FOR YOUNGER READERS thinking about skipping this chapter because you feel it doesn’t apply to you, remember that the ageing process starts to affect our bodies from our thirties onwards, which is one of the reasons why so many sports professionals retire around that age…
As we reach midlife and our later years, it’s time to start thinking about slowing down a bit. Maybe it’s OK to give that middle-aged spread a bit of room, to have dessert after all and to have a nice nap on the sofa after dinner rather than getting out for a run or to the local leisure centre for a bit of exercise. Maybe it’s time to start thinking seriously about investing in a pair of slippers.
But you try telling that to Ed Whitlock. This 85-year-old crossed the finishing line of the Toronto Marathon in 2016 having run a time of three hours, 56 minutes and 34 seconds – the oldest person ever to run a marathon in less than four hours.
You try telling that to Jack Nicklaus, who won his last major golf championship at the age of 46 in 1986 – and had a really good go at winning another at the age of 58, when he finished sixth at the 1996 Masters.
Try telling that to Martina Navratilova, who in 2006, only a month shy of her fiftieth birthday, won the mixed doubles at the US Open championship – breaking her own record as the oldest ever major tennis champion.
To put Ed Whitlock’s time in perspective for the non-marathon runners among us, the average men’s time from 2009 to 2014 was four hours, 13 minutes and 23 seconds1 – and that’s for any age group. Amazingly, at the age of 73 he also ran a marathon in under three hours, a time that would have put him in the top 8 per cent of men of any age at the 2015 London Marathon. But simply seeing him as an outrageous outlier is not the point. The point is that we can have a hand in shaping how we age – if we adapt our Energy Plan accordingly.
I see this first-hand in my own work. I’ve recently taken on a client who is attempting her first marathon at the age of 66, and it makes the idea of ‘acting your age’ seem ludicrous. The idea that you should ‘slow down’ as you get older is a way of thinking that can be every bit as cancerous as the chronic diseases you’re trying to avoid; but it certainly doesn’t have to be this way. Your Energy Plan will need to change as your body changes with age, but through adapting it you can equip yourself with the tools to sustain you through midlife and beyond. And the important thing to realise is that it’s never too late to start.
In mid- and later life you may well be entering the period of your greatest earning potential. A time when you can hopefully start to prioritise the important things in life, like family, that elusive work–life balance, and your health.
In 2018 I was involved in the BBC’s Sport Relief, working with four celebrities – presenter Susannah Constantine, comedian Miles Jupp, entertainer Les Dennis and actress Tameka Empson – each of whom had lost their way with their fitness and nutrition. Over 12 weeks we worked with them to get their bodies back.
Each was facing different challenges: Les Dennis was 64 with pre-diabetes, characterised by higher than normal blood glucose. The hormone insulin regulates blood glucose by signalling to the liver and fat cells to absorb levels from the blood. Being overweight, a lack of exercise and poor nutrition (excess calorie intake and carbohydrates, both sugary and starchy) all contribute to the body clearing glucose less efficiently. But with a structured training programme and Energy Plan consisting of more maintenance foods and less fuel, he reduced his body weight by approximately 6 kg (a stone) in 12 weeks, which – importantly – featured a reduction in his visceral fat, the more dangerous fat in the abdominal cavity linked to chronic disease.
Susannah, 56, noted for her fashion prowess, had lost confidence during the menopause, and found her fitness declining and body fat increasing, meaning she couldn’t get into the clothes that were part of her brand. Over her 12-week training and Energy Plan, she reduced her body fat by almost a stone (and was able to get back into her favourite dress) and enjoyed increased energy levels and fitness.
For all the contestants the final challenge was a gruelling Tough Guy endurance challenge on an ice-cold January day (I was freezing just watching). They all completed the course that some contestants half their ages were struggling with. In just 12 weeks they had achieved life-changing results.
The challenges I faced with Les and Susannah are representative of a broader problem. Some 77 per cent of men and 63 per cent of women in the 40–60-year-old population in Britain are overweight,2 and the number of those diagnosed with diabetes has doubled in the last 20 years.3 As a nation we’ve become accustomed to thinking – incorrectly – that being overweight is an accepted part of ageing.
