Tag Archive for: muscle mass

Saving Muscle While You Reduce Calories

/in /by

Several studies have been published from the CALERIE study data with even more interesting revelations, so I’ll review several over the next few Memos. I’ll start with changes in body composition in those who restricted calories (143 subjects) and those who continued to eat normally (75 subjects), often called ad lib or ad libitum. Remember, the purpose of the study was to achieve a 25% reduction in calorie intake and sustain it for two years in subjects who began at normal BMI.

The caloric restriction (CR) group achieved only an 11.9% decrease in CR over two years but still showed significant changes:

  • 16.7 pounds decrease in weight compared with a one pound gain in the ad libitum (AL) group
  • A decrease in waist circumference of 2.4 inches versus a 0.5 inch increase
  • Fat mass decrease of 11.9 pounds compared with a 1.1 pound gain
  • A 4.4 lb. decrease in fat-free mass compared with no change at 24 months
  • Although the CR subjects lost some fat-free mass, the loss of fat exceeded the expected proportional loss found in the typical weight loss program of 50% fat mass and 50% fat-free mass

That’s the surprising result: the study showed that a moderate reduction in calories did not abnormally impact the proportion of muscle loss to fat loss: fat loss exceeded muscle loss. Rather than protein intake, the calories used in activity contributed to sustaining muscle mass—exercise helped maintain muscle.

We’ll examine another paper from the CALERIE Study on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Am J Clin Nutr 2017;105:913–27.

I’m Back!

/in /by

It’s been an interesting five weeks since my knee replacement. I’ve never taken that much time off before, but I’m healing well—just not as quickly as I want. Researching the best way to gain back joint strength and muscle loss, I’ve come across a new term that combines two conditions: osteosarcopenia. It’s a combination of the loss of bone mass and the loss of muscle mass.

Osteopenia is the loss of bone mass. While associated with aging, other factors play a part such as genetics, lack of exercise, and poor absorption of nutrients.

Sarcopenia, loss of muscle mass, is definitely associated with the lack of exercise, but there are other factors as well. One that was surprising was the deterioration of mitochondrial function, both in number and effectiveness of function. When mitochondria can’t produce energy effectively and can’t repair and replace themselves, it can impact every cell and organ, not just muscle.

I’ve spent a considerable amount of time looking at the research to find out possible solutions to mitochondrial decline. I can tell you that one of the keys is exercise: strength training, stretching, and aerobic exercise. The rest merits significant explanation. That’s why it will be the topic of this year’s Super Bowl Webinar Aging with a Vengeance: Reclaiming Your Power! on Sunday, February 13 at 3 p.m. Eastern Time. More information to come.

What are you prepared to do today?

        Dr. Chet

Aging with a Vengeance and Your Proteome

/in /by

This year’s Super Bowl Webinar focused on aging with a vengeance—becoming the best version of yourself, no matter your age. The study we just reviewed on the proteome suggests that the people were healthier who were biochemically younger than their actual age. Here are the actions I believe can help at the three critical phases of aging that were identified in proteome study. As I find out more, I’ll be more specific.

31 to 37

If you have weight to lose, now is the time to lose it. Take it from me and my decades of experience with weight loss programs: it becomes more difficult the older you get. Find a way to eat that will maintain a reduced body weight and stick with it.

Reduce your protein intake. That may seem a little odd, but this is a time to focus on vegetables, fruit, whole grains, and quality oils.

Focus on your cardiovascular system by doing aerobic exercise on a regular basis. Use interval training to make the most of your time, and when you’re fit enough, you can add high-intensity interval training (HIIT) to your routine.

57 to 63

The kind of 80- to 85-year-old you’re going to be is dependent on what you do now. If you haven’t achieved a normal body weight, that’s a high priority just as it was in the prior age group. I know how difficult this is because it’s eluded me throughout my life; I lost a lot of weight and kept it off for years, but I’d still like to weigh less.

Increase protein intake to 1–1.5 grams per kilogram body weight per day.

Supplement your diet with essential amino acids. While the amounts are still not absolutely clear from the research, 10–20 grams per day is a good goal.

If you’re not already doing so, add weight training to your exercise routine. Start with using your own body weight, then add exercise tubes or light weights, and then use machines or free weights. Now is the time to retain or even increase your muscle mass.

75 and Older

If you haven’t achieved a normal body weight, there’s still time. My wonderful mother-in-law lost a significant amount of weight at this age, and she was an overweight diabetic in a wheelchair.

Increase protein intake to 1.5–2 grams per kilogram body weight per day. It’s difficult because appetite decreases and protein makes us feel full. It will help reduce the muscle loss that’s happening.

Supplement your diet with essential amino acids; the amounts are still between 10–20 grams per day.

