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Maintain the muscle you have: dumbbells and a resistance band on a yoga mat beside a small table with lentils, boiled eggs, milk and water in soft morning light

Build Strength & Fitness

Maintain the Muscle You Have

This page is about keeping the muscle, strength and everyday ability you already have, so that stairs, shopping bags and getting up from a chair stay easy as the years pass. The best-supported steps are simple: some strength work on at least 2 days a week, regular movement, enough protein from food, and quick action to restart after time off.

General information, not medical advice. Last updated October 31, 2026. Written by the AlternativeMed editorial team. Not medically reviewed.

Start here

  • Add muscle-strengthening activity on at least 2 days a week, working the legs, hips, back, abdomen, chest, shoulders and arms. The NHS says to do each activity until you need a short rest before repeating it, and lifting weights, resistance bands, body-weight moves and heavy gardening all count.
  • Keep moving through the week and break up long sitting. The NHS advises 150 minutes of moderate activity a week alongside the strength work, and the WHO says any amount of activity is better than none.
  • Check that you eat protein regularly rather than only at one meal, and see a doctor or dietitian if your appetite has dropped or you are losing weight without trying.

Be careful with

  • If you have not exercised for some time, or you have a heart condition, high blood pressure, diabetes, joint problems or another medical condition, the NHS says to speak to your GP first and match the activity to your fitness.
  • Build up slowly. Mild muscle soreness after new exercise is common; sharp pain, dark urine or sudden weakness is not (see the warning signs below).
  • Muscle-building drugs and hormones such as anabolic steroids and SARMs are risky and not a way to keep muscle. We rate them against, and this page gives no instructions for them.
  • Do not use this page to decide to stop or change any medicine. Talk to the prescriber first.

Get help when

  • Stop exercising and get urgent medical care for chest pain or pressure, fainting, severe breathlessness or new palpitations during activity.
  • Seek prompt medical advice if you pass dark, red or cola-coloured urine, pass much less urine, or have severe muscle pain, tenderness and weakness after hard exercise. MedlinePlus lists these as symptoms of rhabdomyolysis, a muscle breakdown that can damage the kidneys.
  • See a doctor if weakness is new or getting worse, if you find it harder to stand up from a chair or climb stairs, if you have fallen, or if you are losing weight or muscle without trying. These changes have many possible causes and need checking, not guessing.
  • Get help for any fear of eating, rigid food or exercise rules, or exercising to the point of injury or distress. This can be a sign of disordered eating or exercise compulsion, and professional support is available.

About Maintain the Muscle You Have

What this goal means

Maintaining muscle means holding on to the muscle mass, strength and physical function you have now, rather than trying to build a lot more. It is the goal for many adults: people whose strength is fine today and who want it to last, people in midlife who notice they are less strong than they were, and older adults who want to stay independent.

Muscle is more than appearance. It helps you stand up, walk, carry things, climb stairs and catch yourself if you stumble. The NIA says exercise may offer protection against age-related loss of muscle mass, strength and function (called sarcopenia), and that improved physical function makes everyday tasks easier and supports independent living.

1

Common experiences

People often notice muscle changes as small things: getting up from a low chair takes more effort, a bag of shopping feels heavier, jar lids are harder, or walking up stairs leaves your legs tired. These changes have many possible causes, including less activity, illness, low food intake, some medicines and health conditions, so they are worth mentioning to a clinician rather than assuming they are just age.

2

What contributes to muscle loss

The European consensus on sarcopenia describes it as a muscle disease rooted in adverse muscle changes that build up across a lifetime. It is common in older age but can also occur earlier in life. That is why the habits on this page matter at any age, not only after 65.

Short periods of not using a muscle also cost muscle. A systematic review of studies with 4 to 14 days of bed rest, a brace or a cast found muscle mass fell by roughly 0.19 to 0.76 percent a day in older adults and 0.06 to 0.70 percent a day in younger adults, and could not show that older people lose muscle faster. The studies were few and inconsistent, but the lesson is the same: illness, injury and long periods of sitting or bed rest are times to protect your muscle and restart movement early, with medical guidance.

