
Preventing Muscle Loss as We Age - hvo
https://www.nytimes.com/2018/09/03/well/live/preventing-muscle-loss-among-the-elderly.html
======
lysp
I always like to show this picture as an example.

[https://i.imgur.com/ZcDedfo.jpg](https://i.imgur.com/ZcDedfo.jpg)

I don't have an original source but it shows a MRI leg scan comparison between
a 40yo triathlete, a sedentary 70yo and a 70yo triathlete.

The picture tells the story...

~~~
matwood
Most people have no idea I'm 41, and instead think I'm in my 30s. Balding and
grey hair show I'm not in my 20s ;) My 'secret' is I workout _every single
day_. I might do heavy weight training, sled pushing, surfing, or a spin
class. It doesn't matter as long as I do something physically challenging. I
also follow an 80/20 rule on eating paleo-ish. Mainly I try to avoid processed
foods, but I'll still eat a pizza or good sandwich - just not all the time.
Most meals consist of meat/dairy and veggies.

If I'm fortunate enough to live into old age, I don't plan to stop exercising.
It's part of what gets me out of bed every morning.

~~~
lifting_throw
Some folks are able to lift heavy weights frequently, and that's awesome. I'm
jealous. But here's a comment directed at people who've tried that and hurt
themselves.

For years I tried to lift heavy. Big compound barbell lifts. In my early 20s
it was OK, but by 30 I started hurting myself. I always warmed up fully, but
kept tearing things. I tried eating more, eating better, more recovery,
everything I could think of.

Finally I gave up on doing 1 rep max lifts, or even 3-5 reps 90% 1RM. Now I do
very high repetition workouts. I'm talking warm up sets at 20-30 reps, "work"
sets at 10-20, with a minimum of 5 sets, with limited rest between. I focus on
every rep - focus on feeling the muscle contract, and focus on thinking about
moving blood to the contracted muscle. I try to go to failure every set but
the first.

Sounds goofy, but it's been a game changer for me. I don't hurt myself, and I
look much bigger/better than ever before. I'm not sure if I'm really
"stronger" since I don't lift heavy anymore - but I've added pounds of muscle
so I wager I am.

Point is - a lot of folks get huge mileage out of lifting heavy. I wish I was
one of them. For those of use who, for whatever reason, don't have the body
type to handle it. High rep workouts are the next best thing!

~~~
graeme
That's very interesting. I've frequently had to take time off lifting due to
injuries, many of which never really relax properly. Eg a tense spot on my
back I'm still having massage/physio done on.

Do you do barbells lifts at high rep, or other things? Also, how many days a
week do you do it and for how long?

~~~
prostoalex
Have you looked into Starting Strength (the book and the program)? It goes
ridiculously anatomical in order to address the most common injuries uncoached
weightlifters experience.

~~~
graeme
Yeah, I've gone through some of it. Helpful, I was waiting until I got my
current back injuries fixed before trying to apply it. I don't think I can
squat correctly while a certain spot is tight - have tried.

It did help me get closer to the proper position though.

------
rthomas6
Weight training into old age does much more than prevent muscle loss! It also
prevents osteoporosis and increases bone density, decreases likelihood of
falls, and might even prevent cognitive decline. Basically it prevents you
from slowly withering away as you die. Instead you are pretty normal, then one
day you die. It doesn't make you live longer, but it can give you a lot more
quality years.

~~~
SketchySeaBeast
Not only are you less likely to die of a heart attack, diabetes, or a broken
hip, you're also more likely to be still doing the things you love when you do
pass away. It's a win win really.

------
davemp
Am I missing something or is the article just giving a name to very generic
muscle loss and saying that one can workout and get enough protein to combat
it?

