Category — Health research

Stand up!

Yes, I am talking to you.

Stand up right now.

I fear you didn’t take to heart the anti-sitting research I summarized a few months back in Sitting is the New Smoking. Because if you did, I wouldn’t have to be yelling at you right now. (Apologies to the upright-eous.)

Here’s the harrowing recap of a recent meta-analysis (18 studies, close to 800,000 participants): Those who spent the most time sitting increased their risks of diabetes (112%), cardiovascular diseases (147%), death from cardiovascular causes (90%) and death from all causes (49%) compared to those who sat fewer hours. In a 12-year study of more than 17,000 Canadians, researchers found that the more time people spent sitting, the earlier they died—regardless of age, body weight, or how much they exercised.

Got that? Are you standing yet?

And here is more damning data on the health effects of sitting.

Sitting is bad for your brain. A Michigan State University study found that college students who were less fit (thanks to sitting longer hours) had a harder time retaining information than their more physically active classmates. Long-term information, which is anything from more than 30 seconds ago, was more difficult for the lower-fit individuals to remember.

Sitting is bad for your circulation. Those who sit too much have poor circulation in their legs, which can lead to varicose veins and deep vein thrombosis. An Indiana University study found that even just one hour of sitting can impair normal blood flow by up to 50 percent.

Sitting is bad for your spine. Moving around allows soft discs between vertebrae to expand and contract naturally, soaking up fresh blood and nutrients. Sitting causes discs in the back to become squashed unevenly. When that happens, collagen hardens around ligaments and tendons, making your spine less flexible. Chronic sitters are far more at risk for herniated lumbar discs (the most common cause of lower back pain).

Sitting is bad for your hips. Hip flexor muscles – they provide both mobility and balance — stiffen during long periods of sitting.

So it is time – past time – to get yourself a standing desk. Or, as in the photo that companies this post, an inexpensive platform to place on your old desk. I have a true standing desk in my writing office. For my university office (the photo), I requested a standing desk and, after eight months of bureaucratic run-around, I decided that if I wanted a healthy environment I’d have to create it myself. It may be that your employer, like mine, talks about a healthy work environment but doesn’t pro-actively (or even reactively!) provide one. Do it for yourself. My platform (at amazon) was around $125. There are smaller ones for under $100. This is possibly the best investment you can make for your health.

(btw: That’s a poster of a window looking out onto water. My office is actually windowless.)

Good news about Alzheimer’s?

Please say yes. After wincing and weeping my way through Julianne Moore’s sure-to-be Oscar-winning performance in Still Alice, I am more than ready to hear it. And I bet you are too.

It is true that I have maintained an as-positive-as-possible outlook on this horrific disease. I wrote a book, Dancing with Rose, (re-named Finding Life in the Land of Alzheimer’s in paperback) based on my experiences as an in-the-trenches caregiver at an Alzheimer’s care facility. I wrote that there is life after Alzheimer’s. I wrote that we are more than just the sum of our memories, and that when you lose your memory, you do not lose your self. Your personhood. And I still believe that. But I also know, up close and personal, the devastation of this disease. I am therefore thrilled to tell you about this new research from Stanford.

But first I have to say those words you don’t want to hear: It was conducted on mice.

Which means that, game-changing as the findings of the study may be, we are still many years from effective treatment or, dare I say the word, cure. But this is very very exciting stuff.

It turns out that brains contain cells called microglia that chew up toxic substances and cell debris, calm inflammation and make nerve-cell-nurturing substances. They work as garbage collectors, getting rid of molecular trash strewn among living cells — including clusters of a protein called A-beta, notorious for aggregating into gummy deposits called Alzheimer’s plaques, the disease’s hallmark anatomical feature. We love these microglia. We want these guys vigorously and tirelessly working for us.

The new research from Stanford (published in The Journal of Clinical Investigation) suggests that the massive die-off of nerve cells in the Alzheimer’s- affected brain may be due to these microglia falling down on the job. Most excitingly, the researchers found that, in mice, blocking the action of a single molecule on the surface of microglia restored the cells’ ability to get the job done — and, even more excitingly, reversed memory loss and myriad other Alzheimer’s-like features in the animals.

