#1

A good reminder to work on weight / resistance training:

To live a long and healthy life, you need plenty of muscle. But we all start losing it in our 50s. Can a 60-year-old man build himself up – and maybe even get a little ripped?

We lose roughly 1% of muscle every year from our mid-50s; by 80, Attia says, the average person will have shed 8kg, or about 18lb. Not only does this make it harder to carry the shopping or open stuck jars; it undermines our balance and weakens our bones, making it more likely both that we will injure ourselves and that we will fail to get over it.

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#2

A “good reminder” indeed.

That said, while these statistics appear to hold for the general population, I don’t believe that aging causes this 1% loss of muscle every year.

I think the little things the majority of the population stops doing day-by-day, month-by-month, and year-by-year negatively accumulate with respect to our capabilities.

Walk fewer steps every day and by year’s end you’ll lose muscle mass.
Sit a few seconds longer each day and by year’s end you’ll lose muscle mass.

While injury, illness, depression, and life’s general demands can slow us down ( and over time we lose muscle mass), we can improvise and adapt and biohack our way around these limitations.

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#3

People often don’t realize that an injury or illness can result in a rather quick and significant loss of muscle mass.

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#4

Very true. Happened to me in 2021. Went from an intermediate level powerlifter to an almost completely detrained beginner within weeks, with much of the damage done over 2 weeks of involuntary fasting. Only TRT has helped me rebuild.

There’s no mention of testosterone replacement in the article. :thinking: That’s quite an omission. Upper range T and 1-2 IU of HGH for recovery, just for a few months, might do this guy wonders. Risky because of shooting IGF-1 through the roof and potential insulin resistance… but the clock is ticking for that guy. If I had his goals I’d be really aggressive about packing on the muscle for a short time. Maybe first get a Galleri liquid biopsy cancer screening to be on the safe side, or leave out the HGH. But definitely get the T tested.

#5

Further, I think that the gradual muscle loss is directly tied to declining overall health, which in turn makes people less mobile. For example, if you don’t feel good, you are not going to go out for a daily walk… Further, large muscle loss occurs when a person is bedridden. As I see it the best solution is to aim to stay healthy and be very active moving a lot. At this point, I should have seen 10% muscle loss but there is none. Also I don’t do any weightlifting either or attempt to build large muscles. Some pushups, sure. In summary, I think that building yourself up beyond what you were naturally in your mid twenties is NOT of much use. The better payoff is just focusing on overall health and mobility while not overdoing supplements and being careful with trendy meds…

#6

After my heart attack in 2020, I spent two weeks in the hospital and lost 25-30 pounds, mostly muscle. Very disappointing. Like you I went from intermediate to beginner. Nonetheless I got back in the gym a few months later and got back to where I was within six months. (Went on the internet and found some very good material about how to lift after a heart attack, which is contrary to the standard advice to say the least. A large part of recovery was simply walking every day before I went back to the gym. Built up to walking six miles a day every day while I was off work.)

I was doing TRT before my heart attack, and then I stopped. You probably know that there are studies that say TRT increases the risk of heart attack… and other studies that say it doesn’t, or that it even reduces the risk. Unless and until my gym performance starts dropping significantly, I’m going to keep holding off on TRT.

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#7

Yes, this happens a lot in assisted living, and it’s a doom spiral - being in bed with a virus makes them too weak to exercise, which means they stay in bed and get ever-weaker. Requires real determination to break out of that and get stronger.

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#8

The article doesn’t really answer the question “can I build enough muscle in my 60s to make it to 100?” and the article is wrong-headed in the way it leaves the impression he expects to do 12 weeks of exercise at age 60 and that will build “enough” muscle to carry him to age 100. The fact is that if you want to build muscle after 60 and counteract age-related muscle loss, resistance training has to be a habit, something you do 3-5 times a week for the rest of your life.

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#9

When it comes to building fitness I believe in the benefits of having a positive attitude and the evidence is good that it is almost never too late to begin building muscle.

However, for reasons I don’t think are yet fully understood, it is not likely and probably not possible to expect that someone who begins building muscle at 60 will ever see the same level of muscle development as someone who built and maintained muscle over an adult lifetime. Lifelong muscle development results in permanent changes which, among other things, permit it to restore itself very quickly even after prolonged periods of disuse.

I have observed in others better examples of this phenomenon than in me but in my case, after several decades of competitive distance running, I was physically inactive for more than a year each on two occasions. From the Abs down, my muscles diminished in size, strength, and endurance, and the skin surrounding them became wrinkled and loose. Yet in a matter of several weeks after restoring my physical activity, I returned to ~90% of my previous strength. Colloquially, athletes refer to this phenomenon as muscle memory. There are explanations for this but none of them seem complete.

Being now in my late 70’s, I know several people who began getting fit and building muscle for the first time in their 60’s. Some slid back after a few weeks or months but those who stuck with it lost weight, improved their physique, and built useful and measurable muscle. None of them, however, developed musculature to a level comparable or even close to the musculature of someone who spent a lifetime in the gym, on the track, etc.

