Men's muscles after 40: the strength that protects everything else
Everyday loads feel heavier, your grip is weaker, and climbing the stairs leaves you out of breath. With age, muscle quietly melts away — and it's not only about how you look. The good news: muscle responds to training at any age.
Why it matters
- Muscle is the main "consumer" of sugar. The less of it you have, the harder it is for your metabolism and the faster the belly grows.
- Muscle holds up your bones. Along with muscle, bone is quietly lost too, and men cope badly with fractures.
- Strength means independence. Weakness leads to falls, and falls lead to fractures.
Testosterone supports both muscle and bone. But testosterone therapy doesn't protect bone from fractures: in a large trial there were no fewer fractures. What protects bone and muscle is load and food.
What works
Strength training 2–3 times a week, with progression. The basics are squats, pulls and presses. When it gets easy — a bit more weight or more reps. The load should be noticeable: the last reps take effort.
A little impact. Step-ups and light jumps, if your joints allow — this is the signal for bone to stay strong.
More protein than you think. 1.2–1.6 g per kilogram of body weight a day, 30–40 g at every meal. With age, muscle responds worse to protein, so you need more of it. For example: eggs with cottage cheese, a palm-sized portion of meat or fish, lentils with cheese.
Vitamin D and calcium — mostly from food: fish, dairy, leafy greens.
Balance. Balance exercises prevent falls.
What about supplements?
- Creatine — about 5 g a day together with strength training gives a small but real gain in strength. With kidney disease — only after talking to a doctor.
- Protein powder is a handy backup if you can't get enough protein from food.
- "Testosterone boosters" don't build muscle.
How to track it without gadgets
Watches and rings don't measure muscle or bone. Your guide is strength and function: do everyday loads feel heavier, is your grip getting weaker, can you easily get up from a chair without using your hands?
When to see a doctor
- Weakness is getting worse quickly, with no clear reason.
- You've had a fall or a fracture from a minor injury.
- You've lost height or started to stoop.
- You've been on steroids for a long time or are having treatment that lowers testosterone.
What to try this week
- Two 30–40 minute strength workouts on different days.
- A source of protein at every meal, starting with breakfast.
- Every day, at least one flight of stairs instead of the lift.
What this is based on
This article is based on topics from the VIA-L knowledge base. These are the published studies behind them:
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- Key Findings on the Efficacy and Safety of Testosterone Therapy From Two Large Randomized Trials — The Journal of Clinical Endocrinology and Metabolism, 2026 doi
- Metabolic Dysfunction–Associated Steatotic Liver Disease in Adults — JAMA, 2026 doi
- The Effect of Chromium Picolinate Supplementation on Cardiometabolic Biomarkers, Tumor Necrosis Factor-Α Gene Expression, and DNA Damage in Subjects With Metabolic Syndrome: A Randomized Placebo-Controlled Clinical Trial — Biological Trace Element Research, 2026 doi
- Do the Effects of Early Time-Restricted Eating Vary by Cardiometabolic Phenotype, Age, Sex, or Race? A Secondary Analysis of a Randomized Controlled Trial — The Journal of Nutrition, 2026 doi
- Efficacy of Exercise-Based Interventions for Metabolic Syndrome: An Umbrella Review With Meta-Analyses — Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 2026 doi
- 4 — Diabetes Care, 2026 doi
- Safety of 12-Months Administration of Ashwagandha (Withania Somnifera) Standardized Root Extract in Healthy Adults: A Prospective, Observational Study — Phytotherapy Research : PTR, 2025 doi
- Evaluation of Potential Hormonal Activities of Ashwagandha (Withania Somnifera) — Phytotherapy Research : PTR, 2025 doi
- Dietary Patterns and Testosterone Balance: A Review of Clinical Data and Perspectives — Journal of Advanced Research, 2025 doi
- Testosterone Treatment in Middle-Aged and Older Men with Hypogonadism — The New England Journal of Medicine, 2025 doi
