Signed up to work one-on-one with trainers, for a six month program (augmenting what I am already doing). I know I need to grow into lifting heavier weight. As part of the intake I had a scan. It confirmed my fears. While my weight (105) is normal, and overall body fat is 22.5% (not great but not too terrible), my metabolic rate is only about 950 – no wonder I gain weight so easily. My grip strength is abysmally low, but I can hold a plank for upwards of 3 minutes. I think of myself as being very catabolic, so much so that I need to get more anabolic, not a thrust that seems to be consistent with extending longevity.
What’s going on, I think, is that I have way too little muscle, and what fat I do have has gone straight to the abdomen (visceral). Have heard this called “skinny fat,” and “sarcobesity.” Apple shaped body tendency --though I am pretty thin overall. Mother and grandmother also apples.
Clearly need to grow more muscle to “reconfigure” . But: just how concerning is it to have such a low metabolic rate? Doesn’t “burning slower” support longer life? (I think of the Edna St Vincent Millay poem: “I burn my candle at both ends/ It will not last the night/ But oh my foes and ah my friends / it gives a lovely light.” Well, this candle might be getting close to sputtering.
Doing more heavy weights should help metabolism. Also planning to start taking imeglimin and reducing metformin, creatine Hcl, pea protein, and even protein gummies. But getting enough protein when you are at about a less than 1000 calories per day burn rate is challenging. Am considering what might be crazy?: a few days fast of consuming nothing but 2 or 3 Fairlife shakes per day (each one has 42 grams of protein and 230 calories: but talk about processed food!) Would appreciate insights, suggestions, pointers (but not whey – cannot do it)
Thanks for sharing your issue. I think a mix (balance) of anabolic & catabolic products are good for health.
Too much of either side can run into various issues. One might be clear of cardiovascular issues or cancer, but end up dying from a fall.
Some ideas for you to consider:
-Get your various hormones blood tested: testosterone, igf1, thyroid - tsh/t4/t3, dhea, estradiol.
You can get medications to fix any of those things if the levels are out of range or low.
Can look into longevity/anti aging clinics or just get your doctor to test them and see if they can help you fix those levels with medications.
Google search all your meds, supplements to see if any are pushing things too catabolic or any other issues. Your best bet might be to get on testosterone replacement therapy for women and see how that goes.
I do see bone medications (bisphosphonates) rated very high on some doctors longevity lists. Some might say those are a more anabolic type of product.
Who knows what other medications might be on those lists one day. Maybe more bone medications like Teriparatide and abaloparatide. Or some other anabolic type hormones.
Keep tracking your daily calories(in) and daily energy spent through actives (out) to make progress.
Get a mix of fats from polyunsaturated, unsaturated, saturated.
Get enough choline, so if you don’t eat eggs, perhaps get a lecithin product. Take a few grams a day along with some omega 3.
Athletes, or people building muscle will usually do higher carb, moderate protein, low fat for the macro % in a meal. But some do various mixes. As long as your protein is around 25% for a meal, you should be good. Some people do 33% carb, 33% fat, 33% protein etc.
Also look into glycogen loading for muscles. You may need some high carb meals. To transport them into the muscles, search that. Will need enough salt (sodium), water, carbs mainly in complex type, and insulin. Hence the higher carb diets.
I don’t see any carbs mentioned in your post. You should post your daily nutrition plan here.
There are some good carbohydrate powders also you can mix in with your pea protein powder.
Will help add some extra calories.
Hope some of that helps.
@Ambient is right, you need to get anabolic and get your hormone levels checked. Constant mtor inhibition never made much sense to me in practice, although episodic mtor inhibition is clearly beneficial.
Why are you fasting? I’m not sure fasting in sarcopenic conditions with a habitually low calorie diet makes much sense. You need some caloric excess to build muscle. You already have a trainer for your weight bearing exercise. Keep up the cardio - habitual caloric deficit will definitely take from your organ tissues (including heart) and bones (CR studies show this clearly). You don’t have to go crazy with food, but have some mild excess (enough good protein) you then burn off with exercise, including cardio. For cardio, you don’t have to go crazy either, but do get your heart rate up - fast walking, some mild jogging, stationary bike is great, you can put it in front of a TV or read a book, or listen to audio books or whatnot. I’d shoot for 70-90 minutes of cardio a day depending on intensity. Work up to it gradually. Start with the Swedish method “fartlek” - you walk for a bit, jog for a spurt, even as short as 100 yards, and weave that for 70-90 minutes, gradually as your conditioning and endurance improve, you can transition to jogging by steadily lengthening the jogging spurts. You can train for grip strength, important for weight lifting. Just do it gradually, ramp up slowly to avoid injuries. Exercise itself is an anabolic signal.
Have to laugh because as a teen we did fartlek intervals on cross country and we joked that it was because it made you fart. As the teenage mind…
But it was interval training back in 1985 when it wasn’t exactly mainstream. We did a fast 400M followed by a slow and then repeat. Or we did hills - up fast and slow down.
I see the challenge, highish body fat and not enough muscle. Testosterone is your friend. On a women above a certain age, it is almost always low. And who defines low at that point? I would say too low to build muscle with any kind or speed or reliability.
