We spend a lot of time talking about the dangers of being overweight, but there is another side of the equation that deserves just as much attention: losing too much weight and too much muscle as we age.
I recently worked through a case involving an older woman who was quite underweight and frail. She had been very diligent about her health, but after years of eating too little and gradually eliminating foods she thought she reacted to, she had gotten to a point where I was much more concerned about what she had lost than what she weighed. She had lost muscle.
You Can Go Too Far the Other Way
Being thin is not automatically the same thing as being healthy.
People who spend decades in a calorie deficit can gradually lose a significant amount of muscle mass. Add in declining activity as we get older, and it becomes easy to assume, “I’m getting older, so of course I have less energy and strength.”
But sometimes what we’re calling aging is also the result of not eating enough, not getting enough protein, and not using our muscles enough.
I’ve seen people gradually eat less and less over the years. Then they become less active. Then they start eliminating foods because they think they’re reacting to them. Eventually, they’re left with fewer foods, fewer calories, less protein, and less muscle. That’s a dangerous slippery slope.
Protein Becomes More Important With Age
Here’s something that sounds backwards but is important: you may need more protein at 80 than you did at 40.
As we age, the body becomes less responsive to dietary protein, which means we need to pay more attention to getting enough of it. If you’re already eating too little, or if you’re not digesting and absorbing your food well, maintaining muscle becomes even more difficult.
So when I see an older and more frail type of patient, one of the first things I think about is this: Are they getting enough protein? And are they actually digesting and absorbing it?
That second question matters. Eating enough protein doesn’t help much if you’re struggling to break it down and absorb the nutrients your body needs. Digestion is a critical part of the nutritional picture, particularly as we get older. For more on the foundations of healthy digestion, see Fire in the Belly – The 7 Steps to Healthy Digestion.
Your Muscles Need a Reason to Stay
Protein isn’t enough. Your muscles need a reason to stay.
That means resistance training. And I don’t mean that an 80-year-old suddenly needs to start lifting enormous weights. Exercise can be adapted for the individual. Strength training, resistance bands, body-weight exercises, and appropriately modified impact or jumping exercises can all be part of a program.
This is especially important for women as they move through midlife and beyond. Hormonal changes alter the way the body responds to exercise, and the advice we’ve traditionally been given about exercise hasn’t always taken those differences into account.
One resource I often recommend is the work of Dr. Stacy Sims, who has done an excellent job explaining the differences in exercise physiology between men and women and why those differences matter as we age.
Don’t Overlook Stomach Function
We’ve already talked about why digestion and absorption matter when you’re trying to get enough protein. But there’s another piece of this that deserves attention, especially as we get older: stomach function.
Gastric acid production and function can become impaired with age, particularly when conditions such as atrophic gastritis are present. At the same time, more and more people are taking medications that intentionally suppress stomach acid, sometimes for years. These medications can be appropriate in certain situations and for the short term, but are too frequently overused. Long-term acid suppression heavily interferes with the digestion of protein and the absorption of certain nutrients.
So if you’re eating more protein but still struggling with digestion, food tolerance, or maintaining good nutrition, don’t overlook what’s happening in the stomach. Before simply adding more protein, make sure you’re also asking whether your digestive system is able to break it down and make those nutrients available to your body.
I’ve written more about this connection here: MTHFR and Acid Reflux: the Cause and the Cure.
Don’t Just Focus on the Scale
If you’ve spent your life trying to stay thin, this can be a difficult mindset shift.
But as we get older, I would much rather have you thinking about strength, muscle, and function than simply about the number on the scale.
Can you get up from a chair easily? Can you carry your groceries? Can you climb stairs? Can you get up and down from the floor? Can you continue doing the things you want to do with your family?
Those are the things that matter.
Your muscle mass is one of your greatest assets for aging well.
Your muscle is your retirement plan.
The strength you build and maintain today is something you can draw on later in life. The more muscle and strength you preserve, the more capacity you have to stay independent, recover from illness or injury, carry your groceries, climb stairs, travel, play with your grandchildren, and keep doing the things you enjoy.
You can’t deposit muscle into a bank account—but you can invest in it every day.
The Bottom Line
Don’t just try to stay thin as you age. Protect your muscle.
Eat enough. Get enough protein. Make sure you’re actually digesting and absorbing what you’re eating, and don’t overlook stomach function—especially if you have digestive symptoms or use long-term acid-blocking medication. Then give your muscles a reason to stay through regular resistance exercise.
Your muscle is your retirement plan. The investment you make in it today can determine how strong, capable, and independent you are years from now.
Looking for Personalized Support
If you’re struggling with low energy, digestive issues, difficulty maintaining your weight or muscle, or other persistent health concerns, it may be helpful to look beyond the obvious symptom and consider the bigger picture.
At Red Mountain Natural Medicine in Boise, Idaho, I work with patients to explore factors that may be influencing health and function, including nutrition, digestion and absorption, lifestyle, sleep, and other aspects of whole-body health.
I see patients both in person and via telemedicine. To learn more or schedule a consultation, visit Red Mountain Natural Medicine.
Supplements You Can Trust
Not all supplements are created equal — and with so many brands now owned by private equity and holding companies, quality has quietly slipped across the industry. We use NutriDyn, a family-owned, practitioner-exclusive company that’s held its standards since 1973.
To order the formulas we use in clinic, create a Patient account at NutriDyn.com using practitioner code 703900.
