Waist Size and Health Risks in 50-95 Year Olds

Researchers writing in the medical journal Diabetes Care say that while overall body fat and fitness levels are important in predicting health risks, it is your waist size or the measurement of abdominal obesity that is the still the measurement to assess health risk among older adults.

Racette SB, Evans EM, Weiss EP, Hagberg JM, Holloszy JO. Abdominal Adiposity Is a Stronger Predictor of Insulin Resistance Than Fitness Among 50–95 Year Olds. Diabetes Care 29:673-678, 2006

Excerpts From the study abstract
OBJECTIVE—Physical inactivity and increased adiposity contribute to insulin resistance; less is known, however, about the relative contributions of these factors in older adults. The aim of this study was to determine whether cardiovascular fitness, whole-body adiposity, or abdominal adiposity is the strongest predictor of insulin resistance into old age.

CONCLUSIONS—Adiposity and fitness continue to be significant predictors of insulin sensitivity into old age, with abdominal obesity being the most important single factor. These findings support the measurement of waist circumference to assess health risk among older adults.

Weight, Obesity, and Diabetes Research

Menopause and Obesity
After menopause, many women notice that their muscle-to-fat ratio tilts in favor of the latter and the battle of the bulge is increasingly difficult. All the hormones, especially estradiol and testosterone, can help tip the scale back in the right direction.

Estradiol, increases fat breakdown from body fat stores so that it can be used as fuel and increases basal metabolic rate, while testosterone has been shown to maintain muscle tone, volume, and strength, increase metabolism, and decrease body fat. In a 2000 study, featured in Menopause, estrogen supplementation had effects on body fat distribution in postmenopausal women that was associated with improved lipid parameters.

The Journal of Clinical Endocrinology and Metabolism reported that obese women given low doses of testosterone lost more body fat and subcutaneous abdominal fat, and gained more muscle mass than women who were placed on a placebo.

In a 2006 study, researchers writing in the medical journal Diabetes, Obesity & Metabolism found “HRT reduces abdominal obesity, insulin resistance, new-onset diabetes, lipids, blood pressure, adhesion molecules and procoagulant factors in women without diabetes and reduced insulin resistance and fasting glucose in women with diabetes.”

Women are not alone in the hormonal decline department. Men also experience a falling off of hormone levels. In my practice, I have found that most men over forty suffer from low levels of testosterone, a condition called andropause, or male menopause. Testosterone decline may be linked to many age-related symptoms like muscle weakness, bone loss, memory complications, weight gain and heart disease. As far as quality of life is concerned, in the absence of normal-to-high levels of testosterone, men suffer from mood swings, fatigue, and libido dysfunction

Not everyone will benefit from hormone supplementation. The goals, realities, and risks of hormone supplementation should be discussed, at length, with your physician prior to onset of treatment.

Insulin Resistance, Weight Gain Lead to Early Aging
When we eat, our bodies release insulin into our blood stream so that we can process glucose (sugars) from our foods to make energy, especially in our muscles. Glucose belongs in our cells and not in our blood. When it remains in our blood we produce more insulin. Increased insulin, according to many researchers, is the number one factor for accelerated aging.

Waist Size and Health Risks in 50-95 Year Olds
Researchers writing in the medical journal Diabetes Care say that while overall body fat and fitness levels are important in predicting health risks, it is your waist size or the measurement of abdominal obesity that is the still the measurement to assess health risk among older adults.

Exercise, Abdominal Fat, Insulin Resistance
Researchers writing in The Journal of Applied Physiology studied 16 obese men and women, about 63 years old, during a 12 week exercise program.

Low Gylcemic Index Foods for Weight Loss and Diabetes
Researchers writing in The Diabetes Educator say that incorporating more low-glycemic foods helped individuals with weight control and diabetes.

UCSD Study Sheds New Light on Insulin’s Role in Blocking Fat Breakdown in Patients with Type II Diabetes
“Chronically high levels of insulin, as is found in many people with obesity and Type II diabetes, may block specific hormones that trigger energy release into the body, according to researchers at the University of California, San Diego (UCSD) School of Medicine. Their findings, which may point to new approaches to developing improved treatment options for the disease…”

Be Active: Reduce Diabetes Risk, Live Longer
Researchers writing in the medical journal Diabetes Care, examined the relationship between active lifestyle, diabetes, and life expectancy.

