stop old people from falling.....go barefoot?

My work is too busy at the moment for me to do much on this blog, but I am still keeping an eye on news and research.

This study popped up last week and I thought it had some interesting implications.

Altering gait by way of stimulation of the plantar surface of the foot: the immediate effect of wearing textured insoles in older fallers

Conclusions - Stimulating the plantar surface of the foot by way of wearing this type of textured insole causes an immediate effect - in this case a slower, more cautious gait in older fallers. Further work is required to determine how textured insoles can be used to improve gait in older fallers.

The whole study is there for you to look through.

Anyway, what this made me think of was the value of being barefoot.  So much information comes from the feet, from the sole.  While shod, all that information is blunted.  Barefoot there is so much more stimulation and data that can be processed by the brain to feed into the proprioceptive system.

Textured insoles are just a "stepping stone" to being barefoot.  If they can help to prevent falls, maybe being barefoot....on rough rich surfaces...could do even more

keep squatting....and eating coconut oil

I spent the weekend visiting my parents.  My Dad has dementia and is currently in a hospital ward.  His mental state oscillates, but when he is well he is still funny, loving, caring and sharp.  It is just the dislocation from reality that is difficult to witness.

Anyway, I was struck again by how basic and essential it is to be able to stand up from a chair.  There is balance involved, but so much more is the need for basic strength in the hip extensors, back and thighs.  Occupational therapy is fine, but it would be fantastic if we could get them on a leg press a couple of times a week.

I have got my Mum to start giving him coconut oil each day now, especially after listening to this podcast.  Podcast #13: How To Upgrade Your Brain with Coconut Oil & Ketones

Just take the exercise pill

Can we just make drugs which remove the need to exercise?  Perhaps, but I hope not.

"No one can deny that the human body was meant to move, and to move often," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "but the reality is that many of us don't move enough, whether because of disease, injury, or simply a busy schedule. This discovery is another important step towards the treatment of muscle wasting in cancer, severe infection or aging – or to maintain our muscle mass to help face the slings and arrows of outrageous fortune."

The abstract is here

Discrimination is bad, mmmkay?

This is a post copied from Nigel, but it is powerful.  My own Dad has dementia and the reality of it beings all this stuff to life.  I hope he excuses my hijacking of his material but it is very important.  I've seen those things too.....


Discrimination is bad, mmmkay?: What do the following three images have in common? Images found with Google Image search.










They are all unable to fend for themselves or express how they feel. They all need a lot of care and attention and can be very demanding. The last two also have to be fed & toileted.

So why is it that the first two images make people go "Squeeeeeeee!" but the third one doesn't?

Is it because the first two images give you something to look forward to but the third one doesn't?

We're all going to end up old one day if we're "lucky". Just hope and/or pray that when you get there, you either have caring partners and/or relatives to look after you, or independent care for the elderly has improved a lot. I've seen things.

Those old triathletes

Ken Hutchins of Renaissance Exercise makes a good point about that study about the incredible old triathletes  .

"There are amazing CAT scans contrasting the muscularity of triathletic and sedentary elder men. It is apparent that destroying your body in a triathlon can, at least, maintain your muscularity. Or, perhaps the difference is completely due to a genetic aberration whereby the above-average muscularity of the elder man merely enables him to destroy his body in the triathlon. Of course, it is also true that such activities are sarcopenic. "

I had not thought of that when I saw the study but logically he is right. There may be survivor bias going on.   Those still training at 70 are those that have survived....how many have not managed to make it that far through injury or whatever?  What can we really conclude from that study?

Good quote from Coach Rutherford

I heard this as I was walking home last night after a long day at work and a crap week. 

This week Robb Wolf had Michael Rutherford on the podcast  and it was a fun listen, easvesdropping on some pals chatting away really.  One quote stood out:



Your best ally as you age is to take as much muscle mass into your latter years as possible.

Of course it is.

How to live forever

More Health and Fitness News & Tips at Greatist.

It does not matter....but it matters a lot

I have spent the last week with my parents. My Dad has dementia - mixed Alzheimer's and vascular - which is a cruel condition.

It is painful to watch his bewilderment at the world, terrible to see my mum's heartbreak at losing her man, yet wonderful to see them both retain such tenderness towards each other.

It made me realise that so much of all the drama in life does not matter, including all the petty debates around diet and exercise. All the energy that we all expend studying and writing on training and eating mean little in the end. 75 or 80 years on this earth are pretty short.

But I am also thinking of what does matter.

• Love and relationships
• Happiness
• Health and function.