2,3

Conditions that are relevant

Sarcopenia is the age-related loss of muscle mass, strength and function, and a clinician makes the diagnosis. A global review of 151 studies (692,056 people, average age 68.5) found prevalence ranged from about 10 to 27 percent depending on which definition was used, which shows how much the answer depends on how it is measured. Frailty, osteoporosis, falls, long-term illness, kidney disease and eating disorders also affect muscle. Each has its own page.

4,2

Realistic expectations

Maintaining is a realistic and valuable goal. In older adults, a review of 151 randomised trials (6,306 people) found that even low-volume resistance training improved physical function and lean mass and muscle size, while higher volumes seemed needed for bigger strength gains. A Cochrane review of 121 trials found progressive resistance training had a large positive effect on muscle strength in older people.

These are group averages from supervised programmes, mostly in healthy older adults. Evidence was limited for people who are physically impaired. Results vary from person to person, and keeping muscle depends on continuing the habit.

5,6

Who it applies to

Anyone who wants to keep their strength: adults from their 30s and 40s onwards, people who sit a lot for work, people recovering from illness, people losing weight, and older adults. If your goal is to add a lot of muscle, see Build Muscle Mass. If your goal is gaining strength from a low starting point, see Build Muscle Strength. If you are dieting, see Preserve Muscle While Losing Weight.

Related conditions and symptoms

Sarcopenia and muscle loss with age → Frailty → Eating disorders and disordered eating → Falls and balance problems →

A manageable starting plan

An educational starting point, not a personal prescription. Adjust it to your own situation and any advice from your clinician.

Your first actions

  • Strength work on at least 2 days a week, covering all the major muscle groups.
  • Move every day and break up long sitting.
  • Protein foods at each meal; see a clinician if you are losing weight without trying.
  • If you are ill, injured or resting, ask what movement is safe and restart early.

Optional additions

  • Add aerobic activity toward 150 minutes of moderate activity a week.
  • Discuss creatine or vitamin D with a clinician if you have a reason.
  • Join a class or find a training partner.
  • Ask a physiotherapist for a plan if you have joint problems.

What to track

  • How many strength sessions you completed each week.
  • Simple function: how easily you stand from a chair, climb stairs or carry shopping.
  • Your usual protein foods across the day.
  • Any soreness, pain or unexplained weight change.

When to reassess

Check in after 8 to 12 weeks. If you are managing 2 strength sessions a week, do the same task more easily, and feel well, keep going. If you are stuck, in pain, weaker, or losing weight without trying, speak to a GP or physiotherapist. Review the plan after illness, surgery or a change of medicine.

When to seek professional support

  • GP or practice nurse for weakness, weight loss or medical conditions.
  • Physiotherapist for a safe progressive programme.
  • Registered dietitian for protein and energy needs.
  • Local classes or community groups.

What helps

Ordered by how well the research supports each step. Evidence strength is shown on every card; precautions sit next to the advice.

Start here

Strength training on at least 2 days a week

High certainty

Addresses: Helps hold on to muscle strength and everyday function

Why it may help: The NHS guidelines for adults and for people over 65 both advise muscle-strengthening activity on at least 2 days a week, working all the major muscle groups. A Cochrane review of 121 trials (6,700 people, in most trials training 2 to 3 times a week at high intensity) found progressive resistance training had a large positive effect on muscle strength in older people (73 trials, 3,059 people, SMD 0.84) and improved getting out of a chair. In a network meta-analysis of 151 trials, low-volume training improved physical function, lean mass and muscle size, while moderate and high volumes were better for lower-limb strength.

How to apply it: Choose 6 to 8 simple moves that cover legs, hips, back, chest, shoulders, arms and trunk (for example sit-to-stand, squats to a chair, wall or floor press-ups, rows with a band or bag, heel raises). Do each until you need a short rest, and add a little over time. The NHS strength exercises page shows gentle starter moves.

Who it may suit: Most adults, including those who have not trained before, with a doctor's advice if you have medical conditions.

Precautions: Soreness and joint pain were commonly reported in trials that tracked them; serious events were rare but poorly recorded, and the Cochrane authors urged caution applying results to people with illness. Learn good technique, start light, and ask a GP first if you have heart disease, high blood pressure, diabetes or joint problems.

