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The “Inevitabilities” of Aging: How Inevitable Are They?

Posted By Mark Sisson On June 5, 2013 @ 8:00 am In Aging | 167 Comments

How many times have you heard some old timer attribute the dysfunction of a body part or physiological attribute to “gettin’ old”? Or how about that time you tweaked your back and everyone was quick to tell you to get used to it because it’s never going to get any better? “It’s all downhill after 30!” The funny thing is that this is somehow supposed to make you feel better about your prospects. Some people, I guess, prefer to have control over their health wrested out of their hands and distributed to the fates. Some people like the idea of letting “nature take its course.” At least that way nothing that goes wrong is your fault, because you never had a chance anyway. You were always destined to get all soft and flabby, lose your hearing, get brittle bones, and be unable to go to the toilet by yourself. Right?

Wrong. Age isn’t “just” a number, and we can’t maintain Dorian Gray-esque vigor all through life, but that doesn’t mean we’re destined to be frail, brittle things relegated to chairs and walkers and homes and doctor’s offices.

Today, let’s take a look at some common “inevitabilities” of aging and why they may not be so inevitable after all.

Loss of Testosterone

Most men see the age-related decline in testosterone as inevitable, and who can blame them? Testosterone levels do generally decline with age [7]. Younger guys generally do pack on muscle faster and easier than older guys. The association is strong, constant, and almost unwavering. But it’s not inevitable. The passage of time, the changing of seasons, the number of candles on your gluten-free birthday cake do not determine your production of testosterone. Rather, what you do, what you eat, how you exercise, how much body fat you carry, and how much stress you deal with all affect your testosterone levels.

A generational drop in testosterone has been observed [8]. Twenty years go, men of all ages had higher testosterone levels than their counterparts today, meaning an average 50 year old guy in 1993 had higher testosterone than an average 50 year old guy in 2013. Something other than aging is lowering testosterone across the board. This shows that T production is subject to other factors, not just aging.

A recent study [9] found that the “age-related” declinations in testosterone were modified by body weight changes and other lifestyle factors. As body weight went up, T went down. As body weight went down, T went up. As a side note, smoking cessation was associated with a lowering of testosterone, but I wouldn’t recommend picking up the habit as a way to curb T decline. Another study [10] found that metabolic syndrome exacerbates testosterone deficiency.

As long as they maintained “excellent or very good health,” men over the age of forty experienced no declines in testosterone in a recent study [11]. Those who did experience declines appeared to do so [12] because of other “disorders that accumulate during aging, including obesity and heart disease.” Age itself had no independent effect.

Cortisol [13], the stress hormone which opposes testosterone, tends to increase with age [14]. Higher cortisol, lower testosterone. Controlling your stress may not ensure high testosterone, but at least you’ll be taking care of one potential factor.

What about women? Women make and use testosterone, too, but their relationship with the hormone isn’t the same as men’s. As I mentioned earlier, men can stave off age-related testosterone deficiency by staying healthy and avoiding metabolic syndrome. In women, obesity actually increases circulating testosterone levels. This is because women make testosterone in body fat [15], in addition to the ovaries and adrenal glands. But before you go and gain a bunch of testosterone-boosting body fat, you should realize that women are extremely sensitive to testosterone’s effects. Too little testosterone is bad and associated with a lagging libido, lower lean mass, heart disease [16], and poor bone density [17], but too much testosterone is associated with type 2 diabetes [18], PCOS, and breast cancer (although this breast cancer connection may be explained by the conversion of excess testosterone into estradiol [19], and other evidence suggests that testosterone may even be protective against breast cancer [20]).

So, as women age, they’re not so much concerned with “increasing testosterone.” They’re trying to keep their production in the sweet spot that maintains libido, bone, and muscle health without venturing into excess. But I strongly suspect that staying healthy, avoiding metabolic syndrome, and controlling stress will help women just as much as men.

Creaky Joints

Back when I was running, eating, and training like a madman, I had fairly bad arthritis. But not in my knee, or my hips, or my ankles. I had arthritis of the fingers, arthritis so severe that I had trouble holding a pen at times. I figured it was just part of getting old (like everyone told me) and tried to make the best of it. Maybe I’d even be one of those guys that can predict the weather based on the pain level in his joints. When I went grain-free, however, the arthritis evaporated. It just stopped. Now, although there’s not a lot of research into diet and arthritis, there is some strong evidence that rheumatoid arthritis, an autoimmune disease, can be exacerbated by dietary lectins from grains and legumes [21]. The conventional wisdom [22] is that osteoarthritis is purely “wear and tear” arthritis, separate from rheumatoid arthritis, independent of dietary and inflammatory factors, and pretty much inevitable if you live long enough, but (obviously) I disagree [23].

