Australians are living longer – at the age of 65, women can expect to live another 22 years and men another 19 years. Once over 65, serious illnesses such as high blood pressure, heart disease and stroke can begin to limit quality of life. Avoiding falls and debilitating fractures is paramount to maintaining good health and this means maintaining muscle mass, strength and function, according to Professor Caryl Nowson from Deakin University in Melbourne, Australia.
This post has been sponsored by MLA.
The consequences of a fall
A fall is serious. Someone who falls almost always has a low bone density leading to a bone fracture (such as in the hip or leg) and are then not able to walk and get around. They lose their independence, may be forced to leave the family home, and end up in residential or nursing home care.
Around one-half may never walk again without assistance while another one-third may die from the debilitating fracture!
The risk of a bad fall is related to:
- older age
- weak and brittle bones (osteoporosis)
- little activity
- poor muscle mass
- dietary factors such as a low intake of calcium and vitamin D
- malnutrition and/or poor eating.
One solution to reduce falls and prevent frailty is to maintain your muscle health as you grow older. The better your muscle mass, strength and function, the better protected you are. Here are Professor Caryl Nowson’s 5 best strategies: (and remember it is nutrition AND activity that are equally important – can’t have one without the other!)
1. Stay active
This doesn’t have to be sweaty exercise at the gym. Merely walking more, standing rather than sitting and having active hobbies such as swimming, line dancing, sailing, golf, gardening or tennis are all beneficial.
Exercise has many other body benefits such as preventing obesity and type 2 diabetes, reducing dementia, boosting appetite and insulin sensitivity (so the body recognises the hormone insulin it produces).
Losing weight when you’re older is NOT a good idea, says Professor Nowson, as losing weight is associated with losing your muscle – and with it, an increase in the likelihood of falls. Yes a healthy weight is the ideal (and older people are becoming overweight like the rest of the population) but maintaining weight is preferable to losing. (However, this isn’t a license to PUT ON weight as that brings it’s own health problems.)
2. Do progressive strengthening exercises
Resistance training means lifting weights and sounds scary, I know! However it’s really just a means of strengthening your muscles and has been proven to promote muscle growth, as bodybuilders know. You can use free weights (like small dumbbells), weight machines or resistance bands which are long flat or tubular rubber bands. Or your own body weight as in chin-ups or push-ups and if you have trouble doing them on the floor then push off from a wall. Discuss this further with your general practitioner for advice specific to your needs.
Not sure how to do weights and don’t fancy a trip to the gym? Take a look at Miriam Nelson’s Book Strong Women Stay Young to find out how to do it at home.
3. Eat more protein when you do resistance training
To stimulate muscle synthesis, you need a combination of nutrition (involving adequate protein) and weights. This combo has proven effective in preventing falls and fractures, and improving mortality from all-causes.
As an example of how this works, Professor Nowson summarised the Women’s Health and Muscle (WHAM) study findings that she worked on. The study followed 100 older women, over a 14-week controlled trial, where half were randomised to a higher protein diet and the other half to a higher carbohydrate, lower protein diet with both groups following a strengthening exercise program.
Interestingly, the group eating more protein had a 22 per cent increase in muscle strength plus a 0.5kg increase in muscle mass over the 14 weeks compared to the group that ate less protein.
To increase protein intake, the women ate two meals a day each containing 80g red meat for 6 days of the week and the other group ate more pasta and rice and less meat. Professor Nowson said that the women were able to follow the higher protein diet, although it did require them changing their eating patterns.
Before - 48g
Breakfast 8g protein
Oats, sultanas, prunes, banana, milk
Lunch 7g protein
1 slice bread, cheese, tomato, spinach
Dinner 31g protein
1 lamb chump chop, carrot, baked potato, sweet potato, wine, orange
Coffee with milk
After - 98g protein
Breakfast 11g protein
Orange juice, oats, honey, sultanas, walnuts, milk
Lunch 39 g protein
Beef strips with tomato, stock, onion sauce, 1 slice bread, butter, brandy, ginger ale
Dinner 45g protein
Sirloin steak, spinach, 1 egg, ice cream, 1 cone
Coffee with milk
You need MORE protein as you age
Protein requirements are higher after 65 years of age, as more protein is needed to stimulate protein synthesis than in younger people
Older people need from 1.0 to 1.2 g of protein per kilo of body weight a day, preferably 1.2g or more, if doing resistance training. All of the research groups working in this area argue that the current recommendation for protein – based on the older average recommendation of 0.8 g protein per kilogram for men and women – is set too low for those over 65 years. If there’s chronic disease or they’re doing endurance training, even more protein is needed.
For example, a 70kg woman should aim for 84 grams of protein a day, while a 100kg man for 120 grams. Current recommendations are 46 grams for women and 64 grams for men under 70.
Examples of meals with 25-30g protein include: 4 meatballs or a small chop; or steak and vegetables; half a chicken breast chopped through vegetable soup; 2 egg omelette and a handful of grated cheese; 1 small can of tuna or salmon and salad; or one half of a large can baked beans with a slice of cheese on toast.
Timing matters too. For optimal muscle synthesis, protein should be consumed soon after strengthening exercise. In practice, it’s best to spread protein intake throughout the day and not eat it all at dinner. Professor Nowson recommends having 25 to 30g protein at two to three meals a day and ideally, from nutrient-rich choices such as meat, poultry, fish, dairy foods, legumes, tofu and nuts.
Protein requirements can easily be met from protein foods, no need for powders, bars or drinks. Foods such as meat etc., provide protein along with other key nutrients required for good health such as zinc, omega-3 and B vitamins.
4. Get enough vitamin D
Professor Nowson suggests 25 micrograms a day to prevent falls. which can be obtained through regular, safe time spent in sunshine or through supplements if levels are low. Take a look at my post on Vitamin D here.
5. Eat enough calcium
Eat 3 serves of dairy (yoghurt, milk, cheese) or calcium-fortified foods so you get at least 600mg a day ( the calcium requirement) for strong bones. Here are your calcium choices.
The bottom line
Everyone is happy to grow older as long as they are able to function well and have a good quality of life.
Optimising muscle health is therefore a core preventive strategy because its benefits go beyond stronger bones and fewer falls, to reducing the risk of chronic diseases such as diabetes and cholesterol. Win-win.
As Professor Nowson laughs: “It’s a balancing act – weighing up the pleasure of social or celebratory eating against the pain of healthy fare. Treat foods should not replace protein, calcium or fruits/vegetables”, she said.
Foods for protein are the key - have at least one serving twice a day. Include fish twice a week, meat 3-4 times a week, and incorporate dairy and eggs daily (yes this is healthy). If you prefer vegetarian sources then choose legumes, nuts, tofu and soy milks.
Based on a presentation by Professor Caryl Nowson, a dietitian and researcher at Deakin University who focusses on two key issues of aging – high blood pressure (hypertension) and bone health. She specialises in dietary factors to help our elderly avoid fractures and stay active for longer.
Catherine attended the NSA symposium in Sydney on 26 April 2016 where she heard the presentation by Professor Caryl Nowson entitled Guidelines for Active Aging.