Food & Fitness After 50: The Scoop on Collagen

Bob bike 2
Dr. Bob enjoying his just desserts after a long bike ride

Survey data from the Council for Responsible Nutrition (a trade association for dietary supplements) shows that 78% of adults over the age of 55 take supplements. Reasons for supplement use include overall wellness and healthy aging. It is no surprise that people are asking about one of the hottest supplements…collagen. I reached out to my friend and co-author of Food & Fitness After 50 to ask him some of your top questions about collagen. Dr. Bob Murray is an exercise physiologist and is passionate about exercise and health. He consults with many companies on hydration, protein, and supplement use in active populations, including older adults.

Let’s start with the basics. What is collagen and are there different types of collagen in the body?

Collagen-structure.800x345-wWe can think of collagen as the glue that holds us together. Collagen is the name for a large family of proteins found in the body.  In fact, there are so many types of collagen proteins that collagen turns out to be the most abundant protein in the body. Collagen proteins make up connective tissues throughout the body.  The term “connective tissues,” makes many people immediately think of tendons, ligaments, and cartilage, three good examples of connective tissues.  Muscles, skin, and bones also contain large amounts of connective tissues and therefore large amounts of the collagen proteins that intertwine to give those tissues the structure, strength, and elasticity required for the many different roles required of connective tissues. It should be obvious that the connective tissue in bone has a different role to play compared to the connective tissue in muscles or skin. That’s why so many different kinds of collagen proteins are needed throughout our bodies.

When I was younger, I remember my friends dissolving Knox gelatin in water and drinking it to strengthen their nails. Is gelatin the same as collagen?

The connective tissues of cows, pigs, and chickens are the primary source of gelatin produced for human consumption.  As a result, gelatin is rich in collagen proteins.

Is collagen a complete protein, that is one that contains all the essential amino acids needed by the body?

Collagen is an incomplete protein and is low in the amino acids that are associated with building muscle mass and strength.  However, collagen proteins are high in two amino acids—glycine and proline—that appear important in stimulating the growth of connective tissues in physically active people.

There are many claims for collagen supplements…from preventing wrinkles and strengthening skin to improving joint flexibility and strengthening muscles and bone. Is there any good human evidence that collagen supplements will help with any of those body systems?

The best way to sum up the current state of affairs is that the benefit claims for consuming collagen are long on theory and short on evidence.  That’s not to say that there isn’t some evidence suggesting benefits to skin, joints and muscles, but that evidence has yet to reach the levels of quality and quantity required to draw comfortable conclusions about the magnitude and reproducibility of the benefits associated with consuming collagen proteins on a regular basis.

It is well known and accepted that protein is needed for muscle protein synthesis, is collagen any better than simply getting more protein from whey protein or other protein-rich sources?

iStock Older man lifting weights smallMaybe, but much more research is needed to either confirm or deny that consuming collagen benefits muscle mass and strength beyond what we know occurs by increasing dietary protein intake. There are a growing number of studies that report benefits to muscle strength, joint pain, and repair of connective tissue, but there are a greater number of studies that report no benefits.  The unsatisfying answer to your question is that we’re going to have to wait and see what future research has to say,

Do you think older adults need to use collagen as a supplement?

Collagen production does naturally decline with age and there are studies that report benefits of collagen consumption in older adults.  Maybe the best news is that there is little to no risk of trying collagen supplements, aside from the possibility of spending money on something that does not work.

There are so many forms of collagen being sold…hydrolyzed, peptides, raw, undenatured and found in various forms from liquids, powders, tablets, chews and even gummies….if someone wanted to take collagen what is the form and dose that is currently recommended?

The current research indicates that the effective dose seems to be 15-20 grams of collagen per day, along with 200-250 mg of vitamin C to aid in collagen synthesis. The body seems to respond best to the presence of collagen peptides—short chains of a few amino acids—and most forms of dietary collagen contain such peptides. Look for products containing hydrolyzed collagen or collagen peptides on the label.

1800ss_getty_rf_vitamin_cI’m glad that Dr. Bob mentioned vitamin C and its role in collagen production. Vitamin C is most frequently thought of a nutrient that helps our immune system, especially fighting the dreaded winter cold, but it has a fascinating history (well, fascinating to most dietitians!). At the end of the 15th century, a disease called scurvy was the major cause of disability and death of sailors undergoing long sea voyages. Without access to fruits or vegetables, sailors developed bleeding gums, lost their teeth, had poor wound healing, and frequently old wounds would open up (called dehiscence). All because they were deficient in vitamin C and its important role in collagen production. Collagen helps anchor teeth in our gums and jawbone, as well as helping to keep skin healthy and elastic. It wasn’t until the 1930s that a Hungarian scientist, Dr. Albert-Szent-Gyorgyi, discovered and isolated ascorbic acid (a contraction of anti-scorbutic), better known as vitamin C.

Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved

Food & Fitness After 50: Finding the Silver Lining for Active Older Adults During the Pandemic

Food & Fitness After 50 is built on the pillars of eating well, moving well, and being well. So, when Tivity Health, the parent company of of SilverSneakers™, invited me to be a member of their scientific advisory board, I enthusiastically agreed. SilverSneakers embraces the same principles that I hold and while most people think of it as an exercise program, they have an equal emphasis on health, wellness, nutrition and connectivity.

iStock-Older couple runningNow with in-person group exercise classes on pause to stop the spread of COVID-19, how has the change affected SilverSneakers members? Researchers at Tivity Health conducted a number of surveys through the SilverSneakers newsletter on social connections, exercise, and nutrition to understand the concerns of newsletter readers. The survey provides a snapshot of an engaged community and their changing health habits. The infographic shown below (Source: Tivity Health) shows the highligts of the survey conducted between March 26-April 16, 2020. Let’s take a look at how sheltering at home is affecting older adult’s activity, nutrition, and social connections and provide tips on how to make the best of a bad situation…sort of the silver lining for SilverSneakers members.

Being Well and the Power of Social Connection

SilverSneakers Pulse Survey

Let’s start with the loss of social connection. Not surprisingly, ranked as the number one disruptor is the inability to visit with family and friends. I’m sure my SilverSneakers friends miss their coffee corner at our local gym as much as they miss the opportunity to exercise at the facility. The survey also found that limited social interaction contributed to feelings of stress and anxiety.

iStock-Older friends enjoying meal smallSocial support is big part of being well. Research from the Harvard Study of Adult Development found that participants derived their greatest happiness and joy in life from relationships. Men who were socially connected to family, friends, and community were healthier and happier, and they lived longer, than those who had less social connection. Tivity Health’s own research backs up that finding. A study published in 2018 in the Journal of Applied Gerontology found that membership in SilverSneakers not only increased physical activity but also improved health through decreased social isolation and loneliness.

The Silver Lining? Learning how to stay in touch using video chats, live streaming, or social media sites, such as Facebook Live. About 75% of survey respondents say that using various technology tools to stay in contact with friends and family members has helped bridge the physical distance. And with more use comes more confidence in using technology. Everything from religious services, to virtual bridge clubs, to reading stories to their grandchildren, older adults are embracing video capabilities and becoming more comfortable and proficient. That proves that you can teach new skills at any age.

Moving Well: Staying Active in Creative Ways

A big part of SilverSneakers is exercise, and with fitness facilities temporarily shuttered, how do older adults stay active? Survey results show that 93% of all members are still engaging is some form of exercise. Spring brings people out of doors and many find that they can still walk or bike, even with social distancing. And they recognize that activity of any kind is also exercise; from gardening to completing home projects keeps people moving.

iStock Older man lifting weights smallWhile walking is a wonderful fitness activity, we still need to balance our exercise plate with strength training and the ABCs (agility, balance, and coordination). Keeping muscles strong is always important but even more so now. Between the ages of 20 and 90, we can lose over 50% of our muscle mass due to sedentary lifestyle and sarcopenia (which means “vanishing flesh.”) For those who get ill and are confined to bed, a loss of 1% of muscle mass per day compounds the situation. The good news is that strength training just 2 days per week for about 30 minutes per session can reverse muscle loss.

older-adults-tai-chi-outside-e1505160556655Agility, balance, and coordination helps older adults stay active, reduces musculoskeletal injuries, and reduces the risk of falling. While we may never be as agile and coordinated in our body movements at 70 as we were at 20, simple exercises can help improve the ABCs. Yoga, Tai Chi, stretching, balancing on one foot, all can help improve balance.

For those who have replaced their exercise routine with only walking during this time, be sure to start slow when you do return to your pre-COVID-19 workout to avoid injury. In the nutrition world when refeeding a malnourished patient, we use the phrase, “make haste slowly,” and that applies to kick-starting your exercise routine.

The Silver Lining? SilverSneakers offers video home workouts with over 200 videos on demand, so no chance for boredom! There is also the SilverSneakers GO fitness app for smart phones, so workouts are portable. And, with Facebook Live exercise classes offered multiple times per week, activity is possible for these times. Don’t have Facebook but would still love to take part in live classes? Tivity Health recently launched SilverSneakers LIVE, where members can enjoy full-length, live classes and workshops directly through the SilverSneakers website. Create or log in to your account to see the class schedule.

Even without videos, much can be done with exercise bands. I have a set of three bands…light, medium, and heavy resistance that I use for bicep curls, triceps extensions, and shoulder exercises. I hang them on a doorknob as a visual reminder to use them every day.

Eating Well: Get Creative

iStock-Older couple making salad smallSurvey results for nutrition habits show a mixed bag. 56% of respondents report eating more home-cooked meals. Generally, cooking results in healthier meals, so that is a good thing. However, about 25% report making less healthy choices and 30% are eating out of boredom. Comfort foods are definitely “in” right now, but comfort food doesn’t have to be unhealthy food. This might be the right time to lighten up an old family favorite and there are plenty of recipe sites online to help you make substitutions, not sacrifices. Keep healthy snacks on hand so when boredom has you heading to the kitchen choose a snack of fresh fruit, yogurt, or a handful of nuts.

refrigerator-22592466The bad news is that about 1 in 5 people worry about having enough food or being able to restock their supplies. With disruptions in the food supply chain and home delivery of groceries hit or miss (or delayed) it can be a good time to do an inventory of everything in your freezer, fridge, and pantry and plan creative meals around what you have on hand. (For more on this strategy, click here and here.)

The Silver Lining? Many home delivery meal systems are offering significant discounts for meal and snack delivery. And while you may think of meal delivery such as Nutrisystem* as “diet” food, the meals are healthful and could be used to supplement what you have on hand. This is also a good time to dig out appliances hiding in a closet…a George Foreman grill, an Air Fryer, or Crockpot can be used for easy to prepare meals without a lot of fuss. Crockpot cooking can be  an especially affordable and easy way to r batch prep meals, so you can cook once and eat two or three times.