You can and should test it but it will be near zero. The right level to shoot for is subject to debate. Maybe as high as you can before side effects? Not 500 high but maybe 100 or 200? I’d shoot at least for a young women which is somewhere around 50 by memory
So many good ideas: thank you. I will look into testosterone. And lecithin.
Getting enough protein is a challenge–for many people, not just me. I no longer want to eat meat --I take leucine, protein gummies, a bit of the Fairlife (it is casein, not whey), goat yogurt and kefir and a soft “protein bar” that I make out of pea protein, almond flour, allulose, MCT oil, nuts and chopped unsulfured apricots. Lots of salmon. But I know I’m not getting nearly enough protein – probably only half (on a good day) of what I need.
Should probably add, while we’re on the subject of “sarcobesity”: I tried Rybelsus (oral semaglutide) – just the 3mg starter dose-- and just for a week or two, every other day. This is not even a therapeutic dose. I wanted to see if I could get blood glucose a little lower. I lost so much weight, so fast, that I developed gallstones. I lost muscle in my shoulders, legs and butt and now I need to work just to get back to where I was before I started the Rybelsus. Seems I am extremely sensitive to interventions.
I did not see any complex carbohydrates in your list.
I don’t know what else you are taking, but you could be taking stuff that makes you excrete sugars (carbs), which might also be hindering your muscle mass.
Loading glycogen into the muscles is one of the key things to do for building muscles & strength.
Insulin is a big player here.
Hopefully you can add more complex carbs into your nutrition plan. Breads, pastas, potatoes, rices, oats, cereals etc are all ideal. With enough fiber also to meals or between meals if possible like Metamucil.
From looking at your list, I see a lot of protein from those foods which is good. But you did not say the amounts of each food listed so perhaps that is why you say not enough protein.
If you are drinking a lot of Fairlife shakes with 42g protein, that’s good. I think some engineered foods can be amazing.
But some issues I’ve seen in people is too much calcium can inhibit iron.
Try to have 1 meal a day that is low in calcium and high in iron with things that can help absorb iron like vitamin c etc.
From Googling it, your Fairlife shake has like 900mg calcium per shake. So, try to also add in bone support supplements with the meal like vitamin D & K, boron, taurine, creatine, etc.
Consider adding some salt (sodium) in pills or directly in the meal.
Having a Fairlife shake (230 calories) with cereal, say 100 calories of whatever you like.
Rice, wheat, corn type cereals. So around 330 cals per meal now.
Could add some mixed nuts for some fats and more calories. Maybe 1/8 of a cup of mixed nuts around 100 cals, 430 cals for the meal.
Could do 2 of those calcium (Fairlife and cereal) meals a day, and 1 iron type meal.
Iron meal might be meat/fish or plant based meat (100-200 cals after it’s cooked) with complex carb: potatoes, rice, pasta etc (100-200 cals), and fats from whatever source you like (100 cals).
So around 3 meals a day at 400 cals per meal is 1200 calories. Something to try to work up to if you can.
Eventually even going higher in calories on those meals in the future.
More recently I have reintroduced day long water only (actually including fruit tea/tisane and some supplements) fasts. It appears that my metabolism has slowed down on non fasting days as well.
I am not worried myself as I am slowly getting stronger (I use an exercise frame every day for chin ups etc). However, I think @Deborah_Hall may find it worth having a period without the fasting simply to build up and then perhaps reinstate fasting later.
Frailty is an issue.
In part I reinstated fasting as an easier way to take my weight down whilst binge drinking 1 - 3 days a week and this morning I have had my lowest weight (at 80.9 kg) since my teens. I also reinstated fasting to increase mitophagy. I am 189cm tall hence my BMI from various online calculators (I have not checked the formulae) is 22.6.
Do you eat other fish than salmon? Nothing wrong with Salmon but variety helps. Our household hits a wall with Salmon intake because of the monotony although I’m sure different recipes would help. My wife finds wild king a bit filling also - dense.
White fish has less fat and so a bit better on protein but mostly because you can eat more volume. I started up with sardines but those are filling also.
I second testosterone from the perspective of a post menopausal female. I’ve been on it 8 months and have found it quite positive. It has made eating less of a chore for me personally. I’m lifting heavier and finally feel like I’m building muscle. I’m due for a repeat dexa so I don’t have hard data to prove anything but at least I’m not expecting disappointing results. (Please excuse any grammatical errors- iirc you were an English teacher).
blsm – thanks for your note. Will look into testosterone. (In fact, I was an English teacher, briefly, before going into industry).
David Cary – re salmon --yes, we are so tired of salmon, week in, week out: we grill it on the Green Egg, make salad out of leftovers and also eat smoked salmon, and sushi, so try to get salmon at least a couple of times a week. I confess that we are so tired of it that our dog also gets her share of salmon. Occasionally we eat tuna or cod, or shrimp in a stir fry.
As an alternative, you can also eat baby calamari. I get them canned at TJ’s, it’s like $4.5 a can. It’s packed with omega 3 especially DHA in bioavaiable form and tons of other goodies. They also are low in pollutants, heavy metals etc., especially the baby calamari.