It is that last one that keeps me going here on this blog. Health and function If there is any thing that I can do to avoid ending like my dad I want to try to do it. Brain health, sufficient strength, balance, functional movement (climbing stairs, getting out of a chair) good bowel function, life without a catheter - you don't often see those as goals on your training blogs but when we look to our 70s or 80s they are what is important.

Further up that list: happiness. Dad said to me in a moment of clarity, "Get out and enjoy the world son."

I will.

That means training and mountains. It means fewer 10-12 hour days at work. More walks. More laughing.

Love and relationships.

The most important. And that includes the spiritual side of life. Lots to write there.

Och well. Back to reading about exercise and whether a potato will kill me.

As you get older, keep active and keep it intense

A nice report of a study from Norway Peak Oxygen Uptake and Cardiovascular Risk Factors in 4631 Healthy Women and Men

Go and read it, but a few quotes:

Research from the K.G. Jebsen Center goes well beyond the Dallas findings, and shows that fit 50-year olds can be as fit as 20-year olds who don't exercise much. But exercise -- how much, and how intense -- is the key to maintaining this fitness. When the Jebsen Center researchers looked at the importance of the intensity of exercise versus the duration, intensity was far more important than duration in determining peak oxygen uptake.

They have also looked at the benefits of high intensity exercise in the form of interval training -- where four or more short periods (typically 4 minutes) of very high intensity exercise are followed by a similar number of short periods of lower intensity exercise. This approach, called 4x4 interval training, is a quick way to increase your overall fitness, research from the Jebsen Center has confirmed.

The center's research shows that maintaining some level of physical activity is important. The benefit from having been active when young is small if you are inactive now. "Even if you were highly active at a young age, you have to keep being active to get the health benefits from it," says Professor Wisloff.

So how do K.G. Jebsen Center researchers stay fit, given all that they know? Many incorporate exercise into their daily routines. Aspenes -- a 33-year-old father of three, with a full time job now at the Norwegian Directorate of Health -- is lucky because he can ride his bicycle to and from work, which in hilly Trondheim, means that at least part of the ride is up some pretty steep hills. That's an advantage for interval training, he says, because "I ride like hell up the hills."

The anabolic resistance of ageing

This is interesting.  The whole study is again available as a PDF. 

Basically, as you get older your muscles become resistant to the normal anabolic stimulants - resistance training etc.  Maintaining muscle is very important as we age - it is vital to function and to supplying a range of raw materials for the metabolism, not least in terms of immune response.  So we need to understand how to do that, how to keep our muscle.

The key recommendation seems to be to combine resistane training with branched chain amino acids.  Incidentally something that Art Devany has recommended for a while.

Skeletal muscle protein metabolism in the elderly: Interventions to counteract the 'anabolic resistance' of ageing

Maintaining muscle with age.....

This abstract looks interesting (and I know it is rats...and you really need to read the whole study....)

Benefits from calorie restriction while maintaining decent protein intake.  I wonder if they would get the same benefits from IF (intermittent fasting)?

Effect of fast dietary proteins on muscle protein synthesis rate and muscle strength in ad libitum-fed and energy-restricted old rats.

Exercise and Ageing

This sort of study interests me at the moment, given the current state of my Dad's mind.

The meta-analysis showed that individuals who were physically active at the start of the study (baseline) had a significantly reduced risk of developing cognitive decline during follow-up.
The researchers explain that it is already known that physical activity has positive effects on a wide range of health measures, reducing the risk of heart disease and stroke, diabetes, obesity, hypertension and some cancers.

I think it is interesting that it is about moderate exercise:

This study did not find a clear ‘dose dependent’ effect, ie an association in which increasing levels of activity resulted in increasing levels of protection.

Lots of walking here.....

Of course there are also studies about the importance of strength training and balance

Brief exercise reduces impact of stress on aging

I've pointed to research in the past on the effect of different types of exercise on cell aging, as measured by telomere length( for example - Marathons make your muscles old). As usual, things are quite complex.

Anyway, there is some new research just published that

Vigorous physical activity appears to protect those experiencing high stress by buffering its relationship with telomere length.

Chronic psychological stress is responsible for a range of health problems, but it seems that it even has an effect at a cellular level right in the DNA. Exercise however can reduce its negative impacts:

In the study, 62 post-menopausal women – many of whom were caring for spouses or parents with dementia -- reported at the end of each day over three days the number of minutes of vigorous physical activity in which they had engaged. Vigorous activity in the study was defined as "increased heart rate and/or sweating.'' They also reported separately their perceptions of life stress that they had experienced during the prior month. Their blood's immune cells were examined for telomere length.

