So many patients of mine report that as they get older, it gets harder to maintain a healthy weight. They often state that in their 20s and 30s, it was far easier to stay slimmer than it is in their 40s-60s and beyond.

This is not just excuse-making! Certain metabolic adaptations, including the loss of muscle mass, do make it harder to maintain a healthier weight the older we get.

After our 30s and 40s, a slow, gradual loss of muscle mass occurs in men and women — up to 3-5 percent annually — especially if you are physically inactive.

Without intervention, an 80-year-old could have 30 percent less muscle than a 30-year-old.

This loss of muscle mass is also known as sarcopenia.

In addition, the fat distribution in our bodies is known to change with age. Typically, visceral (abdominal) fat increases. Abdominal obesity is a risk factor for cardiovascular disease, regardless of weight or body mass index.

We are learning more and more that sarcopenia plus worsening abdominal obesity is an especially deadly combination. The British Region Heart Study of 4,200 men found that men with sarcopenia plus abdominal obesity had the highest mortality rates versus just sarcopenia alone or obesity alone.

What can we do?

Here’s what you can do to fight the metabolic shift and keep your body as strong as possible:

>> Exercise is the most powerful intervention in reversing muscle loss and preventing sarcopenia. Progressive strength-training exercises like wall push-ups or assisted slow squats can build muscle in as little as two weeks’ time. If you don’t know where to start, a session with a trainer can help you work out safely and effectively. Remember to always check with your doctor before starting any exercise program.

>> Increase your dietary protein intake. Protein is critical for strength and vitality because it repairs and rebuilds damaged or weak muscle fibers. Most of us don’t get nearly enough protein to meet the minimum daily requirements, but if you have already experienced significant muscle loss, you may require even more protein. Remember, muscle is the engine that burns calories for us, and we need protein to fuel our muscle! Good sources of protein include eggs, fish, tofu and lean meats.

>> Watch for other dietary deficiencies. Low levels of vitamin D are common if you carry excess weight and are associated with low muscle mass. Replacement vitamins can help if you do test low.

>> Limit alcohol. Excessive alcohol consumption on a regular basis (more than one drink for women daily or two drinks for men) can severely damage skeletal muscle.

>> Think about your hormones. Age-related declines in testosterone for men and estrogen in women have been linked to muscle loss. Hormone replacement may be an option, but due to potential side effects and other health concerns, not everyone will benefit. Your doctor can help you understand the pros and cons.

Dr. Linda Anegawa joined the Hawaii Pacific Health 360° Weight Management Center team in 2017. Board certified in both internal and obesity medicines, Anegawa enjoys educating her patients on the lifestyle changes necessary to achieve their goals and maintain lifelong wellness.