Exercising in midlife protects heart, says research

By Michelle Roberts Health editor, BBC News online

Gardening counts as moderate exercise

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Making sure you get enough exercise in midlife will help protect your heart, according to research.

Even those who make the switch in their late 40s and 50s can still benefit, the study of over 4,000 people suggests.
And it need not be hard toil in a gym - gardening and brisk walks count towards the required 2.5 hours of moderate activity per week, say experts.
But more work is needed since the study looked at markers linked to heart problems and not heart disease itself.
And it relied on people accurately reporting how much exercise they did - something people tend to overestimate rather than underestimate.

"This research highlights the positive impact changing your exercise habits can have on the future of your heart health,” said Maureen Talbot British Heart Foundation.

In the study, which is published in the journal Circulation, people who did the recommended 2.5 hours of exercise a week had the lower levels of inflammatory markers in their blood.  Inflammatory markers are important, say experts, because high levels have been linked to increased heart risk.

People who said they consistently stuck to the recommended amount of exercise for the entire 10-year study had the lowest inflammatory levels overall.

But even those who said they only started doing the recommended amount of exercise when they were well into their 40s saw an improvement and had lower levels of inflammation than people who said they never did enough exercise.

Exercise recommendations

• Under-fives (once walking independently): three hours every day
• Five to 18-year-olds: at least an hour a day of moderate to vigorous intensity physical activity, plus muscle strengthening activities three times a week
• Adults (including over 65s): 150 minutes a week of moderate to vigorous intensity physical activity, plus muscle strengthening activities twice a week

The findings were unchanged when the researchers took into consideration other factors, such as obesity and smoking, that could have influenced the results in the group of UK civil servants who were included in the study.

Dr Mark Hamer, of University College London, who led the research, said: "We should be encouraging more people to get active - for example, walking instead of taking the bus. You can gain health benefits from moderate activity at any time in your life."
Maureen Talbot of the British Heart Foundation, which funded the work, said: "Donning your gardening gloves or picking up a paint brush can still go a long way to help look after your heart health, as exercise can have a big impact on how well your heart ages.

"This research highlights the positive impact changing your exercise habits can have on the future of your heart health - and that it's never too late to re-energise your life.
"However it's important not to wait until you retire to get off the couch, as being active for life is a great way to keep your heart healthy."

A FINE BALANCE

Friday, March 30, 2012

Falling: We have nothing to fear but fear itself

By Moses Znaimer, Zoomer Magazine Toronto

I need to regain my balance. —Tiger Woods

Whenever I hear or think about the word “Falling,” the associations that flash into my mind are not all bad. There is, as it happens, a positive, exciting version of “Falling” to counteract the more mundane negative one. I’m speaking about love, of course, and the mysterious human mechanism that renders Vertigo in that realm (“falling in love”) sufficiently intoxicating that we seek it out, no matter how reckless or illogical the situation. Listen to Leonard Cohen’s “Crazy to Love You”, a cut on his just-out late-life masterpiece album, Old Ideas, and you’ll see what I mean. “Had to go crazy to love you,” he sings. “Had to let everything fall.” The singer has no choice in the matter, and neither – fortunately, I’d argue – do we. In matters of the heart, I’m all for the risk and passion of Falling. In matters physical, on the other hand, I’m far more pragmatic; and my watchword is Balance.

This year, if current trends continue, about a third of Canadians over the age of 65 who are still living at home will suffer a fall. Half these people will be injured in one way or another; 25 per cent of them significantly and, 20 per cent of those badly enough that they’ll end up in the hospital. They won’t be alone – almost 62 per cent of all injury-related hospitalizations for seniors are the result of falls. (Second only to car accidents, falls are implicated in an amazing 29 per cent of all injury-related hospitalizations for all Canadians.) Nine out of 10 hip fractures suffered by Canadians are caused by falls; and one out of five who break their hips will die within a year of the accident (U.S. figures, even more dire, suggest that a full 50 per cent of seniors who are hospitalized in that country because of falls will not be alive after a year). In other words, dangerous falls are tantamount to an epidemic in the aging population. The conventional reasons given for this are widely known: our bones become more brittle as we age, our muscles weaker and our spatial orientation (the sense of where we are) is diminished. But as undeniable as these deficits are, they’re more the cause of the injuries we suffer when we fall than the cause of falls themselves. The vast majority of the falls are actually the result of the malfunction of a critical “sense” with overtones as metaphysical and poetic as love: our sense of Balance.
Balance is defined physiologically as “the ability to maintain equilibrium against the force of gravity.” Essentially, to function smoothly in everyday life – let alone during athletics or exercise – it’s important that we not tip over. What grants us equilibrium is our ability to process stimuli from our inner ear, our eyes, our legs and our feet simultaneously. It’s an intricate enough process for a nine-year-old; for a 90-year-old, it can be a nightmare. This is because, as we age, the integration mechanisms we use to orient ourselves in space tend to break down.

