So, my 75-year-old MIL just got her bodyfat tested. At 5'2" and 125 lbs, it's 44%. Her doctor's recommendation is to get her weight between 106-118 lbs; her set-point for many years was about 110 lbs, but she now has osteopenia and almost no muscle mass. I don't think losing pounds is going to help her health.
I'm at a bit of a loss of what to tell her to do (considering the below info).
She lost 45 lbs in 9 months three years ago, after being diagnosed with diabetes and going low-carb, and she's kept it off since - maintained her current weight all this time. She's very good at complying with her diet, her blood sugar is great. She eats until she's full, but doesn't eat much food, and mainly for this reason her diet could surely be more nutrient-dense; but she eats mostly meat and veggies, snacks on nuts and some fruit, doesn't eat low-fat. More 'paleo' than almost anyone else I know.
I can't believe her BF is so high still. She does a lot right. If anyone has an explanation for why this would happen, I'd be curious to know.
She works retail (constant movement) 3-4 days per week and does all her own housework (lives alone in a large 3-bedroom house and cooks every night), so she's pretty active for her age, but I think more structured exercise could help a lot; at least it would build her a little more muscle, even if there was no fat loss. I might try to get her lifting weights/doing bodyweight stuff a couple times per week.
I don't think she'd be down with the 'leptin reset'; she just doesn't eat that much food! I'd be surprised if she got anywhere near 50g protein in an entire day.
If anyone has any other suggestions on how to help her, I'd much appreciate it.
The answer is "sarcopenia", the age-related loss of muscle mass that happens starting around the age of 30 if you don't actively work to preserve your muscle mass.
At 125, your mother-in-law is not overweight, she is "over-fat" because her muscle mass, organs, bones, and other "lean" tissue have deteriorated.
General movement is not going to maintain her lean mass (as evidenced by the fact that it hasn't helped thus far). I recommend starting her on a resistance training program along the lines of that proposed in the book Body by Science. I would also do this as soon as possible because her current level of independence is very much at risk. Without muscle and organ reserves, a single fall, hospital stay, and the resultant imposition of sedentary recovery time would send her health into a downward spiral.
Body by Science is the standard Arthur Jones/Nautilus protocol, but it is suitable for seniors and those who don't want to spend a ton of time in the gym. Basically, all you need is a fitness center that has a at least a leg press, chest press, and lat pull-down/pull-over. Equipment like a shoulder press, seated row, leg extension, leg curl, bicep curl, tricep extension, can be helpful too.
Starting off, she would only really need to do 1-2 sets of 8-12 reps per machine 1-2x per week. Keep the weight low at first just to make sure she is using proper form (slow speed of movement, proper settings to the seat, correct mechanics). You may also want to hire a trainer to work with her for the first few sessions, just make sure that they are on board with the program so that you don't end up with her falling off a BOSU ball.
Her strength should increase fairly rapidly, so you do want to progress the weights in order to keep the rep range around 8-12 (assuming form stays perfect) and you should see her body composition improve after just a few months.
I would also make sure that she is properly hydrated. The sensitivity of the thirst response degrades with age and many seniors are chronically dehydrated with affects all metabolic processes.
How are her metabolic markers? I think this is way more important than if she even has (see comment below Beth's) excess fat. If blood lipids/sugars are good, then her "obesity" is not problematic.
No matter what, I would focus on lean muscle weight gain if that's really the case, and addressing the osteopenia and not worry one wit over fat. At the very least, any approach should be centered on maintaining LBM.
Re: strength training -- excellent perhaps for being more self-sufficient but doubt it will do anything to increase bone mass. I heard interesting interview with biomed researcher Dr.Clinton Rubin (Stony Brook -- developing vibrational plates) on Dr. Ronald Hoffman's podcasts (free at WOR station web site). This guy says that while exercise is great when one has the hormones necessary to build back bone/muscle - the reality is that in those who don't - menopausal and older women and also elderly men -- jarring exercise can accelerate bone loss. He says there appears to be a sweet spot vibration which signals bone increase without undue tear down/stress/risk of other injuries -- all things the elderly are prone to. They are beta testing on seniors now and want this plate designed for home use to be the size of a typical bathroom scale and affordable -- not the multi thousand dollar monsters some gyms have. This was supposed to be available very soon from what I recall. He says you just stand on it for prescribed amount of time per day. This makes much sense to me. So does tanning in the sunlight or low/med intensity tanning beds and maintaining adequate vitamin d levels. High calcium diets; calcium supplements and drugs do not. I personally am going to look into the consumer vibration plates because there is tons of osteoporosis in my Italian side of the family and eating plenty of unpasteurized dairy did not prevent it. Dairy tastes divine but it's a crave maker, can be a fat maker and I don't believe it prevents osteoporosis.
Any grains will keep weight on. certain foods put weight back on, for instance, I am CRAVING banana smoothies right now, however, everytime I eat them i put on about two lbs (for two bananas). wish i could help more, good luck
Hey like you said about people who have small bones and others have medium/large bones. But like you said about this body type, the endomorph body type, you was saying that they don't have big, wide/broad, strong/sturdy bones with high body fat%. I mean ectomorphs have small bones while mesomorphs have medium/large bones. But trully, do most endomorphs really have just medium bones other than large bones? Please explain this to me.
How lean can you get with strict paleo? 9 Answers
Ketosis Ratios and Protein Consumption 3 Answers