Healthy Aging Archives - Page 29 of 46

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Healthy Aging & You: The 7 Keys to Fitness Achievement

Nicholas Prukop/19 June 2019/ All MFN blog/

What does it mean to be fit or “be in shape”? We set fitness goals for a variety of reasons that are important to us at the time but in the long run is really losing weight a lasting goal? Do we really ever regard the “real” point of becoming fit? Probably not. Getting older means losing “something” in most people’s minds (mobility, independence, freedom to do what we love to do etc.). It however doesn’t have to be that way. If we think in terms of performance based goal setting and being able to do all the things we love to do over time – regardless of age – we will find that getting older doesn’t have to mean “getting old”. I would like to share with you what I consider the seven keys to fitness that if we maintain over time we will be able to be not only functional but vibrant and healthy as well.

Discussion

I have always maintained that if I remained fit for life that I would be training every day toward becoming an “evolving athlete” – capable of “doing what I want, when I want – without getting hurt”. This is as good a definition of what it means to be fit to me given my track record as a fitness professional. Taking time today to evaluate what you REALLY want from your fitness activities is probably a good idea and worth the effort and time up front so that you can access the benefits that you TRULY want from your training program. Here are the seven keys to fitness that will make your efforts worthwhile:

#1. Strength

Strength is a cornerstone of any fitness program. How we build strength over time is dependent on our effort and focus at being consistent in all we do. I started a weight training program in college with the help of the varsity football team at Syracuse University in 1965 and learned the basic principles of strength training with their help. I am still using those same methods and training principles today 50 years later and the secret to my success is clearly defined methodology and consistency of effort. I record all my results in a written log and am now in a training mode for my 70’s that will enable me to be able to run well into my 80’s thanks to my resistance training program. What do you want to be able to do as you age? Strength training is THE foundation for healthy aging.

#2. Endurance

Endurance is being able to do an activity – any activity – over time without tiring and running out of fuel. Endurance is training for the heart and the cardiovascular system and enables us to be able to do more in our lives without tiring. Running is a key activity that I have engaged in since 1964 and has remained a cornerstone of my training program since then. I am doing 7 mile runs at a variety of speeds and currently have accumulated a body of work that has stretched over 70,000 miles. Since 2000 I have run 23,500 miles and I know these results because I have recorded each of my workouts in detail in a runner’s calendar and know where I have been, where I am in my training and where I am going. I want to be able to run a 6 minute mile on my 80^th birthday in 2026 and current results say I will be able to do it – barring injury or illness. My book on healthy aging is simple but not easy. Pick what you love to do and keep doing it – and continue to learn more about yourself every day. Be a student of your own life and never stop learning!

#3. Power

Power comes from being able to retain “explosive” ability over time. Old people lose their power and never regain it because they may have known they had it in the first place. Power is both mental and physical. It resides in the mind as well as the body. Many forms of exercise help us retain our power from yoga to dance (yes dance) to tai chi – and of course weight training. I use several exercises in my own programming for this purpose – from pushups, dips, bench press, leg press, weighted ab work, lunges, squats and other exercises that allow me to retain the power in my body. My “mindfulness” work is embodied in my meditation and visualization (imagination) work that I am committed to doing daily. I also use sprint workouts in order to increase my anaerobic threshold which determines my ability to engage as many of my “fast twitch” muscle fibers as I can. So far I am doing 250 pushups, 1000 crunches, and running sub 6 minute miles while still bench pressing 250 lbs. for my “power set”. If I maintain these results over time I WILL retain my power as I enter my 70’s next year.

#4. Speed

Most of us lose speed after we leave our 20’s. If we have struggles with health issues we most likely never thought of speed as a part of our lives. Injured joints, soft tissue damage and other debilitating issues will prevent us from ever being fast but it is still worth our time to try and improve our speed of movement. I love to run fast and I will always have this aspect of fitness in the front of my mind as I train my body in the future. I love sprint workouts and will most likely keep the track in my sights going forward. Right now running indoors suits me and I am making real strides in developing leg speed and maintaining a “rhythm” that I positively love. What will you do to address speed in your programming? Seek to rise to a higher level of achievement and see what happens to your confidence!

#5. Agility

Agility is an elusive quality and many of us never really train for it because it is hard to simulate agility in a training program. Athletes must all have some form of agility or quickness to play their sports at the highest level so they routinely add agility drills to their off season programming. It takes effort and desire but can be a real asset to any training regimen. Seek out new ways of addressing this skill set and see how you might incorporate some agility training into your program and see what happens. Personal trainers and group fitness instructors can – and do – use agility training as a part of their instruction. I am thinking about this aspect of fitness as well and have not yet decided on a course for myself yet so I am still an “evolving athlete” too.

