Monday, May 17, 2010

Old and Frail

This weekend, I was at Barnes and Nobles. I came across 'The Blue Zones' by Dan Buettener. In it, he relates advice on how to live longer he learned from studying populations in the world that have the longest lifespans. It was an interesting read and of course there was some obvious adivice: don't smoke, eat healthy foods, be active, etc. But, I got upset when I came to a section on exercise.

I am paraphrasing from memory (I didn't get a chance to write this earlier) but he says exercise is good and people should do it regularly (5 days per week). No arguement so far. But, he goes on to say that you should perform 30-60 minutes of aerobic exercise, of which some should be weight-bearing (like walking as opposed to swimming). However, strength training shouldn't be pursued too much because weight lifters muscles are overdeveloped! Ok, a couple deep breathes and I will start my rant.

I need to preface this rant by saying Mr. Buettener is not the only one spouting this nonsense. Other so-called 'health experts' do too, showing their personal biases. But, he just is the latest to spout this nonsensical advice.

Let me get this right, you should not pursue one of the few activities that has been continually supported by scientific research to be able to positively influence your physiology, reverse the effects of aging, and enhance your functional capacity? Aerobic exercise does improve health and is associated with longevity, but it has several limitations that strength training doesn't. You are not going to reverse or prevent muscular weakness, sarcopenia (muscle loss due to aging) or osteoporosis with aerobic exercise. Even the 'weight-bearing' exercises like walking and running don't load the musculoskeletal system enough to provide an adequate stimulus to build up these tissues. Ironically, when I worked in cardiac rehab, the limiting factor for most patients was not their cardiopulmonary status, but their strength; balance, and joint health.

One of the limitations to even performing aerobic exercise is joint health. So, activities like walking and running generally have to be abandoned or curtailed after several decades. Degenerative changes in the joints are one of the primary obstacles we face with aging and often take away our independence. How many joint replacement surgeries are performed each year? Strength training is one of the few activities that will improve or maintain the active (muscles crossing the joint) and passive (ligaments and cartilage) components of joints.

Mr. Buettener, just because you may have not observed the people in 'the blue zones' performing strength training and your only notion of strength training is what gets purported in the media, don't blow off strength training as not important, especially if someone is interested in maintaining their functional capacity and independence into their ninth or tenth decade of life. There are hundreds and hundreds of studies showing that not only can you increase strength, bone density, joint health, and function at any age, but you actually can reverse or slow the aging process on the cellular level with proper strength training. If that is not enough, one of the current barriers for our aging population are financial restraints. Many Americans, who are over the age 60, are on a fixed income. Medications and assistance for chronic disease management are expensive. Regular strength training would help these individuals cut medication and assistance requirements, thus saving them money so they can even afford to live to 90 or 100 years of age.

I am sure the 95 year-old Jack Lalanne would agree with me!

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