Exercise As We Age

In my last blog, I shared with you the importance of nutrition, particularly protein, to support our functional strength as we age.   Maintaining good functional strength is important to a goal of being able to Age in Place, which is the ability to live in your own home and community safely, independently and comfortably.

Age related loss of muscle mass and function is called sarcopenia. Muscle is key to motion. As we age, significant changes in muscle mass and quality take place. After about age 50, muscle mass decreases at an annual rate of 1–2%. The decline in muscle strength is even higher, amounting to 1.5% per year between ages 50 and 60 and 3% per year thereafter.  Of those 65 and older, 16 to 18 percent of women and eight to 10 percent of men in the United States cannot lift ten pounds, bend forward to pick something up off the ground or kneel to the floor. After the age of 75, this increases to 66 percent of women and 28 percent of men being unable to lift more than ten pounds.

 Muscle strength is strongly correlated to physical independence and fall prevention. Loss of muscle mass and strength is related to functional impairment and an increased risk for a fall. Leg strength, particularly the ability to rise from a chair, has been found to be a major predictor of frailty and mortality. Leg strength and walking gait speed are two variables predicting fall risk. Additionally, muscular endurance necessary to maintain balance under multi-task conditions such as cooking, gardening or recreational activities, and the importance of muscular power in reactive balance such as slipping on ice or tripping over a curb are important fall risk factors in older adults.

What makes the biggest difference in our skeletal muscle mass and strength?  Exercise.  Specifically, weight bearing and resistance-based exercise which also improve our bone density and decrease our risk of osteoporosis.   Weight bearing exercise are activities that force you to work against gravity. Examples are walking, hiking, climbing stairs, playing tennis or golf (walk don’t ride a cart!), and dancing.   Exercise such as riding a bicycle is a weight supportive exercise.  The bicycle supports our weight.  While bicycling isn’t weight bearing exercise, we are using our largest skeletal muscles to power the bicycle.

Resistance-based exercise is also known as strength training.  Strength training is any exercise that causes the muscles to contract against an external resistance. Resistance-based exercises increase strength, mass and endurance depending on how the exercises are performed.  The external resistance can be dumbbells, rubber exercise tubing or flat loop bands, your own bodyweight or any object that causes the muscle to contract. There are three movements of any resistance-based exercise:  concentric, isometric and eccentric.  Knowing how to utilize these movements properly, how much weight-resistance is used, the tempo of the exercise, and using proper technique to avoid injury and maximize effectiveness relative to your specific goals.  Training techniques differ for strength gains, muscle mass and muscle endurance.  For functional health, older adults need to focus on strength, muscle mass and muscular endurance.  While most everyone can implement a walking program into their life without any type of special training or guidance, I highly recommend guidance from a qualified therapist or a trainer who specializes in senior fitness. SilverSneakers® is a good source for exercise modalities for senior adults.   They have a website and a Facebook page where free information is provided to anyone and if you are a member (available through many Medicare Advantage Plans) you can attend SilverSneakers® classes for free or minimal cost if you are not a member.  I personally lead two SilverSneakers® classes every week.  An online resource I recommend is ElderGym.com  that provides quality information and free senior workout programs that can be performed at home, outdoors or in a gym.

Stay Healthy. Be Strong. Get After It.

Nutrition As We Age

In my last blog post I shared with you the obstacles that can get in the way of our Aging In Place, which is the ability to live in your own home and community safely, independently and comfortably.

  • Poor Eyesight and/or Hearing
  • Reduced Muscle Mass/ Less Strength
  • Diminished endurance and stamina
  • Increased risk of accidents due to bone fragility, poor balance, loss of strength
  • Decreased mobility and agility
  • Decreased flexibility

Exercise, Nutrition, Hydration, Social interaction and Mental stimulation are areas to focus on and are things that we can do, right now.    I’m going to talk about Nutrition today and how it relates to keeping us functionally strong (able to do everyday activities) and how proper nutrition supports muscle mass and bone density which goes hand in hand with being functionally strong.   Having more strength, more muscle mass and stronger bones decreases our risk of accidents and better ensures that we can do the basic activities of daily living.