7,8,9,6,5

Build Muscle Strength → Build Muscle Mass → Start Exercising With Confidence →

A little regular movement every day

High certainty

Addresses: Keeps muscles used to work and breaks up long sitting

Why it may help: The NHS advises being active every day, doing 150 minutes of moderate activity a week (or 75 minutes of vigorous) alongside strengthening, and breaking up long periods of sitting. The WHO guidelines say any amount of physical activity is better than none, all physical activity counts, and muscle strengthening benefits everyone. The NIA says older adults can benefit from aerobic, muscle-strengthening and balance exercise, and that household tasks can count.

How to apply it: Walk, cycle, swim, dance, garden or do chores at a pace where you can talk but not sing. Stand up and move for a few minutes after long sitting.

Who it may suit: Almost everyone; scale the amount to your fitness.

Precautions: Speak to your GP first if you have not exercised for some time or have medical conditions.

7,8,10,1,11

Sit Less & Move More → Improve Your Cardiovascular Fitness → Stay Active Throughout Your Life →

Regular protein from food

Moderate certainty

Addresses: Supports the raw material for muscle, especially when you also train

Why it may help: The PROT-AGE expert group recommends that people over 65 average at least 1.0 to 1.2 g of protein per kg of body weight a day, and at least 1.2 g/kg for those who exercise, with more for many people who have acute or chronic illness. A 74-trial meta-analysis in healthy adults who were increasing protein found small extra gains in lean mass in people doing resistance training; the effect was significant at 1.2 to 1.59 g/kg/day for people 65 and over and at 1.6 g/kg/day or more for younger adults. Some authors report ties to food and supplement companies. We read this as protein supporting training, not replacing it.

How to apply it: Include a protein food at each meal, such as eggs, fish, poultry, lean meat, dairy, tofu, beans, lentils or nuts. A dietitian can help you estimate your own needs.

Who it may suit: Most adults; especially people over 65, people training, and people recovering from illness.

Precautions: PROT-AGE notes that people with severe kidney disease (not on dialysis) may need to limit protein, so ask your kidney doctor before raising intake. Pregnancy, breastfeeding and children have their own needs.

12,13

Protein and muscle loss with age → Protein, kidney disease and dialysis → Build Muscle Strength →

Additional options

Mix strength work with some aerobic activity

Moderate certainty

Addresses: Keeps muscle while also looking after your heart, lungs and stamina

Why it may help: In a network meta-analysis of 59 trials in people with sarcopenia, mixed exercise (aerobic plus resistance) ranked best for increasing muscle mass and among the top three for strength and physical performance. In healthy adults, a meta-analysis of 43 studies found adding aerobic training to strength training did not reduce gains in maximal strength or muscle size, though explosive strength was slightly lower, especially when both were done in the same session.

How to apply it: Walk briskly or cycle on some days and do strength work on 2 or more days. Done in the same session, do the strength work first if keeping strength is the priority.

Who it may suit: Most adults who want both fitness and strength.

Precautions: Listen to fatigue. If you are recovering from illness or have a heart condition, ask your clinician how to build up.

14,15

Improve Your Cardiovascular Fitness → Improve Your Endurance → Improve Your Everyday Stamina →

Restart movement soon after illness or time off

Low certainty

Addresses: Limits how much muscle is lost during a break

Why it may help: Muscle can be lost quickly when it is not used: in studies of 4 to 14 days of bed rest or immobilisation, daily losses of muscle mass of up to about 0.76 percent were reported in older adults, with no clear sign that older people lose faster than younger ones. Protein or amino acid supplements did not clearly stop the loss in a meta-analysis of 9 articles from 8 trials, so moving, where medically allowed, matters more than a supplement.

How to apply it: Ask your doctor or physiotherapist what you can do while resting (even small movements and chair-based moves) and how to build back up. Start well below your previous level.

Who it may suit: Anyone after illness, injury, surgery or a long break.

Precautions: Follow medical advice after injury or surgery. Do not exercise through chest pain, fever or unexplained pain.

3,16

Return to Exercise After a Break → Return to Your Routine After Illness → Recovery after exercise →

Enough food overall

Low certainty

Addresses: Gives your body energy so it does not draw heavily on muscle

Why it may help: Protein advice for older adults (PROT-AGE) is framed around overall intake as well as exercise. We did not find a trial that tests simply eating more to keep muscle in healthy adults, so this rests on expert guidance and on the sarcopenia consensus that muscle loss is influenced by lifestyle across life.