#6. Balance

Balance is a key to becoming fit and implies not only physical balance but mental and emotional balance as well. Being balanced means that we can more easily respond to life’s challenges and roll with the punches as change enters our lives. Being physically capable of balancing our bodies is a worthy goal. Yoga is a great way to learn to balance the mind and body. The poses help you acquire a “sense of self” in space and time. I use yoga as a part of my stretching routine to “release” tension from my joints and muscles following my training. I find breathing exercises to be useful in calming me and balancing my mind with my heart and is also a soothing way to address stress in my life. Use basic principles of achieving balance in your life and you will go far and be healthy along the way.

#7. Flexibility

I saved flexibility for last because it captures for me the essence of health and fitness. Being flexible in our thinking and in our physical being is a reward for all our hard work. I am more open to change in my life than I ever thought possible. “Change is the only constant in the natural order” is one of the important lessons I learned from a favorite teacher over 30 years ago and only now am I finally beginning to truly understand this concept as change accelerates in my own life. “Feeling in control” of our lives is important but when we realize that what we love today may change in our lives tomorrow we become more adaptable and willing to change so that we can continue to grow and expand in consciousness. Life is bigger than we can imagine and if we become flexible in body we can save ourselves from injury and if we become flexible in our thinking we can become healthier – and happier – grateful for all that we have been given.

Conclusion

The seven keys to becoming – and staying fit are: Strength, endurance, power, speed, agility (quickness), balance and flexibility. Where do you fall short when it comes to your own fitness? Where do you feel you need to improve your training? What do you REALLY want to accomplish with your training? Looking good is fine but what do you want to DO with your training? I want to travel, water ski, play with my grandson and teach him to be active, empower and inspire audiences to make positive changes in their lives, write more books and articles on healthy aging and live a fulfilling and rewarding (and meaningful life). Time is precious so use it well and gain your freedom to be all you were meant to be!

Reprinted with permission from Nicholas Prukop.

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach and fitness professional with over 25 years of experience. His passion for health and fitness comes from his boyhood in Hawaii, where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

The Still Life

Adrienne Ione/11 June 2019/ All MFN blog/

I am not referring to the still life of the 17^th century, a tradition that originated with Dutch painters and spread throughout Europe, where often there was a religious dimension.^[1] I am also not referring to still in the sense that Don Henley encapsulates in his 1994 song, “Learn to Be Still.” Nor am I insinuating an exploration of the archaic use of still that suggests sedentariness. Quite the opposite, although closely connected to the latter.

It’s 5 a.m. I am seated in a plush black leather chair situated in the corner of a soft-red lighted area of our home designed as a small bistro. The Baja-blue ceramic tea pot is on the stove and I am reading the New York Times. A headline captures my immediate attention: “Lifeguards for Life (Or as Long as Possible).”^[2] In a 1,122 word story covering lifeguards who are greater than 60 years of age, the word “still” was used 5 times. That is, every 224^th word of the story is “still.” My feelings of calm and delight suddenly mix with this internal emblazoned visceral change that underwent chemical synthesis and became a substance fueling the writing this article. I am perplexed at the use of the word still when describing people who are greater than 60 and the daily activities in which they may be involved.

Although well intentioned, selection of the word still is a curious linguistic choice. This particular article did a beautiful representation of using two-polar opposite definitions of this word: one suggesting change and the other stagnation. On the one hand “still” suggests the possibility of change. A growing or morphing into a larger state than at present. For example, there was reference in the article to the late 1950s when “surfing was still in its infancy on the East Coast.” Now, in 2017, from Kennsington Cove off the coast of Nova Scotia to South Beach, Florida, one can surf up and down the East coast and find plenty of other surfers amidst the waves. Thus, in this case, still implies growth.

Then there’s another use of still when referring to an unchanging situation. The vernacular appeal of using still as a compliment is readily apparent. As in describing Mr. Labert, “One of the oldest active lifeguards – the kind who still dash into the surf to rescue swimmers.” However, his livelihood or successes, as he ages, are redefined in terms of stagnation. Continuing to do the same activities. Use of still in this sense implies accomplishment sans change. Other elderly lifeguards are “still ocean-certified” and “still kept watch.” Still can be likened to a lexiconic hologram: it appears one way from one direction, change your position (or age) and your perspective changes, or the image changes. Faced with a continuum of age from congratulations to offense to oppressive to objectification, our language lends itself to prescribing a limiting condition: “the tyranny of still.”^[3]

Some of us will reach, or have reached, an age where marks of success shift from change to stagnation. We could call this the still life. I still live alone. I still drive. I still eat by myself. I still bathroom by myself. While these are not necessarily accomplishments or accolades to be proclaimed at achieving in one’s thirties or forties or fifties, there is that pivotal age when some of the smallest tasks become trophy winning moments. These triumphs are often treated as moments to be captured on camera and lived and relived, with bystanders singing praises such as, “Yay. You are still using a fork.” A comment actually made to a hundred-year-old woman, to which she responded, “Dignity doesn’t age.”

