What is the best training to prevent muscle loss after age 60?

Strength training is the only non-pharmaceutical approach that demonstrably and consistently improves muscle mass, muscle strength, and muscle power in people over 60. Multiple studies confirm this effect, and the combination of strength training with adequate protein intake is regarded as the cornerstone of the approach to age-related muscle loss (also known as sarcopenia). This is the most strongly supported starting point for anyone who wants to maintain or build muscle mass after age 60.

A randomised study in 70-year-olds with pre-sarcopenia shows that just 10 weeks of supervised strength training leads to an average of 1.1 kg more muscle mass and 0.6 kg less fat mass. Functional strength improved significantly, but the broader functional score (a standardised measure of mobility and balance) improved clearly only in men, not in the group as a whole. This suggests that results can vary from person to person.

For people over 60 who are also overweight and want to lose weight, the combination of both strength and endurance training is the most effective for physical functioning: that group improved 21% on a standardised performance test, compared with 14% for either strength or endurance training alone. An important detail: strength training (with or without endurance training) protected muscle mass during weight loss far better than endurance training alone, with muscle mass declining by only 2 to 3% rather than 5%. Note that musculoskeletal injuries occurred as a side effect in all training groups. When combining only endurance training with weight loss, the risk of muscle mass loss is therefore greater.

For those who find it hard to start training, small, frequent strength training moments spread throughout the day, sometimes called 'exercise snacking', are also beneficial. This approach requires little or no equipment and can improve muscle strength and functional capacity. The supporting evidence is based on a narrative review and is less robust than that for traditional strength training, but it can offer a low-threshold way to get moving. Adding endurance training to strength training is worthwhile, but if you train more than three days per week, too much endurance training can actually inhibit strength development.

Regarding supplementation alongside strength training, creatine is the most extensively studied in older adults. A meta-analysis of randomised studies shows that creatine on top of strength training can further improve upper-body strength in older women, particularly in programmes lasting at least 24 weeks. An effect on muscle mass itself was not demonstrated. A caveat: two of the authors of that meta-analysis have financial ties to the creatine industry, which puts the findings in a somewhat different light. Leucine supplementation and other emerging strategies are promising but still too early in the research pipeline to recommend specifically.