Maintaining health over 45: changes to nutritional needs as you age

As we approach our mid 40s it is often a time for reflection and change and this is great time to review our lifestyles, including diet. Our requirement for nutrients increases as we get older, our innate production of antioxidants such as CoQ10 and glutathione declines, and our ability to assimilate nutrients from our food can reduce due to low digestive capacity. Hence, it is essential to ensure your diet provides optimal levels of all nutrients.

This blog aims to highlight specific areas of wellbeing and nutrition which are important to focus on for the over 45s.

---

Health in your younger years directly impacts your health and longevity into old age. It seems that health, particularly muscle mass, in your 40s is essential for healthy aging and protection from chronic disease. As we approach our mid 40s it is often a time for reflection and change.

For many it can be a time when we begin to experience more freedom, as children become older and more independent, or careers are more stable and fulfilling. However, it can also be a stage where there is additional pressure such as ageing parents, while still having other the responsibilities of work and family. We may also begin to see physical signs of ageing a bit more, such as a few wrinkles, difficulty maintaining a heathy weight, or some joint and muscle niggles.

Whatever the situation, 45 is a great time to give the body and mind some extra TLC to help maintain youthful vitality as we get older and provide support for life’s pressures.

As we approach mid-life our nutritional requirements change, and it is a perfect opportunity to ensure that our bodies are fully nourished.

Below we look at how to stay healthy over 45, with a particular focus on essential nutrients, as well as lifestyle interventions, to support health and protect longevity as we age.

How to stay healthy over 45

Maintain your muscle mass

Muscle is considered by some to be the “Anti-Aging God”. Muscle has been shown to improve insulin sensitivity, reduce inflammation and increase resilience to stress. It is essential for protection against frailty, falls and risk of fracture in old age. At 45, it is an opportune time to focus on building or maintaining muscle.

Loss of muscle, known as sarcopenia, is a major driver of aging and increases other risk factors of ageing.

The pathogenesis of sarcopenia is multifaceted and encompasses lifestyle habits, systemic factors (e.g. chronic inflammation and hormonal alterations), local environment perturbations (e.g. vascular dysfunction), and intramuscular specific processes. A significant association between muscle wasting and mitochondrial dysfunction has been identified.¹ Mitochondria, the energy producing powerhouses of cells, become dysfunctional when oxidative damage, which occurs throughout life, reduces their capacity to perform as effectively as they once did. This results in a reduction of ATP (i.e. energy) within the muscle, lowering activity and performance. It can then eventually result in a reduction of muscle fibres.² Many factors contribute to oxidative stress and mitochondrial dysfunction including inflammation, nutrient deficiencies, medications, smoking and alcohol^.1,3,4

To support the maintenance of muscle mass:

• Eat an anti-inflammatory diet rich in antioxidants, reduce red meat and omega-6 fatty acids found in corn and vegetable oils, increase vegetables, especially dark leafy greens and sources of omega-3 fatty acids (oily fish, flax, chia and hemp seeds)
• Ensure an adequate intake of good quality protein e.g. lean meat, fish, eggs, nuts/seeds, beans/pulses
• Ensure good levels of antioxidants- Including zinc and vitamin C
• Support mitochondrial function with nutrients such as B vitamins, alpha lipoic acid, L-carnitine and CoQ10 (see below for more details)
• Keep active and aim for at least the recommended 150 minutes of exercise per week. Weight bearing exercise is important for maintaining muscle and bone strength.

Support energy production with nutrition

Whilst we may have more freedom to engage in activities some may not have the energy. Perimenopause, reducedmuscle mass and sedentary lifestyles can all contribute to feelingl less vital than in our younger years. Having energy isn’t just important for being able to run about, it is essential for the normal function of all body cells. The health of the powerhouse of the cell, the mitochondria is essential for supporting energy and health as we get older.

