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Boomers: Take Care of Your Brain!

Troubling news from a new study, published in the Journals of Gerontology: Social Sciences:  Baby Boomers’ brains aren’t aging well.  Compared to previous generations, Boomers in this ongoing study, of 30,191 Americans over age 50, are experiencing a sharper drop in cognitive function, and are more likely to develop dementia.  And… PAUSE!

Before we start wringing our hands in despair, I want to say right now that I don’t think that shuffling around with an adult diaper is our inevitable fate.  I don’t think that at all, and I don’t think the study’s author, Hui Zheng, Ph.D., from the Department of Sociology, Institute for Population Research, at Ohio State University, believes it.  I think, and I think these results suggest, that this can be changed.

I’m going to come back to this in a minute.  First, let me briefly recap this research project, an analysis of nearly 20 years of results from the Health and Retirement Study.  Among other things, the study’s participants get their cognitive function checked every two years.  Basically, they take a “cognitive battery” of tests:  they do things like remember objects and words they’ve been shown recently, and count backwards from 100 by 7s (If you can’t do this easily, don’t feel bad about yourself; it’s supposed to be a challenge – at least, it is for me!).

In this study, Zheng analyzed the results collected from 1996 to 2014, from people in these groups:  Greatest Generation (born 1890-1923); Early Children of the Depression (born 1924-1930); Late Children of the Depression (born 1931-1941); War Babies (born 1942-1947); early Baby Boomers (born 1948-1953); and mid Baby Boomers (born 1954-1959).  Every generation here born before and during World War II had better cognition scores than the generation before it.

Let’s repeat that:  War Babies did better than Late Children of the Depression, who did better than Early Children of the Depression, who did better than the Greatest Generation on these tests.

The Baby Boomers ended this positive trend.  They not only did not do better than the War Babies; they did worse.  “It is shocking to see this decline in cognitive functioning among Baby Boomers after generations of increases in test scores,” Zheng says.  “But what was most surprising to me is that this decline is seen in all groups: men and women, across all races and ethnicities and across all education, income and wealth levels.”

To make sure the results weren’t being skewed by older members of the Boomer generations, Zheng then looked only at the scores of people in their fifties – and again, Boomers did the worst.  Baby Boomers already started having lower cognition scores than earlier generations at age 50 to 54.  This decline “does not originate from childhood conditions, adult education, or occupation.”

So what’s causing it?  “It can be attributed to lower household wealth, lower likelihood of marriage, higher levels of loneliness, depression and psychiatric problems, and more cardiovascular risk factors – obesity, physical inactivity, hypertension, stroke, diabetes, and heart disease.”

Zheng concludes the study by saying this cognitive decline could become more common in future generations “if no effective interventions and policy responses are in place.”

Now, that’s academic speak; who’s going to make these interventions?  What policy will reverse the course of our brain health?  Let’s sit around with our thumbs and wait for the government and policy-makers to fix it.

Or, let’s see what we can do to make our own brains healthier.  I vote for that option.

As a people, we have never been fatter, had worse diets, or been more depressed and messed-up than we are right now.  We spend too much time on our phones and/or sitting on our butts watching TV.  We don’t exercise enough.  We don’t reach out enough.  We worry too much.  We eat too much processed food.

If you are sitting around watching the news and fueling hatred for one political party or another, you’re not doing your brain a favor.  Step back, turn off the news, and go outside.  You know what they do in Japan?  Take forest baths.  I linked to one story, but there are a bunch of them online, and videos, too.  It’s a “digital detox,” good for your physical and mental health.

If you are overweight, diabetic or borderline diabetic, if you have heart disease or high blood pressure, you are at a higher risk of cognitive impairment.  You have to fight it.  Talk to your doctor, make the effort to eat better, and start some mild exercise.  Every little bit helps.  Go for a walk.  If you can’t go outside, set a timer and walk around your home, or your room.  If you can’t walk, try chair yoga.  No matter your situation, there’s probably something you can do to help your heart, and what’s good for the heart is good for the brain.

I’ve written a lot about dementia on this website.  Just look in the right-hand column for categories, and click on Alzheimer’s (I know, all dementia is not Alzheimer’s; I did that because I thought more people might find my stories on dementia that way).   Here’s one of them, and here’s another, but there are several more.

In addition to diet and exercise, attitude can make a big difference.  Having a positive attitude is good for the brain.  Depression is a risk factor for dementia.  Getting a hearing aid if you need one is good for the brain, because with brain cells, it’s use it or lose it:  if you are just sitting there, not participating in conversation because you can’t hear, if you’re not engaging with other people, your brain figures you don’t need those cells anymore.  Reaching out, getting involved, and volunteering are good for the brain.  Staying connected is important.  Helping other people is important. 

Today I thought of a movie I haven’t seen in way too long, “Apartment for Peggy,” from 1948, starring Jeanne Crain, William Holden, and Edmund Gwenn.  At one point, Edmund Gwenn (Santa Clause in the original “Miracle on 34th Street) says:  “I find it singularly curious that if a doctor tells us that peanut shells are good for us, we eat them.  If a chemist maintains that one gasoline is better than another, we use it.  We’re guided by experts on everything from soap chips to foreign policy and yet on the most important thing of all, how to live, we pay no attention.  Ever since man began to think, great minds have been telling us that the pleasure in living is in helping, that happiness comes from a simple, useful, constructive life.  But yet, we call this kind of advice infantile, impractical and hopelessly idealistic.”

That movie came out just after World War II, and Edmund Gwenn was a member of the Greatest Generation – which means he might score better than today’s Baby Boomers on a cognitive test.  So, give a listen.

 

©Janet Farrar Worthington

 

 

 

 

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How to Stay Healthy: Simple Changes, Big Results

It’s the dream for getting older:  stay healthy, don’t get decrepit, keep all your marbles, and have a good life.  The four horsemen of the anti-apocalypse.  Nobody can guarantee this, and if anyone does, don’t trust that person any farther than you can chuck him or her!  However:  You can give it your best shot, and it’s not that hard!  With some simple changes, you can achieve big results! 

Here to help with some good advice is Elizabeth Platz, Sc.D., M.P.H., an epidemiologist at Johns Hopkins, who does a lot of research on factors that raise and lower your risk of cancer and other health problems.  I interviewed her recently for the Prostate Cancer Foundation’s website.  These tips aren’t prostate cancer-specific, and they will help you to get and stay healthier – so you won’t just be another year older, but another year better! 

Are you ready to start fresh?  Now is the perfect time:  it’s the Chinese year of the Rat – the first in the 12-year rotation of zodiac signs, which means that this is a year of renewal.  Let’s see what we can do to feel better and look forward to a healthier, happier, more active life!  First…

Don’t bother looking for a quick fix.  There isn’t a magic pill or miracle supplement or treatment, no matter what they may say on TV and the internet.  Getting healthier can’t be achieved by anything hawked in an infomercial.  “For healthy living, for good well-being, for avoiding premature mortality,” says Platz, “the right things to do are the things you have to work at,” like eating right and getting exercise.  But take heart:  you can make big changes by doing lots of small things, if you do them steadily.  You can also live it up sometimes – eat that slab of birthday cake, or have pizza night – if, in general, you practice moderation most of the time.

