Use It Or Lose It

Living Proof

Use it or lose it. That’s a fact when it comes to muscle mass, fitness, mobility and general physical wellbeing. And the older you get – and I include you Ms/Mr Forty-Something – the bigger an issue it becomes.

Today is 12 weeks since an accident that put me in a critical care ward with 14 fractures and a damaged lung. I was out after 12 days, but movement was limited. Physio started in mid-June. At the end of July, I rode a bike gently for the first time. I also went to the gym and did dumbbell bench presses with 2kg weights, plus some limited lower body work.

Rolling forward to late August. I find a twenty-mile gentle cycle challenging, but at least I’m rolling. At home, I can do my ATG workout with my physio, and I have returned to the gym a couple more times.

I’m blowing on the bike. That is to be expected. The delayed onset muscle soreness can continue for days with the strength and mobility work. Again, to be expected. I have moderate osteoarthritis in my knees. That is letting itself be known as being not only on the guest list but in the VIP area. My mobility has regressed, and a 15-year-old issue with a protruding disk in my thoracic spine is back.

On the one hand, I’m frustrated with my progress. On the other hand, I’m told I am well ahead of expectations on the rehabilitation timeline.

Using it meant a strong recovery. But losing it became much quicker than I expected. The decline in mass shocked me after only ten days. Use it or lose it has never been more poignant for me.

Keep Moving

The human body is designed to move and move daily, and my body demonstrated that after only 12 days in hospital. Use it or lose it is not a throwaway line. It’s a mandate. From your thirties, you will lose muscle mass between 3% and 8% per decade. So you can stop sniggering at the old guy now. Because it’s happening to you if you’re not doing something about it.

In one’s 60s, the rate of loss accelerates. Muscle mass, strength, and function all reduce. Sadly, some body mass is replaced by fat, and I have always been predisposed to obesity. When I left the hospital a few weeks ago, I looked like a boiled egg with cocktail sticks for limbs. Such was the rate of muscle mass degeneration and my increasing gut.

There’s a risk of insulin resistance increasing, although my blood measures say I’m all good for now. Joint mobility can reduce, and I buy into that. It is a genuine challenge for me. Bone density can reduce, and also a small height reduction can take place. I know the last item hasn’t hit me yet, as I got under the measuring stick in my May medical. People, you need to use it or lose it, adopt it as a mantra.

Slowing The Biological Clock

I was an average athlete at best in my youth and even into my thirties. I mean measurably average when put through any train-to-failure protocol on the Wattbike. Anytime I made the grade in any event or sport as a youth was down to bloody-mindedness. The head telling the body who was the boss.

In my early fifties, it was crunch time for me. My weight had risen above 250 pounds, and I was taking no exercise. Add to that me paying no attention to diet and tipping too much red wine and beer down my gullet. I had entered the classic 50s killing fields phase. I know that my family succumb to this. My obese uncle died of a cardiovascular event at only 48. Parents and grandparents had poor health too. A family firmly in the ‘three score and ten’ longevity league. In several cases with health being poor in the last decade.

I realised all was not well with my mental health at this age. Stressed and depressed, and something was burning inside of me. I started therapy and found it challenging. But hard was good for me. My proactive approach to health became broader, and I returned to cycling, having given it up 20 years previously. My garage found room for an Olympic weight set, bench, and squat stand. The roots of my use it or lose it philosophy were laid down in those years.

Building A Base

Over the last 15 years, I’ve built a fitness base of sorts. I bought a bike (and then another, and another, but that’s a separate story!) Sometimes I’ve been consistent. Sometimes I’ve ebbed and flowed depending on how life has treated me. But I have kept building.

It’s kept me sane sometimes, even if only allowing me to lose myself in my thoughts, given the focus needed to train right. It has resulted in my annual medical checks demonstrating that it makes a real-world difference to my health.

I remain an average athlete. Yet the secret sauce is my still exercising while my contemporaries have largely knocked serious exercise on the head. If they ever started it. My gym performances remain average, although I can deadlift strongly for some reason. Odd, given my long levers.

On a bike, my FTP or power-to-weight ratio is average. Again, I have an outlier: I’m in the top 10% of athletes of my age for a Garmin-calculated VO2. Now I know it’s not that scientific, it’s derived from power and heart rate. But it’s measured against a vast pool of athletes, so it’s a good data set. And it’s a relative measure – I can see it improving or decreasing.

Facing The Competition

I’m always fronting up to the competition. Because it’s me. I set myself big and small targets and chase them. They are never soft targets because I’m tough on myself. I have annual targets and will declare them. I have inner targets that wouldn’t make sense to others, but I nail those too.

