Balance and Longevity

Can you balance on one foot for 10 seconds? Aging adults recognize that as we get older we may experience muscle loss, decreased stamina, and issues with flexibility; balance, however, usually remains unaffected into our fifties and then begins to deteriorate with some rapidity after that. A test of balance that I often use with clients–and this is fairly standard in the fitness world–is a single-leg stance, also known as balancing on one foot. My goals is to get my clients to be able to balance on each foot for 30 seconds; for many of my clients this may never be attainable, but we work our way up as much as we can.

Past research has shown that those who can balance for longer periods of time on one foot are much less likely to experience falls. For older adults, falls can have especially serious consequences as healing takes longer and inactivity takes a greater toll. Falls can also lead to a loss of independence.

The results of a new study published in the British Journal of Sports Medicine suggests that the inability to balance for 10 seconds is linked to nearly double the risk of death from any cause within the next decade. In other words, if you can balance on one foot for 10 seconds you cut your chances of dying in half over then next ten years. A recent article on cnn.com discusses the results. Previous research had linked the inability to balance with fall risk and cognitive decline, but never before with longevity. Of course, the ability to balance may be affected by a number of other health factors; those who failed the test were more likely to be obese, have heart disease, high blood pressure, and type 2 diabetes.

The study does not reach any conclusions about causality. If you practice every day and are able to balance for 10 seconds, does that mean that your longevity will automatically increase? More research will be needed to determine this. More likely, those who are in a normal weight range, have blood pressure and blood sugar under control, and have healthy hearts may engage in more healthy patterns of diet, exercise, and rest. Those who take better care of themselves may therefore be better able to balance on one foot and also live longer. Causality is not yet determined, only linkage.

What does this mean for us? Try the test and see if you are able…or if you are even close; always perform this test near a piece of furniture or kitchen counter, or with someone nearby, rather than in the middle of an empty room in case you fall. If you are unable to pass the test, it may be worthwhile to talk with a medical profession about ways to improve health outcomes. In the meantime, it could not hurt to practice balancing, eat right, exercise, and get plenty of rest; these all contribute to longevity and great enjoyment during those years.

400 Followers!

It has been 3.5 years since I began this blog, and now I have reached the milestone of 400 followers. To mark the occasion, I reread the blog that I posted when I hit 200 followers.

I noted back then, that I had little idea how the whole blogging thing worked. Originally, the blog was supposed to deal with the intersection of Judaism and physical fitness, but it veered more into fitness for older adults a couple of years ago, reflecting my personal training business At Home Senior Fitness.

What is new since I hit 200? My business was still in its early stages and I was struggling to get new clients; now I have a waiting list! I am now a regular contributor to Northeast Ohio Boomer where my column on fitness for seniors appears in each issue. I have taught classes for local organizations including a synagogue, Village in the Heights, and a group supporting individuals and families with Parkinson’s Disease. I have been interviewed for print media, radio, and a podcast!

It will be interesting to see where I am when I get to 600 followers. Currently in development is digital content from my brand, and the strong possibility that I will expand my business to keep up with growing demand.

In the meantime, I will keep bringing you the lastest news, tips, and advice for how to stay healthier and more fit as we age!

Thanks for reading, and feel free to offer feedback and spread the word!

My Interview on Howard Wolpoff’s Podcast.

I was fortunate to be interviewed a few weeks ago for a Podcast by Howard Wolpoff on Small Business Marketing. I am part of a FaceBook networking group when I saw a request for those wishing to participate in a discussion about small businesses and marketing–particularly, after through and “after” the pandemic.

Give a listen if you have interest!

Wondering if given my business, it should be a Bodcast….

Sun’s Out, Suncreen Out

There is an expression, “Sun’s out, gun’s out;” here “guns” refers to biceps, not the epidemic of violence in our country. In other words, when the weather is warm, it is time to expose all those muscles that we have been working on during the colder months of the year.

Perhaps the expression should be changed to “Sun’s out, suncreen out.” This is true at every age. When I was younger, there was not much awareness around the dangers of sunburns and the importance of wearing protective lotions/clothing to prevent them. As person with light skin, I was especially prone to damaging burns and I am paying for it now. Over the last 20+ years I have had more than five skin cancers; thankfully, all of them have been basal cell carcinomas which are removed (sometimes easily, and sometimes with more difficulty) and do not require further treatment.

