Food & Fitness After 50: Coffee with Ted Kyle of ConscienHealth

Meeting Ted in Budapest

I have coffee every morning with Ted Kyle, founder of ConscienHealth. Not literally, but his thoughtful commentary arrives in my email box every morning and I read it as I sip my morning coffee. Seven days a week, Ted produces an insightful commentary on issues surrounding obesity. His goal is to provide sound science to health professionals and consumers to foster solutions to obesity prevention, care, and research. He started ConscienHealth in 2009 and his influential work now reaches more than 20,000 readers around the world.

I’ve admired Ted for his passion, dedication, and commitment to contributing to solving complex problems. After hearing him speak at a conference earlier this year, I examined some my biases about obesity and wrote about it for this blog (click here for the post). It is one of my most shared posts so it must resonate with many people. I wanted to learn more about Ted’s journey to becoming a tireless advocate for obesity and health and gain some personal insights into how he eats well, moves well, and stays well.

Question: I know you as a respected obesity expert and founder of ConscienHealth. Before that you were a registered pharmacist and then worked in the pharmaceutical industry. How did you start on that path and how did you end up developing ConscienHealth?

Ted explained, “in high school I had a part-time job in my hometown pharmacy, and I enjoyed both the science of pharmacy and the interactions with a variety of customers. I also enjoyed creative pursuits, like photography, but a degree in pharmacy seemed a viable profession to earn a living and to help people along the way.” He pursued a 5-year program in pharmacy at the University of North Carolina at Chapel Hill and found time to take some courses to feed his creative side. Journalism and photography classes led him to writing and editing college publications and he landed an internship at Eli Lily in marketing. “My internship combined my love of science with communications and as soon as I graduated with my degree in pharmacy, I decided an MBA would help further my career.”

He landed his first job with a large health care company doing market research. “It allowed me learn about new product development and introduced me some giants in medicine.” One of those giants was Trudy Elion , a pioneering female scientist who developed breakthrough drugs for leukemia, for organ transplant rejection, and for viral infections. Elion earned the Nobel Prize for her work in drug development in 1988.

As his career continued, Ted ended up in Pittsburgh, working on drug development as well as rapid, convenient testing for HIV. One of the drugs he worked on was Orlistat, a medicine to augment diet and lifestyle changes for obesity. It was at that time that his passion for empowering people living with obesity was born. “I interviewed hundreds of people living with obesity and learned a lot about the stigma and bias they face. Through a lifetime of living with a chronic disease, one that involved both biology and behavior, all they ever heard was it was all their fault. I met people who were deeply grateful to have someone listen to them and try to understand their experiences. Hearing the stories of the burdens people face was a deeply moving experience.” Around this time, public health experts recognized what came to be called an obesity epidemic, but Ted found that “the public talked of concern about obesity but mostly just blamed the people affected. Well-intended public health messages were actually counterproductive, and it was then I decided to do something different.”

Question: How did you grow ConscienHealth into the “go to” place for experts around the world?

“It started slow, but I knew that an online presence was needed. Initially, I designed a rather crude website, but then hired a pro to design a simple, easy to navigate website to house our content. I work with a group of people committed to a scientific approach to improve our understanding of obesity and to breaking through the weight bias that exists in us all. I came to understand the science, not just the physiology, but also the behavioral and psychological aspect of living with obesity. Stigma is real and it makes health outcomes worse.”

“Recently, I’ve been writing more about the effects of obesity on COVID-19 outcomes. A European colleague in Italy reached out to me and said there was something going on with obesity and poorer outcomes in those who were infected with the virus. So, I did a lot of digging as more and more compelling data emerged. I have been able to participate in an exchange of knowledge about the interaction between obesity and COVID-19. It’s been quite a journey.” (Click here to read Ted’s post from March of this year.)

Question: Shifting gears here, but you care for many others, what do you do to care for yourself? You are now in your 60s, how do you stay well? How do you eat well, move well, and be well?

“I credit my wife for her smart approach to eating well. We eat what we think is a healthful diet. I have oatmeal and fruit at breakfast, big salads loaded with all kinds of summer veggies, and grilled protein foods for dinner. During the pandemic, grilling fish has become more of a mainstay for us.

