Giving Up Those Pointless Battles

/in /by

Every morning you can hear a “boink” on one of the back windows of the house. Every 15 seconds or so, another one. Then it begins to travel to another window. Boink. Boink. Boink. It’s a female cardinal. Time after time after time. Day after day. Upstairs windows, downstairs windows; the back of our house is almost all windows, so she has many choices. Boink. Boink. Boink. It’s been weeks, and she hasn’t learned yet and most likely is not going to learn to stop doing that. The battle continues. It’s pointless.

I’ve read the reasons why cardinals do this: a reflection of themselves or of the trees or shrubbery they’re on. Why she does it isn’t important—she’s still not getting into the house. And while she concentrates on attacking our windows, she’s not finding a nice male cardinal or building her nest. We’ve decided she’s not the smartest cardinal on the block, so maybe it’s better if she doesn’t reproduce.

Her day-after-day pointless battle raised a question in my mind. What are you doing day in, day out, that’s interfering with attaining the health you want? Starting every day with two pieces of toast with your eggs? Why not just one? Or try it with none? Are you walking at your usual window shopping pace? Why not try to increase the number of steps in the same time frame or get where you’re doing quicker by stepping up the pace? Always doing three sets of 15 repetitions? Why not raise the weight and drop to sets of 10 reps?

Or maybe it goes deeper. Are you fighting pointless battles just because you always have? Are they keeping you from doing what you truly need to do? What struggles could you walk away from?

You’re not a cardinal. You can change what you do to get better results. It may not require a whole lot more effort but unless you change things, you’ll keep getting the same results. Look at every one of your eating, exercise, and supplements habits. Look at where the conflicts are in your life. Where can you make changes that will get you better results?

What are you prepared to do today?

Dr. Chet

 

Your Payment Is Due

/in /by

Today is Tax Day here in the U.S.—if you owe the government any money, today is the day you have to file your taxes and pay up. There are penalties if you’re late, so you want to be sure you pay up on time.

Good health is the same way. The things you do that are beneficial such as eating less, eating better, flossing and brushing your teeth, exercising and many more things impact your health in positive ways. Overeating, refined carbohydrates, smoking, being sedentary, and other poor habits affect your health in negative ways. Done long enough, they’re going to impact your body.

Just like Tax Day, payment will become due. The price you pay depends on whether you have more good habits than poor ones. The only thing you don’t know is when you’ll have to pay that price: diagnosed as prediabetic at your next physical, headaches from high blood pressure, chronic bronchitis. Doesn’t matter whether you’re ready or not, someday you’ll have to pay for how you take care of your body. My advice is to choose wisely today and every day.

In this case, it doesn’t have to be the whole sum at once. Start small right now by skipping refined carbs just for today or taking a few extra steps. Definitely floss tonight before bed. You can sleep well at the end of the day knowing you’re headed in the right direction.

What are you prepared to do today?

Dr. Chet

 

It’s All in the Dash

/in /by

In this Memo, we’re going to pretend the survey’s treatment options for high blood pressure are real. The choices were a pill, a cup of tea, exercise, and an injection once a month. If they were real, which one might be the best option for you? To me, it all comes down to The Dash.

You’ve probably heard about The Dash before. It’s a story about a person’s life such as yours. On your gravestone, there’s a dash between the day you were born and the day you died; your life is in the dash. How does this relate to the treatments offered in the survey, even though hypothetical?

What treatment option will give you the best potential quality of life? Not just adding a month, year, or even five years; what will those years be like? Will you just be alive or will you be really living?

It’s a no-brainer. Whether real or imaginary, the treatment that offers you the best chance to really live during those five years is exercise. A cup of tea may provide some good phytonutrients. A pill or an injection may affect an organ or a system to keep your blood pressure under control. But regular exercise will actually treat the systems involved in hypertension: the heart, blood vessels, muscles, nerves, and even hormone levels. Exercise is not a salve to make you feel better. It’s going to have profound effects and give you the best chance at a good quality of life during those extra five years.

I know the study was just a pilot survey and no treatment can guarantee you that you’ll live longer. But what I said about exercise is real. It gives you the best chance at having a better quality of life, not just during a potential extra five years, but all the years before then as well. What do you want your dash to be like? It just depends on the answer to one real question:

What are you prepared to do today?

Dr. Chet

 

Reference: AHA http://bit.ly/2uXd6qH

 

The Survey’s Most Surprising Results

/in /by

Before I get into what I found surprising, I want to point out that this was a survey about hypothetical treatment options. It was just a preliminary or pilot project just to see how people would answer; the head researcher said as much. The other factor was that subjects were 45 and younger. If an older population were asked the same questions, the results could be different. Or maybe not.