Add weight training to your exercise routine. It will help you to retain or even increase your muscle mass. Stay within any orthopedic or other limitations, and get some help if you need to, but do it. Your primary caregiver will probably be glad to refer you to a physical therapist who can get you started safely.

The Bottom Line

For all that’s been written about healthy aging, we still don’t know very much. Healthy aging begins the day we are born, but we realize that only when it dawns on us that we’re aging. No matter your age, no matter your current state of health, it can be better. You can learn more in the replay of this year’s Super Bowl Webinar, but it will be available for only a little while longer.

The simple things I’ve talked about in this Memo are a beginning. When I know more, so will you. Inevitably, it comes back to a single question:

What are you prepared to do today?

        Dr. Chet

Reference: Nature Medicine. 2019. https://doi.org/10.1038/s41591-019-0673-2

Planning Your Infrastructure Upgrade

/in /by

In order to give you some ideas to help you focus on your body’s infrastructure, I’m going to share my list. I’ll give you my issues and why I feel they’re problems for me; I hope that will stimulate your thinking so you can determine your infrastructure upgrades for 2021. I don’t know that I can accomplish all of them in a single year, but I do know I can make a good start, and that’s what I’m hoping you will do as well.

Increase Muscle Mass

If there’s one getting-older issue that I completely underestimated, it’s the loss of muscle mass. It just sort of crept up on me and while I can’t quantify it in terms of pounds or percentage, I know I’ve lost strength in my upper body, and my legs seem to be a shadow of their former selves. Part of the reason that my legs lost so much mass, I believe, is directly tied to my inability to run consistently. I have no idea when I’ll be able to run freely again, if ever, so strength training is going to be critical to increase strength if not mass.

Improve Skin Quality

I have to confess that I never examine my skin. I don’t spend a lot of time looking at my face in the mirror, and I ignore my arms completely. But lately I’ve noticed that my skin is thinner and a slight scrape against the door frame that doesn’t even hurt can leave a huge purple spot. I’m not trying to recreate the quality of skin I had in my 20s, but I know it can be better than it is. (Has anyone in my household been nagging me about this for years? Um, maybe.)

Decrease Body Fat

The one that drives me crazy is the increase in body fat around my waist. I weigh 45 pounds less than my highest body weight ever, yet my waist circumference is greater now than it was then. The reasons are complicated, from the loss of muscle mass reducing metabolic rate to the gradual reduction in hormones as I get older. I know that there’s no such thing as spot reduction, and I don’t know if the general rule “you lose it first from where you put it on last” applies as you get older. But aside from increasing muscle mass, this one is just not acceptable and is a priority for me.

Increase Bone Mass

I’ve made no secret of the fact that I have osteopenia. In fact, I’m one-tenth of a Z-score from having osteoporosis. I have improved my vitamin D and calcium intake since my last bone-density test. I’ll find out in April whether that has resulted in any change. I’m not interested in continuing to be the amazing shrinking man, so this is an internal infrastructure change that must happen in 2021.

Improve Posture and Balance

This one seems a lot less obvious, but it’s still critical to overall health. Why? Because working on improving posture now, which means resetting the resting “tone” of the postural muscles will help with balance as we get older, and balance is critical if we hope to make it to an advanced age. The inner ear is part of it, but our ability to be able to move and do the things that we want to do can be dramatically impacted by poor balance. The modifications in muscle mass and fat mass, as well as bone mass, will have an impact, but it’s also critical to specifically work on posture and balance movements as well.

The Bottom Line

There you have it: my infrastructure plan for 2021. I’ve begun working on some, but there’s still research to read to find better solutions. That will include different approaches to exercise, whether weight training, stretching, or aerobic exercise. There could be specific dietary approaches that apply rather than just cutting calories. Supplementing with nutrient isolates and specific dietary supplements may also be part of the solution.

How about you? You may have cholesterol and HbA1c that needs to get lowered, cardiac output that needs to increase, and a microbiome overhaul; maybe you need to build strength in specific areas to compensate for arthritis and loss of cartilage.

Identify your three to five areas and write them down. As the year progresses, I’ll share the solutions I’ve found with you because my goal hasn’t changed: to help you become the best version of yourself. Specify where you want to go and let’s get started.

What are you prepared to do today?

        Dr. Chet

Taking Charge of Your Health

/in /by

Flowers and trees have been winterized. The mulch has been spread throughout the yard. The leaves remain a continuing problem, but in short order the snow may take care of that. The one thing that I like about working in the yard is it gives me an extended opportunity to think. There are two things they have been on my mind.

