Exercise and Menopausal Symptoms

Researchers writing in the British Journal of General Practice say that their study “suggest(s) a positive association between somatic and psychological dimensions of health-related quality of life and participation in regular exercise. Women with BMI scores in the normal range reported lower vasomotor symptom scores and better health-related quality of life scores than heavier women.”

Daley A, Macarthur C, Stokes-Lampard H, McManus R, Wilson S, Mutrie N. Exercise participation, body mass index, and health-related quality of life in women of menopausal age. Br J Gen Pract. 2007 Feb;57(535):130-5.

BACKGROUND: Menopausal symptoms can affect women’s health and wellbeing. It is important to develop interventions to alleviate symptoms, especially given recent evidence resulting in many women no longer choosing to take hormone replacement therapy. Exercise may prove useful in alleviating symptoms, although evidence on its effectiveness has been conflicting.
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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)

Heart Health

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.

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.

Does Being Optimistic Really Lower Risk From Cardiovascular Disease in Elderly Men?
Researchers writing in the medical journal the Archives of Internal Medicine say that having an optimistic outlook, DOES lower mortality risk associated with cardiovascular disease.

Menopause and Heart Disease
researchers writing in the medical journal Climacteric say that “an ideal hormone replacement therapy that can overcome hypertension, prevent body weight gain and control serum triglycerides offers an important advance in cardiovascular risk management during the menopause.”

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.

Exercise Frequency in Older Women

Researchers writing in the Archives of Gerontology and Geriatrics say “older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently.”

Nakamura Y, Tanaka K, Yabushita N, Sakai T, Shigematsu R. Effects of exercise frequency on functional fitness in older adult women. Arch Gerontol Geriatr. 2007 Mar-Apr;44(2):163-73.

From the study abstract: This study evaluated the effects of exercise frequency on functional fitness in older women participating in a 12-week exercise program.

Participants (67.8+/-4.6 years) were divided into three different exercise groups (I, II, and III; n=34) and a control group (Group C; n=11). Group I participated in a 90-min exercise program once a week, for 12 weeks, while Group II attended it twice a week, and Group III attended three times a week.

The exercise program consisted of a 10-min warm-up, 20min of walking, 30min of recreational activities, 20min of resistance training, and a 10-min cool-down.

The following items were measured before and after the program: muscular strength, muscular endurance, dynamic balance, coordination, and cardiorespiratory fitness (6-min walking distance).

Comparisons of baseline and post-intervention measures showed significantly greater improvements in body weight, coordination, and cardiorespiratory fitness for Group III compared to the other groups (p<0.05).

In addition, the greatest improvements in body fat, muscular endurance, and dynamic balance were also observed in Group III (p<0.05). However, no significant differences were found in muscular strength.

Older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently. In order to improve functional fitness in older women, an exercise frequency of at least three times each week should be recommended.

Strength Training and Nutritional Counseling Benefits In Women

Sallinen, J. Fogelholm, M. Pakarinen, A.Juvonen, T. Volek, J.S. Kraemer, W.J. Alen, M. Hakkinen, K. Effects of strength training and nutritional counseling on metabolic health indicators in aging women.J. Appl. Physiol. (2005) 30(6): 690-707.

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.

From the study abstract:
“Effects of strength training (ST) and nutritional counseling (NC) on metabolic health indicators were examined in 50 aging women.

Methods: Subjects performed ST for 21 weeks. NC was given to obtain sufficient energy and protein intake, and recommended intake of fat and fiber.

Results: NC increased intake of protein and polyunsaturated fat by 4.5% and 10.7% and decreased intake of saturated fat by 18.3%. Serum concentrations of total cholesterol (TC), LDL-cholesterol (LDL-C), total and HDL-cholesterol (HDL-C) ratio and triacylglycerols (TAG) decreased, and serum HDL-C increased in all subjects after ST.

Respectively, systolic and diastolic blood pressure and serum insulin concentration decreased in all subjects.

Respectively, changes in serum TC levels were related to protein intake, and changes in serum HDL-C to intake of fat, and inversely to carbohydrate and protein in all subjects.

Conclusions: The long-term ST (strength training) had favorable effects on serum lipids, lipoproteins, insulin concentration, and blood pressure. However, NC further contributed to positive changes in serum lipids and lipoproteins.”

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Exercise

Researchers examine the role of exercise on anxiety, depression and quality of life in seniors

Writing in the medical journal Revista Brasileira de Psiquiatria, researchers sought to examine 46 sedentary seniors aged 60-75. The seniors were divided into two groups. One group began an aerobic exercise regiment, the other group (the control group) did not.