Older adults, however, should be extra cautious for a number of reasons. First, many older adults are retired and that means (depending on the climate) they spend less time inside and more time playing golf, gardening, sitting by the pool, or engaging in other outdoor activities. Second, many retire to places where not only is more time spent outside, but due to the latitude the rays of the sun are more direct and intense. Third, as we age our skin becomes thinner and more vulnerable, meaning that burns can have more serious consequences. Finally, older adults are usually not in the habit of applying sunscreen–even if they are going to be at the beach–so this requires an extra step in our regular routines. We must remember that the more exposure to sun, the more likely that burns will occur, and the greater the chances of developing skin cancers–some of which can have very serious consequences.

When should sunscreen be used, and what kind is best for older adults? Some say that it is okay to skip the lotion if you are going to be out less than an hour; this is not good advice since it is often difficult to control how long one will actually be outside. Any time you will be exposed to direct sunlight for more than 5-10 minutes it is a good idea to apply to exposed areas; certainly more than 20 minutes makes it a obligatory. Also, remember that it is necessary to re-apply sunscreen; check the usage directions on the product for more details. Experts recommend at least a 30 SPF for older adults, but depending on the kind of skin you have it may make sense to go with a higher number. I never use anything less than 50 because of the sensitivity of my skin and my past history of basal cell carcinomas. When in doubt, this is a great conversation to have with a dermatologist; if you do not have an appointment coming up soon, you can usually send an email message to your doctor through the practice’s website or through apps like MyChart.

I wish that I knew when I was a kid what I know now. It would have avoided a lot of scares and procedures. I have two children with fair skin and I am grateful that there is much more awareness and better products to prevent sunburn.

It is officially summer! So, sure, go ahead and flash those biceps, quads, pecs, or abs…but make sure they have a layer of sun protection on top first!

Slow Down, You Move Too Fast…Or Not

A recent article on CNN.com reports on a new large study appearing in the Journal of the American Medical Association that shows a connection between slower walking speeds (or gait) and development of dementia. The research seems to show that a decrease in the speed at which older adults walk year to year may be an early indicator of cognitive decline and dementia. The study looked at the pace of walking as well as the ability of participants to answer certain cognitive/memory questions, then drew conclusions about their relationship.

Although it was a large study (17,000 subjects), more research should follow. As I read the article, I wondered about a chicken and egg question. Did walking speed decrease because of lower cognition, or did cognition somehow decrease because of slower walking? If the second is the case, then it would make sense that we should regularly monitor people to see if they are literally slowing down; if so, they should be put on a program to increase the velocity of their gait. The research does show that when both factors (slower walking and cognitive decline) are present, there is a much greater chance of dementia–as opposed to mild cognitive impairment, which is a “normal” part of the aging process.

The study seems to indicate that the connection may exist in the right hippocampus–the area of the brain associated with memory. Believe it or not, the size of the right hippocampus can actually be increased with regular aerobic exercise (the kind that elevates heart and breating rates). It is not as if we simply have to accept the fact that once we slow down we are on a slippery slope to dementia; keeping up the pace of our exercise can have a positive impact. Even stretching exercises were shown to make a difference.

More research will surely be forthcoming. This study will certainly become an important tool in assessing the risks of dementia. It also provides another reason why it is so important for older adults to remain active and engage in regular exercise. It is not just about our physical health, but about our mental well-being too!

Wading (Literally) into Fitness

As a kid I loved going to our local pool each summer. It was a great way to beat the heat, see friends, and have fun.

As an adult, I heard over and over again that exercise in the water was beneficial; I spent a lot of time during my days at the Seminary in the Columbia University swimming pool, and have continued to lap swim up until just a few years ago. I did not stop because I did not like it, but rather because my interests took me elsewhere (running and bicycling). After I became a fitness professional, I learned that there is more to the swimming pool than just swimming. Water aerobics and other water fitness classes can play an important role in better health outcomes, especially as we age. I experienced this first-hand when I was recovering from surgery on my foot and was allowed to participate in water aerobics.

Just as in childhood days, being in the pool is fun and it still helps to beat the heat, but is there an advantage for older adults to exercise in the water as opposed to on dry land? Two recent Australian studies were published in Journal of Sport and Health Science and Journal of Science and Medicine and Sport that indicate that this kind of exercise has a positive impact on cardiorespiratory health–aside from other benefits.

The studies took 72 men and women averaging 62 years of age. All were mostly sedentary, and were randomly assigned to 3 groups: 1. water walking, 2. land walking, and 3. no changes (control group). Groups 1 and 2 increased intensity during the 24 weeks of the research program. Compared to the control group, these two groups saw an increase in maximal aerobic capacity of 4%, a measure that shows how well the heart and veins circulate blood to the rest of the body. Interestingly, they also saw a decrease in visceral fat which is associated with cardiovascular disease, high blood pressure, type 2 diabetes, and insulin resistance. The water walking group also saw improvement in lower limb lean muscle mass–most likely a result of resistance provided by the water.