I hate to be overly critical, but these types of articles published by the
likes of nytimes just make digesting news more difficult. Puff pieces honestly
_subtract_ value from my life. I with more news vendors would think about the
value they provide in the internet age and adjust.

~~~
ekianjo
Agree. I see also way too many NYtimes articles on HN recently. What happened
to the adage that "if its on the popular media, it should probably not be on
HN". Is HN turning into the comment system of the NYT?

~~~
rrishi
> "if its on the popular media, it should probably not be on HN"

Why though? Can't say for all but a majority of articles on popular media
would be mostly right...that's why they are popular. As things go more fringe,
there is less verification.

~~~
ekianjo
It's not about that. It's called "Hacker News" for a reason. I don't mind
having regular stories hitting HN sometimes, but there's nowadays a massive
flux of NYT, and also NewYorker, TheAtlantic just to name a few, which were
not there a few years back.

~~~
dominotw
I think software engineering used to be a nerdy hobby now its for 'everyone' (
due to the rise of amazing tooling/languages ect).

That 'everyone' attitude is reflected on HN.

------
lemming
I've been investigating recommended protein intake recently and counting
calories to lose some weight, and it's _amazing_ how little protein most
people get compared to what is now recommended.

Here's examine.com on the recommended amounts:
[https://examine.com/nutrition/how-much-protein-do-you-
need/](https://examine.com/nutrition/how-much-protein-do-you-need/). I'm of
fairly healthy weight, active and have been losing some weight, so I should be
getting 2.2-3.3 g/kg according to that. I have two protein shakes a day and
build every meal around as much protein as possible while still having it
resemble normal food, and I'm achieving an average of about 2.2g/kg, i.e. just
at the lower end of where I should be. Particularly when trying to lose
weight, getting the amount of protein required in the calories allowed is
really tough. It's easier when maintaining weight or trying to gain weight
since the protein requirements are similar but you have more calories to play
with.

I'm 46, so soon I'll be in the 50+ group which the examine.com article says is
when you start needing more protein in a single dose. For me that's about 36g
per meal - about 6 eggs, for example.

Counting calories is a bit of a pain to get started with, but isn't too bad
once you're going since most people tend to repeat meals frequently. But it's
been really illuminating - I thought I ate well previously, but I was a long
way from where I needed to be. It's pretty geeky but has been really
interesting. I've realised that it's essentially impossible to eat the way I
should do eating food I don't prepare myself - nothing has anywhere near
enough protein. Data driven health FTW.

~~~
st26
1.5g/lb (3.3g/kg) is considered by many in the weight training communities to
be way overkill, and potentially hard on your kidneys.

~~~
lemming
Yeah, 3.3g/kg is really high, and I don't see how you could get there without
living on shakes. From that examine.com article:

 _Eating more than 2.6 g /kg (1.18 g/lb) is probably not going to lead to
greater muscle gains, but it can minimize fat gains when “bulking” — i.e.,
when eating above maintenance in order to gain (muscle) weight._

There doesn't seem to be a lot of evidence for the kidney thing as long as you
don't dramatically increase protein suddenly:
[https://examine.com/nutrition/can-eating-too-much-protein-
be...](https://examine.com/nutrition/can-eating-too-much-protein-be-bad-for-
you/)

~~~
st26
IMO while protein is needed for muscle building, recommendations like 3.3g/kg
(I've even seen recommendations of 4.4g/kg) come from a "more is always
better" mentality, along with a pop culture obsession with protein.

Personally, a simple flat 100g seems both a reasonable & attainable goal for
most regular people building muscle without requiring exceptional diets (here
I fall back on naturalism- I cannot believe that exceptional diets are
required to get fit). You can easily hit that number with 1/4-1/3lb of meat a
day plus whole grains and vegetables.