Yes, reversed.

The ground-breaking idea here is this entirely new approach to preventing and/or curing Alzheimer’s by boosting the brain’s own immune response.

I wish Julianne Moore the best of luck on Oscar’s night. But I wish more that, in the near future, such a portrayal will seem absolutely archaic.

Consider the various health and fitness “truisms” that have turned out to be not so true. As in false.

Eggs are high cholesterol bombs. Avoid them. Uh, no.

Butter is artery-clogging junk. Change to margarine. Nope.

No pain; no gain. So wrong.

Twenty minutes of exercise three times a week is all you need. Sorry, no.

Walking is as good for you as running. Apparently not. This is the latest bit of dogma to bite the dust.

It turns out that running may reverse aging in ways that walking does not, according to a new study of active older people. It was a small study — 30 men and women in their mid- to late-60s or early 70s – conducted at the University of Colorado’s Locomotion Laboratory. (Interesting to note here that Colorado always ranks as the #1 healthiest state in the union. Apparently, the researchers had no trouble whatsoever
recruiting healthy, active volunteers.) For the study period, 15 of these volunteers walked at least three times a week for 30 minutes or more. The other 15 ran (gentle jogging speed) at least three times a week for 30 minutes or more. Then the scientists had each runner and each walker complete three brief walking sessions on specially equipped treadmills that measured the way they moved. The volunteers also wore masks to measure oxygen intake, which helped the scientists determine cardiovascular efficiency.

The results? The runners won. By a lot. They required considerably less energy to move at the same pace as the walkers. In fact, when the researchers compared the walking efficiency of the older runners to that of young people (measured in earlier experiments at the same lab), they found that 70-year-old runners had about the same walking efficiency as a typical sedentary college student. The older walkers, on the other hand, had about the same walking economy as people of their own age who were sedentary.

Yikes.

No one disputes that walking is excellent exercise. All kinds of studies have concluded that older people who walk have significantly lower rates of obesity, arthritis, heart disease and diabetes. But researchers have noted that the walking ability (strength, endurance, efficiency) of walkers decreases with age. They move slower, fatigue more easily, etc. So it was thought that physical decline was a consequence of age, they thought.

The older runners in this study disproved that.

How did they stay so fit – as fit as nonexercisers 40 years their junior? One word: mitochondria. I wrote about these powerhouses within our cells in my book, Counterclockwise. I even had my own mitochondria measured. So the conclusion of the Colorado researchers will sound familiar to my readers: Intense, prolonged aerobic exercise (like running) increases the number and activity and efficiency of mitochondria in the muscles. More mitochondria mean more energy with less effort. More mitochondria mean a higher level of fitness. More mitochondria move us counterclockwise.

Yes, running is tough on joints. And it’s not for everyone. The take-home message is here is that intensity of effort can make a very big difference in cardiovascular health and muscle efficiency. The take-home message is that it is NOT age that accounts for lack of fitness; it is lack of strenuous exercise.

Here are two scary stats for you:

Seventy percent of people older than 70 take blood pressure meds. Yes, you read that right: 7 out of 10. More than 30 million men and women.

And…25 percent of older people who fall and fracture a hip die within a year. Eighty percent are left with mobility problems severe enough that they are unable to walk a city block.

Why am I passing along this depressing information? Usually I’m all upbeat and full of beat-the-clock energy and brimming with just-do-it spirit. It’s not that I’m feeling grouchy today. Au contraire. Things are going very well for me on my latest counterclockwise journey (my quest to dance in The Nutcracker this holiday season). But I feel compelled to comment for two reasons:

First, these two equally depressing, seemingly unrelated health statistics are, in fact, closely related. People who take blood-pressure-lowering medication are at significantly increased risk for serious falls. This according to a study published last April in JAMA Internal Medicine. (Other drugs commonly prescribed for older people including anti-depressants, anti-anxiety drugs and sleep medications can, in the words of a Yale geriatrician who studies falls, “directly affect your balance.”)