You May Need To Exercise More To Avoid Fat Accumulation Associated With Aging
Researchers publishing in the journal Clinical Nutrition say: “Cross-sectional data have shown that sarcopenia (age associated muscle loss) and fat accumulation are associated with aging and can be limited by structured physical training. However, it is often difficult to maintain a long-term compliance to training programs. It is not clear whether leisure-time physical activity is effective in preventing sarcopenia and fat accumulation.

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.

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.

The Importance of Strength Training Exercises in Aging
Researchers writing in the medical journal Aging Clinical and Experimental Research say that “although aerobic exercise is important in maintaining overall health, the resistance type of muscle training may be more applicable to the basic rules of bone adaptation and site-specific effects of exercise, have more favorable effects in maintaining or improving bone mass and architecture, and be safe and feasible for older people.”

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.

Exercise and Menopausal Symptoms
Researchers writing in the British Journal of General Practice say that their study “suggest(s) a positive association between somatic and psychological dimensions of health-related quality of life and participation in regular exercise. Women with BMI scores in the normal range reported lower vasomotor symptom scores and better health-related quality of life scores than heavier women.”

Exercise Frequency in Older Women
Researchers writing in the Archives of Gerontology and Geriatrics say “older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently.”

Exercise Induced and Calorie Reduction Weight Loss
Researchers writing in the Journal of Applied Physiology say that caloric restriction (dieting) can lower extremity muscle size and strength. While weight loss due to exercise does not.

Endurance Training and Age-Related Decline in Immune Function and Endocrine Function.
Researchers writing in the medical journal Immunity and Ageing say that long-term endurance training has the potential to decelerate the age-related decline in immune function but not the deterioration in endocrine function.

Weight Loss Blog

Weight Gain and Thyroid
Estimates say that by age 50, 10% of women will be hypothyroid (not producing enough thyroid hormone) and by age 60 that number can nearly double.

You won’t need a scientific study to know that once over the age of 50, maintaining proper body weight becomes more difficult. When a person become hypothyroid staying trim and fit becomes nearly impossible.

The Evil Cycle of Weight Gain and Hypothyroidism
The Thyroid is a master gland participating and controlling the function of all the major body organs. When thyroid hormone is not produced in sufficient quantities to regulate our energy levels (hypothyroidism), our metabolism slows down to a crawl. This has the following weight gain effect.

1. Even on reduced calorie diets, your metabolism will not burn enough calories and you will retain weight.

2. A slow down in metabolism means a drop in energy and the inability to exercise or lead a sufficiently active life to stay trim.

3. Another consequence of hypothyroidism is constipation, accumulated fecal matter accounts for significant pounds.

4. Let’s add water retention for that bloated feeling.

Diagnosis of hypothyroidism
Hypothyroidism is not easily diagnosed by physicians because the symptoms are that which are routinely attributed to old age, that is the loss of energy, weight gain, etc. A “Thyroid Panel,” measuring TSH, T3, and T4 levels should be part of a basic blood chemistry panel in everyone over 30 so this “old age issue,” may be treated.

Beyond the blood test
Sometimes a suspected Thyroid problem can show “normal blood tests” it is important for the women and the doctor who suspect that thyroid is a problem to look for the following besides those symptoms, weight gain, depression, thinning or losing hair mentioned above.

Especially significant are
* memory and mood disorders
* cold sensitivity
* and menstrual problems

Even after you are put on thyroid supplementation, it is important to monitor these symptoms and your general overall health so that you can guide your physician and together your thyroid the type and amount of thyroid supplementation can be altered to help you be the best you can.

Caloric Restriction
Although the term calorie-restriction may cause some of us to recoil in fear, or scoff that the idea is even possible, the practice could make a big dent in our our rising disease states.

For many, calorie restriction brings to mind a state of starvation, yet, new research, published in the Journal of the American Medical Association, shows that even cutting back a little, has big rewards for many longevity markers. The study demonstrated that fasting insulin levels, body temperature, DNA damage, and metabolism (a free radical generator) were lowered in all the groups on calorie restriction. This was the first study to illustrate lessened DNA damage with calorie restriction.

Below are the different calorie restrictions, the last bullet point being the most extreme case.
-Comparison group: No changes in daily calories
-Calorie restriction group: Calories cut by 25%
-Calorie restriction plus exercise group: Calories cut by 12.5%, calories burned in exercise raised by 12.5%
-Very low calorie group: Calories cut to 890 daily calories until 15% of body weight was lost, followed by a weight-maintenance diet.

