7 Strategies to Increase Lean Body Mass as You Age  

BLD234469Gigi was a fifty-year-old patient who visited me, lamenting that her muscles felt increasingly flabby – or “doughy,” as she put it. When I measured her body fat proportions, she had a healthy body mass index (BMI) of 24.5, yet she had nearly thirty-two percent body fat, and no longer felt lean.

That loss (and, er, gain) wasn’t just in her head. One study in the Muscles Ligaments Tendons journal found that aging leads to distinct muscle mass and strength loss.[1] Indeed, the cut off for obesity in women is a body fat of thirty-two percent or higher. It turns out that in the metrics of aging, maintaining and improving your lean body mass is essential. Unless you get clear about this goal and how to accomplish it, chances are you will become flabbier with age.

Gigi also felt sluggish, with mood swings that vacillated within a few minutes between chipper and outright bitchy – not to mention she hadn’t had that panty-dropping feeling in quite some time.

“My neck and hips feel tight,” she complained, “and I can’t do barre class without feeling pain in my neck when we’re doing core work.”

Gigi hit menopause about a year ago, and her testosterone and estrogen levels both fell to the low end. Those dips follow the typical transition I frequently see among menopausal females: increases in follicle stimulating hormone (FSH) and decreases in anti-Mullerian hormone (AMH), inhibin B, and estradiol.[2] These hormonal fluctuations bring about the importance (dare I say, struggle) of increasing lean body mass as you grow older. The leaner your body mass, the younger you feel.

As Gigi painfully discovered, with muscle loss also comes a reduced resting metabolic rate (RMR) that increases fat mass and reduces fat-free mass.[3] It wasn’t just Gigi’s vanity at stake. Age and physical inactivity are primary and secondary risk factors for numerous chronic conditions, whereas increasing physical activity from midlife to old age results in reduced rates of chronic disease and death.[4] The effects of aging can also dramatically impact your joie de vie, independence and quality of life.

While your neck or hips – and just about every other joint – often feel the burdens of age, the process of aging actually begins in your muscles. As your muscles get smaller and weaker, your bones and joints have less support, and therefore movement becomes harder and more prone to injury. After age forty, muscle strength declines between 16.6-40.9 percent.[5] One study found aging in the musculoskeletal system contributes to osteoarthritis, making your joints more susceptible to abnormal biomechanics, dysfunctional patterns, joint injury, and even your own genetics. Muscle loss and bone less increase your risk for osteoarthritis too.[6]  

Obviously, you want to do everything possible to slow down this decline, and increasing your lean body mass each year will help.  I recommended the following seven strategies to help Gigi lose body fat while regaining lean mass—and, equally important, her confidence and vitality.

  1. Track body composition. What you measure, you can improve. We measured Gigi’s body fat, lean body mass, and total body water and tracked the changes of each as she added modifications to her lifestyle.
  1. Lower stress. Short-term stress can strengthen cellular responses and promote longevity, whereas chronic stress can shorten lifespan.[7] Better stress resistance can potentially slow the aging process. Who doesn’t want that? With patients, I often find stress resides in one specific area of the body. (Like Gigi’s, mine used to linger in habitual tension in my neck.) I suggested Gigi begin doing twice-daily transcendental meditation, as well as some deep breathing exercises. Earthing, or walking barefoot, also helped lower Gigi’s cortisol while improving sleep and reducing pain.[8]
  1. Practice restorative yoga. Gigi started doing restorative yoga classes twice a week to reduce stress and improve flexibility. Research shows yoga also enhances muscular strength; promotes and improves respiratory and cardiovascular function; reduces anxiety, depression, and chronic pain; improves sleep patterns; and enhances overall well-being and quality of life.[9]
  1. Do strength training and burst training. Gigi initially seemed resistant (“I don’t want to become She-Woman,” she balked), yet she soon found regular weight training two to three days a week could build muscle strength and muscle mass while preserving bone density, independence, and vitality. Strength training can also reduce your risk for osteoporosis, heart disease, arthritis, and Type 2 diabetes, and no surprise here, it also improves sleep and reduces depression.[10] We combined strength training with high-intensity interval training (HIIT), also called burst training, which (among its other benefits) improves fat burning and glucose tolerance.[11] For Gigi, burst training meant hitting her office stairwell and getting breathless several times a week.
  1. Take supplements. Beyond foundational supplements such as a quality multivitamin and fish oil, I prescribed dehydroepiandrosterone sulphate (DHEA-S) and branch chain amino acids (BCAAs) during and immediately after burst training to improve testosterone levels. Aging can produce more wear and tear, often from higher cortisol, and lower growth-and-repair hormones, such as DHEA and testosterone. Researchers have reported that DHEA-S levels reduce cortisol – the wear-and-tear hormone – after exercise compared with pre-exercise.[12] Taking BCAAs before exercise increases growth hormone and testosterone.[13] Overall, encouraging robust growth-and-repair hormones may increase your lean body mass.
  1. Receive craniosacral therapy (CST). CST uses therapeutic touch to release restrictions around your spinal cord and brain to restore body function.[14] One study in The Clinical Journal of Pain found CST could help neck pain.[15] Indeed, CST helped release Gigi’s chronic neck tension, and she learned to love the “C-spine” work in barre class.
  1. Take Gyrotonic classes. The GYROTONIC® Method uses circular, flowing movements and corresponding breathing patterns to lengthen and strengthen muscles while stimulating circulation, enhancing joint mobility, and improving coordination.[16] All of these benefits may make it easier to increase lean body mass. Plus, it’s fun and good for the brain to learn something new. For Gigi, Gyrotonics helped mobilize her cervical spine. One study published by the manufacturer found these classes increased overall mindfulness, bestowing important physical and mental health benefits.[17]

