Ageing: Is frailty inevitable?

Today, I wanted to share some insights I gleaned from an article by Peter Attia, a renowned expert in longevity and health. His work, including his book “Outlive,” and podcast have been helpful resources for me in understanding how we can live healthier, more vibrant lives as we age.

In a recent article, Attia delves into the topic of combatting muscle loss as we grow older – a concern that many of us may face as we navigate the journey of aging. I’ve done my best to outline the main points from the article, but you can read the full thing here, if you’d prefer.

Sarcopenia, the age-related decline in muscle mass and strength, can impact our ability to perform daily tasks with ease, from getting out of bed to carrying our shopping bags.

What intrigued me most about Attia’s insights is the role that resistance training plays in reversing some of these age-related changes in our muscles. He discusses how as we age, our muscle fibres, particularly the powerful type 2 fibres, become more irregular in shape, contributing to muscle weakness and making everyday activities more challenging. Type 2 muscle fibres, also known as fast-twitch muscle fibres, are a crucial component of our musculature responsible for rapid and forceful contractions. Unlike their slow-twitch counterparts (Type 1), Type 2 fibres generate quick bursts of power and strength, think of catching yourself when you trip over, quickly getting up from the floor, or powerful gym work/sprinting exercises.

Attia speculates that muscle decline is more about lack of use than simply ageing:

“I find myself, personally, unconvinced that the magnitude of decline we see at the population level is biologically inevitable. Rather, I believe it is driven more by a vicious cycle of inactivity and deconditioning.”

It is the cycle of sedentary behaviour twinned with a lack of exercise or physical activity which, in the long run, is more likely to be the primary culprit. In addition, he tells us the study suggests that lack of use of our type 2 fibres can result in their denervation, a loss of nerve supply to the motor neurones, the nerves that control muscular contractions. This ultimately leads to fibre atrophy (wasting or thinning of muscle mass), deformity, and incapacity.

However, Attia highlights a ray of hope – resistance training. His article showcases a study in which participants engaged in resistance training for just a few months and experienced significant improvements in the quality of their muscle fibres. This suggests that age may not be a barrier to improving muscle strength and function through exercise and implies that maintaining regular physical activity throughout life may play a crucial role in preventing muscle decline both in terms of type 2 fibre maintainence, and the healthy maintenence of nerve supply to our motor neurones.

The article also raises interesting questions about how our culture grapples with and comprehends the effects of aging. No one is denying that the aging process produces some physical decline; it does. However, anyone who has ever studied human physiology will know that appropriate physical stressors encourage growth in bone, muscle, and soft tissue cells. We also know that the appropriate levels of cognitive ‘stress’ (otherwise known as challenging ourselves) throughout life encourage neurogenesis, the formation of new brain cells. I’m certainly not qualified to make a judgment myself, but it is interesting to consider whether some of our assumptions about the inevitability of age-related weakening are overstated, leading us to assume that extreme frailty and immobility are unavoidable consequences later on in life.

Attia’s insights remind us that resistance training isn’t just for athletes or bodybuilders – it’s for all of us who want to stay strong and independent as we age. So, if you want a way to invest in your future health, resistance training might be the place to look.