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: A Deep Dive into Water Aerobics

If you are looking for a non-impact activity that provides all the components of fitness…cardiovascular, muscle strength and endurance, and flexibility, then water aerobics might be for you. And, bonus points for the cooling water in the pool as a great antidote to summer heat and humidity.

Water Aerobics is not Playing, but it is Fun

Sue Ellen
Suellen leading water aerobics

If you think that those folks in the pool are just playing, think again. “Water aerobics is a full body workout,” says Suellen, who at age 73 teaches classes throughout the summer, sometimes as many as five classes a week. Suellen has been an avid exerciser since the early 1980s when she and her friends donned leotards and did Jazzercise until she found water aerobics. “I’ve had lower back problems since I was a teen and the jarring impact of land-based exercise could make my back issues worse and put me out of commission for over a week,” says Suellen. So, she switched to water-based exercise and liked it so much she became a certified water aerobics instructor. “I never planned to be an instructor, but another instructor encouraged me and a friend to take the YMCA-based training and the rest is history.” The certification “wasn’t easy, but I learned CPR, water fitness, and both classroom and in-the-pool exams made me a competent instructor with more confidence,” says Suellen.

The benefits of water aerobics are many:

  • It promotes gains in muscle strength.“The resistance of the water makes an ideal environment to build muscle and there are many ways to change moves to make them more challenging as strength builds,” notes Suellen.
  • It is beneficial in treating osteoarthritis of knee and hip joints. Many people associate water aerobics with exercise for people with arthritis and for good reason. Your body weight is reduced by about 90% from the buoyancy of the water thereby reducing stress on weight-bearing joints. 
  • It is a welcoming environment for those who have been sedentary, who have overweight or obesity, or who have other chronic diseases. “We have all levels of fitness in a typical water aerobics class from those who are very fit to those who have chronic conditions, like rheumatoid arthritis, who find exercise difficult. Suellen always tells her students, to keep three things in mind during any class when they find movement difficult…slow it down, make smaller moves, and substitute an easier move.”
  • Many people choose water aerobics when rehabbing from an injury or surgery. Cathy, a regular in Suellen’s class, told me she was “looking for an exercise class that she could do after she finished physical therapy for knee replacement surgery. I found water aerobics to be of great benefit in strengthening my knee and I think it helped me get back to land-based aerobics more quickly, but I still do water aerobics because I love it!”

ThinkstockPhotos-480904565Suellen says that water aerobics follows the same format as other hour-long aerobics classes, “we start with a warm up of stretching exercises, and then spend most of the time on cardio, followed by a cool down. We use Styrofoam buoys for resistance exercise, and just like weights you use in the gym, these come in different “weights,” so we can increase resistance.”

Can Water Based Exercise Improve Bone Health

Water aerobics can help with bone health but is not as good as land-based exercise to strengthen bone, something Suellen found out when her doctor told her bone density was low. Suellen is working with a personal trainer who is knowledgeable about working with older adults with health issues. (I know this first hand, as I also worked with David when I had hip problems, for more on the benefits of working with a personal trainer, click here.)

Always a Teacher

Water aerobics
Class at YMCA, photo credit Bill Powell

Suellen taught 7th grade math for 29 years before she retired, but she sneaks some math lessons into her water aerobics classes now and then. “I’ll ask them to identify north, east, west, and south while we are in the pool and them ask them how that relates to the numbers on a compass, I guess once a math teacher, always a math teacher!” She loves the reactions she gets from the people who come to her class, “we have several people in their eighties who are regulars and they enjoy the exercise, but they really like the social aspects and the fun of the class.”

Tips for Optimal Aging

When I asked Suellen to identify the top three ways to optimal aging, not surprisingly, her first response was “move, move, move!” “My dad played golf at the age of 94 and moving is what keeps us all going.”

The second tip is to stay socially connected. It could be through an exercise class, volunteer activities, church groups, or as Suellen puts it, “anything that gets people going, gets them up, gets them dressed, and gets them out of the house so they develop a social connection to the place and to the people.” She works at getting to know the people in her class and “making them feel more comfortable about participating and looking forward to coming back is what matters.”

And, lastly, she said, “laughter, having fun and laughing during exercise is so rewarding, we laugh with each other and they laugh at me when I mess up, and that’s OK because it keeps us all laughing, having fun, and moving!”

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

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

 

Why this dietitian promotes healthful eating and exercise for those over 50

When talking about food and fitness for those over 50, it is the best of times, and sometimes the worst of times. Everyone want to know the ”best” exercise or food to eat to prevent aging. A quick Google search will provide you with many answers, unfortunately most of them are less than science-based and are usually trying to separate you from your money. Let’s be clear: there is no one superfood or exercise that will prevent aging.

That is why, I am excited to launch Food & Fitness After 50, with co-author, exercise book-front-pagephysiologist, Bob Murray. The book will be published later this year. While there might not be a “best” exercise or food, that doesn’t mean that food and fitness are unimportant as we age. You can be healthier at 65 than you were at 45 by eating well and starting (or increasing) your physical activity. This is important because so many of us are living longer. Baby boomers, those born between 1946 and 1964, began turning 65 in 2011 and by 2029 when all boomers will be 65, more than 20% of the population will be over 65. Why is 65 an important number? Because people reaching age 65 have an average life expectancy of 19.3 years (20.5 years for women and 18 years for men). How do you want to spend those 20 years? Do you want to travel, enjoy your favorite physical activities, and be a vibrant person in the lives of your grandchildren and great grandchildren? I am sure that we all want that, so being active and eating healthfully are steps you can take right now to increase your odds of being healthy into your later years.