Exercise, Diabetes, Diabetes Risk
Researchers writing in the Medical Journal Diabetes Care say patients may need more convincing that exercise assists in diabetes management and diabetes risk management.

Obesity and Decreased Hormone Production
Researchers writing in the medical journal Clinical Endocrinology say that “Obesity may predict greater decline in testosterone and SHBG levels with age.”

Abdominal Fat Strongest Indication of Health Risks
Researchers writing in the medical journal Obesity, say that waist measurement is one of the most useful indicators of health risk.

Sleep and Diabetes Risk in Men
Researchers writing in the medical journal Diabetes Care say that too little or too much sleep increases diabetes risk. The researchers say that men getting 5 to 6 hours of sleep a night were twice as likely to develop diabetes, men getting more than 8 hours were three times more likely to develop diabetes. They also noted that testosterone may be a factor in sleep on diabetes.

Testosterone, Diabetes, and Cardiovascular Disease
New research says Testosterone may have a protective role in the development of metabolic syndrome and subsequent diabetes mellitus and cardiovascular disease in aging men.

Middle Aged Men, Metabolic Syndrome, Stroke Risk
Finish researchers say that middle aged men with Metabolic Syndrome have twice the risk of suffering from a stroke. Read more

Metabolic Syndrome and Stroke
Researchers writing in the Archives of Internal Medicine say that preventing and controlling Metabolic Syndrome is likely to reduce risk of stroke.

Warm Feet and Sleep

Researchers writing in the medical journal Physiology and Behavior say they “present new data indicating age- and insomnia-related changes in the sleep-onset latency response to foot warming, and evaluate whether different methods of foot warming could provide an applicable strategy to address sleep complaints.”

Physiol Behav. 2007 Feb 28;90(2-3):257-66. Raymann RJ, Swaab DF, Van Someren EJ.

Skin temperature and sleep-onset latency: Changes with age and insomnia.

Throughout the 24-hour day, the occurrence of sleep and wakefulness is closely related to changes in body temperatures.

Changes in skin temperature may causally affect the ability to initiate and maintain sleep.

First, we briefly summarize a previously proposed neurobiological mechanism that couples skin temperature to sleep propensity. Next we review previous findings on the relation between skin temperature and sleep-onset latency, indicating that sleep propensity can be enhanced by warming the skin to the level that normally occurs prior to – and during – sleep. Finally, we present new data indicating age- and insomnia-related changes in the sleep-onset latency response to foot warming, and evaluate whether different methods of foot warming could provide an applicable strategy to address sleep complaints. Foot temperature manipulations included footbaths before sleep onset (1), and heatable bed socks applied either before (2) or after lights-off (3).

In adults, sleep-onset was accelerated by warm and neutral bed socks after lights-off and correlated to the increase in foot temperature. This increase was attenuated in elderly subjects. In elderly subjects without sleep difficulties, sleep onset could be accelerated with neutral bed socks after lights-off and a warm footbath prior to lights-off. In elderly insomniacs, none of the treatments accelerated sleep onset. We illustrate that elderly subjects show an attenuated increase in foot temperature after lights-off and lose the relationship between pre-sleep heat-loss activation and sleep latency. The sensitivity of sleep propensity to foot warming changes with age and is attenuated in age-related insomnia.

Sleep

Sleep and Diabetes Risk in Men Is Testosterone Also Involved?
Researchers writing in the medical journal Diabetes Care say that too little or too much sleep increases diabetes risk. The researchers say that men getting 5 to 6 hours of sleep a night were twice as likely to develop diabetes, men getting more than 8 hours were three times more likely to develop diabetes. They also noted that testosterone may be a factor in sleep on diabetes.

Poor Sleep and Cognitive Function
Researchers writing in the medical journal The Journals of Gerontology Series A: Biological Sciences and Medical Sciences say that Disturbed Sleep was related to poorer cognition.

Hot Flashes and Insomnia
Researchers writing in the Archives of Internal Medicine say: “Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.”

Hot Flashes and Sleep
Researchers writing in the medical journal Menopause say that ambient temperature and REM sleep patterns effect sleep in postmenopausal women.