And second (here’s where I switch back to my just-do-it self): This is AVOIDABLE. (“This” being both the taking of such medications and the falling.) Why do 30 million older people require medication to lower their blood pressure? Elevated blood pressure is not a natural consequence of aging. It is a natural consequence of an out-of-shape heart and stiffened arteries…which are not a natural consequence of aging. They are a natural consequence of lack of exercise, poor diet, obesity, smoking – the decisions we make (or don’t make) and live by every day. And the decisions we make today at age 40 or 50 or 60 WILL have consequences when we are 70 or 80 or older.

Why not have those be good consequences?

Counterclockwise is a belief, an attitude, a behavior (well, more like a set of behaviors). Counterclockwise permeates everything we do, all our choices, our activities, our relationships, our moods.

And our brain.

I write a lot about the body. This week, a few updates about the brain, the sharp, resilient, problem-solving, challenge-loving, creative counterclockwise brain. The brain you want until it’s time to go skydiving for that one last time. (My end-of-life fantasy.)

So here’s a summary of some recent research I’ve been reading:

The brain and physical activity. Being active can reduce your risk of cognitive decline by as much as 38 percent, according to a meta-analysis of 47 studies done by a group of Australian researchers. This activity-brain health connection (exercise increases circulation which means more blood to the brain which means a healthier brain) has been known for a while. It’s the meta-analysis that’s impressive here. If you haven’t paid attention to this particular benefit from exercise, now would be the time.

Obesity and cognitive decline. You know what I’m going to say, right? Well, hear it again: According to a BIG (10,000 people) longitudinal study in the Journal of the American Heart Association, people with BMIs greater than 30 had a 79 percent increase in their risk of cognitive decline compared to those with BMIs under 25. Although the whole BMI measurement thing is quite a bit less than perfect, this is a study to pay attention to. Obesity (defined as a BMI in excess of 30) is implicated in so many health problems. Cognitive decline is now on that list.

Another reason to drink green tea. Researchers at the University of Basel, Switzerland, report that green tea extract enhances cognitive functions, in particular the working memory. It was a small study. But still, given that anti-oxidant-rich green tea has already been linked to other health benefits like longer telomeres, why not drink a cup or two (or three) every day?

And yay for yoga. A group of 60-plus year olds showed significant improvement in immediate and delayed recall of verbal and visual memory, attention and working memory, verbal fluency and processing speed after 6 months of practicing yoga compared to a matched group of non-practicers. Again, it’s a small study (87 people) but…as there’s almost nothing better for flexibility than yoga…and it’s a mood-enhancer and stress-reliever as well, why not get out the mat?

I’m sorry. I lied.

Last week I wrote that there was no one “big thing,” no single secret to living a healthy, weller-than-well counterclockwise life. I said that “the small stuff” was all there was. Let me amend that.

The small, everyday choices we make (or don’t), ARE important. Consider the excellent list of small actions taken by several readers who responded to last week’s post.

But, truthfully, there are a few BIG-ticket items, one-off significant changes that can make a huge difference in how and how quickly (or slowly) we age. The obvious one is smoking. Quitting smoking is probably the single most important health decision a person can make. But I am betting that none of you reading this are smokers, so let’s move on. Here are my top 5 BIG things. (And I promise never to lie to you again).

1. Eat breakfast. You wake up your metabolism and signal your body that you don’t intend to continue starving it. (Remember, you just fasted for 8 or 9 or 10 hours. Your body is now concerned. If you don’t deal with that concern in the morning, your body will want to store as many of the calories contained in the next meal you eat as fat – to guard against starvation.) If you’ve never heard of the Sumo Wrestler’s “Diet,” this is how it works: Starve the body all day, then eat all your calories at once. Then go to sleep. That’s how Sumo Wrestler’s put on all that weight. They DON’T eat 7000 calories a day. They eat a moderate 2500-3500. At one meal. Of course, breakfast is nutrient-dense, protein-rich, calorie-controlled. Greek yogurt, blueberries and chopped almonds, for example. Sorry, pan au chocolat n’est pas bien.

