Happy Healthy Long Life

From the Archives of Internal Medicine--Seven Good Reasons to Exercise and Increase Your Chances For Healthy Aging

Exercising Ladies in their Eighties

Weight Machine Workout for Muscles and the Mind

"Exercise is better than any drug or anything else we have for aging.  There's no downside.  If this were a drug, it would be the safest, most effective drug in the universe."

Dr. James O. Hill, Director of the Center for Human Nutrition at the University of Colorado at Denver

Seven articles--count them!  All in the January 25, 2010 issue of the Archives of Internal Medicine.  

All of them saying the same thing, "Exercise works. Just do it.  Whatever your age.  Start now!"  click here for the Table of Contents.

I must be an exercise geek, because honestly, I find this kind of news exciting, encouraging, and hopeful.  It shows how we really can change our health.  Sure diet is an important partner in health--but exercise has a dual, and synergistic role in the equation.

Why Exercise?  What We Can Learn from Six New Studies & One Editorial?

• Weight-lifting improves the brain. "Resistance Training and Executive Functions,"  Liu-Ambrose, Teresa et al, University of British Columbia.   The Study: Women aged 65-75 who spent 1-2 hours a week on progressive strength/resistance training with dumbbells and weight machines significantly improved their cognitive function after 12 months.  They improved their performance by 10.9-12.6% on the most important brain function: executive ability.  They saw improvements in their decision making, their ability to resolve conflicts, and they were better able to focus on subjects without becoming distracted by competing stimuli.  But alas, no improvements were seen in 2 skills: keeping numbers in their working memory, and shifting from one task to another. The strength training group's skills were measured against a control group who only did balance & toning exercises.  As for the balance and toning group--their scores on executive ability deteriorated by .05%.  The added bonuses found in strength-training?  It counteracts the inevitable muscle loss of aging while improving bone density and strength.  The Canadian group also improved their walking speed--which is a predictor of substantial reduction in mortality.  Big Point: The cognitive benefit showed up after 12 months of training--but not after 6 months.  Those who lifted weights 2 x a week experienced less muscle discomfort than those who lifted only once a week.  No surprise!  Take Away Message: Add strength-training to your exercise routine.  2 or 3 times a week is best.

•  Start exercising at middle-age if you want to stay healthier as you age.  "Physical Activity at Midlife in Relation to Successful Survival in Women at Age 70 Years or Older,"  Sun, Qi et al, Harvard School of Public Health and Harvard Medical School.  Click here for the article.  Harvard researchers looked at the health of over 13,000 women from the well-known Nurses' Health Study who had reached 70 years of age without any physical or mental impairment. Those who had higher levels of physical activity beginning at midlife were less likely to have chronic diseases, heart surgery or any physical, cognitive or mental impairments as they aged.  Take note: regular moderate-intensity (not wimpy) midlife physical activity made all the difference in the world to one's health after age seventy! Those who regularly walked at a moderate pace starting from midlife had a better chance of exceptional health than those who walked at an easy leisurely pace.  Picking up the pace made a huge difference in health--the fastest walkers significantly increased their odds of successful aging over the lollygaggers!  And don't despair, moderate walking improved later-life health in both lean and overweight women.  But those who kept their weight down (BMI range of 18.5-22.9) and exercised more vigorously than moderate walking improved their odds the most. 

Understanding METS.   For women, these are the METS for 1 hour of activity: 12 for running, 8 for stair-climbing; 7 for jogging; bicycling; lap swimming; and playing tennis; 6 aerobics or calisthenics; 2.5 to 4.5 for walking, depending on the pace--easy (<2 mph) normal (2-2.9 mph) brisk (3-3.9 mph) very brisk (4 mph or more)  To get over 15 METS a week you would need to walk 3.5 hrs./week at 4 mph or more.  Example: 30 METS=2.5 hrs of running; 30 METS=6.6 hrs of walking at a pace of 4 mph or more

• Exercise for stronger bones, a better heart, less chance of falls, and to decrease your health care costs. "Exercise Effects on Bone Mineral Density, Falls, Coronary Risk Factors, and Health Care Costs in Older Women-the Randomized Controlled Senior Fitness and Prevention (SEFIP) Study," Kemmler, Wolfgang et al, the Friedrich-Alexander University of Erlangen Nuremberg, Germany. 

"Contrary to pharmaceutical agents, which are typically dedicated to specific diseases, physical exercise affects a variety of risk factors and diseases and therefore plays a vital role in general disease prevention and treatment of the elderly."

In this randomized single-blinded controlled German study, 227 women over age 65 participated in an either an 18 month group exercise program, or in a wellness program (the control group).  The exercise program included 2 60-minute group exercise classes, and 2 20-minute at-home sessions--including aerobic exercise at 70%-85% maximum heart rate, balance training, isometric floor strength training for the lower body, stretching, and upper body thera-band strength training.  The wellness group participated in low-intensity exercise,walking at 50%-60% maximum heart rate, very low-moderate intensity strength training, and progressive relaxation exercises.  Results: Compared to the wellness group, the exercise group significantly improved their bone mineral density in both the lumbar spine & hip; their fall risk decreased with a 50% lower fracture incidence; and both groups (wellness & exercise) significantly reduced their 10-year coronary heart disease risk, mainly because both groups lowered their blood pressure.  Interesting Finding: Participation and adherence was much better in the group exercise classes than with the home exercise component.  Not a surprise to me at all.  I prefer group exercise, hands-down.  Take Away Point:  Even starting after age 65, exercise has a tremendous impact on one's health--and strength training definitely improves bone density.

• Moderate physical exercise reduces the risk of cognitive impairment. "Physical Activity and Incident Cognitive Impairment in Elderly Persons. The INVADE Study,"  Etgen, Thorleif et al, Technische Universitat Munchen, Germany.  This study followed a large group of Bavarians (3,903) age 55 and older for two years.  At the end of the period they compared the incidence of cognitive impairment in the group with their levels of physical activity. The researchers adjusted for all the usual vascular risk factors that might contribute to cognitive impairment.  The Results:  Moderate or high physical activity was associated with a reduced incidence of cognitive impairment after the 2 year follow-up.  For those with no physical activity the incidence of cognitive impairment was 13.9%.  In those with moderate physical activity (less than 3 x a week) the incidence of impairment was 6.7%.  The high physical activity (greater or equal to 3 x a week) seniors had a 5.1% incidence of impairment.  Take Away Point: Exercise can the lower the risk of cognitive impairment--and the more days the better!

• Even in a nursing home exercise can improve the quality of life--but not by that much. "Effects of Exercise Programs to Prevent Decline in Health-Related Quality of Life in Highly Deconditioned Institutionalized Elderly Persons," Dechamps, Arnaud et al, Universite Victor Segalen, Bordeaux, France.  This study included 160 institutionalized out-of-shape elderly (average age of 82) who were still able to understand basic motor instructions & who could move from one position to another.  They were divided into 3 groups: adapted tai chi for 30 minute sessions 3x a week; a cognitive action program which is a type of exercise that is related to everyday actions--from 30-40 minutes 2x a week; and a control group which had no exercise program.  Results:  After 12 months, the non-exercising control group experienced a greater decline in the activities of daily living than the exercisers.  Those in the  exercise programs slowed their health quality decline, however, the improvements experienced by the elderly exercisers weren't considered clinically significant.  Bottom Line:  Although exercise programs in nursing homes can slow down health decline, expecting actual physical improvements may be too much to ask. Don't wait until your eighties to start that exercise program.  You will have a much better shot if you start young--or at middle-age.

• Add exercise and weight loss to the DASH Diet and you will see even greater improvements in blood pressure. "Effects of the DASH Diet Alone and in Combination with Exercise and Weight Loss on Blood Pressure and Cardiovascular Biomarkers in Men and Women with High Blood Pressure," Blumenthal, James et al, Duke University Medical School, North Carolina.  The DASH Diet emphasizes moderate calorie, low fat, low sodium, whole grain foods, along with 6-12 servings of fruits & vegetables a day.  Click here to learn more. The Study: 144 participants with an average age of 52, with an average blood pressure of 138/86 mm Hg, and not on any BP medication were enrolled in the study, and divided into 3 groups: 1. DASH Diet alone with counseling, 2. DASH Diet with a behavioral weight loss program & a supervised exercise program 3x a week at a level of 70%-85% heart rate, or 3. The  "usual diet control" group.  The study lasted 4 months.  Results: The DASH diet + weight loss & exercise group did the best, of course.  Their blood pressure was reduced by 16.1/9.9 mm HG.  Those on the DASH diet alone reduced their blood pressure by 11.2/7.5 mm HG, and those in the  "usual diet control group dropped theirs by only 3.4/3/8 mm Hg. Weight loss: The DASH Diet + exercise & weight management group lost an average of 19.1 pounds.  The DASH Diet alone group lost .7  of a pound.  The "usual diet group" gained 2 pounds.  Cardiovascular Markers:  The DASH Diet + exercise  weight loss group had the greatest improvements in this area-- including less arterial stiffness as measured by pulse wave velocity, an average of 19% improvement in their aerobic capacity (VO2 max), improved baroreflex sensitivity of 33% (less stiffness in the arteries--which is an early side effect of hypertension), and decreases in the size of the left ventricle--a side effect of high blood pressure (increases in the muscle tissue that makes up the wall of the heart's main pumping chamber-the left ventricle).  TAKE AWAY POINT:  The DASH Diet (high in fruits & vegetables, low in salt) + weight loss + exercise is the best combination to lower blood pressure and improve cardiovascular risk factors.

