promote muscle protein synthesis, boost thyroid, and also protect against declining testosterone levels after exercise.
- Insulin resistance. Research7 has shown that a loss of fast twitch fibers and insulin resistance may play an important role in the loss of muscle strength and development of sarcopenia. If your insulin receptors are insensitive, the mTOR mechanism, which is part of the insulin pathway and builds protein in your muscles, remains inactivated, making muscle wasting more or less inevitable. So, needless to say, it's very important to keep your insulin levels low to avoid becoming insulin resistant — not just for your overall health, but also to maintain healthy muscle. A low-carb diet and exercise are crucial components to normalize your insulin and leptin sensitivity. Intermittent fasting is also effective.
- Sleep: Lack of sleep decreases your body’s ability to effectively build and repair itself, so poor sleeping habits can also affect the rate at which you start losing muscle.
Loss of bone mass is a common sign of aging, because as you age your existing bone is absorbed by your body while new bone is created to replace it. In the case of osteoporosis, the formation of new bone falls behind the rate of bone absorption, leading to weakened, thinner, and more brittle bones. A thinning hipbone is a major concern if you are elderly, because any fall increases the risk of a broken hip, which always carries a great risk of complications and usually requires prolonged specialized care for recovery. It's estimated that 25 percent of elderly people suffering a hip fracture die as a direct result.8
Weight-bearing exercise, like resistance or strength training, can go a long way to prevent brittle bone formation, and can help reverse the damage already done. For example, a walking lunge exercise is a great way to build bone density in your hips, even without any additional weights. The last thing you want to consider is to take a drug to improve your bone density, as without question, that is more likely to cause long-term harm than benefit. The featured video created by the University of British Columbia Department of Physical Therapy, demonstrates resistance training for older adults and discusses the many benefits of exercise, which include:
- Improved sleep
- Reducing your risk for medical conditions, such as heart disease, stroke, type 2 diabetes, depression, dementia, cancer, and premature death from any cause
- Preventing falls and fractures
- Improving your overall mood and outlook
Strength training also increases your body’s production of growth factors, which are responsible for cellular growth, proliferation, and differentiation. Some of these growth factors also promote the growth, differentiation, and survival of neurons, which helps explain why working your muscles also benefits your brain and helps prevent dementia.
Dr. Doug McGuff, M.D. is an avid promoter of high-intensity strength training, referred to as super-slow strength training. While I have long recommend high-intensity anaerobic training (Peak Fitness) using an elliptical machine or a recumbent bike, super-slow weight training may have superior benefits, and may be a more suitable form of high intensity exercise for older individuals. While being more effective than conventional strength training, this type of super-slow weight training is also much safer, as it actively prevents you from accidentally harming your joints or suffering repetitive use injury. As Dr. McGuff explains:
"Force is mass times acceleration. If you deprive yourself of the acceleration, you're delivering almost no punishment to your joints. There's no repetitive use injury. The forces are extremely low, and as you become more fatigued, you're becoming much weaker. So you're actually delivering a smaller and smaller force to your body as you fatigue."
By working your muscle to fatigue, you stimulate the muscular adaptation that will improve the metabolic capability of the muscle and cause it to grow. Dr. McGuff recommends using four or five basic compound movements for your exercise set. These exercises can be done using either free weights or machines. The benefit of using a quality machine is that it will allow you to focus your mind on the effort, as opposed to on the movement. Dr. McGuff recommends the following five movements:
- Pull-down (or alternatively chin-up)
- Chest press
- Compound row (A pulling motion in the horizontal plane)
- Overhead press
- Leg press
Here's a summary of how to perform each exercise:
- Begin by lifting the weight as slowly and gradually as you can. The first inch should take about two seconds. Since you're depriving yourself of all the momentum of snatching the weight upward, it will be very difficult to complete the full movement in less than 7-10 seconds. (When pushing, stop about 10 to 15 degrees before your limb is fully straightened; smoothly reverse direction)
- Slowly lower the weight back down
- Repeat until exhaustion
- Immediately switch to the next exercise for the next target muscle group and repeat the first three steps
This super-slow movement allows your muscle, at the microscopic level, to access the maximum number of cross-bridges between the protein filaments that produce movement in the muscle. Once you reach exhaustion, don't try to heave or jerk the weight to get one last repetition in. Instead, just keep trying to produce the movement, even if it's not “going” anywhere, for another five seconds or so. If you're using the appropriate amount of weight or resistance, you'll be able to perform four to eight repetitions. When done in this fashion, your workout will take no more than 12 or 15 minutes. Just one or two of these workouts are needed each week, as you need to make sure you’re sufficiently recovered.
Another newer variation is Super Super Slow developed by Dr. Ellington Darden which he calls negative accentuated exercises. They can be done with body weight or weight equipment. I have just started this type of strength training and am impressed with its efficiency and the science behind it. This is only a one and a half rep exercise done with the same weight as in Super Slow but instead of ten seconds up and down, it is 30 seconds down 30 seconds up and 30 seconds down for a total of 90 seconds for the exercise. Ideally, ten exercises would be completed once a week.
I am experimenting with 16 exercises, about half are body weight exercises (push-ups, chin-ups, dips, sit-ups) and the other half I use dumbbell weights. I do half of them, or 8, once a week and the other half later in the week. The total time spent is similar to Peak Fitness, about 20 minutes. I have not yet discussed this with Dr. McGuff, but look forward to doing that.
While strength training is of particular importance for the aging population, you’d be wise to round out your exercise regimen with a wide variety of exercises. Each form of exercise has its range of benefits. Another critical factor is non-exercise movement, as the evidence clearly shows that sitting for more than a few hours each day will decrease your lifespan. Ideally, you want to stay active and on your feet for the majority of the day, with sitting interrupting your activity rather than the other way around. In addition to strength training and avoiding sitting, I recommend incorporating the following types of exercise into your program:
- High intensity interval (anaerobic) training
- Core exercises
- Stretching: Yoga has terrific benefits here not only for stretching but overall body health
- The elderly in particular can also gain many benefits from incorporating whole body vibration training, using a Power Plate. For more information, please see my previous article: “How Whole Body Vibration Exercises Can Help Improve Fitness in the ...”
Research shows that, no matter your age, you stand to gain significant improvements in strength, range of motion, balance, bone density, and mental clarity through exercise. My mom didn't start working out until she was 74, and was able to gain significant improvements in all of these areas. You can view her demonstrating her strength training program in this previous article. Truly, it’s never too late. But clearly, the sooner you start, the better. When it comes to bone and muscle strength, it’s clearly a lot harder to regain what you’ve lost than maintain what you’ve already got.