2. Trade your desk for a standing desk (or even a treadmill desk). Sitting is the new smoking! Sitting for hours negates the fitness benefits of the time you spend in the gym or the lovely long walk you took with your dog. I’m sorry. It’s true. Proceedings of the Mayo Clinic just reported that, for every hour of sitting, you wipe out 14 percent of the health benefits of one hour of exercise. That means 7 hours of sitting puts you back at square one.

3. Sleep 7 hours. Or, gasp, even 8 if you can manage it. (I can’t.) I’ve gotten along on 6 hours a night for years and years because I love early mornings but can’t seem to get in bed until 11 (and then read for a half hour). By “gotten along,” I mean I have the energy to do what I need and want to do during the day. But the health and antiaging benefits of 7-8 hours of sleep are undeniable.

4. Find and/ or cultivate a fitness buddy or posse. Friendships grounded in physical activity (as opposed to meeting up for drinks or dinner) are rich and rewarding, a fun way to stay on track, a great way to keep moving and stay accountable. When I hooked up with the Sweat Chicas, my fitness life got a HUGE boost.

5. Eat (mostly) plants.

Eat (mostly) plants!

Yes, you’ve heard it before, and here it is again. This is nutritionally sound, research-validated, high-level wellness, powerful anti-aging advice.

The healthiest, longest lived people on earth, the ones with scant heart disease, cancer and Alzheimer’s, the ones with keen hearing and sharp eyesight into their 9th decades, the lively, sprightly ones – those ones – are from different cultures and live in different corners of the world. But they have a few core habits in common, one of which is their mostly plant-based diets. This doesn’t mean that they consume no animal products. It means that their diets are built on vegetables, fruits. beans, seeds and nuts with animal protein as addendums.

What these so-called Blue Zone folks are doing is eating the way the best informed, least faddish, most anti-aging savvy nutritional researchers say we should all be eating: High nutrient density/ low energy density (aka caloric) foods packed with fiber and rich in phytochemicals. Veggies top this list. I don’t have to tell you what’s on the bottom, do I?

Just how good is a (mostly) plant-based diet? Let me count the ways.

An uncomplicated, whole foods, plant-based diet may reduce (or prevent) heart disease, coronary artery disease, high blood pressure, unhealthy cholesterol levels, type II diabetes, metabolic syndrome, obesity and a number of digestive ailments and illnesses. This is pretty much a laundry list of what ages us from the inside out. There is evidence that a plant-based diet may help prevent everything from gallstones to macular degeneration, may have a positive impact on oral health and allergies, and may be tied to improved cognition. One study suggests that this kind of clean eating devoid of processed foods and stingy with animal products can turn back the (biological) clock 14 years. Here are links to the research on all these studies.

And here’s a bit of the text of an article written for physicians about nutrition and health. These are researchers talking to doctors – not diet-of-the-month hucksters trying to sell books, not food faddists jumping on some bandwagon.

“Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, blood sugar, and cholesterol levels. They may also reduce the number of medications needed to treat chronic diseases and lower ischemic heart disease mortality rates. Physicians should consider recommending a plant-based diet to all their patients.” (italics are mine)

And note this conclusion to the article: “The future of health care will involve an evolution toward a paradigm where the prevention and treatment of disease is centered, not on a pill or surgical procedure, but on another serving of fruits and vegetables.”

Or, as Hippocrates said almost 2500 years ago: Let food be thy medicine and medicine be thy food.

But I want to add, although I really hope I don’t have to, that eating this way is not at all like taking medicine. It’s not about limiting options but expanding them. It’s not about deprivation but surfeit, about flavors and colors and textures that make counterclockwise eating-for-wellness also eating for pleasure.