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- Semaglutide improved sperm morphology in obese men with type 2 diabetes mellitus and functional hypogonadism — Diabetes, Obesity & Metabolism, 2025 doi
- Effects of Testosterone Deficiency and Therapy on the Cardiometabolic Syndrome in Men — The American Journal of the Medical Sciences, 2025 doi
- The Effect of Chromium Supplementation on Cardio-Metabolic Risk Factors in Overweight and Obese Patients — Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS), 2025 doi
- Metabolic Effects of Testosterone Added to Intensive Lifestyle Intervention in Older Men With Obesity and Hypogonadism — The Journal of Clinical Endocrinology and Metabolism, 2025 doi
- Efficacy and Safety of Berberine on the Components of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials — Frontiers in Pharmacology, 2025 doi
- Male Hypogonadism: Pathogenesis, Diagnosis, and Management — Diabetes & Endocrinology, 2024 doi
- Dietary Fat Quality and Serum Androgen Concentrations in Middle-Aged Men — European Journal of Clinical Nutrition, 2024 doi
- Do "Testosterone Boosters" Really Increase Serum Total Testosterone? A Systematic Review — International Journal of Impotence Research, 2024 doi
- Testosterone Treatment and Fractures in Men with Hypogonadism — The New England Journal of Medicine, 2024 doi
- Effect of Testosterone Replacement Therapy on Sexual Function and Hypogonadal Symptoms in Men With Hypogonadism — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
- Depressive Syndromes in Men With Hypogonadism in the TRAVERSE Trial: Response to Testosterone-Replacement Therapy — The Journal of Clinical Endocrinology and Metabolism, 2024 doi
- Associations of Testosterone and Related Hormones With All-Cause and Cardiovascular Mortality and Incident Cardiovascular Disease in Men : Individual Participant Data Meta-Analyses — Annals of Internal Medicine, 2024 doi
- Effect of Testosterone on Progression From Prediabetes to Diabetes in Men With Hypogonadism: A Substudy of the TRAVERSE Randomized Clinical Trial — JAMA Internal Medicine, 2024 doi
- Chromium Supplementation and Type 2 Diabetes Mellitus: An Extensive Systematic Review — Environmental Geochemistry and Health, 2024 doi
- The Effect of Berberine Supplementation on Glycemic Control and Inflammatory Biomarkers in Metabolic Disorders: An Umbrella Meta-Analysis of Randomized Controlled Trials — Clinical Therapeutics, 2024 doi
- Intermittent Fasting and Health Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses of Randomised Controlled Trials — EClinicalMedicine, 2024 doi
- Effectiveness of Stress Management Interventions to Change Cortisol Levels: A Systematic Review and Meta-Analysis — Psychoneuroendocrinology, 2024 doi
- Effects on Cardiovascular Risk Factors of a Low- Vs High-Glycemic Index Mediterranean Diet in High Cardiometabolic Risk Individuals: The MEDGI-Carb Study — European Journal of Clinical Nutrition, 2024 doi
- Effects of Various Exercise Types on Visceral Adipose Tissue in Individuals With Overweight and Obesity: A Systematic Review and Network Meta-Analysis of 84 Randomized Controlled Trials — Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 2024 doi
- Prostate Safety Events During Testosterone Replacement Therapy in Men With Hypogonadism: A Randomized Clinical Trial — JAMA Network Open, 2023 doi
- Correlation Between Serum Zinc and Testosterone: A Systematic Review — Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS), 2023 doi
- Cardiovascular Safety of Testosterone-Replacement Therapy — The New England Journal of Medicine, 2023 doi
- The Effects of Sleep Deprivation and Obstructive Sleep Apnea Syndrome on Male Reproductive Function: A Multi-Arm Randomised Trial — Journal of Sleep Research, 2023 doi
- Exploring the Efficacy and Safety of a Novel Standardized Ashwagandha (Withania Somnifera) Root Extract (Witholytin®) in Adults Experiencing High Stress and Fatigue in a Randomized, Double-Blind, Placebo-Controlled Trial — Journal of Psychopharmacology (Oxford, England), 2023 doi
- Metabolic Syndrome and Erectile Dysfunction: A Systematic Review and Meta-Analysis Study — Journal of Endocrinological Investigation, 2023 doi
- Overall and Sex-Specific Effect of Berberine on Glycemic and Insulin-Related Traits: A Systematic Review and Meta-Analysis of Randomized Controlled Trials — The Journal of Nutrition, 2023 doi
- AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease — Hepatology (Baltimore, Md.), 2023 doi
- Sleep, testosterone and cortisol balance, and ageing men — Reviews in Endocrine & Metabolic Disorders, 2022 doi
- Aging and Androgens: Physiology and Clinical Implications — Reviews in Endocrine & Metabolic Disorders, 2022 doi
- Effects of Exercise Training on Anabolic and Catabolic Hormones with Advanced Age: A Systematic Review — Sports Medicine (Auckland, N.Z.), 2022 doi
- Nonpharmacological Interventions for the Management of Testosterone and Sperm Parameters: A Scoping Review — Clinical Therapeutics, 2022 doi
- Examining the Effects of Calorie Restriction on Testosterone Concentrations in Men: A Systematic Review and Meta-Analysis — Nutrition Reviews, 2022 doi
- Proposal for Standardizing Normal Insulin Ranges in Brazilian Patients and a New Classification of Metabolic Syndrome — Frontiers in Medicine, 2022 doi
- Effect of Partial and Total Sleep Deprivation on Serum Testosterone in Healthy Males: A Systematic Review and Meta-Analysis — Sleep Medicine, 2021 doi
- Examining the Effects of Herbs on Testosterone Concentrations in Men: A Systematic Review — Advances in Nutrition (Bethesda, Md.), 2021 doi
- Sociodemographic, lifestyle and medical influences on serum testosterone and sex hormone–binding globulin in men from UK Biobank — Clinical Endocrinology, 2021 doi
- Testosterone and Exercise: Effects on Fitness, Body Composition, and Strength in Middle-to-Older Aged Men With Low-Normal Serum Testosterone Levels — Heart and Circulatory Physiology, 2021 doi
- Effects of Mediterranean Diet on Plasma Metabolites and Their Relationship With Insulin Resistance and Gut Microbiota Composition in a Crossover Randomized Clinical Trial — Clinical Nutrition (Edinburgh, Scotland), 2021 doi
- Effects of Dietary Eicosapentaenoic Acid and Docosahexaenoic Acid Supplementation on Metabolic Syndrome: A Systematic Review and Meta-Analysis of Data From 33 Randomized Controlled Trials — Clinical Nutrition (Edinburgh, Scotland), 2021 doi
- Management of Obesity in Cardiovascular Practice: JACC Focus Seminar — Journal of the American College of Cardiology, 2021 doi
- Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association — Circulation, 2021 doi
- Optimal Threshold of Homeostasis Model Assessment of Insulin Resistance to Identify Metabolic Syndrome in a Chinese Population Aged 45 Years or Younger — Frontiers in Endocrinology, 2021 doi
- Reviewing the Evidence on Vitamin D Supplementation in the Management of Testosterone Status and Its Effects on Male Reproductive System (Testis and Prostate): Mechanistically Dazzling but Clinically Disappointing — Clinical Therapeutics, 2020 doi
- Age and Time-of-Day Differences in the Hypothalamo-Pituitary-Testicular, and Adrenal, Response to Total Overnight Sleep Deprivation — Sleep, 2020 doi
- The Association Between Popular Diets and Serum Testosterone Among Men in the United States — The Journal of Urology, 2020 doi
- A Randomized Controlled Pilot Trial of Sleep Health Education on Body Composition Changes Following 10 Weeks' Resistance Exercise — The Journal of Sports Medicine and Physical Fitness, 2020 doi
- Omega-3 Fatty Acids for the Primary and Secondary Prevention of Cardiovascular Disease — The Cochrane Database of Systematic Reviews, 2020 doi
- Colon-Delivered Short-Chain Fatty Acids Attenuate the Cortisol Response to Psychosocial Stress in Healthy Men: A Randomized, Placebo-Controlled Trial — Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 2020 doi
- Lipid Management in Patients With Endocrine Disorders: An Endocrine Society Clinical Practice Guideline — The Journal of Clinical Endocrinology and Metabolism, 2020 doi
- Causal Link Between Vitamin D and Total Testosterone in Men: A Mendelian Randomization Analysis — The Journal of Clinical Endocrinology and Metabolism, 2019 doi
- A Clinical Perspective of Sleep and Andrological Health: Assessment, Treatment Considerations, and Future Research — The Journal of Clinical Endocrinology and Metabolism, 2019 doi
- Effects of different exercise training programs on body composition: A randomized control trial — Scandinavian Journal of Medicine & Science in Sports, 2019 doi
- Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association — Circulation, 2019 doi