Embedded in these still comments, intended to be compliments, are platitudes served on silver platters. Sure, they appear nice and clean and friendly, yet under the shiny shellacked surface is a sharp jab. What are we saying when we say someone is still capable of completing activities of daily living? Perhaps a round of applause that they are seemingly independent. Why then is inter dependence not congratulated? As a species is there truly anyone who is fully independent? We all rely on someone to some extent. Taking a look across the life span, we can see a continual push to be independent. If we say, “She’s 47 and she still lives alone,” then this begs questions of “What’s wrong with her?” or simply, “Why?” However, the script and responses are very different if we say, “She’s 97 and she still lives alone.” Often, the question then becomes, “Oh, what is she doing right?” With an implied, “If I take similar measures then I too will live to be that age and be active.”

Perhaps there are more connections between the still life of the 17^th century and use of the word still as we age, than is apparent on the surface. Just as with some Dutch painters in the 1600s conveying religious messages, some research suggests we become more religious as we age. Perhaps the use of still is a way of separating the worlds, between the doers and not-doings. If we are still doing something, then we are not dead. If we are still doing, then we are relevant. A good many people desire to be relevant and alive. And one can be both, without adding still into the game. Still relevant and still alive. No. Relevant and alive.

Adrienne Ione is a cognitive behavioral therapist and personal trainer who integrates these fields in support of people thriving across the lifespan. As a pro-aging advocate, she specializes in the self-compassion of dementia.

Website: yes2aging.com
Guided Meditations: insighttimer.com/adrienneIone
Facebook: silverliningsintegrativehealth

References

[1] Vincent Pomarède and Erich Lessing (Nov. 2011) The Louvre: All the Paintings.

[2] Corey Kilgannon. (July 16, 2017). “Lifeguards for Life (Or as Long as Possible).” New York Times.

[3] Bill Thomas (2015). Second Wind: Navigating the Passage to a Slower, Deeper, and More Connected Life.

The Fitness Lifestyle & the Path to Healthy Aging

Nicholas Prukop/17 May 2019/ All MFN blog/

Technology really has changed our lives for the better – and for the worse. The implications of our emerging and overwhelmingly sedentary lifestyle are now only beginning to become apparent to us as we see the obesity crisis emerging as the first “real” medical and health emergency of our time. The long term consequences of this evolving – and expanding – process will be a challenge that we will ALL be affected by on some level in the years ahead. Diminished life expectancy and quality of life, the increasing numbers of people who will suffer from a wide variety of preventable chronic diseases, and finally, the premature loss of life WILL be significant if we can’t find a “way out” of this complex predicament.

Being physically active was always a part of our societal makeup in the first two hundred years of our history due to the nature of work and the lives we had to lead just trying to survive in a world without conveniences and support networks that eventually came into being in the second half of the 20^th century. In the last twenty years of my lifetime, the world has turned into the “sitting of America”. What are the underlying problems we will be facing and how can we address them in order to effectively solve them? That is the question, isn’t it? The answers will emerge over time in the “dialogue” that WILL eventually occur among the parties that CAN help bring about permanent and positive change to people’s lives. Part of the answer lies with each of us in the fitness profession. We MUST define for ourselves how to “translate” what we love into “doable” solutions for those we train and teach. We have to become the change “we wish to see in the world” – one person at a time.

Discussion

The world is complicated by different and opposing points of view. The “post Bush years” have shown us conflict and anger on levels never before seen in our political discourse. We now call it “gridlock” and throw up our hands at the very mention of healthcare and reform. The truth is that approximately 80 million people born into the “baby boomer” generation will be reaching 60 years of age (including my daughter who was born in 1971) in the two decades ahead.

I see the need to have community based “conversations” about the delivery of healthcare to people and how to make it affordable and accessible – and most importantly – understandable. I became a personal trainer in 1990 with my first client and during the period of 1988 to 2011 I did NOT have health insurance because I couldn’t afford it due to the nature of my uncertain and fluctuating income – AND the cost for coverage for those over forty.

