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  • Writer's pictureJulian Molteno

DELAYING AND REVERSING FRAILTY


We all want to have a long life, but no one wants to grow old. My wife Suzy and I sometimes chat about getting older and how we feel about it, and the answer is — generally quite good; a few more aches and pains etc., but feeling pretty positive. I think our attitude is fairly reflective of how most people in their 50’s, 60’s, and beyond feel; we know we are getting older and are experiencing some physical and mental changes, but we still feel pretty young. This state of affairs can continue for many years, well into your 60’s and 70’s, but for many people this changes when a traumatic event occurs, catapulting them from being elderly, but well and robust, to being old and frail. Sometimes this traumatic event comes in the form of an illness, or the necessity for an operation etc., very often, however, it comes in the form of a fall. And when elderly people fall, they generally hurt themselves. I have experienced this first-hand with my mother-in-law. A spritely and energetic woman, she slipped in the bath and, as the surgeon said, she did not just break her shoulder, she shattered it. This fall landed Pam in hospital, and started a chain of events that meant she never went home again. One of the main reasons older people fall is a lack of muscle size and muscle strength. As we age, the vital hormones — human growth hormone, testosterone, oestrogen and insulin-like growth factor — that enable us to build and maintain our musculature, diminish; this process is known as sarcopenia. After 30, physically inactive people can lose 3% to 5% of muscle mass per decade.  

Mostworrying of all is sarcopenic obesity, when muscle atrophy is accompanied by a gain in fat mass. Apart from the obvious negative health implications of this condition, sarcopenic obesity is difficult to diagnose readily, because, unlike sarcopenia, where it is easy to notice a decrease in physical size, with sarcopenic obesity it is the body composition not the body size, that changes. Don’t even get me started on osteo-sarcopenic obesity! 

When we are younger, if we slip or trip, falling can often be avoided because our strong muscles react quickly and keep us upright. Not so when our older, weaker and smaller muscles are required to contract quickly and forcefully, in an effort to avoid a fall. Along with smaller, weaker muscles, we often end up with weaker bones, too. Osteoporosis is a condition that causes brittle bones. We gradually start losing bone density from the age of 35. In women the female hormone oestrogen is essential for healthy bones, and after the menopause, oestrogen levels fall, leading to a rapid decrease in bone density. 

In men, in most cases, the cause of osteoporosis is unknown. However, there is a link to the male hormone testosterone, which helps keep the bones healthy. Men continue producing testosterone into old age, but in men with low levels of testosterone, the risk of osteoporosis is increased. Let’s quickly recap: from our 30’s onward, men and women start to experience a decline in their “youthful” hormones, resulting in a loss of bone density, as well as muscle size and strength. All in all, not a very positive scenario. So what can we do to minimise this gradual decline? My good friend and ex-choir-master Nicholas Head, (who makes an interesting contribution to my Rest-Pause post) sent me a link from the Guardian yesterday. In which was an article on a study by researchers at Dublin University regarding: Delaying and Reversing Frailty: a systematic review of primary care interventions.  

The reason for the study is that as the population grows older, frailty is becoming more prevalent. Researchers looked at what can be done to identify frailty, and ease of implementation of frailty-interventions in primary care. All in all this research looked at 925 studies, involving 15, 690 participants, and their conclusion was this: a combination of muscle strength training and protein supplementation was the most effective intervention to delay or reverse frailty, and the easiest to implement in primary care. Well what a surprise! This is something bodybuilders have known for decades! We have always known how amazing weight-training is, how it keeps you strong and young and energetic and virile! It seems the medical world is finally waking up to the amazing (life-enhancing) benefits of the bodybuilding lifestyle! Let’s not forget, this is the same medical profession that said protein would damage your kidneys, heavy squats and deadlifts would damage your spine and stunt your growth (wtf!), and weights would make you muscle-bound! So . . . now that we have the official thumbs up, (apart from the aforementioned Nick who thinks that gym is “TEDIOUS!”), let’s get into the gym, pump some iron, guzzle some protein, and live a long, strong and healthy life!! 


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