Lifestyle Family Fitness News

Fit, Not Frail: Exercise as a Tonic for Aging

2008-08-05T09:53:19-04:00:00

By JANE E. BRODY

Fact: Every hour of every day, 330 Americans turn 60.

Fact: By 2030, one in five Americans will be older than 65.

Fact: The number of people over 100 doubles every decade.

Fact: As they age, people lose muscle mass and strength, flexibility and bone.

Fact: The resulting frailty leads to a loss of mobility and independence.

The last two facts may sound discouraging. But they can be countered by another. Regular participation in aerobics, strength training and balance and flexibility exercises can delay and may even prevent a life-limiting loss of physical abilities into one's 90s and beyond.

This last fact has given rise to a new group of professionals who specialize in what they call "active aging" and an updated series of physical activity recommendations for older adults from the American Heart Association and the American College of Sports Medicine. These recommendations are expected to match new federal activity guidelines due in October from the United States Health and Human Services Department.

But you need not - indeed should not - wait for the government. Even if you have a chronic Health problem or physical limitation, there are safe ways to improve Fitness and well-being. Any delay can increase the risk of injury and make it harder to recoup your losses.

Miriam E. Nelson, director of the John Hancock Center for Physical Activity and Nutrition at Tufts University in Boston and lead author of the new recommendations, observed last fall in The Journal on Active Aging that "with every increasing decade of age, people become less and less active."

"But," Dr. Nelson said, "the evidence shows that with every increasing decade, exercise becomes more important in terms of quality of life, independence and having a full life. So as of now, Americans are not on the right path."

Jim Concotelli of the Horizon Bay Senior Communities in Tampa, who oversees Fitness and wellness program development for communities for the elderly in several states, noted this year in The Journal on Active Aging that many older Americans were unfamiliar with exercise activities and feared that they would cause injury and pain, especially if they have arthritis or other chronic problems. Yet by strengthening muscles, he said, they can improve joints and bones and function with less pain and less risk of injury.

The key is start slowly and build gradually as ability and strength improve. Most important is simply to start - now- perhaps under the guidance of a Fitness professional or by creating a program based on the guidelines outlined here.

Although medical clearance may not be necessary for everyone for the moderate level of activity suggested, those with a known or possible problem would be wise to consult a doctor. And a few sessions with a trainer can help assure that the exercises are being done correctly and not likely to cause injury.

Until recently, physical activity recommendations for all ages have emphasized aerobics, or cardiovascular conditioning, through moderate to vigorous activities like brisk walking, cycling, lap swimming or jogging for half an hour a day five or more days a week. For those unable to do 30 minutes at a time, the activities can be broken up into three 10-minute intervals a day. If you have long been sedentary, start with even shorter intervals.

For people who prefer indoor workouts, a treadmill, cross-trainer, step machine or exercise bike can provide excellent aerobic training for the heart, lungs and circulation. Those unable to do weight-bearing exercise might try swimming or water aerobics. Keep in mind that 30 minutes a day of aerobic activity five days a week is the minimum recommendation. More is better and can reduce the risk of chronic disease related to inactivity.

Contrary to what many active adults seem to believe, physical Fitness does not end with aerobics. Strength training has long been advocated by the National Institute on Aging, and the heart association has finally recognized the added value of muscle strength to reduce stress on joints, bones and soft tissues; enhance stability and reduce the risk of falls; and increase the ability to meet the demands of daily life, like rising from a chair, climbing stairs and opening jars.

Strength training can be done in a gym on a series of machines, each working a different set of major muscle groups: hips, legs, chest, back, shoulders, arms and abdomen. Or it can be done at home with resistance bands or tubes, hand-held barbells or dumbbells or even body weight. One program, the Key 3 program diagrammed here, was devised by Michael J. Hewitt, research director for exercise science at the Canyon Ranch Health Resort in Tucson. It can be completed in 10 minutes with practice.

As Dr. Hewitt explained in the International Longevity Center-USA newsletter, skeletal muscles can only contract and thus are always arranged in pairs. "One muscle of the pair pulls to bend the joint (flexion), and its antagonist pulls to straighten the joint (extension)." Thus, a strengthening program must be balanced, he said, "pairing every pulling lift with an opposite pushing action."

Dr. Hewitt emphasized that to reduce the risk of injury and premature muscle fatigue, the large muscles should be exercised first, followed by the smaller muscles, with the postural muscles exercised last. For example, one would start with chest and upper back muscles, then the arms and shoulders and finally the lower back and abdomen.

Muscles have to be overworked to grow stronger. The goal for each exercise is three sets of 8 to 12 repetitions to muscle fatigue. Muscles also need time to recover. So strength training should be done two or three times a week on nonconsecutive days.

The new recommendations add flexibility and balance to the mix. Improving balance and reducing the risk of falls is critical as you age - if you fall, break your hip and die of pneumonia, aerobic capacity will not save you. Ten minutes a day stretching legs, arms, shoulders, hips and trunk can help assure continued mobility, and daily exercises like standing on one foot and then the other, walking heel to toe or practicing tai chi can improve balance.

The recommendations, issued last August, are geared to healthy adults 18 to 64, with a companion set for those 65 and older or those 50 to 64 who have chronic Health problems or physical limitations. Details can be found at www.acsm.org. Under "Influence," click on Physical Activity Guidelines From ACSM and AHA.

The experts who made these recommendations urge all adults to adopt them now. As C. Jessie Jones, co-director of the Center for Successful Aging at California State University, Fullerton, said, "People can't wait until they're in residential or long-term care to get started."