~~~
lemming
I don't think it's that, it's more this:

 _Since higher protein intakes seem to have no negative effects in healthy
people, one may want to err toward the higher amounts._

I haven't seen anything over 3.3g/kg recommended anywhere, and most people
seem to recommend 1.4-2g/kg as a good baseline amount. The ISSN recommends
this (see here: [http://stevenlow.org/issn-position-statements-protein-and-
ex...](http://stevenlow.org/issn-position-statements-protein-and-exercise-
diets-and-body-composition-safety-and-efficacy-of-creatine-supplementation-in-
exercise-sport-and-medicine/)), however the ISSN does recommend higher amounts
when losing weight:

 _Higher protein intakes (2.3–3.1 g /kg/d) may be needed to maximize the
retention of lean body mass in resistance-trained subjects during hypocaloric
periods._

Of course, none of this is required to get fit - you don't need to do the
optimal thing to get a basic result. But you'll definitely gain lean mass
faster if you do follow this. Those recommendations for weight gain (say 2g/kg
with a caloric surplus) is easy to achieve with no supplementation and normal
food, at least for an omnivore - vegans may have to work harder to get there.

------
andy_ppp
I can't recommend StrongLifts enough.

[https://stronglifts.com](https://stronglifts.com)

I'm up to squatting 130kg now and feeling great!

~~~
morley
I've used StrongLifts for 2+ years and second the recommendation.

HOWEVER.

Because it's just an app with videos, it's really up to you to learn proper
form and execute it each time. Additionally, the app doesn't know your
limitations, so take your pain seriously.

I hurt my knees squatting a couple years ago, and recently hurt my lower back
deadlifting. It sucks, and I'm crossing my fingers that there's no permanent
damage.

If I were to go back in time, I'd force myself to book yearly or twice-yearly
sessions with a physical trainer who can check you on your form, particularly
when I first got started.

~~~
SketchySeaBeast
Are you still stronglifting after 2 years? How has your progression been for
the last year or so of that? As I understand it it's a fairly novice focused
program with aggressive weight increases, so I was wondering how you modified
it to continue running it after the first 3-6 months of easy gains went away.

~~~
TheCapn
You're not supposed to run it for 2 years. OP has made adhoc adjustments and
is no longer following the program if he has been consistent.

Even the SL5x5 site recommends moving on from the program. Their
recommendation is Madcow 5x5 but there's other options out there.

~~~
SketchySeaBeast
I know, that's why I was curious. If you followed the program as written you'd
be at like 2000 lbs of deadlift.

My own journey has taken me through Starting Strength to Texas method and then
to various 5/3/1's (and occasional returns to Texas) through the years.

------
dataker
I'd also like to mention the use of hormonal replacement technologies (as TRT
and HGH) that can absolutely help the elderly.

We have terrible stereotypes around testosterone because of steroid abuse in
athletes, but reality paints itself very differently.

[https://www.indiatimes.com/news/india/this-103yearold-
bodybu...](https://www.indiatimes.com/news/india/this-103yearold-bodybuilder-
was-indias-first-mr-universe-heres-why-hell-always-be-indias-
pride-244648.html)

My grandmother underwent medical treatment using Deca Durabolin, a well-known
anabolic steroid, and she could walk again after a long time spent in beds
and, at best, chairs.

------
madeuptempacct
More interested in preventing this:

[http://social-quotient.info/sq.4mg.com/brainpower.gif](http://social-
quotient.info/sq.4mg.com/brainpower.gif)

Much less clear on how accomplish that.

Edit: To elaborate, I know exactly what I need to do to stay physically fit
into old age and how to monitor my physical fitness - I know immediately when
I get winded more from my regular run, my lift numbers drop, or I can't reach
my toes.

The scary part is if I stop working out for more than 2 weeks, I see dramatic
and rapid declines.

So how do I monitor my mental health? Is it possible to keep improving it? Do
I do dual-n-back (studies inconclusive), do I learn a languge/to play piano,
do I memorize 5 words a day?

~~~
morsma
Low carb and periodic water fasting (autophagy), and you should be set old
age.