• Exercise--the most effective prescription out there.  It's the best "drug" available to prevent dementia and insure successful aging.  "Evidence Regarding the Benefits of Physical Exercise,"  Drs. Jeff Williamson & Marco Pahor, Institute on Aging, University of Florida.  This editorial in the Archives of Internal Medicine highlights the benefits of exercise on successful healthy aging.

"It is now well established that higher quantities of physical activity have beneficial effects on numerous age-related conditions such as osteoarthritis, falls and hip fracture, cardiovascular disease, respiratory diseases, cancer, diabetes mellitus, osteoporosis, low fitness and obesity, and decreased functional capacity, all conditions that greatly increase the risk of reduced independence in late life. 

Two of these studies (in the Archives of Internal Medicine) evaluated the relationship between physical exercise and decline in cognitive function, a major contributor to loss of independence and related institutionalization in elderly individuals.

Optimism in this area is sorely needed owing to the failure of promising interventions aimed at preventing cognitive decline and dementia in the recent past.

Physical inactivity is one of the strongest predictors of unsuccessful aging for older adults and is perhaps the root cause of many unnecessary and premature admissions to long-term care."

The Longevity/Vigor Quest. It's Centenarian Joe Rollino Matched Against the Anti-Aging Medicine of Cenegenics Medical Institute. Lifestyle Modification vs Pharmaceuticals

The Great Joe Rollino at 103

The Great Joe Rollino as a young man.

Joe Rollino, was 104, just 2 months shy of turning 105, when he was fatally injured by a minivan in Brooklyn on January 11, 2010.  He was on his daily early morning walk to pick up coffee, a tabloid, and a lottery ticket.  Until the end he was strong, healthy, and a picture of health!

If not for the New York Times, I would never have heard of Joe Rollino.  He was man from a different time. Growing up near the turn of the century, quitting school at 10 years old to join the carnival.  He led a career as a Coney Island strongman, a boxer, and a trainer, who billed himself as "The Strongest Man in the World".  

At 5-feet-4-inches 122 pounds, in his prime he once lifted 475 pounds with his teeth, 675 pounds with just one finger, and moved 3200 pounds with his back.  He bent quarters with his teeth and fingers and continued to demonstrate his coin-bending skills into his 100's.

"Pound for pound, in the feats that he practiced, he was one of the greatest performing strongmen we've ever had, if the lifts he's credited with are accurate.   For his size, Joe was apparently one of the strongest men who ever lived."

-Terry Todd, co-director of the Stark Center for Physical Culture and Sports at the University of Texas, who knew Joe for 40 years-

What Can We Learn From New York City's Oldest & Strongest Man?

• He was a lifelong vegetarian, as was his mother--which at the time was unusual.
• He never drank, smoked, or indulged in sweets.  At his 104th birthday party he blew out all the candles on his cake, but passed on eating a piece.  He said if he never would have made it to 104 if he ate that kind of stuff.
• He ate oatmeal every morning.
• "He was the picture of health until he died.  He had no glasses, no hearing aid.  He had no assistive walking device and didn't take any prescription drugs of any kind,"  according to his close friend Arthur Dreschler, president of Joe's club, "The Association of Oldtime Barbell and Strongmen".
• Rain or shine he still walked 5 miles every morning (albeit a little slowly), and exercised daily--which sometimes included swimming laps in the Atlantic ocean.  He continued to lift weights five days a week--even exercising before his 104th birthday party luncheon.
• He was a devotee of the "Iron Game", a body-building philosophy that supports weight-lifting as an enjoyable lifelong hobby but strongly eschews steroid use.
• He was a longtime member of the Coney Island Polar Bear Athletic Club--a group who swims in the icy Atlantic ocean 3 to 4 times a week.   They call it "winter bathing" and attribute their good health to the practice.  They believe "if they stay in for 5 to 10 minutes, the cold water kills germs that fester inside one's body."  All the Polar Bear members claim that once they started "winter bathing" they haven't been sick.  Same for Joe, who at 103 said he couldn't remember the last time he was sick.  His friend, fellow Polar Bear buddy, and former Brooklyn homicide detective,  Louis Scarcella, said Joe held the Club's record, swimming every day, no matter the weather for eight years, never missing a day.
• "Muscle strapped to bone" is how Louis Scarcella described Joe.  Until the day he died, people described him as physically active, agile, and loose.  Mentally lucid and sound.  "His memory was nothing short of astounding, especially when you consider he fought at about 122 pounds, often against boxers weighing 50 pounds more than he.  To say he was a physical marvel, would be a gross understatement." 
• "If he told me he was 75, I would have said he looked great for his age, and here he was 104 years old," said extremely-fit 61 year old  retired NYPD detective, Arthur Perry.
• Friends said he lived life to the fullest, and looked forward to every day with enthusiasm.  He was never skeptical, cynical, angry or resentful. 

To read more about Joe click here.

The Other Side of The Vigor Quest--$10,000 a Year for H.C.G., Growth Hormones, and Testosterone

Contrast Joe Rollino's simple healthy low-tech lifestyle with the kind of big buck pharmaceutical techniques featured in the fascinating January 17th, New York Times Magazine article by Tom Dunkel, "Vigor Quest".  Click here for the full article.

It's the kind of anti-aging medicine that costs lots of out-of-pocket-cash, and follows controversial skimpy medical evidence. It might bring vigor for now, but serious adverse effects down the road.  The jury is still out.  It's part good common sense, like a low glycemic-diet, weight-training, aerobic exercise, omega-3 supplements--and part human lab rat experimentation.

But its devotees say, "Lifestyle alone isn't enough." 

To combat the corrosive effects of aging, every three months the followers of Cenegenics Medical Institute's  brand of anti-aging medicine--and they now number around 10,000--get 10 vials of blood drawn, in order to measure all sorts of hormone and blood chemistry levels--checking to see what sort of pharmaceutical tweaking is in order. 

A little more testosterone?  A bit more human growth hormone?  Perhaps some H.C.G.--human chorionic gondatropin, a commonly used fertility drug that is distilled from the urine of pregnant women, and can stimulate the testes to secrete more testosterone.

Author Dunkel interviewed John Bellizzi,  a 51 year-old amateur soccer player and businessman from Rye, NY, who got fed up with using Advil, hot tubs, and surgery to keep him in the game. 

Two years ago Bellizzi consulted with Manhattan endocrinologist Dr. Florence Comite, who is affiliated with Cenegentics.  Comite calls her work, "...aggressive prevention, the basis of which is metabolism modulation.  Twenty years from now, this will be the standard of care."  She's like an "ace mechanic who keeps Bellizzi running in spite of worn parts."

Turns out, Comite has impeccable credentials--she's Yale-trained, with former stints at the N.I.H., and as a part-time faculty member at Yale.

Now, two years after working with Comite, Bellizzi is a believer.  He no longer collapses on the couch after soccer games, he can play an hour longer than before, he feels mentally sharper, and he is 15 pounds lighter.  It might be the changes in his diet, eliminating the junk food, adding some mainstream supplements, and having a more well-rounded exercise regimen. 

Bellizzi credits his turnaround to the controversial H.C.G. he injects--which also happens to have a list of scary side effects.

The Cenegenics' Poster Child Dr. Jeffrey Life

Who hasn't seen this picture of Dr. Life in every airline's complimentary magazine?  He's the 71 year old doctor, who was once fat and unfit, until he re-invented himself with diet, exercise, and the Cenegenics brand of pharmaceuticals.

For Life this means:

• 1,000 milligrams of calcium a day
• Co-Q10 twice a day
• 5,000 IU of vitamin D a day
• 4 grams of fish oil a day
• 10 mg of melatonin at bedtime
• A testosterone injection once a week
• A human growth hormone injection once a day

Read the article.  Interesting provocative reading, but no thank you!  I'm sticking with my simple lifestyle modification plan of diet and exercise!  It's the Start of the New Year, the Start of the New Decade, and the Start of My Sixties. Some Simple Strategies for Staying Healthy and Happy. At Least I Can Hope!

So, what do you think?  Joe Rollino or Dr. Jeffrey Life?  

Exercise and Diet Derail Diabetes. NPR on Preventing Diabetes - How Small Changes Have Big Payoffs

For Tim Daly (left), losing 14 pounds brought his blood sugar down from pre-diabetic to the normal range.  His identical twin Paul (right), works to manage his diabetes with exercise.

"If it's hard to imagine how small differences in lifestyle can make a big difference in your health, consider this story of identical twins Tim and Paul Daly.  They shared almost everything in childhood, including the same eating habits, the same love of basketball, and the same genes--some of which predispose them to diabetes."

"Preventing Diabetes: Small Changes Have Big Payoff", by Allison Aubrey, NPR Morning Edition 1/04/10

 

I heard this story while driving into work on Monday morning.  It put a big smile on my face!  Frankly, we all have one kind of disease or another in our family closet, and who doesn't want to think we can have at least some control over our health.  Well here's how to foil the diabetes gene!

Turns out diet and exercise can trump the diabetes gene.  And diet and exercise was twice as effective as medicine in preventing diabetes!