How to apply it: Eat regular meals. If your appetite is poor or you are losing weight without trying, speak to a GP.

Who it may suit: People with a small appetite, older adults, and people recovering from illness.

Precautions: Unintended weight loss needs a medical check, not self-treatment.

12,2

Appetite and weight loss in older adults → Gain Weight Safely →

Still being studied

Creatine plus resistance training

Moderate certainty

Addresses: Small extra gains in lean mass and strength on top of training

Why it may help: A 2014 meta-analysis of older adults (357 people) found creatine plus resistance training gave more fat-free mass and some strength gains than training alone. A 2021 meta-analysis again found creatine added to the gains from resistance training in older adults, with a lot of variation between studies, and found creatine taken only on training days also worked. The International Society of Sports Nutrition position stand says short and long-term creatine is safe and well tolerated in healthy people.

How to apply it: It only makes sense alongside regular strength training. Ask a doctor or pharmacist before starting; we do not give a dose here.

Who it may suit: Older adults who already train and want to discuss a supplement.

Precautions: Ask first if you have kidney disease or take medicines regularly. Creatine is not a substitute for training. Read the safety conclusions as healthy-adult data.

17,18,19

Creatine → Collagen and creatine → Supplements for healthy aging →

Whey and other protein supplements

Low certainty

Addresses: Small gains, mostly when protein intake from food is low

Why it may help: A meta-analysis of 49 trials in healthy adults found protein supplements added small gains in strength and fat-free mass on top of resistance training, and the benefit was smaller with increasing age. A 74-trial review reached a similar small-gain conclusion. We found no evidence that a powder is needed if you eat enough protein foods.

How to apply it: Food first; a supplement is a convenience if you cannot eat enough protein.

Who it may suit: People who struggle to reach their protein needs with food.

Precautions: Check labels, allergens (milk, soy) and kidney disease advice. Ask a clinician if powders upset your digestion.

20,13

Whey protein → Protein and muscle loss with age →

Vitamin D

Mixed findings

Addresses: May help balance and mobility in older adults, but a clear muscle-strength benefit was not shown

Why it may help: A meta-analysis of 13 trials in adults 60 and over found vitamin D supplementation modestly reduced postural sway and timed up-and-go time, but the pooled effect on lower-limb strength was close to zero (SMD 0.05, CI -0.11 to 0.20). The NHS says vitamin D helps keep bones, teeth and muscles healthy and advises 10 micrograms a day for adults, with everyone considering a supplement in autumn and winter.

How to apply it: Follow national guidance for your country and talk to a clinician about testing if you are at risk of low vitamin D.

Who it may suit: People at risk of low vitamin D, such as those with little sun exposure.

Precautions: Taking more is not better: high doses can be harmful, so keep to the amounts a clinician or national guidance names.

21,22

Vitamin D → Build Stronger Bones →

Collagen peptides plus training

Very low certainty

Addresses: Possible small extra gain in one small trial

Why it may help: One 12-week randomised trial in 53 men with sarcopenia (average age about 72) reported more fat-free mass and strength gain with collagen peptides plus resistance training than with placebo. Some authors were affiliated with a collagen research company. We did not find larger independent trials.

How to apply it: Not recommended over protein foods and training.

Who it may suit: Not established.

Precautions: Collagen products can come from fish, shellfish, egg or beef sources, so check for allergy.

23

Collagen for muscle mass, strength and sarcopenia →

HMB

Low certainty

Addresses: Little or no added benefit to exercise in older adults

Why it may help: A meta-analysis of 10 randomised trials (384 people, aged 50 to 80) found HMB added to exercise had no or fairly low impact on body composition, muscle strength or physical performance compared with exercise alone.

How to apply it: Not needed for maintaining muscle on current evidence.

Who it may suit: Not established.

Precautions: Ask a clinician before using any supplement if you take regular medicines.

24

Supplements for healthy aging →

Food & nutrition

Protein foods across the day

PROT-AGE advises that people over 65 average at least 1.0 to 1.2 g of protein per kilogram of body weight a day, and at least 1.2 g/kg if exercising, with more for people with many illnesses. The group concluded the evidence on protein quality and timing is not yet strong enough to support specific recommendations. Eating protein foods through the day is a sensible, practical approach.