~~~
madeuptempacct
I keep seeing this on HackerNews - everyone seems to convinced that keto,
intermittent fasting, and fasting are the new holy grail, I am unconvinced. I
_am_ convinced in the good old "enough sleep and cardio" theory though, since
both have known working mechanisms (incread blood flow and debris clean up
during sleep).

~~~
chillingeffect
why are you unconvinced about fasting? have you tried researching and reading
the scientific articles about fasting and the other topics.

If you're thinking in terms of "holy grail," you may be subjecting yourself to
an "all or nothing" fallacy.

Generally, we're discovering how to lead our bodies through the healthy
operating conditions which kept our ancestors alive as we navigate a modern
world of high-tech capabilities, treatments and availability crossed with
widespread lack of discipline and healthy habits.

~~~
strls
Are there any studies on positive effects of fasting which control for caloric
restriction / weight loss?

------
gadders
Related article from Starting Strength - Barbell Training is Big Medicine [1]:

>> I’ll approach a patient who has come to be treated for chronic pain,
fatigue, elevated blood pressure, shortness of breath, or a blood sugar that’s
out of control. I find myself confronted by a very overweight, deconditioned
52 year-old, going on 70, with battered joints, atrophic muscles, no
physiologic reserve, an inability to get off the gurney without groaning and
wheezing, and a grim future. When I work them up, I find no medical emergency,
just what I have come to call “diatensionolesity”—type II diabetes,
hypertension, a screwed-up blood-lipid profile, and obesity.

And I think to myself: If I could get you under the bar, I could change your
life.

[1]
[https://startingstrength.com/article/barbell_training_is_big...](https://startingstrength.com/article/barbell_training_is_big_medicine)

~~~
bproven
Agreed. Starting Strength is a great program to follow for anyone to geting
started with strength training. The focus on big compound movements, short gym
time and strength is perfect - especially as you get older. You can also add
accessory stuff as needed (time allows).

------
zaroth
Ctrl-F Testosterone - was disappoint.

For approximately half of the population, supplementing testosterone into old
age is a great way to maintain (and build) SMM along with that physical
activity which TFA admonishes the lack of.

~~~
SnowingXIV
I was too, basically the article is saying to lift. Which I do agree with but
if you're suggesting TRT (testosterone replacement therapy), something that
has definitely become popular and is being advertised heavily - I'd caution
that it's not for everyone and there have been plenty of lawsuits filed
already and problems allegedly associated with it. I guess like everything,
check with your doctor which the article does suggest. At least 9 products
have been named in the litigation. Fortestam, AndroGel, Axiron, Androderm,
etc.

One of the many lawyers working on these cases:
[https://outline.com/YEpTGg](https://outline.com/YEpTGg)

The MDL source: [http://www.ilnd.uscourts.gov/mdl-
details.aspx?UGlDS1bLxpRHyf...](http://www.ilnd.uscourts.gov/mdl-
details.aspx?UGlDS1bLxpRHyfdf3l5DJQ==)

You do have to wonder about guys like Arnold Schwarzenegger, who is 71
(ridiculous) and is in better shape than most. I can't imagine how much work
he has to put into to keeping that up. Supplements can only do so much.

~~~
imjk
Arnold has also admitted to steroid use in the past and has had multiple open
heart surgeries.

------
jgrahamc
Strength training has worked well for me. I was diagnosed with osteopenia aged
40 and was told the solution was either weird osteoporosis drugs usually given
to women or strength training. I restored my bone density to well above
average for my age with the three big lifts. Didn't do it to get big or
shredded, but it worked.

~~~
caust1c
I think you should still aim to get shredded. I can already see your new book
title: "Use Make, Get Shredded!"