Be active.  Good news!  This doesn’t mean that you must haunt the gym! One of the best things you can do for your health, says Platz, is easy:  avoid sitting all day.  “In the modern world, people tend to sit.”  We sit in the car.  We sit when we’re on our phones.  We sit at the computer.  “We have protracted periods of time where we’re just stationery.  Build intentional activity into your day.”  Get off the old tuchus!

This doesn’t mean you have to spend hours on the treadmill or elliptical; remember, we’re talking about small changes here:  Don’t park right next to the building; park farther out and walk a little longer.  Take the stairs instead of an elevator to go up one floor.  Set a timer and walk around your house.  Take the dog for an extra walk.  Just move around.

Focus on the “big three macros,” proteins, carbohydrates, and fats.  “Macromolecules” is a trendy word, but it describes something very basic: “these major, fundamental components of our diets,” says Platz.

            Protein:  “As we get older, we need more protein to help keep from losing muscle mass.”  How much?  This varies a lot; one study recommends 1.2 to 1.5 grams per kilogram of body weight; this could mean 123 grams for a 180-pound man; the minimum amount recommended by the U.S. government for the average 160-pound man is 56 grams.  Bottom line:  You need more protein than you think, and more than you’re probably getting.  Make a point of eating protein with every meal.  Instead of just having a piece of toast or some cereal for breakfast, for example, add some Greek yogurt (which is higher in protein) or an egg.   Protein doesn’t just come from meat; it’s in fish, beans, dairy products, eggs, and soy products, too.  It’s also in meal replacement drinks like Ensure and Boost, and in protein bars.

            Carbs: Again, moderation:  “Don’t overdo simple carbohydrates,” the kinds of sugars found in sweets, white bread, and even plain old potatoes:  yes, the humble potato, minding its own business and serving as a dietary staple to millions, now finds itself on the nutritional naughty list of “simple carbohydrates,” because it takes less energy to digest a spud than, say, a sweet potato, which is a more complex carb.  “Whole grains can be delicious,” notes Platz.  “They’re more than just what’s in whole-wheat bread” (which, admittedly, can taste like cardboard).  “Many grains can be mixed into your diet without a lot of effort.”  On the pasta aisle in the grocery store, check out faro – a nutty-tasting grain.  There’s also quinoa, barley, and bulgur, to name a few.

            Fats:  “Good fats are good for you.  Try cooking with olive oil instead of butter,” suggests Platz – who is quick to add:  “You don’t have to remove butter from your diet; olive oil just tastes good.”  And watch out for calorie-rich dressings, sauces, and gravy.  Again, this doesn’t mean don’t eat them; “just make sure it’s the right serving size – which is often more like a tablespoon, rather than a quarter-cup.”

Indeed, watch your portions.  One basic strategy to make sure you’re not getting more than you need:  use a measuring cup.  “Even when you’re eating something that’s healthier, make sure you’re not overdoing it from a calorie perspective.”  Those pesky calories add up, and this is how you gain weight: consuming more calories than you burn.

Weigh yourself.  As we get older, sadly, the weight we gain “tends to be fat,” says Platz, “at the same time as we are losing muscle mass.  Loss of muscle mass is particularly worrisome, and is linked to premature death.  It’s not just how much you weigh, but the proportion of lean mass – muscle and bone.”  What’s a good way to maintain and build muscle mass?  “Weight-bearing or resistance exercise.  Lifting weights.”

Weight-bearing exercise.  Again, this isn’t as hard as you may think.  Nobody’s suggesting that you need to bench press the weight of a Saint Bernard, or dead lift the equivalent of Dwayne “The Rock” Johnson.  “I’m talking about hand weights.  Light-weight weights.  You can even use your body weight,” by doing planks, push-ups, or yoga-type exercises.

An engaged brain functions better.  Thus, get a hearing aid if you need one.  “There is solid, very sound research showing that people who have greater hearing loss tend to have greater cognitive decline,” says Platz.  If you can’t hear, “your engagement with others tends to wane.  When your brain is no longer stimulated to the same extent, it’s associated with cognitive decline.”  This is the “use it or lose it” idea; if your brain isn’t actively engaged – if you’re not hearing conversation, or the TV, or the sounds of nature, or a sermon in church, or your friends and family members talking to you – those un-engaged brain cells can shut down.  Isolation is bad for the brain, and bad for your health in general.

So:  Stay active.  Volunteer, play poker, meet friends for coffee, take a class.  Keep your brain working.  Talk to people.  That kind of engagement is good for your brain, and it prolongs life.  We are hard-wired to talk to other people, and to listen to them, and hey!  If we can help others while we’re doing it, it’s a win-win.  “You’ve accumulated wisdom, experience, and expertise, and if you can share that with others, including the next generation, so much the better.”  For more things you can do to prevent dementia and keep your brain engaged, see this post, and this one.

            Take care of your liver.  If you drink too much alcohol, or if you are overweight to the point where you are at risk of becoming pre-diabetic or diabetic, your liver can pay the price.  “Fatty liver disease is emerging as an epidemic in the U.S.,” says Platz.  If the liver is overloaded, it accumulates fat, becomes inflamed, and several things can happen:  the liver can develop fibrosis, or scar tissue, that may even lead to cirrhosis.  “If you feel like you’re starting to go down that path, now is the time to reassess your diet and lifestyle.  The best analogy is foie gras, where we force-feed ducks to create fatty liver and make good pâté.  When you accumulate fat in your liver, it’s the same thing that happens with those ducks.”

Make it your life’s mission not to fall.  The older you get, the harder it is to bounce back from a fall.  A toddler can face-plant and spring back up.  An older man can fall and break a bone, wind up in the hospital, and if he doesn’t push the physical therapy and exercise afterward, not ever fully recover all his flexibility and strength.  So, let’s do our best to avoid this scenario!  Here’s where yoga and some very simple exercises can help you maintain balance and flexibility.  “This needs to be a huge focus for men as they age,” says Platz.   It’s not so much about strength – again, nobody’s asking you to heft a giant barbell – as it is about stretching and working on your balance.  And, keep your bones strong:  make sure you get enough calcium.  Calcium doesn’t have to come from milk and cheese.  You can get it from leafy green vegetables, and some foods you might not expect – like sardines, and even tofu.  However:  “The recommended dietary allowances for men aged 51-70 are 1,000 mg a day of calcium; and for men age 71 and older, 1,200 mg.  A half-cup of raw broccoli has 21 mg.  But if you’re trying to get to 1,000 mg, you’d have to eat an awful lot of broccoli.”  In a perfect world, you would achieve dietary perfection by eating an exceptionally well-rounded diet.  Most of us don’t achieve that, and if you’re not getting enough calcium, you may need a supplement.  Don’t go overboard!  With dietary supplements, it’s not a case of, “if a little is good, more must be better.”  Just getting enough is fine.

Fasting?  Intermittent fasting, in various forms, has been in the news lately, and “some studies suggest there is a biological benefit.”  However, there is an easy way for you to take a break from food every day:  Cut out the late-night snacks.  “If you get the munchies at 10 at night, you’re basically having the calories of another meal.  Just not having food after dinner can make a big difference.  Sometimes, half the battle is simply recognizing what we’re eating.”  Are you eating more than you think?  An easy way to find out is to write it down, or use an app on your phone to record everything you eat.  Keeping a record – just for a few days, even – might make you think twice before saying yes to that late-night piece of pie.

