Tipping Point: Stay Strong, Flexible and Balanced with Exercise Much of life is a balancing act…from learning to sit up as an infant through avoiding falls in the later years. Balance is the ability to distribute your weight in a way that enables you to remain upright and steady. This requires multiple systems in your body to be working in …

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Exercise – A Key Component to Healthy Aging We all experience changes to our bodies as a natural part of growing older. Adapting to these changes can be challenging. While we cannot stop our body’s aging process, we can proactively address the physiological changes that occur in order to reduce the impact of aging on our general health. Commonly, mobility and balance are affected adversely by our aging bones and joints. As balance and mobility become compromised, this can lead to falls. One out of every three Americans over the age of 65 has a significant fall each year, according to the U.S. Centers for Disease Control and Prevention (CDC). Among individuals age 65-84, falls account for 87% of all fractures. Although many individuals may experience problems with their equilibrium as they get older, one of the main causes for a decrease in coordination and balance correlates to decreased muscle mass. As we age, we lose muscle mass (the weight of our muscle) if we do not exercise. A loss in muscle mass translates into decreased strength, flexibility and agility. Additionally, bones tend to shrink in size and density with age, weakening them and putting us at risk for osteoporosis (brittle bones) or broken bones. Research has proven that exercise at any age should improve our health. One such study showed that after participating in an exercise session just three times a week for 20 weeks, participants in their late 60s increased muscle strength. Moreover, the study’s older participants increased blood flow to their legs that was comparable to that of study participants in their late 20s. Blood flow, or circulation, carries oxygen and other nutrients to all the cells in our body, including our lungs, and also rids our body of carbon dioxide and lactic acid. In the process of circulation, endorphins also are released. Endorphins are biochemical substances which help the body naturally relieve pain and can bring about a feeling of well-being. According to the National Association of Sports Medicine, building or improving muscle mass provides the following benefits as we age: Improved bone density and joint health—Strengthening muscle mass places healthy stress on bones which prevents joints and bones from breaking down. Adding muscle tissue through strength training, such as using free weights, helps reduce the chances of osteoporosis, arthritis, joint injury, loss of balance and falling. A healthy metabolism and prevention of weight gain—Muscle burns twice the amount of calories as fat tissue, so by sustaining muscle tissue through proper nutrition and exercise, a healthy metabolism is maintained. In turn, a healthy metabolism can prevent extra weight gain as well as reduce the risk of heart disease and diabetes. Improved strength and balance—An exercise as simple as walking helps keep leg, back and shoulder muscles active and working. This maintains overall flexibility and balance, thus reducing risk for serious falls. If you are looking to begin an exercise routine, feel free to consult our office. We can recommend reputable resources to help you get started safely. The benefits of exercise for every person at every age are well documented. The type of exercise you select is not as significant as the fact that you are doing something to contribute to your long term health and wellness.

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Body Mass Index (BMI) The Body Mass Index (BMI) is a quick, easy and efficient screening tool to identify weight problems in adults. While BMI is a strong indicator of body fat percentage, it can vary for age, race and sex. It is important to note that the BMI should only be utilized as a screening tool and is not, in and of itself, diagnostic. For example, older people tend to have more body fat that those who are younger, and women tend to have more body fat than men. Also, some athletes may score a higher BMI because they have increased muscle mass; therefore, they weigh more because the weight is muscle not fat. In fact, some patients notice when they combine diet and exercise, they may go down a clothing size while their weight remains the same. Overall, learning your BMI is a great starting point for a discussion of your health goals with your physician. How is BMI determined? Body Mass Index calculates a person’s fat level by using a complex mathematical formula based an individual’s height and weight. Automatic calculators can be found online at http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html. The chart to the right, created with information provided by the Centers for Disease Control, highlights BMI scores and their correlating weight status. Once it is determined that you have a weight problem through this calculation, follow up with appropriate assessments for specific health risks that may be associated with a BMI of “underweight,” “overweight” or “obese” is recommended. Body weight is only one indicator of disease risk. Combined with a high BMI, the following factors can place you at an even greater risk for certain diseases: High blood pressure (hypertension) High LDL cholesterol (“bad” cholesterol) Low HDL cholesterol (“good” cholesterol) High triglycerides High blood glucose (sugar) Family history of premature heart disease Physical inactivity Cigarette smoking In conjunction with BMI numbers, a person’s waist circumference is also an effective way to assess weight and health risk. People who carry most of their fat around their waist, an appleshaped body, are at greater risk for type 2 diabetes and heart disease. The risk increases with a waist size that is more than 35 inches for women and greater than 40 inches for men. Scientific evidence shows that when people carry weight around their waistline, abdominal fat tends to surround internal organs, impairing their function. Conversely, people who carry their weight around their hips, a “pear shaped” body, accumulate fat directly under the skin, and thus the fat does not interfere with their organ function. Just as a BMI over 25 can have negative health implications, so too can a BMI of 18.5 or lower, categorized as “underweight” for an adult. A BMI this low could indicate a variety of medical conditions. People with underweight body mass indexes are at increased risk for poor bone health, such as osteoporosis. Younger women classified as underweight may have disruptions of their menstrual cycle and difficulty getting pregnant. Other issues from being underweight can include anemia or a weakened immune system. Together we can discuss appropriate options for diet and exercise that are tailored for you, and that will put you on the path of minimizing your future health risks. Learning your BMI is a great step in this direction.