The new security lead can help you out when you visit HQ.

~~~
jgrahamc
Sounds good to me. I'm happy to be stronger.

------
zokahn
Great article. I always wondered if the decline i see with elderly people is
due to age or just because they become inactive. I hear "I'm too old for this,
i don't have to do this anymore" a lot and i don't agree. Working out is hard
but healthy on any age. I feel sad seeing people giving up on their bodies...

------
corpMaverick
As a 50 yo. This is what I am doing and I feel great.

Day 1: Strength training. kudos /r/bodyweightfitness (1hr) Day 2: Yoga. 25 -35
minutes Day 3: Running ~20 minutes. Some days I do higher intensity other days
lower intensity with increased time.

It takes very little time. Yoga provides mobility and joint integrity which I
feel is important as you age. This programming gives me a lot of rest time to
recover, which is slower as you age.

~~~
beat
I started working out at 52, mostly weight training, and made tremendous
progress. But I have a hard time defending the habit from incursion by the
rest of my life. I've been out for the past couple of weeks because my spouse
just had knee surgery and has needed a lot of care. I got quite cranky when
she and her mother "helping" meant I did not make a planned trip to the gym on
sunday.

But part of the problem there is that I have built my exercise around a "go to
the gym" habit. I need to do things that don't involve going to the gym, a
habit I can work on at home. Habits are the hard part!

------
emersonrsantos
For me it’s bodyweight fitness (which is olympic gymnastics for newbies),
following the recommended routine from the reddit /r/bodyweightfitness
community, plus exercise bike every day.

Used to do weight training, the chance of injury becomes higher as you age.
Also, as you add muscle mass and more training, you will need much more time
to recover. Also always watch for overtraining symptoms.

Our body is the most precious thing we will ever encounter, or possess in
life.

------
baccheion
General/Regular movement (ie, walking) is more likely to overcome effects of
sitting or being sedentary than exercise.

[http://annals.org/aim/article/2653704/patterns-sedentary-
beh...](http://annals.org/aim/article/2653704/patterns-sedentary-behavior-
mortality-u-s-middle-aged-older-adults)

------
chimeracoder
It's too bad that we somehow decided that steroids are immoral and need to be
regulated to the point that they're essentially banned.

Anabolic steroids, when provided in correct dosages and under the care of a
physician, are quite safe and solve this exact problem.

~~~
fcuck_actuarial
What really bothers me is that youtube and instagram are full or
lifting/exercise guru that presume to give people useful advice(and frequently
sell things).

Except most/all of these people that claim they are natural actually take
steroids. Steroids are such a force multiplier - they will completely
overpower mediocre diet and training. A natural lifter could do everything
perfectly and still fall far behind the results of these so called experts.

~~~
cheald
A good filter is to get your advice from people that compete in (or coach
athletes competing in) tested federations. While you can't guarantee they
aren't cheating, those folks tend to be watched very carefully.

------
timbit42
What about rebounding? It looks like it would prevent muscle loss while being
safe for older joints.

------
RobertSmith
LCHF diet plus regular exercise would prevent muscle loss for sure. My
experience says it

------
ausjke
Just do this 7 minutes a day without any tools you will be fine:
[https://7-min.com/](https://7-min.com/), at least it is a good start.

~~~
suprfnk
It might be a good start to get people moving, but I can't imagine this being
enough. That amounts to not even an hour of exercise in the 168 hours in a
week.

Do you have any source for "you will be fine"?

~~~
corpMaverick
[https://well.blogs.nytimes.com/2013/05/09/the-
scientific-7-m...](https://well.blogs.nytimes.com/2013/05/09/the-
scientific-7-minute-workout/)

[https://journals.lww.com/acsm-
healthfitness/Fulltext/2013/05...](https://journals.lww.com/acsm-
healthfitness/Fulltext/2013/05000/HIGH_INTENSITY_CIRCUIT_TRAINING_USING_BODY_WEIGHT_.5.aspx)

------
jimijazz
TL;DR Lift weights in repetitions in a mid-intense way.

------
daddyofive
People from my parents generation are ignorant about the body. My dad treated
his body like a rented car and he died for it. I’m pretty sure that anybody
with any level of biological education and sensibility will not be troubled
too much by this problem.

