After the age of 30 our physical and mental health declines, by nature, inevitably. The good news is, we can slow down the process of ageing by staying active and eating healthy. And it is never too late to start! In this article we dive into the importance of strength training and a high (animal-based) protein diet as we age, especially for women.
The minimum amount of exercise necessary
According to the Dutch Exercise Standards (Gezondheidsraad, 2017) we need to exercise daily to maintain our current health state. So not even to improve it! If we do not exercise every day, our physical and mental health drops like a bomb, leaving us at higher risk for chronic diseases and a significant shorter life expectancy.
To maintain our current health, we need to do the following three things:
1. Exercise every day for at least 30 minutes at moderate intensity, like biking, plus
2. Exercise at least 20 minutes at high intensity three times per week, plus
3. Do strength training twice per week
Especially as we age, strength training becomes more important due to the consequences of ageing.
The consequences of ageing
From the age of 30 we lose about three to eight percent of muscle mass, strength, and function per decade, and even more after the age of 60 (Volpi et al, 2010). Loss of muscle mass means loss of strength and endurance. This not only affects playing sports but also daily activities such as picking up the groceries or walking up the stairs without getting out of breath.
Loss of muscle mass also affects coordination and balance. It increases the risk of injuries and bone fractures and affects the ability to maintain independent later in life. Arthritis, neck and back issues, and osteoporosis are very common among elderly (Volksgezondheidenzorg.info, 2021).
Furthermore, loss of muscle mass goes hand in hand with hormonal changes, weight gain and a significantly higher risk for chronic diseases such as diabetes type 2, obesity, cardiovascular diseases, and depression (Boiry, 2009).
The effects of lifestyle on ageing
Loss of muscle mass is inevitable as we age. Certain factors can worsen this decline, while others can slow down the process of ageing. Some factors are genetic or biological, and therefore hard to control. Other factors such as lifestyle, are within our control. This means that the degree to which the inevitable process of ageing affects daily life, health and well-being is partially within our hands.
Next, we discuss two relevant lifestyle factors: strength training and a high protein diet.
The importance of strength training, especially for women
Research has shown that doing strength training at least two or three times per week helps to slow down the process of ageing. It results in more muscle strength and helps to maintain and/ or improve muscle mass. It improves bone health and reduces the risk of osteoporosis (weakening of bones). It improves postural stability, flexibility, and range of motion, which helps to reduce the risk of injuries and fractures. Strength training also reduces the risk of chronic diseases such as cardiovascular diseases, diabetes type 2, arthritis, and depression. And it helps to improve the quality of sleep. (Seguin& Nelson, 2003).
Additionally, exercising regularly can help to preserve cognitive functioning and reduces the risk of mental health issues. It improves the sense of independence and self- efficacy (the perception of being able to handle life). Overall, exercising daily and doing strength training as a part of that, can improve the quality of life and expand life expectancy (American College of Sports Medicine, 1998).
Especially for women
Due to hormonal changes that start around the age of 30 women are at higher risk for an increase in visceral fat (fat surrounding vital organs), loss of muscle mass and muscle strength, osteoporosis, cardiovascular diseases, overweight and obesity, diabetes type 2, depression and sleeping disorders. Besides hormonal changes, a lack of strength training and inadequate protein intake play a great role in this (Messier et al, 2011; Demers, 2012). Even after the age of 60, strength training and a high protein are important to maintain good health and daily performance and independency (Gregorio et al, 2014; Isanejadet al, 2016).
The importance of a high protein diet
The decrease of muscle mass means a decrease in the ability to process dietary protein, which is needed to maintain and/ or increase muscle mass (Murton,2015). Nevertheless, an adequate nutritional intake of protein, quantitative and qualitative, can counterbalance this (Boiry, 2009). But what is ‘adequate’ exactly?
Adequate quantity of protein intake, especially for women
There is a lot of scientific debate on how much protein one should eat (Gezondheidsraad, 2021). General guidelines are often based on certain reference values, such as averages in height, body weight or activity level. Sometimes dietary guidelines take into account factors such as the climate effects on the production of protein. Therefore, in order to determine the adequate nutritional intake, we need to take a closer look at a more individual level and take into account individual circumstances.
Research has shown that higher intakes of dietary protein is associated with higher muscle mass, particularly among women (Bradlee et al,2017). A higher intake of protein is effective to delay the loss of muscle mass and strength as we age (Murton, 2015; Lonnieet al, 2018).