For activity, we walk every day. I used to log between 6,000 to 10,000 steps a day but during the pandemic I’ve almost doubled that to 12,000 to 18,000 steps. I love being outdoors so walking and biking are my favorite ways to keep moving.”

As for staying well, Ted has his family, friends, and colleagues for social support, but he admits his biggest challenge is sleep, or lack of it. “There is just so much to do that I find it hard to get 8 hours of sleep. I get up about 3 am each day so I can write my commentary for ConscienHealth to get it online by 6 am.” (And, just in time for my morning coffee!)

Question: What 3 tips or advice would you give to others to eat well, move well, and be well?

“The first is to stay curious about everything. Whether it is people, nutrition, health….just stay curious.. Second, be objective about what is known. For me, the essence of communication about science requires sophisticated and ethical messages that are engaging and approachable. This is what I try to do every day with my commentary. The third piece of advice is to care for the needs of the others around you.”

I think we can all agree with his good advice! And, if you are not following ConscienHealth…do so!

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: Is There an Optimal Protein Intake for Older Adults?

A recent paper from three international protein gurus reviews the science behind the recommendations that older adults need more protein than young, healthy adults. The opening sentence of the paper sums up the current state of the science: “The optimum protein intake for adult health remains controversial.” How could that be?  The authors explain that why we know general requirements for protein we don’t know optimal intakes. Why there are limits to what we know about protein and aging?

  • Older adults, especially older women, are often not included as participants in research studies on protein needs.
  • Recommendations for protein are often derived from young, healthy adults. Healthy is a key word because we know that many older adults have chronic health conditions. Obesity, diabetes, high blood pressure, heart disease, and cancer affect 3 of 4 adults over the age of 65.
  • Research studies that look at protein intake and muscle mass in older adults are of short duration; most last less than 6 months. Since muscle loss is gradual, the short-term studies may not have time to show a positive effect of increasing protein.

While we may not have the definitive answer to the question posed in the title of this post, there is much we do know and here are some key points from the article:

  • The Recommended Dietary Allowance (RDA) for protein is inadequate for older adults due to something called the “anabolic resistance” of muscle. (Anabolic means building up and is the opposite of catabolic or breaking down.) Anabolic resistance means that the signals to build up muscle through strength training or eating protein is muted in older adults. This resistance can be overcome with an increased amount of strength training or a higher intake of protein.
  • When older adults experience a period of muscle disuse, which can occur during illness or injury, signals to muscle protein are blunted and a practical way to overcome this is through a higher protein intake, especially protein-rich foods that contain a key amino acid, leucine. Protein is made up of units called amino acids and 9 of the 22 amino acids are considered essential, meaning that we can’t make them in the body, so they must be consumed through diet. Leucine is one of the 9 essential amino acids and has been found to play a critical role in protein synthesis.
  • Sarcopenia, literally meaning vanishing flesh, is the progressive loss of muscle as we age. It doesn’t start when we are 60; it starts at about the age of 40 (even earlier in those who are inactive). Between the ages of 20 and 90, we can lose over 50% of our muscle mass due to sarcopenia and inactivity.

So, where does all of this leave us? The authors conclude that older adults should increase protein…both quality and quantity at meals. Consuming at least 30 grams of protein per meal, with 2.5 grams of leucine or more can overcome the anabolic resistance of aging muscle. While not all studies agree on meal timing, the authors also conclude that spreading the protein evenly across meals is better than backloading all the protein at one meal.

So, what does that mean for us? To recap to maintain muscle you need two things: progressive, resistance strength training and nutrition. Protein is a key nutrient for building and keeping muscle.  A few facts about protein:

  • High quality protein contains all 9 of the essential amino acids (EAAs) and includes:
    • Animal protein (beef, pork, poultry, fish, eggs, milk, cheese, cottage cheese, kefir, yogurt)
    • Soy protein (tofu, edamame, soy burgers, patties, crumbles, soymilk, cheese, yogurt)
  • The following foods do not contain all the EAAs, but they contribute to total protein intake:
    • Nuts (almonds, walnuts, etc.), almond butter, seeds (sunflower, chia, flax), legumes (peanuts, pinto, navy black beans, split peas, black-eyed peas, and other starchy beans and peas), peanut butter, pasta, rice, and whole grain bread.
  • Try and spread the protein evenly in 3-4 meals each day.