Other than dietary factors, simple, chronic inactivity is the major causative factor in the development of stiff, creaky joints. There are no studies on the subject that I know of, but we all know it to be true. Just ask yourself: how do you feel after a day of sitting on your butt and being sedentary? Stiff, tight, and altogether immobile. Now, imagine an entire lifetime of that, and you get the oldster who can’t tie his own shoes or get up off the toilet.

Loss of Lean Mass

True, people tend to lose muscle mass as they age, but that’s primarily because they tend to stop exercising – if they ever did in the first place. Some muscle loss just happens, but not all, or even most of it. We can and should maintain lean mass [24] as we age. Grandma isn’t likely to get ripped, but many studies show that seniors can still gain lean mass through resistance training:

Even immediately after hip surgery [25], the elderly can utilize resistance training to put on lean mass.

In elderly women, resistance training induces hypertrophy and lowers inflammation [26].

Stroke survivors (aged 50-76) were able to enjoy significant hypertrophy [27] with strength training.

Even in subjects older than 80, strength training seems to counter the effects [28] of sarcopenia, or muscle wasting.

Heartening, eh? Just be wary of trying to do too much; one study [29] of older subjects showed that strength training alone was more effective at inducing hypertrophy than a combination of strength and endurance training.

Another cause of muscle wasting in the elderly is low testosterone, which we’ve already covered above. Take steps to mitigate that and resistance training will be even more effective.

Brittle Bones

It’s a terrible thing, to slip and fall in the shower, or while walking through the neighborhood, and end up with a broken hip or wrist for your trouble. It doesn’t have to be that way, though. It shouldn’t be that way, just because you gained a few years.

Nutritional factors certainly play a role:

Vitamin D, which we can get from sun, food, or supplements, is crucial for maintaining bone mineral density [30]. Without it, we’re unable to utilize calcium.

Vitamin K2 is also important and has been shown to improve bone mineral density in older folks with osteoporosis [31]. Without it, we’re unable to put calcium where it belongs (in bones).

Calcium intake, particularly from food (and dairy if you tolerate it [32]), helps determine bone health. We sometimes forget about the raw building blocks in favor of the co-factors (perhaps because conventional wisdom has done the opposite), but we shouldn’t. It matters, too.

Though they get less attention than the previous three, other nutrients, like potassium [33] and magnesium [34] (to name a couple) are also required for good, strong bones.

But nutrition is useless without activity – physical stimulation of the musculoskeletal system. In order for exercise to improve bone mineral density, it must satisfy several requirements [35]. It should be dynamic, not static. It needs to challenge you. You need to progress in weight, intensity, and duration. It should be “relatively brief but intermittent.” No long drawn out sessions that do nothing but overwork and overtrain you. Keep it short and intense. Also, the exercise should place an unusual loading pattern on the bones. That could be different movements, or increased resistance, as long as you’re introducing something “new” to the body. Finally, for exercise to improve bone mineral density it must be supported by sufficient nutrition, especially calcium and vitamin D.

Hearing Loss

Everyone’s got a grandpa whose favorite word is “Huh?” and everyone “knows” that your hearing goes the older you get. But why? Is it a feature inherent to aging? While there’s indeed something called presbycusis, which describes the cumulative effect of aging on hearing, it’s difficult to disentangle true presbycusis from all the other factors that can also affect our hearing. First, of course, is our exposure to noise, either repeated (working in a metal shop) or traumatic (witnessing a massive explosion). The more noise we hear, and the louder it is, the faster our hearing goes, all else being equal. Consider the classic study of the Mabaan people of the Sudan [36]. The Mabaan were completely isolated from industrialization, and without firearms, cars, factories, or any other manmade sources of loud noises, the hearing of their elderly was just as sharp as the hearing of Westernized young adults. It hadn’t degraded at all over the years, showing that noise exposure, rather than aging, is the main arbiter of hearing ability.

At the heart of noise-induced hearing loss appears to be oxidative stress. [37] Upon a loud enough noise, the overstimulated hair cells within the ear generate reactive oxygen species, which damage the cells and eventually impair hearing. Studies [38] have shown that boosting endogenous antioxidant (glutathione) status following noise exposure can reduce hearing loss. Preliminary evidence suggests [39] that dietary precursors to glutathione (NAC) can also reduce hearing loss. It’s likely that eating a diet rich in polyphenols, flavonoids, and other antioxidant compounds could have similar preventive effects. This might be our best bet, short of escaping civilization and avoiding all loud noises.