I never made a “comfortable” living as a trainer because I was always struggling to build my client base, which as we all know, tends to expand and shrink depending upon a wide range of variables including the state of the economy (and jobs), people’s motivation to hire a trainer, personal finances, and other related challenges. I was in my mid forties by the time I transitioned to the fitness profession and was already “old” and a part of the higher risk age groups that tend to pay significant percentages of their income to cover their health insurance costs. I am NOT informed – even today – as to what I will do in the future regarding this issue even though I now have Medicare and a companion program through Blue Shield to help cover me in the event something unexpected happens to me. I am now covered by health insurance and relatively well informed on health and fitness issues and that still DOES NOT qualify me to be a primary resource for solving this problem. However, I WILL make it my business to be a “part of the solution” and this time I am counting on the fitness profession to NOT be an “afterthought” in the discussion! How does that sound to you? It will take, as Hilary Clinton said a while ago in one of her books, “a village” to tackle this massive challenge.

Conclusion

In my book, I describe (what I BELIEVE will work) a concept whereby we bring the “major players” to the table in order to “seize the moment” and save lives in the process. First, we ALL have to agree that it is NOT OK to just “let people die” because they lack health insurance. Second, we have to agree that prevention means MORE than “testing” for diseases and that learning to make better choices (and establishing new priorities) in our daily lives, becoming conscious of our challenges, and FINALLY taking responsibility for all of them is CRITICAL. Third, we have to understand the MAIN ISSUE to be handled WILL be about MONEY (and how to pay for medical services) and we will have to always remember that lives will be at stake with whatever we decide. Fourth, it will take a “cooperative effort” on all our parts – and compromise – among the major “players” (the insurance industry, medical profession, government at ALL levels, the pharmaceutical industry, business and corporate America, health related non-profit agencies, and finally, each of us in our own communities) to decide what it is we are going to do “to fix the system” so that it works for ALL of us – not just a few of us.

My health insurance program over the past 45 years has been my exercise, fitness, and running program – even when I was covered at work during my corporate years. In the intervening years from college to the present time, I have NEVER been in the “system” because I stayed healthy. I am the EXCEPTION – not the rule. What do we DO with all the aging people who aren’t like us – or me – when the time comes to treat them for “whatever ails them”? This is the BIG question we will be facing in the years ahead as we age and I AM betting on my approach with HEALTHY AGING as being one of the KEY components of the solution! Will YOU commit yourself to this journey with me today? NOW is the time and THIS is the place! We ARE the ones who truly CAN make a difference – and save lives in the process!

Reprinted with permission from Nicholas Prukop.

10 Simple Steps to Start Eating Healthier

Regina Saxton/16 May 2019/ All MFN blog/

Whether you have tried every diet in the book to lose weight or just want to modify your food choices to improve your health, making change isn’t always easy. Experts say it can take 3-4 weeks for a new behavior to become a habit and I have seen…

Do Vacations Change You for Good?

Lori Michiel/13 May 2019/ All MFN blog/

Did you ever think after your vacation you’d come back a transformed person?

lori-michiel-vacation When my husband and I returned home from our vacation last month, I noticed, other than the obvious feelings of content and relaxation, my clothes felt looser and I felt recharged. No challenge was too big. A bit grandiose, I know. However, it was short-lived, except I kept the weight off, and refrained from consuming caffeine and sugar. Around the time I had finished three loads of wash, I felt practically back to normal. Time fades. I still felt reinvigorated, but the shift towards normalcy was advancing.

Vacations are supposed to be about creating balance in our lives. Who am I, what is my purpose and why do I do what I do? I don’t pretend to have all the answers, but at 61, I have more than I did at 16. I know that a timeout and real rest is healthy for the soul. It is not so important whether you take a trip or not, as long as there is some form of escape.

In the meantime, I plan to seek some form of meditation I can stay committed to (no luck so far). I have returned to work, continue to read my business journals, and create fun and educational videos for my friends and clients. I am doing the best job I can. So for now, since none of my favorite TV shows are on, I may even pick up another novel to read.

Prepare yourself for the things that matter and have fun when you can.

Reprinted with permission from Lori Michiel. Read more from Lori at her website, lorimichielfitness.com

Lori Michiel NASM-CPT is the owner of Lori Michiel Fitness. She is a trainer, teacher and passionate advocate for fitness. I specialize in helping active adults and seniors fulfill their physical potential and experience the joy of being healthier and more active in their lives.

towel, dumbbells, apples and water bottle isolated on white

Call To Action: May is Global Employee Health and Fitness Month

Diane H. Hart/2 May 2019/ All MFN blog/

What is Global Employee Health & Fitness Month?

Global Employee Health and Fitness Month (GEHFM) is an international and national observance of health and fitness in the workplace, created by 501c3 non-profit organization, the National Association for Health and Fitness. The goal of GEHFM is to promote the benefits of a healthy lifestyle to employers and their employees through worksite health promotion activities and environments.

Formerly titled National Employee Health and Fitness Day, GEHFM has been extended to a month-long initiative in an effort to generate sustainability for a healthy lifestyle and initiate healthy activities on an ongoing global basis with a reach into South America, Europe and Asia.