Try to get more sleep.  Most of us don’t get enough sleep, or don’t sleep well.  There are some simple things you can do for better “sleep hygiene,” including not being on your phone or the computer right before going to bed; the blue light these devices produce messes up your body’s clock.  Drinking caffeine or alcohol too late in the day can affect your sleep, as well.  Herbal tea, with lavender or chamomile, or other natural remedies can help; so can taking melatonin, a hormone your body naturally produces.  We make less melatonin as we get older; ask your doctor about taking an over-the counter melatonin supplement.   Also:  “Many men tend to snore as they get older.  If your partner tells you that you’re snoring, maybe you should do something about it.  Losing weight can help.”  If it’s severe, talk to your doctor.

 

In addition to the book, I have written about this story and much more about prostate cancer on the Prostate Cancer Foundation’s website, pcf.org. The stories I’ve written are under the categories, “Understanding Prostate Cancer,” and “For Patients.”  As Patrick Walsh and I have said for years in our books, Knowledge is power: Saving your life may start with you going to the doctor, and knowing the right questions to ask. I hope all men will put prostate cancer on their radar. Get a baseline PSA blood test in your early 40s, and if you are of African descent, or if cancer and/or prostate cancer runs in your family, you need to be screened regularly for the disease. Many doctors don’t do this, so it’s up to you to ask for it.

©Janet Farrar Worthington

 

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Little Bursts of Exercise, Big Rewards

Two recent studies bring good news for those of us who either don’t have a lot of time to exercise, or just don’t like it and don’t want to spend an hour working out: bursts of cardiovascular activity matter. A lot.

For those of us who are getting older (which, unless you’re dead or cryopreserved, or both, is everybody), nothing is better at delaying aging than exercise, say Mayo Clinic investigators, who recently published a very interesting study in the journal, Cell Metabolism.  In other words, there is no magic bullet pill or thing you can eat that will do as much as exercise to keep you living longer and healthier.

Well, we kind of knew that. But the really good news here – especially for those of us who don’t just have scads of time or willpower to spend at the gym – is that it doesn’t have to be for a huge chunk of time every day.

The Mayo researchers didn’t just look at the things we usually think of with exercise – weight loss, better endurance, muscle mass vs. fat, maybe improvements in mood or functioning. Instead, they looked at the effects of exercise in younger and older adults at the molecular level. Particularly, they were interested in the effects on the mitochondria – the battery packs that produce energy in our cells.

The study’s volunteers – 36 men and 36 women in two age groups: young (18-30) and “older” (age 65-80) – were healthy but sedentary. They underwent tests to establish baseline levels for their aerobic fitness, blood sugar, and the gene activity and health of the mitochondria in their muscle cells. Then they were randomly assigned either to a control group (no exercise) or one of three different exercise programs: high-intensity interval biking (pedaling hard for four minutes, resting for three, and repeating three more times); vigorous strength training with weights; and a combined program of light weights and exercise bike-riding (at a moderate pace for 30 minutes, a few times a week).

After 12 weeks, all the participants had repeat lab tests. As you may expect, everybody who exercised had better fitness and blood sugar levels. The people who did weights gained more muscle mass, and the people who did interval training had better endurance.

But the really significant changes were invisible to the naked eye. In the under-30 people who did the interval training – the vigorous bike-riding for four minutes, four times – 274 genes showed increased activity; those who did the more moderate exercise had changes in 170 genes, and the weight-lifters had changes in 74 genes.

Think that’s exciting? Well, it is, but it’s not nearly as exciting as what happened to the seniors who did the interval training: nearly 400 genes showed higher activity, compared with 33 genes in the weight-lifting group and a sad 19 genes in the people who just did the moderate exercise. The oldsters who did the bursts of exercise had healthier mitochondria, too.

What do we take away from this study? That you’re never too old to benefit from exercise, for one thing. And for another, just because you’re older doesn’t mean you are past the point of vigorous exercise – especially if it’s just for a few minutes at a time.

If you aren’t already exercising, you should talk to your doctor to make sure it’s okay. Then, if you’re cleared for takeoff, don’t be like that guy at the gym who’s reading a book or watching the TV on the wall and cycling about one mile a minute, pedaling so slowly that if he were on a regular bike, he would fall over because he’d have no momentum. That barely even counts, and I see people like this at the gym all the time. They have no problem carrying on a full conversation, either; they certainly aren’t short of breath.

Now, how can you apply this to your own life? If you ride a bike or use a treadmill, the timer is your friend. You don’t have to program anything; you can just increase the speed to a comfortable running level, and lower it to a brisk walking level. Do it for one minute. If you can’t do it for a minute, start with 30 seconds of running or pedaling harder, then work your way up. My favorite thing to do on the treadmill is walk at a brisk pace for a minute and a half, then run for a minute, then walk for a minute and a half, then run for a minute, etc., for 20 minutes. When I started, my speeds for walking and running were pretty pokey. Then one day, I was running at my customary pace and I thought, “Hmm. I can go faster,” so I did. I was walking at my customary pace, and I thought, “I can go faster,” so I did. You will be amazed at how much better you get over time.

This is similar to the kind of exercise our ancient ancestors got. I’m not talking about grandpa or even great-grandpa, but way back to the hunter-gatherer days. They didn’t go out jogging for the heck of it, and they certainly didn’t spin or do Zumba – but what they did do was put on bursts of speed when they had to, so they could bring down the animal they were hunting. Thus, I think that at some level, we are hard-wired to do this. Try it. Start small – just a few minutes total, at first – and see how you do.

This brings us to the next study, published in the Journal of the American Heart Association.

Scientists from the National Cancer Institute and Duke University looked at records of nearly 5,000 people over age 40 from the National Health and Nutrition Examination Survey from 2003-2006, and followed them for more than six years; during that period, there were 700 deaths. Then they looked at the amount of time those people who died had spent in moderate-to-vigorous physical activity (MVPA).

They found that all MVPA counted: even if it was just a few minutes here and there. It all went toward the daily total.

This is huge, because it goes against all the guilt-inducing exercise recommendations we have been treated to for decades. The conventional medical wisdom has been that exercise only counts if it’s sustained – for 20 or 30 minutes, or more. And the worst result of this is that many people have thought, “Well, I don’t have much time today, so I’ll just have to try to get in a good workout tomorrow,” or the next day, or next week.

Au contraire, say the results of this study: All exercise contributes to helping you not die. “For about 30 years, guidelines have suggested that moderate-to-vigorous activity could provide health benefits,” said the study’s senior author, William E. Kraus, M.D., of Duke University School of Medicine,” but only if you sustained the activity for 10 minutes or more. That flies in the face of public health recommendations, like taking the stairs instead of the elevator, and parking farther from your destination. Those don’t take 10 minutes, so why were they recommended?”

Why, indeed? Because every little bit helps. In this study, Kraus and colleagues at the National Cancer Institute found that the length of each period of exercise was not related to the overall benefit of living longer. Five minutes of jogging counts. Five minutes of riding an exercise bike counts.  Or five minutes of swimming a couple laps, or whatever.