So even if you’re in your twenties now, it’s a good idea to start thinking about addressing some of these issues that you have to come. Or perhaps you can support a loved one to make some meaningful changes to their life. As I hope some of the examples I’ve used show, you’re never too old to start.
Let’s take a look at exactly what happens to our bodies as we age.
Just as with an ageing car, as the miles begin to add up on our bodies they start to become less efficient. From our thirties onwards, cellular wear and tear results in our tissue and organs beginning to function less effectively. The changes to our bodies include reductions in:
●Aerobic fitness
●Resting metabolism
●Muscle strength and mass (called sarcopenia)
●Bone mass
●Vitamin D synthesis (from the skin)
●Thirst sensation
Ageing-related decline in sarcopenia (muscle mass and function), means a decline in your resting metabolic rate (the number of calories required to keep your body functioning when at rest). So as each decade passes, you need less fuel to sustain your body every day. How many of us make changes to our nutrition along these lines, though? Without addressing this, and maintaining activity levels, we’ll inevitably see an increase in fat mass from the unused fuel (particularly the more dangerous visceral fat around the organs), weight gain and, if we’re not careful, a cocktail of chronic diseases including type 2 diabetes and heart disease.
The good news is that we have the means to fight the ageing process. A combination of lifestyle changes can make all the difference, and we are going to focus here on two that are at the heart of the Energy Plan: revving the engine (exercise) and the fuel of the Plan (nutrition). As you get older this is definitely one relationship to invest some time in.
Weight gain as we get older doesn’t happen overnight. It comes from running on a positive energy balance for weeks, months and years, and many of us assume it is just a natural part of the ageing process. But by revisiting some of what we talked about in Chapter 1, we can see how managing energy consumption can have a meaningful impact on your weight as you age.
Exercise is a crucial tool in fighting the age-related decline in cells within our organs and tissues. Aerobic exercise (such as jogging, cycling or swimming)4 improves the heart’s function, reducing the risk of cardiovascular disease, and works to keep the brain from conditions involving cognitive decline, such as dementia.5 Resistance exercise helps to protect muscles from age-related decline and loss. Any type of exercise also increases your metabolism, getting your engine firing. The more active you are, the more fuel you require to meet your daily energy needs. As the stats tell us, physical activity levels are on the decline, with the population now being around 20 per cent less active than in the 1960s,6 so the first step is to get moving and do something you enjoy – and the more variety the better.
So, although we’ve covered this before, I’m going to say it again: it’s doubly important as you age for you to marry your carbohydrate intake to your activity levels for the day. Fuel yourself accordingly: for high-activity days you’ll need carbs, but for a day spent at your desk or relaxing with family or friends you won’t need them as much. And if you’re in your thirties, forties or beyond, you’ll need even less of them than you would have ten years before.
The focus here is on getting your meals right to regulate blood glucose and insulin, and provide the right fuels for the body, such as protein for maintenance.
If you’re just hanging out at home on a low-key Saturday, reduce the amount of energy-rich fuel (carbohydrate) you’re consuming. The best opportunities to reduce carbs usually come our way at lunch or dinner, as in these meals we can easily compensate by upping our portions of protein and vegetables. As we will discuss further, maintaining protein intake is still crucial on these days, and including protein-rich snacks such as yoghurt, mixed nuts, edamame or even a protein shake is important.
Instead of letting your evening meal dominate your diet, look at eating more at breakfast and lunch to provide opportunities to fuel the body for harder days. As ever, the type of carbohydrate is vital: focus on adding lower-GI carbs such as boiled sweet potato (lower-GI than baked), rye bread, porridge oats, basmati rice, quinoa (it’s definitely never too late to start with this fashionable grain), buckwheat and lentils for a sustained energy release. Reduce higher-GI carbs such as white bread, potato, rice cakes, crackers, bagels, cakes, doughnuts, croissants and most packaged breakfast cereals.