In facing the competition, I’ve achieved some things that are important to me. Gran Fondos in New York and Italy stand out as I hit my target times. A brutal sportive in Wales. Moving 165kgs of deadlift in my 60s, which is decent for my age group. Having the age group lap record on Regents Park right now.

I face the competition each day, it’s the man in the mirror, and he doesn’t cut me much slack. He has always known this is a use it or lose it game.

VMM

My own experience has been to focus on having a strong VO2 and decent muscle mass. It’s all relative, I hasten to add; I have never been muscular. I know I can push myself hard, resulting in a decent VO2. Joint mobility and muscle flexibility have also become important in the last ten years. I can touch my toes better now than 15 years ago. But looking out at the next 15 years or so of my training, my attention will be firmly on my VMM triumvirate.

VO2

The body of scientific work showing the positive effect of cardiovascular fitness on healthy ageing is substantial. The quote below is from a study of 122,00 older adults. In all groups, including the 70 years and older participants, improved stress test performance resulted in better longevity outcomes. The study shows hard exercise results in a higher quality of life.

“Cardiorespiratory fitness is inversely associated with long-term mortality with no observed upper limit of benefit. Extremely high aerobic fitness was associated with the greatest survival and was associated with benefit in older patients and those with hypertension. Cardiorespiratory fitness is a modifiable indicator of long-term mortality, and health care professionals should encourage patients to achieve and maintain high levels of fitness.”

October 19, 2018
Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing
Kyle Mandsager, MD¹; Serge Harb, MD¹; Paul Cremer, MD¹; et al

Peter Attia does a great job of explaining the data in a podcast you can find here. If I give you this soundbite, you will understand the importance of improving VO2 – “If you then go from low to above average, it’s about a 60% or 70% reduction in mortality. If you compare someone of low fitness to elite, it is a five-fold difference in mortality over a decade.”

Muscle Mass And Strength

Both of these factors become increasingly important as you age. Numerous studies show that increased muscle mass can significantly improve longevity. See here and here.

The benefits go beyond reducing frailty and falls. Improved muscle mass also positively affects bone density and reduces the risk of chronic diseases, including heart, type 2 diabetes, arthritis, and osteoporosis. Non-physiological benefits such as better sleep and a lowering tendency to depression can also occur.

Research shows that not just muscle mass provides benefits but also muscle strength. See studies here and here as a jumping-off point for further research. Interestingly, the positive benefits are the same whether quadricep or grip strength is measured.

We must understand that training 2-3 times a week is needed, and it should be consistent. This is a marathon, not a sprint, as evidenced by positive improvements in athletes in their 70s and 80s.

I have been guilty of missing too many strength sessions, and it’s one with fewer excuses than most exercises. You can do an intense workout with zero equipment at home. Use it or lose it. If you don’t use those muscles and use them regularly, the effects will be much more than cosmetic.

Mobility

The apparent benefit of joint mobility and muscle flexibility is the reduced risk of falls. Falling is the leading contributor to death for the 65 and over age group. But it goes deeper than that; as the lower mobility becomes, the more physiological and mental health is adversely affected.

Much of the text frames mobility as a lack of getting around through walking or simple tasks such as standing or sitting. I frame it as joint and muscle mobility and flexibility, as when these decline, overall mobility becomes adversely affected quite quickly.

My experience is that reduced mobility through a period of inactivity increases discomfort from old injuries and where chronic diseases start to rear their heads. The osteoarthritis in my knees is an excellent example of this. Undoubtedly, the range of motion reduces and pain increases after as little as a week of no exercise. My joints need blood flow and synovial fluid movement to operate effectively.

Again I would hasten to add this isn’t exclusively for older people like me. If you’ve ever made an audible sound when sitting in a chair, or rising from it again, think about your mobility. Yes, you know who you are.

Nutrition

Losing Isn’t Easy

The hard part of use it or lose it for me. I know what I should do and have access to the very best in performance nutrition. But bad habits die hard; by this, I mean bad habits that trace back to my childhood. As I mentioned earlier, there is a tendency to be overweight on one side of my familial line, and I certainly have that tendency.

This isn’t helped by me having the sweetest of sweet tooths. I never saw an ice cream I didn’t like. And in my youth, the confectioners of Lancashire built their fortunes on the removal of any money I may have had.

My last full medical was in May this year, and it was overwhelmingly positive, with one exception. “Lose five centimetres from your waist.” Even my body fat was within the acceptable limit for once. But the belly is still there and has stubbornly refused to move. I remember my arsehole of a father mocking me for it at the age of thirteen.