Energy production within the cell is reliant on many nutrients including B vitamins, CoQ10, omega-3 fatty acids, iron, copper, and magnesium. Therefore, ensuing optimal intake of all nutrients by bridging the nutrition gap with a good quality multivitamin and mineral is essential.^5,6

During energy production mitochondria produce reactive oxygen species, creating oxidative stress and hence damage. This is where our innate antioxidant systems and nutrients within our own bodies come into play to help to counteract this oxidative damage, these include glutathione, superoxide dismutase, alpha lipoic acid and CoQ10.

As we age levels of these antioxidants decrease and the system can become overwhelmed leading to further damage, mitochondrial dysfunction and chronic disease.

Maintaining adequate intake of antioxidants can be an effective way of helping the body to cope with the aging process.

A daily intake of 6-8 portions of vegetables and 1-3 portions of fruit is important, including a large variety of colours and types is a great way to sustain a varied antioxidant intake.

Mitochondrial homeostasis is preserved by the fine co‐ordination between two opposing processes: generation of new mitochondria, by mitochondrial biogenesis, and the removal of damaged mitochondria, by mitophagy.

Supporting mitochondrial homeostasis is essential for preserving and supporting energy.⁷

Mitochondrial biogenesis induction is associated with activation of transcription factors and enzymes that act on mitochondrial genes and with the up regulation of local translation of mitochondrial proteins to stimulate the production of new mitochondria. These include NRF2, SIRT, AMPK, PGC-1, and PPAR. These are stimulated by natural phytonutrients such as tangeretin, resveratrol, green tea, and spirulina.⁸

Many of the above nutrients can be supplemented but they can also be obtained in the diet. Eating a rainbow diet, providing a rich diversity of plant-based phytonutrients (especially polyphenols) can help obtain some of the above. Tangeritin can be found in citrus fruits, particularly sweet oranges, resveratrol in red grapes and berries as well as red wine, sulforaphane in dark leafy greens and brassica vegetables. Cooking with potent spices such as turmeric and ginger as well as garlic can provide many benefits to mitochondrial biogenesis.

Lifestyle factors have also been shown to stimulate mitochondrial biogenesis and putting the body in a slight, reversible state of stress is beneficial for maintaining mitochondrial homeostasis. These lifestyle factors include:⁹

• Caloric restriction
• Cold exposure
• Exercise
• Meditation
• Fasting

Fasting, in particular, has extensive supporting research for the stimulation of mitochondrial biogenesis⁶:

• Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1alpha) is a fasting-induced transcriptional coactivator that mediates mitochondrial biogenesis, activates when the body receives a signal that it needs more cellular energy, and increases in expression during fasting.^8,10
• Nuclear factor (erythroid-derived) factor 2 (Nrf2) is a transcription factor that regulates ROS production by the mitochondria. Studies suggest that Nrf2 is associated with mitochondrial biogenesis and may be involved in mitochondrial quality control systems. A 2019 study evaluated the impact of Ramadan intermittent fasting on the expression of antioxidant genes, including Nrf2, and results suggested that fasting improved the expression of the antioxidant regulatory genes.¹¹

Intermittent fasting – try to go for 12 hours (overnight) without eating, this significantly reduces insulin levels and therefore helps blood sugar regulation. I.e., do not eat between 7pm and 7am. If you can stretch this to 14 or 16 hours, it can be really beneficial. Other options are 5:2 (only consuming 500 calories on 2 days of the week and eating as normal the other 5 days).

For further information see our blog Time restricted eating | Cytoplan blog with Jeannette Hyde

Support digestive function

Nutritional status can be heavily affected by the health and function of the digestive system. As we get older, we can often see reduced gastric acid output as well as a reduced production of the digestive enzyme pepsin (secreted in the stomach and responsible for the digestion of protein).¹²

Exposure to factors such as Helicobacter pylori infections, smoking and other conditions and medications can all affect acid production by the stomach. Unfortunately, many conditions are treated with proton pump inhibitors which then further reduce gastric acid output.

