Sarcopenia, the aging-related loss of lean muscle mass, is as inevitable as your next birthday. Unchecked, it leads to an ever-increasing loss of function, until it becomes diifficult for couch potatoes to even get up off the sofa, let alone climb a set of stairs.
However, as we noted in the first of our series on sarcopenia, it’s possible to prevent the ravages of muscle decline through smart diet choices and exercise.
For this second installment, we turned to an expert on sarcopenia who really walks his talk. Robert Drapkin MD is a Tampa, Florida–based physician who also happens to be a champion bodybuilder at age 72, and the author of Over 40 and Sexy as Hell. He’s a board-certified physician in internal medicine, medical oncology and palliative care, and a member of the American College of Sports Medicine. He began training seriously at age 50, and continues to win and place in masters bodybuilding compeititions.
Drapkin, not surprisingly, contends that you can build muscle at any age.
Pure Cardio Is a No-No
Like Harvard’s Thomas Storer in our first installment, Drapkin cautions that a pure focus on cardio isn’t going to cut it. “If you’re just doing cardio, you’re not staving off sarcopenia,” Drapkin says. “A lot of my endurance-athlete friends are losing muscle and bone density.”
Why do endurance athletes lose muscle? “Because intense endurance exercise blocks the production of the muscle-building enzyme known as mTOR,” Drapkin explains. The point, he says, is to choose your emphasis (cardio or strength), “but don’t neglect the other. Vary your routine. Do the other training on a different day.”
Get a Baseline Muscle Reading
Very important, adds Drapkin, is to get a baseline measurement of lean body mass. “If you don’t measure it, you can’t control it.” He recommends obtaining a Dexa (DXA) scan, which measures your body fat and lean tissue as well as your bone density. Dexa scans are offered in some hospitals and by networks such as BodySpec (which charges $45) and Dexafit. Dexa is distinctly different from BMI (body mass index), which, says Drapkin, “doesn’t give you body composition at all. Get a Dexa scan if you want to know the truth.”
Overcome Your Resistance-Resistance
Then get a resistance training program going. Drapkin recommends two or three muscle-strengthening sessions a week to cover all the major muscle groups. He suggests dividing the sessions into three major categories: pushing-dominant (chest, shoulders, triceps); legs; and pulling-dominant (back and biceps), with core exercises incorporated into each session. His book includes illustrated suggestions of exercises for each muscle group. Those exercises are shown in a gym with machines and dumbbells, but for the gym-averse, Drapkin is also keen on using resistance bands. “They’re great. I keep them in my gym bag all the time.” The Resistance Band Training website offers a range of bands and accessories, as well as a number of video workouts.
Whatever you do, at minimum you should exercise each muscle group to failure at least once a week.
Pump Up the Protein
As for diet, Drapkin is predictably adamant about making common-sense food choices, such as avoiding fast food and high-glucose carbohydrates. “The minimum protein intake for active athletes is 1.4 grams of protein intake for every 2.203 pounds of body weight,” Drapkin cites in his book. A diet that is relatively high in protein—say, 30% of calorie intake—is necessary to minimize lean body mass. But if you’re out to build muscle, consider upping your protein intake to 1 gram of protein per pound of body weight daily. In other words, if you weigh 160, consider consuming 160 grams (5.6 ounces) of protein daily. (FYI, 4 ounces of chicken breast contains about 36 grams of protein; a cup of Greek yogurt contains about 20 grams of protein.)
As a scientist, Drapkin is cautious about advocating supplements, but confidently endorses a few backed by a high degree of scientific evidence. Examples: whey protein, fish oil (omega 3), Vitamin D, and a good multivitamin. Many masters athletes will be pleased to hear that Drapkin is a strong believer in studies that show the fat-burning benefit of caffeine. “If you drink coffee before exercise, you’ll use more calories from fat; thus, you will truly burn fat.”
Born to Exercise
Masters athletes will also applaud Drapkin’s contention that we were born to exercise. Circling back to sarcopenia, he points out the double whammy of modern civilization: how farming led to a diet far higher in carbohydrates than our hunter-gatherer forebears consumed; and that the Industrial Revolution allowed us to use less and less muscle and more machines.
“However, our metabolism remains unchanged, and that is the problem.” We still basically have hunter-gatherer bodies, Drapkin says, “but we live in a culture with dangerous food options and fewer requirements for muscular strength.”
Drapkin’s bottom line: Break out the weights. Or the bands. Even if you’re gym-averse, find someone who knows more than you do and at least get some direction in basic weight training. Get follow-up Dexa scans every few months to track your muscle-building progress.
And finally, say “show me the data” to anyone giving you health advice. (His book cites studies for virtually every contention and piece of advice it contains.)