Results support the UCSF-led discovery six years earlier in premenopausal women that psychological stress has a detrimental effect on immune cell longevity, as it relates to shorter telomeres. The new study showed, however, that when participants were divided into groups – an inactive group, and an active group (i.e., they met federal recommendations for 75 minutes of weekly physical activity) – only the inactive high stress group had shorter telomeres. The active high stress group did not have shorter telomeres. In other words, stress predicted shorter telomeres in the sedentary group, but not in the active group.

There is more in the report here.

It is multifactoral....

The other day Skyler mentioned a book he was reading. He said:

Lessons from “The Blue Zones.” I think there’s some good information here, especially for those who wish to impart a black and white view into diet and exercise.

I was intrigued. I looked around and found the relevant website, and also ordered the book from Amazon.

The book tries to pull out some lessons about living a long healthy life by looking at the factors which some really lon lived communities around the world have in common:

Here at BlueZones.com, we've organized these behaviors into four main categories:

Move Naturally – Make your home, community and workplace present you with natural ways to move. Focus on activities you love, like gardening, walking and playing with your family.

Right Outlook – Know and be able to articulate your sense of purpose, and ensure your day is punctuated with periods of calm.

Eat Wisely – Instead of groping from fad diet to fad diets, use time-honored strategies for eating 20% less at meals. Avoid meat and processed food and drink a couple of glasses of wine daily.

Belong to the Right Tribe – Surround yourself with the right people, make the effort to connect or reconnect with your religion and put loved ones first.

It is worth digging around the site, there are some fascinating ideas in there.

It is an interesting book. What it brought home to me is the importance of thinking multifactorally.

We often tend to think in terms of a single factor - diet, exercise, stress, sunshine vitamin D or whatever. It is however simplistic to think about a single factor. We don't live like that - we are not in carefully controlled experiments with one variable at a time changing - there are lots of things at play. We need to think more broadly. It is not X or Y....usually it is X & Y & Z & A & B etc.....

The idea of there being lots of factors to bring into the mix came up in my interview with Keith and was raised in a recent comment by jleeger on this blog:

I'm always curious as to the value-judgments (and reasons behind them) that we place on things.

"Paleo" or "EV" is no different.

Were humans "freer" in a "paleo" tribe? Is one technology "better" than another? Does "paleo" as a practice extend the lifespan beyond basic, "simple-living?"

I'm still unconvinced that all or any of these "methods" we find today - from Xfit to Z-Phase to Paleo/EV to HIIT - are in any way "single" answers unto themselves.

They reveal the results a person can expect on their own basis, but also, necessarily limit development in other areas.

For instance, none of those hobbies asks its participants to become a better singer, or to learn to sew/knit, or carve wood.

Similarly, none of them teaches people how to be better at business, or how to make a living.

Taken for what they are, they all have value. But in the end, all of these "methods" are just different lenses through which to view a larger reality.

Restricting yourself to any one of them is madness.

Keep thinking......

Does running make you old or keep you young?

I had a post up a couple of weeks ago pointing to a study that said that the muscles of endurance runners aged in proportion to the amount of running they did. The argument was around the length of telomeres in the muscle cells.

Telomeres are structures at the ends of human chromosomes that protect DNA from damage. To help you visualize them, they are often compared to the little plastic tips at the ends of shoelaces. As cells age and replicate, their telomeres shorten. When telomeres become critically short, cells stop functioning properly. So, the general idea is that telomeres may be a “biological clock” that reflects your physiological age/health more accurately than your chronological age. In other words, the longer the telomeres, the healthier the cells. (from here)

This post is just to note that - as ever - it is a complex business and not as straightforward as it might all seem.


There is another study which says that endurance training keeps cells "younger" with longer telomeres:

Leukocyte telomere length is preserved with aging in endurance exercise-trained adults and related to maximal aerobic capacity.

Our results indicate that Leukocyte Telomere length is preserved in healthy older adults who perform vigorous aerobic exercise and is positively related to maximal aerobic exercise capacity. This may represent a novel molecular mechanism underlying the "anti-aging" effects of maintaining high aerobic fitness.

Of course it is all complex. There is an interesting interview here which goes through the background to this. Telomere length, it says can be affected by:

• Genetics
• lack of sleep
• fish oil (there it is again)
• stress
• high blood sugar

So it might not have anything to do with the exercise.

Old and in hospital.....it is better to be fat!