Like the ageing car we all are as we move through our thirties, we become less efficient, and a key part of this physiological decline is sarcopenia, the loss of muscle mass and function. Sarcopenic muscle loss proceeds at a rate of around 0.8 per cent a year, and strength is lost at a rate of 1–3 per cent a year. This decline is most noticeable from your forties onwards.7
In real terms sarcopenia can have a marked impact on your quality of life. This gradual decline in muscle strength and mass might not even be noticeable at first, but just in the same way that weight gain can creep up on you thanks to an energy surplus over several years, you might start to find yourself not quite hitting the heights on the golf course that you once did, or struggling towards the end of your weekend run. And later in life sarcopenia can have serious repercussions, reducing mobility and the ability to perform daily activities you take for granted now, such as climbing the stairs. It also increases progression towards frailty, falls and metabolic disease.8 All of which might sound a bit doom and gloom for a chapter supposedly about the rich potential of your later years! So let’s have a look at what we can do about it.
Resistance training (or strength training, or weights) is the first step in our plan to get ageing’s effects on our muscles under control.
When we make our muscles work against an opposing force, such as a weight, the stress on the muscle cells causes them initially to break down before repairing and growing back stronger. The current UK exercise guidelines9 are for two sessions a week of resistance training – and these should activate the six major muscle groups: legs, abdominals, back, chest, shoulders and arms. These exercises can easily be completed at home, to get your dose, or even through a class at the local gym or leisure centre, such as body pump.
Often people who have prioritised aerobic training throughout their lives make the mistake of disregarding this kind of training. For example, runners who’ve always pounded the pavements for serious distances might feel like they’re in the shape of their lives as they enter middle age, but if they’re not doing any resistance training then they are at risk of sarcopenia too. And it can so easily be addressed with that exercise ‘minimum dose’ from back in Chapter 4, which can be incorporated into a routine without too much burden.
Do note though that, as we’ll come to shortly, that dose might need to increase as we get older.
Training on its own isn’t enough, of course; we need fuel to fight the ageing process too. And it comes in the consumption of maintenance foods – protein. When foods containing protein are digested, they are broken down into small building blocks called amino acids, which are then transported in the blood and taken up by the muscle, to be used to repair and build new muscle tissue. We call this process muscle growth – or muscle protein synthesis – and we initially looked at it back in Chapter 2.
Your muscles are constantly undergoing a cycle of growth and repair, so your daily intake needs to meet this demand and also maintain your overall muscle mass. The current recommended daily protein intake for sedentary people is 0.75g per kg of body weight; however, recent reviews by leading protein metabolism research groups suggest this is too low for the ageing and elderly population, with their recommendation being a minimum of 1.2 g per kg of body weight.10
So for someone weighing 70 kg, that’s a minimum of 84 g per day, which in practice means an approximately 20 g dose four times a day, for breakfast, lunch, a snack and dinner. As an example, a small chicken breast or a large serving of low-fat Greek yoghurt provides this dose.
The reality of the current situation is that 25 per cent of older men and 50 per cent of older women are still falling short of the RDA11 – let alone what the body requires to optimise growth following training.
Breakfast and lunch are the meals to target when looking at protein intake, as research shows us that people find it easier to eat enough in their evening meal, while meals earlier in the day fall short – particularly breakfast (a breakfast of toast and jam, for example, would not provide enough protein).12 Adding a serving of low-fat Greek yoghurt or a whey protein shake (these aren’t just for athletes) can easily increase your intake.
So which are the best foods for muscle maintenance? As we saw in Chapter 1, complete proteins – those that contain a complete range of amino acids – have been shown to be the most beneficial. This means foods such as dairy, poultry and fish, as well as quinoa and buckwheat. Other plant sources such as rice and beans are good sources but are missing at least one amino acid, which means they need to be combined to make them complete. See ‘Performance Plates’, here.
This combination of resistance training and sufficient protein is exactly the same principle that elite athletes follow to keep their muscles strong and powerful. It is worth noting here that ageing causes the muscles to become less responsive (more set in their ways) to both training and protein. This is known as ‘anabolic resistance’13 and it means a bigger dose of either training or protein intake may be required to maintain the body. The best first step is to ensure a good source of protein with each meal and snack.