The participants in the survey wore an accelerometer (similar to a Fitbit or the activity tracker on a smart phone) for up to a week. Looking at the data, the researchers looked at the people in two groups: those who had bouts of MVPA for about five minutes at a time, and those who exercised for longer than 10 minutes at a time.

People who got about an hour a day of MVPA – not an hour at a time, mind you, but an hour of little bits of exercise here and there, all added up – were half as likely to die. Those who got 100 minutes of exercise a day cut their risk of dying even more, by about 75 percent. Again, it was the total time they spent moving, not how long at a time they exercised, that mattered.

In this study, there was no distinction between intentional exercise and just plain old physical activity, like walking up a flight of stairs, or vacuuming the floor, or running to catch a bus.

“Despite the historical notion that physical activity needs to be performed for a minimum duration to elicit meaningful health benefits,” Kraus and colleagues reported, “we provide novel evidence that sporadic and bouted MVPA are similarly associated with substantially reduced mortality.”

In other words, it’s all good.

In addition to the book, I have written about this story and much more about prostate cancer on the Prostate Cancer Foundation’s website, pcf.org. The stories I’ve written are under the categories, “Understanding Prostate Cancer,” and “For Patients.”  As Patrick Walsh and I have said for years in our books, Knowledge is power: Saving your life may start with you going to the doctor, and knowing the right questions to ask. I hope all men will put prostate cancer on their radar. Get a baseline PSA blood test in your early 40s, and if you are of African descent, or if cancer and/or prostate cancer runs in your family, you need to be screened regularly for the disease. Many doctors don’t do this, so it’s up to you to ask for it.

 © Janet Farrar Worthington

 

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Anti-Dementia Action Plan

For many of us, dementia is not an inevitable part of growing older. We have talked about this before, but I feel strongly that it’s time to talk about it again. The idea is still a fairly new one to wrap your mind around, no pun intended, and I’m pretty sure that most people are not going around thinking, “What can I do today to prevent dementia?”

            But they ought to be. We all ought to be.

So here, if you will, is a “Dementia Grab-Bag,” which sounds like a really bad party gift. I have collected some research studies and decided to give them to you all at once. Maybe “Dementia Round-Up” is better, although that just makes me imagine of a lot of sad old cows, or cowboys wearing adult diapers.

What can you do to prevent dementia? In addition to the things we’ve already discussed, here are three easy actions for your consideration. The main thing to think about with all of them is that what is good for the heart is also good for the brain.

Embrace Leafy Greens

Maybe you’re old enough to remember the pickle episode from the Andy Griffith Show, in which Aunt Bee somehow manages to make pickles that taste like kerosene. Andy and Barney try their best to get rid of them, and Aunt Bee makes even more. At length, Andy figures, all they can do is “Learn to love ‘em.”

If you already love salads (not the pale green Iceburg lettuce wedge, but salads with dark green leaves), kale, spinach, collards and other greens, you’re in luck! If not, the best thing you can do is learn to love ‘em, so you can get the brain-helping powers they seem to offer.

In a recent study published in Neurology, scientists found that healthy seniors – there were 960 participants in the study, average age 81 – who ate leafy green vegetables every day had a slower rate of cognitive decline than did those who ate few or no greens.

The seniors (none of whom has dementia) are part of the Memory and Aging Project at Rush University in Chicago, a longitudinal study in which participants undergo yearly tests to assess their memory; they also keep track of what they eat, their exercise, etc. In this study, researchers led by Martha Clare Morris, Sc.D., Director of Nutrition and Nutritional Epidemiology at Rush, divided the participants into five groups, based on the amount of greens they eat. The seniors in the top group ate about 1.3 servings of leafy greens a day (a serving is about half a cup of cooked greens, or a cup of raw greens); those in the bottom group ate hardly any.

After about five years, the rate of decline for those in the top group was “about half the decline rate of those in the lowest,” reports Morris.   And get this: Their mental processes were “the equivalent of being 11 years younger in age.” Higher intakes of leafy greens “were associated with slower cognitive decline.”

Now why is this? Well, the scientists aren’t entirely sure, because even a simple leaf of kale has a bunch of nutrients and bioactive compounds in it, including phylloquinone, lutein, nitrate, folate, alpha-tocopoherol, and kaempferol.   All of these, says Morris, “have different roles and different biological mechanisms to protect the brain.” One thought, she adds, is that if you don’t get enough folate, you can have higher levels of homocysteine (an amino acid), which can lead to inflammation and the buildup of plaque and fat in the arteries – and this, in turn, can lead to a heart attack or stroke. In another recent study, Korean scientists reported that higher blood levels of homocysteine in older adults were associated with cognitive impairment.

And, of course, we can’t overlook the fact that if you’re eating a salad, maybe you’re not also eating fries or chips or macaroni at that particular time.

Note: This study didn’t report that these people never eat red meat, or that they exercised all the time; in fact, they adjusted for a bunch of factors, including education, overall health, exercise, activities, smoking and drinking. All the people in the top group did was eat leafy greens every day. Also, the scientists don’t claim that leafy green vegetables will stop memory decline forever. But there is a definite link: “The association is quite strong,” says Morris.

It’s easy to add greens to your daily diet. You can buy them in a bag salad. Eat collard greens from a can. Drink kale disguised in a strawberry-banana smoothie, if you don’t like the taste.

Embrace Exercise

You need to exercise. Please note that I did not have some condescending headline on here, like, “Get off the couch, you bum.” I don’t presume to know how active you are, and I hate it when people virtue-signal about exercise and diet and just make me feel like a loser because I’m not doing enough.

We’ve all got enough stress – and this is the interesting aspect of the next study I want to tell you about.   Scientists at Brigham Young University (BYU) in Utah found that running sharpens memory and mitigates the damage of chronic stress on the brain.

You don’t like to run? That’s okay. This article is about exercise and the scientists used mice; mice can’t ride a bike, do a rowing machine, or lift weights, so in this study, they ran, maybe with little track suits and sweat bands, I don’t know. The point is, if you don’t like to run, don’t discount this study; you could walk fast, or swim, or ride an exercise bike, or do the rowing machine – anything that gets your cardiovascular system going.

Remember the hippocampus? It’s the part of the brain that’s very important in memory, learning, spatial navigation, and other things. (It’s also deprived of blood flow when you smoke marijuana, which we’ve discussed here.) Well, chronic stress can be hard on the hippocampus; it weakens the synapses (electrical messages fired off by one neuron to another). Specifically, it affects a process called long-term potentiation (LTP), which helps us remember things more clearly.

In other words, prolonged stress hurts the brain and can affect our memory. But exercise acts as an antidote: It is “neuroprotective against the negative effects of stress” on hippocampal LTP, says Jeffrey G. Edwards, Ph.D., on the faculty in the Department of Physiology and Developmental Biology at BYU and the study’s senior author.

For this study, the scientists divided the mice into four groups: sedentary no stress, exercise no stress, exercise with stress, and sedentary with stress. (Don’t worry; they didn’t waterboard the mice or anything like that. They exposed them to some temporary stressful situations, like walking in cold water or on elevated objects).  The mice that had stress but also exercise had “significantly greater LTP” than the sedentary mice did. They also performed much better in a maze – as well as the non-stressed mice did.

