According to the National Institute on Aging we begin to loose muscle mass around age 40. At age 50 we begin to loose about 1/2 pound of muscle per year and gain one pound of fat. So by age 70 the average person has gained 20 lbs of fat and lost 10 lbs of muscle. “ No decline with age is as dramatic or potentially significant as the decline in lean body mass” researchers wrote in the Journal of Nutrition. You have probably heard of an elderly person who fell and broke their hip. The falling was most likely the result of weakness from decreased muscle mass. Then, that person continued to have a down hill course due to poor healing. All-cause mortality rate in older adults is increased 5- to 8-fold 3 months after hip fracture and persists with time, according to the results of a meta-analysis reported in the March 15 issue of the Annals of Internal Medicine.

Loss of muscle mass with age is called sarcopenia. In 2001 the Journal of the American Medical Association stated “Sarcopenia is the backdrop against which the drama of disease is played out: a body already depleted of protein because of aging is less able to with stand the protein catabolism that comes with acute illness or inadequate protein intake. Muscle is the major source of protein for functions such as antibody production, wound healing and white blood cell production during illness. If the body’s protein reserves are already depleted by sarcopenia, there is less to mobilize for illness.”

A well documented way to assess muscle mass, fat mass and water distribution in the body is called bioimpedance analysis or BIA. It involves passing a mild current from the hand to the foot traveling through the body compartments of muscle, fat, bone and water. Standing on the bathroom scale gives limited information. The BIA test can tell down to the tenth of a point if you are gaining or loosing fat or muscle. It is very sensitive to lifestyle and dietary changes. This can be performed in just a few minutes in the doctor’s office.

Some type of resistance or weight bearing exercise is necessary to stimulate muscle growth as well as adequate amounts of protein. Muscle growth can increase at any age although not as fast as younger people.

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The middle-age spread is commonly attributed to “slowed metabolism”, “hormonal changes” or “just getting old”. However, a recent study found that testosterone is the probable cause for the increase in abdominal fat in women during and after menopause. Deep abdominal fat surrounding the internal organs is recognized as an independent risk factor for heart disease and diabetes in women and men. The study evaluated 359 women between 42-60 years old in the Study of Women’s Health Across the Nation (SWAN). They looked at the relationship between blood testosterone levels and CT scans of visceral abdominal fat. The testosterone was a stronger predictor than estradiol for the fat. The reason for the elevated testosterone in the women was due to a rise in diet induced insulin levels. Eating a diet high in refined starches i.e. white breads, potatoes, cereal, rice and pastries causes blood sugar to rise, then the body produces insulin to lower the blood sugar. Insulin is a powerful hormone that can elevate testosterone in women. If the high starch diet continues over a period of years, insulin resistance can develop causing Type II diabetes.

Insulin resistance is the key feature in the Metabolic Syndrome estimated to affect 40% of the adult population in the U.S. It is defined by 3 out of 5 of the following: waist circumference greater than 35 inches in women and over 40 inches in men, blood sugar over 100 mg/dl, blood pressure greater than 130/85, HDL lower than 40 in men and lower than 50 in women and triglycerides over 150 in both sexes. Metabolic Syndrome is not a disease but a constellation of the above factors directly related to insulin resistance that can lead to diabetes heart disease and stroke and possibly cancer. Sedentary lifestyle and a diet high in refined starches and sugar (frequent celebration or holiday foods and deserts) are considered to be the prime causes with less than 30% due to genetics.

The good news is that the middle age spread and Metabolic Syndrome can be successfully decreased by dietary and lifestyle changes. After age 50 the average person will loose gain one pound of fat per year and loose ½ pound of muscle. By age 70 this adds up to 20 lbs fat gain and 10 lbs muscle loss.

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According to recent reports, there are definite signs of an economic recovery starting as soon as this summer. This is hopeful news for both your wallet and your waistline. Looking at this economic downturn from the perspective of diet and nutrition and the effect on general public health, we see that it is much different from the downturn of the Great Depression. Back then most people could not afford high fat meats and dairy products and turned to less expensive homegrown vegetables and beans. The rates of heart disease dropped dramatically. Then, during the growing prosperity of the 1950’s, the rates of heart disease climbed back to their pre-depression levels.

How many people today are turning to homegrown vegetables to cope with the current downturn? Hardly anyone I know. Why, because coinciding with the post-war economic boom was the rise of the fast food industry and the introduction of convenience foods (remember Swanson’s TV dinners) that did not exist in the 1930’s, providing inexpensive, high fat, high salt and sugar, low nutrition foods. In fact, the fast food industry is doing quite well right now with McDonald’s Corp. announced a first-quarter profit of $980 million, up 4% from last year and Burger King 1st quarter profits up 1.6% over last year. So this time instead of a decrease in heart disease and related problems there may be an increase. People’s waistlines are expanding as their wallets have been shrinking.

Our relatives of not so long ago had it right. They switched by necessity to healthier foods. Fresh produce, beans and legumes and poultry are relatively inexpensive today. Spending about one hour a week making a bean and vegetable soup can provide leftovers to last the rest of the week for a lot less money than eating out. Our parents, grandparents and great-grandparents also walked a lot more by necessity in those days than we do now. Unless we learn these important lessons from them, we may emerge from this recession much less healthy than they did when economic times were even worse.

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The causes of low energy can fill a medical textbook. Almost every chronic illness is associated with low energy. There are some easily fixable causes such as anemia and low thyroid. Severe fatigue not related to a diagnosable illness may be an illness in itself called Chronic Fatigue Syndrome in the U.S. or Myalgic Encephalomylitis in England, Canada and Australia. There may be deficiencies of vitamins, minerals and amino acids which can be assessed through blood and urine tests. Correcting these deficiences can improve energy for many people. There may be impairments of the immune system from viruses, bacteria or toxic metals or chemicals which can be evaluated and treated. The course of recovery is highly individual and is based on many environmental and genetic factors. The CDC has recently established the validity of Chronic Fatigue as a specific illness through extensive genetic studies.