What surprised me was that even when asked about something as simple as drinking a cup of tea every day, less than 100% of the people said they would do it for an extra five years of life. The 7% who said they wouldn’t do anything stuns me. It’s a survey! You could misrepresent your answers—go ahead and lie!—who would know? Maybe it’s a function of the under-45 population surveyed; maybe they hadn’t yet started to be concerned about their limited lifespans.

What’s amazing is that most subjects already had high blood pressure according to the report. They knew the treatments were hypothetical, and yet some still couldn’t be bothered to try to add five more years of life. If they care that little about a hypothetical treatment, how are they approaching actual treatment?

On Saturday, I’ll focus on those who said they would do something to live five years longer and which option might be the best—assuming they were real. It all comes down to The Dash.

What are you prepared to do today?

Dr. Chet

 

Reference: AHA http://bit.ly/2uXd6qH

 

What Would You Pay for More Time?

/in /by

What price would you pay if you could gain an extra month of life? How about a year? How about five years? I think the longer you get, the more incentive to pay a higher price. It seems a large group of subjects agree with me according to a study reported this past weekend at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2018.

Researchers surveyed over 1,300 people to determine what price they would be willing to pay for a longer life if they were diagnosed with high blood pressure. Subjects could choose from a daily pill, a daily cup of tea, regular exercise, or a monthly injection. The kind of treatment didn’t matter; the more additional time they got, the more willing the respondents were to consider the treatment.

Which was most appealing? The pill and the cup of tea. The least appealing? The injection. All treatments exceeded 93% if they would give a person an extra five years.

How about you? If you’re diagnosed with hypertension, what would you be willing to do for an extra month, year, or five years? While you think on it, Thursday’s Memo will be about something I found surprising in the study.

What are you prepared to do today?

Dr. Chet

 

Reference: AHA http://bit.ly/2uXd6qH

 

Can We Prevent Sarcopenia?

/in /by

Based on the research presented in Thursday’s Memo, the earlier we address the possibility that sarcopenia will affect us, the more likely we’ll succeed (1). I use fudgy words such as “likely” because we don’t know for sure, but based on the current status of research, here’s what we can do to prevent sarcopenia.

Use It or Lose It

In the study I talked about Thursday, the men who exercised regularly had a lower rate of decline in muscle function. The researchers speculate that chronic exercise helps preserve the motor units, thus preserving the ability of the nerve cells to send out nerve fibers to attach to muscle fibers.

That’s all well and good, but how can we make sure that we preserve the potential and perhaps increase our motor unit activity if we’ve lost some? Research shows that weight training will help. In several studies, resistance training increased muscle strength in the elderly; strength will improve balance and quality of life.

What kind of exercise will work best? It seems to be high intensity exercise. In a study on elderly mice, high intensity interval training (HIIT) increased the muscle mass, muscle fibers, and the number of mitochondria (2). This was a small study and it was on rodents, so the application to humans isn’t assured. To me, it means use your muscles as you mean to keep using them. The harder you exercise within your physical limitations, the better.

Focus on Protein

Retaining muscle mass is not only about exercise. For some reason, as we get older, we decrease our protein intake, but research shows that increasing protein intake can help retain muscle mass. If you don’t have protein in muscle cells, retaining or adding connections to those cells won’t matter much.

How much protein should people try to get? The current recommendation is 0.8 grams per kilogram body weight per day or a third of a gram per pound body weight; someone who weighs 200 pounds would need about 66 grams of protein per day. But research shows that bumping that up to 1.1 grams per kilogram body weight or a half gram per pound may be better as we get older. That’s 100 grams for a 200-pound person (3). That’s easy for even those who are math-challenged: whatever your goal weight, divide by 2, and that’s your daily goal for grams of protein.

It also seems better to stretch protein intake out throughout the day rather than a big slug at one time. Balanced intake will produce a sustained level of amino acids available for muscle repair throughout the day.

The research is far from complete in this area but it seems that as we age, our protein needs revert to when we were younger: we need more of it.

The Bottom Line

Sarcopenia can result in loss of strength and mass, but more important is the loss of quality of life. We don’t think balance while standing or moving is important until we fall; we don’t think brute strength is important until we need to move something and can’t. This week’s Memos give you an idea of how to prevent and perhaps improve nerve and muscle function.

Don’t think this is for only retirees; once you hit 40, it’s a downward trend. Starting early may help minimize the decline. One thing is clear: if you expect to be mobile when you get older, you need to work on it earlier rather than later.

What are you prepared to do today?

Dr. Chet

 

References:
1. J Physiol. 2018 Mar 11. doi: 10.1113/JP275520.
2. J Gerontol A Biol Sci Med Sci. 2018 Mar 14;73(4):429-437.
3. Nutrients 2018, 10, 360; doi:10.3390/nu10030360.

