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Making Muscle a Thing of the Present

New Guidelines Urge Older Exercisers to Put Emphasis on Strength

Training

By Carol Krucoff

Special to The Washington Post

Tuesday, January 26, 1999; Page Z28

When most people start a fitness program, they do an aerobic

activity, such as walking or swimming, to exercise that most

important of muscles, the heart. But very old or frail individuals

should first strengthen the rest of their muscles with a program of

resistance exercises, say new guidelines issued by the American

College of Sports Medicine (ACSM).

" Before one can walk, it is necessary to be able to get out of a

chair (requiring muscle power) and maintain an erect posture while

moving through space (requiring balance), " notes the ACSM in its

guidelines on exercise and physical activity for older adults. " In

the frail elderly . . . aerobic conditioning should follow strength

and balance training, which is, unfortunately, the converse of what

is done today. "

The major health risks for the frail elderly are immobility, falls

and fractures, which are all related to muscle weakness, says

Mazzeo, a professor of exercise physiology at the University of

Colorado in Boulder and chairman of the ACSM group that wrote the

guidelines. " What's limiting their lives is the inability to get up

out of a chair or climb a flight of stairs, " he notes. " Strength

training and balance exercises can help older adults build muscle

strength and improve function so they can safely walk and do other

aerobic activities. "

Over the last decade, there has been a growing recognition of the

importance of strength training for all adults. Sedentary people

begin to lose muscle in mid-life, and " we can see a pretty clear

drop off in muscle mass around age 55, " Mazzeo says. " Studies

indicate that muscle strength declines by approximately 15 percent

per decade in the sixties and seventies and about 30 percent

thereafter. "

This age-related loss of muscle has been named sarcopenia, from the

Greek for " flesh reduction. " Like osteoporosis and arthritis,

sarcopenia is a serious degenerative condition that has obvious

effects on function, such as increased risk for falls and

vulnerability to injury. Less obvious are the wide-ranging metabolic

effects that result when muscle--the body's most metabolically

active tissue--diminishes. Having less muscle alters the metabolism,

with numerous consequences that can include obesity, impaired

glucose tolerance and changes in the body's ability to regulate

temperature. And since muscular contractions help keep bones strong,

muscle loss can mean weaker bones.

Sarcopenia is widespread in our sedentary culture. " Nursing homes

are filled with elderly people who are institutionalized not because

of any disease or cognitive impairment, but because of muscle

weakness, " notes , director of the nutrition,

metabolism and exercise lab at the University of Arkansas for

Medical Sciences, and a member of the group that wrote the ACSM

guidelines.

Until recently, sarcopenia has been overlooked because muscle

weakness was considered an inevitable part of growing old. But

research by and others has shown that strength does not have

to diminish into decrepitude with age. Numerous studies demonstrate

that resistance exercises can help frail elderly people in their

eighties and nineties improve their strength to the point where many

regain the ability to walk and perform other tasks without

assistance.

" Muscles will get stronger in response to strength training no

matter what your age, " says , who notes that much of the muscle

loss attributed to age actually comes from inactivity. Building

muscles builds confidence, too. This can enhance mood, functioning

and quality of life.

Proper nutrition is also important in helping seniors maintain

muscle mass. Yet the guidelines note that half of those over 60

don't consume an adequate amount of protein, which for elderly

adults is between 1 and 1.25 grams per kilogram of body weight.

(This means a 150-pound person would need 60 to 80 grams of protein

daily. One six-ounce can of tuna has 40 grams of protein; four

ounces of meat, fish or poultry has about 30 grams.)

A common mistake many seniors make when they do strength training

exercises is to use weights that are too light, says the University

of Colorado's Mazzeo. For maximum benefit, people should pick a

weight that is about 80 percent of the maximum they can lift.

Typically, this would be a weight someone could lift at least 10 but

no more than 15 times. To help find the appropriate weight and learn

proper technique, get expert instruction at a YMCA or university-

based wellness facility, Mazzeo advises. To improve balance, he

recommends taking tai chi or doing home exercises that involve slow,

controlled movements including standing on one leg.

In general, it takes frail or very old people about three to four

months of doing resistance exercises two or three times a week

before muscles are strong enough to start doing moderate aerobic

activity. The guidelines recommend walking at least three days a

week, working up to a duration of at least 20 minutes per session.

For all older adults, a regular program of strengthening and aerobic

exercises can help reduce or prevent many of the functional declines

associated with growing older, the ACSM guidelines note. Yet more

than two-thirds of older adults don't engage in regular physical

activity, according to the National Institute on Aging (NIA).

" Our society protects older people from doing physical tasks, " says

the NIA's new booklet on exercise for older adults. " That mindset

has led to poor health and disability for millions. In reality,

there are few health reasons that should keep older adults from

exercising and increasing their physical activity, no matter their

age. . . . In the long run, older adults hurt their health far more

by not exercising than by exercising. Let's get rid of the old

mindset and start a new one: As a rule, older people should stay as

physically active as they can. "

For a free copy of " Exercise: A Guide from the National Institute on

Aging, " call 1-800-222-2225. To follow along with animated

exercises, visit the NIA's Web site at http://www.nih.gov/nia

© Copyright 1999 The Washington Post Company

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