An often used scientifically based rule for people who exercise, who want to maintain or increase muscle mass and who want to lose weight, is approximately up to 2 grams of protein per kilogram body weight per day. Ideally, but also practical, divided into several intakes/ meals per the day, Vegetarian and vegans need up to 1,3 times more protein per day (for practical tips, read our previous article) (Tarnopolsky et al, 1992; Phillipset al, 2007; Van Geel & Hermans, 2016; Wu, 2016).
Despite this general rule, it is still important to professionally monitor results periodically and to adjust the nutritional intake based on that. For example, the body cannot store the protein we eat but do not use. Instead, it is converted into and stored as fat. Not ideal for someone who wants to lose weight.
Besides the quantity we also need to look at the quality of dietary protein, the timing of the intake, and the combination with other types of foods we eat.
Adequate quality of protein intake
Protein is essential to maintain and build muscle mass, but also for several other processes in our body such asour immune system and hormonal system. Protein consists of so called amino-acids. During digestion, dietary protein is broken down into amino- acids. After the amino- acids are absorbed by our body, they are being used to build bodily proteins, such as for maintenance of muscle mass.
Amino- acids can be divided into essential, semi- essential and non- essential. Essential means the body cannot produce it and therefor it must come from food. Semi- essential means that in certain diseases, the body is not able to produce certain non- essential amino- acids, requiring extra supplementation (Voedingscentrum, 2021).
Dietary protein that looks the most like bodily protein and that covers all essential amino- acids in the same ratio as in the body, is digested and used the best. This type of protein is found in animal products like meat, fish, eggs and dairy. Yet, eating a lot of animal products especially if it is red, fat and processed meat, can lead to a higher risk of obesity, cancer and cardiovascular diseases. We discussed this in our previous article. (Disregarding the climate effects of eating animal products) (Wageningen University & Research, 2019).
Although a plant- based diet might look more appealing, and whole grains and veggies can protect against several types of cancer (Wageningen University& Research, 2019), planted- based protein does not cover all essential amino- acids or sometimes in the incorrect ratio, and plant- based protein is harder to digest (Voedingscentrum, 2021). Although it can be possible to generate the correct nutritional intake, it sure takes some professional studying and often additional artificial supplementation to get it done correctly. Furthermore, the consequence of meeting the adequate nutritional intake of protein solely with a plant- base diet, is often a (too) high intake of carbs and/or fat and a deficiency in vitamins and minerals.
Research has shown that men and women with higher intakes of animal-based protein had more muscle mass regardless of their activity, compared to men and women who ate plant- based protein. The benefits of plant-based protein was only evident in physically active adults. Among less active individuals, only those consuming more animal- based protein had reduced risks of functional decline (Bradlee, 2017).
So there seems to be a preference for animal- based protein, especially as we age and for women. Therefore, a combination of an animal and plant- based diet seems to be the best solution to meet the adequate protein intake and match up with current trends on healthy and sustainable living (Gezondheidsraad 2021).
Timing of protein intake and combination with other food
Timing of the protein intake is relevant. An important guideline for athletes is to eat 15 grams before and 25 grams within 30 minutes after a training session to maintain and increase muscle mass. In our previous article we discussed the importance of timing in eating and exercising in general. We also previously busted the 30- grams of protein myth.
Last, the combination of protein with other types of food might affect the uptake of protein. There is some, yet not conclusive evidence that fatty food and high doses of anti-oxidants slow down the uptake of protein while certain micronutrients such as vitamin A might enhance the uptake of protein. More research is needed for solid evidence based statements (Friesland Campina Institute, 2021).
A healthy diet and an active lifestyle are essential for healthy ageing. It can prevent and delay the occurrence of chronic diseases, slow down the process of ageing, and increase the quality of life and life expectancy. Active people with higher intakes of animal or plant protein-source foods have 35% lowest risks of functional decline. Especially a higher intake of animal- based protein in combination with a physically active lifestyle, is associated with preservation of muscle mass and functional performance in older adults (Bradlee, 2017).
A healthy diet consists of carbs (preferably in terms of vegetables, some fruit, some whole grain products); lean protein (preferably 50/50 animal and plant- based); and little unsaturated fat. In moderate amounts at the right time.
A higher protein intake and strength training become more important as we age. These two lifestyle factors are within our control and fairly easy to improve. CrossFit provides a safe, effective and fun strength and conditioning program for elderly, as well as professional coaches who can provide evidence based nutritional advice.
American College of Sports Medicine Position Stand. Exercise and physical activity for older adults. Med SciSports Exerc. 1998 Jun;30(6):992-1008. PMID: 9624662.
Boirie Y. Physiopathological mechanism of sarcopenia. J Nutr Health Aging. 2009 Oct;13(8):717-23. doi:10.1007/s12603-009-0203-x. PMID: 19657556.