The consequences of reduced gastric function may be:

• A reduced ability to absorb nutrients, particularly minerals that require stomach acid in order for them to be cleaved from their carrier molecule. It has been established that B12, iron, magnesium, calcium and zinc absorption, in particular, are affected by low hydrochloric acid in the stomach^.13
• Reduced protein digestion (due to low hydrochloric acid and pepsin secretion), therefore means there is a potential for inadequate levels of protein to be absorbed. However, it may also mean that larger protein molecules are present in the small intestine, this can be a trigger for inflammation and leaky gut and is associated with food intolerances, atopic conditions and autoimmune diseases.⁷

Supporting gastric output can be really useful for helping to maintain nutrient status particularly of minerals and B12, as well as aiding full protein digestion which is important for aiding digestion within the small intestine, which helps protect against inflammation and leaky gut.

The composition of our microbiota very much depends on our health and lifestyle when we were younger, but it does tend to change after the age of 40.

It has been shown that a healthy balance of the microbiota is essential for maintaining health as we age and protecting against chronic disease.

The balance of digestive flora can be significantly affected by many aspects of life including living environment, inflammation, diet, stress, health conditions, infections and medications.

“Manipulation of the microbiota and microbiome of older adults holds promise as an innovative strategy to influence the development of comorbidities associated with aging.”¹⁴

Strategies to support stomach function and microbiome balance include:

• Avoiding large amounts of water/fluids with a meal, as it can dilute gastric acid (avoid water 30 minutes before and after a meal)
• Lemon in hot water first thing in the morning can stimulate stomach acid production
• A Betaine HCl and digestive enzyme supplement (containing full spectrum of digestive enzymes, particularly proteases) [not suitable for individuals with certain conditions such as gastritis etc]
• Consuming prebiotic and fermented foods to support the gut microbiome: e.g. miso, kefir, sauerkraut, kombucha, olives, apples, and chicory
• Taking apple cider vinegar with meals. One teaspoon in a little water
• A multi strain live bacteria supplement

Menopause & staying healthy over 45

Perimenopause is the period of time before cessation of menstruation (menopause) when the production of reproductive hormones begins to decline. This can occur for up to ten years before menopause and can begin as early as late 30s, although in most women it will be around the age of 45.

As women enter the menopause, production of oestrogen from the ovaries declines. During this time the adrenal glands will take over and produce small amounts of oestrogen, which can help to alleviate some of the symptoms associated with menopause. Therefore, once menopause begins the adrenals need to work a bit harder.

The adrenal glands are also responsible for the production of stress hormones, cortisol and adrenaline – if stress is a significant factor, then the adrenals will focus on producing stress hormones at the expense of oestrogen and progesterone. Stress management techniques are important as well as providing nutrients which support adrenal function.

These include vitamin B5 (pantothenic acid), vitamin B6 (P5P), vitamin C and magnesium. Adaptogenic herbs are also used to support adrenal function, particularly during perimenopause and beyond, these include: ashwagandha¹⁵, ginseng, Bacopa monnieri,¹⁶ Rhodiola¹⁷ and liquorice.

Oestrogen is involved in the maintenance of bone density.¹⁸ Ensuring there is optimal nutrition for your bones is a great way to help maintain movement, strength and mobility.

Nutrients which are important for bone density may be additionally required including vitamin D3, vitamin K2, magnesium and calcium.⁷ Weight bearing exercise will not only look after your muscles but your bones as well.

Summary

Although exact nutritional requirements for staying healthy over 45 will vary between individuals, it is clear that many factors can increase requirements as we age. Particular consideration should be given to digestive function, supporting muscle mass and providing nutrients to maintain normal energy production.