  • Eggs, fish, poultry and lean meat
  • Milk, yoghurt, cheese and fortified plant alternatives
  • Beans, lentils, chickpeas, tofu and tempeh
  • Nuts and seeds as extras
12,13

Vitamin D, sunlight and bone-supporting foods

The NHS says vitamin D helps keep bones, teeth and muscles healthy. Sources include oily fish, red meat, egg yolks and fortified foods, and from about late March to September most people can make enough from sunlight. The NHS advises everyone to consider a daily 10 microgram supplement in autumn and winter, and all-year supplements for people at higher risk.

  • Oily fish
  • Eggs
  • Fortified foods
  • Safe sun exposure in spring and summer
22

What we did not find

We did not find trials proving that a specific whole food, juice or superfood protects muscle on its own. Food matters mainly through enough energy and protein, together with training.

12

Remedies & supplements

Traditional use, laboratory findings and human trials are kept apart. "Natural" does not mean safe.

Creatine monohydrate (with strength training)

Moderate certainty

Studied form and route: Powder or capsules taken alongside a resistance programme

Intended outcome: Small extra gains in lean mass and strength in older adults who train

Human evidence: A 2014 meta-analysis of older adults (357 people) and a 2021 meta-analysis both found creatine plus resistance training beat resistance training alone, with a lot of variation between studies. The ISSN position stand says long-term use is safe and well tolerated in healthy individuals.

Limits: Benefit depends on training. Study quality and dosing vary. It is not a treatment for sarcopenia by itself.

Interactions and precautions: Ask a doctor first if you have kidney disease, take regular medicines, are pregnant or breastfeeding, or are under 18. We do not give a dose.

17,18,19

Whey or other protein powder

Low certainty

Studied form and route: Powder or ready-to-drink shake

Intended outcome: Convenient protein when food intake is low

Human evidence: Small gains on top of resistance training in healthy adults, smaller with age.

Limits: Not required if you eat enough protein foods.

Interactions and precautions: Allergy to milk or soy, kidney disease and digestive upset are reasons to ask first.

20,13

Vitamin D (when you are low or at risk)

Mixed findings

Studied form and route: Supplement or sunlight

Intended outcome: Supports bone and muscle health and may help balance

Human evidence: A 13-trial meta-analysis found modest improvements in sway and timed up-and-go, and no clear change in lower-limb strength.

Limits: Does not replace strength training. Older trials.

Interactions and precautions: High doses can be harmful; follow national guidance (the NHS names 10 micrograms a day for adults in autumn and winter).

21,22

Therapies & care

Professional help can tailor a safe plan, especially after illness, injury, surgery or a fall. A GP can check for causes of weakness or unexplained weight loss. This page does not replace that care, and we do not recommend changing any medicine.

Physiotherapy

Moderate certainty

Professional exercise guidance A physiotherapist can assess strength, balance and joint problems, and design a progressive resistance programme for you. Supervised resistance training is what most of the trials we read tested.

Who it may suit: People with injuries, joint problems, long-term illness, a recent fall or low confidence.

Precautions: Share your full medical history and medicines.

6,8

Falls and balance problems → Improve Your Balance →

Dietitian support

Low certainty

Professional nutrition guidance A registered dietitian can work out realistic protein and energy goals, especially for small appetites, illness, vegetarian diets or kidney disease.

Who it may suit: Older adults, people with poor appetite or medical conditions.

Precautions: Protein limits may apply in severe kidney disease.

12

Protein, kidney disease and dialysis →

Group classes and community programmes

Low certainty

Social exercise The NIA notes that older adults who exercise with others get added social connection. Classes can also make a routine easier to keep.

Who it may suit: People who like company or need structure.

Precautions: Tell the instructor about any health condition.

1

Build a Consistent Exercise Routine →

Medical review for muscle weakness

Moderate certainty

Clinical assessment A clinician can check for causes of weakness, review medicines, and decide whether sarcopenia needs formal assessment using a consensus definition such as EWGSOP2.

Who it may suit: People with new or worsening weakness, falls or unintended weight loss.

Precautions: Do not stop prescribed medicines without advice.

2

Sarcopenia and muscle loss with age → Frailty →

What to avoid

Habits, products and claims that can get in the way. Never stop a prescribed medicine without talking to the professional who prescribed it.