Gigi began feeling better about a week into her protocol. Within seven weeks, she looked better, had more confidence, lost that doughy feeling and increased her lean body mass. Her fat mass decreased from thirty-two to twenty-nine percent, which is considered “moderately lean” for women.

These seven strategies are part of my anti-aging foundation for patients. Watch this space for an impending blog about the seven anti-aging benefits of regular exercise. They’ll have you lacing up your sneakers in no time.

If you’ve struggled to maintain lean body mass as you grow older, what kind of exercise have you found best improved your body composition? What strategies besides exercise helped? Share your thoughts in the Comment section below, or on my Facebook page.

For more tips and lifestyle habits that will help you age gracefully and beautifully, order your copy of Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

References

[1] Keller, K., et al. “Strength and muscle mass loss with aging process. Age and strength loss.” Muscles, Ligaments and Tendons Journal 3, no. 4 (2013): 346.

[2] Su, H. I., et al. “Hormone changes associated with the menopausal transition.” Minerva Ginecologica 61, no. 6 (2009): 483.

[3] St-Onge, M. P., et al. “Body composition changes with aging: The cause or the result of alterations in metabolic rate and macronutrient oxidation?” Nutrition 26, no. 2 (2010): 152-155.

[4] Hurley, B., et al. “Aging, physical activity, and disease prevention.” Journal of Aging Research 2011 (2011): 782546.

[5] Keller, K., et al. “Strength and muscle mass loss with aging process. Age and strength loss.” Muscles, Ligaments and Tendons Journal 3, no. 4 (2013): 346.

[6] Loeser, R. F. “Age-related changes in the musculoskeletal system and the development of osteoarthritis.” Clinics in Geriatric Medicine 26, no. 3 (2010): 371-386.

[7] Epel, E. S., et al. “Stress biology and aging mechanisms: toward understanding the deep connection between adaptation to stress and longevity.” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 69, no. 1 (2014): S10-S16.

[8] Chevalier, G., et al. “Earthing: health implications of reconnecting the human body to the earth’s surface electrons.” Journal of Environmental and Public Health 2012 (2012).

[9] Woodyard, C. “Exploring the therapeutic effects of yoga and its ability to increase quality of life.” International Journal of Yoga 4, no. 2 (2011): 49.

[10] Seguin, R., et al. “The benefits of strength training for older adults.” American Journal of Preventive Medicine 25, no. 3 (2003): 141-149.

[11] Boutcher, Stephen H. “High-intensity intermittent exercise and fat loss.” Journal of Obesity 2011 (2011).

[12] Heaney, J. L. J., et al. “DHEA, DHEA-S and cortisol responses to acute exercise in older adults in relation to exercise training status and sex.” Age 35, no. 2 (2013): 395-405, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592957/

[13] Carli, G., et al. “Changes in the exercise-induced hormone response to branched chain amino acid administration.” European Journal of Applied Physiology and Occupational Physiology 64, no. 3 (1992): 272-277. http://www.ncbi.nlm.nih.gov/pubmed/1314174

[14] Jäkel, A., et al. “A systematic review to evaluate the clinical benefits of craniosacral therapy.” Complementary Therapies in Medicine 20, no. 6 (2012): 456-465.

[15] Haller, H., et al. “Craniosacral Therapy for the Treatment of Chronic Neck Pain: A Randomized Sham-controlled Trial.” The Clinical Journal of Pain 32, no. 5 (2016): 441-449.

[16] “The Gyrotonic Method”, Gyrontonic.com, accessed August 30, 2016, https://www.gyrotonic.com/gyrotonic.aspx

[17] Caldwell, K., et al. “Developing mindfulness in college students through movement-based courses: effects on self-regulatory self-efficacy, mood, stress, and sleep quality.” Journal of American College Health 58, no. 5 (2010): 433-442.

Sara Gottfried MD About Sara Gottfried MD

Sara Gottfried, MD is the author of the new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years. She's the two-time New York Times bestselling author of The Hormone Cure and The Hormone Reset Diet. After graduating from Harvard Medical School and MIT, Dr. Gottfried completed her residency at the University of California at San Francisco. She is a board-certified gynecologist who teaches natural hormone balancing in her novel online programs so that women can lose weight, detoxify, and slow down aging. Dr. Gottfried lives in Berkeley, CA with her husband and two daughters.