Here's the story of the Daly Brothers of Massachusetts:

• Tim and Paul Daly are 60 year old identical twins--born in 1949.
• At age 24 they were both in excellent shape--5' 10" tall and both weighing 147 pounds.  From that point on their lives took a slightly different direction.
• In their 30's & 40's they both started putting on weight--Paul gaining more than Tim.  At age 47 Paul weighed 220 pounds.  Tim weighed 200 pounds.
• Since Paul's wife worked nights, while he worked days, he ended up eating more fast-food and convenience food than was good for him, and he got zero exercise. Note added 1/6/10: Apologies if this sounds like wives are responsible for the health of their husbands--it wasn't meant it. This was Paul's take on why he was making "less healthy" choices.
• Tim played basketball every Tuesday night with his buddies for 1 hour a week. 
• By 1996, at age 47, Paul's weight had climbed to 220 pounds.  He'd gone from 185 to 220 in a blink of an eye.  At his annual physical he was diagnosed with type 2 diabetes, with nary a symptom.
• The complications of diabetes terrified him:  Loss of vision, kidney failure, amputations because of an effect on the nervous system, and a substantial increase in the risk of stroke and heart disease.

"Because we know that type 2 diabetes is a genetic disease, and since he (Tim) is an identical twin, he has a risk of developing diabetes that's about 95%."

-Dr. David Nathan, Director of the Massachusetts General Hospital Diabetes Center-

How Tim Daly Beat the Curse of the Type 2 Diabetes Gene

• Lucky Tim.  Soon after twin brother Paul was diagnosed with diabetes, Tim jumped at the chance to participate in a large 27-site national diabetes prevention study for people at high-risk of developing the disease. 
  
• 3,234 volunteers were divided into 3 groups:  One group got intensive counseling from a dietitian and a motivational coach who helped develop a plan to eat less and exercise more.  A second group took the diabetes medicine Metformin twice a day.  A third group received placebo pills instead of Metformin.
  
• Lucky Tim.  He got into the diet & exercise group.
• Here's what his dietitian & coach prescribed for him:  2 and 1/2 hours of exercise a week + he had to lose 14 pounds--7% of his body weight.  At the start of the study he weighed 200 pounds--too much for someone who's 5'10".  As for the exercise--since he was already playing basketball 1 hour a week, he added some brisk walks and jogging a couple of miles a week.  He also started walking the golf course instead of using a cart.
• When Tim started the study back in 1996 his blood sugar test showed he was pre-diabetic--with blood glucose levels that were higher than normal--but not yet "worthy" of a diabetes diagnosis.
• Adding more exercise into his week wasn't the hard part for Tim.  The tough part was learning to eat smaller portions--all the time.  He had to turn that into a habit.  He learned the drill--a portion of meat is the size of a deck of cards.  When he wanted potato chips, he learned to pour a small amount into a cup--no more eating out of the bag.
• Losing the 14 pounds moved Tim's blood sugar into the normal range--out of the pre-diabetes state.  Nothing too daunting.  A small change made all the difference. 
  
• 14 years after starting the study, Tim is still diabetes-free.

Diet and Exercise or Metformin or the Placebo.  Which Group Fared the Best?

• The study found that diet & exercise was twice as effective as taking the Metformin in preventing diabetes in the volunteers.
• The point of the study was to encourage life-long habits and behavioral changes--not just put the volunteers on a short-term diet.
• For the other volunteers, all with pre-diabetes, losing 7% of their body weight helped to cut the risk of diabetes by almost 60%.  Tim's results were typical of the other diet/exercise participants.  Small changes--losing 14 pounds in Tim's case--not 50 pounds, made all the difference.
• According to Dr. Nathan, eating better and exercising is incredibly effective in helping to manage type 2 diabetes and pre-diabetes.  When people lose weight, their blood sugars respond favorably.
• "Small steps can result in really large benefits.  Just doing a little more will help enormously to prevent this.  And that's what the Diabetes Prevention Program showed,"  according to Dr. Nathan
• Although Tim has dodged the diabetes bullet now for 14 years, Dr. Nathan says researchers are still studying whether or not it's possible to keep diabetes at bay for the rest of his life.
• With 1.6 million new cases of diabetes diagnosed per year in the U.S., Dr. Nathan hopes people will begin to understand how such small life-style changes can have such a tremendous effect on one's future health.

And What About Brother Paul?

• Since Paul already has type 2 diabetes his battle is tougher, and he's vowed to try harder.
• He's stepped up his exercise, and is kicking up his daily walks a notch.
• Because Paul is exercising more, and eating better, he's been able to manage his diabetes, and doesn't need to take insulin.
• There's strong evidence that even exercise, without weight loss can help improve blood sugar.

How Exactly Does Exercise Prevent Diabetes?

The experts:  Gerald Shulman of Yale University School of Medicine & Arthur Leon of the Univ. of Minnesota

• Exercise can prevent and even reverse Type-2 diabetes
• Again, it's all about insulin resistance.  Too much body weight or a not-so-healthy diet & insulin-resistance develops--then the body can't absorb all the glucose from your digested food. This leads to a build-up of fats in the body which further interferes with the whole glucose transportation system. If the body can't absorb all the glucose in the blood, bad things can happen: like heart disease, nerve damage, blood vessel damage, stroke, or infections.
• Exercise can reverse the whole process.  With vigorous exercise the muscles increase production of an enzyme called AMPK, which breaks down the fats that were interfering with the cells' glucose transportation system. Bingo--the body starts responding to insulin and absorbing glucose just like it's supposed to do.

It's the Start of the New Year, the Start of the New Decade, and the Start of My Sixties. Some Simple Strategies for Staying Healthy and Happy. At Least I Can Hope!

Author Dan Buettner has scoured the Earth — not for the fabled Fountain of Youth — but for the key to a happy old age. He spent five years visiting areas of the world where people tend to live longer, healthier lives, areas he calls "Blue Zones."

Buettner says he has identified four things people can do that can potentially increase life expectancy:

• Create an environment that encourages physical activity
  
• Set up your kitchen in such a way that you're not overeating
  
• Cultivate a sense of purpose 
  
• Surround yourself with the right people.

"These are long-term fixes that have been shown over and over to add not only more years of life, but better years of life."

-NPR story, "Can 'Blue Zones' Help Turn Back the Biological Clock?", June 8, 2008-

If you're reading this through via email, click here to get to the more readable web-version.

It's the start of the New Year. 

It's the start of a new decade.

It's the day I turn sixty.

Look, I'm not a big-birthday-celebration-kind-of-person.  They come and go and I don't even think about the years.  But turning 60 is different.  It's the last quarter of life, with no guarantees on what that quarter is going to look like.

Judging by my parents--that last quarter of life doesn't look so promising.  Which is exactly why I've been paying attention to exercise and eating right since I turned 30. 

That's when my dad had one of those massive debilitating strokes that left him unable to communicate, unable to read or fully understand speech, and eventually unable to walk or do anything.  He was 69 at the time--just when he was getting ready to kick back a little, work a little less, travel, and just enjoy life.  He spent 16 years living in this kind of post-stroke-limbo-state, spiraling downward.

My mom was 62 at the time, and my dad's stroke changed her life in an instant.  One minute she was planning all the trips they'd finally have a chance to take--and enjoying their new role as grandparents--and in the next she was jockeying the world of wheelchairs and therapists.

With the stress of full-time care-giving, and years of no exercise or attention to diet, by 72 she had developed severe coronary artery blockages, hypertension, kidney stones, and painful spinal fractures.  Then came the mini-strokes that finally added up to vascular dementia in her eighties.

And unfortunately, this scenario is all too common.  "[M]ost elderly Americans – more than two-thirds of current 65-year-olds, according to a detailed 2005 projection by a team of health policy analysts — at some point will need assistance to cope with daily living, either paid help or unpaid, at home or in a facility."

So, sixty seems kind of scary to me.

Which is exactly why I'm ready for a more "Conscious Aging" plan.  We already have all the evidence we need to stay healthy.  It's not about adding more years to our lives.  It's all about adding more life to our years!

Just a sampling of the evidence.

• The 52 country INTERHEART study was very clear.  There are 9 easy-to-modify risk factors that are associated with 90% of heart disease.  This was a huge study--30,000 people from every inhabited country--and the results were the same for all races, all sexes, all countries.  All 9 of these risk factors are within our control--and would eliminate 90% of heart disease, regardless of one's genetics. 1. Keep lipids (cholesterol & triglycerides) down; 2. Stop smoking; 3. Prevent or control hypertension; 4. Prevent or control diabetes; 5.  Reduce belly fat; 6.  Find ways to control psychological and social stressors; 7. Increase fruit and vegetable consumption; 8.  Moderate alcohol consumption is protective; 9. Get regular physical exercise   Lancet 364:937-952, Sept. 11, 2004.
• The Nurses' Health Study and Health Professionals Follow-up Study.  "The largest and longest study to date, done as part of the Harvard-based Nurses' Health Study and Health Professionals Follow-up Study, included almost 110,000 men and women whose dietary habits were followed for 14 years.  The higher the average daily intake of fruits and vegetables, the lower the chances of developing cardiovascular disease...[F]or every extra serving of fruits and vegetables that participants added to their diets, their risk of heart disease dropped by 4%." Harvard School of Public Health

• The China Study.  This is Dr. T. Colin Campbell's mammoth 2006 study on the effects of a plant-based diet on health--citing over 750 studies.  The conclusion: People who ate the most-animal-based foods got the most chronic disease.  People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease.  According to Campbell, "Good nutrition supported by exercise, clean water, and sunshine is greater than the sum of its parts.  It's a biological symphony.  My introduction to Dr. T. Colin Campbell

• The Longevity Personality.  From the Journal of the American Geriatrics Society, April 2009 comes this conclusion: Those who live the longest are more outgoing, more active, more easy-going, more empathetic, and more agreeable than those who live a normal life span. The Blue Zones calls it, "likeability".