Restorative sleep. Beauty sleep.  Good sleep hygiene. Safe and restful sleep…sleep…sleep.  Yeah, yeah, yeah.  We all know:  Sleep is good. And necessary. But how good?  And what – if anything — does sleep have to do to with a counterclockwise life?

Plenty.

And not just the obvious, as in the generalized mental and physical recuperative effects of adequate and good-quality slumber.

Here’s the latest word on sleep –not too much (more than 9 hours) but just enough (7-8 hours):

Sleep promotes and helps maintain sharper cognitive function, especially memory. Researchers have long known that lack of sleep impairs reasoning, problem-solving, and attention to detail, among other effects. However, the mechanisms behind sleep benefits in these areas have been unknown. Now University of Rochester Medical Center researchers have discovered a system that drains waste products from the brain. Cerebrospinal fluid, a clear liquid surrounding the brain and spinal cord, moves through the brain along a series of channels that surround blood vessels. The scientists reported that this brain lymph system can help remove a toxic protein called beta-amyloid from brain tissue. Beta-amyloid is renowned for accumulating in the brains of patients with Alzheimer’s disease. Other research has shown that brain levels of beta-amyloid decrease during sleep.  This is a mouse study…so don’t start jumping up and down (unless you are a rodent). But it is potentially good news.

Sleep contributes to a strong and healthy heart. A new study by the Centers for Disease Control and Prevention (CDC) links too little sleep (six hours or less) and too much sleep (10 or more hours) with chronic diseases — including coronary heart disease, stroke, diabetes, high blood pressure, clogging of the arteries anxiety and obesity — in adults age 45 and older. In another study of more than 30,000 adults, those who slept approximately 7 hours a night were far less likely to develop heart disease that those who averaged 5 hours. Poor sleep appears to increase substances in your body, such as c-reactive protein, that indicate inflammation is a problem. Poor sleep also causes the body to produce more stress hormones, which may contribute to cardiovascular disease.

Sleep assists in weigh control.  Brain scans in healthy adults reveal that a good night’s sleep effects areas of the brain that regulate desire for high-calorie food. University of California/Berkeley researchers found that people deprived of a good night’s rest are more likely experience urges to eat fattening food.  The changes in food desirability encouraged by the sleep-deprived brain may originally have been an important adaptation, they say, adding – unnecessarily – that today they are “maladaptive and no longer benefit our health.”

So there you have it: Sleep as an anti-aging strategy.  Sleep in a cool, dark room.  Do not watch TV or use electronic devices right before bedtime (something about the particular light waves that are emitted).  Progressive muscle relaxation techniquees and deep breathing really work.  Are your eyelids getting heavy?

Summertime means fun in the sun. Or does it?

It’s complicated. More complicated than you think.

Gone are the days (for most of us) when we brazenly sunbathed, slathered in baby oil, holding aluminum foil-covered reflectors to our faces. (Or was that just me?) We have been well schooled in the evils of El Sol these days, the big one being skin cancer. It is the most common cancer, and far more common in the gray and misty Northwest (where I live) that you would think. It may be that we Northwesterners are so thrilled when we see the sun that we celebrate its appearance with an overabundance of enthusiasm.

The other, less dire message about sun exposure concerns aging, as in premature aging of the skin, aka photoaging. Sun exposure dries out the outer layers of the skin (moist skin is youthful skin) and does damage to the deeper collagen layer that gives skin its resilience. Dermatologists believe that photoaging trumps chronological aging in terms of those sags and wrinkles you don’t want to see. Add to this the solid research that sun exposure may contribute to the development of cataracts, and it’s enough to make you want to live in a cave all year.

Ah, you say, “Not me. I use sunscreen. I’m safe.” Sorry to deliver some potentially bad news on this front. You may want to take a deep breath:

The titanium dioxide nanoparticles increasingly used in sunscreens to protect the skin (the tiny particles directly absorb the radiation from sunlight) are so tiny that some scientists are raising concerns about whether they might do harm by seeping through the skin and into the bloodstream. Back in 2006, the International Agency on Cancer Research classified titanium dioxide as a potential human carcinogen (based mostly on inhalation studies in animals). Although these concerns has been largely dismissed (whew), there are now new concerns focused on the possibility that these nanoparticles could promote skin aging.