The study showed that any calorie restrictive diet, stressing foods densely packed with vitamins and antioxidants, could ultimately lead to better longevity predictors and weight loss. Although, all four groups lost weight, the groups on a type of calorie restrictive program had the most success. Below is each group’s average percentage of weight lost during the six-month study:
-Comparison group: 1%
-Calorie restriction group: 10%
-Calorie restriction plus exercise group: 10%
-Very low calorie group: 14%

A twenty-five percent calorie restriction daily, or 12.5 calorie restriction with 12.5 calories burned through exercise, is not a big sacrifice when the rewards of longevity and weight loss are possible.

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.

Why Can’t I Lose Weight?
As we get older, a lot of us don’t watch our diets, our sugar burning metabolism doesn’t work as well, and we don’t exercise. So there is weight gain.

You need to exercise to lose weight
When we exercise we raise the adrenal in the body, which lowers the insulin in our body. When insulin levels are up, insulin as a “storage hormone” prevents us from burning fat. Since we don’t exercise as much, we don’t build muscle, we don’t burn fat, and we do the wrong things nutritionally to get rid of the fat.

Drop the insulin levels
Good nutrition is getting the insulin down. I do a simple diet; protein, vegetables and water, nuts, and avocados. Fatty vegetables will help you lose weight. Stay away from grain it’s inflammatory, stay away from dairy products we don’t digest them.

Stay away from fruit
When someone is trying to lose a lot of weight or manage their diabetes we tell them to stay away from fruit. Fruit makes insulin levels rise.

Insulin also makes you age
Our bodies release insulin into our blood stream so that we can process glucose from food 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.

Watch what your meat is eating
Free range meats
We have to be careful about the term “Free Range” because the term may simply mean that they are free ranging BUT eat a lot of grain, and we want these animals to stay away from grain because it is so inflammatory, these animals also eat a lot of corn which is also bad.

Your Hormones and Your Poor Diet
Poor eating habits precipitate more than just an enlarging waistline. They affect every aspect of your health, and although you may not notice it right away, your hormone levels suffer dramatically from sugary, fatty, and nutritionally deficient foods. Many of your beneficial hormones will nose-dive, while the other more dangerous hormones, like insulin, skyrocket.

Insulin Resistance Syndrome
Our bodies DO need sugar (glucose) as a fuel for our cells to perform their daily cellular functions. When we eat sugar or foods that are broken down into glucose such as high-glycemic carbohydrates, our body’s digestive process puts that glucose into the blood stream for the cells to collect and utilize. The cells rely on the pancreas to monitor the blood levels and to alert them when glucose is abundant. The pancreas does this by secreting insulin which circulates through our bodies delivering the message to the cells of glucose’s presence.

In perfect balance, when we eat carbohydrates and produce glucose, the cells use it up as energy and there is little left over.

When our cells ignore insulin and become resistant
Over the course of years as we get older, become more sedentary, and our diets become “sugar loaded,” we process more glucose than our cells can use and the excess floats around in our blood, or is turned into fat in the cells.

Insulin Resistance also increases the symptoms and/or risk factors associated with metabolic syndrome, contributing to:

1. Accumulation of body fat
2. Obesity
3. Elevated triglycerides
4. High blood pressure.
5. Acceleration of the aging process.

Diet
It is commonly accepted that eating large amounts of simple carbohydrates (pastas, breads, and sugar filled foods) could lead to Insulin Resistance, elevated cholesterol, elevated triglycerides, and obesity. For this reason, as part of our program, we recommend that our patients change to a low-glycemic index diet.

The Glycemic Index is the rate that carbohydrates break down into sugar in the blood. The best source of low-glycemic carbohydrates are vegetables. Vegetables are slow burning carbohydrates and help keep insulin levels steady.

A diet rich in vegetables, proteins, good fats in the form of omega-3, and water is optimal for a long health span.

It is important to point out that a single diet will not work for everyone. To optimize your nutritional needs you should visit with an experienced health care professional well versed in the issues of metabolic syndrome and nutrition.

Obesity as a result of stress despite low caloric intake
In our practice we see many patients with complains of fatigue, flu-like symptoms, body aches and pain, headaches, and just not feeling well. To compound this, in some, are complaints of reduced appetite, but increased abdominal fat.

Many of these patients have been to other doctors and leave with a constellation of prescriptions ranging from painkillers to anti-depressants, yet with no real answers to the source of their dilemma other than their chronic health problems are “stress-related,” and a contributing, if not primary cause, of their obesity.

Nature gave our bodies the ability to employ stress beneficially and instinctively as a weapon during the famed flight-fight syndrome. We produce hormones such as adrenaline to give ourselves sometimes “superhuman” abilities, for instance the ability to run extra fast or the ability to lift extra heavy objects.