Here's My Strategy for Staying Out-of-Trouble After Sixty

Some of these are long-time habits, and they're easy for me to follow.  Some of these I don't do as regularly as I should.  Some of these are new goals.  But this much I do know:  If I don't have a plan, if I don't do these consciously, and if I don't carve out time to make them happen--they won't.

1.  Stick with 7-9 servings of fruits and vegetables a day.  The Green Smoothies make it easy.  I get 6 servings in a 27 ounce Klean Kanteen that I divide over breakfast and an afternoon snack.  I calculated the nutritional info on my daily 27 ounce serving that includes, 2 1/2 cups kale, 8 mini-carrots, 1/2 cup pomegranate juice, 1/2 apple, 1/2 orange, 1/2 kiwi, and 3/4 cup frozen black raspberries.  Check out the nutrient content for 27 ounces:

Nutrition Facts The Healthy Librarian's Green Smoothie-kale,blackberries,carrots,orange,kiwi,pom juice,apple
Serving Size: 1 serving
Amount Per Serving
Calories	342
Total Fat	2.2g
Saturated Fat	0.2g
Trans Fat	0g
Cholesterol	0mg
Sodium	140mg
Carbohydrate	82.1g
Dietary Fiber	13.8g
Sugars	49.1g
Protein	8.9g
Vitamin A 729% Vitamin C 485% Calcium    35% Iron 28%

Then throw in some veggie-based soup, a salad, a veggie-based dinner entree, some fruit for dessert, and I'm good to go. 

This eating plan is the same as the DASH Diet (Dietary Approaches to Stop Hypertension)--guaranteed to stop hypertension.  The Cache County (Utah) Study on Memory shows it also prevents cognitive decline.   Dr. Amy Lanou and Michael Castleman, authors of Building Bone Vitality claim it will build and strengthen bones--because the 17 nutrients necessary to build strong bones are all found in a diet high in fruits and vegetables.

2.  A balanced exercise plan.  It's not just about cardio--there are 4 areas that need attention: Cardio (spinning-my fave), Weight-training, Flexibility & Balance (yoga-my fave), and Core Strength.  No, you can't just walk and think you're in good shape.  I'm super regular with my cardio, and not as regular with the weight training and yoga.  Click here to see what my workout looks like. As for core strength--that's pretty much non-existent.  And when it comes to weight-training, according to Randy Raugh, the Canyon Ranch physical therapist, and author of the excellent Prime for Life--Functional Fitness for Ageless Living--to get the maximum benefits you need to do it for 3 non-consecutive days a week--2 at the minimum.  Unfortunately, I often weight train only 1 day a week.  If you want to build strong bones and prevent osteoporosis, and maintain your muscle strength as you age--weight-bearing exercise for the lower body, and weight-training for the upper body is a must-do!  Yoga, helps with balance, preventing future falls, and building strength.  As for core strength, I'm upping my game with Dr. Stuart McGill's routine, and my birthday-present to myself is the physical therapist-designed Pelvicore exercise ball.

3.  A plant-based diet with minimal added fat.  I'm nearing the 2 year mark on eating plant-based, so this is the easy part. I've got this down pat. I still use a little olive oil for cooking and in salads, and very occasionally eat some seafood or dairy when eating with friends.  I'm convinced.  If you want to lower your cholesterol, reduce your risk for type-2 diabetes, lower your blood pressure, reduce your risk of heart disease & stroke, and reduce your belly fat--this is the way to go.  Dr. David J. Jenkins of St. Michael's Hospital in Toronto is one of the pre-eminent researchers on the benefits of a plant-based, low-glycemic diet (like beans, nuts, oats,& quinoa) for improving diabetes control, lowering cholesterol, and preventing cardiovascular disease.  Click here for Jenkins research.  And that's not all--keeping your blood sugar stable with low glycemic plant-based foods and exercise will preserve your brain.  Click here.  And as for too much fat--not only is it bad for your belly--it's bad for your brain--so just ditch it Click here.

4. No time urgency.  This is what keeps the Okinawans calm, relaxed, and living longer.  I'm really working on this one--which goes hand-in-hand with flexibility.  Things don't always go as planned--you either go-with-the-flow or get stressed and anxious.  My favorite 2 words, "Oh well."  Life goes better when you stay in the moment, chill, and don't worry about getting there fast.  When our Christmas Day trip to New York City was aborted because of an ice storm, we checked into a hotel at noon, and enjoyed a dinner of cranberry nut mix, Larabars, Cliff Bars, and clementines.  All the restaurants were closed in this Pennsylvanian town.  Oh well.  We had a good time, and made it to New York safe and sound the next day.

5. More Dancing, Singing, Laughing, Playing, Schmoozing, and Mahjing.  What's the point of staying healthy without having fun?  That's the reason we work at staying healthy. Cool fact: There's a little organ deep in the ear, called the sacculus--and it gives us a great sense of pleasure and well-being when it's stimulated.  But, it can only be stimulated through singing!  So, bring on the Singstar Karaoke!  Click here.

6.  The Supplements.  I'm really bad at regularly taking supplements.  I'm good at counting them out, taking them to work, and bringing them back home with me.  Truth is, there are some supplements worth taking because there's no easy way to get enough of them through diet alone.  Here are my favorites:  Omega-3s (I use Omega-Brite), DHA, (an omega-3 for brain health), Magnesium, Citracal, Vitamin D (I'm up to 3000 IUs), Curcumin (also known as turmeric, the yellow color in curry), and Juvenon (the combo of acetyl l-carnitine & alpha lipoic acid) developed by Dr. Bruce Ames.  Click here to read more about what I take, and what some prominent physicians take.  

7.  Eliminate the time-wasters from my day.  Except for watching "The Middle" or "Glee", TV watching always leaves me bored and unsatisfied.  So, why bother wasting the precious time?  The same goes for my mindless internet cruising, checking in more than necessary with email, the NYT, and other favorite sites.  Enough already!

8.  Maximize my peak energy times of the day.  Over a year ago I blogged about getting in sync with our natural energy ebb and flow throughout the day.  It works--and I intend to start planning my day around them, when possible.  For instance, 9-11 is the peak time for brain work-creativity-and analytical work.  On days when I don't work I would usually use this time for exercise & errands.  Poor use of brain time.  Better to exercise between 3-6.  To read more, click here:  Maximize Your Energy-Match Your Tasks to Your daily Energy Levels.

9.  Give a gift a day for 29 days a month.  When 36 year old Cami Walker of LA learned she had multiple sclerosis, her spirits flagged.  She was tired, in pain, and had the prospect of a debilitating disease ahead of her.  When a holistic health educator gave her the prescription of giving 29 gifts a day for a month she thought it sounded it crazy.  Nothing big (and that's the point)--something like making a supportive phone call or saving a piece of yummy cake for her husband.  Of course the prescription didn't cure her,  but it had a startling effect of helping her cope with her illness and gave her a more positive outlook on life.  I love this idea.  It's a planned regular way to just think about kindness.  No big acts, just something little-done everyday.  To read more, click here.

10. Cultivate my garden of friends and family.  Regular phone calls, visits, dinners, outings, and celebrations.  At 60 there's no time to delay any of these.  It's the glue that keeps us together and makes life worth living.

11.  Once You're Through Learning--You're Through.  This is the philosophy of John Wooden, the 97-year-old retired UCLA basketball coach.  No doubt about it, learning and sharing what I learn is my purpose in life.  I'm lucky to have a job that gives me access to learning about health and medicine, and a hobby that gives me a chance to share what I learn.

12.  Start Eating Less.  OK, I'm ready to shed a few pounds, and I know from past experience that writing down exactly what I eat, and how much I've exercised, really works.  I use something called MyFoodDiary.com and it's set up with all my favorite recipes.  Unfortunately, I haven't used it in quite some time.  The new year is a great time to start!  To read more about this tool, click here.

For some good reasons to eat less, read:  CALERIE: The NIH Calorie-Restriction Experiment. Lessons for Health, Slowing Down the Aging Process, Longevity, and Disease Prevention 

Time to end this list.  I've already maximized my 9-11 brain time and written this post.  It's now time to make my smoothie, do some core exercises, take those supplements, answer birthday phone calls, enjoy a birthday lunch, followed by an evening out with friends who all share the same wedding anniversary--if we can just make it through our foot of snow!

I'd love to hear from anyone who is 60 or over with advice, tips, and wisdom about maximizing life in the sixties, seventies, and more.

"A WSJ-Style" What's Your Workout? A Medical Librarian's Fitness (Re) Search: Spinning, Weight Training, Yoga, & A Good Walk

1965 Junior High Girl's All-Star Basketball Team (find me in top row left)

2009 Weight Machines at the JCC

I got to thinking.  With the way I'm always writing about food and cooking, you might get the idea that eating is the extent of my health & fitness routine.  So...in the spirit of the Wall Street Journal's series, "What's Your Workout", here's what I've been doing to stay in shape.

First off.  I'm not a jock, a gym-rat, or a competitive athlete by any stretch of the imagination.  What I do 5 days a week is something anyone can do.  Believe me, this exercise plan is all about fun. 