This breakdown comes in different forms, says Dr. Bruce McFarlane, a 67-year-old family practitioner in Collingwood, Ont., who’s been involved in the study and treatment of balance issues for nearly 20 years. First are conditions associated with aging that can restrict blood flow to the brain and affect balance – “strokes, carotid artery blockage.” Then there’s diabetes, which “can result in a loss of sensation in the feet, which in turn can cause a loss of balance”; and medications themselves, “which we take more of as we age, particularly anti-infection medication like antibiotics.” Deteriorating vision can also affect balance, as can an erosion of our actual position sense, which lets us know, for instance, where our hand is in the dark. “When you reach a certain age,” says Dr. McFarlane, “you’ll notice that when you get up in the middle of the night, it’s way more difficult to get where you’re going than it used to be. Balance again.”

If that’s not enough, our muscle strength does indeed deteriorate as we get older (“It peaks at 40 and goes over a cliff at 60”), as does our flexibility, which restricts our ability to throw out an arm or hand to restore balance when we’re about to lose it. So it’s a tipsy world we’re contemplating, one that without intervention may only get unsteadier. That’s the bad news. The good news is there’s something we can do about it.

One of the most interesting and counter-intuitively simple treatments for a loss of balance is something called the Epley manoeuvre. The Epley is used specifically in cases of the inner ear disorder BPPV, or benign paroxysmal positional vertigo. The absence of balance is always paired with the presence of dizziness. In BPPV, which is more prevalent in older people, the spinning feeling occurs when the sufferer changes the position of his or her head, an action that can disrupt the fluid in our inner ear, which maintains our equilibrium.

In the Epley manoeuvre, the individual sits up straight, then lies back on her back, holds her head in a centred position, then turns to the right and to the left, and then moves back to a sitting position. Each pose is held for approximately 30 seconds and is intended to dislodge calcium particles called otoconia that adversely affect the inner-ear fluid. In romantic Vertigo, this would be like dislodging the object of our infatuation to regain emotional equilibrium. Both involve a kind of “rebooting” of our sense of balance. Success rates for the Epley in treating physical Vertigo due to BPPV range from 80 to 90 per cent.

More widely known in the treatment of balance problems in older people is Dr. McFarlane’s chosen discipline: the 108 moves, often beautiful and hypnotic, that make up Taoist tai chi, a martial arts-exercise discipline that dates from the second century AD. The moves come under a variety of evocative names: Hold the Ball, Turning the Wheel, Step Back to Repulse Monkey and Partition of the Wild Horse’s Mane. As New-Agey as the names are, several studies have shown the marked efficacy of tai chi in easing dizziness and aiding balance. (Of course, the Chinese have known about the therapeutic value of tai chi for millennia, but the sceptical Western mind generally demands “harder” data.)

The most renowned tai chi study was published in 1996 in the Journal of American Geriatric Society by Stephen Wolfe et al. One group of 200 subjects, average age mid-70s, did tai chi for 15 weeks, while another 200 people used a “balance plate,” a tilting platform that required subjects to shift their weight in order to keep a visible line in front of them level. The balance plate portion of the study, which was relatively expensive, tedious and required one-to-one supervision, resulted in no reduction in falls in the six months following the study. The tai chi portion which, with one instructor for a large group, was inherently cheaper and more fun, resulted in a 47 per cent reduction in falls over the next six months. The findings have been replicated several times over the past 15 years. Older people who do tai chi consistently experience less dizziness, more steadiness and improvements in all the balance-building factors: flexibility, lower body strength, position sense and alignment.

But when it comes to one of the greatest risk factors in our susceptibility to falls, our actual fear of falling itself, it’s helpful to return to the idea of “romantic” falling to understand the remedy. It seems reasonable for us to be more aware of the increased dangers of falling as we get older and to exercise extra caution to try to minimize the chances that we will fall. Concern and caution, you’d think, makes sense! But studies show that the more we give in to the Fear of Falling, the greater the likelihood that we will fall. Collected under this general apprehension is the fear of being hospitalized, of being embarrassed, of losing independence and, most acutely, the fear of having to move from home. The result, says Aysha Bindar, an advanced practice nurse currently working on balance treatment at Baycrest Home for the Aged in Toronto, is that people limit their activity. “They may not drink as much fluid as they need to,” she says, “so they don’t have to go to the bathroom as often. They avoid social gatherings, where there may be large numbers of people and furniture to trip over. The fear of falling isolates people and makes them less physically active, which leads to muscle atrophy and depression, which, of course, then puts them at greater risk for falling. And this happens not just in retirement homes but in the community at large.”

