EXERCISE BENEFITS

Exercise for the aging can be looked at as a sort of "fountain of youth." It can help with weight management, improve skeletal-muscle strength and endurance, cardiopulmonary fitness, flexibility, and enhance feelings of well-being, possibly improve your immune system, and your mental health.

Weight Management

Of course nutrition - diet - is a very significant factor in this issue, but is outside of the scope of this article. We will only address the exercise aspect of weight management.

It is widely accepted that permanent weight loss from diet alone is pretty futile. Exercise is now an integral part of any permanent weight loss program. The two go hand-in-hand: a sensible, healthy diet (often referred to as a low-fat diet), and exercise seems to be the only successful way to maintain long-term weight control. Exercise is important in this formula not just for immediate calorie expenditure, but for increasing the Resting Metabolic Rate (RMR-formerly known as basal metabolic rate, or BMR) so that we expend more calories all day long - even during sleep. [Note that there is some thought that this factor has little effect on weight control.] Exercise can perform this little miracle by increasing muscle tissue, which is more metabolically active than, say, "fat."

And take notice that an exercised body is a more attractive and functional body.

Cardiopulmonary Fitness

This section addresses the physiological changes in the cardiopulmonary system (the heart, blood flow, lungs) effected by exercise.

Age is often accompanied by a rise in both systolic (pressure as blood is pumped out of the heart) and diastolic (pressure as the heart relaxes prior to the next beat) blood pressures. Both can be lowered by exercise; which increases the size and strength of the heart, and the blood supply to the heart. A result of this is a lowering of the heart rate. Lowering of the heart rate and blood pressure reduces risk of heart disease. In the event of a heart attack despite exercise, survival is more likely; as are future heart attacks or strokes less likely.

Maximum oxygen uptake ( the infamous VO2max) decreases with age. It is, in essence, the amount of oxygen that we can utilize during vigorous exercise. Exercise produces higher energy by raising VO2max, which increases your endurance.

Respiration is improved as the breathing muscles are strengthened. Normally, respiratory muscles weaken and shorten with aging; which, along with decreased elasticity of lung tissue, decreases breathing capacity.

Exercise decreases triglycerides and cholesterol in the blood, which reduces risk of developing harmful blood clots; thereby reducing risk of heart attack and stroke.

While lowering cholesterol levels, the level of HDL increases, which helps to stave off heart problems.

And, finally, exercise seems to raise the level of TPA, which decreases the clot-forming substance fibrinogen, a further protection against heart, and blood circulation problems.

Skeletal/Muscle Health

Aging is normally accompanied by loss of muscle strength and bone density. Both problems are mitigated by exercise. Tendons and ligaments are also strengthened by exercise, which helps to stabilize joints, which reduces risk of falls - a serious problem for the elderly. And, stronger joints enhance overall mobility, as well.

Please note that there is no age beyond which exercise cannot be a benefit to one's well-being.

A final note here is that exercise can also help to reduce back pain, among its myriad of physical benefits. Exercise can help to improve posture, and poor posture can cause lower back pain. It can also help sufferers of arthritis, and other musculoskeletal problems.

General Health

There is some support for the idea that exercise enhances the immune system, in general. It may also reduce the risk of getting some cancers - breast and colorectal. It definitely helps prevent development of diabetes in adults, and improves digestion - it is a natural laxative. We have already mentioned its help in preventing falls, and if you end up in a hospital for surgery, the fitter you are, the better your chances of a successful recovery.

Mental Health

Positive results of exercise in this category are pretty subjective, but there are numerous potential results: improved self-image and self-confidence, relaxation from mental stress [Very real, in my experience.], perhaps improved mental acuity, increased sociability, and help to overcome insomnia.

PRE-EXERCISE GUIDELINES

It is a good idea to meet with a physician before starting an exercise program, and explain to him/her what you are planning to do; then, with approval, you can feel safe about starting your program.

There are several health risk factors, which should be either eliminated by you, or at least discussed with your physician as part of your pre-exercise medical consultation. They are: 1) cigarette smoking, 2) obesity (30% or more overfat), 3) diabetes, 4) high blood pressure (untreated), 5) high blood cholesterol level, and 6) family history of death under age 55 from heart (or unexplained) reasons.

