Too Much (or Not Enough) of a Good Thing

The most recent issue of AARP Magazine [August/September 2022] addressed the issue of what we assume to be good habits to stay healthy that can actually be harmful in some cases. I would link the article, but it is not yet posted to their website; it is entitled “Good Habits That Might Age You Prematurely,” by Leslie Goldman.

Goldman addresses five habits that, in general, are good but call for either moderation or at least some counterbalance.

  1. Staying out of the sun. I recently blogged about this; when we are outside it is very important to use proper sunscreen and other protections to prevent skin damage and/or skin cancer. Avoiding the sun altogether, however, can have negative effects. Circadian rhythms (similar to our biological clocks on a daily basis) are set by the sun; they keep all our systems and organs on 24-hour cycles. When we have little or no exposure to the sun, those rhythms can get messed up and make sleep difficult; sleep, of course, has many benefits. Goldman suggests at least 15-30 minutes each day outside in the morning and late afternoon/early evening, or to make use of a light box at a consistent time each morning.
  2. Eating nutrition bars. As the author notes, it may sound healthy but many are loaded with sugar; the same is true of smoothies and fruit juices. This can lead to all kinds of problems like high blood pressure and heart disease. How can you know if your bar is healthy? Add up the number of grams of proteins and the number of grams of fiber. If that number is higher than the number of grams of total sugar, it is not problematic. Consider other ways to get protein that are not loaded with sugar or overprocessed.
  3. Drinking when you are thirsty. If you wait until you are thirsty, you are too late. Estimates are that 70% of adults between the ages of 51-70 may be chronically dehydrated. This increases the risk for all kinds of problems from urinary tract infections to colon cancer to diabetes. Goldman suggest drinking enough so that you have to urinated every 2-3 hours; additionally, it is a good idea to eat foods that have high water contents like celery, cucumbers, tomatoes, watermelon, and peaches.
  4. Walking every day for exercise. I have blogged about this too. Walking is great, but as we age we need to make sure that we vary our exercises and include weight training as well. Weight training helps to rebuild muscle mass that is lost with aging and can also strengthen bones. By the way, the more muscle you have the greater ability you have to store water (see #3 above). Get at least 150 minutes of moderate exercise each week, or 75 minutes of vigorous exercise. Work in 2 days of strength training; a fitness professional can help you do this safely and effectively.
  5. Constantly wearing supportive shoes. This was a shocker to me; and I have blogged about this too. Our feet send messages to our brain that help us to keep our balance. If we wear shoes all the time with lots of padding and support, our brain does not get enough sensory stimulation from the feet–and the nerves can lose sensitivity too. Goldman recommends going barefoot for 30 minutes each day, especially while doing activities where you move around so that the whole foot gets stimulation.

As always, if you have questions or concerns, consult with a medical professional that you trust. It is true that moderation and balance are important guidelines–not only in our relationships, leisure pursuits, and diet, but in our other health habits as well!

Thrown Your Back Out?

There I was, minding my own business on Saturday night, pulling down a shade on the back window, when I “threw my back out.” At the exact moment it happened, it took my breath away and the pain was intense. How did this happen? I had just pulled down two other shades–as I do every night when it gets dark–without incident. What actually occurred?

What exactly is throwing out one’s back? It is the acute onset of low back pain (in the lumbar spine). It can be caused by a number of things: muscle spasm, arthritis, a slipped or ruptured disk, or sometimes for no reason at all (like closing a shade!). Most of the time the condition is temporary, lasting only a few days or weeks. If it lasts longer, it is worth consulting a medical professional as it could be something more serious like a muscle tear, herniated disk, or even a kidney stone.

This is–as they say–not my first rodeo. As someone who is very physically active, this happens every couple of years or so; most of the time it is a result of something silly like this time. My rule of thumb is that if the pain and lack of mobility in my back do not resolve in a few days, I contact my doctor. That happened only once and I was refered to a chiropractor; it took a couple of visits, along with some exercises to finally get back to normal.

Here are some things that can help with a back that has been thrown out:

  1. Treat the pain. Ibuprofen and Naproxen work well to reduce swelling; if you cannot use non-steroidal anti-inflammatory drugs (NSAIDs), use acetamenophin (Tylenol). Pain patches can help as well. Always follow label instructions carefully.
  2. Apply cold. I usually use a cold pack wrapped in a towel and find it brings relief.
  3. Apply heat. Many people swear by this because they feel the cold causes the muscles to contract and cause more discomfort.
  4. Apply cold and heat interchangeably. It works for some people!
  5. Exercise. The common practice used to be to immobilize the back; the latest research indicates that exercise and stretching can shorten the time it takes to recover. It is best not to overdo it while working out (I have been using lighter dumbbells than usual), but the activity can prevent the muscles from stiffening up further. Certain stretches can help as well: Cat/Cows, Cobra Pose, Child’s Pose, Windshield Wipers (keeping feet on the ground), Supine Knee-Ins, and Pelvic Tilts.
  6. Rest. While your body recovers, it uses a lot of energy; be sure to give your body the chance to recharge.

It is Tuesday, and each day I feel better. Interestingly, many of the same exercises and stretches that I use with my clients who have chronic lower back pain are the same ones I am using now. Hopefully, I will feel myself again in a day or two. If not, I will contact my doctor.

In the meantime, is it a problem to leave the shades up at night?

Stop Slouching!