 

Research Update on Sarcopenia

/in /by

We know what sarcopenia is, but what can be done about it? Recent research may give us a clue.

Researchers in the United Kingdom examined a variety of variables related to sarcopenia in a group of men. Remember, a motor unit is a nerve and all the muscle fibers to which it attaches. They looked at the differences between the size of the motor units and the total units between 48 young men, 13 non-sarcopenic elderly men, 53 pre-sarcopenic, and 28 sarcopenic men.

The motor unit potential was greater in non-sarcopenic and pre-sarcopenic men than in young men. Why would that be? The researchers suggested that the nerves are still sending out nerve shoots trying to recruit more muscle fibers. This was not the case with the sarcopenic men; their motor unit potential was much lower. That could mean that once connections are lost, there’s no way to recover muscle function including strength.

While the researchers could not answer that final question with certainty, it’s apparent that preventing potential motor unit loss is critical. How? We’ll talk about that on Saturday.

What are you prepared to do today?

Dr. Chet
Reference: J Physiol. 2018 Mar 11. doi: 10.1113/JP275520.

 

So You Lose a Little Muscle—So What?

/in /by

Any of my former students who read the Memo should remember the following definition quite well:

A motor unit is a nerve and all the muscle fibers to which it attaches.

It’s called a unit because both sides of that equation are important. Muscle fibers contract when stimulated by a nerve. Reduce the number of fibers that the nerve can attach to, and the muscle won’t generate as much force. Losing a little strength is no big deal, right? How about walking up a flight of stairs? Or even being able to maintain balance while standing? Yes—it’s a big deal.

Sarcopenia is the progressive loss of muscle strength and function as people age. How much loss? Just look at the picture from the Journal of Physiology: the loss of muscle is obvious and with that, a loss of function. Let that sink in. I’ll talk about whether anything can be done about it the rest of the week.

What are you prepared to do today?

Dr. Chet

 

Reference: J Physiol. 2018 Mar 11. doi: 10.1113/JP275520.

 

Exercise: It All Counts

/in /by

Here’s something to ponder the rest of the week: why do you exercise? If you don’t, what would your purpose be if you did? I think there are two primary reasons. First, burning calories helps lose weight. Second, if you exercise regularly, you might live longer. But then you hit those exercise recommendations: 150 minutes per week—30 minutes a day five days a week. Who has that much continuous time? Maybe it doesn’t have to be continuous.

A recent published study used data from the NHANES database to determine whether exercise had to be continuous or whether it could be done in shorter segments they called bouts in order to have benefit. They looked at a single outcome: mortality. The subjects wore accelerometers to determine activity levels throughout the day. It turns out that whether you do your 30 minutes of exercise continuously or break the 30 minutes into bouts or segments lasting at least five minutes at a time, there was no difference in the reduction in mortality. Of course, the more total minutes per week were associated with continuing decreases in mortality, but it didn’t matter whether it was in shorter bursts or continuous minutes.

If you want to exercise to live longer, just get moving at least five minutes at a time several times per day. Whether bouted exercise will get you fitter is a different question, but if you want to live longer, get moving.

I know you’ll be busy buying chocolate this weekend no matter what your religious affiliation, so no memo on Saturday. I’ll be back next Tuesday.

What are you prepared to do today?

Dr. Chet

 

Reference: J Am Heart Assoc. 2018;7:e007678. DOI: 10.1161/JAHA.117.007678.

 

Freeze Your Way to Weight Loss?

/in /by

If you pay any attention to the news, you may have heard about a recent pilot study: researchers exposed the vagus nerve to freezing temperatures—the nerve that controls hunger. They apparently didn’t freeze it solid, but just enough to slow down the transmission of signals. Without any other interventions, the 10 subjects lost an average of 3.6% of their initial body weight in 90 days. The purpose of the study was to make sure there were no hazardous side effects. The comments by scientists were what they always are: “Interesting, but much research has to be done.”

No, it doesn’t. This is not normal! Does anyone think that exposing oneself to magnetic waves while a needle is inserted into a nerve to freeze that nerve to lose weight is normal? Looking at the study’s average weight loss for someone 5’4” tall with a BMI of 35, that would be about seven pounds. Over 13 weeks. And at the end, no one has learned how to change his or her lifestyle to maintain whatever weight was lost, as minimal as it was. I know we’re always looking for an easy way out, but there are much better and safer ways to lose a half pound a week. Let’s move on.

What are you prepared to do today?

Dr. Chet

 

Reference: Annual Scientific Meeting of the Society of Interventional Radiology. Los Angeles, CA. 03-21-2018.