Risks that apply to most people

Long, unbroken periods of sitting or bed rest when you do not need them

Moderate certainty

Why: Muscle mass fell by up to about 0.76 percent a day in older adults in studies of 4 to 14 days of immobilisation or bed rest. The NHS advises breaking up long periods of sitting.

Who it applies to: Anyone, especially during illness or recovery.

Try instead: Ask your clinician which movement is safe, and get up and move often.

3,7

Sit Less & Move More → Return to Your Routine After Illness →

Skipping strength work and relying only on walking or cardio

Moderate certainty

Why: The NHS says muscle-strengthening exercises are not always aerobic and need to be done in addition to the 150 minutes of aerobic activity. Aerobic activity alone is not the strength work the guidelines call for.

Who it applies to: Adults who walk or cycle but do no strength work.

Try instead: Add 2 short strength sessions a week.

7,8

Personal triggers to check

Unplanned weight loss or very low food intake

Low certainty

Why: Losing weight without trying can mean losing muscle and may signal a health problem. PROT-AGE notes that illness raises protein needs.

Who it applies to: Older adults, people with illness or poor appetite.

Try instead: See a GP or dietitian and do not self-diagnose.

12

Appetite and weight loss in older adults →

Crash diets and strict calorie cutting without strength work

Moderate certainty

Why: Dieting can reduce muscle along with fat; the page on preserving muscle while losing weight covers the evidence in full.

Who it applies to: People losing weight.

Try instead: Follow a gradual approach with strength training and protein foods.

7

Preserve Muscle While Losing Weight → Lose Weight Sustainably →

Hard exercise after a long break

Low certainty

Why: MedlinePlus lists severe exertion as a cause of rhabdomyolysis and advises plenty of fluids after strenuous exercise.

Who it applies to: People returning after time off, and people doing very intense workouts.

Try instead: Restart well below your old level, build up gradually, and drink enough.

25

Return to Exercise After a Break →

Products that need caution

Anabolic steroids, SARMs and "muscle-building" prohormone products

Evidence against

Why: Anabolic-androgenic steroids can cause acne, high blood pressure, liver damage, abnormal blood fats, low testosterone, erectile dysfunction and heart muscle disease. A review of suspected cases found reports of drug-induced liver injury with SARMs, that no SARM has been approved by the FDA or European Medicines Agency, and that product contents are poorly controlled. They can also lead to doping-control problems in sport.

Who it applies to: Anyone tempted by muscle-building products.

Try instead: Use training, food and time. If you are using these already, talk to a doctor confidentially.

26,27

Pre-workout stimulant blends and fat-burners marketed as protecting muscle

Not enough evidence

Why: We did not find human trials showing these protect muscle. The weight-loss supplements page rates fat-burner claims.

Who it applies to: Anyone with a heart condition, high blood pressure, pregnancy or regular medicines should ask a clinician before using any product.

Try instead: Spend on food, a simple training plan and sleep.

7

Weight-loss supplements and fat burners →

Unsupported claims

"Muscle loss with age is unavoidable"

Evidence against

Why: The sarcopenia consensus describes muscle changes as accruing across a lifetime and influenced by lifestyle, and trials show resistance training improves strength in older people. Not everything can be prevented, but training clearly helps.

Who it applies to: Adults of any age.

Try instead: Treat strength training as routine maintenance.

2,6

"You need protein powder to keep your muscle"

Evidence against

Why: Protein supplements added only small gains in healthy adults, and benefit was smaller with age. Protein foods and training do the heavy lifting.

Who it applies to: People thinking about buying protein powder.

Try instead: Check your protein foods first.

20,13

Whey protein →

"Protein shakes stop muscle wasting when you are resting in bed"

Low certainty

Why: A meta-analysis found protein or amino acid provision did not clearly prevent muscle loss during bed rest or immobilisation.

Who it applies to: People who are ill, injured or recovering.

Try instead: Ask your care team about safe movement and about nutrition.

16

"Supplements can replace exercise"

Evidence against

Why: In the sarcopenia trials we read, supplements were studied as add-ons to resistance training, not replacements for it.

Who it applies to: Anyone worried about muscle loss.

Try instead: Train first; talk about supplements second.