---

---

References

1. Marzetti E, Calvani R, Cesari M, et al. Mitochondrial dysfunction and sarcopenia of aging: from signaling pathways to clinical trials. Int J Biochem Cell Biol. 2013;45(10):2288-2301. doi:10.1016/J.BIOCEL.2013.06.024

2. Kim Y, Triolo M, Hood DA. Impact of Aging and Exercise on Mitochondrial Quality Control in Skeletal Muscle. Oxid Med Cell Longev. 2017;2017:3165396. doi:10.1155/2017/3165396

3. Iannuzzi-Sucich M, Prestwood KM, Kenny AM. Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci. 2002;57(12). doi:10.1093/GERONA/57.12.M772

4. Rosenberg IH. Sarcopenia: Origins and Clinical Relevance. J Nutr. 1997;127(5):990S-991S. doi:10.1093/JN/127.5.990S

5. Depeint F, Bruce WR, Shangari N, Mehta R, O’Brien PJ. Mitochondrial function and toxicity: role of the B vitamin family on mitochondrial energy metabolism. Chem Biol Interact. 2006;163(1-2):94-112. doi:10.1016/J.CBI.2006.04.014

6. Al-Gubory KH. Mitochondria: omega-3 in the route of mitochondrial reactive oxygen species. Int J Biochem Cell Biol. 2012;44(9):1569-1573. doi:10.1016/J.BIOCEL.2012.06.003

7. Bland J et al. Textbook of Functional Medicine.; 2008.

8. Popov LD. Mitochondrial biogenesis: An update. J Cell Mol Med. 2020;24(9):4892. doi:10.1111/JCMM.15194

9. Popov LD. Mitochondrial biogenesis: An update. J Cell Mol Med. 2020;24(9):4892-4899. doi:10.1111/JCMM.15194

10. Storoschuk KL, Lesiuk D, Nuttall J, et al. Impact of fasting on the AMPK and PGC-1α axis in rodent and human skeletal muscle: A systematic review. Metabolism. 2023;152:155768. doi:10.1016/J.METABOL.2023.155768

11. Madkour MI, T. El-Serafi A, Jahrami HA, et al. Ramadan diurnal intermittent fasting modulates SOD2, TFAM, Nrf2, and sirtuins (SIRT1, SIRT3) gene expressions in subjects with overweight and obesity. Diabetes Res Clin Pract. 2019;155. doi:10.1016/J.DIABRES.2019.107801

12. Feldman M, Cryer B, McArthur KE, Huet BA, Lee E. Effects of aging and gastritis on gastric acid and pepsin secretion in humans: A prospective study. Gastroenterology. 1996;110(4):1043-1052. doi:10.1053/gast.1996.v110.pm8612992

13. Champagne ET. Low gastric hydrochloric acid secretion and mineral bioavailability. Adv Exp Med Biol. 1989;249:173-184. doi:10.1007/978-1-4684-9111-1_12

14. Zapata HJ, Quagliarello VJ. The Microbiota and Microbiomein Aging: Potential Implications in Health and Age-related Diseases. J Am Geriatr Soc. 2015;63(4):776. doi:10.1111/JGS.13310

15. Modi MB, Donga SB, Dei L. Clinical evaluation of Ashokarishta, Ashwagandha Churna and Praval Pishti in the management of menopausal syndrome. Ayu. 2012;33(4):511. doi:10.4103/0974-8520.110529

16. Russo A, Borrelli F. Bacopa monniera, a reputed nootropic plant: An overview. Phytomedicine. 2005;12(4):305-317. doi:10.1016/j.phymed.2003.12.008

17. Anghelescu IG, Edwards D, Seifritz E, Kasper S. Stress management and the role of Rhodiola rosea: a review. Int J Psychiatry Clin Pract. 2018;22(4):242-252. doi:10.1080/13651501.2017.1417442

18. Abdi F, Alimoradi Z, Haqi P, Mahdizad F. Effects of phytoestrogens on bone mineral density during the menopause transition: a systematic review of randomized, controlled trials. Climacteric. 2016;19(6):535-545. doi:10.1080/13697137.2016.1238451

---

All of our blogs are written by our team of expert Nutritional Therapists. If you have questions regarding the topics that have been raised, or any other health matters, please do contact them using the details below:

nutrition@cytoplan.co.uk
01684 310099

Find out what makes Cytoplan different

Last updated on 9th August 2024 by cytoffice