It's a cross between dancing up a storm at a wedding (my spinning class), chilling out at a spa retreat (my yoga class), learning from fascinating experts (listening to podcasts while lifting weights), and having a gab fest with friends (taking a long walk with a buddy).

I graduated from college before Title IX existed--which means women's sports teams didn't exist--except for the one Exhibition Game my Girl's All-Star Basketball team played in 1965.  But back in those days we had daily gym class and we walked to school--and that meant walking home for lunch in elementary school.  No school buses, no parent's driving us to school, and hardly a kid with a car in high school.

When Did I Start Exercising? 

I start running in 1976 when I worked as a paralegal for a huge law firm.  It was boring & stressful----and it left me with insomnia for the first time in my life, as well as a twitch in my left eye.

One day, I felt so exhausted & frustrated from lack of a good night's sleep that I decided to start running to burn off some nervous energy.  Bingo!  I found the magic sleep elixir. That night I had my best night's sleep in months.  And the left eye twitch magically disappeared.

I also came to my senses--deciding that the best part of the paralegal job was doing library research--and took the plunge in 1977 & started a program to get a Master's degree in Library Science, with a medical library specialty.

I kept running regularly, competing in a couple of races, but frankly, running wasn't for me.  It was solitary, and I hated running when it was freezing cold outside.

I moved on to Jackie Sorensen's Aerobic Dancing, anyone remember that?   Loved the music, the dancing & the camaraderie. Over the years I've kept up the exercising--right on through to the end of 2 pregnancies.  I've done it all over the years-- high and low aerobic classes, step aerobics (a former favorite), power walking, power weight classes, power yoga, boot camp, bosu, and plain old free weights.

The Present Workout

My routine covers all the important fitness basics: aerobic conditioning--strength--flexibility--and balance.  And my particular mix exercises my body, mind, and spirit.

I'm a card-carrying JCC member since 1976.  And I'm a huge advocate for group exercise classes--no treadmills or ellipticals for me.  Group classes are motivating and provide variety--and at the J there are over 60 classes a week to choose from.  They keep me moving for 60 minutes--long after I'd quit if I were on my own.  They are a lot more fun than going it alone--and at my community center gym I get to meet twenty-somethings to ninety-somethings.  Where else does that happen?

For at least 10 years now I've been sticking to these four activities--but I'm always ready to try something new!  Pilates & Zumba may be next on the agenda.

Spinning - A Dance Party, Boot Camp or Travelogue rolled into one. This is stationary biking in a group--my class usually numbers around 30--men, women, twenty-somethings to an occasional 60-something.  This is my all-time favorite exercise. 60 minutes of heart-pumping sweat-producing interval training.  You're climbing hills and doing wind sprints. 

A guaranteed high calorie burn that's always a challenge, because you can kick up the bike's tension as you get stronger.  Beginner & super athlete alike can exercise together at their own fitness levels. 

When I'm spinning to high-energy motivating music--that changes to each instructor's taste--I get a huge endorphin smile on my face and I feel like I'm dancing while I'm madly pedaling to Beyonce's "Single Ladies".

Every instructor brings a different style to the table.  With Laurie it's definitely a dance party.  With Kate, I'm at a serious athlete's boot camp.  With Rich, it's a training run on the Boston Marathon course, or a history lesson/travelogue through the Antarctic or on the Tour de France.

Yoga -The Spa Retreat.  I'm so "over" power (Ashtanga) yoga, but my slower-moving yoga classes are still challenging.  Yoga is what I do for flexibility, strength, balance, and relaxation.  Chaturanga (a yogic push-up) and up-dog are definitely arm strength builders. 

Moving through sun salutations, down-dogs, the bridge, boat pose,the wheel, pigeon pose, half moon pose, and more, I strengthen my back, open up my too-tight hips, stay flexible, learn to breathe slowly and to concentrate.  The relaxing shavasana (corpse pose) meditation that comes at the end of class is my sweet reward.  I finish up relaxed, mellow, and chilled out--just like a trip to the spa.

Weight Training - My Visiting Scholar Lecture. OK, I'm in a rut with weight training--basically doing what I shouldn't--sticking to the same weight machines at the same number of reps & weights for about 3 years now.  I've been in maintenance mode way too long.  It's time to mix it up, change the routine, and up the ante. 

But this is my automatic pilot time.  My IPOD Nano is loaded with NPR's Health Podcasts, Science Friday, Diane Rehm, Joe Graedon's People's Pharmacy, & various Internal Medicine and Ob-Gyn Audio-Digests.  When I run through my pecs, chest, biceps, triceps, back, pull-overs, lats & more I'm listening to an hour of knowledge.   Nothing boring about this 2-for-one brain & body exercise routine.

The Long Walk - The Gab Fest or the Silent Meditation.  What could be better?  A 3-5 mile walk with my husband or a friend, walking and talking--it's a chance to catch up, exercise, and enjoy nature.  If I go it alone, it's a chance to just let my mind wander & enjoy the changing seasons--and get ideas for what to plant in my garden.  It could be a walk on country roads, a hike in the nearby park or a hike through our world-class arboretum.

The Gear -  Nothing fancy here.  What you see me wearing in the photo above works for spinning, yoga, and walking outside.  I've worn the same work-out clothes for years now.  They just don't wear out.  2 pair of black yoga pants, 2 pair of black bike shorts, assorted sports bras, assorted Target t-shirts, and about 8 multi-colored sleeve-less tops that I got years ago for $5.00 each at BJ's.  I like the sleeveless because it motivates me to do arm exercises.   I've got one pair of running shoes that I use for cycling, walking, or weight training.

My Must-Have All-Time Favorite Equipment - I wouldn't want to exercise without my F6 Polar Heart Rate Monitor.  It's set up for my fitness level, my minimum &  maximum aerobic heart rates, my age, and weight.  It records how long I'm working out in the aerobic range, my highest, lowest, & average heart rates, and how many calories I'm burning.  I know when I need to kick it up a notch, and when I'm working too hard. And all my exercise sessions are saved so I can see what I've done for the past week.  It's motivating & keeps my honest.  For a great guide to exercising with a heart rate monitor, click here.

Cost:  I got mine for about $100 online. 

IPOD Nano.  Love my Nano.  No music on mine.  Just podcasts.   It's a learning machine.  6 months ago I  added a nifty FM receiver that plugs into the Nano & allows me to listen to the radio--in my case that's NPR. I hear the new 2009 model comes already equipped with an FM receiver. 

Cost:  about $140.00 at Costco

The Routine 

Monday:  1 hour yoga class before work or 1 hour weight work-out after work

Tuesday:  1 hour spinning class (+ weight workout if I don't lift on Monday)

Wednesday:  rest day or one hour walk outside

Thursday:  1 hour spinning class (+ occasional yoga class)

Friday:  1 hour weight workout before work

Saturday:  rest day, or leisurely walk or hike outside

Sunday:  1 hour spinning class & 1 hour yoga class

The Diet 

Mostly plant-based--I "try hard" to avoid sugar and baked goods--but I have my lapses.  I load up on whole grains, vegetables, fruit, a daily salad, soups, and one-dish meals.

Breakfast is a Green Smoothie and a mid-morning Larabar or a bowl of fruited oatmeal with a mid-morning Green Smoothie.

Lunch is leftovers from the night before, or a salad topped with teriyaki seitan, or an Amy's frozen vegan meal, or a vegan lentil dal burger on a bun.  Fruit and a few nuts mid-afternoon.  Finishing up any leftover Green Smoothie.

Dinner is usually a one dish meal with a green salad.  One-dish meals could be Veganomicon's Black Bean Mango Quinoa Salad, Spicy Sweet Roasted Butternut Squash with Black Beans, or Obama's African Peanut Vegetable Soup.  For lots of recipes click here.

I love to cook and experiment with new recipes, and I try to prepare enough so I don't have to cook dinner every night.

The Playlist

It Wasn't Me, Strength of a Woman, Come On Get Higher, Here Comes the Sun, Single Ladies, Super Man (2) to name a few, NPR Podcasts Galore

Fitness Tip

Exercise with other people.  You combine socializing with fitness.   Mix it up.  Do something aerobic for your heart, something to improve your flexibility & balance, and some kind of weight training for strength & to kick up your metabolism. Once you start exercising, whatever you do--DO NOT STOP!!!

Most Memorable Fitness Vacation

Hiking with my husband for two weeks across northern England on the Coast-to-Coast trail--which runs from the Irish Sea to the North Sea.  Click here to learn more.

Is Your Ab Workout Hurting Your Back? Dr. Stuart McGill Advises to Trade in the Crunch for the Bird Dog, Side Bridge, & Stir the Pot

Click Here for the video if you don't see it.

Stuart McGill, a professor of spine biomechanics at the University of Waterloo in Canada, demonstrates a core exercise program emphasizing all the major muscles that support the spine.

Stuart McGill know backs.  He's one of the world's foremost authorities on the lower back, advising people with the worst back pain, as well as world-class athletes who want to improve their performance by protecting & strengthening their backs.  To hear an extensive interview with McGill click here.

If I had an unsolvable back pain problem I would want to drive up to Waterloo, Canada & consult with Dr. McGill.  When it comes to biomechanics, he knows how backs work, why they fail us, and how to fix them.

Want to strengthen your back?  Want to prevent back pain?  Want a strong core?

Ditch the traditional ab workout or crunch.  Ditch the sit-up on the exercise ball.  It's not helping.  Be careful with Pilates. 