Just this week, The Journal of the American College of Cardiology published an article on nutrition controversies in preventing heart and blood vessel disease. The article can be found here  http://www.onlinejacc.org/content/69/9/1172?_ga=1.183783078.1620905078.1488293025 and here is an easy to guide to see their recommendations.

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While their article focused on heart disease, our book covers many healthful eating patterns to keep your heart, bones, joints, blood sugar, blood pressure, and brain healthy. Remember there isn’t one “best” eating plan. So, we feature four plans that we think most older adults will find fit their lifestyle and their enjoyment of foods:

  • The DASH eating plan (DASH stands for Dietary Approaches to Stop Hypertension)
  • The Flexitarian plan
  • The Mediterranean Diet
  • The MIND diet (MIND stands for Mediterranean- ASH Intervention for Neurodegenerative Delay)

We also dive into exercise for endurance, strength, agility, balance, and functional fitness. Keeping our heart and lungs strong, halting muscle loss, and keeping agile all contributes to functional fitness….the ability to do the things you did when you were younger without a second thought. I want to be able to lift my suitcase in the overhead bin when I travel and pick up a 50-pound bag of dog food, all examples of functional fitness. Age-related muscle loss usually starts at about age 40. We can lose 10-15% of muscle mass and muscle strength every decade if we don’t engage in progressive, resistance exercise.

We hope that our book can help those over 50 learn to separate usual aging from the disuse of a sedentary lifestyle and sort out the fact from fiction about foods. Please visit our webpage to learn more about the book and leave us a question that you might see featured in an upcoming blog post. Web page for Food & Fitness After 50

 

 

 

 

Calcium and Vitamin D are still important!

The Institute of Medicine Report was published yesterday and I watched the national news outlets do the report a disservice–those darn sound bites just can’t capture the complexity of the report. (The complete report can be found on the IOM website http://www.iom.edu/).

The report concluded that there is not enough evidence to increase the recommended intakes for vitamin D or calcium but that is far from saying that we don’t need these 2 critical nutrients for bone health. Most people don’t get the recommended amounts of these nutrients in their diets but that message was lost in the reporting. I would not want women of any age to abandon their efforts to get calcium from their diet or supplements. I always recommend food first and there are more foods with added calcium–from orange juice to breakfast cereals–available in the grocery store. A recent study looked at calcium intake in post menopausal women and found that dairy foods were the number one source of calcium for white women but grains contribued the most calcium to the diets of black women.

Older women who don’t get enough calcium should use calcium citrate supplements–they are better absorbed than calcium carbonate supplements as we age. But, more isn’t better and I think that is what the report was trying to stress.

The more controversial part of the report was on Vitamin D; this nutrient is also crucial for bone health–nobody disagrees with that–but there are also claims that this sunshine vitamin also plays a role in diabetes, heart disease, auto-immune diseases and some cancers. It is not surprising to me that the report did not find a strong link with Vitamin D and other disorders because the research is emerging and no conclusions can be reached. Science moves slowly but the media reports every little study as if a cure for every disease was as simple as popping a supplement. The hype is often well ahead of the science.

So, don’t throw away your supplements–make sure to get adequate, not excessive, calcium and vitamin D in your diet and then add what is missing from supplements. Remember that supplements are meant to supplement diet–not replace it.

Forty ng/mL? That is the level of vitamin D (also called serum 25(OH)D3) in my blood but what does it mean? Vitamin D is one of the most talked about nutrients and for good reason–along with calcium it is critical for building and maintaining healthy bones, but vitamin D is also one of the most confusing vitamins. We can get vitamin D three different ways:

  • through foods (although very few foods are good, natural sources)
  • through supplements (although it comes in different forms and researchers aren’t always consistent in their advice about which form is best)
  • through sunshine or the ultraviolet rays from the sun to be more precise (but SPF 8 or greater, heavy cloud cover, skin color, aging, and even the angle of the sun in winter blocks vitamin D from being made in sufficient amounts)

So what is an over-50 year old adult to do?

First, choose foods that contain vitamin D or foods that are fortified with vitamin D: salmon, mackerel, tuna and sardines are good sources because fatty fish contain this fat-soluble vitamin. Mushrooms (they are being exposed to ultraviolet light to make them good sources), milk, some but not all yogurts (read the label), many breakfast cereals and orange juice contain vitamin D. A recent study found that half of vitamin D intake comes from milk so that is a good place to start.

Second, consider supplementation; you might be getting some in your multi-vitamin and most contain 400 IU (IU stands for international units, the measure used in supplements). Vitamin D comes in two forms–D2 and D3 and most, but not all, experts recommend the D3 form because early research showed that D3 is more effective at raising vitamin D blood levels than D2. However, some research shows that both forms are effective at improving blood levels.

Third, consider getting some sensible sun–10 to 15 minutes of sun exposure twice a week can improve vitamin D levels. This recommendations is controversial because UV rays from the sun or tanning beds are tied to the million of skin cancer diagnoses each year.

Which leads us back to that 40 ng/mL blood level–is that good or bad? According to the lab report 40 is a healthy level, but trending more toward the insufficient end of the range. A controversial article in an international osteoporosis journal suggests that older adults need 800 to 1000 IU of vitamin D each day to reach the maximal blood levels of vitamin D.

Next time you go to the doctor and have blood drawn, ask for a vitamin D level–in the meantime, increase your intake of vitamin D from foods and if you supplement, look at the supplement label to determine how much vitamin D your supplement provides.

For more information check out Dr. Michael Holick’s website http://www.vitamindhealth.org/ or his new book, The Vitamin D Solution.