Examples of 30-gram protein meals

Sample meals and snacks with ~30 grams of protein

6 oz Greek yogurt (18)*

1 oz granola (4)

Small banana (1)

Skim milk latte (6)

2 scrambled eggs with 1 oz cheese and spinach (21)

8 oz soymilk (7)

½ slice whole grain toast (2)

Smoothie made with 1 ounce whey protein powder (20)**

6 oz Greek vanilla yogurt (18)

½ cup frozen berries (1)

Large green salad with veggies (2)

4 oz grilled chicken or salmon (28)

1 Tablespoon sunflower seeds (1)

1 Tablespoon chopped nuts (1)

3 oz tuna mixed with mayo (21)

2 slices of whole grain bread (7)

Lettuce, tomato, banana peppers or other veggies (2)

1 cup pasta (6)

3 oz turkey or beef meatballs (21)

Green salad with balsamic vinegar dressing (1)

1 cup cottage cheese (28)

1 Tablespoon chopped nuts (1)

3 slices fresh or canned peaches (1)

Stir fry with ½ cup tofu (10)

Carrots, broccoli, edamame (16)

1 cup brown rice (5)

3 oz cheddar cheese (21)

6 whole grain crackers (2)

8 ounces skim milk (8)

*grams protein in parentheses

 **most protein powders have ~20 grams protein per serving, but check labels

For those not used to thinking in terms of grams of protein (probably most of you), here are a few keys to understanding protein:

  • 1-ounce of beef, pork, fish, poultry, and cheese has about 7 grams of protein. Most of us don’t eat 1-ounce portions of these foods, so if you eat a 5-ounce portion of grilled salmon for dinner, you’ve eaten 35 grams of protein and that doesn’t count the other foods you have with the meal.
  • Dairy foods are rich in protein, the amino acid leucine, as well as other nutrients needed for muscle health such as vitamin D and calcium. 8-ounces (1 cup) of dairy milk has 8 grams of protein, but 8-ounces of ultra-filtered milk, such as Fairlife, has 13 grams of protein. Contrast that with Silk Almond milk that has only 1 gram of protein per serving. The point is that not all “milk” is a rich-protein source.
  • Foods carry a nutrition facts panel that tell you 2 important pieces of information: the serving size is of the food and how many grams of protein are in in one serving. That’s an important thing to keep in mind because you might be eating more than the stated serving size, meaning you are also getting more protein.

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  • I like to look for snacks that are nutrient-rich but not too high in calories. My recent favorite is kefir, a fermented milk drink with 11 grams of protein in 8-ounces, and is rich in probiotics, too.

I reached out the authors (aka, protein gurus) to ask them for a practical take-away from their article.

Meet the gurus

Dr. Stuart Phillips is a professor in the Department of Kinesiology at McMaster University, Hamilton, Canada (follow him on twitter @mackinprof).

“I’d recommend emphasizing the consumption of nutrient-dense sources of high-quality protein like dairy and eggs at meals that are traditionally lower protein: breakfast and lunch. My go-to protein food at breakfast (and sometimes lunch too) is Greek-style yogurt or Icelandic Skyr. Both are cultured dairy, rich in high quality protein, and many other necessary nutrients, and tasty and versatile as a base for berries and nuts.”

Dr. Doug Padden-Jones is a professor in the Department of Nutrition and Metabolism at The University of Texas Medical Branch, Galveston, Texas .

“For generally healthy adults, establish a dietary framework that includes a moderate amount of high-quality protein at each meal. Factors such as energy needs, physical activity, health status, body composition goals, and satiety should be weighed to determine protein needs. But, During periods of  physical disuse (injury, illness, inactivity) middle-age and older adults are at increased risk of muscle/function loss so just meeting the RDA for protein ( 0.8 g protein/kg/day)  is insufficient. Aggressive support with high quality protein (whey /leucine) and activity may help preserve muscle health.”

Dr. Donald Layman is a an emeritus professor in the Department of Food Science and Human Nutrition a the University of Illinois at Urbana-Champaign, Urbana, Illinois. (Follow him on twitter @donlayman).