"Is Your Ab Workout Hurting Your Back?"  by Gretchen Reynolds.  New York Times  June 17, 2009 Gretchen Reynolds  

I've never liked abdominal exercises.  They've always made my back & neck hurt--and normally my back is just fine.  I thought that the post-ab-exercise-achiness-in-my-back-and-neck just meant that my back & neck muscles were weak. That may be--but the traditional abs are bad news. Who knew?  Certainly not me! Read Reynolds article to learn more.

So What's the Problem with Sit-ups?

1. According to Dr. Stuart McGill, if you do enough sit-ups you're going to hurt your back.  Our backs only have so many bending cycles in them--everyone is different based on genetics--but our backs are like wire coat hangers.

Bend that coat hanger back & forth so many times and it's going to weaken & finally break. 

Since we only have so many bending cycles available in our backs (a sobering thought), why would anyone want to use them up with something silly like a sit-up?  And as McGill demonstrates in the video, the traditional sit-up is a great way to cause discs to bulge, herniate & impinge on nerves.  According to McGill, "If you did 100's of sit-ups, your back would break before the spine could be trained to a high level!"

2. Lab tests have shown that the traditional sit-up or crunch  "greatly reduces the load that the spine can bear without injury when subjects pull in their belly buttons", press their backs against the floor or an exercise ball, deeply hollowing out their backs.

3. Sit-ups place a "devastating load on the disks".   It's very possible to have 6-pack abs, and a ruined back.

4. The entire core--the muscles & connective tissue surrounding and holding the spine in place--must be strengthened and balanced.  To concentrate solely on the abs destabilizes the spine, pulling it out of alignment.  If the core is strong & stable, the spine remains upright & it can bear heavy loads while the body swivels around it.

There is a better way.  Watch McGill's video & in 2 minutes you'll have the basics with four easy-to-do exercises you can do daily.  They strengthen and stabilize the core, exercising the "important muscles embedded along the back and sides of the core."

1.  A safe effective modified lumbar supported abdominal curl.

2.  Stir-the-pot.  A plank-like exercise done on an exercise ball for strength & stability.

3.  Side bridge

4.  Bird Dog - with 3 ways to increase the challenge.
 

I literally brought my laptop down to the floor to make sure I got these exercises right--and watched them about 5 times until I understood the correct form.  They're easy...but the Bird Dog variations took a while for me to coordinate.  I'm a slow learner!  I definitely plan on incorporating these quick exercises into my daily routine.

McGill's Opinion About Pilates

Gretchen Reynolds asked Dr. Stuart McGill to talk a bit more about Pilates and core workouts.

He said, “Pilates is fine for some people and very troublesome for others. It’s important that each person get an expert assessment to determine who fits in each category, the specific types of Pilates that would be best, the set and rep design to the intervals, etc.”

From the Times of London. "Do Back Exercises Work?"  April 11, 2009  Read the article here.

Core-stability exercise is endorsed by everyone from celebrities to physical therapists, so there has never been cause to question its wisdom. But the beginnings of a backlash have started to appear.

A paper published recently (click here  Br J Sports Med 42:930-31, 2008. Allison & Morris) in the British Journal of Sports Medicine suggests that the benefits of core-stability workouts (that concentrate solely on the transverse abdominals) have been wildly overplayed.  The evidence is just not there.

They cast doubt on the notion that back pain is linked to "less than optimal core stability" and suggest that it is linked to poor trunk rotation and strength instead.

If you hollow in your muscles--as in bringing your navel to your spine--you bring the muscles much closer to the spine and you effectively reduce the stability of the back.

When you lift something or exercise, rather than pulling in from the navel to spine you should brace all the abdominal muscles.  Bracing is stiffening the abdominal wall. Imagine that you are going to be hit in the stomach.  The instinctive reaction is "bracing".

Read more about Dr. Stuart McGill & his work on backs:

McGill's website

A back support to use if you sit long hours at work. Sitting long hours is a key reason for lower back pain.  "Why Sitting In A Chair Hurts Your Back. What You Can Do To Prevent Back Pain" 

British Journal of Sports Medicine 42:930-931, 2008  Transversus abdominis and core stability: has the pendulum swung?  Allison, G.T., Morris, S.L.

***Just came across Dr. Thomas Kerr's post .  Kerr is a chiropractor and a big fan of McGill's work.  He does an excellent job of explaining why a sit-up or crunch is bad news.  It's always good to hear the same thing said in a different way.

Running Man: My "Lab Rat" Husband - Still Running Strong. His Experiences With Training, Yoga, a Plant-Based Diet, Statins & Curcumin

Back on December 5, 2008 when I read Tara Parker-Pope's piece in the New York Times, "A 30-year Running Streak, Still Going Strong", I thought of my husband.

An excerpt from Tara's article:  "Harvard’s Dr. Harvey Simon has long espoused the benefits of moderate exercise. But in reading The Wall Street Journal yesterday, I learned that Dr. Simon holds himself to a higher standard. His daughter, Journal reporter Stephanie Simon, writes that her dad is in the midst of a 30-year running streak. The last day her dad didn’t run was Oct. 30, 1978."

Here's my comment to the 30-year running streak story:

"Dr. Simon looks fantastic–and truly, to each his own. I say Mazel Tov!

My 59 year old husband has been running for about 36 years. Definitely, not daily. After a couple of injuries & mono, somehow he came across an easy-does-it, easy-on-the-joints method of training for long runs.

On Nov. 22 he ran the JFK 50-miler (in below freezing weather) & he ran maybe 3 days a week to train for it. Only 1 day a week did he run for hours–and I mean hours.

Adding yoga a day or two a week & biking for another (when the weather was good) seemed to do it.

The only thing he does obsessively is to run 10 miles on his birthday–which came 5 days after the JFK. 9 years ago, when he ran his last 50-miler he slacked off, and we walked the 10 miles together.

According to him, he’s never felt better and I’ve got to agree with him. I say he owes it all to green smoothies (crammed with veggies), balanced exercise & my healthy cooking.

I have to say, after reading in July about Michael Bicks’ heart attack during a regular Sunday bike ride, I was really nervous about his running a 50 mile race. I made him promise to run with a heart rate monitor.  To read Bicks' story, "Not a Moment Too Soon I Thought of Tim Russert" click here." 

Now I'm in awe of Dr. Simon--he's 66 years old--and hasn't missed ONE day of running in 30 years.  But, I'm also in awe of my husband.  He's been running for 36 years--but only 2 or 3 times a week.  He deserves an interview, too!

Q:  When & why did you start to run?  Why do you keep running?

A: I started running in high school because I thought it was something I might be good at--like cross-country & track. Then Frank Shorter came along in the 1972 Olympics, and that got me more interested; For me, running is a good basis for fitness--it's inexpensive & you can just do it right out your front door.

Q:  Nine years ago you ran the JFK 50 miler (in Hagerstown, MD) & you said you would never do it again.  It was brutal.  What made you decide to run it again?  (here's what the JFK is all about-click here)

A:  Did I really say it was brutal?  A good friend of mine, who had run a lot of marathons wanted to run the JFK in 2008.  He knew I had run it & when he asked me about it, it got me energized.  I wanted a challenge--to force myself to train for something again--and frankly, I wanted the camaraderie.  It gets kind of old running the 4 & 5 hour training runs by yourself.  I thought we could have a good time training together.

Q:  Any difference running it at almost 59 years old, compared to when you ran it at 49 years old?

A:  The difference?  Number one difference was the weather.  In 1999 the weather was perfect for running.  In November 2008 we started out in 19 degree cold--I wasn't expecting that--and the cold made it very difficult.  But mostly, this time I was much tougher mentally.  Since 1999 I've been to a few silent meditation retreats, and that really helped me to stay focused to the moment--and just keep moving forward.  Ironically, I also felt physically stronger this time around, even though I'm running slower--but hey, I'm nine years older.

Q:  You rarely seem to get injured (knock on wood).  It doesn't seem like you run all that much, even though you can run long distances.  How do you explain that?

A:  Simple.  I don't over-run.  That's why I don't get injured.  I vary my exercise routine.  I alternate running with biking, yoga, and some weights.  When I train for long races--my training focus is off of increasing one long run a week--2, maybe 3 other short to medium runs.  Rarely would I run 2 days in a row.  The big thing:  I listen to my body--I don't push it--I know in the long run I'm better off if I just don't push it, especially if I'm not feeling well.

Q:  Inquiring minds want to know.  Do you feel better or worse as an amateur athlete now that you're  eating mostly plant-based?

A:  I feel better.  But of course, it's hard to know.  I definitely don't feel weaker--that's for sure.  I feel my diet has kept me in the game.

Q:  What about the Green Smoothies that your wife is always talking about?  Do you think that has had any effect on your performance, recovery or energy level?

A:  Again, it's hard to know for sure if my performance, recovery & energy are better because of the smoothies.  But, I'll say this.  Without trying too much, I've lost weight--and I attribute it to the change in my diet.  My wife isn't buying me any big boxes of Snyder's Pretzels anymore, so I don't eat junk at night.  I've kind of learned to go to bed a little hungry.  But I'm definitely a big advocate of the smoothies, though--they just make me feel healthier--and I rarely miss a day.  For the link about green smoothies, click here.

Q:  I know you've taken statins (Lipitor/Zocor) to counteract your low HDLs (good cholesterol).  Do you think they have had an effect on your athletic performance?  Did you notice any changes when you decreased your dosage?