Gut fat is not healthy fat. Much of it is visceral fat, which is more dangerous to health, It’s tough to shift too, and I’m living testament to that. But I can’t have “lose five centimetres” dogging my otherwise clean scorecard.

Diets Don’t Work

Here’s a piece of hard learning. Diets do not work. The only time something worked for me was a calorie restriction regime in my forties that dropped me from 245 pounds to 170 pounds. It probably ended up as an eating disorder, and I looked dreadful.

I have tried them all. Low sugar. Low fat. Ketogenic. High protein. The aforementioned borderline disorder. Intermittent fasting. They can all work for a period, but without exception; they are emotional misery and hard to adhere to. I became a keto warrior at one stage – I love meat, eggs, and bacon; how can this not work? Trust me; you can get tired of any diet. I got very tired of the fanatical attitude of the keto warriors.

These diets rely on calorie restriction, whether you realise it or not. By the time your breath and urine stinks and you can’t stand the sight of another rasher of bacon, it also becomes apparent you are eating less than 2,000 calories a day. As I’ve aged, I have realised that it’s an infernal misery to have a daily diet that revolves around taking something away. A denial of a food group or one of the key pillars of protein, carbohydrate, or fat.

Protein Is Central

If you want to adhere to a use it or lose it approach, then this is a crucial element. A globally-regarded exercise physiologist of my acquaintance, Professor James Morton, tells me that I should consume 2 grams of protein for every kilogram of body weight. That’s 200 grams for me, and that’s a lot of protein. I have been giving it a good tilt recently and am convinced it has been a major part of my recovery from multiple fractures.

Protein should be at the centre of every meal, at least 25 grams of it. And the rest of the plate should be colourful. If your meals look brown or beige too often, then your version of the five centimetres around the waist will likely hang around.

Hitting a good quality protein shake in the morning and a slow-release casein protein at night takes care of 60 grams of the target, and three decent meals should get you to 150 grams. The big weakness I have is the snacks between meals. I’ve trained myself reasonably well to have a couple of low-carb protein bars as snacks during the day, and that gets me to my overall target.

Supplements

Are supplements expensive urine? Possibly. But it won’t stop me from supplementing my diet; if it helps a little, then that’s fine for me. I want to build my foundation on good food, but intelligent supplementation can provide an edge, whether it’s for immune support or to support muscle growth.

My absolute number one supplement is Creatine Monohydrate, which has more positive published research than any other supplement. The evidence is clear that it can help build strength and lean muscle mass and help the athlete recover more quickly. While it is available in protein-rich meat, poultry, and fish, supplementing with a good quality Creatine powder can boost performance.

I use a good quality Collagen powder as my next supplement. It’s a protein, although not a complete protein, but 10% of muscle tissue comprises Collagen. It can help with Creatine synthesis and therefore be a powerful assist to lean muscle-building efforts. In addition, it is a potent ally in keeping your bone and joint health in good shape, and there is credible science to support this supplement. It has a second benefit in helping athletes recover from muscle injuries.

If you are serious about use it or lose it, then Creatine and Collagen must be on your daily supplement list.

My other supplements are high-potency Vitamin D, Vitamin B12, and Vitamin K2. The latter is aimed at cardiovascular health in that it assists in controlling calcium deposits in arteries, something a 2019 scan showed me to have. I throw in a good Multi-Vitamin as a “just in case.”

Stress Management

It seems odd to include stress management in the nutrition section. But if you are suffering from chronic stress, it can upset various hormones and subsequently trigger several diseases. High Cortisol – the stress hormone – can trigger blood sugar and blood pressure, induce systemic inflammation, and disturb sleep. Here’s a good study on the subject.

I take a battery of blood tests twice a year, and until recently, high Cortisol has been my only out of healthy range marker. I embraced a range of mental wellness techniques to help manage my stress. Talking therapy, journaling, daily meditation, and natural sleep aids like Valerian. Just taking the time to slow for a moment and take stock can make a huge difference.

I’m open to new thinking in the mental wellness space and have just started to use a Sensate in conjunction with meditation, given its claim to help regulate the Vagus nerve, which controls both “fight or flight” and “rest and digest” states.

Hell, I carry a Pocket Angel on some days if I’m feeling a little edgy. I put it in the palm of my hand and focus on it when I need to ground myself in a self-aware moment. I’ve had the piss taken out of me for that one, and I would guess the people who did so haven’t faced up to themselves thus far.