As people age, their lifestyles suffer. They work more and longer hours. They sleep less. They accumulate more stress, and do more stress-eating. They stop moving as much, particularly if their new adult jobs force them to sit for eight hours a day. They live more poorly, and, in turn, suffer many of the health maladies we regard as “part of getting old.” I’m not suggesting that aging has zero effect on our physiological health. If nothing else, it makes us more vulnerable to our poor lifestyles and gives us more time to accumulate further damage (loud noises, stress-causing responsibilities, etc). I’m just saying that we give it a lot more power that it deserves. By doing that, we cede control over our own health to some abstract function of space-time. If aging is gonna get ya, it’s gonna get ya. Let’s do our best to hold it off at the pass, shall we?


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[7] Testosterone levels do generally decline with age: http://books.google.com/books?hl=en&lr=&id=efEnI1VdmtsC&oi=fnd&pg=PA3&dq=Declining+Androgens+with+Age:+An+Overview&ots=vIRdqQ3RBF&sig=-X1AP3-lXgXB8SCDI0EwH8GOtDA

[8] generational drop in testosterone has been observed: http://www.healio.com/Endocrinology/Hormone-Therapy/news/print/endocrine-today/%7BAC23497D-F1ED-4278-BBD2-92BB1E552E3A%7D/Generational-decline-in-testosterone-levels-observed

[9] study: http://www.ncbi.nlm.nih.gov/pubmed/23425925

[10] study: http://www.ncbi.nlm.nih.gov/pubmed/23488280

[11] in a recent study: http://www.afr.com/p/lifestyle/mens_health/dispelling_testosterone_myth_7t99oPqy2gEC5wMm69mpRN

[12] appeared to do so: http://www.sciencedaily.com/releases/2011/06/110607121129.htm

[13] Cortisol: http://www.marksdailyapple.com/cortisol/

[14] tends to increase with age: http://www.sciencedirect.com/science/article/pii/S0039128X03000837

[15] women make testosterone in body fat: http://www.ncbi.nlm.nih.gov/pubmed/15531721

[16] heart disease: http://www.ncbi.nlm.nih.gov/pubmed/12468054

[17] poor bone density: http://www.ncbi.nlm.nih.gov/pubmed/7616872

[18] type 2 diabetes: http://www.ncbi.nlm.nih.gov/pubmed/16537739

[19] explained by the conversion of excess testosterone into estradiol: http://www.ncbi.nlm.nih.gov/pubmed/22394304

[20] evidence suggests that testosterone may even be protective against breast cancer: http://www.ncbi.nlm.nih.gov/pubmed/18714077

[21] can be exacerbated by dietary lectins from grains and legumes: http://www.ncbi.nlm.nih.gov/pubmed/10884708

[22] conventional wisdom: http://www.marksdailyapple.com/the-definitive-guide-to-conventional-wisdom/#axzz2TnmQaobK

[23] I disagree: http://www.marksdailyapple.com/arthritis-diet/

[24] lean mass: http://www.marksdailyapple.com/organ-reserve-muscle-mass-aging/

[25] immediately after hip surgery: http://www.ncbi.nlm.nih.gov/pubmed/15571536

[26] resistance training induces hypertrophy and lowers inflammation: http://www.ncbi.nlm.nih.gov/pubmed/21253481

[27] significant hypertrophy: http://www.ncbi.nlm.nih.gov/pubmed/21164115

[28] seems to counter the effects: http://www.ncbi.nlm.nih.gov/pubmed/20487503

[29] study: http://www.ncbi.nlm.nih.gov/pubmed/20030775

[30] crucial for maintaining bone mineral density: http://www.ncbi.nlm.nih.gov/pubmed/14529146

[31] improve bone mineral density in older folks with osteoporosis: http://www.ncbi.nlm.nih.gov/pubmed/15320745

[32] dairy if you tolerate it: http://www.ncbi.nlm.nih.gov/pubmed/23550782

[33] potassium: http://www.ncbi.nlm.nih.gov/pubmed/23162100

[34] magnesium: http://www.ncbi.nlm.nih.gov/pubmed/10197575

[35] must satisfy several requirements: http://www.ncbi.nlm.nih.gov/pubmed/16138787

[36] classic study of the Mabaan people of the Sudan: http://archotol.jamanetwork.com/article.aspx?articleid=600299

[37] heart of noise-induced hearing loss appears to be oxidative stress.: http://www.ncbi.nlm.nih.gov/pubmed/16446561

[38] Studies: http://www.ncbi.nlm.nih.gov/pubmed/9518561

[39] suggests: http://www.ncbi.nlm.nih.gov/pubmed/22303701

[40] Primal Blueprint Books: http://primalblueprint.com/categories/Store/Books-and-Media/?utm_source=mda_sidebar&utm_medium=banner&utm_campaign=sidebar_like_article_books

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