It is just a number!  It is not inevitable that ageing will bring with it an unavoidable decline in physical health and vitality

Many people have come to accept that getting old means getting slower, getting weaker and generally losing health and vitality.  But it’s a myth.  Every perceived consequence of age – less muscle mass, more body fat, reduced strength and aerobic capacity, blood sugar intolerance, oxidative stress, more brittle bones – every single one can be fought, avoided or minimised, empowering YOU to increase the years of your life exponentially – and, crucially, the energy, the vitality, in your years.

Let me explain what I mean by taking each of these “perceived consequences of age” in turn.

The dictionary meaning of vitality is having the capacity to live and grow, physical or mental energy, or strength or vigour.  In reality, it is simply the ability to enjoy life.

The UK standard vitality curve is derived from the UK population in 2010, with an average lifespan of 78 years for men and 84 for women.  The peak vitality level is between the ages of 20 and 30.  If we assume that the person continues to follow normal living and take standard healthcare advice, their vitality is expected to decline at a standard rate.

The human ‘biological clock’ indeed now allows for a life well over 90, so the range of the graph can probably be extended.  But this extension of life with no corresponding gain in vitality means the person lives longer but with a lower quality of life.  This results in a serious gap between lifespan and “healthspan”, with the difference needing to be filled with expensive medical and social care.

We can slow down the ageing process by focusing on maintaining health for the longest possible time.  But to do so, we have to keep an eye on the positive aspects of ageing and not focus on cosmetic aspects such as sagging skin or a receding hairline.

The body’s active tissue consists of muscle, bone, and vital organs (its lean body mass.)  This tissue, especially muscle, needs more calories to maintain itself than passive adipose (fat) tissue.  People with high muscle mass have a higher metabolism, a higher calorific need, and they don’t have to worry about how much they are eating or about gaining weight.  On the other hand, obese people have a slower metabolism and a hard time losing (or not gaining more) weight.

To maintain your vitality, you need to keep an eye on your lean body mass, which includes muscles, bones, and visceral organs.  Your bones and muscles represent the hardware, but your organs provide the energy you need to move and to maintain and repair your body.

Your dangerous decline

The declining biological function starts around your mid-30s.  You reach a significant change in your body composition in your mid-40s, with the danger of excess body fat and less muscle.  At this stage, ideally, you need to turn fat into muscle.  Please focus on burning fat to build muscle; losing weight is the wrong goal.

Storing body fat was a survival trick for our hunter-gatherer ancestors, a kind of rainy-day calorie bank.  In modern life, every day is a feast day for most people – with no corresponding famine! – so, there is really no need to keep a large amount of body fat (to survive on during famine), which is, in fact, a recipe for health problems.  The accumulation of visceral fat is the underlying cause of diabetes, hypertension, and heart disease.

Your muscle mass

We tend to lose 3kg (6.6 pounds) of lean body mass with each decade that passes, the rate accelerating after the age of 45.

To maintain muscle mass, you must use it or lose it, keeping a healthy level of anabolic hormones circulating in your blood stream.  Anabolic hormones increase protein synthesis.  The most potent is testosterone, the male hormone.  This explains the higher muscle mass in men compared with women.  Growth hormone has a similar effect.

Therefore, the solution is to exercise and keep a healthy testosterone level by:

  • Exercising and lifting weights
  • Eating protein, fats and carbohydrates
  • Minimising stress and controlling your cortisol levels
  • Enjoying the sun or topping-up with a vitamin D supplement
  • Taking other vitamin and mineral supplements
  • Getting plenty of restful, high-quality sleep

Your muscle strength

Skeletal muscles imply muscles attached to bones.  Your muscles are wired with nerves that make your bones move.  Sets of nerves and muscles are known as motor units.  As we age, we lose motor units.  Studies have shown, for example, that between the ages of 30 and 70, we lose 20% of our thigh motor units.

Our muscles are made up of two types of fibre: slow-twitch fibres are necessary for posture and low-intensity movement; fast-twitch muscle fibres are necessary for high intensity, sprint type of exercises, and lifting heavy objects.  It is the fast-twitch muscle fibres that decline with age.  Studies noticed that the decline of high twitch fibre starts in your early 20s, hence the reason why world-class athletes peak in their late teens and early 20s.

Your muscle mass and strength are crucial vitality markers because when these factors start to topple, so do all the others in turn.

Conventional thinking is that age decreases the ability of the muscles to get bigger and stronger in response to training.  However, a study by Western Colorado University has discovered that older adults were able to adapt to personalised cardio-respiratory and functional/resistance training and so improve their health-related fitness to the same extent as younger people.

Your basal metabolic rate (BMR), or your calorie expenditure at rest, falls with age.  Having a smaller muscle mass, as most middle-aged people do, causes a reduction in BMR, meaning that an average 70-year-old person needs 500 fewer calories per day than a 25-year-old to maintain his or her body weight.

Therefore, people in their 40s who continue to eat as if they were young will inevitably carry a bigger fat mass.  To make things worse, most of the fat deposition happens in the body viscera, converting key vitality organs like the liver, pancreas and even muscles into fat stores with a hugely negative impact on their physiological role in sustaining the body’s health and vitality.