Don’t underestimate stress if you are looking to build a solid use it or lose it approach to health. Mind and body are intrinsically linked. And remember, exercise is a great way to shed stress as my 2019 blog outlined.

Use It Or Lose It – Bringing It Together

I’ve thrown a lot of different ideas on the page in this blog about developing a use it or lose it approach to health. But in reality, it’s pretty simple –

• The evidence that exercise is a valuable lifelong pursuit is not for debate. Get out there and walk, run, cycle, lift, or whatever takes your fancy. Keep pushing.
• Take note of my VMM considerations laid out earlier in the blog and build your plan on strength, VO2, and base fitness work
• While it’s not everyone’s go-to, there is no doubt that doing all we can to reduce muscle mass wastage is at the top of the exercise list. You don’t need to be Arnold, but it’s good to have resistance training as a central pillar of your health regime
• Eat more protein. Cut out the sugary snacks, Have a limited list of good supplements to your cleaned-up diet. Make sure that Creatine and Collagen are in there.
• Manage your stress and try to sleep for 7-8 hours.
• More than anything, be consistent.

My 365 Challenge

The photo above features Sir Chris Hoy, another friend who has massively inspired me on my journey. When the pressure is on, Chris invariably tells me, “Trust the process.” And as a six-time Olympic gold medal winner, the advice should be heeded. In the centre, next to me, Lady Velo, aka Jools Walker, a great change maker in UK cycling. And Ross on the right of the photograph.

Ross has authored several books, and my favourite is “Blueprint: Build a Bulletproof Body for Extreme Adventure in 365 Days.” I read it and thought, “if only I were an athlete like Ross, this would be perfect.”

But it has become apparent to me that a 365 plan is not a mad idea but a necessity. The negative changes in my physiology over the last 12 weeks have been scary—loss of muscle mass, the addition of fat, and pain in various joints. The human body is meant to move, so I’m going to move it and move it every day.

Former boxer and now a trainer and television pundit Dave Coldwell has come through for me with personal support over the last three years. He has hammered into me to do something every day. Do one press-up when you get out of bed, preferably do ten. But do something, and it will spark both body and mind into life. It has changed my whole perspective on the day before me more than once.

Returning to my VMM triangle from earlier in the blog. I need to do something for my VO2 each week. I need to prioritise muscle mass over endurance work. And I must remain mobile. Therefore, given Ross and Dave’s philosophies and my learning, it must be possible to craft something.

Travel can get in the way—or fatigue or illness. Or generally not feeling like it. Yet I have never finished any exercise session and thought, “I wish I hadn’t done that.” My endorphins always send me that small tingle of “well done.”

Structuring The Work

I think a week can look like –

• Two days where I do VO2-based work. These don’t have to be long sessions but must bring some intensity to the game. Tuesday morning hot laps with the guys, an interval session on the indoor bike, or a jog on Hampstead Heath with 20kgs in my TRX Weighted Vest.
• Two to three days of strength training. I can do that in any decent gym, either my home facility of Gymbox, or a hotel gym when travelling. Ben Patrick’s body weight ATG sessions will give anyone a good strength session in the absence of either.
• Two days on endurance and mobility. A long weekend ride with the cycling guys at ChainGang Cyclists and a social ride on Friday.
• Mobility sessions can be done before or after any of the above sessions.

You Always Overtrain

Yes I do. I’ve never been much of an athlete but I can drive myself on. And we all know that recovery is vital, and the older we get, the more crucial it becomes. Therefore I need to be sensible. Sometimes the best interval is the one you don’t do. And sometimes, the best rep is the one you leave on the gym floor.

I must unlearn bad habits, and overtraining is one. I miscalculate, for example, how much a set of heavy deadlifts take out of the central nervous system, not to say the muscle fibres. Work hard, but don’t consistently overstress the system. Too much adrenal stress and systemic inflammation will be a blocker.

Enough Of The Chat – Use It Or Lose It

It’s time to crack on. Even though I’m on a beach holiday in Palma, Mallorca, and my recovery is still in progress, 22nd August 2023 is Day 4. I’ve done press-ups and body weight squats and flexibility work in my hotel room. There is no gym nearby, I have no equipment with me, and there are no excuses. There is always a way to get it done.

The body of scientific research underlines the benefits of my approach. I have no desire to live forever, but I do wish to live my life fully for its duration. I’ve seen what chronic illness has done to family and friends, and in all cases, the outcomes could have been affected positively by this adopting this use it or lose it approach.

Final thought? It’s not too early to start. If you are in your forties, I strongly advise you to consider this approach. And it’s never too late to start either; that has been proven too. So what are you waiting for?