These unprecedented times have us moving in new directions, but the survey results clearly showed that older adults are resilient. We are strong and creative in finding new ways to eat well, move well, and be well. We might just find that we like those Zoom happy hours with our friends and exercising online!

*Nutrisystem is part of the Tivity Health portfolio of products.

Thanks to Tivity Health researchers Dr. Justin Barclay and Lisa Jameson, and Janna Lacatell, Executive Director of Social Determinants Solutions for Tivity Health for providing information about the SilverSneakers survey.

Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

 

Food & Fitness After 50: Tai Chi for Your Knees

Last year I interviewed Chris Cinnamon, owner and head instructor of Chicago Tai Chi™ and an American College of Sports Medicine (ACSM) certified exercise physiologist about the benefits of Tai Chi for older adults.  In the post, Chris answered your questions about Tai Chi for overall health, and we explored his path from Navy flyer to lawyer to Tai Chi expert and healthy aging advocate. To read the post, click here.

Tai Chi book coverToday I want to talk about his new book, Tai Chi for Knee Health, available at Amazon as a softback or E-book by clicking here.

The book is a comprehensive, step-by-step guide to performing this low impact exercise for preventing knee problems, treating knee issues, or recovering after a knee injury or surgery. Since knee osteoarthritis affects about 14 million adults it is likely that you, a family member, or friend have some issues with knee pain. Let’s start with a few observations about the book and then ask the author to elaborate.

The book is divided into 4 parts and 18 chapters, loaded with illustrations to make the content relatable.

The first part is devoted to getting to know your knees and establishing the reasons why Tai Chi is beneficial for knee health. This part is replete with illustrations of the knee and the many structures that support your knee…. bones, ligaments, tendons, cartilage, muscles, and the inner working of the knee itself. I’m sure you’ve all heard of people (or perhaps yourself) who have meniscus tears or ACL repairs. Chris’s clear explanations and accompanying illustrations will help you understand what these structures are, where they are located, and the functions they serve.

The second part focuses on the first three movements of the seven movement Tai Chi for Knee Health exercise system. The basic elements of the movements are discussed, and each step is illustrated, along with practice exercises to make sure you are doing the exercises in a manner that promotes knee health.

Part three presents the next two movements, reinforcing and building upon the lessons in Parts one and two. Part four guides you through the final two movements, then a complete set of movements 1 through 7.

Each chapter ends with a bulleted list of the content wrap up; I found it helpful to read this first and then read the chapter and ending with a review of the wrap up. (I like the bottom-line up-front approach to learning!)

The book includes links to online practice videos where Chris leads you through the exercises, providing helpful cues.  In addition, the book provides a wealth of references for further reading.

What I like most about the book is that is great for beginners, but also a useful tool for seasoned pros to take their practice to the next level.

Question: Can you explain your 3 objectives for writing this book?

I wrote the book for 3 main reasons:

  1. To help more people discover how Tai Chi-based exercises, when properly taught and practiced, can restore knee health, and improve, even eliminate, knee pain.
  2. To guide readers through a gentle exercise program, anchored in solid science, that gives people an alternative, or compliment, to more invasive, and risky, interventions for knee osteoarthritis and other conditions.
  3. To provide a clear, practical, no nonsense guide for knee pain sufferers so they can accomplish the 3 main objectives of the Tai Chi for Knee Health System because until now, these skills have rarely been taught in the west. The skills are to:
    • develop the sensitivity to feel inside your knees
    • develop the skill to precisely align your knees during dynamic movement, so you stop hurting them
    • learn to move in ways that stimulate physiological mechanisms that can restore knee health.

Question: You make a pretty bold claim that Tai Chi can eliminate knee pain. How do you support this claim?

I appreciate your question. That may seem like a bold claim, but when you dig into the science, it’s entirely supportable.

Let me start with my own experience. In my late 40s, after a lifetime of high impact athletics, multiple knee injuries, and surgery, I endured chronic knee pain. It hurt to climb or descend stairs. It hurt to kneel. It hurt to sit at a desk. I took lots of ibuprofen and worried about my ability to stay active.

Then I received a diagnosis of osteoarthritis (OA) in both knees. Knee OA is typically degenerative, meaning it keeps getting worse. I didn’t like that. About that time, I discovered Tai Chi. I was soon hooked by its graceful, powerful, yet low-impact movements. Soon my knees began to feel better. As I continued to practice Tai Chi, my knees continued to improve. Today, my knees are virtually pain-free. And as the Head Instructor of the leading Tai Chi school in Chicago, I lead an active life.

I’ve guided hundreds of students and clients through my Tai Chi for Knee Health system. They learn the material, practice it, and consistently report a reduction in knee pain. All that is anecdotal, I recognize. But there is solid science to back it up.

Multiple research studies have tested Tai Chi as an intervention for knee OA. All of the studies show significant improvements in pain. Most of the studies show significant improvements in function. All without drugs or surgery. In short, Tai Chi for Knee Health works. (Note, there is a comprehensive list of references in the book.)

Question: How long and how many times a week should Tai Chi be practiced for knee health?

I recommend people practice my Tai Chi for Knee Health exercises 15 – 20 minutes per day for 4-6 days per week. A small investment of time for a big payoff in healthier knees and a more active life.