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#10

Unfortunately, what happened to me resulted in a significantly harmed metabolism and endocrine system, hence the need for TRT. I think it makes a lot of sense for anybody in their 60s who is trying to make up for the mistake of not lifting weights to get their T tested and consider an increase if they need it.

I’m very sorry to hear about your heart attack and I completely understand your caution about taking testosterone. I’m sure I would feel exactly the same way. I don’t think we need to worry about conflicting studies anymore, though. Here’s a recent analysis that considered the much anticipated TRAVERSE study among many others:

Cardiovascular safety of testosterone replacement therapy in men an updated systematic review…pdf (880.2 KB)

ABSTRACT

Introduction

The cardiovascular (CV) safety of testosterone (T) replacement therapy (TRT) is still conflicting. Recent data suggested a TRT-related increased risk of atrial fibrillation (AF). To systematic review and meta-analyze CV risk related to TRT as derived from placebo controlled randomized trials (RCTs).

Areas covered

An extensive Medline, Embase and Cochrane search was performed. All placebo-controlled RCTs reporting data on TRT-related CV safety were considered. To better analyze the role of T on AF, population-based studies investigating the relationship between endogenous circulating T levels and AF incidence were also included and analyzed.

Expert opinion

Out of 3.615, 106 studies were considered, including 8.126 subjects treated with TRT and 7.310 patients allocated to placebo. No difference between TRT and placebo were observed when major adverse CV events were considered. Whereas the incidence of non-fatal arrhythmias and AF was increased in the only trial considering CV safety as the primary endpoint, this was not confirmed when all other studies were considered (MH-OR 1.61[0.84;3.08] and 1.44[0.46;4.46]). Similarly no relationship between endogenous T levels and AF incidence was observed after the adjustment for confounders Available data confirm that TRT is safe and it is not related to an increased CV risk.

The entire expert opinion section at the end is worth a read, but the gist is the same as in the abstract:

In conclusion, available data show that TRT is not associated with an increased risk of CV events when hypogonadism is properly diagnosed and treated. In fact, the three largest T RCTs reported to date, T Trials [13], T4DM [14], and TRAVERSE [15], showed no signal for adverse CV events, as does the present meta-analysis.

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#11

This is an important stipulation and one often not observed. Even in aging males, the hormonal system is complex. Personally, I would not initiate TRT without first attempting other methods to reach acceptable free and total levels and a decent ratio. Most will have success without replacement. If other methods fail, I would want a comprehensive workup before initiating TRT and even then would follow up with more than simply measuring free, total, and E2, as is often the case.

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#12

I actually agree with most of that. I haven’t looked for data on how many can have success without replacement. I hesitated for almost 2 years before finally going on TRT… I was much opposed and proceeded (accepted reality?) with great reluctance. I will say I had never done so much bloodwork leading up to it. Vials upon vials upon vials. But I avoided the shady clinics (which seemed to be the majority) who clearly just wanted to sell anybody at all 200mg/wk based on nearly nothing, as you said.

The issue for some is that this can be a bit of a chicken or the egg problem. It can sometimes be very hard to climb out of the hole without an exogenous foothold.

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#13

This 2020 review from Examin found the following with respect to increasing free testosterone with supplements, one of a couple of strategies to try before considering TRT.

Background

Low testosterone is associated with inflammation, weight gain, reduced cardiovascular health, and other health detriments. While many supplements are claimed to increase testosterone, most of them lack evidence supporting their effectiveness.

The study

This systematic review of randomized controlled trials assessed the efficacy of “herbs, spices, plants, or their extracts” on men’s testosterone concentrations. The following compounds were included: Asian ginseng, fenugreek, ashwagandha, Tribulus, maca, Rhodiola rosea, musali, Garcinia, forskohlii, Reishi, stinging nettle, longjack, and Cordyceps. Researchers included 32 studies assessing 2,488 participants in the review.

The results

Four of the six studies on fenugreek, three of four on ashwagandha, one of seven studies on Asian ginseng, and the only study to assess forskohlii showed increases in total testosterone. Three of the four fenugreek studies also found increases in free testosterone. All other studies found no effects. The incidence of adverse effects was described as low.

Note

While the inclusion criteria specified that the researchers would only review studies that included male participants, 2 of the 32 studies included men and women.

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#14

My free & total values tend to be in the 10-12 & 800 area. Perhaps a little low by benchmarks but we have little good data for men my age. My mood is good and I have no difficulty building muscle mass and strength. The only supplement I am taking to boost free T is sold by Life Extension. It contains:

  • Tesnor® 400 mg [std. to ≥ 3.5% punicalagins, ≥ 0.5% theobromine from pomegranate (peel) extract, cacao (Theobroma cacoa) (seed) extract]

  • Luteolin [from Japanese sophora (flower) extract] 275 mg

It seems to have a positive effect. I also experience effects from heavy lifting in major muscle groups (e.g., squats, leg presses). Vitamin D, quality sleep, and a few other factors are also important to the production of testosterone. From what I can tell, individual differences are large. Experimentation and trips to LabCorps are required.