Of course, the best way for us to improve our learning and memory “would be to experience no stress and to exercise,” Edwards says. Although we don’t always have a say in how much stress we have in our lives, “we can control how much we exercise,” and it is empowering to know that we can offset the negative effects of stress on our brains simply by giving our cardiovascular system a workout.

How does this relate to dementia? A lifetime of better brain stewardship will put us in a much healthier position to prevent dementia as we get older.

Don’t Drink Too Much

In a new study published in Lancet, French and Canadian scientists showed that too much alcohol is bad for your brain. They weren’t the first to show this, but their research adds to a growing body of evidence showing a clear link between heavy drinking and dementia.

The researchers looked at the French National Hospital Discharge database and examined the association between alcohol use and dementia, particularly early-onset (younger than age 65) dementia. Out of 1,109,343 patients diagnosed with dementia who had been discharged from French hospitals between 2008 and 2013, there were 57,353 cases of early-onset dementia. Most of these cases of dementia, the scientists report, “were either alcohol-related by definition, or had an additional diagnosis of alcohol use disorders.” They did not include patients who already had certain neurological or other diseases that can lead to rare types of dementia; they just wanted to focus on alcohol consumption.

Now, you may be wondering, what’s an alcohol use disorder? It’s problem drinking that become severe. I’m including a link to the National Institute on Alcohol Abuse and Alcoholism, which has some questions to help people determine if they have a problem. They call alcohol use disorder (AUD) a “chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.” Some questions include: “In the past year, have you had times when you ended up drinking more, or longer than you intended? Spent a lot of time drinking, or being sick or getting over the aftereffects? More than once wanted to cut down or stop drinking, or tried to, but couldn’t?” These and others are here, and they’re good ones.

Also, you may be wondering, what is heavy drinking? The study’s authors used this definition, also used by the World Health Organization and European Medicines Agency: “at least 60 grams of pure alcohol per day for men and at least 40 grams for women.” Definitions for what constitutes a standard drink vary, but in the U.S., a standard drink contains about 14 grams of pure alcohol. This is found in 12 ounces of beer, which is usually about 5 percent alcohol; 5 ounces of wine, typically about 12 percent alcohol; and 1.5 ounces of spirits – your basic shot of whiskey, tequila, etc., — which is about 40 percent alcohol. You can do the math, but if one of those drinks has 14 grams, then knocking back a little over four drinks a day would put you in the heavy drinking category.

Drinking in moderation is one thing; in fact, many reviews show a possible beneficial effect of a glass of wine a day. But drinking more than one or two drinks every day, or even several days a week, is another thing altogether.

We are talking about a big preventable risk factor here. Dementia affects 5 to 7 percent of people age 60 and older worldwide. There are several categories of dementia; Alzheimer’s is the most common, followed by vascular dementia and other types, and some people have mixed types of dementia – problems with the blood flow to the brain, plus some damage from alcohol, disease, or something else.

“Heavy drinking seems detrimentally related to dementia risk, whatever the dementia type,” the researchers say. Too much alcohol affects the brain in several ways. “First, ethanol and its metabolite acetaldehyde have a direct neurotoxic effect, leading to permanent structural and functional brain damage. Second, heavy drinking is associated with thiamine deficiency.” Here’s a link to another paper on thiamine deficiency. Basically, thiamine – vitamin B1 – is an essential nutrient; your body needs it to do many things. It’s especially important for your heart, liver, kidneys, and brain. Thiamine deficiency can harm the body in many ways; mental changes include depression, decrease in short-term memory, confusion, and irritability.

“Third,” the scientists continue, “heavy drinking is a risk factor for other conditions that can also damage the brain, such as epilepsy, head injury, and hepatic encephalopathy in patients with cirrhotic liver disease. Fourth, heavy drinking is indirectly associated with vascular dementia” because it raises vascular risk factors and can cause “high blood pressure, haemorrhagic stroke, atrial fibrillation, and heart failure.” And finally, “heavy drinking is associated with tobacco smoking, depression, and low educational attainment, which are possible risk factors for dementia.” We have talked about cognitive reserve and dementia risk here. “This combined evidence has led to a discussion about establishing a specific diagnosis of alcohol-related dementia.”

 

© Janet Farrar Worthington

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Healthy and Over 75? Keep Getting Screened for Prostate Cancer

We are living longer, and 75 is not the ripe old age it used to be.  But it’s a cutoff age for PSA screening – and this is missing cancer in men who really need to be treated, say Brady investigators.  “There is increasing evidence that this age-based approach is significantly flawed,” says Johns Hopkins urologist Patrick C. Walsh, M.D.  Walsh and I have written several books on prostate cancer, and this new information is being added to the upcoming 4th edition of our book, Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer, which we’re writing now.

 doctor medicineWalsh is the senior author of a recent Johns Hopkins study that looked at high-risk prostate cancer in older men.  The study’s interdisciplinary group of investigators also includes first authors Jeffrey Tosoian and  Ridwan Alam, and Carol Gergis; Amol Narang, Noura Radwan, Scott Robertson, Todd McNutt, Ashley Ross, Danny Song, Theodore Deweese, and Phuoc Tran.   

The U.S. Preventive Services Task Force recommends against screening for men over 75.  “There’s no question that there has been overtreatment of prostate cancer,” says urologist Tosoian. “However, that is getting better; more men are taking part in active surveillance programs, and we are much better at interpreting PSA and other biomarkers to rule out aggressive disease.”

But PSA can’t be interpreted if a man doesn’t get his PSA tested.  Population studies have shown that “men diagnosed at 75 years or older account for 48 percent of metastatic cancers and 53 percent of prostate cancer deaths, despite representing only 26 percent of the overall population,” says Tran, clinical director of Radiation Oncology and Molecular Radiation Sciences at Hopkins.  

Why are older men more likely to die from prostate cancer?  To find out, the team studied 274 men over age 75 who underwent radiation therapy for prostate cancer. “We found that men who underwent PSA testing were significantly less likely to be diagnosed with high-risk prostate cancer, and that men with either no PSA testing or incomplete testing (either a change in PSA was not followed up, or a biopsy was not performed when it was indicated); had more than a three-fold higher risk of having high-risk disease at diagnosis, when adjusted for other clinical risk factors,” says Tran.

Although this was a small study and more research is needed, Walsh says, “we believe that PSA screening should be considered in very healthy older men.”

In addition to the book, I have written about this story and much more about prostate cancer on the Prostate Cancer Foundation’s website, pcf.org. The stories I’ve written are under the categories, “Understanding Prostate Cancer,” and “For Patients.”  As Patrick Walsh and I have said for years in our books, Knowledge is power: Saving your life may start with you going to the doctor, and knowing the right questions to ask. I hope all men will put prostate cancer on their radar. Get a baseline PSA blood test in your early 40s, and if you are of African descent, or if cancer and/or prostate cancer runs in your family, you need to be screened regularly for the disease. Many doctors don’t do this, so it’s up to you to ask for it.