Warm Feet and Sleep
Researchers writing in the medical journal Physiology and Behavior say they “present new data indicating age- and insomnia-related changes in the sleep-onset latency response to foot warming, and evaluate whether different methods of foot warming could provide an applicable strategy to address sleep complaints.”

Power Training and Balance in Older Adults

Researchers in Australia and Massachusetts say that low load, high velocity power training can improve balance and reduce fall risks in aging subjects.

From the abstract:
“Age-related decline in muscle power may be an early indicator of balance deficits and fall risk, even in nonfrail adults. This study examined the dose-dependent effect of power training on balance performance in healthy older adults.

One hundred twelve community-dwelling healthy older adults (69 ± 6 years) were randomized to 8–12 weeks of power training at 20% (LOW), 50% (MED), or 80% (HIGH) of maximal strength, or a nontraining control (CON) group…”

The researchers concluded:
“Power training significantly improved balance performance in participants who underwent power training compared to controls. Low intensity power training produced the greatest improvement in balance performance…

Power training improves balance, particularly using a low load, high velocity regimen, in older adults with initial lower muscle power and slower contraction. Further studies are warranted to define the mechanisms underlying this adaptation, as well as the optimum power training intensity for a range of physiological and clinical outcomes in older adults with varying levels of health status and functional independence.”

Orr R, de Vos NJ, Singh NA, Ross DA, Stavrinos TM, Fiatarone-Singh MA. Power Training Improves Balance in Healthy Older Adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:78-85 (2006)

Walking off Postmenopausal Decreases in bone mineral density, aerobic fitness, muscle strength, and balance

Researchers writing in the medical journal Physical Therapy say that “Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women.”
Asikainen TM, Suni JH, Pasanen ME, Oja P, Rinne MB, Miilunpalo SI, Nygard CH, Vuori IM.

Effect of brisk walking in 1 or 2 daily bouts and moderate resistance training on lower-extremity muscle strength, balance, and walking performance in women who recently went through menopause: a randomized, controlled trial. Phys Ther. 2006 Jul;86(7):912-23.

From the article abstract:
BACKGROUND AND PURPOSE: Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women. The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength (the force-generating capacity of muscle), balance, and walking performance in women who recently went through menopause.

SUBJECTS AND METHODS: The subjects were 134 women who recently went through menopause. The study was a 15-week, randomized, controlled trial with continuous and fractionated exercise groups. The outcomes assessed were lower-extremity muscle strength, balance, and walking time over 2 km. Feasibility was assessed by questionnaires, interviews, and training logs.

RESULTS: One hundred twenty-eight women completed the study. Adherence to the study protocol was 92%. Both continuous and fractionated exercise groups improved equally in lower-extremity muscle strength and walking time but not in balance. Almost 70% of the subjects considered the program to be feasible. Two daily walking sessions caused fewer lower-extremity problems than did continuous walking.

DISCUSSION AND CONCLUSION: Brisk walking combined with moderate resistance training is feasible and effective. Fractionating the walking into 2 daily sessions is more feasible than continuous walking.

Muscle Mass and Strength Research

Risk factors for loss of muscle strength in aging men
The researchers concluded that the following were risk factors:
“Multivariate analyses revealed that besides older age, other risk factors also contributed to the loss of muscle strength in older men, including back pain, use of calcium channel blockers, caffeine intake, and height and weight loss.”

Resistance Training Important for Aging Muscles and Tendons
Researchers writing the medical journal Experimental Physiology say that resistance training is not only good for preventing age-related loss of muscle but for tendons as well.

Strength Training and Nutritional Counseling Benefits In Women
Writing in the Canadian Journal of Applied Physiology, researchers noted that long-term strength training and nutritional counseling had positive effects of metabolic health indicators.

Walking off Postmenopausal Decreases in bone mineral density, aerobic fitness, muscle strength, and balance.
Researchers writing in the medical journal Physical Therapy say that “Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women. The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength (the force-generating capacity of muscle), balance, and walking performance in women who recently went through menopause.”

What is the Effect of Insulin Resistance and Loss of Lean Muscle (Sarcopenia) As We Age?
Researchers writing in the Journal of The Federation of American Societies for Experimental Biology say: “A reduced response of older skeletal muscle to anabolic stimuli (exercise & diet) may contribute to the development of sarcopenia.