Employers everywhere are invited to participate. The website and toolkit are available to participants, healthandfitnessmonth.org

Employers will challenge their employees to create Healthy Moments, form Healthy Groups and develop a Culminating Project. Participants will be able to log these activities on the website through the month, allowing employer and employees to track, share and promote their individual and group activities. GEHFM is structured very simply for ease of use and primarily targeted on companies with 500 employees or less.

Healthy Moments are occasions of healthy eating, physical activity or personal/environmental health. (e.g., cooking a healthy meal or scheduling a dental/doctor visit.)

Healthy Groups are formed to create a sustainable activity continuing even beyond the month. (e.g., healthy lunch groups; company sports team; walking club.)

Culminating Project is an event that promotes health throughout the whole company or community. (e.g., planting a community garden; company/family fitness event.)

When is GEHFM and how it works?

GEHFM is held during the month of May every year (traditionally physical activity month). Health Moments occur daily, even multiple times a day and are created by individuals and groups. Healthy Groups implement activities to be performed several times throughout the month. Finally, the Culminating Project is developed during GEHFM and is executed at the end of May.

Why should employers/employees participate?

GEHFM is a great way to kickoff wellness and fitness programs and bring excitement and can complement existing programs. Workforce wellness programs have been shown to benefit the employer through enhanced employee productivity; reduced health care costs; reduced employee absenteeism and decreased rates of illness and injury. These programs benefit employees by lowering stress levels, increasing well-being, self-image and self-esteem, improving physical fitness, increasing stamina, increasing job satisfaction and controlling BMI and blood pressure.

Benefits of GEHFM

Free, innovative and proven tool kit provided to help guide activities and events
Promotional items advertising GEHFM available for purchase by participants
Ability to log and track moments, groups and projects
Option to implement friendly competitions and challenges to build teamwork
Simple and adaptable to any wellness and fitness program
Creates sustainable healthy programs, environments and policies

About the National Association for Health and Fitness (NAHF)

NAHF was founded in 1979 by the President’s Council on Physical Fitness and Sports and has as its vision that America shares in the social economic, health and environmental benefits that come from living an active lifestyle. Our mission is to improve the quality of life for all individuals in the United States by promoting physical fitness, sports and healthy lifestyles. We also champion environmental and policy support for active living and encourage and share innovation in the States. NAHF values active living (integrating physical activity into daily lives) community involvement and leadership development for all societal sectors; promoting quality physical education in our schools; developing workforce health promotion programs and active-aging programs. With our focus on the States, NAHF “bridges the gap” between federal and local action and unites researcher and community practitioner.

Global Employee Health and Fitness Month website: healthandfitnessmonth.org

Diane Hart, Owner of Hart to Heart Fitness, is a Nationally Certified Fitness Professional, Personal Trainer, Health Educator and is current President of the National Association for Health and Fitness founded in 1979 by the U.S. President’s Council on Sports and Fitness. She is also Chair and one of the original architects of Global Employee Health and Fitness Month, which strives to make healthy the norm in the workplace.

Why For Boomers and Seniors, Price Is Not An Issue

Dan Ritchie/26 April 2019/ All MFN blog/

Watch as Dan Ritchie, co-founder and president of the Functional Aging Institute, discusses why price is less of a concern for boomers and seniors and what is of more value to them than the price itself.

Exercise Combats Frailty

Karl Knopf/23 April 2019/ All MFN blog/

Exercise is key to maintaining muscle mass that enables performance of the activities of daily living.

US Census projections suggest that the majority of baby boomers will turn 65 between 2010 and 2030, reflecting the impending need for increasing medical care within this demographic.^(1-3)

“Baby boomers are now senior boomers, and just as this group has influenced everything in the past, they will impact tomorrow’s health care services as well,” says Patrick Kearns, MD, a geriatrician at El Camino Hospital in Mountain View, California.

The health and function within this group will range from those who are extremely fit and healthy to those who are physically dependent. How an individual ages is, to some extent, determined by the cards (genes) they were dealt and, to a larger extent, how they’ve played those cards. Research confirms the relationship between living a healthful, active lifestyle and both quantity and quality of life. Proactive steps taken throughout a person’s lifetime may prevent or delay the advent of frailty.^(3-5)

The medical profession continues to make significant strides in treating conditions that would have caused death years ago. And while the average life expectancy has increased dramatically since the 1900s, this increase in longevity comes with the possibility of living more years with physical limitations and reduced functional ability.^(3,5)

Some studies have discovered that a sizable number of adults over the age of 65 cannot lift a 10-lb bag of groceries, walk a mile, or easily get up from a chair. One study suggests a significantly increased risk of falling for individuals who cannot lift themselves out of a chair at least eight times in 30 seconds.1 But how can frailty be prevented or even reversed?