 “A key for maintaining muscle health as we get older is dietary protein. Surprisingly, adults have higher protein needs than children because we have a continuous need to repair and replace proteins in our body but our efficiency of making new proteins declines with age. The best proteins are meats (including fish), eggs, and dairy. Vegetable proteins are popular, but they always have lower quality than animal proteins. You will need to consume 30% to 50% more total protein if you chose to use plant proteins. So, a 25 g whey protein shake would require at least 35 g of soy protein to be equivalent.” 

 

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: 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: Fitness Tips for Getting and Staying Active

In Food & Fitness After 50 co-author and exercise physiologist, Dr. Bob Murray, likes to make the distinction between physical activity and exercise.  He defines the terms this way, “physical activity is body movements that require increased energy expenditure. Exercise is body movements that require increased energy expenditure and are planned, structured, and repeated with the goal of improving fitness.”

Dr. Murray explains that “there is an emotional aspect to these definitions. Some people dislike exercise but are very open to increasing physical activity, such as walking, gardening, bike riding, swimming or golfing.” While we all know that regular exercise or physical activity improves our healthspan, the length of time that we are healthy. Increasing the moments spent being physically active benefits our physical and mental health. “We have a sitting disease in this country. Older adults can spend up to 85% of their waking hours being sedentary. Working in periodic exercise snacks, even 5 minutes every hour, increases physical activity and can lead to health improvements,” says Dr. Bob.

Book Cover 2So, it was timely when I was e-introduced to K. Aleisha Fetters and her recently published book, Fitness Hacks for Over 50  (Simon & Schuster, Inc, 2020). The subtitle of her book is 300 easy ways to incorporate exercise into your life. I interviewed Aleisha to learn about her and how her book can help us to get and stay more physically active.

Tell me about yourself, Aleisha.

I’m a Chicago-based certified strength and conditioning specialist who works with people both in-person and online, and the author of Fitness Hacks for Over 50 and several other books. I came to fitness writing through journalism–I got my undergraduate and master’s degree in journalism and worked primarily in health and science journalism.

I originally pursued certification as a strength and conditioning specialist to be a better journalist in the fitness arena but the more I got into it, the more I wanted to be able to connect with people and work directly with them, not just write about it. I continue to write for many publications including US News & World Report, Women’s Health, Men’s Health, SilverSneakers, AARP, and O, The Oprah Magazine. In addition, I am a personal trainer to people at the gym and through online virtual training.

As you are in your early 30s, what made you interested in writing the book for those over 50?

Aleisha Fetters 2
Author, K. Aleisha Fetters

Vital, healthy aging is important for all us and aging should not be synonymous with loss of function, frailty, or a decrease in quality of life. As a trainer, I enjoy working with those over the age of 50. I find older adults are interested in exercise and movement for intrinsic reasons, whereas younger adults tend to go for looking good. Older adults enjoy the functional health benefits that come from exercise…feeling food, being strong, playing with their grandkids. My older clients are excited when they hit their goals and find they are experiencing less shoulder or back pain or that they can do something in the gym that they once thought was out of reach.

I’m glad to hear you mention functional fitness as that is something we emphasize in our book. Everyone has different functional goals but for me a good life means the strength to walk my big, strong dogs and lift a 50-pound bag of dog food in my shopping cart. 

That speaks to how we are more alike than we are unalike. Afterall, we all need to squat, hinge, push, push, rotate, and carry. We all need to foster strength, balance, mobility, and move in ways that we enjoy and allow us to finish our workouts or daily tasks feeling better than when we started them. We need to stay fit not only for the present but for the future. I, for one, plan to age like a fine wine!

What do you think are the reasons people don’t exercise or engage in physical activity as they age?

iStock-Older couple runningI think the reasons people don’t exercise at 50, 60, 70+ are the same reasons people don’t exercise at 20, 30, 40+. Lack of time, thinking exercise isn’t fun, believing in the “no pain, no gain” idea that exercise hurts, or that exercise is a means to burn calories or fix perceived flaws.

However, as people age, there are some unique challenges. Aches and pains can make exercise seem hard and if an older person hasn’t exercised in the past they might not know why or how to start. Many older adults have chronic health conditions, such as osteoarthritis, osteoporosis, diabetes and they don’t know how to find workouts and activities that are right for them and their unique circumstances.

One question I get all the time is what is the “best” exercise I can do? Dr. Bob’s answer to this question is “the one you enjoy doing the most because then you will continue to do it.”