With one important qualification, however. If that amount of exercise causes discomfort, then the person needs to back off and do a lower volume and duration of exercise. Say 3 days per week for 10 minutes per day. Then gradually build from there.

As I explain in the book, you can’t reduce knee pain by moving in a way that hurts your knees. Especially when dealing with knee OA.

Question: You talk about the 70% rule…please explain that because everyone thinks you must give 100% to anything to make it successful.

The 70% Rule holds that we perform no movement or practice greater than 70% of our maximum.

For people like me, raised in a “No Pain, No Gain” society, that may initially seem bizarre.

But when it comes to healing your knees, the 70% Rule makes total sense. By moving within your 70% range, you reduce tension, allowing chronically tense tissue to relax. Relaxation of tissue improves circulation of fluids, which promotes healing. So, when healing is the goal, the 70% rules applies.

In the same vein, by moving within your 70% range (or less depending on your circumstances), you avoid a range of motion that irritates arthritic tissue and triggers pain. Viewed in this way, the 70% Rule helps you avoid hurting your knees while the gentle movements of Tai Chi for Knee Health promote healing.

Question: If you could explain the book in a tweet of 240 characters, what would you say?

My book Tai Chi for Knee Health will guide you, step-by-step, through a low-impact Tai Chi-based exercise system that will:

  • Transform your knee health
  • Eliminate pain
  • Get you moving again

Beyond the limit of 240 characters, The Tai Chi for Knee Health System provides an ideal exercise program for adults experiencing chronic knee pain from knee osteoarthritis, tendonitis, bursitis, patellofemoral syndrome, and other causes. It can be incorporated into prehab and rehab for knee surgery and knee replacement.

The Tai Chi for Knee Health System combines time-tested Tai Chi principles with cutting edge scientific research to deliver a step-by-step program that anyone can do. Richly illustrated, with access to online videos, Tai Chi for Knee Health delivers an ideal resource to help you take charge of your knee health, eliminate pain, and enjoy moving again.

Question: Would you like to add anything else?

I developed the Tai Chi for Knee Health System to help millions of knee pain sufferers experience the transformation I and hundreds of my students have experienced—from chronic knee pain to virtually pain free knees.

The response to the book has been outstanding. Readers across the US and 8 other countries are enjoying the program, checking in with questions, and reporting their progress.

There are lots of sore knees out there. Tai Chi for Knee Health can help many of them.

Chris Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

Food & Fitness After 50: Recovery After Hard Exercise

iStock-Older couple runningMany folks over the age of 50 are incredibility active: pickleball, tennis, swimming, running, hiking, and cycling are all popular with the 50+ crowd. I am often asked about hydration and recovery strategies and sometimes I hear some crazy things. So, what do you really need to help your body recover after a long, hard work out or competition? First let’s talk about two things you don’t need.

One, a new fad called “dry fasting,” or in other words, starvation and dehydration. The idea of dry fasting (no food or water) for a set period (anywhere from 3 days to a couple of weeks) is just plain dumb for everyone, but especially for older, active adults. We’ve talked about the important of hydration in previous posts, so click here for more information on the importance of hydration for older, active people. Just say no when you come across the YouTube videos of dry fasting enthusiastic followers and stick to your tried and true fueling and hydration strategies.

Another thing you don’t need is expensive waters that claim to be “smart” by changing the acidity and alkalinity (pH) of your blood. Organs, like lungs and kidneys, tightly control our blood pH in the range of 7.35 to 7.45; if gets higher it is called respiratory or metabolic alkalosis and if it is lower it is respiratory or metabolic acidosis and both are life threatening. There is no need to try to acidify or alkalize your body because your lungs and kidneys won’t let you do it anyway. The only thing “smart” about these waters is the money they are making for their promoters.

blood ph

For real recovery and hydration, here is what we know:

  • Fluids help restore body water.
  • Carbohydrates replenish muscle carbohydrate stores (glycogen).
  • High quality protein provides key amino acids for repairing muscles.
  • Antioxidant-rich beverages like tart cherry or blueberry juice provide plant compounds that can reduce inflammation and help with muscle soreness after a hard workout.
  • Omega-3s (often called fish oils) are also anti-inflammatory and most Americans don’t get enough of these healthy fats in their diets.

ERSA Norwegian food scientist, Janne Sande Mathisen, has combined all these ingredients into a new recovery beverage called Enhanced Recovery Sports Drink. The beverage contains 20 grams of whey protein with 2 grams of leucine (an amino acid referred to as the anabolic trigger), and 1600 milligrams of omega-3s. It was tricky to find a form of omega-3s that worked in solution that didn’t taste fishy.

The carbohydrate source is from fruit juices (apple, pear, and black current) to give both rapidly absorbed carbs and polyphenol-rich fruits (those antioxidant healthy plant compounds).

I was sent some samples to try and I shared them with some very active friends. The overwhelming consensus is that it is a tasty drink, not too sweet, and serving size of just a little over 8-ounces is the right amount to drink after a workout without bloating, aftertaste, or too much volume. I think it tastes like kefir; others say it tastes like a yogurt smoothie.

I like the food forward approach of this recovery drink and think it might be a good solution for combining recovery elements in to one simple-to-drink beverage. For competitive athletes who may have to undergo drug tests, the product is certified by Informed Sport to contain no banned substances that could disqualify an athlete from competition.

Disclosure: I was sent free samples of the product to try, but I was not asked to or compensated to write this post. I have no connection to the company.