Obesity-Related Cancer On The Rise

2008-08-05T09:51:49-04:00:00

As Americans' collective waistline has continued to expand, so has the prevalence of obesity-related cancer.
According to the June issue of Mayo Clinic Health Letter, an estimated 14 percent of cancer deaths in older men and 20 percent in older women can be attributed to excess body fat. It's not fully understood why excess body fat increases the risk of cancer.

Theories include:
Insulin -- Obesity and inactivity generally lead to higher levels of insulin circulating in the blood. Excess insulin is believed to fuel the growth of cancer cells. In addition, it increases circulating levels of other hormones that likely play a role in cancer development and growth, such as estrogen.
Estrogen -- Adding to insulin's influence on estrogen levels, fat tissue also produces this hormone. Estrogen levels are 50 percent to 100 percent higher in postmenopausal women who are overweight versus those who are lean. It's believed that this alteration increases the risk of estrogen-sensitive cancers such as certain types of breast cancers.
Immune system -- Excess fat is thought to release proteins that may suppress the immune system and increase inflammation. Both may play a role in cancer development and progression.
Other risks of obesity -- Obesity-related problems such as acid reflux, high blood pressure, gallstones and fatty liver may damage tissues of the esophagus, kidney, gallbladder and liver, respectively. This may set the stage for cancer development.
Although there's evidence that gaining weight increases the risk of cancer, there has been almost no research that demonstrates whether losing weight will reduce that risk. Two major components of weight loss -- a healthy diet and exercise -- appear to be excellent ways to reduce cancer risk.
Mayo Clinic200 First St. SWRochester, MN 55902United States
http://www.mayoclinic.com

Lifestyle change alters gene expression in prostate cancer patients

2008-08-05T09:50:58-04:00:00

By Karla Gale

NEW YORK (Reuters Health) - Comprehensive diet and lifestyle modifications alter gene expression in prostate tissue of men with low-risk prostate cancer, investigators report in a prospective pilot study. The results showed that expression of genes involved in tumorigenesis were down-regulated.

"Simple changes in diet and lifestyle have a powerful impact on gene expression," Dr. Dean Ornish, from the Preventive Medicine Research Institute in Sausalito, California, told reporters in a press briefing.

"Two years ago, (we) published the first randomized controlled trial showing that intensive lifestyle changes may slow, stop or even reverse the progression of early stage prostate cancer, and perhaps breast cancer as well," he continued. "At that time, we did not understand the mechanisms by which those changes occurred."

The Gene Expression Modulation by Intervention with Nutrition and Lifestyle (GEMINAL) study was designed to explore the molecular mechanisms involved, he added.

The trial included 30 men with early stage, nonaggressive prostate cancer, with stable prostate specific antigen (PSA) levels and Gleason scores of 6 or less. The patients had elected to forego conventional treatment while undergoing surveillance for tumor progression, according to the report, published in the June 17th Proceedings of the National Academy of Sciences.

The 3-month lifestyle intervention involved "low-fat, whole-foods, plant-based nutrition; stress management techniques; moderate exercise; and participation in a psychosocial support group."

Needle biopsies of prostate tissue were taken at baseline and after 3 months, from which RNA was extracted for gene expression array analysis of 40,000 genes.

Results showed that 48 genes were up-regulated and 453 were down-regulated. "Pathway analysis identified significant modulation of biological processes that have critical roles in tumorigenesis, including protein metabolism and modification, intracellular protein traffic, and protein phosphorylation," the authors report.

Significant improvements in cardiovascular disease risk factors were also observed, including reductions in BMI, blood pressure, waist circumference, and lipid levels.

"It is striking that there were so many changes to such a degree," co-author Dr. Christopher M. Haqq, from the University of California San Francisco, said during the press conference.

"If this had been a drug that we tested, with that degree of change, it would be a block-buster home-run for a drug company," he added.

"These findings may be an antidote to 'genetic nihilism,'" Dr. Ornish said. "Our genes represent our predisposition but not our fate. Knowing that these mechanisms are much more dynamic than we once realized may help capture people's imagination and motivate them to make beneficial lifestyle changes."

Proc Natl Acad Sci USA 2008;105:8369-8374.

Fitness a Key Element in Determining Male Diabetic's Longevity

2008-08-05T09:50:05-04:00:00

7-year study found staying in good shape more important than weight

SUNDAY, June 15 (HealthDay News) -- If you're a man with type 2 diabetes, how long you live may be determined more by how physically fit you are than by how much you weigh.

A new study expected to be presented in San Francisco this weekend at the annual meeting of the Endocrine Society found that physical Fitness appeared to be more important than weight in estimating a male diabetic's longevity.

"Death rates were the highest for those who were 'low fit' in all weight categories," researcher Dr. Roshney Jacob-Issac, an endocrinology fellow at George Washington University Hospital, said in a prepared statement.

Researchers used 2,690 male diabetic veterans in VA hospitals, most of whom were overweight or obese based on their body mass index (BMI), a measure of body fat using height and weight.

The vets were categorized as having low, moderate or high Fitness level, depending on their performance on a standard treadmill exercise tolerance test.

The researchers found that the higher the man's level of Fitness, the lower his risk of dying during the study period. For example, those in the high Fitness level -- whether at normal body weight or overweight -- reduced their risk of death by 40 percent. The findings were even more dramatic for those classified as obese but in reasonable good shape: a cut in death risk of 52 percent, when compared to peers not physically fit, the study found during its seven-year follow-up period.

"Diabetics should improve their Fitness level or exercise capacity to at least a moderate level, by being physically active. Weight loss is great, but being active is just as important," Jacob-Issac advised.

She said people should get at least 30 minutes of moderate-intensity physical activity -- the equivalent to brisk walking at least five days of the week -- to achieve the Health benefits reported in the current study.

More information

The American Diabetes Association has more about diabetes.

-- Kevin McKeever

SOURCE: Endocrine Society, news release, June 15, 2008