Strong is the New Sexy

Muscle mass matters.

Developing strong muscles is a good way to increase your chances of living a long and healthy life. But why?

Muscles burn energy. With more muscle (as opposed to fat) your metabolism works more effectively. This makes weight maintenance easier to achieve and also reduces the risk of developing type II diabetes. They do this by absorbing glucose and increasing insulin sensitivity so that sugars continue to cleared out of the bloodstream efficiently.

Mobility, balance and strength. As we age there is a tendency to lose muscle and also to do less exercise. The two together create the perfect storm and often lead to decreased mobility, loss of good balance and a lack of strength. Falls and a loss of independence may then follow. Age does not necessarily mean loss of function. But it does require effort to keep it up.

Bone health. Strong muscles support bones which have a tendency to become more brittle with age (especially in women once oestrogen declines after menopause). Brittle bones are more likely to break in the event of a fall, but strong muscles aid balance and make falls less likely.

Disease resistance and long life. There is an association between muscle mass and all cause mortality, immune health and shorter recovery time after illness.

Sarcopenia is the name given to age related loss of muscle mass. As we get older muscles respond less well to the stimuli of exercise and protein intake and it becomes harder to maintain muscle. This contributes to frailty, increased risk of falls and also the loss of ability to perform the normal activities of daily life.

Cachexia is the name given to loss of muscle mass, strength and metabolic functioining due to cardiac disease or cancer. It can be rapid and extensive and is an important determinant of survival.

Muscle mass is a key determinant of longevity and disease resistance

How to increase muscle mass? At any age or life stage it is possible to improve your muscle mass and in doing so improve your overall health prospects. (Plus, you'll look great!)

There are basically two ingredients: Protein and resistance (or weight bearing) exercise.

Protein You don't necessarily have to bring out the protein shakes, though for peope with reduced appetite a high protein powder which can be added to food or liquids may be an easy solution to increasing protein in the diet.

There are dietary guidelines for how much protein is required daily for each life stage and for men/women, but to see improvements in muscle mass then it is necessary to increase these so that there are plenty of 'building blocks' at the ready when muscle is stimulated to grow.

How much protein?

An increase of 1.5 x the recommended amount is not at all dangerous (unless you have medical contra-indications such as renal disease). For women aged19 - 70 years the recommendation is 46g protein per day and for men aged 19 -70 years it is 64g protein per day. After age 70 this increases to 1g protein per kg of body weight per day. So, as a 75 year old weighing 80kg you could safely aim for 120g protein per day.

When?

To get maximum effect from your protein intake it is best to eat a 'dose' of 20-25g within two hours of the resistance training. It can be before or after, but within that window. Muscles are stimulated to grow by exercise and so when that impetus is there then it creates ideal conditions to have amino acids (the smallest molecules of proteins) in the bloodstream ready to be used.

Eating some protein before bed is a good strategy too (maybe a milk drink?) as some growth and repair happens whilst we are asleep.

What?

Good protein rich foods can be either animal or plant based. The highest amounts of protein are found in animal foods such as meat, fish, eggs and dairy foods. However, plant sources such as tofu, beans, peas, lentils, nuts and seeds are also useful and contain many other health-giving nutrients such as anti-cancer phytochemicals, vitamins and lots of fibre for good gut health.

There are 22 different amino acids in proteins and nine of them are essential - ie we must eat them, the body can't assemble them from other amino acids. Plant foods rarely contain all the essential amino acids, whereas animal foods do. If you eat only a few, or no animal products then eating a wide range of plant foods ensures that where one amino acid is lacking in one food, another makes up for it eg baked beans with toast.

It's all about balance: Increasing protein in your diet doesn't have to mean increasing red meat, saturated fat or neglecting vegetables. A handy guide to the protein content of various foods can be found here.

Tips for adding more protein

Simple ideas to add more protein could include:

• 'Doubling up' by adding beans or chick peas into meat dishes eg chilli con carne, cassoulet or tagine. Or, adding tofu and chicken or prawns to laksa or curry.

• Swapping a cereal breakfast for eggs, baked beans and high protein toast on training days.

• Buying high protein yoghurt and using on breakfast cereal, as a dessert or snack.

• Sprinkling nuts and seeds on salads

• Using a nut butter instead of butter or margarine.

• Making 'protein balls' as a snack instead of biscuits.

• Having a bedtime milk drink, maybe supplemented with some protein powder.

• Adding lentils to tomato pasta sauces or vegetable soups which otherwise make for low protein meals.

Resistance Exercise

The other magic (and essential) ingredient for building muscle is weight bearing exercise. Don't be put off by visions of massive dumb bells, anything that your body has to push, pull or carry helps. Your own bodyweight is a good start

- push ups after all involve raising your own body off the ground. Not possible? Start with push ups against a wall in a standing position.

Hand weights are available from about 500g upwards, so start small and progress. Progression is important- keep challenging yourself. If you can do 10 repetitions of an exercise easily then it's time to go up to a higher weight.

Muscle is stimulated to grow by undergoing microscopic muscle damage and mechanical tension, which activates repair cells. Resistance exercise does this. The 'burn' you feel when you exercise a muscle is an accumulation of metabolites (the by products of energy being used). These stimulate a hormonal response which increases muscle fibres.

How much and how often?

Consensus seems to be that to to three sessions per week of resistance training, with 8-12 repetitions of exercises on each muscle group is enough to see good improvements. Doing four to six different exercises with three sets of 8-12 repetitions each is a great workout. Having said that, anything is an improvement on doing none! Many online videos and blog posts on this go into more detail, or you can ask at your local gym.

Take Away Message

Prioritise keeping muscles strong throughout life. After you are over 50 start to pay even more attention to regular resistance exercise combined with a high protein intake appropriate to your age and weight.