For more tips on staying healthy while being active, check out Food & Fitness After 50, available on Amazon or other booksellers.

 

Food & Fitness After 50: Good Bones

A recent article in the Washington Post caught my attention because it related to an issue that older adults frequently ask about….how to protect their bones as they age.

Hip-Fracture-Surgery-Infection-640x444According to the study published in JAMA vitamin D supplements showed no effect on reducing hip fractures where as vitamin D plus calcium had about a 16% reduction in the risk of breaking a hip. Hip fracture is one of the most serious threats to health as we age. Here’s a few facts from the Centers for Disease Control and Prevention.

  • Each year over 300,000 older people—those 65 and older—are hospitalized for hip fractures.
  • More than 95% of hip fractures are caused by falling, usually by falling sideways.
  • Women experience three-quarters of all hip fractures.
    • Women fall more often than men.
    • Women more often have osteoporosis, a disease that weakens bones and makes them more likely to break.

Dietary Supplement Use for Bone Health

A recent survey from the Council on Responsible Medicine, a leading trade association for dietary supplements, shows that among consumers over 55 years of age who take dietary supplements, 31% cite bone health as a reason for supplementation. For younger age groups, bone health is not mentioned as a reason for supplementation. That is too bad because the time to build bone is when we are young! Peak bone mass is achieved somewhere around the age of 30 or 35 so waiting until you are 60 to start worrying about bone health is a bit too late. It’s like getting concerned about your cholesterol level after you’ve had a heart attack. (Side note to my older readers…encourage your grandchildren and great grandchildren to get plenty of bone building nutrients now!)

boneMass35Anthony Thomas, Director of Scientific Affairs for Jarrow Formulas puts it this way, “Maximizing peak bone mass is important when we are young to protect against age-related bone loss.  A 10% increase in peak bone mass is estimated to reduce the risk of osteoporotic fracture later in life by 50%, so early life deserves more attention to ensure sufficient nutrient intake and status to support bone health across the lifespan.”

It Takes More Than Calcium and Vitamin D to Make a Healthy Bone

natto
Natto

While the media focuses on calcium and vitamin D, Dr. Thomas reminds us that bone is more than those two nutrients. Healthy bones need the minerals magnesium, potassium, copper, manganese, silicon, boron, and zinc. Two underappreciated vitamins are also key, vitamins C and K. Vitamin C is needed to produce collagen, the most abundant protein in the body and building block of bone. Vitamin K helps calcium get deposited into bones. There are two forms of vitamin K, referred to as K1 and K2. K1 is most well-known for its role in blood clotting. But the K2 form promotes bone building. It is hard to get sufficient K2 from foods. Dr. Thomas points out that “vitamin K2 is from bacterial origin, so it is found in fermented foods in which bacteria are used as starter cultures in cheeses and sauerkraut.  The best dietary source of vitamin K2 in the form of MK-7 is the traditional Japanese dish natto, cooked soybeans fermented by the bacteria Bacillus subtilis subspecies natto, that while popular in Japan, is not much appreciated in the U.S.“ The best way to get this form of the vitamin is with supplements sold as MK-7.

“Based on emerging research, the supplemental doses used in research is a daily dose of vitamin K2 as MK-7 is 45 micrograms upwards of 360 micrograms is recommended,” adds Dr. Thomas.

Fall Protection

While foods and supplementation can help provide nutrients for healthy bones, don’t forget the ABCs (agility, balance, and coordination) as keys to help preventing falls. We’ve written about this before (click here for the post), but it pays to work on your balance with activities like yoga, Tai Chi, or simple exercises such as balancing on one foot when you brush your teeth. When it comes to balance, we can use it….or, we can lose it!

Check out this video from Silver Sneakers for easy exercises to improve your balance

For more information on foods and supplements for bone health and tips to improve your agility, balance, and coordination, see Food & Fitness After 50, available at Amazon and other booksellers.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

Food & Fitness After 50: Citicoline for brain health?

In 2015 I wrote a post on a dietary supplement called citicoline. For the post click here.

HealthyBrainIn the post I wrote about learning of citicoline at a conference and was given a sample. My husband had been experiencing some trouble finding the right word when he was speaking so he wanted to try the supplement. From that day on he has continued to use the product. Although his report of improved brain health is anecdotal (one person’s subjective experience does not equal a fact) there is some research to support the positive effects of the supplement. He is such a disciple of citicoline that many of his family and friends now take it. But, should you?

I was interested in finding additional and more current, research since the 2015 post was written but didn’t find much. One reason might be that dietary supplement companies tend not to invest in rigorous experimental research trials because they are not required to do so to market a supplement. Unlike drugs, dietary supplements don’t have to prove they work to be sold; that’s why there are so many supplements readily available.

Citicholine
Chemical structure of citicoline

To begin, citicoline is a naturally occurring brain chemical. It is not found to any great extent in foods (there is some in organ meats) but when taken as a supplement it is broken down into choline (a B-vitamin) and a compound called cytidine which is then metabolized to uridine. That’s important because citicoline can’t cross the protective blood brain barrier but choline and uridine can. Once in the brain the compounds convert to citicoline, sometimes called CDP-choline. In turn, citicoline increases the brain chemical phosphtidylcholine that helps brain function and increases the number of chemical messengers in the brain.