Power Training and Balance in Older Adults
Researchers in Australia and Massachusetts say that low load, high velocity power training can improve balance and reduce fall risks in aging subjects. The researchers concluded: “Power training significantly improved balance performance in participants who underwent power training compared to controls. Low intensity power training produced the greatest improvement in balance performance.

Insulin Resistance and Metabolic Syndrome

Insulin Resistance Tied To Age-Related Muscle Loss
Writing in the medical journal Diabetes and Metabolism, researchers say: “…insulin resistance could be involved in age-related muscle protein loss, progressively leading to sarcopenia. Therefore in a more general concept, insulin resistance found in many clinical settings, could be considered as a contributor to muscle wasting.”

Insulin Resistence: What Do Some Researchers Say?
When we eat, our bodies release insulin into our blood stream so that we can process glucose (sugars) from our foods to make energy, especially in our muscles. Glucose belongs in our cells and not in our blood. When it remains in our blood we produce more insulin. Increased insulin, according to many researchers, is the number one factor for accelerated aging.

What is the Effect of Insulin Resistance and Loss of Lean Muscle (Sarcopenia) As We Age?
Researchers writing in the Journal of The Federation of American Societies for Experimental Biology say: “A reduced response of older skeletal muscle to anabolic stimuli (exercise & diet) may contribute to the development of sarcopenia. Skeletal muscle protein synthesis is resistant to the anabolic action of insulin in older subjects, which may be an important contributor to the development of sarcopenia.”

Metabolic Syndrome and Stroke
Researchers writing in the Archives of Internal Medicine say that preventing and controlling Metabolic Syndrome is likely to reduce risk of stroke.

Stress at Work and Metabolic Syndrome
Metabolic Syndrome is a combination of symptoms including high blood pressure, abdominal obesity, insulin resistance and others related to coronary heart disease.

The Sooner You Cut Your Risk For Cardiovascular Disease The Longer You Will Live

Writing in the medical journal Circulation, researchers say that if you are at low risk for cardiovascular disease at age 50, it is unlikely that you will suffer from heart disease in your lifetime and that compared to others in the same age group with higher risk, men could expect to live 11 more years and women 9 more years.

From the abstract: “The absence of established risk factors at 50 years of age is associated with very low lifetime risk for CVD and markedly longer survival. These results should promote efforts aimed at preventing development of risk factors in young individuals. Given the high lifetime risks and lower survival in those with intermediate or high risk factor burden at 50 years of age, these data may be useful in communicating risks and supporting intensive preventive therapy.”

Lloyd-Jones DM, Leip EP, Larson MG, D’Agostino RB, Beiser A, Wilson PWF, Wolf PA, Levy D. Prediction of Lifetime Risk for Cardiovascular Disease by Risk Factor Burden at 50 Years of Age. Circulation 2006, doi:10.1161/CIRCULATIONAHA.105.548206

Testosterone May Protect Against Hardening Of The Arteries

Testosterone supplementation has received a fair share of “bad press.” Mostly due to health problems (sterility, coronary artery disease, liver damage, and brain tumors), caused in young men and women who should not be taking testosterone supplementation, but do so at super-physiological doses, to enhance athletic performance.

Many physicians also think, based on some medical studies, that the supplementation of testosterone “encourages” atherosclerosis (Hardening of the arteries)

Now, new research says the opposite maybe true, Testosterone may protect you from atherosclerosis.

Publishing in the May 17, 2005 issue of the American College of Cardiology, researchers found that men with low testosterone levels had more arterial thickening in the carotid artery in the neck than men with “normal” testosterone levels.

In my opinion I have found little evidence to support that testosterone supplementation to restore levels lost to aging can cause health problems. Numerous research supports the opposite. Study participants and researchers noted gained muscle, a slowdown in bone loss, increased sexual desire, and better cognitive skills.

Certain Exemptions – When not to take Testosterone supplementation?
Men taking testosterone supplementation should have PSA tests performed twice a year and have an annual manual examination of their prostate gland. No evidence suggests that testosterone supplementation causes prostate cancer. In fact, studies show a higher incidence of prostate cancer in men with a lower baseline level of testosterone. Studies suggest that in the presence of existing prostate cancer, testosterone supplementation may accelerate tumor growth.

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