Yes, that’s right: The stuff we slather on our skin to prevent damage may, in fact, promote it.

So…sun BAD; sunscreen BAD.  Stay out of the sun entirely?  Not so fast. There are extraordinary benefits to sun exposure, according to ongoing research. Sunlight is the major source of vitamin D-producing Ultraviolet B radiation. At least 1,000 different genes governing virtually every tissue in the body are now thought to be regulated by D3, the active form of the vitamin, including: calcium metabolism, bone health, neuromuscular and immune system functioning, regulation of hunger, fertility, post-work-our resilience and, get this, the inhibiting the growth of some cancers. There is also research on the possibility of sun exposure reducing blood pressure, cutting heart attacks and reducing the incidence of strokes. (In fact, Scientists at the University of Edinburgh in the UK suggest that the heart-health benefits of sun exposure may outweigh the risk of developing skin cancer.) And, as you probably know, sun exposure has also been associated with reduced risk of seasonal affective disorder.

What to do?

Maybe this will help: Dr. Michael Holick, a vitamin D researcher with Boston University School of Medicine says that “the alarmist view that you should never be exposed to one ray of sunshine without wearing sunscreen has led to a pandemic of vitamin D deficiency and health problems.”  We should be cautious.  Not freaked.

How about 20 minutes of unprotected basking — unless you 1)  have had skin cancer or 2) are very light skinned.  Then 1) it’s the cave for you and 2) 10 minutes?

Summertime when the livin’ is easy?  Yeah, right.

Non-solar sources of D coming up next.  Stay tuned.

For years and years — okay decades — I was a cardio-only exerciser.  I swam.  I biked and hiked.  I treadmilled and EFXed.  I cross-country skiied.  Now that I understand the importance of muscle building and maintenance to overall fitness, health and vitality, I train with weights three times a week.  At home, I like the 7-minute workout (app is free), which I repeat three times.  At the gym, I alternate between free weights and machines.  I also take classes at Barre3, an studio routine that uses very light weights and very small movements and is probably the hardest (and most satisfying) exercise I do right now.  All help build muscle, which is far more metabolically active than fat.  That means  muscle burns more calories, even when you’re not using it — so muscle-maintenance is weight maintenance.  But, more important, building and maintaining muscle is a major anti-aging strategy.

More muscle.  Less fat.  That’s the idea.  I’ve written before about the fat-to-lean ratio as a biomarker of aging.  Here I want to talk about strength (as a consequence of muscle) as a biomarker.

Older people are “weaker” than younger people because older people have less muscle mass, and the muscle they do have is less dense and works less efficiently.  Between the ages of 30 and 70, the average person loses 20 percent of the “motor units” (the bundles of muscle fibers and the associated nerves that make up a muscle) in large and small muscle groups, and 30 percent of all muscle cells.  And the cells that remain get smaller. And are marbled with fat.  Less muscle equals less strength.  Less strength leads to “I’ve fallen and I can’t get up” and other such horrors of old(er) age.  Less muscle means less endurance.  Less endurance leads to less activity which leads to decrease in muscle…and so it goes.

The beauty of this — I know this doesn’t sound beautiful, but hold on — is that the progression (or, really, regression) is linear and logical, and therefore both understandable and fixable.  So we can reverse it.  Much of the weakness of older people has less do to with the passage of time than it has to do with the passage of time spent on the couch.  Lack of strength is not a “natural” consequence of aging.  It is a natural consequence of not actively building and maintaining muscle.  Emphasis on the actively.  Want the energy, stamina, strength and endurance that will keep you healthy and vital?  Build muscle.  Want a youthful fat-to-lean ratio?  Build muscle.  When you build muscle you build endurance which helps you…you guess it, build muscle.  And you know what?  It’s even kind of fun.