- Associations Between Homeostasis Model Assessment (HOMA) and Routinely Examined Parameters in Individuals With Metabolic Syndrome — Physiological Research, 2019 doi
- Evaluation and Management of Testosterone Deficiency: AUA Guideline — The Journal of Urology, 2018 doi
- Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline — The Journal of Clinical Endocrinology and Metabolism, 2018 doi
- Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even Without Weight Loss in Men With Prediabetes — Cell Metabolism, 2018 doi
- Hypogonadotropic Hypogonadism in Men With Diabesity — Diabetes Care, 2018 doi
- Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone: A Controlled Clinical Trial — JAMA Internal Medicine, 2017 doi
- A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management — The Journal of Clinical Endocrinology and Metabolism, 2017 doi
- Effect of Magnesium Supplementation on Insulin Resistance in Humans: A Systematic Review — Nutrition (Burbank, Los Angeles County, Calif.), 2017 doi
- Increased Physical Activity Has a Greater Effect Than Reduced Energy Intake on Lifestyle Modification-Induced Increases in Testosterone — Journal of Clinical Biochemistry and Nutrition, 2016 doi
- A Systematic Review and Meta-Analysis of Randomized Controlled Trials on the Effects of Magnesium Supplementation on Insulin Sensitivity and Glucose Control — Pharmacological Research, 2016 doi
- Effect of Magnesium Supplementation on Glucose Metabolism in People With or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials — European Journal of Clinical Nutrition, 2016 doi
- Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? — Diabetes, 2016 doi
- Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association — Diabetes Care, 2016 doi
- Vitamin D supplementation and testosterone concentrations in male human subjects — Clinical Endocrinology, 2015 doi
- Metabolic and hormonal effects of ‘catch‐up’ sleep in men with chronic, repetitive, lifestyle‐driven sleep restriction — Clinical Endocrinology, 2015 doi
- Nutrients other than carbohydrates: their effects on glucose homeostasis in humans — Diabetes/Metabolism Research and Reviews, 2015 doi
- Protective Effects of the Mediterranean Diet on Type 2 Diabetes and Metabolic Syndrome — The Journal of Nutrition, 2015 doi
- Resistance Training Restores Muscle Sex Steroid Hormone Steroidogenesis in Older Men — FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology, 2014 doi
- The Interplay between Magnesium and Testosterone in Modulating Physical Function in Men — International Journal of Endocrinology, 2014 doi
- Age-Associated Changes in Hypothalamic-Pituitary-Testicular Function in Middle-Aged and Older Men Are Modified by Weight Change and Lifestyle Factors: Longitudinal Results From the European Male Ageing Study — European Journal of Endocrinology, 2013 doi
- Effects of Magnesium Supplementation on Testosterone Levels of Athletes and Sedentary Subjects at Rest and After Exhaustion — Biological Trace Element Research, 2011 doi
- The Effect of Mediterranean Diet on Metabolic Syndrome and Its Components: A Meta-Analysis of 50 Studies and 534,906 Individuals — Journal of the American College of Cardiology, 2011 doi
- Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association — Circulation, 2011 doi
- Testosterone Physiology in Resistance Exercise and Training: The Up-Stream Regulatory Elements — Sports Medicine (Auckland, N.Z.), 2010 doi
- Magnesium Effect on Testosterone-SHBG Association Studied by a Novel Molecular Chromatography Approach — Journal of Pharmaceutical and Biomedical Analysis, 2009 doi
- Multiple Biomarkers and Their Relative Contributions to Identifying Metabolic Syndrome — Clinica Chimica Acta; International Journal of Clinical Chemistry, 2009 doi
- Insulin Resistance, the Metabolic Syndrome, and Risk of Incident Cardiovascular Disease: A Population-Based Study — Journal of the American College of Cardiology, 2007 doi
The strength of this evidence varies: some are large reviews and meta-analyses, some are small single studies. The steps in the article are simple, low-risk self-care measures, not treatment, and they may not suit everyone.
This is general information, not a prescription. Tests and treatment are chosen by a doctor.