Bradlee,M. L., Mustafa, J., Singer, M. R., & Moore, L. L. (2017). High-Protein Foods and Physical Activity Protect Against Age-Related Muscle Loss and Functional Decline. The journals of gerontology. Series A, Biological sciences and medical sciences, 73(1), 88–94. https://doi.org/10.1093/gerona/glx070
Demers, Sylvie. (2012). De kracht van vrouwelijke hormonen. Standaard Uitgeverij.
Friesland Campina Institute. Voeding en beweging. Welke factoren zijn betrokken bij de spieropbouw na krachttraining. www.frieslandcampinainstitute.com.Geraadpleegd 18 juli 2021.
Gezondheidsraad. Beweegrichtlijnen2017. www.gezondheidsraad.nl. Geraadpleegd 18 juli2021
Gezondheidsraad. (2maart 2021). Voedingsnormen voor eiwitten. Referentiewaarden voor de inname van eiwitten. Nr. 2021/10. Den Haag.
Gregorio L, Brindisi J, Kleppinger A,Sullivan R, Mangano KM, Bihuniak JD, Kenny AM, Kerstetter JE, Insogna KL. Adequate dietary protein is associated with better physical performance among post-menopausal women 60-90years. J Nutr Health Aging. 2014;18(2):155-60. doi: 10.1007/s12603-013-0391-2. PMID:24522467; PMCID: PMC4433492.
Isanejad M, Mursu J, Sirola J, Kröger H, Rikkonen T, Tuppurainen M, Erkkilä AT. Dietary protein intake is associated with better physical function and muscle strengthamong elderly women. Br J Nutr. 2016 Apr 14;115(7):1281-91. doi:10.1017/S000711451600012X. Epub 2016 Feb 9. PMID: 26857389.
Lonnie, M.,Hooker, E., Brunstrom, J. M., Corfe, B. M., Green, M. A., Watson, A. W.,Williams, E. A., Stevenson, E. J., Penson, S., & Johnstone, A. M. (2018). Proteinfor Life: Review of Optimal Protein Intake, Sustainable Dietary Sources and the Effect on Appetite in Ageing Adults. Nutrients, 10(3), 360. https://doi.org/10.3390/nu10030360
Messier V,Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M. Menopause and sarcopenia: A potential role for sex hormones. Maturitas. 2011Apr;68(4):331-6. doi: 10.1016/j.maturitas.2011.01.014. Epub 2011 Feb 25. PMID:21353405.
Murton AJ. Muscle protein turnover in the elderly and its potential contribution to the development of sarcopenia. Proc Nutr Soc. 2015 Nov;74(4):387-96. doi:10.1017/S0029665115000130. Epub 2015 Mar 31. PMID: 25826683.
Seguin R, Nelson ME. The benefits of strength training for older adults. Am J Prev Med. 2003 Oct;25(3 Suppl 2):141-9. doi: 10.1016/s0749-3797(03)00177-6. PMID:14552938.
Tarnopolsky MA, Atkinson SA, Mac Dougall JD, Chesley A, Phillips S, Schwarcz HP. Evaluation of protein requirements for trained strength athletes. J Appl Physiol(1985). 1992 Nov;73(5):1986-95. doi: 10.1152/jappl.19184.108.40.2066. PMID:1474076.
Van Geel, Anja., Hermans, Joris. (2016). Voeding en sport. Een handboek voor trainers, begeleiders en (topsporters).
Voedingscentrum. Encyclopedie eiwitten. www.voedingscentrum.nl.Geraadpleegd 18 juli 2021.
Volpi,Elena; Nazemi, Reza; Fujita, Satoshi (2010). Muscle tissue changes with ageing. Current Opinion in Clinical Nutrition and Metabolic Care: July 2004 - Volume 7 - Issue 4 - p 405-410. doi:10.1097/01.mco.0000134362.76653.b2
Volksgezondheidenzorg.info. Ranglijst aandoeningen geraadpleegd op basis van voorkomen. www.volksgezondheidenzorg.info. Geraadpleegd 18 juli 2021.
Wageningen University &Research. MOOC Nutrition and cancer. www.edx.org. Geraadpleegd 2019.
WuG. Dietary protein intake and human health. Food Funct. 2016Mar;7(3):1251-65. doi: 10.1039/c5fo01530h. PMID: 26797090.
Phillips, Stuart M., More, Daniel R., Tang, Jason E. (2007). A Critical Examination of Dietary Protein Requirements, Benefits, and Excesses in Athletes. International Journal of Sport Nutrition and Exercise Metabolism