This news is especially welcome since many older adults avoid walking due to fears of falling. Additionally, those with joint problems may find it easier to do exercises in water and see less impact on affected areas. And did we mention, it is fun? The more enjoyable it is, the more likely we are to stick with the program.

4% may not seem like a huge difference, but even small increases in aerobic capacity have been shown over and over again to decrease mortality from cardiovascular disease. So, what are you waiting for? Come on in, the water is fine!

How Much Dairy Should Older Adults Have?

Saturday at sunset begins the Jewish holiday of Shavuot–known in English as the Feast of Weeks or Jewish Pentecost. This festival recalls the harvest of the first fruits in the Land of Israel as well as the receiving of the Law at Mt. Sinai.

Over the centuries, the custom has developed to eat dairy products on Shavuot; cheese blintzes and cheesecake are particularly traditional, popular, and tasty. How did this custom develop? There is no single answer. One explanation has to do with a verse from the Song of Songs (4:11), where it states “honey and milk are under thy tongue;” since this book is seen as an allegory of the love between God and the Israelites, the honey and milk are thought to refer to the Torah, whose words are always spoken (by the tongue). Another interpretation is that the journey to Mt. Sinai was so arduous that the Israelites did not bring animals to slaughter and eat–it would have been too much bother–but rather ate only dairy leading up to the Revelation. Yet another explanation is that until the Torah was given at Mt. Sinai, there were no laws about what was acceptable to eat (the dietary/Kashrut rules are in the Torah); in order to not transgress God’s will, the people only ate vegetarian and dairy. Whatever reason you like best, it all adds up to a tasty and rich holiday.

I will admit that I usually overdo it a little on Shavuot when it comes to the cheesecake and ice cream. It got me wondering just how much dairy is “right” for older adults. Most sources recommend 3 servings daily (each serving being one cup). It seems like a lot; what is the rationale behind this? As we age, the need for calcium becomes all the more important; it helps us to keep our bones strong. We know that one of the biggest fears of older adults is breaking bones, because the healing process is slower and can lead to complications. When it comes to calcium, there are few sources that pack as much punch as dairy products.

Unfortunately, many older adults have a hard time digesting dairy products. There are also many vegans who do not consume them at all. What alternatives exist to get the proper amount of calcium in their diets? Many non-dairy foods contain calcium: soy products (like tofu, tempeh, edamame), legumes (such as beans, peas, lentils), nuts, seeds, some grains, and other vegetables. There are also some drinks such as oatmilk and orange juice that may come enriched with calcium.

Is the real reason why we eat dairy on Shavuot because God knew that the Israelites would need strong bones to wander for 40 years in the wilderness? There is no way to know for sure, but it is about as plausible an explanation as those put for by Jewish tradition over the generations.

In any case, as we grow older, we must be diligent about maintaining the proper levels of calcium in our diets. Maybe that should be the 11th Commandment!

Getting Back on that Horse

Disclaimer: not me in this picture!

You know the old expression: “If you fall off the horse, get right back on.” It acknowledges that setbacks are a part of life; what is important is how we respond to those setbacks. Either we can choose to be defeated and give up, or we can get back in the game and give it another shot, realizing that we might fall off yet again.

I often refer to this adage when counseling clients and others about fitness and weight management. I addressed this in one of my most popular blog posts about a year ago. Sometimes we are really good at getting to the gym, eating right, and taking care of ourselves in general. There are other times, though, when it is a real challenge (vacations, holidays, illness, etc.) and we “fall off the horse.” In that post, I discussed being kind and forgiving to ourselves. There is nothing to be gained by beating up on ourselves. To paraphrase Pumbaa in The Lion King, often the best thing to do is put your past behind you (or put your behind in the past…one of those two!) Do not dwell on the failure, but get back on the horse and make a change that very day.

This has been on my mind a lot as I have been watching the scale slowly creep upward. Last year, I started doing Noom to take off some extra pounds and to prepare for some upcoming surgery. After the surgery, I was quite a bit underweight and struggled for several months to put the pounds back on. I can report that I solved that problem and then some. I am now above the point on the scale that I vowed I would never hit again. I am not obese or unhealthy, but rather want to make sure that I keep healthy habits as I age.

