Tag Archive for: balance

Stretch Your Body, Stretch Your Lifespan

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“Stretching reduces your risk of dying from all causes” was the message from Tuesday’s Memo. How does that work? Why would stretching decrease mortality? There are no definitive answers, but here are a few possibilities.

It may be that stretching strengthens the blood vessels as well as the connective tissue; that may decrease the potential for blockages or building up plaque in the arteries. Or it may be that the deep breathing that’s associated with most forms of stretching also contributes to the health of the heart and lungs.

One of the other benefits of stretching is a resultant increase in strength, which could help keep the muscles more pliable, and that’s important at any age. I’ve already mentioned that there may be an improvement in arterial function when undertaking stretching, but associated with stretching is a reduction in resting heart rate and an increase in vasodilation. Their possible net impact could lower blood pressure, which would reduce mortality.

I think that one of the most important benefits is going to be related to mobility and balance. We often only think of the flexibility of the muscles of our hips and our knees, but something as simple as raising your hands above your head can benefit stretching those lower joints as well. And all that contributes to your ability to move in space as you get older; maybe you move more if you stretch regularly. By regularly, that means five days a week, the criterion in one of the studies I mentioned.

Finding out the why stretching helps may take a while, but the fact is that there are benefits to what we would consider the easiest forms of exercise. As you move forward through this year, when you have a few minutes in every day, whether it’s waiting for the microwave to finish heating a cup of coffee, washing your hands after using the bathroom, or standing alone on an elevator, taking the time to do purposeful stretching may provide a benefit that you don’t envision. To take it one step further, put together a short routine of three to ten minutes that you do every day; if you have old injuries or joint issues, an appointment with a physical therapist can help you devise a routine you can do safely. And now that spring has sprung and you can get out of the house a little easier, try a class in yoga, tai chi, or qigong. Be sure to look for one that’s within your abilities; Paula and I tried a class a few years ago and were embarrassed that we couldn’t get up and down as easily as the 20-somethings.

The net effect should be that your muscles and your connective tissue will be more pliable. Who knows, you just may end up living a little while longer as well! Sounds like a good investment of time to me.

What are you prepared to do today?

        Dr. Chet

References:
1. Med Sci Sports Exerc. 2020 Dec;52(12):2554-2562

2. BMC Public Health. 2023; 23:1148.

Aging Stressor: The Muscular System

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Sarcopenia is the number one issue that impacts muscles—that’s the loss of skeletal muscle mass and strength that comes with age. It can begin as early as the 20s in some and accelerates once we pass 60; it’s thought to be primarily due to the genetics of aging. There’s also little question that a sedentary lifestyle contributes to muscle loss. Losing muscle mass impacts not just strength, but also stamina, posture, balance, and the ability to move your body.

There are several types of muscle fibers, but they all appear to become slow-twitch fibers as we age. And they get smaller. However, and this is important, they don’t ever seem to go away completely. Strength training has been shown to be effective even for people who are 100 years old; they get stronger, which helps deal with all those issues I mentioned before. The research hasn’t demonstrated that muscles will get larger, but most studies end at three to six months, which is too soon to really judge results; it’s probably going to take more than six months to gain back what we lost over many decades.

The key to dealing with sarcopenia is strength training—the earlier in life the better, but it’s never too late. Strength training can encompass many approaches from doing squats by standing up from sitting in a chair (using a walker if balance is an issue), push-ups and other calisthenics, and weight training using bands, tubes, machines, and free weights.

There are hundreds of programs and thousands of exercises to help build strength using every modality. I think it should all begin with an evaluation by a healthcare professional to test posture and balance, as well as strength. The next step is to see a physical therapist who can evaluate your limitations and put together a plan to get you started safely; it’s hard to keep your positive attitude if you get hurt right away and need to pause. Once you get approval and a plan to train, then getting muscles prepared is important. Calisthenics, which include chair exercises for those with arthritis, are a good place to begin.

Final memo before Christmas on Tuesday with one more place to attack when we’re aging with a vengeance.

What are you prepared to do today?

        Dr. Chet

Wait a Minute!

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It was a beautiful day in Grand Rapids on Thursday: 65 degrees, hazy sunshine, no wind, and a perfect day to take a kid to the park. Riley likes basketball (as is required of all children in the Midwest); he can’t hit the rim with the net at 10 feet, but that didn’t stop him and three other kids his size. Attempts were many, but baskets were few, and they didn’t seem to care.

Naturally I had to give it a try. I tried from 10 feet to the right of the basket, but my shot fell two feet short. Whoa! Tried again, and watched the ball sail under the basket. So in spite of having a three-month old knee, I tried a jumpshot—and stumbled a little as I landed. Yikes. My balance, spatial awareness, equilibrium, and power all seem to have left me in the past few months.

I sat down on a bench and pondered, “How do I get back from this far down?” I never expected things to get this bad so quickly; or has it really been even longer? I haven’t attempted anything like a jumpshot in a while. Then a phrase Riley likes to say popped into my head: “Wait a minute!” I already know the answers: Eat less. Eat better. Move more.

Moving more may mean going back to working on balance movements; spatial awareness may mean standing tall, closing my eyes, and touching my nose with my index finger. Neural pathways have to be awakened. They’re still there, just dormant.