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#15

Absolutely. Though this presupposes that the person “can” lift. Aging can bring a myriad of issue that can prevent weight-training. I have bilateral 1st CMC severe osteoarthritis (thanks mom). (Arthritis of the base of the thumb.) This prevents my use of some of the machines at the gym. Still, I make do.

But for most, sure. Start low, start slow, but w/in a few weeks get to that point where you “fail.” Where, someone could walk up to you and wave a $100 bill and say: “do one more, and it’s yours.” If you get the bill—you are not getting the training response you need. For the first 8-12 weeks, even getting close, is enough, but eventually, it’s that singular failure that tells your body: “We need to be able to do this task,” and “voila,” the body builds itself.

Even the “grunters,” at the gym often fail to do a repetition to exhaustion—with good form. Many use inertia. Impressive to an onlooker, but inertia does not tell the body to build stronger muscles. I’m aged 74. Over the past several years, 5 episodes of flat-on-my-back in bed devastated my musculature. Surgery fixed that, which led to 54lb fat loss which returned me to the gym happy to have a “second chance.” I’m thrilled today to have trouble putting my shirt on due to DOMS (delayed onset muscle soreness). (That muscle soreness you get the day or two after lifting).

From what I’ve researched the ideal for building muscle is 4-meals/day (30 grams protein) at each. I figure the quantitative amount of leucine and supplement to get to 4 grams.

If a senior eats 20 grams protein, they won’t move to an anabolic state. If a senior eats 20 grams protein w/ one or two grams of leucine (total 3.5-4g) they will move to an anabolic state.

If a person aged 30 eats 20 grams of protein, they will move to an anabolic state. Leucine seems to act as a sort of messenger, so for those over 60, getting enough protein per meal to trigger the anabolic state seems important, though perhaps, not crucial as I’ve read that time restricted fasting 8/24 w/ adequate protein will still be enough, but perhaps, not optimal.

Note: There are lots of studies that look at leucine supplementation in elderly without resistance training, and indeed many call the leucine threshold a “myth,” and so it may be, but we’re talking about the over-60 crowd, so if you research it, use proper parameters.

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#16

I’d differ a little on a few of your recommendations. Lifting to failure is not required for max muscle gain. Protein requirements for older individuals is 1.5-2 grams per kg body weight per day.

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#17

I think it would be more proper / accurate to state that lifting to failure is not needed for consistent muscle gains. Adjetives are not quantified especially an absolute like “maximum” Do we really know definitively what is or isn’t needed for maximum muscle hypertrophy short and/or long term?

The goal of lifting can be very different. The most basic of differences is the goal of absolute muscle mass vs strength/power. Most want something inbetween. Aka Three little bears

The foundational key to increased muscle hypertrophy from resistance training is progressive overload princple adaption. How that is achieved can have profound effects on the rate of muscle gain as well as strength. Past strength or muscle mass baring injury or other reason to prevent it will effect how quickly gains or regains are made.

Protein and most specifically amino acid intake timing and frequency can have profound effects on gains of muscle mass. Same with muscle group training activation frequency and iinroads into recovery (degree of microdamage).

Its one of those things that can be both extremely simple and basic or extremely complex with everything inbetween.

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#18

I’m not an expert in muscle development but have been a mostly regular gym goer for more than 50 years. Overall, I never lifted to what I would subjectively call maximum effort or true muscle failure yet I have built muscle in a straight forward proportion to the number of reps, sets, and weight. Being older, it now seems wise to me to be cautious about maximum weight sets so I now favor reps and sets over minimum weight. I generally top out at weights for which I can do at least 10 reps. Still, I build muscle and strength at a rate that seems similar to what I did when I was younger.

I am also mindful of the massive amount of longitudinal demographic data associating protein intake at the lower end with longevity. I build muscle fine with a protein intake of ~1.0 gram per/kg body weight. For me at least, too much is made of these issues.

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#19

It is hard for me to get over 70 grams of protein per/day.
I must use protein drinks in addition to the fairly high amount of meat I eat daily to get to this level. Currently, I weigh ~ 78 Kg so I get a little less than 1 gm/Kg. So far I have experienced no measurable muscle loss since I started taking rapamycin. In fact, I have gained some measurable muscle mass.

“European Union Geriatric Medicine Society (EUGMS), in cooperation with other scientific organizations, appointed an international study group to review dietary protein needs with aging (PROT-AGE Study Group). To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher protein intake (ie, ≥ 1.2 g/kg body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or chronic diseases need even more dietary protein (ie, 1.2-1.5 g/kg body weight/d)”

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#20

There’s a lot of data on this. Look up Andy Galpin.

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