I agree, exercise you enjoy and will help you cultivate a healthier relationship with your body and movement. However, I will add that the deadlift is my definition of a “best” exercise and I’m not talking about being able to lift a massive load. A deadlift is simply picking a dead weight up off the ground–it’s a fundamental movement pattern and strengthens the entire body while focusing on the posterior muscles, which are prone to weaknesses and injury, and have a huge effect on everyday function. It’s the number-one exercise in my book for reducing the risk of lower-back injury! We’ve all heard, “lift with your legs, not your back,” for good reason!

It seems that this book is perfect for exercise instructors, like Silver Sneakers instructors, to give them ideas and creative ways to keep people interested in fitness. Was that one of your goals or was it written for the consumer?

That wasn’t the intention when writing the book, but once it came together, I realized it had that going for it. After all, even the best trainers can benefit from collaboration and what trainer hasn’t wracked his or her brain trying to think of more exercises or active lifestyle tips when training clients? But it really works for the everyday person; training during structured classes and workouts is one thing, but the difference-maker is what people do when they’re not at the gym or taking a class. This book gives a lot of practical solutions for both trainers and the average older adult who want to change things up.

How should people use this book? What type of equipment do you think people should have at home to get and stay fit?

I would encourage people to use it as a movement menu. Every person might not want to perform every exercise in the book, and it was purposefully designed that way. I encourage people to try out different fitness hacks and see what feels good and meets a person’s unique needs.

Within each chapter, the exercises progress upon one another. So, work on mastering a single-leg stand before trying a single-leg sit to stand. There are notes for exercises to illustrate how they can be safely performed and how they build on one another. I would also encourage people to read the full instructions, tips, and recommendations on modifying exercises based on mobility or other unique circumstances.

exercise bandsAs for equipment, most of the exercises can be done with the resistance of your own body weight, simple household items, or resistance bands. Resistance bands are my number-one equipment choice because they are incredibly versatile, space-saving, and inexpensive–and open the possibility of doing a lot of fun exercises.

What are your 3 favorite fitness hacks? 

As I’m answering your questions, I’m doing “Strike a Tree Pose!” The tree pose, usually associated with yoga, is modified in the book using a kitchen countertop for stability. This pose helps both balance and stability. I would say my favorites are:

  • “Do the Deadlift,” for reasons mentioned above.
  • “Do the I, Y, T” for improving upper-back muscles and posture. The I, Y, and T refer to position of the arms, sort of like the movements in the old song, YMCA!
  • “Hollow Your Core” a foundational exercise for core strength.
  • “Pull Apart” using a resistance band to strengthen should and back muscles.

Dr. Bob talks about activity snacks, and Fitness Hacks for Over 50 gives us lots of “snacks” for variety! I’m going to gift this book to my favorite personal trainer….after I learn all 300 hacks!

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: 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: Supplements for healthy aging?

VitaminsType “supplements for healthy aging” in Google and 26,200,000 results show up! I’m constantly being asked about supplements but I want to know what supplements are on your radar. I’m working on an article for health professionals on supplements commonly used by those of us in our 50s, 60s, 70s, and beyond. And, your input is important to help me narrow down the wide field.

I know from consumer survey data from supplement trade groups that that vitamins (like vitamin D) and minerals (like magnesium) are popular, as are supplements that claim to support “healthy aging,” “heart health, and “bone health.” But, I don’t know what supplements fit neatly into those boxes and would like to know if you take any supplements or are curious about supplements you’ve read about or seen advertised in print or on television.

When I reviewed some of those 26,200,000 results, I was impressed with the creativity of the names and claims. From youngevity to longevity to herbal supplements that claim to be the “root of anti-aging.” (And, of course, we all know there is no such thing as anti-aging; even animals kept in the purest environments age.)  And, the names are cool, too, sort of like the names of the paint samples in Home Depot: “cell shield,” “ReVerse,” “Imortalium, ” and my favorite…. Super Ultra Mega longevity, because super isn’t a strong enough descriptor.

Broccoli and pillsSo, email me (chrisrosenbloom@gmail) or hit me up on twitter @chrisrosenbloom and help me compile my list. And, of course I promise to share what I learn about the supplements (what works, what doesn’t, what might, and what is just plain hype) with you in a future post.

Thanks!