BUT WHAT TYPE OF PROTEIN?
Working out which type of protein foods to focus on can be confusing. See the protein guide in the appendix for the full breakdown but, in general, it’s good to include more fish, especially oily fish containing omega 3 fatty acids, such as salmon, tuna (fresh, not canned), mackerel, sardines, trout and herring. Although the evidence is still emerging, the studies so far suggest that they also reduce inflammation and potentially lower the risk of heart disease, cancer and arthritis, all very real risks as we get older.
Replacing red meat (especially processed meat such as bacon, sausages, ham and salami) is recommended due to the increased risk of bowel cancer linked to these types of meat. Chicken, fish and fresh, non-processed meat are better. And a combination of beans, tofu, lentils, eggs and higher-protein grains, such as quinoa and buckwheat, can all increase the protein content of your meal whether you’re vegetarian, vegan or just want to cut down your meat consumption.
So far we’ve looked at reducing your energy foods (carbs – particularly the simple sugars) and increasing your maintenance foods (protein). And now we need to address the third component of your fuel, the protection foods (micronutrients).
When we’re young, it’s easy to think of things like heart disease, diabetes and cancer as almost abstract concepts – things that happen to much older, other people. But as we age these conditions sadly become more a fact of life, for friends and family members and even for ourselves. And it’s as we enter later life that the pay-off for including more fruit and vegetables in our diet becomes clearer.
Increased fruit and vegetable intake is linked to a reduction in these kinds of conditions. And the pay-off is potentially huge. A large public health study looked at the eating habits of 65,226 people and found a significant relationship between eating fruit and vegetables and death at any age. Eating five to seven portions a day reduced risk of death by 36 per cent, and for those hitting more than seven portions a day, risk of death was reduced by 42 per cent.14 And more recently it’s been found that the benefits are higher again at ten portions a day.15
But let’s get real here for a second and put this into perspective. The latest UK findings, published in March 2017, show that only 26 per cent of adults are reaching five or more portions of fruit and veg each day.16 And with there being benefits for each extra portion of fruit and veg we consume each day, we need to shift the focus to increasing our intake, not aiming for an unrealistic amount we’ll never get through. We’re looking for progress, not perfection.
HOW CAN I INCREASE MY FRUIT AND VEGETABLE INTAKE?
But why are fruit and vegetables so good for us? Well, for starters they provide the fibre to maintain a healthy digestive tract and prevent constipation, and they contain a host of vitamins and minerals to support the health of all the body’s tissues. But more recently the importance of the phytochemicals (or phytonutrients, if you prefer) found in fruit and vegetables (phyto refers to the Greek word for plants) has been discovered. Most research so far has looked at the polyphenol family (which includes flavonoids, anthocyanins and others) and another group called carotenoids, which includes lycopene (which tomatoes are rich in) and beta-carotene.
WHICH SHOULD YOU BE REACHING FOR?
Essentially each colour of vegetable has different benefits:
●Root vegetables (e.g. carrots, beetroots, sweet potato) are high in fibre for a healthy digestive system, keeping food passing through and reducing constipation.
●Cruciferous vegetables (‘your greens’ – such as broccoli, kale, rocket, bok choi, cabbage) are high in glucosinolates, which activate enzymes that may protect against cancer.
●Red and purple fruits and vegetables (e.g. berries) – are high in antioxidants and also anthocyanins, which dilate blood vessels, improve cardiovascular health and may reduce DNA damage. Tomatoes are high in the antioxidant lycopene, which can reduce LDL (‘bad’) cholesterol and improve heart health. Red and black grapes deliver resveratrol, which has anti-cancer properties, and peppers and chillies are great vitamin C providers.
●The oranges, greens and yellows of citrus fruits are high in vitamin C, which boosts immunity and collagen production for strong connective tissue including ligaments and tendons.
●Lighter coloured fruit and vegetables (such as onions, grapes and apples) and also green tea all contain quercetin, which has been shown to have beneficial effects on immunity.