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Surprising Places where Germs hide When it comes to avoiding germs, your smart phone may not be so smart. Experts say cell phones are hot spots for bacteria growth. As we head into the height of cold and flu season, it is important to be aware of where germs lurk and some practical ways to avoid these germs and stay healthy. Cell phones are so commonly used by most people that they are almost an extension of our ears and hands. They are also a popular depository for germs and bacteria, including staph and salmonella, based not only on their proximity to our mouths, but also where we set them down. These devices are set on tables at restaurants, dropped on the ground and placed on gym equipment during a work-out. Also, the protective cases covering cell phones provide additional nooks and crannies for germs to hide. Be aware of where you put your phone and make a habit of cleaning both your cell phone and its case twice a week with a disinfecting wipe. In addition, take the time to regularly wipe down the television and video game remote controls in your home, particularly if someone who is sick handles these devices. The same advice applies to office and home phones. Think about the frequency that elevator buttons are pushed. Therefore, it is not surprising that these buttons become a depository for germs— particularly the first floor button. It is just as easy to use your knuckle or elbow instead of your fingertip— or wait to see if someone else pushes your floor first! If you do use the elevator buttons, or hold an escalator handrail, wash your hands at the next opportunity or use a hand sanitizer. Remember, the keypads on your microwave oven, telephone, home and office computer, and ATMs are also germ depositories. For keypads in your home, wipe them down regularly with a disinfectant wipe or spray. When using keypads in public, use your knuckle or wash your hands soon after touching. How Clean is Your Kitchen? The kitchen is often the hub of our homes. As a heavy traffic area for family and friends, and the site of our daily food preparation, the kitchen has many areas needing special cleaning attention. Prevention magazine recently reported that in thousands of homes across the United States, 7 percent of kitchen dish towels were contaminated with MRSA (methicillin-resistant Staphylococcus aureus), the difficult-to-treat staph bacteria that can cause life-threatening skin infections. Part of the cause is that people use dish towels to wipe up kitchen spills, hang them to dry, and then use them again. Instead, use paper towels to wipe down counter tops and soak up spills. Dish towels should be replaced and laundered at least twice a week, more frequently for families with children where usage is high. When cleaning refrigerators, most people are diligent about the inside, but forget one crucial area—the seal around the doors. A University of Arizona survey found that the home refrigerator seals tested positive 83% of the time for common molds. These molds can spread to food or become airborne each time the door is open. Finally, don’t forget the kitchen sink and the garbage disposal. The sink and disposal are the final stops for foods that we rinse off or meals that we scrape down the disposal. Make sure to clean these areas with a diluted bleach solution once a week. Pay close attention to the seal around the disposal and give it a good scrub to remove the particles of food that accumulate there. Consider running your sink stopper/strainer through your dishwasher on a regular basis. Finally, most of us know that sponges are a breeding ground for germs—and they are. However, the Agricultural Research Service, (the in-house research arm of the U.S. Department of Agriculture), found that micro – waving sponges for one minute or running them through a dishwasher, killed approximately 99.9 percent of bacteria present on the sponges. Good Old Fashioned Hand Washing… and Hand Sanitizing According to the Infectious Disease Society of America, hand washing with soap remains the best way to prevent infection from germs. Remember to rub your hands vigorously while washing with soap, for at least 20 seconds. Alcohol-based hand sanitizers are a good alternative if there is not a sink and soap readily available. They should contain at least 60% alcohol. Like hand washing, use enough sanitizer to wet your hands completely and rub together for at least 20 seconds until your hands are dry. It is important to note that the majority of the germs that exist in our environment are not “bad”. Scientific and medical experts agree that most of the estimated 60,000 germs that people come in contact with daily are harmless. It is estimated that only 1 to 2 percent of these germs are potentially unsafe to people with normal immunity, according to Philip Tierno, PhD, author of the book The Secret Life of Germs. Common sense and good hygiene are always the best defense against germs.

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Feeling SAD When It Is Dark And Gloomy? Do you feel moody or have trouble waking up when the days grow shorter and darker? Many people do—and the symptoms can range from mild unhappiness at the lack of sunshine to a clinical condition called “Seasonal Affective Disorder (SAD).” The National Institutes of Health estimates that more than 36 million Americans suffer from a seasonal depression that begins in the fall and may last until the daylight hours increase significantly. Some of the symptoms may include: Loss of energy Oversleeping (feeling like you want to pull the covers over your head) Appetite changes, especially a craving for foods high in carbohydrates – often associated with weight gain Loss of interest in activities you normally would enjoy Difficulty concentrating and processing information Irritability Anxiety Many experts blame a lack of light as the culprit. Exactly how the darker days cause depression is still in question… but the January 2008 issue of the Harvard Health Letter offered these theories: On many winter days our only exposure is to indoor lighting, which may be too weak to perk up some sufferers. Lack of light may put people out of sync with their biological clocks, so their internal timers want them in bed when they should be awake and active. Additionally, this lack of adequate bright light may disrupt brain chemicals such as serotonin and dopamine, which play a role in monitoring mood. Our brains also produce a hormone called melatonin during hours of darkness. It is involved with regulation of sleep, body temperature, and release of hormones. Some people produce too much melatonin during long dark winter months. This disrupts the internal body clock, leading to depressive symptoms. If the above symptoms describe how you feel at about the same time every year, there is no need to brush off that yearly feeling as simply a case of “winter blues” or a seasonal funk that you believe you have to “tough out” on your own. Feel free to call my office and we can talk about treatment options. These may include light therapy (phototherapy), medications, and/or psychotherapy. Addressing the problem now can help you keep your mood and motivation steady throughout the year.

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