Age related loss of skeletal muscle mass and function is called sarcopenia.  Throughout childhood and until about the age of 30, muscles grow larger and stronger. In those who are physically inactive, muscle mass declines between three and eight percent each decade after the age of 30 and increases to five and 10 percent each decade after age 50.  After age 50, those who are inactive can experience a 15 percent loss of strength per decade. Of those 65 and older, 16 to 18 percent of women and eight to 10 percent of men in the United States cannot lift ten pounds, bend forward to pick something up off the ground or kneel to the floor. After the age of 75, this increases to 66 percent of women and 28 percent of men being unable to lift more than ten pounds.

Muscle strength is strongly correlated to physical independence and fall prevention. Loss of muscle mass and strength is related to functional impairment and an increased risk for a fall. Leg strength, particularly the ability to rise from a chair, has been found to be a major predictor of frailty and mortality. Leg strength and walking gait speed are two variables predicting fall risk. Additionally, muscular endurance necessary to maintain balance under multi-task conditions such as cooking, gardening or recreational activities, and the importance of muscular power in reactive balance such as slipping on ice or tripping over a curb are important fall risk factors in older adults.

Nutrition and resistance-based exercise are vitally important to minimize sarcopenia and the loss of function as a result.  They go together.  I will talk about exercise in my next column.  We must fuel our bodies with the nutrients it needs to keep us thriving and performing.  This is especially true as we get older since. We simply don’t have time to recover and rebound from poor choices.

What do our bodies need?  Food with nutrients: vitamins, minerals, antioxidants, amino acids, phytonutrients, omega 3 fatty acids, and fiber.  These are substances that our bodies need to thrive, not just survive.  We find these nutrients in vegetables, fruit, unbroken whole grains, healthy fat from whole food sources and lean protein (animal &/or plant-based).  We should base our diet (the way we eat) on these whole foods. Eating a variety of fruits and vegetables is an across-the-board great dietary habit to get into since produce is rich in vitamins, minerals, antioxidants and phytonutrients. The more colorful the better; Think dark green, orange, purple, yellow and red.

Protein. Calcium. Vitamin D.   We need to especially focus on these 3 things since they support healthy, dense bones and muscle mass.   Older adults need more protein than they are likely eating; if your diet is too low in protein, then the rate of muscle mass loss accelerates because you are not giving your body the building blocks needed to maintain or build muscle mass.

Protein is present in every cell of the body and is needed to perform a variety of functions from muscle repair to immune function to fluid balance.  Our bodies don’t store or manufacture the protein we need, so we must get it from the food we eat. Older adults have an increased need for protein to improve bone health, strength, function and muscle mass – all of which decline with age. In general, older adults need between 1 – 1.5 g per 1 kg of body weight.  To keep it simple: 100 lbs. of bodyweight = 50 – 75 grams of protein.  Protein is found in a variety of animal and plant-based foods; ensuring you are getting in a good amount of protein isn’t difficult, but you do need to keep your eye on the ball.   Aim to have protein with each meal and snack.  Where to find it?

  • Plain Greek or Icelandic Yogurt, 1 cup   20g
  • Flavored Greek Yogurt, 1 cup                   13 g
  • Cottage Cheese, 1 cup                                 20 g
  • 1 oz.  hard cheese                                          7 g
  • Large egg                                                         6 g
  • Chicken Breast 3 oz                                      30g
  • Turkey Breast, 3 oz                                       30g
  • Ground Beef. 3 oz                                          30g
  • Steak, 3 oz                                                       30g
  • Pork Chop 3 oz                                               30g
  • Fish, 4 oz                                                         30g
  • Shrimp. 4 oz                                                   30g
  • Lobster tail, small                                         20g
  • Scallop, 1 average                                           3g
  • Canned Tuna, 4 oz                                        30g
  • Canned Salmon, 4 oz                                    25g
  • Beans & Lentils, 4 oz                                   13-18g
  • Vegetables        All vegetables have protein, but they are not as rich of a protein source as animal-based protein, beans or lentils.  Asparagus, Cauliflower, Broccoli, Brussels Sprouts, Artichoke, Watercress, yellow corn are the top 7 vegetables highest in protein.    1 large spear of asparagus or broccoli has ½ g of protein on average; therefore 10 spears will have 5 g of protein.

Set a goal of paying attention to your protein intake ensuring you are eating protein with every meal and snack. Ask yourself: “What am I going to eat with my protein”?  Challenge yourself to always think protein first when planning your meals and snacks.

Stay Healthy. Be Strong. Get After It.