We’ve already discussed the idea of ‘eating the rainbow’, and that kind of variety is key here to ensure a full range of protection benefits. Ensure that you are including at least three colours in each meal to optimise your intake.
It’s not just our muscles that feel the effects of ageing. Bone density peaks around our mid-thirties, and from then on there is a gradual decline; the rates of breakdown begin to exceed growth. Osteopenia, a condition in which your bones are weaker than normal, is most likely to occur in your fifties; it shouldn’t be confused with osteoporosis, a more serious condition where your bones are significantly weaker and more likely to fracture. Although women lose bone density rapidly in the first few years after the menopause, and are at greater risk of osteoporosis, men can also suffer from it. Nutrition, particularly in the form of micronutrients, and exercise can both play an important part in keeping bones strong.
With your exercise, keep it weight-bearing. Resistance training counts as weight-bearing, as do things like tennis, running and dancing.
And with nutrition, the micronutrients calcium and vitamin D have a big part to play. Calcium is, of course, famous for its role in bone health – 99 per cent of our body’s calcium is found in our bones. The RDA for adults is 700 mg (achievable by consuming three glasses of milk or calcium-enriched milk alternatives like soya, oat or nut). This RDA increases to up to 1,200 mg per day in menopausal women and men over 55.17
There are other sources of calcium than milk, of course – dairy such as yoghurt and cheese, tofu, fortified soya, rice and oat drinks, and vegetables such as broccoli and spring greens are all good sources.
But consuming calcium alone isn’t the answer. It needs its partner, vitamin D, so that our bodies can effectively absorb the calcium and build new bone tissue. Dubbed the ‘sunshine vitamin’ because it is produced by exposure to sunlight, vitamin D is a true protection nutrient, improving immunity and muscle function. There is also emerging evidence to show its impact on chronic conditions such as cardiovascular disease and type 2 diabetes, as well as conditions of cognitive decline such as dementia and Alzheimer’s disease.
Some bad news, again, however: ageing reduces the ability of our skin to synthesise vitamin D, meaning that deficiencies can occur. Your vitamin D level is easily discovered by requesting a blood test from your doctor, and the table of micronutrients in Chapter 2 gives more information on foods containing vitamin D and supplementation.
Part of the host of physiological changes that occur with ageing is that total body water reduces.18 Also, as we get older our perception of thirst reduces, and the kidneys’ ability to maintain body water is diminished. All these things together mean that staying hydrated can become more challenging in later years, and if you exercise regularly, drinking only when you feel thirsty may not be enough to offset dehydration.
For more information on developing your personalised hydration plan, head here (Moving the Needle: Monitoring Your Progress chapter).
ENERGY EXPRESS: YOUR AGEING PLAN
●Rev the engine each day. On days where you don’t have time for a fitness class or a run, just increasing your step count (for example, with a brisk 30-minute walk at lunchtime) can make a big difference to reducing body fat.
●Don’t resist resistance. Aim for two resistance sessions a week, at the gym or at home, to activate the six major muscle groups: legs, abdominals, back, chest, shoulders and arms. Book a session with a personal trainer to take you through the exercises to build confidence, or try a class such as body pump.
●Less exercise = less carbs. If you’ve had a day stuck behind your desk or relaxing with family and friends, cut down on the fuel. Often the easiest way is to reduce carbs at dinner. Just increase your portion of protein (fish, poultry, pulses, tofu) and mixed vegetables to bulk out the meal. And cut out the snacking between meals.
●Prioritise the protein. There are lots of ways to achieve this: a portion of lean meat (or fish or poultry); including extra nuts, seeds or beans in your meal; some yoghurt or eggs with breakfast.
●Up the protection. Protection foods can support your immune system, muscles and bones on a daily basis as well as warding off chronic diseases. Aim for at least two varieties (colours) of vegetables with each meal to maximise the protective benefits.
●Pace yourself. The points above are the big hitters around training and nutrition, so bring them in over time. For example, it is natural for building resistance training into your routine to take a while – it’s a big step.