GENERAL EXERCISE SAFETY GUIDELINES

1) Drink lots of water - before, during, and after exercise - keep hydrated.

2) Warm-up and cool-down. Start an exercise session with a warm-up. Some guidelines for a very thorough warm-up are:

1. Limber up for 6-7 minutes. This may be slow walking, pedaling on a stationary bicycle, or some similar aerobic activity.

2. Rhythmic exercise for 5-6 minutes. This is a series of movements designed to move specific muscles, to get them fully prepared to do the actual resistance exercises.

3. Very mild stretching for 1-2 minutes.

For a cool-down, the following suggestions are offered:

1. A standing cool-down should last about 5-7 minutes. This may be easy walking, or a very gentle ride on a stationary cycle, or other aerobic activity.

2. Stretching for at least 5 minutes.

Note that it is recommended that the head not be allowed to drop below the chest - some older exercisers may faint as a result.

Note that this cool-down description is more applicable to an aerobic workout, and may be tailored for a calisthenics or weight workout, which won't normally raise heart rate and breathing to sustained high levels.

If an exerciser experiences: 1) dizziness, 2) queasiness or nausea, 3) extreme shortness of breath, or 4) shakiness; the appropriate reaction is to slow down, or stop for a rest.

Working a muscle to fatigue helps it grow stronger, but don't go to the point of being completely "wasted." An injury can result from uncontrollable, exhausted muscles - especially as we get older.

And remember that "no pain, no gain" is not a good indicator of just working hard. You must learn to distinguish between real pain, and just being tired. Fatigue is one thing, and pain is another. As we get older, tissue injuries are slower to heal, so we should strive to avoid them.

If you experience joint pain, it is wise to avoid the movement that caused it, but some muscle soreness around a joint is okay. It will go away, and you will get stronger. Unless muscle soreness is really intense, mild exercise is better than simple rest to make it disappear.

To minimize muscle soreness:

1. Fully warm-up.

2. Fully cool-down

3. Exercise muscles to fatigue, but never to pain or collapse.

4. Increase activity level only gradually - about 10% at a time. Only make increases when your current level of activity feels easy. If you get too tired, back off in approximately 10% decrements.

Don't exercise right after heavy meals - wait about two hours. And hard exercise should be limited to five days a week, and about one hour at-a-time - to help prevention of injuries.

Use good posture when you exercise - no swayback, weight evenly distributed on both feet, "soft" knees, tightened abdom-inal and buttock muscles, and keep your neck in-line with your spine (i.e., if you are standing, you should be looking forward; if you are bent 90 degrees at the hips, you should be looking at the floor). Don't hyperextend or lock joints. And work through a full range-of-motion. Don't do ballistic movements - stay under control, always. Don't use momentum. And, please, don't forget to breathe. I like to see forceful breathing (at least the exhaling part) when training someone, so that I can easily tell, and don't have to keep asking: "are you breathing?" Exhale on the exertion phase, and inhale on the "return" phase. You could pass out if you don't heed this advice. At the very least, your exercise effort will be subverted by lack of an adequate oxygen supply.

As with all segments of the population, there are three appropriate modes of exercise: aerobics, resistance training, and stretching.

Before getting to formal exercise, it is important to mention that many aging individuals find themselves very unfit; not so much because of the aging process itself, but from an accumulation of a mostly sedentary lifestyle - excess weight (fat), weak muscles, a general decrease in joint flexibility, an increased risk of getting heart disease cancer, or diabetes, and more. These conditions make one susceptible to falls, for one thing - a leading percentage of deaths among the elderly.

There is one simple solution - get moving, and keep moving. Lawn work, gardening, bicycling, hiking, golf (but walk, don't ride), tennis - any activities that are just part of your life, but aren't formal exercise. Take the stairs instead of the elevator. Park at the far end of a parking lot, and walk a little. Anything is better than nothing? [I apologize for using this trite cliche', but it is true.]

Clearly, being more active has positive fitness effects, but to really help offset things like loss of strength, balance, bone density, atherosclerosis (There is some evidence that existing buildup may be reduced, as well as future buildup being retarded.), high blood pressure, high cholesterol levels, maybe some types of cancers, and on-and-on; formal exercise programs can make a difference.

Due to a space problem, the exercise mode introductions, and specific exercises must be deferred to next month's Newsletter.