Your aerobic capacity

Aerobic capacity is your ability to process oxygen within a given time.  This ability depends on how efficient your lungs are in extracting oxygen from the environment and how good your circulation is in delivering the oxygen load to the various parts of your body.  You need healthy lungs, a powerful heart and a good vascular network to achieve optimum performance.

Most people’s aerobic capacity declines with age.  It starts in our early 30s, typically reaching a 30-40% decline at the age of 65, compared with young adults.  The decline is greater in sedentary people.  This decline is due to anatomical changes in the rib cage that adversely affect the chest wall and lungs, as well as deterioration in the heart muscles and vascular network.

The aerobic capacity is measured in the lab (your VO2 max.)  It is viewed as a good index of overall cardiovascular fitness, a truly holistic health measurement.

Regular exercise (especially the movements that make you huff and puff) can bring a large increase in the muscle oxidative capacity in old age – a much greater improvement than to the heart or the cardiovascular system.

This is the main difference in the way young and old people respond to aerobic exercise.  A bigger muscle mass consumes more oxygen when you become cardiopulmonary (heart and lungs) effective.  However, a smaller, weak musculature lowers your aerobic capacity, as you have less muscle tissue demanding oxygen.

We are not cars!

I have met many people who are worried that exercise may result in body depreciation.  But, unlike a car, the human body gets stronger and more efficient the more you move.

Both aerobic exercise (walking, jogging, swimming) and strength training (including high interval intensity training, or HIIT, and weight training) are important in achieving a good level of vitality.

Your heart rate, blood pressure, blood sugar

Your resting heart rate is another marker of vitality and fitness.  It is generally between 60 and 100 but gradually decreases as you get fitter.  As you attain a high level of cardiopulmonary fitness, your heart does not need to contract as often to deliver the required oxygen.

And well-controlled blood pressure, under 120/80, is a great marker of health and vitality at any age.

Knowing how efficient your body is in dealing with sugar is crucial if you want to enjoy a high level of vitality.  Blood sugar dysregulation interferes with your energy and vitality during the day and your quality of sleep at night.  This can make your energy levels fluctuate during the day, with an afternoon slump.  People who are not efficient in regulating their blood sugar also wake up at night – typically between 1 and 3 am – and often cannot go back to sleep.  This also results in daytime sleepiness and a decline in vitality.

Our blood sugar level rises with age, as does the risk of developing type 2 diabetes.  By the age of 70, some 20% of men and 30% of women have an abnormal glucose tolerance curve.

Going back to mother nature and eating mainly plant-based, real foods – fruit, vegetables, beans, nuts and seeds – will help you to become more efficient in dealing with sugar at any age.

Your oxidative stress

Oxidative stress can damage your cell “machinery” (your cells’ proteins, energy plants or mitochondria, and DNA) and can contribute to ageing (rusting) and the development of chronic health conditions.

I always explain oxidative stress to my patients by saying that free radicals are generated in every cell while the body burns fuel (glucose or fat) to make energy.  Out of this big metabolic fire, sparks emerge, and if they are not neutralised immediately, they will fall onto the cell machinery and damage them.

In war terms, oxidants are like missiles that can cause damage, but your body can confront these missiles and neutralise them before they hit the target.

Therefore, it is important to make sure you have adequate antioxidants, including vitamins A, E and C, as well as master antioxidants like glutathione and alpha lipoic acid.  Consuming rainbow-coloured vegetables on a regular basis is great because each colour has a different and powerful antioxidant capacity.

Your bone density

There is an age-related decline in the mineral content of your bones, frequently resulting in osteoporosis and breaks.  These are more commonly related to poor dietary habits, hormonal imbalances in women after menopause, a sedentary life, and low vitamin D.  Consuming a diet rich in calcium – leafy greens, milk and dairy products, as well as vitamin D, seafood and mushrooms – together with good physical activity and sunshine will cover you in this respect.

The bottom line

There is a lot to take in here, but think of it like this – if you can take the straightforward steps outlined above – turn fat into muscle with a good mix of strength and aerobic exercise, and eat a diet of real, plant-based foods for blood sugar tolerance, take the necessary supplements and rainbow-coloured vegetables for antioxidants, as well as vitamin D for bone density – you can enjoy the upper lifeline illustrated below.

The graph is a stark reminder of the difference that these steps – and they are all measures that the Vitality Clinic can help you with – can make in your life.  Just to take one example, someone in their late 70s who does nothing will see their vitality level reduced practically to zero, whereas if you follow our principles, the 78-year-old ‘you’ can enjoy vitality up near 80%!

As always, my friends, please share your thoughts and ask any questions on this subject, and please do subscribe to the newsletter so that you don’t miss further vital information.  Thank you!



You can control the aging process, Biomarkers, the 10 keys to prolonging vitality, is a book written by William Evans, PhD and Irwin H. Rosenberg, M.D, professors of nutrition and medicine, TUFTS University with Jacqueline Thompson.

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