There’s edamame for you too and Nurra has a delicious shake that tastes like an actual milkshake and comes with 30 g of protein. Two of those a day can cover your bases. Just supplement the rest. These days they even make protein chips, protein pancake mix etc. to switch up the sources.
Deborah, just in case this might be relevant: have you ever looked into how well your pancreas is functioning? When the pancreas isn’t producing enough digestive enzymes (like protease, amylase, and lipase), it can make it harder for the body to properly break down and absorb proteins, fats, and carbs. That malabsorption can contribute to lower muscle mass, slower metabolism, and feeling more catabolic over time – even if you’re eating decent protein.
I’ve noticed that not many doctors routinely check pancreas function. I hope yours does, but if it’s been years since you’ve had any testing, it might be worth mentioning a simple check like fecal elastase, especially if building muscle keeps feeling unusually difficult despite your training and protein intake.
The Hallmark symptom of malabsorption is loose BMs. The pancreas is a pretty decent organ when it comes to producing digestive enzymes as far as reliability. We have extensive backup when it comes to absorbing things. We have about 800cm of small bowel and only need about 100 to live. People with 100 will have malabsorption and loose BMs that need management but they survive.
Fat intake causing loose BMs is pretty reliable if there is pancreatic insufficiency. And lots of people have that with normal pancreatic function. Fat is harder to absorb than protein.
I come at this as someone who was a top prescriber of all 3 pancreatic enzyme replacement.meds. And Gattex which is a short bowel treatment.
Raquel, thank you for your suggestions. My PCP did test and amylase was a little high – 110. My fasting insulin is low. Before starting metformin my glucose was high; now it is about 86 and HA1C is 5.5. I suspect that what I have is “glucokinase mody,” a syndrome in which the beta cells are not sensitive enough to glucose and do not put out adequate insulin. I do have a genetic tendency to obesity (low adiponectin among other things) and T2Diabetes. So, there are two reasons I am starting Imeglimin: first, because it supposedly acts on the beta cells to make them more responsive, and second, because metformin is supposedly a hindrance to development of muscle / response to exercise, would like to see if I can very gradually titrate from at least some of the metformin to the Imeglimin.
Honestly, I think you might be overthinking things. Metabolic rates, leucine intake, hormone levels. Is it not just more likely that you’re a middle-aged slim lady who has low daily calorie intake and has no prior lifting experience? In that case, why would you expect to have significant muscle, a good body composition or strength if you’ve never worked towards it? (Please don’t take that as an attack. My point is that there’s nothing wrong, unusual or unexpected about any of this. Anybody meeting those criteria would be “skinny fat”).
How many pushups can you do? How many pull-ups? If the answer is zero, then you don’t need to worry about anything related to diet or glycogen or testosterone. The way to get better at these things is just by doing them. It’s really simple, and there are studies out there showing that even people aged 70+ make great gains when start to lift weights.
Please, please, please - don’t let your trainer do a bunch of useless stuff. If you have no sort of mobility issues, you should be doing squats, deadlifts, pulldowns, rows etc. Those are the best bang-for-buck in terms of building strength and muscle, shedding the skinny-fat look, and everything else you want. If you can sit on a stool and stand up without using your hands, you can barbell squat in the gym. If you can pick up a box off the floor, you can deadlift. The name of the game is “progressive overload” - every session aim to do a bit more than the last session. More weight on the bar, or some extra reps, or pushing those reps out faster. That’s it. No need to go crazy. No need to do super heavy single reps.
FWIW, my wife has lifted consistently, but only 2x per week, for the last ~15 years and she has totally changed her body composition and metabolism. It’s better now than it was before having kids. She lifted until 8 months pregnant. There’s really nothing stop you, or anybody, from making huge progress. I’m super passionate about this stuff, so let me know if you have any questions.
Thank you Relaxed Meatball, for your post. Although I have been exercising for decades (running, yoga, weights, swimming) I cannot do a single pushup or pull up. I am now working on goblet squats and upper body weights with the trainer and also at home.
And thank you David Cary for your explanation of the relationship between fat absorption, bowels, and pancreatic insufficiency. It helped me understand some of the things I have seen happening lately.
Thank you for your reply and for sharing your experience prescribing pancreatic enzymes. I completely understand that overt malabsorption with loose or fatty stools is the classic sign. However, I wanted to gently mention fecal elastase because, in my own case, I lived with a pancreatic enzyme deficit for decades without any obvious digestive symptoms or steatorrhea. It was only discovered much later, and it was silently affecting my nutrient absorption, energy, and ability to maintain muscle mass.
That’s why I thought it could be worth checking in @Deborah_Hall’s case especially since she has very low grip strength, extremely low RMR, and is struggling to build muscle despite training and protein intake, even without clear gastrointestinal complaints.
In Brazil, the test is actually quite accessible and usually covered by private health plans, so the cost isn’t usually a major barrier.
Would you consider it reasonable to rule it out in a patient with this profile, or do you still see it as low-yield?