So by attempting to overprotect ourselves, we leave ourselves open to greater injury. Isn’t this precisely what happens in the emotional world? The more we attempt to insulate ourselves from the hazards of love – romantic or platonic – the more we leave ourselves open to emotional atrophy and greater depression.
In other words, in trying to keep ourselves safe, we court a fate worse than what we fear. To stay “upright” in this life, we need to cultivate two kinds of balance: physical and emotional. Without risk, we risk falling more and living less, forfeiting the ever more precious moments that make our lives worthwhile.

As Mary Pickford, the Canadian-born America’s Sweetheart of the silent screen, once said: “You may have a fresh start any moment you choose, for this thing we call ‘failure’ is not the falling down but the staying down.”

Zoomer Magazine

How Exercise Fuels the Brain

February 22, 2012, 12:01 am
How Exercise Fuels the Brain

By GRETCHEN REYNOLDS
New York Times

Does exercise keep your brain running?

Moving the body demands a lot from the brain. Exercise activates countless neurons, which generate, receive and interpret repeated, rapid-fire messages from the nervous system, coordinating muscle contractions, vision, balance, organ function and all of the complex interactions of bodily systems that allow you to take one step, then another.
This increase in brain activity naturally increases the brain’s need for nutrients, but until recently, scientists hadn’t fully understood how neurons fuel themselves during exercise. Now a series of animal studies from Japan suggest that the exercising brain has unique methods of keeping itself fueled. What’s more, the finely honed energy balance that occurs in the brain appears to have implications not only for how well the brain functions during exercise, but also for how well our thinking and memory work the rest of the time.
For many years, scientists had believed that the brain, which is a very hungry organ, subsisted only on glucose, or blood sugar, which it absorbed from the passing bloodstream. But about 10 years ago, some neuroscientists found that specialized cells in the brain, known as astrocytes, that act as support cells for neurons actually contained small stores of glycogen, or stored carbohydrates. And glycogen, as it turns out, is critical for the health of cells throughout the brain.
In petri dishes, when neurons, which do not have energy stores of their own, are starved of blood sugar, their neighboring astrocytes undergo a complex physiological process that results in those cells’ stores of glycogen being broken down into a form easily burned by neurons. This substance is released into the space between the cells and the neurons swallow it, maintaining their energy levels.
But while scientists knew that the brain had and could access these energy stores, they had been unable to study when the brain’s stored energy was being used in actual live conditions, outside of petri dishes, because brain glycogen is metabolized or burned away very rapidly after death; it’s gone before it can be measured.
That’s where the Japanese researchers came in. They had developed a new method of using high-powered microwave irradiation to instantly freeze glycogen levels at death, so that the scientists could accurately assess just how much brain glycogen remained in the astrocytes or had recently been used.
In the first of their new experiments, published last year in The Journal of Physiology, scientists at the Laboratory of Biochemistry and Neuroscience at the University of Tsukuba gathered two groups of adult male rats and had one group start a treadmill running program, while the other group sat for the same period of time each day on unmoving treadmills. The researchers’ aim was to determine how much the level of brain glycogen changed during and after exercise.
Using their glycogen detection method, they discovered that prolonged exercise significantly lowered the brain’s stores of energy, and that the losses were especially noticeable in certain areas of the brain, like the frontal cortex and the hippocampus, that are involved in thinking and memory, as well as in the mechanics of moving.
The findings of their subsequent follow-up experiment, however, were even more intriguing and consequential. In that study, which appears in this month’s issue of The Journal of Physiology, the researchers studied animals after a single bout of exercise and also after four weeks of regular, moderate-intensity running.
After the single session on the treadmill, the animals were allowed to rest and feed, and then their brain glycogen levels were studied. The food, it appeared, had gone directly to their heads; their brain levels of glycogen not only had been restored to what they had been before the workout, but had soared past that point, increasing by as much as a 60 percent in the frontal cortex and hippocampus and slightly less in other parts of the brain. The astrocytes had “overcompensated,” resulting in a kind of brain carbo-loading.
The levels, however, had dropped back to normal within about 24 hours.
That was not the case, though, if the animals continued to exercise. In those rats that ran for four weeks, the “supercompensation” became the new normal, with their baseline levels of glycogen showing substantial increases compared with the sedentary animals. The increases were especially notable in, again, those portions of the brain critical to learning and memory formation — the cortex and the hippocampus.
Which is why the findings are potentially so meaningful – and not just for rats.
While a brain with more fuel reserves is potentially a brain that can sustain and direct movement longer, it also “may be a key mechanism underlying exercise-enhanced cognitive function,” says Hideaki Soya, a professor of exercise biochemistry at the University of Tsukuba and senior author of the studies, since supercompensation occurs most strikingly in the parts of the brain that allow us better to think and to remember. As a result, Dr. Soya says, “it is tempting to suggest that increased storage and utility of brain glycogen in the cortex and hippocampus might be involved in the development” of a better, sharper brain.
Given the limits of current technologies, brain glycogen metabolism cannot be studied in people. But even so, the studies’ findings make D.I.Y. brain-fuel supercompensation efforts seem like an attractive possibility. And, according to unpublished data from Dr. Soya’s lab, the process may even be easy.
He and his colleagues have found that “glycogen supercompensation in some brain loci” is “enhanced in rats receiving carbohydrates immediately after exhaustive exercise.” So for people, that might mean that after a run or other exercise that is prolonged or strenuous enough to leave you tired, a bottle of chocolate milk or a banana might be just the thing your brain is needing.