We also produce Cortisol, the primary stress hormone, which pumps large sugar stores into the blood stream. The sugar is used as “high-octane” fuel during fight/flight. Cortisol also controls energy distribution through the use of “rolling black outs.” Temporarily shutting down the immune system and other systems it sees as non essential for “immediate survival” (This is why people who are chronically stressed seemingly always have colds)

Stress and Weight Gain
When stress, fear, or anxiety becomes chronic our bodies stay in a state of alarm, negatively impacting our physical well-being including our ability to stay well and lose weight. Cortisol, in addition to pumping sugar into the blood, has also been shown to increase fat production and storage.

Losing Weight
When we see a patient with stress and abdominal obesity, depending on the severity of each individual case, we begin the patient on a low glycemic diet. Patients have heard us refer to this as the Paleolithic Diet or the Cave Man Diet. This is a diet consisting mainly of proteins and vegetables in the beginning and slowly introducing back fruits and nuts in moderation later. This type of diet helps maintain consistent and even sugar levels in the blood, a main component of stress reduction and reduced fat production.

We do ask that patients absolutely refrain from processed sugar for obvious reasons and that they avoid dairy products, grains (breads and pasta products) as they are converted quickly into sugars in the body.

We also teach people how to meditate. Of course these are general recommendations; if you would like more information, please call our office.

DHEA, Bone Mineral Density, Older Adults

Researchers writing in the medical journal The Journal of Clinical Endocrinology & Metabolism, say that DHEA replacement therapy for one year improved hip Bone Mineral Density in older adults and spine Bone Mineral Density in older women.

Jankowski CM, Gozansky WS, Schwartz RS, Dahl DJ, Kittelson JM, Scott SM, Pelt RE, Kohrt WM. Effects of DHEA Replacement Therapy on Bone Mineral Density in Older Adults: A Randomized, Controlled Trial. J Clin Endocrinol Metab. 2006 May 30

Predicting Mortality: Researchers Have A Formula

Lee SJ, Lindquist K, Segal MR, Covinsky KE, Development and Validation of a Prognostic Index for 4-Year Mortality in Older Adults. JAMA. 2006;295:801-808.

From the Journal of the American Medical Association (JAMA)
ABSTRACT: “Context Both comorbid conditions and functional measures predict mortality in older adults, but few prognostic indexes combine both classes of predictors. Combining easily obtained measures into an accurate predictive model could be useful to clinicians advising patients, as well as policy makers and epidemiologists interested in risk adjustment.

Objective: To develop and validate a prognostic index for 4-year mortality using information that can be obtained from patient report.

Results:…Twelve independent predictors of mortality were identified: 2 demographic variables (age: 60-64 years, 1 point; 65-69 years, 2 points; 70-74 years, 3 points; 75-79 years, 4 points; 80-84 years, 5 points, >85 years, 7 points and (being male), 2 points), 6 comorbid conditions (diabetes, 1 point; cancer, 2 points; lung disease, 2 points; heart failure, 2 points; current tobacco use, 2 points; and body mass index <25, 1 point), and difficulty with 4 functional variables (bathing, 2 points; walking several blocks, 2 points; managing money, 2 points, and pushing large objects, 1 point. Scores on the risk index were strongly associated with 4-year mortality in the validation cohort, with 0 to 5 points predicting a less than 4% risk, 6 to 9 points predicting a 15% risk, 10 to 13 points predicting a 42% risk, and 14 or more points predicting a 64% risk….

Conclusion: This prognostic index, incorporating age, sex, self-reported comorbid conditions, and functional measures, accurately stratifies community-dwelling older adults into groups at varying risk of mortality.

Researchers look at what makes people age successfully

Factors associated with the successful aging of the socially-active elderly in the metropolitan region of Porto Alegre. Rev Bras Psiquiatr. 2005 Dec;27(4):302-308. Moraes JF, Souza VB.

Writing in the medical journal Revista Brasileira de Psiquiatria, researchers studied some of the inhabitants of the metropolitan region of the Brazialian city Porto Alegre. What they sought to do was “identify the factors associated with aging of the socially-active elderly in the metropolitan region of Porto Alegre.”

What they concluded was: “Independence in performing daily life activities and autonomy, as well as satisfaction with family relations and friendships, were independent predictive factors of successful aging for both men and women.

For women in particular, there were various predictive factors: material comfort; feeling physically well; body image and appearance; self-esteem; positive feelings; interpersonal relationships; social support; participation in recreational activities;… spirituality; and beliefs.

The elderly maintain a relationship with themselves, with others and with their beliefs. Family is the main social support system.”

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