A:  YES!!!  They produced a subtle muscle weakness and I was only on a low dose!  What does muscle weakness mean?  My muscles fatigued earlier--I didn't have that core oomph.  I've stopped & started taking statins enough to know that they've (even the lowest possible dose) definitely had a negative effect on how I felt.  Running--going up a hill was much easier once I had stopped taking them for 7-10 days.  And the Tricor/Lipitor combination the doctor once tried me on was deadly.  I remember thinking in yoga class, "I must be getting old."  It was an amazing turnaround when I quit.  Now I just eat plant-based and don't worry much about taking statins.

Q:  What about curcumin, the anti-oxidant in the spice turmeric.  What are you taking it for & has it worked?  Yes, I know it's anecdotal evidence-placebo-effect-study-of-one-stuff, but I've read reports about its anti-inflammatory benefits & I've heard pharmacologist Joe Graedon of "The People's Pharmacy" singing its praises.

A:  I take it for very annoying foot & toe cramps that I get while I'm sleeping.  They would wake me up & sometimes I had to get out of bed to work them out.  Yes, I've noticed a dramatic reduction in these muscle cramps.  I take 2 pills of curcumin (500 mg each) in the morning, maybe 4-5 times a week.  I only take vitamins in the car--so it's not an everyday thing with me.  I haven't changed anything else--so I must conclude--the curcumin has killed the cramps.

Q:  What about the effect of yoga & running?  Think it helps?

A:  I can't say if it helps running, or has made me a better runner.  No idea.  I don't do it to improve my running.  I do it for flexibility, discipline, and as a meditation-in-motion kind of thing.  It definitely helped my recovery in the JFK run.  I see the difference with my friends who run, but don't do yoga.  They have the aches and pains you get from lack of flexibility.  After the JFK my quadriceps were sore--that's inevitable from lactic acid build-up.  In 1999--a week after I ran the JFK--I couldn't run my annual 10 mile birthday run.  I had to walk it.  And I was better trained in 1999.  This year, my 10 mile birthday run came just 5 days after the JFK--and I ran it. 

Q:  Aren't your joints killing you?  Don't you think running at your age (59) is asking for trouble?

A:  No, my joints aren't killing me.  Occasionally my left knee bothers me--and sometimes I feel a little something in my hip.  I just don't overdo it.  There are more days that I don't run, than days that I do run.  I keep my weight down.  I don't force the issue.  If it were detrimental, I'd stop it.  I don't feel obsessive about running at all.

Q: What do you think about the advice you get from The Healthy Librarian?  Now be nice!

A:  I think it's excellent advice.  Always informative & beneficial.  The best thing she's done is writing the post about my mom.  I've reread it many times.  I love seeing my mom's pictures online--when she was out in the sun & looks so alive.

Unhappiness: When Those Closest To You Face Difficult Times and You Can't Make It OK

I had never heard of Jonathan Fields before I read Gretchen Rubin's interview of him in the Happiness Project on January 15, 2009.  His answer to her question about unhappiness got filed away in my brain.  And when I woke up this morning it was on my mind.

Gretchen: Have you always felt about the same level of happiness, or have you been through a period when you felt exceptionally happy or unhappy – if so, why? If you were unhappy, how did you become happier?

Jonathan: I’ve definitely run the gamut. Much of my unhappiness, when it’s been more present, has come from either an unwillingness to accept my lack of control over certain circumstances in life or seeing those close to me going through challenging times and being unable to make it okay.

Seeing Those Close to Me Going Through Challenging Times--Unhappiness is Viral

• After recuperating from major cancer surgery (and receiving a positive prognosis) last November my mother-in-law has landed in a small town community hospital in Florida--stuck there now for 6 days.  An uncomfortable chest tube stuck between her ribs.
• To catch up--read A Parent's Illness--Act Four  and What Your Doctor Never Tells You.  What He Really Thinks.  Maybe.  The November surgery was a success.  Her cancer was not ovarian.  All that was left was a follow-up regimen of what was supposed to be mild chemotherapy and 25 quicky rounds of radiation therapy that would be similar to a chest x-ray.  Side effects would be minimal.  Probably just fatigue.  Or so we were told.  After 7 days of treatment she felt like she wanted to die.  Worse than she had felt with powerful chemo or after surgery.
• 6 days in the hospital. Still no diagnosis.  Arrogant, uncommuncative doctors.  Lack of follow-through with lab tests.  Over medication.  A lack of confidence with the physicians in charge.
• Nothing is worse than seeing those close to me going through challenging times and being unable to make it okay.  My mother-in-law, my husband, my sister-in-law.
• All of this brings back my memories of the long slow declines of my own parents, and how going into a hospital just sets off a cascade of further decline.  Confinement to a bed, de-conditioning, medical errors & mishaps, over medication & the resultant confusion.
• Add all this to the continual barrage of bad economic news we read and hear about every day...

Dr. Jerald Winakur--The Dangers of the Hospital--an Insider's View

Dr. Winakur is a geriatrician, the director of a skilled nursing facility, and a son who cared for his own father.  With all his knowledge and savvy he knows the dangers that hospitalization holds for the elderly.
I've linked to his articles in Health Affairs in a previous post, but here's an excerpt from his 2005 Health Affairs article, "What Are We Going To Do With Dad?".  It explains my fears.

Hospital Dangers

"Three years ago my father, a longtime heart patient, had trouble breathing and complained of chest pain. He was admitted into the hospital with congestive heart failure. This is the hospital in which I have made rounds almost every day for the past three decades. Many of the nurses and therapists and I call each other by our first names. The CEO is my friend and patient. My father’s physician is one of my young associates, well-trained and eager. I was confident that my father would receive the best medical care he could get in America today. Yet I would not leave him alone in his hospital room. During the day, if I or my brother or mother could not be there, I had a hired sitter by his bed.

It’s rarely talked about, but acute hospitalizations are the most dangerous times for the elderly. Even if they have never before manifested any signs of confusion or disorientation, it is in the hospital—in a new and strange and threatening environment, under the influence of anesthetics, pain pills, anti-emetics, and soporifics—where the elderly (competent or not) will meet their match. Add to this the iatrogenic mishaps (caused by the "normally expected" side effects and complications of standard medical procedures) and the human errors (mistakes in drug dosing, the right medication given to the wrong patient)—now multiplying in our modern hospitals like germs in a Petri dish—and it is almost a miracle that any elderly patient gets out of the hospital today relatively unscathed.

I stayed with my father every night; I slept in the reclining chair by his bed. I got up when he did; ran interference with bedrails, side tables, and IV poles; guarded his every move to the bathroom; looked at every medication that was handed to him and every fluid-filled bag plugged into his arm. I was not afraid to question the nurse or even call his physician. Each day my father descended deeper and deeper into paranoid confusion. He couldn’t rest, he was intermittently unsure of who I was. At first I could calm him with my voice, talking about the old days, reminding him of our fishing trips on the Chesapeake Bay when I was young. Then he needed the physical reassurance of my hand on his arm or shoulder at all times. Finally, so that he could get some rest, I got in the bed with him and held him, comforting him as he once—in a long-ago life—did for me.

After four days and nights in the hospital, I knew I had to get my father out of there. His doctor came by and told me that his heart failure was better and that his dementia evaluation did not show a treatable or reversible cause. But he didn’t like the way my father looked—he was agitated and sleep-deprived and deconditioned, a perfect candidate for some time in the SNU. And, after all, here I was, his senior associate, the medical director of the SNU. Surely my dad would get good care there. 

I took my father home.  I knew if I didn’t get him home at that moment, he would never come home again."

Wisdom from Michael Kirk--the producer of the PBS Documentary: Caring For Your Parents

• I've watched caretakers take on so many burdens that their own health is jeopardized, and I've also seen wonderful transformations where children & parents talk, really talk, for the first time in their lives.
• I saw love in action.  I saw that the caregivers who could transcend their own needs (a lot of the time) were the beneficiaries of a very positive experience-and so were their parents.
• I also saw the effects of stress and emotional strain on the health of caregivers.  It is too big a job for one person. 
• Bring patience and your best self to the task.  Take care of yourself physically, don't believe a magical transformation is going to take place and start with the realization that as long as your parents are capable of making decisions they should be allowed.

When There's Nothing You Can Do, There's Always Prayer

Wisdom from Terry Pluto, sports and spirituality writer extraordinaire--what a combo!

"Someone once told me, "Prayer often does not change the situation, but it does change how we think and feel about it.  So keep praying."

I began to pray, "OK, God, get me through this."

It's a prayer I've heard from cancer patients, from parents of adult children who are having problems, from people who find themselves without a job, a spouse, even hope.

On the surface, nothing changed.  Inside, I did."

If you ever wondered why I was so passionate about eating right, exercising, staying positive and learning--well, when it comes down to it--they are all variables that we can control--that are in our hands--and they all help to bring us a Happy, Healthy, Long Life.

Never More Than Today! Austin Opera Singer Cindy Sadler's Weight Loss Journey

 
                   October 2007                                                January 2009

I just read Cindy Sadler's inspiring weight-loss story in this morning's NYT Well blog, written by Tara Parker-Pope.  The story is called, "The Incredible Shrinking Opera Singer".

That is exactly what Cindy calls the photo series she has posted on her blog, The Next 100 Pounds, which chronicles her weight-loss journey.  Be sure to check it out for wisdom, advice, inspiration & recipes!