 ©Janet Farrar Worthington

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Preventing Dementia: What You Need to Know

I’ve had a lot of requests to print a talk I recently gave. Here it is. — Janet

Recently, I took part in a large, two-day dementia seminar in Prescott, Arizona, presented by Prescott United Methodist Church for the community.  There was a full house both days; hundreds of people came, which shows that the need is great for all kinds of information about dementia. 

But with all the doctors, nurses, social workers, financial people, and other experts talking about caring for people with dementia, and caring for the caregivers, and the desperate needs for daycare, home care, and for respite care so that exhausted, stretched-to-their-limit caregivers can have a break, there was only one person who talked about preventing dementia.  I was it.  What’s wrong with this picture?

Why was I the only one?  Why aren’t very many doctors talking about this?  Why do so many patients and their families hear that there is nothing they can do?  I wasn’t there to paint an artificially rosy picture.  I know what it’s like to try to care for someone with dementia; I know what it costs, financially, physically, mentally, spiritually.  It’s happened to two people I love, and it’s heartbreaking. 

But I also know from my work as a science writer that dementia is not always inevitable, and new research has shown that even when someone has Alzheimer’s, changes in diet, sleep, and exercise may make symptoms better. 

Many people have asked for copies of my talk, so here it is.  Longtime readers of this blog will find some of this material familiar, but I’ve collected it all into one place.  I’m sharing it with you now because I want you to know that there really is hope.

* * *

I’m going to start talking about the brain via an organ I know a little bit better: the prostate.  Bear with me.

Scientists have long known that, at autopsy, many men are found to have prostate cancer that never spread, never caused a problem, and never needed to be treated. They died with it, not of it. Sometimes, diseases only show up at autopsy. Men live a good long life and never show any signs of disease, and yet, when they die, there it is under the microscope.  But the disease never got out of hand. Men died with it, not of it. 

I did not know, until I interviewed Dr. Richard O’Brien, that the same thing happens with Alzheimer’s. O’Brien, who was Chairman of Neurology at Johns Hopkins Bayview Medical Center, now Chairman of Neurology at Duke, told me that some people, at autopsy, have Alzheimer’s pathology. They have the telltale brain plaques and protein tangles seen in Alzheimer’s disease – but they never develop any cognitive impairment. Other people have the exact same pathology, and they die of heartbreaking dementia. Why is this?

O’Brien sees opposing forces at work in the brains of people as they age.

In Alzheimer’s, the tipping point – the game-changer, the key factor that weights the scales toward dementia – seems to be ischemic disease. Stroke, or mini-stroke. “With a given amount of Alzheimer’s disease pathology in the brain,” O’Brien told me, “there are two forces at work. One is driving you to become demented, and the other is protecting you from being demented. The biggest force that we’ve found thus far is cerebrovascular disease.”

This does not mean that everyone who has had a stroke or who has cerebrovascular disease is going to get Alzheimer’s. That’s not what he’s saying at all.

What it does suggest is that if someone has significant atherosclerosis, or has had a stroke, even if it’s asymptomatic – AND also has the plaques and tangles, that is a very powerful predictor that he or she will develop dementia.

The body has a limited capacity for insults. Stroke is an insult. Plaques are an insult. Think of a boxer who can take a lot of punches, but he can only withstand so much. The brain has a tipping point, too. O’Brien believes that “either one of these alone isn’t enough, but the two existing together in the same brain are enough to tip you over.”

Here’s some very good news:

Doctors are getting better at spotting and treating the risk factors that lead to stroke. Two recent studies found that the incidence of dementia has declined over the last 30 years. “The primary reason for that is the treatment of coexisting cardiovascular risk factors,” O’Brien says.

None of these treatments prevents the Alzheimer’s pathology from building up – but they “prevent it from becoming manifest. So you die with your plaques and tangles, but you’re still cognitively intact.”

So, what can you do to protect your brain?

One thing is Exercise. In a report published in the Annals of Internal Medicine, scientists followed about 20,000 people who took part in treadmill testing in the 1960s as part of a cardiovascular study. Today, these people are in their eighties, nineties, or are deceased. “The scientists found that the people who had been in the fittest 30 percent of that group had a dementia rate that was half that of the other people in the cohort… One of the side effects of regular exercise is a significant reduction in your risk of dementia.”

Another huge factor is cognitive reserve, and this is from education. It turns out that people who go to college tend to have more cognitive reserve than people who don’t.  If you didn’t go to college, don’t worry.  If you read and learn a lot, you are building up a cognitive reserve, too. Learning a language or playing a musical instrument, doing research for your work, or singing in a choir – basically, anything that challenges your brain, as opposed to sitting on the couch and staring passively at the TV – these have beneficial effects on your ability to think, on the brain’s ability to make neural connections.

Not being obese plays a similar role, too. Fat, especially belly fat, changes your levels of hormones. It also increases your risk of dying of cancer. Scientists are still figuring it out, but chances are good that obesity is not of great benefit to the brain.

“People with certain types of personality traits are less likely to get demented,” says O’Brien.  Wait, personality traits?

pexels-photo-156731People who are positive and upbeat seem to have some protection from dementia. Why? Well, it may be that people who are positive are more likely to educate themselves and exercise.  The good news is that positivity and resilience can be learned. You can actually become more positive by working on gratitude, being around more positive people, and being more connected to your family and community. 

Positive people may also be more likely to do crossword puzzles or sign onto Luminosity, although O’Brien doesn’t think doing a puzzle here or there is enough by itself; in other words, you probably can’t Luminosity yourself out of dementia.  Now, one study published in the New England Journal of Medicine showed that people who did crossword puzzles had a lower rate of dementia than did people who spent a lot of time watching TV. But O’Brien thinks the brains of people who choose to do crossword puzzles are different from those of people who like to watch TV. “If you forced the people who are watching TV all the time to do crossword puzzles, would they have a lower incidence of dementia? I doubt it.”

Cognitive reserve is a very robust thing, according to O’Brien. “If you look at the neurons of people with high levels of cognitive reserve, they’re pretty resistant to the toxic effects of Alzheimer’s disease pathology. They actually have bigger neurons in the key areas of the brain. Their neurons are more healthy, even if there’s a lot of Alzheimer’s disease pathology.”

And then there’s diet.

O’Brien suspects that the Mediterranean diet might have a significant effect on dementia, because it also has significant effects on cardiovascular health. “The data’s pretty clear that if you can prevent cerebrovascular disease, your chances of becoming demented are much lower.”

In 2014, scientists at UCLA published a priority research paper in the journal, Aging, that showed for the first time, memory loss being reversed.  It wasn’t because of a drug or procedure, but a comprehensive and personal approach that showed how Alzheimer’s is a complex disease, affected by diet, exercise, and even sleep.  All of these things contribute to the brain’s plasticity, said Dale Bredesen, the study’s principal investigator.  Ten people with memory loss, some with brain scan-confirmed patterns of Alzheimer’s, participated in a small study called MEND, for Metabolic Enhancement for NeuroDegeneration.

The participants made dramatic lifestyle changes.  They avoided simple carbs, gluten, and processed foods.  They ate more fish, did yoga, and meditated.  If they didn’t sleep well, they took melatonin.  They took vitamin B-12, vitamin D-3, and fish oil.  Within 6 months, 9 patients had a noticeable improvement in memory.  One patient, who was in the late stages of Alzheimer’s, did not show improvement, so there may be a point at which it’s too late.  But these findings suggest that at least early on, changing your metabolism can improve your cognitive function. 