Identifying the Problem

Anyone, young or old, can experience frailty, which is the loss of some physical function and can result from various causes. Among the most common are a chronic medical condition; loss of a sensory system; changes in medical, mental/emotional, or functional fitness status; age-related muscle loss (sarcopenia); falls; or a sedentary lifestyle.^(1,3,5)

Many times a combination of these factors results in a person’s inability to function independently, leading to the classification of frailty. The term “frail elder” often refers to the role age plays in the above conditions. Most of us can visually identify a physically frail person, but currently no definitive criteria exist for defining frailty. However, some professionals are attempting to develop a universal objective definition of elder frailty traits.^(3,6)

Often family members, in concert with health care professionals, are the first to recognize an elder’s decline in strength and level of independence. Assessment of diminished balance and muscle strength suggest the need to initiate a comprehensive general conditioning program.⁽¹⁾

Never Too Late

A recent study published in the Journal of Aging and Health showed that a group of octogenarians involved in a 16-week program of walking or resistance training could improve significantly in strength, flexibility, agility, and balance.^(1,7) Of course, prevention is cheaper than treatment, so the intervention of a well-rounded fitness program should begin long before frailty concerns emerge. Some older adults admit that if they had known they’d live so long, they would have taken better care of themselves when they were younger.

Sarcopenia plays a major role in what many believe advances functional loss and contributes to becoming frail. Studies have shown that without the intervention of progressive resistance training, lean muscle tissue loss can begin as early as the age of 30.^(1,3,5) These small changes go unnoticed or are even accepted as part of normal aging until a person finds difficulty in completing simple tasks. While the outward circumference of a limb may remain the same, the interior integrity of the muscle mass is decreasing. We can visualize the muscle loss as analogous to a lean steak’s transformation to one with marbled fat. So it is with humans: A muscle biopsy shows intermuscular fat within the muscle.

Why is less muscle detrimental? One reason is that muscle tissue is the furnace that revs the metabolism, thus assisting an individual to better control body weight, which in many cases decreases the risk of type 2 diabetes, hypertension, and other metabolic diseases. An increase of only 7.7% in resting metabolic rate derived from strength training would result in an increase of 50,000 extra calories expended in one year, which could result in a loss of 14 lbs of fat (in a 180-lb person).^(1,5,7)

Strong leg muscles lead to improved balance.1 Strong functional muscles enable a more active and independent lifestyle. Being involved in a sensible strength conditioning program can foster improved bone density. Wolf’s Law says the strength of the bones is in direct proportion to the forces applied to them. If a person sits during most of the day, then he or she will have bones made for that kind of lifestyle. “Use it or lose it” applies to muscle strength as well as bone strength.

The hallmark study done by Maria Fiatarone, MD, a researcher at Harvard Medical School, placed 100 frail nursing home residents aged 72 to 98 into several experimental groups.^(1,3,5-7) Her research found that those participating in progressive resistance exercises improved their strength significantly vs. those who were given nutritional supplements. The strength-training group increased their overall strength by 113%; gait velocity improved significantly as well stair-climbing ability over the nonexercising groups.

The take-home message was that resistance training is superior to nutritional supplementation and is far more cost-effective.

Exercise Benefits

A review of the literature appears to prove that proper physical activity has broad and positive influences over many of the characteristics associated with normal aging. It could be said that everything that physically declines with age can be positively influenced with proper exercise.^(4,8,9)

We’re all familiar with normal aging, but healthful aging often is determined by the activity or lack of activity that precedes old age. An inexpensive strategy to improve the prospects of living long and well includes a regular dose of sensible physical activity. Some commonly acknowledged benefits of a well-rounded exercise program include improved self-efficacy, metabolism, sleep patterns, cardiovascular capacity, balance, muscular strength, endurance, and movement along with reduced fatigue, depression, anxiety, and arthritic and low back pain.^(1,8,9)

Designing a Fitness Program

While it’s never too late to feel great, it’s best to start early. While this article attempts to show ways to intervene with a patient experiencing some level of frailty, the best solution is to encourage patients to engage in activities that help prevent it. It’s better to do a little bit of anything than a lot of nothing. Remind patients to start slow and progress cautiously. All of the exercises suggested below can be done simply with a chair. It’s even possible to perform some of the exercises in bed.^(4,8,9)

Providing motivation to embark on an exercise regimen and stick with it presents a challenge, though. Suggesting participation in activities patients don’t want to do requires patience and skill. Focus on ways to make the activities appealing while preventing injury. Matching the exercise routine to a person’s personality and physical abilities often is more of an art than a science. A good coach/teacher can motivate a patient to do something he or she doesn’t want to do—and thank the coach for it later.^(4,8,9)

