Aging: Vegetable Consumption and Exercise May Protect Against Muscle Mass Loss

Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South Interview with:
Yunhwan Lee, MD, DrPH

Director, Institute on Aging
Professor of Preventive Medicine & Public Health
Ajou University School of Medicine
Suwon, South Korea

Dr. Lee wishes to acknowledge Jinhee Kim, PhD, the lead author of the study.

Medical Research: What is the background for this study?

Dr. Lee: We have known for some time that there is a progressive loss of muscle mass with aging, where older people lose on average about 1% of their skeletal muscle mass per year. A decline in muscle mass is serious in that it increases the person’s risk of falls, frailty, disability, and death.

Because there is currently no “cure” for muscle mass loss, prevention is the best strategy. Over the years, researchers have studied various lifestyle factors to identify potentially modifiable behaviors that may prevent or slow the loss of muscle mass. The majority of prior research so far have found that diet, in the form of protein supplementation, and exercise, especially resistance exercise, may confer some benefits.

More recently, the scientific community have begun to pay attention to the positive role of vegetables and fruits intake on the muscle. The role of aerobic exercise on muscle mass is, however, less clear. Also, because people tend to adopt various lifestyles, we were interested in finding out whether those engaging in healthier patterns of diet and exercise retained higher muscle mass. This is why bodybuilders pay such close attention to their diet and make sure their muscle mass is at it’s peak. They can also take supplements like SARMs (see for more information about that) to improve muscle mass but their diet has a massive effect on it too. This is where some of the inspiration for this research came from as we knew what an effect food had on bodybuilders so we wondered how it could effect the elderly.

Using data from a nationally representative sample of older adults, we investigated whether those who had healthier diet and participated in regular exercise, individually and in combination, maintained higher muscle mass. We looked at five healthy lifestyle factors that included dietary intake of three food groups (meat, fish, eggs, legumes; vegetables; and fruits) and participation in two types of exercise (aerobic and resistance).

Medical Research: What are the main findings?

Dr. Lee: More women than men consumed the recommended level of three food groups, including meat products, vegetables, and fruits. In contrast, more men than women engaged in aerobic and resistance exercise. A higher percentage of women (18%) than men (11%) adhered to three or more of these healthy lifestyle factors.

We found that older women who consumed a recommended level of 5 or more vegetables per day were 48% less likely to have low muscle mass than those who consumed less. Women who participated in aerobic exercise of moderate intensity for more than 150 minutes per week or vigorous intensity for more than 75 minutes per week were 38% less likely to experience low muscle mass, compared with those who exercised less.

As to the combined lifestyle factors, those who adopted more number of healthy lifestyle factors were less likely to have low muscle mass. Particularly in women, those who adhered to three or more of the healthy lifestyle factors versus none had 55% lower odds of low muscle mass.

Medical Research: What should clinicians and patients take away from your report?

Dr. Lee: For patients and older people in general, our findings point to the importance of maintaining healthy diet and exercise in late life. It is important to keep in mind that vegetables consumption and aerobic exercise may protect against muscle mass loss.

Clinical professionals need to assess the older person’s lifestyle behaviors to recommend behavior change that might be conducive to preventing decline in muscle mass. Monitoring the older patient for appropriate dietary consumption and encouraging regular exercise may help to lower the risk of muscle mass loss.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Lee: We have to be cautious in implying any causality from the study results, as these were based on a cross-sectional study. Longitudinal data with prospective study design would help to clarify the relationship between healthy lifestyle factors and low muscle mass.

Clinical trials would help to identify individual lifestyle changes that prevent muscle mass loss. A multi-modal approach incorporating multiple healthy lifestyle factors may provide insight into developing effective health promotion programs. In addition, we need more intervention studies that are individually tailored, for example targeting those at high risk of and vulnerable to muscle mass loss, and community-based to be able to recommend preventive strategies to a wider population for higher impact.


Kim, J., Lee, Y., Kye, S., Chung, Y.-S. and Kim, K.-M. (2015), Association Between Healthy Diet and Exercise and Greater Muscle Mass in Older Adults. Journal of the American Geriatrics Society. doi: 10.1111/jgs.13386 Interview with: Yunhwan Lee, MD, DrPH (2015). Aging: Vegetable Consumption and Exercise May Protect Against Muscle Mass Loss