When I first reviewed the literature the small number of studies that had been published cautiously suggested that supplemental citicoline could be an effective treatment for mild cognitive impairment but more research was needed to see if the effect was long term (most studies are short term…a few weeks to a few months) and if it could slow the progression to dementia.

A study published in 2012 was well-controlled: by a well-controlled study I mean the participants in the study were randomized to treatment and it was double-blind…neither the researchers nor the participants knew who was getting the citicoline or placebo. The researchers studied 60 healthy women, between the ages of 40 and 60, and showed that when given either 250 or 500 milligrams of citicoline both groups improved on tests to measure mental attention compared to the placebo group. However, this was another short-term study; just 28 days.

My quest to find more current research was unsuccessful so I turned to Natural Medicines Database for their review. The conclusion, which was last updated in November of 2019, was that citicoline is “possibly effective” for a decline in memory and thinking sills that occur with normal aging. Supplemental citicoline “seems to help memory loss in people aged 50 to 85 years.” The review noted there is insufficient evidence to say it prevents or reverses memory losses in those with Alzheimer’s Disease. There are minimal side effects, although some people report trouble sleeping, headache, or nausea.

The dose of citicoline ranges from 250 milligrams to 2000 milligrams a day, but the range of 250 to 500 milligrams is a usual dose used the research studies.

If you choose to try citicoline, it is always recommended to discuss with your health care provider. And, be sure to include all over-the-counter medications, including dietary supplements, when your doctor asks about medications you are taking.

CDP_suplrgI found over 150 products marketed that contain citicoline, some with fanciful names, liked Active Mind or Brain Wave that claim to “speed up your brain.” Many of those products also contain caffeine; the likely source of “speeding” the brain. If you get the blessing from your physician and want to try it, stick to one that just contains citicoline. Two reputable products are Cognizin (Kyowa Hakko) and Citicoline CDP choline (Jarrow). The Jarrow formula is the one that my husband takes.

As for me, my memory is good and I haven’t found a reason to try a supplement, but my husband believes it has helped him.

To learn more about dietary patterns and supplements for those 50, 60, 70, and beyond, check out Food & Fitness After 50available on Amazon and other booksellers.

Disclosure: I have no financial connection to any dietary supplement, including the citicoline brands mentioned in this article.

 

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

 

Food & Fitness After 50: Unlocking the MIND Diet

While there is no one best diet for those over the age of 50, in Food & Fitness After 50, we highlight four healthy eating plans that can work for just about everyone. And, it happens that these are the top four plans identified as the “Best Diets” by U.S. News & World Report in their 2019 review. The four plans are:

  • The Mediterranean Diet
  • The DASH Eating Plan
  • The Flexitarian Diet
  • The MIND Diet

minddietThe MIND diet stands for the official mouthful name of the Mediterranean-DASH Intervention for Neurodegenerative Delay. A much catchier title is the MIND diet because its premise is that diet can delay cognitive decline.  Researchers at Rush University Medical Center in Chicago studied over 900 older adults from retirement communities for 5 years; those who had the greatest adherence to the MIND diet suffered less cognitive decline than those who did not. This was an observational study, meaning that it shows association with diet and brain health, but it doesn’t prove it. So, the researchers are in the midst of conducting a longer, more rigorous study with adults in both Chicago and Boston. The results will be available in a couple of years.

However, the diet plan is healthy and while it can’t promise to prevent all cognitive decline with aging, it certainly can’t hurt as the plan is comprised of healthy foods that we should all be consuming.

Today, we feature the MIND diet by posing questions to registered dietitian, author, colleague, and friend, Maggie Moon. I met Maggie many moons ago at a CIA meeting…. Culinary Institute of America, not the spy agency, in her role as nutrition communications director for the Wonderful Company. The folks that bring us tasty, healthful foods, like pistachios, almonds, pomegranates and juice, and Halo mandarins. Maggie has written two books: The MIND Diet and the Telomere Diet Cookbook.

Chris and MaggieAs you can see from the photo of the two of us together at the annual meeting of the Academy of Nutrition and Dietetics conference, she is not in my age demographic, so my first question was obvious!

Question: You are a young woman…. how did you get interested in writing about food and nutrition to prevent cognitive decline which is something we think about as a part of aging?

Answer: I’ve been a registered dietitian for more than ten years and while I do still feel youthful, to answer your question, I think about when I was truly young. I grew up in a three-generation household with my parents and my grandmother. They were all immigrants from a war-weary and economically depressed South Korea in the late 1960s, so my immediate family is all I have. I am lucky to have a handful of siblings, but no big extended family. Because of this I feel extremely close to my parents and am ferociously driven to support their wellbeing. And because I was just as close to my grandmother, I’ve been aware of the importance of healthy aging from a young age.

I’ve always had an affinity for the elderly, probably because of my relationship with my grandmother. I love helping them and it is upsetting to my core when I hear about mistreatment of older adults. Truth is, I’m looking forward to being old lady! I’m in no rush, but it is something I think of fondly. I think of aging as a privilege.

This is a long answer to a simple question, but I guess it boils down to my writing what I care about. And I care about helping people thrive as they age and improving their health in longevity. It starts with my own parents, but then extends to my and my husband’s future, and finally to all humans that I can reach with my work, whether they’re worried about their own health or someone else’s.

 Question: Can you describe the MIND diet in your own words. What is it about the diet that would appeal to older adults and when is the best time to adopt the MIND principles? I can image some people in their 60s saying “it’s too late for me.”

