Client profile
Eddie was a 52-year-old male natural bodybuilder and self-employed builder with over 35 years of training experience, predominantly in resistance training and martial arts. He was married with two adult sons and was supported in his lifestyle and nutritional practices by both his family and his two employees.
Eddie had competed at a national level in bodybuilding for the past 10 years, reaching the finals six times and placing in the top three on two occasions. His current goal was to win a national title within the next three years, aiming to retire from competition by the age of 55.
Training history and current regime
Eddie trained year-round, with his off-season routine consisting of:
- Resistance training: 4 sessions per week, combining free weights and machines.
- Cardiovascular training: 4–5 sessions of Zone 2 (low to moderate intensity, steady-state) cardio per week.
Despite his age and occupational demands, Eddie reported good progress in strength and hypertrophy, although he was increasingly focused on identifying ‘marginal gains’ to improve competitive outcomes.
Nutritional assessment
Eddie followed a self-described “80% clean” omnivorous diet and currently supplemented with:
- Whey protein
- Creatine monohydrate
- Multivitamin/mineral complex
- Omega 3/6/9 fatty acid blend
- Over-the-counter ‘testosterone booster’
He reported some digestive discomfort during the off-season, difficulty sleeping, and occasional joint pain. Recent blood work had also raised concerns from his primary care physician.
Clinical concerns and relevant biomarkers
Recent blood panels indicated the following abnormalities:
Clinical contextualisation
It was essential to interpret these lab results in the context of Eddie’s training status. As Tiller and Stringer note, blood biomarkers in highly trained individuals, especially a bodybuilder, often fall outside typical clinical reference ranges (1). Elevated CK, AST, and ALT, in particular, are well-documented in resistance-trained populations due to muscle turnover and do not necessarily imply pathology.
Initial interventions and recommendations
1. Nutrition and digestive health
Protein intake and distribution
With age-related anabolic resistance, older athletes may require higher protein intakes to maximally stimulate muscle protein synthesis (MPS). Recommendations for Masters athletes range from 2.0 g/kg/day, with short-term increases up to 3.0 g/kg/day during intensive training cycles (2). Leucine-rich protein sources, especially from whey and animal-based foods, should be prioritised to achieve ~3g leucine per meal (3).
Meal distribution should support digestive function and MPS. Given Eddie’s gastrointestinal symptoms, four to five smaller meals per day were recommended alongside mindful eating practices to reduce digestive load and improve nutrient absorption (4).
Digestive function support
Given Eddie’s age and symptom profile, there was a possibility of hypochlorhydria or early-stage atrophic gastritis, both of which are common in older adults and can be associated with decreased gastric acid and intrinsic factor production (5).
Key next steps included:
- Symptom tracking (e.g., bloating, reflux, gas, post-prandial discomfort)
- Exploring the impact of dietary fibre quantity and type
- Trialing fermented foods (e.g. kimchi, sauerkraut, kefir) and gut-supportive broths
If symptoms persisted, supplemental digestive support (e.g., betaine HCl, digestive enzymes) and gut health aids (e.g., broad-spectrum probiotics, L-glutamine) may have been warranted.
Supplement review
The current use of a commercial testosterone booster needed to be re-evaluated. Most over-the-counter testosterone-boosting supplements lack robust clinical evidence and may contain unregulated or ineffective compounds.
A comprehensive micronutrient review was also warranted. While macronutrient tracking is common among bodybuilders, suboptimal intake of vitamins and minerals (e.g., magnesium, zinc, B-complex) may impair recovery, hormonal balance, and metabolic processes essential for hypertrophy.
2. Joint health and NSAID use for a bodybuilder
Given his trade and training load, chronic joint stress was to be expected. However, Eddie habitually used non-steroidal anti-inflammatory drugs (NSAIDs). Although such use is common amongst athletes, they carry significant long-term risks, including gastrointestinal, renal, and cardiovascular complications (6,7). Alternatives for joint support suggested to Eddie included:
- Collagen peptides + vitamin C
- Omega-3 fatty acids (in anti-inflammatory dosages)
- Curcumin, boswellia, or other evidence-backed botanical agents
3. Sleep and stress management
Eddie’s intermittent insomnia may have reflected a cumulative allostatic load from training as a bodybuilder, combined with his work and personal responsibilities. Sleep quality is a critical determinant of recovery and hormonal regulation. Interventions suggested included:
- Implementing sleep hygiene protocols (e.g. blue light reduction, consistent bedtime routine)
- Encouraging micro-recovery strategies during the workday (e.g. short breaks, breathing practices)
- Screening for psychosocial stressors within his occupational and family ‘ecosystem’
Understanding the broader context of Eddie’s life helped to identify potential behavioural barriers or facilitators. This type of thinking aligns with a systems-based ‘ecosystem’ approach, which bridges the gap between mechanisms (e.g. adequate protein intake) and long-term outcomes (e.g. sustained hypertrophy). Adherence and sustainability are the products of interventions harmonised with an athlete’s unique environment.
4. Training adjustments
Given Eddie’s age and joint discomfort, it was appropriate to regularly re-evaluate his training variables. Key recommendations included:
- Periodically reduce training load and increase repetitions, leveraging metabolic stress for hypertrophy while minimising joint strain
- Integrate deload weeks and non-traditional hypertrophy methods (e.g. blood flow restriction training, tempo variation)
- Incorporate mobility and recovery work regularly, especially after cardiovascular sessions
Conclusion and outlook
At 52 years of age and nearing his competitive ceiling as a bodybuilder, Eddie’s progress will likely come from accumulated marginal gains across training, nutrition, recovery, and lifestyle domains. Interventions should be individualised, evidence-informed, and iteratively evaluated. The use of an ecosystem model, recognising the interconnectedness of biology, behaviour, and context, provides a valuable lens through which to maximise outcomes in aging athletes.
By refining dietary quality, supporting digestive health, enhancing recovery, and making data-informed training modifications, Eddie can continue to perform at a high level as a bodybuilder, while safeguarding long-term health and functionality.
- Tiller NB and Stringer WW (2023). Exercise-induced increases in “liver function tests” in a healthy adult male: Is there a knowledge gap in primary care? J Family Med Prim Care. 12(1):177–180.
- Jäger R et al. (2017). International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 14(1):20.
- Phillips SM (2016). Current concepts and unresolved questions in dietary protein requirements and supplements in adults. Front Nutr. 3:13.
- Trommelen J et al. (2023). The distribution of protein intake across the day and its impact on muscle protein synthesis. Nutrients. 15(3):654.
- Gille D (2010). Overview of the physiological changes and optimal diet in the golden age generation over 50. Eur Rev Aging Phys Act. 7:27–36.
- Marcum ZA and Hanlon JT (2010). Recognizing the risks of chronic NSAID use in older adults. Ann Long-Term Care. 18(9):24–27.
- Lundberg TR and Howatson G (2018). Analgesic and anti-inflammatory drugs in sport: implications for exercise performance and training adaptations. Scand J Med Sci Sports. 28(11):2252–2262.
Paul K Ehren is the owner of a bespoke personal fitness consultancy, based in Essex and East London, which he has now run for over 20 years. During this period, he competed as a Masters Bodybuilder, becoming the British Champion and also winning a number of regional and international titles. Paul’s current focus is on healthy ageing, or ‘HealthSpan’, working with both clients and practitioners. He believes that individuals who work at the ‘coal face’ of practitioner-client interaction are best placed to navigate a path through the plethora of sometimes conflicting advice on healthy ageing, and to guide athletes to maintain optimal functional health throughout life stages.