There may be no NBA in my future, but I’ll get back to hitting that 15-foot baseline jumper this summer. Lucky for me, I have a built in practice buddy who’s always ready to play. Grandkids are the best!

What are you prepared to do today?

        Dr. Chet

Planning Your Infrastructure Upgrade

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In order to give you some ideas to help you focus on your body’s infrastructure, I’m going to share my list. I’ll give you my issues and why I feel they’re problems for me; I hope that will stimulate your thinking so you can determine your infrastructure upgrades for 2021. I don’t know that I can accomplish all of them in a single year, but I do know I can make a good start, and that’s what I’m hoping you will do as well.

Increase Muscle Mass

If there’s one getting-older issue that I completely underestimated, it’s the loss of muscle mass. It just sort of crept up on me and while I can’t quantify it in terms of pounds or percentage, I know I’ve lost strength in my upper body, and my legs seem to be a shadow of their former selves. Part of the reason that my legs lost so much mass, I believe, is directly tied to my inability to run consistently. I have no idea when I’ll be able to run freely again, if ever, so strength training is going to be critical to increase strength if not mass.

Improve Skin Quality

I have to confess that I never examine my skin. I don’t spend a lot of time looking at my face in the mirror, and I ignore my arms completely. But lately I’ve noticed that my skin is thinner and a slight scrape against the door frame that doesn’t even hurt can leave a huge purple spot. I’m not trying to recreate the quality of skin I had in my 20s, but I know it can be better than it is. (Has anyone in my household been nagging me about this for years? Um, maybe.)

Decrease Body Fat

The one that drives me crazy is the increase in body fat around my waist. I weigh 45 pounds less than my highest body weight ever, yet my waist circumference is greater now than it was then. The reasons are complicated, from the loss of muscle mass reducing metabolic rate to the gradual reduction in hormones as I get older. I know that there’s no such thing as spot reduction, and I don’t know if the general rule “you lose it first from where you put it on last” applies as you get older. But aside from increasing muscle mass, this one is just not acceptable and is a priority for me.

Increase Bone Mass

I’ve made no secret of the fact that I have osteopenia. In fact, I’m one-tenth of a Z-score from having osteoporosis. I have improved my vitamin D and calcium intake since my last bone-density test. I’ll find out in April whether that has resulted in any change. I’m not interested in continuing to be the amazing shrinking man, so this is an internal infrastructure change that must happen in 2021.

Improve Posture and Balance

This one seems a lot less obvious, but it’s still critical to overall health. Why? Because working on improving posture now, which means resetting the resting “tone” of the postural muscles will help with balance as we get older, and balance is critical if we hope to make it to an advanced age. The inner ear is part of it, but our ability to be able to move and do the things that we want to do can be dramatically impacted by poor balance. The modifications in muscle mass and fat mass, as well as bone mass, will have an impact, but it’s also critical to specifically work on posture and balance movements as well.

The Bottom Line

There you have it: my infrastructure plan for 2021. I’ve begun working on some, but there’s still research to read to find better solutions. That will include different approaches to exercise, whether weight training, stretching, or aerobic exercise. There could be specific dietary approaches that apply rather than just cutting calories. Supplementing with nutrient isolates and specific dietary supplements may also be part of the solution.

How about you? You may have cholesterol and HbA1c that needs to get lowered, cardiac output that needs to increase, and a microbiome overhaul; maybe you need to build strength in specific areas to compensate for arthritis and loss of cartilage.

Identify your three to five areas and write them down. As the year progresses, I’ll share the solutions I’ve found with you because my goal hasn’t changed: to help you become the best version of yourself. Specify where you want to go and let’s get started.

What are you prepared to do today?

        Dr. Chet

What Do Tests Tell Us?

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Based on last week’s push-up challenge, many of you have emailed me to let me know how you did. No matter how many or how few push-ups you did, it’s a start that can help you increase your muscular strength and stamina. All you have to do is to continue to do them as part of your exercise plan.

You may have seen an article in the Washington Post that examined another test associated with increased mortality. The idea is that you’re supposed to start by standing and then lower yourself to a sitting position on the floor with your legs crossed; then rise again. You start with 10 points and deduct one point every time you have to use your hands, arms, or sides of your legs while getting up or down. The fewer the points, the higher your risk of dying sooner.

I’m a dead man if that’s the case. I couldn’t get down because my knee couldn’t handle the stress, hands or no hands; Paula has two bad knees, so she’s out of luck, too. If you can’t get down, you can’t get up.

Maybe you couldn’t do any full push-ups. Are you toast as well?

Understand what the tests mean. If you have strength, you’ll have better balance. If you’re flexible, that helps with core strength and also balance. Stamina indicates you have aerobic fitness. These all speak to your quality of life as well as your cardiovascular fitness, and those are associated with living longer. The simple tests provide a snapshot of where you stand in relation to other people 50 and older. If these tests don’t play to your strengths, there are other tests to assess your strength, flexibility, and balance; don’t give up until you’ve tried those.

Want to live longer? Make fitness a part of your everyday life. Maybe you’ll live longer, maybe not, but you’ll have a better quality of life in however days you live.

What are you prepared to do today?

        Dr. Chet

Can We Prevent Sarcopenia?

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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.