It’s wise for health care professionals to provide patients with guidelines of indications and contraindications related to exercise. If possible, try to match patients with suitable options within the community that match their physical abilities, personalities, and social and economic issues. Some long term care facilities offer in-house and/or programs available to local older adults.^(4,6,7)

An exercise program for patients at risk of becoming frail should aim to improve functional activities of daily living. An assessment by an occupational therapist, physical therapist, or nurse should provide some direction on the major areas to be addressed. While the aim of the intervention is to improve function, make sure the person leading the session keeps some fun in functional. This may require some socializing and interacting with patients. If patients are unmotivated to perform activities or exercise, even the best program will have low compliance rates and not produce the desired outcomes. All programs should follow some type of evidence-based guidelines.^(8,9)

Improving muscular strength and endurance helps enhance patients’ functional muscular endurance and strength to perform daily activities without becoming fatigued. The basic concept of progressive resistance training, commonly called strength training, weight training, or weight lifting, is to begin with a resistance that can be comfortably performed six to eight times and then continue increasing the number of times (reps) until he or she can perform the movement easily between 10 and 15 times.⁽⁶⁾

Once that level is attained, patients can add small amounts of resistance to again challenge the muscles. As an individual advances, another set (a grouping of reps) can be added. The number of reps and sets varies depending on the objective. Matching activities to the functional tasks a person needs to perform can involve lifting a milk jug, opening jars, getting up from the toilet, or walking outside to get the mail, for example. The goal should be to build up a reserve of strength so patients can engage in any necessary activities.⁽⁴⁾

Strength training can include the use of resistance bands that come in varying levels of resistance. Light water bottles, hand weights, or attachable wrist/ankle weights work well. For patients who are particularly weak, simply using the weight of their limbs is a fine starting point.⁽⁴⁾

Cardiovascular Fitness

Aerobic simply means with oxygen. Most exercise physiologists use the example of anything you could do while holding your breath as anaerobic while the opposite characterizes aerobic exercise. Running a 100-yard dash could be called anaerobic and walking a mile aerobic. The goal of aerobic exercise is to improve the ability to move freely without becoming winded or to execute activities that facilitate locomotion, whether it’s propelling a wheelchair farther or safely walking unassisted to the dining room. This addresses breathing function as well as aerobic exercise to assist in reducing cardiovascular diseases and burning calories. Seated aerobics, peddling a stationary bike, and even walking exercise can be suitable options.

Balance and posture exercises should aim to improve the muscles that influence posture, such as the core muscles and muscles that retract the scapula as well as muscles that promote proper neck alignment. There is evidence that improved posture translates into standing erect and improved balance.

Balance activities should include both static and dynamic movements. Physical therapists can offer recommendations on exercises to enhance balance. Experts suggest patients can begin balance work in a chair, similar to activities for spinal cord-injured and post-stroke patients, as a safe exercise method.

Comprehensive Program Design

Attempting to include all of the aspects listed above would be ideal; no one element supersedes another. However, it’s often advisable to establish a baseline of patient stamina. A comprehensive exercise class can easily include each element. An example of such a class could include five to 10 minutes of warm-up moves, five to 10 minutes of upper and lower body strength training, and five to 15 minutes of light aerobic exercise followed by some light flexibility moves. All of these can be done safely if the activities match a patient’s ability. Individualization is the key even for a group exercise class.⁽⁴⁾

Ideally, providers can perform individual patient assessment. Utilizing a group assessment method such as the Senior Fitness Test also can provide information on fitness levels and achievable goals.

The bottom line is that exercises and activities should be adapted to a patient’s abilities and should never exacerbate an existing condition, as patient safety is more important than any exercise. If an instructor cannot appropriately adapt the movements, then he or she is not qualified to be teaching this segment of the population.

Basic Activities

A sample exercise program to prevent and improve the status of frailty should include the following:

• Range of motion/flexibility: Motion is lotion to stiff joints. A warm-up that addresses the major joints and helps prepare the body for physical activity should last between five and 15 minutes. Include gentle range-of-motion/flexibility activities that foster functional movements, such as putting on socks and shoes or getting dressed. In the early stages, this may be the limit of a patient’s capability, so stopping here is fine.

• Muscular strength and endurance: The focus is to improve functional muscular endurance and strength to enable a patient to perform daily activities without becoming fatigued. The activities should be matched to the tasks an individual needs to perform, such as lifting, dressing, and walking.