Mind diet coverThe MIND diet was born from research led by Dr. Martha Clare Morris at Rush University in Chicago. Its foundation is a blend of two well-studied heart-healthy diets, but what makes it different is that it’s been optimized for brain health based on the available evidence for which specific foods support cognitive health, slow down decline, and reduce the risk of developing dementia. The two landmark studies that came out in late 2015 suggest that following the MIND diet keeps the brain 7.5 years cognitively younger and reduces the risk of Alzheimer’s by 53% compared to those who didn’t follow the principles of the diet.

It’s never too late, especially for someone in their 60s. Most of the research related to the MIND diet is with older adults, so it’s clearly relevant throughout older adulthood. The Alzheimer’s study was conducted with people ages 58-98 and the average age in the cognitive decline study was 81 years old.

That said, the results indicate that the longer someone followed the dietary principles the greater the benefit for brain health, suggesting that more years of healthy eating was more protective. Therefore, I think it’s important for people to eat for brain health at any age, but especially after age 40.

Question: What are the core principles of the diet? How did you develop the recipes for the book?

The core principles of the MIND diet includes ten healthy food groups that make up the foundation of the eating pattern. It also includes five food groups that should be limited.

The MIND diet includes whole grains, vegetables, olive oil, red wine (for those who drink alcohol), leafy greens, nuts, beans, berries, poultry, and seafood. From a culinary and cultural sensitivity perspective, I appreciate that the food groups are so broad that they can be adapted to many different heritage diets and preferences. The foods to limit include processed and red meat, solid fats from butter, margarine and cheese, fried food in general but especially from fast food, and added sugars from pastries and other sweets.

Here is a breakdown of recommended food groups to consume:

Foundation (these are minimums, except for red wine)

  • Whole grains – 3 times a day
  • Vegetables – daily
  • Olive oil – used as main fat
  • Red wine – a glass with a meal (only one; excess here is detrimental, and of course, if you don’t drink you won’t miss the benefits of the diet)
  • Leafy greens – six times/week
  • Nuts – 5 times/week
  • Beans – 4 times/week
  • Berries – 2 times/week
  • Poultry – 2 times/week
  • Seafood – 1 time/week

Limit

  • Processed and red meat – less than 4 times/week (e.g. no more than 3 times/week)
  • Butter/margarine – less than 1 tbsp/day (e.g. no more than 1-2 tsp/day)
  • Cheese – less than 1 time/week (e.g. once every two weeks)
  • Fried food – less than 1 time/week (e.g. once every two weeks)
  • Sweets – less than 5 times/week (e.g. no more than 4 times/week)

The recipes for the book were developed by me and other culinary dietitians. For the guest recipes, I collaborated with trusted colleagues. I provided the recipe parameters and then reviewed submissions to ensure they fit the guidelines and added a good variety of options before selecting them for my book.

Question: Let’s describe your newest book about telomere health….fill us in on how this ties into the MIND diet.

telomere-book-cover-on-amazonMy newest book, The Telomere Diet & Cookbook, came out in fall of 2019. It’s about genetic aging on a cellular level, and how what we eat can slow or accelerate biological aging. Telomeres are protective endcaps to our chromosomes, and they prematurely dwindle when exposed to inflammatory diets, environmental toxins, and poor sleep, to name a few. They protect the DNA in our chromosomes like shoelace tips protect shoelaces from unraveling and growing dysfunctional. Telomere length is a widely-accepted gauge for biological aging in research.

Telomere health is ultimately tied back to fighting inflammation and oxidative stress, which are also systemic issues the MIND diet attacks and improves. Both books are about healthy aging for all. In both books, the evidence-based perspective is that the more years spent eating healthfully the better. That sounds like common sense, and to some degree it is, but it actually signals a shift in thinking about aging: in this paradigm, aging is a continuum that begins at birth, not just once we hit a certain birthday. This is why two 50-year old people can be in completely different stages of biological aging while at the same chronological age – one vibrant, active and thriving; the other sedentary, sluggish and beleaguered with chronic health conditions. Of course, genetics, socio-economic factors, and lifestyle all play a part, but what we eat is something under our control.

Question: What the 3 key takeaways that you want people to know about cognitive health as we age?

  1. It’s never too late to start to eat healthfully.
  2. The earlier you start the better.
  3. Prevention through a healthy diet and lifestyle, not waiting for a miracle medication, is currently the best defense against age-related cognitive decline.

For more information on both diets, check out Maggie’s website by clicking here.

For more tips on eating well, moving well, and being well, check out Food & Fitness After 50 available at Amazon and other booksellers.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

 

Food & Fitness After 50: Beat the Barriers

This post was written by Dr. Bob Murray, co-author of Food & Fitness After 50.

“Move more and eat less” is the simplest advice for maintaining both a healthy body and a healthy body weight.  As simple as that advice might be, both sides of that equation can be fraught with complications.  However, none of those complications are insurmountable; in fact, even minor adjustments in our lifestyle habits can translate into major changes in our fitness, body weight, and overall health.

On the “move more” side of the equation, study after study consistently point to the undeniable benefits of daily physical activity to health and longevity. A recent study on 122,007 adults conducted over 23 years concluded that increased aerobic fitness “… was associated with reduced long-term mortality with no observed upper limit of benefit.” Simply put, keeping our bodies moving as often as possible extends our healthspan, allowing us to live as healthy as possible for as long as possible.  But even for the most motivated among us, each day presents barriers to staying active, barriers that we have to overcome or at least side step so that we can move more and sit less.