One of the biggest issues with which I deal in my work with older adult clients is posture. While some clients stand up straight, many others have a slouched posture and a neck and head that often protrude forward. You have certainly seen this yourself–perhaps when you look in the mirror.

Several years ago, I began to experience numbness and tingling in three of my fingers on my left hand. I went to see my physician who referred me to a physical therapist. Much to my surprise the issue was not my fingers but rather my cervical spine; three fingers was a tell-tale sign that it was caused by an impingement. The issue was that my posture had put things out of place and it was time for me to correct that. I was given a few exercises to do each day and within a few weeks the symptoms disappeared; I still continue to do some of the exercises on a regular basis to keep myself and my posture in tip-top form.

The causes of poor posture are many. Some are structural such as scoliosis or joint degeneration. Otherwise, there is a kind of chicken/egg scenario; bad habits such as slouching and a sedentary lifestyle can cause muscle fatigue that will lead to poor posture. In other words, slouching leads to more slouching. Another cause is the tightening of chest muscles over time and the weakening of upper back muscles–and other core muscles; the chest muscles pull the shoulders forward and the back muscles are not strong enough to keep them in place. Of course, weak core muscles also play a major role in compromised posture.

So, what if we are living with poor posture> Are we stuck for life? In some cases, the damage may not be 100% correctable, but improvements can be made almost at any age. There are three exercises that I do and that I have my clients do as well; they make a real difference.

  1. Chin Tucks. I have blogged about this exercise in the past. To do a chin tuck stand or sit up straight, pulling your head back. The best way to think about this is it is as if someone is coming in to give you a kiss and you want to avoid it; you simply draw your head back and away. Do not put your chin on your chest or tilt your head back. This can be held for 30 seconds or 12-15 reps if you prefer. I do this several times a day to combat the effects of looking at my phone, peering over my prayerbook, and simply being lazy.
  2. Scapular Retractions. There are a number of ways to do these, but I suggest standing straight, relaxing the shoulders (no shrugging), bending the elbows at your side, and then slowly bringing the elbows together behind your back; do not worry if they do not touch! This can be done as a 30-second hold or 12-15 reps. I do scapular retractions several times a day as well. This helps to stretch out the chest muscles that pull the shoulders forward while putting the shoulder blades back in their proper position.
  3. Wall Hand Sliders. Stand as close as you can to a wall without picture, moulding, etc.; I do it with my nose and tummy literally touching the wall. Do make sure that you are not so close that you will lose balance and fall backwards. Place the palms of both hands on the wall at shoulder height, then slide the hands up the wall as high as possible; bring them back down to shoulder height and repeat 12 times for 2 sets. This is another great chest stretch that also helps with raising the arms overhead, which becomes difficult for many as we age.

If you are experiencing very poor posture associated with pain, make sure to talk with your physician as there could be structural or other issues that should be addressed in addition to, or instead of, these exercises. Otherwise, incorporate these exercises into your daily routine and you may just find that you are standing a little taller, a little straighter, feeling less achy, and looking better in the mirror. It takes some adjustment, but just remember what your mother used to say: “stand up straight!”

Have You Got Skin in the Game?

We know that as we age there are lots of changes that occur in our bodies. It makes sense that the largest organ in our bodies, our skin, would be affected as we grow older. And it is about more than just wrinkles. With age, our skin thins out, loses fat, and does not look as “full” as it used to. As the skin thins out, it is easier to see bones and blood vessels underneath the surface. Injuries take longer to heal. Exposure to sun over a long period of time can lead to wrinkles, dryness, age spots, and even cancer.

The National Instutes of Health (NIH) offers great information about what happens to our skin and what we can do about it. For instance, dry and itchy skin can be treated with moisturizers; even a humidifier in the room can help. It also helps to take fewer baths/showers, using warm water instead of hot, and bathing with mild soaps.

Another condition is more frequent bruising that may take longer to fade. If bruises appear and you do not know how you got them–especially if they are in areas that are usually covered by clothes–consult a doctor to make sure it is nothing more serious.

There are many factors that cause skin to wrinkle: gravity, smoking, exposure to too much sun, etc. There are many products that claim to reduce the “appearance” of wrinkles, but most are not really effective. The only way to treat wrinkles requires a trip to a dermatologist who specializes in medical procedures and injections; these can be quite costly and may have only limited impact.

Age spots and skin tags are unsightly and show up more and more in the elderly. To prevent the appearance of more age spots, use appropriate sunblock and protective clothing. Skin tags are growths that rise above the surface of the skin; they are harmless, but if they are bothersome or in an area that causes concern of discomfort, they can be removed by a professional.

Finally, skin cancer is quite common as well. I blogged about this in 2020 and also last month. I am a skin cancer survivor several times over. Know the signs of skin cancer: Assymetry of a growth, Borders of the growth that are irregular, Color changes or more than one color, Diameter greater than that of a pencil eraser, and Evolving (meaning that the size, color, shape, or symptoms are changing). Check yourself regularly (once/month) and have regular checks with a dermatologist. Caught early, many skin cancers can be quickly and efficiently treated.

There will be changes in our skin as we age. Even so, we can still take care of this organ so that it will take care of us. Use sunscreen, avoid tanning, wear protective clothing (hats, coverups), and limit sun exposure. We only have one set of skin, so make sure it lasts! After all, we’ve all got skin in the game.

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!

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!