So tomorrow I’m hopping back on that horse. I am still subscribing to Noom. I will continue to track my weight. I will start logging my meals again. I will get back in touch with my coach. I cannot wait to get back in the saddle again!

We all face obstacles in life–at work, at school, in relationships. This is a given in the human experience. The true test is how we respond. Will we simply give up? Or, will we be resilient? The choice is ours. I will keep you posted as I gallop toward back toward healthier habits.

One Year Kidney-versary

Today is a very special day. May 25, 2022 is exactly one year since I underwent my donor nephrectomy surgery. That is fancy for donating a kidney.

Those of you who follow my blog saw many posts in the first few months after the surgery, but things have been quiet for a while now. And that is as it should be. The doctors and other medical personnel at the Cleveland Clinic told me that within a few months I would feel like I did before the surgery; there were times–especially during the first two weeks–when I did not believe them. Thank God, I am feeling great and so is the recipient. My donation has not limited my physical activity in any way. I have 5 scars, but they are “war wounds” that I wear with pride.

I am excited that our “daisy chain” of donors and recipients will be getting together this Friday evening for a Shabbat dinner at our home. Looking forward to getting caught up with this eclectic mix of people who share nothing in common except for a 4 oz organ. We will toast to good health and to the amazing advances in medical technology that made these life-saving procedures possible.

A few thoughts on this anniversary.

  1. Most people think they have to be dead to donate organs. This is not 100% true. Kidneys and partial livers can be donated, and they are in most cases preferable to cadaver organs. If you are in good health, consider donating and saving a life.
  2. It has been great to talk with people who saw what I did and have expressed interested in donating. Next month, one of those people will be donating to a total stranger. I cannot tell you how thrilled I was to hear this.
  3. Not everyone can donate an organ. There are many ways to save a life, though. Blood and platelet donations are also life-saving. Learn CPR and how to operate and AED (Automated External Defibrilator). Get involved in policy decisions that help promote laws that save lives. Take good care of your own health and well-being.

I am grateful to have been given the opportunity to make a difference. Donating a kidney was definitely one of the hardest things I have ever done (makes a half marathon look like a piece of cake!), but also one of the best things I have ever done. One year later, I am feeling blessed!

How Do I Know if I’m Working Out Hard Enough?

My last post tackled the question of how we know if we are making progress in our exercise program. That discussion took more of a long view of things, but how do we know if we are working hard enough in any given workout? This is a topic that I have blogged about in the past as well: once on 9/6/2020 and then a few days later on 9/10/2020.

To recap, when it comes to cardio exercise there is a formula that is often used to determine if the workout is effective. It is not exact, but the equation is 220 minus your age; that number gives you the maximum heart rate, but the goal is to be at 65-85% of that number. For instance, a person who is 70 should not exceed 150 beats/minute; the “sweet spot” is between 97 and 127. When it comes to resistance training (weights), it is a little more complicated as it will depend on what the goal is. Rather than going into detail here, consult your favorite fitness professional; recommendations will vary in relation to a number of factors such as age, current level of fitness, injuries, etc.

Still, in any given workout, is there an easy way to get a sense of things? For cardio, there is something called the “talk test.” If a person is able to talk while doing the exercise (running, biking, etc.) it would be considered moderate; if a person can talk with difficulty but not sing, that is a more vigorous level. If the person is unable to speak at all (like during a sprint), that is the highest level of exertion–one that can only be carried out for a limited amount of time. What level is appropriate? It will depend on a number of factors (are you just trying to stay fit, or are you training for a marathon?), but going back to the formula above will help.

For resistance training, I usually recommend a weight that allows the client to do 12 reps with the last few being difficult. If all 12 reps are easy, it is time to either add weight or reps, or in some other way increase the level of difficulty. Those looking to bulk up, will follow a different set of standards–generally, heavier weight with less reps. I also use the RPE or Rated Perceived Exertion; this is fairly subjective, but it asks the exerciser to rate how difficult an exercise is. I use a 1-10 scale with 10 being the most difficult; most clients are honest (although we all know the adage “never tell a personal trainer something is too easy!”) This is a relatively simple way to gauge the level of work for both resistance and cardio training.

The key is not to rest on one’s laurels. When an exercise becomes to easy, it will not help to accomplish the fitness goal. Progression to a more challenging level is what is called for.

Although it can seem confusing at times, we are usually our own best judges of how hard we are working. We need to be honest with ourselves, though, so as not to overwork or underwork. Being honest with ourselves is a good rule in every aspect of our lives.