Barrier-Construction4Below are six common barriers that we can all relate to, along with some simple ways to keep them from becoming everyday excuses.

I’m too busy.  We all have the same 1,440 minutes each and every day, including those whose family, work, and personal demands keep them crazed from the time they wake until the time they sleep.  Even when it feels as though our lives are out of control, we can still find a few minutes to move.  Brief “activity snacks” throughout busy days can help relieve stress and break up long periods of sitting.  Walking stairs, taking the long way around the office, doing isometric exercises while seated, a few pushups, squats, or toe-raises are all ways to sneak physical activity into a crammed day.  And if the work week just doesn’t allow time for much movement, then being a weekend warrior is much better than just collapsing in front of the TV.push up

I’m too tired.  We can all relate to feeling absolutely drained—and there are times when taking a nap is a healthier choice than forcing yourself to exercise.  When energy levels are so low that a workout is just out of the question, a good alternative is to take a walk, even if that means strolling through your home during television commercials.  Any movement is better than no movement and just taking a walk can help boost our spirits and energy.

It’s too painful.  Aches and pains are an inevitable part of aging and sometimes pain can be so debilitating that moving is out of the question.  But for lesser aches and pains, we can find ways to keep ourselves moving without aggravating nagging problems.  Bad knees or hips?  Keep your upper body and core active with seated or standing movements and exercises that don’t make matters worse.  Arthritic hands?  Walking is an obvious option, as are simple hand, arm, and shoulder exercises with light or no resistance can help relieve arthritic pain and strengthen surrounding muscles.

It’s too expensive.  There is no doubt that exercise can become expensive, but only if we choose it to be.  Joining a health club, working with a personal trainer, buying a bicycle, or even getting new exercise shoes all cost money.  But walking is free, as are many online exercise videos, traditional calisthenics (think of sit-ups, push-ups, jumping jacks, burpees, etc.), stair climbing, yard work, household chores, etc.  The goal is to keep moving whenever possible and there are endless ways to do just that.

Older walkersIt’s too boring.  Some people just hate the regimented nature of group exercise classes or tire quickly of traditional activities such as walking, running, swimming, and cycling.  The challenge then becomes finding activities that keep us engaged.  Even if we regularly flitter from one activity to another, the very fact that we’re active is what is most important.  There are lots of ways to fit move movement into each day and the best of those are the ones that we enjoy the most.

removing barriersIt’s too late (to do any good).  One of the goals of Food and Fitness After 50 is to remind readers that it’s never too late to get and stay active.  Experts sometimes refer to regular physical activity as a polypill, a medicine with multiple benefits.  Even if you’ve led a sedentary life for the past 50 years, adding more movement to every day will dramatically improve your healthspan.  Staying active keeps us fit and strong, and that directly contributes to happier, healthier, longer lives.

For more tips on eating well, moving well, and being well, check out Food & Fitness After 50, available on Amazon.

Food & Fitness After 50: The Value of Life-Long Learning

Elizabeth CarlsonWe often hear about the value of life-long learning, but how many of us are stuck in our daily grinds and tell ourselves that someday we’ll get around to reading that book or taking an online class to improve a skill that has eluded us? Well, not Elizabeth, who at age 89, is still learning. Recently, she enrolled in financial planning courses so she could manage her own investments (which she does quite well from her laptop!) Elizabeth had to learn to do for herself at an early age. Her husband died when she was just 43 years old so she set her priorities: get a job, raise her three children (who were in high school at the time), and make sure she had enough money to help her kids get to college. From a research librarian to working in consumer affairs for a regional grocery store chain, she did whatever she needed to do to support her family.

When asked about her path to healthy aging, Elizabeth recounted how her parents set a great example on healthy eating, which she has passed on to her children. “My father had a garden and we always had fresh vegetables on the dinner table. I learned to can what we grew so there would always be vegetables in the house, even in the harsh New England winters.” Her parents also raised chickens and had fresh eggs, and they encouraged her and her three siblings to choose “colorful” foods, long before the dietary mantra to do so came to be popular. She became a canning leader for the local high school to teach boys and girls how to preserve food. She thinks that Americans have “come full circle,” enjoying gardening and shopping at Farmer’s Markets and trying to choose healthier foods.

As for exercise, she was always active. “I grew up before the Internet and screen time was a thing; we were just outside all of the time. My dad played baseball so there was always a game going on in the field near our house.” Today, she belongs to the local YMCA, but hasn’t exercised as much as she would like as she recuperates from a broken wrist, but she knows she will get back to it soon. “I love group exercise for the social aspects; my fellow exercisers are my friends, even if I never see them outside of the gym.” She loved riding a bicycle, but she gave that up 3 years ago (at the age of 86), because she didn’t feel “safe” on the bike any longer.

Elizabeth worries for many older adults who live on a fixed income and can’t afford healthy foods. Indeed, food insecurity, the lack of money to buy food, is estimated to affect 5 million older adults in the U.S. Elizabeth admits she is a “worrier,” but she is learning to relax and urges everyone to “enjoy their life.”

I am sure that Elizabeth will celebrate her 90th birthday in February, surrounded by her children and 5 grandchildren and will be setting her next learning goal, while enjoying her life. Thank you for sharing your journey, and keep on inspiring us to be life-long learners.