14,17

Common mistakes

Training through warning signs

Low certainty

Why: Chest pain, fainting, severe breathlessness or dark urine with severe muscle pain are reasons to stop and seek care.

Who it applies to: Everyone.

Try instead: Stop and get medical advice.

25,7

Letting exercise rules or food rules take over

Low certainty

Why: Rigid exercise or eating rules, or exercising despite injury, can signal an eating disorder or exercise compulsion.

Who it applies to: Anyone who feels anxious or guilty when they skip a session or a meal.

Try instead: Talk to a doctor or eating-disorder service.

Eating disorders and disordered eating →

Evidence & safety

What the research shows

The strongest evidence is for resistance training: reviews of randomised trials show it improves muscle strength and physical function in older adults, and even low volumes help lean mass and function. Aerobic activity mixed with strength work looks complementary. Protein supports training, with small added benefit from supplements. Creatine adds a small gain to training in older adults, while vitamin D, collagen and HMB are weak or mixed. Most trials are short, in healthy people, and measure lean mass rather than muscle itself, so long-term maintenance over years is less well tested.

Limits of the evidence

  • Many trials are short, often 12 weeks or so, and in supervised settings, so they say less about decades of maintenance.
  • Most participants were healthy older adults; evidence is limited for people who are physically impaired, and few trials were in women or in midlife.
  • Lean mass or fat-free mass is used as a stand-in for muscle in many studies.
  • Several supplement reviews include authors with industry ties or heterogeneous doses, and adverse events were poorly recorded.
  • We did not find large trials that directly test maintaining muscle in healthy middle-aged adults over many years.

Precautions and interactions

  • Check with a GP before starting if you have heart disease, high blood pressure, diabetes, joint problems or have been inactive.
  • Kidney disease may require limits on protein and creatine advice from a specialist.
  • Anabolic steroids and SARMs carry serious risks and we rate them against.
  • Never stop or change a prescribed medicine without talking to the prescriber.

Life-stage considerations

  • Midlife adults: the same habits apply, and starting earlier is easier; we found few midlife trials.
  • Older adults: the PROT-AGE protein advice and NHS guidance for over 65s apply; strength, balance and flexibility work are advised on at least 2 days a week.
  • Pregnancy and postpartum: the NHS says the adult guidelines are suitable and strength training should be included, and to match your pre-pregnancy activity level; see a midwife or GP and avoid supplement use without advice.
  • Under 18s and people with an eating-disorder history need clinician or specialist guidance before training or supplement plans.

Warning signs

  • Chest pain, fainting, severe breathlessness or new palpitations during activity.
  • Dark, red or cola-coloured urine, much less urine, or severe muscle pain and weakness after exercise.
  • New or worsening weakness, falls, or difficulty standing from a chair.
  • Unintended weight loss.
  • Signs of disordered eating or compulsive exercise.

Claim checks

Strength training helps older adults keep muscle strength and function

High certainty

Supported. A Cochrane review of 121 trials found a large effect on strength, and a 151-trial network meta-analysis found even low-volume training helped lean mass and function in healthy older adults.

6,5

Protein powder is needed to keep muscle

Moderate certainty

Not supported. Supplements added small gains in healthy adults, less with age; food protein is the base.

20,13

Creatine helps older adults who strength train

Moderate certainty

Partly supported. Meta-analyses show small extra gains in lean mass and strength; study quality varies.

17,18

Vitamin D builds muscle strength

Mixed findings

Mixed. A 13-trial meta-analysis found modest balance gains but near-zero pooled strength effect.

21

Older people lose muscle faster than younger people when immobilised

Low certainty

Not shown. A systematic review found no clear difference, though studies were inconsistent and few.

3

Steroids or SARMs are a safe way to keep muscle

Evidence against

Against. Steroids have serious side effects and SARMs have been linked to liver injury and are not approved.

26,27

Questions people ask

How much strength work do I need to keep my muscle?

The NHS advises strengthening activity on at least 2 days a week for adults and for people over 65. In one network meta-analysis of older adults, even low-volume programmes improved function and lean mass, with higher volume needed for greater strength gains.

Is walking enough to maintain muscle?

Walking is valuable for your heart and stamina, but the NHS says muscle-strengthening activity is needed in addition to your aerobic activity.