Now that our feature article has been deferred to next month's Newsletter, some space has been liberated, and will be filled by some information on "natural medicine" (a.k.a. naturopathy), and those who practice it - naturopathic physicians (NPs). Natural medicine, as practiced by NPs, refers to a number of non-invasive therapeutic techniques, excluding conventional drugs and surgery.

A major weapon in the NP's arsenal is nutrition counseling (where herbs are an important aspect). Also massage and homeopathy, as well as other techniques, among them some fairly bizarre (in my mind) therapies like color-therapy and aroma-therapy.

Seattle, Washington is a relative hot bed of naturopathy. It is the site of the largest of only two schools in the United States dedicated to naturopathic medicine - Bastyr University. The other one is the National College of Naturopathic Medicine, in Portland, Oregon. Washington is one of only 11 states (see Note 1) that licenses naturopaths to legally practice medicine.

The formal education of an NP starts with a standard pre-med course; the same as any conventional physician would take. After acceptance into one of the two naturopathic medical schools, the education of the NP continues to be similar to that of a conventional M.D. - lots of basic science; e.g., pathology, physiology, biochemistry. During the last two years of the four years that the aspiring NP spends in school, he/she takes a smattering of specialties like pediatrics, gynecology, dermatology, and opthamology - just like the conventional M.D.; but spends less time with these specialties. The future NP's time is filled out by study of nutrition, herbal medicine, physical medicine (e.g., massage and physical therapy), and counseling. Most NPs don't go through residency, as do conventional M.D.s. This is a major educational difference, but some NPs do go through the residency phase; and they all get more nutritional education than the conventional M.D.

For anyone who decides to consult an NP, remember that only a few states license them, which can open up Pandora's Box. Any Bozo can put up a shingle. Pick a licensed NP, or in a state without licensing, select only NPs who have graduated from one of the two naturopathic medical schools.

One almost universally accepted, positive characteristic of NPs is that they are generally more caring, and more willing to spend extra time with their patients on diagnostic procedure; whereas, many conventional M.D.s are often less willing to give time to the patient - more of an assembly line mentality. This patient contact is a "plus" for NPs.

______________________________
Note 1 - Alaska, Arizona, Connecticut, Florida, Hawaii, Maine, Montana, New Hampshire, Oregon, and Utah are the others.

QUESTIONS AND ANSWERS

(Q)What is homeopathy?
J.N., Myrtle Creek, OR

(A)A system of medical practice that treats a disease, especially by the administration of minute doses of a substance that, in larger doses in a healthy person, would cause symptoms of the disease. That is, small doses cure the disease; large doses cause it.

(Q)My dad smokes, and doesn't believe that secondhand smoke is actually dangerous. Do you think he is right?
J.G., Los Gatos, CA

(A) You're kidding, right? I think he has his head in the sand. There are numerous studies on the perils of secondhand smoke. Here is one. A study by the American Heart Association - the biggest ever on passive smoke - found that life-long non-smokers, married to smokers; had a 20% greater risk of dying from heart disease than those married to a non-smoker. It is speculated that 35,00 to 40,000 deaths per year can be attributed to secondhand smoke. It is not difficult to imagine that children of smokers are also infected by heart and lung diseases.

(Q)Tell me about RICE (not Jerry).
A.L., Los Altos, CA

(A) Let's take each therapy mode in turn.

Rest is really obvious. If your injury is serious, rest completely. If it is less serious, continue your athletic endeavors, but at a lesser level. [Duh?]

Ice should be applied for 20-30 minute periods. Apply ice (a bucket of cold water works good); let the cold area warm to normal temperature; then ice it again. This cycle might need to be repeated for 12-48 hours. If inflammation persists, consult a physician.

Compression of an injured area limits swelling. An elastic bandage works well, but don't make it so tight that circulation is cut off.

Elevation - elevate the affected area above the heart to reduce swelling.

_______________________________
For questions, call (408) 739-0501, or write to:
MAF, 964 Ponderosa Ave., Suite 25, Sunnyvale, CA 94086-8931.
Yearly mailed subscriptions are $12.00, payable to M.A. Fenner.
Email to Mike_Fenner@netcom.com

Click here to send an email to the author, Mike Fenner