Plan of Action

There are not enough physical and occupational therapists nor insurance dollars available to provide all the functional fitness needs of this burgeoning group of older adults. We need to have a stable of well-trained fitness professionals prepared to serve the fitness requirements of today’s elders. The medical community needs to have confidence that when they refer someone to a fitness class, the instructor will do no harm. The fitness trainers of the future should understand the diversity within this group and understand how to assess and train older adults with varying degrees of ability and fitness. It’s essential to adapt fitness methods to a patient’s abilities and conditions and focus goals on improving functional wellness.

Ideally, this article will serve as a wake-up call, not only to the fitness industry but also to health care professionals to work toward establishing national standards for trainers who work with older adults. A great opportunity will be lost if there are not enough trained fitness professionals available to serve this burgeoning demographic.

The field of gerontology promotes aging in place as a viable option. If early and comprehensive frailty prevention programs can be conducted in senior centers, hospital settings, or assisted-living communities, it could possibly delay the onset of frailty along with the associated costs.

In Conclusion

The evidence is convincing that elders’ chronic illness is a powerful driver of medical costs. Research shows that a proactive lifestyle can lessen the challenges often seen in old age. Think of prevention as wholesale and treatment as retail in helping patients understand physical maintenance of their bodies. The goal is to inspire patients to be internally motivated to take positive steps toward becoming the best they can be, no matter what their age or disability.

Originally published in Today’s Geriatric Medicine. Reprinted with permission from Karl Knopf.

Karl Knopf, Ed.D, was the Director of The Fitness Therapy Program at Foothill College for almost 40 years. He has worked in almost every aspect of the industry from personal trainer and therapist to consultant to major Universities such as Stanford, Univ. of North Carolina, and the Univ. of California well as the State of California and numerous professional organizations. Dr. Knopf was the President and Founder of Fitness Educators Of Older Adults for 15 years. Currently, he is the director of ISSA’s Fitness Therapy and Senior Fitness Programs and writer. Dr. Knopf has authored numerous articles, and written more than 17 books including topics on Water Exercise, Weights for 50 Plus to Fitness Therapy.

References

1. Rose DJ. Fallproof! A Comprehensive Balance and Mobility Training Program. 1st ed. Champaign, IL: Human Kinetics; 2003.

2. Durstine JL, Moore G, Painter P, Roberts S. ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities. 3rd ed. Champaign, IL: Human Kinetics; 2009.

3. National Institute on Aging. Exercise & Physical Activity. Bethesda, MD: National Institutes of Health; 2009. NIH Publication No. 09-4258.

4. Knopf K. Total Sports Conditioning for Athletes 50+: Workouts for Staying at the Top of Your Game. Berkeley, CA: Ulysses Press; 2008.

5. National Institute on Aging. In Search of the Secrets of Aging. 2nd ed. Bethesda, MD: National Institutes of Health; 1996. NIH Publication No. 93-2756.

6. Brody LT, Hall CM. Therapeutic Exercise: Moving Toward Function. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2010:1-49.

7. Ehrman JK, Gordon PM, Visich PS, Keteyian SJ. Clinical Exercise Physiology. 2nd ed. Champaign, IL: Human Kinetics; 2009:135-146.

8. Knopf K. Creating wellness. Paper presented at: Wellness Conference at the Palo Alto Medical Foundation Annual Meeting; October 2012; Palo Alto, CA.

9. Knopf K. Grow well, not old. Paper presented at: El Camino Hospital Aging In-Service; May 2013; Mountain View, CA.

What Will You Leave Behind?

Maurice D. Williams, MS/19 April 2019/ All MFN blog/

I can’t quite remember where I heard it, but somewhere I once heard someone say that their deepest desire in life is to not leave an ounce of potential behind when they’re gone.

It made me re-evaluate how I live in each major area of my life – health/fitness, relationships, business, finance, and much more. It still helps me focus on constant improvement in each area.

Also, it’s important to consider the legacy you will leave behind. Likewise, how do you want to be remembered?

If you get one body in this lifetime, do you want to give it the best care and the attention that it deserves? Or do you want to neglect it, to take it for granted?

I want you not only to leave an incredible legacy behind in every area of your life, but I also want you to feel the magic of tremendous self-care, much of which happens through fitness and the choices we make regarding our health every single day.

So, tell me, what do you want to be your full legacy? And how, specifically, do you want to care for this amazing human body you have?

In conclusion, are you giving your body the chance to live up to its full potential?

Originally printed on Move Well Fitness blog. Reprinted with permission.

Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD. With almost two decades in the industry, he’s worked with a wide range of clients, including those with health challenges like diabetes, osteoporosis, multiple sclerosis, hypertension, coronary artery disease, lower back pain, pulmonary issues, and pregnancy. Maurice is also a fitness educator with Move Well Fit Academy and NASM.