How much protein do I need?

PROT-AGE suggests at least 1.0 to 1.2 g per kg of body weight a day for people over 65, and at least 1.2 g/kg if exercising, with exceptions such as severe kidney disease. A dietitian can tailor this.

Do I need a protein supplement?

Not if you eat enough protein foods. Supplements added only small gains in trials, and less in older adults.

Is creatine safe and does it help?

Meta-analyses show creatine plus resistance training gives small extra gains in older adults, and the ISSN position stand says it is safe in healthy people. Ask a doctor first if you have kidney disease or take medicines.

Does muscle loss start in midlife?

The sarcopenia consensus says it is most common in older age but can occur earlier. We did not find reliable numbers for the age it starts in healthy people, so we do not quote one.

Can I keep muscle while I am ill or injured?

Muscle can be lost quickly with bed rest or immobilisation, and protein alone did not prevent it in one review. Ask your care team what movement is safe and restart gradually.

Do vitamin D supplements keep muscle?

A meta-analysis found small gains in balance but no clear strength gain. The NHS advises 10 micrograms a day in autumn and winter for adults.

Are steroids or SARMs ever okay?

No. They carry serious health risks and can cause doping-control problems in sport. Talk to a doctor if you are already using them.

What should I do if I think I am losing muscle?

See a GP. Weakness or weight loss can have many causes, and a clinician can check for them and decide whether sarcopenia needs assessment.

How does this page differ from Build Muscle Strength and Build Muscle Mass?

This page is about holding on to what you have. Build Muscle Strength and Build Muscle Mass cover gaining strength and size, and Preserve Muscle While Losing Weight covers dieting.

References

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  3. Hodgson H et al. Older adults are not more susceptible to acute muscle atrophy after immobilisation compared to younger adults: a systematic review. Eur J Trauma Emerg Surg 2022. PMID 34081160. source
  4. Petermann-Rocha F et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2022. PMID 34816624. source
  5. Radaelli R et al. Effects of resistance training volume on physical function, lean body mass and lower-body muscle hypertrophy and strength in older adults: a systematic review and network meta-analysis of 151 randomised trials. Sports Med 2025. PMID 39405023. source
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  9. NHS. Strength exercises (last reviewed 28 February 2024). Read 2026-10-31. source
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  19. Kreider RB et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 2017. PMID 28615996. source
  20. Morton RW et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med 2018. PMID 28698222. source
  21. Muir SW, Montero-Odasso M. Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 2011. PMID 22188076. source
  22. NHS. Vitamin D. Read 2026-10-31. source
  23. Zdzieblik D et al. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr 2015. PMID 26353786. source
  24. Courel-Ibanez J et al. Health benefits of beta-hydroxy-beta-methylbutyrate (HMB) supplementation in addition to physical exercise in older adults: a systematic review with meta-analysis. Nutrients 2019. PMID 31484462. source
  25. MedlinePlus Medical Encyclopedia. Rhabdomyolysis. Read 2026-10-31. source
  26. Bond P, Smit DL, de Ronde W. Anabolic-androgenic steroids: how do they work and what are the risks? Front Endocrinol 2022. PMID 36644692. source
  27. Leciejewska N et al. Selective androgen receptor modulator use and related adverse events including drug-induced liver injury: analysis of suspected cases. Eur J Clin Pharmacol 2024. PMID 38059982. source

Related on AlternativeMed

Related goals

Build Muscle Strength → Build Muscle Mass → Preserve Muscle While Losing Weight → Improve Your Endurance → Improve Your Cardiovascular Fitness → Improve Your Everyday Stamina → Start Exercising With Confidence → Build a Consistent Exercise Routine → Improve Your Physical Performance → Return to Exercise After a Break → Stay Active Throughout Your Life → Build Stronger Bones → Improve Your Balance → Sit Less & Move More →

Ingredients, foods and supplements

Whey protein → Creatine → Collagen and creatine → Vitamin D → Protein and muscle loss with age → Weight-loss supplements and fat burners →

Research, safety and claim-check resources

BMI, body composition and muscle → Recovery after exercise → Maintaining independence as you age → Medicines, supplements and older adults → Supplements for healthy aging → Return to Your Routine After Illness → Protein, kidney disease and dialysis →