As we age, our body composition changes. You may have noticed that since turning 30, you have gained weight, particularly around your mid-section, and that weight loss techniques that have worked well for you in the past, such as calorie restriction and cardiovascular exercises, have had little to no impact on your body. This is a common experience, and it can be attributed to the natural process of sarcopenia, our shifting hormonal levels, and lifestyle habits that intensify these changes.
What is Sarcopenia?
Sarcopenia refers to the natural muscle loss that begins in middle age and continues throughout our lives. Beginning around age 30, we naturally lose about 1 percent of our muscle mass each year, and this process accelerates once we reach age 40. This contributes to weight gain as the lean muscle mass that we lose is replaced by fat. Muscle burns more calories than fat, so our metabolism accordingly slows down as muscle mass decreases. So, if you are eating the same amount as you did your twenties, you are consuming too many calories. The excess calories will be stored as more body fat, compounding the issue.
Many of my patients turn to cardiovascular exercise and dieting to counteract middle-aged weight gain. However, as diets that are deficient in protein and cardio exercises can both further decrease lean muscle mass, these strategies either cause no discernible difference or backfire. What can be done to reverse a slowing metabolism?
Reversing Muscle Loss with Protein
There are two excellent ways to regain lost muscle mass, and to protect the muscles that you currently have. The first is to eat a diet rich in protein. Protein is comprised of amino acids. These are the chemical compounds in food that are responsible for building and repairing the muscles, as well as every other organ in your body. Eating a diet rich in protein ensures that your muscles are being fed the amino acids that they need to guard against loss and regenerate new cells. I advise my patients to concentrate on lean protein sources in their meals, including seafood, poultry, lean beef, and soy. Add to those choices a variety of fresh produce and a small amount of whole grains for healthy, balanced meals that nourish the body. When our diets are deficient in vitamins and minerals, we experience that lack as hunger pangs. Eating a variety of fresh fruits and vegetables of many different colors guards against those cravings.
Protein smoothies are another excellent way to keep muscles nourished and accelerate weight loss, as long as the smoothies are not sweetened with added sugars. Receiving protein via smoothies, shakes, and other liquid meal replacements provides an added weight loss benefit. When we take a short break from solid foods, we encourage our bodies to tap into stored fat for energy. When we pair that technique with protein, it accelerates weight loss, while simultaneously protecting our muscles. Other proven health benefits of intermittent fasting include a decreased risk of type 2 diabetes, lower blood pressure, an improved metabolism, and decreased inflammation in the body. Try substituting protein smoothies made with unsweetened protein powder and fresh fruits and vegetables for your breakfast or lunch. If you have a significant amount of weight to lose, I recommend incorporating one full smoothie day per week.
Reversing Muscle Loss with Strength Training
The second strategy involves strength training or working out with weights. When we are sedentary, as many in our culture are, this sends a message to our bodies that we don’t need our muscles, which contributes to more muscle loss. To reverse this trend, try strength training a couple of times per week. This will not only build up your lean muscle mass, boost your metabolism, and improve your muscle-to-fat ratio, but has also been shown to improve cardiovascular health, prevent bone loss, reduce back pain, sharpen your memory, and reduce risks of major diseases, including cancer, type 2 diabetes, and high blood pressure.
Many middle-aged patients are intimidated by the idea of working out with weights. I like to reassure them that starting out with lighter weights and a lower number of repetitions is an excellent place to start. As you become stronger and more confident, build up in weight and intensity.
In one study published by the American College of Sports Medicine, participants aged 45-54 lost an average of four pounds of fat and gained around three pounds of muscle over a 10-week period through performing strength training exercises. In that study, weight lifting as little as twice per week was enough to bring about these changes.
In middle age, the amount of estrogen that the ovaries produce decreases. In order to compensate for this hormonal change, our fat cells, which are also capable of producing estrogen, swell in size. These fat cells tend to gather around the waistline, as they are able to produce the most estrogen in this area. For men, something similar happens. Testosterone levels drop, usually beginning in the 40s, and continue to decline by one to two percent per year. Since testosterone works in the male body to both build muscle and burn fat, a softer, heavier body results from the lower testosterone production.
Eating for Hormonal Balance
While our hormonal levels will continue to shift throughout mid-life, the good news is that we are able to alleviate the symptoms of low estrogen and testosterone through adjusting the diet. There are certain foods that both improve and exacerbate the hormonal side effects of aging. Since the hormonal needs of men and women differ, these foods will not always be the same.