Six of the people in the study who’d had to quit working were able to return to their jobs.  Some patients were followed up to two and a half years, and the memory improvements remained.  Larger studies are under way.

Let’s come back to exercise.

300_200_walk_gravelA study led by scientists from the University of Maryland School of Public Health, published in the Journal of Alzheimer‘s Disease, found that just 12 weeks of moderate exercise – basically, walking fast enough on a treadmill to get your heart rate up, but not so much that you couldn’t carry on a conversation with someone else while you did it – made a difference in how people’s brains functioned.

It made their brains work better; their neurons were more efficient. People could remember things more easily, and their brains didn’t have to work as hard to do it.

Scientist, J. Carson Smith, of the University of Maryland’s Neuroimaging Center, and said, “No study has shown that a drug can do what we showed is possible with exercise.”

The people in the study weren’t spring chickens, either. They ranged in age from 60 to 88. They weren’t athletes – far from it; they were considered “physically inactive older adults.” Some had already shown mild cognitive impairment. The people in both groups – those with the mild impairment and those with healthy brain function – improved their cardiovascular fitness by about 10 percent in the three months of the program.

They also improved their memory. MRI brain scans taken before and after the study showed “a significant improvement in 11 brain regions.” Even more exciting, the places in the brain that got better are the same ones that are affected in Alzheimer’s – the precuneus region, the temporal lobe, and the parahippocampal gyrus. Their word recall – remembering as many as possible out of a list of 15 words – improved.

What does this mean for you? It means that, whatever age you are, you can make your brain work better even with a small amount of effort. You don’t have to be in marathon-running shape. You don’t have to go grunt and sweat and dead-lift huge weights. Just walk for two and a half hours a week – 30 minutes a day, five days a week. If you don’t have 30 minutes, do it twice for 15 minutes. Any effort is going to pay off.

Other Things:

Prevent frailty. Frailty is your enemy.  But O’Brien says:  “I don’t think that falling apart when you get old is something that has to happen.”

Recently, Johns Hopkins geriatrician Jeremy Walston looked at what healthy older people have in common — at what they eat and don’t eat, and how they live – and came up with some practical tips. 

Nutrition:  Make Every Bite Count

If you do it right, just about everything you eat can help your body.  This doesn’t mean you have to eat just nuts and berries or be a food martyr who never eats comfort food.  What does it mean?

Eat Fresh Fruits and Veggies

grilled veggiesI know, duh.  Who doesn’t know that fresh fruits and vegetables are good for you?  But what’s in them matters, too. Walston says potassium is important, and “Fresh fruits and vegetables are rich in potassium.” 

When you get your blood pressure tested, it’s a fraction, one number over another.  That top number is systolic blood pressure, and potassium can lower it by several points.  It also helps regulate the heart rhythm.  If you are eating foods rich in potassium, this also means you’re not loading up on saturated fat, and this will help lower your cholesterol.

Get More Protein

As we get older, we need more protein.  “Protein helps muscles function better, and it is also important to help maintain muscle mass.” You don’t have to spend big bucks; you can get salmon in a can, or yogurt, or eggs, or an energy bar. Epic Bars are good sources of meat protein when you’re on the go.

Get Plenty of Vitamin D

Vitamin D helps keep your bones strong.  It also helps keep your muscles, heart, brain and immune system healthy, and can help prevent cancer.  Having low levels of Vitamin D is bad: A study published in the Archives of Internal Medicine found that people with the lowest levels of Vitamin D had more then twice the risk of dying from heart disease as people with higher levels.  You can get it from sunlight, 20 minutes a day twice a week or so, or in a supplement.  The National Institutes of Health recommends 600 international units of Vitamin D a day if you’re under 70, and 800 IU a day if you’re over 70.

Get your shots

Lower your risk of getting the flu, or pneumonia, or shingles by getting a shot. Anything you can do to prevent being laid up is a good thing. 

Keep Moving

My husband, Mark Worthington, is a gastroenterologist, and he tells me that many of the older people he sees fall into two categories.  He always asks them what they do, and some will say, “We volunteer, we hike, we love to go out to dinner with our friends.”  Others basically do nothing.  All day.  Not good.  These people tend not to do as well.

Jeremy Walston says, “Stay active as long as possible.  Don’t sit for long periods of time, especially in the late afternoon or evening.  Studies show that those are low-activity times for many people, so it’s good to try to boost your activity during those times.”  Go for a walk after dinner.  Walking is good; in fact, you should walk a lot, or do some aerobic activity – there’s plenty to choose from. 

“It’s also important to do exercises that help you stay flexible, that help your balance and gait, and that help strengthen your muscles.  Don’t forget your shoulders,” which are important for maintaining core body strength and higher levels of function.  And if you have an “orthopedic issue,” like knee or hip trouble, address it, so you can keep moving as long as possible.”

However: 

Don’t Fall

Falling is bad.  The body literally takes a hit when you fall.  Many older people, who otherwise have been doing pretty well, take a turn for the worse after a fall.  Just being laid up for a few days can be difficult for the elderly because they tend to lose strength quickly.  The best way not to fall is to prevent it, says Walston.  “Things that can make you fall include: not watching your medication; vision problems; weakness in the lower extremities; and balance and gait problems.” 

One huge risk factor is easy to fix:  “low lighting and a cluttered living area.”  Make sure your rooms are well lit – that you not only have enough lights, but that the bulbs are high-powered enough so you can see where you’re going.  And go after the clutter.  It doesn’t take much – maybe a stack of books or magazines that slips over, a puzzle left by a grandchild on the floor, or pet toys – to make a walkway treacherous.  Sometimes, you’re so used to looking at clutter that you don’t see it.  This is why Walston recommends bringing in a friend or relative who is not used to your home, who can see potential trouble spots you haven’t noticed.

A personal note: When my aunt, who had dementia caused by a stroke, had to go to the nursing home, we asked what we could bring for her room.  They said:  Only one thing, because clutter makes demented people more agitated.  I figure, if demented people are the canary in the coal mine, and clutter stresses them out a lot, it most likely stresses us out, too, on a low level.  So not only can you trip on it, clutter agitates.

You can lower the odds of falling by working on your balance.  Tai Chi is a great way to do this, and so is yoga. 

What else?

“Cognitive risk factors include diabetes, elevated lipids, and high blood pressure,” says Walston.  Medications can keep all of these problems in check, which will help your blood vessels, which will help your brain.

Poor hearing:  If you don’t feel connected, you may tend to withdraw from the conversation, smiling politely, not engaging, because you don’t know what people are saying.  This is bad.  “Get a hearing aid if you need one.”  It won’t just help your hearing; it will help your brain.  There’s a feedback loop: When you stay connected, you are giving of yourself, talking and listening, and that stimulates your brain. When you don’t hear, you just sit there and don’t participate, you’re not getting that stimulation, and if you don’t use your brain as much as possible, you may lose function.

Depression:  If you are depressed, you are going to be withdrawn, you may not eat or sleep very well, and you may not get enough exercise.  Treating it is good “cognitive protection,” says Walston. 