------
ubermonkey
ZOMG find something to do, and keep doing it.

Cycling is very nerd-friendly. There are numbers and gadgets and even what
amounts to an MMO in Zwift.

~~~
Mc_Big_G
According to the article, cycling isn't enough. You need to do heavier
resistance training.

~~~
rezeroed
Change gear.

~~~
cultus
Speaking as a former bike racer, cycling does not build muscles unless you are
already wildly out of shape. Pedaling in a tall gear still isn't much
resistance, typically less than body weight.

Muscle is built only by getting near the limit of musclular strength. Cycling
only challenges your cardiovascular system. I always squatted and deadlifted
to get better at sprints. Other racers who were climbing specialists had
skinnier legs than the average man, yet they could climb hills incredibly
fast.

~~~
Yajirobe
Is climbing a good sport according to this 'limit of muscular strength'
requirement?

~~~
cultus
I wear my arms out pretty fast rock climbing, but that's only a small
proportion of the body. I kind of doubt it is a good replacement for strength
training.

------
baccheion
Preventing muscle and bone loss mainly involves keeping
hormones/vitamins/minerals/nutrients in range and maintaining efficient
metabolism. And maybe exercising.

~~~
jmcgough
Diet often isn't enough as you age. You will almost certainly lose muscle (and
thereby lose autonomy) as you age, unless you're getting some form of strength
training. Strength training also stimulates osteoblasts, strengthening bones.

~~~
baccheion
Not true. Adding vitamin D3, vitamin K2 MK-4, iodine/iodide, boron, silica
(monomethylsilanetriol), etc does a lot to slow decline. And eventually
topical pregnenolone + DHEA (5 mg : 5 mg). Strength training is also great.

If exercise continues into old age without proper nutrition and the additions
mentioned above, it can worsen decline. And just adding supplements, improving
nutrition, and ensuring regular movement (ie, not really exercising) still
slows decline.

~~~
jmcgough
At worst, you'll get injured if you aren't exercising correctly, but it's
never going to directly worsen decline.

Solving aging, mental or physical health problems isn't as simple as taking a
dozen supplements. Obviously proper nutrition is important, but regular
exercise is the closest thing we have to a panacea right now.

------
atomical
Notice that there is no mention of diet because diet doesn't matter that much
as long as there is a surplus. The body is pretty amazing.

~~~
doctorcroc
This is an extremely ignorant comment. In what other system would you ever
say, "the inputs are irrelevant provided you supply enough volume"? Diet
absolutely matters tremendously. We just don't have a good understanding of
how individual variability and gut microbiomes affect one's optimal diet. But
we can all universally agree that humans need to avoid sugar, eat little to no
processed food, and eat less in general.

~~~
adrianN
Eating less is not good advice if you want to build muscle. Frail elderly
people often don't eat enough, or lack fiber, for example because their teeth
hurt. Appetite also declines with age.

~~~
presscast
>Frail elderly people often don't eat enough, or lack fiber, for example
because their teeth hurt. Appetite also declines with age.

You're strongly implying causation here. I'm unaware of any serious body of
research that indicates elderly people are getting frailer _because_ of a
decrease in appetite.

~~~
adrianN
I did not mean to imply that, I just wanted to make the point that eating less
is not always good advice, in particular in the age bracket that suffers from
age related muscle loss.

~~~
doctorcroc
You're right, and there's always exceptions to the rule. Eg some of those with
life threatening injuries probably need processed food in the interim. But the
general point stands which is that human longevity had been correlated with
caloric restriction. Even in Ben Franklin's wit and wisdom, he remarks that to
preserve one's life, one should eat less. This observation is timeless

~~~
atomical
Human longevity has also been correlated with many other things.

[https://en.wikipedia.org/wiki/Blue_Zone](https://en.wikipedia.org/wiki/Blue_Zone)