91-year-old yoga teacher asks, 'Why should I quit?'

Bernice Bates, who at 91 is officially the world's oldest yoga instructor, teaches in front of a yoga class, as she's been doing since 1960.
By Lisa Flam TODAY.com contributor

Before her feet even touch the floor each morning, Bernice Bates is practicing yoga. While still in bed, she does her vinyasa, a series of seven or eight postures that gets her blood flowing. She puts her arms above her head for a stretch and a yawn, pulls her knees to her chest, “walks” the ceiling with her feet and stretches her shoulders and hands. “By the time you’re through — it takes about eight minutes — you’re ready to walk, instead of slopping around,” Bates said.
“You can walk to the kitchen, to the bathroom, whatever your procedure is and not sort of drag yourself and say, ‘I don’t want to do this. I don’t want to do that.’ You’re ready to go.” Yoga has been a way of life for Bates, 91, for more than half her life: She began practicing and teaching hatha yoga in about 1960. In a fitting tribute to her decades of helping others learn her passion, she recently won the distinction of the Guinness World Record holder of oldest yoga instructor. Guinness says she is the oldest yoga instructor to complete the complex verification process.
It’s an honor, the humble yogi feels, that isn’t hers alone. “I don’t have this reward by myself,” she said. “I share it with all the students I’ve taught through the years.” Bates credits yoga with keeping her flexible, fit and healthy. “I think yoga is the best exercise there is,” says Bates, who has always been active and still swims laps. “I’ve never had anything I had to go to the doctor for, except checkups,” says Bates, who tips the scale at 105 pounds and is about 5 foot, 2 inches tall. “That should say something.” Yoga involves the whole body — muscles, ligaments, organs, she says, and gives you energy without exhausting your body. “You’re not just standing on a treadmill and going, going, going and you get off and can hardly walk,” she says. “Yoga itself means yoke, that’s to join. We join our mind, our body and our spirit in everything we do.
“Yoga gives you flexibility like you’ve never had before, and it makes you healthy because you’re working on the whole body, inside and out,” she said. Bates, who has instructed children and adults, now leads a weekly one-hour class nine months a year at the Mainlands Retirement Community Center in Pinellas Park, Fla., where she lives. Most students are in their 60s and 70s, though she has two fellow nonagenarians and several students in their 80s. She leads her students through 10 to 12 poses and ends with relaxation. “We go over our whole body and tense each part, then we relax,” she said. Bernie, as her students call her, provides handouts so they can practice at home. And when they can finally do something they once couldn’t, like touch their toes, “it makes me feel like it’s worthwhile,” she says. Some students have been with her for the 15 years she’s taught at Mainlands, and they all adapt to the class as they grow on in years. Some participate while sitting on chairs. “It’s for everybody,” she says enthusiastically about yoga.
“There’s thousands of postures. You can pick and choose. You do what you can. “It’s non-competitive, which is the best thing about it,” she said. Bates is a widow of eight years and a mother of three, grandmother of seven and great-grandmother of three. Yoga has enhanced her full life. “It just encouraged me to keep going and it made my life better,” Bates said. “You’re active, so you don’t gain 100 pounds.” She lives alone and tends to her flower garden, does the housework and likes to rearrange her furniture, so she’s always moving it around.
“If I didn’t keep myself in shape, I wouldn’t be able to do it at 91,” she says. Her decades of physical activity have only added to her strong Methodist faith. “Anything you do for your body that’s good is going to enhance improvement in your religion too,” she said. “You get more faith that way.” With students seeking her guidance each week, the world’s oldest yoga teacher is going to keep on teaching.
“Why should I quit? she asks. “As long as I can do it and be a help to someone else, I’ll just stay as long as I can. I get a joy out of seeing someone learning.”