Finally, Stay connected.  Talking to people — volunteering, driving, interacting with others in church, clubs, or other groups, being around family or friends – protects your brain.

©Janet Farrar Worthington

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Shape Up, Part 2

 It’s Really Hard to Lose Weight, and Now You’ve Just Depressed Me

I get it.  It is really hard to lose weight, and I would have depressed myself, too – except I know it can be done.  I am shaping up, myself, and I’m seeing results.  My kids got me to start going to the gym a few years ago.  Then I stopped doing weights and started running, but although I enjoyed it, I got plantar fasciitis and was hobbling around every morning when I got out of bed. 

Then my daughter sent me a link to this great website called Bodybuilding.com.  After doing just weights, and then switching to just cardio, I have finally figured out that it’s better to do both.  (I also want to state publicly that my daughter tried to tell me this, years ago, but I didn’t get it.  I do now.)

None of this is as hard as you might think.  Here’s the routine I have been doing:  http://www.bodybuilding.com/fun/randy29.htm

I don’t even do all of it!  It starts with crunches.  I don’t do them.  I go to my local YMCA, and frankly, the floor is gross.  They have mats you can use, but they’re gross, too.  I don’t want to be on them.  This is not your fancy clientele, as evidenced by the sign over the water fountain telling people not to spit in it.  Sometimes people don’t read the sign, that’s all I’m going to say. 

There are 12 exercises, and before you think, “oh, Lord, how long will that take,” let me reassure you that each one just takes a few minutes.  And again – I don’t do them all!  It’s not that bad. 

barbellI start with the “barbell bench press.”  I do 40 pounds.  Don’t laugh; it used to be 30.  That’s okay.  If 40 gets easy, I will move up to 50.  Baby steps, people.  Then I do the dumbbell shoulder press.  I do 12 pounds each; again, you could laugh at the girly lack of weight, but it used to be 10 pounds.  One-arm dumbbell row, 25 pounds; it used to be 15.  Wide-grip lat pulldown:  I do 50 pounds.  It used to be 40.  Seated cable rows: I do 40 pounds.  That hasn’t changed, but I was doing it wrong at first, and now that I’m doing it right, that’s a good weight for me.  Barbell curl:  I don’t do it, but I do the dumbbell curls instead; 15 pounds, used to be 10.  Triceps pushdown:  I do 45 pounds.  I used to do 40.  Barbell full squat:  The pole that holds the barbells weighs 45 pounds; I add 50 to that.  Leg extensions: I do 50 pounds; used to do 30 when I started.  Lying leg curls: I do 50 pounds.  I don’t like them, so I often don’t do them.  And that’s okay, because I’m doing the other stuff.

treadmillThen I do 20 minutes on the treadmill; I used to run, now I walk briskly.  I also have a Chocolate Lab who is insane, and I take her for long walks, too.  Combining both the weights and the walking really has made a huge difference for me.    

I have also changed what I eat.  This has been difficult, because God help me, I love comfort food.  I grew up in the South, and when I go to South Carolina to visit my family, I gravitate to fried chicken, fried okra, fried catfish… notice a theme here?  Fried foods are very bad, as we talked about in a previous post.  Also, sweet tea is the house wine in the South.  I am drinking it straight, without the cup of sugar in each gallon.  My relatives are still speaking to me.

More concerning for me, is where my body likes to store fat.  I don’t have junk in the trunk, or thunder thighs.  Instead, my body wants to put on fat right in the tummy, where it causes the heart to work hardest.  It’s not much, but it’s more than I want.

I’m eating food that is better for me, and in return, I actually feel better for it.

You may find a diet that is perfect for you, and if that’s the case, more power to you.  I have found that slow and steady wins the race. 

Here’s my best tip: Every single little thing you do makes a tiny difference.  Have mustard instead of mayo.  If you get a sandwich, skip the cheese.  Get it on whole-grain bread. 

Don’t get chips with it.  If you say, “No way, I’m getting chips,” of course that is your right, and it’s your life.  How about maybe you get the small size instead of the “sharing size?”  At least there are fewer chips in there.  You’ve got to start somewhere.

Chicken has fewer calories than beef. 

Drink only water or something with no calories, like unsweetened tea.  Avoid soda like the plague.  Alcohol has a lot of calories.  You could start to lose weight right away if you just cut back on that.  Watch out for juice; it has a lot more calories than you think.  Eat a piece of fruit instead.  If you go to Starbucks, get a Refresher, which only has about 35 calories, instead of a Frappucino.  Don’t rely on diet drinks; that’s a whole ‘nother blog post, but they still make your body crave sweet things, and this does bad things to your insulin receptors. 

Make the effort to limit processed food.  Yes, when you’re tired and you just want to eat something fast, it’s a pain to cook from scratch.  I know this.  I have never been one to make a bunch of meals ahead of time, so I can’t recommend that approach, although a lot of people do it.  But it’s not that hard to get a piece of chicken and cook it.  You can buy frozen brown rice and microwave it; it takes three minutes.  Or cut up that chicken and stick it on top of a store-bought salad mix, then add a simple vinaigrette dressing.   

Fast food is bad.  Now, you may say, “But I have no choice, I’m on the road, I can’t carry food all the time.”  Keeping in mind that you actually could carry granola bars and fruit, I’ll say, “Okay, then watch your calories.”  McDonald’s posts the calories right on the sign.  If you just have to have a burger, limit your portion size, as the doctors say.  Get one of their original small hamburgers, not a cheeseburger.  Get a small fry instead of a large.  For God’s sake, don’t get a soda.  Your insulin receptors will thank you. It’s not great, and I wish you would do something else, but at least you will save hundreds of calories right there.  (I will note here that some nutritionists would say I’m being a traitor to the cause:  “Eek! Fast food burgers and fries are evil!  Shun them!  Get a salad instead.”  But a lot of people feel that when their doctor gives them a diet, it’s “my way or the highway,” and if they leave the highway once, they might as well just stay off-road.  I am hoping you will stay on the road for the long haul.)

Speaking of salads: Salads are good, but if you load them up with a creamy ranch dressing, lots of cheese and croutons, maybe some ham or bacon for good measure, with a big side of bread and butter, you are defeating your purpose.

Take the stairs. 

Don’t drive circles around the parking lot looking for that lazy spot right in front of the store.  Park farther away from the store and walk. 

When you start to exercise, don’t start with heavy weights.  Work up to it.  Don’t get on the treadmill, run fast and then poop out after two minutes.  Start by walking slowly.  In my opinion, it’s better to walk slowly for 20 minutes than speed-walk for five.  If you don’t have access to a treadmill, set a timer and walk for 20 minutes, at any speed you choose.  Anything you do is more than you would accomplish by just sitting still.  Trying means a lot.

Don’t get discouraged.  The worst thing you can do is try something, decide it’s too hard, then quit because you just know it’s never going to happen, and that you’re a loser, or whatever you might say to yourself.  You’re not a loser because you’re trying.  No judgment, only encouragement.  You are making the effort. 

Baby steps.

This lifestyle we have – I’m including myself here, because I’m fighting it, too – has got to change. 

We can do this.

©Janet Farrar Worthington

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