For women, I recommend eating a diet rich in soy products, such as tofu, edamame, and tempeh. Soy contains isoflavones, which are similar in structure to estrogen, and can help ease some of the side effects of menopause. Flaxseed meal is another beneficial addition to the diet, as it is both rich in the fiber that helps us to feel full longer between meals and contains compounds called lignans, which imitate estrogen in the body. For the same reasons, men should limit the amount of these foods in the diet.
For men, I recommend concentrating on foods that increase testosterone production, such as whole eggs and foods rich in zinc, including seafood, spinach, and lean meats. Both sexes should avoid added sugars, which exaggerate hormonal imbalance and interfere with weight loss.
Sleep: The Third Pillar of Weight Loss
Many of my patients follow a healthy diet and exercise regularly, but still, have difficulty losing weight. Why is this? Though there are several potential answers to this question, a common one involves a lack of sufficient sleep. Your body repairs itself during sleep. This includes the muscles, the hormones that control the metabolism, and the processes involved in rational decision-making. Without consistently receiving 7-9 hours per night, you set yourself up for muscle loss, heightened hunger and stress hormones, and a compromised ability to avoid unhealthy food choices.
It often becomes more difficult to receive a sound night’s sleep in middle age. Melatonin production declines after age 30, making it more difficult to both fall asleep and stay asleep throughout the night. For women, hot flashes often interrupt sleep as well. Men have an equally difficult time, as falling testosterone levels are associated with decreased amounts of time in deep sleep. Fortunately for both sexes, there are certain dietary adjustments that can help us to receive more deep sleep.
- Add more protein to the diet. Not only does this assist in building up your lean muscle mass, a diet high in protein stimulates the release of hormones that assist with reaching deep sleep and inducing sleepiness at the end of the day.
- Eat foods high in L-tryptophan. This amino acid helps our bodies to fall asleep faster, stay asleep longer, and wake less frequently due to hormonal side effects. It can be found in fish, poultry, eggs, and low-fat dairy products.
- Tart cherry juice concentrate. This food is rich in both antioxidants and melatonin, one of the primary hormones responsible for lulling you to sleep. Try a little a few hours before bed, taking care to select an unsweetened variety.
Lifestyle habits affect our ability to sleep deeply as well. Avoid all phones, computers, and other blue light-emitting screens a couple of hours before bed. Keep a consistent sleep schedule, including on the weekends. Manage your stressors, and take time every evening to engage in a relaxing activity, such as reading, a warm bath, or gentle stretching to prepare your body for sleep.
Other Lifestyle Habits
As you begin to eat a diet rich in protein and the foods that promote hormonal balance, practice strength training a couple of times per week, and make sleeping a priority, you will notice positive changes in your body composition. Here are some other tips to bear in mind that assist with weight loss. This is not intended to be a comprehensive list, but are other techniques to add in as you progress.
- Drink plenty of water. Aim for 7-11 glasses per day. Every function your body performs relies on water, and drinking plenty of water, especially before meals, helps to guard us against overeating.
- Speak with your doctor. Some medications interfere with weight loss, and certain underlying health conditions, such as hypothyroidism, make losing weight more difficult as well. Get evaluated in person if you have trouble losing weight.
- Keep a food diary. In my experience, most people tend to underestimate the amount that they eat in a day, especially when we are balancing several responsibilities. Keep yourself accountable.
- Eliminate unhealthy foods from your home. Even the sight of sweet and fatty foods activates the reward and pleasure centers in our brains. Most junk food items contain no nutrients or protein to assist with satiety. They add empty calories to our diet and set us up for energy crashes and cravings for more later on. Remove them from your home.
- Limit eating out. The only way to be certain of what you are eating is to prepare it yourself. The average restaurant meal contains far more calories, fat, and sugar than should be consumed in a single meal. Simply avoiding restaurants is often enough to cause significant weight gain for many of my patients.
- Find ways to be more active throughout the day. Take the stairs, park at the back of the parking lot, take a 20-minute walk after lunch or dinner, and play outside with your grandchildren. All of these small changes add up to increased calorie burn, decreased pain, and higher quality of life.
Are you interested in more helpful articles about weight loss after middle age? Check out my website, DrApovian.com, where you’ll find free recipes, advice, and articles written just for you.
About the Author
For over twenty-five years, Dr. Apovian has held a position at the forefront of the weight-management and nutrition field. One of the world’s premier weight-loss experts, she has distinguished herself as a leading researcher, treatment provider, teacher, and New York Times, bestselling author. She is currently the Director of the Nutrition and Weight Management Center at the Boston Medical Center, a Professor of Medicine at the Boston University School of Medicine, and the Vice President of the Obesity Society.