You can find the first NYT Well blog (June 2008) & video  about Cindy's journey in  "An Opera Singer's Fat Relocation Project.

Do not miss today's video of Cindy's weight loss--you'll find that here! 

When Did Cindy Start?

• September 2007.  It's been a 16 month process.  She was overweight most of her adult life.

How Much Weight Has She Lost?

• From September 2007-June 2008 (9 months) she lost 100 pounds
• Today she has lost a total of 130 pounds. 
• She has 30 more pounds to go.

How Has Life Changed for Cindy?

• She really enjoys the life style changes that have come about as a result of the weight loss.
• It's not about the the weight loss--it's all about the positive changes in her health. The weight loss is just the "icing on the cake".
• She has more energy.
• She's more active. 
• She's jogging now! She says she's the last person in the world she would ever expect to be jogging. During those first 2 to 3 minutes of jogging she thinks, "Oh I hate my life!"  Then it's smooth sailing.  I feel exactly the same way at the start of each challenging yoga pose or the start of a spinning class. The feeling soon passes.
• She has completely reversed her Type-2 Diabetes!  Her proudest achievement.
  

 Her First Audition Season Since the Weight Loss Has Just Ended.  What Changes Has She Noticed?

• She doesn't get out-of-breath.
• She's able to run around the stage much more easily.
• She's physically stronger.
• The quality of her voice has stayed the same. Which just happens to be amazing!

Recent Changes in Cindy's Diet

• She's not a 100% vegetarian or vegan, but she's leaning in that direction. 
• Meat is mostly out. Fish & eggs are in. A little dairy here & there. 
• She's a fan of the Moosewood cookbooks (me too!), The Fat-Free Vegan Kitchen blog (me too!), and Deborah Madison's Vegetarian Cooking for Everyone.

Words of Wisdom from Cindy

• "Diets do fail. I have never liked the term, "diet", and I don’t consider myself to be on a diet."
• "I consider myself to be in the process of making a lifestyle change."
• "The main motivation is that I like how I look and feel now."
• "I like eating and exercising the way I do now, better than I liked the way I looked, felt and ate before."
• "The main thing is to get the mental game in place. The mental game has to be tight. Counter roadblocks & be honest with yourself."
• What book is her bible?  Dr. Judith Beck: The Beck Diet Solution: Train Your Brain to Think Like a Thin Person
• Cindy wears a necklace for inspiration.  It's a inscribed with the words: 

NEVER MORE THAN TODAY

SHE NEVER WANTS TO WEIGH MORE THAN SHE DOES TODAY!

Dr. Servan-Schreiber's People's Pharmacy Interview: The Top 5 Reasons for the Increase in Cancer Today

Dr. David Servan-Schreiber is one of my favorite health experts and I recently had a chance to listen to his interview with Joe & Terry Graedon on The People's Pharmacy.

A partial summary follows:

Who is Dr. David Servan-Schreiber?

I first wrote about Dr. Servan-Schreiber back in Sept. 2008, and you can read that post here.  

Fifteen years ago, when Servan-Schreiber was a 31-year old ambitious neuroscientist he used himself as a research subject when a volunteer failed to show up for an MRI brain scan.  He was completely taken by surprise when the scan revealed he had a brain tumor.

After surgery and chemotherapy, he asked his oncologist what he could do to lead a healthy life style and hopefully avoid a relapse. The oncologist replied, "Lead your life normally.  We'll do CAT scans at regular intervals and if your tumor comes back we'll detect it early."  Servan-Schreiber went back to his usual lifestyle. Coke, McDonald's, working too hard.

The cancer returned and this time Servan-Schreiber took his health into his own hands. After 9 months of research he began to understand how he could help his body "protect itself against cancer."

 Dr. David Servan-Schreiber, MD, PhD, is currently a neuroscientist and clinical professor of psychiatry at the University of Pittsburgh School of Medicine. He co-founded the Center for Integrative Medicine there. He is also a founding member of Doctors Without Borders.  

Why Has Cancer Risen Dramatically Since the 1940's?

According to the World Health Organization, cancer will soon be the Number 1 cause of death, supplanting heart disease.  Rates have risen dramatically since the 1940's & they can't be explained away easily by saying, "The population has aged--and cancer rates increase in older populations."  Or by saying "We have better detection and screening methods."  According to Servan-Schreiber, age & screening tools explain at most 50% of the increases. 

1. Consider this: cancer rates in children have increased steadily at a rate of 1-1.5% per year--children's ages always stay the same---and kids aren't screened for cancer!
2. Look at regions where cancer rates haven't changed at all--like remote provinces of China.  These are regions where no breast cancer exists, even when women are screened by modern methods.  Since these same women develop cancer in 1-2 generations when they move to Western cultures, the obvious conclusion is that they are protected by their lifestyle, not by their genes.

What Are the Top 5 Reasons for the Cancer Rate Increase in Western Countries?

• Sugar Consumption.  The rate of sugar consumption has climbed steadily in the U.S.  In the 1800's we consumed on average 12 lbs. of sugar per person, per year.  In 2000 we consumed on average 154 lbs. of sugar per person, per year.  Cancer cells can only feed on sugar--and we even use that property to detect cancer in the body with PET scans, by injecting the body with radioactive glucose to scan where it accumulates!  Glucose accumulates in cancer cells.  The more sugar we eat, the more we feed cancer cells.  Sugar isn't a carcinogen, like tobacco--it doesn't cause cancer--It Just Feeds Cancer.  One of three New Year's resolutions is to eliminate sugar.  So far, so good.
  

• Fats we consume.  The kinds of fats we consume has changed dramatically since the 1940s.  We consume increased amounts of inflammatory omega-6 oils, like: corn, soybean, safflower, sunflower and assorted other vegetable oils.  They're in practically everything we eat--if we buy processed foods. Trans fats--think French fries- (hydrogenated oil) became popular in the 1940's when butter was rationed & margarine gained favor.  In the 1950s the American Heart Association encouraged us to use vegetable oils, under the mistaken belief that it would prevent heart disease.  (click here for the history of trans fats).  These kinds of fats also contribute to the growth of cancer--and they can double the rate of breast cancer in women if you compare the cancer rates in women who eat more, with women who eat less.

• Environmental chemicals.  The number of chemicals in our environment has increased dramatically since the 1940s.  Never before have people been exposed to as many chemicals as they are now.  Many of these chemicals can change our bodies--like Bisphenol A, (BPA)-- the chemical in hard plastic which has been in the news lately--and I've written about (click here & here)  And that's just one example.  It leaches out of containers that are heated up, like baby bottles, water bottles, canned goods & plastic tea kettles.  BPA promotes the growth of cancer cells--it's known as an endocrine (hormone) disruptor--and it can promote the growth of breast, prostate and uterine cancers.

• Exercise.  Think of our grandparents, and many of our parents--they all walked to school--unlike kids today.  For that matter, most of our grandparents (and parents) didn't drive much--they walked everywhere.  Physical activity protects us from "growing cancer".  It's been researched widely. Click here, here, here, and here.

• Social Networks.  Our social networks--our family, friends, community involvement & religious institutions--aren't what they used to be--and they've been fraying at the seams since the 1940s.  We move on average every 5 years--and families are separated by too many miles.  Bowling leagues & club memberships--they're history--think Robert Putnam's  Bowling Alone.  When things are going well social networks aren't all that important--but in times of stress--like now!--social networks are the No. 1 factor to alleviate stress.  How do our social networks protect against cancer?  High levels of stress produce nasty chemicals, like cortisol and norepinephrine which contribute to the growth of cancer.  And besides--if you want to be happy--it's all about that social network and showing up for each other!

Today's Cancer News Story

High Insulin Levels Raise the Risk of Breast Cancer in Postmenopausal Women- Need any more evidence of the sugar-cancer link?

Higher-than-normal levels of insulin place postmenopausal women at an increased risk of breast cancer, researchers at Albert Einstein College of Medicine of Yeshiva University report. Their findings, published in the January 7, 2009 issue of the Journal of the National Cancer Institute, suggest that interventions that target insulin and its signaling pathways may decrease breast cancer risk in these women.  Higher insulin levels mean insulin resistance--and the question we should be asking is:

What causes insulin resistance and how can we prevent it?

"How does insulin resistance happen? First, there is a genetic tendency. The family history of someone with insulin resistance often includes heart disease, stroke, high blood pressure, obesity, diabetes, and high cholesterol. This genetic tendency is then accentuated by improper diet.

Second, if susceptible individuals are exposed to high levels of insulin for prolonged periods of time, their bodies lose their responsiveness to insulin and begin to develop more resistance to the effects of insulin. The same is true of many other substances including alcohol, painkillers, and most medications as well as hormones such as insulin.

The treatment of insulin resistance is relatively straightforward and effective. The goal of treatment is to lower insulin levels, and keep them low long enough for our bodies to regain their sensitivity to insulin. In order lower insulin levels, we must avoid the two main causes of high insulin: 1) SUGAR, as well as any foods our bodies convert to sugar rapidly, and 2) Large meals.

Therefore, the person with insulin resistance should be sharply reducing sources of sugar from their diets. They should also be limiting those foods such as bread, pasta, potatoes, rice, cereals & excess alcohol, which our bodies convert rapidly to sugar. They should also be eating smaller, more frequent meals as opposed to larger meals once or twice a day."    According to Drs. Mark Liponis & Mark Hyman (authors of Ultra Prevention)