Body Composition and Aging

I completely underestimated the change in body composition that occurs as we get older. I weigh about seven pounds more than I did about a year ago; the problem is that it’s all settled right around my waist. I’ve lost muscle mass in my arms, shoulders, and even my legs. From a strictly physical perspective, that’s the challenge I intend to address next. This will not be a “by the end of the year” thing because it’s going to take some time. I’ll write about how I intend to do it and then keep you posted on how it goes. Everyone is welcome to join me.

COVID-19 Isn’t Going Away

The second thing I’ve been thinking about is the COVID-19 virus. I’ve had the opportunity to read a lot of material I want to cover in upcoming memos that are not related to the pandemic. But the damage from this pandemic continues to increase, at least for the time being, and it would not be responsible for me to ignore COVID-19 all together. There’s some fascinating research that I think adds to the Swiss cheese approach in the last Memo.

Many people seem to be working themselves into a frenzy over possible state restrictions on activities and the insistence on wearing masks. Many of you know that attitude is everything. If we, as a nation, could just make up our minds that we’re going to do the best we can in each and every state, we could get through these temporary restrictions and get back to living our lives more completely than we are able to right now. If we don’t, then this is going to continue until we all decide to take things seriously.

The Bottom Line

Every morning, when I take Riley to school, we review our rules. The first rule is “Do the best you can.” It doesn’t have to be perfect. And you will make mistakes. Just do the best you can each and every day, because that’s all you can do. We review it after school on the drive home, and he gives me a thumbs up if he did his best that day. I hope we all can do the same thing in dealing with our health. The bottom line is that in all phases of our health, let’s do the best we can.

The Insider Conference Call is Wednesday evening. Do you have questions you’d like answered about supplements, weight loss, or any other topic related to health? Become an Insider today and gain the benefit of our discussion.

What are you prepared to do today?

        Dr. Chet

Can We Prevent Sarcopenia?

/in /by

Based on the research presented in Thursday’s Memo, the earlier we address the possibility that sarcopenia will affect us, the more likely we’ll succeed (1). I use fudgy words such as “likely” because we don’t know for sure, but based on the current status of research, here’s what we can do to prevent sarcopenia.

Use It or Lose It

In the study I talked about Thursday, the men who exercised regularly had a lower rate of decline in muscle function. The researchers speculate that chronic exercise helps preserve the motor units, thus preserving the ability of the nerve cells to send out nerve fibers to attach to muscle fibers.

That’s all well and good, but how can we make sure that we preserve the potential and perhaps increase our motor unit activity if we’ve lost some? Research shows that weight training will help. In several studies, resistance training increased muscle strength in the elderly; strength will improve balance and quality of life.

What kind of exercise will work best? It seems to be high intensity exercise. In a study on elderly mice, high intensity interval training (HIIT) increased the muscle mass, muscle fibers, and the number of mitochondria (2). This was a small study and it was on rodents, so the application to humans isn’t assured. To me, it means use your muscles as you mean to keep using them. The harder you exercise within your physical limitations, the better.

Focus on Protein

Retaining muscle mass is not only about exercise. For some reason, as we get older, we decrease our protein intake, but research shows that increasing protein intake can help retain muscle mass. If you don’t have protein in muscle cells, retaining or adding connections to those cells won’t matter much.

How much protein should people try to get? The current recommendation is 0.8 grams per kilogram body weight per day or a third of a gram per pound body weight; someone who weighs 200 pounds would need about 66 grams of protein per day. But research shows that bumping that up to 1.1 grams per kilogram body weight or a half gram per pound may be better as we get older. That’s 100 grams for a 200-pound person (3). That’s easy for even those who are math-challenged: whatever your goal weight, divide by 2, and that’s your daily goal for grams of protein.

It also seems better to stretch protein intake out throughout the day rather than a big slug at one time. Balanced intake will produce a sustained level of amino acids available for muscle repair throughout the day.

The research is far from complete in this area but it seems that as we age, our protein needs revert to when we were younger: we need more of it.

The Bottom Line

Sarcopenia can result in loss of strength and mass, but more important is the loss of quality of life. We don’t think balance while standing or moving is important until we fall; we don’t think brute strength is important until we need to move something and can’t. This week’s Memos give you an idea of how to prevent and perhaps improve nerve and muscle function.

Don’t think this is for only retirees; once you hit 40, it’s a downward trend. Starting early may help minimize the decline. One thing is clear: if you expect to be mobile when you get older, you need to work on it earlier rather than later.

What are you prepared to do today?

Dr. Chet

 

References:
1. J Physiol. 2018 Mar 11. doi: 10.1113/JP275520.
2. J Gerontol A Biol Sci Med Sci. 2018 Mar 14;73(4):429-437.
3. Nutrients 2018, 10, 360; doi:10.3390/nu10030360.