Carrying on the theme thinking about age, this has just been published which I thought was interesting.

For old people in hospital, it is actually better for them to be fatter.

Fat mass protects hospitalized elderly persons against morbidity and mortality

Background: It is well established that the combination of protein-energy malnutrition and low body mass index (BMI) increases the risk of death in elderly patients, but recent studies indicate that the risk of death may decrease with higher body weight. However, these studies did not perform direct, separate, and reliable measurements of fat and lean mass by using a reference technique.

Objective: Our objective was to evaluate the relation between body composition, based on the 4-compartment model, and morbidity and mortality in hospitalized elderly patients.

Design: This prospective study enrolled 125 elderly patients evaluated at admission for body composition on the basis of BMI plus fat mass, lean mass, appendicular skeletal muscle mass, and body cell mass indexes (calculated as the ratio of the mass to the square of the height) measured by X-ray absorptiometry and bioelectrical impedance analysis. Outcomes were assessed 6 mo later by using a score system that takes into account complications (pressure ulcers and/or infections) and 6-mo mortality.

Results: The fat mass index correlated positively (r = 0.19 and P = 0.023 adjusted for sex; r = 0.18 and P = 0.043 adjusted for sex, albuminemia, and C-reactive protein) with outcome score (1: death, 2: complications, 3: no complications). There was no significant correlation between outcome score and BMI, lean mass, appendicular skeletal muscle mass, and body cell mass indexes.

Conclusions: This study clearly indicates that the generally accepted rule that overweight is associated with morbidity and mortality does not apply to hospitalized elderly patients, for whom fat mass is associated with a decreased risk of adverse events.

Ageing....

I spent some time with my Dad this last weekend and it really got me thinking about the whole process of getting old.

My Dad is 75, probably not that old in the scheme of things but I really noticed over the last few days, probably for the first time that he has become an old man.

How much of ageing is just inevitable? What can you do to prevent some of the major problems associated with getting older?

Looking at my Dad I noticed a few things:

• A loss of muscle - I remember him as a big man, with a huge barrel chest and some lean mass around his upper body. Somehow in recent months that has gone. The muscle is disappearing.
• Posture - he is bending over. The tonic muscles are getting tighter and he is bending at the hips and neck...stooping.
• Confidence - he is starting to be less confident in his own abilities, physically and mentally.
• Balance - he looks unsteady.

I think training could remedy much - posture, muscle mass, balance. In Body by Science, McGuff and Little talk about a study done into resistance training for the elderly and how it can actually reverse ageing in human skeletal muscle.

Resistance Exercise Reverses Aging in Human Skeletal Muscle

Human aging is associated with skeletal muscle atrophy and functional impairment (sarcopenia). Multiple lines of evidence suggest that mitochondrial dysfunction is a major contributor to sarcopenia. We evaluated whether healthy aging was associated with a transcriptional profile reflecting mitochondrial impairment and whether resistance exercise could reverse this signature to that approximating a younger physiological age. Skeletal muscle biopsies from healthy older (N = 25) and younger (N = 26) adult men and women were compared using gene expression profiling, and a subset of these were related to measurements of muscle strength. 14 of the older adults had muscle samples taken before and after a six-month resistance exercise-training program. Before exercise training, older adults were 59% weaker than younger, but after six months of training in older adults, strength improved significantly (P<0.001) such that they were only 38% lower than young adults. As a consequence of age, we found 596 genes differentially expressed using a false discovery rate cut-off of 5%. Prior to the exercise training, the transcriptome profile showed a dramatic enrichment of genes associated with mitochondrial function with age. However, following exercise training the transcriptional signature of aging was markedly reversed back to that of younger levels for most genes that were affected by both age and exercise. We conclude that healthy older adults show evidence of mitochondrial impairment and muscle weakness, but that this can be partially reversed at the phenotypic level, and substantially reversed at the transcriptome level, following six months of resistance exercise training.







I wish my Dad would train. However while I think training could do something, maybe we are also fooling ourselves. We are going to get older and we will deteriorate.

The other thing that seeing him made me think about was the shortness of life. No matter what you do for your health - exercise, diet, whatever - you will die. This will end.

There is a passage in the Bible (Ecclesiastes 7:2) that says:

[It is] better to go to the house of mourning, than to go to the house of feasting: for that [is] the end of all men; and the living will lay [it] to his heart.

Going to a funeral is better than going to a party because it makes you appreciate that all men will die. It makes you take to heart your own mortality and the fact that you will not be here forever.

What do you do with that? Appreciate what you have now. Reflect on eternity.